Abstract
Recruitment to qualitative research is an important methodological consideration. However, the process of recruitment is under-communicated in qualitative research articles and methods textbooks. A robust recruitment plan enhances trustworthiness and overall research success. Although recruitment has recently received increased attention in the qualitative methodology literature, a more nuanced understanding is required. We realized successful recruitment to our focused ethnographic inquiry. Numerous nurse educators, researchers, and administrators volunteered within three months of study initiation. Using Gibbs’ Reflective Cycle, we conducted a critical reflection on the recruitment log and participant interview data to surface factors contributing to our success. This article offers our insights into the facilitators of successful recruitment. Our reflection revealed four themes contributing to successful enrollment: (a) laying the groundwork, (b) recruitment plan, (c) building rapport, and (d) participant motivations. Two new recruitment strategies accounted for over 60% of our sample. Reporting on successful strategies for recruiting participants to qualitative research and specifying participants’ motivations to volunteer, from their perspective, make important contributions to the recruitment literature. Our article offers guidance to qualitative researchers pursuing successful recruitment. Additional research is required to evaluate the relative influence of various recruitment strategies.
Keywords
Introduction
Recruitment is foundational to research methodology. Enrollment of participants to research can be challenging (Spratling, 2013); yet it is an important factor in research outcomes (Newington & Metcalfe, 2014). Furthermore, recruitment influences the trustworthiness of qualitative research (Jessiman, 2013). Unfortunately, the process of recruitment is underreported in qualitative research studies and often overlooked in textbooks devoted to qualitative methods (Kristensen & Ravn, 2015). Recently, recruitment has received increased attention in the qualitative methodology literature (e.g., Giorgi, 2021; Price et al., 2020; Turner & Almack, 2017). However, the recruitment process merits further consideration to facilitate a greater understanding of how recruitment is planned and enacted.
The methodology literature contains articles chronicling recruitment difficulties in qualitative research (e.g., Bonisteel et al., 2021; Price et al., 2020), but reports of successful recruitment are limited. Motivations to participate in research have received some attention in the literature, but such accounts of motivation are largely anecdotal and from the perspective of the researcher (e.g., Newington & Metcalfe, 2014; Price et al., 2020). There appears to be a scarcity of literature on why individuals volunteer for research, from their own viewpoint. Furthermore, while authors address recruitment in particular populations (e.g., Fletcher et al., 2020; Lindsay et al., 2021), recruitment of nurse educators is absent from published articles. Without a comprehensive representation of the recruitment process in the literature, researchers lack guidance in achieving recruitment success (Boxall et al., 2016; Marks et al., 2017).
A more “critical and reflexive perspective” of recruitment is necessary for the success of research studies (Kristensen & Ravn, 2015, p. 734). Preparing a detailed recruitment plan can be challenging because it is predicated on the reactions of others; yet preparation for recruitment is essential (Kristensen & Ravn, 2015). Part of this planning is knowing the target population which helps to determine optimal recruitment techniques (Coyne et al., 2016). Nurse researchers with expertise in oncology had an advantage in recruiting oncology nurses to their qualitative clinical study given their knowledge of this population (Coyne et al., 2016). Such specialized nurse researchers anticipated factors that could influence enrollment to their study, thereby adjusting their recruitment plan.
Being familiar with the population under study is also important in ascertaining the inclusion/exclusion criteria that will address the research question. Narrowly defined selection criteria can negatively affect recruitment (Kristensen & Ravn, 2015). Kristensen and Ravn (2015) described how, in a study by Ravn (2004; as cited in Kristensen & Ravn, 2015), the researcher sought to achieve a sample of eight categories of persons based upon gender, family status, and employment status. Having so many selection criteria challenged their ability to attract informants for some of the predetermined categories. Broader selection criteria can result in the timely identification of sufficient eligible volunteers (Price et al., 2020).
The use of incentives, with ethics board approval, can also facilitate recruitment. Kelly et al. (2017) found that monetary incentives were more likely to motivate individuals to volunteer for research than non-monetary inducements. Along with a monetary incentive, Broyles et al. (2011) provided food to entice participation. Others have chronicled how non-monetary incentives can function as effective motivators (Coyne et al., 2016; Ferguson & Wynne, 2021).
The interval between submission of an ethics application and its approval by the research ethics board also impacts recruitment. Several authors have reported challenges in obtaining expeditious ethics approval which caused delays in the initiation of recruitment (Coyne et al., 2016; Newington & Metcalfe, 2014).
Once ethics approval is received, the researcher must gain entrance to the field. Recruitment cannot begin without the expressed approval of gatekeepers, or those who control access to potential participants (Lysaght et al., 2016). Gatekeepers can be either obstructive or supportive of the research (Namageyo-Funa et al., 2014). Thomas et al. (2007) drew on a number of their research studies, concluding that gatekeepers who are supportive of a research endeavour can positively impact recruitment.
