| Research Brief Samples |
Here is a sample which can be used as a guide, in preparing your Research Brief for submission.
Implications of Study Complexity on the Recruitment of Volunteers for a Home-Based Women's Walking Program
JoEllen Wilbur, PhD RN CS; Arlene Miller, PhD RN CS; Andrew Montgomery, PhD; and Peggy Chandler, PhD
Women's Health Research Section
Background
Women tend to find that their work, family, and social obligations present major barriers to exercise. A goal of our study is to determine the effectiveness of a 24-week home-based, moderate intensity walking program in improving exercise behavior and fitness in healthy, sedentary, employed women (45-65 years old) from two racial groups. Recruitment of women into interventions that involve high levels of participant burden and stringent eligibility criteria is a difficult challenge facing nursing researchers.
Research in progress
Eligibility screening included a questionnaire, blood draw, health history and physical examination, and maximal aerobic fitness test. Women were not eligible if they had signs or symptoms of cardiopulmonary disease or metabolic disease or two coronary risk factors: were taking betablockers, psychotropic medications, or female hormones; had a body mass index (BMI) greater than 35 kg/m 2; or were pregnant. Our plan was to recruit 180 women over three years. This would allow for a 25% dropout rate. After two years of recruitment, we have received 411 calls from interested women, with 130 eligible for the study. This means 2 out of 3 women who call in are not eligible. Primary reasons for not meeting eligibility requirements were obesity, use of psychotropic drugs, and use of female hormones. However, we are still on target for our anticipated recruitment of approximately 60 participants per year.
Methodological challenge
Very complex studies have many variables and the way the variables are measured determines the eligibility criteria. For example, our decision to measure exercise adherence with heart-rate monitors precluded inclusion of women on beta-blockers. Obese women were eliminated from the eligibility pool by our decision to measure body composition with dual photon X-ray absorptiometry.
Creative recruitment efforts are necessary to maintain a balance between the complexity of the study and the adequacy of the pool. Previous research has taught us that when eligibility criteria are stringent a large subject pool is necessary for obtaining the required number of volunteers. Our location in a large metropolitan area and active recruitment efforts using news media, community presentations, and flyers have provided us with a large enough number of volunteers to execute a complex study.
This study was funded by NINR/NIH, 1RO1 NRO4143
JoEllen Wilbur and Arlene Miller are associate professors, Andrew Montgomery is a senior research specialist, and Peggy Chandler is project director of the Women's Walking Program at the College of Nursing, University of Illinois at Chicago. JoEllen Wilbur can be contacted at jwilbur@uic.edu.
Tailored Hormone Replacement Therapy Newsletters for Rural Older Women
Susan Noble Walker, EdD RN FAAN and Carol H. Pullen, EdD RN
Gerontological Nursing Research Section
Background
Menopause marks the beginning of changes in health risks for women. Although women live longer than men, they experience more illness episodes and are more likely to have disabling conditions. Cancer, coronary heart disease (CHD), osteoporosis and Alzheimer's Disease (AD) affect many women. For those without contraindications, hormone replacement therapy (HRT) may significantly modify their risk for disability and death from these diseases. The U.S. Preventive Services Task Force (USPSTF, 1996) concluded that, although there was insufficient evidence to advocate for or against hormone therapy for all postmenopausal women, all women need to receive information and counseling regarding the risks and benefits of hormone replacement therapy. Rural women may have more limited access to health care and are among the lower users of preventive services. These women should have access to counseling that enables them to make an informed choice to take or not take HRT, taking into consideration family history, life experiences, risk factors for disease, personal preferences, and a clear understanding of the probable benefits and risks.
Preliminary Studies
Only about 15% of women in the U.S. who were eligible for HRT in 1995 were receiving it, leaving 85% who either did not want or need it or who did not know about it. In our two earlier studies of rural Nebraska women, we found the prevalence of HRT to be 15.7% among 51 women aged 63-79 in study 1 and 27.8% among 97 women aged 50-79 in study 2. The higher percentage in study 2 can be attributed to the fact that many perimenopausal women take HRT for a short time while experiencing acute menopausal symptoms, but stop when symptoms disappear and thus do not get the disease-preventing benefits of long-term therapy. Many of the women said that their physicians did not listen to their concerns or give them enough information to make an educated decision about HRT.
Research in Progress
The purpose of our study currently in progress is to evaluate the effectiveness of individually tailored newsletters in influencing decision-making about and use of HRT among 150 women age 50 to 79 in rural Nebraska who are not currently taking HRT. Baseline assessment is being conducted via telephone. The intervention will include a series of mailed newsletters tailored on assessment data regarding a) perceived and actual risk for breast and colorectal cancer, CHD, osteoporosis and AD, b) perceived benefits of, barriers to and self-efficacy for taking HRT and c) history of HRT use. Women also will receive guidance about discussing HRT with their primary care provider. After 6 months, the primary outcomes of women's discussion of the pros and cons of taking HRT with their primary health care provider and initiation of the use of HRT, and the secondary outcomes of change in perceptions of risk for disease, benefits of HRT, barriers/risks of HRT, and HRT self-efficacy will be measured via a second telephone interview. This distance delivery model is being evaluated as a prototype that can be used by rural health care providers to facilitate change in a variety of primary preventive health behaviors to benefit the growing population of midlife and older rural women.
*Funded by a University of Nebraska Medical Center Outcomes Grant.
Susan Noble Walker is professor and department chair of gerontological, psychosocial and community health nursing at the College of Nursing, University of Nebraska Medical Center. Carol H. Pullen is an associate professor and assistant dean for rural nursing education at the College of Nursing, University of Nebraska Medical Center. Susan Walker can be contacted at 402/559-6561, e-mail swalker@unmc.edu.
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