Evaluating recruitment, retention, and adherence patterns in the GET FIT fall prevention exercise trial in older, postmenopausal cancer survivors

Abstract

Purpose: The GET FIT trial tested fall prevention exercise approaches in older (50-75 years) post-chemotherapy, postmenopausal cancer survivors. We describe recruitment, retention, and adherence patterns from GET FIT to inform future trials.

Methods: Participants were recruited through multiple strategies (e.g., cancer and research registries, clinician referral, outreach, electronic health record (EHR) screening) and were randomized to one of three supervised, facility-based, group exercise programs (strength training, tai ji quan, or stretching control) for 6 months and then were followed for 6 months after supervised training stopped. We compared effectiveness of accrual across recruitment strategies, examined characteristics of women who completed the interventions to those who withdrew, and women with good (≥ 50%) versus poor (< 50%) adherence to training.

Results: Of 1490 interested women, 442 women were eligible, randomized, and received the assigned intervention (30% accrual rate). Accrual was similar across recruitment strategies, except for EHR screening which yielded no accruals. Retention over 12 months was 87% with most dropouts occurring within the first month. There were no differences in baseline characteristics between women who did or did not drop out. Poor adherers (n = 60) had higher baseline BMI, comorbidities, pain, disability, and lower physical functioning (p < 0.05) compared to more adherent women (n = 377).

Conclusions: A variety of recruitment strategies appear to be effective for enrolling older, postmenopausal cancer survivors into a facility-based exercise trial, except for directly approaching women identified through the EHR. Women with poorer health were at risk for study drop-out and poor adherence to exercise.

Implications for cancer survivors: Women with poorer initial health may need additional retention strategies to help them stick with supervised, facility-based, group exercise.

Trial registration: Clinicaltrials.gov: NCT01635413.

Keywords: Cancer survivorship; Exercise training; Fall prevention; Feasibility; Older adult.