Overcoming challenges to recruiting mothers for family violence research

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Overcoming challenges to recruiting mothers for
family violence research
Katie Young, MPhil Linda Duffet-Leger, MN RN Nic
ole Letourneau, PhD RN
November 2007
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Acknowledgements

• Academic Team Members Kimberly Critchley, Carmen
  Gill, Jean Hughes, Nicole Letourneau, Loretta
  Secco, Miriam Stewart, and Doug Willms,
  
• Community Team Members Anne Darrah, Jeff
  denOtter, Shannon Edgett, Steven Fletcher, Julie
  Gallant, Elizabeth Godbout, Tammy Kitchen,
  Claudette Landry, Liz Lautard, Amanda Lawson,
  Christine LeBlanc, Janet McGeachy, Annette
  Richard, and Elaine Stewart
• Funders Canadian Institute for Health Research
  (CIHR), Peter Lougheed Foundation

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Overview

• Research recruitment
• Recruiting vulnerable populations
• Case study
• Recruitment challenges
• Recruitment strategies

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Research Recruitment

• Steps to participation
• Awareness of research
• Recognizing eligibility criteria
• Motivation
• Time and resources to participate

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Recruiting Vulnerable Populations

• Recruitment considerations
• Other research with the population
• Population size
• Potential effects of recruitment delays on
  research outcomes
  
• Significance of research to the populations and
  society

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Recruiting Vulnerable Populations

• Recruitment considerations
• What population specific barriers are there to
  participation?
  
• Will the research affect the populations
  vulnerability?
  
• How can the researchers be sure not to be
  coercive?

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Case Study

• The Mothering Study
• Supporting mother-infant relationships affected
  by violence
  

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Mothering Study

• 90 Maritime mothers who
• Had an infant while in a violent relationship
• Have left the violent partner
• Whose child is still 3 or under

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Levels of Recruitment

• Micro (individual) personal circumstance and
  belief factors
  
• Mediator gate-keepers, front-line workers
• Macro systems, culture, social structure

Levkoff and Sanchez (2003). Lessons learned
about minority recruitment and retention from the
centres on minority aging and health promotion.
The Gerontologist, 43(1) pp. 18-44.
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Individual Level Challenges

• Resource limitations (time, transportation, child
  care)
  
• Perceived burden of research
• Compensation versus inducement
• Trust
• Safety
• Location

• Child protection and custody concerns
• Isolation
• Stigma
• Damaged self-esteem
• Time-frame

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Individual Level Strategies

• Provide child care and honoraria
• Be flexible about interview times and locations
• Assure participants confidentiality
• Make special arrangements for confidentiality
  concerns
  
• Talk openly about safety concerns
• Provide relevant information
• Discreet advertisement

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Individual Level Strategies

• Wide advertizing efforts
• Provide participants a way to help others
• Provide participants relevant feedback or
  referral when desired
  
• Make all contacts with participants validating
  and supportive
  
• Take participants' concerns seriously
• Be persistent when scheduling interviews with
  mothers
  
• Use non-stigmatizing language

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Mediator Level Challenges

• Distrust/excessive gatekeeping
• Negative past experiences or perceptions of
  research
  
• Misplaced good intentions (protective of
  population)

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Mediator Level Strategies

• Community presence
• Newspaper and radio stories
• In-service presentations and discussion
• Articles in targeted publications
• Follow-up calls with community members
• Communicate protocols and researcher
  qualifications
  

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Macro Level Challenges

• Representations of the population
• Perceived value of research to the population and
  larger community
  
• Resource constraints
• Relationships with population
• Power relationships
• Fragmented systems

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Macro Level Strategies

• Communicate with relevant organizations pre-mid-
  and post research
  
• Work with community members
• Sensitivity to social norms and community values
• Ensure value-added to community members
• Have reasonable expectations of community
  members
  
• Community-based research strategies

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Key points

• There is overlap between strategies
• Approaches should take all levels into
  consideration
  
• Plan carefully in advance and budget
  appropriately
  
• Relationship building
• Build on relationships through a program of
  research