Optimizing Strategies to Maximize Patient Recruitment Yield (OSPREY)

This platform trial aims to evaluate the effectiveness of different messaging strategies within a MyChart messaging program for research recruitment. MyChart is a patient portal system within the Electronic Medical Record (EMR), and messages can be sent directly to patients about research opportunities.

Study Overview

• Status: Recruiting
• Conditions: Recruitment
• Intervention / Treatment: Behavioral: Baseline (control) message; Behavioral: Positively-valenced message; Behavioral: Payment-inclusive message; Behavioral: Positively-valenced, payment-inclusive message

Detailed Description

Recruitment of participants presents a significant and persistent bottle neck in the research process. Failure to reach participant enrollment targets may delay or halt study progression, wasting limited resources. Insufficient rates of participant accrual are the leading cause for termination among clinical trials with results posted on ClinicalTrials.gov. Additionally, studies must enroll representative samples to ensure generalizability and comply with NIH guidelines. Investigators often cite recruitment difficulties - including lack of interest, difficulty reaching specific populations, and limited resources - to explain failure to reach enrollment goals. However, these recruitment difficulties may not actually be due to a lack of willingness to participate among eligible patients. A national survey conducted by Harris Interactive in 2001 found that 85% of patients were either unaware or unsure that participation in a clinical trial was an option at the time of diagnosis. 75% of these patients said they would have been willing to enroll had they known it was possible. Innovation in recruitment is sorely needed to make recruitment more efficient and more representative.

In recent years, researchers have begun to leverage patient portals and electronic health records (EHRs) for recruitment. This method allows for engagement of broad populations within a health system in a cost-effective way. Emerging evidence of EHR recruitment shows promise. The researchers of this study have examined the use of EHR recruitment to identify and contact eligible patients via MyChart direct-to-patient messaging across a range studies within Emory Healthcare. Having completed a pilot program within the Emory system, this service is now available to all Emory investigators for whom MyChart recruitment is appropriate.

While the feasibility of MyChart messaging has been documented, little is known about best practices for how recruitment messages should be designed. There are, however, good reasons to believe that how messages are designed and framed may impact potential participants' responses to them.

This project is a platform trial that will allow for serial testing of various aspects of portal-based messaging. Consistent with platform trial design, the researchers will use a common set of outcome measures across various studies, and the portal-based messaging strategy allows for easy randomization (generally at the patient level) of patients to specific messaging approaches.

In the context of broader use of MyChart messaging, the researchers have designed this study to examine the impact of message design on patients' responses. Specifically, this study will examine the impact of including positively-valenced language that describes the value of the study and the impact of inclusion of information regarding any payments that participants will receive in the study. Both of these factors are ones that are grounded in behavioral economics and may be meaningful to potential participants.

The first proposed trial will involve randomly assigning patients who are identified as potentially eligible for studies using the MyChart recruitment mechanism to receive a recruitment message using 1 of 4 templates: 1) the current standard template; 2) a template with inclusion of positively-valenced language describing the study's value; 3) a template containing information about payment to participants; and 4) a template with both positively-valenced language and payment information. For all studies using the MyChart mechanism, all 4 messages will be created, and assignment will be done based on the last two digits of the patient's medical record number (MRN).

The primary endpoint is the rate at which individuals respond that they are interested in participating in the study to which they are invited. Additionally, this study will examine the non-response rate and the rate of individuals responding that they are not interested in the study. It will also track the rate at which individuals exposed to a MyChart recruitment message change their permission settings for contact about research opportunities. Study teams whose study invitations are used in this trial will be contacted about the rate of enrollment among patients who responded as "interested" to the message so that the researchers can estimate enrollment rate within each intervention group. Finally, select patients will participate in short interviews to understand their impressions of the message they were sent and their attitudes towards research more generally.

• Study Type: Interventional
• Enrollment (Estimated): 100000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Neal Dickert, MD, PhD; Phone Number: (404) 712-6834; Email: njr@emory.edu

Study Locations

• United States
  • Georgia
    • Atlanta, Georgia, United States, 30322
      • Recruiting
      • Emory Healthcare System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria for primary studies that are recruiting participants:

• All studies using the MyChart recruitment service are eligible, including both clinical trials and observational studies.

