Strategic recruitment and retention for pediatric research: a systematic review and meta-analysis

Objective: To evaluate the effectiveness of recruitment and retention strategies in pediatric clinical studies, focusing on achieving adequate representation across a range of demographic considerations. Study design: A systematic review was conducted using PubMed, PsycNET, and Cochrane databases to identify articles published between January 1, 1993, and September 1, 2024. Inclusion criteria targeted general pediatric studies emphasizing recruitment diversity. We compared success rates of these strategies across different races and ethnicities, targeted age groups, and community location, to current published national recruitment rates in pediatric research. Results: Of the 2,272 studies identified, 23 studies were included that detailed specific recruitment and retention strategies specifically targeting diverse pediatric populations for general pediatric health topics. These studies enrolled a total of 5,482 participants with ages ranging from 0.55-19.8 years of age for child and adolescent populations, and a mean parental age of 35.5 years for studies targeting parents of children. Community-based recruitment strategies were most effective for engaging underrepresented populations. Family services and flexible scheduling were particularly effective for parents and young children, while monetary compensation and group-oriented efforts resonated more with adolescents. Retention strategies, including flexible scheduling, family services, and compensation, were successful across populations. Conclusion: Tailored recruitment and retention strategies addressing cultural, social, and logistical needs are essential for ensuring diversity of age, race, ethnicity and geographic location in pediatric research. Community-based strategies enhanced recruitment, while compensation and logistical incentives, such as follow-up reminders and family services improved retention. Addressing data gaps on recruitment and retention efforts are critical for future research to achieve adequate representation and improve health outcomes in pediatrics.