Objective: Decentralized clinical trial models may enhance participation, but participant-reported drivers of enrollment and sustained engagement remain underexplored; understanding these experiences can help ensure objectives are met without compromising safety and data quality.
Methods: We developed a 17-item REDCap survey by adapting established core domains, including staff responsiveness, interpersonal relationships, clarity of information, and overall logistical ease, alongside trial-specific items like parking, courier services, and community laboratory experiences. Our survey used a 5-point Likert scale, ranging from strongly disagree (1) to strongly agree (5), plus the three open-ended questions seeking feedback on study pros/cons and motivating factors for participation. Categorical data were summarized descriptively. Differences between remote and in-clinic participant responses were measured using student t-tests. Free text responses were not analyzed but reviewed from a trial improvement perspective and to identify themes. Surveys with missing data were excluded from analysis at the question level. No limit of significance was planned for this exploratory study.
Results: Of 97 participants across 6 provinces, 65 responded (67%): 23 in-person, 34 remote, and 8 hybrid; all questions were answered by all respondents. Satisfaction was high (mean 4.65 in-person vs 4.82 remote; p=0.28). No significant differences were observed between participation modalities for any question, however, a positive connection to study staff was stronger in those who participated in-clinic vs remotely (p=0.09). Overall, participants felt informed, safe, and that participation was meaningful. Open-ended responses emphasized altruism and connection, along with a desire for trial burden reduction.
Conclusion: Remote and hybrid participation options support patient-centered research without compromising trial objectives. In fact, utilizing a remote option permitted a contribution by individuals who would otherwise have been excluded, an opportunity described as important by participants. Trial designers should consider participant priorities, communication strategies, and flexibility to enhance enrollment and retention.