Background Effective recruitment of patients by health professionals is challenging but pivotal to the success of clinical trials. Many trials fail to include the required number of participants, which affects the power of the study, generalizability of results, and timely dissemination of positive outcomes. Existing research is inconclusive regarding factors influencing recruitment results, and most research does not focus on perceptions of recruiting health professionals themselves. Therefore, thorough evaluations of recruitment facilitators and barriers in trials are needed in order to optimize future patient recruitment in trials. We observed divergent recruitment results among nurses who recruited diabetes patients to our trial, which examined the effectiveness of an eHealth programme. Therefore, we aimed to describe nurses’ recruitment results and related shifts over time, and to qualitatively explore factors influencing nurses’ recruitment results. Methods Nurses’ recruitment results and related temporal shifts were derived from trial data (NTR6840). Based on their recruitment results, nurses were categorized as non-, low-, medium-, or high-recruiters. Subsequently, a subset of nurses per group participated in an individual semi-structured telephone interview. Interviews were analysed using NVivo software, applying an inductive coding approach. Results Ninety-six nurses participated in our trial and recruited on average seven patients (range: 0–32). Fifteen nurses did not recruit any patients. Most patients were recruited close to recruitment onset. Nurses who did not recruit patients close to recruitment onset generally ended up recruiting no patients. Data show a relatively high number of early recruited patients that progressively declined over time. High-recruiters were generally successful throughout the entire recruitment period. Recruitment facilitators and barriers comprised organizational, study, patient, and especially recruiter characteristics. Contrary to non- and low-recruiters, medium- and high-recruiters reported more in-depth knowledge about the study and trial requirements, expressed more personal participation-related benefits and fewer barriers, and incorporated more recruitment activities, reminders, and barrier-focused coping strategies. Conclusion and implications To optimize patient recruitment to clinical trials, suggested intervention targets include the continued inclusion of recruiters after initial recruitment onset and the encouragement of early recruitment success. A personalized approach may aid recruiters to become and remain successful. Primarily, it is important to provide recruiters with sufficient information on trial requirements and to address salient benefits for participation in the trial, both for themselves and for their patients. Finally, teaching recruiters skills on how to overcome barriers may further enhance motivation and recruitment capacities.

中文翻译：

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一项随机对照试验对糖尿病患者招募护士招募结果的影响因素探讨

背景 卫生专业人员有效招募患者具有挑战性，但对临床试验的成功至关重要。许多试验未能包括所需数量的参与者，这会影响研究的效力、结果的普遍性以及积极结果的及时传播。现有研究对影响招聘结果的因素没有定论，而且大多数研究并不关注招聘卫生专业人员本身的看法。因此，需要对试验中的招募促进因素和障碍进行彻底评估，以优化未来试验中的患者招募。我们观察到招募糖尿病患者参加我们试验的护士的不同招募结果，该试验检查了电子健康计划的有效性。所以，我们旨在描述护士招聘结果和相关随时间的变化，并定性探索影响护士招聘结果的因素。方法护士的招聘结果和相关的时间变化来自试验数据（NTR6840）。根据招聘结果，护士被分为非招聘人员、低招聘人员、中招聘人员或高级招聘人员。随后，每组的一部分护士参加了单独的半结构化电话采访。访谈使用 NVivo 软件进行分析，采用归纳编码方法。结果 96 名护士参加了我们的试验，平均招募了 7 名患者（范围：0-32）。15 名护士没有招募任何患者。大多数患者在招募开始时招募。接近招募开始时没有招募患者的护士通常最终没有招募患者。数据显示，随着时间的推移，早期招募的患者人数相对较多。在整个招聘期间，高级招聘人员通常都很成功。招聘促进因素和障碍包括组织、研究、耐心，尤其是招聘人员的特征。与非和低招聘者相反，中高招聘者对研究和试验要求的了解更深入，表达了更多与个人参与相关的好处和更少的障碍，并加入了更多的招聘活动、提醒和障碍——重点应对策略。结论和意义 为了优化临床试验的患者招募，建议的干预目标包括在最初招募开始后继续让招募人员参与进来，并鼓励早期招募成功。个性化的方法可以帮助招聘人员成为并保持成功。首先，重要的是向招募者提供有关试验要求的足够信息，并说明参与试验的显着益处，无论是对他们自己还是对他们的患者。最后，教授招聘人员如何克服障碍的技能可以进一步提高动机和招聘能力。重要的是要向招募者提供有关试验要求的足够信息，并说明参与试验对他们自己和患者的显着好处。最后，教授招聘人员如何克服障碍的技能可以进一步提高动机和招聘能力。重要的是向招募者提供有关试验要求的足够信息，并说明参与试验对他们自己和患者的显着好处。最后，教授招聘人员如何克服障碍的技能可以进一步提高动机和招聘能力。