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Cummins L, Dawson K, Bayes S, Wilson V, Meedya S. Using the principles of practice development to address challenges in recruitment and data collection when face-to-face methods are unavailable. Nurse Res 2024; 32:22-30. [PMID: 38419422 DOI: 10.7748/nr.2024.e1898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Researchers conducting studies involving pregnant women often find recruitment challenging. The COVID-19 pandemic added further complexity to studies requiring face-to-face participation. AIM To demonstrate how to maintain the principles of practice development (PD) when a study must switch from face-to-face to remote methods of collecting data. DISCUSSION The number of participants in the authors' study increased when they moved from face-to-face to telephone engagement during the COVID-19 pandemic. They continued using PD principles when they changed method and the quality of the data they collected remained constant, even once lockdown restrictions were in place. CONCLUSION PD principles can offer ways for nurse researchers to engage, collaborate with and reflect with people for research projects, including when constraints compete with participation. They can also assist researchers in optimising and maintaining recruitment and data collection when face-to-face research methods are impossible. IMPLICATIONS FOR PRACTICE The telephone can be a valuable alternative medium for recruiting participants and collecting data when face-to-face methods are impossible to use. PD principles can be maintained and response rates and participation may even be greater when using it.
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Affiliation(s)
- Leanne Cummins
- Australian Catholic University, Blacktown, NSW Australia
| | - Kate Dawson
- Faculty of Health Science/School of Nursing, Midwifery, Australian Catholic University, Melbourne, Victoria
| | - Sara Bayes
- Australian Catholic University, Melbourne, Victoria
| | - Valerie Wilson
- person-centred healthcare, Ingham Institute, Liverpool, NSW Australia
| | - Shahla Meedya
- Australian Catholic University, Blacktown, NSW Australia
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2
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Vinson A, Paul R, Chubiz J, Raghuraman N, Kelly JC, England SK, Carter EB. The Association between Mode of Transportation Support and Research Study Visit Attendance among Pregnant Patients. Am J Perinatol 2024; 41:e3363-e3366. [PMID: 38101443 DOI: 10.1055/s-0043-1777441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
OBJECTIVE This study aimed to examine the association between transportation assistance and study visits, and explore differences by transportation modality. STUDY DESIGN This was a secondary analysis of prospective cohort study. We identified patients requesting transportation support for research ultrasound visits and identified controls (1:2 ratio) who did not request support matched for age, race, and insurance type. Conditional logistic regression examined the association between transportation support and mode of transportation with study visit attendance. RESULTS Transportation support was requested by 57/1,184 (4.8%) participants. Participants that requested transportation support were three times more likely to attend visits than their matched controls (adjusted odds ratio [aOR] = 3.16, 95% confidence interval [CI]: 1.76-5.68). Among visits with transportation support, those supported by a ridesharing service had five-fold higher odds of attendance than visits supported with taxi service (aOR = 5.06, 95% CI: 1.50-16.98). CONCLUSION Transportation support, especially a ridesharing service, is associated with improved attendance at research study visits in a sample of predominantly low-income, Black, pregnant participants. Implementing transportation support may be a promising strategy to improve engagement in research studies. KEY POINTS · Participants utilizing transportation assistance were more likely to attend study appointments.. · Participants using ridesharing had higher likelihood of attendance than those using taxi service.. · Transportation assistance may improve research engagement for historically marginalized people..
