Public Perceptions of Research

Background

This report presents the findings of a study commissioned by the Health Research Authority (HRA) to understand public perceptions of health and social care research in the UK.

Their core purpose is to protect and promote the interests of patients and the public in health and social care research. In support of this, the new three-year strategy, ‘making it easy to do research that people can trust’, is underpinned by two pillars:

• to include, so that health and social care research is done with and for everyone
• to accelerate, so that research findings improve care faster

This research was commissioned as part of the ‘include’ pillar and asks a diverse group of people about health and social care research. It provides a better understanding of what matters to people in research and what is important to earn their trust.

Approach

YouGov collected data from a representative sample of 5,030 people from across the United Kingdom (UK), collected through online methods. This means that controls were applied to ensure the distribution of participants accurately reflects the adult UK population across key characteristics. Demographic information on the collected profile is available in appendix B. Fieldwork was conducted between the 27 April 2023 and 16 May 2023.

Notes on analysis

Where two or more groups are discussed, only statistically significant differences to the 95% confidence interval are mentioned. Significance testing is not applied for figures based on fewer than 50 respondents.

The report discusses differences in findings between people who have been involved in research and those who have not participated. These groups are drawn from a question asked in the survey and are self-reported; no further information on what type of research people were involved in is available.

The number of respondents in various demographic groups is available in appendix B.

Figures in charts and images may not add to 100% due to rounding or due to the question allowing multiple selections.

Executive summary

The general public are broadly positive about health and social care research that happens in the UK – two-thirds are confident it improves people’s health and wellbeing (67%). Additionally, three-quarters think that, if they took part, they would be treated with dignity and respect (75%). This is also reinforced by high levels of willingness to participate, with just over two-thirds of UK adults saying they would take part if asked (68%).

Previous participation in research studies appears to lead to a positive perception of health and social research studies. People who have previously been a participant are more confident than those without involvement to believe UK studies improve people’s health and wellbeing (79%) and they are more confident participants are treated with dignity and respect (85%). Women also tend to have a more positive perception of health and social research studies. They are more likely than men to participate (71%, 65% men) and more confident they would be looked after during a study (72%, 68%).

People tend to trust their friends / family members – both their experiences of health and social care generally (83%) as well as being a source of information on health and social care research (77%). Friends and family are a key source of research information for people from lower social grades [1] – they are more likely than higher social grades to trust friends / family about research information, despite there being no difference across social grade for trust in friends / family about experiences in health and social care.

The NHS is another key source of trusted information about health and social care research, especially when it comes from a local healthcare professional such as an individual’s doctor or dentist (83%). However, people put more emphasis on the content of information over an NHS logo – they trust information which is easy to understand (58%), providing key details about the research such as the funder (59%) or what standards are adhered to (58%).

Involvement from members of the public can support clear and appropriate communication, and having clear information can encourage more members of the public to participate in research. Most UK adults would be more likely to take part in a study where members of the public ensured the participant information is easily understood (55%) or ensuring the research findings are accessible (54%). As well as general accessibility, knowing that participants will be told about the research’s findings also encourages people to participate in health and social care research studies (69%). In particular, knowing that there is public involvement in deciding the priorities of research funding encourages younger adults to take part (44%) – crucial when younger people tend to be less likely to participate in general (63% ages 16 to 24 compared to 73% of those aged 65 years and above).

Communication about research findings is key. How the findings are going to be used is one of the top pieces of information people would like to know when deciding whether to participate in a health and social care research study (70%), equal with knowing what the risks are (70%). Just under two-thirds would like to know the research funder (64%).

People in the UK tend to be less favourable towards privately funded studies – 46% say knowing a study is industry-funded makes them less likely to participate and a similar proportion say it would make them less confident in the research findings (48%). There is notable variation across demographics – white adults and women are particularly averse to industry-funded studies, but a third of black adults say they are more likely to participate in these (36%) and over a quarter of black adults would be less likely to participate in government-funded research (28%).

Negative associations with privately funded studies also seem weakly held – as soon as additional information is provided about a study, people’s confidence in the findings is improved. For example, two-fifths of UK adults say that an industry-funded study involving members of the public at various stages makes them more confident in the research findings (41%). Efforts towards transparency, such as being on a public register and data being available to other researchers, also makes them more confident in the research findings of industry-funded study (49%) .This is also supported by the findings from the ‘MaxDiff’ exercise, where respondents were asked to make choices between two key factors in a hypothetical research study (detailed in appendix A). Here, private funding was the least important factor driving participation in a research study. Rather, key things that motivate people to take part are research making a difference to the people it is for and about, and researchers acting in their best interests.

Including a diverse mix of participants has the largest impact on confidence in findings from a privately funded study (53%). This may be linked to the fact that most UK adults think it is important for health and social care research studies to include a diverse mix of participants (88%). The majority of people still hold this view, even if ensuring diversity means the research costs more money (70%) or takes more time (74%) – indicating that people would prefer researchers ensure that the study understands how different groups of people are affected over research cost or speed.

Conducting research with the public is key to developing people’s trust in health and social care research in the UK. Previous participation in research studies is strongly associated with positive perceptions of health and social care research and people would be more likely to take part in research studies where members of the public are involved from the outset. There is also clear impetus for diversity in research participants – the public think it is important to do so, it would encourage them to take part, and it diminishes concerns about particular funding sources. Researchers should evaluate the points of public involvement, research transparency and participant diversity as part of a wider, people-centred approach when conducting health and social research in the UK.

[2] Social grades are a social classification which assigns every household a grade based on the occupation and employment of the chief income earner. There are six grades in total: A, B, C1, C2, D, E.

For the purposes of the report, the social grades are grouped into ABC1 and C2DE. ABC1 comprises the three highest socio-economic grades. C2DE comprises the three lowest socio-economic grades.

Section 1 – How do people feel about research?

Confidence in research

• two-thirds of the general public are confident that health and social care research which happens in the UK improves people’s health and wellbeing (67%)
• significantly more people who have participated in research are confident in this (79% previous participants)
• those with a disability or long-term health condition show lower confidence compared to those without (27% with a disability, 20% without)

Two-thirds of UK adults feel confident that health and social care research which happens in the UK improves people’s health and wellbeing (67%). Following this, six in ten (62%) feel confident that research is undertaken ethically (i.e. being conducted with integrity and adhering to guidelines) and around half feel confident that research is being done by the right people in the areas that matter to people (53%). Confidence in whether research findings are shared with the public is lower with 46% who are confident compared to 41% who are not, while 34% of the public are confident research findings are shared without delay compared to 50% who are not.