Following gatekeeper approval, recruitment of participants is launched. Passive or indirect methods of recruitment, such as flyers, posters (Fleming et al., 2015), and newsletters (Porter & Lanes, 2000) are commonly used. Active or direct strategies, involving person-to-person interactions, have been compared with passive recruitment strategies (e.g., Fleming et al., 2015; Namageyo-Funa et al., 2014). Some researchers advocate a multi-modal approach to recruitment using both active and passive strategies (Broyles et al., 2011; McCormack, 2014).
Successful recruitment is also predicated on the researcher’s ability to establish rapport with potential participants. Building trust, exhibiting confidence and respect, and establishing credibility are necessary in establishing rapport (Boxall et al., 2016; Jessiman, 2013). Additionally, if the researcher is known to the population they are sampling from, then this could aid recruitment (Coyne et al., 2016). Flexibility in accommodating participants’ schedules can also facilitate rapport and eventual enrollment (Marland & Esselment, 2019; Spratling, 2013).
Participants’ motivations to volunteer for research also affect recruitment. Altruistic individuals may be more inclined to volunteer for research (Newington & Metcalfe, 2014). Altruism is reflected in participants’ desire to help others, to make a difference to existing knowledge, and to change practice (Clark, 2010; Coyne et al., 2016). Furthermore, if participants are interested in the research topic or consider the research question to be important, they are more inclined to enroll (Clark, 2010; Keightley et al., 2014). Conversely, people are unlikely to participate if they believe they are too busy or have nothing significant to contribute (Coyne et al., 2016; Kristensen & Ravn, 2015).
Early on, it became apparent that recruitment for our study was successful. We define successful recruitment as enrolling a sufficient number of candid and articulate participants who meet the inclusion criteria and achieving data saturation in a relatively brief time frame. We sought to ascertain a comprehensive understanding of the reasons for our success. The aim of this article is to present a critical reflection on the successful outcome of the recruitment process employed in our recent focused ethnography study.
The Exemplar: A Qualitative Research Study
This critical reflection is based on a focused ethnography study conducted to examine how a nursing education culture influenced nurse educators in building expertise in gerontological nursing (Negrin et al., 2022). Following ethical clearance by a Western Canadian university’s research ethics board (Study ID–Pro00078597) and informed written consent, 22 nurse educators, researchers, and administrators were recruited to the study within three months. Convenience, purposive (including maximum variation), and snowball sampling were used. A multi-modal recruitment plan involved several strategies: short presentations at two faculty meetings with circulation of a sign-up form for attendees to request additional study information; an email to faculty outlining the study and requesting volunteers; posters; a flyer placed in faculty mailboxes; a faculty e-newsletter notice; and a faculty conference poster presentation. The 22 participants were interviewed, and some were also observed. Of the 22 participants, 12 were purposively sampled for second interviews, with two declining invitations. Interviews were audio-recorded and transcribed. Confidentiality was maintained through the assignment of pseudonyms. To help us understand the surprising success of recruitment for this study, the following questions were added after several initial interviews: “What prompted you to participate in this study?” and “Which recruitment strategy sparked your decision to volunteer?” This question guided the critical review: “What factors contributed to successful recruitment of nursing education program staff to a focused ethnography study?”
The Process of Critical Reflection
A critical reflective analysis, using Gibbs’ (1988) Reflective Cycle, was conducted. Gibbs’ (1988) Reflective Cycle involves a structured critical appraisal of an experience. Our critical reflection began with the descriptive phase. We started by carefully examining our recruitment efforts, objectively detailing what occurred during this process. Additionally, we explored and recorded how we felt about our recruitment experience, from which we made value judgements about our experience. Feelings of surprise, excitement, and satisfaction were associated with our successful recruitment. In making a value judgement, we determined that we enacted a reasoned approach to recruitment, resulting in an appropriate plan that heightened our chances of success. In the evaluative phase, an appraisal of what went well and what could have been improved was conducted. We considered factors contributing to our success and what might have been amended. We explored potential obstacles we faced prior to enrollment, the recruitment strategies used, the researcher’s possible influence, and participants’ motivations for volunteering. Subsequently, analysis of the experience occurs when the person endeavours to make sense of the situation, bringing in external ideas to determine the meaning of the experience. Part of analysis includes consideration of whether others’ experiences were mirrored or were significantly different. In the analysis phase, we compared and contrasted our findings with the recruitment literature. After our analysis, we drew conclusions about the recruitment experience. Gibbs (1988) describes how, following the development of conclusions, an action can be devised to address what the person might do differently should they encounter similar experiences in the future. We developed an action plan to guide future recruitment, including the continued use of a multi-modal approach, incorporating the new strategies developed for our focused ethnography, yet predicated on the population under study.
This critical reflection used data from the recruitment log (Lindsay et al., 2021) and participant interviews. The recruitment log included documentation of the recruitment plan and any changes that occurred, the effectiveness of each recruitment strategy, and decisions made throughout the process. Our reflection also included exploring the influence of the recruiter on engaging volunteers for our study. Data revealing participant motivations to volunteer were mined from interview transcripts. A combined critical reflection on both data sources culminated in themes explaining our successful recruitment.
