1
|
Denford S, Holt L, Essery R, Kesten J, Cabral C, Weston D, Horwood J, Hickman M, Amlôt R, Yardley L. Engagement in rapid public health research among young people from underserved communities: maximising opportunities and overcoming barriers. BMC Public Health 2024; 24:2217. [PMID: 39143472 PMCID: PMC11325622 DOI: 10.1186/s12889-024-19762-6] [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: 07/12/2024] [Accepted: 08/12/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Inclusion in public health research of young people from low-income households and those from minority ethnic groups remains low. It is recognised that there is a need to change the way in which research is conducted so that it becomes more inclusive. The aim of this work was to identify novel and innovative ways to maximise recruitment and inclusion of diverse participants when doing co-production within very short time frames for emergency responses. METHOD We conducted interviews with young people from low-income and minority ethnic backgrounds, and members or leaders of groups or organisations supporting or representing young people from underserved communities. RESULTS A total of 42 participants took part in an interview. This included 30 young people from low income or minority ethnic backgrounds and 12 community leaders/service providers. Of the 30 young people, 26 participants identified as female and 12 participants identified as being from a minority ethnic background. Participants discussed a number of interrelated barriers to research involvement and identified ways in which barriers may be reduced. Prejudice and discrimination experienced by young people from underserved communities has led to substantial mistrust of educational and governmental establishments. Rigid and unfamiliar research practices further limit the involvement of young people. Four themes were identified as ways of supporting involvement, including: making opportunities available for young people, adaptations to research governance, understanding and acknowledging challenges faced by young people, and ensuring reciprocal benefits. CONCLUSION This research explored barriers to engagement in rapid public health co-production. Working with communities to co-produce rapid recruitment and research procedures to suit the needs and the context in which young people live is necessary.
Collapse
Affiliation(s)
- Sarah Denford
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK.
- School of Psychological Science, University of Bristol, Bristol, UK.
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK.
| | - Lydia Holt
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
| | - Rosie Essery
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Joanna Kesten
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Christie Cabral
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Dale Weston
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- Behavioural Science and Insights Unit, Health Security Agency, Porton Down, Salisbury, UK
| | - Jeremy Horwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, Bristol, BS8 1TU, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Richard Amlôt
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- Behavioural Science and Insights Unit, Health Security Agency, Porton Down, Salisbury, UK
| | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol in collaboration with UK Health Security Agency, Bristol, UK
- Academic Unit of Psychology, University of Southampton, Southampton, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| |
Collapse
|
2
|
Habersham L, George J, Townsel CD. Substance Use in Pregnancy and Its Impact on Communities of Color. Obstet Gynecol Clin North Am 2024; 51:193-210. [PMID: 38267128 DOI: 10.1016/j.ogc.2023.10.004] [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] [Indexed: 01/26/2024]
Abstract
Stigma toward pregnant and postpartum people who use drugs is common and seeks to define addiction as a moral weakness rather than a chronic medical illness that requires resources and treatment. More concerning is the additive impact of substance use and racial discrimination, whose intersections present particularly challenging circumstances. In this article, the authors review the history of substance use in the United States and focus on 3 substances of abuse that illustrate the inequity faced by pregnant person of color who use drugs.
Collapse
Affiliation(s)
- Leah Habersham
- Department of Obstetrics, Gynecology and Reproductive Sciences, 22 South Greene Street, Suite P6H310, Baltimore, MD 21201, USA
| | - Joshua George
- Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Courtney D Townsel
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland Baltimore, 250 West Pratt Street, Suite 880, Baltimore, MD 21201, USA.
| |
Collapse
|
3
|
Zgierska AE, Gramly T, Prestayko N, Symons Downs D, Murray TM, Yerby LG, Howell B, Stahlman B, Cruz J, Agolli A, Horan H, Hilliard F, Croff JM. Transportation, childcare, lodging, and meals: Key for participant engagement and inclusion of historically underrepresented populations in the healthy brain and child development birth cohort. J Clin Transl Sci 2024; 8:e38. [PMID: 38476249 PMCID: PMC10928703 DOI: 10.1017/cts.2024.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Participant recruitment and retention (R&R) are well-documented challenges in longitudinal studies, especially those involving populations historically underrepresented in research and vulnerable groups (e.g., pregnant people or young children and their families), as is the focus of the HEALthy Brain and Child Development (HBCD) birth cohort study. Subpar access to transportation, overnight lodging, childcare, or meals can compromise R&R; yet, guidance on how to overcome these "logistical barriers" is sparse. This study's goal was to learn about the HBCD sites' plans and develop best practice recommendations for the HBCD consortium for addressing these logistical barriers. Methods The HBCD's workgroups developed a survey asking the HBCD sites about their plans for supporting research-related transportation, lodging, childcare, and meals, and about the presence of institutional policies to guide their approach. Descriptive statistics described the quantitative survey data. Qualitative survey responses were brief, not warranting formal qualitative analysis; their content was summarized. Results Twenty-eight respondents, representing unique recruitment locations across the U.S., completed the survey. The results indicated substantial heterogeneity across the respondents in their approach toward supporting research-related transportation, lodging, childcare, and meals. Three respondents were aware of institutional policies guiding research-related transportation (10.7%) or childcare (10.7%). Conclusions This study highlighted heterogeneity in approaches and scarcity of institutional policies regarding research-related transportation, lodging, childcare, and meals, underscoring the need for guidance in this area to ensure equitable support of participant R&R across different settings and populations, so that participants are representative of the larger community, and increase research result validity and generalizability.
