Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context

The experiences of clinical gatekeepers in an observational cohort study

Maria Loades, Lucie Smith, Nina Higson-Sweeney, Lucy Beasant, Paul Stallard, David Kessler, Esther Crawley

Research output: Contribution to journalArticle

Abstract

Background:

Studies in both paediatric and psychiatric settings often experience problems in recruitment. This can compromise the ability of the study to recruit to target, meaning studies are potentially underpowered. It can also result in a biased sample if a non-representative group are selectively recruited. Recruitment to studies in health contexts often depends on healthcare professionals, who act as gatekeepers by screening patients for eligibility and obtaining consent for the research team to contact them. The experience of health professionals as gatekeepers in paediatric studies is poorly understood and may affect whether recruitment is successful or not.

Methods:

Six out of seven eligible healthcare professionals from a specialist paediatric chronic fatigue syndrome (CFS) team were interviewed. All participants were undertaking initial clinical assessments within which they were asked to identify eligible patients for an observational study of co-morbid mental health problems in adolescents with confirmed CFS/ME. This study had experienced particular recruitment problems, more so than other studies in the same service. Interview questions were designed to explore perceptions of research, and barriers and facilitators of recruitment. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used.

Results:

Participants espoused their commitment to the value of research. However, they perceived there to be a number of barriers to recruitment. Barriers within the clinical context included time pressures and the emotional nature of initial clinical assessments. Barriers posed by the wider research context included recruiting to multiple studies at the same time. Factors specific to the observational study of mental health in CFS/ME included aspects of the study design, such as the name and nature of the study, as well as the focus of the study itself. Participants made a number of recommendations about how recruitment barriers could be overcome.

Conclusions:

The current study highlights the need to carefully consider, at design stage, how to overcome potential barriers to recruitment. Gatekeepers should be actively involved at this stage to ensure that the study is set up in such a way to best enable recruitment activities within the clinical setting.
Original languageEnglish
Article number89
JournalBMC Medical Research Methodology
Volume19
Issue number1
Early online date27 Apr 2019
DOIs
Publication statusPublished - 27 Apr 2019

Keywords

  • CFS
  • Cohort study
  • Gatekeeping
  • Paediatric
  • Recruitment

ASJC Scopus subject areas

  • Epidemiology
  • Health Informatics

Cite this

Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context : The experiences of clinical gatekeepers in an observational cohort study. / Loades, Maria; Smith, Lucie; Higson-Sweeney, Nina; Beasant, Lucy; Stallard, Paul; Kessler, David; Crawley, Esther.

In: BMC Medical Research Methodology, Vol. 19, No. 1, 89, 27.04.2019.

Research output: Contribution to journalArticle

@article{98fa7de71f6e417aa828194585241eab,
title = "Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context: The experiences of clinical gatekeepers in an observational cohort study",
abstract = "Background:Studies in both paediatric and psychiatric settings often experience problems in recruitment. This can compromise the ability of the study to recruit to target, meaning studies are potentially underpowered. It can also result in a biased sample if a non-representative group are selectively recruited. Recruitment to studies in health contexts often depends on healthcare professionals, who act as gatekeepers by screening patients for eligibility and obtaining consent for the research team to contact them. The experience of health professionals as gatekeepers in paediatric studies is poorly understood and may affect whether recruitment is successful or not.Methods:Six out of seven eligible healthcare professionals from a specialist paediatric chronic fatigue syndrome (CFS) team were interviewed. All participants were undertaking initial clinical assessments within which they were asked to identify eligible patients for an observational study of co-morbid mental health problems in adolescents with confirmed CFS/ME. This study had experienced particular recruitment problems, more so than other studies in the same service. Interview questions were designed to explore perceptions of research, and barriers and facilitators of recruitment. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used.Results:Participants espoused their commitment to the value of research. However, they perceived there to be a number of barriers to recruitment. Barriers within the clinical context included time pressures and the emotional nature of initial clinical assessments. Barriers posed by the wider research context included recruiting to multiple studies at the same time. Factors specific to the observational study of mental health in CFS/ME included aspects of the study design, such as the name and nature of the study, as well as the focus of the study itself. Participants made a number of recommendations about how recruitment barriers could be overcome.Conclusions:The current study highlights the need to carefully consider, at design stage, how to overcome potential barriers to recruitment. Gatekeepers should be actively involved at this stage to ensure that the study is set up in such a way to best enable recruitment activities within the clinical setting.",
keywords = "CFS, Cohort study, Gatekeeping, Paediatric, Recruitment",
author = "Maria Loades and Lucie Smith and Nina Higson-Sweeney and Lucy Beasant and Paul Stallard and David Kessler and Esther Crawley",
year = "2019",
month = "4",
day = "27",
doi = "10.1186/s12874-019-0730-z",
language = "English",
volume = "19",
journal = "BMC Medical Research Methodology",
issn = "1471-2288",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Obstacles to recruitment in paediatric studies focusing on mental health in a physical health context

