Setting and participant recruitment
Myocardial Ischaemia, Trauma, Diabetes
BLOOD, RECRUITMENT, DIABETES
We developed our online trial in partnership with five United Kingdom (UK) national clinical audit programmes: the Myocardial Ischaemia National Audit Project (MINAP), the National Comparative Audit of Blood Transfusion (NCABT), the National Diabetes Core Audit (NDA), the Paediatric Intensive Care Network (PICANet), and the Trauma Audit and Research Network (TARN). Each audit programme emailed study invitations to their own networks of clinicians, managers, and administrators, all of whom were eligible to participate. These networks were mainly hospital-based, with the exception of the National Diabetes Core Audit, which included most general practices in England and Wales.The email invitations included a link to the trial website, through which recipients could consent to participate, select their relevant audit, and provide information about their role and organisation. Participants were randomised automatically, stratified by audit, to one of the 32 different fictional versions of performance feedback. Immediately after viewing their assigned feedback, participants were required to complete a 14-item questionnaire assessing their responses to the feedback, mostly using 1–5 Likert scales with radio buttons. We aimed to maximise ease of completion. Participants could then request a £25 voucher by entering an email address that was manually checked by an administrative member of staff before the voucher was sent. We deliberately placed the request for email addresses at the end of the survey, after participants had entered, in line with the usual practice for survey design in placing requests for personal data after the main survey questions. To preserve participant anonymity, email addresses provided for voucher requests were not linked to trial data. A ‘dashboard’ allowed real-time monitoring of the number of participants entering the study and completing the questionnaire for each audit programme and the total number of vouchers claimed; it did not include any automated data validity checks.We based our recruitment approach on several assumptions. First, financial incentives may improve study recruitment [