A process evaluation: Does recruitment for an exercise program through ethnically specific channels and key figures contribute to its reach and receptivity in ethnic minority mothers?

Marieke A Hartman,Karien Stronks,Stephan W Cremer,Arnoud P Verhoeff,Vera Nierkens

doi:10.1186/1471-2458-13-768

Abstract

BackgroundEthnic minority women from low-income countries who live in high-income countries are more physically inactive than ethnic majority women in those countries. At the same time, they can be harder to reach with health promotion programs. Targeting recruitment channels and execution to ethnic groups could increase reach and receptivity to program participation. We explored using ethnically specific channels and key figures to reach Ghanaian, Antillean, and Surinamese mothers with an invitation for an exercise program, and subsequently, to determine the mothers’ receptivity and participation.MethodsWe conducted a mixed methods process evaluation in Amsterdam, the Netherlands. To recruit mothers, we employed ethnically specific community organizations and ethnically matched key figures as recruiters over Dutch health educators. Reach and participation were measured using reply cards and the attendance records from the exercise programs. Observations were made of the recruitment process. We interviewed 14 key figures and 32 mothers to respond to the recruitment channel and recruiter used. Content analysis was used to analyze qualitative data.ResultsRecruitment through ethnically specific community channels was successful among Ghanaian mothers, but less so among Antillean and Surinamese mothers. The more close-knit an ethnic community was, retaining their own culture and having poorer comprehension of the Dutch language, the more likely we were to reach mothers through ethnically specific organizations. Furthermore, we found that using ethnically matched recruiters resulted in higher receptivity to the program and, among the Ghanaian mothers in particular, in greater participation. This was because the ethnically matched recruiter was a familiar, trusted person, a translator, and a motivator who was enthusiastic, encouraging, and able to adapt her message (targeting/tailoring). Using a health expert was preferred in order to increase the credibility and professionalism of the recruitment.ConclusionsRecruitment for an exercise program through ethnically specific organizations seems to contribute to its reach, particularly in close-knit, highly organized ethnic communities with limited fluency in the local language. Using ethnically matched recruiters as motivator, translator, and trusted person seems to enhance receptivity of a health promotion program. An expert is likely to be needed for effective information delivery.

Highlights

Ethnic minority women from low-income countries who live in high-income countries are more physically inactive than ethnic majority women in those countries
This study aims to test the potential utility of targeting recruitment channels and recruiters to specific ethnic minority groups, with a particular focus on the conditions and mechanisms underlying their impact
The success of using ethnically specific channels varied between the targeted ethnic communities: 37 Ghanaians, 6 Antilleans, and 6 Surinamese mothers were reached (Table 3)

Summary

Introduction

Ethnic minority women from low-income countries who live in high-income countries are more physically inactive than ethnic majority women in those countries. In high-income, Western countries, non-Western ethnic minority groups have been found, on average, to be less physically active than the host population [1,2] They tend to exercise less during leisure time [3,4]. As the Western countries become increasingly more ethnically diverse [5], there is a need to promote physical activity within multiethnic populations It can be a challenge for health professionals to reach ethnic minority groups with health promotion programs, such as exercise programs [6,7]. Thereby the accessibility of health promotion in the target group, employing an ethnic group’s community resources is a promising recruitment method Examples of such resources are churches, local community leaders and organizations, ethnically specific media, networks, and events [7,8]. Health providers may be seen as outsiders and less trustworthy [10]

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