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Messaging Modality and Content for Recruitment of Research Participants: A Randomized Clinical Trial
Pishoy Gouda1,2, LáShauntá Glover1,3, Aarti Kenjale4
1Duke Clinical Research Institute, Durham, North Carolina.
JAMA Network Open
|May 22, 2026
Summary
Email recruitment significantly increased participant interest compared to patient portals, especially for older adults. Message framing had minimal impact, though altruistic appeals benefited younger individuals. These findings offer insights for optimizing clinical trial recruitment strategies.
Area of Science:
- Clinical research methodology
- Digital health strategies
- Participant engagement
Background:
- Optimizing participant recruitment is crucial for clinical research success and generalizability.
- Limited randomized clinical trial (RCT) evidence exists comparing digital recruitment strategies and message framing effects on engagement.
- This study addresses the need for evidence-based digital recruitment approaches.
Purpose of the Study:
- To determine the impact of different recruitment strategies on engagement with potential research participants.
- To compare the effectiveness of email versus patient portal recruitment modalities.
- To evaluate the influence of altruistic versus individualistic message framing on participant interest.
Main Methods:
- A 2x2 factorial randomized clinical trial embedded within the RESILIENCE study.
- Participants were recruited online from a single academic health system.
- Randomization to recruitment modality (email vs. patient portal) and message content (altruistic vs. individualistic).
Main Results:
- Email recruitment yielded higher participant interest (9.9%) than patient portal messaging (5.9%), with a relative risk (RR) of 1.68.
- Message content type (altruistic vs. individualistic) did not significantly impact overall engagement (RR, 1.08).
- Exploratory analyses showed altruistic messaging was more effective in younger participants (<60 years), while email was more effective in older participants (>60 years) and those with obesity.
Conclusions:
- Email-based recruitment strategies are more effective than patient portal messages for increasing participant interest in clinical research.
- Tailoring recruitment messages based on age demographics may enhance engagement.
- These findings provide valuable insights for designing effective digital recruitment strategies in future clinical trials.
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