Discussion
acne
ACNE
This paper described the experiences of participants taking part in a partially decentralised dermatology trial [For many interview participants, their first interaction with the SAFA trial was through the social media advert. Findings from this study show that trusted affiliations and the perceived quality of the social media advert increased initial trust, which is a particularly important motivator that should be focused on during social media advertising campaigns [In a broader context, the themes of trust and validation align with a recent overview of systematic reviews focused on psychosocial barriers and facilitators [Commonly reported barriers to trial participation include fear, perceived risk and practical difficulties [Building upon the significance of trust and validation it’s important to discuss the comprehension of the different components of the trial and its role in participation and engagement. A recent meta-analysis revealed that the proportion of participants in clinical trials who understood different components encountered during informed consent (e.g. placebo, randomisation, study purpose) ranged from 52 to 76% [Also, interview data from this study suggest that participants believed they may be able to provide more accurate data in follow-up questionnaires if they had access to previously completed versions. The impact on questionnaire validity should be carefully considered alongside existing guidelines on optimal questionnaire design and administration to enhance completeness in a clinical trial [A primary concern raised by participants was around the photographic acne assessment. A recent meta-analysis suggested that ‘teledermatology’ diagnoses are less reliable than those made in person [Future trials may consider the use of image validation software that can provide instant feedback to participants, and participants should be assured that where there is doubt, they will be invited to attend a face-to-face appointment.