Table 2 Summary of challenges, opportunities, and recommendations for conducting collaborative epidemiological studies in Puerto Rico
Challenges: |
• Multiple IRB approvals • Time-, cost-, and labor-intensive training and retraining of interviewers • Turnover of interviewers caused uneven recruitment flow and loss of potential interviews • Perception of long interviews from participants • Internet connectivity lost occasionally • Emotional reactions from some participants during sensitive questions • Re-contacting participants was not always possible • Errors in data entry and data quality checks • Extensive process of accessing and abstracting data from medical records • Specific characteristics of the source population of each site may bias the results |
Opportunities: |
• Motivation and engagement from partners and interviewers • Community clinics were easily accessible to participants and had necessary resources • Ample and positive interest and cooperation from participants, with high completion rates • Fast recruitment that met target goals in the expected time period • Standardized methods and questionnaires available (translated and validated in Spanish) • Extensive data across numerous topics collected in one interview • Real-time data capturing electronic system • General trust from participants in the research study and in culturally-sensitive interviewers • Incentives were appealing; snacks provided were received favorably • No adverse events reported • Recurrent process evaluation helped correct issues during the study • Exhaustive data quality checks corrected any errors and allowed for a clean dataset • Study established trust, feasibility, training, capacity-building, resources, and expertise • Multisite recruitment helped increase representation of the population |
Recommendations: |
• Work in partnership, and consider a multisite approach to increase representation • All collaborators prepare together written agreements at the beginning of the study • Leverage existing resources (such as medical records, interview rooms, internet connection) • Employ well-paid full-time interviewers to support steady recruitment and interview schedule • Assign site liaisons and senior coordinator to run logistics, administrative tasks, quality checks • Consider ways to shorten or expedite the interviews and procedures • Train/retrain culturally-sensitive interviewers frequently; train on sensitivity and friendliness • Include a pilot period to correct any on-field issues even if questions were pre-piloted • Schedule weekly or biweekly team meetings for process evaluation • Record feedback from interviewers and participants, qualitatively and qualitatively • Conduct frequent checks on recruitment logs and data quality • Incentive should match scope and effort of participation; these should be clearly conveyed • Provide additional incentives; i.e.: food, health literature, transportation, or giveaways • Use electronic data capturing, with paper-based questionnaires as back-up for Internet losses • Request multiple re-contacting information, and keep updated during the course of the study • Follow up with participants immediately if they need to complete the interviews later on • Provide certificates of appreciation or other recognitions to interviewers and partners • Report results to clinics and the community |