Transportation, childcare, lodging, and meals: Key for participant engagement and inclusion of historically underrepresented populations in the healthy brain and child development birth cohort.

Introduction: Participant recruitment and retention (R&R) are well-documented challenges in longitudinal studies, especially those involving populations historically underrepresented in research and vulnerable groups (e.g., pregnant people or young children and their families), as is the focus of the HEALthy Brain and Child Development (HBCD) birth cohort study. Subpar access to transportation, overnight lodging, childcare, or meals can compromise R&R; yet, guidance on how to overcome these "logistical barriers" is sparse. This study's goal was to learn about the HBCD sites' plans and develop best practice recommendations for the HBCD consortium for addressing these logistical barriers. Methods: The HBCD's workgroups developed a survey asking the HBCD sites about their plans for supporting research-related transportation, lodging, childcare, and meals, and about the presence of institutional policies to guide their approach. Descriptive statistics described the quantitative survey data. Qualitative survey responses were brief, not warranting formal qualitative analysis; their content was summarized. Results: Twenty-eight respondents, representing unique recruitment locations across the U.S., completed the survey. The results indicated substantial heterogeneity across the respondents in their approach toward supporting research-related transportation, lodging, childcare, and meals. Three respondents were aware of institutional policies guiding research-related transportation (10.7%) or childcare (10.7%). Conclusions: This study highlighted heterogeneity in approaches and scarcity of institutional policies regarding research-related transportation, lodging, childcare, and meals, underscoring the need for guidance in this area to ensure equitable support of participant R&R across different settings and populations, so that participants are representative of the larger community, and increase research result validity and generalizability.

Trust in African Americans' Healthcare Experiences.

PURPOSE: The purpose of the study is to clarify the concept of trust, identify its defining attributes, antecedents, and consequences, and apply to the healthcare experiences of African Americans. BACKGROUND: For African Americans, mistrust in the healthcare system is the result of unequal treatment that began in slavery. Fear and negative experiences engender a reluctance to trust healthcare providers, which contributes to health disparities. DESIGN: Walker and Avant's method of concept analysis was used to clarify the concept of trust. The concept was applied to African Americans' healthcare experiences with discussion of opportunities for trust building. DATA SOURCE: Data support for concept development was done using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and online reference sources. REVIEW METHODS: Literature review was guided by using the keyword trust. Further contextual explication was done by adding a review of literature from sociology and history regarding the evolution of African American mistrust of the U.S. healthcare system. RESULTS: The defining attributes of trust are dependence, willingness, and met expectations. Antecedents to trust include a need requiring the help of another and prior knowledge or experience. The consequence of trust is an evaluation of the congruence between expected and actual behaviors of the trusted person or thing. Literature review of the African American culture adds a dynamic aspect for nurses to consider when developing relationships in minority communities. CONCLUSION: Trust is the willingness to enter a dependent relationship to have the needs addressed, and is maintained by met expectations. Rebuilding trusting relationships between providers and African American patients is a vital step toward reducing health disparities. Murray.