Niloufar Hadidi, Kathleen Buckwalter, Ruth Lindquist, Christine Rangen

Recruitment and retention are considered among the most challenging steps in the research process. This becomes especially significant when the research population is stroke survivors with complex health needs and poststroke sequelae. The purpose of this article was to set forth and discuss challenges, barriers, and strategies in recruitment and retention of stroke survivors in a pilot study. This pilot study was carried out to assess the feasibility and effectiveness of problem-solving therapy for prevention and treatment of poststroke depression and for enhancement of quality of life, utilizing a randomized controlled design. Twenty-seven patients were recruited, and of those, 22 were retained and randomized to 2 groups. Treatment group participants (n = 11) received 10 weeks of problem-solving therapy by a trained nurse, and control group participants (n = 11) received 10 weeks of telephone calls only. Both groups were followed up to 3 months after intervention completion. Careful field notes were recorded throughout the study to guide future larger scale studies. Challenges revolved around being accommodative to stroke survivors' schedules, establishing realistic inclusion and exclusion criteria, and providing incentives to the study participants in the control group. Recommendations include careful planning and organization of study procedures, soliciting feedback and support from physicians and administrative staff on the unit early in the process, developing a collaborative relationship with multidisciplinary staff, and continuously monitoring progress and implementing changes as needed.