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Affiliation(s)
- Ariel Vinson
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
- Meharry Medical College, Nashville, Tennessee
| | - Rachel Paul
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Jessica Chubiz
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Nandini Raghuraman
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Jeannie C Kelly
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Ebony B Carter
- Department of Obstetrics and Gynecology , University of North at Chapel Hill
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Davis JW, Serna ADL, Carey C, Ally F, Giurgescu C. Pilot Study of the FitMoms2B Physical Activity Promotion Program Among Black Women With High-Risk Pregnancies. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00038-8. [PMID: 38552675 DOI: 10.1016/j.jogn.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVE To explore the feasibility of recruitment, adherence, and retention and the acceptability of the FitMoms2B physical activity promotion program and study measures among non-Hispanic Black women with high-risk pregnancies. DESIGN One-arm pilot feasibility study. SETTING A large regional high-risk prenatal clinic in the southeastern United States. PARTICIPANTS Non-Hispanic Black women who had singleton, high-risk pregnancies at 16 to 23 weeks gestation with no contraindications to physical activity (N = 13). METHOD We evaluated the feasibility and acceptability of a multicomponent intervention, which included physical activity coaching, support from a workout partner, and an activity tracker. We also assessed the feasibility of study measures for future trials of the program. RESULTS Of 179 patients screened, 20 were eligible, and 13 consented and enrolled (65%). Of the 13 participants, 9 completed data collection at Time Point (T) 1 (16-23 weeks gestation) and T2 (24-30 weeks), and 8 completed data collection at T3 (31 or more weeks). Adherence met expectations for coaching (63%), exercise with a workout partner (100%), and use of the activity tracker (92%). Acceptability was high (100%). CONCLUSION We found that recruitment, retention, and adherence are feasible for the FitMoms2B physical activity promotion program. The program and study measures were acceptable to participants in our sample. We provide preliminary support for a randomized controlled trial to study physical activity promotion with virtual coaching, workout partner support, and activity tracking among Black pregnant women with high-risk pregnancies without contraindications to physical activity.
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Zgierska AE, Gramly T, Prestayko N, Symons Downs D, Murray TM, Yerby LG, Howell B, Stahlman B, Cruz J, Agolli A, Horan H, Hilliard F, Croff JM. Transportation, childcare, lodging, and meals: Key for participant engagement and inclusion of historically underrepresented populations in the healthy brain and child development birth cohort. J Clin Transl Sci 2024; 8:e38. [PMID: 38476249 PMCID: PMC10928703 DOI: 10.1017/cts.2024.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Participant recruitment and retention (R&R) are well-documented challenges in longitudinal studies, especially those involving populations historically underrepresented in research and vulnerable groups (e.g., pregnant people or young children and their families), as is the focus of the HEALthy Brain and Child Development (HBCD) birth cohort study. Subpar access to transportation, overnight lodging, childcare, or meals can compromise R&R; yet, guidance on how to overcome these "logistical barriers" is sparse. This study's goal was to learn about the HBCD sites' plans and develop best practice recommendations for the HBCD consortium for addressing these logistical barriers. Methods The HBCD's workgroups developed a survey asking the HBCD sites about their plans for supporting research-related transportation, lodging, childcare, and meals, and about the presence of institutional policies to guide their approach. Descriptive statistics described the quantitative survey data. Qualitative survey responses were brief, not warranting formal qualitative analysis; their content was summarized. Results Twenty-eight respondents, representing unique recruitment locations across the U.S., completed the survey. The results indicated substantial heterogeneity across the respondents in their approach toward supporting research-related transportation, lodging, childcare, and meals. Three respondents were aware of institutional policies guiding research-related transportation (10.7%) or childcare (10.7%). Conclusions This study highlighted heterogeneity in approaches and scarcity of institutional policies regarding research-related transportation, lodging, childcare, and meals, underscoring the need for guidance in this area to ensure equitable support of participant R&R across different settings and populations, so that participants are representative of the larger community, and increase research result validity and generalizability.
