Barriers and facilitators to recruitment in mental health services: Care coordinators' expectations and experience of referring to a psychosis research trial

Abstract

Objective High‐quality research trials are necessary to provide evidence for the effective management of mental health difficulties, but successful recruitment can be challenging. Design This qualitative study examines the perceived barriers and facilitators to referring mental health service users to research trials. Seven care coordinators (n = 7) who facilitated the recruitment of participants to a cognitive behaviour therapy – informed psychosis intervention trial were interviewed. Method Demographic information was collected by questionnaire and a semi‐structured guide was used to explore barriers and facilitators to referring to a partially randomized participant preference trial. Qualitative data were thematically analysed. Results Four key themes, each with a number of sub‐themes, were identified: (1) engage the care coordinator in the recruitment process, (2) barriers to referring to research studies, (3) facilitators to referring to research studies; (4) organisational constraints impact on implementing research outcomes into routine clinical practice. Conclusions Understanding the barriers and facilitators to recruitment in mental health research could improve recruitment strategies. Our findings highlight the need for researchers’ to closely consider their recruitment strategies as service users are not always given the choice to participate in research. Several key recommendations are made based on these findings in order to maximize successful recruitment to research studies. Overall, we recommend that researchers’ adopt a flexible, tailor‐made approach for each clinical team to ensure a collaborative relationship is developed between research staff and clinicians. Practitioner points A qualitative approach to understanding recruitment challenges provides a useful opportunity to explore the barriers and facilitators to recruiting participants to research studies. These findings have practical implications that highlight the need for a collaborative partnership between researchers and clinical services. Understanding the challenges and issues related to recruitment can help researchers consider strategies to overcome recruitment issues. More research with a larger sample, across a broader population and in different mental health services is required.

Barriers and facilitators to participant recruitment to randomised controlled trials: A qualitative perspective

“…Well‐designed randomised controlled trials (RCTs) are considered the “gold standard” in clinical research because they provide high‐quality evidence related to the management of specific conditions, including VLUs . Unfortunately, recruitment issues for participation in the RCTs experienced by health professionals are not uncommon . These issues are related to researchers’ inability to recruit the required number of participants or to retain the recruited participants in the study .…”

“…4 Unfortunately, recruitment issues for participation in the RCTs experienced by health professionals are not uncommon. [5][6][7] These issues are related to researchers' inability to recruit the required number of participants or to retain the recruited participants in the study. 8,9 Findings from a systematic review 10 of discontinued RCTs indicate that 76% of the discontinued RCTs were related to poor recruitment.…”

What proportion of patients with psychosis is willing to take part in research? A mental health electronic case register analysis

“…[1][2][3] The National Institute for Health Research (NIHR) performance report for 2013/2014 showed that only five mental healthcare providers were among the top 100 performing healthcare providers recruiting to clinical research. 4 One potential contributing factor is the marked discrepancy in research funding for mental and physical healthcare.…”

Trial staff views on barriers recruitment in a digital intervention for psychosis and how to work around them: A qualitative study within a trial

“…However, trial staff sometimes seemed able to negotiate this challenge by invoking the trial protocol and reminding staff that determining directly from the service user their willingness (or not) to participate was an important outcome within a feasibility study. Mental health staff ltering what patients ended up being approached for recruitment was a key theme identi ed in previous research exploring barriers to recruitment to non-digital psychosis studies (62). Excluding participants for reasons not contained in the protocol likely has implications for the replicability and robustness of research ndings because the selection criteria are obscured (61) and samples likely become biased.…”