Use of strategies to improve retention in primary care randomised trials: a qualitative study with in-depth interviews
Use of strategies to improve retention in primary care randomised trials: a qualitative study with in-depth interviews
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DOI：
10.1136/bmjopen-2013-003835
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Rait, G.
中科院分区：
文献类型：
--
作者：
Brueton, V. C.;Stevenson, F.;Rait, G.
目的探讨在初级保健随机试验中提高保留率的策略。设计定性的深度访谈和主题分析。参与者29名英国初级保健主管和首席研究员、试验管理人员和研究护士。方法采用面对面的深度访谈。结果初级保健研究者使用激励和沟通策略来提高试验中的保留率，但不确定其效果。小额货币奖励被用来增加对邮寄调查问卷的回答。使用了非货币激励措施，尽管有人对这些措施对留任的影响持怀疑态度。护士通常使用电话交流来鼓励参与者返回进行试验跟踪。试验经理使用头等职位、较短的调查问卷和改进的问卷设计，目的是提高问卷回答。受访者认为开放式试验设计可能会导致有偏见的结果，并对使用行为策略来提高保留率持否定态度。受访者一致认为，与参与者的有效沟通和融洽、参与者的利他主义、尊重参与者的时间、试验人员和预约时间表的灵活性以及试验信息有助于提高保留率。受访者注意到在心理健康试验和涉及青少年的试验中关于保持的特殊挑战。结论这项定性研究的结果使我们能够反思关于保持的研究实践，并强调这种实践与当前证据之间的差距。受访者描述了在没有文献证据的情况下根据经验行事，这支持使用小额货币激励来改善问卷答复。非金钱奖励或头等职位不存在这样的证据，其使用可能需要重新考虑。在其他研究背景下探讨保留的障碍和促进者可能是合理的。
Objective To explore the strategies used to improve retention in primary care randomised trials.Design Qualitative in-depth interviews and thematic analysis.Participants 29 UK primary care chief and principal investigators, trial managers and research nurses.Methods In-depth face-to-face interviews.Results Primary care researchers use incentive and communication strategies to improve retention in trials, but were unsure of their effect. Small monetary incentives were used to increase response to postal questionnaires. Non-monetary incentives were used although there was scepticism about the impact of these on retention. Nurses routinely used telephone communication to encourage participants to return for trial follow-up. Trial managers used first class post, shorter questionnaires and improved questionnaire designs with the aim of improving questionnaire response. Interviewees thought an open trial design could lead to biased results and were negative about using behavioural strategies to improve retention. There was consensus among the interviewees that effective communication and rapport with participants, participant altruism, respect for participant's time, flexibility of trial personnel and appointment schedules and trial information improve retention. Interviewees noted particular challenges with retention in mental health trials and those involving teenagers.Conclusions The findings of this qualitative study have allowed us to reflect on research practice around retention and highlight a gap between such practice and current evidence. Interviewees describe acting from experience without evidence from the literature, which supports the use of small monetary incentives to improve the questionnaire response. No such evidence exists for non-monetary incentives or first class post, use of which may need reconsideration. An exploration of barriers and facilitators to retention in other research contexts may be justified.