Influences on Recruitment
Successful recruitment for our focused ethnography was realized. Twenty-two individuals who met the inclusion criteria agreed to participate within 3 months of study initiation. This was a sufficient number of participants to reach data saturation. Successful recruitment was also evident in the broad range of participant roles (educator, researcher, administrator), in the breadth of their perspectives, and in their forthright and articulate comments. Upon reflection, four themes became apparent: laying the groundwork, recruitment plan, building rapport, and participant motivations.
Laying the Groundwork
Qualitative research design is understood to be emergent. That is, the researcher must be flexible in making decisions as the design evolves (Jessiman, 2013); however, advanced planning is still required (Loiselle et al., 2011). In laying the groundwork for recruitment, our research team devised a multi-modal recruitment plan. This was deemed necessary to complete recruitment in a timely manner given that the principal investigator (PI), a PhD candidate, had a fixed timeline to complete their dissertation research.
Laying the groundwork for recruitment also included understanding the population under study, namely nurse educators, nurse researchers, and administrators from a university pre-licensure nursing program in Western Canada. The PI is a nurse educator with 30 years of teaching and administration experience in several pre-licensure nursing programs. As such, they were aware of how educators accessed information and the values they held (or not) about nursing research. The PI was also mindful that contracted clinical instructors spent most of their time off campus working with students in their clinical teaching placements. Therefore, the recruitment strategies had to align with how this group of educators accessed information.
Selection criteria for participation in the focused ethnography were broad and likely played an important part in successful recruitment. We planned to recruit participants if they were educators, researchers, and/or administrators who worked with pre-licensure nursing students in the study site. Faculty members who were recruited also had to be able to inform on the phenomenon of interest: the experiences of nurse educators in building their gerontology teaching practice.
Next, ethics approval was sought from the research ethics board of the university and was received 2 weeks after submitting our application. Amendments submitted to the research ethics board after recruitment commenced were also approved in a timely manner, enabling the expansion of the recruitment plan. In preparing our initial ethics application, we included a detailed description of the recruitment strategies we had planned. We decided not to offer an incentive to enroll in our study; however, we did provide a gift card to participants after their first interview. These details were outlined in our ethics application. The gift card was not advertised at the outset of recruitment and involved a minimal monetary amount, thus mitigating concerns about coercion. This small token was meant to convey gratitude for participants’ engagement.
Following ethics approval, we approached gatekeepers. The Vice Dean of the Faculty of Nursing and the Associate Dean, Undergraduate Programs were sent brief emails containing essential study information. Timely approval was secured from both. As such, gatekeepers did not impede initiation of recruitment.
Recruitment Plan
Recruitment Outcomes by Strategy, n = 22.
First, the PI presented the research project at meetings for tenure-track and contracted faculty. The five-minute presentations were appropriately concise yet informative. A unique and highly successful adjunct strategy was the development and circulation of a form for attendees to provide their contact information indicating their desire for additional study information. The document was distributed during the presentations and collected at the end. This document specifically stated that by adding their names, faculty were only requesting additional information about the study and were not indicating their desire to participate. This pre-consent communication was also emphasized during the presentations. Prompt follow-up emails to those 17 participants who completed the sign-up form included a succinct information letter containing contact details for the researcher. The PI received email responses or phone calls from 10 of the 17 persons contacted. Those 10 were successfully enrolled in the study. Two faculty members who signed the form, but did not respond to the email, followed up by approaching the PI in the workplace to confirm their desire to participate. The PI sent a follow-up email to the remaining five faculty who did not respond to the initial email. These latter five prospective participants were no longer interested, stating they were either too busy or no longer available. Originally, our research team had been concerned that circulating the sign-up form, while the PI was in the room, might be considered coercive. We clarified our recruitment strategy in our research ethics application, stressing how we intended to eliminate the potential for coercion. Upon providing clarification, we received approval to proceed.
Another unique active strategy, not part of the original recruitment plan, presented itself when the PI’s poster, representing their focused ethnography research proposal, was selected for presentation at a faculty conference. Being aware that some of the target population would be attending the conference, the research team devised a creative strategy that involved offering viewers of the poster an information letter inviting them to participate. The research ethics board promptly approved an amendment to the ethics application, and the conference organizers granted permission to recruit participants during the poster presentation. This conference poster presentation strategy resulted in two additional participants.
An active strategy that occurred organically was snowball sampling. The research team did not originally plan to ask participants to nominate other faculty they thought could inform on the phenomenon of interest. However, during the PI’s initial interviews, participants requested additional information letters and flyers to disseminate to colleagues. Yet another amendment to the ethics application led to prompt approval of this new strategy. Snowball sampling resulted in two more participants. Being flexible by amending the recruitment plan as opportunities arose enhanced the multi-modal recruitment plan and fostered successful enrollment of participants.
Several passive strategies were also enacted that produced varied success (Table 1). Succinct and visually appealing posters, including selection criteria and the researcher’s contact information, were placed in strategic locations within the Faculty of Nursing workplace: inside the photocopy rooms, outside faculty offices, at department assistants’ desks, and at refreshment stations/lunchrooms. The PI visited these poster sites periodically to ensure that the posters had not been removed or become obscured by other announcements. Posters led to one participant. Flyers, which were placed in faculty mailboxes, failed to attract any participants. An email to all faculty members was disseminated through the assistant to the Associate Dean, Undergraduate Programs. This strategy was moderately successful, yielding four volunteers. The study was also advertised in the e-newsletter for faculty teaching in the pre-licensure program. This strategy resulted in engaging one additional faculty member.
