New Insights into Maternal and Paternal Recruitment and Retention: Findings from the Community Child Health Network St

1. Bowen Chung, Robin Gaines Lanzi, Peter Schafer, Maxine Vance, Elizabeth Clark-Kauffman, Latoya Sahedeo, Felica Jones 5138.0 Improving Pregnancy Outcomes: Findings from the Community & Child Network PreconceptionalStudy American Public Health Association Annual Meeting American Public Health Association Annual Meeting San Francisco, CA Wednesday, October 31, 2012 New Insights into Maternal and Paternal Recruitment and Retention: Findings from the Community Child Health Network Study of Preconception Health Funded by NICHD and NINR

2. Presenter Disclosures No relationships to disclose.

3. Background • Understanding father’s impact on perinatal outcomes and child development requires high quality data • No studies that we are aware of examined what factors, maternal and paternal, are associated with father participation in this research

4. To describe • Maternal and paternal participants • Attrition rates • Procedure modifications to increase enrollment • Variables associated with recruitment and retention Goals

5. Mean age – 25.7 years • 53% African American, 24% Latino, 22% White • 19% <HS;43% HS diploma/GED/tech diploma; 22% some college; 14% 4 year degree • 43% below federal poverty; 27% 100-200% federal poverty; 30% >200% federal poverty • 31% married • Mean age – 29.6 years • 38% African American, 24% Latino, 23% White • 21% Less than HS diploma; 37% HS diploma/GED/tech diploma; 11% some college; 18% 4 year degree • 26% below federal poverty; 19% 100-200% federal poverty; 36% >200% federal poverty • 39% married Mothers N=2510 Fathers/Partners N=1179 CCHN Phase 2 Study Sample

6. Mother Attrition Rate

7. Father/Partner Attrition Rate

8. Research perceptions: experiences with research • Participants social instability: Frequently moves, phone numbers changing/disconnected • Inconvenience of study procedures: number and length of interviews, biomarker collections • Competing demands on time and resources (work) • Mother’s encouragement around father participation in child’s life and study. Factors Impacting Retention

9. Community Experiences and Insights • Academic Researchers Experiences and Insights • Review of the Literature Community-Academic Steps to Address Recruitment and Retention Issues

10. Study staff were hired to be reflect local community • Hired staff from local communities • Hired males to interview fathers • Improvements in Interviewer tools and support • Each interview has own caseload • Use interviewer specific tracking sheets • Tailored caseload discussion • Extend recruitment window • Flexible about interview location • Provide incentives at time of assessment Recruitment and Retention Strategies

11. Improvements in recruitment and retention resources • Individualized mailings • Cards: Birthdays, For new babies, I’ve moved cards • Branded materials: Study magnets and calendars • Books: Children’s books, Healthy Start/Grow Smart books • Miscellaneous items: food, cribs, pack n play, diapers • Family photographs • Pregnancy resource information • Father specific changes • Father Advisory Council at each of 5 sites • Resources adapted for fathers, e.g. books and resource guides Recruitment and Retention Strategies

12. Improvements in Maternal Recruitment

13. CCHN Mother Enrollment By Month Jump in recruitment: function of new recruitment strategies

14. Improvements in father recruitment

15. CCHN Father Enrollment By Month Jump in recruitment: function of new recruitment strategies

16. Maternal characteristics offering permission for T0

17. Maternal characteristics offering permission for T0

18. Dependent measures • Model 1) Maternal permission to contact the father • Model 2) Father enrollment and completing of T1 • Model 3) Father completion of T3 • Co-variates • Race & household income (1&2), income only (3) • Independent measures • Age, income (≤ 100 FPL, ≤ 200% FPL, > 200% FPL), employment, relationship status, relationship quality, interpersonal violence, language spoken, problems with alcohol, drugs, partner wanted pregnancy, born in the U.S, # moves in past year. Variables for Regression

19. Model 1: Maternal permission to contact the father • Older Age, being marriedor in a relationship, living together, want future of relationship, and moves in last year (p<0.001) • Model 2: Father enrollment and completing of T1 • living together all the time (p=0.0001) • Model 3) Father completion of T3 • Higher income, HS degree equivalent or above maternal education (P<0.05) Variables significant in regressions

20. Sub-study to ascertain perceived barriers and benefits of participating in research • Lead by Healthy African American Families II • Attempted to contact 340 fathers who participated at any time point in CCHN • Offered 5 phone calls • Contacted 54 men • Asked questions such as: • 1. What would help/helped you be a part of a study like CCHN? • 2. What would help/helped you stay a part of a study like CCHN? LA Fatherhood substudy

21. LA Fatherhood substudy

22. LA Fatherhood substudy

23. LA Fatherhood substudy

25. Acknowledgements The Child Community Health Network (CCHN) is a community-based participatory research network supported through cooperative agreements with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U HD44207, U HD44219, U HD44226, U HD44245, U HD44253, U HD54791, U HD54019, U HD44226-05S1, U HD44245-06S1, R03 HD59584) and the National Institute for Nursing Research (U NR008929). CCHN reflects joint endeavors of five local sites: 1) Baltimore: Baltimore City Healthy Start and Johns Hopkins University (Community PI Maxine Vance, Academic PI Cynthia S. Minkovitz); 2) Lake County, Illinois: Lake County Health Department and Community Health Center and the Northshore University Health System (Community PI Kim Wagenaar, Academic PI Madeleine Shalowitz); 3) Los Angeles: Healthy African American Families, Cedars-Sinai Medical Center, and University of California, Los Angeles (Community PI Loretta Jones, Academic PI Calvin J.Hobel, Academic Co PIs Christine Dunkel-Schetter, Michael Lu); 4) East Carolina University, NC Division of Public Health, NC Eastern Baby Love Plus Consortium, and University of North Carolina, Chapel Hill (Community PIs Sharon Evans, Richard Woolard, Academic PI John Thorp); 5) Washington, DC: Georgetown Center on Health and Education, Washington Hospital Center, and Developing Families Center (Community PI Loral Patchen, Academic PI Sharon L. Ramey, Robin Lanzi Academic Co PI, Lorraine Klerman). Critical contributions to CCHN were also made by the Data Coordination and Analysis Center at the Pennsylvania State University (PI Vernon M. Chinchilli), Steering Committee Chairs Mark Phillippe and Elena Fuentes-Afflick*, and NIH Program Scientists (V. Jeffrey Evans, TonseRaju) and Program Officers (Yvonne Bryan*, Michael Spittel, Linda Weglicki, Marian Willinger). We thank the hospitals and other facilities sponsoring participant recruitment and the local community advisory boards at each site. *Indicates those who participated in the planning phase of the CCHN.