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Wei M, Richards KA, Graber KC. Physical Education Teachers' Perceptions of and Strategies for Managing Bullying: The Influence of Socialization. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:625-634. [PMID: 38241175 DOI: 10.1080/02701367.2023.2294088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/01/2023] [Indexed: 01/21/2024]
Abstract
Purpose: This study aimed to investigate how teachers' socialization experiences influence their perceptions of and responses to bullying. Methods: Thirty in-service physical education teachers were recruited to participate. One semi-structured, individual interview was conducted with each participant lasting approximately 60 minutes. Data analysis employed inductive and deductive techniques. Results: Two themes emerged that described teachers' perceptions of and responses to bullying. These themes included: (a) socialization experiences and socializing agents influence teachers' perceptions and behaviors in relation to bullying, and (b) teachers have developed strategies to address bullying but also experience significant challenges. Discussion: The current study suggests that while enrolled in a physical education teacher education program, preservice teachers should be provided greater knowledge about and strategies for addressing bullying. In-service teachers are encouraged to pursue professional development that increases their self-efficacy in managing bullying.
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Affiliation(s)
- Mengyi Wei
- University of Illinois at Urbana-Champaign
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2
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Travis E, Kerrison RS, O'Connor DB, Ashley L. Barriers and facilitators to colonoscopy for cancer detection: patient and practitioner perspectives. Psychol Health 2024; 39:1263-1283. [PMID: 36373225 DOI: 10.1080/08870446.2022.2141241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To further understand the barriers and facilitators to attending colonoscopy examination following a positive routinely offered stool test result, from the perspective of patients and Specialist Screening Practitioners (SSPs). METHODS Qualitative semi-structured interviews were conducted. Participants (N = 32) were patients (n = 20) who, as part of the Bowel Cancer Screening Programme (BCSP) in England, were invited to attend a colonoscopy examination, and SSPs (n = 12), who worked for the BCSP in England. Framework analysis included inductive and deductive coding. RESULTS Anxiety was as a key barrier cited by patients and SSPs, arising from the moment the patient received the invitation letter. Notably, procedural-related anxieties centred upon the fear of pain and discomfort and test invasiveness. The role of family, friends and the SSP were recognised by patients and SSPs to facilitate participation. Many patients, yet not SSPs, emphasised an obligation to attend all medical test invitations. CONCLUSION Practically orientated strategies suggested by patients and SSPs address the patient barriers identified. These include earlier information to patients on the option of sedation for pain relief, earlier notification of potential financial support for patients unable to fund their own travel costs, and fewer uses of the term cancer within written materials.
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Affiliation(s)
| | | | | | - Laura Ashley
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
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3
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Travis E, Ashley L, O'Connor DB. Effects of a modified invitation letter to follow-up colonoscopy for bowel cancer detection. Br J Health Psychol 2024; 29:379-394. [PMID: 37953726 DOI: 10.1111/bjhp.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 10/10/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To investigate whether modifications made to the current National Health Service (NHS) invitation letter for follow-up colonoscopy examination affect participant state anxiety and behavioural intentions to attend. METHODS Five hundred and thirty-eight adults of bowel cancer-eligible screening age (56-74) were randomized to receive the current NHS invitation letter or the modified version of the letter as a hypothetical scenario. Modifications to the letter included fewer uses of the term cancer and awareness of alternative screening options. The history of the colonoscopy invitation, anticipated state anxiety, behavioural intention to attend the nurse appointment, and colonoscopy concerns upon reading the letter were measured. RESULTS Behavioural intentions were high in both conditions; however, participants reading the current letter reported significantly higher behavioural intentions compared to the modified letter. There was no main effect of previous invite status or interaction between previous invite status and letter condition on behavioural intentions. However, the effect of the letter on levels of anxiety depended on the participant's invitation history. Those never invited for a colonoscopy were more anxious when reading the modified letter compared to the current letter. Conversely, previous colonoscopy invitees were less anxious following reading the modified letter than those reading the current letter. Those never invited for a colonoscopy were more concerned about embarrassment and test invasiveness. All findings remained the same when controlling for age and education. CONCLUSION Modifications to the invitation letter were not beneficial to levels of screening intention or anxiety.
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Affiliation(s)
| | - Laura Ashley
- School of Humanities & Social Sciences, Leeds Beckett University, Leeds, UK
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4
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Mendez GG, Nocek JM, Brambilla DJ, Jacobs S, Cole O, Kanter J, Glassberg J, Saving KL, Melvin CL, Gibson RW, Treadwell M, Jackson GL, King AA, Gordeuk VR, Kroner B, Hsu LL. Social determinants of health and treatment center affiliation: analysis from the sickle cell disease implementation consortium registry. BMC Health Serv Res 2024; 24:291. [PMID: 38448911 PMCID: PMC10916176 DOI: 10.1186/s12913-024-10717-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/13/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Adults with sickle cell disease (SCD) suffer early mortality and high morbidity. Many are not affiliated with SCD centers, defined as no ambulatory visit with a SCD specialist in 2 years. Negative social determinants of health (SDOH) can impair access to care. HYPOTHESIS Negative SDOH are more likely to be experienced by unaffiliated adults than adults who regularly receive expert SCD care. METHODS Cross-sectional analysis of the SCD Implementation Consortium (SCDIC) Registry, a convenience sample at 8 academic SCD centers in 2017-2019. A Distressed Communities Index (DCI) score was assigned to each registry member's zip code. Insurance status and other barriers to care were self-reported. Most patients were enrolled in the clinic or hospital setting. RESULTS The SCDIC Registry enrolled 288 Unaffiliated and 2110 Affiliated SCD patients, ages 15-45y. The highest DCI quintile accounted for 39% of both Unaffiliated and Affiliated patients. Lack of health insurance was reported by 19% of Unaffiliated versus 7% of Affiliated patients. The most frequently selected barriers to care for both groups were "previous bad experience with the healthcare system" (40%) and "Worry about Cost" (17%). SCD co-morbidities had no straightforward trend of association with Unaffiliated status. The 8 sites' results varied. CONCLUSION The DCI economic measure of SDOH was not associated with Unaffiliated status of patients recruited in the health care delivery setting. SCDIC Registrants reside in more distressed communities than other Americans. Other SDOH themes of affordability and negative experiences might contribute to Unaffiliated status. Recruiting Unaffiliated SCD patients to care might benefit from systems adopting value-based patient-centered solutions.
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Affiliation(s)
- Gustavo G Mendez
- University of Illinois Chicago, 840 S. Wood St., MC 856 Pediatrics, 60612, Chicago, IL, USA
| | - Judith M Nocek
- University of Illinois Chicago, 840 S. Wood St., MC 856 Pediatrics, 60612, Chicago, IL, USA
| | | | - Sara Jacobs
- RTI International, Research Triangle Park, USA
| | | | - Julie Kanter
- University of Alabama at Birmingham, Birmingham, USA
| | | | - Kay L Saving
- University of Illinois College of Medicine at Peoria, Peoria, USA
| | | | | | | | - George L Jackson
- Duke University, Durham, USA
- Durham Veterans Affairs Health Care System, Durham, USA
- University of Texas Southwestern Medical Center, Dallas, USA
| | | | - Victor R Gordeuk
- University of Illinois Chicago, 840 S. Wood St., MC 856 Pediatrics, 60612, Chicago, IL, USA
| | | | - Lewis L Hsu
- University of Illinois Chicago, 840 S. Wood St., MC 856 Pediatrics, 60612, Chicago, IL, USA.
