gms | German Medical Science

Background and status of (inter)national research: So far, research on recruitment for health-related studies focusses on reviewing barriers and facilitators to recruitment, interviewing researchers about their perspectives on recruitment, and analysing recruitment data qualitatively or quantitatively – mostly for clinical and randomized trials [1]. These and related contributions seem to draw their conclusions solely based on how researchers plan and do recruitment. A theoretical basis is missing to describe motivational and volitional decision-making processes of potential participants and to explain their influence on engaged study participation. This clarification is essential to develop target group-specific recruitment strategies.

Research question and objective: We aimed to summarize central motivational and behavioral components of a person's attention, intention formation, and continuation of research participation by qualitatively adapting a framework for recruitment and determine its applicability.

Methods: Based on the “Health Action Process Approach” [2], a framework for active participation in research studies was elaborated to outline individual components of the recruitment process from the perspective of study participants (framework development). Within the multicenter research group “DFG FOR 2959: Health Literacy in Early Childhood Allergy Prevention”, four independent recruitment processes – that targeted parents of infants, pediatrics and midwifes – were used to define and describe the components of the adapted model and to differentiate which factors determine recruitment success and valid study results (framework application, based on qualitative evidence synthesis).

Results: The model encompasses three phases and a total of 18 components. In the first phase (“Pre-Intentional”), once there is an opportunity to participate in research, the individual appraises the study’s seriousness, utility, and effort and assesses own interest and motivation. Additionally, the confidence in being able to participate, and cues regarding how the study is perceived and communicated within the social environment are considered. Phase two (“Intentional”), concerns the concrete planning of participation, i.e. required study tasks, handling of potential difficulties, available resources, and expected support by the research team. In phase three (“Actional”), initial participation leads to an evaluation of whether expectations and interests have been met, which in turn triggers a decision to continue or cancel further participation, and potential support by communicating the study call to peers.

Discussion: The adapted model provides researchers with an understanding of basic behavioral and motivational aspects that guide an individual’s participation decision. It offers a more nuanced and comprehensive process for approaching and maintaining study participants. Researchers should consider the differences of distinct target groups regarding the importance and application of the model’s components. Future research should explore the model’s utility for reducing recruitment challenges and suggest modifications where necessary.

Funding: Einzelförderung (BMG, DRV, BMBF, DFG, etc); DFG FOR2959 CU 438/1-1)