The most optimal school recruitment strategies for school-based obesity prevention and health promotion research in the United States: A systematic review with Delphi study

Authors: CEPNI, ALIYE - University Of Houston; VILSON, RESHMA - University Of Houston; HELBING, RACHEL - University Of Houston; WALSH, DAVID - University Of Houston; JOHNSTON, CRAIG - University Of Houston; YOON, CYNTHIA - University Of Houston; HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); LEDOUX, TRACEY - University Of Houston

Submitted to: Obesity Reviews
Publication Type: Review Article
Publication Acceptance Date: 7/8/2024
Publication Date: 7/20/2024
Citation: Cepni, A.B., Vilson, R., Helbing, R.R., Walsh, D.W., Johnston, C.A., Yoon, C.Y., Hughes, S.O., Ledoux, T.A. 2024. The most optimal school recruitment strategies for school-based obesity prevention and health promotion research in the United States: A systematic review with Delphi study. Obesity Reviews. Article e13808. https://doi.org/10.1111/obr.13808.
DOI: https://doi.org/10.1111/obr.13808

Interpretive Summary: One of the critical factors in developing a successful evidence-based obesity prevention program for use in schools is to identify effective strategies for recruiting schools. Effective recruitment strategies can lead to reaching recruitment goals within a specified timeframe while using resources efficiently and optimizing the utilization of time, money, and human resources. To identify these strategies for recruiting schools into health promotion interventions, we conducted a systematic review. Based on an extensive literature search, most published school-based intervention manuscripts did not report the duration of school recruitment, the actual size of school, and strategies used to recruit the schools into the intervention. Also, there were no reports regarding why the schools declined to participate in the interventions. Based on a specialized type of descriptive approach using experts in the field, a number of strategies were identified. These included 1) using pre-existing partnerships as well as creating new partnerships, being flexible in the intervention, limiting school disruptions, and using transparent communication with the schools. Costs for implementing new strategies included staff time and travel to and from the schools. In summary, improved reporting of strategies in published articles will allow for better time management and resources and will create confidence in reaching targeted schools.

Technical Abstract: This systematic review with the Delphi study aimed to identify effective and resource-efficient (optimal) strategies for recruiting schools into health promotion interventions. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school-based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 experts in school-based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher-order categories based on school recruitment strategies. Experts reported that 1) creating new or leveraging pre-existing partnerships, 2) intervention champion, 3) minimal school disruptions, 4) working with open mind/flexibility, and 5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school-based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size.