Enhancing Recruitment in Urinary Incontinence Care

Why It Matters

Effective recruitment translates into earlier detection and treatment of UI, reducing patient burden and health‑system costs. Scaling proven strategies can improve care quality for a large, often hidden patient population.

Key Takeaways

• Leadership engagement consistently boosted practice recruitment
• Embedding UI screening in intake increased patient enrollment
• Incentives alone failed to drive recruitment
• Approval delays slowed adoption in large health systems
• 21% of screened patients tested positive for UI

Pulse Analysis

Urinary incontinence (UI) is one of the most common chronic conditions affecting women, with more than half of adult females experiencing symptoms at some point. Despite its prevalence, UI often goes unreported because of embarrassment and the mistaken belief that it is a normal part of aging. Primary‑care clinicians are uniquely positioned to identify and treat UI early, yet routine screening remains rare. The lack of systematic detection not only diminishes quality of life but also drives higher downstream costs for complications such as skin breakdown, infections, and mental‑health comorbidities.

The recent multi‑grantee initiative surveyed 32 leaders, 47 providers and staff, and tracked recruitment across 1,950 practices that screened 134,852 patients. No single outreach method proved universally effective, but three tactics repeatedly correlated with higher enrollment: leveraging existing professional relationships, deploying dedicated practice facilitators, and holding in‑person recruitment meetings. Crucially, practices where leadership actively championed the project and where UI screening was woven into the standard intake workflow saw the greatest provider and patient uptake. By contrast, financial incentives and broad advertising generated only modest gains, and large health‑system approvals introduced costly delays.

These insights suggest that health systems aiming to scale UI programs should prioritize leadership endorsement and workflow integration over generic incentive schemes. Embedding a brief UI questionnaire into electronic health‑record intake can capture the 21% of patients who test positive, creating a ready pool for targeted interventions. Future research must explore how these recruitment models perform across diverse populations and address equity gaps, especially in underserved clinics. Policymakers and payers may consider tying reimbursement to documented screening rates, thereby aligning financial incentives with the proven drivers of successful UI care delivery.