Understanding barriers to involving community midwives in identifying research participants; experience of the first steps randomised controlled trial

• Many clinical research trials experience difficulties recruiting.
• Community midwives discussed their role in participant identification.
• Time pressure and poor communication hampered involvement.
• If interventions include midwifery care there may be additional barriers.
• Midwifery education should cover approaches to research recruitment.

Objectiveto explore barriers to the involvement of community midwives in identifying women in early pregnancy as potential participants in the first steps study, a randomised controlled trial of a new intervention to provide health and parenting support to potentially vulnerable women.Designdescriptive qualitative investigation using semi-structured audio-recorded interviews.Settingcommunity midwifery offices.Participantsvolunteer sample of 13 community midwives.Measurementthemes derived from content analysis.Findingsunderstanding of their role in the research process was unclear to many midwives. Confusion arose about the difference between potential participant identification and trial recruitment. There were concerns about the eligibility criteria and it was suggested that there was insufficient time during booking appointments, and sometimes insufficient information, to determine potential eligibility. Midwives had concerns about some aspects of the intervention, which incorporated routine midwifery care, and had expectations that women may not like a group programme. This may have led some not to mention the trial. They were, however positive about the programme׳s potential for beneficial impacts on mothers and infants.Key conclusionsdedicated research midwives may be the best option if research studies need to identify potential participants early in pregnancy, so that they can communicate with all their colleagues.Implications for practiceif community midwives are asked to be involved in time-critical research they are likely to need additional local resources and support.