Theme 1: the influence of trust when deciding to enrol
’d, I’d been reading, acne
ACNE
This first theme describes participants’ motivators for enrolling on the trial and factors that they described as important in this. Many participants had tried and tested new treatments for acne off the shelf or through their doctor, but due to a lack of effective results continued to read about possible treatment options on websites and online acne communities.Many participants belonged to Facebook groups, Reddit forums and reported using the internet to contribute and read about acne treatments, which led some to be aware that Spironolactone is used as a treatment in America.I found out about it [Spironolactone] on Reddit..it’s sort of like a forum/social media site. The way it works is there’s different communities on there, where people can put up posts and share things. There’s one dedicated to skincare and I’m part of a worldwide skincare one. Katy, age 27Due to the trusted information received from this source, several participants were already aware of the use of Spironolactone for acne and unsuccessfully sought it from their GP. It is possible that when they became aware of the SAFA trial, they saw an access point to a new but familiar treatment. This familiarity may have contributed to their low level of safety concern.I’d been reading about spironolactone and hearing about it, because it’s used widely in America. I’d actually tried to acquire some off licence, through my GP, years ago. I actually thought it was a very good thing, because I’d already known about it - then the success they’ve had in America, where it is used widely. Natalie, age 27Had the drug been an unknown one, I would have not been so keen to take part. Helen, age 30Participants felt that advertisements for the trial were produced to a high standard of quality and not something easily produced by the layperson, which in combination with the affiliated University and NHS logos, were a strong sign of legitimacy.It was at the University of [University Name], or [Hospital Name] Hospital, so yes, went and just applied. Sam, age 25Participants that enrolled through social media felt that it provided a safe, low-effort and direct access point to research from home and a seamless transition into the trial.I was worried there might be loads of hoops to jump through and it would end up dragging on for so long that I’d give up! But actually it was really quick and easy to get involved. Laura, age 36One concern reported by participants was the self-taken digital photo used to assess the severity of their facial acne and eligibility for the trial. Many worried the photos would not provide an accurate representation of their skin due to the lighting or picture clarity, with concerns that the severity of the acne might not be recognised.I had to take my own photos of my skin and send them in for the doctor to review, and then you’ve got, obviously, the deep concerns for my end, as did I get the right photos? Are they clear enough?..it’s very different sending in a photo than someone actually physically looking at your skin face-to-face. Linda, age 32Concerns of inaccurate representation raise issues around participants’ trust in the digital assessment process and subsequent validation of the severity of their acne.