Community midwives’ and health visitors’ experiences of research recruitment: a qualitative exploration using the Theoretical Domains Framework

Background: Successful research is frequently hampered by poor study recruitment, especially in community settings and with participants who are women and their children. Health visitors and community midwives are well placed to invite young families, and pregnant and postnatal women to take part in such research, but little is known about how best to support these health professionals to do this effectively. Aim: This study uses the Theoretical Domains Framework to explore the factors that influence whether health visitors and community midwives invite eligible patients to take part in research opportunities. Method: Health visitors (n=39) and community midwives (n=22) working in four NHS Trusts and one community partnership in England completed an anonymous, online survey with open-ended questions about their experiences of asking eligible patients to take part in research. Qualitative data were analysed using directed content analysis and inductive coding to identify specific barriers and enablers to patient recruitment within each of the 14 theoretical domains. Findings: Six key TDF domains accounted for 81% of all coded responses. These were (a) environmental context & resources; (b) beliefs about capabilities; (c) social/professional role and identity; (d) social influences; (e) goals; (f) knowledge. Key barriers to approaching patients to participate in research were time and resource constraints, perceived role conflict, conflicting priorities, and, particularly for health visitors, negative social influences from patients and researchers. Enablers included feeling confident to approach patients, positive influence from peers, managers and researchers, beliefs in the relevance of this behaviour to health care and practice, and good knowledge about the study procedures, its rationale and the research topic. The findings suggest that to improve research recruitment involving health visitors and community midwives a package of interventions is needed to address the barriers and leverage the enablers to participant approach