Project Overview

PTSD Experimental Treatment Trial (PETT): Comparing two talking therapies for the treatment of post-traumatic stress disorder in UK military veterans. King’s College London used our digital expertise to assist with recruitment to their PTSD Experimental Treatment Trial (PETT) trial. This interventional trial was investigating two new experimental treatments for PTSD and required military veterans over the age of 18 to complete a baseline questionnaire, before being randomised into one of two groups.

We spoke with Jackie Sturt, Professor of Behavioural Medicine in Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London to discuss how our recruitment service was applied to the PETT trial.

What were you trying to achieve?

It all started around June 2020 because we were trying to recruit 60 veterans in Northern Ireland. We were running a randomised controlled trial (RCT) and were primarily aiming to recruit through veterans organisations. We had only recruited one person when Covid hit and our original idea was to meet participants face to face. Despite the difficulties, I didn’t worry at that point. We had the pathways, we just needed participants to be able to access them a different way. This meant redeveloping the interventions into online versions. In other words to change the way the therapy organisations we were partnering with worked. While we prepared for this we paused the study for 3 months. Then we turned attention back to recruitment but we immediately realised we had an unexpected bottleneck. Covid had meant that the veterans organisations were not getting people referred through to them. So they couldn’t promote our trial to potential participants. The caseworkers simply were not getting new veterans to work with. For a while we kept trying. Then we expanded the study to recruit across the whole of the UK. We were trying to be creative using things like radio broadcasts but we were only getting a few recruits here and there. By the start of 2021, it became clear that our pathways were still not working.

How did the project work? 

At this point I got a cold email from nativve. Good timing on their part! And so I asked for a bit more information and realised that they had worked with other people I knew. I asked if my contacts would recommend them and got excellent feedback. Me and my trial manager then met with nativve and worked on a marketing strategy together. This was really simple. Pretty soon we were able to go back to our funder for a cost extension related to Covid changes and for working with nativve. We went back to ethics to agree we could enhance the pathway to use social media marketing for the whole of the UK. By June 2021 we were ready to launch the campaign. And we were able to wrap up all of our recruitment in a manageable but rapid time. In fact, and this is really important, nativve helped us to manage the flow of participants. So we didn’t overwhelm the therapists. They were able to repeatedly pause and restart the marketing to do this. We were delighted when we got our 60th recruit 1 week before the end of recruitment period. What a success.

What do you like about nativve’s method? 

I love to talk about this way of working, but it surprises me how other researchers only see problems. They are concerned about biassed samples, whether or not the target population is digitally active, who does or doesn’t spend time on social media. But these are all excuses that are not real. Or that can be overcome by adjusting the recruitment strategies live.

In our case, we were told repeatedly that veterans are highly social-media-engaged and look out for each other at a community level. So they gather around people when they see things that are good and embrace it which means that social media was an obvious place to look for recruits. But would the average researcher have assumed that? As it turned out, the report we got from nativve said it was the biggest amount of engagement they had ever seen. But we even reached the veterans who are not social media active. Family members were passing on the links to other veterans. People who saw the campaign, whether they were eligible or not, were telling other people about it, so there’s a genuine democracy to it. The gatekeepers are fewer. We were not dependent on GPs, endocrinologists or others to refer people on (and adding in a layer of bias if you think about it). In short, biases are moveable. You have to assess them. Social media was democratising for our study. It wasn’t just an efficient way of working, it was the best way of working. So to any other researchers out there, I would say, there are other ways of finding participants, not just going through the NHS. Don’t be afraid to try.

Would you like to learn how we can help with your recruitment? Get in touch with us to discuss.