Door-to-door recruitment during the COVID-19 pandemic: Lessons learned from a population-based, longitudinal cohort study in North Carolina, USA

BACKGROUND: The COVID-19 pandemic has disproportionately impacted many of the same communities that have been historically harmed by or underrepresented in public health research. In a prospective cohort study on COVID-19 in North Carolina, USA, we employed a door-to-door recruitment strategy on a randomly selected sample of households to maximize inclusivity and improve study diversity. DISCUSSION: Rapidly shifting current events and an evolving pandemic required continuous updating of our approach. Using a variety of recruitment strategies and participation methods allowed us to quickly adapt and to reach a broad range of people with diverse needs and circumstances. Door-to-door recruitment had many unexpected benefits, allowing us to easily reach people that were working from home and leaving people with positive impressions of public health research. However, even when we were able to elicit a response from prospective participants, follow-up has remained a substantial challenge. CONCLUSIONS: It is paramount for public health practitioners to employ creative strategies and to invest time and resources to include hard-to-reach communities in research.