Recruitment to clinical trials: a meta-ethnographic synthesis of studies of reasons for participation
Journal of Health Services Research and Policy
This is the final draft, after peer-review, of a manuscript published in J Health Serv Res Policy 2013;18(4):233-41. The definitive version, detailed above, is available online at www.rsmjournals.com Recruitment to clinical trials: A meta-ethnographic synthesis of studies of reasons for participation. ABSTRACT Objectives Randomised controlled trials are important for evaluating healthcare interventions, but recruitment can be difficult. Studies of potential participants' perspectives on trial
... rticipation are accumulating but their collective contribution is not obvious. In 2007 we conducted a meta-ethnographic synthesis of people's reasons for accepting or declining participation. This paper reports a second synthesis, conducted separately on the same topic, using studies published subsequently. It discusses both the substantive findings and the methodological implications for updating meta-ethnographies. Methods Systematic searches identified relevant papers published between 1996 and 2005 (first synthesis), then 2005 and 2010 (second synthesis). We used a meta-ethnographic interpretive process of translation to examine the relationships between study findings. Findings The two syntheses were broadly compatible, but the line of argument developed in the second more clearly highlighted how potential participants' health states and healthcare situations at the time of recruitment could interact with other considerations. In particular they could influence the nature and significance for trial entry decisions of people's 2 judgements about: their communication and relationship with trial recruiters; the personal implications of trial interventions and processes; and the "common good" (helping others) and what their non/participation might say about their identity. Conclusions Our work highlights the need for trialists to consider potential participants' health and healthcare situations when designing recruitment approaches. It also provides the first empirical insights on the process of updating meta-ethnographies that we are currently aware of. Approaches to updating meta-ethnographies need further investigation.