Confidence is higher among those who have previously participated in research. Significantly more people who have previously been a research participant have confidence in research’s ability to improve people’s health and wellbeing (79% for research participants, 66% not involved in any way). The same pattern is evident for perceptions of whether research is undertaken ethically (75% for research participants, 61% with no involvement).

When looking at whether research findings are shared with the public and without delay, those who have previously been a research participant show the highest confidence – for example 55% of previous participants are confident that research findings are shared with the public compared to 44% who are not involved in research in any way, while 45% of previous participants feel confident research findings are shared without delay compared to 32% with no research involvement.

Those with a disability or long-term health condition [3] show lower confidence across all measures. For example, those with a disability or health condition are more likely to say they are not confident that research improves people’s health and wellbeing compared to those without (27% with a disability, 20% without).

Figure 1. Confidence in UK health and social care research

Download a csv file for figure 1.

Figure 1 alt text: a horizontal stacked bars with green, red and grey colours indicating confidence in UK health and social care research. It shows that the green (more confident) bar is largest for 'research improves people's health and wellbeing' and smallest for 'research findings are shared without delay'.

Question: thinking about health and social care research that happens in the UK. How confident, if at all, are you in each of the following? Base: all UK adults (5,030)

Willingness to participate in research

• most UK adults would take part in a research study if asked (68%)
• there is a clear trend by age, with older respondents more likely than younger respondents to say they would participate (63% ages 16 to 24, 73% ages 65 and above)
• women are more likely to say they would take part compared to men (71% women, 65% men)
• adults in higher social grades are more likely than those from lower social grades to say they would take part (72% higher grade, 63% lower grade)

The majority (68%) of the public say they would be likely to take part in a health and social care research study if asked, while one in five (21%) say they would be unlikely. Those who have already participated in research are the most likely to say they would participate again (92%).

Figure 2. Likelihood of participating in a health and social care research study

Question: imagine you were asked to take part in a health and social care research study. How likely or unlikely would you be to take part? Base: all UK adults (5,030)

Download a csv file for figure 2.

Figure 2 alt text: a circular chart with green, red and grey colours indicating the likelihood to participate. It shows that the green (likely) bar is largest than the red (unlikely). Grey represents do not know, which is 11%.

There is also variation across demographics, with women being more likely to say they would take part compared to men (71% women, 65% men). There is a clear directional pattern in age, in which older groups are more willing to take part compared to their younger counterparts (figure 3). Additionally, adults in higher social grades are more likely than those from lower social grades to take part (72% ABC1, 63% C2DE) and those who are currently unpaid carers [4] (79%) are more likely than those who have never been a carer (66%).

Figure 3. Likely to participate in a health and social care research study, by gender, age, social grade, and carer status

Question: imagine you were asked to take part in a health and social care research study. How likely or unlikely would you be to take part?

Base: male (2,429); female (2,601); 16 to 24 (683); 25 to 34 (727); 35 to 44 (893); 45 to 64 (1,531); 65 and above (1,196); ABC1 (3,010); C2DE (2,017); current unpaid carer (606); previous unpaid carer (835); never unpaid carer (3,326)

Download a csv file for figure 3.

Figure 3 alt text: vertical green bars indicating likelihood to participate in a health and social care research study by age, gender, social grade and carer status.

Confidence in how you would treated when taking part in research

• three-quarters of UK adults are confident that, if they were asked to take part in a health / social care research study, they would be treated with dignity and respect (75%)
• women are more confident than men that they would be looked after while participating in research (72% women, 68% men)
• black adults are less confident that they would be looked after whilst taking part in research (30%), compared to Asian adults (20%) and white adults (18%)

When asked about confidence in the different elements of taking part in a research study, most people are confident that they would be treated with dignity and respect, with three-quarters (75%) saying this. Following this, around seven in ten feel confident they would be told what the research was for (72%) or that they would be looked after (70%).

In line with their willingness to participate, women are more likely to feel confident across all measures compared to men – for example, 72% of women think they would be looked after while participating in research, compared to only 68% of men. White adults are the most confident they would be looked after, while 30% of black adults are not confident (20% Asian adults, 18% white adults).

Confidence is also higher across all measures for those who have previously been a research participant, compared to those who have never been involved; for example, 85% of previous participants are confident they would be treated with dignity and respect (75% no involvement).

Figure 4. Confidence in treatment during health / social care research

Question: if you were asked to take part in a health and social care research study. How confident would you be, if at all, in each of the following?

Base: all UK adults (5,030)

Download a csv file for figure 4.

Figure 4 alt text: a horizontal stacked bars with green, red and grey colours indicating confidence in treatment during health and social care research. It shows that the green (very confident) bar is largest for 'you would be treated with dignity and respect'.

Confidence in treatment of their data

• three in ten UK adults are not confident that their data would not be used for anything they did not agree to (33%), or not confident that their data would be held securely (30%)
• previous research participants are more assured about their data security; 79% are confident their data would be held securely, compared to 59% of people who have not been involved in research before

The public are less confident about how the data about them will be treated – a third are not confident the data about them would not be used for anything they did not agree to (33%), and three in ten are not confident their data would be held securely (30%).

Consistent with their confidence in treatment, women are more likely than men to feel confident in the treatment of their data; 63% are confident their data would be held securely (59% men), and 59% are confident it would not be used for anything they did not agree to (54% men). There are no significant differences across different ethnicities in terms of confidence in treatment of data.

People who have previously been a research participant are more assured about data security – eight in ten believe their data would be held securely (79%, 59% no involvement) and three quarters believe the data would not be used for anything they did not agree to (74%, 54% no involvement).

Figure 5. Confidence in treatment of data during health / social care research

Question: if you were asked to take part in a health and social care research study. How confident would you be, if at all, in each of the following?
Base: all UK adults (5,030)

Download a csv file for figure 5.

Figure 5 alt text: a horizontal stacked bars with green, red and grey colours indicating confidence in treatment of data during health and social care research. It shows that the green (very confident) bar is smallest for 'the data about you would not be used for anything you did not agree to'.

When asked why they are not confident about data protection, lack of trust in the researchers and data security were key themes. Respondents felt information could be leaked or shared either accidentally or on purpose. Respondents also felt that organisations or businesses may have their own agenda for doing the research and lack transparency about their objectives and what the data is being used for.

