Women with substance use disorder may evade research participation because of individual and societal factors. Limited information exists on recruitment of women with substance use disorder. The purpose of this study was to delineate recruitment challenges among women with substance use disorder and identify successful recruitment strategies. An exploratory case study was used to examine recruitment of women with substance use disorder. This case study was informed by a pilot study in 2017-2018, where data were generated from 25 direct observations and three key informants from a drug rehabilitation treatment agency. Analysis took an explanation-building approach, which incorporated chronological field notes from direct observations, memos from key informant conversations, and the extant literature to revise our initial proposition. Macro-level contextual factors influencing recruitment were: (a) establishment of a triage system, (b) reactivation of agency ethics committee, (c) scheduled accreditation site visits, (d) varied guidelines, and (e) required treatment regimen. Recruitment may benefit from multiple sites, staff training in protocol, increased researcher presence, and the opportunity for women’s voices to be heard. This study advances knowledge of macro-level challenges faced during recruitment of women with substance use disorder in southeast USA. Indirect and direct recruitment, when combined, could maximize participation.


research recruitment, women, substance use disorder, case study

Author Bio(s)

Kristy J. Cook, Ph.D., RN, IBCLC is a registered nurse and lactation consultant with 10 years of experience caring for women with substance use disorder and their infants during the postpartum period. Please direct correspondence regarding this article to kristy.cook@vidanthealth.com.

Kim L. Larson, Ph.D., MPH, RN, FNAP is a registered nurse with expertise in maternal-child health, adolescent sexual health, and community-based participatory action research. Please direct correspondence regarding this article to larsonk@ecu.edu.


Appreciation is given to Dr. Chandra Speight for reviewing this article. KC and KL analyzed data, were major contributors to writing, and read and approved the final manuscript. The authors declare that they have no competing interests.

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