Scientists take on recruitment challenge

About 50 biomedical researchers from across the country gathered in Buffalo recently to examine the state of the science on recruitment for clinical trials and to explore approaches for developing and evaluating improved methods.

Participants in the 2017 Creative Scientist Workshop, titled “Novel Approaches to Clinical Trials Recruitment,” came from Buffalo Translational Consortium partner institutions and a range of other CTSA hubs and institutions, including the University of Rochester, Vanderbilt University, Johns Hopkins University, University of Pennsylvania, The Ohio State University and Case Western Reserve University.

Attendees heard from national experts on recruitment strategies and formed small work groups to share ideas and formulate strategies.

The issue is crucial; at present, recruitment of participants represents the single largest obstacle to successful clinical trials. The group reached consensus on at least one topic: the need for more empirical data, rather than guesswork and anecdotes, about what actually does and doesn’t work in the recruitment of subjects.

Workshop organizer Larry Hawk, UB professor of psychology who conducts clinical trials to help cigarette smokers kick the habit, reviewed the modest literature on evidence-based best practices in recruitment and led the push to improve it. “We need to build a research base for better recruitment, as opposed to the usual hand-wringing, throwing money at it, etc.,” Hawk said.

The conference employed a facilitated workshop format now being used by the National Science Foundation, National Institutes of Health and the National Center for Advancing Translational Sciences to catalyze scientific innovation. Workshop attendees brought a diverse set of perspectives to the table, presenting a range of informative case studies and suggested best practices.

Speakers at the workshop presented on practical and theoretical issues, including:

• Loretta Byrne, research services consultant and project manager for ResearchMatch, Vanderbilt University. Byrne described coming updates to the ResearchMatch volunteer database platform designed to provide more value for patients who sign up, such as the ability to search for trials and find information about specific diseases, and a forum for their voices to be heard.
• Jean Wactawski-Wende, dean of the UB School of Public Health and Health Professions. Wactawski-Wende discussed case studies of successful trials for which she has recruited, stressing the importance of knowing the needs of your participants, ongoing assessment of recruitment strategies and a willingness to pivot to new strategies when needed.
• Brandon M. Welch, assistant professor in the Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina. Welch demonstrated doxy.me, a web-based tool he developed for telemedicine to allow patients and physicians to come together in a secure online videoconference. Attendees were able to see a mock participant be remotely consented in real time, a feature that could markedly facilitate recruitment efforts.
• Susan M. Czajkowski, chief of the Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute. Czajkowski unequivocally stated that “recruitment problems are behavioral problems.” She provided a range of examples to support her contention that the large literature on volunteer behavior, researcher behavior, behavioral economics and persuasion provides a strong foundation to improving recruitment and retention in clinical studies.
• Paul A. Harris, professor in the departments of Biomedical Informatics and Biomedical Engineering, Vanderbilt University. Harris reported on progress in the new NCATS Recruitment Innovation Center (RIC) at Vanderbilt, noting RIC is utilizing the national network of CTSA hubs to coordinate studies on recruitment methods, standardize electronic health-records data and share best practices.

Between presentations, facilitator Andy Burnett led groups in discussion of key principles and a range of possible best practices and ideas to evaluate. The importance of building trust between scientists and the community was a major recurring theme during the workshop.

The ideas generated in the workshop are being collated and will be posted on the workshop website, where slides and videos of the talks already are available. Next steps include further development of collaborative teams around promising ideas into innovative grant proposals.

Interested researchers are invited to join the group by contacting Erin O’Byrne.

The workshop was sponsored by the UB Clinical and Translational Science Institute, supported by the National Center for Advancing Translational Sciences of the NIH under award number UL1TR001412.