Overcoming Barriers in Incentive Management: Organizational Empowerment Enhancing Patient Engagement in Clinical Research
Aims of Research: Expanding global trial access ensures sustainability by incorporating local contexts and prioritizing patient engagement. This research explores how Organizational Empowerment (OE) and incentive management enhance patient involvement in clinical trials, with Contract Research Organizations (CROs) playing a key role. We propose a paradigm shift based on Grothe-Hammer’s organizational contributorship, where participation replaces formal membership, enabling active decision-making and engagement. Methods: This qualitative research with holistic case study approach explores the role of incentive management in Organizational Empowerment (OE) within Contract Research Organizations (CROs). Through interviews and analysis, it examines the impact of incentive structures on both employees and patients, assessing their effectiveness in aligning organisational goals with patient-centricity principles. Results: A key outcome of the study is the call for a shift in patient roles, proposing that patients transition from non-contributing to contributing members within the organization. The study demonstrates that patient-centered interventions, including logistical and financial support through third-party organizations, can enhance patient retention, engagement, and diversity in clinical trials. These interventions benefit both patients and the organizations by improving trial efficiency and reducing dropout rates. In advancing the field, this research makes a contribution by integrating organizational theory with clinical research management practices, a perspective that has been underexplored. The application of institutional theory to understand regulatory frameworks and their impact on incentive management reveals how external constraints shape organizational behavior. Conclusion: The clinical trial ecosystem relies on collaboration among stakeholders to enhance patient care, requiring a shift toward a patient-centric model for better treatment adherence and outcomes. This study highlights the role of Organizational Empowerment (OE) and incentive management in fostering inclusivity, advocating for contributorship over traditional membership to strengthen stakeholder engagement in clinical research. Keywords: incentive management, organisational empowerment, patient centricity, clinical trials, CRO
- Research Article
6
- 10.1007/s40271-020-00436-5
- Jul 29, 2020
- The patient
The updated international draft guidelines, the "General Considerations for Clinical Studies, ICH E8 (R1)", state that patient engagement ensures that all perspectives are captured in the research process; however, this is not well understood, specifically in Japan. This study examined the current status and perceptions of patient engagement in clinical research from the perspectives of patient groups, pharmaceutical corporations, and researchers in Japan, using anonymous self-administered questionnaires. Three online surveys were conducted with patient groups (n = 100), pharmaceutical corporations (n = 66), and researchers (n = 300) in May and June 2019. The main variables were the current status and the current perception of patient engagement in clinical research. The response rate was 71% for patient groups and 85% for pharmaceutical corporations, and there were 300 valid responses (emergence rate: 4.9%) from researchers. Experiences with clinical research involving patient engagement were reported by 76.5% of the patients, 21.4% of the pharmaceutical corporations, and 51.7% of the researchers. Patient groups reported three major factors that negatively impacted their relationship with pharmaceutical corporations and researchers: (1) 'lack of understanding of the benefits of partnering'; (2) 'lack of transparency or openness'; and (3) 'unclear or ill-defined processes'. Pharmaceutical corporations in Japan have less experience with patient engagement in clinical research than other stakeholders. A neutral connecting system among the stakeholders with a constructive co-learning system will allow effective involvement/engagement of patient groups for enhancing the effectiveness of clinical research.
- Research Article
8
- 10.1177/2374373521998852
- Jan 1, 2021
- Journal of Patient Experience
Despite the fact that millions of individuals living in the United States are coping with disabilities associated with traumatic brain injury (TBI), limited work has explored strategies for patient engagement in research among those with such injuries. The Coalition for Recovery and Innovation in Traumatic Brain Injury Care Across the Lifespan (CRITICAL) brought together those living with TBI, caregivers, clinicians, researchers, and advocates with the goal of developing a new patient-centered research agenda. This platform was also used to explore strategies to engage those with moderate to severe TBI in the research process. The CRITICAL was formed of 6 survivors of moderate to severe TBI, 2 caregivers of survivors of moderate to severe TBI, and 8 TBI professionals. The CRITICAL identified 3 priority topic areas: Relationship Quality, Caregiver Needs, and Thriving. Furthermore, strategies associated with Communication, Preparation, and the Environment facilitated research engagement. Employing the strategies outlined in this article is expected to promote patient engagement in clinical research, which can improve patient-centered interventions and outcomes for individuals living with TBI.
