Training Programs for Improving Communication about Medical Research and Clinical Trials: A Systematic Review

Objectives: The aim of this article is to provide recommendations on the structure, materials, and outcomes that should be adopted for communication training programs designed to improve clinical trial education for patients

Assessing Communication Practice during Clinical Trial Recruitment and Consent: The Clinical Trial Communication Inventory (CTCI)

The development and evaluation of training programs with the potential to improve informed consent and accrual to clinical trials depend heavily on the ability to measure outcomes of these trainings. In this chapter, we present the development of an instrument, the clinical trial communication inventory (CTCI). Data were collected from 87 clinical research professionals at three academic medical centers, which were analyzed using factor analytic methods and reliability testing procedures. This testing resulted in eight subscales representing verbal, nonverbal, and privacy protection behaviors. While the final CTCI instrument would benefit from further validity testing, it represents a resource that can be used to evaluate future trainings of research professionals

The art and science of engaging patients into medical research: using professional recruiters' experiences to inform physicians and scientific directors' strategic choices.

In order to advance medical care, it is necessary to invest resources, both human and financial, in medical research. However, these investments sometimes are not sufficient to ensure the success of research studies. No progress can be made without the participation of patients in research studies and clinical trials. These potential participants are normally identified by their physicians, or by professional recruiters, depending on the patient clinical profile. However, often patients are intimidated by the idea of engaging in clinical trials for several reasons, including the fear of side effects, to the difficulty of understanding specific research-related terms. The main objective of this project was to identify the communication strategies used by recruiters to help patients enroll into medical research projects. Another goal of the study was to identify key information that would help PIs and researchers make more effective decisions in terms of design and methodology. A total of 11 focus groups were conducted in two large, ethnically diverse cities: Indianapolis and Miami (USA). Our analyses indicated that recruiters use a variety of verbal and nonverbal communication strategies to create a relationship with potential participants. In addition, recruiters consider the cultural background of the people they interact with, the environment in which they live, the resources available, and the possible support of family members

The role of cognitive absorption in the persuasiveness of multimedia messages

We propose cognitive absorption as a mental state that influences the processing of multimedia messages such as animations. An experiment was designed to assess (1) whether cognitive absorption is experienced when individuals view whiteboard animations; (2) the relationship between cognitive absorption and message elaboration; (3) the relationship between cognitive absorption and outcomes such as perceived argument strength, knowledge, and attitudes related to key concepts relevant to clinical trial participation. The study involved 927 cancer patients and survivors who were exposed to either whiteboard animations or brochures. Several interesting findings emerged. First, individuals experienced greater cognitive absorption while viewing the animations than when reading brochures. Second, cognitive absorption was associated with a systematic elaboration of the information provided by the animations. Third, cognitive absorption mediated the effect the animations had on individuals’ perceived argument strength and attitudes, but not knowledge. Theoretical explanations for the educational and persuasive effects of animations are provided. •Experimental study comparing whiteboard animations and brochures providing information about clinical research.•Individuals experience cognitive absorption when watching whiteboard animations.•Cognitive absorption and individuals' processing of the information from whiteboard animations are positively correlated.•Cognitive absorption mediates perceptions of the strength of the arguments presented.•Recommendations for research on, and practice with, whiteboard animations

Animations about Clinical Trial Participation for Cancer Patients and Survivors

Communicating about clinical trials and medical research is challenging. An appropriate communication is essential to reduce some of the barriers associated with poor patients' enrollment in clinical trials and with patients' uninformed consent or uninformed refusal. An experiment was conducted to assess the effects of educational animations compared to brochures with and without visuals, and with the materials currently used by the NIH. These materials focused on explaining placebos, randomization, the steps necessary to enroll in a clinical trial, and how and by who patients' protection is ensured. A total of 1194 cancer patients and survivors completed this 4 by 4 experiment through a Qualtrics panel. The findings showed that animations improved participants knowledge about and attitudes toward clinical trials and were more effective than brochures presenting information from the NIH, especially for those individuals with low motivation and low ability to comprehend health-related information. Several evidence-based theoretical explanations of the functioning of animations are provided

