Challenges in recruiting South Asians into prevention trials: health professional and community recruiters' perceptions on the PODOSA trial

Background: Recruitment of ethnic minority groups into trials is important. This was studied from the recruiters' perspective in the Prevention of Diabetes and Obesity in South Asians (PODOSA) trial.

Methods: Semi-quantitative questionnaire survey of all 22 health professionals and 27 community workers involved in Edinburgh and Glasgow. Numbers and proportions were tabulated, while free-text responses were grouped into themes.

Results: The response rate was 40/49 (82%). In the closed questions, family responsibilities, prior general practitioner screening and low interest were the main factors reported by recruiters as hindering referrals (each 28%), followed by fear of needle pricks and finding out their diabetes status (each 23%). The importance of the prevention of diabetes (60%), explaining the trial in a South Asian language (46%), verbal dialogue (43%) and the recruiter's personal relationship with the recruitee (40%) favoured referrals. Health professionals' perceived strength was their knowledge of diabetes (66%), and community workers' strength was explaining the trial in South Asian languages (65%). Strategies to improve recruitment included stronger partnership between researchers and community organizations. The open-ended response identified seven main themes: (1) shortage of recruiters' and recruitees' time; (2) poor understanding of the trial by recruitees; (3) lack of knowledge about the disease among recruitees; (4) lack of motivation and interest among recruitees; (5) delay in receiving appointments from the PODOSA team; (6) mistrust of research; and (7) narrow entry criteria.

Conclusion: These insights into recruiters' perspectives should help trialists improve participation by ethnic minority populations.