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Sonika Bhatnagar, MD, MPH, and Jill Demirci, PhD, discuss recruitment strategies.
Jill Demirci, PhD, RN, IBCLC: Dr. Bhatnagar thank you so much for sharing what it takes for succeeding in recruiting for clinical trials.
Sonika Bhatnagar, MD, MPH: Sure, Jill. I’m excited to share with you what we’ve learned from our experience and literature. As you know, successful recruitment in clinical trials is essential to the quality, generalizability, equity, and cost-effectiveness of clinical research. However, 50 to 63 percent of clinical trials fail to achieve recruitment targets or require extended recruitment periods. Under-recruitment results in inadequate sample size, Type II error, reduced statistical power, and poor generalizability. Extended recruitment periods result in increased cost, delays in implementation of effective interventions, and risk of study closure.
Demirci: So what are some effective strategies to overcome these barriers to recruitment?
Bhatnagar: There are actually several effective strategies that you can do to help clinicians and the pediatric and minority populations overcome barriers to participation.
First, let’s address your role as an investigator working with a clinician. The most important and effective strategy is to build a trusting relationship. Also, foster the clinician’s sense of pride and contribution. Finally, minimize the clinician’s workload. After all, the clinician is choosing to participate in clinical research in the midst of a busy clinical practice.
Next, let’s address your role as an investigator working with the pediatric population (families-of-eligible-children). There are a few key aspects. First, be sure to promptly contact the family of an eligible child while the concern is acute, so within 1 to 2 days of the diagnosis. Also, be culturally sensitive and respectful in your discussion. Be sure to accommodate the family’s schedule. Most importantly, go above and beyond research. For example, meet the child and family at a non-study but clinically indicated diagnostic test and then contact the family immediately after with the results.
OK, now that we’ve addressed the pediatric population, let’s address your role as an investigator working with the minority population. Again, there are a few critical aspects. First, provide education on the importance of research and emphasize decisional empowerment without coercion. Culturally tailor the recruitment materials and offer a diverse research team. Be sure to engage the community. Offer tangible benefits from study participation. Finally, provide transportation and parking, and offer flexible scheduling.
So Jill, to summarize the take home points, we know that successful recruitment of participants in clinical trials is essential to the quality, generalizability, equity and cost-effectiveness of clinical research.
The key to successful recruitment is to overcome barriers between the (1) investigator and clinician, (2) investigator and pediatric population, and (3) investigator and minorities. The most effective strategies to overcome these barriers are to build relationships and trust, demonstrate respect, and go above and beyond what is necessary for the clinical trial.
Return to “Recruitment”
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