Recently, the CSSi team addressed some of the extra considerations that are required when enrolling patients into pediatric trials (http://cssienroll.com/blogs/item/33-successful-pediatric-trials-the-parent-link-patient-recruitment). Another variation on this theme is targeting populations that require some of the same considerations and a few that are different: the adolescent population.
Adolescence (typically between 12 and 18 years of age) is a period of dramatic physical, cognitive, and emotional changes. Add a medical condition to that mix -- be it a serious and dire cancer diagnosis, an equally serious psychological disorder such as depression or anorexia, or simply a less threatening condition such as psoriasis – and it’s not a huge leap to understanding and appreciating the turmoil of an adolescent facing a medical situation that may impact quality of life. There are already numerous hurdles to any clinical trial, but adolescent patient recruitment can have additional and costly time delays, so it’s important to have the right media and message strategies.
Adolescent trials still operate very much like pediatric trials that target younger children. Adolescent recruitment efforts still entail targeting and reaching a decision-maker who is not the patient. Media strategies for minors are really all about the gatekeeper and that usually means Mom. Mom is essential for consent and transportation. So, the successful media plans that drive adolescent enrollment are the ones that use Mom-targeted strategies. However, the Mom with an adolescent child is usually a bit older and more likely to be working outside the home. Plus, Mom, the adolescent patient, and probably the whole family are a lot busier, driving to school events, sports competitions, and other extra-curricular activities. So plan your media accordingly, perhaps using a stronger mix of radio to reach the targets during those school and business commutes. Also, create strong online messaging for this tech-savvy family. In addition, community outreach to health, school and sports professionals can improve adolescent enrollment. Partnerships between primary care pediatric practices, school nurses, athletic league professionals, and church youth organizations can all supplement the media advertising campaign.
A second hurdle in adolescent recruitment is addressing the nature of adolescence itself. Teens are not always forthcoming about health matters, holding back information about risky behavior, for instance, that may include sexual activity, alcohol and tobacco use, and additional poor health habits. Unease about confidentiality, the fear of being lectured or scolded, discomfort with pregnancy screening, and other communication concerns can undercut the consent process. In addition, teens flip-flop almost daily between clinging to parental dependence and striking out for personal independence. It is of greatest value in the consent process that both the parent and the adolescent are equally educated about the confidentiality of the study, the importance of research, and the value of participation. Financial and case management needs can be complicated for many families, so it’s important to foster sufficient personal incentives for the adolescent. Yes, there are many reasons why a patient chooses not to enroll or drops out of a study, including seeking treatment elsewhere or avoidance of treatment altogether. But, an equally engaged patient and parent are key part of a successful recruitment.
So what sort of messaging might drive patient enrollment for an adolescent study? The CSSi team realizes that compelling advertisements and materials designed for a clinical trial are the first step toward consent. Creating an image and message that will draw the attention of both the Mom and the adolescent is extremely important. These first impressions about a program pave the way for more steps toward becoming educated about the clinical trial. Keep in mind that, unlike younger pediatric studies, this adolescent, both dependent and independent at the same time, is viewing and regarding the recruitment message together with the parent. So be sure your message educates, generates interest, and stresses the value of the study in a way that both parent and patient can agree.
With a team of Local Enrollment Specialists, management experts, and media professions, CSSi can create a message and an image that will resonate with both generations. Give us a call today to discuss your next adolescent clinical trial!