Background: Ethnic minorities have a relatively higher prevalence of mental disorders but are underrepresented in mental health research. Researchers often face difficulties recruiting ethnic minority participants to mental health research. There is a need to develop and evaluate recruitment strategies for ethnic minorities to participate in mental health research. This thesis aimed to systematically develop a recruitment programme (SHAMIL) and assess its effectiveness in improving the recruitment of British South Asian participants into mental health research. Methods: I adopted a mixed-methods approach, using the Medical Research Council complex interventions framework, comprising: 1) a systematic review to identify the evidence base and describe the recruitment strategies used in previous trials; 2) a qualitative study using semi structured interviews with researchers (n=25 ) to understand researchers perspectives on ethnic minority recruitment; 3) development of a glossary and use of the User Testing method to improve South Asian participants understanding of study materials. A between group design with two rounds of testing was undertaken to test the readability of participant information sheets (PIS) among the South Asian women (n=31); 4) an attempt was made to evaluate the complete SHAMIL recruitment programme using a study within a trial (SWAT); 5) development and evaluation of a SHAMIL mental health research awareness workshop in a within group design. The aim was to improve South Asian participants' (n=152) knowledge, willingness and attitudes towards participation in mental health research. Results: Twenty-one included randomised controlled trials (RCTs) identified various strategies to recruit ethnic communities to trials. These were described under three overarching themes: adaptation of screening and outcome measures; culturally specific recruitment training; and recruitment processes. The review highlighted that researchers employed limited strategies to enhance recruitment. The qualitative study revealed issues in attitudes, practices, and experience about the inclusion of ethnic minority people in research. The study highlighted the need to plan for extra resources to recruit ethnic minority groups, improve training opportunities for researchers, employ culturally sensitive strategies, and raise awareness in the community. I showed that User Testing led to a higher proportion of information being understood in a revised PIS. In the SWAT study, logistical issues with the host trial meant it was not feasible to evaluate the impact of the SHAMIL programme. Lastly, I showed that the SHAMIL mental health awareness workshop improved knowledge, attitudes, and willingness to participate in mental research. Conclusion: Moreover, the National Institute of Health Research (NIHR) INCLUDE framework provides a roadmap to improve the inclusion of underrepresented groups in research. The SHAMIL recruitment programme may improve South Asian recruitment in mental health research. Further research is needed to evaluate the complete SHAMIL recruitment programme. Based on the findings of this thesis, I identified a number of future research priorities to build on the current findings, help achieve the aims of the INCLUDE framework, and improve the mental health of patients from ethnic minority communities in the future.
|Date of Award||31 Dec 2021|
- The University of Manchester
|Supervisor||Peter Bower (Supervisor) & Waquas Waheed (Supervisor)|
- SHAMIL Recruitment strategies
- Mental Health Research
- British South Asians
- Ethnic minorities