Including culturally diverse samples in health research: A case study of an urban trial of social support

Objectives. To describe the recruitment procedures used in a study of Social Support and Family Health carried out in a disadvantaged urban area of the UK in 1999-2001; to consider the impact of using inclusive recruitment procedures on the final research sample and implications for the conduct of the research and data obtained. Design. Face-to-face recruitment of eligible women, using interpreters where necessary, to a randomized controlled trial of two alternative strategies for providing support to women with infants. Results. Of the 1,263 women eligible to enter the trial, 731 were successfully recruited. Forty-five languages other than English were spoken by eligible women; 14% needed an interpreter for the recruitment visit, and a further 30% spoke English as a second language. Inclusive recruitment practices added significant costs, resulted in a study sample with a different social profile from the sample that would have been achieved without these, and challenged some of the assumptions underlying the model of informed consent commonly used in much health services research. Conclusion. Procedures can be developed for recruiting people with diverse cultural backgrounds to take part in research. This helps to address the issue of possible bias in generalizing research findings by increasing external validity, and respects the ethic that everyone should have the right to be eligible for inclusion in research.