Table 1.
Category system for thematic analysis.
| Facilitators for the recruitment of community-based healthcare providers | Motivation for participation of healthcare providers | Intrinsic motivation | Relevance of the trial topic |
| Professional development; improving care; support research | |||
| Openness to learn something new/be up to date | |||
| Improving professional cooperation | |||
| Extrinsic motivation | Collegial obligation (generated by peer-to-peer recruitment) | ||
| Committed to professional politics; professional–political mandates | |||
| Financial Compensation | |||
| Continuing education credits for informational event and training | |||
| General set up of routine healthcare practice | Lifestyle topics were already part of regular care before entering the trial | ||
| Awareness that there is pent-up demand in medical care | |||
| Promising contact channels | Presentations at quality circles and Stammtisch events | ||
| Letters sent by the Association of Statutory Health Insurance Physicians (ASHIP) | |||
| Cold calls | |||
| Repeated personal visits combined with small presents for practice staff | |||
| Practice organization/distribution of tasks within the practice team | Coordination and communication within the practice teams | ||
| Participation of the physician’s assistant in trial tasks and close exchange with the gynecologist | |||
| Other facilitators | Individual characteristics of the healthcare providers | ||
| Efficient and charming communication and adapting communication to individual situation in the practice | |||
| Particularly high need among patients (practices in deprived areas) | |||
| Low trial burden | |||
| Barriers for the recruitment of community-based healthcare providers | General set-up of routine healthcare practice | Lack of time and excessive workload in day-to-day routine | |
| Lifestyle topics were NOT part of regular care before entering the trial | |||
| Information management on the part of the physicians’ assistants | |||
| Practice organization | Healthcare providers are reluctant to upset well-established practice structures | ||
| Physicians’ assistants often work part-time. Trial tasks must, therefore, be carried out by several people | |||
| Change of staff in the practice | |||
| Rejection of the entire practice team | |||
| Trial-related processes (inclusion and implementation) | Financial compensation is perceived as too low by some healthcare providers | ||
| Incentive for patients is perceived unattractive | |||
| Structure and content of the trail preparation workshop should be improved | |||
| Inclusion criteria sometimes not feasible in day-to-day practice | |||
| Digital data documentation: some practices only work paper-based | |||
| Professional policy | Target group in trial regions not included in planning (only professional associations) | ||
| Lack of support from the professional association | |||
| Organizational aspects within the team of study coordinators | Using the most appropriate communication and marketing strategies was difficult at the beginning | ||
| Uncertainty about frequency of repetitive cold calls and reminders | |||
| Participant clientele | Healthcare providers do not perceive any need for intervention among their well-educated patient clientele | ||
| Healthcare providers perceive that their socially vulnerable patient clientele has too many other burdens and cannot be reached by the intervention | |||
| Participant rejection | Healthcare providers have difficulties to “sell” the trial | ||
| Administrative effort too high and benefits too low | |||
| Characteristics of patients: both groups with high and low intervention needs | |||
| Data privacy concerns | |||
| No interest | |||
| Lack of trust between patient and healthcare provider | |||
| Recruitment at an unsuitable time point: uncertainty in early pregnancy leads to rejection | |||
| Other barriers | Individual characteristics of healthcare providers | ||
| Healthcare provider does not have any experience in recruiting patients | |||
| Adjustments to trial workflows were delayed by long bureaucratic processes | |||
| Skepticism regarding trials in general | |||
| Explanations for inactive practices | No active participation at all | Enrollment out of obligation; no honest interest | |
| Participation for receiving a free workshop and continuing education credits | |||
| Active participation discontinued during the trial | Frustration as colleagues in the region do not participate | ||
| Perceived complexity of the trial leads to problems and, ultimately, to healthcare providers quitting | |||
| Repeated rejection by patients to participate in the trial | |||
| Unrelated discussion points and other matters | Suggestions for improvements | ||
| Expertise and knowledge exchange | |||