“And Then He Got into the Wrong Group”: A Qualitative Study Exploring the Effects of Randomization in Recruitment to a Randomized Controlled Trial

Birthe Andrea Lehmann, Lara Lindert, Silke Ohlmeier, Lara Schlomann, Holger Pfaff and Kyung-Eun Choi
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Birthe Andrea Lehmann: Communication Science, University of Amsterdam, 1001 NH Amsterdam, The Netherlands
Lara Lindert: Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, 50933 Köln, Germany
Silke Ohlmeier: Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, 50933 Köln, Germany
Lara Schlomann: Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, 50933 Köln, Germany
Holger Pfaff: Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, 50933 Köln, Germany
Kyung-Eun Choi: Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, 50933 Köln, Germany

IJERPH, 2020, vol. 17, issue 6, 1-16

Abstract: Background: Randomized controlled trials (RCTs) are regarded as the most internally valid means of estimating the effectiveness of complex public health interventions, but the recruitment of participants can be difficult. The aim of this study was to explore factors that may have affected the recruitment of employees with musculoskeletal disorders (MSDs) to a multicenter worksite health promotion program from the perspective of recruiting case managers. Methods: Factors in recruitment to the RCT were explored using three focus group discussions with case managers. Data were processed using MAXQDA and analyzed with a combination of content and sequence analysis. Results: Findings showed that randomization is a major challenge for recruitment. Case managers adapted their communication with, and approaches to possible participants because of the randomization design and employed coping strategies to compensate for allocation into the control arm of the study. Perceptions of the superiority of the intervention group over the control group, perceptions of the (mis)match of participants to one of the groups, as well as the understanding of the necessity of randomization for effectiveness evaluations, further affected recruitment. Perceived expectations of possible participants and their (emotional) reactions to the randomization allocation also complicated recruitment. Conclusion: We were able to gain insight into the challenges of randomization for the recruitment of participants to a multicenter RCT. This study assisted the development of strategies to overcome barriers in the ongoing implementation process of the trial (i.e., the adaption of best practice information sheets and newsletters). There remains a need to develop effective interventions to help those recruiting to trials.

Keywords: recruitment barriers; randomization; RCT; qualitative research; case managers (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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