Recruitment and retention challenges in communication interventions with low socioeconomic position (SEP) populations: Data from the Click to Connect project

Researchers have underscored the importance of including minority and underserved populations in clinical trials and behavioral interventions. So, too, have they highlighted the difficulties of recruiting and retaining these populations. However, most studies have focused on racial/ethnic minorities; substantially less is known about the challenges associated with recruiting and retaining persons of low socioeconomic position (SEP). This study presents data from the Click to Connect project, a federally-funded intervention to improve Internet and health literacy among low SEP populations by providing home access to high-speed Internet, computer and Internet training classes, a web portal that facilitates Internet navigation, and ongoing technical support. The intervention was conducted in three waves, with each intervention period lasting nine months. Project staff made 190 recruitment presentations to nearly 1,800 students at adult basic education classes in greater Boston. Of these, 530 met the eligibility criteria, which included being a novice Internet user with no home broadband connection. Staff made 3,350 recruitment calls to enroll 336 participants (175 experimental, 161 control). Nearly 60% of participants live below the federal poverty level. Recruitment challenges included disconnected telephone service and language barriers. Subsequent retention challenges included participants moving, losing their phone service, and missing training classes due to competing interests (e.g., working multiple jobs). Nonetheless, retention remained at 88% across all waves due to extensive retention efforts: staff made 3,340 calls to participants for reasons including training class reminders and technical support follow-up. The implications for communication and behavioral interventions with low SEP populations will be discussed.