The representation of vulnerable populations in quality improvement studies

Rolnitsky, Asaph; Kirtsman, Maksim; Goldberg, Hanna R.; Dunn, Michael; Bell, Chaim M.

doi:10.1093/intqhc/mzy016

Cited by 18 publications

(11 citation statements)

References 32 publications

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“…Despite the increased need for research to understand major health issues in remote settings, a recent review shows that among clinical research studies, 3.27% are dedicated to women, 1.72% to the poor, 1.66% to rural residents and 1.55% to visible minorities (104). Our study may not be comparable to populations where most clinical research originates, but it reflects the reality of an important proportion of the world population, where women have limited access to technology and where the utility of simple biomarkers such as blood pressure and SFH needs to be maximized.…”

Section: Limitationsmentioning

confidence: 99%

Identification of High-Risk Pregnancies in a Remote Setting Using Ambulatory Blood Pressure: The MINDI Cohort

Gonzalez‐Fernandez

Pons²,

Rueda

et al. 2020

Front. Public Health

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Conclusion: MINDI were bi-directionally associated with blood pressure indicators. In this MINDI cohort, infections, nutrients and cytokines both raised, and lowered BP indices. The presence of eMAP identified pregnant women at risk of hypertension whereas low PP was associated with lower SFH. Therefore, MAP and PP may help in detecting women at risk of adverse pregnancy outcomes in settings with limited access to technology.

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Section: Limitationsmentioning

confidence: 99%

Identification of High-Risk Pregnancies in a Remote Setting Using Ambulatory Blood Pressure: The MINDI Cohort

Gonzalez‐Fernandez

Pons²,

Rueda

et al. 2020

Front. Public Health

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“…39,40 This study addresses an identified gap, The strengths of this project come from learning about implementation across multiple professional groups and contexts, with a cohort of patients previously excluded from self-management programmes and under-represented in participatory quality improvement. 41 Limitations included the duration of evaluation within this project's time frame, in which we were not able to assess sustainability in settings where frequent staff turnover is unavoidable. We discuss findings in more detail below, drawing on headings recommended in SQUIRE 2.0.…”

Section: Understandings Of Coproduction Vary and What Is Being Producedmentioning

confidence: 99%

Supporting self‐management after traumatic brain injury: Codesign and evaluation of a new intervention across a trauma pathway

Mäkelä

Jones

Abreu

et al. 2019

Health Expectations

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Background Supported self‐management (SSM) is a recognized approach for people with long‐term conditions but, despite the prevalence of unmet needs, little is known about its role for people with traumatic brain injury (TBI). Objectives To codesign an SSM intervention with people with TBI and evaluate feasibility of implementation through multidisciplinary staff across a trauma pathway. Setting and participants People who had previously been admitted to a Major Trauma Centre following TBI and family members participated in a series of codesign activities. Staff attended SSM workshops and used the intervention with patients in acute and rehabilitation settings. Methods We used Normalization Process Theory constructs to guide and interpret implementation. Knowledge, beliefs and confidence of staff in SSM were assessed through pre‐ and post‐training questionnaires, and staff, patients' and families' experiences were explored through semi‐structured interviews. Qualitative data were analysed thematically, and clinical measures were mapped against a matched sample. Results Codesigned resources were created and used within an SSM approach for which 110 staff participated in training. Evaluation demonstrated significant differences in staff SSM confidence and skills, following training. Qualitative evaluation revealed adoption by staff, and patients' and families' experiences of using the resources. Challenges included reaching staff across complex pathways to achieve collective implementation. Conclusion This is the first project to demonstrate feasibility of SSM for people after TBI starting in an acute trauma setting. Through an open approach to codesign with a marginalized group, the SSM resources were valued by them and held meaning and relevance for staff.

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“…Vulnerable populations, including individuals with a low socioeconomic status (SES), are at the greatest risk of developing chronic diseases as well as adopting poor lifestyle habits such as inadequate dietary habits, sedentary lifestyles, smoking, and alcoholism [1-3]. Such populations are generally underrepresented in health studies [2,4]. Therefore, identifying beliefs such as facilitators and barriers among low SES populations is essential for increasing their participation in health studies and, hence, increasing the generalizability of results from population-based research.…”

Section: Introductionmentioning

confidence: 99%

Beliefs Related to Participation in a Large Web-Based Prospective Survey on Diet and Health Among Individuals With a Low Socioeconomic Status: Qualitative Study

et al. 2019

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BackgroundNutriQuébec is a Web-based prospective study on the relationship between diet and health as well as the impact of food-related health policies in the adult population of Québec, Canada. Recruitment and retention of individuals with a low socioeconomic status (SES) in such a study are known to be challenging, yet critical for achieving representativeness of the entire population.ObjectiveThis study aimed to identify the behavioral, normative, and control beliefs of individuals with a low SES regarding participation in the NutriQuébec project and to identify their preferences regarding recruitment methods.MethodsA total of four focus groups were conducted in community centers located in low-income areas of Québec City, Canada. On the basis of the theory of planned behavior, participants’ beliefs associated with attitude, subjective norm, and perceived behavioral control regarding hypothetical participation in the NutriQuébec project were identified. Focus groups were recorded, transcribed, and coded by two analysts.ResultsParticipants (16 men and 12 women) were aged between 28 and 72 years, and a majority of the participants had an annual household income of Can $19,999 or less. The main perceived advantages of participating in the NutriQuébec project were contributing to improved collective health and supporting research. The only disadvantage identified was the risk of having to fill out too many questionnaires. Participants could not, in general, identify persons from their entourage who would approve or disapprove their participation in the study. The main facilitators identified were obtaining a brief health assessment and the ability to complete questionnaires in a way that is not Web-based. The main barrier was the lack of internet access. The preferred means of recruitment were through social media, television, and community centers.ConclusionsThese results provide insightful information regarding the best methods and messages to use in order to recruit and retain individuals with a low SES in a population-based prospective study on lifestyle and health on the internet.

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The representation of vulnerable populations in quality improvement studies

Cited by 18 publications

References 32 publications

Identification of High-Risk Pregnancies in a Remote Setting Using Ambulatory Blood Pressure: The MINDI Cohort

Identification of High-Risk Pregnancies in a Remote Setting Using Ambulatory Blood Pressure: The MINDI Cohort

Supporting self‐management after traumatic brain injury: Codesign and evaluation of a new intervention across a trauma pathway

Beliefs Related to Participation in a Large Web-Based Prospective Survey on Diet and Health Among Individuals With a Low Socioeconomic Status: Qualitative Study

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