Qualitative evaluation to improve participant engagement and retention in remote COVID-19 treatment trials

Clinical trials, although recognized as the gold standard for scientific research, encounter various challenges with participant recruitment and retention. Yet, given the surge in global research endeavors during the COVID-19 pandemic, mass recruitment and retention were needed to ensure study power. While participant engagement in clinical research has been investigated, there is limited literature underscoring motivations for participation in COVID-19 clinical trials conducted remotely. To address this gap, we conducted a longitudinal, qualitative evaluation study of participant engagement and retention in a remote, COVID-19 clinical trial. In-depth, semi-structured interviews were conducted between December 2020-March 2021 (timepoint 1; n = 19) and January-February 2022 (timepoint 2; n = 11) to gain insights from participants regarding their experiences, motivations, and challenges with clinical trial engagement during the COVID-19 pandemic. Findings identified several factors described to increase participant engagement, including perceived contribution to the greater good, protecting oneself and others, and gaining improved access to healthcare. Further, key themes underscoring the enhancement of retention, such as perceived trial-related challenges and recommendations for future studies, were also identified. Findings underscore the utility of embedding qualitative methods within clinical trials, and how they contribute to a broader understanding of factors influencing participation in COVID-19 trials while providing valuable insights to enhancing recruitment and retention strategies. Consequently, this study provides essential knowledge aimed at optimizing participant engagement and retention in clinical trials, thereby advancing our comprehension of and response to research mobilization during unprecedented events.