Recruiting Rural Participants for a Telehealth Intervention on Diabetes Self-Management


  • Funding: This study was funded by the National Institute of Health American Recovery and Reinvestment Act of 2009 grant number 3UL1RR024146-04S2. The project described was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through grant number UL1 TR000002.

  • Acknowledgments: The authors acknowledge the valuable contributions of the site champions and site coordinators who participated in this study, and our team, including Sergio Aguilar-Gaxiola, Lars Berglund, Erin Griffin, Danise Gonzalez, Colleen Hogan, Samira Jones, Bridget Levich, Roxann Moritz, James Nuovo, Ayan Patel, Julie Rainwater, and Glee Van Loon. We would also like to acknowledge the many resources of the Clinical and Translational Science Center for its contributions to this study.

  • For further information, contact: Sheridan Miyamoto; Betty Irene Moore School of Nursing; 4610 X Street, Suite 4202; Sacramento, CA 95817; e-mail:


Purpose: Recruiting rural and underserved participants in behavioral health interventions is challenging. Community-based recruitment approaches are effective, but they are not always feasible in multisite, diverse community interventions. This study evaluates the feasibility of a rapid, multisite approach that uses rural clinic site coordinators to recruit study participants. The approach allows for rural recruitment in areas where researchers may not have developed long-term collaborative relationships.

Methods: Adults with diabetes were recruited from rural Federally Qualified Health Center (FQHC) clinics. Recruitment feasibility was assessed by analyzing field notes by the project manager and health coaches, and 8 in-depth, semistructured interviews with clinic site coordinators and champions, followed by thematic analysis of field notes and interviews.

Findings: Forty-seven rural sites were contacted to obtain the 6 sites that participated in the study. On average, sites took 14 days to commit to study participation. One hundred and twenty-one participants were acquired from letters mailed to eligible participants and, in some sites, by follow-up phone calls from site coordinators. Facilitators and deterrents affecting study recruitment fell into 4 broad categories—study design, site, site coordinator, and participant factors.

Conclusion: The rapid multisite approach led to quick and efficient recruitment of clinic sites and participants. Recruitment success was achieved in some, but not all, rural sites. The study highlights the opportunities and challenges of recruiting rural clinics and rural, underserved participants in multisite research. Suggestions are provided for improving recruitment for future interventions.