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Cost per participant should be considered with the rate of recruitment.
Consider the daily cost of running or extending a research project, and consider the savings that a speedy recruitment will have, regardless of the cost per participant.
For student research projects, where only time is invested, the cost per participant may be the primary concern. However, for large research projects where daily running costs are in the magnitudes of thousands of dollars, then the importance of rate of recruitment may shadow individual participant recruitment costs.
It is crucial that recruitment priorities are identified so that appropriate marketing methods and budgets are applied. Consider, for example, the differences between mass-media advertising and targeted search engine advertising. A traditional national advertising campaign is more likely to connect with a larger number of potential participants immediately, and may therefore result in a rapid response at the expense of a very high cost per participant. Conversely, search engine advertising may be extremely cost effective, yet is more likely to provide a more gradual stream of applicants. Of course, the ideal approach is to find a happy medium of mass-targeted communication. Specialised resources such as Health-tv, Family Health Diary and Getparticipants are perfect examples here.
As the Getparticipants database grows (approximately 1500 at the time of this blog post), we are seeing increasing applicant rates with reciprocally decreasing costs per applicant* (cost per applicant more accurately described conversions in the Getparticipants model. Reports indicate that approximately 50% of applicants become participants). Recent listings with relatively open criteria have received between 50 and 100 applicants within the first 24-hours (with rates declining exponentially thereafter), and studies with more restrictive criteria receiving between 5 and 20 applicants in the first 24-hours. At a current cost of $60 per month for advertising, recent listings are achieving very rapid response rates with the costs per applicant ranging between $12 and $0.6.
* The reciprocal relationship exists with monthly subscriptions, not with prepaid credits
Getparticipants provides a service of helping researchers find applicants for their studies (while also providing the general public with research opportunities). The value is in providing individuals that qualify and then become part of the study. To understand the quality of our applicants we ran a small survey with our researchers who had received at least five participant applicants (10 respondents). We are happy to share these results.
Our respondents told us that approximately 49% (stdev of 28) of their applicants proceeded to take part in their study. When identifying reasons that may prevent applications from participating we found out that 76% (stdev 24) of applicants successfully engaged in further communication with the researcher, and of these, 88% (stdev 10) had correctly read the criteria that was posted on the website.
Overall, we are happy with the fact that approximately half of all applicants proceed to take part in the research that they apply for. We are unaware of anywhere else that would be able to provide contacts with such a high conversion rate.
It appears that establishing communication can sometimes be a barrier for processing applicants. In this regard, we recommend allowing some time and resources to this component. Given that the majority of applications occur as a result of the email notifications, the email addresses that are provided should be valid and up to date. However, we can also include a small “submit your contact details” form for your applicants if you wish to prevent difficulties in this area (let us know).
We were happy to see that the great majority of applicants had read the inclusion/exclusion criteria correctly. Therefore, we recommend making the most of this component and ensuring that sufficient detail is provided to help filter your applicants. We can also include a short screening form for applicants to complete with the responses being sent directly to you. This option may help speed up the overall process and perhaps save you time on the phone. Please let us know if you are interested in these options.
When people look to participate in a study they may be interested in the novel intervention or free treatment. Indeed, this is a powerful motivator for many research participants, and the attractiveness of free or novel interventions is often employed in advertising material. However, when there is the chance of being randomised into the control group some individuals may feel less excited about the opportunity. Also, randomising people to control groups means that your advertising material must be awkwardly worded to ensure that you are not building false hopes. In dong so, applicants may feel reluctant to apply for the study owing to the possibility of “lucking-out” and ending up in a control group.
Where possible, and to help create a study design and advertising material that is more attractive to potential participants, why not look to give the people of the control group the intervention at the end of the study? Or at least something additional to the control intervention. A simple add-on after the final testing session for example.
While it will not apply to all study designs (e.g. blinded designs or complex interventions), many studies may have the resources to provide the novel intervention to both groups, thereby ensuring all participants feel like they can be part of something new and exciting. This would most likely increase the change of someone applying for the study, and perhaps encourage them to discuss it with their friends afterwards and look forward to their next opportunity.
