Peer-led recruitment of ‘hard to reach’ older limbless veterans: A case-study discussion

  • Gill McGill
  • Gemma Wilson
  • Nick Caddick
  • Matthew D. Kiernan
Keywords: Hard to reach, peer-led approach, peer-driven recruitment, veteran


Military veterans in the United Kingdom are considered a group at risk of experiencing health inequalities and a vulnerable population (Coll, Weiss, & Yarvis, 2012), particularly older veterans and those who have lost limbs.  Recruiting so-called ‘hard to reach’ populations has been a key focus of much health-related research.  A key reason for this is the fundamental importance of selecting an appropriate sample from a population which, at times, can be difficult to find and engage.  There is a lack of research examining the experiences of peer-recruiters, specifically the nature of research that is truly led by peer researchers as opposed to peer involvement in an element of the research process.  This study aimed to explore the peer recruiters’ experience of being involved in a research study, and their perceptions of their involvement impacting the recruitment process.

A case-study methodology was employed to support an in-depth investigation into the experience of two peer-recruiters, and to provide insight into aspects that extend beyond participant recruitment alone.  This case study was part of a larger study which aimed to explore the physical, psychological and social wellbeing of older, limbless veterans across the life-course of which the peer-recruiters were involved.  Peer-recruiters took part in semi-structured telephone interviews and both interviews were recorded and transcribed verbatim. Thematic Analysis was used to analyse the data (Braun & Clarke, 2006).

Three themes were generated: Importance of the insider perspective; involvement in the wider project; personal and professional gain.  The peer recruiters believed that recruitment benefitted from the peer researchers’ shared understanding of the participants’ unique needs, as well as their understanding of barriers typically preventing engagement in research. This shared understanding was also perceived as having benefit to the participants’ welfare throughout the research process. Peer recruiters also discussed their own involvement in the study, and felt a sense of enjoyment and satisfaction of helping others, as well as feeling as though their experiences positively impacted their own work.  However, geographical separation to the wider research team and communication issues within meetings were problematic and hindered their participation within the wider research study.

Peer recruitment was a successful method of recruiting a ‘hard-to-reach’ sample of older veterans with limb loss in this study.  Within policy-oriented health research, it is paramount that research findings should represent the full range of views, perspectives and needs of the target population (Thompson & Phillips, 2007).  Moreover, where underserved communities existing with particular healthcare needs, effective sampling is necessary in order to avoid bias, to recruit a large enough sample, and to ensure the needs of the most vulnerable members of a population are taken into consideration (Sadler, Lee, Lim, & Fullerton, 2010). To effectively engage participants in the recruitment process, the peer researchers utilised their own personal understanding of the veterans’ unique needs and also the potential barriers that prevent engagement in research.  It is important to understand the ‘military mind-set’ in order to engage and develop a relationship of trust with the participants (Coll et al., 2012).