An Analysis of Recruitment for a Non-treatment Based Advance Care Planning Research Study in Terminal Cancer Patients

Open Access
Stewart, Renee Ruth
Graduate Program:
Public Health Sciences
Master of Science
Document Type:
Master Thesis
Date of Defense:
November 21, 2014
Committee Members:
  • Benjamin H Levi, Thesis Advisor
  • Michael Jay Green, Thesis Advisor
  • Jane Ruth Schubart, Thesis Advisor
  • Elana Farace, Thesis Advisor
  • Chengwu Yang, Thesis Advisor
  • Recruitment
  • Advance Care Planning
  • End of Life
  • Cancer
  • non-treatment
This analysis examines the recruitment for a single-blind randomized controlled study, involving the sensitive topic of advance care planning, the vulnerable population of patients with terminal cancer, and a non-treatment based study intervention. The purpose of this examination was to identify key differences between the groups of patients that enrolled versus those who did not participate, in order to better understand recruitment for this type of study. Statistical analysis of the non-parametric distributions of data identified significant differences in age (p = 0.021), distance to study site (p = 0.010), race (p = 0.031), and number of follow-up phone calls (p < 0.001). Gender (p = 0.88), referring specialty (p = 0.076), and season of referral (p = 0.22) were not significantly different. Specifically, non-participants were slightly older, lived farther from the medical center, required more outreach phone calls, and were more likely to report feeling too ill or being uninterested as a reason to not participate. Some barriers to participation were outside of investigators control (i.e. patients who died before contact, were too ill, or unreachable) and represent an inherent inefficiency in recruiting terminally ill participants. The present findings suggest that recruitment efforts can be prioritized to patients who live closest to the study site and towards making initial contact with potential participants.