Best Practices

One of the top reasons for health research study termination is the failure to recruit participants. Studies should take into consideration a participant or community's beliefs, values and norms to develop relevant and responsive recruitment tactics.

Researchers can build trust and reduce uncertainty by forming authentic, long-term relationships with the communities they hope to involve. We can flip the script by engaging with the communities we hope to recruit from to learn about their real-world challenges and issues that research might help to address. This can lead to more meaningful and responsive research and can enhance recruitment efforts.

Potential challenges related to participation 

• Transportation

• Language/health literacy

• Apprehension regarding medical research

• Limited availability for study visits 

Population norms or emotional factors 

• What are the beliefs or values of your intended participants that may impact how you approach them for research?

• What are the motivating factors to participate in a research study?

• Have your potential participants recently been diagnosed with a condition?

Opportunities beyond the current research study 

If potential participants don’t meet the eligibility criteria for your study, try to match them to another study that your team or a colleague is conducting. Consider referring participants to Studyfinder.psu.edu for additional research opportunities.

A recent survey found (Wahlstrom-Edwards and Hess, 2019):

• 75% of research participants reported that the major reason or one of the major reasons they joined the clinical trial was to help future patients.

• 69% said they participated to improve their quality of life.

• 63% indicated they were highly motivated to participate to receive the best care possible.

Now that you know who your potential participants are, consider these considerations and move forward with a recruitment strategy.

Use methods that will work with your study population 

For example, did you know that older adults are an increasing demographic on Facebook? Or that a reputable institutional logo is more effective than a catchy study name? Work with your college’s marketing and communications team for current marketing trends that can optimize your recruitment strategy. 

Realistic goal setting 

Forecasting recruitment milestones based on historical data (marketing data) will ensure you are not over- or underestimating the feasibility of reaching your recruitment goals. College of Medicine research teams are encouraged to connect with the Office of Strategic Marketing and Communications early in the planning stages of a research project to develop an appropriate recruitment plan and allocate sufficient funds to cover recruitment expenses.

Effective recruitment campaigns target the right audience with the right message. Tailor your communication materials to your study population—this includes both the photos you are using and the language you are using. It's important to keep study materials to a middle-school reading level. Consider uploading your recruitment materials to a readability website.

What action do you want your audience to take? This is a “call to action.” Do you want them to complete a survey? Do you want them to call the study team? Make sure the next steps are clear.

The study title and description are the first items a potential participant will read. They introduce a complex research study to the reader, who may not fully understand the technical nature of the study. Aim to keep both items direct and concise.

Which of the following study titles is easier to read?

• “A randomized, double-blind, placebo-controlled, parallel-group, multicenter, event-driven Phase III study to investigate the efficacy and safety of…”

• “A clinical research study to study the efficacy and safety of...”

Both examples could be used to title a study, but the second example is a more lay-friendly and more concise option.

Study descriptions can also become too long. According to the National Institutes of Health’s Plain Language guidelines, a sentence should not exceed around 20 words in length. Use concise language by eliminating unnecessary or redundant words to help decrease the description length.

Research teams can improve their recruitment message by writing a succinct title and aiming for five sentences or less in the description. Concise writing has many benefits and is strongly recommended for all patient-facing research literature.

There is a short window to attract attention and an even shorter time to hold attention. When writing study details, it is important to consider the audience.

• Are you trying to reach parents who have a child or children with a chronic health condition?

• Are you trying to reach older adults who are experiencing joint pain?

How would the study listing differ between these two groups?

Consider your audience to craft a more meaningful study listing. Are healthy volunteers are needed? A healthy volunteer could be less familiar with specific medical conditions; remember this when writing study details.

Language is important when connecting with an audience. The combined language guide offered as a resource on this site could be helpful.

The National Institutes of Health definition of plain language is grammatically correct language that includes complete sentence structure and accurate word usage. Every research team should write their study listing in plain language.

It is important to note that plain language does not mean unprofessional writing, “dumbing down” or “talking down” to the reader. Rather, plain language can help a broader population of potential volunteers understand the initial details of a study and overcome challenges in comprehending the full depth and breadth of the research study. Aiming for clarity in communication to get your message across is always the best option.

Practical tools for writing a study listing in plain language:

• Spell out an acronym first, then add the acronym in parentheses.

• Include a call-to-action by stating what is wanted of volunteers in the first sentence.

• Avoid technical or scientific jargon.

• Use positive instead of negative words.

• Use only active voice.

• Break up blocks of descriptive text.

Several online tools can help identify areas for improvement. Websites like Readable or VisibleThread offer free versions that analyze and grade content immediately. This plain language medical dictionary may also be a resource to help describe medical terminology.

Check out the National Institutes of Health Plain Language Initiative for additional resources, including the guide, “Plain Language: Getting Started or Brushing Up.”

Participants often want to know if compensation for time and effort will be provided. The amount and schedule of compensation must be approved by the IRB and cannot be emphasized in recruitment materials but may be indicated.

