Overcoming challenges in the changing environment of practice-based research

Area of Science:

• Public Health
• Clinical Trials
• Pediatric Research

Background:

• National practice-based research networks face logistical and methodological hurdles.
• Pediatric Research in Office Settings (PROS) has experience adapting to these challenges.
• The Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention aims to reduce secondhand smoke exposure in children.

Purpose of the Study:

• To describe practical challenges and novel strategies used to implement and test the CEASE intervention.
• To assess the feasibility of conducting a national-level cluster-randomized controlled trial within PROS.
• To evaluate methods for overcoming barriers in practice-based research.

Main Methods:

• A national-level cluster-randomized controlled trial involving 20 PROS practices, randomized to CEASE intervention or control.
• Enrollment of parents of children who smoked in the past 7 days, with postvisit interviews and 3- and 12-month follow-ups.
• Strategies to address challenges in practice recruitment, parent screening and enrollment, and achieving adequate 12-month telephone response rates.

Main Results:

• 20 practices across 16 states were enrolled, with 1,980 parents enrolled after screening 18,607.
• Initial 12-month telephone interview response rate was 56%, with nonresponses largely due to incorrect/disconnected numbers.
• Response rate increased to 67% after implementing strategies like obtaining new contact numbers and using text messages, leading to 389 completed interviews.

Conclusions:

• The study successfully implemented novel strategies to overcome methodological barriers in a national intervention trial.
• Data collection was completed within the office setting, demonstrating feasibility.
• The applied strategies effectively increased the telephone interview response rate, improving data quality.