Methods: The purpose of the parent study was to promote physical activity among midlife Asian American women using a Web-based physical activity promotion program with three different strategies. Subsequently, three different groups of midlife Asian American women were recruited for the study using a convenience sampling: (a) 94 Asian Americans using the Web-based intervention only (Group 1); (b) 46 women using the Web-based intervention with the use of Fitbits Charge HR (Group 2); and (c) 25 women using a Web-based intervention with office visits (urine collection and blood pressure and heart rate measures) and the use of Fitbits Charge HR (Group 3). The parent study was a repeated measures pretest/posttest (pre-test, post 1 month, & post 3 months) randomized control group study. Throughout the research process, the research team wrote research diaries on issues raised during the research process and kept the minutes of research team meetings during the research process. Then, the data from diaries and minutes were reviewed and analyzed using content analysis by Weber.
Results: The recruitment and retention rates are summarized in Table 1. The retention rates at the post 1-month were different in individual groups; 12% in Group 3 to 36.9% in Group 2. Also, the retention rates at the post 3-month were also different in each group; 0% in Group 3 to 36.9% in Group 2.
Table 1. The recruitment and retention rates in the intervention groups using three different strategies.
|
|
Group 1 |
Group 2 |
Group 3 |
Total |
|
# of those screened |
112 |
70 |
35 |
217 |
|
# of those recruited |
94 |
46 |
25 |
165 |
|
# of those retained by the post 1-month |
21 |
17 |
3 |
41 |
|
Retention rates by the post 1-month (%) |
22.3 |
36.9 |
12.0 |
24.8 |
|
# of those retained by the post 3-month |
21 |
17 |
0 |
38 |
|
Retention rates by the post 3-month (%) |
22.3 |
36.9 |
0.0 |
23.0 |
The issues were categorized into six themes: (a) recruitment difficulties, (b) the essential use of community consultants/gatekeepers, (c) cultural differences in recruitment and retention, (d) the importance of timing, (c) Fitbits as a facilitator, and (d) not-preferring office visits. First of all, the recruitment of Asian American midlife women into the Web-based intervention study was not an easy task across the strategies. Especially, the recruitment and retention of Group 3 was the most difficult among the three groups. Second, the use of community consultants/leaders was essential in recruitment and retention of the participants across the three groups. However, it was difficult to involve community consultants/leaders in recruitment and retention of the participants without former relations. Third, the recruitment of Chinese was much easier than the recruitment of Koreans across the strategies. Fourth, because of Thanksgiving and Christmas holidays, it was difficult to recruit and retain the participants across the strategies. Finally, the use of Fitbits attracted more participants, especially younger participants aged between 20 to 30 years in Group 3. Finally, the participants reported difficulties in making multiple office visits because of difficulties in transportation and parking. They also reported difficulties in finding time to make multiple visits due to their busy daily schedules.
Conclusions: The use of Fibits with development of user guidelines and the involvement of community consultants/leaders are proposed for future Web-based interventions. Also, more studies on cultural attitudes toward physical activity, research participation, and Web-based interventions are needed. Finally, we suggest the use of community consultants/leaders in the recruitment of midlife ethnic minority women regardless of the strategies adopted in a Web-based intervention.