Abstract
BackgroundRandomised controlled trials of healthcare interventions depend on the participation of volunteers who might not derive any personal health benefit from their participation. The idea that altruistic-type motives are important for trial participation is understandably widespread, but recent studies suggest considerations of personal benefit can influence participation decisions in various ways.MethodsNon-participant observation of recruitment consultations (n = 25) and in-depth interviews with people invited to participate in the UK REFLUX trial (n = 13).ResultsWillingness to help others and to contribute towards furthering medical knowledge featured strongly among the reasons people gave for being interested in participating in the trial. But decisions to attend recruitment appointments and take part were not based solely on consideration of others. Rather, they were presented as conditional on individuals additionally perceiving some benefit (and no significant disadvantage) for themselves. Potential for personal benefit or disadvantage could be seen in both the interventions being evaluated and trial processes.ConclusionsThe term 'conditional altruism' concisely describes the willingness to help others that may initially incline people to participate in a trial, but that is unlikely to lead to trial participation in practice unless people also recognise that participation will benefit them personally. Recognition of conditional altruism has implications for planning trial recruitment communications to promote informed and voluntary trial participation.Trial registrationISRCTN15517081
Highlights
Randomised controlled trials of healthcare interventions depend on the participation of volunteers who might not derive any personal health benefit from their participation
Some still had poor symptom control, and some had concerns about taking long-term medication. Most were prescribed their acid-suppression medication by a general practitioner, and several had not consulted a specialist about their gastro-oesophageal reflux disease (GORD)
We suggest that the term ‘conditional altruism’ might more accurately describe what was observed in our study
Summary
Randomised controlled trials of healthcare interventions depend on the participation of volunteers who might not derive any personal health benefit from their participation. The idea that altruistic-type motives are important for trial participation is understandably widespread, but recent studies suggest considerations of personal benefit can influence participation decisions in various ways. It is widely assumed that altruistic-type motives are important for trial participation. The proportion achieving targets did not appear to improve over time [4]
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