Recruitment of Adolescent Girls Involved with the Juvenile Justice System: Lessons Learned from the Choices-Teen Randomized Controlled Trial

Background: Adolescent girls in the juvenile justice system are an under-researched, under-served, and high-need population. Despite distinct developmental and risk profiles than their male involved peers, there are limited gender-responsive interventions that efficiently engage these young women in community settings. The provision of empirically supported community-based prevention services is a public health priority for this population. High-quality research is necessary to inform these efforts, but recruitment and retention has been a challenge with this population for past studies due to the many barriers these youth and families experience. Lessons learned based on experience and recruitment data from a large randomized controlled trial (RCT) testing the efficacy of the Choices-Teen intervention with a large urban probation department will be described.

Methods: Recruitment efforts in partnership with an urban probation department will be described, including challenges with the COVID-19 pandemic and changes in programming during the RCT to reduce incarceration and increase diversion programming. Descriptive statistics will document the frequency of referrals, engagement with youth and parents for eligibility screening, and enrollment in the study. These numbers will be juxtaposed with the dates of various study efforts to expand and increase recruitment and retention so that visual trends can be inspected.

Results: As the RCT is ongoing, recruitment results will be updated to reflect any recruitment changes or efforts. Due to the pandemic, referrals started in February 2022, and over more than a two-year period have received 379 referrals. Forty-two (11%) were eligible for the study. Among those eligible, 20 (48%) have been enrolled in the study, 19 (45%) need follow-up, and 3 (7%) declined participation. The highest yield recruitment within the probation system have come from in-person recruitment events or educational settings (n=289; 78%). The volume of referrals increased dramatically as we expanded recruitment into all parts of the system. Some common barriers to recruitment for the study included difficulty contacting youth and parents by phone/text for follow-up, engaging busy parents in supporting their child’s participation, confusion about the study, distrust, and lack of office hours to accommodate the families. Efforts to address these barriers included a parental incentive, access to a study phone with a hotspot, offering online research assessments, a fireside chat to discuss study expectations and barriers, having Spanish-speaking staff and materials, and using youth-endorsed recruitment materials and videos.

Implications: Improving the recruitment and retention of justice-involved young women in efficacy trials is essential to identifying and disseminating interventions that will help address their overlapping needs. Lessons from early recruitment in this RCT suggest broad expansion into all programs from the start is essential when recruiting adolescent girls in these settings, as numbers are lower and engagement can be a challenge. It is also essential to learn from other probation and other community service providers who are trying to engage the youth. Early communication about study expectations and barriers does seem to improve retention once youth are engaged.