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A nudge toward participation: Improving clinical trial enrollment with behavioral economics

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Science Translational Medicine  20 Jul 2016:
Vol. 8, Issue 348, pp. 348fs13
DOI: 10.1126/scitranslmed.aaf0946

Tables

  • Table 1. Taxonomy of proposed interventions.
    ApproachBenefitsConcerns
    Information
    provision
    • Descriptive norms• Relatively inexpensive• If norm of participation is low, normative information may reduce desire to participate
    • Injunctive norms• Informed participants are less likely to make mistakes during clinical trial
    • Reciprocity
    • Personalization• Serves ethical goal of informed consent• Too much information can reduce desire to engage
    • Simplified consent forms
    • Providing information at appropriate times• Depends on trust in the source of the information
    Choice
    architecture
    • Defaults• Recruitment procedure has to be developed anyway, so little added effort to incorporate choice architecture• Some procedures are not fully transparent
    • Active choice
     • Enhanced active choice• May backfire, by introducing “no” options or by asking wrong questions
     • Expanded active choice• Grant greater sense of control/autonomy to participants
    • Ethical concerns about fully informed consent
    • Structured decision flow• Relatively inexpensive
     • Foot-in-the-door
     • Self-prophecy
    • Incentives• Direct financial payment• Compensates participants for time, opportunity cost, and taking on risk• Can be expensive
    • Lottery payment• Undue inducement
    • Material prizes• Delivery of incentives can be structured to motivate continued participation• Unjust inducement
    • Rewards that facilitate participation (e.g., bus pass)• Potential participants may fail to disclose exclusion criteria
    • Social recognition
    • Providing RCT results

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