Skip to main content
Top
Published in: Trials 1/2022

Open Access 01-12-2022 | Care | Methodology

Development of a co-designed behaviour change intervention aimed at healthcare professionals recruiting to clinical trials in maternity care

Authors: Vivienne Hanrahan, Louisa Lawrie, Eilidh Duncan, Linda Biesty, Katie Gillies

Published in: Trials | Issue 1/2022

Login to get access

Abstract

Background

The evidence on what strategies can improve recruitment to clinical trials in maternity care is lacking. As trial recruiters, maternity healthcare professionals (MHCPs) perform behaviours (e.g. talking about trials with potential participants, distributing trial information) they may not ordinarily do outside of the trial. Most trial recruitment interventions do not provide any theoretical basis for the potential effect (on behaviour) or describe if stakeholders were involved during development. The study aim was to use behavioural theory in a co-design process to develop an intervention for MHCPs tasked with approaching all eligible potential participants and inviting them to join a maternity trial and to assess the acceptability and feasibility of such an intervention.

Methods

This study applied a step-wise sequential mixed-methods approach. Key stages were informed by the Theoretical Domains Framework and Behaviour Change Techniques (BCT) Taxonomy to map the accounts of MHCPs, with regard to challenges to trial recruitment, to theoretically informed behaviour change strategies. Our recruitment intervention was co-designed during workshops with MHCPs and maternity service users. Acceptability and feasibility of our intervention was assessed using an online questionnaire based on the Theoretical Framework of Acceptability (TFA) and involved a range of trial stakeholders.

Results

Two co-design workshops, with a total of nine participants (n = 7 MHCP, n = 2 maternity service users), discussed thirteen BCTs as potential solutions. Ten BCTs, broadly covering Consequences and Reframing, progressed to intervention development. Forty-five trial stakeholders (clinical midwives, research midwives/nurses, doctors, allied health professionals and trial team members) participated in the online TFA questionnaire. The intervention was perceived effective, coherent, and not burdensome to engage with. Core areas for future refinement included Anticipated opportunity and Self-efficacy.