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Affiliation(s)
- Aleksandra E. Zgierska
- Departments of Family and Community Medicine, Anesthesiology and
Perioperative Medicine, and Public Health Sciences, Pennsylvania State
University College of Medicine, Hershey, PA,
USA
| | - Tatum Gramly
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Nicholas Prestayko
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Danielle Symons Downs
- Department of Kinesiology and College of Medicine, Department of
Obstetrics and Gynecology, Pennsylvania State University College of Health and
Human Development, University Park, PA,
USA
| | - Traci M. Murray
- National Institutes of Health, National Institute on Drug
Abuse, Bethesda, MD, USA
| | - Lea G. Yerby
- Department of Community Medicine and Population Health, The
University of Alabama College of Community Health Sciences,
Tuscaloosa, AL, USA
| | - Brittany Howell
- Department of Human Development and Family Science, Virginia Tech,
Fralin Biomedical Research Institute, Roanoke,
VA, USA
| | - Barbara Stahlman
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Jennifer Cruz
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Arjola Agolli
- Department of Family and Community Medicine, Pennsylvania
State University College of Medicine, Hershey,
PA, USA
| | - Holly Horan
- Department of Obstetrics and Gynecology, Global and Rural Women’s Health
Program, Heersink School of Medicine, The University of Alabama at
Birmingham, Birmingham, AL,
USA
| | | | - Julie M. Croff
- Oklahoma State University Center for Health Sciences,
Tulsa, OK, USA
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5
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Kraft SA, Duenas DM, Shah SK. Patient priorities for fulfilling the principle of respect in research: findings from a modified Delphi study. BMC Med Ethics 2023; 24:73. [PMID: 37735658 PMCID: PMC10512546 DOI: 10.1186/s12910-023-00954-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. METHODS We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas of agreement among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item's mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. RESULTS Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. CONCLUSIONS Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research.
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Affiliation(s)
- Stephanie A Kraft
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 1900 Ninth Ave., M/S JMB-6, Seattle, WA, 98101, USA.
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
| | - Devan M Duenas
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, 1900 Ninth Ave., M/S JMB-6, Seattle, WA, 98101, USA
| | - Seema K Shah
- Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Edwards TL, Greene CA, Piekos JA, Hellwege JN, Hampton G, Jasper EA, Velez Edwards DR. Challenges and Opportunities for Data Science in Women's Health. Annu Rev Biomed Data Sci 2023; 6:23-45. [PMID: 37040736 PMCID: PMC10877578 DOI: 10.1146/annurev-biodatasci-020722-105958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The intersection of women's health and data science is a field of research that has historically trailed other fields, but more recently it has gained momentum. This growth is being driven not only by new investigators who are moving into this area but also by the significant opportunities that have emerged in new methodologies, resources, and technologies in data science. Here, we describe some of the resources and methods being used by women's health researchers today to meet challenges in biomedical data science. We also describe the opportunities and limitations of applying these approaches to advance women's health outcomes and the future of the field, with emphasis on repurposing existing methodologies for women's health.
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Affiliation(s)
- Todd L Edwards
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
| | - Catherine A Greene
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
- Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jacqueline A Piekos
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
- Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jacklyn N Hellwege
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Gabrielle Hampton
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
| | - Elizabeth A Jasper
- Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Center for Precision Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Digna R Velez Edwards
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
- Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Jacobson LT, Wolfe M, Zackula R, Okut H, Hampton FE, Grainger DA, Griebel-Thompson AK, Ling Kong K, Befort C. Electronic Monitoring Of Mom's Schedule (eMOMS TM): Recruitment of pregnant populations with elevated BMI in a feasibility randomized controlled trial. Prev Med Rep 2023; 34:102254. [PMID: 37292426 PMCID: PMC10244679 DOI: 10.1016/j.pmedr.2023.102254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/27/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Underrepresentation of pregnant populations in randomized controlled trials of lifestyle change interventions is concerning due to high attrition and providers' limited clinical time. The purpose of this evaluative study was to assess intervention uptake of pregnant individuals enrolled in a three-arm feasibility randomized controlled trial, electronic Monitoring Of Mom's Schedule (eMOMSTM), examining lifestyle changes and lactation support alone, and in combination. Measures included: (1) participation and completion rates, and characteristics of intervention completers versus other eligible participants; and (2) provider experiences with screening and enrolling pregnant participants. Pregnant people with a pre-pregnancy body mass index ≥ 25 and < 35 kg/m2 were enrolled into the eMOMSTM trial between September 2019 - December 2020. Of the 44 consented participants, 35 were randomized, at a participation rate of 35%, and 26 completed the intervention, resulting in a completion rate of 74%. Intervention completers were slightly older and entered the study earlier in pregnancy compared to non-completers. Completers were more likely to be first-time mothers, resided in urban areas, had higher educational attainment, and were slightly more racially and ethnically diverse. A majority of providers reported willingness to participate, believed the study aligned with their organization's mission, and were satisfied with using iPads for screening. Lessons learned to guide recruitment success include use of: (1) designated research staff in combination with physician support; and (2) user-friendly technology to help mitigate time burden on physicians and their staff. Future work should focus on successful strategies to recruit/retain pregnant populations in clinical trials.
