Enrollment and Avoiding No-Shows

Once your volunteer has passed phone screening, the in-person appointment needs to be booked as soon as possible—if your volunteer is keen to participate and they’re ready to book the appointment, it is important not to delay.

Immediacy is key during all steps of the recruitment process, and this one is no different. If you cannot get people to book their in-person appointment as soon as possible, one (or all of) the following things will happen:

  • Your volunteer will lose interest over time;
  • Your volunteer will have every intention of participating but life will just get in the way. Even though they want to participate and they had the time a couple of weeks ago, now they’re just too busy; and/or,
  • Other people will talk your volunteer out of participating in your study.

Avoiding No-Shows

We know it is incredibly frustrating, and often a huge waste of resources, when someone books an appointment and then doesn’t show up. But why does this happen?

The reason people do not show up to appointments is because the volunteer-researcher relationship was not developed enough. You did not demonstrate enough credibility, appreciation, or did not give the volunteer the personal treatment they were expecting—all these combined factors caused the volunteer to lose interest over time, and thus not show up to the appointment.

Or perhaps it was easier for a volunteer to just not turn up to their appointment because you didn’t convince them your study is worth their time, they don’t feel you’ll appreciate their participation, or they’re not sure about your credibility.

So what can you do to prevent no-shows? Below we’ve enumerated a list of things you might consider doing if you’re experiencing a lot of no-shows.

First Impressions Are Everything

You never get a second chance at a first impression—that is why the way volunteers are contacted and phone screened has a big impact on credibility, interest, and the volunteer-researcher relationship.

If the first contact with your volunteer failed to establish credibility, this will negatively impact your volunteer’s interest in the study. If any of your volunteers’ questions were left unanswered during phone screening, or they were treated in a brisk and impersonal manner, then it is unlikely they will want to enroll in your study.

There’s much more to successfully contacting and phone screening volunteers in a manner that leads to enrollment, which is why we’ve created full guides for each of these. So make sure your volunteers’ first impression of your study is a positive one during the contact and phone screening stages of your recruitment process.

Do Not Delay

If your volunteer is ready to come in two days and the only appointment you have available isn’t until two weeks’ time, then chances are you’ve lost that volunteer’s interest.

You should be bending over backwards to get people in as soon as they’re interested and not waste any time. Do whatever you can to ensure that first visit happens quickly. Make yourself available after-hours and get your volunteers through the door as soon as possible.

Don’t Advertise Too Early

It is extremely important not to advertise too early. Make sure you’re properly resourced before advertising—if you can’t get people in yet, don’t start recruiting a month or even two weeks before your study, otherwise people will lose interest and your chances of getting no-shows will increase dramatically.

Ensure You’re Adequately Resourced

Ensure your recruitment activities line up so that you can get people in quickly, and make sure you have enough resources to handle the volume of volunteers. If volunteers perceive you as disorganised, you will immediately lose their trust. And if your volunteers cannot trust you, they will not be confident putting their health in your hands, they will not show up for their appointments, and they will not enroll.

Be Honest

It is a tremendous waste of time and resources when someone books an appointment and then doesn’t show up. But as we mentioned earlier, the reason your volunteers are not showing up is because the volunteer-researcher relationship has not been adequately developed.

However, many people find it easier to just not turn up rather than tell you they’re no longer interested—and it’s not because they’re inconsiderate. Most people do not realize how disruptive and expensive it is if they do not show up to their appointment.

So, a good way to avoid no-shows is to just let people know it takes a lot of time and effort to set up for that first visit. Explain to people that it is very disruptive and expensive to simply not show up for an appointment, so if they change their mind about participating, to please let you know in advance. For example, at the end of the screening call (or during your last contact with the patient), just say something like:

“This is something we let everyone know, but just please be aware: there’s a lot of resources that go into that first appointment (doctors, equipment, etc.) that are wasted if someone can’t make an appointment. Because of that we just ask that if you change your mind or if you cannot make that appointment then you let us know ahead of time.”

Meet and Greet

The first in-person appointment is a big commitment for your volunteers. Regardless of the fact that you still haven’t determined their final eligibility, by turning up to the first appointment that have signaled that they want to participate in your study.

But while they’ve talked to someone during the phone screening, they have not met you and they do not know you, and so asking for this level of commitment before they’ve really got to know you may be too much for some volunteers at this stage.

Keep in mind that clinical trials still have a very negative perception among most of the public. Your volunteers do not know how legitimate your operation is or they may still have people trying to talk them out of it. So before asking for a big commitment from your volunteers by asking them to come to the first appointment to participate in your study, consider hosting an informal meet and greet.

