Providing multimedia information to children and young people increases recruitment to trials: pre-planned meta-analysis of SWATs

Peter Knapp*, Thirimon Moe-Byrne, Jacqueline Martin-Kerry, Rebecca Sheridan, Jenny Roche, Elizabeth Coleman, Peter Bower, Steven Higgins, Catherine Stones, Jonathan Graffy, Jenny Preston, Carrol Gamble, Bridget Young, Daniel Perry, Annegret Dahlmann-Noor, Mohamed Abbas, Payal Khandelwal, Siobhan Ludden, Augusto Azuara-Blanco, Emma McConnellNicky Mandall, Anna Lawson, Chris A Rogers, Helena J M Smartt, Rachael Heys, Simon R Stones, Danielle Horton Taylor, Sophie Ainsworth, Jenny Ainsworth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Randomised controlled trials are often beset by problems with poor recruitment and retention. Information to support decisions on trial participation is usually provided as printed participant information sheets (PIS), which are often long, technical, and unappealing. Multimedia information (MMI), including animations and videos, may be a valuable alternative or complement to a PIS. The Trials Engagement in Children and Adolescents (TRECA) study compared MMI to PIS to investigate the effects on participant recruitment, retention, and quality of decision-making.

METHODS: We undertook six SWATs (Study Within A Trial) within a series of host trials recruiting children and young people. Potential participants in the host trials were randomly allocated to receive MMI-only, PIS-only, or combined MMI + PIS. We recorded the rates of recruitment and retention (varying between 6 and 26 weeks post-randomisation) in each host trial. Potential participants approached about each host trial were asked to complete a nine-item Decision-Making Questionnaire (DMQ) to indicate their evaluation of the information and their reasons for participation/non-participation. Odds ratios were calculated and combined in a meta-analysis.

RESULTS: Data from 3/6 SWATs for which it was possible were combined in a meta-analysis (n = 1758). Potential participants allocated to MMI-only were more likely to be recruited to the host trial than those allocated to PIS-only (OR 1.54; 95% CI 1.05, 2.28; p = 0.03). Those allocated to combined MMI + PIS compared to PIS-only were no more likely to be recruited to the host trial (OR = 0.89; 95% CI 0.53, 1.50; p = 0.67). Providing MMI rather than PIS did not impact on DMQ scores. Once children and young people had been recruited to host trials, their trial retention rates did not differ according to intervention allocation.

CONCLUSIONS: Providing MMI-only increased the trial recruitment rate compared to PIS-only but did not affect DMQ scores. Combined MMI + PIS instead of PIS had no effect on recruitment or retention. MMIs are a useful tool for trial recruitment in children and young people, and they could reduce trial recruitment periods.

Original languageEnglish
Article number244
Number of pages16
JournalBMC Medicine
Issue number1
Publication statusPublished - 4 Jul 2023

Bibliographical note

© 2023. The Author(s).


  • Adolescent
  • Humans
  • Child
  • Multimedia
  • Patient Selection
  • Surveys and Questionnaires
  • Randomized Controlled Trials as Topic

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