clinical research motivation letter

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How to Write a Good Cover Letter for a Research Position

Writing a cover letter can be intimidating, but it doesn’t have to be!

Some people believe cover letters are a science. Others seem to think they are more akin to black magic. Regardless of how you feel about cover letters, they are one of the most important parts of the job application process. Your resume or CV may get you an interview, but a good cover letter is what ensures that the hiring manager reads your resume in the first place.

Writing a cover letter for any job is important, but the art of writing a good cover letter for a research position can make or break your application. While writing a cover letter for a research position, you have to walk a fine line of proving your expertise and passion while limiting jargon and dense language.

In this post, we will explain cover letter writing basics, and then dive into how to write a research specific cover letter with examples of both good and bad practices.

What Is A Cover Letter and Why Do Cover Letters Matter?

A cover letter is your opportunity to tell a story and connect the dots of your resume. Resumes and curriculum vitae (CVs) are often cold and static—they don’t show any sort of character that will give companies a hint about if you will fit in with their culture. 

Your cover letter gives you the chance to demonstrate that you are an interesting, qualified, and intelligent person. Without proving that you are worth the time to interview, a company or research organization will set your application in the rejection pile without giving it a second look. 

So, what is a cover letter, exactly? It is an explanation (written out in paragraph form) of what you can bring to the company that goes beyond the information in your resume. Cover letters give a company a glimpse into the qualities that will make you the ideal candidate for their opening. 

Note that a cover letter is not the same as a letter of intent. A cover letter is written for a specific job opening. For example, if I got an email saying that the University of Colorado was looking for a tenure track faculty member to teach GEO 1001, and I chose to apply, I would write a cover letter. 

A letter of intent, however, is written regardless of the job opening. It is intended to express an interest in working at a particular company or with a particular group. The goal of a letter of intent is to demonstrate your interest in the company (or whatever type of group you are appealing to) and illustrate that you are willing to work with them in whatever capacity they feel is best. 

For example, if I loved the clothing company, Patagonia and wanted to work there, I could write a letter of intent. They may have an opening for a sales floor associate, but after reading my application and letter of intent, decide I would be better suited to a design position. Or, they may not have any positions open at all, but choose to keep my resume on hand for the next time they do. 

Most organizations want a cover letter, not a letter of intent, so it is important to make sure your cover letter caters to the specifics of the job posting. A cover letter should also demonstrate why you want to work at the company, but it should be primarily focused on why you can do the job better than any of the other applicants.

How to Write a Good Cover Letter: The Basics 

Writing a cover letter isn’t hard. Writing a good cover letter, a cover letter that will encourage a hiring manager to look at your application and schedule an interview, is more difficult (but certainly not impossible). Below, we will go over each of the important parts of a cover letter: the salutation, introduction, body, and conclusion, as well as some other best practices.

How to Write a Good Cover Letter Salutation

Don’t start with “Dear Sir/Ma’am” (or any iteration of a vague greeting, including “to whom it may concern”). Avoiding vague greetings is the oldest trick in the book, but it still holds a lot of weight. Starting a cover letter with the above phrase is pretty much stamping “I didn’t bother to research this company at all because I am sending out a million generic cover letters” across your application. It doesn’t look good. 

The best practice is to do your research and use your connections to find a name. “Dear Joe McGlinchy” means a lot more than “Dear Hiring Manager.” LinkedIn is a great tool for this—you can look up the company, then look through the employees until you find someone that seems like they hire for the relevant department. 

The most important thing about the salutation is to address a real human. By selecting someone in the company, you’ve demonstrated that you’ve done some research and are actually interested in this company specifically. Generic greetings aren’t eye-catching and don’t do well.

How to Write a Good Cover Letter Introduction

Once you’ve addressed your cover letter to a real human being, you need a powerful introduction to prove that this cover letter is worth the time it will take to read. This means that you need a hook. 

Your first sentence needs to be a strong starter, something to encourage the hiring manager not only to continue reading the cover letter, but to look at your application as well. If you have a contact in the company, you should mention them in the first sentence. Something along the lines of “my friend, Amanda Rice (UX/UI manager), suggested I apply for the natural language processing expert position after we worked together on a highly successful independent project.” 

The example above uses a few techniques. The name drop is good, but that only works if you actually have a connection in the company. Beyond that, this example has two strengths. First, it states the name of the position. This is important because hiring managers can be hiring for several different positions at a time, and by immediately clarifying which position you are applying for, you make their job a little bit easier.  Next, this sentence introduces concrete skills that apply to the job. That is a good way to start because it begins leading into the body, where you will go into depth about how exactly your experience and skills make you perfect for the job. 

Another technique for a strong lead-in to a cover letter is to begin with an applicable personal experience or anecdote. This attracts more attention than stereotypical intros (like the example above), but you have to be careful to get to the point quickly. Give yourself one or two sentences to tell the story and prove your point before you dive into your skills and the main body of the cover letter.

A more standard technique for introductions is simply expressing excitement. No matter how you choose to start, you want to demonstrate that you are eager about the position, and there is no easier way to do that than just saying it. This could take the form of “When I saw the description for X job on LinkedIn, I was thrilled: it is the perfect job for my Y skills and Z experience.” This option is simple and to-the-point, which can be refreshing for time-crunched hiring managers. 

Since we’ve provided a few good examples, we will offer a bad example, so you can compare and contrast. Don’t write anything along the line of: “My name is John Doe, and I am writing to express my interest in the open position at your company.” 

There are a few issues here. First, they can probably figure out your name. You don’t need that to be in the first sentence (or any of the sentences—the closing is an obvious enough spot). Next, “the open position” and “your company” are too generic. That sounds like the same cover letter you sent to every single employer in a hundred mile radius. Give the specifics! Finally, try to start with a little more spice. Add in some personality, something to keep the hiring manager reading. If you bore them to death in the first line, they aren’t going to look over your resume and application with the attention they deserve. 

How to Write a Good Cover Letter Body

So, you’ve addressed a real human being, and you’ve snagged their attention with a killer opening line. What next? Well, you have to hold on to that attention by writing an engaging and informative cover letter body. 

The body of a cover letter is the core of the important information you want to transmit. The introduction’s job was to snag the attention of the hiring manager. The body’s job is to sell them on your skills.  There are a few formatting things to be aware of before we start talking about what content belongs in the body of the cover letter. First, keep the company culture and standards in mind when picking a format. For example, if I want to work for a tech startup that is known for its wit and company culture, I can probably get away with using a bulleted list or another informal format. However, if I am applying to a respected research institution, using a standard five paragraph format is best. 

In addition, the cover letter should not be longer than a page. Hiring managers are busy people. They may have hundreds of resumes to read, so they don’t need a three page essay per person. A full page is plenty, and many hiring managers report finding three hundred words or less to be the idea length. Just to put that into context, the text from here to the “How to Write a Good Cover Letter Body” header below is about perfect, length-wise. 

Now, on to the more important part: the content. A cover letter should work in tandem with a resume. If you have a list of job experiences on your resume, don’t list them again in the cover letter. Use the valuable space in the cover letter to give examples about how you have applied your skills and experience. 

For example, if I have worked as a barista, I wouldn’t just say “I have worked as a barista at Generic Cafe.” The hiring manager could learn that from my resume. Instead, I could say “Working as a barista at Generic Cafe taught me to operate under pressure without feeling flustered. Once…” I would go on to recount a short story that illustrated my ability to work well under pressure. It is important that the stories and details you choose to include are directly related to the specific job. Don’t ramble or add anything that isn’t obviously connected. Use the job description as a tool—if it mentions a certain skill a few times, make sure to include it!

If you can match the voice and tone of your cover letter to the voice of the company, that usually earns you extra points. If, in their communications, they use wit, feel free to include it in your letter as well. If they are dry, to the point, and serious, cracking jokes is not the best technique.

A Few Don’ts of Writing a Cover Letter Body   

There are a few simple “don’ts” in cover letter writing. Do not: 

• Bad: I am smart, dedicated, determined, and funny.
• Better: When I was working at Tech Company, I designed and created an entirely new workflow that cut the product delivery time in half. 
• Bad: When I was seven, I really loved the monkeys at the zoo. This demonstrates my fun-loving nature. 
• Better: While working for This Company, I realized I was far more productive if I was light-hearted. I became known as the person to turn to in my unit when my coworkers needed a boost, and as my team adopted my ideology, we exceeded our sales goals by 200%. 
• Bad: I would love this job because it would propel me to the next stage of my career.
• Better: With my decade of industry experience communicating with engineers and clients, I am the right person to manage X team. 
• Bad: I know I’m not the most qualified candidate for this job, but…
• Better: I can apply my years of experience as an X to this position, using my skills in Y and Z to… 
• Bad: I am a thirty year old white woman from Denver…
• Better: I have extensive experience managing diverse international teams, as illustrated by the time I…  

The most important part of the cover letter is the body. Sell your skills by telling stories, but walk the razor’s edge between saying too much and not enough. When in doubt, lean towards not enough—it is better for the hiring manager to call you in for an interview to learn more than to bore them.

How to Write a Good Cover Letter Conclusion

 The last lines of a cover letter are extremely important. Until you can meet in-person for an interview, the conclusion of your cover letter will greatly affect the impression the hiring manager has of you. A good technique for concluding your cover letter is to summarize, in a sentence, what value you can bring to the company and why you are perfect for the position. Sum up the most important points from your cover letter in a short, concise manner. 

Write with confidence, but not arrogance. This can be a delicate balance. While some people have gotten away (and sometimes gotten a job) with remarks like, “I’ll be expecting the job offer soon,” most do not. Closing with a courteous statement that showcases your capability and skills is far more effective than arrogance. Try to avoid trite or generic statements in the closing sentence as well. This includes the template, “I am very excited to work for XYZ Company.” Give the hiring manager something to remember and close with what you can offer the company. 

The final step in any cover letter is to edit. Re-read your cover letter. Then, set it aside for a few hours (or days, time permitting) and read it again. Give it to a friend to read. Read it aloud. This may seem excessive, but there is nothing more off-putting than a spelling or grammar error in the first few lines of a cover letter. The hiring manager may power through and ignore it, but it will certainly taint their impression. 

Once the cover letter is as flawless and compelling as it can be, send it out! If you are super stuck on how to get started, working within a template may help. Microsoft Word has many free templates that are aesthetically appealing and can give you a hint to the length and content. A few good online options live here (free options are at the bottom—there is no reason to pay for a resume template).

How to Write a Cover Letter for a Research Position

Writing a cover letter for a research position is the same as writing any other cover letter. There are, however, a few considerations and additions that are worth pointing out. A job description may not directly ask for a cover letter, but it is good practice to send one unless they specifically say not to. This means that even if a cover letter isn’t mentioned, you should send one—it is best practice and gives you an opportunity to expand on your skills and research in a valuable way.

Format and Writing Style for a Research Position Cover Letter

Research and academics tend to appreciate formality more than start-ups or tech companies, so using the traditional five paragraph format is typically a good idea. The five paragraph format usually includes an introduction, three short examples of skills, and a concluding paragraph. This isn’t set in stone—if you’d rather write two paragraphs about the skills and experience you bring to the company, that is fine. 

Keep in mind that concise and to-the-point writing is extremely valuable in research. Anyone who has ever written a project proposal under 300 words knows that every term needs to add value. Proving that you are a skilled writer, starting in your cover letter, will earn you a lot of points. This means that cover letters in research and academia, though you may have more to say, should actually be shorter than others. Think of the hiring manager—they are plowing through a massive stack of verbose, technical, and complex cover letters and CVs. It is refreshing to find an easy to read, short cover letter. 

On the “easy to read” point, remember that the hiring manager may not be an expert in your field. Even if they are, you cannot assume that they have the exact same linguistic and educational background as you. For example, if you have dedicated the last five years of your life to studying a certain species of bacteria that lives on Red-Eyed Tree Frogs, all of those technical terms you have learned (and maybe even coined) have no place in your cover letter. Keep jargon to an absolute minimum. Consider using a tool like the Hemingway Editor to identify and eliminate jargon. While you want to reduce jargon, it is still important to prove that you’ve researched their research. Passion about the research topic is one of the most valuable attributes that a new hire can offer. 

Use your cover letter to prove that you have done your homework, know exactly what the institution or group is doing, and want to join them. If you have questions about the research or want to learn more, it isn’t a bad idea to get in touch with one of the researchers. You can often use LinkedIn or the group’s staff site to learn who is working on the project and reach out.

What Research Information Should be Included in a Cover Letter

A research position cover letter is not the place for your academic history, dissertation, or publications. While it may be tempting to go into detail about the amazing research you did for your thesis, that belongs in your CV. Details like this will make your cover letter too long. While these are valuable accomplishments, don’t include them unless there is something  that pertains to the group’s research, and your CV doesn’t cover it in depth. 

If you do choose to write about your research, write about concrete details and skills that aren’t in your CV. For example, if you have spent the last few years working on identifying the effects of a certain gene sequence in bird migration, include information about the lab techniques you used. Also, try to put emphasis on the aspects of your resume and CV that make you stand out from other candidates. It is likely that you will be competing with many similarly qualified candidates, so if you have a unique skill or experience, make sure it doesn’t get lost in the chaos—a cover letter is the perfect place to highlight these sorts of skills. 

Industry experience is a great differentiator. If you have relevant industry experience, make sure to include it in your cover letter because it will almost certainly set you apart. Another valuable differentiator is a deep and established research network. If you have been working on research teams for years and have deep connections with other scientists, don’t be afraid to include this information. This makes you a very valuable acquisition for the company because you come with an extensive network

Include Soft Skills in Your Cover Letter

Scientific skills aren’t the only consideration for hiring managers. Experience working with and leading teams is incredibly valuable in the research industry. Even if the job description doesn’t mention teamwork, add a story or description of a time you worked with (or, even better, lead) a successful team. Soft skills like management, customer service, writing, and clear communication are important in research positions. Highlight these abilities and experiences in your cover letter in addition to the hard skills and research-based information. 

If you are struggling to edit and polish your letter, give it to both someone within your field and someone who is completely unfamiliar with your research (or, at least, the technical side of it). Once both of those people say that the letter makes sense and is compelling, you should feel confident submitting it.

Cover letters are intended to give hiring managers information beyond what your resume and CV are able to display. Write with a natural but appropriately formal voice, do your research on the position, and cater to the job description. A good cover letter can go a long way to getting you an interview, and with these tips, your cover letters will certainly stand out of the pile.

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Clinical Research Associate Cover Letter Examples & Writing Guide

• Updated August 27, 2023
• Published January 23, 2023

Are you looking for a Clinical Research Associate cover letter example? Read our ultimate Clinical Research Association cover letter writing guide, and learn from our tips, examples, and proven strategies to land a job interview.

Clinical Research Associates (CRAs) are responsible for monitoring clinical trials to ensure the safety of participants, the accuracy of data, and the overall quality of the research. They typically work in hospitals, research organizations, or the pharmaceutical industry.

CRAs typically perform a variety of functions during clinical trials. This includes: designing and implementing the trial protocol, monitoring compliance with Good Clinical Practice (GCP) guidelines, reviewing participant data for accuracy and completeness, and ensuring that all relevant regulatory requirements are met.

Additionally, CRAs may be responsible for recruiting and training study site staff, coordinating patient visits and follow-ups, and providing education to healthcare professionals about the trial results. Finally, they are often responsible for preparing documents related to the trial and submitting them to the appropriate regulatory agencies.

Overall, Clinical Research Associates play an important role in ensuring the safety and efficacy of new drugs and treatments by monitoring clinical trials and ensuring that all applicable standards are met.

Clinical Research Associate Cover Letter

A cover letter is a crucial part of any job application, and a Clinical Research Associate (CRA) position is no exception. A cover letter allows you to introduce yourself and demonstrate your fit for the role to the hiring manager.

As a CRA, you will be responsible for overseeing clinical trials and ensuring that they are conducted ethically and efficiently. Therefore, it is important to showcase your relevant skills and experience in your cover letter.

In the following paragraphs, we will provide tips and guidance on how to write a strong cover letter for a CRA position.

Clinical Research Associate Cover Letter Example 1

Dear [Hiring Manager],

I am writing to express my strong interest in the Clinical Research Associate position at your company. With a background in nursing and extensive experience in research coordination and management, I believe I am well-suited for this role.

During my time as a nursing professional, I gained valuable experience in patient care and communication, skills that have proven invaluable in my research roles. As a Clinical Research Associate at XYZ Medical Center, I coordinated and managed multiple phase II-IV clinical trials, working closely with investigators and sponsors to ensure compliance with protocols and regulations. I also trained and supervised research coordinators and assistants and played a key role in data management and analysis.

In my current role at ABC Biotech, I have further honed my skills in project management and regulatory compliance, leading the successful implementation of several clinical trials. I have a strong attention to detail and a proactive approach to problem-solving, which have allowed me to consistently meet deadlines and deliver high-quality results.

I am excited about the opportunity to bring my skills and experience to your company as a Clinical Research Associate. Thank you for considering my application. I look forward to the opportunity to discuss how I can contribute to your team’s success.

Related :  Research Associate Interview Questions & Answers

Clinical Research Associate Cover Letter Example 2

I am writing to express my interest in the Clinical Research Associate position at your company. With a degree in Biology and three years of experience as a Clinical Research Coordinator, I am confident in my ability to excel in this role and make valuable contributions to your team.

During my time as a Clinical Research Coordinator, I gained a deep understanding of the clinical research process and developed strong skills in project management, data analysis, and regulatory compliance. I have keen attention to detail and am able to communicate with both research staff and study participants effectively.

In my current position, I have been responsible for managing multiple clinical trials simultaneously and ensuring that all study protocols are followed. Furthermore, I have been responsible for data management and analysis and for writing and reviewing study reports.

I am excited to bring my skills and experience to your team and contribute to the success of your clinical research projects. I am highly organized and efficient, and I am eager to apply my knowledge and expertise to this role.

Thank you for considering my application. I look forward to discussing the opportunity further with you.

Clinical Research Associate Cover Letter Example 3

I am writing to express my strong interest in the Clinical Research Associate position at XYZ Company. With over five years of experience in the clinical research field and a strong background in both scientific research and patient care, I am confident in my ability to make a positive contribution to your team.

As a Clinical Research Associate at ABC Company, I have gained extensive experience in managing clinical trials, including protocol development, data collection, and regulatory compliance. In addition, I have a proven track record of collaborating with multidisciplinary teams and effectively communicating research findings to various audiences.

My strong attention to detail, ability to multitask and dedication to patient safety make me an asset to any clinical research team. I am highly skilled in using electronic data capture systems and have a strong understanding of Good Clinical Practices (GCP). Also, I am proficient in both Microsoft Office and clinical trial management software.

I am excited about the opportunity to join XYZ Company and contribute to the advancement of clinical research. Thank you for considering my application. I look forward to discussing the position further with you.

Clinical Research Associate Cover Letter Example 4

I am writing to express my interest in the Clinical Research Associate position at your company. As a highly motivated and detail-oriented individual with a strong background in the healthcare industry, I am confident that my skills and experience make me an excellent fit for this role.

I have a Bachelor’s degree in Biology and a Master’s degree in Public Health, and I have gained valuable experience working as a Research Assistant at XYZ University, where I participated in numerous clinical research studies and developed a strong understanding of the research process. In this role, I demonstrated my ability to manage multiple tasks and projects, work effectively in a team, and maintain accurate and thorough documentation.

In addition to my academic and professional experience, I have strong communication, and problem-solving skills, which I believe are crucial for success in this field. I am also proficient in several research-related software programs, including REDCap, Qualtrics, and SAS.

I am excited about the opportunity to join your team and contribute to the important work of advancing healthcare through clinical research. Thank you for considering my application. I would welcome the opportunity to discuss my qualifications in more detail and learn more about this exciting opportunity.

Related :  Clinical Research Nurse Interview Questions & Answers

Clinical Research Associate Cover Letter Example 5

I am writing to express my interest in the Clinical Research Associate position at XYZ Company. With a Bachelor’s degree in Biology and over three years of experience in clinical research, I am confident in my ability to excel in this role.

In my current position at ABC Company, I have gained invaluable experience conducting clinical trials, managing study budgets, and collaborating with cross-functional teams. I have also developed strong communication and problem-solving skills, which have allowed me to successfully manage multiple projects simultaneously.

I am excited about the opportunity to join the team at XYZ Company and contribute to the development of innovative medical treatments. Furthermore, I am particularly impressed by the company’s focus on improving the lives of patients and its commitment to ethical research practices.

In addition to my experience and skills, I have a strong passion for clinical research and a desire to make a positive impact in the medical field. I believe I would be a valuable asset to your team and would welcome the opportunity to discuss how my qualifications can benefit your company.

Thank you for considering my application. I look forward to the opportunity to discuss my qualifications in more detail.

Clinical Research Associate Cover Letter Writing Tips

Below you will find some general and specific tips that you can use to your advantage when writing your cover letter.

General tips for a Clinical Research Associate cover letter:

• Address the letter to the specific person or department who will be reviewing your application.
• Use a professional and formal tone throughout the letter.
• Keep the letter concise and to the point, no longer than one page.
• Use bullet points or numbered lists to highlight your relevant skills and experience.
• Use specific examples from your previous work or education to demonstrate your abilities.

Specific tips for a Clinical Research Associate cover letter:

• Emphasize your knowledge of clinical research protocols and regulatory guidelines.
• Highlight your experience in data collection, analysis, and reporting.
• Demonstrate your ability to work effectively in a team environment.
• Mention any relevant certifications or training in clinical research.
• Explain why you are interested in this specific position and why you believe you would be a good fit for the role.

