Methods. The project had a multi-level recruitment strategy requiring recruitment of randomly selected practices before randomly selecting GPs, practice nurses and caregivers of children enrolled at those practices. Detailed quantitative and qualitative recruitment data were recorded on an access database. Post-recruitment, recruiters underwent semi-structured interviews. Analysis was mixed method, with triangulation of descriptive statistics of the number of calls and time course to recruitment and general inductive thematic analysis of qualitative data. Results. Identifying key decision makers and how individual practice processes work can save significant recruitment time. Factors identified as assisting practice recruitment included using a personal approach from doctor to doctor, getting buy-in from all practice staff, streamlining the research process to minimize disruption to the practice and flexibility to accommodate practices. Conclusions. The task of recruiting should not be underestimated. Adequate time and resource need to be allocated from the onset. Long periods where practices have no added burdens such as audits, mass vaccination programmes or influenza season are unlikely, therefore there are always considerable challenges in recruiting practices for research. Remaining flexible to individual practice styles and influences and acknowledging the commitment of participants is important.

/pdf/recruitment-of-practices-in-primary-care-research-the-long-17yz8vyl55.pdf

Recruitment of practices in primary care research: the long and the short of it

Objectives. This study was undertaken to develop a novel approach to measure compliance of general practitioners (GPs) in sentinel public health surveillance. More specifically, its purpose was to determine the characteristics in the SGP's profile which can be objectively associated with perseverance. Methods. Since 1984, the French sentinel network has collected weekly data on eight communicable diseases, involving volunteer SGPs. In this study, 'compliance' was defined as the length of time during which a SGP complies with a given theoretical surveillance protocol. This left-censored variable was computed from individual SGP's connection time series. Kaplan-Meier method was used to estimate the compliances survival distribution for all the SGPs (1824 SGPs who have been part of the network, at one point or another, since 1984). Using Cox regression model, a prospective survey on the 376 most recent recruits allowed us to select the characteristics associated with a longer compliance. Sensitivity analyses were carried out using the bootstrap method. Results. According to the maximum number of silences allowed by the given theoretical protocol, median compliances varied between 11.7(95% Cl : 11.1-12.3) and 38.8 (95% Cl : 35.7-40.7) months. In multivariate analyses, we observed long compliances for SGPs whose main motivation for being involved in the network was an interest in epidemiology and SGPs with ≤5 or ≥20 years seniority. On the other hand, interest in local epidemiological surveys and previous experience with other surveillance networks were associated with short compliances. We found no statistical association between compliance and computing experience, having a medical secretary, a particular feeling of being a 'public health actor', or the desire to belong to a GPs' network. Conclusion. We have shown our longitudinal method to be an efficient tool for monitoring non-compliant SGPs with respect to given surveillance protocols. Furthermore, this approach allows us to select out of the SGPs' profile the characteristics which are associated with a longer compliance. This regression model could be further refined by extending the SGPs' profile. The additional variables to be taken into account in this profile could be identified through a complementary sociological approach. Our work addresses the question of understanding what determines the motivation of GPs to participate in public health surveillance. This question is essential if we hope to turn general practice information systems into genuine public health surveillance tools.

/pdf/monitoring-the-compliance-of-sentinel-general-practitioners-2lt8guwxdb.pdf

Monitoring the compliance of sentinel general practitioners in public health surveillance: which GPs persevere?

Results. Compared to the regional sample, network GPs were more likely to complete survey questionnaires (92% versus 69%) and to participate in the study (66% versus 23%). Compared to national reference data, study participants from both populations were younger, had a higher level of professional training, and included more men. These differences were already present in the network target sample, but were largely attributable to selective participation in the regional sample. Network membership remained the strongest determinant of participation in multiple logistic regression (odds ratio 5.01; 95% confidence interval 2.53‐9.91). A younger age, higher professional training, and membership in the German Society of General Practice were also predictive of participation. Conclusions. Although network-based recruitment of GPs increases participation rates, sample effects are similar in size and direction as effects of non-participation in the regionally defined population. Careful analysis of participants based on publicly available data is therefore crucial for the assessment of generalizability.

http://www.allgemeinmedizin.med.uni-goettingen.de/de/media/2005_Wetzel_QualityOfCare.pdf

Participation in a quality of care study and consequences for generalizability of general practice research.

Recruiting the Family

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Recruiting the Family