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5
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Mikolajczak-Degrauwe K, Slimmen SR, Gillissen D, de Bil P, Bosmans V, Keemink C, Meyvis I, Kuipers YJ. Strengths, weaknesses, opportunities and threats of peer support among disadvantaged groups: A rapid scoping review. Int J Nurs Sci 2023; 10:587-601. [PMID: 38020843 PMCID: PMC10667317 DOI: 10.1016/j.ijnss.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To explore the current state of knowledge and evidence about peer support for various disadvantaged groups; to identify the strengths, weaknesses, opportunities, and threats of peer support to critically reflect on peer support within health and social services. Methods A rapid scoping review was conducted according to Arksey and O'Malley's framework, aiming to identify eligible studies in PubMed, APA PsychInfo, Education Resources Information Center, Cochrane Library, Academic Search Premier, ScienceDirect, Directory of Open Access Journals, ResearchGate, WorldCat, and Google Scholar. According to Rodgers' concept analysis steps and the SWOT model, data was reported using thematic synthesis. Results Forty-five studies were included, describing a variety of peer support initiatives among groups of young migrants and unsupervised minors, young adults with autism, people with (mental) health problems, foster/shelter families, vulnerable pregnant women, people outside the labour force, older adults, and homeless people. The strength of peer support is its positive effect on the quality of life among vulnerable people. The weakness is represented by peers both being too involved and focused on personal interest or by peers lacking expertise and knowledge. Opportunities for peer support are mutual learning, the anticipated long-term effects, and the potential to facilitate social inclusion. Culture, language barriers, drop-out rates, securing sustainability, and peers' lack of time and commitment are regarded as threats to peer support. Conclusion Although peer support offers good outcomes for various groups of vulnerable people, the weaknesses and threats need to be considered to provide and proliferate peer support.
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Affiliation(s)
| | - Sybren R. Slimmen
- Research Group Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Dylan Gillissen
- Research Group Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Petra de Bil
- Research Group Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Valerie Bosmans
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
| | - Corrine Keemink
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
| | - Inge Meyvis
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
| | - Yvonne J. Kuipers
- Department of Health and Social Studies, School of Midwifery, Artesis Plantijn University of Applied Sciences, Antwerp, Belgium
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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Alwan NA, Clutterbuck D, Pantelic M, Hayer J, Fisher L, Hishmeh L, Heightman M, Allsopp G, Wootton D, Khan A, Hastie C, Jackson M, Rayner C, Brown D, Parrett E, Jones G, Smith K, Clarke R, Mcfarland S, Gabbay M, Banerjee A. Long Covid active case finding study protocol: A co-produced community-based pilot within the STIMULATE-ICP study (Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways). PLoS One 2023; 18:e0284297. [PMID: 37471432 PMCID: PMC10358953 DOI: 10.1371/journal.pone.0284297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/28/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND AND AIM Long Covid is a significant public health concern with potentially negative implications for health inequalities. We know that those who are already socially disadvantaged in society are more exposed to COVID-19, experience the worst health outcomes and are more likely to suffer economically. We also know that these groups are more likely to experience stigma and have negative healthcare experiences even before the pandemic. However, little is known about disadvantaged groups' experiences of Long Covid, and preliminary evidence suggests they may be under-represented in those who access formal care. We will conduct a pilot study in a defined geographical area in London, United Kingdom to test the feasibility of a community-based approach of identifying Long Covid cases that have not been clinically diagnosed and have not been referred to Long Covid specialist services. We will explore the barriers to accessing recognition, care, and support, as well as experiences of stigma and perceived discrimination. METHODS This protocol and study materials were co-produced with a Community Advisory Board (CAB) made up primarily of people living with Long Covid. Working with voluntary organisations, a study leaflet will be distributed in the local community to highlight Long Covid symptoms and invite those experiencing them to participate in the study if they are not formally diagnosed. Potential participants will be assessed according to the study's inclusion criteria and offered the opportunity to participate if they fit them. Awareness of Long Covid and associated symptoms, experiences of trying to access care, as well as stigma and discrimination will be explored through qualitative interviews with participants. Upon completion of the interviews, participants will be offered a referral to the local social prescribing team to receive support that is personalised to them potentially including, but not restricted to, liaising with their primary care provider and the regional Long Covid clinic.
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Affiliation(s)
- Nisreen A. Alwan
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
| | - Donna Clutterbuck
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Marija Pantelic
- Brighton and Sussex Medical School, University of Sussex, Falmer, United Kingdom
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Jasmine Hayer
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Lere Fisher
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Lyth Hishmeh
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Melissa Heightman
- University College London Hospitals NHS Trust, London, United Kingdom
| | - Gail Allsopp
- Royal College of General Practitioners, London, United Kingdom
| | - Dan Wootton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Asad Khan
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Claire Hastie
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
- Long Covid Support Charity, https://www.longcovid.org/, London, United Kingdom
| | - Monique Jackson
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Clare Rayner
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Darren Brown
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
- Long COVID Physio, https://longcovid.physio/, London, United Kingdom
| | - Emily Parrett
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Geraint Jones
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Kerry Smith
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Rowan Clarke
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
| | - Sammie Mcfarland
- Community Advisory Board (as person with lived experience of Long Covid), STIMULATE-ICP, London, United Kingdom
- Long Covid Kids Charity, https://www.longcovidkids.org/, Salisbury, United Kingdom
| | - Mark Gabbay
- NIHR Applied Research Collaboration North West Coast, Liverpool, United Kingdom
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom
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Richard E, Vandentorren S, Cambon L. Conditions for the success and the feasibility of health mediation for healthcare use by underserved populations: a scoping review. BMJ Open 2022; 12:e062051. [PMID: 36127102 PMCID: PMC9490640 DOI: 10.1136/bmjopen-2022-062051] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This article aims to analyse the conditions under which health mediation for healthcare use is successful and feasible for underserved populations. METHOD We conducted a scoping review on the conditions for effective health mediation according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews standards. We searched for articles in the following databases: PubMed, PsychINFO, Scopus and Cairn published between 1 January 2015 and 18 December 2020. We selected the articles concerning health mediation interventions or similar, implemented in high-income countries and conducted among underserved populations, along with articles that questioned their effectiveness conditions. We created a two-dimensional analysis grid of the data collected: a descriptive dimension of the intervention and an analytical dimension of the conditions for the success and feasability of health mediation. RESULTS 22 articles were selected and analysed. The scoping review underlines many health mediation characteristics that articulate education and healthcare system navigation actions, along with mobilisation, engagement, and collaboration of local actors among themselves and with the populations. The conditions for the success and the feasability were grouped in a conceptual framework of health mediation. CONCLUSION The scoping review allows us to establish an initial framework for analysing the conditions for the success and the feasability of health mediation and to question the consistency of the health mediation approach regarding cross-cutting tensions and occasionally divergent logic.
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Affiliation(s)
- Elodie Richard
- PHAReS, Bordeaux Population Health, Centre Inserm U1219, Université de Bordeaux, Bordeaux, France
- Health Pole, FNASAT-GV, Paris, France
| | - Stephanie Vandentorren
- PHAReS, Bordeaux Population Health, Centre Inserm U1219, Université de Bordeaux, Bordeaux, France
- Direction scientifique et internationale, Santé publique France, Saint-Maurice, France
| | - Linda Cambon
- PHAReS, Bordeaux Population Health, Centre Inserm U1219, Université de Bordeaux, Bordeaux, France
- CHU de Bordeaux, Bordeaux, France
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Harrison D, Wilson R, Graham A, Brown K, Hesselgreaves H, Ciesielska M. Making every contact count with seldom-heard groups? A qualitative evaluation of voluntary and community sector (VCS) implementation of a public health behaviour change programme in England. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3193-e3206. [PMID: 35218264 PMCID: PMC9544506 DOI: 10.1111/hsc.13764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/19/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Making Every Contact Count (MECC) is a national, long-term public health strategy in England. It supports public-facing workers to use opportunities during routine contacts to enable healthy lifestyle changes. This paper reports the findings from an external evaluation of voluntary and community sector (VCS) delivery of MECC in the North East of England, which focused on engaging under-represented client groups. The study aimed to (a) Establish if (and how) MECC had impacted the workforce, including changes to staff knowledge, confidence and behaviour; (b) Identify benefits, challenges and unintended consequences; and (c) Explore outcomes for service users. A multi-stage qualitative design focused on understanding both process and outcomes. The study utilised three data collection methods, including a journey mapping workshop (n = 20), semi-structured interviews with delivery leads, VCS workers and volunteers who had accessed MECC training (n = 11), and focus group discussions with clients (n = 22). The findings illustrated positive early outcomes, including improvements in self-reported staff knowledge and confidence as well as emerging examples of organisational culture shift and individual behaviour change. Alongside this, the data provided a rich picture of barriers and challenges which are examined at different levels-national programme, local programme, VCS sector, partner organisation, worker and client. The research highlights clear successes of the VCS delivery model. However, it is presented as a 'double-edged sword,' in light of associated challenges such as sector-level funding uncertainty and accessibility of MECC resources to diverse client groups. The discussion considers issues related to the measurement and attribution of behaviour change outcomes for brief interventions, as well as fidelity, legacy and long-term sustainability challenges. The recommendations call for system-level analysis and comparison of different MECC implementation models, to improve our understanding of challenges, opportunities and programme reach for behaviour change intervention programmes-particularly in relation to seldom-heard client groups.
