1
|
Johnson CK, Leung MM, Ma GX, Ogunwobi OO. Effective Recruitment Strategies Utilized to Examine Dietary Practices of Blacks in New York City in the Midst of the COVID-19 Pandemic. J Racial Ethn Health Disparities 2024; 11:764-772. [PMID: 36929490 PMCID: PMC10019415 DOI: 10.1007/s40615-023-01559-9] [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: 10/28/2022] [Revised: 02/11/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Black Americans have long been considered a hard-to-reach population for research studies, whether quantitative surveys or for clinical research. Studies have explored multiple rationales for why Blacks are hard to reach, and the explanations have included historical mistrust, the need to assess the benefits from participating in research, and the expense of spending time participating in research, among others. What has not been explored is the continuous merging of all individuals who identify as Black, particularly when exploring reasonings for a lower interest in participating in research. This paper addresses this issue by investigating the participation rate of individuals identifying as Black in New York City in a study exploring dietary practices as a predictor of colorectal cancer screening behavior. Participants were asked to self-report screening behavior, intent to screen, and dietary and other lifestyle practices. In this analysis, we discuss the unique experience encountered in recruiting Black American participants to participate in this study, particularly amid a worldwide pandemic of COVID-19. METHODS The methodology for this study included a systematic review of the literature, a two-part recruitment process, and data analysis. The first part of the recruitment process involved registering individuals who were interested in participating in the study and consented to be contacted and reminded to come to the location where they were recruited on a scheduled date to complete the actual survey. With this part of the recruitment process, we engaged with n = 488 Black men and women between November 2019 and February 2020. The second part of the recruitment process utilized availability sampling outside of NYC subway stations and other high traffic areas as well as large community events. We engaged with n = 319 individuals. Total engagement with n = 807 individuals yielded a sample size for the survey of 504 completed surveys. RESULTS Of the total engaged (n = 807), 14% declined to participate due to a lack of time, 11% chose not to participate in the study because the incentive was not enough to compensate for their time 0.02% declined due to not trusting institutions conducting research, and 0.03% did not feel comfortable understanding the questions due to a language barrier. We had a sample size of (n = 504) of the total 807 individuals engaged. CONCLUSIONS Recruiting Black Americans into our colorectal cancer study did not prove to be challenging with the two-tiered model of recruitment that involved consistent engagement and having the primary researcher lead this recruitment process. Extracting within race differences is critical in demystifying the conclusion of numerous studies that African Americans specifically are hesitant to participate due to historical mistrust related to tragedies such as the Tuskegee Experiment and numerous other occurrences of African Americans being treated as guinea pigs for the advancement of research. This data contributes knowledge to this field regarding understanding recruitment challenges in the Black population, but further work needs to be conducted. Mistrust in this study primarily came from the individuals engaged in Caribbean neighborhoods, where many expressed more comfort with home remedies and bush doctors when asked about colorectal cancer screening and declined to participate. Innovative communication, qualitative research, and recruitment strategies tailored to the Caribbean population are needed in future studies to address this recruitment challenge that we experienced.
Collapse
Affiliation(s)
- Cicely K Johnson
- Hunter College Center for Cancer Health Disparities Research, Hunter College of the City University of New York, New York, NY, USA
| | - May May Leung
- Nutrition Program, School of Urban Public Health, Hunter College of the City University of New York, New York, NY, USA
| | - Grace X Ma
- Center for Asian Health, Temple University, Philadelphia, PA, USA
| | - Olorunseun O Ogunwobi
- Hunter College Center for Cancer Health Disparities Research, Hunter College of the City University of New York, New York, NY, USA.
- Department of Biological Sciences, Hunter College of the City University of New York, New York, NY, USA.
