Rethinking participant engagement: why understanding populations should inform study design
Participant engagement is often discussed in terms of recruitment and retention, but these activities represent the outcome of decisions made much earlier in the life of a study.
Dr Claire Sears
Published 27 August 2026
In my role as Senior Director of Participant & Site Enablement at EMS Healthcare, I manage a team spanning data & insights, feasibility, participant recruitment, Primary Care partnerships, and community engagement. While these functions have distinct objectives, they all contribute to the same overarching goal: understanding how research can be designed and delivered around the populations we aim to serve.
For sponsors looking to conduct research in the UK, this means understanding far more than where research sites are located. It means understanding the people those studies are intended to reach, how healthcare is accessed across different regions, and how geography, demographics and local infrastructure influence participation.
Understanding populations, not just sites
Feasibility has traditionally focused on identifying research-active sites with the experience and capacity to deliver a study. Those considerations remain important, but they only provide part of the picture.
The UK offers a unique opportunity for clinical research, with a nationally coordinated healthcare system and a diverse population distributed across urban, rural and coastal communities. Disease prevalence, socioeconomic factors, ethnicity, healthcare utilisation, transport networks and local health inequalities vary considerably across the country.
Understanding these differences is essential when selecting where research should take place.
Rather than assuming historical recruitment performance will predict future success, study planning should begin with a detailed understanding of the population the protocol is designed to recruit. This creates a stronger evidence base for site selection and helps improve both accessibility and representation.
Bringing different sources of evidence together
Location intelligence provides valuable insight into where eligible populations are concentrated, but those findings become more meaningful when considered alongside local healthcare pathways, relationships with Primary Care, and an understanding of the communities themselves.
At EMS Healthcare, this integrated approach combines population analytics through LASER with insights gained through long-standing partnerships across primary care and locally based community engagement teams. This enables feasibility to become a broader assessment of recruitment potential rather than simply an evaluation of site capability.
Equally important is recognising that local knowledge cannot be replicated through data alone. Teams who live and work within their communities understand local health priorities, and the trusted communication channels and practical considerations that influence participation. Bringing together these quantitative and qualitative insights enables more informed decisions about where research can have the greatest impact.
Delivering research that reflects the UK population
The UK has a population of more than 69 million people, characterised by significant regional, demographic and socioeconomic diversity.
Designing studies that reflect this requires more than opening sites in established research centres. It requires understanding where eligible populations live, how they interact with healthcare services and how barriers to participation differ across communities.
By integrating population insights, feasibility, primary care partnerships and community engagement, it becomes possible to design studies that are not only operationally efficient but also more representative of the populations who will ultimately benefit from new medicines and technologies.
Participant engagement is the result of understanding populations, applying evidence thoughtfully and designing studies around the realities of people's lives.
Closing reflection
One of the most rewarding aspects of my role is managing a team whose expertise spans data science, feasibility, partnerships, community engagement and participant recruitment. Each discipline offers a different perspective, but together they reinforce an important principle: successful clinical research starts with understanding people.
As the UK continues to strengthen its position as a destination for global clinical research, our greatest advantage is our ability to understand the populations we serve, recognise the diversity that exists across the country, and use those insights to design studies that are more accessible, more representative and ultimately more successful.
Join the conversation
Each month, InSites draws on more than two decades of experience supporting communities across the UK, sharing what has worked, what we are learning, and what we are seeing across an evolving research landscape.
Dr Claire Sears, Senior Director of Participant & Site Enablement, EMS Healthcare