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Affiliation(s)
- Lisette T. Jacobson
- University of Kansas School of Medicine-Wichita, Department of Population Health, 1010 North Kansas, Wichita, KS 67214, USA
- University of Kansas School of Medicine-Wichita, Department of Obstetrics and Gynecology, 1010 North Kansas, Wichita, KS 67214, USA
| | - Michael Wolfe
- Ascension Via Christi Hospitals Wichita, Inc., Ascension Via Christi Maternal Fetal Medicine Clinic, 1515 South Clifton Avenue, Suite 130, Wichita, KS 67218, USA
| | - Rosey Zackula
- University of Kansas School of Medicine-Wichita, Office of Research, 1010 North Kansas, Wichita, KS 67214, USA
| | - Hayrettin Okut
- University of Kansas School of Medicine-Wichita, Department of Population Health, 1010 North Kansas, Wichita, KS 67214, USA
- University of Kansas School of Medicine-Wichita, Office of Research, 1010 North Kansas, Wichita, KS 67214, USA
| | - Faith E. Hampton
- University of Kansas School of Medicine-Wichita, Department of Population Health, 1010 North Kansas, Wichita, KS 67214, USA
| | - David A. Grainger
- University of Kansas School of Medicine-Wichita, Department of Obstetrics and Gynecology, 1010 North Kansas, Wichita, KS 67214, USA
| | - Adrianne K. Griebel-Thompson
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Christie Befort
- University of Kansas School of Medicine-Kansas City, Department of Population Health, 3901 Rainbow Boulevard, Mailstop 1003, Kansas City, KS 66160, USA
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Atif N, Rauf N, Nazir H, Maryam H, Mumtaz S, Zulfiqar S, Shouket R, Rowther AA, Malik A, Rahman A, Surkan PJ. Non-specialist-delivered psychosocial intervention for prenatal anxiety in a tertiary care setting in Pakistan: a qualitative process evaluation. BMJ Open 2023; 13:e069988. [PMID: 36822801 PMCID: PMC9950893 DOI: 10.1136/bmjopen-2022-069988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES A manualised cognitive-behavioural therapy-based psychosocial intervention for prenatal anxiety called Happy Mother Healthy Baby is being tested for its effectiveness through a randomised control trial in Pakistan. The aim of this study was to evaluate the intervention delivery process and the research process. DESIGN Qualitative methods were used to explore in depth the intervention delivery and research process. SETTING This process evaluation was embedded within a randomised control trial conducted in a tertiary care facility in Rawalpindi, Pakistan. PARTICIPANTS Data were collected through in-depth interviews (n=35) with the trial participants and focus group discussions (n=3) with the research staff. Transcripts were analysed using a Framework Analysis. RESULTS The evaluation of the intervention delivery process indicated that it can be effectively delivered by non-specialist providers trained and supervised by a specialist. The intervention was perceived to be culturally acceptable and appropriately addressing problems related to prenatal anxiety. Lack of awareness of 'talking' therapies and poor family support were potential barriers to participant engagement. The evaluation of the research process highlighted that culturally appropriate consent procedures facilitated recruitment of participants, while incentivisation and family involvement facilitated sustained engagement and retention. Lack of women's empowerment and mental health stigma were potential barriers to implementation of the programme. CONCLUSION We conclude that non-specialists can feasibly deliver an evidence-based intervention integrated into routine antenatal care in a tertiary hospital. Non-specialist providers are likely to be more cost effective and less stigmatising. Inclusion of family is key for participant recruitment, retention and engagement with the intervention. TRIAL REGISTRATION NUMBER NCT03880032.
