PROMoting THE USE of SWATs (PROMETHEUS)
The PROMETHEUS programme (funded by the Medical Research Council (MRC) aimed to facilitate the development of strategies to increase the evidence base around recruitment and retention strategies rapidly.
This programme funded 42 SWATs, embedded within 31 host trials, across 12 CTUs in the UK between 2018 and 2021. This was done by offering trial teams up to £5000 to embed a SWAT within their host trial, alongside methodological support.
This is the biggest single effort to generate SWAT evidence worldwide to date. Below we summarise our work with the PROMETHEUS programme.
What was found?
Initially, the programme aimed to fund 25 SWATs, however, as the average cost was lower than anticipated (£4007), further SWATs were able to be funded. Additionally, the centralised coordination of the programme proved to be efficient. See (Doherty et al., 2022) for more information.
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Research areas included in PROMETHEUS
- Surgical - 11 SWATs
- Respiratory, smoking cessation, Oncology, Fall reduction, Orthopaedic, Wound care - 3 SWATs in each area.
- Community Pharmacy, Physiotherapy, Primary care (Signs and symptoms), Rheumatology, Urology - 2 SWATs in each area
- Oral health, Gastrointestinal, and Gynaecology - 1 SWAT in each area.
The programme’s impact
- 42 SWATs were funded.
- Outputs include SWAT result publications, papers on learnings from the program, and a comprehensive HTA report.
- A database of reviewers for SWAT publications was developed to increase the pool of reviewers and speed up the reviewing process.
- This programme collaborated with Trial Forge to create the ‘Trial Forge SWAT Network’ as a network that would aid in linking research groups globally that are undertaking methodological (SWAT) research.
Publications (as of May 2023)
SWAT Publications
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SWATs (Two-arm & Factorial)
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Host trial
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DOI
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Sending pre-notification cards to trial participants before a face-to-face primary outcome measurement to increase attendance (SWAT 76)
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ACTWELL
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https://doi.org/10.12688/f1000research.50890.2
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Personalised versus standard text message prompts
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GRASP
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https://doi.org/10.21203/rs.3.rs-262194/v1
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Using pens as an incentive for questionnaire return in an orthopaedic trial
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KREBS
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https://doi.org/10.12688/f1000research.23018.1
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Personalised text messages compared to non-personalised text messages in an orthopaedic setting
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KREBS
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https://doi.org/10.12688/f1000research.24244.1
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Pre-notification and personalisation of text messages to increase questionnaire completion in a smoking cessation pregnancy RCT
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MiQUIT
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https://doi.org/10.12688/f1000research.51964.1
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Including a pen and/or cover letter, containing social incentive text, had no effect on questionnaire response rate
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OTIS
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https://doi.org/10.12688/f1000research.23767.1
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Enclosing a pen to improve the response rate to postal questionnaire
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SSHeW
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https://dx.doi.org/10.12688%2Ff1000research.23651.1
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Timing of electronic reminders did not improve trial participant questionnaire response
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UK FROST
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https://doi.org/10.1016/j.jclinepi.2020.03.001
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Including a wet-ink signature and photograph in the patient invitation letter for a clinical trial
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CLEAR
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https://f1000research.com/articles/11-174
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Christmas Card SWAT (eight trials)
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C-GALL, CPIT III, DISC, FUTURE, PROFHER-2, PUrE RCT, REFLECT, SWHSI-2.
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https://doi.org/10.1136/bmj-2021-067742
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Staff training SWAT (four trials)
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DISC, IntAct, PROFHER-2, START: REACTS
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https://doi.org/10.1177/26320843221106950
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Other Publications
Three papers have been published in the Research Methods in Medicine & Health Sciences Journal describing the learning derived from this programme:
- (Arundel et al., 2023) - Challenges and solutions to the implementation of studies within a trial: The experiences of the PROMETHEUS programme
- (Clark et al., 2022) - The PROMoting the USE of SWATs (PROMETHEUS) programme: Lessons learnt and future developments for SWATs.
- (Doherty et al., 2022) - PROMoting the use of studies within a trial (PROMETHEUS): Results and experiences from a large programme to evaluate the routine embedding of recruitment and retention strategies within randomised controlled trials routinely.
- With a comprehensive HTA report in the process of being disseminated.
Useful links:
Press release
For further details about PROMETHEUS please see the following press release.
PROMETHEUS Hosted Webinars
PROMETHEUS Collaborate Webinar
This webinar gives an overview of both the PROMETHEUS programme and the Trial Forge and describes their collaboration and efforts to promote SWATs and SWAT knowledge.
The implementation and management of Studies Within A Trial (SWATs)
This webinar gives an overview of how SWATs have been implemented and managed in various Trials units in the UK and Ireland with experiences from the teams at:
- Nottingham Clinical Trials Unit
- York Trials Unit
- Oxford Clinical Trials Research Unit
- Centre for Healthcare Randomised Trials
- HRB-TMRN
- Derby Clinical Trials Support Unit (CTSU)
- Pragmatic Clinical Trials Unit - Queen Mary University of London
Webinar
Implementation guidance for SWATs assessing personalised SMS for retention and pens for recruitment
This webinar gives an overview on guidance on how to go about answering questions such as “Where do we need to replicate SWATs?” and “Where do we need to innovate SWATs?”. It also discusses guidance on implementing two SWATs (assessing personalised SMS for retention and pens for recruitment) and who to turn to if support is required to undertake a SWAT.
Webinar
Researcher experiences of conducting recruitment and retention research and an introduction to the new Trial Forge Studies Within a Trial (SWAT) network
This webinar was presented by PROMETHEUS programme collaborators and included the experiences of undertaking SWATs in low and middle-income countries and the use of digital tools for recruitment and retention. The newly established Trial Forge SWAT Network was also outlined.
PROMETHEUS Christmas webinar
This webinar presented the results of a simultaneous SWAT evaluating Christmas Cards as a retention strategy. The logistics of setting up this simultaneous SWAT and the processes involved were also detailed. The results of this SWAT are available at: https://doi.org/10.1136/bmj-2021-067742
Economic evaluations alongside SWATs: an introduction and practical examples
This webinar introduced cost-effectiveness analyses in SWATs. The current evidence base was summarised, with findings presented from a recent systematic review of economic evaluations alongside SWATs for improving recruitment and retention in RCTs.
Project details
| Funder: |
Medical Research Council
Grant number MR/R013748/1
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| Sponsor: |
University of York |
| Start date: |
1st April 2018 |
| End date: |
30th September 2020 |
External Collaborators
- Professor David Beard, University of Oxford [Oxford Surgical Intervention Trials Unit]
- Professor Peter Bower, University of Manchester
- Professor Paul Brocklehurst, Bangor University [NWORTH CTU]
- Professor Cindy Cooper, University of Sheffield [Sheffield CTU]
- Dr Lucy Culliford, University of Bristol [Bristol CTEU]
- Professor Declan Devane, The National University of Ireland Galway
- Professor Sandra Eldridge, Queen Mary University of London [The Pragmatic CTU]
- Professor Richard Emsley, King’s College London
- Dr Sandra Galvin, The National University of Ireland Galway
- Professor Alan Montgomery, University of Nottingham [Nottingham CTU]
- Dr Chris Sutton, University of Manchester [MAHSC CTU]
- Professor Shaun Treweek, University of Aberdeen [CHaRT Aberdeen]
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