Lessons learnt in recruiting disadvantaged families to a birth cohort study
Tóm tắt
Dental decay in early childhood can be prevented by a model based on shared care utilising members of primary care team such as Child and Family Health Nurses (CFHNs) in health promotion and early intervention. The aims of this study were to identify the facilitators and barriers faced by CFHNs in recruiting research participants from disadvantaged backgrounds to a birth cohort study in South Western Sydney, Australia. Child and Family Health Nurses recruited mothers-infants dyads (n = 1036) at the first post-natal home visit as part of Healthy Smiles Healthy Kids Study, an ongoing birth cohort study in South Western Sydney. The nurses (n = 19) were purposively selected and approached for a phone based in-depth semi-structured interview to identify the challenges faced by them during the recruitment process. Interviews were audio-recorded, subsequently transcribed verbatim and analysed by thematic analysis. The nurses found the early phase of parenting was an overwhelming stage for parents as they are pre-occupied with more immediate issues such as settling and feeding a newborn. They highlighted some key time-points such as during pregnancy and/or around the time of infant teething may be more appropriate for recruiting families to dental research projects. However, they found it easier to secure the family’s attention by offering incentives, gifts and invitations for free oral health services. The use of web-based approaches and maintaining regular contact with the participants was deemed crucial for long-term research. Cultural and linguistic barriers were seen as an obstacle in recruiting ethnic minority populations and the need for cultural insiders in the research team was deemed important to resolve the challenges associated with conducting research with diverse cultures. Finally, nurses identified the importance of inter-professional collaboration to provide easier access to recruiting research participants. This study highlighted the need for multiple time-points and incentives to facilitate recruitment and retention of disadvantaged communities in longitudinal research. The need for cultural insiders and inter-professional collaboration in research team are important to improve research participation.
Tài liệu tham khảo
Centre for Oral Health Strategy. Early childhood oral health guidelines for child health professionals. 2nd ed. Sydney: NSW Health; 2009.
Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent. 2011;2011: Article ID 725320.
Hallett KB, O'Rourke PK. Social and behavioural determinants of early childhood caries. Aust Dent J. 2003;48:27–33.
Arora A, Schwarz E, Blinkhorn AS. Risk factors for early childhood caries in disadvantaged populations. J Investig Clin Dent. 2011;2:223–8.
Ha DH, Roberts-Thomson KF, Arrow P, Peres KG, Do LG. Children’s oral health status in Australia. In: Do LG, Spencer AJ, editors. Oral health of Australian children: the National Child Oral Health Study 2012–14. Adelaide: University of Adelaide Press; 2016. p. 2012–4.
Pitts N, Chadwick B, Anderson T. Report 2: dental disease and damage in children. Child dental health survey 2013 - England, Wales and Northern Ireland. Leeds: National Health Service; 2015.
Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009;140:650–7.
de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, et al. Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev. 2016; https://doi.org/10.1002/14651858.CD009837.pub2.
George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Ajwani S. Promoting oral health during pregnancy: current evidence and implications for Australian midwives. J Clin Nurs. 2010;19:3324–33.
Morrow JW, Keels MA, Hale KJ, Thomas HF, Davis MJ, Czerepak CS, et al. Preventive oral health intervention for pediatricians. Pediatrics. 2008;122:1387–94.
Slack-Smith LM. Dental visits by Australian preschool children. J Paediatr Child Health. 2003;39:442–5.
Arora A, Bedros D, Bhole S, Do LG, Scott J, Blinkhorn A, et al. Child and family health nurses' experiences of oral health of preschool children: a qualitative approach. J Public Health Dent. 2012;72:149–55.
Goldfeld S, Wright M, Oberklaid F. Parents, infants and health care: utilization of health services in the first 12 months of life. J Paediatr Child Health. 2003;39:249–53.
Maher L, Phelan C, Lawrence G, Dawson A, Torvaldsen S, Wright C. The early childhood oral health program: promoting prevention and timely intervention of early childhood caries in NSW through shared care. Health Promot J Austr. 2012;23:171–6.
National Oral Health Promotion Clearing House. Oral health promotion for infants, preschool and school children Adelaide: The University of Adelaide; 2011 [cited 2017 7 May].
Johnson M, George A, Dahlen H, Ajwani S, Bhole S, Blinkhorn A, et al. The midwifery initiated oral health-dental service protocol: an intervention to improve oral health outcomes for pregnant women. BMC Oral Health. 2015;15:2.
