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Background Poor recruitment and retention of patients in clinical trials is an ongoing issue and innovative methods are required to address these issues. The National Institute for Health and Care Research (NIHR) mandates Patient and Public Involvement and Engagement (PPIE) through all stages of the grant application and trial delivery process. This was incorporated in the development of a Study Within a Trial (SWAT) for the BOAT (Bronchiectasis Optimizing Azithromycin Therapy) trial. This trial compares continuing vs stopping azithromycin therapy in patients with non-cystic fibrosis bronchiectasis. The SWAT was developed to reduce disparities in patient participation from ‘seldom heard groups’ using a recruitment video translated into four languages.Methods A PPIE approach was used during the grant application and video development process. The discussions were led by ‘Asthma and Lung UK’ foundation with an aim to identify the visuals, style and narration preferred by patients to create an accessible and engaging video. In addition, we aimed to ensure the video will effectively explain the trial to potential participants and motivate them to take part in it. Volunteers received 3 video examples from other clinical trials, 4 different versions of the trial script and questions to prompt feedback/ideas.Results 8 volunteers with bronchiectasis (age range 42- 80 years) of varying ethnicity (5 Caucasians, 2 Asian/Asian British and 1 British/Black/African/Caribbean) participated in the sessions. 3 volunteers had hearing impairment.The majority of participants had taken azithromycin at some point for an infection, but the duration of their treatment did vary. Some patients had taken it as a long-term prophylactic while others for acute infection.A focus group was conducted with 4 volunteers, followed by 2 individual interviews and 2 written feedback. The approach used during the PPIE process is shown in figure 1.Abstract S125 Figure 1Conclusion Patients are centre to clinical trials and provide important feedback essential for effective trial development. The focus groups and use of a charity organisation allowed a broad consensus and permits robust critique of initial drafts. Future clinical trials should adopt this approach more frequency to address retention and recruitment issues.