Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial Nessa Thomas Yeliz Prior 10.17866/rd.salford.7637639.v1 https://salford.figshare.com/articles/journal_contribution/Health_care_professionals_views_of_the_factors_influencing_the_decision_to_refer_patients_to_a_stroke_rehabilitation_trial/7637639 <p>Abstract</p><p>Background: Effective recruitment is an essential element of successful research but notoriously difficult to achieve.</p><p>This article examines health care professionals’ views on the factors influencing decision-making regarding referral</p><p>to a stroke rehabilitation trial.</p><p>Methods: Semi-structured interviews and a card-sorting task were undertaken with stroke service staff in acute and</p><p>community hospital trusts. Data analysis used a thematic framework approach.</p><p>Results: Twenty-seven qualified health care professionals from 12 (6 acute and 6 community) hospital trusts and</p><p>one charity participated. Four main factors emerged: patient-related, professional views, the organisation and</p><p>research logistics, which all contributed to staff’s decision about whether to refer patients to a trial.</p><p>Clinicians identified patient-related factors as the most frequent influence and considered themselves the patients’</p><p>advocate. They used their knowledge of the patient to anticipate the patients’ reaction to possible participation and</p><p>tended to only refer those whom they perceived would respond positively.</p><p>Participants also identified experience of research, a sense of ownership of the project and a positive view of the</p><p>intervention being evaluated as factors influencing referral. The need to prioritise clinical matters, meet managerial</p><p>demands and cope with constant change were organisational factors impacting negatively on referral. Staff often</p><p>simply forgot about recruitment in the face of other higher priorities. Quick, simple, flexible research processes that</p><p>were closely aligned with existing ways of working were felt to facilitate recruitment.</p><p>Conclusions: Patient- and professional-related factors were the most frequent influence on clinicians’ recruitment</p><p>decisions, which often had a ‘gate-keeping’ effect. Managerial and clinical responsibility to juggle multiple (often</p><p>higher) priorities was also an important factor.</p><p>To facilitate recruitment, researchers need to develop strategies to approach potential participants as directly as</p><p>possible to enable them to make their own decisions about participation; ensure that research processes are as</p><p>quick and simple as possible; align with existing clinical pathways and systems; and give regular reminders and</p><p>ongoing support to promote recruitment.</p><p>Trial registration: ISRCTN, 98287938. Registered 6 May 2015</p> 2020-06-25 08:56:58 recruitment strategy Decision Making trials bias Rehabilitation and Therapy (excl. Physiotherapy)