Janice L. Krieger and Jordan M. Neil
Strategic communication is an essential component in the science and practice of recruiting participants to clinical research studies. Unfortunately, many clinical research studies do not consider the role of communication in the recruitment process until efforts to enroll patients in a timely manner have failed. The field of communication is rich with theory and research that can inform the development of an effective recruitment plan from the inception of a clinical research study through informed consent. The recruitment context is distinct from many other health contexts in that there is often not a behavioral response that can be universally promoted to patients. The appropriateness of a clinical research study for an individual is based on a number of medical, psychological, and contextual factors, making it impossible to recommend that everyone who is eligible for a clinical research study enroll. Instead, clinical research study recruitment efforts must utilize strategic communication principles to ensure that messages promote awareness of clinical research, maximize personal relevance, minimize information overload, and facilitate informed choice. This can be accomplished through careful consideration of various aspects of the communication context described in this chapter, including audience segmentation, message content, message channels, and formative, process, and outcome evaluation, as well as the enrollment encounter.
Dialogue and its extension to polylogue are presented as an intersubjective basis of communication. The intersubjective aspect cannot be explained by any discipline without a contradiction, since any explanation would require intersubjective awareness. While necessary, dialogue requires a third aspect: dialogue about something, a theme, a subject matter, a problem, a point of disagreement, such that the topic sets a limit to the dialogical partners. This third aspect shifts the discussion away from subject-to-subject encounter as inadequate and moves to the subjects as partners who first are engaged in a dialogue about something. While speaking to someone about something, there is a mutual exchange of awareness and a broadening of horizons of both, with an addition of others who are co-present even if they are not empirically available. To speak to someone of physical laws is also to speak with Newton, Einstein, Planck, and others who form a polylogical field—forming an extension of the awareness of dialogical partners. The issue that arises is whether the individual can form her own position, or whether she is dominated by a historical tradition of interpretation. The dialectical debate between Habermas and Gadamer shows the problem, which is finally resolved by an extension of dialogue through education. The final and most concrete aspect of dialogical communication is present at the level of praxis as bodily activity which is equally intercorporeal. We build our world and thus our history and form a depth of intercorporeal communication of what we can do.
While the dialogical domain is the focus of this research, it also includes suggestions on critical evaluation of specific theories and mutual controversies among theorists, e.g., Habermas and Gadamer. Such controversies are necessary to show how dialogical procedures not only posit different theoretical positions but help such positions to become clearer and more articulated.