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Affiliation(s)
- Deborah Harrison
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
| | - Rob Wilson
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
| | - Andy Graham
- Public Health ConsultantLocal GovernmentNorth East EnglandUK
| | - Kristina Brown
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
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Marthinsen GN, Helseth S, Småstuen M, Bjorvatn B, Bandlien SM, Fegran L. Sleep patterns and psychosocial health of parents of preterm and full-born infants: a prospective, comparative, longitudinal feasibility study. BMC Pregnancy Childbirth 2022; 22:546. [PMID: 35794538 PMCID: PMC9258469 DOI: 10.1186/s12884-022-04862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background The early birth and hospitalization of a preterm infant in neonatal intensive care unit can produce several emotional and behavioural responses including sleep problems for parents. Few studies have explored sleep and its associations with health and HRQoL over time in this vulnerable parent population. This purpose of this study was to evaluate the feasibility of a prospective, comparative, longitudinal study of the sleep patterns and psychosocial health of preterm and full-born infants’ parents during the first postpartum year. Methods A prospective, comparative, longitudinal feasibility study was conducted. Parents of preterm infants were compared to parents of full-born infants to identify if there were differences in outcomes between the groups. The parents were instructed to wear actigraphs and complete sleep diaries for two consecutive weeks, and responded to a digital questionnaire covering stress, insomnia, fatigue, depression, social support, self-efficacy, and health-related quality of life. Survey data were collected at infant ages of 2, 6, and 12 months, actigraphy and sleep diary data were collected at infant age of 2 months only. Descriptive analysis was used to describe recruitment and attrition rates. Differences between completers and dropouts were analysed with a chi-square test (categorical data) and Mann–Whitney–Wilcoxon test for two independent samples (continuous variables). Results Between June 2019 and March 2020, 25 parents of a preterm infant and 78 parents of a full-born infant were recruited from four neonatal intensive care units and two maternity wards, respectively, in four Norwegian hospitals. Feasibility was predefined as recruiting ≥ 75 parents each of preterm and full-born infants. The target for the full-born group was reached. However, the preterm group recruitment was challenging. Actigraphs, sleep diaries, and questionnaires were evaluated as feasible for use in a future study. Attrition rates were high in both groups at 6 and 12 months. No parent-related characteristics were associated with participation at 6 months. At 12 months, dropouts had a statistically significantly lower age in the full-born group (both parents) and higher age and body mass index in the preterm group (fathers). Conclusions A longitudinal study is feasible; however, procedural changes, including using active methods and contacting participants, are necessary to increase the recruitment of preterm infants’ parents. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04862-1.
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Savard I, Kilpatrick K. Tailoring research recruitment strategies to survey harder-to-reach populations: A discussion paper. J Adv Nurs 2022; 78:968-978. [PMID: 35084799 DOI: 10.1111/jan.15156] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 12/12/2022]
Abstract
AIMS A discussion of the challenges of recruiting participants from harder-to-reach populations for quantitative survey studies and potential avenues for tailored strategies to address these challenges. DESIGN Discussion paper. DATA SOURCES The search was conducted on August 2, 2021, in the CINAHL and PubMed databases, and in Google scholar. The initial search identified 5880 articles, and the final analysis included 44 articles that met the inclusion criteria. Articles were retained if they addressed methodological challenges or strategies for recruitment and concerned research with harder-to-reach populations. IMPLICATIONS FOR NURSING This article draws on the literature regarding the challenges of recruiting research participants from harder-to-reach populations and known strategies for overcoming them. These strategies include, for example, establishing a trusting relationship between the researcher and the participant community and gaining in-depth knowledge of the target population. These challenges and strategies for recruiting participants from these populations are discussed specifically in the context of quantitative survey research. CONCLUSION Nurse researchers conducting quantitative survey studies with participants from harder-to-reach populations must tailor their recruitment strategies to the target population and, most importantly, be flexible and creative in their recruitment methods. IMPACT The article discusses the challenges of recruiting participants from harder-to-reach populations and strategies to overcome them in quantitative survey studies. Successful recruitment requires researchers to develop a thorough understanding of the harder-to-reach population, develop partnerships to locate and access potential participants, build trust with the community, tailor their language, minimize participation risk and resource constraints, recognize the cognitive and physical demands required, and be flexible and creative in developing recruitment strategies. This knowledge can enable the inclusion of more people from harder-to-reach populations in survey studies and provide evidence that can inform research and practice to provide healthcare tailored to their needs and ultimately help improve their health and well-being.
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Affiliation(s)
- Isabelle Savard
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, Quebec, Canada
| | - Kelley Kilpatrick
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
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Garnett A, Northwood M. Recruitment of Community-Based Samples: Experiences and Recommendations for Optimizing Success. Can J Nurs Res 2021; 54:101-111. [PMID: 34841904 PMCID: PMC9109582 DOI: 10.1177/08445621211060935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Recruitment in health and social science research is a critically important but often
overlooked step in conducting successful research. The challenges associated with
recruitment pertain to multiple factors such as enrolling groups with vulnerabilities,
obtaining geographic, cultural, and ethnic representation within study samples,
supporting the participation of less accessible populations such as older adults, and
developing networks to support recruitment. Purpose This paper presents the experiences of two early career researchers in recruiting
community-based samples of older adults, their caregivers, and associated health
providers. Methods Challenges and facilitators in recruiting two community-based qualitative research
samples are identified and discussed in relation to the literature. Results Challenges included: identifying potential participants, engaging referral partners,
implementing multi-methods, and achieving study sample diversity. Facilitators included:
making connections in the community, building relationships, and drawing on existing
networks. Conclusions Findings suggest the need for greater recognition of the importance of having clear
frameworks and strategies to address recruitment prior to study commencement as well as
the need to have clear outreach strategies to optimize inclusion of marginalized groups.
Recommendations and a guide are provided to inform the development of recruitment
approaches of early career researchers in health and social science research.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt School of Nursing, 6221Western University, London, Ontario, Canada
| | - Melissa Northwood
- School of Nursing, 3710McMaster University, Hamilton, Ontario, Canada
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Caminada S, Turatto F, Iorio S, Paglione L, Errigo M, Mazzalai E, Jaljaa A, Giannini D, Tofani M, Michelazzo MB, Landi A, Napoli M, Brandimarte MA, Salvatori LM, Angelozzi A, Baglio G, Di Rosa E, Battisti A, Marceca M. Urban Health and Social Marginality: Perceived Health Status and Interaction with Healthcare Professionals of a Hard-to-Reach Community Living in a Suburban Area of Rome (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168804. [PMID: 34444550 PMCID: PMC8394967 DOI: 10.3390/ijerph18168804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
The study reports an urban health investigation conducted in Bastogi, an outskirt of Rome (Italy) characterised by social marginalization and deprivation. Our aim was to analyse the health perception, health-related behaviours, and interaction with healthcare professionals of the inhabitants of Bastogi compared to the population living in the area of the same local health unit (ASL). The Progresses of Health Authorities for Health in Italy questionnaire (PASSI) was administered to a sample of 210 inhabitants of Bastogi. Data were analysed and compared to those of the ASL collected in 2017–2018. The socio-economic indicators showed an overall worse condition for the inhabitants of Bastogi, with a significantly higher proportion of foreign and unemployed residents and a lower educational level compared to the ASL. Significant differences in the prevalence of non-communicable diseases, mental health complaints, and participation in prevention strategies, including cancer screening, were found. The questionnaire showed a lower help-seeking behaviour and a lack of reliance on health professionals in Bastogi inhabitants. Our findings highlight how social determinants produce health inequities and barriers to accessing healthcare. The difficulties of conducting quantitative research in complex and hard-to-reach contexts, characterized by high social vulnerability, are outlined.
