Recruitment and Retention in Front-line Services: The case of childcare

This article highlights how problems of recruitment and retention in front-line services create a particular challenge to traditional HRM models and solutions. Private day nurseries make an interesting example of the challenges facing managers in the service sector as the combination of a feminised workforce, a price-sensitive service, public-private competition and state regulation create particular difficulties. We report on a study of 33 day nurseries involving interviews with managers and employees over an eight-month period. Our findings show that childcare providers have to cope with recruitment and retention problems associated with high-end interactive service provision compounded by gender segregation and small business characteristics. Our analysis of employer and employee perspectives examines labour market issues affecting recruitment, and categorises the reasons for staff turnover into internal 'push' factors, external 'pull' factors, outside factors and functional turnover.

Researcher and Employee: Reflections on Reflective Practice in Rural Development Research

This article describes an ethnographic study that was used to critically assess the links between rural development policy and practice. It does so from the novel perspective of the researcher as an employee in the organisation where the ethnography study was conducted. The article argues that this distinctive position gives rise to specific methodological issues. Particular attention is paid in the analysis to marginalised issues in reflexive practice literature, namely, the structural context. In so doing this research places at centre stage the importance of reflexivity in the field of rural sociology, an area in which to date it has had limited acceptance.

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care.

Background Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs) is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers’ and participants’ experiences of its implementation and to inform future strategies to maximise recruitment and retention. Methods In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection. Results We achieved high retention rates for practices (100%) and for patients (85%) over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners’ contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention. Conclusions Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT results. A continuous dynamic process of monitoring progress within trials and tailoring strategies to particular circumstances, whilst not compromising trial protocols, should allow maximal recruitment and retention.