A patient-centered analysis of enrollment and retention in a randomized behavioral trial of two cognitive rehabilitation interventions for mild cognitive impairment
Open accessAbstract
BACKGROUND: A major potential barrier for studying behavioral interventions for patients with Mild Cognitive Impairment (MCI) is the willingness and ability of people to enroll in and adhere to behavioral interventions, especially when the intervention involves dyads of patients with MCI and support partners. Details regarding recruitment strategies and processes (such as number of dyads screened) are often missing from reports of behavioral trials. In addition, reports do not detail the reasons a potentially eligible candidate opts out of participation in a research study. OBJECTIVES: To describe the challenges and successes of enrollment and retention in a behavioral trial for persons with MCI and their care partners, and to better understand barriers to participation from the patient’s point of view. DESIGN: Multi-site, randomized trial. SETTING: Major medical centers. PARTICIPANTS: Our accrual target for the study was 60 participants. Potential candidates were patients presenting to memory evaluation clinics whose resulting clinical diagnosis was MCI. A total of 200 consecutive potential candidates were approached about participating in the study across the three sites. INTERVENTION: Detailed recruitment and retention data of a randomized trial comparing two behavioral interventions (memory notebook training versus computer training) provided in two separate training time frames (10 days versus 6 weeks). MEASUREMENTS: Structured interview with those declining to participate in the trial. RESULTS: Overall recruitment 37% with a range of 13%-72% across sites. Overall retention 86% with a range of 74%-94% across sites. CONCLUSIONS: The primary barriers to enrollment from the patient’s perspective were distance to the treatment center and competing comprehensive behavioral programming. However, retention data suggest that those dyads who enroll in behavioral programs are highly committed.
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Time commitment is a common barrier to engaging in interventions for older adults with MCI.
“time commitment is a common barrier to engaging in interventions [53]”
From A phase I trial of accelerated intermittent theta burst rTMS for amnestic MCI (2024) · cites this paper as [53]
The Discussion says time commitment was a relatively low concern for this group, although it concerned some participants. It identifies travel distance and lack of a program partner as more prominent barriers, contrary to describing time commitment as a common barrier in this study. (LLM, conf=0.86)
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- Authors
- Locke, D. E. C., Chandler Greenaway, M., Duncan, N., Fields, J. A., Cuc, A. V., Hoffman Snyder, C., Hanna, S., Lunde, A., & Smith, G. E.
- Affiliations
- Mayo Clinic in Arizona (US)
- Emory University (US)
- Mayo Clinic (US)
- Venue
- The Journal of Prevention of Alzheimer's Disease
- Publisher
- Elsevier BV
- Published
- 2014
- Volume
- 1
- Issue
- 3
- Pages
- 1-8
- ISSN
- 2274-5807 (ISSN-L)
- PMC
- PMC4936534
- OpenAlex
- W2490505272
- Cited by
- 11
- References
- 32
- Citations by year
- 2024: 2 · 2022: 2 · 2021: 2 · 2019: 1 · 2017: 4
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Prevention of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG031581, P30AG019610, P50AG025688, P50AG016574)
- National Institute of Nursing Research (R01NR012419)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- mild cognitive impairment, cognitive rehabilitation, behavioral interventions, clinical trial recruitment, participant retention, recruitment barriers, dyadic intervention, care partners, computer training, memory clinics
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