Figure 6. Reasons for lack of confidence in research

You said you would not feel confident if you were asked to take part in a health and social care research study. Why is this? Answers were provided as free-text. Responses exemplifying the key themes are shown here.

Figure 6 alt text: a selection of quotes in speech bubbles showing why people do not feel confident in taking part in a health and social care research study.

Motivations for taking part in a health or social care research study

• women are more motivated than men to take part if their participation is beneficial – half feel motivated to take part if their involvement ensures people like them are represented (48%), compared to just over a third of men (36%)
• people with a disability are particularly keen to participate if their involvement ensures representation (51%)
• when forced to make choices between two key factors in a hypothetical research study (a ‘MaxDiff’ exercise), research making a difference to people it is for and about comes out as being most important. Knowing that researchers act in participants’ best interests and that the people taking part are cared for throughout are both in the top ten most important factors in the model

Two-thirds or more would be motivated to participate if their involvement led to better ways of detecting disease early (69%), helped other people (66%), or led to new ways to prevent ill-health (66%). Six in ten would feel motivated to take part if their participation helped family / friends (57%) and half would do so if they would personally benefit (50%).

Figure 7. Motivations for taking part in a health / social care research study

Question: please imagine that you were invited to participate in a health and social care research study. Which, if any, of the following do you think would motivate you to take part in the research?

Base: all UK adults (5,030)

Download a csv file for figure 7.

Figure 7 alt text: horizontal purple and grey bars indicating motivations for taking part in a health / social care research study. It shows that 'led to better ways of detecting disease early' has the biggest bar, while 'ensure people like me are represented' has the smallest. The grey bars represent 'none of these' (3%) and 'do not know' (6%).

People with a disability or long-term health condition (53%) are more likely than those without (49%) to feel motivated by a personal benefit, if their participation ensured people like them are represented (51% with a disability, 39% without), or if the research helps to understand underlying causes of ill-health (68% with a disability, 65% without).

As noted earlier, women are generally more likely than men to feel confident taking part in a research study and display more trust in health and social care research. They also display higher levels of motivation to take part in a study if they feel their participation is beneficial in some way. For example, nearly half of women would feel motivated to take part in a health and social care study if their participation ensured people like them are represented (48%), while just over a third of men feel the same (36%).

Figure 8. Motivations for taking part in a health / social care research study, by gender

Question: please imagine that you were invited to participate in a health and social care research study. Which, if any, of the following do you think would motivate you to take part in the research?

Base: all UK adults (5,030)

Download a csv file for figure 8.

Figure 8 alt text: horizontal blue and green bars indicating motivations for taking part in a health / social care research study by gender. It shows that the blue bar (women) is generally higher for all motivation points.

A ‘MaxDiff’ exercise was carried out to further understand how people decide to take part in a health and social care research study. The exercise forces respondents to make 'trade-offs' between attributes in a hypothetical research study and ultimately provides an understanding of how important each factor is in determining likelihood to participate. Further details of the exercise can be found in appendix A.

The analysis found that factors related to individuals’ treatment in the research study had high levels of relative importance – meaning they are important drivers of participation in a research study. Knowing that researchers act in participants’ best interests is the second highest attribute tested in the model and there is also high relative importance for knowing that people taking part are cared for throughout. This indicates that information about a positive participant experience is likely to encourage people to participate in health and social care research studies.

Diversity of participants

• nearly all adults think it is important for health and social care research studies to include a diverse mix of participants (88%). They continue to think diversity of participants is important even if the research costs more money (70%) or takes longer (74%)
• just as they are more motivated to take part to ensure representation, women are more likely than men to think having diversity of participants is important (91% women, 81% men)
• adults from an ethnic minority background are less likely than white adults to say diverse participants are important (81% ethnic minority, 89% white), but this may be due to higher uncertainty (8% did not know if it is important, 4% white adults)

Approximately nine in ten of the public think it is important for health and social care research studies to include a diverse mix of participants (88%). Perceived importance is highest among previous research participants increasing to 96% compared to 89% of those with no involvement.

Women are more likely than men to think having a diversity of participants is important (91%, 84% men). Those from an ethnic minority [4] (81%) are less likely than white adults (89%) to say diversity is important, although this may be due to higher levels of uncertainty amongst ethnic minority adults (8% do not know, 4% white adults).

Most of the public still feel it is important to include a diverse mix of participants even if the research costs more money (70%) or takes more time (74%). Similar to overall perceived importance of including a diversity of participants, people who have previously participated in research are more likely than average to feel it is important even if the research costs more money (81%) or takes more time (82%).

Figure 9 . Importance of health and social care research studies including a diverse mix of participants

Question: how important, if at all, do you think it is for a health and social care research study to include a diverse mix of participants? / Including a diverse mix of participants in health and social care research can lead to a better understanding of how different groups of people are affected by conditions and any variation in how effective treatments are for them. Sometimes including a diverse mix of participants can cost more money and / or result in the research taking more time to conduct.

How important do you think it is for a health and social care research study to include a diverse mix of participants.

Base: all UK adults (5,030)

Download a csv file for figure 9.

Figure 9 alt text: vertical stacked bars with green, red and grey colours indicating the importance of health and social care research studies including a diverse mix of participants. It shows that the green (more important) bar is largest for 'importance of having a diverse mix of participants overall' and smallest for 'importance if the research costs more money'.

In the ‘MaxDiff’ exercise (detailed in appendix A) factors related to the outcome of the research or participant experience are relatively more important than simple diversity of the participant group. However, as noted before, knowing the research is conducted with and for the communities it affects is one of the top ten most important factors for a hypothetical research study. Including a diverse mix of participants is relatively less important but ranks higher than other factors – including all factors relating to the research funder.

Section 2 – What earns trust in research?

Research Ethics Committees

• after being informed about Research Ethics Committees, most of the UK public would feel more confident about taking part in a health and social care research study (69%) and more confident about the research findings (68%)

After being informed about Research Ethics Committees, most of the UK public would feel more confident taking part in a health and social care research study (69%) and the research findings (68%) if they knew it has been reviewed by an ethics committee. One in five feel it would not change their confidence in taking part in the study (20%) or in the research findings (21%). Only a small minority say it would make them feel less confident in taking part or the findings (both 4%).

Similar to overall confidence, those who have previously taken part in research as a participant would feel more confident in taking part in the study and the research findings if it has been reviewed by a Research Ethics Committee compared to those who have not – 83% of those who have been a research participant felt more confident in taking part in the study, compared to 68% of those who have no prior involvement. However, this is due to those who have not taken part in research being more likely to say they are uncertain rather than being less confident (2% of participants are unsure, compared to 7% with no involvement).

