Awareness, attitudes, willingness, and organizational readiness regarding decentralized clinical trials among Saudi healthcare professionals: a cross-sectional study

Background Decentralized clinical trials (DCTs) allow some trial activities to be conducted outside traditional research sites and may reduce participants’ travel time and effort. However, their implementation depends on whether healthcare professionals are willing to support these trials and whether their institutions are prepared to conduct them. This study assessed DCT component awareness, perceptions, willingness, and perceived organizational preparedness among healthcare professionals in Saudi Arabia. Methods We conducted an anonymous cross-sectional electronic survey from March to August 2025. The primary cohort included consenting healthcare professionals who completed at least 31 of 38 substantive DCT items (≥80%). Responses were summarized descriptively. Associations with favorable willingness to refer and favorable perceived organizational preparedness, defined as response categories 4-5 versus 1−3, were examined using mean bias-reduced binary logistic regression, with continuous predictors standardized before model fitting. Results The primary cohort included 421 healthcare professionals from medicine, pharmacy, nursing, dentistry, and allied health professions. Overall, 251 of 420 respondents (59.8%) reported that they were somewhat or very willing to refer an eligible patient to a DCT. Among respondents with available data, 69 of 411 (16.8%) had received formal DCT training, 155 of 416 (37.3%) considered their organization prepared, and 63 of 418 (15.1%) felt adequately trained to support DCTs. Geographic diversity was the most frequently recognized benefit (70.2%), while insufficient training was the most frequently reported considerable or significant barrier (59.7%). In the adjusted willingness model, perceived organizational preparedness (adjusted odds ratio [AOR], 2.07; 95% confidence interval [CI], 1.57−2.71) and stronger outcome-and-access beliefs (AOR, 1.65; 95% CI, 1.18−2.30) were associated with favorable willingness, while greater concerns were associated with lower odds (AOR, 0.73; 95% CI, 0.55−0.97). In the preparedness model, longer professional experience was associated with lower odds of favorable perceived organizational preparedness (AOR, 0.77; 95% CI, 0.61−0.97). Conclusion Most surveyed healthcare professionals in Saudi Arabia were willing to refer eligible patients to DCTs, but formal training and perceived organizational preparedness were limited. Workforce training, clear institutional procedures, and objective site-readiness assessments are needed before wider implementation.