Feasibility and Acceptability of Remote Hair Sample Collection in Parent-Child Dyads

Abstract

Background: Chronic stress contributes to adverse health outcomes and may be transmitted intergenerationally. Hair cortisol concentration is a noninvasive biomarker of chronic stress; yet the feasibility and acceptability of optional remote collection in rural families remains unclear.

Objectives: We evaluated the feasibility and acceptability of remote hair sample collection, identified factors associated with hair sample completion, and assessed the preliminary effects of a family-centered, mindfulness-based, motivational interviewing intervention on hair cortisol concentration.

Methods: In this pilot randomized trial, 46 rural parent-child dyads were assigned to either a remote mindfulness meditation-based motivational interviewing intervention or an active control. Hair sample collection was optional at baseline and post-intervention. Families opting in received mailed kits with written/video instructions, optional Zoom support, and a $40 incentive. Descriptive and exploratory analyses assessed participation patterns and associations with demographic and behavioral characteristics.

Results: Of 46 families, 36 (78%) consented to hair collection; 24 (67%) returned baseline samples, and 12 (50%) returned post-intervention samples. The average turnaround from mailing to receipt was 14 days. Participants rated instructions as clear and helpful; no families used Zoom assistance. Demographics were not significantly associated with completion, though trends indicated lower return rates among minority and full-time employed parents. At baseline, non-completers reported higher physical activity and greater child sugary beverage intake. Nonsignificant trends also suggested that completers had more depressive symptoms and greater body fat percentage compared to non-completers. No significant intervention effects on HCC were observed.

Discussions: Optional remote HCC collection is feasible and acceptable among many rural families, though retention declined over time. Future studies should investigate strategies to reduce barriers and promote sustained engagement when biospecimen submission is voluntary.

Keywords: biomarker collection; chronic stress; parent–child dyads; stress physiology.