Getting started — Part 8: Engaging with Participants and Improving Compliance

Background

One of the major risks in decentralised research - particularly work off-site - is that data submissions aren't being monitored sufficiently and that oversight can risk losses in data. People are busy - they might forget that they need to provide some data for the study. So how do we keep on top of this? How do we ensure that we get the data we need for completeness?

Automatic Reminders (General)

General reminders can be useful for many reasons. For example, you might want to remind participants at specific times every day to take their intervention. Even with the best intentions, participants will forget, and who is to say that the traditional way of monitoring compliance (returning opened packets, empty bottles and so on) is not so reliable? By all means, continue to do this - but prompts like intervention reminders can be incredibly useful in ensuring that your intervention is getting the chance to make an impact. It would be disappointing if your study failed to show any outcomes because participants forgot and lied about taking intervention regularly!

To set these reminders, click on the Messages tab and then on Automatic Messages. Participants using the smartphone (Apple or Android) version of the app can be prompted here by push notification. You will be able to see who is push-enabled in the Participants table: a bell icon beside their ID means they can receive push notifications, and their record shows a Push badge.

Each message you have set up can be edited later — use the pencil button beside it to reopen it and change its wording, attachments, trigger, schedule or send methods. Changes apply to sends still to come; messages already sent aren't affected, and a message set relative to an anchor date never reaches a participant twice — so if you need an amended version to go to everyone, copy it rather than editing it. Beside it, the copy button makes a duplicate and opens it for you to tweak before creating it, which saves rebuilding a message from scratch when you want to send the same thing at, for example, a different offset from an anchor date or at a different time of day. Both are also available for messages scheduled for an individual participant, from the Manage button in that participant's messenger.

Automatic Replies (Scorch)

When a participant writes in, the message usually waits for your team to read and answer it. Trialflare's AI assistant, Scorch, can answer some of those messages by itself. Switch it on under Messages > Automatic messages > Automatic replies — the setting is visible to everyone who can see the trial, and switching it on (and editing the context) needs permission to manage the trial. There is one more thing to write there: extra context for Scorch to use, which is the place for plain facts a participant might ask about that the trial doesn't record — where visits happen, where to park, what to bring.

Scorch only replies when it can find the answer, and it will not guess. It draws on the trial itself — its name and description, who the sponsor is, its registration numbers, its privacy statement, its consent forms, the context you have written — and on the participant's own position: when they consented and by which method, their whole schedule (every form they have completed and every one still to come, not only what's overdue or due soon), their upcoming meetings and calendar events, and the sites they attend — name, address and the contact details they can already see in the app. It is deliberately unable to give health or legal advice and will not talk about anything outside Trialflare and your trial, so messages that touch on those, or anything it doesn't know, are left for your team. When it does reply, the reply appears in the conversation as an ordinary message from the study team, with the system avatar and marked Sent by Scorch so your team can tell. When it decides a question is for the team, the reason it left it unanswered is shown beside the message, so you can see what it wouldn't answer and why. Replies are sent only in the participant app, with a push notification — never by email, SMS or WhatsApp — so Scorch doesn't reply to a participant who hasn't used the app, such as someone who writes in only by text message; those messages wait for your team as usual.

Each reply is charged to the trial's wallet, like the other AI features: if the balance runs out, Scorch stops replying until it is topped up, and messages sent in the meantime aren't answered later. Two further settings sit under the same area: Mark the message as read when Scorch replies marks the message Scorch answered as read, so it stops showing as unread; anything else unread in the conversation, such as a message Scorch left for your team, stays unread; and Notify by email when Scorch replies names the team members who are emailed each automatic reply — the participant's message and Scorch's reply, side by side, with a link to the conversation. With no one selected, no notifications are sent. Emails stop for anyone who leaves the team. Your team still sees every participant message as normal — an automatic reply is Scorch helping with the routine questions, not a replacement for reading what participants send you.

Stage-specific Reminders

You will want participants to be aware of what to fill out and when. If they are off-site and you aren't directly communicating with them regularly, automatic reminders on specific days are very useful. For example, "Your Week 3 well-being questionnaire is due!" and "It's 19:00, you still need to submit today's sleep quality questionnaire data!". You are free to customise the content of all of these messages and send as many as you need to.

To do this, in the Stages tab, navigate to the stage you need to set reminders for, click the Edit button, then select the Reminders tab. Here you can customize your messages.

Stage reminders are different to Automatic Messages as they are response-driven. This means that once the data for this stage or stage recurrence has been submitted, the participant won't receive reminders for it anymore!

Important: If you are using recurring stages, you can use the %n placeholder to iterate over repeating recurrences. "Week %n" on the platform which repeats 3 times, will show up to participants as "Week 1, Week 2 and Week 3). If you would rather name particular occurrences yourself, you can do that on the stage instead — see Naming each occurrence.

Participant Instant-messaging

For whatever reason, you might want to engage with a participant directly. Every participant has a conversation with the study team, found in the Messages box on their record and under Messages > Participant messenger. Each message can go by push notification, email, SMS or WhatsApp, depending on the contact details the participant has, and is kept in the conversation whichever way it was sent. Over WhatsApp, the participant is told they have a new message rather than sent its text, and over SMS a message longer than 500 characters is cut short with a note to read the rest in the app. Remember, you can see who you are able to reach by push by looking for the bell icon in the Participants table.

Every message sent to participants is recorded in the trial's event log (Settings > Audit > Logs): the ones your team sends by hand under the name of whoever sent them, and automatic messages and platform reminders as sent by the system. Creating, editing and deleting automatic messages is recorded there too, including what a deleted message said.

Going further. Recipe: re-engaging participants who fall behind puts reminders, behind-schedule alerts, follow-up lists and personal contact together into one routine.