Internet Recruiting: Lessons Learned From a Failed Worker’s Compensation Back Pain Education Program

Background: The Internet has the potential to become a powerful tool for the delivery of health education programs. However, it also presents challenges with recruitment and data collection. This paper reports on the failed recruiting efforts for a back pain Internet patient education study. Methods: Six hundred injured workers with back pain were needed for the study. To be eligible one must have been on disability and missed more than 10 days of work. Recruitment efforts included use of electronic medical records to identify potential subjects, web site links, direct mailings, phone calls, talks with clinic staff, as well as brochures and pamphlets in the clinic. Results: Over a fourteen-month period, only 20 subjects were recruited. A study of the barriers to recruitment revealed system related problems including: missing data in electronic medical records and inability to integrate recruiting into the medical visit. Individual problems such as computer access and language also posed barrier to recruitment. Conclusions: Developing a screening tool to identify patients who are most at risk for developing chronic back pain or re-injury may be necessary for successful recruitment. In addition, creative recruitment efforts as well as collaboration with on-line organizations such as disease specific advocacy groups, health plans, e-health publications and newsletters, employee wellness websites, as well as collaborating with other state workers compensation and insurers web sites may prove to be more effective means of recruiting on-line for injured workers.