Strategies to improve engagement of 'hard to reach' older people in research on health promotion: a systematic review

Ann Liljas , Kate Walters, Ana Jovicic , Steve Iliffe , Jill Manthorpe , Claire Goodman, Kalpa Kharicha

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)
109 Downloads (Pure)

Abstract

Background: This review aimed to identify facilitators, barriers and strategies for
engaging 'hard to reach' older people in research on health promotion; the oldest old (≥80 years), older people from black and minority ethnic groups (BME) and older people living in deprived areas.
Methods: Eight databases were searched to identify eligible studies using quantitative,
qualitative, and mixed research methods. Using elements of narrative synthesis,
engagement strategies, and reported facilitators and barriers were identified, tabulated
and analysed thematically for each of the three groups of older people.
Results: Twenty-three studies (3 with oldest-old, 16 with BME older people, 2 within
deprived areas, 1 with both oldest-old and BME, 1 with both BME and deprived areas)
were included. Methods included 10 quantitative studies (of which 1 was an RCT), 12
qualitative studies and one mixed-methods study. Facilitators for engaging the oldest
old included gaining family support and having flexible sessions. Facilitators for BME
groups included building trust through known professionals/community leaders,
targeting personal interests, and addressing ethnic and cultural characteristics. Among
older people in deprived areas, facilitators for engagement included encouragement by
peers and providing refreshments. Across all groups, barriers for engagement were
deteriorating health, having other priorities and lack of transport/inaccessibility. Feeling
too tired and lacking support from family members were additional barriers for the
oldest old. Similarly, feeling too tired and too old to participate in research on health
promotion were reported by BME groups. Barriers for BME groups included lack of
motivation and self-confidence, and cultural and language differences. Barriers
identified in deprived areas included use of written recruitment materials. Strategies to
successfully engage with the oldest old included home visits and professionals
securing consent if needed. Strategies to engage older people from BME groups
included developing community connections and organising social group sessions.
Strategies to engage with older people in deprived areas included flexibility in timing
and location of interventions.
Conclusions: This review identified facilitators, barriers and strategies for engaging
'hard to reach' older people in health promotion but research has been mainly
descriptive and there was no high quality evidence on the effectiveness of different
approaches.
Original languageEnglish
JournalBMC Public Health
Volume17
DOIs
Publication statusPublished - 21 Apr 2017

Keywords

  • ageing, health promotion, inequalities, older people, oldest old, ethnicity, deprivation

Fingerprint

Dive into the research topics of 'Strategies to improve engagement of 'hard to reach' older people in research on health promotion: a systematic review'. Together they form a unique fingerprint.

Cite this