A feasibility study that proposed the use of energy smart meter analytics to monitor changes in the functional ability in the daily lives of older adults was planned. However, the project had many challenges with recruiting potential participants and the study was unable to continue.

The evaluation team therefore focused their report on the issues faced and lessons learned in attempting to recruit single older adults to a study that would use digital technology to promote independence in their own homes by monitoring behaviour.

Introduction

The proposed feasibility study was to monitor the electricity use of older people who lived alone in their own home using an existing smart meter app. The intention was to test whether it would be possible to identify short term anomalies and changes in electricity usage as this could indicate a change in the person’s daily living activities or care needs. If changes were detected, the person’s next of kin or carer would be alerted by the app, facilitating earlier intervention and preventing issues escalating.

Most academic discourse available focuses on recruiting older adults into clinical trials. There is little research about recruiting older adults into applied health / social science research. Following a literature review and an evaluation meeting with gatekeepers, older adults and carers, including a reflective account of some members of the project team, the evaluation report provides an in-depth understanding of the barriers and difficulties in recruiting older adults for a research project that used digital technology, and makes some recommendations that could inform researchers and health and social care providers. 

The revised report includes:

• Chapter two: Explains the original planned project, its aim and methodology. It explains the inclusion and exclusion criteria of participants and the recruitment strategy used.
• Chapter three: Explores the literature around why the recruitment for the study may have failed.
• Chapter four: Explains who contributed to this evaluation report and the reasons why. It goes on to explain the methodology of how data was collected and analysed.
• Chapter five: This demonstrates the findings from feedback and reflections from various people who were involved in recruiting for the research. Findings are presented thematically.
• Chapter six: This discusses the data findings and makes recommendations for other researchers or health and social care professionals recruiting for similar studies.

Key lessons learned

The report highlighted the following themes:

• Perceptions of energy use pattern and its use for monitoring daily living activities in older adults
• Mistrust of the research study
• Apathy and participation in a research process among older adults
• Researching in the social context of Covid-19
• Recruiting within Leicester city households

People who contributed to this evaluation report reflected on recruitment of older adults to a health-related technological study which monitored behaviour within the home. There was misperception of the research aim and mistrust of the planned technology that would be used in participants homes.

This mistrust was possibly heightened due to technological scams increasing during the COVID-19 pandemic. Another factor identified was the cost-of-living crisis with electricity prices at an all-time high and the association of electricity costs with a smart meter.

A key lesson learnt was the importance of clear communication and taking time to build trust amongst older adults, their carers and community organisations throughout the research process. It would also be beneficial for uptake in recruitment if the older adults could see and interact with the planned technology during the recruitment process to help further alleviate any concerns.

Recommendations

The challenges that the research team experienced with the recruitment process were interlinked. They make the following recommendations to facilitate the recruitment of older adults’ participation in technological interventions health-related research:

• Consult with representatives of older adults, carers, gatekeepers and community organisations during the research process design. This may assist in identifying barriers/challenges in advance of the recruitment process beginning, so amendments can be made quickly.
• Build within the recruitment phase, a period for establishing trust and rapport with potential participants, their carers and relevant community groups to assist in easing their concerns about the technology, the research process and working with researchers and developers from outside their communities.
• Showcase the technology and allow the potential participants to interact with the device during the recruitment process to reassure and allow complete comprehension and aid technology literacy.
• Ensure that individuals who are recruiting participants have basic knowledge about the technology and the research study (so they can answer questions).
• For large health research projects using technology intervention and comprising interdisciplinary research team members, there should be a named person who is a member of the team with extensive experience in research recruitment of older adults who oversees the recruitment process, with an in-depth understanding of the technology, who will act as the named person for further information for the recruitment team.
• Focusing recruitment on the strong relationships between clinicians, social care professionals and patients may have greater success in direct face-to-face clinical contexts as opposed to mailshots and cold calling.
• Researchers need to be aware of individuals, community and external factors that could impact participation and be adaptable and consider alternative recruitment strategies as challenges arise.
• Consider mechanisms for incentivising potential participants to participate in the study.

Resources

Evaluation report

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