Figure 10. Impact of research ethics committee on confidence

Question: health and social care research that directly involves patients, recipients of social care, or healthy volunteers is reviewed and approved by a Research Ethics Committee before it takes place.

Most studies using patient data also need this approval. A Research Ethics Committee has a mix of experts (who work or have worked in the field of health and social care, such as a care worker or doctor) and members of the public. Each committee has up to 18 people. Research Ethics Committee members are volunteers and are independent from the research being reviewed. The aim of the Research Ethics Committee is to protect the rights, safety, dignity and wellbeing of patients taking part in a health and social care research study.

If you knew a health and social care research study had been reviewed by a Research Ethics Committee, would this make you more or less confident about:

Base: all UK adults (5,030)

Download a csv file for figure 10.

Figure 10 alt text: two horizontal stacked bars, with green, amber, grey and red colours indicating the level of confidence. It shows the impact of a Research Ethics Committee are very similar across the research findings and taking part in the study.

Trust in participation through public involvement

• over half say that public involvement in the communication of the research makes them more confident about taking part – whether this is ensuring participant information is easily understood (55%) or ensuring the findings are accessible (54%)
• younger adults are more favourable than older adults towards public involvement in setting priorities for funding (44% ages 16 to 24, 38% ages 65 and above), although some of this is driven by older adults saying public involvement has no impact on their favourability

Survey respondents were told about public involvement in health and social care research, to explore whether this has an impact on their confidence in taking part in a study. The majority of UK adults say that members of the public being involved in the communication of research makes them more confident about taking part – whether this is ensuring participant information is easily understood (55%) or ensuring the research findings are accessible (54%).

Women are more likely than men to say that public involvement in the participant information makes them more confident in taking part (58% women, 52% men), while there is no difference across gender for public involvement in the research findings (55% women, 53% men).

Figure 11. Impact of public involvement on participation confidence (communication statements)

Question: researchers are expected to work with members of the public during a health and social care research project. These can be patients with a relevant condition, carers of people with a relevant condition, or general members of the public.
If you knew a health and social care research study had involved members of the public at each of the following stages, would this make you more or less confident about taking part in a study?

Base: all UK adults (5,030)

Download a csv file for figure 11.

Figure 11 alt text: two horizontal stacked bars with green, amber and red colours indicating the levels of confidence. It shows the impact of public involvement is very similar across the two statements:

1. 'ensuring the information shared with participants is easily understood by non-researchers
2. 'ensuring the research findings are written and shared in an accessible way'

UK adults are more split on other areas of public involvement, with around two-fifths saying members of the public being involved in each of the following makes them more confident in taking part:

• involved in the submission of research proposal to research ethics committees (45%)
• designing the study (41%)
• deciding on priorities for funding (39%)

However, a similar proportion say public involvement in each of these would not impact their confidence either way.

Figure 12. Impact of public involvement on participation confidence (non-communication statements)

Download a csv file for figure 12.

Figure 12 alt text: three horizontal stacked bars with green, amber, red and grey colours indicating the levels of confidence. The largest colour is amber, indicating that, for many, the statements have no impact. Green, indicating that the statements encourage people to be more confident, is close behind.

Question: researchers are expected to work with members of the public during a health and social care research project. These can be patients with a relevant condition, carers of people with a relevant condition, or general members of the public.

If you knew a health and social care research study had involved members of the public at each of the following stages, would this make you more or less confident about taking part in a study?

Base: all UK adults (5,030)

Younger adults are particularly favourable towards public involvement in deciding priorities for funding – they are more likely than older adults to say this makes them more confident in taking part (44% ages 16 to 24, 38% ages 65 and above). However, this is broadly because people become more ambivalent - the proportion saying public involvement in deciding funding priorities would have no impact on their confidence rises with age (figure 12).

Figure 13. Impact of public involvement in deciding priorities for funding, by age

Question: researchers are expected to work with members of the public during a health and social care research project. These can be patients with a relevant condition, carers of people with a relevant condition, or general members of the public.

If you knew a health and social care research study had involved members of the public at each of the following stages, would this make you more or less confident about taking part in a study? - Deciding on priorities for funding (for example, which projects should get funding)

Base: ages 16 to 24 (683); ages 25 to 34 (727); ages 35 to 44 (893); ages 45 to 64 (1,531); ages 65 and above (1,196)

Download a csv file for figure 13.

Figure 13 alt text: vertical stacked columns with green, amber, red and grey colours indicating the levels of confidence. It shows the amber (no impact) column grows with age, while the green column (more confident) slightly decreases with age.

Few say public involvement in each area would make them less confident about taking part, but this tends to be higher for ethnic minority adults. For example, 12% of ethnic minority adults are less confident about participation if they know members of the public are involved in deciding funding priorities (8% white adults). However, black adults do not feel this way – half say members of the public being involved in priorities for funding makes them more confident in taking part (50%), significantly higher than white adults (39%).

Impact of funding on participation

• people are split on the impact a funder makes on their participation - around two-fifths say the type of funder has no impact on their participation, but 46% of UK adults say knowing the research funder is a private business makes them less likely to participate
• white adults are particularly averse to taking part in research funded by a private business – just under half say they are less likely to take part in a privately-funded study (47%)
• this is not the case for ethnic minority adults. Asian adults are twice as likely to say private-funded research encourages participation (18% Asian, 9% white adults) and this rises to over a third of black adults (36%). On the other hand, finding out a study is funded by the government discourages black adults (28% would be less likely to participate)
• in a forced-choice exercise, factors relating to the research funding are generally the least important drivers of participation. The funder of a study being a private business is the least important factor included in the model – meaning that other factors are more likely to affect participation

In broad terms, people are most favourable to research funded by universities and least favourable to research funded by private businesses – nearly half of UK adults say knowing a university is funding the research would make them more likely to participate (48%), but a similar proportion say knowing the same about a private business makes them less likely to participate (46%). However, around two-fifths consistently say the different type of funders make no impact on their participation (figure 14).

Figure 14. Impact of funder on likelihood to participate

Question: if you knew a health and social care research study had been funded by the following group, how would that affect your likelihood to take part in the study?

Base: all UK adults (5,030)

Download a csv file for figure 14.

