“Hard-To-Reach” or Hardly Reaching? Critical Reflections on Engaging Diverse Residents From Low Socio-Economic Status Neighborhoods in Public Health Research

Keywords: questionnaire survey, low socio-economic neighbourhoods, recruiting minorities, child studies, play street, school street While socioeconomically disadvantaged populations are more likely to experience poor health, they are less likely to be represented in public health research [1][2][3].This is particularly true in the case of low SES first-generation immigrant communities who may neither speak the language of their adopted country nor be computer literate.The low representation of such communities in research is in part due to the additional strategies needed to recruit and retain these populations, leading researchers to sometimes label socioeconomically disadvantaged immigrant populations as "hard-toreach."The labeling effectively blames these populations for their lack of engagement in research and can lead to further exclusion [2,4].Ensuring their inclusion in public health research should be prioritized in order to dismantle the structures that keep them in poor health in the first place [5].In this regard, a number of studies have outlined the need for flexibility and tailoring of data collection methods but still, the methodological rigor of these studies is variable, and the body of evidence has significant gaps.Furthermore, approaches effective in one setting or one population may not be generalizable to another, which emphasizes the importance of more studies in varying communities.This paper aims to explore the importance of using tailored methods in the recruitment of socioeconomically disadvantaged populations in order to increase the representation of these groups in public health research as well as some of the caveats of these methods.The recruitment we describe took place as part of a project entitled "Levelling the Playing Fields," a population health intervention research project studying the effects of Play Street (PS) and School Street (SS) interventions on children's free play, independent mobility, and active transportation.In this paper, we present the strategies we used to mitigate barriers to participation in low SES first-generation immigrant neighborhoods as well as the methodological implications we faced.As such, we argue that methodological tailoring requires continual readjustments throughout the process of conducting research in such communities in order to make participation more accessible.Our research suggests that "hard-to-reach" populations are not "hard-to-reach" per se, but in fact reachable if conventional public health research methods are adapted to the needs of their targeted populations.From July to November 2021 we sought to recruit study participants from two socioeconomically disadvantaged neighborhoods in Montreal, Quebec, both of which contained important proportions of racialized people recently immigrated to Canada from the Global South.The target population was parent-child pairs from the neighborhoods where the SS and PS would be operating.

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