A multilevel framework for recruitment and retention in implementation trials: An illustrative example

We conducted a multi-state hybrid type III effectiveness-implementation trial that maintained high recruitment and retention across all relevant levels amid a global pandemic. The newly developed multilevel recruitment and retention framework and assessment guide presented here, which integrates behavioral theory, a relationship-focused lens, and evidence-based strategies for participant recruitment and retention at multiple levels, can be adapted and used by other researchers for implementation, hybrid, and multilevel pragmatic trials as well as other implementation studies.