Figure 14 alt text: horizontal stacked bars with green, amber, red and grey colours indicating the likelihood to participate. It shows that the green (more likely) bar is largest for 'universities' and smallest for 'private businesses'. The amber (no change) bar is broadly similar across all options.

Men are more likely than women to say the funder being a private business encourages their participation (12% men, 9% women). One in ten men also say that they would be less likely to take part in research funded by a university (11% men), significantly higher than the proportion of women who say the same (7% women).

White adults are particularly averse to taking part in research funded by a private business – just under half say they are less likely to take part in a privately-funded study (47%). This is not the case for ethnic minority adults (figure 15). In fact, Asian adults are twice as likely to say private-funded research encourages participation (18% Asian, 9% white adults) and this rises to over a third of black adults (36%). On the other hand, finding out a study is funded by the government strongly discourages black adults (28% would be less likely to participate).

Figure 15. Impact of private business funder on likelihood to participate, by gender and ethnicity

Question: if you knew a health and social care research study had been funded by the following group, how would that affect your likelihood to take part in the study? Private business 'Do not know' figures not shown

Base: men (2,492); female (2,601); white (4,367); Asian (189); black (80); other (140); NET: ethnic minority (409)

Download a csv file for figure 15.

Figure 15 alt text: a dot-plot with green, amber and red colours indicating the levels of likelihood to participate. It shows that men are more likely than women to participate. Those from an ethnic minority, particularly black adults, are much more likely than white adults to participate.

In the ‘MaxDiff’ exercise (detailed in appendix A) attributes related to funding generally had the lowest relative importance – meaning they are the least important drivers of participation in a research study. In particular, the funder of a research being a private business is the least important factor included in the model. This suggests that, although people self-report that they would not participate in an industry-funded study, other factors such as the research process are much more likely to positively impact decisions to participate.

Trust in findings through research transparency

• the UK public would feel more confident in health and social care research findings:
  • if the project was added to a public register before it started (65%)
  • the results were made publicly available as soon as possible after the study (65%)
  • if participants will be told about the findings (69%)
• those with higher levels of education are more likely than those with lower levels of education to say transparency increases their confidence in the research findings (54% high education, 49% medium education, 45% low education)

Two-thirds of the UK public would feel more confident in health and social care research findings if the project was added to a public register before it started (65%) or the results were made publicly available as soon as possible after (65%). Around a quarter would feel no change either way (24% public register, 23% publicly available). Seven in ten (69%) would feel more confident in the findings if participants will be told about the findings, while one in five (20%) feel it would make no change.

There is an upward trend by education for each activity – those with higher levels of education [5] are more likely to say they have increased confidence if a research study made efforts to be transparent. For example, six in ten respondents with a low education level say the research being on a public register makes them more confident in the findings (60%), rising to 64% of those with a medium level of education, and seven in ten with a high level of education (70%).

Figure 16. Impact of transparency on confidence in research findings

Question: if you knew a health and social care research study had taken the following steps to ensure transparency, would this make you more or less confident in the research findings?

Base: all UK adults (5,030)

Download a csv file for figure 16.

Figure 16 alt text: horizontal stacked bars with green, amber, red and grey colours indicating the confidence in findings. It shows that each green (more confident) bar is roughly similar size. It is largest for 'if you take part, you will be told about the findings where appropriate.'

Impact of funding on trusting research findings

• studies funded by universities generate more confidence in findings (52%), while private-funded studies lead to less confidence in their findings (12%)
• white adults are less confident than ethnic minority adults in the research findings from a study funded by private business – only one in ten say they would be more confident about the research findings (11%), compared to a fifth of Asian adults (20%) and over a third of black adults (35%)
• half of UK adults say that efforts towards transparency, such as being on a public register and data being available to other researchers, makes them more confident in the research findings of a privately-funded study (49%)

Earlier, this chapter discussed that people are most likely to participate in research funded by universities and least likely to participate in research funded by private businesses (figure 13). This pattern is also seen across trust in the research findings – studies funded by universities generate more confidence in findings, while private-funded studies lead to less confidence in their findings (figure 16). Again, a notable proportion of UK adults say their opinion of the research findings are not changed either way regardless of the funding body.

Figure 17. Impact of funder on confidence in findings

Question: if you knew a health and social care research study had been funded by the following group, would this make you more or less confident in the research findings?

Base: all UK adults (5,030)

Download a csv file for figure 17.

Figure 17 alt text: horizontal stacked bars with green, amber, red and grey colours indicating the confidence in findings. It shows that the green (more confident) bar is largest for 'universities' and smallest for 'private businesses'. The amber (no change) bar is broadly similar across all options.

Again, the demographic patterns are repeated – people who change their participation behaviour based on the funder are also likely to change their perception of the findings. Men are more likely than women to say privately-funded research makes them more confident in the findings (figure 17). Also, white adults are less confident than ethnic minority adults in the research findings from a study funded by private business – only one in ten say they would be more confident about the research findings (11%), compared to a fifth of Asian adults (20%) and over a third of black adults (35%).

Although knowing the government is funding a research study would make black adults less likely to participate, there is no difference between black adults and other ethnicities for having confidence in the research findings of a government-funded study.

Figure 18. Impact of funder on confidence in findings, by gender and ethnicity

Question: if you knew a health and social care research study had been funded by the following group, would this make you more or less confident in the research findings? Private business 'Do not know' figures not shown.

Base: men (2,492); female (2,601); white (4,367); Asian (189); black (80); other (140); NET: ethnic minority (409)

Download a csv file for figure 18.

Figure 18 alt text: a dot-plot with green, amber and red colours indicating the levels of likelihood to participate. It shows that men are more likely than women to have confidence in research findings. Those from an ethnic minority, particularly black adults, are much more likely than white adults to be more confident.

Exploring the intersection of various research issues and funding, survey respondents were presented with three scenarios, in a random order, about a privately-funded research study. The scenarios are as follows:

• public involvement: the study involves members of the public at various stages such as deciding how people will be asked to participate and what they will be told about the study, and what they will be asked to do
• research transparency: the study makes sure the research and its findings are made visible to the public, such as the research being added to a public register, respondents being informed of the research findings, and data being made available to other researchers with appropriate safeguarding
• participant diversity: the study includes a diverse mix of participants, for whom the outcome of research is relevant

Public involvement in industry-funded studies

• when told that a research study funded by business also involves members of the public, two-fifths say this makes them more confident about the findings (41%)
• white adults are less likely than adults from an ethnic minority to say that public involvement in privately funded studies makes them more confident in findings (40% white, 53% ethnic minority)

Involvement from members of the public in participant information leads people to be more confident in participating in a research study (figure 10). The positive impact of public involvement is particularly apparent when looking at industry-funded studies. When they are told that a research study funded by a private business also involved members of the public at various stages, two-fifths say this makes them more confident about the research findings (41%).

