Research challenges to recruitment and retention in a study of homebound older adults: lessons learned from the nutritional and dental screening program.

This paper attempts to describe the many reasons why it is difficult to recruit homebound older adults to participate in research studies. The reasons, not surprisingly, are more practical than theoretical. Complicated procedures for participants to follow, cross-cultural communication, fear of the medical establishment, convoluted consent forms, making contact on the telephone, finding the participants' homes, and a host of other nagging problems combine to erect enormous barriers to running successful studies. It is our hope that in identifying these difficulties we will also shed light on how to design studies that minimize their impact.