Evaluation of the cost and effectiveness of diverse recruitment methods for a genetic screening study

Abstract

Purpose: Recruitment of participants from diverse backgrounds is crucial to the generalizability of genetic research, but has proven challenging. We retrospectively evaluated recruitment methods used for a study on return of genetic results.

Methods: The costs of study design, development, and participant enrollment were calculated, and the characteristics of the participants enrolled through the seven recruitment methods were examined.

Results: A total of 1118 participants provided consent, a blood sample, and questionnaire data. The estimated cost across recruitment methods ranged from $579 to $1666 per participant and required a large recruitment team. Recruitment methods using flyers and staff networks were the most cost-efficient and resulted in the highest completion rate. Targeted sampling that emphasized the importance of Latino/a participation, utilization of translated materials, and in-person recruitments contributed to enrolling a demographically diverse sample.

Conclusions: Although all methods were deployed in the same hospital or neighborhood and shared the same staff, each recruitment method was different in terms of cost and characteristics of the enrolled participants, suggesting the importance of carefully choosing the recruitment methods based on the desired composition of the final study sample. This analysis provides information about the effectiveness and cost of different methods to recruit adults for genetic research.

Keywords: cost-efficiency; genomic research; personalized medicine; recruitment methods; socioeconomic diversity.

Figure 1.

Variable costs across seven recruitment methods A. Extrapolated number of participants who completed enrollment per one FTE for each recruitment method (assuming the same average number of CBQ participants over 12 months). Abbreviations: consent blood and questionnaire complete (CBQ), electronic health records (EHR), full time equivalent (FTE). B. Average cost including fixed start-up cost, supply cost and marginal cost, per CBQ participant for each recruitment method.

Figure 2.

Number of participants screened, invited, consented, who provided a blood sample and completed a questionnaire (CBQ) by each recruitment method. Only eligible individuals were invited, and for the EHR and Biobank only individuals who answered the phone call were counted as invited. Abbreviations: not available for certain methods (na), electronic health records (EHR), individuals who provided written consent, blood and completed the questionnaire (CBQ completed)