This is the first study to investigate the recruitment success of community-engaged strategies aimed at enrolling older adult women in a clinical trial focused on preventing falls and urinary incontinence (UI). Women from racial and ethnic minority groups are at higher risk for UI and remain underrepresented in clinical research [1]. Therefore, effective recruitment strategies are essential to ensure adequate representation of these populations in trials evaluating conservative UI treatments [2].
The Mobility and Voiding Exercises in Older Women with Urinary Incontinence (MoVEonUP) study is a single-site, randomized controlled trial designed to assess the short- and long-term efficacy of a home-based, multicomponent conservative intervention (Figure 1) for reducing UI and falls among community-dwelling women aged 70 years and older [3]. A central objective of the study is to recruit a diverse sample that reflects the broader target population.
To achieve this, we implemented multiple community-engaged recruitment strategies across a variety of locations. This analysis compares the effectiveness of two such approaches—clinician-led bladder health education sessions and outreach at community health fairs—in recruiting participants for the MoVEonUP trial.

To enhance recruitment, we partnered with the Penn Bladder Health Network (PBHN), a longstanding collaboration between a U.S. university-based research staff and local community organizations This partnership facilitated outreach in a large urban city where 55% of women are minorities. 
Recruitment strategies included educational sessions at senior centers, senior living complexes, religious organizations, and community health fairs. Each 30-minute educational session, titled “Bladder Fitness after 60”, was led by a continence nurse specialist or physician. These sessions provided bladder health strategies and included the distribution of an booklet covering UI information. At community health fairs, PBHN team members distributed similar educational materials and engaged with attendees. Women interested in the study were given the opportunity to sign up for pre-screening for MoVEonUP either after attending an educational presentation or during the health fairs.
We calculated recruitment yield as the number of interested women divided by the total number of adults reached. Comparative analyses were conducted between educational sessions and health fairs, as well as across different recruitment locations, using non-parametric statistical tests.

Recruitment began in June 2022, with intervention and follow-up ongoing. This analysis includes outreach efforts through March 2025. A total of 48 presentations were conducted and attendance at 18 health fairs (Figure 2). Of the 326 individuals expressing interest, 54 (18%) consented to participate in the study.  Over two-thirds of participants (69%) came from racial minority groups, with the highest group being Black women (Figure 3).   
Recruitment yield was similar between educational presentations and health fairs (p= 0.08). However, presentations held at senior housing complexes and religious organizations demonstrated significantly higher recruitment rates compared to those at senior and community centers. (p<0.01).

Approximately, 1 in 5 individuals participating in community outreach efforts expressed interest in MoVEonUP. Notably, these numbers do not include referrals to the study made by community members who attended an educational session or health fair. This trial demonstrates the success of using community-engaged research approaches in recruiting diverse older women, addressing a critical gap in UI research. Given that many women do not seek care for UI, this strategy may help identify otherwise untreated individuals who may be interested in participating in conservative treatment clinical trials.

These findings offer valuable insights and provide guidance in use of community-engaged recruitment strategies for intervention studies addressing UI and fall prevention in women.  Conducting educational sessions at senior living housing complexes and religious organizations has proven to be an effective community engagement strategy for recruiting diverse participants.

Mckay, E. R., Davila, J. L., Lee, J. A., Rolston, R., Agalliu, I., & Abraham, N. E. (2021). Representation of minority groups in key pelvic floor disorder trials. Female Pelvic Medicine & Reconstructive Surgery, 27(10), 602–608
Wieland ML., Njeru JW., Alahdab F., Doubeni CA., Sia IG. Community-Engaged Approaches for Minority Recruitment Into Clinical Research: A Scoping Review of the Literature. Mayo Clin Proc. n March 2021;96(3):733-743
Andy U.U., Newman D.K., Wyman J.F., Klusaritz H., Walsh W., Shou H., Koepler N., Schmitz K.H., Reaves S., Arya L., Brown R.T. The Mobility and Voiding Exercises in Older Women with Urinary Incontinence (MoVEonUp) randomized controlled trial: study protocol and rationale. BMC Geriatr. 2024, Dec 4;24(1):994.