Recruiting for research on sensitive topics in schools: an experience with Vaxcards, a collectable vaccine card game

D S Epstein,C Barton,J C Enticott,H J Larson

doi:10.1186/s13063-021-05288-4

D S Epstein, C Barton + Show 2 more

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https://doi.org/10.1186/s13063-021-05288-4

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Abstract

Undertaking recruitment for research in schools is an effective way to recruit young people for research participation but it is not without its challenges. Gaining access and coordinating many levels of different organisations and stakeholders whose cooperation and approval are crucial all add time and sometimes logistical challenges for the research team. In addition, recruiting around sensitive research topics can elicit additional barriers to successful research.The research team aimed to conduct a pragmatic cluster randomised controlled trial involving schools in a local government region in Victoria, Australia, to assess the effect of a vaccination-based educational card game called “Vaxcards” on vaccine consent returns. Schools were contacted via phone and email to determine which staff member would best be a contact point for a face-to-face meeting to discuss the methods and purpose of the study. Email follow-ups were scheduled to follow up non-responsive schools and consent forms. The minimum required sample size was 13.Of 31 eligible schools, 13 were recruited. The research team encountered several unanticipated challenges before achieving the recruitment target. The most common reasons for non-participation were being too busy with other commitments, concerns regarding the topic of vaccination being too sensitive, and concerns that key stakeholders in the school would not approve of the research topic of vaccination. One school required a review by a private research ethics board that rejected the study. Significant hesitancy and misinformation about vaccine science was observed that affected engagement with a small number of schools.This paper highlights the challenges of recruiting schools in the context of public anxieties about vaccines and has several important learning lessons for successful recruitment about sensitive topics. This includes navigating approval processes for research in schools, the importance of local champions, dealing with misinformation and the importance of strong relationships and organisational trust.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001753246. Prospectively registered on 25 October 2018 8:24:21 AM

Highlights

This paper describes the experiences of the research team recruiting young people from schools in Victoria for a trial of an intervention to improve return of consent to vaccinate forms
The trial was instituted to test the effectiveness of a collectable card game to educate school-aged students about vaccine-preventable diseases and to incentivise students to engage in the vaccine schedule
The research team tried to identify the coordinating staff member of the government vaccination program within each school, but found that this role varied by school and included staff whose primary roles included school nurse, year level coordinator, Vice Principal, Principal, student wellbeing officer or health subject teacher

Summary

Introduction

This paper describes the experiences of the research team recruiting young people from schools in Victoria for a trial of an intervention to improve return of consent to vaccinate forms. The research team focus especially on challenges in standardising recruitment strategies within schools and the impact on recruitment for research on a polarising topic such as vaccination. There is increasing focus on recruiting participants from primary care and community settings in order to increase the applicability and translation of research findings [1,2,3]. Recruitment strategies should be reported in research for several reasons This includes ensuring recruitment reports in evaluations are transparent and reproducible, documenting deviations in methodology (which can be common in pragmatic research designs), providing context and setting for complex interventions and ensuring accurate reporting of pragmatic data

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