Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Shedding light on research participation effects in behaviour change trials: a qualitative study examining research participant experiences

Authors: Virginia MacNeill, Marian Foley, Alan Quirk, Jim McCambridge

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

The sequence of events in a behaviour change trial involves interactions between research participants and the trial process. Taking part in such a study has the potential to influence the behaviour of the participant, and if it does, this can engender bias in trial outcomes. Since participants’ experience has received scant attention, the aim of this study is thus to generate hypotheses about which aspects of the conduct of behaviour change trials might matter most to participants, and thus have potential to alter subsequent behaviours and bias trial outcomes

Methods

Twenty participants were opportunistically screened for a health compromising behaviour (unhealthy diet, lack of exercise, smoking or alcohol consumption) and recruited if eligible. Semi structured face to face interviews were conducted, after going through the usual processes involved in trial recruitment, baseline assessment and randomisation. Participants were given information on the contents of an intervention or control condition in a behaviour change trial, which was not actually implemented. Three months later they returned to reflect on these experiences and whether they had any effect on their behaviour during the intervening period. Data from the latter interview were analysed thematically using a modified grounded theory approach.

Results

The early processes of trial participation raised awareness of unhealthy behaviours, although most reported having had only fleeting intentions to change their behaviour as a result of taking part in this study, in the absence of interventions. However, careful examination of the accounts revealed evidence of subtle research participation effects, which varied according to the health behaviour, and its perceived social acceptability. Participants’ relationships with the research study were viewed as somewhat important in stimulating thinking about whether and how to make lifestyle changes.

