Predictors for Research Participation in Critically Ill Patients

Introduction: Research is vital for improving care among critically ill and injured patients, yet despite this awareness, enrollment in critical care trials remains challenging. The high acuity of a patient’s condition often impacts emotional and physical health, in turn affecting disposition on research participation. Furthermore, key demographic groups remain underrepresented. We hypothesized that factors such as race, sex, age, education, and clinical acuity influence willingness to participate in critical care research, and motivators/deterrents vary across these demographic groups.


Methods: We conducted a single-center cross-sectional survey at a tertiary hospital over 10 months, enrolling adult ICU patients or their legally authorized representatives (LARs). A validated survey containing 20 closed-ended questions measured willingness to participate in research and identified motivators/deterrents. Demographic and clinical data were obtained from the electronic health record. Statistical analysis included univariate testing and multivariable logistic regression.


Results: Out of 700 participants, 70.1% indicated that they would be willing to participate in research. Multivariable analysis revealed that participants of older age (p=.041) and better well-being (p=.071) were predictors of willingness. Key motivators included the belief that research would benefit future patients (81.3%) and personal/family members’ outcomes (74.9%). However, Black participants were significantly less likely than White participants to select benefiting future patients as a motivator (70.9% vs. 23.1%, p=.010). Major deterrents across respondents included fear of being experimented on (46.6%) and potential side effects (43.5%). Participants with lower education were more likely to cite distrust in research and fear of personal data misuse as deterrents.


Conclusions: Our study found that the majority of patients/LARs were open to participating in critical care research. Age and current well-being affected willingness to participate, while motivators and deterrents varied widely by demographics. By understanding the motivators and deterrents across demographic groups, we can enable thoughtful engagement with patients/LARs that address their specific concerns, thus increasing research participation among the critically ill.