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Participant and patient engagement, recruitment, and retention

Need assistance with participant engagement, recruitment, or retention?

Successful participant engagement, recruitment, and retention in research studies can be one of the most challenging aspects of conducting research. Effective and efficient engagement, recruitment, and retention strategies are critical to successfully achieving enrollment targets while also prioritizing participant safety, well-being and trust.

This page provides resources, best practices and tools for developing and implementing robust engagement, recruitment, and retention strategies. However, it’s important to note that there is no one-size-fits-all approach to good planning. In fact, effective engagement, recruitment and retention planning should:

  • Take time
  • Be proactive
  • Start upstream at study design
  • Anticipate and account for downstream barriers
  • Be data-driven and evidence-based
  • Be thoughtful and realistic
  • Include input from all relevant stakeholders
  • Be participant-centered
  • Be resourced appropriately
  • Be adjusted as needed

Request a free consultation with the Recruitment Innovation Center or consider the Consultations and Help resources available in the “Related Resources” section.

Population or cohort discovery

Defining the population or cohort is an important step in determining the feasibility of the project and to identify the most effective recruitment strategies. The following tools are available to help with cohort discovery and enrollment feasibility assessments:

Participant or patient engagement and recruitment strategies

Once the cohort or population has been identified, recruitment plans should consider which strategies and messaging are most appropriate to engage the intended audience, while also adhering to Federal Regulations and institutional policies and guidance.

Before identified potential participants can be recruited engagement must happen. Engagement, in this sense, is about delivering content to the right person, at the right time, with the right frequency, through the most effective channel.

True stakeholder engagement should happen as early in the study design process as possible. However, that’s not always an option when Duke is a participating site in “someone else’s research study” – when this is the case, we think of engagement as the strategies used to share information about a study with potential participants. This may include one or more of the following channels:

  • Duke Health Research Volunteer Registry
  • ResearchMatch
  • Social media (e.g., Facebook ads)
  • Print media (e.g., flyers, brochures, etc.)
  • Online/digital content (e.g., a study website or search engine ads)
  • Radio or TV spots
  • Letters or emails
  • Phone scripts for personal phone calls
  • MyChart messages
Advertising Tools, Regulations, Policies and Guidance

Advertising, regardless of the chosen channel(s), must follow federal regulations, Duke policies, and Duke branding requirements. Links below provide information about allowable typography, colors, use of logos, and additional tools.


Discover Duke Research 

The Recruitment Innovation Center manages the Discover Duke Research Facebook and Instagram pages and offers free social media marketing consults to all Duke research teams. During a social media marketing consult, the RIC team and investigator will work together to begin drafting a social media marketing plan to submit to the IRB for approval. Ads can be launched by the RIC from the Discover Duke Research accounts (Facebook/Instagram, Reddit, and Google) or the investigator may launch them from another approved social media channel per the Duke Social Media Recruitment SOP. RIC services (e.g., assisting in the development of a social media marketing plan, acquiring high quality images for advertising, managing the campaign, etc.,) are free of charge but there is a fee for the ads themselves.


Duke Health Clinical Trials Directory 

The Recruitment Innovation Center manages content on the Duke Health Clinical Trials Directory. Reviewing the SIP Console Training in LMS (course #00129901) is recommended before reaching out to the RIC for assistance ( in having a study posted on the Directory.

Literacy and Readability

Engagement, recruitment and retention planning should take into consideration best practices for literacy, numeracy, and health literacy as well as principles of good readability. Principles of readability and tailoring to the health literacy needs of a population include adherence to the following principles:

  • Responsibility: Clear research communication is the responsibility of all stakeholders in the research enterprise
  • Life Cycle Adherence: All research communication should be clear and easy to comprehend throughout the research life cycle
  • Partnership: Research communication should be developed in partnership with the intended audience(s)
  • Cultural Sensitivity and Respect: are integral to clear communication about research
  • Tailoring: Research materials for participants should integrate literacy and health literacy practices, including plain language, numeracy, visualization and design techniques, and cultural considerations
  • Evaluation: Participant research materials should be evaluated to ensure the intended audience can understand the information
  • Confirmation: In-person communication should encourage dialogue and confirm understanding
  • Institutional Support: All stakeholders in the institutional research enterprise should support the development and implementation of organization policies that integrate literacy, numeracy and principles of good readability
Participant and patient engagement resources

Engagement, Recruitment, and Retention Certificate Program

The Engagement, Recruitment, and Retention Certificate Program is a certificate and skills-building program designed for Clinical Research study teams. The intention of the program is to help staff develop and expand competency in participant engagement, recruitment, and retention.

Participant Retention Strategies

Good retention starts with a strong, feasible, well-considered engagement and recruitment plan and a participant-centered research study. Many a study has been derailed by inadequate attention to recruitment and retention barriers and lack of effective strategies to overcome them.

Approaching recruitment and retention by ensuring a protocol is participant-centered will enhance the chances of a successfully completed study that finishes enrollment on time with a strong retention rate. Being participant-centered requires an investigator to consider every element of the project from the perspective of a participant and a variety of other characteristics (e.g., relevance of the study question to them, motivation - altruism, compensation, access to novel therapy, etc. - disease state, therapeutic options and opportunity costs, etc.). Adopting both a participant-focus and a quality-by-design framework can help examine study objectives and identify the factors that are critical to achieving them, while minimizing the burden of participation for participants. In terms of recruitment and retention, this should (at minimum) include attention to the following:

  • Eligibility criteria – each criterion should be reviewed for its importance to achieving the study aims, its effect on the availability of the population and its acceptability to providers, participants and (if applicable) patient advocacy organizations.
  • Accrual feasibility – does the study population as described actually exist? Is there one (or more) particular criteria that will weed out a large number of potential participants? Are there adjustments to the eligibility criteria that should be made?
  • Adequate compensation – not all studies have the option of compensating participants. However, it’s important to consider the time, effort and hassle participants are enduring to take part in a study. Compensation in the form of money, expense reimbursement (e.g., travel, parking, meals), meaningful/useful tchotchkes or give-aways, etc., are all appropriate methods of compensating participants.
  • Study procedures and event schedules – are the study procedures, including their invasiveness and risks, length and frequency of visits and location of participation particularly burdensome for the target population?
  • Feasibility in the clinic – examine the study from the perspective of providers and clinic staff and their daily clinic operations. Will the study impact their clinic workflow? Engage them early in study design to mitigate against this risk; otherwise, ensure flexibility to minimize disruption.
  • Reducing the burden of participation – research participants are often busy people, deeply embedded in dynamic personal lives. A research study is not part of their job. Providing flexible appointment times, short visits, and convenient locations for in-person study visits can ensure that it’s easy for participants to remain in a study. Consolidate visits when possible and provide “remote” options when feasible.
  • Clear, frequent communication – Well-timed communication, including study visit reminders, via participant-preferred methods (SMS, email, phone call), an updated website, newsletters about study progress and milestones achieved, etc. are all good ways to keep participants engaged and interested in a study. Lay summaries of findings can be useful, especially if an abstract or a poster about the project is published.
  • An attitude of humble gratitude – People are not required to participate in research. Their participation is a gift to be appreciated. Frequent communication of gratitude and recognition of the time and effort participants are sharing is often cited by participants as important to their continued participation. A commitment to providing a lay-summary of the study results at the end of the study is a great way to demonstrate appreciation and turn research participants into research evangelists.

Through Innovation, Connections, Collaborations and Education, the Recruitment Innovation Center is available to help with recruitment needs. For assistance and support across the enterprise, reach out to the RIC at or request a consult today.