4-year PhD Studentship: Using a QuinteT Recruitment Intervention to optimise recruitment of people from ethnic minority groups to randomised controlled trials in the UK: a feasibility study

Ethnic minority (EM) groups are disproportionately affected by ill health (e.g. diabetes, cardiovascular diseases) and report poorer quality of life and access to/experiences of healthcare services than their White peers.[1] Yet, they are consistently under-represented in health research,[2] with this paradox notably laid bare during the covid-19 pandemic and related research.[3] Inclusion of ethnic minorities in clinical trials is acknowledged to be instrumental in ensuring trial participants are representative of the wider population and has been prioritised through guidance issued in the US/UK.[4,5] Systematic reviews have identified barriers/facilitators and strategies to recruit EM groups to health research,[6] but there is little rigorously evaluated evidence for the same.

The QuinteT Recruitment Intervention (QRI)[7] is a well-established approach that has been applied to about 70 randomised controlled trials (RCTs) over two decades, aimed at optimising recruitment and informed consent. It involves two iterative phases i) to understand recruitment challenges (through methods such as staff/patient interviews; audio-recordings of trial discussions) and ii) to collaboratively develop/implement a plan of action to overcome identified challenges. QRI’s flexibility, problem-solving and applied nature, and ability to draw from existing literature while also tailoring strategies to individual RCTs makes it amenable to being applied to optimise EM recruitment.

Aims and objectives

The overarching aim is to investigate the feasibility of optimising recruitment of EM groups to RCTs using the QRI approach,[7] situated within a participatory action research framework.[8]

Objectives:

a. To identify barriers, facilitators and strategies to recruit EM groups as reported in the wider literature

b. To explore the feasibility of applying established QRI methods alongside participatory research methods to understand the barriers to recruiting EM groups (in specific RCTs) and to co-produce and implement strategies to overcome the barriers

c. To identify methods that can be integrated within ongoing or new QRIs, as necessary, to optimise EM recruitment

Methodology

The student will employ aspects of the QRI,[7] guided by principles of participatory action research,[8] where researchers and participants work together to enable redressing power imbalances inherent in traditional research approaches. A patient and public involvement (PPI) group comprising people from EM groups will be convened to discuss/provide input into study components below.

a. A review of reviews/grey literature to map established barriers/facilitators and strategies to recruit EM groups to RCTs will be undertaken, with findings presented to PPI members. Next steps and end-of-study criteria to assess feasibility of methods will be agreed upon.

b. Above discussions will inform methods to understand barriers to EM recruitment in chosen RCTs, including established QRI methods (e.g., interviews with trial staff, eligible patients who accept/decline participation; audio-recordings/observations of trial discussions) as applied to EM groups and other suitable methods.

c. Findings will be discussed with the PPI and wider EM groups, using participatory methods (e.g., world café) to co-produce strategies to overcome the identified barriers.

d. Feasibility of above methods will be assessed against pre-determined criteria (set in ‘a’) and recommendations made for methods that can be integrated within ongoing/new QRIs.

The student will develop skills in EM research; QRI; qualitative research; PPI.

How to apply for this project

This project will be based in Bristol Medical School - Population Health Sciences in the Faculty of Health Sciences at the University of Bristol.

Please visit the Faculty of Health Sciences website for details of how to apply