Table 3.

Summary of trial recruitment intervention co-design workshop discussion with maternity healthcare professionals and maternity service users: workshop 1

Recruiter’s list and compare advantages and disadvantages of inviting all eligible women to participate in a trial 9.2 Pros and cons (linked subthemes—the ‘right’ participants and acceptability of the intervention)	• Good to do at start of study, discuss how to approach and reassess once study is underway • Depends on resources and capacity to screen women to do this • Inviting all women promotes research—helpful for future studies • This is not something consciously done at the moment • Important to include underrepresented, non-English speaking, ethnic, and cultural minorities • Wouldn’t use this method—prefer team-based approach to make trial more appealing, educate public about what a trial involves • Tool is more helpful for trials difficult to recruit to or struggling—could modify approach by recognising problem
Set an agreed daily/weekly goal to invite all eligible women 1.1 Goal setting (behaviour) (linked subthemes—putting women’s clinical care and wellbeing first and commitment to the research and recruitment targets)	• Setting targets helps—nice to be first to recruit and gain sense of achievement • Depends on trial, some trials you really can’t set goals for (lack of staff, not enough patients, etc.) • Tool could be helpful in identifying where problems are—should be reward rather than punishment system • Goals depend on staff availability and staff to support women throughout the trial ‘• Goals’ focuses on quantity not quality—talking to everyone spreads yourself too ‘thin on the ground’ • ‘Goals’ not good, means just another pressure—wouldn’t benefit the trial • Better to concentrate on areas to target (ward, clinics etc.) for recruitment rather than numbers
Set an agreed weekly goal to have increased the number of women invited to the trial 1.3 Goal setting (outcome) (linked subthemes—recruitment targets)	• This one is about incentivising people to approach more women than they are doing currently • If you are recruiting well, you do not need this • Inviting everyone could be a tick box exercise (invitees may not sign up for study) • Most multicentre sites do not know how many women have been invited—screening logs are not routinely looked at • Tool might be useful on a local level to know if you are targeting the right areas • Tool is useful if talking to lots of women means lots of recruits • It is the quality of the chat not the numbers invited—its deeper than just numbers • Goals motivate people; it gets people working together on something • It would be more beneficial to look back retrospectively to learn rather than set goals
Experienced recruiters give talk (or video clip) about resolving situations that commonly occur prior to inviting a woman to a trial 4.2 Information about antecedents (linked subthemes—planning and preparation and being visible and benefit of experience)	• Include people from different backgrounds, recruiters from ethnic minorities have different experiences and are asked different questions • This could cover a range of difficulties faced—talk through and present ways of resolving those • Also helpful in deflecting concerns and uncertainties in the clinical team—addressing these head on is sensible • May not video but a meeting or something at local level—because issues differ from site to site • Could be PI, R&D lead, research midwife/nurse delivering • Could be virtual conservation so people could ask questions, and provide recording to watch back • Zoom meetings for recruiters are held for some trials but are not always accessible as timing does not always suit staff • WhatsApp voice notes are helpful for recruiters to communicate their methods to other recruiters • Good idea to have one video at set up and one subsequently as may need to adapt approach as trial goes on
Recruiters keep diary of recruitment or potential recruitment encounters (reflecting on diary and shared learning with peers) 2.3 Self-monitoring of behaviour (linked subthemes—being visible and planning and preparation)	• Writing in diary is useful, means you will remember • Write significant encounters, difficulties, or learnings—do not want to record every single thing • Fill them out when you have time—can be brief as they need to be • Diary is reflective and more useful than a screening log • Could be recorded centrally or as a personal record—Sharing diary is not problematic (all agreed) • Positive consequence—the record shows difficulties or missed opportunities which could justify argument for more resources • Tool could be helpful to show R&D why recruitment is problematic • Not sure reflection is helpful—if you are recruiting well why are you reflecting on it? • Diary provides retrospective perspective, helpful in identifying where women could potentially be missed
Regular review (with trial team) of the change in behaviour being used by recruiters 1.5 Review behaviour goals (linked subthemes—recruitment targets)	• Might be helpful if you are not recruiting well—see where you could improve • Not regular review—better to positively motivate people with degree of healthy competition • Trial team already send league tables—giving shout out to top recruiter • On a local level you can incentivise with chocolates, etc.—small stuff means something • Already being done—it really helped concentrating on where is focus efforts • Review of behaviour change ensures you are doing your best and change if necessary
Trials teams carry out monthly review to reveal if all eligible women had been invited to the trial 1.7 Review outcome goals (linked subthemes—recruitment targets)	• This is not achievable as there is no record of ‘all women’—not possible to know about all eligible women • You already know if you have approached all eligible women, and if not, you know why • This is not useful because capacity of the team is often the problem • Review helps people write down the issues and address them • A positive consequence might be reallocation of staff following review