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Table 3 Summary of responses to proposals for nested recruitment studies

From: Trials within trials? Researcher, funder and ethical perspectives on the practicality and acceptability of nesting trials of recruitment methods in existing primary care trials

Type of intervention

Perceived advantages

Perceived disadvantages

Points to consider in implementation

Financial incentives to patients and professionals

Worth trying, extra resource; straightforward; it is justified to pay people for their time

May create ethical dilemmas, difficult to set right payment level; managing preferences may pose problems

May be more acceptable for professionals than patients; consult widely to set levels; avoiding coercion; avoiding drop-outs due to preferences?

Attachment of additional, dedicated research nurses for sessions in participating centres

Dedicated extra resource; logical; gives continuity within the research; creates ownership; stimulate interest on site

May impact on continuity of care; may cause logistical problems; more relationships to manage

Local input to staff selection; consider continuity of care; integration in practice; contractual issues

Use of DVD of previous trial participants discussing their experiences of trial participation

Worth trying; good idea; visual media are attractive; could work for lots of trials

Lack of time; unwillingness to watch; content may not be believed; may over-simplify; technical challenges

Mode of delivery, content, run-time; whether study specific or generic; age group biases; Information equity

Mass media approaches to change attitudes to trials among patients

Very important; good idea; may work well in areas with high refusal rates; challenge notion of 'guinea pig'

Expensive, difficult to focus message on local area or topic; may not produce immediate impact

Cost difficulties, measuring impact; avoiding bias

Educational incentives to clinicians: e.g. seminar on trials and research methods

Others report this works; may bring lasting benefit; research understanding will motivate participation

Lack of time; lack of interest; burden; difficult to motivate clinicians

Motivating clinicians; clinician preferences; how learning occurs; training location

Training for clinicians in seeking consent for trials

Interesting idea; may lead to more positive explanations of research; reduce clinician fear

Few studies use clinicians to consent patients; lack of time and motivation; burden

Assess numbers of studies using clinicians to consent; motivating clinicians; training location; control arm

Option to refer patients to a dedicated research centre

Feasible; interesting; participants will get more information and attention; professional

Additional cost and burden of travel; data collection and co-ordination

Defraying travel costs; coordinating data

Support for investigators on project management, monitoring and contingency planning

Good idea, but should be in place anyway

Difficult to randomize if only used by those who want help

Designing to enable randomization