Best Practices in Research Participant Recruitment Nestor L Lopez-Duran, PhD Associate Professor, University of Michigan

Disclosure Nestor Lopez-Duran is one of the founders of Ripple Science, which will be mentioned frequently in this workshop.

Poor participant recruitment is the #1 reason why clinical trials fail The Problem Poor participant recruitment is the #1 reason why clinical trials fail 80% of trials do not meet recruitment targets https://doi.org/10.1371/journal.pone.0127242.t001

The Problem Recruitment is a complex marketing challenge and recruitment teams are unprepared and unequipped to address the challenge Identified causes of poor patient accrual Team Inexperience Ineffective Methods Poor Conversion and Retention Poor Community Engagement Inadequate Analytics https://doi.org/10.1111/j.1365-2702.2009.03041.x https://doi.org/10.1186/1745-6215-10-52

The Lifecycle of an Effective Recruitment Campaign A-B Testing Source Identification Strategy Matching Message Creation Lead Tracking Performance Analytics Follow Up Automation The Lifecycle of an Effective Recruitment Campaign

Efficient and Effective Clinical Trial Recruitment Planning 1. Identify all stakeholders and partners. 5. Develop a realistic communication budget. 2. Identify participant locations based on where participants may seek treatment. 6. Monitor and evaluate both the recruitment process and performance with meaningful metrics. 3. Develop and test tailored messages. 7. Develop a structured lead tracking process. 4. Develop creative material and select appropriate channels for delivery.

The Problem The Lifecycle of an Effective Recruitment Campaign A-B Testing Source Identification Strategy Matching Message Creation Lead Tracking Performance Analytics Follow Up Automation The Lifecycle of an Effective Recruitment Campaign

Sources vs. Sites The Problem Sources: Schools Hospitals Sites: Case: Study recruiting 12-16 kids at familial risk for depression WHO IS YOUR TARGET? Sources: Schools Hospitals Dentists Pediatricians Internet Youth Centers & Clubs Sporting Facilities Churches Sites: Facebook Instagram Snap Chat Tumblr YouTube Lab Website

Sources vs. Sites The Problem Sources: Schools Hospitals Dentists Case: Study recruiting 12-16 kids at familial risk for depression WHO IS YOUR TARGET? Sources: Schools Hospitals Dentists Pediatricians Internet Youth Centers & Clubs Sporting Facilities Churches Sites: Ann Arbor IHA Dr. Mary Ballard Dr. Thomas Brent UMHS - Westside UMHS - Briarwood Contact : Name Address History Notes

Recruitment Source Management The Problem Recruitment Source Management  Sources  Sites

Recruitment Source Management The Problem Recruitment Source Management

What are the core sources for your target sample? The Problem What are the core sources for your target sample?

Strategy Matching The Problem Sources: Schools Hospitals Dentists Case: Study recruiting 12-16 kids at familial risk for depression WHO IS YOUR TARGET? Sources: Schools Hospitals Dentists Pediatricians Internet Youth Centers & Clubs Sporting Facilities Churches Sites: Facebook Instagram Snap Chat Tumblr YouTube Lab Website Strategy: PPC Sponsored Posts Group Announcements Content Marketing

Strategy Matching The Problem Sources: Schools Hospitals Dentists Case: Study recruiting 12-16 kids at familial risk for depression WHO IS YOUR TARGET? Sources: Schools Hospitals Dentists Pediatricians Internet Youth Centers & Clubs Sporting Facilities Churches Sites: Ann Arbor IHA Dr. Mary Ballard Dr. Thomas Brent UMHS - Westside UMHS - Briarwood Strategy: Waiting Room Brochures Welcome Package Social Work Collaboration Outside Info Table

Recruitment Strategy Management The Problem Recruitment Strategy Management  Strategy  Tasks & AB Tests

Identify Strategies Beyond Flyers The Problem Select 2-3 Sources and Identify Strategies Beyond Flyers

A lesson at the dentist: The Problem Message Creation A lesson at the dentist: “Looking for parents of teens to participate in a research study”