Building Rapport
Upon reflection, it was evident that the PI’s actions to build rapport with potential participants positively influenced recruitment. Not knowing the faculty members might have been a barrier to recruitment; however, the PI overcame this potential obstacle with careful attention to building trust and confidence, demonstrating respect, establishing expertise, and displaying confidence in interactions with potential volunteers. During the presentations to faculty, the PI used eye contact, smiled, and used humour to facilitate the development of mutual trust. Emphasis on research ethics board approval and gatekeeper support earned both trust and confidence. Furthermore, explaining that the sign-up form requesting more information was not meant to pressure attendees into participation developed trust. Demonstrating respect for faculty members’ time, the PI ensured presentations began and ended as predetermined. Underscoring the PI’s content expertise, and past teaching and research experience, also inspired confidence.
While recruiting during the conference poster presentation, the PI also endeavoured to establish credibility with a clear, appealing, and informative poster and through a confident, explicit, and concise presentation. Explaining the education and research background of the PI also conveyed credibility. When offering the information letter to visitors of the poster, trust and respect was established by stressing that accepting the information letter did not indicate an agreement to volunteer.
During all encounters with potential volunteers, the PI emphasized a willingness to be flexible in scheduling interviews and observations at convenient times and locations for participants. This flexibility, which demonstrated respect for would-be volunteers’ time, likely fostered participants’ willingness to volunteer for the study.
Participant Motivations
While the PI’s successful rapport-building influenced recruitment, participant motivations also impacted study enrollment. Critical reflection on participants’ motivations prompting them to volunteer for the study revealed their wish to help others, their interest in the topic, and their view that the research was important. Another motivation was their belief that they had valuable insights to share about our topic. A perceived need to affect professional development policy within their workplace also persuaded participants to volunteer. Finally, the novel opportunity to participate in research was also a motivator.
Helping a graduate student motivated participants to enroll in our study. Jamie stated: “I think it’s important to help support the people that are doing master’s or doctoral work. I know, having done master’s work, it’s difficult to find research participants for studies.” Echoing Jamie’s statement, Sophia said: “I just think it’s good to support people…it’s always hard to recruit people, so I figured…I should be collegial.”
Participants were also inclined to participate if they were interested in the topic. Corey explained: “I was really excited about your topic area, gerontology, because it is the area that I have linked myself with in my nursing practice.” Lane’s interest was piqued because they saw the research as a means to enhance teaching in their focus area: Whenever I see efforts to study gerontology and to ensure that students, in particular, have a positive view about older people and appropriate information to care for well and ill older people, I’m really interested and happy to participate, so…I applaud the study. I’m glad you’re doing it.
Additionally, participants were motivated to volunteer for our study because they saw the research as important. Bobbie volunteered “because of the importance of the topic.” Corey concurred: “I think it’s a really important topic area and so that’s part of the reason. I thought, wonderful, let’s have some more research in this area.” More specifically, participants saw our research as an important means to facilitate change in their nursing program. Participants expressed their concerns that their pre-licensure nursing program was not adequately preparing students to provide optimal care to older persons due to curriculum deficits and ageism. By voicing their views, participants were drawing attention to these deficiencies to underscore the need for educational practice change. Jamie explained: “I think that there’s value in what you’re doing…Our population is aging…and just looking at how we educate our younger generations about the elderly and how to care for them is important.” Bobbie agreed: “I thought, well, I’ll talk to you and if any of this helps in terms of informing our curriculum and doing our best, that’s good.”
Furthermore, Bobbie saw that by having their concerns about ageism within the nursing program included in our study, our research might lead to positive change in how students were educated about older persons. Bobbie said: Ageism is a terrible problem in healthcare…and it affects the care we give older adults. So, we need to do something and one of the best ways is to think about our nursing students and how they’re prepared.
Micah was also motivated to participate because of the negative attitudes about older persons and their care being conveyed, perhaps not intentionally, to the nursing students within the program: “I remember looking at [your advertisement] and thinking…this is really important. I see this kind of antipathy. I see this assumption that care of the elderly is boring and so-called basic nursing.” Nora offered a solution to address ageism within the program, suggesting that our research could make a positive contribution: It’s important for us to be instilling…the value in the care of older adults with students from the very beginning. And so, if there’s ways that we can be doing that better, then I think it would be great to find out.
Additionally, participants believed they had important insights to contribute to the research which also motivated them to participate in our study. Sophia believed they could provide an understanding of gerontological nursing education in the context of the pre-licensure curriculum. They stated: “[Gerontology is] not a target of the research I do, but in my administrative position, I look across the whole program. So, I figured maybe I’m helpful in that respect.” Furthermore, Nora articulated that because their research focus aligned with our topic, they might make a valuable contribution to our research: “I’m such a new assistant professor and I wasn’t sure, at first, if you’d be able to learn too much from me. But then I thought, well, my work is in the area of older adults.”