Conclusion

We developed a behaviour change recruitment intervention which is based on the accounts of MHCP trial recruiters and developed in a co-design process. Overall, the intervention was deemed acceptable. Future evaluation of the intervention will establish its effectiveness in enabling MHCPs to invite all eligible people to participate in a maternity care trial, and determine whether this translates into an increase in maternity trial recruitment rates.
Appendix
Available only for authorised users
Literature
1.
go back to reference Walters SJ, Bonacho Dos AnjosHenriques-Cadby I, Bortolami O, Flight L, Hind D, Jacques RM, et al. Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme. BMJ Open. 2017;7(3):e015276.CrossRef Walters SJ, Bonacho Dos AnjosHenriques-Cadby I, Bortolami O, Flight L, Hind D, Jacques RM, et al. Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom Health Technology Assessment Programme. BMJ Open. 2017;7(3):e015276.CrossRef
2.
go back to reference Button KS, Ioannidis JP, Mokrysz C, Nosek BA, Flint J, Robinson ES, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14(5):365–76.CrossRef Button KS, Ioannidis JP, Mokrysz C, Nosek BA, Flint J, Robinson ES, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14(5):365–76.CrossRef
3.
go back to reference Treweek S, Pitkethly M, Cook J, Fraser C, Mitchell E, Sullivan F, et al. Strategies to improve recruitment to randomised trials. Cochrane Database Syst Rev. 2018;2:MR000013.PubMed Treweek S, Pitkethly M, Cook J, Fraser C, Mitchell E, Sullivan F, et al. Strategies to improve recruitment to randomised trials. Cochrane Database Syst Rev. 2018;2:MR000013.PubMed
4.
go back to reference Salman RA-S, Beller E, Kagan J, Hemminki E, Phillips RS, Savulescu J, et al. Increasing value and reducing waste in biomedical research regulation and management. Lancet. 2014;383(9912):176–85.CrossRef Salman RA-S, Beller E, Kagan J, Hemminki E, Phillips RS, Savulescu J, et al. Increasing value and reducing waste in biomedical research regulation and management. Lancet. 2014;383(9912):176–85.CrossRef
5.
go back to reference van der Zande ISE, van der Graaf R, Hooft L, van Delden JJM. Facilitators and barriers to pregnant women’s participation in research: a systematic review. Women Birth. 2018;31(5):350–61.CrossRef van der Zande ISE, van der Graaf R, Hooft L, van Delden JJM. Facilitators and barriers to pregnant women’s participation in research: a systematic review. Women Birth. 2018;31(5):350–61.CrossRef
6.
go back to reference Ballantyne A, Rogers W. Pregnancy, vulnerability, and the risk of exploitation in clinical research. In: Baylis FB, A., editor. Clinical Research Involving Pregnant Women Research Ethics Forum. 3. Switzerland: Springer; 2016. https://doi.org/10.1007/978-3-319-26512-4. ISBN978-3-319-26512-4. Ballantyne A, Rogers W. Pregnancy, vulnerability, and the risk of exploitation in clinical research. In: Baylis FB, A., editor. Clinical Research Involving Pregnant Women Research Ethics Forum. 3. Switzerland: Springer; 2016. https://​doi.​org/​10.​1007/​978-3-319-26512-4.  ISBN978-3-319-26512-4.
7.
go back to reference Hanrahan V, Gillies K, Biesty L. Recruiters’ perspectives of recruiting women during pregnancy and childbirth to clinical trials: a qualitative evidence synthesis. PLoS ONE. 2020;15(6):e0234783.CrossRef Hanrahan V, Gillies K, Biesty L. Recruiters’ perspectives of recruiting women during pregnancy and childbirth to clinical trials: a qualitative evidence synthesis. PLoS ONE. 2020;15(6):e0234783.CrossRef
8.
go back to reference Heyrana K, Byers HM, Stratton P. Increasing the participation of pregnant women in clinical trials. JAMA. 2018;320(20):2077–8.CrossRef Heyrana K, Byers HM, Stratton P. Increasing the participation of pregnant women in clinical trials. JAMA. 2018;320(20):2077–8.CrossRef
9.
go back to reference Tooher RL, Middleton PF, Crowther CA. A thematic analysis of factors influencing recruitment to maternal and perinatal trials. BMC Pregnancy Childbirth. 2008;8:36.CrossRef Tooher RL, Middleton PF, Crowther CA. A thematic analysis of factors influencing recruitment to maternal and perinatal trials. BMC Pregnancy Childbirth. 2008;8:36.CrossRef
10.
go back to reference Monaghan H, Richens A, Colman S, Currie R, Girgis S, Jayne K, et al. A randomised trial of the effects of an additional communication strategy on recruitment into a large-scale, multi-centre trial. Contemp Clin Trials. 2007;28(1):1–5.CrossRef Monaghan H, Richens A, Colman S, Currie R, Girgis S, Jayne K, et al. A randomised trial of the effects of an additional communication strategy on recruitment into a large-scale, multi-centre trial. Contemp Clin Trials. 2007;28(1):1–5.CrossRef
11.
go back to reference Tilley B, Mainous A, Elm J, Pickelsimer E, Soderstrom L, Ford M, et al. A randomized recruitment intervention trial in Parkinson’s disease to increase participant diversity- early stopping for lack of efficacy. Clin Trials. 2012;9:188–92.CrossRef Tilley B, Mainous A, Elm J, Pickelsimer E, Soderstrom L, Ford M, et al. A randomized recruitment intervention trial in Parkinson’s disease to increase participant diversity- early stopping for lack of efficacy. Clin Trials. 2012;9:188–92.CrossRef
