Sites
word carcinoma, cancer’
DCIS, RECRUITMENT
Initially, four communication workshops were held, two in London, one in Birmingham and one in Wycombe, with a total of twenty delegates attending. Two further workshops, both in London, held as part of the Recruitment Recovery Plan, were attended by 17 health care professionals. The delegates were a mixture of trial coordinators, research nurses, radiologists, radiographers, and surgeons. Analysis of the pre- and post- workshop questionnaires resulted in a significant improvement in knowledge (The response rate to the postal survey about which aspects of the LORIS protocol was perceived as challenging was good from PIs, 34/47 (72%), and site leads, 45/53 (85%), but poor from other members of the recruiting team, 12/197 (6%). Most respondents reported they were well aware of the aims of LORIS (88/91, 97%) and comfortable with these (87/91, 96%). However, only about half stated they themselves would participate in LORIS, if relevant, or encourage a friend or relative, (45/87, 52%), many were unsure (35/87, 40%) and a few would not participate (7/87, 8%).Most respondents were clear about the study logistics pathway (78/91, 86%) and thought the process of obtaining histopathology slides for central review was streamlined (64/85, 75%). However, the need for a second biopsy to confirm eligibility was sometimes or often thought to deter team members from recruiting patients by nearly half of respondents (37/83, 45%), and sometimes or often thought to act as a deterrent to potential participants by most respondents (68/83, 82%). Another challenge for sites was changes in their key staff since LORIS opened at their site, reported by 38/89 (43%) of respondents.When asked about the most challenging aspect of recruiting patients (free text item), the most common reason given was the low number of eligible patients (34/81, 42%). Additionally, some respondents (12/81, 15%) noted that many patients were deemed ineligible following central review. The second most common barrier, reported by 18/81 (22%), was that many women had a strong preference for a particular treatment arm. The challenge of trying to explain active surveillance (7/81, 9%), and local logistic issues (6/81, 7%) were also barriers reported by more than one respondent. In the semi-structured phone interviews, held with 20/47 PIs (43%) and 40/53 site leads (75%), the same barriers were identified more frequently. These interviews also provided an opportunity for participants to describe in more detail specific local challenges. Some interviewees suggested that it would be beneficial to educate the general public about DCIS and the LORIS trial in general. There was also an issue noted with the use of the word carcinoma in DCIS and the use of the term ‘cancer’ in the patient information provided by hospitals, in that this could lead to more women having a strong preference for surgery.Based on the information gained from the survey and interview, refresher SIVs were suggested for six sites and attendance at a communication workshop for 14 sites. Online refresher SIVs were held for all six sites but only five sites sent delegates to a communication workshop.