Issues impacting participation in preterm birth prevention interventions: Lessons learned from a qualitative study of African American women

Developing and testing interventions to reduce preterm birth is critical to understanding how to reduce infant mortality and health disparities in birth outcomes. However, recruiting participation in research to test the effectiveness of these interventions remains a multifaceted challenge. As part of the Preterm Prevention Project at Drexel University COM, interventions designed to influence factors associated with increased risk of preterm birth are being implemented in a randomized clinical trial. Women experiencing a preterm birth, less than 35 completed week's gestation, were recruited and randomized into the intervention or usual care arm of the study. Engaging the predominately African American population of women in the intervention group to participate in multiple interventions is complicated. Issues impacting this type of decision making process are not well understood for this population. Previous research has documented that this decision making process may be influenced by language, culture, perceived need for or comfort from risk behaviors or previous negative encounters with health care providers. This qualitative interview and focus group study provided an in-depth examination of the often long term decision making process of women who either agreed to participate or refused to participate in any or all of the research interventions for which they were eligible (e.g., nutrition, smoking, housing, depression, infection, and literacy ). Lessons learned from this study, including how these interventions fit into the context of the women's lives, will be shared. These findings may help to facilitate recruitment and intervention development in similar research studies.