Additionally, some participants volunteered to facilitate capacity building of educators with expertise in the care of older persons. Nora illustrated this view: “How are educators prepared [in gerontology]?.. There’s some work to be done around that, right? [It] sort of feels slightly self-taught.” Furthermore, Zoe stated: “There’s no purposeful, intentional [professional development] activity.” By expressing the necessity for policy change around professional development, they hoped to draw attention, through our research, to the need for deliberate faculty development strategies in the care of older persons.
Finally, one nurse educator participant explained that the reason they chose to volunteer for the study was because they had never been asked to take part in research about nurse educators and nursing education. Virginia revealed: “I have never really seen people doing research on nurse educators. I’ve never been asked to participate in this kind of research and so I thought I would volunteer.” This may reflect the participant’s curiosity about being involved in a research study.
Discussion
Critical reflection on recruitment for our focused ethnography study revealed that our success was predicated on carefully laying the groundwork for recruitment, a multi-modal recruitment plan, the positive influence of the researcher/recruiter, and participant motivations to volunteer.
Laying the Groundwork
Laying the groundwork for recruitment is essential. Planning for recruitment acknowledges its complexity and facilitates enrollment (Newington & Metcalfe, 2014; Ward et al., 2009). In building our foundation for recruitment, we identified several factors that positively influenced the engagement of volunteers for our study.
Although the development of a multi-modal recruitment approach was a key element in laying the groundwork for enrolling our participants, an initial recruitment plan may not include all eventual strategies used. Bonisteel et al. (2021) characterized recruitment as dynamic. Jessiman (2013) argued that because qualitative research is inherently iterative, this affords researchers the flexibility needed to amend their recruitment as barriers arise. While we did not encounter barriers to recruitment, the qualitative nature of the study allowed us to amend the recruitment plan as new opportunities arose.
Despite qualitative studies affording researchers flexibility in their recruitment efforts, careful planning is still necessary, including knowing the target population (Boxall et al., 2016; James et al., 2014). Based on their prior research with the Latino population, Lindsay et al. (2021) developed a multi-modal recruitment plan to engage Latino fathers, an underrepresented group in paediatric research. These researchers realized greater success in using direct methods of recruitment, such as in-person recruiting and snowball sampling. Our research team’s familiarity with the population under study, those nurse educators, researchers, and administrators from a university pre-licensure nursing program in Western Canada, facilitated the selection of recruitment strategies that were successful in reaching those we wished to recruit.
Broad inclusion criteria also facilitated recruitment to our study. James et al. (2014) conducted a phenomenological study, initially experiencing slow enrollment of young persons with type 1 diabetes. To facilitate successful recruitment, the researchers expanded their original selection criteria to encompass other geographical areas. Price et al. (2020) also experienced low recruitment for their qualitative study of patients in emergency departments. Reflecting upon their recruitment challenges, these authors concluded that they would have realized greater success had their selection criteria been less restrictive.
We received speedy ethics approval for our study and for subsequent amendments. This was a distinct advantage that facilitated prompt initiation of recruitment. The literature chronicles instances of lengthy ethics approval processes that obstructed recruitment. In Newington and Metcalfe’s (2014) qualitative study of research teams’ experiences with recruitment, participants reported that more rapid ethics clearance would have accelerated recruitment to their studies. Conversely, James et al. (2014) expected that obtaining ethics approval for their qualitative study would be challenging; however, with minor amendments, they were granted relatively swift approval. The need to submit amendments to the original protocol can further delay ethics clearance (Samir et al., 2021).
The use of incentives to enroll in research can facilitate recruitment; however, this strategy can be viewed as coercive and must receive research ethics board approval (Jessiman, 2013). We considered incentives as part of our ethics application. Kelly et al. (2017) found that monetary incentives were more effective than non-monetary enticements in motivating persons to volunteer for research. However, Ferguson and Wynne (2021) explained that when recruiting clinicians and students for focus groups, food and branded merchandise can prompt participant engagement. We did not offer an incentive. However, we did provide nominal gift cards after initial interviews which were well-received and may have helped foster participant retention.
Other sources of potential coercion must also be considered. Our research team contemplated the potential for coercion in the implementation of our novel strategy to conduct research presentations to prospective participants while circulating a sign-up form with the PI present. Indeed, Haggerty (2004) noted that the presence of the researcher during recruitment encounters with potential participants could indirectly pressure individuals to volunteer. We diligently mitigated the possibility for coercion by clearly outlining the purpose of the form.
The potential for coercion could also involve gatekeepers, such as nurse administrators, primary care physicians, hospital administrators, and administrators of educational institutions. In a focused ethnography study to understand experiences with teamwork and job satisfaction of healthcare professionals, the researchers were concerned about coercion in accessing prospective participants (Dahlke & Stahlke, 2020). At one of two study sites, the manager’s enthusiasm about the research led to their creation of a list populated with the names of staff members who were then assigned times to meet with the researchers during the initial information session. Staff perceived their manager’s direct involvement in the recruitment process as coercive. The researchers rectified the situation with the manager and staff by re-emphasizing strict adherence to ethical research principles, which helped mitigate the misunderstanding and/or breakdown in communication. Likewise, Thomas et al. (2007) and Namageyo-Funa et al. (2014) also confirmed that gatekeepers can influence potential participants to believe they are obligated to volunteer. Other than disseminating study information, the gatekeepers in our study remained uninvolved in the recruitment process.
