Strategic communication is an essential component in the science and practice of recruiting participants to clinical research studies. Unfortunately, many clinical research studies do not consider the role of communication in the recruitment process until efforts to enroll patients in a timely manner have failed. The field of communication is rich with theory and research that can inform the development of an effective recruitment plan from the inception of a clinical research study through informed consent. The recruitment context is distinct from many other health contexts in that there is often not a behavioral response that can be universally promoted to patients. The appropriateness of a clinical research study for an individual is based on a number of medical, psychological, and contextual factors, making it impossible to recommend that everyone who is eligible for a clinical research study enroll. Instead, clinical research study recruitment efforts must utilize strategic communication principles to ensure that messages promote awareness of clinical research, maximize personal relevance, minimize information overload, and facilitate informed choice. This can be accomplished through careful consideration of various aspects of the communication context described in this chapter, including audience segmentation, message content, message channels, and formative, process, and outcome evaluation, as well as the enrollment encounter.
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Communication and Recruitment to Clinical Research Studies
Janice L. Krieger and Jordan M. Neil
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Perceptions of the Childfree
Elizabeth A. Hintz and Rachel Tucker
Being voluntarily childless (i.e., “childfree”) is a growing trend in the United States and around the world. Although most childfree people know early in life that they do not wish to become parents, the decision to forgo having children is an ongoing process that requires childfree people to construct a life that deviates from the normative family life cycle. Increasing rates of voluntary childlessness is a trend spurred by a variety of shifting social, economic, and environmental factors. Yet despite the increasing normalcy of voluntary childlessness, childfree people (and especially childfree women) face social sanctions for deciding not to become parents, being broadly perceived more negatively than childless people (who do not have children but want them) and parents. Such sanctions include social confrontations in which others (e.g., family members) question or contest the legitimacy of their childfree identity. Media coverage of voluntary childlessness forwards the notion that motherhood and femininity are inseparable and that voluntary childlessness is an issue that primarily concerns and affects women. Furthermore, childfree people face discrimination in health care contexts when seeking voluntary sterilization and in workplace contexts when “family-friendly” policies create unequal distributions of labor for those without children. Members of the childfree community use the Internet to share resources and seek support to navigate challenging interactions with outsiders. Beyond this, although some studies have begun to interrogate the roles of geographic location, race, and sexual orientation in shaping the experience of voluntary childlessness, at present, a largely White, wealthy, able-bodied, cisgender, heteronormative, and Western view of this topic is still perpetuated in the literature.
