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Placing evidence in context: A response to Fry's commentary

Williams, B   Entwistle, V   Haddow, G   Wells, M

Social Science and Medicine   66 (7) 1461-1462

April 2008

http://www.sciencedirect.com/science/article/pii/S027795360700682X

In our original short report 'Promoting research participation: why not advertise altruism?', (Williams, Entwistle, Haddow, & Wells, 2008), we argued that communications that highlight the ways in which individuals' participation in health-related research can help others and promote participation as a social good or norm might help slow or reverse falling participation rates. We suggested such communications might be incorporated into both project-specific recruitment materials and more general media advertising campaigns without contravening the ethical principles of non-deception and non-coercion. In urging consideration of these means, we do not advocate the promotion of research participation at any cost.

Craig Fry (2008) helpfully locates these suggestions in the context of the broader debate about research participation. He identifies a number of questions that should be addressed in relation to (1) understanding the reasons behind health research (non-) participation; (2) the social value of research and altruism; and (3) media advertising campaigns and research participation. We agree further work and debate relating to these three themes is likely to be fruitful, and offer a few further suggestions in relation to each.

First, while a better understanding of what motivates individuals to participate in research in different settings and circumstances is likely to be useful, we would suggest that the most effective solution to a problem does not always lie in addressing its cause directly. Indeed, if Fry (2008) is correct in suggesting that 'participation rates may stem from complex issues' it may be extremely difficult, if not impossible to tackle them all. Considering 'simpler' strategies as one way of addressing an issue with complex roots is itself evident in Fry's suggestion that research into the role of financial incentives should be further explored. Evaluations of attempts to promote research participation by advertising altruism, perhaps alongside payments/incentives and the adoption of different recruitment methods, as Fry suggests, should proceed alongside attempts to improve our understanding of individual motivations.

Second, we agree that there are potential dangers from basing recruitment strategies on publicising the likely short term, tangible benefits to individuals and society of particular research projects. In theory, such an approach could devalue more conceptual and basic research where benefits may still be significant but be acquired in the longer-term and/or be less tangible. However, it is also possible that such an emphasis might mean that individuals may be attracted to participate in a research project that has important and tangible benefits and then find that participation is relatively easy, unobtrusive and rewarding and thus be more willing to take part in other research projects even if they have a lower perceived social value. In addition, studies of the ways in which different groups of people see value (or otherwise) in different types of research might counter the current emphasis on 'Ëśmeasurable' research impact (Jacobsson, Carstensen, & Borgquist, 2005), and could usefully inform efforts to communicate the potential benefits of research participation.

Third, in relation to media advertising, it will be important to differentiate between campaigns that form part of the recruitment strategy for specific research projects and campaigns that aim more generally to encourage research participation as socially beneficial and desirable. The responses of different members of the public (and not just those who are eligible to participate in specifically advertised projects) to both types of campaign merit consideration. Project-specific recruitment tends to employ targeted recruitment methods that media campaigns may not allow. However, we are not convinced that this is necessarily problematic. Recruitment to a particular research project may need to be targeted but there is no reason why publicity to facilitate such recruitment should necessarily exclude a wider audience. Such a policy may in fact be beneficial and generate an appreciation of ongoing research among the broader population. The cost of attempting to be more targeted and trying to reach only a very narrow audience, is that we are correspondingly less sensitive in our approach and may fail to reach many of our potential participants or systematically miss particular social groups thus resulting in recruitment biases.

The search for appropriate ways to promote recruitment to important research studies requires a combination of foundational research into the nature of the problem of low participation rates and the development and evaluation of (ethical) strategies for increasing participation rates. We hope that communication about the social benefits and social desirability of participation in well designed and conducted research studies will be among the strategies that are developed and evaluated.