Whatever it is, try and have something in it for the participants – what ever group they are in.
To effectively advertise your study you need to ensure that your advertisement reaches the right audience. Not only that, you also want to conserve your advertising funds by not advertising to the wrong people.
Targeted advertising means exactly this, and for executing a tightly targeted campaign there is no place like the internet. Through various mechanisms, advertising can be targeted with various considerations:
- Geographic targeting is a relatively common feature for internet advertising, and it means you can ensure that you are not paying to have your advertisement presented to people who do not live in your specified regions.
- Keyword targeting is ubiquitous in search engine advertising (e.g. Google). What better place to capture people searching for related information on the internet (who are also from your geographical region)?
- Gender and age targeting are perhaps the most beneficial for participant recruitment when combined with the above strategies.
Bonus # 1
What makes this even better, is that this kind of advertising is often provided in a Cost-Per-Click (CPC) medium. That means you don’t pay for unnoticed advertisements, and you only pay when someone clicks the advertisement and visits your study web page (all the more reason to have an on line recruitment portal). Additionally, CPC advertising campaigns do not require any budgets and are completely flexible.
Bonus # 2
Being on the internet means that everything can be tracked and recorded so that your advertising campaign can easily be made as effective as possible. One such strategy is to run several versions of the same advertisement and then focus on the one that does the best. By “best” I do not mean the most clicks (as that would be the most “expensive”), but those advertisements that provide the most successful results; i.e. the highest conversion rate. The conversion rate is the number of people who, once they have clicked the advertisement, decide to apply for the study. Conversion rates can be calculated with on-line analytics programmes and data such as Cost-per-Participant can be compared between advertisements.
So all together it is possible to target your advertising to a very specific audience, then only pay for their actions, and be able to track and develop your campaign based on factual and detailed reporting data – this all goes well beyond the capabilities of traditional advertising!
Getparticipants, along with a growing team of collaborators and partners, is looking to develop an Australian New Zealand Participant Registry (ANZPR). This will not be the first participant registry to be created. Indeed, numerous participant and patient registries already exist in New Zealand, Australia, and internationally for the purpose of facilitating recruitment, data analysis, benchmarking and collaboration. However, existing registries are typically exclusive in that their data is not shared among other research organisations or disciplines.
The ANZPR is being planned with the following objectives in mind:
- Enabling data sets to be easily shared between researchers, disciplines, organisations and countries in a way that protects the participants’ privacy.
- Facilitating participant recruitment by establishing a broad and shared database of consenting participants.
The subsequent downstream benefits include:
- Facilitating research collaboration: Data sharing between researchers, disciplines, organisations and countries; researcher notification of relevant data uploads; and facilitating the connection of joint and multi-site research projects.
- Data analyses for ongoing research: Both prospective when coupled with study design data and retrospective with existing data.
- Benchmarking: Enabling researchers to collate data to use as benchmarks for control group statistics and intervention research.
- Research design: Enabling researchers to identify similar data that has been collected, so that subsequent research designs can be made highly compatible and novel.
- Participant recruitment for numerous future studies can be significantly more cost and time efficient.
Designing the registry will require a complex database architecture (the details of which are well outside the scope of a blog post) and stable security measures, all housed in a system with data query and output systems that are intuitive and highly compatible. For this, we are assembling a team of international experts with extensive combined experience in international clinical documentation and registry systems such as MEMdoc, and Spine Tango.
Building a registry and having it successfully meet the needs of local researchers will require support from the individuals in the local research industry.
Our call to you:
If you are interested in this concept and think it could be of value, then we invite you to share your thoughts by commenting on this post or by emailing us at info@getparticipants.com.
Progress updates for the ANZPR will be posted on the blog as they happen, so sign-up for email alerts if you want to be kept in the loop (note that the blog uses a different sign-up system to the main website)
Following a few requests from researchers, we have gone through our database and are happy to now provide you with the numbers, as they stand in March 2010.
