206180 Reaching the hard-to-reach: Lessons learned in promoting health of women with mobility impairments

Sunday, November 8, 2009

Emily Walsh, MPH, CPH , Child Development & Rehabilitation Center, RRTC: Health & Wellness, Portland, OR
Elizabeth A. McNeff, MPA: HA , Regional Research Institute, Portland State University, Portland, OR
Janet Campbell, BS , Aging & Disability Services, Multnomah County, Portland, OR
Rie Suzuki, PhD , Department of Health Sciences and Administration, University of Michigan-Flint, Flint, MI
Jana J. Peterson, MPH, PhD , UMKC Institute for Human Development (UCEDD), University of Missouri - Kansas City, Kansas City, MO
Gloria L. Krahn, PhD, MPH , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Promoting Access to Health Services (PATHS) is a randomized controlled trial of the efficacy of a patient activation intervention to increase receipt of clinical preventive services among women with mobility impairments. Previous research in this area typically recruits a more affluent, educated and medically better-served sample. This presentation describes a recruitment methodology to reach “hard-to-reach” women, and the unanticipated characteristics of the resulting sample as observed from baseline survey data and interactions with intervention participants.

The recruitment strategy used enrollee rosters of Oregon's Medicaid provider and a durable medical equipment vendor within a geographically designated area in Oregon. Two rounds of mailings requesting interested recipients contact the intervention team were sent to women aged 35 – 64 identified with mobility impairments. Women who were not current with recommended guidelines for regular mammography, Papanicolou tests, and/or clinician weight checks were eligible for the study.

Baseline survey results indicate that participants (n=144) report very low incomes (65.7% annual family income < 10,000), education levels (52.5% ≤ high school graduate), and experience very high rates of obesity (60% with BMI > 30; 38% with BMI > 40).

Revelations during intervention workshops indicate other unanticipated characteristics of this group. These include frequent reporting of sexual abuse, domestic violence histories, and mental health issues of participants. Many participants do not use mobility aids and have “invisible” disabilities affecting mobility. Participants cite obesity as a major barrier to preventive screening receipt. Methods used to address these issues and implications for researchers and program planners will be discussed.

Learning Objectives:
At the end of the presentation, attendees will be able to: 1. Describe a methodology used to recruit “hard-to-reach” women with mobility impairment. 2. Identify characteristics of this sample that may commonly be unanticipated in health promotion research.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a Research Assistant and Research Associate for the past three years with RRTC on Health and Wellness and coordinated the study this abstract concerns as part of my job duties there. I was responsible for coordinating all recruitment and screening efforts for this study. I have also managed both the intervention and control groups in the study, planned intervention workshops, and managed data for the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.