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Tactful screening & participant sensitivity

Screening participants can involve asking personal questions that could be perceived as intrusive. Here CMR explores the implications of such lines of questioning.

When a client contacts CMR with a view to conducting research with patients, they typically have a clear picture of their target participant in mind. For example;

  • Demographic criteria - aged between 18 and 45 years, equal split between male and female.
  • Medical requirements - living with a specific condition, following a particular therapy type, user of a specific medical device, user of that device for at least a year.
  • Then, depending on the nuances of the project, perhaps something slightly more abstract, such as affinity to technology or a particular personality trait or mindset

And so, a screening questionnaire is created, in order to identify a set of individuals whose specific characteristics align with a pre-defined set of criteria. This process is also constricted to an extent by the BHBIA guidelines for healthcare market research, which states; “Screeners should be used purely for recruitment purposes and not data collection. All questions included should screen respondents in or out. Screening interviews should be concluded when a respondent is definitively screened out”, thus ensuring that the questions asked to potential respondents really do serve a purpose. All in all, a straight-forward, tick-box exercise? Not always.

Approaching screening questions with tact and sensitivity

Given the nature of the work we do here at CMR, it’s not uncommon for screeners to contain questions that if not handled skilfully, even in the context of establishing eligibility for a market research study, could leave the potential participant feeling uncomfortable. Let’s look at a few examples;

  • Combined household income
    • Relevant in the context of a medical device that is widely self-funded in the UK
    • If below £35,000 per annum > screen out
  • Have you ever been diagnosed with any of the following conditions?
    • Relevant in the context of dealing with needles where there is a risk of needlestick to both participant and moderator
    • If HIV positive > screen out
  • Current weight and amount of weight lost (in a given time period)
    • Relevant in the context of a study on obesity and successful weight loss
    • If not lost more than ‘X’ > screen out
  • Are you sexually active (and currently using birth control?)
    • Relevant in the context of contraceptives
    • Not sexually active > screen out

This is where the process is far from black and white and requires a tactful approach, remembering that behind the characteristics of a potential participant, is an individual with feelings.

Providing ‘just enough’ information

At the beginning of a screening call, we give as much information as possible to the person about the project, with a view to providing the background to some of those seemingly personal questions. It’s also important to cover everything that will latterly be included within the participant recruitment agreement, ensuring that there are no surprises further down the line. This is balanced with the need to withhold some of the finer project details, to avoid impacting how they behave and what they say during the research, should they be selected to participate. Whilst uncommon, there are times where potential participants choose not to answer certain ‘personal’ questions which, of course, is well within their rights. However, particularly when recruiting for niche participants with a specific set of characteristics, the last thing we want is for someone who meets all the criteria to be ‘turned off’ by one specific question. After all, the research we conduct depends on the willingness of others to take part, hence the importance of approaching that screening call with understanding.

Screening out - without offending

When it comes to ineligible participants, do we really want to stop the process to say “unfortunately you do not earn enough to take part in this research” or similarly, “you haven’t lost enough weight to take part in this research”? If someone screens out at a sensitive criterion, we take the approach of completing the screener and concluding politely that they are not right for this particular project, without highlighting on what grounds they have been excluded. The key here, is leaving them on a positive note, ensuring that they remain open to future projects that we and our clients may well need them for.

Laying the foundations for a high-quality research experience

Finally, whilst the screener takes place prior to the research and is much more practical in its intention i.e. asking short, non-exploratory questions in order to establish eligibility, it’s important to remember that even at this early stage, expectations for the study are being built and if a person is ineligible, the exchange could impact their decision to take part in future research. As such, a conversational approach to the screening ‘script’ goes a long way to making the individual feel valued; “I’m so sorry to hear you are unwell, would you be willing to talk to us about your condition?” A more personable style also serves to demonstrate empathy, particularly when it comes to the questions that for us simply establish the facts, but for them, could stir emotions.

In summary, it would be easy for the screening process to become very mechanical, focusing on the project requirements and the task at hand. However, given that we work in the healthcare space, we must also carefully consider the participants’ needs, treating them with dignity and respect. As such, the screening process requires tact, balancing the needs of the client with those of a potential participant - remembering that the first point of interaction with a participant, is not only fundamental in ensuring the success of the research project at hand, but may also have an impact on future research studies.

23rd July 2019

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Creative Medical Research

01473 832211

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Address:
9 Pegasus
Orion Court
Great Blakenham
Ipswich
IP6 0LW
United Kingdom

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