Baxter J, Vehik K, Johnson SB, Lernmark B, Roth R, Simell T. Differences in recruitment and early retention among ethnic minority participants in a large pediatric cohort: the TEDDY study. Contemp Clin Trials. 2012;33:633–40.
Ford DY, Grantham TC, Whiting GW. Culturally and linguistically diverse students in gifted education: recruitment and retention issues. Except Child. 2008;74:289–306.
Diaz VA, Mainous AG 3rd, McCall AA, Geesey ME. Factors affecting research participation in African American college students. Fam Med. 2008;40:46–51.
Goode PS, FitzGerald MP, Richter HE, Whitehead WE, Nygaard I, Wren PA, et al. Enhancing participation of older women in surgical trials. J Am Coll Surg. 2008;207:303–11.
McSweeney JC, Pettey CM, Fischer EP, Spellman A. Going the distance: overcoming challenges in recruitment and retention of black and white women in multisite, longitudinal study of predictors of coronary heart disease. Res Gerontol Nurs. 2009;2:256–64.
Jacobs EA, Rolle I, Ferrans CE, Whitaker EE, Warnecke RB. Understanding African Americans' views of the trustworthiness of physicians. J Gen Intern Med. 2006;21:642–7.
Australian Bureau of Statistics. Socio-economic Indexes for Areas (SEIFA): 2006: Australian Bureau of Statistics; 2008 [cited 2017 15 March]. Available from: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/72283F45CB86E5FECA2574170011B271/$File/2039055001_socio-economicindexesforareas(seifa)- technical paper_2006.pdf. Accessed 15 Mar 2017.
Arora A, Scott J, Bhole S, Do L, Schwarz E, Blinkhorn A. Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study. BMC Public Health. 2011;11:28. https://doi.org/10.1186/1471-2458-11-28.
Kuzel AJ. Sampling in qualitative inquiry. In: Crabtree BF, Miller WL, editors. Doing qualitative research. 2nd ed. Thousand Oaks: SAGE Publications; 1999. p. 33–46.
Patton MQ. Qualitative research and evaluation methods 4th ed. Thousands Oaks: SAGE Publications; 2015.
Chapple A. The use of telephone interviewing for qualitiative research. Nurse Res. 1999;6:85–93.
Braun VCV. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.
Arora A, McNab MA, Lewis MW, Hilton G, Blinkhorn AS, Schwarz E. ‘I can’t relate it to teeth’: a qualitative approach to evaluate oral health education materials for preschool children in new South Wales, Australia. Int J Paediatr Dent. 2012;22:302–9.
Arora A, Nguyen D, Do QV, Nguyen B, Hilton G, Do LG, et al. ‘What do these words mean?’: A qualitative approach to explore oral health literacy in Vietnamese immigrant mothers in Australia. Health Educ J. 2014;73:303–12.
Arora A, Liu MN, Chan R, Schwarz E. ‘English leaflets are not meant for me’: a qualitative approach to explore oral health literacy in Chinese mothers in southwestern Sydney, Australia. Community Dent Oral Epidemiol. 2012;40:532–41.
Miller WR, Bakas T, Buelow JM, Habermann B. Research involving participants with chronic diseases: overcoming recruitment obstacles. Clin Nurse Spec. 2013;27:307–13.
Sygna K, Johansen S, Ruland CM. Recruitment challenges in clinical research including cancer patients and caregivers. Trials. 2015;16:428.
Newington L, Metcalfe A. Factors influencing recruitment to research: qualitative study of the experiences and perceptions of research teams. BMC Med Res Methodol. 2014;14:10.
Wigen TI, Espelid I, Skaare AB, Wang NJ. Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age. Community Dent Oral Epidemiol. 2011;39:311–7.
Manca DP, O’Beirne M, Lightbody T, Johnston DW, Dymianiw D-L, Nastalska K, et al. The most effective strategy for recruiting a pregnancy cohort: a tale of two cities. BMC Pregnancy Childbirth. 2013;13:75.
Dela Cruz GG, Rozier RG, Slade G. Dental screening and referral of young children by pediatric primary care providers. Pediatrics. 2004;114:e642–e52.
Warner ET, Glasgow RE, Emmons KM, Bennett GG, Askew S, Rosner B, et al. Recruitment and retention of participants in a pragmatic randomized intervention trial at three community health clinics: results and lessons learned. BMC Public Health. 2013;13:192.
