Recruitment of minority and underserved populations in the United States: the Centers for Population Health and Health Disparities experience

ObjectiveThe recruitment of minority and underserved individuals to research studies is often problematic. The purpose of this study was to describe the recruitment experiences of projects that actively recruited minority and underserved populations as part of The Centers for Population Health and Health Disparities (CPHHD) initiative.MethodsPrincipal investigators and research staff from 17 research projects at eight institutions across the United States were surveyed about their recruitment experiences. Investigators reported the study purpose and design, recruitment methods employed, recruitment progress, problems or challenges to recruitment, strategies used to address these problems, and difficulties resulting from Institutional Review Board (IRB) or Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements. Additionally, information was collected about participant burden and compensation. Burden was classified on a three-level scale. Recruitment results were reported as of March 31, 2007.ResultsRecruitment attainment ranged from 52% to 184% of the participant recruitment goals. Commonly reported recruitment problems included administrative issues, and difficulties with establishing community partnerships and contacting potential participants. Long study questionnaires, extended follow-up, and narrow eligibility criteria were also problematic. The majority of projects reported difficulties with IRB approvals, though few reported issues related to HIPAA requirements. Attempted solutions to recruitment problems varied across Centers and included using multiple recruitment sites and sources and culturally appropriate invitations to participate. Participant burden and compensation varied widely across the projects, however, accrual appeared to be inversely associated with the amount of participant burden for each project.ConclusionRecruitment of minority and underserved populations to clinical trials is necessary to increase study generalizbility and reduce health disparities. Our results demonstrate the importance of flexible study designs which allow adaptation to recruitment challenges. These experiences also highlight the importance of involving community members and reducing participant burden to achieve success in recruiting individuals from minority and underserved populations.     

在护理职业教育中培养学生突发公共卫生事件应急能力的尝试

目的探讨护理职业教育中对学生突发公共卫生事件应急能力培养的必要性和方法。方法实验组在传染科护理和急救护理教学中贯穿突发公共卫生事件应急基本常识,增设选修课程,采用现场演练培养实践能力,组织学生会和志愿者成立应急机构培养组织指挥能力,制作各种宣传栏培养宣传动员能力,培养灾难忧患意识等。对照组采用传统教学方法。结果与对照组比较,实验组学生喜爱这样的教学方式,突发公共卫生事件应急知识及格率较对照组高,在甲型H1N1流感流行季节在校园应对能力高于对照组。结论在护理职业教育中培养学生突发公共卫生事件应急能力是必要的,也是可行的。     

Registered Nurses' personal rights vs. professional responsibility in caring for members of underserved and disenfranchised populations

Aims. Health disparities exist and refer to the chasms in health status between the advantaged and disadvantaged. Intense multiculturalism will require different approaches and moral obligations to work with these groups and urgency exists to develop nursing caring strategies when dealing with these populations. Development of nursing curricula which identify prejudicial thinking and intolerance for marginalized groups will help to decrease fears and increase nurses’ willingness to provide culturally competent health care for underserved and disenfranchised populations. Background. Caring for members of disenfranchised groups instills fear at some level in nurses who are working with these individuals. This fear may be due, in part, to the potential harm nurses perceive the patient may cause them, or perhaps it is because they feel they could possibly be in the individual's situation at some point in their lives. Prejudice and discrimination continue to exist in society and have adversely affected the health care system and the nursing profession. Discrimination may be based on differences due to age, ability, gender, race, ethnicity, religion, sexual orientation, or any characteristics by which people differ. Relevance to clinical practice. Registered Nurses are accountable for nursing decisions and actions regardless of personal preferences. Due to the rapidly changing healthcare system the nurse faces increasing ethical dilemmas and human rights issues. Nurses are individually accountable for caring for each patient and the right to refuse an assignment should be carefully interpreted to avoid patient abandonment. Nurses’ objections can be based on moral, ethical, or religious beliefs not on personal preferences and in an emergency the nurse must provide treatment regardless of any personal objections.     

Acts of caring: nurses caring for nurses

Caring behaviors displayed toward nurses by nurse managers and nurse peers play a significant role in establishing relationships that promote a healthy work environment. A qualitative study was done to identify behaviors perceived to be caring toward nurses. The theoretical background used for the study was Nursing as Caring by Boykin and Schoenhofer. Data were collected from focus groups consisting of registered nurses currently employed in the practice setting. Content analysis was used for the analysis. The overarching category that was identified was tending to a caring environment. The following emergent categories were also found: caring through helping and supporting, caring through appreciating, and acknowledging unappreciated caring. The findings suggest that nurses demonstrate caring behaviors toward their colleagues by coming to know them on both a professional and a personal level. These behaviors form the foundation for an environment that supports a consistent demonstration of caring.     

健康教育在体检中心的应用效果

目的 评价健康教育在体检中心的应用效果.方法 随机抽取1200名体检者,通过常规宣教、群体宣教、个体宣教、重点宣教的方法 进行健康教育后,采用自行设计的问卷调查,并与健康教育前该问卷的调查结果进行比较.结果 体检者健康教育后对自身健康状况和疾病预防知识知晓率较健康教育前明显提高(p＜0.001).结论 体检中心开展健康教育对提高全民的健康水平有积极作用.