Conducting Behavioral Intervention Research in Rural Communities: Barriers and Strategies to Recruiting and Retaining Heart Failure Patients in Studies

BACKGROUND: Heart failure is a major public health problem, and self-management is the primary approach to control the progression of heart failure. The low research participation rate among rural patients hinders the generation of new evidence for improving self-management in rural heart failure patients. PURPOSE: The purpose of this study is to identify the barriers and strategies in the recruitment and retention of rural heart failure patients in behavioral intervention programs to promote self-management adherence. METHOD: This is a descriptive study using data generated from a randomized controlled trial. RESULTS: Eleven common barriers were identified such as the inability to perceive the benefits of the study, the burden of managing multiple comorbidities, and the lack of transportation to appointments. Possible gateways to improve recruitment and retention include using recruiters from the local community and promoting provider engagement with research activities. Multiple challenges inhibited rural heart failure patients from participating in and completing the behavioral intervention study. CONCLUSION AND IMPLICATIONS: Anticipation of those barriers, and identifying strategies to remove those barriers, could contribute to an improvement in the rural patients’ participation and completion rates, leading to the generation of new evidence and better generalizability of the evidence.