Message Creation The Problem Who is the study’s target? Who is the ad’s target? Why should I care? What will I be asked to do? Who Are You? Why should I trust you? Looking for children to participate in a research study. If you or someone you know has a child with autism, you may qualify for our research study. If you are interested, please call 555-555-5555 or email crappy.ad@notachance.com

Message Creation The Problem Who is the study’s target? Does your child have autism? Help us understand how kids with autism manage their routines! A study at the University of Michigan is exploring daily routines in kids with autism by having parents keep a daily diary for 2 weeks. Compensation provided. If you are interested please call 555-555-5555 or email better.ad@achance.com Who is the study’s target? Who is the ad’s target? Why should I care? What will I be asked to do? Who Are You? Why should I trust you? BUT WHAT ABOUT ADVERTISING $$$$$$?

Standardizing Lead Tracking The Problem Standardizing Lead Tracking Screen Fail Follow Up Fail ENROLLED

Standardizing Lead Tracking The Problem Standardizing Lead Tracking Best Practices: Categorize lead by their status To Contact Contacted – In Progress Scheduled Screen Failed Follow Up Failed Create a standardized follow up process Follow up via email AND phone The first 24 hours Structured cadence for next 7 days Have formal scripts https://ripplescience.com/get-more-participants-with-better-leads/

Standardizing Lead Tracking The Problem Standardizing Lead Tracking First 24 hour (day 1 and day 2): Reply via email and phone call immediately after receiving the lead and for the rest of the day following this schedule: 9am, 12:30pm, 4pm, 7pm (only leave a message the first time you call).  Day 3: Call at 9am Day 4: Call at 12pm Leave message Day 5: Email. Call at 7pm Day 6: Call at 11am Day 7: Email. Call at 6pm Week 2-6: Call and email once. Week 7: Move to loss to follow up.  LEAD CADENCE https://ripplescience.com/get-more-participants-with-better-leads/

Potential Participant Management The Problem Potential Participant Management Manage Lead Flow

Tracking Performance Analytics The Problem Tracking Performance Analytics Think about your current recruitment: What is your conversion rate? Are you on track? – What does this mean? When will you finish recruitment? How many participant will you really have by the time you are supposed to finish? What works and what does not?

The Problem 48% Sep 6, 2019 50 Data 8/31/18 Start Date 1/1/18 End Date 12/31/18 Goal = 100. Recruited: 32 Tot W = Total Weeks = 52 W = Weeks since start of campaign = 35 Actual Actual 32 32 48% On Target Performance Expected (Goal /Tot W) * W (100 /52) x 35 67 = Start Date + Projected Number of weeks at current rate1 Projected Completion Date Sep 6, 2019 1Projected Weeks = Goal / weekly rate2 = 100 / 1.09 = 91 2Weekly rate = W / Actual = 35 /32 = 1.09 Projected Sample Size 50 Actual + Weekly Rate * W Left = 32 + 1.09 * 17 = 50 https://ripplescience.com/improving-participant-recruitment-analytics/

The Problem Real Time Site-Specific Analytics and Projections

The Problem Real Time Site-Specific Analytics and Projections

Automate Follow Up to Increase Retention The Problem Automate Follow Up to Increase Retention The calculation of dates for future appointments and notification should be automated.

Automate Follow Up to Increase Retention The Problem Automate Follow Up to Increase Retention

The Problem The Lifecycle of an Effective Recruitment Campaign A-B Testing Source Identification Strategy Matching Message Creation Lead Tracking Performance Analytics Follow Up Automation The Lifecycle of an Effective Recruitment Campaign Recruitment campaigns are more than distributing flyers Understand your target and craft the right message for the right target Standardize your leads tracking Track your performance and projections Automate your follow up

THANK YOU Nestor L Lopez-Duran, PhD Founder, Ripple Science Associate Professor, University of Michigan NestorL@umich.edu & Nestor@ripplescience.com www.ripplescience.com