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Affiliation(s)
- Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
- Correspondence:
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Silvia Iorio
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy;
| | - Lorenzo Paglione
- Department of Civil, Constructional and Environmental Engineering, Sapienza University of Rome, 00184 Rome, Italy;
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | - Miriam Errigo
- Department of Social Sciences and Economics, Sapienza University of Rome, 00185 Rome, Italy;
| | - Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Marco Tofani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Maria Benedetta Michelazzo
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Adelaide Landi
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | - Massimo Napoli
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | | | | | - Aurora Angelozzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Giovanni Baglio
- Research and International Relations Office, Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS), 00187 Rome, Italy;
| | - Enrico Di Rosa
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | - Alessandra Battisti
- Department of Planning, Design, and Technology of Architecture, Sapienza University of Rome, 00196 Rome, Italy;
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
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Holland-Hart D, McCutchan GM, Quinn-Scoggins HD, Brain K, Hill L, Shanbag S, Abel M, White K, Evans A, Rees S, Bowen S, Gemine R, Collier G. Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms. BMJ Open Respir Res 2021; 8:e000772. [PMID: 34376398 PMCID: PMC8354290 DOI: 10.1136/bmjresp-2020-000772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 07/11/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Lung cancer survival rates in the UK are among the lowest in Europe, principally due to late-stage diagnosis. Alternative routes to earlier diagnosis of lung cancer are needed in socioeconomically deprived communities that are disproportionately affected by poor lung cancer outcomes. We assessed the feasibility and acceptability of a community-based pharmacy referral service to encourage earlier symptomatic referral for chest X-rays. METHODS Seventeen community pharmacies located in a deprived area of Wales participated between March 2019 and March 2020. Stakeholder interviews were conducted with four patients, seven pharmacy professionals and one general practitioner. Four focus groups were conducted, including one with healthcare professionals (n=6) and three with members of the public who were current and former smokers (n=13). Quantitative data regarding patient characteristics and clinical outcomes were collected from hospital records and patient referral questionnaires completed by pharmacists and analysed using descriptive statistics. Qualitative data sets were analysed thematically and triangulated. RESULTS Twelve patients used the pharmacy referral service, all of whom were male. Average length of the pharmacy consultation was 13 min, with a mean 3 days to accessing chest X-rays in secondary care. Patients experienced a mean 46-day wait for results, with no lung cancer detected. Participants found the service to be acceptable and considered the pharmacy element to be broadly feasible. Perceived barriers included low awareness of the service and concerns about the role and capacity of pharmacists to deliver the service. Facilitators included perceived approachability and accessibility of pharmacists. A well-publicised, multifaceted awareness campaign was recommended. CONCLUSIONS A community pharmacy referral service for lung symptoms was considered an acceptable alternative pathway to symptomatic diagnosis of lung cancer in deprived communities. Wider implementation of the service would require workforce capacity and training to be addressed to ensure optimum utilisation and promotion of the service.
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Affiliation(s)
- Daniella Holland-Hart
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Grace M McCutchan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | | | - Kate Brain
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Lucy Hill
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
| | - Savita Shanbag
- Medical Directorate, Hywel Dda University Health Board, Llanelli, Carmarthenshire, UK
| | - Michael Abel
- Public Patient Representative, Ceredigion, Wales, UK
| | - Kelly White
- Hywel Dda University Health Board, Felinfoel Community Resource Centre, Llanelli, Carmarthenshire, UK
| | - Angela Evans
- Hywel Dda University Health Board, Felinfoel Community Resource Centre, Llanelli, Carmarthenshire, UK
| | - Sarah Rees
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
| | - Sarah Bowen
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
| | - Rachel Gemine
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
- Swansea University College of Medicine, Swansea University, Swansea, Wales, UK
| | - Gareth Collier
- Department of Respiratory Medicine, Hywel Dda University Health Board, Llanelli, Carmarthenshire, UK
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Tully L, Spyreli E, Allen-Walker V, Matvienko-Sikar K, McHugh S, Woodside J, McKinley MC, Kearney PM, Dean M, Hayes C, Heary C, Kelly C. Recruiting 'hard to reach' parents for health promotion research: experiences from a qualitative study. BMC Res Notes 2021; 14:276. [PMID: 34289873 PMCID: PMC8293495 DOI: 10.1186/s13104-021-05653-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022] Open
Abstract
Objective Marginalised populations are less likely to take part in health research, and are sometimes considered ‘easy to ignore’. We aimed to describe our approach and results of recruiting parents who experience disadvantage, for focus groups exploring infant feeding on the island of Ireland. Upon receiving ethical approval, we implemented recruitment strategies that included building rapport with community organisations through existing networks, targeting specific organisations with information about our aims, and utilising social media groups for parents. Results We approached 74 organisations of which 17 helped with recruitment. We recruited 86 parents/carers (one male) for 19 focus groups (15 urban/4 rural). Seventy two percent met at the eligibility criteria. Most participants were recruited through organisations (91%), and the remainder on social media (9%). Recruitment barriers included multiple steps, research fatigue, or uncertainty around expectations. Factors such as building rapport, simplifying the recruitment process and being flexible with procedures were facilitators. Despite comprehensive, multi-pronged approaches, the most marginalised parents may not have been reached. Further alternative recruitment strategies are required for recruiting fathers, rural populations, or those without the capacity or opportunity to engage with local services. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05653-1.
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Affiliation(s)
- Louise Tully
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland.
| | - Eleni Spyreli
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - Virginia Allen-Walker
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | | | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Jayne Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - Michelle C McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | | | - Moira Dean
- School of Biological Sciences, Institute for Global Food Security, Queens University Belfast, Belfast, UK
| | | | - Caroline Heary
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland
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Chandra-Mouli V, Neal S, Moller AB. Adolescent sexual and reproductive health for all in sub-Saharan Africa: a spotlight on inequalities. Reprod Health 2021; 18:118. [PMID: 34134737 PMCID: PMC8208826 DOI: 10.1186/s12978-021-01145-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- Venkatraman Chandra-Mouli
- Department of Sexual and Reproductive Health and Research/Human Reproduction Programme, World Health Organization, Geneva, Switzerland.
| | - Sarah Neal
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Ann-Beth Moller
- Department of Sexual and Reproductive Health and Research/Human Reproduction Programme, World Health Organization, Geneva, Switzerland
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16
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Dinnissen CS, Ocké MC, Buurma-Rethans EJM, van Rossum CTM. Dietary Changes among Adults in The Netherlands in the Period 2007-2010 and 2012-2016. Results from Two Cross-Sectional National Food Consumption Surveys. Nutrients 2021; 13:1520. [PMID: 33946365 PMCID: PMC8146163 DOI: 10.3390/nu13051520] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/22/2022] Open
Abstract
Insight into dietary trends is important for the development and evaluation of dietary policies. The aim of this study is to describe changes in dietary intakes of Dutch adults and to evaluate these changes by age, gender, and education. In 2007-2010 and 2012-2016, two national food consumption surveys were conducted including 2106 and 1540 adults, respectively. Data collection included two non-consecutive 24 h dietary recalls. Mean habitual intakes of foods and nutrients relevant for a healthy diet of both surveys were estimated. Between the two periods the mean consumption of red or processed meat, dairy, sodium and alcohol and the ratio of whole-grain to cereal products decreased by 4-30% and the consumption of fibre and unsaturated fatty acids increased by about 3% and 6%, respectively. For most food groups, changes in consumption were comparable for both sexes and in all age groups. A healthier consumption pattern and several favorable changes were observed among higher-educated people. Most, but not all, changes in food consumption are favorable from a public health point of view. However, there is still a large potential for further improvements. A healthier consumption pattern was observed in adults with a higher educational level which calls for attention to social disparities when developing dietary policies.