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Affiliation(s)
- Najia Atif
- Human Development Research Foundation, Islamabad, Pakistan
| | - Nida Rauf
- Human Development Research Foundation, Islamabad, Pakistan
| | - Huma Nazir
- Human Development Research Foundation, Islamabad, Pakistan
| | - Hadia Maryam
- Human Development Research Foundation, Islamabad, Pakistan
| | - Sidra Mumtaz
- Human Development Research Foundation, Islamabad, Pakistan
| | | | - Rabail Shouket
- Human Development Research Foundation, Islamabad, Pakistan
| | - Armaan A Rowther
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abid Malik
- Human Development Research Foundation, Islamabad, Pakistan
- Public Mental Health Department, Health Services Academy, Islamabad, Pakistan
| | - Atif Rahman
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Hilliard F, Goldstein E, Nervik K, Croes K, Ossorio PN, Zgierska AE. Voices of Women With Lived Experience of Substance Use During Pregnancy: A Qualitative Study of Motivators and Barriers to Recruitment and Retention in Research. FAMILY & COMMUNITY HEALTH 2023; 46:1-12. [PMID: 36383229 PMCID: PMC10321245 DOI: 10.1097/fch.0000000000000349] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Despite concerns about negative neurocognitive effects of in utero substance exposure on child and brain development, research in this area is limited. This study gathered perspectives of persons with lived experience of substance use (eg, alcohol, prescription and illicit opioids, and other illicit substances) during a previous pregnancy to determine facilitators and barriers to research engagement in this vulnerable population. We conducted structured, in-depth, individual interviews and 2 focus groups of adult persons with lived experience of substance use during a previous pregnancy. Questions were developed by clinical, research, bioethics, and legal experts, with input from diverse stakeholders. They inquired about facilitators and barriers to research recruitment and retention, especially in long-term studies, with attention to bio-sample and neuroimaging data collection and legal issues. Interviews and focus groups were audio-recorded, transcribed, and analyzed using inductive coding qualitative analysis methods. Ten participants completed in-depth interviews and 7 participated in focus groups. Three main themes emerged as potential barriers to research engagement: shame of using drugs while pregnant, fear of punitive action, and mistrust of health care and research professionals. Facilitative factors included trustworthiness, compassion, and a nonjudgmental attitude among research personnel. Inclusion of gender-concordant recovery peer support specialists as research team members was the most frequently identified facilitator important for helping participants reduce fears and bolster trust in research personnel. In this qualitative study, persons with lived experience of substance use during a previous pregnancy identified factors critical for engaging this population in research, emphasizing the involvement of peer support specialists as research team members.
