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Strategies to improve recruitment in mental health clinical trials: a scoping review (RE-MIND study)
Mais Iflaifel1, Charlotte L Hall2,3, Heidi R Green4,5
1Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK.
Background:
Lower-than-expected recruitment continues to be one of the major causes of trial delays, and trials to improve mental health are no exception. Indeed, recruitment challenges in trials of vulnerable populations, such as those living with mental health illness, can even be exacerbated. To address this, researchers are turning to digital and online recruitment strategies, e.g. web-based approaches and multi-media in order to (1) increase recruitment efficiency (recruit to target and on time) and (2) improve diversity in mental health clinical trials to be more inclusive and reduce health inequity. There is, however, inconclusive evidence on the success of digital and online recruitment strategies in mental health clinical trials. The RE-MIND study comprised a scoping review to assess the impact of using such recruitment strategies in mental health clinical trials to inform a more systematic scoping review.
Methods:
A cohort of 191 recently published RCTs and randomised feasibility studies were identified from the NIHR Journals Library and top two mental health journals (based on citation metrics), Lancet Psychiatry and JAMA Psychiatry. Population characteristics including gender, ethnicity and age were summarised for inclusivity using descriptive statistics, and recruitment strategies were compared to examine differences in their success in recruiting to target.
Results:
After screening, 97 articles were included for review. The review findings showed no evidence that offline or mixed strategies were superior for achieving recruitment targets in mental health trials. However, there was a suggestion that trials using a mixed recruitment strategy improved inclusivity and tended to recruit closer to the target.
Conclusions:
The key finding was that consideration should be given to a mixed methods approach to recruitment not only to enable wider and more diverse participation in mental health trials but also to realize greater efficiency.
Insights
Mixed recruitment strategies enhance diversity and efficiency in mental health clinical trials. A review suggests combining online and offline methods improves inclusivity and participant recruitment success.
Area of Science:
- Clinical Trials
- Mental Health Research
- Recruitment Strategies
Background:
- Clinical trial delays are common, particularly in mental health research, due to recruitment challenges.
- Vulnerable populations with mental health conditions face exacerbated recruitment difficulties.
- Digital and online strategies aim to boost recruitment efficiency and diversity in mental health trials.
Purpose of the Study:
- To assess the impact of digital and online recruitment strategies in mental health clinical trials.
- To inform a more systematic scoping review on recruitment strategies.
- To evaluate the success of different recruitment approaches in mental health research.
Main Methods:
- A scoping review of 191 randomized controlled trials (RCTs) and feasibility studies from the NIHR Journals Library and top mental health journals.
- Analysis of population characteristics (gender, ethnicity, age) for inclusivity.
- Comparison of recruitment strategies to determine success rates in meeting recruitment targets.
Main Results:
- 97 articles were included after screening.
- No evidence found that offline or mixed strategies were superior for meeting recruitment targets.
- Trials using mixed recruitment strategies showed improved inclusivity and tended to recruit closer to targets.
Conclusions:
- Mixed methods recruitment approaches should be considered for mental health trials.
- Combining strategies can lead to wider and more diverse participation.
- A mixed approach may also enhance overall recruitment efficiency.
