Abstracts

interviewer assessed these responses by the child’s guardian. The following were marked with a plus if exhibited: interested; responsible (checked calendar, etc.); friendly; accepted participation; made appropriate inquiries about the study. The following were marked with a minus if exhibited: apathetic acceptance; loud background noise; frequent interruptions; diffcult to contact; reluctant acceptance.

The number of minuses was subtracted from the number of pluses. If this difference was 2 0, normal scheduling procedures were followed. If the difference was < 0, it was unlikely they would keep their first appointment. In order to more efficiently utilize the time of the staff, another participant was scheduled at the same time.

The findings of thii paper are not based on formal statistical analyses. Investigation of the reliability and validity of the PPR form are a topic for future study.

P13 EFFORTS TO ENHANCE PARTICIPATION IN A

LOW SOCIO-ECONOMIC STATUS POPULATION

Annette M. Clerici, Stephen R. Wisniewski, Herbert L. Needleman, Raquel R. Ingraham

and Loretta C. Kemp University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania

We conducted a randomized clinical trial, funded by the Centers for Disease Control and Prevention, to test whether improved nutrition and housecleaning lowers household dust lead and blood lead levels in children 1 to 5 years of age with moderate blood lead elevations (lo-24 pg/dl). The subjects were assigned to receive either

education, nutrition, or nutrition and housecleaning. The initial rate of recruitment in the study was low, and traditional means of

improvement (monetary incentive, small gift) did not effectively increase participation. Two of&e visits were required before a child was randomized to one of the

treatment groups; if either of these appointments were broken more than 2 times, the child was disqualified from the study. This rule was made to select against noncompliant families. We noted that if a family came in for visit 1 (n=37), they were likely to return for visit 2 and be subsequently randomized (n=32, 86%). Our efforts then focused on ways to encourage completion of the first office visit.

Four procedures were initiated which improved enrollment. First, the time from telephone acceptance to their first appointment was shortened to 48 hours. Second, every effort was made to allow the subject to choose a time, instead of assigning an appointment to them. Third, a letter was dropped off to their home confirming the time and date of their appointment, and also included a map and directions to the office. This gave our staff an opportunity to meet the guardian and build rapport with the family. Fourth, any time a participant scheduled an initial or follow-up appointment, several confuming phone calls were made. On average, a call was made 2-3 days prior to visit 2, the day before, and the morning of the appointment. Since using these procedures, 47 eligible families came in for visit 1 and 46 (98%) were randomized after keeping their second appointment.