Barriers to Research Participation Identified by Rural People

It has been suggested anecdotally that rural people are less receptive to participating in research than other populations. Proposed reasons include culture, knowledge, attitudes, and barriers. Barriers to health care may also be barriers to research participation. A random sample of 5,000 households from a sampling frame of 45,000 property owners in a rural upstate New York county was selected. This article is a report of development of a barrier scale from the findings of 865 completed surveys. The survey in this study contained 100 questions and was adapted from a pre-existing survey of public attitudes regarding willingness to participate in medical research. Factor analysis was utilized to isolate a "barriers to participation in research" scale. Comparison of demographics and perceived barriers to participation were completed. Those who were classified as younger than the median sample age and male scored significantly lower on the barrier scale, indicating more barriers to participation in health care research. Those with the highest perception of barriers were among the least willing to participate as research subjects. The findings inform assumptions that researchers make about barriers to research, and strategies are suggested to remove such barriers. Opening the doors to inclusion of rural people in health research studies will ultimately result in improved individual and community health in rural places.

Integrative research review of risk behaviors among adolescents in rural, suburban, and urban areas

PURPOSE

The purpose of this integrative review was to describe the state of the science regarding adolescent risk behaviors, with particular emphasis on comparisons among rural, urban, and suburban populations.

METHOD

The review was done at two levels, moving from the major national survey studies which included data collected in the late 1980s up to 1993, to more focused topical areas including studies with data collection and publication between 1990 and 1996 within each identified category of adolescent health issues. A total of 137 published works across several disciplines were reviewed. Suggestions for clinical practice were drawn from the significant research findings. In addition, risk behaviors were compared to national baseline data and objectives.

RESULTS

The level of research in this topic area was primarily descriptive. Currently, only a small portion of the national objectives for decreasing adolescent risk behaviors have been met. Successful intervention programs, although few in number, usually included not only topical education but also adolescent interaction with peers and support systems to raise awareness and change behaviors.

CONCLUSIONS

The risk behaviors for the adolescent population as a whole have been well described. Education alone is not sufficient to change behaviors. Objective outcomes must be identified and health care providers need to use research findings in their practice with adolescents. It is time to intervene with developmentally and culturally appropriate strategies. There was a large gap in the literature regarding risk behaviors and protective factors for rural adolescents. The few studies that included subjects from rural settings indicated that the view that rural adolescents are engaged in fewer or less severe risk behaviors is misleading.

Uterine myomas: treatment options

Myomas (also called fibroids) are the most common solid pelvic tumors. Treatment options for myomas include medical and surgical management. The goals of medical management are to shrink the myoma and reduce its blood supply. Surgical interventions include therapies for women who wish to preserve fertility or retain their uterus. Newer treatment options include myomectomy achieved through an abdominal, laparoscopic, or hysteroscopic approach. Nurses assess and counsel women regarding treatment options.

Effective use of the research consultant

A principal investigator (PI) often includes a consultant in a proposal for a research project either at the request of the funding agency or because a consultant may add expertise to the research team. The most effective use of the consultant may vary according to the needs and gaps in areas of expertise of the team. Lippitt and Lippitt (1978) developed a model for guiding consultation that has been adapted in this article to guide not only the consultant but also the researcher in how to effectively use a consultant. The model is adaptable whether the principal investigator is new to designing and implementing research projects and needs a consultant expert in the research process or the PI has much research experience and needs a clinically expert consultant. The six phases of this model from contact and entry through contract completion is a step-by-step guide that is adaptable to the needs of the PI and research team.

The abdomen, thigh, and arm as sites for subcutaneous sodium heparin injections

The purpose of this study was to evaluate three subcutaneous injection sites for low-dose heparin therapy (5,000 units). One hundred and one subjects were randomly placed in one of three groups. Group A received injections in the abdomen, Group B, in the thigh, and Group C in the arm. Each subject received three injections at the one site. Activated partial thromboplastin time (APTT) was measured prior to initiation of heparin and again four hours after the first injection. Bruising was measured at 48, 60, and 72 hours postinjection. There were no statistically significant differences among groups for either changes in APTT or bruising at 60 and 72 hours postinjection. Thus the clinical practice of utilizing the abdomen as the only or preferred site for subcutaneous heparin injections was not supported.