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Motivation for Participation

Understanding what motivates people to volunteer for research is extremely beneficial for successful participant recruitment.

Motivators can be categorised as intrinsic or extrinsic. It is worth mentioning that intrinsic factors are frequently found to be more influential that extrinsic, or tangible, factors (Aitken, 2003).

Intrinsic factors

Below are some of the most widely cited reports of intrinsic motivation for people to volunteer for research:

  • An understanding of the importance in supporting scientifically controlled studies, as they are important and will benefit other current or future patients (Bell 2008, Aitken 2003, Patel 2003)
  • To gain more information about their own condition, new techniques to cope, or better access to care (Halpern 2003, van Stuijvenberg 1998, Wright 2004)
  • Most participants hope that the treatment being studied will benefit them directly (Chang 2004, Aitken 2003, Patel 2003)
  • A desire to put something back into the health care service that helped them or a perception that some particular studies have a high level of importance to community well-being (Aitken 2003)
  • An understanding that previous volunteers have helped develop their current treatment, and a responsibility to support future health care (Aitken 2003)
  • Greater patient / researcher (clinician) relationship (Aitken 2003)
  • Greater communication via newsletters and phone calls (Aitken 2003)
  • Perception of a greater level of care than would otherwise occur (Aitken 2003)

Extrinsic factors

Monetary and other tangible gifts are obvious motivators, but it some cases may be considered coercion. As such, these must be reviewed on a case by case basis by relevant ethical committees and the role of financial motivation will not be discussed in detail. However, should you be able to provide some extrinsic motivation, here is what is recommended:

  • Meaningful items, such as nappies (for a pregnancy or baby study) or clothing (Kelly 1996, Hellard 2001, McKenzie 1999)
  • Direct payments of cash typically have better responses than gifts of equal value (Rudy 1994)
  • Lotteries (Hellard 2001, Kalantar 1999)
  • Note: increasing financial rewards do not linearly increase response (more on this later!)

Decision to enroll

Although interested and eligible, a potential participant may still choose not to enroll.

  • Encouragement from trusted health care providers is understood as a powerful force of persuasion for enrollment (Chang 2004)
  • A persons decision to enroll may depend on their perceptions of condition stability (Corbie-Smith 2003, Lowton 2005)
  • Participants are unlikely to enroll unless they can identify with the value of the study (Patel 2003)

Also see Barriers for Participation

References:
  1. Aitken L., Gallagher R., Madronio C. (2003) Principles of recruitment and retention in clinical trials. International journal of nursing practice; 9(6)
  2. Bell et. al., (2008). Participant recruitment and retention in rehabilitation research. American Journal of Physical Medicine and Rehabilitation; 87(4)
  3. Chang BH, Hendricks AM, Slawsky MT, et al: Patient recruitment to a randomized clinical trial of behavioral therapy for chronic heart failure. BMC Med Res Methodol 2004;4:8
  4. Corbie-Smith G, Viscoli CM, Kernan WN, et al: Influence of race, clinical, and other socio-demographic features on trial participation. J Clin Epidemiol 2003;56:304–9
  5. Halpern SD, Karlawish JH, Casarett D, et al: Hypertensive patients’ willingness to participate in placebo-controlled trials: implications for recruitment efficiency. Am Heart J 2003;146:985–92
  6. Hellard ME, Sinclair MI, Forbes AB, Fairley CK. Methods used to maintain a high level of participant involvement in a clinical trial. Journal of Epidemiology and Community Health 2001;55: 348–351.
  7. Kalantar JS, Talley NJ. The effects of lottery incentive and length of questionnaire on health survey response rates: a randomized study. Journal of Clinical Epidemiology 1999;52:1117–1122.
  8. Kelly PJ, Cordell JR. Recruitment of women into research studies: a nursing perspective. Clinical Nurse Specialist 1996;10: 25–28.
  9. Lowton K: Trials and tribulations: understanding motivations for clinical research participation amongst adults with cystic fibrosis. Soc Sci Med 2005;61:1854–65
  10. McKenzie M, Tulsky JP, Long HL, Chesney M, Moss A. Tracking and follow-up of marginalized populations: a review. Journal of Health Care for the Poor and Underserved 1999;10: 409–429.
  11. Patel M.X., Doku V., Tennakoon L. (2003) Challenges in recruitment of research participants. Advances in Psychiatric Treatment; 9(3)
  12. Rudy EB, Estok PJ, Kerr ME, Menzel L. Research incentives: money versus gifts. Nursing Research 1994;43: 253–255.
  13. Wright JR, Whelan TJ, Schiff S, et al: Why cancer patients enter randomized clinical trials: exploring the factors that influence their decision. J Clin Oncol 2004;22:4312–8
  14. van Stuijvenberg M, Suur MH, de Vos S, et al: Informed consent, parental awareness, and reasons for participating in a randomised controlled study. Arch Dis Child 1998;79: 120–5
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