Cancer Division, University College Hospitals NHS Foundation Trust, London, UK.
School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
BMJ Open. 2017 Nov 8;7(11):e018291. doi: 10.1136/bmjopen-2017-018291.
BRIGHTLIGHT is a national evaluation of cancer services for teenagers and young adults in England. Following challenges with recruitment, our aim was to understand more fully healthcare professionals' perspectives of the challenges of recruiting young people to a low-risk observational study, and to provide guidance for future recruitment processes.
Qualitative.
National Health Service (NHS) hospitals in England.
Semistructured telephone interviews with a convenience sample of 23 healthcare professionals. Participants included principal investigators/other staff recruiting into the BRIGHTLIGHT study. Data were analysed using framework analysis.
The emergent themes were linked to levels of research organisational management, described using the levels of social network analysis: micro-level (the individual; in this case the target population to be recruited-young people with cancer); meso-level (the organisation; refers to place of recruitment and people responsible for recruitment); and macro-level (the large-scale or global structure; refers to the wider research function of the NHS and associated policies). Study-related issues occurred across all three levels, which were influenced by the context of the study. At the meso-level, professionals' perceptions of young people and communication between professionals generated age/cancer type silos, resulting in recruitment of either children or adults, but not both by the same team, and only in the cancer type the recruiting professional was aligned to. At the macro-level the main barrier was discordant configuration of a research service with a clinical service.
This study has identified significant barriers to recruitment mainly at the meso-level and macro-level, which are more challenging for research teams to influence. We suggest that interconnected whole-system changes are required to facilitate the success of interventions designed to improve recruitment. Interventions targeted at study design/management and the micro-level only may be less successful. We offer solutions to be considered by those involved at all levels of research for this population.
BRIGHTLIGHT 是一项针对英格兰青少年和年轻癌症患者服务的全国性评估。在招募工作面临挑战后，我们的目的是更全面地了解医疗保健专业人员对招募低风险观察性研究中年轻人的挑战的看法，并为未来的招募流程提供指导。
定性研究。
英格兰国民保健署（NHS）医院。
采用便利抽样法，对 23 名参与 BRIGHTLIGHT 研究的医疗保健专业人员进行半结构式电话访谈。数据采用框架分析法进行分析。
出现的主题与研究组织管理水平有关，使用社会网络分析的水平来描述：微观层面（个体；在这种情况下，即招募的目标人群——患有癌症的年轻人）；中观层面（组织；指招募地点和负责招募的人员）；宏观层面（宏观层面；指 NHS 的大规模或全球结构以及相关政策）。与研究相关的问题发生在所有三个层面，这些问题受到研究背景的影响。在中观层面，专业人员对年轻人的看法以及专业人员之间的沟通导致了年龄/癌症类型的隔阂，导致要么由同一个团队招募儿童，要么招募成人，但不能同时招募，而且只能招募与招募专业人员所属癌症类型相匹配的患者。在宏观层面，主要障碍是研究服务与临床服务的配置不匹配。
本研究确定了主要在中观和宏观层面上的招募障碍，这些障碍对研究团队的影响更大。我们建议需要进行相互关联的全系统变革，以促进旨在改善招募的干预措施的成功。针对研究设计/管理和微观层面的干预措施可能效果较差。我们为所有参与研究的人员提供了针对这一人群的解决方案。
