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Recruitment and Retention
for Diabetes Prevention Carol Percy, RN, MS
Shiprock DPPOS Program CoordinatorRoz Barber
Shiprock DPP Recruitment and Retention Coordinator
January 13, 2005
Diabetes Prevention Program ClinicsDiabetes Prevention Program Clinics
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Southwest American Indian Center
• Gila River Indian Community• Navajo Nation- Shiprock, New
Mexico• Phoenix Urban Indian Community• Salt River Pima- Maricopa Indian
Community• Zuni Pueblo Indian Community
Recruitment into the DPP
• Recruitment phase 6/96-2/99• 171 American Indians recruited• Recruitment Coordinator at each site• Team approach to support Recruitment
Coordinator• Multi-layered recruitment approach• Recruitment oversight program
Eligibility Talking PointsDiabetes Prevention
Program• At least 25 years old.• Non-diabetic with Impaired
Glucose Tolerance.• No serious illness or reason not to
take any of the treatments.• Willingness to participate in a six
year program.
Eligibility Talking PointsLifestyle Balance Program
• Age• Non-diabetic with Impaired Glucose
Tolerance• No serious illness or reason not to be
able to eat less or exercise• Length of time to participate• Able to attend group classes• Others?
Timeline to Join DPP
• Step 1- Initial contact(s)• Step 2- Oral Glucose Tolerance
Test Screening visit• Step 3- Three week run-in period
(three visits)• Step 4- Join the Study
(Randomization)
Shiprock Recruitment
Step 1 Step 1 ScreeningScreening
Step 2 Step 2 OGTTOGTT
Step 3 Step 3 start run-instart run-in
Step 4 Step 4 Join StudyJoin Study
Number of participant contacts/Number of participant contacts/% of previous step% of previous step
3,5863,586
1,117 (31%)1,117 (31%)
128 (31%)128 (31%)
9494 Step 3 Step 3 End run-inEnd run-in
# with IGT
409 (37%)
80 (63%)20% from IGT
Phoenix Urban Recruitment
Step 1 Step 1 ScreeningScreening
Step 2 Step 2 OGTTOGTT
Step 3 Step 3 start run-instart run-in
Step 4 Step 4 Join StudyJoin Study
Number of participant contacts/Number of participant contacts/% of previous step% of previous step
1,0001,000
200 (20%)200 (20%)
Step 3 Step 3 End run-inEnd run-in
# with IGT
47 (24%)
14 (30%)
Timeline to Join Lifestyle Balance
• Hold two groups/year of 12 participants
• Recruit at least 20 to get 12• Number of months to recruit first
group• Use Shiprock and Phoenix numbers
– # contacts needed to schedule OGTT– # OGTT to complete to find IGT– # with IGT to Join Lifestyle Balance
Layered Recruitment Approach
• One on one contact• Brochure• Flyers and posters• Radio PSA’s and print ads• Newspaper article on program• Mailed/delivered program
brochures• Presentations to health providers
Strategies for Reservation Recruitment
• One-on-One Contact and visibility• Use community events and
locations• Local worksites• Leadership support • Community flyers• Community newspapers• Door to door
Urban Indian Recruitment
• Targeted work place presentations• Pow-Wows• Phoenix Indian Medical Center/ Events• Brochures placed in work places• Community gatherings of American
Indians• Local Native American Newspaper
Incentives
• 1st level- talk to us• 2nd level- if interested make an
appointment• 3rd level- complete step screening visit• Establish honest and trusting relationship• Motivation for joining-DM prevention• Lifestyle Balance motivator is weight loss
Community Screening
• Talking points to attract people• Blood glucose screening-OGTT if
>120• Use ADA are you at risk• Person walks away with something
written with location, phone
Phone Contact/Written Contact
• Establish phone number for program– Live voice best-Connect with person on day they call
• Written materials include– Program location, walk-ins expected– Place to write appointment date/time– Appointment instructions ex: fasting
Keys to Success
• Flexible Clinic Schedule • Telephone reminders• Postcard reminders• Follow-up a missed appointment• One-on-One support/ building
relationship
Retention
• Plan early and integrate• Long commitment to DPP for 3-5
years• Begins at first contact• Recruitment is the key to retention
Retention and Participation
• 99.6% of the study cohort alive at study end
• 93% completed study
• 93% of annual visits completed
• Average follow-up 2.8 years (range 1.8 - 4.6)
• 86% joined DPPOS
Retention-Create Belonging
• Group Events• Contracts• Incentives• Connection with staff• Mailings- newsletters, health
information, birthday cards
Group Events
• Gathering around a community event
• Group walks or hikes• Community attractions• Learning a new skill• Include the family
Getting Started Your Recruitment Action
Plan• Define your program objective• Define your recruitment goals/target
groups• Assess your community resources• Prepare recruitment plan and timeline• Produce written materials, PSA’s, mailings• Define talking points• Begin community contacts and
presentations
Recruitment Coordinator • Enthusiastic about program• Able to work independently/ team leader• Lead by example• Outgoing• Bi-lingual• Member of your community• Realistic amount of time to recruit if other
job responsibilities• Visible to participants throughout the
program
Recruitment Oversight
• Centrally track recruitment progress
• Centrally produce written materials• Yearly gathering of Recruitment
Coordinators• Phone check-ins with programs