Our research team successfully collaborated with gatekeepers to obtain permission to approach potential volunteers for our study. Marks et al. (2017) also described working in cooperation with a gatekeeper to gain timely access to the population they were endeavouring to sample. Similarly, Turner and Almack (2017) described how they gained gatekeeper approval for their study, surmising that their success was due, in part, to the first author’s well-established professional relationship with key decision-makers in the study sites. Meanwhile gatekeepers created barriers to accessing participants in other studies (e.g., Lysaght et al., 2016; Namageyo-Funa et al., 2014).
Having the backing of other key players in an organization is also vital to accessing research participants. During recruitment for their qualitative study of inpatient nurses, Broyles et al. (2011) found that gaining the support of nurses and nurse administrators within the organization facilitated recruitment. Likewise, a supportive culture in which research is valued facilitates successful recruitment (Higgins et al., 2010). Despite the PI having no prior relationships with gatekeepers at the university, they were still able to gain the support of individuals within the study site. This could be, in part, due to the university’s research-intensive culture (Keightley et al., 2014).
Recruitment Plan
Our recruitment plan involved active, face-to-face recruitment strategies. The efficacy of such approaches has been described in the literature, with authors chronicling success using a variety of active strategies. Lindsay et al. (2021) were successful in recruiting for their child health studies by using in-person interactions between the research staff and potential volunteers. Namageyo-Funa and colleagues (2014) secured the assistance of gatekeepers to facilitate enrollment in their studies.
We employed the active recruitment strategy of snowball sampling. Snowball sampling was added to our original recruitment plan with some success, a finding supported in the literature. This strategy resulted in additional participants who added important insights to Kristensen and Ravn’s (2015) studies. Likewise, Lindsay et al. (2021) reported that in three of their five child health studies involving Latino fathers, snowball sampling was the most successful approach used during the recruitment process. However, snowball sampling can result in a non-representative sample (Leighton et al., 2021; Sharma, 2017). Aware of this limitation of snowball sampling, we also incorporated the use of maximum variation sampling in this study.
Our face-to-face recruitment strategies also included two unique active approaches that facilitated the recruitment of over 60% of our sample: the conference poster presentation and the presentations to faculty during which a sign-up form was circulated for attendees to indicate their interest in further information. Regarding the faculty presentations, Acrury and Quandt (1999) promote “addressing a gathering of site members” as a means of recruitment (p. 129). However, we contend that more than the presentations per se, the use of the sign-up form facilitated the overwhelming response. Having the names of prospective participants gave the PI permission to email each person following the meetings. McCormack (2014) asserts that there is a need for advances in participant recruitment. We believe that these two unique strategies contribute to that advancement.
The literature also describes how passive or indirect strategies for recruitment, such as flyers, posters, emails, and newsletters, have been both effective (Fleming et al., 2015; Spratling, 2013) and ineffective (Lindsay et al., 2021; Marks et al., 2017). None of our participants reported being motivated by flyers, yet we had some success in using posters, emails, and an e-newsletter advertisement (Table 1). It is possible that the passive strategies we implemented had more influence than we realized. Fleming et al. (2015) argued that those who are exposed to study information numerous times may be more likely to volunteer for research. It could have been that participants’ exposure to our flyers heightened their awareness of our study, although this strategy was not reported as the trigger for enrollment. As such, the numbers of participants we recruited per strategy may not accurately represent the actual influence of individual strategies.
Our focused ethnography involved a multi-modal recruitment plan, the combined use of both passive and active strategies. Researchers caution against relying on a single strategy when initiating recruitment (Marks et al., 2017; Namageyo-Funa et al., 2014). Several authors have described using a combination of active and passive strategies (Kristensen & Ravn, 2015; Spratling, 2013). In their successful recruitment for an ethnographic study, Davies (2011) placed leaflets in mailboxes in addition to following up with face-to-face door knocking. Furthermore, Fleming et al. (2015) recommended using multiple recruitment strategies to promote blanket coverage as well as strategies specifically targeting the population under investigation. Consistent with Fleming et al. (2015), we included a combination of passive and active strategies to facilitate comprehensive exposure of our population of interest to the study information.
Building Rapport
Our successful recruitment can be attributed, in part, to the PI’s ability to build rapport with potential participants. When researchers establish rapport with potential participants, successful recruitment is more likely to occur (Felsen et al., 2010). As Spratling (2013) discovered in their study of children and adolescents, “parent and participant rapport with the researcher is essential” (p. 64). A number of important factors facilitate rapport-building: being trustworthy, credible, respectful, and flexible.
