Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study

BMC Public Health

Research Article

Iain N Findlay¹  Paul MacIntyre¹  Caroline Morrison²  Anne Scoular²  Paul Docherty³  Christopher Harkins⁴  Michelle Gillies⁴  Kate MacIntyre⁴  Rebecca Shaw⁴  Fiona MacKay⁵  Heather Sloan⁵  Heather Cunningham⁵ 

[1] Department of Cardiology, Royal Alexandra Hospital, PA2 9PN, Paisley, UK;Greater Glasgow & Clyde NHS Board, Dalian House, 350 St Vincent Street, G3 8YZ, Glasgow, UK;NHS Greater Glasgow & Clyde Health Information & Technology, Development Department, Westward House, St James Street, PA3 2HL, Paisley, UK;Public Health and Health Policy, University of Glasgow, 1 Lilybank Gardens, G12 8RZ, Glasgow, UK;Renfrewshire Community Health Partnership, NHS Greater Glasgow & Clyde, Renfrewshire House, PA1 1UJ, Paisley, UK;

关键词: Focus Group;    Coronary Heart Disease;    Focus Group Discussion;    Focus Group Participant;    Social Marketing;   

DOI  :  10.1186/1471-2458-10-391

 received in 2009-08-04, accepted in 2010-07-02,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundPreventative medicine has become increasingly important in efforts to reduce the burden of chronic disease in industrialised countries. However, interventions that fail to recruit socio-economically representative samples may widen existing health inequalities. This paper explores the barriers and facilitators to engaging a socio-economically disadvantaged (SED) population in primary prevention for coronary heart disease (CHD).MethodsThe primary prevention element of Have a Heart Paisley (HaHP) offered risk screening to all eligible individuals. The programme employed two approaches to engaging with the community: a) a social marketing campaign and b) a community development project adopting primarily face-to-face canvassing. Individuals living in areas of SED were under-recruited via the social marketing approach, but successfully recruited via face-to-face canvassing. This paper reports on focus group discussions with participants, exploring their perceptions about and experiences of both approaches.ResultsVarious reasons were identified for low uptake of risk screening amongst individuals living in areas of high SED in response to the social marketing campaign and a number of ways in which the face-to-face canvassing approach overcame these barriers were identified. These have been categorised into four main themes: (1) processes of engagement; (2) issues of understanding; (3) design of the screening service and (4) the priority accorded to screening. The most immediate barriers to recruitment were the invitation letter, which often failed to reach its target, and the general distrust of postal correspondence. In contrast, participants were positive about the face-to-face canvassing approach. Participants expressed a lack of knowledge and understanding about CHD and their risk of developing it and felt there was a lack of clarity in the information provided in the mailing in terms of the process and value of screening. In contrast, direct face-to-face contact meant that outreach workers could explain what to expect. Participants felt that the procedure for uptake of screening was demanding and inflexible, but that the drop-in sessions employed by the community development project had a major impact on recruitment and retention.ConclusionSocio-economically disadvantaged individuals can be hard-to-reach; engagement requires strategies tailored to the needs of the target population rather than a population-wide approach.

【 授权许可】

Unknown   
© Harkins et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.