This thesis maps the growth of the use of internet technologies in randomised controlled trials in health care and public health, and explores the methodological and ethical issues that arise from their use from the perspective of researchers and participants. Online clinical trials are growing in number, and claim to offer benefits for researchers and participants, providing solutions to some of the inherent problems associated with traditional trials. However, little is known about how many internet-based trials have been conducted, what methodological research has been undertaken, or what impact the new technologies might have on researcher or participant experience. The thesis followed a step-by-step approach, using information science, research synthesis, and qualitative methods. The creation of a database of internet-based clinical trials established that they have grown rapidly in number, use internet technologies primarily to deliver an intervention, predominantly in behavioural, mental health, or life-style public health settings. A two-stage systematic review, comprising a descriptive map and a qualitative synthesis, established what is known about the methods, conduct or participant experience in internet-based trials. A qualitative primary study was then carried out, based on the findings of the review, to further explore the views, attitudes and experiences of researchers, participants and the public, into the motivations, benefits or barriers to taking part in internet-based clinical trials. Themes emerging from the research suggest complex interactions between design and technology, particularly in the area of participant characteristics and choice; convenience versus intrusion; impact of time and place; the pace of change and impact of societal changes in the use of technology. A range of ethical considerations emerged, including the nature of informed consent, ethical approval, and the need for a systematic approach to patient and public involvement. Recommendations are made to help inform and improve research practice in the digital age.

Low-income affordable housing remains an issue for the town on Martha's Vineyard where this study was conducted, in which an estimated 54% of low-/moderate-income households spend more than 50% of monthly income on housing. Using Schneider and Ingram's work regarding the social construction of target populations as the foundation, the purpose of this qualitative research was to assess how the perceived social standing and political power contributed to determining the benefits and burdens allocated to the town's low-income households. Data for this study consisted of 14 individual semistructured interviews with members of low-income households who were seeking or in affordable housing. The research concentrated on the obstacles and reactions the low-income households experienced in the quest for affordable housing. Data were coded and analyzed using a value coding procedure followed by thematic analysis. Three themes emerged from the research: a perception by the participants of not being valued in the community and a lack of attention by town leadership to their affordable housing struggles; a self-reliance to find affordable housing; and coping strategies by renting bedrooms with shared kitchen and living areas or resorting to a 9-month lease and being displaced during the summer tourist season. The research illuminated the low-income community's housing experiences and perceptions, thereby helping town leaders to form housing policy and make fiscal decisions. The implications for positive social change include recommendations to town leadership to examine incentivizing homeowners to offer affordable rentals, investigating congregate housing solutions, and developing multifamily affordable housing for the town's low-income households.