Recruitment Techniques Used for Clinical Trials and the Potential Impact of Nudges: Qualitative Interview Study with Recruiters.

Abstract

While clinical trials are essential to improving public health, little research has examined the range of recruitment techniques used or whether they involve behavioral nudges. Behavioral nudges have been defined as "any aspect of the choice architecture [the manner in which options are presented] that alters people's behavior in a predictable way without forbidding any options or significantly changing their economic incentives"; these may influence individuals' autonomy in deciding to participate. To investigate, the study team conducted 39 semi-structured interviews with clinical trial recruiters at two academic medical centers, asking about their recruitment techniques and any perceived ethical concerns. Through inductive qualitative analysis, five main themes emerged: impact of relationships (among recruiters, healthcare teams, and participants), financial compensation, community benefit, study risks and benefits, and personalized study information. The study then assessed whether these techniques were seen as nudges and explored their ethical implications for informed decision-making.