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Affiliation(s)
- Florence Hilliard
- University of Wisconsin, School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplaine Ct, Madison, WI 53715
| | - Ellen Goldstein
- University of Wisconsin, School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplaine Ct, Madison, WI 53715
| | - Kendra Nervik
- University of Wisconsin, Department of Sociology, 8128 William H. Sewell Social Sciences Building, 1180 Observatory Drive, Madison, WI, 53706-1393
| | - Kenneth Croes
- University of Wisconsin Survey Center, Sterling Hall, 475 N. Charter Street, Madison, WI 53706
| | - Pilar N. Ossorio
- University of Wisconsin Law School, 975 Bascom Mall, Rm. 9103, Madison, WI 53706-1399
- Morgridge Institute for Research, 330 N. Orchard St, Madison, WI 53715
| | - Aleksandra E. Zgierska
- Pennsylvania State University, College of Medicine, Departments of Family and Community Medicine, Anesthesiology and Perioperative Medicine, and Public Health Sciences, 700 HMC Crescent Road, Hershey, PA 17033
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LeCroy MN, Potter LN, Bandeen-Roche K, Bianco ME, Cappola AR, Carter EB, Dayan PS, Eckstrom E, Edwards DF, Farabi SS, Fisher SD, Giordano J, Hanson HA, Jenkins E, Juhn Y, Kaskel F, Stake CE, Reeds DN, Schleiss MR, Wafford QE, McColley SA. Barriers to and solutions for representative inclusion across the lifespan and in life course research: The need for structural competency highlighted by the COVID-19 pandemic. J Clin Transl Sci 2022; 7:e38. [PMID: 36845306 PMCID: PMC9947617 DOI: 10.1017/cts.2022.510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Exclusion of special populations (older adults; pregnant women, children, and adolescents; individuals of lower socioeconomic status and/or who live in rural communities; people from racial and ethnic minority groups; individuals from sexual or gender minority groups; and individuals with disabilities) in research is a pervasive problem, despite efforts and policy changes by the National Institutes of Health and other organizations. These populations are adversely impacted by social determinants of health (SDOH) that reduce access and ability to participate in biomedical research. In March 2020, the Northwestern University Clinical and Translational Sciences Institute hosted the "Lifespan and Life Course Research: integrating strategies" "Un-Meeting" to discuss barriers and solutions to underrepresentation of special populations in biomedical research. The COVID-19 pandemic highlighted how exclusion of representative populations in research can increase health inequities. We applied findings of this meeting to perform a literature review of barriers and solutions to recruitment and retention of representative populations in research and to discuss how findings are important to research conducted during the ongoing COVID-19 pandemic. We highlight the role of SDOH, review barriers and solutions to underrepresentation, and discuss the importance of a structural competency framework to improve research participation and retention among special populations.
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Affiliation(s)
- Madison N. LeCroy
- Department of Pediatrics, Division of Academic General Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lindsey N. Potter
- Center for Health Outcomes and Population Equity (HOPE), Department of Population Health Sciences, Huntsman Cancer Institute and the University of Utah, Salt Lake City, UT, USA
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Institute for Clinical and Translational Research, Baltimore, MD, USA
| | - Monica E. Bianco
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anne R. Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ebony B. Carter
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University, School of Medicine, St. Louis, MO, USA
| | - Peter S. Dayan
- Department of Emergency Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Elizabeth Eckstrom
- Department of Medicine, Division of General Internal Medicine & Geriatrics, Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Dorothy F. Edwards
- Collaborative Center for Health Equity, Institute for Clinical and Translational Research and Department of Medicine, School of Medicine and Public Health, University of Wisconsin Madison, Health Sciences Learning Center, Madison, WI, USA
| | - Sarah S. Farabi
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
- Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO, USA
| | - Sheehan D. Fisher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine/Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Judy Giordano
- University of Rochester Medical Center, Rochester, NY, USA
| | - Heidi A. Hanson
- Department of Surgery and Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Emerald Jenkins
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Young Juhn
- Precision Population Science Lab and Artificial Intelligence Program, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Frederick Kaskel
- Department of Pediatrics, Division of Pediatric Nephrology, Children’s Hospital at Montefiore, Bronx, NY, USA
| | - Christine E. Stake
- Division of Pediatric Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Dominic N. Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
- Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO, USA
| | - Mark R. Schleiss
- Department of Pediatrics, Division of Infectious Diseases, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Q. Eileen Wafford
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susanna A. McColley
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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11
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Weiler HA, Vanstone CA, Razaghi M, Gharibeh N, Patel S, Wei SQ, McNally D. Disparities in Vitamin D Status of Newborn Infants from a Diverse Sociodemographic Population in Montreal, Canada. J Nutr 2021; 152:255-268. [PMID: 34612495 PMCID: PMC8754562 DOI: 10.1093/jn/nxab344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation. OBJECTIVES We aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status. METHODS In this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy. RESULTS Infants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07). CONCLUSIONS In this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.
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Affiliation(s)
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Maryam Razaghi
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Sharina Patel
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Shu Q Wei
- Québec National Institute of Public Health, Montréal, Québec, Canada
| | - Dayre McNally
- Division of Critical Care, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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