- Research Article
- 10.1111/jocn.70401
- Jun 19, 2026
- Journal of clinical nursing
To identify and map evidence on factors that influence nurses' engagement in clinical research. A scoping review was conducted in accordance with the JBI methodology. First, titles and abstracts of articles, then full-text articles, were screened by two independent researchers against inclusion and exclusion criteria. Data was extracted into a data extraction table. Findings from articles were synthesized using thematic analysis. Searches were conducted in Medline All (Ovid), Embase (Ovid), APA PsycInfo (Ovid), CINAHL Plus with Full Text (Ebsco) and Scopus on April 28, 2025. Seventy-nine articles were included in this review. There were significant barriers that prevented nurses from engaging in research, including: lack of time, inadequate training, negative internal beliefs, insufficient organizational support and an unsupportive research culture. Factors that facilitated nurses' engagement in research included: research infrastructure, training and mentorship, visionary leadership, unit-level support, improved motivational components and enhanced organizational research culture. A multi-level framework and strategic recommendations are provided, along with an overview of the 23 interventions reported in the included articles are provided. Nurses are constrained from conducting research to generate nursing knowledge due to multiple barriers. Visionary leadership is needed that prioritizes nursing research, establishes infrastructureand creates a culture of research excellence to enhance the quality and safety of nursing care. Healthcare organizations should support nursing research by providing nurses with paid release time from their clinical duties and building an accessible infrastructure. Infrastructure can include programmes, centres and academic-practice partnerships that provide nurses with access to research training, experienced mentorship, librarian and statistical support, grant and manuscript writing assistance and funding pathways for small and large studies. This scoping review is reported in accordance with the PRISMA-ScR guidelines. No patient or public contribution. Registered with the Open Science Framework: 10.17605/OSF.IO/5VWE9 (12/03/25).
- Research Article
- 10.1016/j.aucc.2026.101630
- Jun 19, 2026
- Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
Enhancing the adoption of patient engagement in critical care research: Insights from a qualitative study.
- Research Article
14
- 10.1016/j.clinthera.2019.07.018
- Aug 1, 2019
- Clinical Therapeutics
Assessing Biopharmaceutical Company Experience with Patient-centric Initiatives
- Research Article
- 10.54920/scto.2021.rawatch.6.31
- Oct 1, 2021
- Regulatory Affairs Watch
While the concept of patients as partners in clinical research is becoming increasingly prevalent, there is still room for improvement. The development and validation of partnership models to engage patients in the design and governance of clinical research programmes are still in the early stages, and approaches that can ensure substantial and effective patient contributions to research are needed. In this article, we describe the patient partnership model being developed at Geneva University Hospitals (HUG) to engage patients and their caregivers in the design of clinical research studies and to encourage research groups in their efforts to involve patients within their teams.