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Affiliation(s)
- Ceciel S. Dinnissen
- National Institute for Public Health and the Environment (RIVM), 3721 BA Bilthoven, The Netherlands; (M.C.O.); (E.J.M.B.-R.); (C.T.M.v.R.)
| | - Marga C. Ocké
- National Institute for Public Health and the Environment (RIVM), 3721 BA Bilthoven, The Netherlands; (M.C.O.); (E.J.M.B.-R.); (C.T.M.v.R.)
- Division of Human Nutrition and Health, Wageningen University and Research, 6708 WE Wageningen, The Netherlands
| | - Elly J. M. Buurma-Rethans
- National Institute for Public Health and the Environment (RIVM), 3721 BA Bilthoven, The Netherlands; (M.C.O.); (E.J.M.B.-R.); (C.T.M.v.R.)
| | - Caroline T. M. van Rossum
- National Institute for Public Health and the Environment (RIVM), 3721 BA Bilthoven, The Netherlands; (M.C.O.); (E.J.M.B.-R.); (C.T.M.v.R.)
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Pivetti M, Melotti G, Mancini C. Vaccines and autism: a preliminary qualitative study on the beliefs of concerned mothers in Italy. Int J Qual Stud Health Well-being 2021; 15:1754086. [PMID: 32298221 PMCID: PMC7178877 DOI: 10.1080/17482631.2020.1754086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: While a large body of evidence has shown that the administration of the measles-mumps-rubella (MMR) vaccine is not associated with an increased risk of autism spectrum disorder (ASD), a hesitant attitude towards childhood vaccination is still present among the public. In this study, we aim to investigate the mothers’ perceptions of the cause of their child’s ASD in order to increase our understanding of vaccine hesitancy. Methods: This study draws on the analysis of 18 semi-structured interviews of mothers of children with ASD on the causes of autism. Results: The interview material was content-analysed. The main themes were 1) childhood vaccines; 2) genetics; 3) specific conditions of the mother or the newborn at the moment of delivery; 4) environmental factors such as the mother’s lifestyle or her diet. The link between vaccines and autism was prevalent. About one third of the mothers reported that their child’s ASD was a consequence of a combination of two or more factors, i.e., childhood vaccines and specific conditions of the newborn or the mother at the moment of delivery. Conclusion: This study provides preliminary insights into recurring sets of beliefs concerning the causes of ASD among the mothers of affected children.
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Affiliation(s)
- Monica Pivetti
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Giannino Melotti
- Department of Education Studies «Giovanni Maria Bertin»(E.D.U.), University of Bologna, Bologna, Italy
| | - Claudia Mancini
- Department of Psychological, Health and Territorial Sciences (Di.S.P.U.Ter.), University of Chieti-Pescara, Chieti, Italy
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Ali P. Places of worship can be health promotion spaces for faith-based black, Asian and minority ethnic (BAME) communities. Evid Based Nurs 2021; 24:26. [PMID: 31848182 DOI: 10.1136/ebnurs-2019-103140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Parveen Ali
- Health Sciences School, University of Sheffield, Sheffield, South Yorkshire, UK
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Führer A, Korn M, Brzoska P. [The usability of information material for refugees. An exemplary evaluation of Saxony-Anhalt's "Health Booklet for Asylum Seekers"]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2020; 158-159:1-9. [PMID: 33239253 DOI: 10.1016/j.zefq.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS In response to the large number of asylum seekers coming to Germany since 2015, lots of informational materials, translation aids, leaflets, etc. have been developed. However, hardly any of these materials have been evaluated with respect to their acceptance and usability in clinical practice. The aim of the present study was to exemplarily evaluate the 'Health Booklet for Asylum Seekers' that has been in use in Saxony-Anhalt since 2017. METHODS A cross-sectional survey was combined with qualitative interviews in an explanatory sequential mixed methods design. The survey included general practitioners (n=41), nursing staff (n=7), refugees (n=19) and other stakeholders (n=30); the Systems Usability Scale (SUS) was used to assess the usability of the booklet. The qualitative part of the study involved 35 interviews with the above-mentioned participants and two focus group discussions with physicians and refugees; the aim was to better understand the different actors' perception of usability. RESULTS Most general practitioners did not know the booklet and had never used it before, but were eager to make use of it in the future. Overall, the booklet was rated as highly usable by 65 % of all respondents, while the median score in the SUS was above the threshold value for good usability. Respondents explained that the booklet improved patient care, helped patients to better understand the health care system and their health issues, increased patient autonomy and has symbolic value as an expression of diversity management. DISCUSSION The different stakeholders predominantly perceived the health booklet to be a useful tool and assumed that its application in clinical practice would help alleviate some of the practical problems in providing medical care for asylum seekers.
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Affiliation(s)
- Amand Führer
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Epidemiologie, Biometrie und Informatik, Profilzentrum Gesundheitswissenschaften, Halle (Saale), Deutschland.
| | - Marie Korn
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Epidemiologie, Biometrie und Informatik, Profilzentrum Gesundheitswissenschaften, Halle (Saale), Deutschland
| | - Patrick Brzoska
- Lehrstuhl für Versorgungsforschung, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
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Kolovou V, Moriarty Y, Gilbert S, Quinn-Scoggins H, Townson J, Padgett L, Owen S, Buckle P, Edwards A, Hepburn J, Lau M, Matthews M, Mitchell C, Neal R, Playle R, Robling M, Smits S, Trubey R, Wood F, Brain K. Recruitment and retention of participants from socioeconomically deprived communities: lessons from the Awareness and Beliefs About Cancer (ABACus3) Randomised Controlled Trial. BMC Med Res Methodol 2020; 20:272. [PMID: 33148184 PMCID: PMC7641826 DOI: 10.1186/s12874-020-01149-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recruitment of research participants poses challenges in socioeconomically deprived areas. The Awareness and Beliefs About Cancer (ABACus) phase 3 Randomised Control Trial recruited adult participants from socioeconomically deprived areas using a combined healthcare/community engagement model. We report the strategies used to successfully recruit and retain our trial participant sample. METHODS Community and healthcare settings in areas of high socioeconomic deprivation were identified by lay advisors who recruited participants opportunistically or by appointment. Follow-up was done by telephone or post at 2-weeks and 6-months after recruitment, and all participants were offered financial incentives. Qualitative interviews were conducted with lay advisors regarding their experience and reflections. RESULTS The lay advisors identified and contacted 107 potential recruitment venues across South and West Yorkshire and South East Wales of which 41.1% (n = 42) were opened for recruitment. A total of 234 participants were recruited, with 91% (n = 212) retention at 2-weeks and 85% (n = 199) at 6-months. Community settings yielded 75% (n = 176) of participants. Participants had a mean age of 61.3 years and 63.3% (n = 148) were female, with 66% (n = 154) resident in the most deprived geographical areas. Lay advisors described recruitment as intensive, although engaging participants was easier in community settings. CONCLUSIONS The ABACus3 trial achieved recruitment and high retention with a population that is often "hard to reach" or entirely missed in health research. Strategies were specifically tailored to engage the venues and adult residents of highly deprived areas. Future studies recruiting adults living in the most deprived areas might benefit from community recruitment and from collaborating with local gatekeepers who are key to engagement. This study adheres to CONSORT guidelines. TRIAL REGISTRATION Retrospectively registered with ISRCTN ( http://www.isrctn.com/ISRCTN16872545 ) on 12.01.2018.