Underrepresentation of Hispanics and Other Minorities in Clinical Trials: Recruiters' Perspectives

Clinical trials and research studies often fail to recruit participants from the minorities, hampering the generalizability of results. In order to mitigate this problem, the present study investigated how race/ethnicity affects the process of recruiting people from racial and ethnic minority groups, by conducting 11 focus groups with professional recruiters. Several themes emerged, such as how to adapt to potential participants' language competency and literacy levels, the importance to engage in culturally appropriate verbal and non-verbal communication, and to establish a sense of homophily between recruiters and patients. In addition, recruiters pointed out possible solutions to accommodate socioeconomic concerns, to adapt to contextual factors-including immigration status-and ultimately to respond to potential participants' mistrust of medical research. These findings are discussed, and future recommendations are provided

The Effects of Animations and Multimedia Messages on Public Engagement in Precision Medicine: Assessment of Moderation and Mediation

Public participation in precision medicine (PM) research is essential to achieving effective health care but has been impeded by a lack of awareness and basic knowledge. There is a critical need for educational materials that can clearly explain PM to foster involvement. This randomized controlled trial with a posttest-only control group design aims to assess the effects of educational messages delivered through animations relative to live-action videos and leaflets on intentions of involvement in PM research. Knowledge as the moderator and four mediators (engagement, vividness, trustworthiness, and cognitive value) of the intended effects were also evaluated. A total of 326 U.S. adults were sampled from Amazon Mechanical Turk. Among participants with less knowledge about PM, animations produced stronger information-seeking intentions and willingness to participate than leaflets. The effects of three message modalities were not significantly different among average and highly knowledgeable participants. Engagement and vividness mediated the effects of animations relative to two other message modalities. Trustworthiness and cognitive value mediated the effects of animations relative to live-action videos. Overall, animations can be an effective communication strategy to motivate involvement in PM but its effectiveness could decline as knowledge increases. The explanations and implications of the findings were discussed

The Role of Nonverbal Communication Behaviors in Clinical Trial and Research Study Recruitment

Few studies have examined the communication behaviors of those who recruit for clinical trials and research studies, particularly of nonmedical professionals who often do the bulk of recruiting. This focus-group study of 63 recruiters analyzes the ways in which nonverbal communication behaviors support the process of recruitment, using the lens of communication accommodation theory. Results indicate that recruiters first "read" potential study participants' nonverbal communication for clues about their state of mind, then use nonverbal communication to achieve a sense of convergence. Specific nonverbal communication behaviors were discussed by recruiters, including smiling, variations in the use of voice, adjusting body position, the appropriate use of physical touch, the management of eye contact, and the effect of clothing and physical appearance. Implications for recruitment practice are discussed

Clinical Trial and Research Study Recruiters' Verbal Communication Behaviors

The lack of accrual to research studies and clinical trials is a persistent problem with serious consequences: Advances in medical science depend on the participation of large numbers of people, including members of minority and underserved populations. The current study examines a critical determinant of accrual: the approach of patients by professional recruiters who request participation in research studies and clinical trials. Findings indicate that recruiters use a number of verbal strategies in the communication process, including translating study information (such as simplifying, using examples, and substituting specific difficult or problematic words), using linguistic reframing or metaphors, balancing discussions of research participation risks with benefits, and encouraging potential participants to ask questions. The identification of these verbal strategies can form the basis of new communication protocols that will help medical and nonmedical professionals communicate more clearly and effectively with patients and other potential participants about research studies and clinical trials, which should lead to increased accrual in the future

Work with the community or go home: local engagement in Mozambique

A health intervention in a complex crisis, such as the one in Cabo Delgado, Mozambique, can only succeed if the community is effectively engaged and actively participates in the response