Strategies for improving patient recruitment to focus groups in primary care: a case study reflective paper using an analytical framework

The focus group formed part of modelling a complex intervention in primary care in the Resources for Effective Sleep Treatment (REST) study. Despite a considered approach at the design stage, there were a number of difficulties with recruitment. The recruitment strategy and subsequent revisions are detailed.The researchers' modifications to recruitment, justifications and evidence from the literature in support of them are presented. Contrary evidence is used to analyse why some aspects were unsuccessful and evidence is used to suggest improvements. Recruitment to focus group studies should be considered in two distinct phases; getting potential participants to contact the researcher, and converting those contacts into attendance. The difficulty of recruitment in primary care is underemphasised in the literature especially where people do not regularly come together, typified by this case study of patients with sleep problems.We recommend training GPs and nurses to recruit patients during consultations. Multiple recruitment methods should be employed from the outset and the need to build topic related non-financial incentives into the group meeting should be considered. Recruitment should be monitored regularly with barriers addressed iteratively as a study progresses.Timely recruitment is important for completion and generalisability of research studies, but delays and problems recruiting to studies are commonly reported. Campbell et al[1] commented that 53% of studies they reviewed required grant extensions for completion. Barriers to participation are well documented and, although some studies have reported successful recruitment strategies, there is little evidence available to predict the effectiveness of particular approaches[2].Recruitment to primary care studies is especially complex, because it may involve organisations (general practices or primary care trusts), practitioners (general practitioners, nurses and other primary health care professionals) or pa