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.
Identifying ‘hard-to-reach’ groups and strategies to engage them in biomedical research: perspectives from engagement practitioners in South East Asia
Dr
Mary Chambers
(She/Her)
Senior Lecturer
Faculty of Medical & Life Sciences
University of Oxford
Our workshop participants highlighted that in order to reach underserved communities, it is important to gain a meaningful and genuine understanding of the target population as well as a comprehensive approach to facilitate sustainable changes.
Overview
Research on why some groups are harder to reach – an outcome to a 2 day workshop with 38 engagement practitioners working in SE Asia (36 SE Asian nationals).
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.
Key Findings
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 research
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.
Public engagement projects in public health and biomedical research must be sensitive of challenges faced by marginalised communities, and implemented collaboratively with these groups.
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About this research
This journal article was part of a collaborative effort
Phaik Yeong Cheah
Ha Nguyen Thanh
The PE workshop was funded by a grant from the Wellcome Trust (106680). OUCRU PE activities are funded by numerous grants from the Wellcome Trust (106680, 099493), Sanofi Espoir Foundation, Bayer, Global Health Bioethics Network (Wellcome Strategic Award no. 096527). MORU PE activities is funded by a Wellcome Trust Provision for Public Engagement grant (106698). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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UN Sustainable Development Goals
This research contributes to the following SDGs
About this research
The PE workshop was funded by a grant from the Wellcome Trust (106680). OUCRU PE activities are funded by numerous grants from the Wellcome Trust (106680, 099493), Sanofi Espoir Foundation, Bayer, Global Health Bioethics Network (Wellcome Strategic Award no. 096527). MORU PE activities is funded by a Wellcome Trust Provision for Public Engagement grant (106698). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
This paper was co-authored
Phaik Yeong Cheah
Ha Nguyen Thanh
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What findings means
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
Methodology
Brainstorming around main hard to reach groups and summarising key issues and suggestions.
Working with a limited group in workshop representing 6/7 SE Asian countries, therefore not fully scaleable or exhaustive.
Glossary
Hard to reach population
Groups 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.
Want to read the full paper? It is available open access
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.
