Conducting Health Literacy Research With Hard-to-Reach Regional Culturally and Linguistically Diverse Populations: Evaluation Study of Recruitment and Retention Methods Before and During COVID-19.

BACKGROUND: In health research, culturally and linguistically diverse (CALD) health care consumers are cited as hidden or hard to reach. This paper evaluates the approach used by researchers to attract and retain hard-to-reach CALD research participants for a study investigating health communication barriers between CALD health care users and health care professionals in regional Australia. As the study was taking place during the COVID-19 pandemic, subsequent restrictions emerged. Thus, recruitment and retention methods were adapted. This evaluation considered the effectiveness of recruitment and retention used throughout the pre-COVID and during-COVID periods. OBJECTIVE: This evaluation sought to determine the effectiveness of recruitment and retention efforts of researchers during a study that targeted regional hard-to-reach CALD participants. METHODS: Recruitment and retention methods were categorized into the following 5 phases: recruitment, preintervention data collection, intervention, postintervention data collection, and interviews. To compare the methods used by researchers, recruitment and retention rates were divided into pre-COVID and during-COVID periods. Thereafter, in-depth reflections of the methods employed within this study were made. RESULTS: This paper provides results relating to participant recruitment and retainment over the course of 5 research phases that occurred before and during COVID. During the pre-COVID recruitment phase, 22 participants were recruited. Of these participants, 15 (68%) transitioned to the next phase and completed the initial data collection phase. By contrast, 18 participants completed the during-COVID recruitment phase, with 13 (72%) continuing to the next phase. The success rate of the intervention phase in the pre-COVID period was 93% (14/15), compared with 84.6% (11/13) in the during-COVID period. Lastly, 93% (13/14) of participants completed the postintervention data collection in the pre-COVID period, compared with 91% (10/11) in the during-COVID period. In total, 40 participants took part in the initial data collection phase, with 23 (58%) completing the 5 research phases. Owing to the small sample size, it was not determined if there was any statistical significance between the groups (pre- and during-COVID periods). CONCLUSIONS: The success of this program in recruiting and maintaining regional hard-to-reach CALD populations was preserved over the pre- and during-COVID periods. The pandemic required researchers to adjust study methods, thereby inadvertently contributing to the recruitment and retention success of the project. The maintenance of participants during this period was due to flexibility offered by researchers through adaptive methods, such as the use of cultural gatekeepers, increased visibility of CALD researchers, and use of digital platforms. The major findings of this evaluation are 2-fold. First, increased diversity in the research sample required a high level of flexibility from researchers, meaning that such projects may be more resource intensive. Second, community organizations presented a valuable opportunity to connect with potential hard-to-reach research participants.

Use of healthcare consumer voices to increase empathy in nursing students.

Nurses need to be well prepared to address the needs of a diverse population and facilitate positive experiences in an equitable and inclusive approach to care. The aim of the study was to determine whether the integration of consumer lived experience interviews into the content of a first-year course influenced empathy in nursing students. A one group pre-test, post-test design was used. A convenience sample of first-year undergraduate nursing students (N = 32) from a regional Australian university was recruited for the study. The pre and post tests were conducted using the Kiersma Chen Empathy Scale and t-tests performed to analyse the data. Results showed overall that nursing students demonstrated moderate levels of empathy; pre-test score of (M = 75.53; SD = 5.76). After the intervention the post-test results showed that there was a statistically significant increase in students' empathy towards vulnerable, disadvantaged and stigmatised population groups. The healthcare consumer voice has the potential to strengthen current teaching practices that promote caring behaviours in nursing students.