Title: Enhancing knowledge about and attitudes towards participation in clinical trials: Systematic evaluation of a user-friendly educational video
Abstract:
Background: Clinical trials are a cornerstone of modern healthcare where scientific hypotheses are forged into life-saving therapies that define evidence-based care. The World Health Organization ( 2023) identifies clinical trials “as a fundamental component” of a learning health system and essential for achieving Universal Health Coverage (UHC). Despite the pivotal role in advancing health equity and innovation, globally about 80% of trials fail to enrol on time, costing millions daily and delaying treatment (Brøgger-Mikkelsen, M., et al., 2020). The enrolment crisis constitutes multi-level challenges. At the macro level, low enrolment reflects systematic barriers in public research literacy (Brody et al., 2012), equitable research access (FHI Clinical, 2022) and societal trust (Rodríguez-Torres et al, 2021; Reber et al., 2025). At the meso level, clinical trial efficiency is often hindered by high screen-failure (Wong et al., 2018), lengthy recruitment timeline (Wandile, 2023), and administrative burden (Briel et al., 2021). Critically, at the micro level, misconceptions, fear of exploitation and limited understanding of trial processes directly reduce willingness to participate (Abujarad et al., 2021; Kaur et al., 2025). Therefore, these factors collectively impede progress in evidence generation and compromise diversity in research participation. Despite being a thriving hub for clinical trials in the Asia-Pacific region, Singapore’s community participation remains modest, highlighting a critical need for accessible education. Addressing this gap falls within the core domain of nursing leadership, as nurses play a crucial role in promoting research literacy (Hines et al., 2022), informed decision-making (Sevy Majers and Warshawsky, 2020) and public trust (Wilandika et al., 2023).
Methods: This Doctor of Nursing Practice (DNP) project involves the systematic evaluation of a user-friendly educational video aimed at improving knowledge and attitudes towards clinical trial participation. Guided by the Health Belief Model (HBM) and the “Reach, Effectiveness, Adoption, Implementation, and Maintenance” (RE-AIM) framework, the intervention directly targets the micro-level barrier to foster informed, equitable and sustainable engagement with clinical research. Employing a one-group pre-post quasi-experimental design, we will enlist about 200 Singapore residents via digital and selected clinical avenue. The intervention's effect on knowledge, perceived safety, and desire for participation will be assessed using modified, validated questionnaires. The RE-AIM methodology facilitates the assessment of implementation feasibility, including reach, adoption and maintenance.
Results: Following project execution, outcomes will assess the intervention's efficacy in achieving statistically significant enhancements in primary outcomes (T0 to T1) and its practical viability using RE-AIM indicators.
Conclusion: This project represents a scalable, evidence-based approach to reducing barriers to clinical trial participation. By integrating behavioural and implementation science, it positions nursing leadership at the forefront of fostering a more informed, trusting, and research-engaged public, thereby accelerating the translation of science into lifesaving treatment.
