title: More than the money: a review of the literature examining healthy volunteer motivations.
abstract: OBJECTIVE
  Few existing data report the motivations of healthy volunteers in clinical research trials. Some worry that volunteers consider only financial motivations. This study summarized and analyzed existing empirical research on self-reported motivations of healthy volunteers participating in studies not intended to offer benefit from participation.
  
  
  METHODS
  A systematic PubMed search was conducted. Inclusion criteria captured English-language empirical studies on the self-reported motivations, reasons, or factors influencing the decision of healthy volunteers to enroll in clinical research. Thirteen studies involving more than 2000 healthy volunteers met the criteria and were included in this review.
  
  
  METHODS
  Independent review by the authors and extraction of information about the sample, methodology and objectives of the motivations study, description of the clinical trial and whether participation was actual or hypothetical, reported primary and secondary motivations of the healthy volunteers, risk evaluation, and reported differences in motivations related to sociodemographic variables.
  
  
  RESULTS
  This review showed that although financial reward is the primary motivation for healthy volunteers to participate in clinical trials, financial motivations are one among many other reported motivations, including contributing to science or the health of others, accessing ancillary healthcare benefits, scientific interest or interest in the goals of the study, as well as meeting people and curiosity. Volunteers consider risk when making a decision about participation.
  
  
  CONCLUSIONS
  Although financial incentives are important in recruiting healthy volunteers, their motivations are not limited to financial motivations. Further research is needed to examine motivations in different contexts and countries, the decision making of healthy volunteers, and the dynamics of repeat participation.
authors.affiliation: Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Leanne
authors.initials: L
authors.lastname: Stunkel
authors.forename: Christine
authors.initials: C
authors.lastname: Grady
mesh_terms: D002986:Clinical Trials as Topic / Q000191:economics / Q000523:psychology*; D064368:Healthy Volunteers / Q000523:psychology*; D006801:Humans; D009042:Motivation; D018579:Patient Selection; D018570:Risk Assessment; D012959:Socioeconomic Factors