Exclusion Criterion for primary studies that are recruiting participants:

• Not using MyChart for recruitment.
• At least 500 messages sent, 125 for each arm

Inclusion Criteria for patients:

• All patients receiving messages via MyChart will be included
• Potential eligibility for a study using MyChart requirement based on the planned query/criteria for that study.

Exclusion Criteria for patients:

• Minor
• Excluded from primary study that is recruiting participants.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Baseline (control) message; Patients in the Emory Healthcare system, who have not opted out of research contact, receiving MyChart messaging for research recruitment using the current standard template.	Behavioral: Baseline (control) message; The MyChart study recruitment program will send a message based on the current template, which is a brief message with a neutral tone.
Experimental: Positively-valenced message; Patients in the Emory Healthcare system, who have not opted out of research contact, receiving MyChart messaging for research recruitment using a template with inclusion of positively-valenced language describing the study's value.	Behavioral: Positively-valenced message; The MyChart study recruitment program will send a message based on a template that contains positively-valenced language related to the value/importance of the study.
Experimental: Payment-inclusive message; Patients in the Emory Healthcare system, who have not opted out of research contact, receiving MyChart messaging for research recruitment using a template containing information about payment to participants.	Behavioral: Payment-inclusive message; The MyChart study recruitment program will send a message based on a template that includes more detailed information about participant payment.
Experimental: Positively-valenced, payment-inclusive message; Patients in the Emory Healthcare system, who have not opted out of research contact, receiving MyChart messaging for research recruitment using a template with both positively-valenced language and payment information.	Behavioral: Positively-valenced, payment-inclusive message; The MyChart study recruitment program will send a message based on a template that includes both positively-valenced language and detailed information about participant payment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of "interested" response to recruitment messages	The primary endpoint is the rate at which individuals respond that they are interested in participating in the study to which they are invited. The primary outcome is a binary variable of "interested" response.	Month 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of non-response	This study will examine the rate of non-response to recruitment messages.	Month 12
Rate of "not interested" responses	This study will examine the rate of individuals responding that they are not interested in the study.	Month 12
Rate of change in MyChart permissions to contact	This study will examine the rate at which individuals exposed to a MyChart recruitment message change their permission settings for contact about research opportunities.	Month 12
Rate of enrollment among "interested" patients	Study teams whose study invitations are used in this trial will be contacted about the rate of enrollment among patients who responded as "interested" to the message.	Month 12
Patient impressions on recruitment messages	Some patients will participate in short interviews to understand their impressions of the message they were sent. Qualitative data are collected during the interviews and there is not a standardized questionnaire or scale that will be used.	Month 12
Patient impressions on research in general	Some patients will participate in short interviews to understand their attitudes towards research more generally. Qualitative data are collected during the interviews and there is not a standardized questionnaire or scale that will be used.	Month 12

Collaborators and Investigators

• Sponsor: Emory University
• Collaborators: American Heart Association; National Center for Advancing Translational Sciences (NCATS); Georgia Clinical and Translational Science Alliance (GaCTSA)
• Investigators: Principal Investigator: Neal Dickert, MD, PhD, Emory University

Study record dates

Study Major Dates

• Study Start (Actual): February 19, 2026
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): April 1, 2027

Study Registration Dates

• First Submitted: December 15, 2025
• First Submitted That Met QC Criteria: December 15, 2025
• First Posted (Actual): December 18, 2025

Study Record Updates

• Last Update Posted (Actual): February 25, 2026
• Last Update Submitted That Met QC Criteria: February 23, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Research recruitment; Patient portal-based communication
• Additional Relevant MeSH Terms: BaseLine dental cement
• Other Study ID Numbers: 2025P013508; UL1TR002378 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Deidentified data will be available for sharing. This will include deidentified participant-level demographic characteristics, intervention assignment, and enrollment/non-enrollment status within the parent trial. This will include a de-identified data spreadsheet, readme file, and a data dictionary.
• IPD Sharing Time Frame: Data will be uploaded into a repository at the time of publication of findings from this study.
• IPD Sharing Access Criteria: Deidentified participant-level data and associated metadata will be uploaded into the Emory Dataverse (https://dataverse.unc.edu/dataverse/Emory).
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No