Although women are more likely than men to say public involvement in participant information makes them more confident in taking part (figure 10), there is no difference across gender for whether public involvement affects confidence in the research findings of an industry-funded study. However, those from an ethnic minority say it makes them more confident in the findings (53%, 40% white). This is particularly driven by high confidence from black adults (60%), in line with their higher confidence in findings from private businesses in general (figure 17).

Figure 19. Impact of public involvement on confidence in the findings of a privately-funded research study

Question: if you knew an industry-funded study had involved members of the public, would this make you more or less confident in the research findings?

Base: all UK adults (5,030)

Download a csv file for figure 19.

Figure 19 alt text: a circular chart with green, red and grey colours indicating the impact on confidence. The largest proportion is amber (no change), followed by green (a little more confident).

Transparency in industry-funded studies

• efforts towards research transparency in privately-funded studies makes UK adults more confident in the research findings (49%)
• adults from an ethnic minority are more likely than white adults to say research transparency in industry-funded studies makes them more confident in the findings (57% compared to 49%), but this is predominately driven by black adults (67%) who report this more than any other ethnic minority

Half of UK adults say that efforts towards transparency, such as being on a public register and data being available to other researchers, makes them more confident in the research findings of a privately-funded study (49%).

There is a clear trend by education for having confidence increased by transparency efforts – those with higher levels of education are more likely than those with lower levels of education to say this increases their confidence in the research findings (54% high education, 49% medium education, 45% low education). Adults from an ethnic minority are more likely than white adults to say efforts towards transparency make them more confident in the research findings of an industry-funded study (57%, 49%). However, the most likely to have increased confidence as a result of transparency are black adults, with over two-thirds (67%) saying that transparency in the research makes them more confident of the research findings, more than any other ethnic minority group.

Figure 20. Impact of research transparency on confidence in the findings of a privately-funded research study

Question: if you knew an industry-funded study had taken steps to make it more visible, would this make you more or less confident in the research findings?

Base: all UK adults (5,030)

Download a csv file for figure 20.

Figure 20 alt text: a circular chart with green and red colours indicating the impact on confidence. The largest proportion is green (more confident) followed by amber (no change)

Participant diversity in industry-funded studies

• just over half of UK adults say if a privately-funded research study included a diverse mix of participants, they would be more confident in the research findings (52%)
• when an industry-funded study has diverse participants, it increases the confidence in the findings among LGB+ adults (60%) and women (54%)

Similarly, half of UK adults say, if an industry-funded research study includes a diverse mix of participants for whom the outcome is relevant, they would be more confident in the research findings (52%) – the highest proportion of the three scenarios tested.

The other two scenarios tested did not result in any difference across gender or sexuality. However, when an industry-funded study has diverse participants, it increases the confidence amongst LGB+ adults [6] (60%, 51% heterosexual adults) and women (54%, 49% men).

However, men are more likely than women to say that a diverse mix of participants makes them less confident in the research findings from a privately-funded research study (9%, 6% women). Similarly, those from lower social grades are more likely than those from high social grades to say diverse mix of participants makes them less confident in the findings (8% C2DE, 6% ABC1).

Figure 21. Impact of participant diversity on confidence in the findings of a privately-funded research study

Question: if you knew an industry-funded study had included a diverse mix of participants, would this make you more or less confident in the research findings?

Base: all UK adults (5,030)

Download a csv file for figure 21.

Figure 21 alt text: a circular chart with green, amber, grey and red colours indicating the impact on confidence. The largest proportion is amber (no change), followed by green (more confident).

Section 3 – What information do people want about research?

• UK adults trust their friends and family generally about health and social care (83%) and trust them as a source of information about health and social care research (77%)
• generally, those from lower social grades are less likely to trust each source of information about health and social care research. For example, 72% from higher social grades trust information from a research regulator, compared to 61% from lower social grades
• however, those from lower social grades specifically trust friends / family as a source of research information. They are more likely than higher social grades to trust research information from this group, but there is no difference by social class for general information about health and social care

UK adults generally have high levels of trust in the experiences of their family / friends as a source of information on health and social care (83% trust a lot / fair amount), and they have a similar level of overall trust in information based on research findings (80%). The public are slightly more likely to say they trust research findings ‘a lot’ (28%) compared to friends or family (26%), while family / friends are more likely to be trusted ‘a fair amount’ (57%, 52% research findings). Nearly two-thirds of UK adults say they do not trust the experiences of people they do not know (65%).

Trust in information about health and social care based on research findings rises for those who have previously participated in research (86%), while those who have never been involved in any way are more likely to trust their friends / families (86%).

Young people are the most likely to trust strangers’ experiences about health and social care, with a clear downward trend by age – approximately a third of those under 25 years old trust the experiences of people they do not know (36%), but this falls to 16% of those aged 65 or over. Those with a disability or long-term health condition are more likely than those without to trust the experiences of strangers (27% with a disability, 23% without a disability). Similarly, unpaid carers are more likely than those who have never been a carer to trust information about health and social care based on the experiences of people they do not know (35% unpaid carers, 23% never been a carer).

Figure 22. Trust in types of information about health / social care

Question: to what extent, if at all, would you say you trust each of the following types of information about health and social care?

Base: all UK adults (5,030)

Download a csv file for figure 22.

Figure 22 alt text: horizontal stacked bars with green, red, and grey colours indicating the trust in types of information about health/ social care. It shows that the green (higher trust) bar is largest for 'experiences of family / friends' and smallest for 'experiences of people that you do not know'.

Trust in sources of information about health and social care

• the most-trusted source of information about health and social care research is someone’s local NHS (83%)
• just under a fifth of UK adults trust information about health and social care research from private businesses (18%), but this rises to a quarter of previous research participants (26%)

The NHS is the most trusted source of information about health and social care research (83%), with a third of UK adults saying they trust their local NHS ‘a lot’ (32%) and half saying they trust it a fair amount (51%). In line with the earlier finding about trust in general health and social care information, family / friends are the second most-trusted source of information about health and social care research (77% a lot / fair amount).

Over half of UK adults trust information about health and social research from a research regulator (67% a lot / fair amount), charities (64%), or government departments such as the Department of Health and Social Care (62%). Just under one fifth trust information from private businesses (18%) and one in ten trust information on social media (10%).

