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Table 2 Identified psychosocial facilitators and barriers to research participation, mapped to the Theoretical Domains Framework (TDF) and tested recruitment interventions

From: Why do patients take part in research? An overview of systematic reviews of psychosocial barriers and facilitators

Identified theme Systematic reviews reporting the theme Domain (components) of the TDF (from Cane et al., 2012) [14] Interventions which probably affect recruitment to research (from Treweek et al., 2018) [8] Interventions shown not to affect recruitment to research, or with uncertain effects (from Treweek et al., 2018) [8]
Facilitators
 Personal benefit (including therapeutic benefits; closer monitoring; access to new treatments; gaining knowledge of own health) Reported in 20 SRs:
Dhalla, 2014; Fayter, 2007; Fisher, 2011; Forcina, 2018; Grand, 2012; Gregersen, 2019; Hughes-Morley, 2015; Liljas, 2017; Limkakeng, 2013a; Limkakeng, 2013b; McCann, 2007; McCann, 2013; Martinsen, 2016; Nalubega, 2015; Nielsen, 2019; Nievaard, 2004; Nobile, 2013; Quay, 2017; Tromp, 2016; van der Zande, 2018
Optimism (Reflective Motivation) Mentioning scarcity of trial places
Positive framing of potential treatment benefits
Patient preference trial design
 Altruism (including benefits to science; helping others) Reported in 18 SRs:
Dhalla, 2014; Fayter 2007; Fisher 2011; Forcina, 2018; Gregersen, 2019; Hughes-Morley 2015; Limkakeng, 2013a; Limkakeng, 2013b; Martinsen, 2016; McCann, 2007; McCann, 2013; Nalubega, 2015; Nobile, 2013; Nielsen, 2019; Nievaard, 2004; Quay, 2017; Tromp, 2016; van der Zande, 2018
Beliefs about consequences (Reflective Motivation)   
 Confidence or trust in the physician or the research Reported in 13 SRs:
Crane, 2017; Grand, 2012; Gregersen, 2019; Hughes-Morley, 2015; Liljas, 2017; Limkakeng, 2013a; Limkakeng, 2013b; Martinsen, 2016; McCann, 2007; McCann, 2013; Nielsen, 2019; Nievaard, 2004; Nobile, 2013
Reinforcement (Automatic Motivation) Endorsements of previous participants  
 Low burden or convenient research Reported in 4 SRs:
Limkakeng, 2013a; Nobile, 2013; Tromp, 2016; van der Zande, 2018
Belief about consequences (Reflective Motivation)
Social or Professional Role & Identity (Reflective or Automatic Motivation)
Opt-out consent method Two-stage randomisation method (may increase perceived inconvenience to the participant)
 Financial benefit or incentives Reported in 3 SRs:
Limkakeng, 2013a; Nalubega, 2015; Tromp, 2016
Goals (Reflective Motivation) Financial incentives  
Barriers
 Fear and perceived risk (to health, of experimental treatment or adverse effects; to personal consequences) Reported in 14 SRs:
Dhalla 2013; Forcina, 2018; Fisher 2011; Grand, 2012; Hughes-Morley, 2015; Martinsen, 2016; McCann, 2013; Nalubega, 2015; Nielsen, 2019; Nievaard, 2004; Quay, 2017; Tromp, 2016; van der Zande, 2018; Woodall, 2010
Belief about consequences (Reflective Motivation) Emphasising pain in information (−) Emphasising risk in information
 Practical difficulties (including additional procedures or appointments; transport; costs; work or caring responsibilities) Reported in 13 SRs:
Fayter, 2007; Forcina, 2018; Glover, 2015; Grand, 2012; Hughes-Morley, 2015; Liljas, 2017; Martinsen, 2016; McCann, 2007; Prescott, 1999; Quay, 2017; Tromp, 2016; van Der Zande, 2018; Woodall, 2010
  Financial incentives
Internet-based data collection
(−)
Two-stage randomisation method (may increase practical demand)
Email (not postal) invitations
 Distrust of research or researchers (particularly amongst ethnic minorities) Reported in 10 SRs:
Glover, 2015; Hughes-Morley, 2015; Limkakeng, 2013a; Limkakeng, 2013b; McCann, 2007; Nalubega, 2015; Quay, 2017; Tromp, 2016; van der Zande, 2018; Woodall, 2010
   
 Aversion to randomisation Reported in 7 SRs:
Forcina, 2018; Hughes-Morley, 2015; McCann, 2007; McCann, 2013; Nievaard, 2004; Tromp, 2016; van der Zande, 2018
Environmental context and resources (Physical Opportunity) Open trial design Cluster trial design
 Treatment preferences (for specific therapy; against placebo) Reported in 5 SRs:
Fayter, 2007; Grand, 2012; McCann, 2007; Prescott, 1999; Tromp, 2016
Reinforcement (Automatic Motivation) Open trial design Patient preference trial design
 Stigma associated with health condition Reported in 5 SRs:
Dhalla, 2013; Hughes-Morley, 2015; Nalubega, 2015; Woodall, 2010; Quay, 2017
Social influences (Social Opportunity)   
 Uncertainty (particularly in relation to trials; its links to randomisation) Reported in 4 SRs:
Fayter, 2007; Fisher 2011; Nievaard, 2004; Prescott, 1999
Belief about consequences (Reflective Motivation)   Patient preference trial design
 Personal health Reported in 4 SRs:
Hughes-Morley, 2015; Liljas, 2017; Limkakeng, 2013b; Woodall, 2010
Emotion (Automatic Motivation)   
 Desire for choice Reported in 3 SRs:
Grand 2012; Fisher 2011; Tromp 2016
Goals (Reflective Motivation)   Patient preference trial design
Factors reported as facilitators and barriers   Belief about consequences (Reflective Motivation)   
 Influence of physician, family or friends Reported in 11 SRs:
Fayter 2007; Forcina, 2018; Hughes-Morley, 2015; Gad 2018; Gregersen, 2019; Liljas, 2017; Limkakeng, 2013a; Nielsen, 2019; Prescott 1999; Tromp, 2016; van der Zande, 2018
Belief about consequences (Reflective Motivation) Endorsements of previous participants  
 Information quality and participant’s knowledge of the research Reported in 5 SRs:
Crane, 2017; Fayter 2007; Forcina, 2018; Glover, 2015; Gregerson, 2019
Social influences (Social Opportunity) Enclosing questionnaire on study method Researcher reading out information (?)
Easy-to-read consent form
Optimising information through user testing or user feedback
Brief patient information leaflet
Providing information by phone
Providing information by video (?)
Providing audio record of recruitment discussion (?)
Providing booklet on trial methods (?)
Total or discretionary information disclosure (?)
Educational package on study
  1. Key: (−) negative effect on recruitment, (?) uncertain effect on recruitment