Lessons learnt in recruiting disadvantaged families to a birth cohort study

Abstract

BackgroundDental 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.MethodsChild 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.ResultsThe 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.ConclusionsThis 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.

KUNO-Kids birth cohort study: rationale, design, and cohort description

“…This is also the case in our study. Previous studies have identified barriers to participation in birth cohorts, such as limited language or literacy skills, burden imposed by excessive information or demanding study procedures, and lack of cultural sensitivity among study personnel [27, 28]. The assessment of reasons for non-participation in the KUNO-Kids study yielded similar findings.…”

“…On the other hand, experience from other cohorts suggests that at least some barriers to study participation can be overcome by intensified recruitment efforts [27, 29, 30]. Considering the low participation rate in our study, we decided to modify the recruitment strategy in the next phase of the study.…”

Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants—Results from HSHK Birth Cohort Study

“…Public hospitals were chosen with an intent to recruit under-represented socio-economically disadvantaged population groups and also because the entire Sydney region cannot be covered geographically [28]. Child and Family Health Nurses (CFHNs) during their first post-natal home visit (four to six weeks postpartum) recruited the mother-infant dyads [27,29]. The CFHNs described the study to the mothers and obtained their written informed consent.…”

Factors Influencing the Early Introduction of Sugar Sweetened Beverages among Infants: Findings from the HSHK Birth Cohort Study

“…Written consent was obtained at this time and interpreter services for non-English speakers were provided along with written material in the respective languages of the women [28]. This study was conducted in public hospitals in order to better recruit the under-represented population groups found in Sydney including socioeconomically disadvantaged and ethnically diverse groups [29].…”