BackgroundDespite the growing emphasis on the inclusion of ethnic minority patients in research, there is little published on the recruitment of these populations especially to randomised, community based, lifestyle intervention trials in the UK.MethodsWe share our experience of recruitment to screening in the PODOSA (Prevention of Diabetes and Obesity in South Asians) trial, which screened 1319 recruits (target 1800) for trial eligibility. A multi-pronged recruitment approach was used. Enrolment via the National Health Service included direct referrals from health care professionals and written invitations via general practices. Recruitment within the community was carried out by both the research team and through our partnerships with local South Asian groups and organisations. Participants were encouraged to refer friends and family throughout the recruitment period.ResultsHealth care professionals referred only 55 potential participants. The response to written invitations via general practitioners was 5.2%, lower than reported in other general populations. Community orientated, personal approaches for recruitment were comparatively effective yielding 1728 referrals (82%) to the screening stage.ConclusionsThe PODOSA experience shows that a community orientated, personal approach for recruiting South Asian ethnic minority populations can be successful in a trial setting. We recommend that consideration is given to cover recruitment costs associated with community engagement and other personalised approaches. Researchers should consider prioritising approaches that minimise interference with professionals' work and, particularly in the current economic climate, keep costs to a minimum. The lessons learned in PODOSA should contribute to future community based trials in South Asians.Trial RegistrationCurrent Controlled Trials ISRCTN25729565
Children and parents value and support children's independent outdoor activity. Differences in children's and parents' understanding of what activities are permissible and in their judgements about the appropriate age for children's independent activities, may partly underline variations by sex, age and socio-economic status in injury patterns.
Ethnic variations deserve further study, including in White European origin subgroups and the Chinese. Extremely high rates in South Asian and African origin were not corroborated in Scotland. Linkage methods are practical in Europe.
OBJECTIVETo investigate the independent contributions of waist circumference, physical activity, and sedentary behavior on glycemia in South Asians living in Scotland.RESEARCH DESIGN AND METHODSParticipants were 1,228 (523 men and 705 women) adults of Indian or Pakistani origin screened for the Prevention of Type 2 Diabetes and Obesity in South Asians (PODOSA) trial. All undertook an oral glucose tolerance test, had physical activity and sitting time assessed by International Physical Activity Questionnaire, and had waist circumference measured.RESULTSMean ± SD age and waist circumference were 49.8 ± 10.1 years and 99.2 ± 10.2 cm, respectively. One hundred ninety-one participants had impaired fasting glycemia or impaired glucose tolerance, and 97 had possible type 2 diabetes. In multivariate regression analysis, age (0.012 mmol ⋅ L−1 ⋅ year−1 [95% CI 0.006–0.017]) and waist circumference (0.018 mmol ⋅ L−1 ⋅ cm−1 [0.012–0.024]) were significantly independently associated with fasting glucose concentration, and age (0.032 mmol ⋅ L−1 ⋅ year−1 [0.016–0.049]), waist (0.057 mmol ⋅ L−1 ⋅ cm−1 [0.040–0.074]), and sitting time (0.097 mmol ⋅ L−1 ⋅ h−1 ⋅ day−1 [0.036–0.158]) were significantly independently associated with 2-h glucose concentration. Vigorous activity time had a borderline significant association with 2-h glucose concentration (−0.819 mmol ⋅ L−1 ⋅ h−1 ⋅ day−1 [−1.672 to 0.034]) in the multivariate model.CONCLUSIONSThese data highlight an important relationship between sitting time and 2-h glucose levels in U.K. South Asians, independent of physical activity and waist circumference. Although the data are cross-sectional and thus do not permit firm conclusions about causality to be drawn, the results suggest that further study investigating the effects of sitting time on glycemia and other aspects of metabolic risk in South Asian populations is warranted.
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