Table 3.

Challenges and recommendations to enhance study recruitment and onboarding.

Challenges	Recommendations
Need proactive approach to working with participants with pain and PTSDa	Document and track barriers and solutions for institutional review board and funding agency Pilot protocol early in the project to make modifications to onboarding, data collection, and processes to meet participants’ needs
SIb more common than general population	Increase ceiling on SI reporting—change SI trigger from thoughts to plan and intent Consider a dedicated clinical psychologist to screen for SI and respond to reported participant mental health needs
Withdraw from studies at higher rates than the general population	Set realistic expectations Simplify and ensure a user-friendly onboarding process Proactively identify health factors and disqualifiers in advance; refer to published studies for guidance
Increased risk of frustration with onboarding and data collection processes	Simplify the onboarding process and provide personal support Increase automation where possible and reduce the use of usernames and passwords Color envelopes or add study-specific stamps to differentiate study-mailed materials from other VAc-mailed materials
Potential perceived data collection burden	Be cognizant of emotional, mental, and physical health burdens Revisiting trauma as a risk factor Use validated measures but also avoid multiple measures to reduce redundancy to minimize response burden Digitize onboarding paperwork for payment processing and inclusion of caregiver dyads as participants
Lack of engagement in project processes	Simplify processes Provide reminders Provide a project navigator

^aPTSD: posttraumatic stress disorder.

^bSI: suicidal ideation.

^cVA: Department of Veterans Affairs.