title: Understanding barriers to involving community midwives in identifying research participants; experience of the first steps randomised controlled trial.
abstract: OBJECTIVE
  to explore barriers to the involvement of community midwives in identifying women in early pregnancy as potential participants in the first steps study, a randomised controlled trial of a new intervention to provide health and parenting support to potentially vulnerable women.
  
  
  METHODS
  descriptive qualitative investigation using semi-structured audio-recorded interviews.
  
  
  METHODS
  community midwifery offices.
  
  
  METHODS
  volunteer sample of 13 community midwives.
  
  
  METHODS
  themes derived from content analysis.
  
  
  RESULTS
  understanding of their role in the research process was unclear to many midwives. Confusion arose about the difference between potential participant identification and trial recruitment. There were concerns about the eligibility criteria and it was suggested that there was insufficient time during booking appointments, and sometimes insufficient information, to determine potential eligibility. Midwives had concerns about some aspects of the intervention, which incorporated routine midwifery care, and had expectations that women may not like a group programme. This may have led some not to mention the trial. They were, however positive about the programme׳s potential for beneficial impacts on mothers and infants.
  
  
  CONCLUSIONS
  dedicated research midwives may be the best option if research studies need to identify potential participants early in pregnancy, so that they can communicate with all their colleagues.
  
  
  CONCLUSIONS
  if community midwives are asked to be involved in time-critical research they are likely to need additional local resources and support.
authors.affiliation: Institute for the Study of Children, Families and Social Issues, Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK. Electronic address: j.stuart@bbk.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Stuart
authors.affiliation: Institute for the Study of Children, Families and Social Issues, Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK. Electronic address: jacqueline.barnes@bbk.ac.uk.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Barnes
authors.affiliation: School of Health Sciences, 12th Floor, Tower Building, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: helen.spiby@nottingham.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Spiby
authors.affiliation: Department of Medical Statistics, London School of Hygiene and Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK. Electronic address: Diana.elbourne@lshtm.ac.uk.
authors.forename: Diana
authors.initials: D
authors.lastname: Elbourne
mesh_terms: D003144:Communication Barriers; D003153:Community Health Services; D005260:Female; D006801:Humans; D008427:Maternal Health Services; D008880:Midwifery; D018579:Patient Selection; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Pregnancy; Qualitative methods; RCTs; Recruitment