BackgroundVery few researchers have reported on procedures of recruiting, obtaining informed consent, and compensating participants in health research in the Arabian Gulf Region. Empirical research can inform the debate about whether to adjust these procedures for culturally diverse settings. Our objective was to delineate procedures related to recruiting, obtaining informed consent, and compensating health research participants in the extremely high-density multicultural setting of Qatar.MethodsDuring a multistage mixed methods project, field observations and qualitative interviews were conducted in a general medicine clinic of a major medical center in Qatar. Participants were chosen based on gender, age, literacy, and preferred language, i.e., Arabic, English, Hindi and Urdu. Qualitative analysis identified themes about recruitment, informed consent, compensation, and other research procedures.ResultsA total of 153 individuals were approached and 84 enrolled; the latter showed a diverse age range (18 to 75 years); varied language representation: Arabic (n = 24), English (n = 20), Hindi (n = 20), and Urdu (n = 20); and balanced gender distribution: women (n = 43) and men (n = 41). Primary reasons for 30 declinations included concern about interview length and recording. The study achieved a 74% participation rate. Qualitative analytics revealed key themes about hesitation to participate, decisions about participation with family members as well as discussions with them as “incidental research participants”, the informed consent process, privacy and gender rules of the interview environment, reactions to member checking and compensation, and motivation for participating. Vulnerability emerged as a recurring issue throughout the process among a minority of participants.ConclusionsThis study from Qatar is the first to provide empirical data on recruitment, informed consent, compensation and other research procedures in a general adult population in the Middle East and Arabian Gulf. This investigation illustrates how potential research participants perceive research participation. Fundamentally, Western ethical research principles were applicable, but required flexibility and culturally informed adaptations.
BackgroundHealth care researchers working in the Arabian Gulf need information on how to optimize recruitment and retention of study participants in extremely culturally diverse settings. Implemented in Doha, Qatar in 2012 with 4 language groups, namely Arabic, English, Hindi, and Urdu, this research documents persons’ responses to recruitment, consent, follow-up, and reminder procedures during psychometric testing of the Multicultural Assessment Instrument (MAI), a novel self- or interviewer-administered survey.MethodsBilingual research assistants recruited adults in outpatient clinics by approaching persons in particular who appeared to be from a target language group. Participants completed the MAI, a second acculturation instrument used for content-validity assessment, and a demographics questionnaire. Participants were asked to take the MAI again in 2–3 weeks, in person or by post, to assess test-retest reliability. Recruitment data were analyzed by using nonparametric statistics.ResultsOf 1503 persons approached during recruitment, 400 enrolled (27 %)—100 per language group. The enrollment rates in the language groups were: Arabic-32 %; English-33 %; Hindi-18 %; Urdu-30 %. The groups varied somewhat in their preferences regarding consent procedure, follow-up survey administration, contact mode for follow-up reminders, and disclosure of personal mailing address (for postal follow-up). Over all, telephone was the preferred medium for follow-up reminders. Of 64 persons who accepted a research assistant’s invitation for in-person follow-up, 40 participants completed the interview (follow-up rate, 63 %); among 126 persons in the postal group with a deliverable address, 29 participants mailed back a completed follow-up survey (response rate, 23 %).ConclusionsResearchers in the Arabian Gulf face challenges to successfully identify, enroll, and retain eligible study participants. Although bilingual assistants—often from the persons’ own culture—recruited face-to-face, and our questionnaire contained no health care-related content, many persons were reluctant to participate. This occurrence was observed especially at follow-up, particularly among participants who had agreed to follow-up by post.
Background: Novel survey instrument development requires reliability testing, but limited information informs the preferred approach in Qatar. The testing of survey characteristics of the Multi-Cultural Assessment Inventory-Qatar (MAI-Q), a novel multicultural assessment tool in Arabic, English, Hindi and Urdu, provided the opportunity to investigate survey distribution procedures. Objective: To determine willingness to participate, and response rates during survey reliability testing by mail and in person. Methodology: To examine participation preferences and rates, patients were recruited through HMC and six primary health centers. When recruited, subjects could choose to take the MAI-Q a second time for the reliability testing in person or by mail. Subjects were either scheduled for follow-up in-person, or were sent the survey in a prepaid, preaddressed envelope. Results: Among 387 subjects who initially took the survey, 177 (46%) declined taking the survey a second time for reliability testing. Of 210 subjects who agreed to take the survey a second time for reliability testing, 145/210 (69%) chose mail, and 65/210 (31%) were offered and chose in person follow-up. Actual follow-up to complete reliability testing was only 29/145 (21%) by post but 40/65 (63%) in person. Conclusion: These findings reveal challenges researchers face when developing and distributing surveys in Qatar. Nearly half of subjects initially recruited were not willing to participate in follow-up testing. Among those agreeing to follow-up testing, the majority chose mail, but only a fifth of them returned instruments. The majority of subjects who chose in person follow up completed testing. These data inform researchers about the tough choices for developing and conducting surveys in Qatar.
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