Underrepresentation of ethnic minorities in hypertension research—a survey of enablers and barriers among South Asian and African communities in Glasgow

Lip, S., Dempster, G., Jain, S., Brooksbank, K., Ghouri, N. , McCallum, L. and Padmanabhan, S. (2022) Underrepresentation of ethnic minorities in hypertension research—a survey of enablers and barriers among South Asian and African communities in Glasgow. Trials, 23, 609. (doi: 10.1186/s13063-022-06542-z) (PMID:35906700) (PMCID:PMC9335986)

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Background: Hypertension is the biggest contributor to the global cardiovascular burden with evidence for ethnic differences in treatment response and outcomes. Under-representation of ethnic minorities in clinical research is well known, and despite wide-ranging public engagement events by the Glasgow Blood Pressure Clinic team, there was a lack of participation of ethnic minorities in both engagement activities and clinical trials conducted by them. This study aims to explore the awareness and knowledge of hypertension and the facilitators and barriers to participation in hypertension clinical research among South Asian (SA) and African (AFR) communities in Glasgow. Methods: A survey questionnaire was co-developed with representatives from South Asian (SA) and African (AFR) patients and community members in Glasgow to understand awareness and knowledge of hypertension and enablers and barriers to participation in clinical research. The survey was distributed to adults (aged > 18) years of SA or AFR ancestry at public engagement events at venues that were frequently visited by these two communities in Glasgow. Results: The survey response rate was 337 (67.4%) consisting of 242 (71.8%) South Asian (SA) and 56 (16.9%) African (AFR) respondents. Thirty-nine questionnaires were excluded because of incompletion. Most of the respondents were not born in the UK and were in the 35–53-year group (AFR 29 (51%), SA 113 (47%)). The proportion living in the most deprived (SIMD 1) and least deprived (SIMD 5) was respectively 26 (12.4%) and 34 (16.2%) for SA and 20 (42.6%) and 2 (4.3%) for AFR. There was a considerable recognition that treatment needs to be ethnicity-specific (SA/AFR = 107 (48%)/23 (45.1%)) and that current cardiovascular disease treatment guidelines were not tailored for different ethnicities 84 (38.5%)/23 (45.1%). The key enablers encouraging research participation are enhanced health information, conducting aspects of their clinical research visits/appointments at a location they frequently visited and allowing a family member to accompany them. Barriers included concerns about the use of personal information and side effects of the new treatment. Conclusion: Our survey confirmed enablers and barriers to ethnic minority participation in research. We find improving and evolving awareness and beliefs among the ethnic minority population including community leaders. Thus, continual review of researchers’ beliefs and attitudes is also essential to ensure engagement activities keep up with these changing perceptions.

Item Type:Articles
Additional Information:Funding: S.P. is funded by the Medical Research Council (MR/M016560/1; AIM-HY Study), the British Heart Foundation (BHF CS/16/1/31878; RE/18/6/34217) and HEART Research UK (Registered Charity No.1044821, RG2690/21/24).
Glasgow Author(s) Enlighten ID:Lip, Dr Stefanie and Padmanabhan, Professor Sandosh and Brooksbank, Dr Katriona and Ghouri, Dr Nazim and McCallum, Dr Linsay
Authors: Lip, S., Dempster, G., Jain, S., Brooksbank, K., Ghouri, N., McCallum, L., and Padmanabhan, S.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Trials
Publisher:BioMed Central
ISSN (Online):1745-6215
Copyright Holders:Copyright © The Author(s) 2022
First Published:First published in Trials 23: 609
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
173522Clinical study of UMOD NKCC2 interaction on salt-sensitivity in hypertensionSandosh PadmanabhanBritish Heart Foundation (BHF)CS/16/1/31878Institute of Cardiovascular & Medical Sciences
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science