| |
Collapse
|
2
|
Odhiambo AJ, O’Campo P, Nelson LRE, Forman L, Grace D. Structural violence and the uncertainty of viral undetectability for African, Caribbean and Black people living with HIV in Canada: an institutional ethnography. Int J Equity Health 2023; 22:33. [PMID: 36797746 PMCID: PMC9935247 DOI: 10.1186/s12939-022-01792-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/15/2022] [Indexed: 02/18/2023] Open
Abstract
Biomedical advances in healthcare and antiretroviral treatment or therapy (ART) have transformed HIV/AIDS from a death sentence to a manageable chronic disease. Studies demonstrate that people living with HIV who adhere to antiretroviral therapy can achieve viral suppression or undetectability, which is fundamental for optimizing health outcomes, decreasing HIV-related mortality and morbidity, and preventing HIV transmission. African, Caribbean, and Black (ACB) communities in Canada remain structurally disadvantaged and bear a disproportionate burden of HIV despite biomedical advancements in HIV treatment and prevention. This institutional ethnography orients to the concept of 'structural violence' to illuminate how inequities shape the daily experiences of ACB people living with HIV across the HIV care cascade. We conducted textual analysis and in-depth interviews with ACB people living with HIV (n = 20) and health professionals including healthcare providers, social workers, frontline workers, and health policy actors (n = 15). Study findings produce a cumulative understanding that biomedical HIV discourses and practices ignore structural violence embedded in Canada's social fabric, including legislation, policies and institutional practices that produce inequities and shape the social world of Black communities. Findings show that inequities in structural and social determinants of health such as food insecurity, financial and housing instability, homelessness, precarious immigration status, stigma, racial discrimination, anti-Black racism, criminalization of HIV non-disclosure, health systems barriers and privacy concerns intersect to constrain engagement and retention in HIV healthcare and ART adherence, contributing to the uncertainty of achieving and maintaining undetectability and violating their right to health. Biomedical discourses and practices, and inequities reduce Black people to a stigmatized, pathologized, and impoverished detectable viral underclass. Black people perceived as nonadherent to ART and maintain detectable viral loads are considered "bad" patients while privileged individuals who achieve undetectability are considered "good" patients. An effective response to ending HIV/AIDS requires implementing policies and institutional practices that address inequities in structural and social determinants of health among ACB people.
Collapse
Affiliation(s)
- Apondi J. Odhiambo
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Patricia O’Campo
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ,grid.415502.7St, Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
| | - La Ron E. Nelson
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ,grid.415502.7St, Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada ,grid.47100.320000000419368710Yale School of Nursing, New Haven, CT USA
| | - Lisa Forman
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Daniel Grace
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| |
Collapse
|
3
|
Djiadeu P, Yusuf A, Ongolo-Zogo C, Nguemo J, Odhiambo AJ, Mukandoli C, Lightfoot D, Mbuagbaw L, Nelson LE. Barriers in accessing HIV care for Francophone African, Caribbean and Black people living with HIV in Canada: a scoping review. BMJ Open 2020; 10:e036885. [PMID: 32859664 PMCID: PMC7454192 DOI: 10.1136/bmjopen-2020-036885] [Citation(s) in RCA: 12] [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: 12/25/2022] Open
Abstract
INTRODUCTION In 2001, 50%-55% of French-speaking minority communities did not have access to health services in French in Canada. Although Canada is officially a bilingual country, reports indicate that many healthcare services offered in French in Anglophone provinces are insufficient or substandard, leading to healthcare discrepancies among Canada's minority Francophone communities. OBJECTIVES The primary aim of this scoping systematic review was to identify existing gaps in HIV-care delivery to Francophone minorities living with HIV in Canada. STUDY DESIGN Scoping systematic review. DATA SOURCES Search for studies published between 1990 and November 2019 reporting on health and healthcare in Francophone populations in Canada. Nine databases were searched, including Medline, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the National Health Service Economic Development Database, Global Health, PsychInfo, PubMed, Scopus and Web of Science. STUDY SELECTION English or French language studies that include data on French-speaking people with HIV in an Anglophone majority Canadian province. RESULTS The literature search resulted in 294 studies. A total of 230 studies were excluded after duplicates were removed. The full texts of 43 potentially relevant papers were retrieved for evaluation and data extraction. Forty-one studies were further excluded based on failure to meet the inclusion criteria leaving two qualitative studies that met our inclusion criteria. These two studies reported on barriers on access to specialised care by Francophone and highlighted difficulties experienced by healthcare professionals in providing quality healthcare to Francophone patients in Ontario and Manitoba. CONCLUSION The findings of this scoping systematic review highlight the need for more HIV research on linguistic minority communities and should inform health policymaking and HIV/AIDS community organisations in providing HIV care to Francophone immigrants and Canadians.
Collapse
Affiliation(s)
- Pascal Djiadeu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
- Yale University School of Nursing, Yale University, West Haven, Connecticut, USA
- Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
| | - Abban Yusuf
- Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
| | - Clémence Ongolo-Zogo
- Department of Health Research Methods, Evidence and Impact, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Centre Province, Cameroon
| | - Joseph Nguemo
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Apondi J Odhiambo
- Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
| | - Chantal Mukandoli
- Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
- AFRICANS IN PARTNERSHIP AGAINST AIDS (APAA), Toronto, Ontario, Canada
| | - David Lightfoot
- St Michael's Health Sciences Library, St Michael's Hospital, Toronto, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Centre Province, Cameroon
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - LaRon E Nelson
- Yale University School of Nursing, Yale University, West Haven, Connecticut, USA
- Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Ontario, Canada
| |
Collapse
|