When recruiting from a large population, it is possible to have many inquiries from ineligible participants. This can cause additional administrative work for research teams and can be frustrating for potential study participants if they’ve invested time to inquire about the study only to realize they do not qualify. Staff can avoid this extra work by creating an IRB-approved REDCap pre-screener survey that asks direct questions about a potential volunteer’s eligibility for the study.

If screening survey data will be used solely to determine eligibility, and not stored for research data use, consent is generally not required for this type of activity. However, the HRPP should be consulted if there are questions about whether consent is required for screening activities.

Anticipate general questions from participants. Participants typically want to know details of what will be expected of them during the study. Consider writing the study description with answers to these questions included.

Some common questions from a potential volunteer may be:

• How much time will I have to invest?

• Where will I have to go?

• What is expected of me?

• Will I qualify to participate in the study?

• Who is doing the research?

This strategy seems obvious, but participants particularly want access to staff who can quickly answer questions. Accurate contact information should be included in the listing, as well as any further correspondence with study participants.

For emails, include a Health System or University email address. It may be beneficial to have a research team or general staff email account alias that can be accessed by multiple team members. This helps prevent delays when specific staff members are out of the office.

Confirm that the phone number listed is staffed and that the study contact name is included (both first and last name). This simple step can help potential volunteers feel confident participating in a study.

After a participant inquires about a study, further connect with them by answering questions and providing next steps. Hold their attention by responding in a professional and clear tone and within 48 hours. Don’t forget to include the study team’s contact information, the study title, and a sincere “thank you for your interest.”

Note that the volunteer’s personal information may need to be removed from this correspondence. Contact the HRPP for assistance or questions on these requirements.

Conducting research with participants from rural communities presents unique challenges. A central principle of research is to engage a variety of populations so that all groups can benefit. Therefore, participants from rural communities should be included in research and, thereby, represented in the study results.

Research-Related Factors:

• Research is misunderstood or there is a lack of appreciation of study benefits.

• There is a perceived research burden and interruption of daily life activities.

• There is apprehension regarding the research enterprise and a sense of being in an unfamiliar situation.

Health Related Factors:

• Having multiple comorbidities may make participation difficult.

• Having a negative outlook on life.

• Low literacy rates create communication challenges.

Personal Factors:

• Individuals are unaware of opportunities to participate in research.

• There is a reluctance to engage in self-management behaviors that are important for research participation.

• Unwilling to accept study requirements.

• Lack of resources and support for research participation.

• Multiple demands create time and other constraints for participation.

• Other life issues are of greater importance (concerns related to employment, housing, food) that preclude participating in research.

• Unavailable and/or unreliable transportation can be a barrier to research participation.

• For digital communication, access to the internet and connectivity may be insufficient.

• Benefits of study participation are not obvious.

Further resource: Rural Health Information Hub. 

Given the importance of studying rural populations, there are demonstrated strategies that are effective in recruiting rural participants. To do this well, it takes time and a willingness to explore multiple options.

Research Related Factors:

• Build sustainable relationships with recruiter(s) and research teams. It is important to maintain community involvement for future studies, which requires a time investment.

• Use the State Cooperative Extension Service to learn about rural communities.

• Build connections by involving community health workers and community members in the study design, activities and decision-making. Use Practice-Based Research Networks (PBRN). PBRNs are networks of local health practitioners with strong ties in rural communities. Researchers need to find meaningful ways to collaborate with PBRNs. Work with Federally Qualified Health Centers and Rural Health Clinics. Also consider working with community pharmacies and paramedics.

• Obtain provider buy-in and engagement in recruitment.

• Understand the previous research that has been conducted in the rural community and how it was received.

• Provide meaningful research incentives.

• Target marketing approaches (mailings, telephone calls, the media and social media) in a way that is understandable. Personal follow-up can be helpful to promote recruitment.

• Communicate at multiple levels. Involve the local clinic healthcare personnel and patients. Use telemedicine to network with rural clinics to advertise the study.  Use digital health tools and social media for recruiting.

• Access home-based rehab programs (i.e., cardiac rehab) to deliver study information.

• Access placed-based care (pharmacies, shopping retail areas). Also, access school-based health centers and churches and other faith-based organizations.

Health Related Factors:

• Find study participants who want to take action to stay healthy or improve their health status. Providing education programs about good health may incentivize participation in research.

• Learn about the previous experiences of community members with self-care of chronic diseases (and actions taken for prevention of chronic diseases).

• Learn about the community’s beliefs in and practices of lifestyle medicine.

• Learn about the healthcare-seeking behavior in the rural community.

Personal Factors:

• Determine whether the presence of support systems is sufficient for research participation.

• Gauge the extent of positive outlook.

• Assess feelings of loneliness.

• Strive to make accessibility convenient and try to provide free transportation.

• Lower the threshold for participant involvement. Consider using telehealth interventions.

• Share research findings. Share each participant’s results with them to the extent possible, and share the results of the study and its importance with study participants.

Further Resource: Rural Health Information Hub.