A process evaluation: Does recruitment for an exercise program through ethnically specific channels and key figures contribute to its reach and receptivity in ethnic minority mothers?

BMC Public Health

Arnoud P Verhoeff¹  Karien Stronks²  Stephan W Cremer³  Vera Nierkens²  Marieke A Hartman⁴ 

[1] Department of Sociology and Anthropology, University of Amsterdam, Oudezijdse Achterburgwal 185, DK 1012 Amsterdam, the Netherlands;Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, AZ 1105 Amsterdam, the Netherlands;Department of Epidemiology, Documentation, and Health Promotion, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, WT 1018 Amsterdam, the Netherlands;Department of Behavioral Sciences and Health Promotion, University of Texas School of Public Health, 7000 Fannin, Houston, TX 77054, USA

关键词: Exercise/physical activity;    Cultural targeting;    Health promotion;    Ethnic minorities/migrants;    Community health worker;    Channel segmentation;    Recruiter;    Recruitment;   

Others  :  1161914
DOI  :  10.1186/1471-2458-13-768

 received in 2012-12-04, accepted in 2013-08-07,  发布年份 2013

【 摘 要 】

Background

Ethnic minority women from low-income countries who live in high-income countries are more physically inactive than ethnic majority women in those countries. At the same time, they can be harder to reach with health promotion programs. Targeting recruitment channels and execution to ethnic groups could increase reach and receptivity to program participation. We explored using ethnically specific channels and key figures to reach Ghanaian, Antillean, and Surinamese mothers with an invitation for an exercise program, and subsequently, to determine the mothers’ receptivity and participation.

Methods

We conducted a mixed methods process evaluation in Amsterdam, the Netherlands. To recruit mothers, we employed ethnically specific community organizations and ethnically matched key figures as recruiters over Dutch health educators. Reach and participation were measured using reply cards and the attendance records from the exercise programs. Observations were made of the recruitment process. We interviewed 14 key figures and 32 mothers to respond to the recruitment channel and recruiter used. Content analysis was used to analyze qualitative data.

Results

Recruitment through ethnically specific community channels was successful among Ghanaian mothers, but less so among Antillean and Surinamese mothers. The more close-knit an ethnic community was, retaining their own culture and having poorer comprehension of the Dutch language, the more likely we were to reach mothers through ethnically specific organizations. Furthermore, we found that using ethnically matched recruiters resulted in higher receptivity to the program and, among the Ghanaian mothers in particular, in greater participation. This was because the ethnically matched recruiter was a familiar, trusted person, a translator, and a motivator who was enthusiastic, encouraging, and able to adapt her message (targeting/tailoring). Using a health expert was preferred in order to increase the credibility and professionalism of the recruitment.

Conclusions

Recruitment for an exercise program through ethnically specific organizations seems to contribute to its reach, particularly in close-knit, highly organized ethnic communities with limited fluency in the local language. Using ethnically matched recruiters as motivator, translator, and trusted person seems to enhance receptivity of a health promotion program. An expert is likely to be needed for effective information delivery.

