The people we spoke to had different views on how much feedback they wanted or expected from the cohort studies they took part in. There were two main types of feedback talked about:
- Individual feedback about their test results and personal health
- Study findings on the data collected from all participants
Not all studies will provide individual feedback. Jenny, a senior researcher, explained that the researchers may pick up a health problem for a participant through tests and study activities “but overall the cohort study is to change our understanding for people in the future, rather than the people who are participating.” This is usually discussed when people are first invited to join a cohort study.
Cohort studies can run for a long time and this often means that the overall findings are not available as quickly as some people would like. Malcolm thought that it would help keep participants interested and keen to stay involved if the
study team kept in touch about their progress.
Some people wanted feedback of both types, whilst others were content not to receive much, if any at all. For Teresa, the level of feedback from her study was enough and she was “not inundated”. Luke felt it was important that participants should be able to choose for themselves how much information and detail about the study findings they want to delve into, and that the research teams support their decision. This might include choosing to read the study newsletter, look for more detailed information, and talking to research staff at study visits.
But some people were disappointed by how little feedback they had been given. Margaret Ann didn’t have much information back from the researchers which left her wondering “what do they do with it [our data]?”
Feedback on personal health
Other people didn’t want or expect feedback about their individual results, and not every study gave this type of feedback. Some people were happy with this arrangement and recognised that the main focus of a cohort study was on collecting together data from lots of people. Luke didn’t expect much feedback on his personal health and instead emphasised that studies like this are really “going to be that sort of aggregated population level” data. Douglas took part in a study where some results were kept “all terribly secret”, but he did receive feedback on other aspects of his health such as his platelet level. But Emily found it “a bit disappointing” when “sometimes they say, ‘I’m sorry, we’re just going to do this test and we’re not going to tell you [the outcome]’.”
People who were enrolled into a study because they had a diagnosis (such as motor neurone disease/MND) or had experienced a medical event (such as a transient ischaemic attack/TIA/’mini stroke’) often hoped that they would get some extra information, feedback and support with their health. They had wanted more information about why they had become unwell and access to extra monitoring of their health. Some people felt that being in a study gave them a direct line to research-active healthcare professionals so that they could get advice or be seen quicker.
Feedback on personal health was sometimes given to the participant by a research professional at the time of a study visit. Other times the person was sent a letter afterwards to thank them for taking part and summarise their individual results. Nadera received a letter with graphs to say “everything is normal” but she felt more explanation was needed and so “I went back myself, researched it” to understand the information better. Some people had taken test results from the study to their GP, to help them better understand the information or to flag concerns.
Quite often, people were told they wouldn’t be contacted directly but that their GP or another healthcare professional might be sent the information. Alan Z thought this was “perfectly adequate” because of the large number of participants. Alan Y agreed to his individual test results (like results from blood samples and blood pressure readings) being added to his medical records. In some studies, people were advised that their GP would only be contacted if there was something “concerning”. Keith was told that his GP would be notified if there was “something amiss”; at first, he had wanted to see the scan results but now he is “very happy to assume that’s alright”. Nadera felt it was a missed opportunity that blood test results from one sub-study she took part in wouldn’t be shared with her healthcare professionals.
Sometimes a lack of feedback on personal health caused worry. Iram had a hair sample taken as part of a cohort study which she thought was being analysed to look for cancer risks. She hadn’t heard back and thought “it could be that they still haven’t found out [results] yet.” Lucy wasn’t sure whether she or her GP would be told about any health concerns found through the research, and this caused her concern.
Richard and Luke felt that the research activities of cohort studies shouldn’t be seen as a robust way to monitor a person’s health. Richard, who decided not to take part in a biobanking study, thought the NHS should be providing “tests more routinely” rather than studies being seen as a way for people to get a health check-up.
Overall study findings
The wish to help improve knowledge and benefit future generations was very motivating for many people we spoke to. Receiving feedback on study findings helped some feel part of a group and that taking part was worthwhile.
Study findings were sometimes shared with participants at study visits, through newsletters sent in the post, or signposted to online (for example, on a website run by the research team or through their social media accounts and groups). Some birth cohort studies sent people an annual Christmas or birthday card with a newsletter inside. Isobel and Ronald thought it was important not to forget about sharing findings with participants who don’t have access to a computer or use social media. Salma encouraged researchers to communicate their findings in “simple terms” and to be aware that English is a second language for some people.
As well as hearing about study findings directly from the research team, Gareth and Luke had seen them reported in the news. Gareth was pleased because it showed the work was valued and “nationally recognised.” But Luke felt frustrated with the way the media sometimes interpreted and represented the results of a study he is part of.
Not everyone had received study findings, and some people couldn’t remember if they had or not. Derek and Ronald both receive cards every year from a birth cohort study team but didn’t think these included newsletters. Jess was also part of a birth cohort study and knew of friends who the research team had stayed in touch with, but she herself hadn’t been contacted or invited to a reunion event.
Some people who had received only little or no feedback on study findings said they would have liked a short summary update every year to learn what the study is finding out, how they are using the data and future plans. Steve had only received occasional feedback over the years and said that “a yearly bulletin would be fantastic because then I would feel I’m actually part of this”. For Malcolm, participants “deserve” to hear about findings and this doesn’t have to be much: “just little updates, not in-depth, just a few lines, a few pages of report maybe”.
A few of the birth cohort studies had organised special ‘get-together’ events for participants. For studies that had been running many decades, these meet-ups typically marked a milestone in terms of how long the study had been running and the birthdays of participants. Linda had been to a reunion where she learnt more about how the researchers had been using the data and she enjoyed talking with fellow participants. Another study, which had begun more recently and enrolled parents and children, held a yearly festival or picnic.
Many people spoke about wanting to receive timely information about the study findings from the researchers, but also suggested why this might not be possible. Gareth recognised that it may be many years before findings can be drawn from a cohort study because of how long the data collected period often is. Keith, Gill and Brian thought that cost and time might be factors. They agreed they would rather funding and staff resources were focused on doing the research rather than sending findings to participants. Mr S thought feedback on a study might be lacking because of low enrolment numbers or if the results were not very “concise”.
The impact of receiving feedback
Sometimes feedback from a study had quite an impact on the people who took part. This included finding out news about their personal health, which might require more tests, treatments or changes in their diet and lifestyle. Gareth had some results about his cholesterol levels and a scan of his body fat distribution which made him think “that’s where I’ve got to put a bit of exercise in at the gym.” Alan Y felt that his study had made him more aware of diet and the importance of taking care of himself.
Those who had been in birth cohorts for many decades often said they were interested to see how life had developed for their fellow participants and how it compared to their own. Reminiscing was enjoyable for some but, as Steve pointed out, it is also important to recognise “the bad things that we went through and how it affected people”. For some, it highlighted opportunities they were grateful to have had and accomplishments they were proud of.