Structure of a Meet and Greet

The purpose of a meet and greet is to increase your credibility by having volunteers come to a real, physical place and meet you in person. Most research sites are quite impressive to the average volunteer, and go a long way to dispelling any potential concerns about being a “human guinea pig”, so do not take your space for granted. Getting your volunteers to see your physical location is one of the best ways to increase your credibility and build interest.

Minimal Commitment

A meet and greet is an opportunity to really establish and strengthen the volunteer-researcher relationship, increase credibility, and address concerns with little commitment from the volunteer. Because a meet and greet is informal (i.e. your volunteers are not having any tests done, they’re not agreeing to participate in the study, they’re not agreeing to anything but showing up to a time that is convenient to them), it allows you to further build credibility and establish trust between you and your volunteer.

Instead of having to show up and agreeing to participate in the study, all your volunteers have to do for a meet and greet is show up—so, you’re establishing trust while also lowering the bar of commitment. Therefore, it is important to keep it simple during the meet and greet—do not ask too much of your volunteers (e.g. no tests) and keep it easy, short, and informal.

Make It Convenient

You’ll have noticed that most of our advice revolves around catering to your volunteers as you would to a customer. And it is because this approach works extremely well in getting volunteers to enroll in your study.

So, if you want people to attend your meet and greet, it is extremely important to make sure it is convenient for your volunteers to do so. Let your volunteers pick a time whenever it is most convenient for them. If you have a time during which you can fit in multiple people, that’s fine—however, if someone can’t make it, make sure you ask them when it would be most convenient for them to attend.

Appointments always have to suit the participant, and not you. Being respectful of your volunteers’ time and their commitments will make it so that they will more likely to be respectful of yours. If you are not respectful of your volunteers’ time, they will not reciprocate.

Keep It Consistent

At this point in the meet and greet, your volunteer was contacted by and has spoken to the same person (if you’ve followed our advice from the contact section), and then that same person phone screened them and suggested they come in and meet them. Now, that same person should be showing them around the facilities and helping them learn what participating in the study might be like.

Consistency raises credibility and builds trust. If three different people have spoken to the same person and now a fourth, different person is showing your volunteer around the facilities, your volunteer will be less likely to trust you. They will feel like a small, unimportant cog in a big machine, which will negatively affect the way your volunteer perceives the importance of them participating in your study.

Make It Personal

An excellent way to start meet and greet is by asking your volunteers about their interest in your study, if you haven’t already done so. What is their interest and what are they hoping to gain from participating? By putting the focus on them, you’re tailoring the study to your volunteers’ needs, which makes them more likely to participate.

Be Willing to Reschedule

If a volunteer has a very busy schedule, be flexible and willing to reschedule. However, make it clear to your volunteers that some things can be rescheduled and some things cannot. If their next appointment involves a lot of time and resources, make it known that rescheduling it would waste a lot of resources.

No Consent Forms

You might think you’re killing two birds with one stone by handing over an innocuous consent form to your volunteers at the end of the meet and greet. However, what you’re really doing is creating questions for them that no one will be able to answer when they read your consent form later that evening, resulting in them questioning their decision to participate in your study.

Do not give your volunteers consent forms at the end of the meet and greet unless you’re prepared to go through it with them and answer their questions.

Next Steps

One of the most important parts of the meet and greet is ensuring you’ve established clear next steps. Make sure the first visit is booked soon and at a time that is convenient for your volunteer—bend over backwards to get the next appointment in the next day or two. If you schedule it in a week or two, your volunteer will lose interest over time, and perhaps in a week or two be too busy or no longer motivated enough to come in for that appointment or respond to your calls.

Consent Forms

It is tempting to email consent forms before your volunteers come in before an appointment; however, we do not recommend doing this, as it often gets put in the “too hard” basket.

Remember that is very easy for people to put even the simplest tasks in the “too hard” basket. And if you ask too much of your volunteers before their interest is high enough, or before the volunteer-researcher relationship is developed enough, you run the risk of losing them as potential participants.

That’s why any written information about the study should always be provided in person, as this gives your volunteers plenty of opportunity to ask questions. By answering your volunteers’ questions and concerns immediately and in person, you are being personal and understanding—this builds your credibility and your volunteer’s interest, which means they will be more likely to participate in your study.

Conclusion

Once you establish a strong volunteer-researcher relationship by being credible, personal, respectful, appreciative, and diligent, most volunteers that meet the eligibility criteria will successfully enroll in your study.

These steps might seem like extra time and effort on your part—however, taking the time to develop the volunteer-researcher relationship is a lot more efficient than needing to recruit additional volunteers because most of your volunteers changed their minds or, worse, did not show up at all.

If you ensure all these aspects of the volunteer-researcher relationship are taken care of, then you can become one of the handful of researchers who truly excel at recruiting volunteers.

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