A practical guide to implementing a successful social media recruitment strategy: lessons from the Eczema Monitoring Online trial

"I Respect Whatever Decision You Make!" How Autonomy Support and Exemplars in Short-Form Videos Influence Clinical Trial Recruitment

This study was designed to test two message features (autonomy support and evidence type) found in clinical trial recruitment videos on social media. Using an online experiment in which 606 individuals watched short-form videos about clinical trials, we assessed the impact of varying autonomy support conditions (supportive vs. non-supportive) and incorporating exemplars of a previous clinical trial participant's experience (vs. base-rate information about participating). The findings show that communicating about clinical trials with an autonomy-supportive approach can reduce psychological reactance and improve perceived message effectiveness, attitudes toward clinical trial participation, intentions to engage with the content (i.e., "liking" and sharing the content), and intentions to participate in clinical trials. When combined with an exemplar, autonomy-supportive messaging can be especially effective at reducing psychological reactance and improving attitudes toward clinical trials. The findings are well-timed, as researchers are increasingly turning to social media to enhance clinical trial recruitment.

Experiences, acceptability and feasibility of an isometric exercise intervention for stage 1 hypertension: embedded qualitative study in a randomised controlled feasibility trial

BACKGROUND

Healthy lifestyle changes for patients with stage 1 hypertension are recommended before antihypertensive medication. Exercise has antihypertensive benefits; however, low adoption and high attrition are common. Patients need easily adoptable, effective and manageable exercise interventions that can be sustained for life. We present participant and stakeholder perceptions of an isometric exercise intervention for stage 1 hypertension delivered in the National Health Service (NHS, UK).

METHODS

An embedded qualitative study within a randomised-controlled feasibility study included intervention arm participants (n = 10), healthcare professionals from participating NHS sites (n = 3) and non-participating NHS sites (n = 5) taking part in semi-structured interviews to explore feasibility of delivering an isometric exercise intervention within the study design and an NHS context. Data was analysed using reflective thematic analysis.

RESULTS

Three themes were identified: study deliverability; motivators and barriers; support for study participation. Findings indicated that the study was well designed. Health benefits, unwillingness to take medication, altruism and interest in the study helped motivation and adherence. Study support received was good, but healthcare professionals were insecure in intervention delivery with regular training/supervision needed. Perception of health improvement was mixed, but, in some, uptake of wider lifestyle changes resulted from participation. Stakeholders felt that current service challenges/demand would make implementation challenging.

CONCLUSIONS

Despite participant positivity, delivery of an isometric intervention in an NHS setting was considered challenging given the current service demand, although possible with robust effectiveness evidence. Findings support further effectiveness data and implementation development of the isometric exercise intervention.

TRIAL REGISTRATION

ISRCTN, ISRCTN13472393 . Registered 18 September 2020.

Decentralized Clinical Trials in Early Drug Development-A Framework Proposal

The COVID-19 pandemic has led to a rethinking of clinical trial design to maintain clinical research activity, with regulatory changes allowing for the wider implementation and development of decentralized design models. Evidence of the feasibility and benefits associated with a remote design comes mainly from observational studies or phase 2 and 3 clinical trials, in which implementation is easier with a better-established safety profile. Early drug development is a slow and expensive process in which accrual and safety are key aspects of success. Applying a decentralized model to phase 1 clinical trials could improve patient accrual by removing geographic barriers, improving patient population diversity, strengthening evidence for rare tumors, and reducing patients' financial and logistical burdens. However, safety monitoring, data quality, shipment, and administration of the investigational product are challenges to its implementation. Based on published data for decentralized clinical trials, we propose an exploratory framework of solutions to enable the conceptualization of a decentralized model for phase 1 clinical trials.

Sugary snack restriction enhances body composition improvement in overweight women engaging in non-face-to-face walking during COVID-19

Introduction

This study assesses the impact of dietary modification, specifically sugary snack restriction, in conjunction with a brisk walking program on overweight management in young overweight women, with a focus on changes in body composition and glucose metabolism.

Method

An 8-week randomized controlled trial was conducted amidst the COVID-19 pandemic, utilizing a remote intervention approach to comply with health guidelines and ensure participant safety. The study's remote nature highlights adaptability in health interventions during challenging periods, such as the COVID-19 pandemic. Twenty-one overweight Korean women aged 20-39, with an average BMI of 24.6, were selected for the study. They were divided into two groups: one engaging in brisk walking and the other combining this exercise with a sugary snack restriction, demonstrating the study's focus on comparative intervention efficacy.

Results

The exercise-only group showed notable reductions in glucose, insulin, HOMA-IR (p < 0.05), and total cholesterol levels (p < 0.01). In contrast, the group that combined exercise with dietary modification displayed more pronounced improvements in body weight, fat mass, and waist circumference (p < 0.05). This differential outcome emphasizes the added benefit of integrating dietary control with physical activity.

