Social validity of randomised controlled trials in health services research and intellectual disabilities: a qualitative exploration of stakeholder views.

Publisher: BioMed Central Country of Publication: England NLM ID: 101263253 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-6215 (Electronic) Linking ISSN: 17456215 NLM ISO Abbreviation: Trials Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2006-

Attitude of Health Personnel* ; Health Knowledge, Attitudes, Practice* ; Patient Selection* ; Social Values*; Caregivers/*psychology ; Disabled Persons/*psychology ; Health Personnel/*psychology ; Intellectual Disability/*therapy ; Randomized Controlled Trials as Topic/*methods; Adult ; Comprehension ; Female ; Health Services Needs and Demand ; Health Services Research ; Humans ; Informed Consent ; Intellectual Disability/psychology ; Interviews as Topic ; Male ; Middle Aged ; Perception ; Qualitative Research ; United Kingdom ; Young Adult

Background: Randomised controlled trials (RCTs) are the gold standard of evidence-based practice in medicine but they have had limited influence in the field of intellectual disabilities. Previous literature suggests that participants and professionals have limited tolerance for this type of research methodology. However, it is not known how well service users, carers and other health professionals understand and accept the need for RCTs, and why it is important for individuals with intellectual disabilities to be included in this kind of research.
Methods: We examined individual perceptions of RCTs in 51 participants (18 carers, 6 service users and 27 professionals) using semi-structured interviews. A framework approach was adopted in the analysis of data.
Results: We found that participants had concerns about capacity and resource allocation but held positive views towards this type of research methodology. Understanding of the principles behind RCTs was poor amongst service users and a minority of carers, but mediated by previous exposure to research for professionals.
Conclusions: The social validity of RCTs in intellectual disabilities may be compromised by lack of understanding of the design and the on-going concerns about obtaining informed consent especially in incapacitated adults. However, the overall finding that the need for this form of research was seen in a positive light suggests that there is a turning point in the perceptions of stakeholders working in intellectual disabilities services. We recommend that researchers include on-going education on RCT design during trials, tailoring it to all stakeholders with emphasis on strong service user and care involvement. This could be a pivotal element in improving acceptability of, and recruitment to RCTs.

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Date Created: 20110611 Date Completed: 20111115 Latest Revision: 20211020

20240628

PMC3135548

10.1186/1745-6215-12-144

21658215