Stepwise strategies to successfully recruit diabetes patients in a large research study in Mexican population.

AIMS: Describe stepwise strategies (electronic chart review, patient preselection, call-center, personnel dedicated to recruitment) for the successful recruitment of >5000 type 2 diabetes patients in four months. METHODS: Twenty-five family medicine clinics from Mexico City and the State of Mexico participated: 13 usual care, 6 specialized diabetes care and 6 chronic disease care. Appointments were scheduled from 11/3/2015 to 3/31/2016. Phone calls were generated automatically from an electronic database. A telephone questionnaire verified inclusion criteria, and scheduled an appointment, with a daily report of appointments, patient attendance, acceptance rate, and questionnaire completeness. Another recruitment log reviewed samples collected. Absolute number (percentage) of patients are reported. Means and standard deviations were estimated for continuous variables, χ2 test and independent "t" tests were used. OR and 95% CI were estimated. RESULTS: 14,358 appointments were scheduled, 9146 (63.7%) attended their appointment: 5710 (62.4%) fulfilled inclusion criteria and 5244 agreed to participate (91.8% acceptance). Those accepting participation were more likely women, younger and with longer disease duration (p<0.05). The cost of the call-center service was $3,010,000.00 Mexican pesos (∼$31.70 USD per recruited patient). CONCLUSIONS: Stepwise strategies recruit a high number of patients in a short time. Call centers offer a low cost per patient.

Physical activity is a prognostic factor for bone mineral density in Mexican children

Background. Bone mass is similar in pre-pubertal girls and boys and double in both genders between the onset of puberty and early adult life. Exogenous factors such as nutrition and exercise contribute to the acquisition of bone mass. The objective of this project was to correlate calcium intake and level of physical activity with bone mineral density (BMD) in a sample of Mexican school-age children. Methods. Avalidated questionnaire was applied. The questionnaire included the following dimensions: (a) sociodemographic information, (b) type of sports and games that involved physical activity and hours per week dedicated to them, (c) inactivity measured by hours expended watching TV or playing videogames per day and (d) dietary calcium. After completing the questionnaire, the children were invited to have a BMD and total body composition assessment using a dual-energy x-ray absorptiometry (DXA) (Prodigy LUNAR). Results. In this cross-sectional study, 212 children were included, 48.6% were girls. The average total BMD in boys and girls was 0.8805 ± 0.056 g/cm² and 0.8788 ± 0.056g/cm², respectively, with significant differences in the groups of 10- and 12-year-old girls. An average of 10.9 ± 6.48 h of weekly physical activity was reported in boys and 10.6 ± 7.31 h in girls. Number of glasses of milk consumed was reported (1.7 ± 0.95 and 1.33 ± 0.91) per day in boys and girls, respectively. Differences in BMD in 10- and 12-year-old girls adjusted according to menarche were found. In the linear regression analysis, lean body mass was significantly associated with total, L2-L4, pelvis, and forearm BMD. Physical activity was significantly associated with leg BMD and age was associated with pelvis and forearm BMD. Conclusions. High lean body mass, menarche and regular intense physical activity are predictors for a higher BMD in school-age children in Mexico City.