Recruiting people with HIV to an online self-management support randomised controlled trial: barriers and facilitators
Karen M. Klassen
A H , Tanya Millard A , Julia Stout A , Karalyn McDonald A , Sarity Dodson B , Richard H. Osborne B , Malcolm W. Battersby C , Christopher K. Fairley D , Michael R. Kidd E , James McMahon A , David Baker F and Julian H. Elliott A G
A Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Vic. 3004, Australia.
B Health Systems Improvement Unit, Centre for Population Health Research, School of Health and Social Development, Deakin University, Geelong, Vic. 3125, Australia.
C Flinders Human Behaviour and Health Research Unit, Flinders University, Adelaide, SA 5001, Australia.
D Melbourne Sexual Health Centre and Department of Medicine, Central Clinical School, Monash University, Melbourne, Vic. 3000, Australia.
E Department of Family and Community Medicine, University of Toronto, Toronto M5G 1V7, Canada.
F East Sydney Doctors, 102 Burton Street, Darlinghurst, NSW 2010, Australia.
G Cochrane Australia, School of Public Health and Preventative Medicine, Monash University, Melbourne, Vic. 3004, Australia.
H Corresponding author. Email: karenklassen@gmail.com
Sexual Health 16(4) 340-347 https://doi.org/10.1071/SH18130
Submitted: 17 July 2018 Accepted: 8 March 2019 Published: 25 June 2019
Abstract
Background: Recruitment of people to randomised trials of online interventions presents particular challenges and opportunities. The aim of this study was to evaluate factors associated with the recruitment of people with HIV (PWHIV) and their doctors to the HealthMap trial, a cluster randomised trial of an online self-management program. Methods: Recruitment involved a three-step process. Study sites were recruited, followed by doctors caring for PWHIV at study sites and finally PWHIV. Data were collected from study sites, doctors and patient participants. Factors associated with site enrolment and patient participant recruitment were investigated using regression models. Results: Thirteen study sites, 63 doctor participants and 728 patient participants were recruited to the study. Doctors having a prior relationship with the study investigators (odds ratio (OR) 13.3; 95% confidence interval (CI) 3.0, 58.7; P = 0.001) was positively associated with becoming a HealthMap site. Most patient participants successfully recruited to HealthMap (80%) had heard about the study from their HIV doctor. Patient enrolment was associated with the number of people with HIV receiving care at the site (β coefficient 0.10; 95% CI 0.04, 0.16; P = 0.004), but not with employing a clinic or research nurse to help recruit patients (β coefficient 55.9; 95% CI –2.55, 114.25; P = 0.06). Conclusion: Despite substantial investment in online promotion, a previous relationship with doctors was important for doctor recruitment, and doctors themselves were the most important source of patient recruitment to the HealthMap trial. Clinic-based recruitment strategies remain a critical component of trial recruitment, despite expanding opportunities to engage with online communities.
Additional keywords: clinical trial, recruitment.
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