Effective Strategies to Recruit Rural Family/friend Caregivers of Persons Living with Dementia in the United States into a National Randomized Controlled Trial: Preliminary Results

Background Family/friend caregivers of persons living with dementia (PLWD) in rural areas of the United States (U.S.) are more isolated and under‐served than urban counterparts[1] and are under‐represented in randomized controlled trials (RCTs)[2,3]. Our objective was to identify effective strategies for recruiting rural caregivers into a national RCT and describe baseline characteristics of enrolled caregivers. Methods We recruited U.S. rural caregivers of PLWD into an ongoing RCT evaluating the impact of an online asynchronous 6‐week workshop (“Building Better Caregivers”) on caregiver psychological health (June 2020‐present)[4] using multiple strategies (Table, row 1). We prospectively recorded characteristics of recruitment efforts (e.g., strategy type, cost, date) and caregiver responses (tick‐box, free‐text) to the eligibility survey question “How did you hear about the Building Better Caregivers study?” We performed descriptive analyses to determine the level of recruitment success of each strategy. Results Of 669 eligible caregivers, 360 (54%) enrolled to date (enrollment ends April 2023). Caregivers had mean age of 62.0 years (range 23‐86); identified primarily as White (87%), female (83%), and straight/heterosexual (90%); were caring for a spouse (44%), parent (43%), other relative (7%), or friend/neighbor (6%); and lived in all U.S. Census regions (34% West, 25% Midwest, 24% South, and 18% Northeast). Recruitment efforts with advertisements on Facebook, Google, and large media outlets (e.g., daily newspapers) had low success and cost money, whereas efforts through websites of trusted community/government agencies or local media (e.g., weekly newspapers) had medium‐to‐high success and were free (Table, row 2). Efforts to recruit through national associations had limited (low‐medium) success. Efforts to recruit through community agencies and health systems achieved high success when they had robust, searchable databases of PLWD/caregivers, mailing lists, and online resources. Some frontline caregiver experts (e.g., rural caregiver support specialists) achieved high recruitment but were challenging to identify in individual states and regions. Conclusions We successfully recruited rural dementia caregivers into a national RCT. We found that recruitment efforts were most effective when they engaged community‐based media, organizations, and experts to reach rural caregivers who trusted them. Rural recruitment is possible and necessary to achieve equitable trial access for vulnerable rural caregivers.