Does digital, multimedia information increase recruitment and retention in a children's wrist fracture treatment trial, and what do people think of it? A randomised controlled Study Within A Trial (SWAT).



Moe-Byrne, Thirimon, Knapp, Peter, Perry, Daniel ORCID: 0000-0001-8420-8252, Achten, Juul, Spoors, Louise, Appelbe, Duncan, Roche, Jenny, Martin-Kerry, Jacqueline M, Sheridan, Rebecca and Higgins, Steven
(2022) Does digital, multimedia information increase recruitment and retention in a children's wrist fracture treatment trial, and what do people think of it? A randomised controlled Study Within A Trial (SWAT). BMJ open, 12 (7). e057508-e057508.

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Abstract

<h4>Objectives</h4>To evaluate digital, multimedia information (MMI) for its effects on trial recruitment, retention, decisions about participation and acceptability by patients, compared with printed information.<h4>Design</h4>Study Within A Trial using random cluster allocation within the Forearm Fracture Recovery in Children Evaluation (FORCE) study.<h4>Setting</h4>Emergency departments in 23 UK hospitals.<h4>Participants</h4>1409 children aged 4-16 years attending with a torus (buckle) fracture, and their parents/guardian. Children's mean age was 9.2 years, 41.0% were female, 77.4% were ethnically White and 90.0% spoke English as a first language.<h4>Interventions</h4>Participants and their parents/guardian received trial information either via multimedia, including animated videos, talking head videos and text (revised for readability and age appropriateness when needed) on tablet computer (MMI group; n=681), or printed participant information sheet (PIS group; n=728).<h4>Outcome measures</h4>Primary outcome was recruitment rate to FORCE. Secondary outcomes were Decision-Making Questionnaire (nine Likert items, analysed summatively and individually), three 'free text' questions (deriving subjective evaluations) and trial retention.<h4>Results</h4>MMI produced a small, not statistically significant increase in recruitment: 475 (69.8%) participants were recruited from the MMI group; 484 (66.5%) from the PIS group (OR=1.35; 95% CI 0.76 to 2.40, p=0.31). A total of 324 (23.0%) questionnaires were returned and analysed. There was no difference in total Decision-Making Questionnaire scores: adjusted mean difference 0.05 (95% CI -1.23 to 1.32, p=0.94). The MMI group was more likely to report the information 'very easy' to understand (89; 57.8% vs 67; 39.4%; Z=2.60, p=0.01) and identify information that was explained well (96; 62.3% vs 71; 41.8%). Almost all FORCE recruits were retained at the 6 weeks' timepoint and there was no difference in retention rate between the information groups: MMI (473; 99.6%); PIS (481; 99.4%).<h4>Conclusions</h4>MMI did not increase recruitment or retention in the FORCE trial, but participants rated multimedia as easier to understand and were more likely to evaluate it positively.<h4>Trial registration number</h4>ISRCTN73136092 and ISRCTN13955395.

Item Type: Article
Uncontrolled Keywords: Wrist, Humans, Radius Fractures, Parents, Research Design, Multimedia, Child, Cost-Benefit Analysis, Female, Male, Surveys and Questionnaires
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 07 Sep 2022 09:09
Last Modified: 18 Jan 2023 20:45
DOI: 10.1136/bmjopen-2021-057508
Open Access URL: https://bmjopen.bmj.com/content/12/7/e057508
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3163730