Identifying ‘hard-to-reach’ groups and strategies to engage them in biomedical research: perspectives from engagement practitioners in South East Asia

2 day workshop with 38 engagement practitioners working in SE Asia (36 SE Asian nationals). Brainstorming around main hard to reach groups and summarising key issues and suggestions.

Dr

Mary Chambers

(She/Her)

Senior Lecturer

Faculty of Medical & Life Sciences

University of Oxford

English
2 day workshop with 38 engagement practitioners working in SE Asia (36 SE Asian nationals). Brainstorming around main hard to reach groups and summarising key issues and suggestions.

Key Takeaways

  • Corresponding with published literature, economic disadvantage was also reported in our workshop as one of the most important barriers to engagement with research and health care.
  • All three discussion groups emphasized that the mobility in residence and workplace of these hard-to-reach populations is a significant challenge for local authorities and any social organizations wishing to monitor or engage with them.
  • Differences in culture, language and lifestyles of the hard-to-reach groups often create barriers against their participation in mainstream interventions and biomedical research. This is a particular issue in the urban poor and ethnic communities.

How To Apply Insights

  • Each hard to reach group has its own context, so programmes cannot be taken from other situations, they must be tailor made from formative research to understand the context.
  • Local staff and agencies are an important factor in smoothing interactions and promoting participation with the communities as they are familiar with and have the trust of local people. For the urban poor, we can cooperate with local social and non-profit organizations. In Thailand, there are many community-based organisations that have long-established work with the street communities while in Vietnam urban areas, there are voluntary groups who organizing support classes and charitable activities for homeless or disadvantaged children. For ethnic minorities, local gatekeepers such as village and religious leaders, elders, or representatives from local administration groups like Youth Union staff or a Women’s Union officer can be very helpful in encouraging participation.

Why This Research Matters

 

While public engagement is an increasingly important component in public health programmes and biomedical research, the public health interventions are limited in focus – currently these ‘public’ activities tend to reach a ‘convenient sample’ and thus miss out on a number of ‘hard-to-reach’ populations. The less socially visible groups, therefore, may have to be sacrificed for the need of maximised efficiency of public engagement interventions. But failure to engage the disadvantaged groups may result in a generalisation of the evidence of effective strategies used with the advantaged groups.

Findings & Research Conclusions

Public engagement projects in public health and biomedical research are limited by the demographics they effectively communicate with; particular hard-to-reach groups go underserved by these interventions, so new strategies must be developed.

In this workshop discussion, practitioners identified the main demographics and characteristics of populations that are underrepresented by public engagement programmes of biomedical research.
These populations fit broadly into 3 groups: urban poor, ethnic minority groups, and children in rural primary schools.

While each group is contextually separate, common barriers to engagement were identified:

1) Financial instability
2) Mobility in residency and work
3) Discrimination and isolation
4) Limitations in local resources

Engagement programs should use the following strategies to better engage these groups (FIND):

  • Formative research to improve understanding of the population
  • Integrating into local life
  • Networking with relevant stakeholders
  • Developing local resources

Research's methodology

Public engagement projects in public health and biomedical research must be sensitive of challenges faced by marginalised communities, and implemented collaboratively with these groups.

However..

Working with a limited group in workshop representing 6/7 SE Asian countries, therefore not fully scaleable or exhaustive.

ConceptDefinition
Hard to reach populationGroups of a population that are less accessible/ have less access to engagement activities and public health messaging, so miss out on the benefits of medical science.

Reference this research

Nguyen Thanh H., Cheah PY., Chambers M. (2019) ‘Identifying ‘hard-to-reach’ groups and strategies to engage them in biomedical research: perspectives from engagement practitioners in SoutheastAsia.’ Wellcome Open Research 4: 102.

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Reference

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