What can we learn from a failed trial: insight into non-participation in a chat-based intervention trial for adolescents with psychosocial problems

BACKGROUND: Psychosocial problems are highly prevalent among Dutch adolescents. We have conducted a trial to test whether offering chat-based consultations could be of added value within the context of Dutch Youth Health Care. This trial was ended prematurely because of recruitment issues. The aim of this study is to learn from this failed trial and to provide more insight into non-participation. Sources of data were non-participation forms, oral clarification, patient records, telephone interviews with adolescents that declined to participate, and a questionnaire-based process evaluation among nurses. RESULTS: Non-participation appears to be a multi-factorial problem. Of those 290 adolescents eligible to participate, the majority (n = 165, 57%) declined to do so. Two-third of those (n = 109) also refused usual care, which might be indicative of not wanting help and/or experiencing problems and the validity of the assessment instrument. The other one-third (n = 56) did enrol in usual care and indicated other reasons for non-participation, such as a preference for face-to-face consultations, the extensive information that was provided, and not liking the idea of being randomized. CONCLUSIONS: This study shows that even if a trial fails, we can learn about the challenges of recruiting adolescents in intervention trials. TRIAL REGISTRATION: NL37668.068.11/METC11-3-077.