Direct mailing was a successful recruitment strategy for a lung-cancer screening trial

J Clin Epidemiol. 2007 Aug;60(8):853-7. doi: 10.1016/j.jclinepi.2006.11.005. Epub 2007 Mar 26.


Objective: To analyze advertising, recruitment methods, and study participant demographics for the National Lung Screening Trial (NLST) site at Wake Forest University School of Medicine to define efficient ways to recruit participants for general clinical trials.

Study design and setting: Recruitment method data, demographics, geographic location, and date of enrollment were collected from all 1,112 NLST participants. Marketing data and financial records were analyzed to determine the effectiveness of each recruitment method.

Results: The total amount spent on advertising was $144,668, with the cost of enrollment per participant averaging $130. For black participants, the recruitment cost per person was $406, whereas for white and other race participants, the cost was $122 (P<0.0001). To encourage minority enrollment, $13,192 was spent on television advertising geared toward black viewers, resulting in eight black participants at an average cost per person of $1,649. Direct mailing cost $143 per participant recruited, whereas TV ads cost $382 per participant.

Conclusion: Direct mailing to a targeted group was the most efficient way to recruit participants. Printed advertising methods, that is, newspaper ads and brochures, were quite effective, whereas television ads were expensive. Appropriate minority recruitment needs sufficient attention and resources to ensure census groups are adequately represented.

MeSH terms

  • Advertising / economics
  • Black People
  • Clinical Trials as Topic
  • Costs and Cost Analysis
  • Demography
  • Geography
  • Humans
  • Lung Neoplasms / diagnosis*
  • Mass Screening / methods
  • Patient Selection*
  • Postal Service / economics
  • Sample Size
  • Television / economics
  • White People