Open Access Research article

Program design features that can improve participation in health education interventions

Enza Gucciardi12*, Jill I Cameron34, Chen Di Liao5, Alison Palmer6 and Donna E Stewart27

Author Affiliations

1 School of Nutrition Ryerson University, Toronto, Ontario, Canada

2 University Health Network Women's Health Program, Toronto, Ontario, Canada

3 Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada

4 Toronto Rehabilitation Institute, Toronto, Ontario, Canada

5 Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada

6 Department of Family and Community Medicine at the University of Toronto, Ontario, Canada

7 Faculty of Medicine, University of Toronto, Ontario, Canada

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BMC Medical Research Methodology 2007, 7:47  doi:10.1186/1471-2288-7-47

Published: 9 November 2007



Although there have been reported benefits of health education interventions across various health issues, the key to program effectiveness is participation and retention. Unfortunately, not everyone is willing to participate in health interventions upon invitation. In fact, health education interventions are vulnerable to low participation rates. The objective of this study was to identify design features that may increase participation in health education interventions and evaluation surveys, and to maximize recruitment and retention efforts in a general ambulatory population.


A cross-sectional questionnaire was administered to 175 individuals in waiting rooms of two hospitals diagnostic centres in Toronto, Canada. Subjects were asked about their willingness to participate, in principle, and the extent of their participation (frequency and duration) in health education interventions under various settings and in intervention evaluation surveys using various survey methods.


The majority of respondents preferred to participate in one 30–60 minutes education intervention session a year, in hospital either with a group or one-on-one with an educator. Also, the majority of respondents preferred to spend 20–30 minutes each time, completing one to two evaluation surveys per year in hospital or by mail.


When designing interventions and their evaluation surveys, it is important to consider the preferences for setting, length of participation and survey method of your target population, in order to maximize recruitment and retention efforts. Study respondents preferred short and convenient health education interventions and surveys. Therefore, brevity, convenience and choice appear to be important when designing education interventions and evaluation surveys from the perspective of our target population.