Novel recruitment strategies to increase participation of women in reproductive health research in India

Abstract

In India, care seeking for reproductive health among women is inadequate. This poses a unique challenge to researchers recruiting cohorts for studies in clinic-based settings. The purpose of this paper is to describe the recruitment process used in a prospective cohort study investigating the relationship between bacterial vaginosis and acquisition of HSV-2 among sexually active women in Mysore, India. Participants were initially recruited from an obstetrics/gynaecology outpatient clinic. Results were compared with a ‘community supported’ enrolment process, which included community preparation and reproductive health education followed by screening of potential participants. During November 2005, 1,054 women were screened in the clinic. Of the total screened, 246 (23%) were eligible and only 78 (7%) enrolled. Between December 2005 and April 2006, investigators adopted a community supported enrolment process. During that period, 1,077 potential participants were screened, 947 were eligible, and 918 (85%) enrolled. Fifty-six (72%) participants recruited from the clinic returned for their first follow-up visit, compared with 795 (97%) participants recruited using the community supported enrolment process. Since obstetrics/gynaecology departments in India are poor places to recruit non-pregnant women of reproductive age, a community supported process yields more eligible potential participants to screen, and results in significantly better study retention.

Keywords:

• India
• recruitment
• research
• reproductive health
• women

Acknowledgements

Dr Madhivanan is a fellow in the International AIDS Training and Research Program supported by the Fogarty International Center (1-D43-TW00003-16). For their generous assistance on this project, the authors would also like to thank the director of CSI Holdsworth Memorial Hospital, Dr. S.C. Karat, all the NGOs who assisted with outreach programmes, and women in the study for their participation. Special thanks to Anne Ericson, V.H.T. Swamy, B.S. Renuka, K.S. Gururaj, Muralidhar Singh for assisting on the project, and Dr. Srinivas Ghante and Dr. Parthasarathy of Asha Kirana Hospital, Jeanne Moncada of University of California, San Francisco, for providing technical support and helpful suggestions. I would also like to acknowledge the HSV-2 Study Team: Fazila Begum, Prabhavathi, Sathyanarayana, M.M. Shyla, and Rani, without whose hard work the study would not have been possible.