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Affiliation(s)
- Vasiliki Kolovou
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK.
| | - Yvonne Moriarty
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Stephanie Gilbert
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | | | - Julia Townson
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Louise Padgett
- Department of Health Sciences, University of York, York, UK
| | - Sioned Owen
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Peter Buckle
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Adrian Edwards
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Julie Hepburn
- Lead Lay Research Partner Wales Cancer Research Centre, Cardiff, Wales, UK
| | - Mandy Lau
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | | | - Caroline Mitchell
- Academic Unit of Primary Medical Care, University of Sheffield, Sheffield, UK
| | - Richard Neal
- Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - Rebecca Playle
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Mike Robling
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Stephanie Smits
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Rob Trubey
- Centre for Trials Research Cardiff Metropolitan University, Cardiff, Wales, CF14 4YS, UK
| | - Fiona Wood
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Kate Brain
- Division of Population Medicine, Cardiff University, Cardiff, UK
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21
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Corbett TK, Cummings A, Lee K, Calman L, Fenerty V, Farrington N, Lewis L, Young A, Boddington H, Wiseman T, Richardson A, Foster C, Bridges J. Planning and optimising CHAT&PLAN: A conversation-based intervention to promote person-centred care for older people living with multimorbidity. PLoS One 2020; 15:e0240516. [PMID: 33064764 PMCID: PMC7567392 DOI: 10.1371/journal.pone.0240516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Older people are more likely to be living with cancer and multiple long-term conditions, but their needs, preferences for treatments, health priorities and lifestyle are often not identified or well-understood. There is a need to move towards a more comprehensive person-centred approach to care that focuses on the cumulative impact of a number of conditions on daily activities and quality of life. This paper describes the intervention planning process for CHAT& PLANTM, a structured conversation intervention to promote personalised care and support self-management in older adults with complex conditions. METHODS A theory-, evidence- and person-based approach to intervention development was undertaken. The intervention planning and development process included reviewing relevant literature and existing guidelines, developing guiding principles, conducting a behavioural analysis and constructing a logic model. Optimisation of the intervention and its implementation involved qualitative interviews with older adults with multimorbidity (n = 8), family caregivers (n = 2) and healthcare professionals (HCPs) (n = 20). Data were analysed thematically and informed changes to the intervention prototype. RESULTS Review findings reflected the importance of HCPs taking a person-centred (rather than disease-centred) approach to their work with older people living with multimorbidity. This approach involves HCPs giving health service users the opportunity to voice their priorities, then using these to underpin the treatment and care plan that follow. Findings from the planning stage indicated that taking a structured approach to interactions between HCPs and health service users would enable elicitation of individual concerns, development of a plan tailored to that individual, negotiation of roles and review of goals as individual priorities change. In the optimisation stage, older adults and HCPs commented on the idea of a structured conversation to promote person-centred care and on its feasibility in practice. The idea of a shared, person-centred approach to care was viewed positively. Concerns were raised about possible extra work for those receiving or delivering care, time and staffing, and risk of creating another "tick-box" exercise for staff. Participants concluded that anyone with the appropriate skills could potentially deliver the intervention, but training was likely to be required to ensure correct utilisation and self-efficacy to deliver to the intervention. CONCLUSIONS CHAT&PLAN, a structured person-centred conversation guide appears acceptable and appealing to HCPs and older adults with multimorbidity. Further development of the CHAT&PLAN intervention should focus on ensuring that staff are adequately trained and supported to implement the intervention.
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Affiliation(s)
- Teresa K. Corbett
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Highfield, Southampton, United Kingdom
| | - Amanda Cummings
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Kellyn Lee
- School of Health Sciences, University of Southampton, Highfield, Southampton, United Kingdom
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Vicky Fenerty
- University of Southampton Library, University of Southampton, Southampton, United Kingdom
| | - Naomi Farrington
- University Hospital Southampton & University of Southampton, Southampton, United Kingdom
| | - Lucy Lewis
- Health Education England South East, University Hospital Southampton NHS Foundation Trust and University of Southampton, Otterbourne, Winchester, United Kingdom
| | - Alexandra Young
- School of Health Sciences, University of Southampton, Highfield, Southampton, United Kingdom
| | - Hilary Boddington
- Wessex Macmillan GP, Wessex Cancer Alliance, Southampton, United Kingdom
| | - Theresa Wiseman
- The Royal Marsden NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Alison Richardson
- NIHR ARC Wessex, School of Health Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust Mailpoint, Southampton General hospital, Southampton, United Kingdom
| | - Claire Foster
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Jackie Bridges
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, United Kingdom
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Carandang K, Mruk V, Ardoin SP, Huynh B, Clowse MEB, Berlan ED, Edens C. Reproductive health needs of adolescent and young adult women with pediatric rheumatic diseases. Pediatr Rheumatol Online J 2020; 18:66. [PMID: 32807193 PMCID: PMC7433038 DOI: 10.1186/s12969-020-00460-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/03/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify reproductive health knowledge gaps and topics that concern adolescent and young adult (AYA) women with pediatric rheumatic diseases and their parents. METHODS Data collection occurred in two cohorts. In the first cohort, young women (15-20 years old) with pediatric-onset rheumatic conditions and their parents were recruited from a single, academic pediatric rheumatology center. In the second cohort, young women (18-25 years old) with pediatric-onset rheumatic conditions were recruited from a national conference for families with pediatric rheumatic diseases. This resulted in 20 adolescents and young adults (18.3 ± 2.4 years old), and 7 parent focus group participants. Focus group leaders facilitated discussions centered on reproductive health topics that participants identified as important, their sources of knowledge, and preferences for patient education and ongoing follow-up. Data were summarized independently by 4 researchers to reduce potential bias and subsequently analyzed using rapid qualitative analysis. RESULTS All participants, regardless of diagnosis, medication, current sexual activity, or current intention to have children, expressed concern about the effect of their rheumatic condition and medications on fertility, risks to mother and child during and after pregnancy, and obtaining safe and effective contraception. Additionally, some participants discussed the burden of disease and its potential impact on motherhood. Finally, participants raised concern around the effect of disease and medication on routine reproductive health care, such as menstrual cycles, feminine self-care, and preventive exams. Three themes emerged: 1) participants had been advised to avoid unplanned pregnancy, however reported receiving inadequate explanation to support this instruction, 2) participants conceptualized reproductive health as tied to rheumatic disease management and thus suggested ways to include family members in discussion, and 3) rheumatology practitioners were not considered a resource of reproductive health information. CONCLUSIONS Young women and their parents reported dissatisfaction with the availability, quantity, and quality of reproductive health information they received, particularly when related to their pediatric-onset rheumatic disease. These findings provide an initial step in understanding the patient perspective of reproductive health in rheumatology, and how to address these concerns in the care of young women with rheumatic diseases.
