Dyadic recruitment in complementary therapy studies: experience from a clinical trial of caregiver-delivered reflexology.

PURPOSE: As home-based care continues to be a growing trend in health care, involvement of friend and family caregivers in the management of illness becomes essential. However, before nurses can prepare caregivers to engage in various types of care, an evidence base needs to be established via randomized controlled trials (RCTs). Research suggests that recruiting cancer patients and their friend or family caregivers into RCTs presents challenges. The purpose of this paper is to illustrate the barriers to recruitment of patient-caregiver dyads into a RCT of caregiver-delivered reflexology and to recommend strategies to address such barriers. METHODS: This paper reports on a nurse-directed RCT that involved recruitment efforts unique to a caregiver-delivered reflexology protocol for advanced-stage breast cancer patients. Ineligibility due to caregiver-related reasons, consent among eligible patients (out of 551 approached patients), and reasons for refusal were analyzed. RESULTS: Almost one-third of patients were found to be ineligible due to the lack of a caregiver to participate with them and provide this form of social support. Among eligible patients, the consent rate for this dyadic study is much lower than that of previous RCTs of reflexologist-delivered reflexology that enrolled just patients, not dyads. CONCLUSION: Implications for nursing practice and research include addressing the need for greater social support for patients and strategies for problem-solving refusal reasons during study enrollment.

Combating weight-based cyberbullying on Facebook with the dissenter effect.

Weight-based cyberbullying is prevalent among youth and adolescents and can have lasting negative psychological effects on the victims. One way to combat these negative effects is through modeling dissenting behavior. When a bystander challenges the bully or supports the victim, this models dissenting behavior. In this study, 181 participants were exposed to message manipulations posted on a Facebook page aimed at testing the conformity effect, the dissenter effect, and the bystander effect in response to enactment of weight-based bullying. Facebook is a common social media site where cyberbullying is reported. Results indicate that in the dissenting condition, participants' comments were significantly more positive or supporting for the victim, as compared to other conditions. This effect was more pronounced for men than for women. In addition, in the dissenting condition, men were less likely to consider the victim unhealthy than women and men in other conditions. These results support the effectiveness of efforts to model dissenting behavior in the face of bullies and extend them to online contexts. Implications are discussed.