T2 - The experiences of clinical gatekeepers in an observational cohort study

AU - Loades, Maria

AU - Smith, Lucie

AU - Higson-Sweeney, Nina

AU - Beasant, Lucy

AU - Stallard, Paul

AU - Kessler, David

AU - Crawley, Esther

PY - 2019/4/27

Y1 - 2019/4/27

N2 - Background:Studies in both paediatric and psychiatric settings often experience problems in recruitment. This can compromise the ability of the study to recruit to target, meaning studies are potentially underpowered. It can also result in a biased sample if a non-representative group are selectively recruited. Recruitment to studies in health contexts often depends on healthcare professionals, who act as gatekeepers by screening patients for eligibility and obtaining consent for the research team to contact them. The experience of health professionals as gatekeepers in paediatric studies is poorly understood and may affect whether recruitment is successful or not.Methods:Six out of seven eligible healthcare professionals from a specialist paediatric chronic fatigue syndrome (CFS) team were interviewed. All participants were undertaking initial clinical assessments within which they were asked to identify eligible patients for an observational study of co-morbid mental health problems in adolescents with confirmed CFS/ME. This study had experienced particular recruitment problems, more so than other studies in the same service. Interview questions were designed to explore perceptions of research, and barriers and facilitators of recruitment. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used.Results:Participants espoused their commitment to the value of research. However, they perceived there to be a number of barriers to recruitment. Barriers within the clinical context included time pressures and the emotional nature of initial clinical assessments. Barriers posed by the wider research context included recruiting to multiple studies at the same time. Factors specific to the observational study of mental health in CFS/ME included aspects of the study design, such as the name and nature of the study, as well as the focus of the study itself. Participants made a number of recommendations about how recruitment barriers could be overcome.Conclusions:The current study highlights the need to carefully consider, at design stage, how to overcome potential barriers to recruitment. Gatekeepers should be actively involved at this stage to ensure that the study is set up in such a way to best enable recruitment activities within the clinical setting.

AB - Background:Studies in both paediatric and psychiatric settings often experience problems in recruitment. This can compromise the ability of the study to recruit to target, meaning studies are potentially underpowered. It can also result in a biased sample if a non-representative group are selectively recruited. Recruitment to studies in health contexts often depends on healthcare professionals, who act as gatekeepers by screening patients for eligibility and obtaining consent for the research team to contact them. The experience of health professionals as gatekeepers in paediatric studies is poorly understood and may affect whether recruitment is successful or not.Methods:Six out of seven eligible healthcare professionals from a specialist paediatric chronic fatigue syndrome (CFS) team were interviewed. All participants were undertaking initial clinical assessments within which they were asked to identify eligible patients for an observational study of co-morbid mental health problems in adolescents with confirmed CFS/ME. This study had experienced particular recruitment problems, more so than other studies in the same service. Interview questions were designed to explore perceptions of research, and barriers and facilitators of recruitment. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used.Results:Participants espoused their commitment to the value of research. However, they perceived there to be a number of barriers to recruitment. Barriers within the clinical context included time pressures and the emotional nature of initial clinical assessments. Barriers posed by the wider research context included recruiting to multiple studies at the same time. Factors specific to the observational study of mental health in CFS/ME included aspects of the study design, such as the name and nature of the study, as well as the focus of the study itself. Participants made a number of recommendations about how recruitment barriers could be overcome.Conclusions:The current study highlights the need to carefully consider, at design stage, how to overcome potential barriers to recruitment. Gatekeepers should be actively involved at this stage to ensure that the study is set up in such a way to best enable recruitment activities within the clinical setting.

KW - CFS

KW - Cohort study

KW - Gatekeeping

KW - Paediatric

KW - Recruitment

UR - http://www.scopus.com/inward/record.url?scp=85064979696&partnerID=8YFLogxK

U2 - 10.1186/s12874-019-0730-z

DO - 10.1186/s12874-019-0730-z

M3 - Article

VL - 19

JO - BMC Medical Research Methodology

JF - BMC Medical Research Methodology

SN - 1471-2288

IS - 1

M1 - 89

ER -