Research Project Case Study

Uni of York


The TRECA (TRials Engagement in Children and Adolescents) study is a three-year research project led by the Department of Health Sciences at the University of York.

Morph was approached to design and build a series of websites, animations and videos to be used in the study. It is an unusual project as we are generating media that is being used as part of the research. More usually we are used to presenting, explaining or disseminating the research itself. Here is an overview of the project in their own words…


Randomised controlled trials are the best way to determine the effectiveness and safety of healthcare interventions…

However, there are relatively few healthcare trials involving children and adolescents meaning that important clinical decisions are based on evidence extrapolated from trials involving adults.

A key barrier to paediatric trials is the high rates of patient (or parent) refusal to participate, though it is possible that this could be reduced by improving the quality of information that they receive about trial participation. The printed information sheets, which are currently used in most trials have been widely criticised for being too long, technical and lacking in visual appeal.

Multimedia information resources (MMIs) are websites with animations, video, text, illustrations. TRECA wants to see whether MMIs have the potential to better inform children and adolescents and their parents about trials, potentially leading to their increased engagement.

Graphic Style

We needed to find a style that would enable us to communicate potentially tricky and complicated information to two different audiences.

The first audience is children below twelve and the second group are young people between twelve and seventeen as well as their parents. So we needed an adaptable design style that could be tailored to these different audiences. From a technical point of view it also needed to be a style that would work well for the animations. TRECA undertook interviews with children, young people and their parents to identify their preferences for design of the characters. This information was provided to us to ensure the characters would suit potential end users. For each of the new trials we will generate new graphics following the agreed general style but illustrating their particular features.

Participatory design

It has been an interesting process as the design has been through extensive review by children, young people and parents, both in interviews and also in user testing which was done to make sure that families could easily find and understand information in the MMIs. It is unusual in our experience for our design to be so rigorously tested so this has been quite challenging but we understood this participatory approach is central to the process.

There were two clear groups who needed to be part of this process. Firstly the children, young people and their parents in the target age groups as the project is assessing techniques for recruiting children to the trials; and secondly the health professionals who would actually present the media, for example doctors and nurses. Clearly using these tools adds some complication compared with simply handing over a pile of papers but the involvement has been key to developing the MMIs and ensuring they are most likely to suit the end users. The TRECA research team values the flexibility and responsiveness that we have shown in the development of each MMI.

Test websites

TRECA also asked children, young people and their parents about what content was important for them to know before deciding to participate in a trial. This enabled us to develop a template for the MMIs that can then be populated with trial-specific content.

To seek feedback from those who were interviewed in the development stages of TRECA and to enable the user testing, we created two websites (MMIs), one aimed at younger children and one for teenagers. The websites were based on a real trial looking at two ways to administer insulin to children and young people who have recently found out they have diabetes. We made some talking heads videos, with an expert from the trial and real participants in the trial and their parents. Plus we made some animations that explained more general information about medical trials.

Real trials

We are now about to start work on the media for the first of six UK trials that will use the TRECA MMIs. For each trial we will produce websites that will include age specific content, video clips about the specific trial and an explainer animation for the homepage.

Success or failure

Success from our point of view will me measured by having happy clients (the TRECA research team) who feel they have been able to fully test their ideas. In order to do this they need professional digital media that has been developed based round the feedback from the user groups and experts in the field as well as Morph making recommendations and pushing back in helpful ways where we feel there are better solutions.

I guess the bottom line is we do believe that these communication tools should be a more effective way of communicating this information. The big question is perhaps to what extent will better communication increase participation in the trials and for that we will just have to wait and see…


Morph have been a great partner in the TRECA Study. The TRECA study is complex and requires a lot of input and feedback at various stages of the website development. We really value the flexibility and responsiveness that Morph show on a daily basis to ensure that the websites meet the needs of children and young people, as well as TRECA and the trials that are using the websites for their recruitment.

The level of creativity by the Morph team is amazing and we are really impressed with the quality of their work. Always a pleasure to interact with, and work with, as we create these websites.

Dr Jackie Martin-Kerry, TRECA Study