Table 3 Summary of responses to proposals for nested recruitment studies
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 |