- Research Article
- 10.35460/2546-1621.2025-0233
- Oct 26, 2025
- Journal of Medicine, University of Santo Tomas
This editorial looks at the concept of artificial intelligence (AI) as a “new digital species,” emphasizing its growing influence in medicine, education, and research. AI’s capacity for communication, reasoning, and data analysis offers transformative opportunities—from adaptive learning and virtual simulations in medical education to improved trial design and patient engagement in clinical research. However, ethical challenges such as bias, fairness, and data privacy demand vigilant governance and responsible use. The Journal of Medicine, UST (JMUST) continues to embrace digital innovation through its electronic publishing platform, contributing to global medical knowledge while upholding academic integrity and collaboration. Keywords: artificial intelligence, digital species, medical education, clinical research, ethics, bias, JMUST, governance
- Research Article
- 10.1158/1538-7445.am2023-714
- Apr 4, 2023
- Cancer Research
Following the advent of groups like PCORI, patient engagement in clinical research is no longer a novel concept. However, involvement of lay stakeholders in areas such as artificial intelligence or biomedical informatics can pose challenges. Community stakeholder involvement in cancer research can prove especially challenging as cancer has personally impacted nearly everyone. The purpose of this study was to assess whether addressing needs outlined in the Self-Determination Theory (SDT) helped community stakeholders feel prepared for this role. The University of Florida (UF) health science center employs Citizen Scientists (CSs) as partners in the research process to offer insight otherwise unavailable to researchers. To prepare for this role, CSs complete an online curriculum, co-created by their peers and UF researchers, to educate them about clinical research. The UF Health Cancer Center created the CS Cancer Curriculum (CSCC) as a companion piece to the clinical research course. To create the CSCC, researchers, administrators, and CSs and participated in a needs assessment to identify common interests. Through this needs assessment, the research team found that each CS had personal connections to cancer and the team felt an empathic approach to the course design was necessary to respect these experiences. The SDT and reflective questions were applied throughout the course. Storytelling was used to present a multipart case study series with a patient, family members, and physician. Those videos were accompanied by a note that the story may cause the viewer to recall their own painful experiences. The note then prompted viewers to review resources from the National Cancer Institute support services page if needed. All but two of the nine CSs scored a 95% or higher across all questions in the CSCC. Overall course assessments included a pre/posttest and a case study assessment based on the SDT. Relatedness (100%) and autonomy (83%) were the highest construct scores of the case study assessment, indicating that CSs felt most empowered in their role once they had more of an emotional connection to the subject matter. For the pre/posttests, confidence in their ability to learn and apply the content to their work grew slightly (79% to 80%). However, scores for the “Capable” construct rose by several percentage points. At the pretest, 81% felt they were capable of learning the content and, at the posttest, 86% felt that they were capable of applying the content. Taking the time to ensure that the psychological needs of learners are met can result in committed, engaged research partners who can provide pragmatic feedback and have long-lasting effects on cancer research. The CSs in this study were passionate about this work, despite the intimidating jargon and dense concepts used in this field. They are an excellent example of how impactful community stakeholders can be if researchers can meet them where they are. Citation Format: Janet Brishke, Zachary Jones, Elizabeth A. Shenkman. Using empathy-driven instructional design to reimagine cancer research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 714.
- Research Article
21
- 10.1186/s40900-020-00230-5
- Oct 14, 2020
- Research Involvement and Engagement
AimThough patient engagement in clinical research is growing, recent reports suggest few clinical trials report on such activities. To address this gap, we describe our approach to patient engagement in the development of a clinical trial protocol to assess a new immunotherapy for blood cancer (chimeric antigen receptor T-cell therapy, CAR-T cell therapy).MethodsOur team developed a clinical trial protocol by working with patient partners from inception. Two patient partners with lived blood cancer experience were identified through referrals from our team’s professional network and patient organization contacts. Our patient partners were onboarded to the team and engaged in several studies conducted to develop the clinical trial protocol, including a systematic review of the existing literature on the therapy, patient interviews and a survey to obtain perspectives on barriers and enablers to participating in the trial, an early economic analysis, and a retrospective cohort study.ResultsEngaging patient partners enhanced our research in ways that would not have otherwise occurred. By selecting patient important outcomes for data collection, our partners helped flag that quality of life and health utility measures have not been reported in previous CAR-T cell therapy trials for blood cancer. Our partners also co-developed a non-technical summary of the systematic review that summarized results in an accessible manner. Our patient partners reviewed interview and survey questions, to improve the language and appropriateness; provided recruitment suggestions; and provided a patient perspective on the results, thereby confirming the importance of findings. Input was also obtained on costs for the early economic analysis. Our patient partners identified costs that may be a burden to both patients and caregivers during a trial and helped to confirm that the overall structure of the economic model reflected the patient care pathway. Our patient partners also shared their diagnosis and treatment stories, which helped to provide the research team with insight into this experience.ConclusionsContributions by our patient partners were invaluable to each component study, as well as the overall development of the trial protocol. We plan to use this approach in the future in order to meaningfully engage patients in the development of other clinical trials; we also hope that by reporting our methods this will help other research teams to do the same.Trial registrationAffiliated with the development of NCT03765177.
