Using Mixed Methods to Generate Data with Women Participating in U.S. Microenterprise

Purpose: Microenterprise programs provide vulnerable populations, the majority of whom are women, access to educational and financial resources to start small businesses. Many international programs acknowledge the employment-health link and promote health as a form of collateral through primary and secondary prevention interventions. Health promotion is not as prevalent in United States (US) programs and further investigation is required to identify the health needs of women microentrepreneurs. The study was conducted in collaboration with a community development financial organization which provides credit and services to entrepreneurs who do not have access to traditional lending.

Methods: The community organization assisted with the recruitment of women for surveys and hosted three focus groups. REDCap, a web application that allows for the secure building and management of surveys and databases, was used to administer The Center for Epidemiologic Studies Depression Scale (CES-D), the SF-12 health survey, a demographic survey, and a feasibility questionnaire regarding the use of on-line methods to collect data. The purpose of this mixed method pilot study was to: 1) explore how women discuss health and the challenges of working in a U. S. microenterprise, and 2) assess the feasibility of using on-line health instruments to collect data for this population.

Results: Three focus groups (n=9) were conducted to address the first aim of the study. Using content analysis, these focus groups revealed similar findings to those seen in the two previous U. S. microenterprise qualitative studies. Although the freedom, flexibility, and independence of self-employment was rewarding; creating work-life balance, prioritizing self-care, and sustaining a business was challenging. On-line surveys (n=23) were administered to address the second aim of the study. The majority (92%) of women that participated in the on-line surveys completed all questionnaires and indicated that on-line surveys were a good way to share health-related information with researchers. Importantly, 64% of the participants reported that they were likely or very likely to participate in on-line surveys about their health in the future. In addition, 72% indicated that on-line surveys were more meaningful than other 1:1 interviews or focus groups in terms of sharing information with researchers.

Conclusion: Microenterprise continues to gain popularity in the US. In 2012 there were 816 microenterprise programs identified. Women microentrepreneurs have been shown to be good social and economic investors and a strong link to generational health. Designing interventions that promote health using primary and secondary prevention is a good investment and has the potential to decrease health disparities and improve population health. These study findings suggest that on-line surveys (which are less costly) are a feasible method to collect health related information among women with microenterprise businesses.