Related posts:

• Clinical Research Coordinator Cover Letter Examples & Writing Guide
• Research Intern Cover Letter Examples & Writing Guide
• Clinical Pharmacist Cover Letter Examples & Writing Guide
• Program Associate Cover Letter Examples & Writing Guide
• Museum Guide Cover Letter Examples & Writing Guide

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Clinical Research Associate Cover Letter Example

A Clinical Research Associate is an individual who monitors and evaluates the stages involved in the clinical trials of medicines. He sets up the trial study locations and assists the trial investigators. He develops the trial protocols which consist of the methodology on how to conduct trials. He prepares reports on the study and analyses the progress and the results.

Write your perfect Clinical Research Associate Cover Letter using our sample and professional writing tips. To make things easier, we have come up with a simple and convenient cover letter builder to help you get your dream job.

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• Healthcare & Wellbeing

What to Include in a Clinical Research Associate Cover Letter?

Roles and responsibilities.

A Clinical Research Associate coordinates with the committee that keeps track of the safety, well-being, and rights of the subject taking the trial. He liaises with different consultants and researchers while conducting the trials. He trains the staff and junior research associates to conduct the trials using trial-specific industry regulations. He archives the relevant study documents and related correspondences after the trial is completed.

• Coordinate patient visits and procedures related to research.
• Act as a resource for study participants by answering questions and explaining related procedures.
• Ensure the study site is in compliance with all local and federal laws and regulations.
• Monitor study sites and activities to ensure the appropriate industry protocols and terms of the study are being followed.
• Oversee the hiring and training of staff members who are working on the study.
• Create thorough documentation of study protocol and update it as needed.

Education & Skills

Additionally, the cover letter for Clinical Research Associate should mention the following skillset :

• Knowledge of relevant health and safety laws.
• Knowledge of medical sciences.
• Communication skills.
• Organizational skills.
• Time management skills.

Successful cover letters for a Clinical Research Associate often mention the following qualification(s):

• Bachelor’s or Master’s degree in Nursing, Life Sciences, or Medical Sciences; proven work experience.

Clinical Research Associate Cover Letter Example (Text Version)

Dear Mr./Ms.,

This letter is regarding my interest in applying for the post of Clinical Research Associate at your company. With my advanced qualification and experience in the field of Research and Medical Sciences, combined with my organizational and team collaboration skills, I am certain that I would significantly benefit your Research Centre.

[XXX Hospital and Research Centre] is one of the most famous and trusted hospitals in the district. The hospital’s diversified work which incorporates traditional medicinal ideas and modern technology has never failed to amaze me. I would be honored to be a part of an ambitious Centre.

I have a Master’s degree in Medical Sciences with a specialization in Pharmaceutical medicines. I currently work at [YYY Medical Centre] where I perform the following duties and tasks:

• Assisted in the testing of 64 medicinal trials.
• Reviewed and analyzed documents and cross-evaluated the submissions of the IRB trials.
• Assisted in the drafting of trial protocols, standard reports, subject-consent forms, and rights.
• Monitored the final result data to decrease discrepancies in the provided.
• Increased the recruitment rate of assisting staff by 15%.

I bring strong expertise in medical science and research evaluation. My interpersonal skills allow me to work with professionals as well as trial participants. My experience has offered me an effective and well-rounded and skill-set that is relevant to the field. I believe that I could be an asset to your Medical Centre.

I look forward to meeting you in person so that we can discuss the opportunity in detail. Thank you for your time and consideration.

Sincerely, [Your Name]

A noteworthy Clinical Research Associate Cover Letter should highlight and focus on key career achievements and expertise that make you particularly suited to perform well in the position. Include statements about your enthusiasm regarding the role. Use our Clinical Research Associate Resume Sample to create a good resume and increase your chances of getting your dream job.

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Tips for Writing a Successful Motivation Letter for Ph.D. [+Sample]

How To Write a Motivation Letter For Ph.D. Application [+Sample]

Ph.D. applications are not just sorted out in the same way as any other random application. There are processes involved without which your chances of getting in might be truncated.

If you’ve been considering applying for a Ph.D. then this post is especially directed at you. A motivation letter as used in the case of a Ph.D. application can be much likened to a Personal statement.

There is a need to know if you’re truly qualified to do a Ph.D. while writing an application to a school, so the motivation letter is the perfect insight into who you really are and they expect you to do it justice.   

• An introduction which should state in clear terms which program you are applying for.
• A Summary of your Academic Background.
• Why do you want to do a Ph.D.?
• The significance of your research on society.
• Your career plans.

Avoid Making Spurious Claims

It is quite easy to get lost while writing a motivation letter and forget that motivation cannot be achieved without the necessary evidence to back it up.

Nobody’s really interested in how awesome you are while writing a motivation letter, no offense but anybody can look good on paper but without the proper evidence to back it up, they wouldn’t be any motivation.

For Example, it is very common to see people write; “I work well with other people, or I am an expert at working under pressure”. Well, it is not a cover letter , it’s a motivation letter and you need to give realistic scenarios such as; “my leadership ability was demonstrated when I had to be in charge of a group of colleagues during my internship which required intense marketing management skills.”

Try As Much As Possible to Be Specific

It is equally very important to avoid being vague while writing your motivation letter. The reason why you’re required to write a motivation letter is that someone or some people have to know, if not you wouldn’t have to attempt one.

Saying that your undergraduate days in Marketing was very interesting is too vague to fit into a motivational letter, it sounds like something that should rather be written to a pen friend. You should be more specific about the courses you took as an undergraduate, why you love them and what you learned from them.

Show How Much Skill or Work Experience You Have

While writing a motivational letter, it is very important to concisely include how much skill and/or working experience you possess. A Ph.D. is about more than just a sequel to your past academic endeavors, it is a true test of education and education is more than just owning degrees.

They will be interested in the skills and/or work experience you’ve gathered over the years, skills which are strong enough to make you qualified to bag a Ph.D. That research, data analysis, etc. skills you thought you’d never have to flaunt, well I think this would be a perfect opportunity to talk about them.

Be Professional

It is equally quite important that you are very professional while writing a motivation letter for a Ph.D. application . It will be in your own best interest to ensure that you present your motivation letter with professional grammar, font and the appropriate writing style in which you’d rather prefer to be accepted.

Your professionalism sends a good message about your personality and would go a long way into helping you get accepted. 

Sample Motivation Letter for a Ph.D. Application

Suggested Reading:

• Cover Letter Examples
• 2024 Letter of Interest - Example & Writing Guide
• Students and Graduates Resume Example

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Clinical Research Associate Cover Letter Example for 2024 (Skills & Templates)

Create a standout clinical research associate cover letter with our online platform. browse professional templates for all levels and specialties. land your dream role today.

Are you interested in becoming a clinical research associate (CRA)? This guide provides you with the tips and tricks to writing a successful cover letter for your job application. Learn how to highlight your experience, knowledge, and skills to stand out from the competition and land that CRA position.

We will cover:

• How to write a cover letter, no matter your industry or job title.
• What to put on a cover letter to stand out.
• The top skills employers from every industry want to see.
• How to build a cover letter fast with our professional Cover Letter Builder .
• What a cover letter template is, and why you should use it.

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Clinical Research Associate Cover Letter Sample

Dear [Hiring Manager],

I am writing to apply for the Clinical Research Associate role at [company name]. With my experience in clinical research, I am confident that I have the qualifications and skills necessary to fill this role.

Having worked as a Clinical Research Associate for the past three years, I have developed a comprehensive understanding of the principles and techniques of clinical research. I have a proven track record of successfully carrying out clinical trials, organizing and analyzing data, and preparing reports for senior management. I have a strong knowledge of Good Clinical Practice (GCP) and other applicable regulations, and I am also well versed in the use of Microsoft Office, statistical software, and other data analysis tools.

In addition, I have exceptional written and verbal communication skills, which I have used to develop relationships with key personnel and stakeholders. I am also highly organized and detail-oriented, enabling me to manage multiple projects and tasks simultaneously. Finally, I am a quick learner and am always looking for ways to improve my knowledge and skills.

I am excited to join your team and contribute to the success of your clinical research programs. I believe I have the necessary skills and experience to make a positive impact in this role.

Thank you for your consideration. I look forward to discussing my candidacy further.

Sincerely, [Your name]

Why Do you Need a Clinical Research Associate Cover Letter?

A Clinical Research Associate cover letter is an essential part of your job application package. It is your opportunity to introduce yourself to the hiring manager and explain why you are the best candidate for the job. Here are some reasons why you need a Clinical Research Associate cover letter:

• Highlight your relevant experience: A cover letter allows you to highlight your relevant experience and qualifications for the position in a concise and easy to read format.
• Showcase your personality: A cover letter is a great way to showcase your personality and give the hiring manager an idea of who you are as a person.
• Stand out from the crowd: A well-written cover letter can help you stand out from the other applicants and make you more memorable to the hiring manager.
• Make a good impression: A cover letter can give you an opportunity to make a good impression on the hiring manager and show that you are a professional and serious about the job.

A Few Important Rules To Keep In Mind

• Start with a strong opening statement that clearly outlines your interest in the position and the company.
• Focus on what you have to offer the employer, rather than simply restating the job description.
• Highlight your most relevant experience and qualifications, and explain how they make you an ideal candidate for the position.
• Include specific examples of your skills and successes that demonstrate your ability to succeed in the role.
• Mention any awards, certifications, or impressive academic achievements that demonstrate your commitment to the field.
• Keep your letter concise and maintain a professional yet enthusiastic tone throughout.
• Proofread your letter several times to ensure that there are no grammar or spelling mistakes.
• End with a polite and confident closing statement that expresses your appreciation for the employer's consideration.

What's The Best Structure For Clinical Research Associate Cover Letters?

After creating an impressive Clinical Research Associate resume , the next step is crafting a compelling cover letter to accompany your job applications. It's essential to remember that your cover letter should maintain a formal tone and follow a recommended structure. But what exactly does this structure entail, and what key elements should be included in a Clinical Research Associate cover letter? Let's explore the guidelines and components that will make your cover letter stand out.

Key Components For Clinical Research Associate Cover Letters:

• Your contact information, including the date of writing
• The recipient's details, such as the company's name and the name of the addressee
• A professional greeting or salutation, like "Dear Mr. Levi,"
• An attention-grabbing opening statement to captivate the reader's interest
• A concise paragraph explaining why you are an excellent fit for the role
• Another paragraph highlighting why the position aligns with your career goals and aspirations
• A closing statement that reinforces your enthusiasm and suitability for the role
• A complimentary closing, such as "Regards" or "Sincerely," followed by your name
• An optional postscript (P.S.) to add a brief, impactful note or mention any additional relevant information.

Cover Letter Header

A header in a cover letter should typically include the following information:

• Your Full Name: Begin with your first and last name, written in a clear and legible format.
• Contact Information: Include your phone number, email address, and optionally, your mailing address. Providing multiple methods of contact ensures that the hiring manager can reach you easily.
• Date: Add the date on which you are writing the cover letter. This helps establish the timeline of your application.

It's important to place the header at the top of the cover letter, aligning it to the left or center of the page. This ensures that the reader can quickly identify your contact details and know when the cover letter was written.

Cover Letter Greeting / Salutation

A greeting in a cover letter should contain the following elements:

• Personalized Salutation: Address the hiring manager or the specific recipient of the cover letter by their name. If the name is not mentioned in the job posting or you are unsure about the recipient's name, it's acceptable to use a general salutation such as "Dear Hiring Manager" or "Dear [Company Name] Recruiting Team."
• Professional Tone: Maintain a formal and respectful tone throughout the greeting. Avoid using overly casual language or informal expressions.
• Correct Spelling and Title: Double-check the spelling of the recipient's name and ensure that you use the appropriate title (e.g., Mr., Ms., Dr., or Professor) if applicable. This shows attention to detail and professionalism.

For example, a suitable greeting could be "Dear Ms. Johnson," or "Dear Hiring Manager," depending on the information available. It's important to tailor the greeting to the specific recipient to create a personalized and professional tone for your cover letter.

Cover Letter Introduction

An introduction for a cover letter should capture the reader's attention and provide a brief overview of your background and interest in the position. Here's how an effective introduction should look:

• Opening Statement: Start with a strong opening sentence that immediately grabs the reader's attention. Consider mentioning your enthusiasm for the job opportunity or any specific aspect of the company or organization that sparked your interest.
• Brief Introduction: Provide a concise introduction of yourself and mention the specific position you are applying for. Include any relevant background information, such as your current role, educational background, or notable achievements that are directly related to the position.
• Connection to the Company: Demonstrate your knowledge of the company or organization and establish a connection between your skills and experiences with their mission, values, or industry. Showcasing your understanding and alignment with their goals helps to emphasize your fit for the role.
• Engaging Hook: Consider including a compelling sentence or two that highlights your unique selling points or key qualifications that make you stand out from other candidates. This can be a specific accomplishment, a relevant skill, or an experience that demonstrates your value as a potential employee.
• Transition to the Body: Conclude the introduction by smoothly transitioning to the main body of the cover letter, where you will provide more detailed information about your qualifications, experiences, and how they align with the requirements of the position.

By following these guidelines, your cover letter introduction will make a strong first impression and set the stage for the rest of your application.

Cover Letter Body

Dear Hiring Manager,

I am writing to apply for the role of Clinical Research Associate at your organization. With my experience in clinical research and study design, I am confident that I am an ideal candidate for this position.

I have a degree in Medical Science and have been working in clinical research for the past three years. During this time I have gained a deep understanding of clinical study design, Good Clinical Practices, and regulatory compliance. My experience has enabled me to plan and manage a variety of clinical research projects from start to finish, from initial study design to data collection and analysis. I have also regularly worked collaboratively with clinical teams to ensure that studies are conducted in accordance with applicable regulations.

I am an excellent communicator and have a knack for quickly grasping complex concepts. I have a knack for quickly grasping complex concepts and I am comfortable working with computerized data management systems. I am proficient with Microsoft Office Suite, SAS programs, and I am familiar with medical terminology.

I believe my experience and skills make me an ideal candidate for this position and I would be thrilled to join your team. I am confident that I can help you to achieve your research goals in a timely and efficient manner.

Thank you for your time and consideration. I look forward to hearing from you soon.

Sincerely, [Your Name]

Complimentary Close

The conclusion and signature of a cover letter provide a final opportunity to leave a positive impression and invite further action. Here's how the conclusion and signature of a cover letter should look:

• Summary of Interest: In the conclusion paragraph, summarize your interest in the position and reiterate your enthusiasm for the opportunity to contribute to the organization or school. Emphasize the value you can bring to the role and briefly mention your key qualifications or unique selling points.
• Appreciation and Gratitude: Express appreciation for the reader's time and consideration in reviewing your application. Thank them for the opportunity to be considered for the position and acknowledge any additional materials or documents you have included, such as references or a portfolio.
• Call to Action: Conclude the cover letter with a clear call to action. Indicate your availability for an interview or express your interest in discussing the opportunity further. Encourage the reader to contact you to schedule a meeting or provide any additional information they may require.
• Complimentary Closing: Choose a professional and appropriate complimentary closing to end your cover letter, such as "Sincerely," "Best Regards," or "Thank you." Ensure the closing reflects the overall tone and formality of the letter.
• Signature: Below the complimentary closing, leave space for your handwritten signature. Sign your name in ink using a legible and professional style. If you are submitting a digital or typed cover letter, you can simply type your full name.
• Typed Name: Beneath your signature, type your full name in a clear and readable font. This allows for easy identification and ensures clarity in case the handwritten signature is not clear.

Common Mistakes to Avoid When Writing a Clinical Research Associate Cover Letter

When crafting a cover letter, it's essential to present yourself in the best possible light to potential employers. However, there are common mistakes that can hinder your chances of making a strong impression. By being aware of these pitfalls and avoiding them, you can ensure that your cover letter effectively highlights your qualifications and stands out from the competition. In this article, we will explore some of the most common mistakes to avoid when writing a cover letter, providing you with valuable insights and practical tips to help you create a compelling and impactful introduction that captures the attention of hiring managers. Whether you're a seasoned professional or just starting your career journey, understanding these mistakes will greatly enhance your chances of success in the job application process. So, let's dive in and discover how to steer clear of these common missteps and create a standout cover letter that gets you noticed by potential employers.

• Forgetting to include contact information
• Using a generic and impersonal cover letter
• Not utilizing keywords and industry-specific language
• Not researching the company you are applying to
• Failing to explain how your skills and experiences are related to the job
• Not proofreading for typos and errors
• Adding irrelevant information

Key Takeaways For a Clinical Research Associate Cover Letter

• Highlight your experience in the clinical research field
• Focus on your attention to detail and organization
• Discuss your familiarity with regulatory guidelines
• Emphasize your communication skills
• Mention your ability to multi-task
• Showcase your problem-solving abilities

Clinical Researcher Cover Letter Examples

A great clinical researcher cover letter can help you stand out from the competition when applying for a job. Be sure to tailor your letter to the specific requirements listed in the job description, and highlight your most relevant or exceptional qualifications. The following clinical researcher cover letter example can give you some ideas on how to write your own letter.

or download as PDF

Cover Letter Example (Text)

Lindzee Flaming

(357) 383-2411

[email protected]

Dear Ms. Basko,

I am writing to express my interest in the Clinical Researcher position at PAREXEL International Corporation as advertised. With five years of dedicated experience in clinical research at ICON plc, I bring a wealth of knowledge and a track record of success in managing clinical trials that I am eager to leverage in a new and challenging environment.

At ICON plc, I honed my skills in designing and implementing clinical studies, ensuring compliance with regulatory standards, and managing cross-functional teams to meet project milestones. I have developed a strong proficiency in data analysis, patient recruitment strategies, and the preparation of detailed reports and presentations for stakeholders. My commitment to excellence has been recognized on several occasions, resulting in significant improvements in trial efficiency and data integrity.

I have always been passionate about the impact of clinical research on patient care and the advancement of medicine. My role at ICON plc allowed me to collaborate with experts in various therapeutic areas, providing me with a broad perspective that I believe will be beneficial in addressing the diverse challenges faced by PAREXEL International Corporation. I am particularly impressed by PAREXEL's commitment to innovation and its patient-centric approach, which aligns perfectly with my professional values and goals.

Furthermore, my ability to adapt quickly to changing protocols and regulations, coupled with my strong communication and organizational skills, ensures that I can contribute effectively from day one. I am confident that my proactive nature and dedication to continuous improvement will make me a valuable addition to your team.

I am very excited about the opportunity to bring my expertise to PAREXEL International Corporation, and I look forward to the possibility of contributing to your esteemed research programs. Thank you for considering my application. I am eager to discuss how my background, skills, and enthusiasms can align with the goals of your organization.

Warm regards,

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7 Clinical Research Coordinator Cover Letter Examples

Introduction.

In today's competitive job market, a well-tailored cover letter can make all the difference when it comes to landing your dream job as a clinical research coordinator. As a crucial component of your job application, a cover letter allows you to showcase your skills, experience, and passion for the field. It provides a unique opportunity to highlight your suitability for the role and capture the attention of hiring managers.

A well-crafted cover letter can help you stand out from the crowd and demonstrate your commitment to excellence in clinical research coordination. In this article, we will provide you with a collection of clinical research coordinator cover letter examples to inspire and guide you as you craft your own personalized cover letter. These examples will cover a range of scenarios and highlight different aspects of the role, giving you valuable insights into what makes a cover letter effective in this field.

Whether you are a seasoned clinical research coordinator looking to take the next step in your career or a recent graduate eager to make your mark in the industry, these cover letter examples will help you present yourself as the ideal candidate for the job. So let's dive in and explore the key elements of a strong clinical research coordinator cover letter!

Example 1: Entry-Level Clinical Research Coordinator Cover Letter

Key takeaways.

Sarah's cover letter effectively highlights her relevant education and experience, positioning her as a strong candidate for the entry-level Clinical Research Coordinator position at the National Institute of Health.

When applying for an entry-level position, it is crucial to showcase any relevant education and experience that demonstrates your ability to handle the responsibilities of the role. This helps the hiring manager see your potential as a valuable asset to the organization.

Sarah emphasizes her practical experience as a Research Assistant at Johns Hopkins Medicine, where she gained hands-on experience in data collection, analysis, and documentation. This showcases her attention to detail and organizational skills, which are essential for a Clinical Research Coordinator.

Highlighting specific tasks and responsibilities from previous roles can help demonstrate your ability to handle similar responsibilities in the target position. This shows the hiring manager that you have the necessary skills and experience to excel in the role.

She also mentions her volunteer experience as a Research Coordinator at the American Cancer Society, emphasizing her ability to coordinate patient enrollment and ensure compliance with research protocols. This demonstrates her communication and interpersonal skills, which are crucial for working effectively with patients and healthcare professionals.

Don't overlook volunteer or extracurricular experiences that are relevant to the position. These experiences can provide valuable insights into your abilities and dedication, especially for entry-level roles.

Sarah's cover letter could be further improved by highlighting any specific achievements or notable contributions she made during her previous roles, such as successfully completing a research project or implementing improvements to a research process.

Whenever possible, include specific achievements or contributions that highlight your impact and value. This helps differentiate you from other candidates and showcases your ability to deliver results.

Example 2: Senior Clinical Research Coordinator Cover Letter

Michael's cover letter effectively showcases his extensive experience and expertise in clinical research coordination, positioning him as an ideal candidate for the Senior Clinical Research Coordinator position at Mayo Clinic.

When applying for a senior-level position, it's crucial to highlight your relevant work history and accomplishments. This demonstrates your ability to handle complex research projects and lead teams effectively.

He emphasizes his experience in managing multiple research projects, ensuring adherence to protocols and timelines, which demonstrates his strong organizational skills and attention to detail.

Highlighting your ability to manage multiple projects and maintain strict adherence to protocols showcases your ability to handle the demands of a senior clinical research coordinator role.

Michael also highlights his experience in mentoring junior team members and developing standard operating procedures to improve efficiency and streamline processes, which indicates his leadership skills and commitment to continuous improvement.

Demonstrating your leadership abilities and commitment to process improvement can set you apart as a candidate for a senior-level position. Highlight any experience you have in mentoring, training, or implementing process enhancements.

Overall, Michael's cover letter effectively conveys his qualifications, experience, and passion for clinical research coordination, making him a strong candidate for the Senior Clinical Research Coordinator position at Mayo Clinic.

Example 3: Oncology Clinical Research Coordinator Cover Letter

Emily's cover letter effectively showcases her extensive experience and expertise in oncology research and clinical coordination. Her specific examples highlight her ability to manage complex clinical trials and collaborate effectively with various stakeholders.

When applying for a specialized role like an Oncology Clinical Research Coordinator, it's crucial to highlight your specific experience and qualifications in the field. This demonstrates your in-depth understanding of the unique challenges and requirements of oncology research.

Emily emphasizes her success in patient recruitment and retention, as well as her attention to detail in maintaining accurate records and ensuring compliance with study protocols.

In clinical research coordination, attention to detail and adherence to protocols are crucial. Highlighting your ability to effectively manage these aspects demonstrates your commitment to maintaining high-quality data and ethical research practices.

She also mentions her experience in coordinating multi-center clinical trials, showcasing her ability to collaborate with diverse teams and manage complex logistics.

The ability to coordinate multi-center trials is highly valued in the field of oncology research. Highlighting your experience in this area demonstrates your ability to work effectively with multiple stakeholders and navigate the challenges of conducting research across different institutions.

To further strengthen her cover letter, Emily could mention specific achievements or outcomes from her previous research projects to highlight the impact of her work.

Including specific achievements or outcomes from your previous research projects can provide concrete evidence of your contributions and demonstrate the value you can bring to MD Anderson Cancer Center.

Example 4: Pediatric Clinical Research Coordinator Cover Letter

Samantha's cover letter effectively highlights her extensive experience in pediatric clinical research, positioning her as an ideal candidate for the Pediatric Clinical Research Coordinator position at Children's Hospital of Philadelphia.

When applying for a niche role like Pediatric Clinical Research Coordinator, it is crucial to emphasize your specific experience and expertise in the field. This demonstrates your understanding of the unique challenges and requirements of the role.

She showcases her practical skills in study coordination, data analysis, and regulatory compliance, emphasizing her ability to handle the complexities of pediatric clinical research.

Highlighting your technical skills and knowledge of research methodologies is essential in a cover letter for a clinical research position. This demonstrates your proficiency in executing research protocols and analyzing data accurately.

Samantha also emphasizes her compassionate approach and ability to build rapport with patients and their families, which is crucial in a pediatric setting.

In a field focused on pediatric medicine, showcasing your ability to work with children and families is essential. Highlight your empathy, communication skills, and ability to create a supportive environment for study participants.

To further strengthen her cover letter, Samantha could have provided specific examples of successful research projects she has contributed to, including any notable publications or achievements.

Including specific examples of your contributions to research projects can provide tangible evidence of your impact and demonstrate your ability to contribute to the advancement of pediatric medicine at the institution you are applying to.

Example 5: Behavioral Clinical Research Coordinator Cover Letter

Rachel's cover letter effectively showcases her qualifications and experience as a Behavioral Clinical Research Coordinator, positioning her as an ideal candidate for the position at Stanford University School of Medicine.

When applying for a specialized research coordinator role, it's crucial to emphasize your experience and accomplishments in the specific field of research. This demonstrates your expertise and your ability to contribute to the organization's research goals.

She highlights her role as a Behavioral Clinical Research Coordinator at the University of Pennsylvania and describes her responsibilities, including developing study protocols, recruiting participants, and analyzing data. Rachel also emphasizes her accomplishment of leading a study that resulted in the development of a highly effective behavioral intervention for individuals with anxiety disorders.

Highlighting specific achievements and successful research projects helps to demonstrate your impact and the value you bring to the field. This can set you apart from other applicants and show your ability to contribute to groundbreaking research.

Rachel expresses her interest in Stanford University School of Medicine and its reputation for excellence in research and advancement of scientific knowledge in the field of behavioral health. This demonstrates her enthusiasm for the organization and her alignment with its mission and values.

When applying to a prestigious institution known for its research, it's essential to convey your genuine interest and enthusiasm for the organization. This shows that you are motivated and committed to contributing to their research endeavors.

Example 6: Contract Clinical Research Coordinator Cover Letter

Kevin's cover letter effectively highlights his experience and skills as a Clinical Research Coordinator, positioning him as an ideal candidate for the Contract Clinical Research Coordinator position at PRA Health Sciences.

When applying for a specific role, it's crucial to showcase your relevant experience and expertise that directly align with the job requirements. This demonstrates your ability to hit the ground running and contribute immediately.

Kevin emphasizes his experience in managing clinical trials from start to finish, showcasing his ability to handle the complexities of coordinating complex trials.

Highlight your experience in managing various aspects of clinical trials, such as protocol adherence, data collection, and analysis. This demonstrates your attention to detail, analytical skills, and ability to navigate regulatory requirements.

He also highlights his strong organizational skills and ability to multitask effectively, which are essential qualities for a Clinical Research Coordinator.

Emphasize your organizational skills and ability to manage multiple trials simultaneously. This showcases your ability to handle competing priorities and ensure the smooth execution of studies.

Kevin expresses his genuine interest in PRA Health Sciences and aligns his skills and experience with the company's mission and values.

Research the company you're applying to and highlight specific aspects that resonate with you. This shows your enthusiasm and dedication to contributing to the organization's success.

Example 7: Remote Clinical Research Coordinator Cover Letter

Maria's cover letter effectively showcases her experience and expertise as a Clinical Research Coordinator, positioning her as an ideal candidate for the Remote Clinical Research Coordinator position at Medpace.

When applying for a specific role, emphasize your relevant experience and skills that align with the company's requirements. This demonstrates your understanding of the role and your ability to contribute effectively.

She highlights her experience in managing multiple clinical trials, ensuring compliance with regulatory requirements, and maintaining accurate documentation. These accomplishments demonstrate her attention to detail and organizational skills, which are crucial for a Clinical Research Coordinator.

Highlight specific achievements and responsibilities that are directly relevant to the role you are applying for. This helps the hiring manager understand your capabilities and the value you can bring to the organization.

Maria also emphasizes her experience in remote clinical research coordination, showcasing her ability to adapt to the challenges of remote work and effectively collaborate with stakeholders using various communication tools.

In today's remote work environment, it is important to highlight your adaptability and proficiency in remote collaboration tools. This demonstrates your ability to thrive in a remote role and effectively communicate with team members.

The cover letter could be further strengthened by mentioning specific projects or studies Maria has worked on, as well as any certifications or specialized training she has completed in the field of clinical research coordination.

Providing specific examples of projects you have worked on and highlighting relevant certifications or training helps to further establish your expertise and qualifications for the role.

Skills To Highlight

As a clinical research coordinator, your cover letter should highlight the unique skills that make you a strong candidate for the role. These key skills include:

Attention to Detail : Clinical research coordinators are responsible for ensuring accuracy and precision in all aspects of the research process. This includes meticulous documentation, data collection, and adherence to protocols. Highlight your ability to pay close attention to detail and provide examples of how your attention to detail has contributed to the success of previous research projects.

Organizational Skills : Clinical research coordinators are often responsible for managing multiple research projects simultaneously. Strong organizational skills are essential for keeping track of timelines, coordinating with research teams, and maintaining accurate records. Showcase your ability to effectively manage tasks, prioritize responsibilities, and meet deadlines.

Communication Skills : Effective communication is crucial for clinical research coordinators as they interact with various stakeholders, including investigators, sponsors, study participants, and regulatory authorities. Highlight your ability to communicate clearly and professionally, both verbally and in writing. Provide examples of how you have effectively communicated complex medical information to different audiences.

Clinical Trial Management : Clinical research coordinators play a key role in the management of clinical trials. They are responsible for coordinating study activities, recruiting and screening participants, obtaining informed consent, and ensuring compliance with study protocols. Emphasize your experience in managing clinical trials and your familiarity with the regulatory requirements and ethical considerations involved.

Regulatory Compliance : Clinical research coordinators are responsible for ensuring that all research activities comply with applicable regulations, guidelines, and ethical standards. Demonstrate your knowledge of regulatory requirements, such as Good Clinical Practice (GCP) guidelines and Institutional Review Board (IRB) processes. Mention any certifications or training you have received related to regulatory compliance.

By highlighting these key skills in your cover letter, you can demonstrate to potential employers that you have the necessary qualifications and abilities to excel as a clinical research coordinator.

Common Mistakes To Avoid

When crafting your cover letter for a clinical research coordinator position, it's important to avoid these common mistakes:

Not Addressing the Job Requirements : One of the biggest mistakes you can make is failing to address the specific job requirements mentioned in the job posting. Take the time to carefully read the job description and tailor your cover letter to highlight how your skills and experience align with what the employer is looking for. This shows that you have taken the time to understand the needs of the company and are genuinely interested in the role.

Using Generic Statements : Avoid using generic statements that could apply to any job. Instead, focus on providing specific examples of your experience and skills that are relevant to the clinical research coordinator role. Use concrete language to demonstrate your expertise in areas such as managing clinical trials, maintaining regulatory compliance, and coordinating research activities. Providing specific examples will make your cover letter stand out and show that you have the necessary qualifications for the position.

Failing to Showcase Experience in Clinical Trial Management : As a clinical research coordinator, it's crucial to highlight your experience in managing clinical trials. This includes coordinating study procedures, recruiting and screening participants, collecting and analyzing data, and ensuring compliance with regulatory requirements. Failure to emphasize your experience in these areas may give the impression that you are not a strong candidate for the position. Be sure to clearly articulate your experience and achievements in clinical trial management to demonstrate your ability to successfully carry out the responsibilities of a clinical research coordinator.

Not Highlighting How Your Expertise Can Address the Company's Needs : A cover letter is an opportunity to show how your expertise can help address the specific needs of the company. Research the organization and try to understand their current projects, goals, and challenges. Then, highlight how your skills and experience can contribute to the success of their clinical research efforts. This shows that you have taken the time to research and understand the company and are genuinely interested in making a positive impact.

By avoiding these common mistakes, you can create a strong and compelling cover letter that showcases your qualifications, experience, and enthusiasm for the clinical research coordinator role.

In conclusion, a well-crafted cover letter plays a crucial role in a clinical research coordinator's successful job application. It serves as an opportunity to showcase relevant skills, experience, and passion for the field of clinical research. By following the examples provided in this article, you can enhance your chances of landing a rewarding position in this competitive field.

Remember, the key takeaways from the cover letter examples include:

• Clearly stating your interest in the specific role and organization
• Highlighting relevant skills, experience, and achievements
• Demonstrating your knowledge of clinical research protocols and regulations
• Tailoring your cover letter to the job description and company culture

Avoid common mistakes such as generic or overly formal language, excessive detail, and neglecting to customize your cover letter for each application.

By taking the time to craft a compelling cover letter, you can stand out from other applicants and make a positive impression on hiring managers. Good luck with your clinical research coordinator job applications!

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Writing A Scientific Motivation Letter: How to write a research motivation letter for PhD, Postdoc, or any position.

Writing a Motivation Letter for a Ph.D., Postdoc, or any Research position can be reasonably challenging, but we need to put extra effort into it, which cannot be avoided.

You need to give proper attention to this part (motivation letter for ph.d., postdoc, or any research positions) like other preparation. knowing some significant ideas and approaches can help you in this process..

A motivation letter helps the admissions board/professor compare outstanding students and impressive ones. With this help, they can prosper in choosing worthy research students. Still, admission boards will surely think of this as the classification to significantly find a suitable candidate for his research group. Showing you are preferred depending on what you write, however much more on just how you design, particularly the tone you use and the level of interest you receive in your writing that matters.

• A motivation letter is a document where you express your expert capability and the personal impulse to examine a particular study area at a specific college/research group.
• A motivation letter is a possibility you have to impress the selection panel.
• To procure the listing of candidates, selection panels regularly use motivation letters.
• The candidates thought finest are ultimately chosen for the program.
• The success of your application mainly trusts by the motivation letter.
• The motivation letter can be much likened to an Individual statement.
• It is just as crucial to stay clear of being humble while writing your Motivation Letter.
• It seems like something that would be written to a friend instead of a penfriend.
• It’s not a cover letter and requires giving reasonable circumstances in which it’S a Motivation letter.
• You need to give proper attention to this part (Motivated Letter for Ph.D., Postdoc, or any Research positions) like other preparation.
• Knowing some significant ideas and approaches can help you in this process.
• Give your statements much attention to pushing your statements as much as possible to suit your situation.
• Try not to claim something that you wouldn’t have tried to do if you were a different person or had a different job.
• Try to be honest about your experiences and how you would like to use them to your advantage.
• You can also include teaching and research experience, work outside an academic field, and even volunteering, given that all matters in terms of the abilities and expertise you gained.
• You should also include the info regarding your previous scholastic and professional experience, as well as your work outside of the academic field.
• There is a demand to recognize if you’re qualified to do a research/degree position while writing an application.
• Hence, the motivation letter is the perfect insight into what you genuinely are and anticipate doing it justice.
• It can be effortless to confuse while writing a Motivated Letter and neglects that motivation can not be completed without the necessary proof to back it up.
• Yet what requires to go in this, and what tone is suitable for it?
• To give you some suggestions, today, we’re sharing all about motivation letters, so you can see what your motivation letter needs to include or correct.
• It’s a good idea to write a motivation letter because a person or some individuals must be required to write it because they have to know some individuals or some people have to have to do it themselves.
• The best way to start is by writing a short intro defining the program you want to get into and why you would be appropriate for studying there.
• This defines why you wish to embark on that position and why it is appropriate for you to study there.
• It also defines just how your scholastic, as. Your professional achievements make you a beneficial candidate for the Ph.D. degree/Research position you are related to.
• It should be written to make it easy for people to read it and understand what you are trying to say.
• It must be written with a sense of humor and be clear that you are not trying to make a point that you think is important to make to the person you are applying to.
• You must be clear of making spurious cases, and you should be clear about the reasons you are doing it.

The motivation letter is the possibility you have to impress the selection panel. To procure the listing of candidates, selection panels regularly use motivation letters. The candidates thought finest are ultimately chosen for the program. The motivation letter is the most substantial part of your application. The success of your application is mainly trusted by the motivation letter.

Any Motivation Letter should consist of a short intro defining the program you would like to get.

Stay clear of making spurious cases, demonstrate how much ability or work experience you have, be specific, the main message of the letter-, closing of the motivation letter, q- key things to bear in mind when you write the motivation letter, q- what are a couple of points for writing an excellent motivation letter for a ph.d., q- exactly how should i structure my motivation letter, q- how to end a motivation letter., q- what key points should i include within my ph.d. motivation letter, q- what not to include when writing a scholarship motivation letter, q- why motivation letter require, and how much important it is, q- how long should a phd motivation letter be, q- should i write various motivation letters when looking for several research programs, q- what are the best motivation letter, q- what is the difference between the lom – letter of motivation and the sop statement of purpose, q- how to start a motivation letter., q- what’s the difference between a cover letter and a motivation letter, sample – motivation letter.

The motivation letter (likewise known as “declaration of objective”) is a document where you express your expert capability and personal impulse regarding picking to examine a particular study area at a specific college/research group.

A motivation letter can be much likened to an Individual statement.

When you apply for a Ph.D./Postdoc and some research position, you must write a research proposal and a Motivation Letter. Especially, a motivation letter is more required for Ph.D. candidates. This defines why you wish to embark on that position and why you would be appropriate for studying there. Yet what needs to go in this, and what tone is suitable for it? To give you some suggestions, today, we’re sharing all about motivation letters, so you can see what your motivation letter needs to include or correct.

First, state a clear objective of your future task and the reasons for picking this individual Ph.D. program.

Provide the info regarding your previous scholastic and professional experience. You can also include teaching and research experience, work outside an academic field, and even volunteering, given that all matters in terms of the abilities and expertise you gained. All your experiences must, in some way, attach to your picked Ph.D. program, as you would need to define just how your scholastic and professional achievements make you a beneficial candidate for the Ph.D. degree/Research position you are related to.

Your applications are not just sorted out in the same way as any other random application. There are processes involved without which your chances of getting in may be reduced.

There is a demand to recognize if you’re qualified to do a research/degree position while writing an application. Hence, the motivation letter is the perfect insight into what you genuinely are and anticipate doing it justice.

It is relatively easy to confuse while writing a Motivation Letter and neglects that motivation can not be completed without the necessary proof to back it up.

Nobody’s interested in exactly how incredible you are until there is no backup proof of it. Yet, there would not be any motivation without the proper evidence to back it up.

For Example, it is very typical to see people create; “I work well with other people, or I am a specialist at working under pressure.” Well, it is not a cover letter; it’s a Motivation Letter, and also you required to give reasonable circumstances such as; “my leadership ability was demonstrated when I needed to be in charge of a group of coworkers during my teaching fellowship, which needed intense pushing management abilities.”

Give much attention to your statements.

Try As Much As Feasible to Be Certain

It is just as really crucial to stay clear of being humble while writing your Motivation Letter. You’re required to write a motivation letter because someone or some individuals have to know; otherwise, you wouldn’t have to try one.

Claiming that your previous days were extremely intriguing is unclear to suit a Motivation Letter. It seems like something that must instead be written to a penfriend. It would be best if you were more specific about the programs you took as a previous study, why you enjoy them, and what you learned from them.

While writing a motivational letter, it is essential to include just how much ability and working experience briefly. A Ph.D. has to do with more than just a sequel to your previous academic endeavors; it is an actual test of education and learning, and also, teaching and knowledge are more than just having degrees.

They will be interested in the abilities and work experience you have collected over the years, strong enough skills to make you qualified for a Ph.D. That research, data analysis, etc., abilities you thought you’d never have to show off, well, I believe this would be a perfect chance to talk about them.

Steps for writing research motivation letter

• 1. The first step to writing a good motivation letter is to read the job ad carefully
• 2. The second step is to try to understand the researchers and the kind of research they do
• 3. The third step is to carefully read a previous motivation letter and try to understand why the letter was successful
• 4. The fourth step is to make sure that you address the letter to the right people
• 5. The fifth step is to explain why you choose to apply to this position and this lab
• 6. The sixth step is to explain how your research interests align with the research of the lab
• 7. The seventh step is to explain how your previous research background relates to the position
• 8. The eighth step is to explain why you are applying for that position

It is equally essential that you are incredibly professional while creating a motivation letter for a Ph.D. or any research position application. It will remain in your very own best interest to guarantee that you offer your Motivation Letter with expert grammar, font, and the proper writing design in which you prefer to choose to be approved.

Your professionalism and trust send an excellent message about your personality and would certainly go a long way into helping you get accepted .

– What has encouraged you to do a Ph.D. (or other position where you are applying)?

Based on the history details you give, you will undoubtedly determine 3 or 4 key aspects that inspire you to do a Ph.D.

The present research study shows that Ph.D. applicants may be encouraged by several aspects such as:

• Determination to improve potential as a candidate;
• Enthusiasm for research study as well as mentor;
• The desires to find out new points.

You require to describe what inspires you and what you want to accomplish due to your research studies.

If you published academic journals, you must mention that and provide information or evidence about your published work.

State a few of your native qualities on how they could be considered helpful for your study subject and your field of study in general.

In the closing of your Motivation Letter, include a couple of sentences on your research’s impact on your life, research location, and experience generally. This will certainly aid you in showing the value of your research study in the context of a bigger photo. Mostly, demonstrate how the research community and college can benefit from having you as a pupil.

You should also mention that you understand that Ph.D. programs draw in several prospective and affordable candidates.

Also Read – Write an Email to Professor: Complete Dos and Don’ts Discussion

FAQ about motivation letter

• Essential details you must emphasize throughout your Motivation Letter are your intellectual interest in the Ph.D. course/Research position and the area you intend to study, and the research study experience you have had so far. Bear in mind to maintain an expert and sharp tone, yet at the same time, declare and also enthusiastic.
• Prevent adhering to things in your writing.
• The motivation Letter needs to consist of a brief intro specifying the program you want to apply to.
• Clearly, you should not consist of false evidence, accomplishments and should not attempt to make any overstatement or use pompous allegories.
• Normally, a Motivation Letter ought not to be longer than one page.
• Show your level of interest rate and what you have actually done so far to display that desire. They do not desire some geek with Terrabytes of expertise as well as formulas.
• Truthfully state the reason that you want the seat, highlight your desire in the topic.
• State the reasons and circumstances from your life, which will show that you have a genuine need.
• A motivation letter ‘s significance is that the admissions committee can compare excellent trainees and exceptional trainees. They will both succeed in ending up being valuable study students. Yet, admission committees will consider the latter category to contribute to the college’s research study area.
• Confirming you are exceptional does not always depend on what you write, but extra on just how you compose, particularly the tone you use and the degree of enthusiasm you present in your writing.

Important- Follow-up email to a professor: When and how you should write

A strong motivation letter for Ph.D./Research applications will certainly include:

• A concise intro stating which program you are applying for
• Your scholastic history as well as expert work experience
• Any vital skills you have and what makes you the perfect prospect
• These attributes must display in the best possible way in your motivation letter without seeming flat. Otherwise, it will be considered insufficient!

• Binding up the motivation letter is where most people battle. Usually, individuals can easily describe their academic background and why they intend to research, yet persuading the reader they are the most effective prospect for the research program is typically more difficult.
• The ending remarks of your motivation letter should highlight the influences of your suggested study, particularly: the brand-new contributions it will certainly make to your area, the benefits it will certainly carry society, and exactly how it harmonizes your goals.
• With this, wrap up your professional objectives. For instance, do you want to go after an academic job or end up being a scientist or a private organization? Doing so will certainly reveal you have placed a great deal of belief into your choice.
• Admissions into a Ph.D. degree or Research position are extremely competitive, and supervisors spend a great deal of time mentoring their students. As a result, supervisors naturally favor those that reveal the most dedication. Your verdict ought to remind the viewers that you are not just passionate about the study task but that the university will benefit from having you. 
• There are no rules for what to include within your Ph.D. motivation letter, yet, extensively speaking, your entry needs to include references to the following.
• You are what your personality is and what collections you apart from various other prospective Ph.D. candidates. Your motivation letter needs to be a sales tool that must make any committee choose you to join their team. 
• Your skills and achievements (together with any evidence to corroborate your claims).
• Your study into academic institutions’ details (why you intend to attend that specific institution and what makes it a good fit for you). 
• The motivation letter must attach your academic and expert future strategies with the scholarship you are making an application for.
• It should offer the viewers an understanding that you are truly thinking about researching a specific field. Also, your choice is not only beneficial for you, however likewise for the scholarship resource.
• It develops reasons why you deserve it more prominent than other candidates.
• Usually, a Motivation Letter ought not to be longer than one page. The key to success is a clear structure, passion for your research study subject, and capacity to show your research’s value and effect.
• Information and declarations you must keep in the motivation letter.
• You should not include false facts and success and not try to make any overstatements or use pompous metaphors. The team from the admission board will continuously determine if a motivation letter is real or phony.
• Prevent saying phrases like: “my childhood years desire, “I am highly inspired to research X,” “my biggest ambition is to pursue scientific study at the highest degree,” “I have always been captivated by the clinical research study.”
• Attempt not to applaud the college excessively, as well as don’t shut your letter with the expression, “It would be an honor to be confessed to this college.”
• Attempt not to commend the university too much and don’t shut your letter with the expression “It would certainly be an honor to be confessed to this college.” Secret things to bear in mind when you write the motivation letter Important information you must worry about throughout your motivation letter are your intellectual passion for the Ph.D. program and the area you intend to research—the study experience you have had so far.
• It does not need to be individual in such a way that makes you show up non-serious, instead focus on your intellectual individuality. Take care not to delight a whole lot in your deficit side; constantly concentrate on your stamina and why you are the university’s appropriate person.

A motivation letter is an essential part of your Ph.D. application. The program committee uses this letter to decide whether you should be admitted to the doctoral program. You, the applicant write the letter, and it should describe why you want to go to graduate school, why you want to pursue a particular Ph.D. program, and why you should be accepted. In the introduction, the author should state the letter’s purpose and why the committee should care about it. The opening is typically a brief paragraph or two in which the applicant explains how they believe their background, training, and professional experiences are well-suited to the proposed program. As a letter of motivation, it should not be like an autobiography.

• A motivation letter can play a crucial part in the application process. It permits the admission committee to assess a team of Ph.D. candidates with similar scholastic backgrounds and also pick the optimal candidate based upon their inspirations for applying.
• Academic credentials alone are inadequate for the admission team to indicate whether students will succeed in their doctorate. In this feeling, a motivational letter will permit them to judge your enthusiasm for the field, dedication to study, and also suitability for the program, every one of which far better enables them to evaluate your possibility.
• There is a need to know if you’re truly certified to do a Ph.D. or other research position while composing an application to a research group/college. Hence, the motivation letter is the ideal understanding right into that you truly are, and they expect you to do it justice. 
• It’s the most personalized and important document you can develop to send to a university during the application process. The motivation letter will commonly make the largest difference between obtaining admission and getting denied at the university you’re sending your application to.

A great rule of thumb for a Ph.D. motivation letter is to keep it around one side of A4. A little longer than one page is acceptable; however, two pages are typically considered long. This is associated with around 500-1000 words.

A Ph.D. motivation letter is a short essay that you write to show admissions officers that you are passionate and committed to pursuing your Ph.D. The length of this essay should be appropriately matched to your statement. Although the two papers will not be identical, they should complement each other in size and content. A Ph.D. motivation letter should be between 500 to 1000 words.

Construct a bridge between the intended level course and the scholarship you are looking for.

• Yes, you should change the motivation letter according to the research group or program. But the core content about you should be the same; always don’t try to change core details.
• You can modify research interests, particular expertise, and letter format according to the position.

Helpful Article- How to Write a Research Paper: Step-by-Step Guide

• In the letter, you can create appropriate and captivating details on your own, confirming to the admission team that you are the right candidate to be picked to engage in their program. 
• These qualities should receive the best possible method of your motivation letter. Otherwise, it will certainly be considered insufficient!
• The motivation letter needs to link your academic and expert future strategies with the scholarship you are getting.
• It needs to offer the visitor an understanding that you are actually interested in studying a particular field.
• Your option is not only valuable for you but also for the scholarship source. It shows up reasons that you deserve it more than other candidates.
• A motivation letter has many similarities to a cover letter and an individual statement, and organizations will certainly not ask you to send each one of these. Nonetheless, it is a one-of-a-kind record, and you must manage it, therefore. In the context of supporting a Ph.D. application, the difference is nuanced; all three files detail your viability for the Ph.D. research study.
• Nonetheless, compared to a cover letter and individual declaration, a motivation letter puts even more focus on your motivation to seek the particular Ph.D. position you are getting.
• For a Ph.D. application, what is the difference between a letter of inspiration and a declaration of purpose?

Introduction: Begin with a brief intro to clearly state your intention to apply for a particular program. Think of this as explaining your record/score to a stranger.

Education and learning: State what you have researched as well as where. Your higher education will be your most important academic experience, so focus on this. Highlight any relevant components you took on as part of your research studies that pertain to the program you are applying for. You must also point out exactly how your research has affected your decision to pursue a Ph.D. task, especially if it remains in the same area you are presently putting on.

Important Tip- 5 Important Tips About How To Choose Where to Apply Postdoc

• Both are pretty comparable in regards to the framework but have various objectives. The motivation letter is generally on education; for that reason, there are various motivation letterS.
• For example, you might need a motivation letter for a scholarship, a motivation letter for college admission, etc. At the same time, the cover letter is used primarily to make an application for jobs.
• Academic cover letters are a lot more typical in UK colleges, while motivation letters are extra usual abroad.
• This letter is meant to come as a free product to your Curriculum Vitae, where you display your certifications. You support the Curriculum Vitae by providing extra factors and experiences that make your certifications deserving of a motivation letter. Therefore, the motivation letter is a bit extra personal interaction between you and the other party, at the very least for its provided method.
• The motivation letter is the 3rd essential file in your application behind your level and your grades from the previous education and learning to a specific level. Naturally, when using at a University, there are numerous students with the same certifications and qualities as you. The only point that helps the admission board strain the best candidates is by looking at your motivation letter.

Bottom Line

In conclusion, your letter is a great opportunity to show off your research skills and knowledge of the field. Don’t just say the same things you would in your cover letter. Instead, use this space to show your knowledge of the topic and your enthusiasm for the field. Remember to use the first person and be personal, however, don’t be too informal. Remember, you’re talking to a professor as a peer, not as a friend.

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Postdoctoral Researcher in Supramolecular Chemistry, Universiteit Leiden, Netherlands

Phd position in comfort systems, empa, switzerland.

Resume Worded   |  Career Strategy

13 clinical research assistant cover letters.

Approved by real hiring managers, these Clinical Research Assistant cover letters have been proven to get people hired in 2024. A hiring manager explains why.

Table of contents

• Clinical Research Assistant
• Senior Clinical Research Coordinator
• Clinical Research Coordinator
• Clinical Trial Assistant
• Entry-Level Clinical Research Associate
• Alternative introductions for your cover letter
• Clinical Research Assistant resume examples

Clinical Research Assistant Cover Letter Example

Why this cover letter works in 2024, highlighting relevant experience.

By mentioning a specific project and its outcome, this cover letter demonstrates the candidate's relevant experience and skills while still being conversational and genuine.

Illustrating Passion for the Industry

This sentence showcases the candidate's passion for clinical research by sharing a personal experience from volunteering at a hospital's research unit. It helps the reader understand their motivation for pursuing this career path.

Mention the Origin of Your Interest

When you share the moment or event that sparked your interest in the field, it shows recruiters your genuine fascination and dedication. This makes you memorable and helps them understand your long-term commitment to the field.

Highlighting impact through measurable achievements

In mentioning the 20% increase in efficiency of the clinical data management system, you're showing that your work has concrete, measurable impact. Employers love to see that you can bring about tangible improvements. It's also great to see you mentioning the skills you've gained from these experiences, as it reinforces your suitability for the role.

Expressing enthusiasm for the company's mission

Pfizer's mission clearly resonates with you and it shows. By expressing your excitement for the role and the company, you're showing your potential employer that you're not just after any job, you're after this job. That kind of passion can make you a very appealing candidate.

Displaying willingness to grow and learn

It's great to see that you're not just looking to do a job, but to grow as a professional. You're showing that you're eager to learn and adapt, which is a very appealing quality in a potential employee. Plus, by expressing a desire to make a tangible impact, you're reinforcing your commitment to the company’s mission.

Connect your passion with the company’s mission

When you talk about your passion for the field and how it aligns with the company's goals, it shows you've done your homework and you're not just looking for any job, but specifically this one.

Show your hands-on experience in clinical research

Demonstrating real-world experience, especially in a challenging environment, proves you can handle the responsibilities of a clinical research assistant and have already contributed to the field.

Value the company’s work culture

Expressing admiration for the company's collaborative spirit and supportive environment indicates you're not just after a job but a place where you can grow and contribute positively.

Assert your suitability for the role

Being confident in your abilities and how they match the job requirements makes it easier for the hiring manager to see you in the role.

Express eagerness to contribute to the company’s goals

Showing enthusiasm about how you can help the company achieve its mission suggests you’re looking forward to making a meaningful impact.

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Connect to the company's vision from the start

Starting your cover letter by acknowledging the company's leadership in the field shows you've done your homework. It sets a positive tone and demonstrates your genuine interest in contributing to our mission.

Demonstrate impact in previous roles

Sharing specific achievements, like improving the data entry process, proves you can deliver results. This tells me you're not only capable but also innovative and focused on efficiency, qualities we value in our team.

Share your passion for the research field

Expressing excitement about contributing to groundbreaking research signals that you find meaning in your work. This passion is infectious and important for staying motivated in challenging projects.

Invite further discussion on your qualifications

Encouraging a discussion about how your skills align with our goals shows confidence in your abilities. It also demonstrates your eagerness to engage with us and explore how you can contribute to our mission.

Show excitement for the clinical research role

Starting your cover letter by expressing genuine enthusiasm for the job and the company’s mission can set a positive tone. It shows you have a personal connection to their work.

Highlight relevant clinical trial experience

Mentioning specific experience, especially on relevant projects like Phase III clinical trials, shows you have the practical skills needed for the role. It tells me you're not starting from scratch.

By sharing how you improved a process or reduced errors in your past work, you prove that you not only do your job but also look for ways to do it better. This is exactly what we need.

Express alignment with company values

When you talk about what draws you to the company, especially its innovative approaches, it suggests you’ve done your homework and see yourself fitting in with their culture and goals.

Show eagerness to contribute

Closing with a forward-looking statement about contributing to the company’s mission emphasizes your desire to be part of their team and make a difference.

Senior Clinical Research Coordinator Cover Letter Example

Showing leadership and efficiency.

By mentioning the landmark study you led, you're demonstrating leadership and the ability to deliver results. That's a powerful combination. It also shows that you can work effectively under pressure, which is crucial in a demanding role like Senior Clinical Research Coordinator.

Aligning personal and company values

You're not just looking for a job, you're looking for a role where you can make a difference and mentor others. This shows a commitment to the broader goals of the company and the industry. It's a nice touch that shows you're thinking about the bigger picture.

Emphasizing commitment to the role

By stating that you're eager to apply your skills and experience to drive clinical research projects forward, you're showing a strong commitment to the role. This is something that employers always appreciate. It also shows your dedication to ensuring that the research is conducted ethically and with the potential to bring about real change, confirming your alignment with the company's values.

Clinical Research Coordinator Cover Letter Example

Highlight your relevant background and confidence.

Starting with a strong statement about your background and how it equips you to contribute significantly to the team showcases your confidence and readiness for the role.

Quantify your achievements in clinical research

Using numbers to highlight your accomplishments, like participant recruitment and retention rates, offers a clear measure of your effectiveness and efficiency.

Admire the company’s innovative approach

Appreciating the company's use of technology and its global impact suggests you're excited about being part of pioneering work in healthcare.

State your comprehensive skills and passion

Emphasizing your technical skills alongside your dedication to clinical research underlines your holistic suitability for the coordinator role.

Offer to discuss how you align with the company’s objectives

Inviting further discussion about your fit for the role and the company’s goals demonstrates openness and a proactive attitude towards collaboration and contribution.

Show your clinical research interest and background

Pointing out your background in biomedical sciences and your experience in clinical research right away helps me see your fit for the role immediately.

Highlight interpersonal skills in clinical research

Telling about your ability to connect with patients and teams shows that you understand the importance of teamwork and empathy in clinical trials.

Connect with the company's mission

Expressing your interest in the company's global impact and technology use makes your application more personal and shows that you care about where you work.

Express gratitude and openness for further discussion

Thanking the hiring manager for reviewing your application and showing eagerness to discuss your alignment with the company's goals feels respectful and proactive.

Show enthusiasm for the clinical research coordinator role

When you express excitement about applying and link your background directly to the job, it shows you are not just looking for any job, but specifically this one. This makes a strong first impression.

Highlight specific achievements in clinical research

Talking about your success in managing a complex study with many participants proves you can handle responsibility and challenges. This kind of example gives me confidence in your abilities.

Illustrate leadership and innovation in clinical studies

Initiating a training program that leads to more efficient onboarding shows you're not just a participant but a proactive problem-solver. This demonstrates valuable leadership qualities.

Match your skills with the employer's mission

Connecting your desire to contribute to the specific goals of PRA Health Sciences makes your application more relevant. It shows you've done your homework and see yourself as part of their team, advancing crucial research.

End with a strong call to action

Inviting further discussion on how you can contribute demonstrates confidence and eagerness to engage. It's a polite yet assertive way to suggest the next step in the hiring process.

Clinical Trial Assistant Cover Letter Example

Align your goals with the company's mission.

When you show that your career goals match the company's purpose, it makes your application strong. This tells me you understand what we do and are likely to be passionate about working with us.

Show clinical trial assistant experience with details

Describing specific tasks you've handled, like managing trial master files, shows you have the experience we need. It also tells me you can manage important responsibilities that are critical to our success.

Express enthusiasm to join the team

Your excitement about working with us is important. It suggests you will be a motivated and positive addition to our team, eager to learn and grow in the clinical research field.

Appreciate the recruitment process

Thanking for the consideration of your application is polite. It wraps up your cover letter on a respectful note, showing you value the opportunity to apply.

Highlight your dedication to clinical research

Mentioning your dedication and attention to detail shows me you're serious about contributing to our work. This is exactly the kind of attitude that makes a difference in clinical research.

Connect your education to the job

Linking your degree and passion for medical research directly to the job at the outset helps make a clear case for why you’re a good fit, right from the start.

Detail hands-on clinical trial support experience

Describing your internship experiences, especially tasks directly related to the clinical trial assistant role, shows me you have a solid foundation and are ready to hit the ground running.

Highlight problem-solving abilities

Sharing a specific instance where you identified and solved a problem not only shows your attention to detail but also your proactive attitude and ability to prevent issues before they become bigger problems.

Emphasize the match with company goals

When you express admiration for the company’s work and your desire to contribute to its mission, it demonstrates that you have a deep interest in what they do and how they impact the field.

Convey enthusiasm for joining the team

Ending your letter on an eager and positive note about joining the company shows your enthusiasm and readiness to be part of their success story.

Entry-Level Clinical Research Associate Cover Letter Example

Express eagerness for the entry-level clinical research role.

Starting your cover letter by showing excitement and passion for clinical research helps me feel your genuine interest in the field and the position.

Demonstrate your research skills and attention to detail

Talking about your hands-on experience in research and your ability to communicate findings clearly shows that you have practical skills and can handle the detailed work required in clinical trials.

Value alignment with the company's diversity goals

Highlighting your appreciation for the company's commitment to diversity indicates that you share important values with the organization, making you a potentially great cultural fit.

Show gratitude and ambition in your career start

Thanking the hiring manager while stating your ambition to start your career with the company shows humility and drive, traits that are appealing in a candidate.

Alternative Introductions

If you're struggling to start your cover letter, here are 6 different variations that have worked for others, along with why they worked. Use them as inspiration for your introductory paragraph.

Cover Letters For Jobs Similar To Clinical Research Assistant Roles

• Clinical Research Assistant Cover Letter Guide
• Entry Level Research Assistant Cover Letter Guide
• Graduate Research Assistant Cover Letter Guide
• Psychology Research Assistant Cover Letter Guide
• Research Assistant Cover Letter Guide
• Undergraduate Research Assistant Cover Letter Guide

Other Administrative Cover Letters

• Administrative Assistant Cover Letter Guide
• Administrative Coordinator Cover Letter Guide
• Executive Assistant Cover Letter Guide
• Inventory Manager Cover Letter Guide
• Loan Processor Cover Letter Guide
• Office Manager Cover Letter Guide
• Project Administrator Cover Letter Guide
• Virtual Assistant Cover Letter Guide
• Warehouse Manager Cover Letter Guide

Thank you for the checklist! I realized I was making so many mistakes on my resume that I've now fixed. I'm much more confident in my resume now.

How to Write an Exceptional Research Scholarship Motivation Letter

Haven’t heard from the scholarship committee yet? Another email of rejection? Numerous drafts, constant search for an ideal template, and yet couldn’t receive the scholarship? What could be the reason? The time and effort you put in writing personal statement and creating a powerful academic CV may have gone to vain, if the scholarship review committee never even saw it. And what do you think must have kept them from doing so? Yes, it is the scholarship motivation letter that you either didn’t care to write or if you did, it wasn’t compelling enough.

In today’s age, lack of financial ability must not serve as a hindrance in attaining higher education. With rising competition, your key to winning that scholarship is by drafting an exceptional letter of motivation to make you stand out from other applicants.

Table of Contents

What is a Scholarship Motivation Letter?

A scholarship motivation letter is an opportunity to display your knowledge to the recruiter before you are called for an in-person interview. It speaks out some of the important aspects of your  research proposal  that connects it with your academic competence and personality. It is a crucial part that can make or break your application. Rather, it can be a deciding factor for the recruiters if you are eligible to be called for an interview.

A scholarship motivation letter  is similar to a cover letter; it is not needed for every application; however, critical if mentioned specifically. Moreover, motivation letters are used to narrow down review committee’s pool of applicants.

Your scholarship motivation letter must answer the following questions:

• Why are you the ideal fit for the scholarship?
• How do your skills and abilities contribute to the university or your research field?
• How you plan to execute your education?

General Guidelines to Follow While Writing a Scholarship Motivation Letter

Generally, the application does not specify how long your motivation letter should be. However, you must use your best judgment to write a concise yet impactful scholarship motivation letter.

• It should usually range from 500 to 1,000 words.
• Divide them into 3 paragraphs for easy comprehension and better readability. This eases the job of the review committee members.
• Ensure the font is universally used, such as Times New Roman, Calibri, or Arial in a font size not smaller than 12.

What Should a Scholarship Motivation Letter Include?

What is the Scholarship Motivation Letter Format?

Since there is no standard structure for writing a motivation letter for scholarship, it has been a challenge to structure a convincing one. While the motivation letters may vary by universities and scholarship awards, the 3 consistent elements are an introduction, three content paragraphs, and a conclusion.

1. Introduction

• The introduction of your scholarship motivation letter should include a brief introduction specifying the program you would like to apply for and the reason for choosing it.
• It must clearly state objective of your future projects and career.
• Most importantly, your introduction must include your name and highest educational qualification so far.

2. Three Content Paragraphs

• The first paragraph of the main body of the motivation letter should include information about your academic and professional experience. Your professional experience may not only include academic related work such as teaching and research experience, but also work outside academic sector such as volunteering that demonstrates relevant skills and knowledge. Furthermore, this paragraph must showcase your career growth in chronological order. Finally, mention your professional ambitions you plan to achieve with education from this program.
• The second paragraph should explain what you hope to gain from your education. Furthermore, how you plan to contribute to the society and the problems you aim to solve with the help of your education. Emphasize on your willingness to improve career prospects and aspiration to discover and learn new things.
• The third paragraph should demonstrate your plans for the future. This could include additional knowledge or corresponding course you plan to pursue. You need to clearly describe what motivates you and what you would like to achieve as a result of your studies. Additionally, it should provide facts of your published work. Finally, display your soft skills and explain how they could be considered beneficial for your research conduction and for your field of study in general.

3. Conclusion

• While concluding, mention the impact your study/studies may have in your life, research area, and society at large.
• Explain how the scientific community and university can benefit from selecting you as a candidate for the program.
• Furthermore, state that you are aware of the competitive nature of the program and how you will be an asset to it.
• More importantly, it must reinstate how you are an ideal candidate and why must the selection committee choose you over other applicants.

Common Mistakes to Avoid When Writing a Scholarship Motivation Letter

Your scholarship motivation letter will probably be the first thing you are judged by. Hence, you should be scrupulous while writing and eventually submitting it. Beware of the common mistakes to avoid in the letter:

• It should be well-written with no grammar or spelling errors .
• Use a professional tone throughout the letter.
• Avoid slangs, clichés, colloquialisms, or jargon.
• Use of vague generalizations should be avoided.
• Avoid irrelevant information.
• Do not include false achievements .
• Avoid praising the university too much.

Key Takeaways

Since a scholarship motivation letter is your way to get through the review committee and convince them how you are an ideal candidate for the position, it must be written with a plan. Allow at least three days to write the letter. Get it reviewed from your colleagues or professors. Be your critic and edit it attentively.

Now it’s your turn to draft an award winning scholarship motivation letter. Refer to the scholarship motivation letter sample below and write one yourself. Let us know how these tips helped you.

Scholarship Motivation Letter Sample

The Scholarship Committee Department of Biological Sciences Stanford University United States of America

To Whom It May Concern:

My name is Steve Boult and I am a third year student at Oklahoma State University. I am currently pursuing a four-year Bachelor of Engineering Degree, and I plan to follow up with a one-year master’s degree after I graduate.

While in high school, I interned with a reputable chemical plant in the Research and Development department. I learned about the construction process of refineries from the ground up, and I discovered the importance of its function. I worked closely to develop and optimize the machinery to increase the output at the plant. Additionally, I volunteered at an NGO to design and implement new technologies in the water supply mechanism of the town.

My education is largely focused on this mindset: function over form, stability over showmanship. I have enrolled in several classes that amalgamates Chemical Sciences with Engineering in order to have a comprehensive view of how design meets structure. I have worked on four extra-credit chemical plant and oil refinery design projects under the supervision of my professors (Dr. A and Dr. B) to accelerate my research and education.

I believe in avoiding accidents than fixing the loss it causes. Thus, as an engineer, I want to create accessible, cost-effective, productive, and durable AI-based operational systems that inform us about the potential malfunctions in advance. Coming from a mechanical background, I believe that there is a need for an operational system that is reliable.

I appreciate your consideration. With your assistance, I can continue my schooling in engineering and design to put an end to uncalled for accidents in plants and other industries.

Sincerely, Steve Boult

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Prevention at home in older persons with (pre-)frailty: analysis of participants’ recruitment and characteristics of the randomized controlled PromeTheus trial

• Original Article
• Open access
• Published: 23 May 2024
• Volume 36 , article number  120 , ( 2024 )

Cite this article

You have full access to this open access article

• Tim Fleiner 1 , 2   na1 ,
• Corinna Nerz 3   na1 ,
• Michael Denkinger 1 , 2 ,
• Jürgen M. Bauer 4 ,
• Christian Grüneberg 5 ,
• Judith Dams 6 ,
• Martina Schäufele 7 ,
• Gisela Büchele 8 &

PromeTheus Study Group

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The “PromeTheus” trial is evaluating a home-based, multifactorial, interdisciplinary prevention program for community-dwelling (pre-)frail older adults. These individuals often suffer from reduced participation, which can complicate the recruitment and enrollment in a clinical trial.

The aim of this study was to evaluate different recruitment strategies and differences in participant characteristics in relation to these strategies.

This cross-sectional study used baseline data from the randomized-controlled PromeTheus trial, in which community-dwelling (pre-)frail older persons (Clinical Frailty Scale [CFS] 4–6 pt., ≥ 70 years) were recruited via general practitioners (“GP recruitment”) or flyers, newspaper articles, and personalized letters (“direct recruitment”). Differences in the sociodemographic, clinical, physical, functional, mobility-related, psychological and social characteristics were analyzed in relation to the recruitment strategy.

A total of 385 participants (mean age = 81.2, SD 5.9 years; women: n  = 283, 73.5%) were enrolled, of which 60 (16%) were recruited by GPs and 325 (84%) through direct recruitment. Participants recruited via GPs had significantly higher subjective frailty levels (CFS), were more often physically frail (Fried Frailty Phenotype), and showed lower physical capacity (Short Physical Performance Battery), participation (disability component of the short version of the Late-Life Function and Disability Instrument), and life-space mobility (Life-Space Assessment) compared to those recruited via the direct approach ( p  = 0.002–0.026). Costs per randomized participant were 94€ for the GP recruitment strategy and €213 for the direct recruitment strategy.

Different strategies may be required to successfully recruit (pre-)frail home-living older adults into preventive programs. Direct recruitment strategies, in which potential participants are directly informed about the prevention program, seem to be more promising than GP recruitment but may result in enrolment of persons with less functional impairment and higher recruitment costs.

Trial registration

German Clinical Trials Register, DRKS00024638. Registered on March 11, 2021.

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Among community-dwelling adults aged 70 years and older, the prevalence of frailty is estimated to be 20–31% and pre-frailty about 50%, depending on the frailty instrument used (e.g., Fried Frailty Phenotype [FFP], Frailty Index) [ 1 ]. Frailty is characterized by a decline in physiological reserves and resistance to stressors leading to increased vulnerability to adverse health outcomes, a higher risk of decompensation for home care, and greater healthcare utilization and costs [ 2 , 3 ]. Implementing preventive measures for (pre-)frail older people is a key challenge for healthcare systems in aging societies, and effective strategies to prevent or reduce physical decline and frailty are deliberately needed to enable them to live socially integrated and independently at home for as long as possible [ 4 , 5 ].

Currently, outpatient physiotherapy or inpatient geriatric rehabilitation are the health services prescribed by general practitioners (GPs) in Germany to counteract the steady decline in physical capacity and daily functioning of community-dwelling (pre-)frail older people. However, common physiotherapy programs are usually only episodic, one-dimensional, not intensive, and not frequent enough and not sustainable. In addition, many older adults prefer to age in place, which is also more desirable from a health economic perspective, as it avoids the high costs for institutionalization [ 6 ]. However, other community-based alternatives to physiotherapy to prevent or reduce physical decline and frailty are not yet established. As part of the Australian Frailty Intervention Trial (FIT) project [ 7 ], a multifactorial, interdisciplinary intervention program was shown to be (cost-)effective in reducing frailty, mobility limitations, and the fall risk [ 8 , 9 , 10 ]. The main component of the FIT project is a home-based training program (WEBB = “Weight-bearing Exercise for Better Balance”) supervised by a physiotherapist, which can be complemented by optional counseling services [ 11 ]. The FIT intervention serves as a model for the PromeTheus project in Germany, which aims to establish a 12-month community-based prevention program for (pre-)frail older adults living at home [ 12 ].

Inclusion of (pre-)frail older people in clinical trials can be particularly challenging [ 13 ], and some researchers report of concerns about trial participation of this target group [ 14 , 15 , 16 , 17 ]. In contrast to this, older adults have been reported to be curious and interested in research that focuses on their needs and resources such as prevention, recognition, and management of frailty for research in later life [ 18 , 19 ]. Confirming this high interest in prevention trials, previous recruitment analyses have reported that frailty was not associated with higher or lower trial participation rates [ 20 ]. Current evidence on the recruitment of (pre-)frail older adults in clinical trials points to the following three key aspects: (a) continuous monitoring of the recruitment strategy to adapt methods and study procedures, (b) the involvement of GPs and healthcare providers who know the people and can encourage them to participate (“GP recruitment”) (c) the use of newspaper advertisements, direct mailings, and personalized letters to approach potential participants directly (“direct recruitment”) [ 18 , 21 ]. Effective recruitment of community-dwelling (pre-)frail older adults would also provide the basis for studying and establishing the FIT intervention as a preventive role model in German healthcare. However, there is a lack of knowledge about the effectiveness of different strategies to engage this population in preventive intervention programs.

Therefore, this analysis of the PromeTheus study aims to (a) evaluate the effectiveness of two different recruitment strategies (“GP recruitment” vs. “direct recruitment”) and (b) explore differences in participant characteristics in relation to the recruitment strategy.

Study design

This is a secondary analysis of baseline data of the PromeTheus study, a multicenter, assessor-blinded, randomized, controlled trial conducted in southern Germany with study sites in Stuttgart, Heidelberg, and Ulm. The PromeTheus study aims to analyze the effects of a 12-month multifactorial, interdisciplinary intervention on the prevention of functional and mobility decline in 400 community-dwelling (pre-)frail older adults. The detailed study protocol has been published elsewhere [ 12 ]. The PromeTheus study was approved by the local ethics committees at each study site (approval numbers: Stuttgart, #732/2020B01; Heidelberg, #S-072/2021; Ulm, #26/21) and the Ethics Committee of the State Medical Association of Baden-Wurttemberg (#B-F-2021-042). The PromeTheus was registered in the German Clinical Trials Register (DRKS00024638) on March 11, 2021.

Recruitment and eligibility criteria

Recruitment of participants started in May 2021, with the goal of being carried out over the following 12 months by GPs registered with the study, ending at the end of April 2022. This process, referred to as “GP recruitment”, involved GPs identifying and preliminarily screening patients who met the eligibility criteria during routine visits. Eligible patients were those aged 70 years or older, living independently or in assisted living facilities, capable of walking ≥ 10 m with or without the aid of a walking device, pre-frail (Clinical Frailty Scale [CFS] = 4 pt.) or mildly (CFS = 5 pt.) or moderately (CFS = 6 pt.) frail [ 22 , 23 , 24 ], no medical contraindications (heart failure [NYHA III-IV], stroke within the last 6 months, Morbus Parkinson (Hoehn & Yahr Stage ≥ 3), advanced cancer, severe lung disease, multiple sclerosis), and members of the Allgemeine Ortskrankenkasse (AOK). The AOK is one of the largest providers of statutory health insurance in Germany, with approximately 27 million insured persons and a market share of more than one-third (37%) of all statutory health insurance members [ 25 ]. If eligibility was confirmed by the GP, the potential participant was referred to the study center. For each referral of a potential participant, the study-registered GPs received financial compensation via a supplementary contract. The study center then confirmed further exclusion criteria by a telephone screening (walking ability > 800 m without walking aid or breaks, inadequate German language skills/ visual acuity) and by an initial home visit (cognitive impairment = Short Orientation-Memory-Concentration Test [SOMCT] score > 10 pt. [ 26 , 27 ]). If all eligibility criteria were met, the home visit was continued with the assessment measures.

During the COVID-19 pandemic German GPs were responsible for administering the COVID-19 vaccine in Germany [ 28 ] and had very limited capacity to screen or refer potential participants in 2021. Therefore, an alternative recruitment strategy focusing on direct communication (“direct recruitment”) was implemented and the recruitment period was extended to October 2022. Potential participants were informed in February 2021 and 2022 via flyers ( n  = 32,500 each) inserted in the local health magazines of the AOK health insurance company and via articles in local magazines and newspapers. In addition, personalized letters with study information and an eligibility assessment template for GPs were mailed to AOK members aged ≥ 70 years living at home or in assisted living facilities in the three study regions. A total of 33,796 letters were mailed to potential participants. Interested individuals contacted the local study center, were informed about the study, and were referred to a GP for eligibility assessment. The subsequent steps in the recruitment (telephone screening, initial home visit) were the same as for the GP recruitment strategy. The same inclusion and exclusion criteria were used for the GP recruitment strategy as well as for the direct recruitment strategy.

Measurements

All data were collected in-person at participants’ homes, with the exception of sociodemographics collected during telephone screening. All interviews and test procedures were consistently administered by research staff who had received extensive training in all aspects of assessment. Sociodemographic characteristics included age, gender, martial status, living arrangements, and years of education. Clinical information included number of medications, body mass index (BMI), and nutritional status as assessed by Mini Nutritional Assessment-Short Form [ 29 ]. The CFS [ 22 ] was used to assess subjective frailty, and the FFP [ 30 ] to assess objective frailty based on the five Fried frailty criteria: (1) self-reported unintentional weight loss (> 4.5 kg in the past year); (2) exhaustion (two items from the Center for Epidemiological Studies Depression Scale [ 31 ]); (3) low physical activity (< 150 min of moderate-to-vigorous physical activity per week in accordance with the WHO physical activity guidelines [ 32 ], measured with the German Physical Activity Questionnaire 50 + [ 33 ]); (4) slowness (gender- and height-adjusted slow gait speed), and (5) weakness (gender- and BMI-adjusted low handgrip strength). The number of falls in the last 6 months was recorded, and fear of falling was assessed using the Short Falls Efficacy Scale-International (Short FES-I) [ 34 ]. Physical capacity was measured using the Short Physical Performance Battery (SPPB) [ 35 ], gait speed and 5-chair stand test (as part of the SPPB), and handgrip strength. Self-reported physical activity was assessed with the German Physical Activity Questionnaire 50+ [ 33 ]. The use of an assistive mobility device was recorded. Functioning in activities of daily living (ADL) was measured with the function component (FC) of the Late-Life Function and Disability Instrument (LLFDI), and disability and participation with the disability component (DC) of the short version of the LLFDI [ 36 ]. The University of Alabama at Birmingham Life‐Space Assessment (LSA) [ 37 ] was used to assess life-space mobility. Cognitive status was assessed using the Short Orientation‐Memory‐Concentration Test [ 26 ]. Psychosocial characteristics were assessed for global affect (visual analogue scale) [ 38 ], loneliness (UCLA 3‐item loneliness scale [ 39 ]), and health-related quality of life (EuroQol‐5‐Dimension 5‐Level, EuroQol visual analogue scale) [ 40 ]. Social status was assessed using the 6-item Lubben Social Network Scale (LSNS-6) [ 41 ]. Costs for the implementation the GP recruitment strategy (informative letter for study registration by GPs, documents for recruitment and eligibility assessment by study-registered GPs, financial compensation to GPs for referring potential participants) and the direct recruitment strategy (flyers in AOK health magazines, articles in local magazines and newspapers, personalized letters to potentially eligible AOK members) were recorded to determine the cost per participant (= total costs per recruitment strategy divided by the number of participants enrolled by that strategy).

Statistical analyses

Descriptive data are presented as means and standard deviations, medians and interquartile ranges (IQR), or frequency and percentage. Unpaired t tests, Mann–Whitney U Test, or Chi-Square tests (with Bonferroni adjusted post-hoc tests) were performed to analyze between-group differences in the participant characteristics according to the recruitment strategy (GP recruitment vs. direct recruitment). Statistical analyses were performed using IBM SPSS Statistics for Windows, version 29.0 (IBM Corp., Armonk, NY, USA).

Due to the COVID-19 pandemic, the recruitment process was very challenging and only 385 (96.3%) of the initial target of 400 participants could be recruited into the study, despite the implementation of the secondary direct recruitment strategy and the extension of the recruitment period from 12 to 18 months. For the GP recruitment strategy, 87 (14.3%) of the 609 potential GPs at the different study sites signed the supplemental contract and participated in the study. Approximately half of these ( n  = 47, 54.0%) and an additional 3 non-registered GPs referred 95 potential participants to the study after a positive eligibility assessment (Fig.  1 ).

Flowchart of the GP recruitment strategy

The direct recruitment strategy yielded 406 potential participants after eligibility assessment by their GPs (Fig.  2 ). Of the total 501 eligible individuals, 105 (21.0%) were excluded after the telephone screening. The most common reason for exclusion in the direct recruitment was the ability to walk ≥ 800m (59.7%), while participants referred by GPs could mostly not be included due to a lack of motivation to participate after detailed study information was provided (34.7%). At the final cognitive screening at the person’s home, 11 (2.8%) out of the 396 individuals were excluded due to relevant cognitive impairment (SOMCT > 10 pt.), resulting in a final sample size of 385 participants who met all inclusion criteria. A total of 60 (15.6%) participants were enrolled by the GP recruitment strategy and 325 (84.4%) participants were enrolled using direct recruitment strategy.

Results of the recruitment strategy illustrated as flow-chart

Table 1 presents the participant characteristics of the total sample and the two subgroups according to GP recruitment and direct recruitment. The mean age of the total sample was 81.2 (SD 5.9) years. Most participants were female ( n  = 283, 73.5%) and lived alone ( n  = 261, 67.8%). The median CFS score was 4 [IQR 4–5] points, indicating pre-frailty based on subjective assessment. More than 85% were classified as pre-frail ( n  = 195, 50.6%) or frail ( n  = 134, 34.8%) according to the FFP. Physical capacity was limited, with a mean SPPB score of 6.5 ± 2.6 points, a mean gait speed of 0.68 ± 0.24 m/s, and a median 5CST duration of 17.7 [IQR 13.1–24.3] s. The mean LLFDI-FC score of 47.6 ± 7.7 points indicated limitations in ADL functioning. Restricted life-space mobility (LSA < 60 pt.) was observed in 72.2% ( n  = 272), more than one-third ( n  = 142, 36.9%) reported a fall history within the last 6 months, and about three-quarters had a moderate (Short FES-I = 7–9 pt.: n  = 187, 48.6%) or high (Short FES-I ≥ 14 pt.: n  = 135, 35.1%) fear of falling. Approximately one-sixth were classified as being lonely (UCLA ≥ 6 pt.: n  = 65, 16.9%), and one-third as being socially isolated (LSNS-6 < 12 pt.: n  = 128, 33.2%).

Significant differences in participant characteristics were observed according to recruitment strategy (Table  1 ). Participants recruited by GPs had significantly higher levels of subjective frailty (median CFS: 5 [IQR 4–5] pt. vs. 4 [IQR 4–5] pt., p  = 0.012), were more often frail according to the objective FFP (50% vs. 32%, Bonferroni adjusted p  = 0.043), showed lower physical capacity (mean SPPB: 5.8 ± 2.9 pt. vs. 6.7 ± 2.6 pt., p  = 0.021), and less frequent participation (mean LLDFI-DC, frequency: 23.6 ± 5.1 pt. vs. 25.5 ± 4.2 pt., p  = 0.002), and lower life-space mobility (mean LSA: 43.2 ± 21.6 pt. vs. 50.1 ± 18.0 pt., p  = 0.023) as compared to those enrolled via the direct recruitment strategy. Post-hoc power analysis revealed that these significant differences ( p  < 0.05) were detected with a statistical power of 64% for the SPPB, 68% for the FFP, 75% for the LSA, 80% for the CFS, and 87% for the LLDFI-DC.

The total costs for the GP recruitment strategy were €5659 (financial compensation for referrals = €3780; informative letters = €1309, documents for study-registered GPs = €570), while those for the direct recruitment strategy were €69,280 (personalized letters = €53,678, advertising articles = €10,576, flyer in AOK health magazines = €5026). Consequently, costs per randomized participants were €94 for the GP recruitment strategy and €213 for the direct recruitment strategy.

The results of this analysis showed that the different recruitment strategies had an impact on the characteristics of the participants. Participants enrolled through GP recruitment were more frail and showed lower physical capacity, participation, and life-space mobility as compared to those enrolled through direct recruitment (flyers, newspaper articles, personalized letters).

Despite taking into account key aspects for successful recruitment and enrollment of (pre-)frail older adults in clinical trials (i.e. continuous monitoring/adaption of the recruitment strategy, GP involvement, direct communication) [ 18 , 21 ] and extending the recruitment period from the initial 12 months to 18 months, the targeted sample size of the PromeTheus study could not be achieved. On the GP recruitment side, this is probably mainly due to the COVID-19 pandemic and the limited capacity of the GPs during this period. Despite the financial incentive for GPs, only 8% (50 out of 609) of GPs in the study regions referred potential participants. The low recruitment capacity of GPs may be reflected in the fact that only about half (54%) of the GPs registered to participate in the study participation referred potential participants.

The direct recruitment strategy was much more successful, as documented by the more than fivefold higher enrollment rate achieved with this strategy compared to the GP recruitment (84.4% vs. 16.6%). The direct recruitment strategy involved mailing 33,799 personalized letters to AOK member potentially eligible for participation and distributing 65,000 flyers in the AOK health magazines, which may have resulted in some potential participants being contacted twice. The resulting recruitment rate from these efforts can be estimated to be less than 1% (direct mailings: 325 /33,799 = 0.96%, mailings & flyers: 325/98,799 = 0.33%). The recruitment rates observed here are consistent with those seen in other preventive lifestyle interventions targeting older adults. For instance, the SHAPE project utilized direct mailing of brochures and cover letters to 1477 households to recruit inactive older adults for a neighborhood walking trial, achieving a recruitment rate under 1% with 39 participants enrolled [ 42 ]. A potential more effective approach regarding the direct mailings was used in the “Lifestyle Matters RCT” and the “Putting Life in Years RCT” having GPs send personalized invitation letters, study leaflets, and pre-paid response cards to potential participants. These trials including the GPs in the mailings have achieved a 2.3% recruitment rate [ 43 ]. The cost of recruiting and enrolling a participant in the PromeTheus study was about half as expensive via the GP recruitment (€94) as via the direct recruitment strategy (€213). These results align with findings from the “Community Aging in Place, Advancing Better Living for Elders-trial”, which identified direct mailing as the most effective yet most expensive recruitment method per participant [ 44 ]. To accurately assess the cost-effectiveness of recruitment strategies, whether they involve medical referrals or direct mailings, it is essential to standardize the analysis and reporting methods [ 45 ].

The overall participant characteristics of the study sample are comparable to the recent prevention trials in community-dwelling (pre-)frail older people, such as the Australian FIT trial [ 7 ] or the Finnish HIPFRA (Home physiotherapy for HIP fracture and FRAilty) trial [ 46 ]. The differences in participant characteristics with respect to the recruitment strategy, showing that participants recruited through GPs were more frail and less physically fit, participative, and mobile in their life space, may be due to an effect of extrinsic and intrinsic motivation. The most common reason for an exclusion after GP recruitment was “lack of motivation” ( n  = 16, 34.7%). This could be explained by a primary extrinsic motivation following the recommendation of the GP in his role as a confidant. After the GP referral, these individuals decided not to participate after receiving and discussing detailed information about the study procedure with the study staff. On the other hand, the main reason for exclusion after the direct recruitment strategy was the ability to walk ≥ 800m ( n  = 43, 59.7%). This suggests a higher intrinsic motivation of physically more fit individuals to participate in programs with physical exercise as a main component, also reported as the “healthy volunteer” effect [ 47 ]. This aspect may also explain the differences in the lower levels of frailty and higher physical capacity, participation, and life-space mobility in participants recruited directly.

However, the finding of higher limitations among participants recruited through the GP, also illustrates that those with a higher need for support and prevention measures are likely to be better reached through via a recruitment strategy involving health professionals such as GPs. Sufficient recruitment capacity of GPs seems to be crucial in this context. Following the multidisciplinary geriatric perspective, other health professionals such as physiotherapists, occupational therapists, speech therapists, or nurses who recognize the need for support and preventive measures could be empowered in the future to support the recruitment of community-dwelling (pre-)frail older people into preventive programs.

This study has some limitations. First, this is a secondary analysis of the PromeTheus study, thus the sample size was not specifically tailored to the research question in this study and there was a risk of the analyses being underpowered. Second, the study was conducted during the COVID-19 pandemic, which may have had a major impact not only on the recruitment and referral of potential participants by the GPs, but also the recruitment rates of vulnerable, (pre-)frail older adults into research studies in general during this period. Finally, the calculated costs for the recruitment strategies only referred to recruitment and enrollment-related materials (e.g., flyers, newspaper articles, personalized letters, advertising articles, GP documents) and the GP compensation. Staff salary and time were not included, so the recruitment costs were not comprehensive.

Different recruitment strategies may be required to successfully enroll (pre-)frail home-living older persons in prevention programs. Direct recruitment strategies, in which potential participants are informed directly about the prevention program, appear to be more promising than GP recruitment but may result in enrolment of persons with less functional impairment and higher costs.

Availability of data and materials

The data sets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank the AOK Baden-Wurttemberg and the Kassenärztliche Vereinigung Baden-Wurttemberg for supporting the project. We also thank Catherine Sherrington, Nicola Fairhall, and Catherine Kirkham for their support in the design of the intervention program and the translation as well as adaption of the WEBB program. Members of the PromeTheus study group.

Open Access funding enabled and organized by Projekt DEAL. The PromeTheus project is funded by the German Innovation Fund (‘New Forms of Care’) coordinated by the Innovation Committee of the Federal Joint Committee (in German: “Innovationsausschuss beim Gemeinsamen Bundesausschuss”, G-BA) under the number 01NVF19020. The funders had no role in the study concept and design, data collection, analysis and interpretation, or the preparation and the decision to submit this manuscript for publication.

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Tim Fleiner and Corinna Nerz have shared first authorship.

Authors and Affiliations

Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany

Tim Fleiner & Michael Denkinger

Geriatric Center, Agaplesion Bethesda Clinic, Ulm, Germany

Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany

Corinna Nerz

Geriatric Center, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany

Jürgen M. Bauer

Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany

Christian Grüneberg

Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

Judith Dams

Department of Social Work, University of Applied Sciences, Mannheim, Germany

Martina Schäufele

Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany

Gisela Büchele

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Contributions

KR (principal investigator), JMB, MD: study concept and design. TF, CN, CW: study organization and coordination. KR, MD, JB, CN, CW: selection of outcome parameters and assessments. CN, TF, CW: statistical analysis. TF, CN, CW: draft of manuscript. TF, CN, CW, JMB, MD, KR, GB, CG, MS, JD: critical revision of manuscript for important intellectual content. All authors read, revised, and approved the final version of the manuscript.

Corresponding author

Correspondence to Tim Fleiner .

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Conflict of interest.

The authors declare that they have no competing interests.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All participants provided informed consent prior to their participation.

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Members of the PromeTheus study group are listed in the Acknowledgements.

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Fleiner, T., Nerz, C., Denkinger, M. et al. Prevention at home in older persons with (pre-)frailty: analysis of participants’ recruitment and characteristics of the randomized controlled PromeTheus trial. Aging Clin Exp Res 36 , 120 (2024). https://doi.org/10.1007/s40520-024-02775-x

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Letter from the ceo.

Since our launch in 2016, CRIO  has achieved our mission of becoming the leading site-centric eSource and CTMS technology, now reaching 2,000+ sites in 25+ countries.

To prepare for CRIO’s upcoming growth phase, we conducted a meticulous fundraising process led by a healthcare specialized investment bank. Following extensive engagement with potential investors, we are thrilled to announce our partnership with The Riverside Group, a distinguished growth equity firm renowned for its expertise in software, healthcare, and, notably, the eClinical sector, as evidenced by their prior investment in Greenphire.

Riverside has acquired a controlling stake in CRIO and has further bolstered our growth trajectory with an additional capital injection. Our existing management team will continue at the helm, supplemented by the strategic addition of senior leadership, including a new CFO slated to join next month. Riverside brings more than just financial backing; they will offer invaluable operational guidance and consulting, drawing from their extensive track record of fostering success in the mid-market segment, particularly within rapidly expanding technology firms such as CRIO.

Jonathan Andrus and I have assumed the shared role of Co-CEO. Jonathan, who joined us as President and Chief Operating Officer two years ago, has played a pivotal role in propelling our organization’s growth and spearheading our expansion into new markets. Our collaborative approach to leadership has long been established, and by formalizing our positions as Co-CEOs, we can now strategically divide our focus within the company. Jonathan will take the lead on sales, marketing, and customer experience, while I will concentrate on product development, engineering, and M&A activities.

In the coming years, expect to see substantial improvements to our software platform. Near-term, we will be launching several major modules. These include:

• Our new, revised eSource data collection module
• Revised GAAP-oriented finance database that tracks changes at the transaction level
• A Partners Program that includes a network of pre-integrated recruiting vendors
• Central Lab integration and digital workflow for investigator review of lab values
• Launch of CRIO Connect to promote the use of CRIO sites by sponsors and CROs
• AI chatbot for enhanced customer support and improved training searches

Longer-term, we will achieve our vision of becoming a site-centric end-to-end platform for clinical research, whether through organic development, acquisition or partnership. Prioritized target areas are:

• Enhanced eSource functionality, including cross-form logic, timed alerts, repeatable visits, procedure-specific file uploads, and corresponding review capabilities in Reviewer.
• eSource-EHR interoperability, including the ability to enable two way communication with sites’ local EHR systems.
• APIs to seamlessly integrate IWRS, ePRO, device and other vendors into the site workflow, enabling sites to send and receive data to and from CRIO.
• Enterprise-grade eRegulatory system for multi-site document management, and centralized startup management.
• Continued improvements in Finance and other CTMS capabilities, such as cross-site invoicing and payments, more powerful user management, and more.

Thank you to all of our employees, clients, and partners who have helped bring us to this milestone. Together, we’re poised to propel clinical research into the future!

CRIO Poised for Continued Expansion Following Significant Investment by The Riverside Company

Industry leading eSource provider plans accelerated expansion of its product roadmap to further enhance its value proposition to clinical research sites, biopharmaceutical companies and CROs. Boston, MA, May 21, 2024 – CRIO, Inc., a leading provider of eSource and other eClinical technologies, announced that it has received a significant investment from The Riverside Company, a...

JSCDM: Comparison of electronic health records and electronic source data in clinical research trials

The Journal of the Society for Clinical Data Management (JSCDM) recently published the original research article “Comparison of electronic health records and electronic source data in clinical research trials: a retrospective review” which was co-authored by Amelia Tian, CRIO Solutions Consultant, and Olivia Dennis, CRIO Analytics and Data Migration Manager, alongside Dr. Elena Christofides (Endocrinology...

CRIO Announces Partnership with Algorics

CRIO is thrilled to announce an exciting partnership with Algorics! This partnership represents our continued efforts in revolutionizing the landscape of clinical trials technology. At CRIO, our commitment has always been to provide innovative solutions that drive data quality and enhance patient safety, while saving CRIO sites and sponsors both time and money. “CRIO is...

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Efficacy of interventions and techniques on adherence to physiotherapy in adults: an overview of systematic reviews and panoramic meta-analysis

• Clemens Ley   ORCID: orcid.org/0000-0003-1700-3905 1 &
• Peter Putz   ORCID: orcid.org/0000-0003-2314-3293 2  

Systematic Reviews volume  13 , Article number:  137 ( 2024 ) Cite this article

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Adherence to physiotherapeutic treatment and recommendations is crucial to achieving planned goals and desired health outcomes. This overview of systematic reviews synthesises the wide range of additional interventions and behaviour change techniques used in physiotherapy, exercise therapy and physical therapy to promote adherence and summarises the evidence of their efficacy.

Seven databases (PEDro, PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO and CINAHL) were systematically searched with terms related to physiotherapy, motivation, behaviour change, adherence and efficacy (last searched on January 31, 2023). Only systematic reviews of randomised control trials with adults were included. The screening process and quality assessment with AMSTAR-2 were conducted independently by the two authors. The extracted data was synthesised narratively. In addition, four meta-analyses were pooled in a panoramic meta-analysis.

Of 187 reviews identified in the search, 19 were included, comprising 205 unique trials. Four meta-analyses on the effects of booster sessions, behaviour change techniques, goal setting and motivational interventions showed a significantly small overall effect (SMD 0.24, 95% CI 0.13, 0.34) and no statistical heterogeneity ( I 2  = 0%) in the panoramic meta-analysis. Narrative synthesis revealed substantial clinical and methodological diversity. In total, the certainty of evidence is low regarding the efficacy of the investigated interventions and techniques on adherence, due to various methodological flaws. Most of the RCTs that were included in the reviews analysed cognitive and behavioural interventions in patients with musculoskeletal diseases, indicating moderate evidence for the efficacy of some techniques, particularly, booster sessions, supervision and graded exercise. The reviews provided less evidence for the efficacy of educational and psychosocial interventions and partly inconsistent findings. Most of the available evidence refers to short to medium-term efficacy. The combination of a higher number of behaviour change techniques was more efficacious.

Conclusions

The overview of reviews synthesised various potentially efficacious techniques that may be combined for a holistic and patient-centred approach and may support tailoring complex interventions to the patient’s needs and dispositions. It also identifies various research gaps and calls for a more holistic approach to define and measure adherence in physiotherapy.

Systematic review registration

PROSPERO CRD42021267355.

Peer Review reports

Adherence to physiotherapeutic1 treatment and recommendations is crucial to achieving the planned goals and desired effects [ 1 , 2 ]. This is because the desired effects are usually only achieved in the long term if the recommended treatment and home-based exercises are carried out regularly. However, non-adherence in physiotherapy can be as high as 70%, particularly in unsupervised home exercise programmes [ 1 , 3 ] and may differ among medical conditions [ 4 ]. The World Health Organization defines adherence to therapy as ‘the extent to which a person’s behaviour—taking medication, following a diet and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider’ [ 5 ]. Long-term adherence often requires lifestyle changes, which can be supported by behaviour change techniques (BCTs). BCTs are considered the ‘active, replicable and measurable component of any intervention designed to modify behaviour’ ([ 6 ],cf. [ 7 ]). BCTs are defined and operationalised in the behaviour change taxonomy [ 8 ], based on theoretical underpinnings and a Delphi study. Theoretical models to explain (non-)adherence and (a) motivation as well as techniques to promote behaviour change have been extensively studied in health and exercise psychology [ 9 , 10 , 11 ]. Rhodes and Fiala [ 12 ] argue that despite several strong psychological theories that have been developed to explain behaviour, few provide guidance for the design and development of interventions. Furthermore, theories may not be equally applicable to all behavioural domains, therapeutic regimes and settings. For example, the factors determining adherence to (passive) medication use differ from those influencing adherence to (active) physical therapies and exercise behaviour (cf. [ 5 ]). This review specifically addresses the domain of physiotherapy and therapeutic exercise.

Existing reviews of predictive studies identified factors influencing adherence positively or negatively, showing the predominately conflicting and low evidence of a wide range of predictive factors for adherence [ 1 , 2 , 13 ]. Moderate to strong evidence was shown for some factors, referring to previous (adherence) behaviour and treatment experiences, physical activity level, social support and psychosocial conditions, number of exercises and motivational dispositions. Such predictive studies have identified the possible targets for intervention but do not provide evidence on the efficacy of interventions. In contrast, randomised control trials (RCTs) are recognized as the preferred study design for investigating the efficacy of interventions. Thus, this overview of reviews Footnote 1 aimed at providing a synthesis of reviews that examined RCTs, allowing for the discussion of the efficacy of different interventions and BCTs on adherence-related outcomes.

There are numerous reviews on adherence to physiotherapy and (home-based) exercise, and on BCTs to increase physical activity levels, therapeutic exercise or self-organised exercise [ 1 , 2 , 3 , 14 , 15 , 16 , 17 , 18 ]. Yet, no systematic overview of reviews has been identified that specifically synthesised the efficacy of interventions and techniques to enhance adherence to physiotherapy.

Objectives and research questions

Therefore, the aim of this overview of reviews was to synthesise the evidence on the efficacy of interventions and techniques on adherence in physiotherapy, to explore heterogeneity regarding the theoretical underpinnings, types of interventions used, and the adherence-related measures and outcomes reported, and finally to identify research gaps. Thus, the primary research question is the following: How efficacious are interventions and techniques in increasing adherence to physiotherapy? Secondary research questions are as follows: What types of intervention and behaviour change techniques were investigated? Which theoretical underpinning was reported? How was adherence defined and related outcomes measured?

This overview of reviews is guided by the research questions and aligns with the common purposes of overviews [ 19 , 20 ] and the three functions for overviews proposed by Ballard and Montgomery [ 21 ], i.e. to explore heterogeneity, to summarize the evidence and to identify gaps. This overview approach is appropriate for addressing the research questions specified above by exploring different types of interventions and behaviour change techniques and by synthesising the evidence from systematic reviews of RCTs on their efficacy. The review protocol was registered ahead of the screening process in PROSPERO (reg.nr. CRD42021267355). The only deviations from the registration were that we excluded reviews of only cohort studies, due to the already broad heterogeneity of intervention and outcome measures, and that we additionally performed a panoramic meta-analysis.

Information sources, search strategy and eligibility criteria

The search in seven databases, PEDro, PubMed, Cochrane Library, Web of Science, Scopus, PsycInfo and CINAHL (Cumulative Index to Nursing and Allied Health Literature), was last updated on January 31, 2023. The search strategy was structured according to the PICOS (Population, Intervention, Comparison, Outcome and Study Type) scheme. The search terms related to physiotherapy and motivation or behaviour change and adherence and effectiveness/efficacy (details on the searches are listed in Additional file 1 ). A filter was applied limiting the search to (systematic) reviews. No publication date restrictions were applied.

Table 1 outlines the study inclusion and exclusion criteria. Only studies published in peer-reviewed journals were included. The review addressed adult patients, with any illness, disease or injury, and thus excluded studies on healthy populations. Reviews in the field of physiotherapy, physical therapy or the therapeutic use of exercise or physical activity were included if they investigated adherence as a primary outcome. Studies measuring adherence as a secondary outcome were excluded as they do analyse interventions that were not primarily designed to promote adherence and thus are outside the scope of this overview. Reviews that analysed only studies on digital apps or tools (e.g. virtual reality, gamification, exergames or tele-rehabilitation) were excluded from this overview, as they were outside of the scope of this overview. Only systematic reviews that appraised RCTs were included. Reviews appraising RCTs and other study designs were included if RCT results could be extracted separately. Systematic reviews are in our understanding literature reviews of primary studies with a comprehensive description of objectives, materials and methods; considering the risk of bias and confidence in the findings; and reporting according to the PRISMA statement [ 22 , 23 , 24 ]. Adherence is defined as the extent to which a person’s behaviour corresponds with treatment goals, plans or recommendations [ 5 ]. Related terms used in the literature are compliance, maintenance, attendance, participation and behaviour change or lifestyle modification and were thus included in the search strategy.

Screening and selection process

Author CL conducted the search in the seven different databases and removed duplicates, using the Zotero bibliography management tool. Following this, authors CL and PP both independently screened the titles and abstracts of the resulting sources (see Fig.  1 Flow diagram). After removing the excluded studies, PP and CL independently screened the remaining full texts in an unblinded standardised manner. Reasons for exclusion were noted in a screening spreadsheet. Any discrepancy was discussed, verified and resolved by consensus.

Data collection process and data items

Data extraction was done by CL after agreeing with PP on the criteria. A spreadsheet was created with the following data extraction components: (i) objectives and main topic of the review; (ii) study design(s) and number of studies included and excluded; (iii) search strategies (incl. PICO); (iv) population including diagnosis, sample sizes and age; (v) intervention and comparison, theoretical foundations and models used for designing the intervention; (vi) time frames, including follow-up; (vii) adherence-related outcome and outcome measures; (viii) key findings; (ix) analysis of primary studies (meta-analytical, other statistical or narrative analysis); and (x) tools used for the quality assessment, risk of bias and evidence grading. Primary outcomes on adherence included, adherence rates or categories, engagement, attendance and participation, and accomplished physical activity levels. PP verified the data extraction results. The data was extracted as reported in the systematic reviews, then reformatted and displayed in the tables and used for the narrative synthesis.

Assessment of risk of bias across reviews

Systematic reviews of RCTs are ranked highest in the evidence level [ 25 ], but are subjected to risk of bias (RoB). In an overview of reviews of systematic reviews, there are further risks of bias, in addition to those deriving from the primary studies and those deriving from the review of those studies. Particularly, the overlap of reviews regarding the included individual studies may bias the findings. According to the purpose of this overview, i.e. to synthesise the wide range of interventions and behaviour change techniques used to promote adherence and to summarise the evidence of their efficacy, the overlap of reviews regarding intervention or population was not an exclusion criterion. For considering the overlap of primary studies among the reviews, CL extracted the primary RCTs from the included reviews, identified the unique trials and compared the frequency of their use across the reviews (see results overlap of review and Additional file 2 ). Furthermore, where two or more reviews provided findings on the same technique (e.g. on the efficacy of behavioural graded activities), the overlap of primary studies was assessed specifically for that finding. If the evidence came from the same study, this was taken into account and marked accordingly in Table  5 to avoid double counting and overestimation of evidence.

Assessment of risk of bias within the reviews

CL and PP independently assessed the quality and risk of bias of the systematic reviews included, using the AMSTAR-2 tool [ 26 ]. Any discrepancy was discussed and resolved by consensus. AMSTAR (A MeaSurement Tool to Assess systematic Reviews) was developed to evaluate systematic reviews of randomised trials. The AMSTAR-2 revision enables a more detailed assessment of systematic reviews which may also include non-randomised studies of healthcare interventions. The applied AMSTAR-2 checklist consists of 16 items, whereof seven are classified as critical, and the appraisal results in an overall confidence rating distinguishing between critically low, low, moderate or high [ 26 ]. In addition, the overall confidence in the review was stipulated by the number of positive assessments in relation to the applicable domains (depending if meta-analysis was performed or not) and considering whether an item represents a critical domain or not [ 26 ].

Synthesis methods

Panoramic meta-analysis.

Among the included reviews, there were four meta-analyses [ 7 , 16 , 27 , 28 ], which were pooled as a panoramic meta-analysis based on the reported effect sizes and standard errors using IBM SPSS Version 29 (IBM Corp., Armonk, NY, USA). All four meta-analyses used the standardized mean difference as effect size. Standard errors were calculated from the reported 95% CI as \(\frac{\mathrm{upper bound }-\mathrm{ lower bound}}{3.92}\) . Inverse variance was used to weight the meta-analyses, statistical heterogeneity was assessed by I -squared and a fixed-effects model was selected based on the absence of statistical heterogeneity of true effects. Eisele et al. [ 7 ] included 15 primary trials that examined the effect of BCTs on physical activity adherence. They pooled results for medium-term (3–6 months) and long-term (7–12 months) interventions, from which we selected the medium-term model that best matched the eligibility criteria of the other included meta-analyses. Levack et al. [ 27 ] included nine primary trials that examined the effect of goal-setting strategies on engagement in rehabilitation. Among models with other outcomes, we selected this model because it best matched the aim of this overview, and it was most consistent with the outcomes of the other included meta-analyses. McGrane et al. [ 28 ] included six primary trials, representing 378 subjects that examined the effects of motivational interventions on physiotherapy session attendance. They reported another model with perceived self-efficacy as an outcome, but we selected the attendance model because it best matched the aim of this overview, and it was most consistent with the outcomes of the other included meta-analyses. Nicolson et al. [ 16 ] included two primary trials that examined the effect of booster sessions on self-rated adherence. Results were summarized by a forest plot and publication bias was assessed graphically by a funnel plot, although the small number of individual meta-analyses included limits its interpretability. Alpha was set at 0.05.

Narrative synthesis

The narrative synthesis was performed by CL in constant dialogue with and verification of PP. Guided by the research questions, the narrative synthesis of the extracted data was manifold. First, we explored the heterogeneity of interventions, measures and adherence-related outcomes across and within the reviews using the data extraction table. Definitions and measures of adherence were compared among the reviews and discussed. Second, analysis of the descriptions of the interventions and their respective components/techniques, their theoretical underpinning and their objectives was used to classify the interventions according to different types of intervention, namely the informational/educational, the cognitive/behavioural/motivational and the relational/psychosocial intervention. Consequently, for each type of intervention, the results on the efficacy were narratively synthesised. In addition, reported differences in efficacy among medical conditions, theoretical underpinnings and physiotherapeutic settings were summarised based on the data extraction table. Third, the results on the efficacy of the interventions and BCTs were further summarised in a table and then restructured according to the evidence level as reported in the systematic reviews and the confidence in the reviews as analysed by the AMSTAR-2. Therefore, the levels of evidence were extracted as reported in the reviews, which are based on different evidence appraisal schemes: GRADE (high, moderate, low, very low certainty of evidence), Cochrane Collaboration Back Review Group Evidence Levels (strong, moderate, conflicting, limited, no evidence) and self-developed tools. Afterwards, they were compared for the respective intervention/technique across the relevant reviews, considering the confidence in the review and the comprehensiveness of the review as well. The levels of evidence are presented in the table with the categories high, moderate, low and very low. The efficacy supported by the evidence is also based on the results reported in the reviews. In case of overlapping reviews or discrepancies between the reviews, the primary studies were consulted. The category yes refers to results of merely positive effects, and inconsistent refers to findings of positive and no effects of the intervention (techniques) analysed. The category no indicates that the intervention was not efficacious. No negative effects (i.e. favouring the control condition) were reported for the intervention (techniques) shown.

The reporting of findings followed the PRIOR reporting guideline for overviews of reviews of healthcare interventions [ 29 ].

Study selection results

Of the 187 records screened, 19 were included (see Fig.  1 ). Main reasons for exclusion were not a systematic review of RCTs ( n  = 79), adherence not the primary outcome ( n  = 60), and lack of physiotherapy relevance ( n  = 39) (see Fig.  1 ).

Flow diagram, based on PRISMA [ 24 ] and PRIOR [ 29 ] guidelines. Legend: *Multiple reasons for exclusion were possible

Characteristics and diversity of included reviews

The selection strategy resulted in a broad heterogeneity of included reviews. The 19 included reviews differed in their eligibility criteria of the primary studies as well, resulting in substantial clinical diversity, i.e. the inclusion of heterogenous conditions, intervention types and settings (see Table  2 ) and methodological diversity, i.e. the variability in study design, outcome measurements and risk of bias (see Tables 3 , 4 and 5 ). Musculoskeletal diseases [ 6 , 7 , 17 , 30 , 31 , 32 ] and pain [ 13 , 16 , 33 , 34 , 35 ] were the most investigated medical conditions. Those reviews that did not limit their search to a specific disease [ 12 , 27 , 28 , 36 , 37 , 38 , 39 , 40 ] yielded predominantly studies on musculoskeletal diseases. All reviews included adults only (18 and older). One focused on elderly (65 and older) people [ 40 ] and one on older (45 and older) adults [ 16 ]. Fourteen of the 19 reviews analysed RCTs only [ 6 , 7 , 16 , 17 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 ]; one also included besides RCT cohort studies [ 13 ] and three [ 12 , 37 , 38 ] also included any other quantitative study design (see Table  3 ). Four reviews performed a meta-analysis [ 7 , 16 , 27 , 28 ], and two studies were Cochrane Reviews [ 27 , 35 ]. Four reviews [ 6 , 7 , 17 , 40 ] analysed the use of BCTs and rated the interventions according to a BCT taxonomy [ 8 ].

Results of the individual reviews

The 19 reviews contained a total of 205 unique RCTs. Table 3 shows the main results of each review.

Results of quality assessment and confidence in the reviews

The critical appraisal with the AMSTAR-2 tool (see Table  4 ) showed that four reviews were rated with moderate to high quality [ 7 , 16 , 27 , 35 ], whereas all others resulted in a critically low to low overall confidence in the review. Frequent shortcomings were not explaining the reasons for the inclusion of primary study designs, and an insufficient discussion of the heterogeneity observed. Furthermore, as many reviews did not explicitly mention a pre-established, published or registered protocol or study plan, it is uncertain whether the research followed a pre-specified protocol and whether there were changes and/or deviations from it, and, if so, whether decisions during the review process may have biased the results [ 26 ].

Risk of bias and evidence assessment within reviews

The reviews used various approaches to appraise the evidence, particularly the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system [ 13 , 16 , 26 , 27 ], the evidence levels by the Oxford Centre for Evidence-Based Medicine [ 28 ] or the system by Cochrane Collaboration Back Review Group [published by 25,30] [ 31 , 32 , 33 , 34 ]. Three reviews modified existing or developed their own tool or checklist [ 12 , 35 , 36 ]. For the assessment of the risk of bias and/or quality of the individual studies, the reviews used the following tools: PEDro Scale [ 7 , 13 , 26 , 32 , 37 ], Cochrane Collaboration Back Review Group Quality Assessment Tool [ 31 , 34 ], Cochrane Risk of Bias criteria [ 6 , 16 , 17 , 27 , 33 , 37 , 38 , 39 ], the Delphi List [ 40 ] or modified or developed own tools [ 12 , 35 , 36 ].

A recurring concern regarding potential performance bias was the lack of therapist blinding, which is almost impossible to implement in this research field [ 7 ]. Attrition bias, due to low sample size or drop-outs, and measurement bias, due to the mere use of subjective measures, were also highlighted in the reviews. Another concern was the availability and selection of adequate control groups. Control groups, such as usual practice, unspecific exercise group or alternative intervention commonly include varying numbers of BCTs which must be considered when assessing and comparing contents of interventions [ 7 ]. The comparability of the intervention and control group regarding adherence-related outcomes is further hindered by poor descriptions of the intervention, uncertainty about treatment fidelity and implementation processes, varying competences and proficiency of the therapist, and the diverse translation of theoretical models and use of intervention techniques [ 7 , 34 , 39 ]. Rhodes and Fiala [ 12 ] pointed out that procedures of RCTs, such as several pre-screenings and measurement batteries, may lead to a potential self-selecting of only the most motivated individuals. This may limit the ability to compare intervention to the control group, as both groups are (already) highly motivated, and to detect changes, due to the already high motivation and disposition to adhere. This may explain in part, that the reviews reported many studies that failed to provide evidence for intervention efficacy on adherence. In addition, the restricted timeline (limited duration for observation and follow-up) of the studies may confound/skew the results, as drop-out may occur shortly after the end of the study and long-term adherence is not measured [ 12 ].

Overlap of reviews

The 19 reviews included from 3 to 42 individual RCTs. In sum, the reviews included 261 RCTs (multiple publications on the same trial were counted as one; thus, the number of trials was counted), whereby 34 trials were included in various reviews (see Additional file 2 , Overlap of reviews), resulting in 205 unique RCTs. Of these 34 trials included in multiple reviews, 25 were included in two different reviews. The following trials were included more than twice: Basler et al. 2007 (8x), Friedrich et al. 1998 (7x), Schoo et al. 2005 (4x), Vong et al. 2011 (4x), Asenlof et al. 2005 (3x), Bassett and Petrie 1999 (3x), Brosseau et al. 2012 (3x), Bennell et al. 2017 (3x), Gohner and Schlicht 2006 (3x) and Duncan and Pozehl 2002, 2003 (3x).

In total, the overlap of primary trials in the reviews is considered low; except among reviews [ 27 , 39 ] and among reviews [ 12 , 16 , 28 , 30 ]. Two reviews [ 27 ] and [ 39 ] were conducted by the same authors, within the same field, i.e. goal planning and setting, however with a different approach and research question. Reviews [ 12 , 16 , 28 , 30 ] have a considerable amount of overlap. Still, each of these reviews included unique RCTs, not analysed in any of the other reviews, and they do focus on different research questions, foci and analyses. Therefore, we did not exclude an entire review due to an overlap of studies.

Synthesis of results

The synthesis focused on answering the research questions. We began by presenting the narrative synthesis findings on how adherence was measured, what types of intervention and BCTs were investigated, and which theoretical underpinnings were reported. Afterwards, we synthesised the evidence on the efficacy of the interventions and BCTs, both meta-analytically and narratively.

Measures of adherence and related outcomes

The reviews included studies with a heterogeneous use, breadth and measures of adherence. Mostly, they refer to adherence as the extent to which a person’s behaviour corresponds with treatment goals, plans or recommendations ([ 30 ],cf. [ 5 ]). McLean and colleagues [ 30 ] expressed that within physiotherapy, the concept of adherence is multi-dimensional and could refer to attending appointments, following advice or undertaking prescribed exercises. The terms adherence and compliance were sometimes used interchangeably, referring to the degree of treatment attendance or accomplishment of physical activity levels, participation and recommendations, irrespective of how the treatment goals and plans were established. Yet, for definition purposes, the distinction between agreed and prescribed goals and plans was occasionally used in the reviews to distinguish adherence from compliance .

For analytical purposes, adherence was frequently dichotomised, establishing a cutoff point or percentage used to distinguish adherence from non-adherence. One was considered adherent, for example, if he/she achieved more than 70% or 80% of the targeted, recommended or prescribed sessions. Few studies graded the degree of adherence according to multi-categorical cut-off points (e.g. very low, low, moderate and high adherence). Only in one review [ 13 ], one study was named that distinguished a certain fluctuation in the adherence pattern, i.e. Dalager et al. [ 41 ] included besides the minutes exercised in a week the regularity of participation, distinguishing regular from irregular participation. Self-reported diaries, exercise logs and attendance lists were the most commonly used data recording instruments [ 33 , 35 , 37 ]. Adherence to home-based programmes was mainly measured with self-reported diaries, which are problematic as the only source, due to poor completion rates, and the possibility of inaccurate recall and self-presentation bias [ 18 , 33 ]. Digital devices (e.g. accelerometers or pedometers) may be used additionally to measure adherence; however, their use may also be problematic, as they require certain adherence to a systematic use of the device and the mere use of the device also may increase adherence [ 18 , 33 ]. One study reported the use of the Sport Injury Rehabilitation Adherence Scale (SIRAS) [ 42 ], which measures the patients’ degree and manner of participation in a session and compliance with the therapist’s instructions and plan. Thus, it does not measure adherence over a certain period of time nor adherence to recommendations or home-based exercise, but it can be used to assess the intensity of rehabilitation exercises, the frequency with which they follow the practitioner’s instructions and advice, and their receptivity to changes in the rehabilitation programme during that day’s appointment [ 42 ].

Interventions used to promote adherence

The reviews included a wide range of different interventions, which we grouped into three different intervention types:

Information provision and patient education were investigated in seven reviews [ 12 , 13 , 30 , 31 , 33 , 34 , 36 ], including (i) video- and audio-assisted patient education, (ii) phone calls, (iii) use of supporting materials and spoken or graphically presented information or (iv) other didactical interventions. Patient education has been defined as ‘any combination of learning experiences designed to facilitate voluntary adoption of behaviour conducive to health’ [ 43 ]. Niedermann et al. [ 31 ] distinguished between ‘purely’ educational programs based on knowledge transfer and psychoeducational programs. In the latter, motivational techniques and shared knowledge-building processes are added to the educational programme, which is done similarly in health coaching [ 34 ], and thus also relate to the cognitive, behavioural and relational/psychosocial interventions.

Cognitive and behavioural motivational interventions were relating frequently to cognitive-behavioural and social-cognitive theories, and applied (i) behavioural graded exercise; (ii) booster sessions, refresher or follow-up in situ by the therapist or via phone call; (iii) behavioural counselling (focusing on readiness to change); (iv) psychoeducational counselling; (v) supervision; (vi) (unspecified) motivational intervention; (vii) positive reinforcement; (viii) action and coping planning; and (ix) goal setting [ 7 , 12 , 13 , 16 , 27 , 28 , 30 , 32 , 33 , 34 , 39 ].

Relational and psychosocial interventions were less investigated overall. Related aspects included (i) social support; (ii) patient-centeredness, in particular patient-led goal setting, motivational interviewing and the therapeutic or working alliance; and (iii) emotional components [ 6 , 13 , 17 , 33 ].

The included reviews focused either on one particular or several types of intervention. Particularly, four reviews [ 6 , 7 , 17 , 40 ], which used a BCT taxonomy to analyse the interventions of the primary studies, described BCTs relating to all three intervention types. While this distinction of different types of interventions is useful to showcase the range of diverse interventions and techniques, they do have a great overlap and include a mix of different BCTs. For example, the way of facilitation of information, supervision or goal setting was approached differently according to the relational approach, i.e. being more instructive, directive or more collaborative, participatory, patient-led ([ 31 ],cf. [ 34 ]).

Theoretical underpinning of interventions

No review focused on only one theoretical foundation or excluded studies based on any theoretical model or not underpinning the intervention. In total, the reviews included studies with diverse theoretical models and varying degrees of theoretical underpinning. References to the cognitive behavioural theory (CBT) and to the social-cognitive theory were frequent in the individual studies. Furthermore, the self-determination theory, the transtheoretical model, the health belief model, the social learning theory and the socioemotional selectivity theory were used in some individual studies (cf. [ 11 ]). The heterogeneity in the theoretical underpinning of the interventions is reinforced by the given overlap of the theories and models (cf. [ 11 ],[ 28 ]) and various BCTs are key components of several theories [ 17 ]. Furthermore, theories were not used enough to explicitly inform and underpin interventions and they were translated into practise in different ways; thus, interventions based on the same theory may differ substantially [ 17 ].

The BCT Taxonomy v1 [ 8 ], which relates to various theoretical models, was used in four reviews [ 6 , 7 , 17 , 40 ] to identify BCTs in interventions in a standardized manner. The Behaviour Change Wheel [ 44 ], which is linked to the BCT Taxonomy v1, was referred to in one review [ 40 ] pointing to its usefulness for designing a behaviour change intervention. The number of BCTs used appears to be relevant, as interventions using a higher number (≥ 8) of BCTs achieved a significant effect (pooled SMD = 0.29, 95% CI 0.19–0.40, p  < 0.001), whereas interventions using a lower number (< 8) of BCTs did not (pooled SMD = 0.08, 95% CI -0.11 to 0.27, p  = 0.41).

Overall efficacy and heterogeneity according to the panoramic meta-analysis

Although there was statistical heterogeneity ( I 2 from 41 to 63%) between the primary studies included in each meta-analysis [ 7 , 16 , 27 , 28 ], there was no heterogeneity between the pooled effects of these four meta-analyses ( I 2 0%). This means that all variability in the effect size estimates (SMD from 0.20 to 0.39) was attributable to sampling error, but there was no variability in the true effects. Although the interventions were selected based on different eligibility criteria (BCTs, goal-setting strategies, motivational interventions and booster sessions), they appear to be very similar in terms of the effects they trigger. There was no overlap between the primary trials included in the meta-analyses. The pooled SMD was 0.24 (95% CI 0.13, 0.34) (Fig.  2 ). Effect size estimates were somewhat larger in those meta-analyses with less weight in the model (i.e. due to a larger standard error). However, no obvious publication bias could be detected in the funnel plot (Fig.  3 ). Sensitivity analyses in the meta-analysis in Eisele et al. [ 7 ], considering only studies with PEDro scores of 6 or more, revealed slightly lower effect sizes but still statistically significant effect sizes regarding medium-term effects (SMD PEDro>=6 0.16, 95% CI 0.04–0.28, p  < 0.01 versus SMD all 0.20, 95% CI 0.08–0.33, p  < 0.01) and higher numbers of BCTs (SMD PEDro>=6  = 0.26, 95% CI 0.16–0.37, p  < 0.001 versus SMD all  = 0.29, 95% CI 0.19–0.40, p  < 0.001), indicating that low-quality studies may tend to overestimate the efficacy ([ 7 ],cf. [ 31 ]).

Forest plot of panoramic meta-analysis: interventions aiming at improving adherence, adherence-related outcomes

Legend: Eisele 2019. Intervention: Interventions aiming at improving physical activity levels or adherence, containing at least one BCT. Comparison: Usual care, minimal intervention, placebo or no intervention. Outcome: Any measure of physical activity level or adherence to any kind of physical activity. Levack 2015. Intervention: Goal setting (with or without strategies to enhance goal pursuit). Comparison: No goal setting. Outcome: Engagement in rehabilitation. McGrane 2015. Intervention: Motivational interventions as part of a package, psychological strategies, theory-based instructional manuals, Internet-based behavioural programmes and relapse prevention, and re-inforcement strategies. Comparison: Any comparison (not specified). Outcome: Attendance at physiotherapy sessions/exercise classes. Nicolson 2017. Intervention: Booster sessions to increase adherence to therapeutic exercise. Comparison: Contextually equivalent control treatments. Outcome: Self-rated adherence

Funnel plot of publication bias

Efficacy of informational and educational interventions

The results of five—partly overlapping—reviews [ 12 , 30 , 31 , 34 , 36 ] showed, with a very low evidence base, that interventions that primarily aimed at information provision and knowledge transfer to the patient had limited efficacy on adherence-related outcomes. There was conflicting evidence and inconsistent efficacy of video-assisted patient education [ 36 ] and individualised exercise videos [ 12 , 30 ] in modifying behaviour or adherence. However, the authors identified the format in which the educational information is presented and the complexity of the addressed behaviour as crucial factors [ 36 ]. Videos that provide only spoken or graphically presented health information are inappropriate tools for changing patient behaviour. However, videos with a narrative format appear to be a powerful education tool [ 36 ]. Low evidence based on one study [ 12 , 30 ] indicates that additional written information seems superior to verbal instructions alone (mean difference between groups 39.3%, p  < 0.001). With a high overlap of studies, two reviews [ 30 , 31 ] showed that there is limited evidence for long-term effects of patient education targeting knowledge acquisition. While the informative and instructive educational approach is an essential part of patient education, patient education often involves more than the transfer of knowledge [ 30 , 31 , 34 ]. Niedermann et al. [ 31 ] compared educational and psychoeducational interventions and provided arguments in favour of psychoeducational approaches that enrich patient education with motivational strategies and techniques (cf. [ 34 ]).

Efficacy of cognitive and behavioural motivational interventions

Several (though partly overlapping) reviews [ 12 , 16 , 28 , 30 , 33 , 37 ] examined studies on additional motivational interventions that were based on social-cognitive or cognitive-behavioural theories. McGrane et al. [ 28 ] concluded heterogeneity of motivational interventions, outcomes and measurements as potential causes for conflicting evidence regarding effects on exercise attendance and PT adherence, as they found no significant difference ( p  = 0.07) in exercise attendance between additional motivational intervention groups and their controls (pooled SMD 0.33, 95% CI -0.03 to 0.68, I 2 62%), but a significant ( p  < 0.01) medium-sized effect of additional motivational interventions on self-efficacy beliefs (pooled SMD 0.71, 95% CI 0.55 to 0.87, I 2 41%). The heterogeneity hindered in this meta-analysis the statistical analysis of subgroups to determine and compare the efficacy of different components and approaches to motivational interventions [ 28 ]. Another meta-analysis [ 16 ] found moderate-quality evidence that booster sessions with a physiotherapist helped people with hip/knee osteoarthritis to better adhere to therapeutic exercise (pooled SMD 0.39, 95% CI 0.05 to 0.72, p  = 0.02, I 2 35%). Moderate evidence for the efficacy of supervision (2 studies, n  = 193) favouring adherence was shown [ 13 , 33 , 35 ].

In four reviews [ 16 , 32 , 33 , 35 ], four unique high-quality trials supported the use of motivational strategies and behavioural graded exercise to improve adherence to exercise (effect sizes 0.26–1.23)[ 16 ]. Behavioural graded exercise includes a preset gradual increase of the physical activity through facility-based interventions followed by booster sessions [ 45 ] and uses principles of operant conditioning and self-regulation [ 16 ].

While cognitive behavioural programmes seem superior to exercise alone for short-term adherence and clinical attendance [ 30 ], behavioural counselling focusing on readiness to change, action and coping plans and/or audio/video exercise cues seem not to improve adherence significantly [ 16 ]. Holden [ 34 ] concludes inconsistent evidence for health coaching based on the transtheoretical model of change, with one RCT showing some efficacy on exercise compliance (SMD = 1.3). However, the frequently referred to study of Göhner and Schlicht [ 46 ], who analysed a cognitive-behavioural intervention with a strong emphasis on action and coping planning [ 12 ], showed no difference between experimental and control groups in the first 11 weeks, but a significant difference 5 months later on behaviour (SMD = 0.83) as well as differences over all time-points on self-efficacy (interaction effect of time by group, F (3, 43) 10.36, p  < 0.001, n  = 47) favouring the intervention [ 46 ]. Motivational interventions, including positive reinforcement, increased (i) adherence to home exercise in one RCT [ 33 ], (ii) reported frequency of exercise in two RCTs [ 35 ] and (iii) self-efficacy beliefs in two RCTs, in the short-term (SMD = 1.23) and in the long-term (SMD = 0.44) ([ 16 ],cf. [ 30 ]). Self-efficacy beliefs relate to the trust in one’s capacities/competencies to cope with daily demands [ 47 ] and are associated (moderate evidence) with adherence [ 13 , 48 ].

Levack et al. [ 27 ] conclude some evidence that goal planning/setting improves engagement in rehabilitation (motivation, involvement and adherence) over the duration of the programme (9 studies, 369 participants, SMD 0.30, 95% CI -0.07 to 0.66). Furthermore, they show a low-quality evidence for effects on patient self-efficacy from more structured goal setting compared to usual care with or without goal setting (2 studies, 134 participants; SMD 0.37, 95% CI 0.02 to 0.71) and from goal setting compared to no goal setting (3 studies; 108 participants; SMD 1.07, 95% CI 0.64 to 1.49). The review did not detect differences in efficacy between the approach taken to goal planning. However and similar to patient education [ 34 ], the review authors argue that the lack of clarity about the effects and the low evidence is due to the heterogeneity of the implementation of goal planning, lack of detailed descriptions of the goal-setting process in the intervention groups but also in the control groups, and methodological flaws ([ 27 , 39 ],cf. [ 13 ]).

The BCTs from the cluster goals and planning showed various positive effects, although not fully consistently [ 6 , 7 , 40 ]. Eisele et al. [ 7 ] identified goal setting (behaviour) , problem-solving , goal setting (outcome) , action planning and reviewing behaviour goal(s) as often used in non-effective interventions but also in effective ones. A trial that showed negative effects included problem-solving and goal setting (outcome) as well. Room et al. [ 40 ] found one study on older people and Thacker et al. [ 6 ] two home-exercise-related studies that used BCTs from the goals and planning cluster (i.e. problem-solving and action planning), but none of the studies found differences in favour of the intervention. Willett et al. [ 17 ] adjusted the BCTv1 taxonomy to differentiate patient-led and therapist-led goal setting and showed that patient-led goal setting (behaviour) achieved among the highest efficacy ratios across time points.

Efficacy of relational and psychosocial interventions

The BCT Social Support (unspecified) refers to ‘advise on, arrange or provide social support (e.g. from friends, relatives, colleagues, ’buddies’ or staff) or non-contingent praise or reward for the performance of the behaviour . It includes encouragement and counselling, but only when it is directed at the behaviour’ [8, Supplementary Material]. Eisele et al. [ 7 ] identified this BCT in 19 interventions and 10 control conditions. They found this BCT in three trials supporting efficacy and in seven trials supporting inefficacy. In contrast, Thacker et al. [ 6 ] found this BCT in all effective interventions but not in the non-effective ones. Willet et al. [ 17 ] concluded from their review that this BCT has among the highest efficacy ratios across time points to promote adherence to physical activity.

Social support may come along with monitoring and feedback, which can be graphically or narratively presented by the therapist. Willett et al. [ 17 ] recommend that self-monitoring (e.g. activity diaries), feedback on behaviour as well as social support should be used—beyond monitoring purposes—for explicit intervention purposes (e.g. to foster self-efficacy beliefs). Feedback on behaviour alone does not seem to be efficacious [ 6 ], but feedback can be efficacious for instance in combination with social support or goal setting and planning [ 17 , 40 ].

Patient-centred approaches were also included in the relational/psychosocial intervention type. Motivational interviewing, which is a collaborative, patient-centred communication style to promote behaviour change [ 49 ], was used in three studies, indicating positive effects on exercise compliance, physical activity and exercise at home in two trials, whereas no effect in a pilot study [ 28 ]. There is low evidence from three RCTs for positive effects of the therapist-patient alliance on global assessments; however, the efficacy on adherence-related outcomes is unclear [ 36 ]. The terms working or therapeutic alliance refer to the social connection or bond between therapist and patient/client, including reciprocal positive feelings, (assertive) communication, empathy, and mutual respect as well as collaboration, shared decision-making, agreement on the treatment goals and tasks [ 36 , 50 ]. The therapeutic alliance is a patient-centred approach as well. Patient-led goal setting was more often a component within efficacious interventions than therapist-led goal setting [ 17 ].

None of the included reviews focused specifically on affective interventions. However, some interventions relate to affective components, for example patient-led goal setting or motivational interviewing may cover emotional needs [ 27 ]; health coaching, therapeutic alliance or social support may include emotional support [ 13 , 34 , 35 , 38 ]; monitoring may consider emotional consequences [ 6 ]; or messaging and information provision may include emotional components [ 36 ]. Room et al. [ 40 ] included one RCT [ 51 ], comparing emotionally meaningful messages against factual informational messages, but with no significant differences between the groups.

Efficacy according to the theoretical underpinning

McGrane et al. [ 28 ] provide a narrative analysis of the efficacy of interventions according to the different theoretical underpinnings. In their review, the cognitive-behavioural theory (CBT) was the most popular theory (4 primary studies) and showed to be efficacious in improving self-efficacy and activity limitations, but not consistently regarding attendance and attrition [ 28 ]. The social-cognitive theory was used in three studies, showing improvements in self-efficacy, action and coping planning, and attendance, but conflicting results for exercising in the short and long term. One intervention [ 52 ] based on self-determination theory showed to be efficacious to improve adherence to physical activity. In contrast to McGrane et al. [ 28 ], the reviews [ 12 , 30 , 35 ] point to moderate to conflicting evidence for no or inconsistent efficacy of CBT-based approaches to physiotherapy programmes (see Efficacy of cognitive and behavioural motivational interventions ). Jordan [ 35 ] concluded that the addition of transtheoretical model-based counselling to physiotherapy is no more effective than physiotherapy and a sham intervention (GRADE: High (high quality); Silver). Notably, the interventions may not be representative of the theory described due to diverse translations of the theory into practice and the overlap of the same BCTs among the theories.

Various theories (e.g. the transtheoretical model or the Health Action Process Approach [ 53 ]) and studies [ 54 ] distinguish the action or adoption phase from the maintenance phase at 6 months. Interestingly, Willet et al. [ 17 ] found in total higher short (< 3 months) and long-term (12 months and more) than medium-term (around 6 months) efficacy ratios, pointing to the risk of drop-out when changing from the (short-term) adoption phase to the (long-term) maintenance phase [ 17 ]. Eisele et al. [ 7 ] divided in their meta-analysis the short-term (< 3 months), medium-term (3–6 months) and long-term (7–12 months post-intervention) differently, showing a small medium-term overall effect (pooled SMD 0.20, 95% CI 0.08–0.33, p  < 0.01), but no significant long-term effect of interventions comprising BCTs in enhancing physical activity adherence (pooled SMD 0.13, 95% CI 0.02–0.28, p  = 0.09).

Efficacy according to the different types of exercise, physiotherapeutic settings and medical condition

In their Cochrane review, Jordan et al. [ 35 ] compared the evidence for the efficacy of different types of exercises and physiotherapy settings. Graded exercise is beneficial for adherence (moderate evidence). The exercise type does not appear to play an important role (moderate evidence). Whether water-based exercise favours adherence is unclear (low evidence and inconsistent results). Furthermore, the supervision of exercising (moderate evidence) is beneficial for adherence, but also self-management programmes improve exercise frequency compared to waiting list or no-intervention control groups (moderate evidence). Exercising individually seems to improve attendance at exercise classes more than exercising in a group (moderate evidence), as individual sessions could be scheduled at more convenient times and missed sessions could be rescheduled, whereas group sessions were scheduled at relatively inflexible times, and missed sessions could not be rescheduled [ 35 ]. However, adding group exercise to a home exercise programme can increase overall physical activity levels (moderate evidence) [ 35 ]. While the results of home- versus clinic-based interventions were conflicting and confounded by the intervention approaches, a combination of home- and clinic-based approaches may be promising [ 12 ] and aligns with the moderate-quality evidence that self-management programmes, refresher or booster sessions with a physiotherapist assist people to better adhere to therapeutic exercise [ 16 ].

No study was identified in the reviews that compared other settings, such as private- and public-funded physiotherapy or primary care and rehabilitation settings regarding adherence outcomes. No review and no study comparing the same educational, motivational, or BCT-based intervention across different conditions were identified.

This overview of systematic reviews addresses adherence in the physiotherapy and therapeutic exercise domain, aiming to summarise the evidence on the efficacy of interventions, to explore heterogeneity and to identify research gaps. The overview of reviews provided an adequate approach to generate answers to the research questions. Nineteen reviews, covering 205 unique trials, were included and narratively synthesised. In addition, four meta-analyses were pooled in a panoramic meta-analysis. The findings provide an overview of the diverse interventions and techniques aiming to enhance adherence, ranging from informational/educational to cognitive/behavioural/motivational and to relational/psychosocial intervention types. Furthermore, it synthesised their efficacy in physiotherapy for adults.

Confidence in the reviews was rated moderate or high in four reviews [ 7 , 16 , 27 , 35 ], but low or very low in the others (Table  3 ). The individual reviews considered the evidence levels as mostly low or very low (Table  4 ; see Risk of bias and evidence assessment ). Table 5 summarizes the evidence on the efficacy of each intervention and technique according to (a) whether the evidence supports efficacy, (b) the evidence level based on the report in the systematic reviews and (c) the confidence in the reviews as assessed with AMSTAR-2. It must be noted that the components of the intervention which caused the efficacy were not always clear. Some interventions lacked detailed definitions and descriptions of the specific BCTs included [ 33 ]. A single technique or mechanism of action was not always identifiable; moreover, various techniques seem to influence each other in such a way that they achieved efficacy only jointly [ 17 , 40 ].

No clear conclusion can be drawn on the efficacy of informational/educational interventions. Five reviews [ 12 , 30 , 31 , 34 , 36 ] showed low evidence for the efficacy of interventions on knowledge acquisition and low evidence for limited short-term efficacy on adherence. Providing knowledge alone seems not enough and should be complemented with supportive material (very low evidence) and combined with other interventions (low evidence). Patient education should also include social-cognitive or cognitive-behavioural approaches, psychoeducational interventions and collaborative processes as it is included in the therapeutic alliance approach [ 31 , 34 , 36 ]. Patient education with a more constructive educational approach builds upon the knowledge of the patient, supporting him/her in exploring and co-constructing knowledge which is very relevant in physiotherapy as research has shown [ 55 , 56 ].

The reviews on additional motivational, cognitive and behavioural interventions showed findings ranging from non-efficacy of behavioural counselling based on readiness to change (with low to moderate evidence) to moderate efficacy for booster sessions and behavioural graded physical activity (with moderate evidence) (see Table  5 ). Overall, a small overall effect size (SMD 0.24) for motivational interventions is indicative of the findings of the panoramic meta-analysis. The four pooled meta-analyses [ 7 , 16 , 27 , 28 ] included studies analysing interventions with a considerable amount of content overlap (e.g. goal-setting and booster sessions are BCTs and often part of motivational interventions), and no statistical heterogeneity of the true effect was found. Nevertheless, the diversity of interventions and techniques included constrain the explanatory power for potential components responsible for the efficacy of adherence. The sensitivity analyses in the meta-analysis of Eisele et al. [ 7 ] indicate that low-quality studies tend to overestimate the efficacy (cf. [ 31 ]). While some evidence exists on short- and medium-term effects of motivational programmes on adherence, no clear evidence for long-term effects can be concluded [ 7 , 30 ]. Furthermore, there is moderate and low evidence that additional motivational interventions and goal planning/setting improve adherence to self-efficacy beliefs [ 27 , 28 , 39 ]. Since self-efficacy beliefs play an important role in motivation and adherence [ 13 , 48 ], the results are relevant for physiotherapists to promote motivation and adherence. Experiencing that one can reach the set goals and manage daily challenges, complemented with feedback and reinforcement from the therapist (or important others), may increase self-efficacy beliefs and human agency [ 48 , 57 , 58 , 59 ].

A closer look at how and in which manner goals and actions are planned and reviewed seems crucial. The patient-led approach was only reported in 5 of the 26 interventions that incorporated the BCT goal setting (behaviour) , although it is associated with greater engagement and achievement than goals which are set by the therapist [ 17 ]. Goal setting and action planning should be informed by the patient’s motives, interests and values in order to promote intrinsic motivation, self-determination and subsequently better adherence ([ 17 ],cf. [ 27 , 28 , 60 , 61 ]). The reviews on the BCTs displayed various positive effects relating to the BCT cluster goals and planning ; however, they point out that the BCT goal setting is not used alone but in connection with several other BCTs. Feedback on outcomes of behaviour , behavioural contract and non-specific reward as well as patient led-goal setting , self-monitoring of behaviour and social support (unspecified) was included in efficacious interventions [ 17 ]. Social support seems to have an important influence on adherence [ 6 , 7 , 17 , 40 ], for example through regular phone-calls or home visits, encouraging messaging, supervision or community-based group programs (cf. [ 1 , 2 , 3 ],[ 37 , 62 ]). Social support also relates to the promotion of self-efficacy beliefs, if it endorses confidence in own abilities and competences [ 6 ].

Some BCTs seem inherent to standard practices of physiotherapy [ 6 ] even though physiotherapists seem to use rather a small number of BCTs [ 15 ]. Control groups also contained BCTs [ 6 , 7 ]; in particular instruction on how to perform a behaviour , generalisation of the target behaviour and social support (unspecified) were frequently coded [ 6 ]. Thus, it seems difficult to identify those BCTs that are (most) efficacious in promoting adherence ([ 7 ],cf. [ 50 ]). Unsurprisingly, the reviews revealed conflicting results and a high risk of bias in the individual studies. However, combining a greater number of BCTs (≥ 8) can be highly recommended, as this achieved a larger effect than interventions using fewer BCTs [ 7 ]. It is fairly unlikely that any single BCT changes adherence [ 6 , 7 , 17 , 40 ]. In that regard, Ariie et al. [ 63 ] argue that not only the amount of BCTs but also the quality, appropriateness and feasibility of the use of the BCTs is crucial.

Meaningful combinations of several BCTs are required. However, the combinations of BCTs may also differ among conditions, personal factors and therapeutic interventions ([ 7 ],cf. [ 63 , 64 ], [ 64 , 65 , 66 ]), and over the time. Two reviews consistently point to the same crucial time point (i.e. after 6 months) when BCT efficacy seems to drop, and more attention is required to maintain adherence [ 7 , 17 ]. Action planning , feedback on behaviour and behavioural practice/rehearsal seem efficacious particularly on short-term. Patient led-goal setting , self-monitoring of behaviour and social support (unspecified) are among those BCTs that seem more efficacious at long-term [ 17 ]. These findings are also in line with findings in non-clinical adults [ 54 ] and with motivational theories (e.g. the Health Action Process Approach [ 53 ]).

Limitations

Conducting an overview of reviews is per se associated with methodological limitations. A limitation is that reviews were analysed and not the original RCTs, which adds further risks of bias domains such as selection, analysis and reporting bias. A specific potential source of bias in overviews of reviews is the overlap of primary studies among the included reviews. The small overlap, caused by a few reviews with similar thematic scope, was controlled for in the data analysis. The substantial non-overlap of primary studies across the reviews reflects the clinical and methodological diversity of the included reviews and showcases the efforts to address (a) motivation and (non-)adherence as complex phenomena and from various perspectives.

Another methodological limitation originates from the search strategies. Considering different health-care systems and delimitations of the physiotherapy profession among countries, divergences among the definitions of terms and the use of diverse approaches to physical therapy, physiotherapy or the therapeutic use of exercise and physical activity, made a clear delimitation in the search strategy and inclusion/exclusion criteria difficult. Therefore, we may have missed out some relevant reviews by reducing our search to the two terms physiotherapy and physical therapy. Equally, we may also have included some aspects that were not primarily investigated for physiotherapists or physical therapists. Including only studies with adults, the findings may not be applicable to promote adherence among children.

While we did not exclude reviews from another language, the search was conducted only in English, which may omit important reviews in other languages. All included reviews (and as far as reported, also the original RCTs) were conducted in economically developed countries; however, social-cultural and context-specific factors influence participation and adherence [ 67 , 68 , 69 , 70 , 71 ]. Furthermore, we are aware that our own cultural background and experiences may have influenced the analysis and synthesis of the results and that conclusions drawn in this overview of reviews may not be suitable for every setting around the world. Therefore, we encourage the readers to critically assess the applicability of the findings to their specific context.

Another gap in coverage of this overview is that interventions that were analysed in RCTs but not included in any systematic review are not considered in this overview. Thus, there may be new or alternative intervention approaches that resulted efficacious but were not covered by this overview. Furthermore, reviews that focused only on the use of digital apps or tools, e.g. virtual reality, gamification, exergames or tele-rehabilitation, were excluded from this overview. Several reviews in this field include adherence-related outcomes, showing potential efficacy as well as limitations of the use of digital tools [ 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 ].

Research gaps, recommendations and measuring adherence

This overview of reviews highlighted some gaps in the existing knowledge. First, there is a lack of clear evidence on the efficacy of the interventions. The use of BCTs in the intervention as well as in the control groups may be a reason for inconsistent findings and conflicting evidence. Furthermore, the clinical and methodological heterogeneity constrains drawing clear conclusions on the efficacy. Second (and related to the previous), interventions are insufficiently described regarding their theoretical underpinning and active ingredients/techniques and thus limit the comparison of interventions. Theoretical underpinnings were used partly and translated into practise differently. Difficulties concerning the derivation or deduction of concrete, practical techniques or strategies from the theories were reported. A broader use of the BCT taxonomies would make interventions more comparable. Recently, the BCT Ontology was published, which claims to provide a standard terminology and a comprehensive classification system for the content of behaviour change interventions, suitable for describing interventions [ 84 ]. Third, there is a need for studies on holistic approaches, complex interventions based on integrative theories and the combination of multiple BCTs. While many theories are based on cognitive and behavioural approaches, affective and psychosocial factors are hardly investigated, overlooked and probably underestimated. Rhodes and Fiala [ 12 ] call for studying the influences of affective attitudes on adherence (e.g. enjoyment and pleasing behaviour) which may oppose the more cognitive, instrumental attitudes (e.g. the utility of behaviour). Jordan et al. [ 35 ] refer to a meta-analysis in another therapeutic regime [ 85 ] to explicit the potential efficacy of affective interventions (e.g. appealing to feelings, emotions or social relationships and social supports) in combination with educational and behavioural interventions on patient adherence [ 35 ]. Fourth, more research in patient-led approaches to goal setting and action planning and the relationship of patient-centeredness to adherence is promising [ 60 , 61 , 86 , 87 ].

Fifth, the reviews reported many studies that failed to provide evidence for intervention efficacy on adherence, particularly on long-term adherence. There is a need for prolonged observation to investigate long-term effects on adherence. Probably, intervention or follow-up interventions (e.g. booster sessions) must also be prolonged or repeated to avoid drop out to medium-term follow-ups (around 6 months) and to maintain participation. Sixth, studies should pay more attention to the actual efficacy of adherent behaviour on the desired therapeutic outcomes.

Seventh, another research gap lies in the analysis of the potential variation of the intervention efficacy across medical conditions, physiotherapeutic settings, personal characteristics (e.g. age, gender, sociocultural background) and dispositions (e.g. motives, affective attitudes, previous behaviour) and diverse context-related factors. Huynh et al. [ 79 ] showed for the case of multiple sclerosis that the efficacy of BCTs is not investigated in all disease stages or throughout the disease course; participants with mild-to-moderate level disability were more frequently included in the studies (cf. [ 18 ]). Ariie et al. [ 73 ] stated that the response to BCTs may be different according to the condition (cf. [ 76 ]). On the one hand, studies analysing the use of the same intervention or same combination of BCTs in different intervention groups (according to the categories mentioned above) could be beneficial for comparison purposes. On the other hand, studies should analyse how to find the ‘right’ (ideally, the ‘most efficacious’) adherence promotion intervention for the patient or target group. Qualitative studies may explore adequate combinations of BCTs and contribute to the understanding of complex intervention processes. The findings showcased that different interventions and BCTs may contribute to adherence and that the BCT Taxonomy defines a wide range of techniques, providing the physiotherapists with an overview of which techniques are useable and thus may inspire and support them to develop additional interventions and to enrich their current physiotherapeutic practise. The physiotherapist may use this knowledge to tailor interventions in a patient-centred manner to promote adherence, and to adapt to the condition, characteristics, dispositions and context-related factors of the patient. Hence, experimental studies could compare the efficacy of tailored to not-tailored interventions.

Finally, the outcome adherence should be better defined and holistically assessed. The definition of adherence (as the extent to which a person’s behaviour corresponds with treatment goals or plans) and calculation of adherence rates (by reported exercise or attended sessions divided by the recommended or prescribed exercise or sessions) are simplifying a complex phenomenon. The average or the percentages of attended or completed sessions do not picture interruptions, regularity or periods of more and less adherence. Attendance regularity can change over the time and different participation and fluctuation patterns can be identified [ 88 , 89 ]. For example, an adherence rate of 50% can imply (a) that a person attended regularly every second session throughout the period of observation or (b) that a person attended all sessions of the first half of the observation period and then stopped attending. The underlying reasons and motivational factors may be quite different in these two cases. Besides assessing participation and fluctuation patterns, the three dimensions of the SIRAS scale [ 42 ], i.e. frequency, intensity and reciprocity, could be considered for a holistic account of adherence. The findings of this overview emphasized the importance of a patient-led goal setting and planning, which includes a shared decision-making process and the mutual agreement to adhere to the jointly established plan (cf. WHO definition of adherence, [ 5 ]). The measurement of adherence should be able to distinguish a patient-led approach from a therapist-led approach (cf. [ 17 ]) and to appraise the extent of a shared decision-making process. In conclusion, a holistic approach to measure adherence in physiotherapy may include measures of the frequency of attendance/exercising (e.g. attended sessions out of the prescribed/recommended sessions), the regularity of participation and fluctuation (e.g. timeline with pauses and interruptions, visualizing more and less adherent periods), the intensity of attendance/exercising (e.g. the number or the increment of exercises and repetitions performed in comparison to the plan), reciprocity and fidelity to the agreed goals and plan (e.g. therapist’s and patient’s subjective appraisal of the degree of accomplishment of the agreed plan) and persistence/perseverance over the time (e.g. measuring volition via questionnaires or rating persistence in participation in spite of the experienced challenges and barriers).

We conclude that moderate certainty of evidence supports that (i) additional motivational interventions and behaviour change programmes can increase adherence and patients’ self-efficacy beliefs and (ii) interventions applying BCTs increase adherence, particularly when using a greater number of BCTs and combining various BCTs, and particularly on short to medium term. The BCTs’ patient-led goal setting , self-monitoring of behaviour and social support seem promising to promote maintenance; (iii) graded activities, booster sessions with a physiotherapist and supervision foster adherence.

There is low certainty of evidence that (i) goal setting and planning improves adherence to treatment regimens, particularly if a patient-centred approach is taken; (ii) motivational interventions including various techniques, such as positive reinforcement, social support, monitoring or feedback, can foster adherence; (iii) social support seems to play an important role in promoting adherence; however, evidence is low as this BCT is frequently found in the control group; and (iv) information provision and transfer of knowledge to the patient may improve adherence-related outcomes when combined with motivational techniques, as in psychoeducational programmes. Additional written information is superior to verbal instructions alone; (v) a combination of home-based exercise programmes with clinical supervision, refresher or booster sessions, or/and self-management programmes seems promising to increase adherence.

Regarding the implications for future research, a holistic approach to measure adherence in physiotherapy and the investigation of clearly defined interventions combining multiple BCTs is recommended.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its supplementary information files.

Overview of reviews, umbrella review and reviews of reviews are considered as synonyms in this article (cf. [ 19 ]).

Abbreviations

Behaviour change technique

Cognitive behavioural/cognitive behavioural theory

Control/comparator group

Grades of Recommendation, Assessment, Development and Evaluation

Intervention/experimental group

Physical activity

Preferred Reporting Items for Overviews of Reviews

Preferred Reporting Items for Systematic Reviews and Meta-Analysis

Physiotherapy

Randomised controlled trial

Standardised mean difference

Systematic review

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CL and PP conceived and designed the review. CL did the database search and data extraction. CL and PP did screening and quality assessment. CL did the narrative synthesis and drafted the manuscript. PP conducted the panoramic meta-analysis and critically revised and substantially contributed throughout the writing of the manuscript. The authors read and approved the final manuscript.

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Ley, C., Putz, P. Efficacy of interventions and techniques on adherence to physiotherapy in adults: an overview of systematic reviews and panoramic meta-analysis. Syst Rev 13 , 137 (2024). https://doi.org/10.1186/s13643-024-02538-9

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DOI : https://doi.org/10.1186/s13643-024-02538-9

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