Recruitment strategies for rural and non-rural physical therapy pragmatic clinical trial

Fibromyalgia (FM) is a chronic widespread pain condition (1). Individuals with chronic pain living in rural communities report a higher incidence of chronic pain, are more likely to have functional limitations as a result of pain and are less likely to receive specialty care for pain (2, 3). A recent study confirmed the higher incidence of chronic pain in rural Americans (31% vs 20%), and they showed rural Americans were less likely to receive non-pharmacological therapies like physical therapy (PT) (20% vs. 42%) as compared to Americans living in the urban areas (2). People living in the most rural areas (populations less than 10,000 people) have lower income, are more likely to live in poverty, and are less likely to have a college education, all of which are risk factors for poor health outcomes. Our aim is to enhance recruitment of rural, low socio-economic, and racially/ethnically diverse participants by targeting specific PT clinics in our pragmatic clinical trial.