20.2 Recruitment and Retention of Program Participants

Population Considerations: Health Care Providers

Some community health programs utilize health care providers (HCPs) to deliver interventions and assist with program planning, participant recruitment, and program evaluation. For example, community health workers (CHWs) are public health workers who liaise between health services and the community to improve access to services (Carter et al., 2016). One method to promote CHWs and link clients to them is to have HCPs refer their clients to or write prescriptions for a CHW. In these circumstances, the program team considers the recruitment and retention of HCPs and clients.

Multiple factors influence HCP participation. The program team designs strategies to enhance their recruitment and retention and reduce barriers to their participation. For example, HCPs are more likely to participate in community health programs when they understand the program’s value for themselves and their clients, the burden of performing the intervention is low, and the provider’s needs match community needs that are met by an evidence-based interventions (Krebs et al., 2021). Conversely, the HCP may be less likely to participate when they lack knowledge and training before program implementation, are inexperienced with client recruitment, have inadequate communication with the program team, and lack time to perform interventions (Krebs et al., 2021).

To successfully recruit and retain HCPs, Krebs et al. (2021) recommend including health care providers in all levels of planning, developing a recruitment strategy at the beginning of the planning process, training HCPs on how to recruit clients and implement the intervention, and using frequent, clear, goal-oriented communication.

Population Considerations: Youth

Facilitators and barriers to recruitment and retention may also differ when youth are the target population. Hull et al. (2022) provide a resource guide to enhance recruiting and retaining this demographic in community health programs, with strategies such as these:

• Include youth and parents/caregivers in planning and recruitment
  • Assess youth needs, values, and motivators
  • Collaborate with youth to develop recruitment and program materials, including choice of marketing strategy such as type of social media
  • Host a youth and parent night to provide program information and address questions
  • Train a youth champion to participate in the program and promote the program
• Identify barriers to recruitment and retention
  • Youth may need transportation, provide childcare for siblings, or have scheduling issues due to academics, athletics, or work
  • Consider offering the program during school hours, on weekends, and in shorter sessions
• Establish partnerships with implementation location
  • School-based locations may be best due to fewer transportation issues, youth familiarity with the location, and the potential to incorporate the program into the school schedule
• Provide incentives for participation, such as gift cards, non-tangible items, and/or food
• Ensure the environment and program materials promote a safe and inclusive environment
  • Plan strategies that empower youth and allow their opinions to be heard
  • Clarify program goals, participant expectations, and benefits of participation
  • Translate material into languages and use images that represent the target population
  • Provide opportunities for youth engagement and the communication of values and beliefs
  • Incorporate real-life youth experiences into program activities
  • Ensure program staff are positive, respectful, and supportive of youth

Population Considerations: Sociocultural and Linguistic Needs

Facilitators and barriers to recruitment and retention may also differ based upon sociocultural and linguistic needs. The program team must understand the target population’s needs and incorporate them into recruitment and retention strategies. Cultural Influences on Health Beliefs and Practices discusses the impact of culture on individual health behaviors, values, and attitudes. Culturally and Linguistically Responsive Nursing Care and Culturally and Linguistically Appropriate Program Design describe strategies to meet the target population’s cultural and linguistic needs. Community programs are more effective when:

• program planning, recruitment and retention planning, and program implementation include the target population;
• linguistic needs are met through provision of materials and activities in English and in any other language used by program participants;
• cultural values, beliefs, and needs are incorporated into program strategies; and
• program staff provide a welcoming and inclusive environment, acknowledge and respect cultural differences, and know how to communicate with those from a different culture.

Prevention First (2022) provides a guide to increase cultural responsiveness of prevention programs. Table 20.4 lists actions to increase personal and program cultural responsiveness and provides examples of related actions.