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Studies Within A Trial (SWATs) are a good way of generating evidence to support trial process decision-making.  SWATs are designing to be replicated, which means it’s important to have some focus otherwise we end up with lots of single evaluations that don’t really provide much certainty as to what is and is not effective.

The Trial Forge SWAT Centre (University of York) in conjunction with the Trial Forge SWAT Network have recently been working to develop resources on the design and delivery of Studies Within A Trial (SWATs). These include a range of resources (animations, infographics and flow diagrams) on all stages of a SWAT and with both academic and Plain English versions to ensure all research stakeholders are able to access and make use of these.

When conducting research, it is crucial that the knowledge generated is disseminated and shared with the people who can use it to improve care and outcomes. This is known as knowledge mobilisation. Whilst lots of research is published in academic journals only a small percentage actually influences practice or policy. One reason for this is that researchers don’t always know which approaches or strategies work best to share their research effectively with the people who need it.

To address this gap, the NIHR has launched an exciting new initiative. In 2023, the NIHR Health Technology Assessment programme expanded the remit of studies with a trial or project (SWATs) to include studies testing alternative ways of disseminating and sharing knowledge with key evidence users. Research teams can apply for up to an additional £30,000 to embed dissemination and knowledge mobilisation SWATs in their main study. This is an innovative way to build understanding about the best way to disseminate and share research knowledge to promote its uptake and use.

So, for example, a team applying for NIHR HTA funding might include a dissemination and knowledge mobilisation SWAT that compares a face-to-face stakeholder event to a written summary of research results sent to study participants. Participants could be patients, the public, and/or healthcare professionals, depending on the SWAT. A randomized design could be used to allocate study participants to receive the study findings in one of these two ways, and a mixed methods evaluation completed to consider acceptability and knowledge gained from the two dissemination methods.

While SWATs are welcome across NIHR programs, for now, this particular type of SWAT is being encouraged within the HTA program. Depending on how things go there, other programs may start to encourage similar knowledge mobilization SWATs in the future.

NIHR has some new ‘Plan knowledge mobilization‘ pages, which will be a useful reference for those considering a SWAT testing alternative ways of disseminating and sharing knowledge.

Professor Vicki Goodwin at Exeter University has led work to develop best practice recommendations on including older people in health and social care research based on the NIHR INCLUDE framework.

Older people are a broad heterogenous group, ranging from healthy individuals to those with severe health issues and dependency. Due to restrictions in upper age limits, the presence of comorbidities, and cognitive impairment, they are often excluded in some areas of health and social care research whilst being one of the highest users of health and care resources.

The recommendations aim to provide researchers with practical advice on how to improve the inclusion of older people in research. They include direct action recommendations across four factors – individual, interpersonal, organisation, and community – as well as four questions that may guide those developing, reviewing, and funding research relevant to older people.

For more information, please visit: Link to the full article

The STRIDE project has come up with eight recommendations for trial teams grappling with how to decide which ethnic groups their trial needs. The recommendations came as a result of discussions with panels of public contributors, trialists, health professionals, and others.

Some of the key messages include the fact that decisions need to be made by the trial team together with people from diverse ethnic communities with lived experience of the disease or condition, as well as professionals with experience of treating the disease or condition. When a trial team cannot reach a conclusion regarding the ethnic groups needed, STRIDE suggests including ethnic groups in at least the same proportion found among the population of people with the condition targeted by the trial. And where these data do not exist or cannot be obtained, include ethnic groups at the same proportion as is found in the most recent census data. Additionally, trial sites need to be placed as close to the places where people in the needed ethnic groups live.

For more information and to access the full recommendations, please visit: Link to the full article

This is only v1.0 of the recommendations, and feedback is welcome. If you’d like to provide comments or feedback, please contact them at info@trialforge.org.