Conclusion

These participants described no dramatic impacts attributable to taking part in this study. This study demonstrates the likely value of well conducted qualitative studies of subtle research participation effects, which may be particularly important to explore for alcohol. Separating unintended influences in trial participation from the effects of behaviour change interventions being evaluated therein is necessary for valid estimates of intervention effects.
Literature
1.
go back to reference Miller WR. Motivational interviewing in service to health promotion (the art of health promotion). Am J Health Promot. 2004;18(3):1–10.CrossRef Miller WR. Motivational interviewing in service to health promotion (the art of health promotion). Am J Health Promot. 2004;18(3):1–10.CrossRef
2.
go back to reference French DP, Sutton S. Reactivity of measurement in health psychology: how much of a problem is it? What can be done about it? Br J Health Psychol. 2010;15(Pt 3):453–68.CrossRefPubMed French DP, Sutton S. Reactivity of measurement in health psychology: how much of a problem is it? What can be done about it? Br J Health Psychol. 2010;15(Pt 3):453–68.CrossRefPubMed
3.
go back to reference McCambridge J, Kypri K, Elbourne D. In randomisation we trust? There are overlooked problems in experimenting with people in behavioural intervention trials. J Clin Epidemiol. 2014;67:247–53.CrossRefPubMedPubMedCentral McCambridge J, Kypri K, Elbourne D. In randomisation we trust? There are overlooked problems in experimenting with people in behavioural intervention trials. J Clin Epidemiol. 2014;67:247–53.CrossRefPubMedPubMedCentral
4.
go back to reference McCambridge J. From question-behaviour effects in trials to the social psychology of research participation. Psychol Health. 2015;30(1):72–84.CrossRefPubMed McCambridge J. From question-behaviour effects in trials to the social psychology of research participation. Psychol Health. 2015;30(1):72–84.CrossRefPubMed
5.
go back to reference McCambridge J, Butor-Bhavsar K, Witton J, Elbourne D. Can research assessments themselves cause bias in behaviour change trials? A systematic review of evidence from Solomon 4-group studies. PLoS ONE. 2011;6(10):e25223.CrossRefPubMedPubMedCentral McCambridge J, Butor-Bhavsar K, Witton J, Elbourne D. Can research assessments themselves cause bias in behaviour change trials? A systematic review of evidence from Solomon 4-group studies. PLoS ONE. 2011;6(10):e25223.CrossRefPubMedPubMedCentral
6.
go back to reference McCambridge J, Kypri K. Can simply answering research questions change behaviour? Systematic review and meta analyses of brief alcohol intervention trials. PLoS ONE. 2011;6(10):e23748.CrossRefPubMedPubMedCentral McCambridge J, Kypri K. Can simply answering research questions change behaviour? Systematic review and meta analyses of brief alcohol intervention trials. PLoS ONE. 2011;6(10):e23748.CrossRefPubMedPubMedCentral
7.
go back to reference McCambridge J, de Bruin M, Witton J. The effects of demand characteristics on research participant behaviours in non-laboratory settings: A systematic review. PLoS ONE. 2012;7(6):e39116.CrossRefPubMedPubMedCentral McCambridge J, de Bruin M, Witton J. The effects of demand characteristics on research participant behaviours in non-laboratory settings: A systematic review. PLoS ONE. 2012;7(6):e39116.CrossRefPubMedPubMedCentral
8.
go back to reference McCambridge J, Witton J, Elbourne D. Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67:267–74.CrossRefPubMedPubMedCentral McCambridge J, Witton J, Elbourne D. Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67:267–74.CrossRefPubMedPubMedCentral
9.
go back to reference Snowdon C, Garcia J, Elbourne D. Making sense of randomization; responses of parents of critically ill babies to random allocation of treatment in a clinical trial. Soc Sci Med. 1997;45(9):1337–55.CrossRefPubMed Snowdon C, Garcia J, Elbourne D. Making sense of randomization; responses of parents of critically ill babies to random allocation of treatment in a clinical trial. Soc Sci Med. 1997;45(9):1337–55.CrossRefPubMed
10.
go back to reference Snowdon C, Elbourne D, Garcia J. “It was a snap decision”: parental and professional perspectives on the speed of decisions about participation in perinatal randomised controlled trials. Soc Sci Med. 2006;62(9):2279–90.CrossRefPubMed Snowdon C, Elbourne D, Garcia J. “It was a snap decision”: parental and professional perspectives on the speed of decisions about participation in perinatal randomised controlled trials. Soc Sci Med. 2006;62(9):2279–90.CrossRefPubMed
11.
go back to reference Scott C, Walker J, White P, Lewith G. Forging convictions: The effects of active participation in a clinical trial. Soc Sci Med. 2011;72(12):2041–8.CrossRefPubMed Scott C, Walker J, White P, Lewith G. Forging convictions: The effects of active participation in a clinical trial. Soc Sci Med. 2011;72(12):2041–8.CrossRefPubMed
12.
go back to reference Locock L, Smith L. Personal experiences of taking part in clinical trials - a qualitative study. Patient Educ Couns. 2011;84(3):303–9.CrossRefPubMed Locock L, Smith L. Personal experiences of taking part in clinical trials - a qualitative study. Patient Educ Couns. 2011;84(3):303–9.CrossRefPubMed
13.
go back to reference Elbourne D, Snowdon C, Garcia J. Informed consent. Subjects may not understand concept of clinical trials. BMJ. 1997;315(7102):248–9.PubMedPubMedCentral Elbourne D, Snowdon C, Garcia J. Informed consent. Subjects may not understand concept of clinical trials. BMJ. 1997;315(7102):248–9.PubMedPubMedCentral
14.
go back to reference Heaven B, Murtagh M, Rapley T, May C, Graham R, Kaner E, et al. Patients or research subjects? A qualitative study of participation in a randomised controlled trial of a complex intervention. Patient Educ Couns. 2006;62(2):260–70.CrossRefPubMed Heaven B, Murtagh M, Rapley T, May C, Graham R, Kaner E, et al. Patients or research subjects? A qualitative study of participation in a randomised controlled trial of a complex intervention. Patient Educ Couns. 2006;62(2):260–70.CrossRefPubMed
