Exploring recruitment strategies for place-based research in rural areas of Australia: a comparative case study analysis

Abstract Background Recruitment of participants into research studies is commonly challenging and becomes more difficult when targeting underrepresented population groups. Recruiting individuals living in rural locations, must use appropriate strategies if the sample size is to be achieved. The aim of this case study was to explore factors associated with research capacity, and to determine their impact on recruitment strategies, including timeframe and participant recruitment outcomes. Methods This case study investigated the recruitment outcomes of four rurally based research projects performed between 2016-2024. Participants were enrolled either directly by the researchers (face-to-face method f2f), or through General Practitioners as trusted local intermediaries (TLI) through which all recruiting materials were passed. Projects were also categorised as large or small, according to the geographical size of the recruiting region. Cooke’s framework on measuring progress with research capacity building was used to create the dataset, with time and personnel used as the units of analysis. Data was analysed using cross-case synthesis and descriptive statistics. Results When the researchers performed their own f2f recruitment, the smaller study delivered 132% of anticipated 50 health checks (n=66) and achieved 72% of 25 interviews (n=18) across three separate time-points. The larger f2f study recruited 674 participants over seven events. The smaller TLI study took twice as long to recruit participants than planned (4 years) and achieved n=25 (25%) of the sample size. The larger TLI study took 43% longer (4.3 years) and achieved 44% (n=132) of the target sample size. Key factors in research capacity building were linked to staffing continuity and sustainability, as well as partnerships and collaborations that impact on recruitment. High turnover of staff affected both TLI studies, with one having eight different people in the recruitment role over two years. All studies were adapted iteratively to ensure the research was ‘close to practice’. Conclusion Recruitment in rural settings is complex with many factors impacting recruitment success. Researchers had greater capacity to recruit participants f2f, using intensive periods which was less affected by staff turnover. Both the research focus and recruitment strategy need to be ‘close to practice’ for all involved. Trial registration RuralCVD: n/a, CHAaRGE: 20: n/a, Health SMaRT: n/a, Healthy Rural Hearts: ACTRN12621001495819 (Date registered: 03/11/2021).