- Discussion
6
- 10.1017/cts.2018.12
- Feb 1, 2018
- Journal of Clinical and Translational Science
The purpose of this study was to obtain feedback from a diverse group of community advisory board members about different clinic or hospital-based approaches to increasing research participation. Members of an established community engagement advisory board (n=16) provided qualitative and survey data regarding attitudes and preferences for 3 hospital and clinic system strategies to recruit patients into clinical research including universal consent for research, patient registries, and patient portals. Overall, there was moderate support for each of the 3 approaches discussed. Board members described advantages and disadvantages of each method. Based on the qualitative data, universal consent was viewed as the best strategy for consenting high volumes of patients for research. However, patient registries and portals were seen as more acceptable, less-intrusive and more likely to result in higher participation rates. Survey data were consistent with qualitative findings. Input from community stakeholders is needed to identify strategies to enhance participation and increase diversity in clinical research. Members of our CEAB identified patient registries and portals as feasible and nonintrusive approaches to increasing research participation. Additional research is needed to confirm these findings and to establish best practices for supporting patients in using registry approaches.
- Research Article
10
- 10.2217/cpr.14.68
- Dec 1, 2014
- Clinical Practice
peer reviewed
- Research Article
33
- 10.1016/j.ijrobp.2016.11.008
- Nov 18, 2016
- International journal of radiation oncology, biology, physics
Acute and Late Adverse Events Associated With Radical Radiation Therapy Prostate Cancer Treatment: A Systematic Review of Clinician and Patient Toxicity Reporting in Randomized Controlled Trials
- Research Article
2
- 10.1016/j.jcjd.2020.10.019
- Nov 9, 2020
- Canadian Journal of Diabetes
Restructuring Clinical Trials in Type 1 Diabetes and Exercise in the Context of Adult Patient-Oriented Research: An Intervention Codevelopment Protocol
- Research Article
7
- 10.2217/cer-2019-0175
- Apr 1, 2020
- Journal of Comparative Effectiveness Research
Patient engagement in clinical research refers to the involvement of patients beyond the role of research subject. To date, the goals of patient engagement have not been clearly defined for each stage of the research enterprise, which, when viewed broadly, encompasses stages such as setting research priorities, interpreting and incorporating research results in clinical guidance, and translating study results into insurance coverage policies. This article presents a new framework for patient engagement by first describing the goals of patient engagement at each stage of the research enterprise and then establishing how to prioritize the types of patient expertise that are needed to achieve these goals.
- Research Article
32
- 10.1177/17449871211034545
- Mar 1, 2022
- Journal of Research in Nursing
Research active hospitals have better patient outcomes and improvements in healthcare are associated with greater staff engagement in research. However, barriers to research activity include inadequate knowledge/training and perceptions that research is a specialist activity. Nursing is an academic discipline but the infrastructure supporting nursing research worldwide is variable and sustaining clinical academic careers remains challenging. The National Institute of Health Research 70@70 Senior Nurse Research Leader programme provides dedicated time to increase clinical academic opportunities and foster a research culture across England; we describe initiatives developed by one National Institute of Health Research 70@70 leader to increase clinical staff engagement in research. The purpose of this work was to develop initiatives to facilitate clinical research opportunities and bridge the gap between clinical care and research. New strategies were developed in one health service to increase clinical staff engagement in research activity. This included: (a) Chief Nurse Research Fellows: clinical staff undertaking bespoke research training to identify local clinical research priorities, (b) an exemplar nurse-led Embedding Research In Care unit to pioneer innovation, evaluation and research participation supported by a research facilitator and (c) a Clinical Academic Network for nursing, midwifery and allied healthcare professionals to aid collaborative working. The first cohort of Chief Nurse Research Fellows have successfully completed a bespoke training programme and, with mentoring, developed projects to tackle clinical problems. The Embedding Research In Care unit initiative was configured and the first Embedding Research In Care unit has been awarded. A Clinical Academic Network group of 25+ nurses, midwives and allied health professionals was established and provides peer support and mentoring. This multi-faceted approach has successfully supported research training/engagement, enabled career development and identified nurses/midwives with potential to undertake clinical academic careers. A range of strategies, such as those described in this paper, are required to successfully bridge the gap between clinical care and research and provide additional opportunities for clinical staff to become engaged in a research active career.