title: A qualitative study of recruiting for investigations in primary care: Plan, pay, minimise intermediaries and keep it simple.
abstract: OBJECTIVE
  We sought successful strategies to recruit patient and practitioner participants for studies from primary care.
  
  
  METHODS
  We interviewed people who had participated and who had not participated in a randomised controlled trial that did not reach recruitment target and successful primary care researchers. The participants and non-participants were mostly Pacific peoples. Interviews were recorded, transcribed, and analysed and reported using qualitative description. The study took place in New Zealand in 2013-2014.
  
  
  RESULTS
  A total of 31 people were interviewed. Researchers agreed that recruitment was usually the single most important phase of research but was usually under-planned and under-funded. All researchers recommended a pilot study that addressed recruitment. Successful researchers actively monitored recruitment and adapted the process as needed. Most projects were undertaken by our researchers recruited via an intermediary such as a general practice nurse. Strategies were adapted to the target population, such as specific acute or chronic conditions, age, ethnicity and gender. Intermediaries were actively recruited and retained in a manner that was often more intense than actual participant recruitment and retention. 'Layers' of intermediaries were kept to a minimum as each layer needed to be actively recruited and retained and each layer reduced participant recruitment rates. The task of intermediaries was kept simple and minimal and they were paid in some manner. Similarly, participant workload was kept to a minimum and they were paid in some manner that was intended to cover their participation costs and perhaps a little more. Even the most experienced researchers did not always achieve recruitment targets. Our interviews focused on patient participants but included recruiting general practitioners, nurses and others as research subjects.
  
  
  CONCLUSIONS
  Strategy details varied with the target population but had in common the need to intensively recruit and retain intermediaries, minimise layers of intermediaries, and the need to pay and minimise workload for both intermediaries and participants.
authors.affiliation: Departments of Medicine and General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Kenealy
authors.affiliation: Community & Public Health Advisory Committee, Counties Manukau District Health Board, Auckland, New Zealand.
authors.forename: Sefita
authors.initials: S
authors.lastname: Hao'uli
authors.affiliation: Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand.
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
keywords: Recruitment; family practice; general practice; patient selection; primary health care; research design