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Affiliation(s)
- Kristine Carandang
- Department of Psychiatry, University of California, La Jolla, San Diego, California, USA. .,Child and Adolescent Services Research Center, 3665 Kearny Villa Rd., Suite 200N, San Diego, California, 92123, USA.
| | - Veronica Mruk
- grid.240344.50000 0004 0392 3476Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943The Ohio State University, Columbus, OH USA
| | - Stacy P. Ardoin
- grid.240344.50000 0004 0392 3476Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943The Ohio State University, Columbus, OH USA
| | - Brittany Huynh
- grid.257413.60000 0001 2287 3919Indiana University School of Medicine, Indianapolis, IN USA
| | - Megan E. B. Clowse
- grid.189509.c0000000100241216Duke University Medical Center, Durham, North Carolina USA
| | - Elise D. Berlan
- grid.240344.50000 0004 0392 3476Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943The Ohio State University, Columbus, OH USA
| | - Cuoghi Edens
- grid.170205.10000 0004 1936 7822University of Chicago, Chicago, IL USA
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23
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Unvaccinated children as community parasites in National Qualitative Study from Turkey. BMC Public Health 2020; 20:1087. [PMID: 32652961 PMCID: PMC7353754 DOI: 10.1186/s12889-020-09184-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background This national qualitative study explores (1) the experiences, observations, and opinions of health care workers (HCWs) about beliefs, socioeconomic, cultural, and environmental characteristics of parents refusing vaccination and (2) regional differences in the identified risk factors; (3) recommended solutions to improve vaccine acceptance in each of 12 regions in Turkey. Methods In total, we carried out 14 individual semi-structured in-depth interviews and 10 focus group discussions with 163 HCWs from 36 provinces. A thematic analysis was performed to explore HCWs’ observations about the parents’ decisions to reject vaccination and possible solutions for vaccine advocacy. Results Within the analyzed data framework, vaccine refusal statements could be defined as vaccine safety, the necessity of vaccines, assumptions of freedom of choice, health workers’ vaccine hesitancy, lack of information about national vaccination schedule and components, not trusting the health system, anti-vaccine publications in social media and newspapers, and refugees. Suggestions based on the HCWs suggestions can be summarized as interventions including (1) creating visual cards with scientific data on vaccine content and disease prevention and using them in counseling patients, (2) writing the vaccine components in a way understandable to ordinary people, (3) highlighting the national quality control and production in the vaccine box and labels, (4) conducting interviews with community opinion leaders, (5) training anti-vaccine HCWs with insufficient scientific knowledge and (6) reducing the tax of parents whose children are fully and punctually vaccinated. Conclusions The solution to vaccine rejection begins with the right approaches to vaccination during pregnancy. Prepared written and visual information notes should present the information as “vaccination acceptance” rather than “vaccination refusal”. Further studies on vaccine refusal rates should be carried out in various regions of the world so that region-specific actions are implemented to decrease the anti-vaxxer movement and to prevent an outbreak of infectious diseases.
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24
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Woof VG, Ruane H, French DP, Ulph F, Qureshi N, Khan N, Evans DG, Donnelly LS. The introduction of risk stratified screening into the NHS breast screening Programme: views from British-Pakistani women. BMC Cancer 2020; 20:452. [PMID: 32434564 PMCID: PMC7240981 DOI: 10.1186/s12885-020-06959-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND UK national guidelines suggest women at high-risk of breast cancer should be offered more frequent screening or preventative medications. Currently, only 1 in 6 high-risk women are identified. One route to identify more high-risk women is via multifactorial risk assessment as part of the UK's NHS Breast Screening Programme (NHSBSP). As lower socioeconomic and minority ethnic populations continue to experience barriers to screening, it is important that any new service does not exacerbate issues further. To inform service development, this study explored views of women from underserved backgrounds regarding the introduction of risk stratification into the NHSBSP. METHODS Nineteen semi-structured interviews were conducted with British-Pakistani women from low socioeconomic backgrounds from East Lancashire, UK. Fourteen interviews were conducted via an interpreter. RESULTS Thematic analysis produced three themes. Attitudes toward risk awareness concerns the positive views women have toward the idea of receiving personalised breast cancer risk information. Anticipated barriers to accessibility emphasises the difficulties associated with women's limited English skills for accessing information, and their I.T proficiency for completing an online risk assessment questionnaire. Acceptability of risk communication strategy highlights the diversity of opinion regarding the suitability of receiving risk results via letter, with the option for support from a healthcare professional deemed essential. CONCLUSIONS The idea of risk stratification was favourable amongst this underserved community. To avoid exacerbating inequities, this new service should provide information in multiple languages and modalities and offer women the opportunity to speak to a healthcare professional about risk. This service should also enable completion of personal risk information via paper questionnaires, as well as online.
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Affiliation(s)
- Victoria G Woof
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Room 1.13, Coupland 1, Coupland Street, Off Oxford Road, Manchester, M13 9PL, UK.
| | - Helen Ruane
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
| | - David P French
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Room 1.13, Coupland 1, Coupland Street, Off Oxford Road, Manchester, M13 9PL, UK
| | - Fiona Ulph
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, MAHSC, Room 1.13, Coupland 1, Coupland Street, Off Oxford Road, Manchester, M13 9PL, UK
| | - Nadeem Qureshi
- NIHR School of Primary Care, School of Medicine, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - Nasaim Khan
- Department of Genomic Medicine, Division of Evolution and Genomic Science, MAHSC, University of Manchester, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - D Gareth Evans
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK.,Department of Genomic Medicine, Division of Evolution and Genomic Science, MAHSC, University of Manchester, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - Louise S Donnelly
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
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25
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Cavers D, Cunningham-Burley S, Watson E, Banks E, Campbell C. Setting the research agenda for living with and beyond cancer with comorbid illness: reflections on a research prioritisation exercise. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:17. [PMID: 32368351 PMCID: PMC7191759 DOI: 10.1186/s40900-020-00191-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND People living with and beyond cancer are more likely to have comorbid conditions and poorer mental and physical health, but there is a dearth of in-depth research exploring the psychosocial needs of people experiencing cancer and comorbid chronic conditions. A patient partnership approach to research prioritisation and planning can ensure outcomes meaningful to those affected and can inform policy and practice accordingly, but can be challenging. METHODS We aimed to inform priorities for qualitative inquiry into the experiences and support needs of people living with and beyond cancer with comorbid illness using a partnership approach. A three-step process including a patient workshop to develop a consultation document, online consultation with patients, and academic expert consultation was carried out. The research prioritisation process was also appraised and reflected upon. RESULTS Six people attended the workshop, ten responded online and eight academic experts commented on the consultation document. Five key priorities were identified for exploration in subsequent qualitative studies, including the diagnostic journey, the burden of symptoms, managing medications, addressing the needs of informal carers, and service provision. Limitations of patient involvement and reflections on procedural ethics, and the challenge of making measurable differences to patient outcomes were discussed. CONCLUSIONS Findings from this research prioritisation exercise will inform planned qualitative work to explore patients' experiences of living with and beyond cancer with comorbid illness. Including patient partners in the research prioritisation process adds focus and relevance, and feeds into future work and recommendations to improve health and social care for this group of patients. Reflections on the consultation process contribute to a broadening of understanding the field of patient involvement.