Dancy BL, Wilbur J, Talashek M, Bonner G, Barnes-Boyd C. Community-based research: barriers to recruitment of African Americans. Nurs Outlook. 2004;52:234–40.
Hillier FC, Batterham AM, Nixon CA, Crayton AM, Pedley CL, Summerbell CD. A community-based health promotion intervention using brief negotiation techniques and a pledge on dietary intake, physical activity levels and weight outcomes: lessons learnt from an exploratory trial. Public Health Nutr. 2012;15:1446–55.
Gao X, Lo ECM, McGrath C, Ho SMY. Innovative interventions to promote positive dental health behaviors and prevent dental caries in preschool children: study protocol for a randomized controlled trial. Trials. 2013;14:118.
Lane TS, Armin J, Gordon JS. Online recruitment methods for web-based and mobile health studies: a review of the literature. J Med Internet Res. 2015;17:e183.
Robinson KA, Dennison CR, Wayman DM, Pronovost PJ, Needham DM. Systematic review identifies number of strategies important for retaining study participants. J Clin Epidemiol. 2007;60:757. e1-. e19.
Robinson KA, Dinglas VD, Sukrithan V, Yalamanchilli R, Mendez-Tellez PA, Dennison-Himmelfarb C, et al. Updated systematic review identifies substantial number of retention strategies: using more strategies retains more study participants. J Clin Epidemiol. 2015;68:1481–7.
Effoe VS, Katula JA, Kirk JK, Pedley CF, Bollhalter LY, Brown WM, et al. The use of electronic medical records for recruitment in clinical trials: findings from the lifestyle intervention for treatment of diabetes trial. Trials. 2016;17:496.
Ruffin MT, Nease DE. Using patient monetary incentives and electronically derived patient lists to recruit patients to a clinical trial. J Am Board Fam Med. 2011;24:569–75.
Newman LA, Biedrzycki K, Baum F. Digital technology access and use among socially and economically disadvantaged groups in South Australia. J Community Inf. 2010;6(2).
Thomas J, Barraket J, Ewing S, MacDonald T, Mundell M, Tucker J. Measuring Australia's digital divide: the Australian digital inclusion index 2016. Melbourne: Swinburne University of Technology; 2016.
Choi NG, DiNitto DM. TThe Digital Divide Among Low-Income Homebound Older Adults: Internet Use Patterns, eHealth Literacy, and Attitudes TowardComputer/Internet Use J Med Internet Res. 2013;15(5):e93 doi:https://doi.org/10.2196/jmir.2645.
Deloitte Touche Tohmatsu Limited. Mobile Consumer Survey 2016 Sydney: 2016.
Lee SK, Sulaiman-Hill CR, Thompson SC. Overcoming language barriers in community-based research with refugee and migrant populations: options for using bilingual workers. BMC Int Health Hum Rights. 2014;14:11.
Suwankhong D, Liamputtong P. Cultural insiders and research fieldwork: case examples from cross-cultural research with Thai people. Int J Qual Methods. 2015;14:1–7.
Manohar N, Liamputtong P, Bhole S, Arora A. Researcher positionality in cross-cultural and sensitive research. In: Liamputtong P, editor. Handbook of research methods in health social sciences. Singapore: Springer Singapore; 2017. p. 1–15.
Liamputtong P. Performing qualitative cross-cultural research. Cambridge: Cambridge University Press; 2010.
Ramsden IM. Cultural safety and nursing education in Aotearoa and Te Waipounamu. Wellington: Victoria University of Wellington; 2002.
Greenwood S, Wright T, Nielsen H. Conversations in context: cultural safety and reflexivity in child and family health nursing. J Fam Nurs. 2006;12:201–24.
Gerlach AJ. A critical reflection on the concept of cultural safety. Can J Occup Ther. 2012;79:151–8.
Casamassimo PS, Lee JY, Marazita ML, Milgrom P, Chi DL, Divaris K. Improving Children's oral health: an interdisciplinary research framework. J Dent Res. 2014;93:938–42.
Australian Government Department of Health and Aging. Medicare Benefit Schedule primary care items: healthy kids check–fact sheet. Canberra: Commonwealth of Australia; 2010 [cited 2017 7 May].
Liamputtong P. Qualitative research methods. 4th ed. South Melbourne: Oxford University Press; 2013.