Dr Sarah Howcutt

Background.

South Asians make up the largest ethnic minority group in England and Wales.  Yet this group is underrepresented in some programmes to promote health, such as cancer screening.  A challenge to addressing such health disparities is the difficulty of recruiting South Asian communities to health research. Effective recruitment requires the development of participants’ knowledge about research and their trust.  Researchers also need to increase their cultural understanding and to think about how they will communicate information despite language barriers.  This article describes the use of an organogram, informed by social network analysis, to identify the community contacts likely to encourage participation of South Asian adults (aged 50 to 75 years) in interviews to identify the facilitators of home bowel cancer screening.

Methods.

We developed an organogram which represented the directional relationships between organizations and key informants against the level of recruitment success to visualize where networking engaged participants. Primary data were recruitment records (February 2019-March 2020).

Results

The majority of participants were recruited from faith centres. The topic of bowel cancer was a barrier for some, but recruitment was more successful with the advocacy of leaders within the South Asian communities. Visualizing community networks helped the research team to understand where to concentrate time and resources for recruitment.

Conclusions.

The organizational chart was easy to maintain and demonstrated useful patterns in recruitment successes.

Policy summary.

An organogram can provide a practical tool to identify the best strategies and community contacts to engage South Asian participants in studies to inform policy on health promotion activities such as cancer screening. 

Introduction: The effect of socioeconomic status on adolescent substance abuse may be mediated by family socialization practices. However, traditional mediation analysis using a product or difference method is susceptible to bias when assumptions are not addressed. We aimed to use a potential outcomes framework to assess assumptions of exposure‐mediator interaction and of no confounding of the results.

Method: We revisited a traditional mediation analysis with a multiple mediator causal mediation approach using data from 17,761 Norwegian young people (13–18 years), 51% female. Data were collected through a print questionnaire. Socioeconomic status was operationalized as parental education and employment status (employed or receiving welfare); drinking behavior as the frequency of alcohol consumption and frequency of intoxication in the past year; and socialization practices as general parenting measures, alcohol‐related parental permissiveness, and parent drinking behavior.

Results: There was no consistent evidence of exposure‐mediator interaction. Formal sensitivity analysis of mediator‐outcome confounding was not possible in the multiple mediator model, and this analysis supported the hypothesis that socioeconomic status effects on adolescent substance abuse are fully mediated by family socialization practices, with apparently stronger effects in younger age groups observed in plots.

Conclusion: We found that the effect of socioeconomic status on adolescent substance abuse was fully mediated by family socialization practices. While our analysis provides more rigorous support for causal inferences than past work, we could not completely rule out the possibility of unmeasured confounding.

Lifecourse epidemiology suggests that preconception is a valuable opportunity for health promotion with young women.  Yet young women are less likely than older women to be research participants, limiting evidence about their needs and risks.  Marketing data indicate that young adults are not engaged with one advertising strategy because they transition through three life stages: (1) limited independence and focus on own interests, (2) increased independence and time with peers, (3) establishing a home and family.  The aim of this study was to explore whether these marketing lifestage categories could inform the tailoring of strategies to recruit young women.Three focus groups per lifestage category were conducted (49 women aged 16 to 34 years).  Lifestage category (1) was represented by further education students, category (2) by women in workplaces, and (3) by mothers.  Questions explored participants’ lifestyles, identity, reasons for  participation in the current study and beliefs about researchers.   Three major themes were identified through framework analysis: Profiling how young women spend their time; Facilitators of participating in research; and Barriers to participating.  Students and women in work valued monetary remuneration whereas mothers preferred social opportunities.  Participants’ perceived identity influenced whether they felt useful to research.   All groups expressed anxiety about participation.  Altruism was limited to helping people known to participants.  Therefore, the marketing categories did not map exactly to differences in young women’s motivations to participate but have highlighted how one recruitment strategy may not engage all.   Mass media communication could, instead, increase familiarity and reduce anxiety about participation.