Table 3 Changes proposed to recruitment and intervention for a future pilot RCT

- LLTTF made significant changes to the content of the farming specific modules.-

- To tailor it towards the farming community in response findings of the qualitative research findings.

- Paper copies of the LLTTF intervention made available.

- To allow an alternative format for those who experience poor internet connectivity or problems with technology.

- Standardised questionnaires used at baseline and at several subsequent points during the period of follow-up.

- To help farmers reflect on their own mental health, as some report being oblivious to their declining wellbeing over time.

- Support offered alongside LLTTF.

- To address the problem of loneliness and isolation, and to provide support with technology and accessing the online modules.

- Practical support for farmers (such as help with completing forms and interpreting an information leaflet), is provided in our study by RSABI.

- For those who are struggling with paperwork or feeling trapped within farming life.

- Images, leaflets etc.

- Same images used in leaflets and online promotion.

- To promote recognition and reinforcement which might cause people to become more familiar with the idea of the study.

- Leaflets and social media referencing ‘crofting’.

- To capture the demographic of crofters who may not identify with the label of ‘farmer’.

- The intervention is made available in both written and video format online.

- Modules in video format help to provide additional options for those who struggle with reading.

- Participant information sheet and consent forms are re-written to be understandable to a wide range of reading ages.

- To consider the high proportion of farmers who may have difficulty with reading. There was a struggle to balance the mandatory university requirements for informed consent with a format that was suitable for this audience.

- Videos of other farmers talking about mental health and wellbeing, to supplement written materials.

- To respond to suggestions of using case studies of others in the farming community and normalising mental health issues.

- Images of farmers, rather than of livestock.

- To reinforce the concept of farmers looking after themselves, not just their animals.

Meeting farmers where they are

- Using social media for recruitment.

- To reach farmers who may use social media and also to overcome some of the difficulties of recruiting during COVID lockdowns.

- Leaving leaflets at petrol stations, veterinary practices, auction marts, agricultural solicitors, machinery suppliers etc.

- To target recruitment at places where farmers are likely to visit.

- Using church ministers and church offices as gatekeepers for recruitment.

- Acknowledging the importance of religious organisations to many in the rural community and targeting recruitment through these.

- Recruiting through the Scottish Women’s Institutes and sports clubs, e.g. curling clubs.

- Targeting specific sports and local community groups that are known to be popular with people in rural areas. Also to specifically target women.

- Recruiting through the Young Farmers Associations.

- To specifically target younger farmers or those who may recognise mental health issues amongst older friends and family members.

- In person recruitment at Livestock Auction Marts by members of the research team.

- Face-to-face contact is seen to be one of the most important aspects of recruitment in the farming community.