While we are very happy to be as transparent as we can, we would like to remind you to not be discouraged if your target population appears under represented here. Remember, this population has been built based on the studies that are listed; the more studies we have for a certain population, the more that population will grow on our database.
Members: 886
Gender: 65% Female
Mean Age: 37 years
As a student or young researcher, getting your writing skills up to a level worthy of publication in desired journals can be a real challenge, particularly when working in a second language.
I recently found a great article that will surely be invaluable to students looking for that first publication, or simply to help sharpen their scientific writing skills.
Title: Algorithm for writing a scientific manuscript
Abstract:
We present an algorithm for the construction of a strong initial draft. It is designed to overcome writer’s block and to assist scientists who are not native English speakers. The writing starts with making figures and tables. These suggest several terse summary statements, the few major conclusions or observations the author will present to the scientific community. After identification of the audience, the specific community addressed, materials and methods are written to explain how the tables and figures were generated. Results are initially restricted to describing the logical data relations in each table and figure. The discussion then converts each data relationship into mechanistic cause-and-effect interpretations suitable for the abstract. A brief epilogue deals with the submission and the fate of the final manuscript once submitted. Although other models for the initial draft exist, this model has worked for us and new researchers in our laboratories and addresses problems we encountered while editing manuscripts
Link
Recruitment would not be a problem if everyone who were eligible was interested in participation. However, as many understand, this is not the case. Unfortunately, sometimes there aren’t as many eligible people as estimated, and many of those that are eligible are not interested. This pitfall in ineffective recruitment is a phenomenon called Lasagna’s law (Spilker & Cramer 1992, Torgerson et al. 2001) or the ‘funnel effect’ of recruitment. Basically, it refers to the researcher’s tendency to overestimate the pool of available patients who meet the inclusion criteria and would be willing to enroll.
The response rate is the proportion of those approached who agree to participate in research. Initial response rates can be as low as 1% (Cooley et al. 2003). Overall response rates can be enhanced by employing a multi-tiered approach strategy, where non-respondents are approached a second or even a third time until a response is achieved (a response being either acceptance or refusal). When using this approach, researchers should expect response rates to reduce by approximately half for each subsequent approach (Patel et. al., 2003).
As the response rate for intervention studies can be as low as 1%, researchers should consider numerous variables that could affect someone’s decision to respond, such as patients motivation and their barriers for participation.
- Spilker B & Cramer JA (1992) Patient Recruitment in Clinical Trials. Raven Press, New York.
- Torgerson JS, Arlinger K, Kappi M & Sjostrom L (2001) Principles for enhanced recruitment of subjects in a large clinical trial. Controlled Clinical Trials 22, 515–525.
- Cooley ME, Sarna L, Brown JK, Williams RD, Chernecky C, Padilla G & Danao LL (2003) Challenges of recruitment and retention in multisite clinical research. Cancer Nursing 26, 376–384.
- Patel MX, Doku V & Tennakoon L (2003) Challenges in Recruitment of Research Participants. Advances in Psychiatric Treatment, vol. 9, 229–238
Time and travel are repeatedly identified as prominent barriers for participation in research studies, particularly when numerous visits are required. Sometimes these barriers can be lifted by providing taxi fare or having affiliates conduct some of the research for you. However, both options are likely to require significant funds or resources.
Performing as much of your research as you can on-line could reduce the amount of time or travel required from the participant and make your study more attractive to potential applicants. Even by having your participants complete their questionnaires on-line before they come in could take 10 to 30 minutes off the total time. It may even reduce the need for one of the visits. If your research requires a more interactive response, then consider hiring a web programmer so your participants can engage from home.
Getparticipants.com can help by providing custom content pages, which can contain videos, calendars, maps, and questionnaires. Should third party sites or applications be required, Getparticipants can link directly to external locations to direct your participants, and save you both time.
By Trina Jones.
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