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Challenges of recruiting farm injury study participants through hospital emergency departments
  1. Lesley Day1,
  2. John Langley2,
  3. Voula Stathakis1,
  4. Rory Wolfe4,
  5. Malcolm Sim4,
  6. Don Voaklander3,
  7. Joan Ozanne-Smith1
  1. 1Accident Research Centre, Monash University, Melbourne, Australia
  2. 2Injury Prevention Research Unit, Department of Prevention and Social Medicine, University of Otago, Dunedin, New Zealand
  3. 3School of Public Health, University of Alberta, Canada
  4. 4Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
  1. Correspondence to:
 Dr L Day
 Monash University Accident Research Centre, Clayton, Melbourne, Victoria, 3800 Australia;{at}


Background: Hospital emergency departments are common recruitment sites for injury studies. Yet recruitment method details, capture rates and response fractions are not consistently reported. As privacy legislation increasingly impinges on research activity, these parameters become even more important. The authors describe their experience with recruitment via emergency departments and outline subsequent adjustments to the recruitment approach.

Methods: The FIRM study was an Australian case-control study of serious farm work-related injury. Cases were identified prospectively by hospital staff on presentation to emergency departments. Consistent with the Victorian Health Records Act, potential cases were initially approached by hospital staff, and full recruitment was subsequently undertaken by study staff. Manual hospital record audits were conducted at five recruitment sites to determine the proportion of eligible cases approached.

Results: Among 660 medical records audited, 19 eligible cases were confirmed, 9 of whom were approached by hospital staff (47%, 95% CI 25 to 70%). In response, an additional process was established to capture missed cases, who were sent a letter from the hospital providing the opportunity to opt out of telephone contact by study staff. Early indications were that 34% (41/122) of missed cases actively declined to be contacted. Among those who were contacted and eligible, 84% (21/25) agree to study participation.

Conclusions: Recruitment of injury research participants via hospital emergency departments is challenging, particularly where authorities require an intermediary to make the initial contact. Removal of some constraints imposed by privacy legislation would considerably simplify recruitment and enhance scientific rigour in conducting epidemiological research.

  • AIS, Abbreviated Injury Scale
  • FIRM, Farm Injury Risk among Men study
  • VEMD, Victorian Emergency Minimum Dataset

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  • See linked commentary, p 75

  • Source of funding: Project grant from Australian National Health and Medical Research Council. LD supported by Senior Research Fellowship from the Council.

  • Competing interests: None.

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