12.
go back to reference Treweek S, Barnett K, Maclennan G, Bonetti D, Eccles MP, Francis JJ, et al. E-mail invitations to general practitioners were as effective as postal invitations and were more efficient. J Clin Epidemiol. 2012;65(7):793–7.CrossRef Treweek S, Barnett K, Maclennan G, Bonetti D, Eccles MP, Francis JJ, et al. E-mail invitations to general practitioners were as effective as postal invitations and were more efficient. J Clin Epidemiol. 2012;65(7):793–7.CrossRef
13.
go back to reference Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, et al. Framework for the development and evaluation of complex interventions: gap analysis, workshop and consultation-informed update. Health Technol Assess. 2021;25(57):1–132.CrossRef Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, et al. Framework for the development and evaluation of complex interventions: gap analysis, workshop and consultation-informed update. Health Technol Assess. 2021;25(57):1–132.CrossRef
14.
go back to reference Treweek S, Bevan S, Bower P, Campbell M, Christie J, Clarke M, et al. Trial Forge Guidance 1: what is a Study Within A Trial (SWAT)? Trials. 2018;19(1):139.CrossRef Treweek S, Bevan S, Bower P, Campbell M, Christie J, Clarke M, et al. Trial Forge Guidance 1: what is a Study Within A Trial (SWAT)? Trials. 2018;19(1):139.CrossRef
15.
go back to reference Brehaut JC, Lavin Venegas C, Hudek N, Presseau J, Carroll K, Rodger M. Using behavioral theory and shared decision-making to understand clinical trial recruitment: interviews with trial recruiters. Trials. 2021;22(1):298.CrossRef Brehaut JC, Lavin Venegas C, Hudek N, Presseau J, Carroll K, Rodger M. Using behavioral theory and shared decision-making to understand clinical trial recruitment: interviews with trial recruiters. Trials. 2021;22(1):298.CrossRef
17.
go back to reference Gillies K, Brehaut J, Coffey T, Duncan EM, Francis JJ, Hey SP, et al. How can behavioural science help us design better trials? Trials. 2021;22(1):882.CrossRef Gillies K, Brehaut J, Coffey T, Duncan EM, Francis JJ, Hey SP, et al. How can behavioural science help us design better trials? Trials. 2021;22(1):882.CrossRef
18.
go back to reference Michie S, Atkins L, West R. The behaviour chane wheel: a guide to designing interventions. 1 ed. Great Britain: Silverback; 2014. Michie S, Atkins L, West R. The behaviour chane wheel: a guide to designing interventions. 1 ed. Great Britain: Silverback; 2014.
19.
go back to reference Castillo G, Lalu M, Asad S, Foster M, Kekre N, Fergusson D, et al. Hematologists’ barriers and enablers to screening and recruiting patients to a chimeric antigen receptor (CAR) T cell therapy trial: a theory-informed interview study. Trials. 2021;22(1):230.CrossRef Castillo G, Lalu M, Asad S, Foster M, Kekre N, Fergusson D, et al. Hematologists’ barriers and enablers to screening and recruiting patients to a chimeric antigen receptor (CAR) T cell therapy trial: a theory-informed interview study. Trials. 2021;22(1):230.CrossRef
20.
go back to reference Guillot M, Asad S, Lalu MM, Lemyre B, Castillo G, Thebaud B, et al. So you want to give stem cells to babies? Neonatologists and parents’ views to optimize clinical trials. J Pediatr. 2019;210(41–7): e1. Guillot M, Asad S, Lalu MM, Lemyre B, Castillo G, Thebaud B, et al. So you want to give stem cells to babies? Neonatologists and parents’ views to optimize clinical trials. J Pediatr. 2019;210(41–7): e1.
21.
go back to reference Ellis S, Geana M, Griebling T, McWilliams C, Gills J, Stratton K, et al. Development, acceptability, appropriateness and appeal of a cancer clinical trials implementation intervention for rural- and minority-serving urology practices. Trials. 2019;20(1):578.CrossRef Ellis S, Geana M, Griebling T, McWilliams C, Gills J, Stratton K, et al. Development, acceptability, appropriateness and appeal of a cancer clinical trials implementation intervention for rural- and minority-serving urology practices. Trials. 2019;20(1):578.CrossRef
23.
go back to reference Presseau J, McCleary N, Lorencatto F, Patey AM, Grimshaw JM, Francis JJ. Action, actor, context, target, time (AACTT): a framework for specifying behaviour. Implement Sci. 2019;14(1):102.CrossRef Presseau J, McCleary N, Lorencatto F, Patey AM, Grimshaw JM, Francis JJ. Action, actor, context, target, time (AACTT): a framework for specifying behaviour. Implement Sci. 2019;14(1):102.CrossRef
24.
go back to reference Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRef Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRef
25.
go back to reference Carey RN, Connell LE, Johnston M, Rothman AJ, de Bruin M, Kelly MP, et al. Behavior change techniques and their mechanisms of action: a synthesis of links described in published intervention literature. Ann Behav Med. 2019;53(8):693–707.PubMed Carey RN, Connell LE, Johnston M, Rothman AJ, de Bruin M, Kelly MP, et al. Behavior change techniques and their mechanisms of action: a synthesis of links described in published intervention literature. Ann Behav Med. 2019;53(8):693–707.PubMed
26.
