A systematic review to explore factors affecting participation in health research trials amongst underrepresented socio-economically disadvantaged populations in the UK and Ireland.

BackgroundThose with the greatest health inequalities and highest burden of poor-health have the lowest representation in health research. Meaning that diseases which are known to have higher prevalence in disadvantaged populations are being studied in healthier populations, so findings will be inappropriately applied to those that face the greatest challenges to their health. This systematic review is concerned with those defined as socioeconomic-deprived, gypsy/traveller/Roma communities, and homeless people. ObjectivesTo understand the barriers or facilitators to research participation in specific underserved groups to inform how equality, diversity and inclusion in research trials can be improved. MethodsA systematic review of etiology of quantitative and qualitative primary research conducted in the UK and Ireland in the previous 10 years, to produce a narrative synthesis of the themes identified. ResultsKey themes of barriers and facilitators were identified across the groups. All facilitators reported were common to all the groups. The value of peer-researchers, gatekeepers, community relationships and participatory approaches was a prominent feature within the facilitators. Reporting of barriers overall was lower, with fewer commonalities seen across the groups. The SE deprived group had the fewest barriers reported. ConclusionThe lack of identified barriers suggests that more work should be done to learn what these may be for specific groups, particularly in the SE deprived group. It seems likely that barriers exist in this group. The fact that these were not reported may indicate lack of reach to the most deprived sections of this population. Therefore, more research needs to be done to fully explore the barriers in the most deprived groups. By developing engagement approaches in a way which is tailored to separate underserved groups this will address barriers and help to shape the future of research.