Low Parental Participation in a Randomised Clinical Trial of Video Tutorials: A Qualitative Study

AIM: Parents calling a Danish out-of-hours nonurgent medical helpline were invited to a trial comparing video tutorials on managing children's acute illnesses with telephone triage by health professionals. Participants allocated to videos were disconnected from the helpline. Facing only 6% participation, this study explored barriers to engagement and the participants' experiences.

METHODS: We conducted 39 semistructured interviews (25 nonparticipants, 14 participants who watched videos) and applied Clarke and Braun's thematic analysis.

RESULTS: We identified five themes: (1) initial response: annoyance and anger; (2) participation barriers: urgency and ambiguity; (3) participation facilitators: efficiency and resources; (4) video tutorials: confidence and reassurance; and (5) accessing video: timing of information. Parents who declined found their child's condition too urgent for a video-based intervention, doubted the videos' relevance to their situation, preferred individualised care and opposed the automatic call disconnection since the callback option would delay telephone triage. In contrast, participants found the videos time-efficient, calming and empowering.

CONCLUSION: The study design hindered participation. Future studies should address relevance and benefits, such as time efficiency, to improve parental engagement. Longitudinal studies are needed to evaluate the long-term impact of the videos on parental healthcare-seeking behaviour and explore global potential.