Factors associated with non-participation in a health study: Observations from community engagement experiences in a home-based VCT randomized controlled trial in Monze

Abstract

Participation in research is crucial to the success of any study and it has been widely argued to be an important factor in conducting research and implementation of the findings. Non-participation has numerous consequences such as sampling bias, delays in completion of the study as well as increased costs (Williams et al., 2007). For this reason factors associated with non-participation in a health study were explored in selected communities in Monze district. Methodology :Qualitative approaches using ethnographic methods that included observation and contextualization were employed. Triangulation was achieved using observation, in-depth interviews and focus group discussions (FGDs). Purposive sampling was used to select participants for the 8 FGDs (stratified by sex) in which each FGD consisted of 6-12 respondents. In-depth interviews were conducted with key informants. Snowball sampling was used to select the 20 key informants. Data collected was transcribed replacing all identifiers with coded labels. Thematic content analysis employing iterative approaches and word processing guided the analysis. In addition, systematic textual analysis was used to highlight quotes that supported or refuted identified themes. Results :Overall there were 20 in-depth interviews and 8 focus group discussions. Majority of the respondents from the FGDs were male (56.3%) aged between 25-49 years. Superstition and mistrust of the research assistants was cited consistently as a key reason for non-participation in the home based VCT RCT baseline survey by majority (97.8%) of the respondents. Many of the respondents described fears about the drawing of blood to test for HIV. Most of the key informants (15/20) cited mistrust to be the main reason of non-participation. The other factors that were identified included lack of understanding the study and benefits of participating, failure to respect culture and tradition, fear of violence from an intimate partner following HIV testing and disclosure of results, poor timing and prior negative engagements with the community.