Lindsay et al. (2021) reported that trust in the researcher was important in their endeavours to recruit Latino fathers to child health research. Jessiman (2013) built trust with potential participants by presenting concise study information at professional meetings. Boxall et al. (2016) found that a confident, experienced, and credible researcher promotes trust and increases the likelihood of successful recruitment. In disability-related research, Lysaght et al. (2016) found that researcher credibility was a factor in employers’ inclination to volunteer. Engaging face-to-face with potential participants provides an opportunity for the researcher to establish trust and credibility. A researcher’s flexibility in scheduling participants for interviews or focus groups can also facilitate participant recruitment (Lindsay et al., 2021; Marks et al., 2017; Marland & Esselment, 2019) and demonstrates respect for participants’ time. Researchers being known or having personal contacts in an organization can also act as facilitators to recruitment (Eide & Allen, 2005). Although the PI in this study was unknown within the research setting, successful rapport-building mitigated this possible obstacle.
Participant Motivations
Participant motivations can forecast a person’s inclination to volunteer for research. The literature offers anecdotal accounts about persons’ motivations for research engagement, leading to a call for empirical evidence (Clark, 2010). Although researcher and clinician perspectives about recruitment are beginning to appear in the literature (Newington & Metcalfe, 2014), there is a dearth of reports from the participant’s viewpoint. Understanding participants’ experiences with recruitment can inform modifications to the recruitment plan (Lindsay et al., 2021). Our critical reflection on participants’ perspectives about their motivations to volunteer for our study makes an important contribution to the recruitment literature.
Tarpey (2006) argued that individuals volunteer for research for personal reasons and social interest. Advancing Tarpey’s (2006) position, Clark (2010) categorized their respondents’ motivations as either individual or collective level mechanisms, emphasizing that the two can overlap. Clark (2010) found that participants’ individual supporting mechanisms included, for example, a subjective interest in the focus of the study and a curiosity about participating in research. Motivations at the collective level included, in part, representation, political empowerment, and the opportunity to inform change. All of these motivations were represented in our data.
In our focused ethnography study, one motivator was our participants’ wish to assist a graduate student in their dissertation research. In accord, Peel et al. (2006), who asked their study participants about their reasons for volunteering, reported that participants expressed their desire to help others, including the researchers. Peel et al. (2006) maintained that the wish to assists others is an example of participants’ altruistic comportment. Altruism has been described in the literature as a value that prompts individuals to volunteer for research (Jessiman, 2013; Newington & Metcalfe, 2014). Tarpey (2006) asserted that altruism reflects a social interest in helping others and Clark (2010) referred to this desire as a collective level mechanism.
The literature confirms that successful recruitment is also more likely if a person is interested in the topic (Bonisteel et al., 2021; Newington & Metcalfe, 2014), either as individuals or as members of a group (Clark, 2010). Our participants were drawn to our study because our research was focused in their subject areas. From an altruistic perspective (Tarpey, 2006), they were also interested in our research because they imagined that our findings could positively impact nursing students and the care of older persons. Furthermore, participants may also have been attracted to our study because of their overall interest in research and their valuing of scientific inquiry (Fletcher et al., 2020; Keightley et al., 2014). Since our study was conducted in a research-intensive university setting, it could be that participants possessed an inherent interest in and a valuing of research, although this was not expressly stated.
Furthermore, participants regarded our topic as important and, therefore, were more inclined to participate (Keightley et al., 2014; Kristensen & Ravn, 2015). Their perceptions that our research was important can be understood at the collective level and further demonstrates participants’ altruism. Volunteers expressed that the importance of our research was due to its focus on older persons and gerontological nursing education. Specifically, participants stated that their concern for older persons was, in part, ignited by ageism and the negative views about this population expressed within their workplace, nursing education as a whole, and the healthcare system. Participants expressed the view that care of older persons must be more positively portrayed within their nursing program. Furthermore, participants were drawn to our study because of their concerns about curriculum deficiencies in preparing students to provide quality care to older persons. Their “wider social interests and experiences” (Clark, 2010, p. 404) prompted participants to view our research as important, relevant to them, and of significance to society (Keightley et al., 2014; Kristensen & Ravn, 2015; Lysaght et al., 2016; Newington & Metcalfe, 2014).
Moreover, at both the individual and collective levels, our participants indicated that they had important insights to contribute to the research (Clark, 2010; Kristensen & Ravn, 2015; Tarpey, 2006). Participants indicated that given their teaching, research, and administrative roles, they might be able to contribute to our study in meaningful ways. Additionally, at the collective level and suggesting an altruistic stance, participants wished to share their perspectives to potentially facilitate meaningful change in gerontological nursing education to the benefit of both students and older persons (Clark, 2010; Coyne et al., 2016; Newington & Metcalfe, 2014; Tarpey, 2006).
Based on participants’ concerns about their professional development in older person care, the desire to fuel political empowerment, a collective mechanism (Clark, 2010), may have been a motivator. Participants described how they were impeded from developing their expertise in older person care due to their employer’s lack of a purposeful strategy for their professional development. By having their concerns made public through our research, participants’ intent may have been to foster empowerment of faculty to “act within discourses that they wanted to be part of” (Clark, 2010, p. 412). Tarpey (2006) contends that the desire to affect change can also be for personal reasons, namely seeking to “hav[e] a voice” (p. 13). Our volunteers may have wished to have input into deliberate strategies to develop their teaching practice in older person care and to influence the educational environment affecting their own careers.
