title: Barriers and facilitators to recruitment in mental health services: care coordinators' expectations and experience of referring to a psychosis research trial.
abstract: OBJECTIVE
  High-quality research trials are necessary to provide evidence for the effective management of mental health difficulties, but successful recruitment can be challenging.
  
  
  METHODS
  This qualitative study examines the perceived barriers and facilitators to referring mental health service users to research trials. Seven care coordinators (n = 7) who facilitated the recruitment of participants to a cognitive behaviour therapy - informed psychosis intervention trial were interviewed.
  
  
  METHODS
  Demographic information was collected by questionnaire and a semi-structured guide was used to explore barriers and facilitators to referring to a partially randomized participant preference trial. Qualitative data were thematically analysed.
  
  
  RESULTS
  Four key themes, each with a number of sub-themes, were identified: (1) engage the care coordinator in the recruitment process, (2) barriers to referring to research studies, (3) facilitators to referring to research studies; (4) organisational constraints impact on implementing research outcomes into routine clinical practice.
  
  
  CONCLUSIONS
  Understanding the barriers and facilitators to recruitment in mental health research could improve recruitment strategies. Our findings highlight the need for researchers' to closely consider their recruitment strategies as service users are not always given the choice to participate in research. Several key recommendations are made based on these findings in order to maximize successful recruitment to research studies. Overall, we recommend that researchers' adopt a flexible, tailor-made approach for each clinical team to ensure a collaborative relationship is developed between research staff and clinicians.
  
  
  CONCLUSIONS
  A qualitative approach to understanding recruitment challenges provides a useful opportunity to explore the barriers and facilitators to recruiting participants to research studies. These findings have practical implications that highlight the need for a collaborative partnership between researchers and clinical services. Understanding the challenges and issues related to recruitment can help researchers consider strategies to overcome recruitment issues. More research with a larger sample, across a broader population and in different mental health services is required.
authors.affiliation: School of Psychological Sciences, University of Manchester, UK.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bucci
authors.affiliation: School of Psychological Sciences, University of Manchester, UK.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Butcher
authors.affiliation: School of Psychological Sciences, University of Manchester, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Hartley
authors.affiliation: Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK.
authors.forename: Sandra T
authors.initials: ST
authors.lastname: Neil
authors.affiliation: The Beacon, Mersey Care NHS Trust at HMP Garth Prison, Preston, UK.
authors.forename: John
authors.initials: J
authors.lastname: Mulligan
authors.affiliation: School of Psychological Sciences, University of Manchester, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Haddock
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D019090:Case Management / Q000592:standards; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards; D008875:Middle Aged; D018579:Patient Selection; D011618:Psychotic Disorders / Q000628:therapy*; D036301:Qualitative Research; D012017:Referral and Consultation / Q000592:standards*
keywords: care coordinators; case managers; gatekeeping; psychosis; randomized controlled trial; recruitment