Subsequent to a traumatic brain injury (TBI) or stroke, Veterans and their families face a myriad of care issues in concert with changes in each Care Partner’s respective roles and responsibilities and thus, negative psychosocial outcomes (i.e., depression, anxiety, strain) for both Care Partners. Developing and evaluating non-pharmacological interventions to address these care issues are essential. However, researchers conducting dyadic research face challenges in recruiting, enrolling and retaining both Care Partners. The following study reports recruitment and enrollment data from ANSWERS-VA (Acquiring New Skills While Enhancing Remaining Strengths), which via a strength-based approach, addresses the wide range of care issues faced by Veterans with TBI/stroke and their family Caregivers including: communication, cognitive engagement, understanding emotions and behaviors, and managing role changes and social activities. Data are reported from a two-step recruitment and enrollment process consisting of: 1) chart review to determine initial eligibility (e.g., Veteran has a history of stroke and/or TBI); and, 2) an in-depth review with each Care Partner to determine eligibility (e.g., Care Partner availability to participate in the study). A total of 1,307 charts were initially reviewed for study eligibility. Of the n=738 (56%) who met the initial study eligibility and were contacted: n=272 (37%) were ineligible at the 2nd step; n=263 (36%) refused; n=120 (16%) could not be reached during the recruitment period; and, n=83 (11%) consented to participate and were subsequently enrolled and randomized in the study. The most frequent reasons for study ineligibility at the 2nd step  included: n=119 (44%) had no informal family/friend Caregiver; n=61 (22%) were no longer community-dwelling in the designated area or were deceased; n=43 (16%) were too impaired based on cognition, vision, hearing, or physical health; and, n=49 (18%) had a range of different reasons (e. g., drug and/or alcohol abuse, homeless, incarcerated). Common reasons for study refusal included: n=139 (53%) were not interested in participating and n=65 (25%) indicated the Caregiver was too busy. These data highlight the difficulties in recruiting and enrolling Veterans and their family Caregivers in dyadic intervention protocols, and consequently, the unique challenges to researchers, which may hinder study progression and limit generalizability of study findings. Particularly, in the current study, many Veterans and their families had competing demands for their time (e.g., work-life balance; child rearing), were not equipped to participate in a research study, and/or may not have believed there was a benefit to participate. Additionally, this dyadic research requires participation of both Care Partners, which necessitates a more complex set of inclusion/exclusion criteria to be met. Discussion will focus on lessons learned including: 1) streamlining recruitment processes; 2) strategies for enrolling caregiving dyads; and 3) working with vulnerable populations and their families.

Challenges in Recruitment and Retention of Dyadic Care Partners in a Veterans Affairs’ Intervention: ANSWERS-VA