Reframing Recruitment: Evaluating Framing in Authorization for Research Contact Programs

Candace D. Speight, Charlie Gregor, Yi An Ko, Stephanie A. Kraft, Andrea R. Mitchell, Nyiramugisha K. Niyibizi, Bradley G. Phillips, Kathryn M. Porter, Seema K. Shah, Jeremy Sugarman, Benjamin S. Wilfond, Neal W. Dickert

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: The changing clinical research recruitment landscape involves practical challenges but introduces opportunities. Researchers can now identify large numbers of eligible patients through electronic health record review and can directly contact those who have authorized contact. Applying behavioral science-driven strategies to design and frame communication could affect patients’ willingness to authorize contact and their understanding of these programs. The ethical and practical implications of various strategies warrant empirical evaluation. Methods: We conducted an online survey (n = 1070) using a nationally-representative sample. Participants were asked to imagine being asked for authorization for research contact in clinic. They were randomly assigned to view one of three flyers: #1-neutral text flyer; #2-a positive text flyer; or #3-positive graphics-based flyer. Primary outcomes included likelihood of enrollment and comprehension of the program. Chi-Square tests and regression analyses were used to examine whether those who saw the positive flyers were more likely to enroll and had increased comprehension. Results: Compared to the neutral flyer, individuals who received the positive text flyer were numerically more likely to enroll, but this was not statistically significant (24.2% v. 19.0%, p = 0.11). Individuals who received the positive graphics flyer were more likely to enroll (28.7% v. 19.0%, p = 0.002). After adjustment, individuals assigned to both novel flyers had increased odds of being likely to enroll (OR = 1.55 95%CI [1.04, 2.31] and OR = 1.95 95%CI [1.31, 2.91]). Flyer type did not affect overall comprehension (p = 0.21), and greater likelihood of enrollment was observed only in individuals with better comprehension. Conclusions: This study demonstrated that employing behavioral science-driven communication strategies for authorization for research contact had an effect on likelihood of hypothetical enrollment but did not significantly affect comprehension. Strategies using simple, positive language and visual tools may be effective and ethically appropriate. Further studies should explore how these and other approaches can help to optimize research recruitment.

Original languageEnglish (US)
Pages (from-to)206-213
Number of pages8
JournalAJOB Empirical Bioethics
Issue number3
StatePublished - 2021


  • Informed consent
  • clinical research
  • electronic health records
  • recruitment
  • research ethics
  • survey

ASJC Scopus subject areas

  • Health(social science)
  • Philosophy
  • Health Policy


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