We know it is frustrating and often a huge waste of resources when someone books an appointment and then doesn’t show up. Maintaining a good relationship will improve communication, allowing you to inspire them to participate.
The following are some ways you can address concerns before appointments:
Limit wait times for Clinic Screenings
- Limit the time between pre-screening, Phone Screenings, and Clinic Screenings as much as possible, reducing the chances of participants being too busy, being talked out of, or just losing interest in your study.
- Coordinate recruitment activities by aligning recruitment efforts to ensure prompt scheduling and accommodate the volume of participant screenings.
- Be mindful of participants’ commitments by accommodating their schedules. Offer flexible hours (including weekends and before/after typical work hours) and remote visits when possible.
Maintain Consistent Communication
- Each participant should have one point of contact following up with them throughout the study.
- Provide participants with their team member’s contact details should they have any questions or concerns at any point before or after the Clinic Screening.
- Offer an optional meet and greet to participants (either in-person or remote) to give them the opportunity to get to know the study team and research facility.
- Include expectations for the next steps at every juncture. Provide the date, time, and location of their visit, a detailed description of what the visit will entail, a map of the building, and parking instructions. If it’s a larger building, specify where to go within the building, and who they’ll be meeting with.
Continue Building the Participant-Researcher Relationship
- To minimize no-shows, maintain transparency and open dialogue with potential participants on all aspects of the study including their participation requirements.
- For example, location, frequency, duration, and number of visits as well as the purpose of the visits, and any procedures.
- During the Phone Screening inform them about the significant resources involved in setting up their first visit and kindly request that they notify you in advance if they decide not to participate. Explain that while they are free to change their mind, not showing up without notice is disruptive and costly.
- Confirm their appointment and give them an option to reschedule or cancel if they need to.
- If you have a strong relationship, they will show you the same respect you show them. Refer to our Participant-Researcher Relationship Best Practice Guide for further recommendations.
Informed Consent
- Choose the best timing and method of providing consent forms.
- We know it’s tempting to email consent forms before your potential participant comes in for an appointment, however, this runs the risk of scaring them off.
- Ensure that the informed consent process is conducted in person or over a phone call to ensure that all questions, concerns, and hesitations are addressed immediately.
- Informed consent forms are often perceived as lengthy legal documents which intimidate many participants.
- Address any and all cultural barriers that might be posed by the Informed Consent process – including but not limited to language, literacy, and knowledge of medical/study terms.
- Include a comprehensive overview of the study, including study requirements, possible outcomes, as well as how it could help others.
- The informed consent form is full of reasons why not to join the study (commitment level, medical terminology, requirements). Putting the responsibility on the participant to review this document on their own will increase the likelihood of scaring them off because they won’t have anyone to reassure them throughout
Following Up on No-Shows
Despite meticulous planning, instances where participants fail to appear for clinic screenings can occur. Following up on no-shows is essential to maintain study momentum and achieve enrollment goals effectively.
Here are the 4 areas to consider when following up on no-shows:
Be Persistent yet Respectful
- Initiate contact with the participant promptly after the missed appointment. Delaying follow-up increases the risk of unsuccessful attempts to reconnect.
- Continuously attempt to contact the participant while respecting their contact preferences. Trialfacts recommends 10 contact attempts before considering a participant unreachable.
- Develop a consistent follow-up schedule (e.g. daily for the first three days, then every second day for a week, then once a week)
- Utilize phone calls, emails and text messages as primary methods of communication, use alternative contact details provided by the participant during initial screening or consent.
- If none of these attempts are successful, leave a clear and polite message requesting the participant to contact you to reschedule or provide a reason for their absence.
Address Participant Concerns
- Immediately address any concerns or issues the participant may have regarding the absence or study itself.
- Reassure the participant that they are welcome to reschedule the appointment if they are still interested in participating.
- If the participant is apologetic about missing their appointment, respond with empathy and understanding.
Maintain Participant Engagement
- During the follow-up process, keep participants informed about their involvement in the study and how their contribution could help the community with the same condition.
- Provide updates on study progress and any relevant developments.
- Encourage participants to provide feedback on their experience and reasons for non-attendance.
Assess and adjust
- After a reasonable number of attempts (based on study protocols or Trialfacts’ recommendation of 10 attempts), evaluate the effectiveness of follow-up strategies. Identify points in the referral process where participants are dropping out and investigate potential root causes for these occurrences.
- Documenting reasons for no-shows, screening failures, and lack of interest among participants will enhance the efficiency and effectiveness of this process.
- Evaluate the effectiveness of your follow-up procedures and incorporate any lessons learned into future participant engagement strategies.