Clinical trials are becoming increasingly digital, yet efforts to strengthen community engagement have not always kept pace with this shift. While technology is now commonly used for recruitment, data collection, and analysis, less attention has been given to how digital tools can deepen relationships with communities and improve equity in research. This review explores how digital approaches can move engagement beyond simple recruitment and towards more meaningful involvement. It focuses on three main areas, which are digitising trial processes to decentralise studies, using online crowdsourcing to shape trial components, and applying digital qualitative methods to better understand community perspectives.
Digitising trial procedures can make participation more accessible and inclusive. Remote consent, online recruitment, wearable devices, and app-based monitoring can reduce the need for travel and allow people from rural or underserved areas to take part. Large-scale digital trials have shown that such approaches can increase diversity among participants and lower costs. At the same time, the review recognises real concerns. The digital divide remains a barrier, especially for older adults, people with disabilities, and those with limited internet access. There are also risks linked to privacy, data security, biased self-reporting, and regulatory gaps, and without careful planning, digital trials may unintentionally widen existing inequalities rather than reduce them.
For communities to be involved more directly in shaping health research, crowdsourcing and digital hackathons provide another avenue. Furthermore, through open calls, online competitions, and collaborative problem-solving events, members of the public can assist in designing intervention materials, refining trial processes, and proposing solutions that reflect lived realities. These methods have, in some cases, broadened participation beyond traditional community advisory boards and increased inclusion of marginalised voices. However, access to technology, internet costs, and language barriers can still restrict who participates. The review emphasises the importance of combining digital engagement with existing structures and tailoring methods to local contexts.
Digital qualitative methods, such as online interviews, virtual focus groups, digital storytelling, and chat-based discussions, can further amplify community voices. These tools can create flexible and sometimes safer spaces for sharing sensitive experiences, while also reducing costs and logistical barriers. They can improve representation and offer insights into how interventions work in real-life settings. Yet they may also result in shorter or less detailed responses, challenges in interpreting emotions, and ethical concerns around consent and confidentiality. Overall, the review concludes that digital approaches hold strong potential to enhance community engagement and promote equity in clinical trials, but only if they are implemented thoughtfully, with attention to inclusion, privacy, and the broader social and regulatory environment.
Please Sign in (or Register) to view further.