Those who have been involved in research are more likely than those who have not been involved to trust private businesses’ information about health and social care research. A quarter of research participants trust private businesses a lot / fair amount (26%), but only 16% who have not been involved in health and social care research trust private businesses.

Those in lower social grades are less likely than higher social grades to trust each source of information about health and social care research. For example, 72% from higher social grades trust information from a research regulator, compared to only 61% from lower social grades. However, the exception to this pattern of lower trust are friends / family members – those from lower social grades are more likely than those from higher social grades to trust information about health and social care research from their friends / family members (75% ABC1, 79% C2DE). Friends / family are specifically trusted by this group as a source of research information as there is no difference across social grade for general trust in the experiences of friends / family members about health and social care (both 83%).

Figure 23. Trust in sources of information about health and social care research

Question: to what extent, if at all, would you say you trust information about health and social care research from each of the following sources?

Base: all UK adults (5,030)

Download a csv file for figure 23.

Figure 23 alt text: horizontal stacked bars with green, red and grey colours indicating trust in sources of information about health and social care research. It shows that the green (higher trust) bar is largest for 'your local NHS' and smallest for 'social media'.

Factors affecting trust in information

• the factors that encourage trust in information about health and social care research are information on the funder (59%), plain language (58%), and information about research standards (58%)
• around half of UK adults say that inclusion of the NHS logo would help them trust information about health and social care research (48%). In particular, the NHS logo increases trust among those who have not been involved in research before (51%, 40% previously involved)

Although a person’s local NHS is the most-trusted source of information for health and social care research, the inclusion of an NHS logo is fourth in terms of trustworthy features in the information itself (48%). Instead, more than half of UK adults say that information about funding, using plain language, and information on the research standards are key in their trusting information about health and social care research (figure 23).

The NHS logo increases trust more among those who have not previously been involved in research (51%, 40% who have been involved in research in any way). Adults with a disability / health condition (50%) are more likely than those without (45%) to say that not needing to search for information helps them trust the information. They are also more likely to say that the research team being easy to contact helps them trust the information (39% with a disability, 33% without).

Figure 24. Features which support trust in information about health / social care research

Question: when you read or hear about health and social care research. Which, if any, of the following would help you trust the information?

Base: all UK adults (5,030)

Download a csv file for figure 24.

Figure 24 alt text: horizontal bars with purple colours indicating features which support trust in information about health / social care research. It shows that the bar is largest for 'it tells you who funded the research' and smallest for 'logo of another recognised authority (not NHS)'.

Factors affecting decision to participate in research.

• when deciding whether to take part in a research study, UK adults most want to know what the risks are (70%) and how the findings are going to be used (70%)

Seven in ten UK adults say that key information to decide their participation in a health and social care research study is what risks there are and how the findings are going to be used (both 70%). Over half of the public want to know how much time the study will require (65%), who is funding the research (64%), how data about them will be kept safe (63%), and how the findings will be shared (61%). Around half would want to know the qualifications of researchers (50%) or what the personal benefits are (48%).

Broadly, women are more likely than men to say they would want each piece of information – for example, three-quarters of women want to know what the risks are (75%), compared to less than two-thirds of men (64%). Similarly, those from higher social grades tend to be more likely than lower social grades to want each element, such as how the findings are going to be used (72% ABC1, 66% C2DE). The opposite is true for personal benefits – those from lower social grades are more likely than higher social grades to want this information to help decide their participation (47% ABC1, 50% C2DE).

Figure 25. Information wanted to help decide whether to take part in a health / social care research study

Question: please imagine you were deciding whether or not to take part in a health and social care research study. Which, if any, of the following would you want to know to help you make your decision?

Base: all UK adults (5,030)

Download a csv file for figure 25.

Figure 25 alt text: horizontal purple bars indicating the information wanted to help decide whether to take part in a health / social care research study. It shows that the bar is biggest for 'what are the risks to me' and smallest for 'what are the benefits to me'.

Section 4 – How do people want data to be used?

• just over a third of the UK public prefer anonymised data to be accessible by other researchers on request if they uphold rules set by the original research team (35%)
• three in ten (31%) would prefer the data to be accessible within a secure environment where other researchers can interact but not download the data

If data was to be accessed by other researchers outside of the original research team after participating in a health and social care research study, over a third (35%) of the UK public would prefer anonymised data to be accessible by other researchers on request if they uphold rules set by the original research team. Three in ten (31%) would prefer the data to be accessible within a secure environment where other researchers can interact but not download the data and sign a confidentiality agreement. A minority (17%) would prefer only the original research team to access the data and answer questions from other researchers.

There is a difference by education – wanting the original research team to answer queries falls with education level (22% low, 17% medium, 13% high), while anonymised data being accessible to other researchers within certain rules is preferred by higher education levels (26% low, 35% medium, 44% high). Those who have participated in research prefer anonymised data accessible within rules (42%).

Figure 26. Preferred data transparency method

Question: please imagine you had recently taken part in a health and social care research study and the data could be accessed by other researchers outside of the original research team to support further health and social care research. In which, if any, of the following ways would you prefer the data to be accessed? Here anonymised means researchers would not be able to identify the individuals whose data they are looking at.

Base: all UK adults (5,030)

Download a csv file for figure 26.

Figure 26 alt text: horizontal purple and grey bars indicating the preferred approach to data transparency.

Appendix A: relative importance of research study attributes in driving participation

The results in this section are the outputs of a Maximum Difference Scaling (‘MaxDiff’) analysis. The exercise forces respondents to make choices between attributes in a research study and provides the relative importance of each attribute in determining likelihood to participate. Respondents were presented with a random set of five attributes related to a hypothetical research project and asked which would make them most likely and least likely to participate in that study. The trade-off is repeated with different combinations until data on all meaningful comparisons is collected.

The scores within each MaxDiff exercise are calculated using Hierarchical Bayesian utility scores for each individual, which are converted into probability scores for ease of understanding. The conversion is done by taking 100 points and assigning them between all attributes based on the derived importance given by respondents. The scores provided in the following chapter and charts are the means of the scores for each attribute provided by all respondents. The scores should be interpreted relative to each other, with a score of 10 noting an attribute twice as important as an attribute with a score of five.

Attributes across five different topics were included: funding, people-centred practice [7], public involvement, data protection, and the research process. Charts in this section have been colour-coded to indicate which attributes belong to which topic and analysis of each topic has been included.

