Attitudes, Barriers and Motivators of Clinical Research Recruitment in State of Qatar: Findings from PERCEPTIONS Study

Objective: To explore the perceptions and attitudes about clinical research participation prevalent amongst the general public in State of Qatar. Background: Recruitment into research trials is a major challenge and an ongoing problem for biomedical researchers.1 A recent report indicates that only 6% of eligible subjects actually participate in a clinical trial.2 Costs of low recruitment rates are high. This includes not just loss of investment made in conducting the research but a more detrimental damage of investigator and institutional reputation as a result of a failed study.3 Surveys of attitudes to research participation have rarely been done.4 There is an urgent need to study and address recruitment shortfalls to ensure that trials meet their recruitment target.1 PERCEPTIONS Study (Perceptions about Enrollment and Recruitment in Clinical Research Prevalent In State of Qatar) PERCEPTIONS Study is an elaborate, three phased, mixed design research project. Phase 1 was conducted to explore the existing attitudes and behaviours prevalent in the population in Qatar. With the dynamic National Vision 2030, Qatar is set to become world leader in health care research. Diabetes, hypertension, cancer and personalized medicine are some of the projected research goals therefore it is essential to gain an insight about the thoughts, beliefs and concerns of people that this research is meant to thrive with and eventually benefit. Methods: A survey was conducted at two large-scale public events held within the State of Qatar. Residents of Qatar who were 18 years of age or older were surveyed following a verbal consent. Those visiting/touring Qatar or under 18 years were excluded from the survey. Filled surveys were entered in Microsoft Excel and analyzed on SPSS version 23. Results: Total of 2517 surveys were conducted of which 2379 valid forms were analyzed. According to the data 5.6% respondents (n = 137) had previously been approached to participate in a clinical study. Of these 74.6% (n = 86) agreed to participate while 37.3% (n = 51) declined. Remaining 88.7% (n = 2114) of the surveyed population had never been approached to participate in a clinical study. Data was missing for 5.5% (n = 131) respondents. Main reasons for declined consent included: time constraint (50%, n = 11), ‘fear’ (13.6%, n = 3), lack of awareness about clinical research (9.1%, n = 2) and lack of interest in research (9.1%, n = 2). Maximum participation was reported in studies related to diabetes (n = 19) followed by heart diseases (n = 4). ‘To help others’ (n = 24) and ‘thought it might improve my access to health care’ (n = 21) were the prime motivators for participation. Maximum respondents (up to 50%) agreed that their research experience was associated with positive outcomes for self and others, research conduct was ethical and opportunities for participation were and will be welcomed. There was also significant disagreement that research had strong emotional repercussions or that the procedures were ‘too long’, ‘boring’ or ‘inconvenient’. Conclusion: Rate of clinical research participation in Qatar needs improvement. Out- reach to potentially eligible subjects is poor where an overwhelming majority is not approached for consent. Time constraints, lack of trust in and poor state of awareness about clinical research are main barriers to participation. Altruism, monetary benefits, improved health access are prime motivators. Length of stay in Qatar is a statistically significant determinant of recruitment in research (p < 0.002). Deeper insight into the factors affecting clinical research participation is needed to devise evidence based policies for improvement in recruitment strategies and the future of evidence based medical care. Keywords: Attitudes, Barriers, Motivators, Clinical Research, State of Qatar References: 1. Trauth JM, Musa D, Siminoff L, Jewell IK, Ricci E. Public attitudes regarding willingness to participate in medical research studies. J Health Soc Policy 2000;12(2):23–43. 2. Nair SC, Ibrahim H, Celentano DD. Clinical trials in the Middle East and North Africa (MENA) Region: grandstanding or grandeur? Contemp Clin Trials 2013 Nov;36(2):704–710. 3. McCullagh MC, Sanon MA, Cohen MA. Strategies to enhance participant recruitment and retention in research involving a community-based population. Appl Nurs Res 2014 Nov;27(4):249–253. 4. Teschke K, Marino S, Chu R, Tsui JK, Harris MA, Marion SA. Public opinions about participating in health research. Can J Public Health 2010 Mar-Apr;101(2):159–164.