Abstract

Introduction: Challenges in engaging and recruiting rural communities into health research stem from known barriers such as decreased healthcare awareness, less access to health research, community context and low education. Within rural communities, the demographic that is the most challenging to recruit is men ages 25-44 years. However, there is little data on what factors improve participation among young men in rural areas. The purpose of our study was to explore the reasons for the reluctance of men ages 25-44 to participate in research and identify factors can encourage their willingness to participate in the NHLBI’s Risk Underlying Rural Areas Longitudinal (RURAL) Study. Methods: In June 2022 and June 2023 respectively, the Mississippi (MS) Core of the RURAL Study conducted health fairs in Oktibbeha and Panola counties. Investigators used the health fairs as an opportunity to recruit participants for focus group interviews to explore questions related to men’s health awareness, health behaviors and likelihood to participate in the RURAL Study. Those recruited included community advisory board members and health fair attendees. One focus group in each county consisted of men only. Investigators conducted 4 virtual focus group interviews in each of the two counties. Thematic analysis was used to identify key themes and sub-themes. Results: Thirty-two (32) interviewees, including 25 women. participated in focus groups across the two counties (17 Oktibbeha,15 Panola). Four key themes and 8 subthemes were identified. Lack of health awareness, fear of harm, inability to see the benefits of participation, and lack of incentives were among the reasons men ages 25-44 do not participate in research in these rural areas. Investigators learned that providing health education with reassurance of no harm, promoting the benefits of participation to themselves their families and communities, providing meaningful incentives, and motivating them through influences from family, friends and third parties can encourage participation by men in this age group. Particularly, it was suggested health awareness investigators should host events explicitly for men (including small group question and answer sessions) and be visible in the community by going where the young men go such as barbershops, sporting events, gyms, and men’s organizational meetings and by staying in touch. Conclusion: In this study consisting of 8 focus groups conducted across two rural communities, key themes identified to improve young male participation in health research include: 1) addressing perceived concerns through awareness and reassurance of no harm,2) informing potential candidates for the study the benefits of participation, 3) maintaining a presence in the community through community engagement and 4) identifying and social motivators such as family, friends and third-party influencers.

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