Can audit and feedback be applied to target healthcare professionals recruitment and retention behaviour in RCTs? A mixed methods exploration

仅2022年至今，就有超过700万参与者被要求参加注册的临床试验。在英国，国家健康研究所健康技术评估（NIHR HTA）计划在2019-2020年期间花费了1亿英镑用于试验。除了昂贵之外，临床试验往往由于试验进行的问题而无法交付，这涉及行为的过程。目前，临床试验的开展还没有从行为透镜的角度进行概念化，然而，行为是临床试验交付的核心，行为科学的社会科学学科可以为临床试验社区提供重要的见解-通过改善研究来改善健康。招募和/或保留仍然是成功交付试验的最大挑战。例如，只有56%的英国NIHR HTA资助的试验招募了他们的样本量，有些试验的失访率高达77%。在努力改善征聘和保留试验方面，与征聘地点的工作人员分享这些活动的数据。这通常涉及与其他网站的比较，例如最佳招聘和保留网站，目的是改变临床工作人员的行为。这些信息通常以新闻稿或报告的形式反馈。与向研究中心报告的“标准”相比，对招募和保留活动的评估可被视为审计和反馈（A&F），这是医疗质量改进的一个广泛使用的、基于证据的组成部分。现有的目标驱动策略，以改善试验招募和保留目前没有概念化的A&F行为改变策略，因此，这种基于证据的行为方法的有效性的潜力还没有最大化。此外，一些研究强调，招募参加审判的人员的过程受到复杂社会现象的影响，需要深入了解这些现象才能解开谜团。本次培训旨在解决这一差距。

More than 7 million participants have been required to participate in clinical trials registered thus far in 2022 alone. In the UK, the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme spent £100 million on trials during 2019-2020. In addition to being expensive, clinical trials often fail to deliver due to problems with trial conduct, process which involves behaviours. Trial conduct is not currently conceptualised through this behavioural lens, yet, behaviours are at the heart of clinical trial delivery and the social science discipline of behavioural science can provide critical insights for the clinical trials community- improving health by improving research.Recruitment and/or retention continue to be the biggest challenge for successful trial delivery. For example, only 56% of UK NIHR HTA funded trials recruited their sample size, and some suffered loss to follow up of up to 77%. In efforts to improve recruitment and retention trials share data on these activities with staff at recruiting sites. This typically involves comparisons with other sites, such as the best recruiting and retaining sites, with the aim of changing the behaviour of clinical staff. This information is often fed back as newsletters or reports. This assessment of recruitment and retention activity compared to a 'standard' reported back to sites can be considered as audit and feedback (A&F) a widely used, evidence based, component of healthcare quality improvement. The existing target driven strategies to improve trial recruitment and retention are not currently conceptualised as A&F behaviour change strategies and as such the potential for effectiveness of this evidence based behavioural approach has not been maximised. In addition several studies have highlighted that the process of recruitment to trials is influenced by complex social phenomena that require in depth understanding in order to unpack. This studentship aims to address this gap.