1. Planning efficient recruitment

2. Based on EHES Manual, Part A
Based on EHES Manual, Part A. Planning and preparation of the survey, 2nd edition, Available at: and
EHES Manual, Part B. Fieldwork Procedures, 2nd edition, Available at:
These slides can be used freely, translated and adapted to national use (e.g. concerning the recruitment practices).

3. Recruitment process
Needs to be specified in each country according to:
National and regional legislation
Ethical acceptance
Cultural norms
Survey budget

4. Participation rate
High participation is the basis for reliable results which represent the target population
Participation rates have been declining
Some groups are often under-represented (young adults, men and those from lower socioeconomic class)
→ Recruitment should be carefully planned, monitored during fieldwork and adapted whenever needed

5. Written materials
Potential participants’ response to invitation highly depend on the contents and format of written materials
Written materials may include
Information leaflet
Invitation letter
Letter with instructions to participant
Information sheet

6. Information leaflet Usually sent with the invitation letter
Less formal
Basic information in a concise form
Interesting; pictures and colors
Easy to understand
Main goal is to raise interest and to motivate people to participate

7. Contents of information leaflets
The leaflet should give answers:
What is this survey about? Why is it needed?
Why am I selected?
Why is it important to participate?
How do I benefit by participating?
What measurements are included?
Is my information really confidential?
Is my participation compulsory?
Where can I get more information?

8. Contents of invitation letters
A personal invitation
Short description of survey and selection of participants
Description of measurements
Pre-scheduled appointment time (with possibility to change time) or instructions for scheduling
Importance of participation explained
Benefits for participant
Signed by a survey leader (or other notable person)
Confidentiality explained
Contact information

9. Instructions to participant
Separate letter or in the invitation letter
How to prepare for the examination visit, e.g.
Instructions for fasting
Need to show an ID-card
Practical issues, e.g.
Travel instructions and map of the examination site

10. Information sheet Includes detailed information on survey
Must be provided to participants before obtaining informed consent
Given at the examination site or sent home with the invitation

11. Inviting participants
Invitation letter is usually the first contact attempt (pre-notice card may precede it)
Invitation letter without appointment time
Survey personnel call to schedule a visit or
participant books time after receiving the letter
Problems: Missing phone numbers, people not answering to phone calls, people who need more motivation to book appointment
Invitation letter with appointment time
Problems: If the appointment is not confirmed, many people will not show up, no possibility for extra motivation if needed

12. Scheduling appointments
Personal contact and reminders increase participation
Direct contact (phone call or home visit)
Possibility to answer questions and to motivate people
Possibility to change appointment times
Reminders
Reduce forgotten appointment times
A day – one week before appointment by a letter/ card/ text message/ phone call /
May include instructions for participants

13. Re-contacts Needed if previous invitations were not successful
At least one re-invitation even if participation rate is high (70 % or over)
At least two re-invitations if participation
rate < 70%
By letter or card, phone calls, s, text messages, home visits
Check accuracy of addresses, phone numbers
Mailed and/or web-based non-participant questionnaire or phone interview offered for all who refuse to participate

14. The value of competent personnel
Competent and well trained personnel
Understand the importance of high participation
Familiar with frequently asked questions
Know how to motivate persons
Have good social skills
Motivating the personnel
Satisfaction of staff is important for the work quality
Positive work environment, supervision, support and feedback increase staff satisfaction

15. Other means to increase participation
Local media campaigns before examinations
To raise interest towards the survey
TV and radio interviews, articles in newspapers, posters, social media etc.
Pre-notification of the survey
Flexibility in scheduling appointments
Home visits, if participation is not possible otherwise
Using several languages in information material and questionnaires

16. What motivates participants?
Benefits
Information on their own health
Incentives or reimbursements of travel expenses
Appreciation for serving public health and giving benefits for future generations

17. Improving participation through co-operation
Discussions in focus groups with representatives of potential participants
To gain information: what motivates participation
Provide information to
Health authorities and health professionals
Local government, communities
Co-operate with
Hospitals, non-governmental organizations, research centers and universities
Other places/groups which are important for the community

18. Acknowledgements
Slides prepared by Sanna Ahonen, Katri Sääksjärvi, Päivikki Koponen, Hanna Tolonen
Photographs by Hanna Tolonen with voluntary participants
Experiences and feedback from the EHES network have been utilized in the preparation of these slides
Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in through SANCO/2008/C2/02-SI EHES and Grand Agreement number , and in through Grand Agreement number /BRIDGE Health

19. Disclaimer
The views expressed here are those of the authors and they do not represent the Commission’s official position.