【 授权许可】

   
2013 Hartman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Caperchione CM, Kolt GS, Mummery WK: Physical activity in culturally and linguistically diverse migrant groups to Western society: a review of barriers, enablers and experiences. Sports Med 2009, 39:167-177.
• [2]Sternfeld B, Ainsworth BE, Quesenberry CP: Physical activity patterns in a diverse population of women. Prev Med 1999, 28:313-323.
• [3]de Munter JS, van Valkengoed IG, Agyemang C, Kunst AE, Stronks K: Large ethnic variations in recommended physical activity according to activity domains in amsterdam, the netherlands. Int J Behav Nutr Phys Act 2010, 7:85. BioMed Central Full Text
• [4]He XZ, Baker DW: Differences in leisure-time, household, and work-related physical activity by race, ethnicity, and education. J Gen Intern Med 2005, 20:259-266.
• [5]Rechel B, Mladovsky P, Devillé W, Rijks B, Petrova-Benedict R, McKee M: Migration and health in the European Union. Maidenhead: Open University Press; 2011.
• [6]Brill PA, Kohl HW, Rogers T, Collingwood TR, Sterling CL, Blair SN: The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in a worksite health promotion program. Am J Health Promot 1991, 5:215-221.
• [7]UyBico SJ, Pavel S, Gross CP: Recruiting vulnerable populations into research: a systematic review of recruitment interventions. J Gen Intern Med 2007, 22:852-863.
• [8]Netto G, Bhopal R, Lederle N, Khatoon J, Jackson A: How can health promotion interventions be adapted for minority ethnic communities? Five principles for guiding the development of behavioural interventions. Health Promot Int 2010, 25:248-257.
• [9]Kreuter MW, McClure SM: The role of culture in health communication. Annu Rev Publ Health 2004, 25:439-455.
• [10]Rhodes SD, Foley KL, Zometa CS, Bloom FR: Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review. Am J Prev Med 2007, 33:418-427.
• [11]Brodie M, Kjellson N, Hoff T, Parker M: Perceptions of Latinos, African Americans, and Whites on Media as a Health Information Source. Howard J Commun 1999, 10:147-167.
• [12]O'Malley AS, Kerner JF, Johnson L: Are we getting the message out to all? Health information sources and ethnicity. Am J Prev Med 1999, 17:198-202.
• [13]Hornik RC, Ramirez AS: Racial/Ethnic Disparities and Segmentation in Communication Campaigns. Am Behav Sci 2006, 49:868-884.
• [14]Resnicow K, Baranowski T, Ahluwalia JS, Braithwaite RL: Cultural sensitivity in public health: defined and demystified. Ethn Dis 1999, 9:10-21.
• [15]Bellows-Riecken KH, Rhodes RE: A birth of inactivity? A review of physical activity and parenthood. Prev Med 2008, 46:99-110.
• [16]Aalders M, Overgoor L, Wieringen J: Big!Move: Beweging in Gezondheid [Big!Move: Health in Motion. In Dutch]. TSG 2009, 87:82-84.
• [17]Dijkshoorn H, van Dijk TK, Janssen AP: Zo gezond is Amsterdam [This healthy is Amsterdam. In Dutch]. Amsterdam: Drukkerij Leijten; 2009.
• [18]GGD Amsterdam DO: Zo gezond is Amsterdam Zuidoost [This healthy is Amsterdam South-East! In Dutch]. Amsterdam: Drukkerij Leijten; 2009.
• [19]Canatan K, Oudijk CH, Ljamai A: De maatschappelijke rol van de Rotterdamse Moskeeën [The societal role of Rotterdam's Mosques. In Dutch]. Rotterdam: Department of Research and Statistics; 2003.
• [20]da Graça AA: Hoofdstuk 5: Overbruggende schakels [Chapter 5: Bridging links]. PhD Thesis. 2010.
• [21]van Pelt K, Singels L, van de Laar K: Handreiking participatie allochtonen in gezondheidsbevordering [Toolkit for the participation of ethnic minorities in health promotion. In Dutch]. Woerden: NIGZ; 2011.
• [22]Hylkema C, de Bruijn I: Amsterdam in cijfers 2011 [Amsterdam in figures 2011. In Dutch]. Amsterdam: Department of Research and Statistics; 2011.
• [23]Gijsberts M, Dagevos J: Jaarrapport integratie 2009 [Annual report integration 2009. In Dutch]. Den Haag: Sociaal Cultureel Planbureau; 2009.
• [24]Gijsberts M, Huijnk W, Dagevos J: Jaarrapport integratie 2011 [Annual report integration 2011. In Dutch]. Den Haag: Sociaal Cultureel Planbureau; 2012.
• [25]Chang MW, Nitzke S, Guilford E, Adair CH, Hazard DL: Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. J Am Diet Assoc 2008, 108:1023-1028.
• [26]Brown PR, Brown WJ, Miller YD, Hansen V: Perceived constraints and social support for active leisure among mothers with young children. Leis Sci 2001, 23:131-144.
• [27]Lewis B, Ridge D: Mothers reframing physical activity: family oriented politicism, transgression and contested expertise in Australia. Soc Sci Med 2005, 60:2295-2306.
• [28]McLean CA, Campbell CM: Locating research informants in a multi-ethnic community: ethnic identities, social networks and recruitment methods. Ethn Health 2003, 8:41-61.
• [29]Kreuter MW, Lukwago SN, Bucholtz RD, Clark EM, Sanders-Thompson V: Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav 2003, 30:133-146.
• [30]Linnan L, Steckler A: Chapter 1: Process evaluation for public health interventions and research: an overview. In Process evaluation for public health interventions and research. Edited by Linnan L, Steckler A. San Francisco: Jossey-Bass Publishers; 2002:1-23.
• [31]Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet 2001, 358:483-488.