Using marketing theory to inform strategies for recruitment: a recruitment optimisation model and the txt2stop experience

Abstract

BackgroundRecruitment is a major challenge for many trials; just over half reach their targets and almost a third resort to grant extensions. The economic and societal implications of this shortcoming are significant. Yet, we have a limited understanding of the processes that increase the probability that recruitment targets will be achieved. Accordingly, there is an urgent need to bring analytical rigour to the task of improving recruitment, thereby increasing the likelihood that trials reach their recruitment targets. This paper presents a conceptual framework that can be used to improve recruitment to clinical trials.MethodsUsing a case-study approach, we reviewed the range of initiatives that had been undertaken to improve recruitment in the txt2stop trial using qualitative (semi-structured interviews with the principal investigator) and quantitative (recruitment) data analysis. Later, the txt2stop recruitment practices were compared to a previous model of marketing a trial and to key constructs in social marketing theory.ResultsPost hoc, we developed a recruitment optimisation model to serve as a conceptual framework to improve recruitment to clinical trials. A core premise of the model is that improving recruitment needs to be an iterative, learning process. The model describes three essential activities: i) recruitment phase monitoring, ii) marketing research, and iii) the evaluation of current performance. We describe the initiatives undertaken by the txt2stop trial and the results achieved, as an example of the use of the model.ConclusionsFurther research should explore the impact of adopting the recruitment optimisation model when applied to other trials.

Recruiting pregnant smokers from Text4baby for a randomized controlled trial of Quit4baby

“…Effective techniques for recruiting hard to reach populations like pregnant smokers include providing an incentive [18][19][20][21] and targeting recruitment messages and materials to the population [5,[22][23][24]. Using emotion to frame messages may be an effective form of targeting.…”

Research recruitment: A marketing framework to improve sample representativeness in health research

“…By suggesting how to tailor and place messages to engage intended audiences, the seven parts of this model conceptualise how to promote perceived benefit and reduce the barriers, Galli et al. () describe how the 7Ps Marketing Mix usefully informed the design of recruitment to the Text2Stop study. The marketing approach highlighted the importance of learning and adapting strategies through monitoring of recruitment progress.…”

“…Therefore, as Galli et al. () suggest, constant monitoring of recruitment patterns and consultation with potential participants are needed to react dynamically to participants' changing appraisals.…”

“…This may explain why persuasive strategies, which seem sufficient at the time of planning (from experiences of previous studies or observations of behaviour), may not account for participants' responses in a new study. Therefore, as Galli et al (2014) suggest, constant monitoring of recruitment patterns and consultation with potential participants are needed to react dynamically to participants' changing appraisals.…”

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