428 - Recruiting Family Caregivers of Children for Qualitative Research in the Emergency Department: Lessons Learned from an In-Depth Interview Study

Publication Number: 4419.428

Rachel L. Wattier, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Odessa Garay, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Ryman R. Crone, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Shabir U. Din, UCSF Benioff Children's Hospital San Francisco, El Sobrante, CA, United States; Andrea Y. Huerta, UCSF Benioff Children's Hospital San Francisco, vallejo, CA, United States; Elizabeth Butrick, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Aaron Kornblith, UCSF, San Francisco, CA, United States; Anneka Hooft, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Sunitha V. Kaiser, University of California, San Francisco, San Francisco, CA, United States

Background: Patient and caregiver perspectives provided in qualitative interviews are valuable to research on emergency department (ED) care. However, there are barriers to ED-based qualitative research recruitment including emergent nature of care, lack of continuity, and time burden. Few studies report strategies to optimize qualitative research recruitment in the ED setting.

Objective: To describe insights gained from recruiting caregivers of children in an ED for an in-depth interview study about children's urinary tract infection (UTI) evaluation.

Design/Methods: We recruited English and Spanish-speaking caregivers of children age 2 months- < 12 years who had a urine test, excluding visits by severely ill or injured children. We recruited using active (direct approach) and passive (study posters) strategies. Clinical research coordinators (CRCs) screened visits from June-August 2025 and approached eligible caregivers. Interested caregivers completed an intake survey to confirm eligibility and facilitate remote interview coordination after visits. The study team evaluated and optimized recruitment through continuous monitoring, on-site study team interactions with observation and debriefing, seeking participant input, and reflexive journaling. We summarized adaptations to recruitment using numeric screening and contact log data, and thematic analysis of qualitative data from team meeting notes, adapted recruitment materials, reflexive journal entries, field notes, and participant interview transcripts.

Results: Over a 3-month active recruitment period, we screened 383 visits, identified 70 as eligible, and approached 66 families (summary, Table 1). In Month 1, 19 caregivers completed intake surveys, yet only 3 (16%) took part in interviews. We incorporated adaptations to recruitment in four domains: team familiarization, recruitment language, post-visit contact, and interview procedures (adaptations, Table 2; timeline, Figure 1). In Month 2-3 there were fewer intake survey responses, but caregivers who responded were more likely to complete interviews - 3/11 (27%) in Month 2 and 6/7 (86%) in Month 3. During the same period, 2 additional interviews were completed from passive recruitment.

Conclusion(s): We increased interview participation by caregivers of children recruited from the ED. Adaptations to recruitment enabled our team to speak to caregivers' motivation to help other families, build trust, provide clarity, and improve convenience. Our adaptive approach and identified adaptations to recruitment could be applied to strengthen ED-based caregiver recruitment for other qualitative research topics.

Table 1. Numeric data for caregiver active and passive recruitment by month


Table 2. Study adaptations to optimize caregiver recruitment


Figure 1. Annotated recruitment timeline and process measures for caregiver active recruitment by month.
Approached:eligible, proportion of eligible caregivers who were approached to discuss the study; intake survey:approached, proportion of approached caregivers who completed an intake survey; interview:intake survey, proportion of survey respondents who completed interview.