Barriers and facilitators for engaging underrepresented ethnic minority populations in healthcare research: an umbrella review.

Abstract

Background: Research highlights that participation of ethnic minority individuals in research is low when compared to white counterparts. This poses challenges for healthcare planning and delivery, as lack of representativeness in research means that findings are generalised across all ethnic groups, and do not provide stakeholders with a full picture of how minority populations are affected. This contributes to health inequalities as these populations may then be underserved and not get the best possible management if differences due to ethnicity were to exist. This study synthesises the barriers to engaging minority individuals in research to understand, and enablers to better engagement of different minority communities in healthcare research.

Methods: Five databases were searched (MEDLINE, CINAHL, PsycINFO and Web of Science and EMBASE) up to 29th April 2024, resulting in 897 articles, of which 11 met the inclusion criteria. Data were extracted from reviews and synthesised using qualitative meta-aggregation techniques. The socio-ecological framework was applied to synthesise the main outcomes. A protocol for this review was registered on PROSPERO (CRD42024532686).

Results: The main barriers for research participation included: mistrust of healthcare professionals, research and researchers; socioeconomic and logistical challenges; language and cultural barriers; lack of awareness; external influences and perceived bias. Facilitators to support better research participation included: Community engagement and personalised approaches; culturally sensitive research strategies; linguistically appropriate study materials and study advertising; education workshops.

Conclusions: To enable wider participation, it is important to understand not only the barriers but also to employ culturally appropriate facilitators, engaging with patient and public involvement (PPI) groups that communities trust, offer cultural training for researchers, and adopt a more collaborative and transparent way of working. This overview highlights the work that needs to be done on an intrapersonal, interpersonal, community and policy level to make research accessible and inclusive for ethnic minority groups.