Perspectives of trial staff on the barriers to recruitment in a digital intervention for psychosis and how to work around them: qualitative study within a trial

Allan, S. et al. (2021) Perspectives of trial staff on the barriers to recruitment in a digital intervention for psychosis and how to work around them: qualitative study within a trial. JMIR Human Factors, 8(1), e2405. (doi: 10.2196/24055) (PMID:33666555) (PMCID:PMC7980120)

Abstract

Background: Recruitment processes for clinical trials of digital interventions for psychosis are seldom described in detail in the literature. Although trial staff have expertise in describing barriers to and facilitators of recruitment, a specific focus on understanding recruitment from the point of view of trial staff is rare, and because trial staff are responsible for meeting recruitment targets, a lack of research on their point of view is a key limitation. Objective: The primary aim of this study was to understand recruitment from the point of view of trial staff and discover what they consider important. Methods: We applied pluralistic ethnographic methods, including analysis of trial documents, observation, and focus groups, and explored the recruitment processes of the EMPOWER (Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-being, Engagement, and Recovery) feasibility trial, which is a digital app–based intervention for people diagnosed with schizophrenia. Results: Recruitment barriers were categorized into 2 main themes: service characteristics (lack of time available for mental health staff to support recruitment, staff turnover, patient turnover [within Australia only], management styles of community mental health teams, and physical environment) and clinician expectations (filtering effects and resistance to research participation). Trial staff negotiated these barriers through strategies such as emotional labor (trial staff managing feelings and expressions to successfully recruit participants) and trying to build relationships with clinical staff working within community mental health teams. Conclusions: Researchers in clinical trials for digital psychosis interventions face numerous recruitment barriers and do their best to work flexibly and to negotiate these barriers and meet recruitment targets. The recruitment process appeared to be enhanced by trial staff supporting each other throughout the recruitment stage of the trial.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Bradstreet, Dr Simon and Whitehill, Miss Helen and Matrunola, Miss Claire and McLeod, Professor Hamish and Farhall, Professor John and Allan, Ms Stephanie and Clark, Miss Andrea and Gumley, Professor Andrew
• Authors: Allan, S., McLeod, H., Bradstreet, S., Bell, I., Whitehill, H., Wilson-Kay, A., Clark, A., Matrunola, C., Morton, E., Farhall, J., Gleeson, J., and Gumley, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing; College of Science and Engineering > School of Psychology
• Journal Name: JMIR Human Factors
• Publisher: JMIR Publications
• ISSN: 2292-9495
• ISSN (Online): 2292-9495
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in JMIR Human Factors 8(1):e24055
• Publisher Policy: Reproduced under a Creative Commons License