Discussion

The findings suggest that adding a dietary component, particularly a sugary snack restriction, to an exercise regimen can significantly enhance the effectiveness of overweight management in young women. This study underscores the importance of holistic lifestyle interventions that combine dietary and physical activity modifications for improved health outcomes.

Reasons for unsuccessful recruitment of children with atopic dermatitis in primary care in the Netherlands to a cohort study with an embedded pragmatic, randomised controlled open-label trial: a survey

BACKGROUND

The Rotterdam Eczema Study was an observational cohort study with an embedded pragmatic randomised controlled open-label trial. It was conducted in children with atopic dermatitis (AD) in the Dutch primary care system. The objective of the trial was to determine whether a potent topical corticosteroid (TCS) is more effective than a low-potency TCS.

OBJECTIVE

We are aiming to communicate transparently about the poor recruitment for the trial part and to explore the reasons why recruitment was weak.

DESIGN

We used a survey to find out what patients in the cohort did when they experienced a flare-up.

METHODS

Descriptive statistics were used to present the baseline characteristics of participants in the trial and the results of the survey.

RESULTS

In total, 367 patients were included in the cohort. Of these, 32 were randomly assigned to a trial treatment; they had a median age of 4.0 years (IQR 2.0-9.8). A total of 69 of the 86 children (80.2%) who could participate in the survey responded. 39 (56.5%) suffered a flare-up during the follow-up (making them potentially eligible for inclusion in the trial). 26 out of 39 (66.7%) increased their use of an emollient and/or TCS themselves. Only 12 of the 39 (30.7%) contacted their general practitioner (GP) as instructed in the study protocol, but 8 out of these 12 did not meet the inclusion criteria for the trial.

CONCLUSION

The main reason why cohort participants did not take part in the trial was that they did not contact their GPs when they experienced an AD flare-up. Furthermore, the majority of patients who contacted their GPs did not match the inclusion criteria of the trial. We expect that the lessons learnt from this study will be useful when developing future studies of children with AD in primary care.

Exploring the Strategic Use of TikTok for Clinical Trial Recruitment: How audiences' Prior Short-Form Video Usage Influences Persuasive Effects

Guided by the elaboration likelihood model and framing theory, this study explores the potential of short-form video platforms (e.g. TikTok), for targeted clinical trial recruitment. An online experiment compared doctor vs. peer-led videos addressing logistical or psychological barriers to participation, mimicking common TikTok communication tactics. Results indicate that high (vs. low) TikTok users are more persuaded by recruitment messages, and they exhibit stronger intentions to participate in clinical trials. Although doctor-sourced messages generate greater credibility and a more favorable message attitude, peer-sourced messages may be more effective in increasing participation intention. Lastly, doctor-sourced videos that address logistical barriers and peer-sourced videos that discuss psychological barriers result in higher self-efficacy for clinical trial participation. This study contributes to the growing body of research on new media's role in health communication and provides insights into how to strategically utilize TikTok and other short-form video platforms for clinical trial recruitment.

Evaluating the effect of weekly patient-reported symptom monitoring on trial outcomes: results of the Eczema Monitoring Online randomized controlled trial

BACKGROUND

Patient-reported outcome measures (PROMs) are commonly used in eczema clinical trials. Several trials have used PROMs weekly for symptom monitoring. However, the increased frequency of patient-reported symptom monitoring may prompt participants to enhance the self-management of eczema and increase standard topical treatment use that can lead to improvements in outcomes over time. This is concerning as weekly symptom monitoring may constitute an unplanned intervention, which may mask small treatment effects and make it difficult to identify changes in the eczema resulting from the treatment under investigation.

OBJECTIVES

To evaluate the effect of weekly patient-reported symptom monitoring on participants' outcomes and to inform the design of future eczema trials.

METHODS

This was an online parallel-group nonblinded randomized controlled trial. Parents/carers of children with eczema and young people and adults with eczema were recruited online, excluding people scoring < 3 points on the Patient Oriented Eczema Measure (POEM), to avoid floor effects. Electronic PROMs were used for data collection. Participants were allocated using online randomization (1 : 1) to weekly POEM for 7 weeks (intervention) or no POEM during this period (control). The primary outcome was change in eczema severity based on POEM scores, assessed at baseline and week 8. Secondary outcomes included change in standard topical treatment use and data completeness at follow-up. Analyses were conducted according to randomized groups in those with complete data at week 8.

RESULTS

A total of 296 participants were randomized from 14 September 2021 to 16 January 2022 (71% female, 77% white, mean age 26.7 years). The follow-up completion rate was 81.7% [n = 242; intervention group, n = 118/147 (80.3%); control group n = 124/149 (83.2%)]. After adjusting for baseline disease severity and age, eczema severity improved in the intervention group (mean difference in POEM score -1.64, 95% confidence interval -2.91 to -0.38; P = 0.01). No between-group differences were noted in the use of standard topical treatments and data completeness at follow-up.

CONCLUSIONS

Weekly patient-reported symptom monitoring led to a small perceived improvement in eczema severity.