Collapse
Affiliation(s)
- Aleksandra E. Zgierska
- Departments of Family and Community Medicine, Anesthesiology and
Perioperative Medicine, and Public Health Sciences, Pennsylvania State
University College of Medicine, Hershey, PA,
USA
| | - Tatum Gramly
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Nicholas Prestayko
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Danielle Symons Downs
- Department of Kinesiology and College of Medicine, Department of
Obstetrics and Gynecology, Pennsylvania State University College of Health and
Human Development, University Park, PA,
USA
| | - Traci M. Murray
- National Institutes of Health, National Institute on Drug
Abuse, Bethesda, MD, USA
| | - Lea G. Yerby
- Department of Community Medicine and Population Health, The
University of Alabama College of Community Health Sciences,
Tuscaloosa, AL, USA
| | - Brittany Howell
- Department of Human Development and Family Science, Virginia Tech,
Fralin Biomedical Research Institute, Roanoke,
VA, USA
| | - Barbara Stahlman
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Jennifer Cruz
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Arjola Agolli
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Holly Horan
- Department of Obstetrics and Gynecology, Global and Rural Women’s Health
Program, Heersink School of Medicine, The University of Alabama at
Birmingham, Birmingham, AL,
USA
| | | | - Julie M. Croff
- Oklahoma State University Center for Health Sciences,
Tulsa, OK, USA
| | | |
Collapse
|
4
|
Zgierska AE, Hilliard F, Deegan S, Turnquist A, Goldstein E. Promoting research engagement among women with addiction: Impact of recovery peer support in a pilot randomized mixed-methods study. Contemp Clin Trials 2023; 130:107235. [PMID: 37211273 PMCID: PMC10330478 DOI: 10.1016/j.cct.2023.107235] [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: 02/12/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The impact of involving peers on research engagement is largely unknown. The purpose of this pilot study, a part of a larger research, was to evaluate the impact of recovery peer involvement as a study team member on recruitment/retention of persons with lived experience of SUD during pregnancy and to assess participant perceptions about factors impacting engagement of this population and their children in research, especially brain magnetic resonance imaging (MRI). METHODS This study randomly assigned participants (1:1) to either Peer or Research Coordinator (RC) arms. Eligible participants were English-speaking adult, non-pregnant females with lived experience of substance use during pregnancy. Certified Peers were recruited word of mouth and completed study-specific training. The impact of trained, certified Peer versus RC on research engagement was assessed by between-arm comparison of retention rates. Quantitative and qualitative survey data on participant perceptions were summarized. RESULTS Thirty-eight individuals enrolled into the study (19 Peer, 19 RC). Peer versus RC had 7.2 times greater odds of completing Visit 2 (Fisher's exact test; 95%CI: 1.2, 81.8; p = 0.03). The majority (70.4%) of respondents identified being accompanied by a peer and getting a tour of the MRI facility/procedures as 'extremely' helpful for improving participant comfort and engagement in future studies. Motivators of future research engagement also included creating a trusting, supportive, non-judgmental research environment, and linkages to treatment and other services. CONCLUSION Findings support the notion that peers involved as research team members could boost research engagement among persons with substance use during pregnancy.
Collapse
Affiliation(s)
- Aleksandra E Zgierska
- Departments of Family and Community Medicine, Anesthesiology and Perioperative Medicine, and Public Health Sciences, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, United States of America.
| | - Florence Hilliard
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Shelbey Deegan
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Alyssa Turnquist
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
| | - Ellen Goldstein
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL 60612, United States of America.
| |
Collapse
|
5
|
Martin CE. Commentary on Nowakowski et al.: Bringing the participants' own words into addictions research-a win-win for patients and investigators. Addiction 2023; 118:1105-1106. [PMID: 36987854 PMCID: PMC10175214 DOI: 10.1111/add.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023]
Abstract
Bringing the participant’s own words into the design of clinical investigations, such as with qualitative and mixed methodologies, should be prioritized in addictions research across the translational science spectrum.
Collapse
Affiliation(s)
- Caitlin E Martin
- Department of Obstetrics and Gynecology, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
6
|
Shover CL, Spoliansky JG, Godvin M. Polysubstance use and lived experience: new insights into what is needed. Curr Opin Psychiatry 2023:00001504-990000000-00070. [PMID: 37191654 DOI: 10.1097/yco.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW During the current overdose crisis in the United States and Canada, both polysubstance use and interventions involving people with lived experience of substance use disorder have grown. This review investigates the intersection of these topics to recommend best practices. RECENT FINDINGS We identified four themes from the recent literature. These are ambivalence about the term lived experience and the practice of using private disclosure to gain rapport or credibility; efficacy of peer participation; promoting equitable participation by fairly compensating staff hired for their lived experience; challenges unique to the current polysubstance-dominated era of the overdose crisis. People with lived experience make important contributions to research and treatment, especially given the additional challenges that polysubstance use creates above and beyond single substance use disorder. The same lived experience that can make someone an excellent peer support worker also often comes with both trauma related to working with people struggling with substance use and lack of opportunities for career advancement. SUMMARY Policy priorities for clinicians, researchers and organizations should include steps to foster equitable participation, such as recognizing expertise by experience with fair compensation; offering career advancement opportunities; and promoting self-determination in how people describe themselves.
Collapse
Affiliation(s)
- Chelsea L Shover
- Division of General Internal Medicine and Health Services Research
| | - Jordan G Spoliansky
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, California
| | - Morgan Godvin
- The Action Lab, Center for Health Policy and Law, Northeastern University, Boston, Massachusetts, USA
| |
Collapse
|