Consumer-Centered Recruitment Approach for Midlife South Asian Indian Immigrant Women into Health Promotion Research

Purpose: The purpose of this study was to explore the utilization of a culturally relevant consumer-centered approach in recruiting midlife South Asian Indian Immigrant women into a research study that focused on physical activity as a lifestyle modification for health promotion.  

Methods: A descriptive study design was used to explore the utilization of a culturally relevant consumer-centered approach in recruiting midlife South Asian Indian Immigrant women into five focus groups. This was part of a larger qualitative study where data was gathered with focus group approach to determine factors that SAI women view as motives and barriers to participation in lifestyle physical activity. The subjects for this study were volunteer SAI immigrant women born in India, who immigrated to the United States directly from India, Hindi (the most commonly spoken language in India) or English-speaking, aged 40 to 65 years, had no disability that interferes with walking, had ownership of a cell phone; and had sent or received at least one text message a month, in the past 6 months. Forty midlife SAI women between 40 and 65 years of age were recruited. Participants were recruited into Hindi and English language groups. Three focus groups included women fluent in Hindi (two with age 40-50 and the other 51 and above) and two focus groups of women fluent in English (one with age 40-50 and the other 51 and above). Participants were recruited from the Chicago metropolitan area utilizing consumer- centered recruitment approach. Participants were recruited using the following techniques: community presentations, community event participation, reminder calls in participants’ language of choosing, involvement of community stakeholders, snowball technique, solicitation of participants at faith and non-faith based SAI community organizations, use of bilingual recruitment team, translated material with distribution of flyers in English and Hindi, research team’s adaptation to religious and cultural customs (wearing Indian clothes, covering head, removing shoes), and study purpose being in alignment with the  SAI community’s need. Potential participants were assured that a South Asian Indian immigrant female researcher fluent in English and Hindi, will moderate the focus groups. Purposeful and word of mouth techniques were used. The potential participants were encouraged to inform other SAI immigrant women about the study.  

Results: The consumer centered recruitment approach with various cultural sensitive techniques such as involvement of South Asian Indian religious institutions and significant community stakeholders, bilingual recruitment team, translated recruitment material, event participation, and adaptation to religious and cultural customs, yielded recruitment of a diverse sample of midlife South Asian Indian Immigrant women. Fifty seven percent (n= 23) of the participants were between 40 and 50 years of age and 43% (n= 17) between 51 and 65 years of age. The mean age of the participants was 50 years (SD=7.0).  Forty percent (n=16) of the participants had immigrated from north, 40% (n=16) from south, 15% (n=6) from central, and 5% (n=2) from west regions of India. The sample included working and non-working women. Two thirds (n=26) of the participants were employed and 87.5% (n=35) had some college degree. About 62.5% (n=25) of the participants were Hindus 35% (n=14) Sikhs and 2% (n=1) Christians. Duration of immigration to the United States varied from 2 years to 30 plus years. Participants were predominantly married (n=38; 95%) with average household size of 4.3 (SD= 1.25). More than 90 % (n=39) of the participants had yearly household income >$50,000.  Enrollment of 40 participants lasted from November 2014 to January 2015. Due to the utilization of various multiple culturally sensitive recruitment techniques, enrollment period was fairly quick. The most effective recruitment strategy was the utilization of faith based organizations, which yielded 82.5% recruitment. The second most effective recruitment strategy was social networking among participants lead by the community stakeholders, which yielded 62.5% of the recruitment. The third most effective recruitment strategy was the community presentations arranged by the community stakeholders, which yielded 37.5% of the recruitment. One other key finding was that none of these three recruitment strategies will be effective without strong support of the key community stakeholders.

Conclusion: The consumer-centered recruitment approach amongst SAI minority women is one of the initial steps in utilization of evidence based approach in addressing the health disparities in South Asian Indian immigrant minority women. Nurse practitioner researchers need to advocate networking with SAI community stakeholders at the religious intuitions as a gateway for minority SAI women at risk for cardiovascular disease and diabetes mellitus to voluntarily participate in a health promotion research focusing on lifestyle modification.