Researching Researchers: How to Help Them Help Others

By Katherine Calhoun

Plenty of research exists about the challenges that can arise during a study, but much of it focuses on the numbers, such as the number of participants or whether the sample was diverse enough for the findings to be applicable to the broader population. But what about the more intricate details of these challenges that can’t be explained in percentages or frequencies? How can we overcome them if we don’t know exactly what is going on?

A study by Dr. Kaitlyn Jaffe and Dr. Celia Fisher published in the Substance Abuse Treatment, Prevention, and Policy explored the challenges of conducting research about substance use disorders with underserved populations by interviewing researchers who face these obstacles firsthand. The study included 36 researchers who had worked on randomized controlled trials (RCTs) —a type of study in which participants are randomly assigned to either an experimental group, receiving a treatment or medication under investigation, or to a control or comparison group receiving an alternative or placebo treatment. Specifically,  the researchers focused on RCTs testing medications for people who use drugs (PWUD), particularly those with opioid or stimulant use disorders. These trials were described as pragmatic RCTs, meaning they were carried out in real-world healthcare settings to enhance the generalizability of their findings to broader populations. 

The study reports that conducting RCTs and performing research on PWUD present unique challenges, making it essential to understand how these challenges can be overcome. Attempting RCTs on PWUD exacerbates its difficulty for a variety of reasons, especially when trying to reach PWUD who experience other social and economic struggles and barriers. Therefore, a lot of marginalized populations are left out of this research, meaning people who could benefit from it will not, and the results might not accurately reflect how the treatment or medication would work for these populations. It is very important that a diverse population be recruited for studies like RCTs for PWUD so that the most effective medications and treatments can be developed and so people who are struggling can receive the help they need, making it imperative that we understand the challenges and overcome them.  

This study found that it is especially difficult to recruit PWUD because of the distrust they feel due to stigma about drug use and their understanding of the study. Many PWUD worry that when they admit to using drugs, the researchers might turn them in to the authorities or judge them for their habits. There are also limits to how researchers can describe a study when they are advertising it: they usually can’t put the exact drug name, like meth, on an advertisement, which can mean they are vague or attract people who ultimately won’t be able to participate in the study. Some of the researchers overcame these recruiting challenges by establishing trust with the participants, assuring them that they would not be judged or turned in to the authorities. They could also attract more participants by establishing referral systems, where clinicians at nearby treatment centers could refer potential patients to the research study. It can be challenging to get clinicians to support this, but when they do, it can be very helpful in overcoming recruitment barriers.

Once recruitment barriers are overcome, the issue of retention barriers arises, which involves maintaining the same participants in the study. PWUD often face socioeconomic barriers that can prevent them from being in a study. Some examples include consistently and on time arriving at a research site, which can require having a car or someone to drive them. Participants often need a phone to participate. Research sites are typically open from 9 A.M. to 5 P.M., so not everyone can miss time during their normal work hours to participate. Research staff worked on improving retention by making the research experience a positive one, where participants were excited to come in and talk to the researchers. Often, this was because they would consistently meet with the same researcher, who could recall their story and share casual facts about them, thereby establishing a good relationship. The researchers’ ability to be flexible also improves retention. If participants became incarcerated during the study, some researchers were able to meet them in jail so they could continue to participate. Other researchers would meet participants in their home or arrange rideshares for them to the research site. While these researchers went the extra mile to accommodate their participants, doing so is not always possible and can lead to burnout for researchers. 

The ability to identify and work towards overcoming these barriers was due to knowledgeable and dedicated researchers, who have great insight into the intimate details of the research process when working with people in marginalized populations who use drugs. While some research staff were able to implement strategies that boosted their recruitment and retention, not all of these methods were sustainable or feasible for all researchers to use. Researchers should continue to be innovative in their solutions. Still, there should be further work in addressing these barriers on a large scale, so that marginalized PWUD are able to participate in studies and receive the help they need. 

Reference:
Jaffe, K., & Fisher, C. B. (2025). “The hardest part of what we’re doing”: Research staff perspectives on engaging marginalized populations in substance use trials. Substance Abuse Treatment, Prevention, and Policy, 20, Article 28. https://doi.org/10.1186/s13011-025-00657-7