Lastly, one of our participants voiced their desire to participate because they had never been approached to enroll in research about nursing education, nor had they noticed recruitment materials advertising for nurse educator volunteers. This could reflect an individual supporting mechanism, namely the participant’s curiosity about the novel endeavour of being involved in a research study (Clark, 2010). Seen through the collective lens of representation (Clark, 2010), it could be that this participant was implying they were part of an under-researched population, wishing to have nurse educators’ voices represented in the literature. In a qualitative study about refugees, Omata (2020) noted that some groups of refugees were concerned that they were not being studied, prompting an absence of their perspectives from the discourse. Omata (2020) contended that being part of an under-researched population can be a motivator to volunteer for research. As such, this participant could have been implying they belonged to an under-researched group, thus prompting their engagement in our study.
Our findings have implications for research and education. We recommend that researchers consider a multi-modal recruitment plan to facilitate participant engagement. The comprehensive manner in which we approached recruitment, using a variety of active and passive strategies, yielded successful enrollment of participants. We propose that researchers base their multi-modal recruitment plan on knowing the population from which their sample is to be drawn and on a review of the recruitment literature to ensure their plan is evidence-informed. A research team, composed of experienced researchers who are knowledgeable about recruitment strategies, would also support successful enrollment. Our flexibility in adding strategies, as opportunities presented, strengthened our original multi-modal approach as did our creativity in developing novel strategies to attract volunteers. Hence, to promote successful recruitment, qualitative researchers are encouraged to approach participant engagement with flexibility and creativity. Additionally, our experience emphasizes that rapport building is essential for researchers during the recruitment process. Furthermore, inquiring about our participants’ motivations to volunteer for our study suggests that researchers may gain further guidance in identifying appropriate recruitment strategies by considering a person’s motivation to engage in research. As such, faculty who teach research courses at the undergraduate and graduate levels must provide learning opportunities that specifically address recruitment. An added focus on recruitment would enable researchers, especially novice scientists, to be better prepared and more confident in the recruitment phase of their research studies.
Finally, we agree with Kristensen and Ravn (2015) that next steps ought to include an enhanced focus on recruitment in qualitative methods textbooks and in research articles. Likewise, we concur with Jessiman (2013) that journal editors and authors of textbooks ought to consider the reporting of recruitment as an essential criterion for judging the trustworthiness of a study. More attention to the process of recruitment in the research literature would provide further guidance to researchers in their recruitment endeavours (Boxall et al., 2016; Marks et al., 2017). The inclusion of participants’ motivations in volunteering for our study underscores the importance of understanding how central to recruitment these motivations are. Development of an evidence base about participants’ reasons for volunteering, from their perspective, would extend the literature and provide further guidance to researchers. Moreover, this literature would be further enriched by studies inquiring into the motivations of persons who are members of distinct populations, presuming that those from different populations may have varied intentions for engaging in research. Finally, building a research base on the relative influence of particular recruitment strategies on the enrollment of participants would inform researchers in selecting approaches that are more likely to lead to recruitment success.
Strengths and Limitations
This article contributes to the methodological literature by identifying factors that contributed to successful recruitment in a qualitative study. Two novel recruitment strategies were introduced, accounting for a large proportion of our sample. We address an identified gap in the literature: reporting the participants’ perspectives on being recruited for research. Gibbs’ (1988) Reflective Cycle offered a structured approach for our critical reflection on the process of recruitment.
As with all research, there are limitations to be reported. We did not inquire about all of the recruitment strategies to which participants were exposed; thus, reports of the strategy triggering a decision to participate in the study may not have been the only recruitment approach contributing to their choice to engage. Finally, since the recruitment process is, in part, dependent on the population under study, it is possible that our recruitment plan, or its individual strategies, may not be applicable for other populations.
Conclusion
This critical reflection offers valuable insights for researchers into the elements that may promote successful recruitment. Laying the groundwork to achieve successful recruitment for our focused ethnography study involved developing a multi-modal recruitment plan; knowing the population under study; identifying broad selection criteria; achieving swift ethics approval; and gaining the support of gatekeepers. A flexible multi-modal recruitment plan, including both active and passive strategies, was advantageous. Two novel active strategies contributed significantly to successful recruitment. Likewise, the PI’s flexibility in scheduling data collection, along with their ability to establish rapport with potential participants, positively influenced enrollment. Importantly, participant motivations inspired their engagement in our study. Chronicling successful strategies for recruiting participants to qualitative research, and specifying participants’ motivations to volunteer, make an important contribution to the recruitment literature. More evidence-based research is needed to formally evaluate the impact of specific strategies on the recruitment process.
Footnotes
Author contributions
KN was responsible for conceptualization of the article and critical reflection on the data, drafting the manuscript, responding to feedback from the co-authors, and approval of the final version of the article for submission. SS contributed to conceptualization of the article, critical reflection on the data, revision of the manuscript for important intellectual content, and approval of the final version of the article for submission. SD and JO contributed to conceptualization of the article, revision of the manuscript for important intellectual content, and approval of the final version of the article for submission.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