go back to reference Michie SAL, West R. The APEASE criteria for designing and evaluating interventions. In: The Behaviour Change Wheel: A Guide to Designing Interventions. London: Silverback Publishing; 2014. Michie SAL, West R. The APEASE criteria for designing and evaluating interventions. In: The Behaviour Change Wheel: A Guide to Designing Interventions. London: Silverback Publishing; 2014.
27.
go back to reference Farr M. Power dynamics and collaborative mechanisms in co-production and co-design processes. Crit Soc Policy. 2018;38(4):623–44.CrossRef Farr M. Power dynamics and collaborative mechanisms in co-production and co-design processes. Crit Soc Policy. 2018;38(4):623–44.CrossRef
28.
go back to reference Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRef Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRef
29.
go back to reference Duncan E, O’Cathain A, Rousseau N, Croot L, Sworn K, Turner KM, et al. Guidance for reporting intervention development studies in health research (GUIDED): an evidence-based consensus study. BMJ Open. 2020;10(4):e033516.CrossRef Duncan E, O’Cathain A, Rousseau N, Croot L, Sworn K, Turner KM, et al. Guidance for reporting intervention development studies in health research (GUIDED): an evidence-based consensus study. BMJ Open. 2020;10(4):e033516.CrossRef
30.
go back to reference Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.CrossRef Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.CrossRef
31.
go back to reference Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17(1):88.CrossRef Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17(1):88.CrossRef
32.
go back to reference Bower P, Brueton V, Gamble C, Treweek S, Smith CT, Young B, Williamson P. Interventions to improve recruitment and retention in clinical trials: a survey and workshop to assess current practice and future priorities. Trials. 2014;15:399. https://doi.org/10.1186/1745-6215-15-399. Bower P, Brueton V, Gamble C, Treweek S, Smith CT, Young B, Williamson P. Interventions to improve recruitment and retention in clinical trials: a survey and workshop to assess current practice and future priorities. Trials. 2014;15:399. https://​doi.​org/​10.​1186/​1745-6215-15-399.
33.
go back to reference Townsend D, Mills N, Savovic J, Donovan JL. A systematic review of training programmes for recruiters to randomised controlled trials. Trials. 2015;16:432.CrossRef Townsend D, Mills N, Savovic J, Donovan JL. A systematic review of training programmes for recruiters to randomised controlled trials. Trials. 2015;16:432.CrossRef
34.
go back to reference Daly D, Hannon S, Brady V. Motivators and challenges to research recruitment - a qualitative study with midwives. Midwifery. 2019;74:14–20.CrossRef Daly D, Hannon S, Brady V. Motivators and challenges to research recruitment - a qualitative study with midwives. Midwifery. 2019;74:14–20.CrossRef
35.
go back to reference Rose J, Lynn K, Akister J, Maxton F, Redsell SA. Community midwives’ and health visitors’ experiences of research recruitment: a qualitative exploration using the Theoretical Domains Framework. Prim Health Care Res Dev. 2021;22:e5.CrossRef Rose J, Lynn K, Akister J, Maxton F, Redsell SA. Community midwives’ and health visitors’ experiences of research recruitment: a qualitative exploration using the Theoretical Domains Framework. Prim Health Care Res Dev. 2021;22:e5.CrossRef
36.
go back to reference Ellis SD, Geana M, Mackay CB, Moon DJ, Gills J, Zganjar A, et al. Science in the Heartland: exploring determinants of offering cancer clinical trials in rural-serving community urology practices. Urol Oncol. 2019;37(8):529 (e9- e18).CrossRef Ellis SD, Geana M, Mackay CB, Moon DJ, Gills J, Zganjar A, et al. Science in the Heartland: exploring determinants of offering cancer clinical trials in rural-serving community urology practices. Urol Oncol. 2019;37(8):529 (e9- e18).CrossRef
38.
go back to reference Donovan J, Rooshenas L, Jepson M, Elliott D, Wade J, Avery K, et al. Optimising recruitment and informed consent in randomised controlled trials: the development and implementation of the Quintet Recruitment Intervention (QRI). Trials. 2016;17(1):283.CrossRef Donovan J, Rooshenas L, Jepson M, Elliott D, Wade J, Avery K, et al. Optimising recruitment and informed consent in randomised controlled trials: the development and implementation of the Quintet Recruitment Intervention (QRI). Trials. 2016;17(1):283.CrossRef
39.
go back to reference O’Cathain A, Croot L, Sworn K, Duncan E, Rousseau N, Turner K, et al. Taxonomy of approaches to developing interventions to improve health: a systematic methods overview. Pilot Feasibility Stud. 2019;5:41.CrossRef O’Cathain A, Croot L, Sworn K, Duncan E, Rousseau N, Turner K, et al. Taxonomy of approaches to developing interventions to improve health: a systematic methods overview. Pilot Feasibility Stud. 2019;5:41.CrossRef
Metadata
Title
Development of a co-designed behaviour change intervention aimed at healthcare professionals recruiting to clinical trials in maternity care
Authors
Vivienne Hanrahan
Louisa Lawrie
Eilidh Duncan
Linda Biesty
Katie Gillies
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Care
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06816-6

Other articles of this Issue 1/2022

Trials 1/2022 Go to the issue