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Affiliation(s)
- D. Cavers
- Usher Institute, University of Edinburgh, Medical School, Rm 123, Doorway 1, Teviot Place, Edinburgh, EH8 9AG UK
| | - S. Cunningham-Burley
- Usher Institute, University of Edinburgh, Medical School, Rm 123, Doorway 1, Teviot Place, Edinburgh, EH8 9AG UK
| | - E. Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Marston, Oxford, OX3 0FL UK
| | - E. Banks
- c/o NCRI, 2 Redman Place, Stratford, London, E20 1JQ UK
| | - C. Campbell
- Usher Institute, University of Edinburgh, Medical School, Rm 123, Doorway 1, Teviot Place, Edinburgh, EH8 9AG UK
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Alcaraz KI, Vereen RN, Burnham D. Use of Telephone and Digital Channels to Engage Socioeconomically Disadvantaged Adults in Health Disparities Research Within a Social Service Setting: Cross-Sectional Study. J Med Internet Res 2020; 22:e16680. [PMID: 32234699 PMCID: PMC7160701 DOI: 10.2196/16680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/13/2020] [Accepted: 02/29/2020] [Indexed: 12/28/2022] Open
Abstract
Background Engaging socioeconomically disadvantaged populations in health research is vital to understanding and, ultimately, eliminating health-related disparities. Digital communication channels are increasingly used to recruit study participants, and recent trends indicate a growing need to partner with the social service sector to improve population health. However, few studies have recruited participants from social service settings using multiple digital channels. Objective This study aimed to recruit and survey 3791 adult clients of a social service organization via telephone and digital channels. This paper aimed to describe recruitment outcomes across five channels and compare participant characteristics by recruitment channel type. Methods The Cancer Communication Channels in Context Study recruited and surveyed adult clients of 2-1-1, a social service–focused information and referral system, using five channels: telephone, website, text message, web-based live chat, and email. Participants completed surveys administered either by phone (if recruited by phone) or on the web (if recruited from digital channels, ie, website, text message, Web-based live chat, or email). Measures for the current analysis included demographic and health characteristics. Results A total of 3293 participants were recruited, with 1907 recruited by phone and 1386 recruited from digital channels. Those recruited by phone had a moderate study eligibility rate (42.23%) and the highest survey completion rate (91.24%) of all channels. Individuals recruited by text message had a high study eligibility rate (94.14%) yet the lowest survey completion rate (74.0%) of all channels. Sample accrual goals were achieved for phone, text message, and website recruitment. Multivariable analyses found differences in participant characteristics by recruitment channel type. Compared with participants recruited by phone, those recruited from digital channels were younger (adjusted odds ratio [aOR] 0.96, 95% CI 0.96-0.97) and more likely to be female (aOR 1.52, 95% CI 1.23-1.88), married (aOR 1.52, 95% CI 1.22-1.89), and other than non-Hispanic black (aOR 1.48, 95% CI 1.22-1.79). Those recruited via phone also were more likely to have more than a high school education (aOR 2.17, 95% CI 1.67-2.82), have a household income ≥US $25,000 a year (aOR 2.02, 95% CI 1.56-2.61), and have children living in the home (aOR 1.26, 95% CI 1.06-1.51). Additionally, participants recruited from digital channels were less likely than those recruited by phone to have public health insurance (aOR 0.75, 95% CI 0.62-0.90) and more likely to report better overall health (aOR 1.52, 95% CI 1.27-1.83 for good-to-excellent health). Conclusions Findings indicate the feasibility and utility of recruiting socioeconomically disadvantaged adults from the social service sector using multiple communication channels, including digital channels. As social service–based health research evolves, strategic recruitment using a combination of traditional and digital channels may be warranted to avoid underrepresentation of highly medically vulnerable individuals, which could exacerbate disparities in health.
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Affiliation(s)
- Kassandra I Alcaraz
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, United States
| | - Rhyan N Vereen
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, United States
| | - Donna Burnham
- United Way of Greater Atlanta, Atlanta, GA, United States
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Woof VG, Ruane H, Ulph F, French DP, Qureshi N, Khan N, Evans DG, Donnelly LS. Engagement barriers and service inequities in the NHS Breast Screening Programme: Views from British-Pakistani women. J Med Screen 2019; 27:130-137. [PMID: 31791172 PMCID: PMC7645618 DOI: 10.1177/0969141319887405] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives Previous research has largely attempted to explore breast screening experiences of South Asian women by combining opinions from Pakistani, Bangladeshi, and Indian women. This research often fails to reach the most underserved sub-groups of this population, with socioeconomic status not routinely reported, and English fluency being a participation requirement. With uptake low amongst British-Pakistani women, this study explores the experiences these women encounter when accessing the NHS Breast Screening Programme. Methods 19 one-to-one semi-structured interviews were carried out with British-Pakistani women from East Lancashire, UK. 14 interviews were conducted via an interpreter. Results Data were analysed using thematic analysis. Three themes were identified: ‘Absence of autonomy in screening and healthcare access’ describes how currently the screening service does not facilitate confidentiality or independence. Access requires third-party intervention, with language barriers preventing self-expression. ‘Appraisal of information sources’ makes distinctions between community and NHS communication. Whereas community communication was invaluable, NHS materials were deemed inaccessible due to translation incongruences and incomprehensible terminology. ‘Personal suppositions of breast screening’ explores the subjective issues associated with disengagement, including, the cultural misalignment of the service, and perceiving screening as a symptomatic service. Conclusions British-Pakistani women face some unique challenges when accessing breast screening. To promote uptake, the service needs to address the translation of screening materials and optimize upon community networks to disseminate knowledge, including knowledge of the screening environment within the context of culture to promote informed choice about attendance.
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Affiliation(s)
- Victoria G Woof
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Ruane
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Manchester, UK
| | - Fiona Ulph
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - David P French
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Nadeem Qureshi
- NIHR School of Primary Care, School of Medicine, University Park, Nottingham, UK
| | - Nasaim Khan
- Department of Genomic Medicine, Division of Evolution and Genomic Science, MAHSC, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - D Gareth Evans
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Manchester, UK.,Department of Genomic Medicine, Division of Evolution and Genomic Science, MAHSC, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - Louise S Donnelly
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust (MFT), Manchester, UK
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Leveraging Geospatial Approaches to Characterize the HIV Prevention and Treatment Needs of Out-of-School Adolescent Girls and Young Women in Ethiopia. AIDS Behav 2019; 23:183-193. [PMID: 31134462 PMCID: PMC6773675 DOI: 10.1007/s10461-019-02537-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Adolescent girls and young women (AGYW) remain underserved and at risk for HIV acquisition in Ethiopia. However, there is significant risk heterogeneity among AGYW with limited consensus on optimal strategies of identifying vulnerable AGYW. This study assessed the utility of venue-based sampling approaches to identify AGYW at increased risk for HIV infection. Venue mapping and time-location-sampling (TLS) methods were used to recruit AGYW from three sub-cities of Addis Ababa, February–June 2018. Interviewer-administered surveys captured socio-demographic and behavioral characteristics. Measures of AGYW vulnerability were assessed geographically and described by venue type. A total of 2468 unique venues were identified, of which 802 (32%) were systematically selected for validation and 371 (46%) were eligible including many sites that would traditionally not be included as venues in need of HIV prevention services. Overall, 800 AGYW were enrolled across 81 sampled venues. AGYW reached were largely out-of-school (n = 599, 75%) with high proportions of AGYW reporting transactional sex (n = 101, 12.6%), food insecurity (n = 165, 20.7%) and migration (n = 565, 70.6%). Taken together, these data suggest the utility of TLS methods in reaching vulnerable, out-of-school AGYW in Addis Ababa, Ethiopia.
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Marlow LA, Chorley AJ, Rockliffe L, Waller J. Decision-making about cervical screening in a heterogeneous sample of nonparticipants: A qualitative interview study. Psychooncology 2018; 27:2488-2493. [PMID: 30095862 PMCID: PMC6220875 DOI: 10.1002/pon.4857] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/18/2018] [Accepted: 07/31/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE According to the precaution adoption process model, cervical screening nonparticipants represent a heterogeneous group including those who are unaware of, unengaged with, or undecided about screening, as well as intenders and decliners. We aimed to explore beliefs about cervical screening among these different types of nonparticipant. METHODS Semistructured interviews were carried out with women aged 26 to 65 years living in Britain (n = 29). Women were purposively sampled to represent different nonparticipant types. Interviews were transcribed verbatim, and data were analysed thematically using framework analysis. RESULTS The salience of some barriers to screening varied between different types of nonparticipant. Bad experiences were prominent in the discussions of women who had decided not to attend, while practical barriers were more prominent among intenders. There was also some overlap between nonparticipant types. For example, many of the undecided women described not wanting to go for screening, but with less certainty than decliners. Some intenders (particularly those who had not been screened before) described not really wanting to attend but feeling they ought to. Women's views on the invitation/reminder process also varied; intenders and maintainers appreciated written reminders and general practitioner (GP) prompts but decliners sometimes perceived these as "badgering." Throughout the interviews, women described changing views on screening in the wider context of ageing and motherhood. CONCLUSIONS The salience of screening barriers varies by nonparticipant type, offering possibilities for tailored interventions. However, the fluidity of women's stage of screening adoption might have implications for this approach to intervention design.
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Affiliation(s)
- Laura A.V. Marlow
- Cancer Communication and Screening Group, Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Amanda J. Chorley
- Cancer Communication and Screening Group, Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Lauren Rockliffe
- Cancer Communication and Screening Group, Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Jo Waller
- Cancer Communication and Screening Group, Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
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