15.
go back to reference Featherstone K, Donovan J. Random allocation or allocation at random? Patients’ perspectives of participation in a randomised controlled trial. Br Med J. 1998;317:1177–80.CrossRef Featherstone K, Donovan J. Random allocation or allocation at random? Patients’ perspectives of participation in a randomised controlled trial. Br Med J. 1998;317:1177–80.CrossRef
16.
go back to reference McCann S, Campbell M, Entwistle V. Reasons for participating in randomised controlled trials: conditional altruism and considerations for self. Trials. 2010;11(1):31.CrossRefPubMedPubMedCentral McCann S, Campbell M, Entwistle V. Reasons for participating in randomised controlled trials: conditional altruism and considerations for self. Trials. 2010;11(1):31.CrossRefPubMedPubMedCentral
17.
go back to reference Wolters A, de Wert G, van Schayck O, Horstman K. Constructing a trial as a personal lifestyle change project: Participants’ experiences in a clinical study for nicotine vaccination. Soc Sci Med. 2014;104:116–23.CrossRefPubMed Wolters A, de Wert G, van Schayck O, Horstman K. Constructing a trial as a personal lifestyle change project: Participants’ experiences in a clinical study for nicotine vaccination. Soc Sci Med. 2014;104:116–23.CrossRefPubMed
18.
go back to reference Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT - Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. Geneva: World Health Organization; 2001. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT - Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. Geneva: World Health Organization; 2001.
19.
go back to reference Forcehimes AA, Tonigan JS, Miller WR, Kenna GA, Baer JS. Psychometrics of the Drinker Inventory of Consequences (DrInC). Addict Behav. 2007;32:1699–704.CrossRefPubMed Forcehimes AA, Tonigan JS, Miller WR, Kenna GA, Baer JS. Psychometrics of the Drinker Inventory of Consequences (DrInC). Addict Behav. 2007;32:1699–704.CrossRefPubMed
21.
go back to reference Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ. Psychometric properties of the Impact on Participation and Autonomy Questionnaire. Arch Phys Med Rehabil. 2001;82(2):210–6.CrossRefPubMed Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ. Psychometric properties of the Impact on Participation and Autonomy Questionnaire. Arch Phys Med Rehabil. 2001;82(2):210–6.CrossRefPubMed
22.
go back to reference Millen AE, Midthune D, Thompson FE, Kipnis V, Subar AF. The National Cancer Institute diet history questionnaire: validation of pyramid food servings. Am J Epidemiol. 2006;163(3):279–88.CrossRefPubMed Millen AE, Midthune D, Thompson FE, Kipnis V, Subar AF. The National Cancer Institute diet history questionnaire: validation of pyramid food servings. Am J Epidemiol. 2006;163(3):279–88.CrossRefPubMed
23.
go back to reference NVivo qualitative data analysis software; QSR International Pty Ltd. Version 10, 2012. NVivo qualitative data analysis software; QSR International Pty Ltd. Version 10, 2012.
24.
go back to reference Glaser BG. Emergence vs. forcing. Basics of grounded theory analyses. Mill Valley, CA: The Sociology; 1992. Glaser BG. Emergence vs. forcing. Basics of grounded theory analyses. Mill Valley, CA: The Sociology; 1992.
25.
go back to reference Green J, Thorogood N. Qualitative methods for health research. Sage: London; 2004. Green J, Thorogood N. Qualitative methods for health research. Sage: London; 2004.
27.
go back to reference Oakley A, Strange V, Bonell C, Allen E, Stephenson J, Team RS. Process evaluation in randomised controlled trials of complex interventions. BMJ. 2006;332(7538):413–6.CrossRefPubMedPubMedCentral Oakley A, Strange V, Bonell C, Allen E, Stephenson J, Team RS. Process evaluation in randomised controlled trials of complex interventions. BMJ. 2006;332(7538):413–6.CrossRefPubMedPubMedCentral
28.
go back to reference McCambridge J, Sorhaindo A, Quirk A, Nanchahal K. Patient preferences and performance bias in a weight loss trial with a usual care arm. Patient Education and Counselling. 2014;95(2):243–7.CrossRef McCambridge J, Sorhaindo A, Quirk A, Nanchahal K. Patient preferences and performance bias in a weight loss trial with a usual care arm. Patient Education and Counselling. 2014;95(2):243–7.CrossRef
29.
30.
go back to reference Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.CrossRefPubMed Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.CrossRefPubMed
31.
go back to reference Heather N, McCambridge J, Team UR. Post-treatment stage of change predicts 12-month outcome of treatment for alcohol problems. Alcohol Alcohol. 2013;48(3):329–36.CrossRefPubMedPubMedCentral Heather N, McCambridge J, Team UR. Post-treatment stage of change predicts 12-month outcome of treatment for alcohol problems. Alcohol Alcohol. 2013;48(3):329–36.CrossRefPubMedPubMedCentral
32.
go back to reference Butler CC, Simpson SA, Hood K, Cohen D, Pickles T, Spanou C, et al. Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial. BMJ. 2013;346:f1191.CrossRefPubMedPubMedCentral Butler CC, Simpson SA, Hood K, Cohen D, Pickles T, Spanou C, et al. Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial. BMJ. 2013;346:f1191.CrossRefPubMedPubMedCentral
33.
go back to reference McCambridge J, Kalaitzaki E, White IR, Khadjesari Z, Murray E, Linke S, et al. Impact of length or relevance of questionnaires on attrition in online trials: randomized controlled trial. J Med Internet Res. 2011;13(4):e96.CrossRefPubMedPubMedCentral McCambridge J, Kalaitzaki E, White IR, Khadjesari Z, Murray E, Linke S, et al. Impact of length or relevance of questionnaires on attrition in online trials: randomized controlled trial. J Med Internet Res. 2011;13(4):e96.CrossRefPubMedPubMedCentral
Metadata
Title
Shedding light on research participation effects in behaviour change trials: a qualitative study examining research participant experiences
Authors
Virginia MacNeill
Marian Foley
Alan Quirk
Jim McCambridge
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2741-6

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue