A question that often arises when planning recruitment strategies is: “How should we deal with gatekeepers?” “Gatekeeper” is a term used to describe individuals or groups who control access to potential research participants. Like a physical gate that can open or close, gatekeepers may either facilitate or restrict access to participants. It is typically the restriction of access that concerns research teams, and gatekeepers are often cited as a barrier to recruitment.
While this concern resonates with many of the research teams we work with, a more nuanced understanding of gatekeeping may lead to more effective recruitment strategies.
The existing literature suggests that gatekeepers can play a valuable role as protectors of participants. However, this protective role can also reduce participant autonomy and limit opportunities to engage in research that may offer individual or societal benefit. Among older adults, for example, family members or physicians may directly advise against all research participation. Importantly, gatekeepers bring their own attitudes and beliefs about research—including mistrust, limited information, or competing demands on their time—which can influence whether they “open” or “close” the gate.
Understanding these perspectives is critical. Research has shown that gate-closing behaviors are often driven by concerns about burden, safety, or lack of perceived benefit. Addressing these concerns through clear communication, education about the value of research, and intentional relationship-building can help shift these dynamics.
This topic came up at the 2026 National OAIC Annual Meeting, where Dr. Jeff Williamson from the Wake Forest Pepper Center, who has led numerous large-scale clinical trials in older adults, posed a different framing. Instead of asking, “How do we deal with gatekeepers?” he suggested asking: “Why is there a gate in the first place?”
Reflecting on this question can be powerful. Family members may restrict access out of concern for safety, feeling overwhelmed by caregiving responsibilities, or misunderstanding the risks and benefits of research. These insights can inform recruitment strategies that better address these valid, real-world concerns rather than simply attempting to bypass them.
In this way, gatekeeping becomes not just a barrier to overcome, but a starting point for understanding and addressing concerns. We also suggest that research teams draw on the 5Ts framework—particularly Team, Time, and Tips—to identify strategies that acknowledge and support the needs of caregivers and other key stakeholders.