The top factor is knowing the research makes a difference to the people it is for and about (7.63), followed by knowing researchers act in the respondent’s best interests (6.93). Knowing someone has checked the research is being conducted ethically and fairly have similar levels of relative importance (6.71, 6.69 respectively).

Overall, attributes related to direct participation or the research process are the most likely to be important for encouraging participation in a hypothetical health and social care research project in the UK (figure 26). Data protection is the only other topic with an attribute in the top 10 - people taking part know what they are going to be asked and how the information about them will be used being important (5.63).

Figure 27. Relative importance in driving participation (top 10)

Base: all UK adults (5,030)

Download a csv file for figure 27.

Figure 27 alt text: horizontal bars in a range of colours, showing the relative importance in driving participation for a hypothetical research study. The chart is mostly light pink and blue, indicating that the most important factors are related to people-centric practice and the research process.

Looking specifically at the attributes around the research process (figure 27), the only attribute that does not feature in the overall top 10 is it being easy to find out how the research was approved (3.81). This does not mean that it is an unimportant aspect of a research study, just that it is relatively less important than the other attributes in encouraging respondents to participate.

Figure 28. Relative importance of attributes around the research process

Base: all UK adults (5,030)

Download a csv file for figure 28.

Figure 28 alt text: horizontal pink bars showing the relative importance of attributes related to the research process. The most important is 'researchers act in my best interests, honestly and fairly' while the least important is 'it's easy to find out how the research was approved'.

Among people-centred practice attributes, the outcome of the research is more important than simple diversity of participants – knowing the research makes a difference to the people it is for and about (7.63) is the most important attribute across all factors respondents were asked about. Knowing the research is conducted with and for the communities it affects (4.52), including a diverse mix of participants are relatively less important (4.40). However, they are seen as more important than attributes in other topics.

Figure 29. Relative importance of attributes around people-centred practice

Base: all UK adults (5,030)

Download a csv file for figure 29.

Figure 29 alt text: horizontal blue bars showing the relative importance of attributes related to people-centred practice. The most important is 'the research makes a difference to the people it is for and about' while the least important is 'everyone who could be impacted by the study is able to take part'.

Across the data protection attributes, people taking part knowing what they will be asked to do and how information will be used is the most important (5.63). It is the only data protection attribute to feature in the overall top 10 factors. Following this, UK adults think that participants being told about the research findings (4.23) is more important than the research data being available to other researchers (3.58) or publicly (3.08). The research findings being shared without delay (2.92) is relatively less important than these.

Figure 30. Relative importance of attributes around data protection

Base: all UK adults (5,030)

Download a csv file for figure 30.

Figure 30 alt text: horizontal purple bars showing the relative importance of attributes related to data protection. The most important is 'people taking part know what they are going to be asked and how information about them will be used' while the least important is 'the research findings are shared without delay'.

None of the public involvement factors appeared in the top 10 most important attributes. This is not to mean that they are not important in general, but when people are given a trade-off exercise, these attributes are relatively less important. Generally, these attributes see similar levels of importance (1.90 to 2.01), indicating that they are mostly seen as equally important. Slightly less important is whether members of the public are consulted about communication with participants (1.46).

Figure 31. Relative importance of attributes around public involvement

Base: all UK adults (5,030)

Download a csv file for figure 31.

Figure 31 alt text: horizontal green bars showing the relative importance of attributes related to public involvement. All the bars are relatively short and are of similar size. The statement 'members of the public are consulted about communication with participants' is slightly smaller than the rest.

Figure 32. Relative importance of attributes around funding

Base: all UK adults (5,030)

Download a csv file for figure 32.

Figure 32 alt text: horizontal red bars showing the relative importance of attributes related to funding. All of the bars are relatively short. One statement is much smaller than the rest, shorter than any other bar in this chapter - 'funded by a private business'.

Overall, attributes around funding have lower levels of relative importance than other factors. This suggests that the funder is not as likely to affect participation as other attributes around participation, the research process, and data protection. In particular, the funder being a private business is the least important factor across all included in the model (0.85).

Appendix B: sample profile

A breakdown of the sample by demographics is provided below.

References

[1] Social grades are a social classification which assigns every household a grade based on the occupation and employment of the chief income earner. There are six grades in total: A, B, C1, C2, D, E.

For the purposes of the report, the social grades are grouped into ABC1 and C2DE. ABC1 comprises the three highest socio-economic grades. C2DE comprises the three lowest socio-economic grades.

[2] 'people with a disability or long-term health condition' includes those whose day-to-day activities are limited because of a health problem or disability which has lasted, or is expected to last, last least 12 months.

[3] 'unpaid carers' includes people who help look after a family member / friend who needs care an support as a result of old age, physical illness, disability, mental health problems, or addiction. This includes, but is not limited to, day-to-day care such as helping them wash / bathe, accompanying them to medical appointments, shopping for them etc.

This does not include being employed as a professional carer.

[4] Throughout the analysis, respondents are grouped into two categories: white or ethnic minorities. White minorities such as Gypsy, Roma, and Irish Traveller are included in the aggregated 'white' figures. Figures for ethnic minority respondents do not include white minorities.

[5] Throughout the analysis, respondents have been categorised into various education levels depending on the highest qualification they have attained. The broad categories are as follows:

• high education level: university or CNAA first degree (such as BA, B.Sc, B.Ed); university or CNAA higher degree (such as M.Sc, Ph.D)
• medium education level: completed recognised trade apprenticeship; advanced city and guilds certificate; ONC; GCE A Level or Higher certificate; Scottish Higher certificate; nursing qualification (such as SEN, SRN, SCM, RGN); teaching qualification (not university degree); university diploma; other technical, professional, or higher qualification
• low education level: city and guilds certificate; CSE grade 1; GCE O level, GCSE; school certificate; CSE grades 2 to 5; Scottish Ordinary / Lower certificate; youth training certificate / skills seekers; clerical and commercial qualifications; no formal qualifications

[6] 'LGB+ adults' includes people who are lesbian, gay, bisexual, or another non-heterosexual orientation (LGB+). The report does not include analysis by transgender / non-binary gender identity (i.e. where current gender identity does not align with the sex assigned at birth).

[7] The people-centric factors are modelled from the hallmarks of people centred clinical research. Available at: https://www.hra.nhs.uk/planning-and-improving-research/best-practice/people-centred-clinical-research/#sixhallmarks (Accessed 29 June 2023)