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      Attitudes to participating in a birth cohort study, views from a multiethnic population: a qualitative study using focus groups

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          Abstract

          Background

          Recruitment to birth cohort studies is a challenge. Few studies have addressed the attitudes of women about taking part in birth cohort studies particularly those from ethnic minority groups.

          Objective

          To seek the views of people from diverse ethnic backgrounds about participation in a proposed birth cohort examining the impact of infections.

          Design and setting

          Eight focus groups of pregnant women and mothers of young children took place in GP surgeries and community centres in an ethnically diverse area of east London. Purposeful sampling and language support ensured representation of people from ethnic minority groups. Audio recordings were taken and transcripts were analysed using the Framework approach.

          Main outcome measures

          The views of participants about taking part in the proposed birth cohort study, in particular concerning incentives to taking part, disincentives and attitudes to consenting children.

          Results

          There was more convergence of opinion than divergence across groups. Altruism, perceived health gains of participating and financial rewards were motivating factors for most women. Worries about causing harm to their child, inconvenience, time pressure and blood sample taking as well as a perceived lack of health gains were disincentives to most. Mistrust of researchers did not appear to be a significant barrier. The study indicates that ethnicity and other demographic factors influence attitudes to participation.

          Conclusions

          To recruit better, birth cohort studies should incorporate financial and health gains as rewards for participation, promote the altruistic goals of research, give assurances regarding the safety of the participating children and sensitive data, avoid discomfort and maximize convenience. Ethnicity influences attitudes to participation in many ways, and researchers should explore these factors in their target population.

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          Most cited references27

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          What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies

          Background A commonly reported problem with the conduct of multicentre randomised controlled trials (RCTs) is that recruitment is often slower or more difficult than expected, with many trials failing to reach their planned sample size within the timescale and funding originally envisaged. The aim of this study was to explore factors that may have been associated with good and poor recruitment in a cohort of multicentre trials funded by two public bodies: the UK Medical Research Council (MRC) and the Health Technology Assessment (HTA) Programme. Methods The cohort of trials was identified from the administrative databases held by the two funding bodies. 114 trials that recruited participants between 1994 and 2002 met the inclusion criteria. The full scientific applications and subsequent trial reports submitted by the trial teams to the funders provided the principal data sources. Associations between trial characteristics and recruitment success were tested using the Chi-squared test, or Fisher's exact test where appropriate. Results Less than a third (31%) of the trials achieved their original recruitment target and half (53%) were awarded an extension. The proportion achieving targets did not appear to improve over time. The overall start to recruitment was delayed in 47 (41%) trials and early recruitment problems were identified in 77 (63%) trials. The inter-relationship between trial features and recruitment success was complex. A variety of strategies were employed to try to increase recruitment, but their success could not be assessed. Conclusion Recruitment problems are complex and challenging. Many of the trials in the cohort experienced recruitment difficulties. Trials often required extended recruitment periods (sometimes supported by additional funds). While this is of continuing concern, success in addressing the trial question may be more important than recruitment alone.
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            Focus-group interview and data analysis.

            In recent years focus-group interviews, as a means of qualitative data collection, have gained popularity amongst professionals within the health and social care arena. Despite this popularity, analysing qualitative data, particularly focus-group interviews, poses a challenge to most practitioner researchers. The present paper responds to the needs expressed by public health nutritionists, community dietitians and health development specialists following two training sessions organised collaboratively by the Health Development Agency, the Nutrition Society and the British Dietetic Association in 2003. The focus of the present paper is on the concepts and application of framework analysis, especially the use of Krueger's framework. It provides some practical steps for the analysis of individual data, as well as focus-group data using examples from the author's own research, in such a way as to assist the newcomer to qualitative research to engage with the methodology. Thus, it complements the papers by Draper (2004) and Fade (2004) that discuss in detail the complementary role of qualitative data in researching human behaviours, feelings and attitudes. Draper (2004) has provided theoretical and philosophical bases for qualitative data analysis. Fade (2004) has described interpretative phenomenology analysis as a method of analysing individual interview data. The present paper, using framework analysis concentrating on focus-group interviews, provides another approach to qualitative data analysis.
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              Attitudes and beliefs of African Americans toward participation in medical research.

              To describe barriers to participation of African Americans in research. Focus group interviews conducted in 1997. Thirty-three African-American adults presenting to an urban public hospital for outpatient medical care participated in one of five focus groups. African-American patients' attitudes toward medical research were measured. Mistrust of doctors, scientists, and the government was reported consistently by the participants. Many participants described concerns about the ethical conduct of clinicians and investigators when poor or minority patients are involved and cited examples of exploitation as supporting evidence for their mistrust of the medical establishment. While participants were clear about the violation of human rights in the Tuskegee Syphilis Study, all were misinformed of the historical facts of the study. Few participants understood the concept of informed consent. Participants saw signing the document as relinquishing their autonomy and as a legal protection for physicians. Despite these concerns, participants gave recommendations to improve minority participation in research. African-American participants in this study described distrust of the medical community as a prominent barrier to participation in clinical research. Participants described real and perceived examples of exploitation to support their distrust of researchers. The goal of the consent process, to inform patients of risks and benefits so as to facilitate self-determination, was misinterpreted by these participants. Understanding the importance of interpersonal trust within the clinical relationship may prove to be a significant factor in enhancing participation in clinical trials.
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                Author and article information

                Contributors
                Role: Honorary Research Fellowneeru.garg@manchester.ac.uk
                Role: Academic Clinical Fellow
                Role: Research Fellow
                Role: Professor of Health Services Research
                Role: Professor of Primary Care
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                17 June 2016
                February 2017
                : 20
                : 1 ( doiID: 10.1111/hex.2017.20.issue-1 )
                : 146-158
                Affiliations
                [ 1 ] NIHR School for Primary Care Research Centre for Primary CareUniversity of Manchester ManchesterUK
                [ 2 ] Department of Primary Care and Public Health ResearchKing's College London LondonUK
                [ 3 ] NIHR Greater Manchester Primary Care Patient Safety Translational Research CentreUniversity of Manchester ManchesterUK
                [ 4 ] NIHR School for Primary Care Research Manchester Academic Health Science CentreUniversity of Manchester ManchesterUK
                [ 5 ] Centre for Health SciencesQueen Mary University of London LondonUK
                Author notes
                [*] [* ] Correspondence

                Dr Neeru Garg, MBChB MSc

                Honorary Research Fellow

                Centre for Primary Care

                The Williamson Building

                Oxford Rd

                Manchester M13 9PY

                UK

                E‐mail: neeru.garg@ 123456manchester.ac.uk

                Article
                HEX12445
                10.1111/hex.12445
                5217869
                27312575
                a40de70c-eb1d-40d5-854d-2803512ecca5
                © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 January 2016
                Page count
                Figures: 0, Tables: 4, Pages: 13, Words: 7794
                Funding
                Funded by: Bart's Charity
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                hex12445
                February 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.0 mode:remove_FC converted:04.01.2017

                Health & Social care
                birth cohort,children,ethnicity,focus groups,recruitment,research participation
                Health & Social care
                birth cohort, children, ethnicity, focus groups, recruitment, research participation

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