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. 2025 Mar 7;25(1):908.
doi: 10.1186/s12889-025-22033-7.

Engaging, recruiting, and retaining pregnant people from marginalized communities in environmental health cohort studies: a scoping review

Ghazal S Fazli  1   2 , Erica Phipps  3   4 , Eric Crighton  3 , Anglena Sarwar  3 , Jillian Ashley-Martin  5
Affiliations

Engaging, recruiting, and retaining pregnant people from marginalized communities in environmental health cohort studies: a scoping review

Ghazal S Fazli et al. BMC Public Health. .

Abstract

Objectives: To identify barriers to and strategies for improving the representation of pregnant people from marginalized communities in pregnancy cohort studies that measure environmental chemicals.

Methods: Guided by the Arksey O'Malley and Levac Frameworks, we conducted a scoping review of peer-reviewed literature published between 2000 and 2022. Included studies discussed barriers and/or strategies related to engaging, recruiting, and retaining pregnant participants or participants of reproductive age from marginalized communities into environmental health research.

Results: Twenty-nine peer-reviewed articles were included in the review. Overall, 31% (9/29) of the studies reported on engagement, recruitment, and retention of participants from racialized communities, 10% (3/29) reported on involvement of participants identifying as Indigenous, and 10% (3/29) of studies reported on participants living in households or areas of low socioeconomic status. We identified four key barriers: participant burden, social inequities, lack of trust, and lack of cultural relevance. We reported identified strategies to mitigate these barriers.

Conclusion: Although there is limited coverage in the literature on strategies to effectively engage people from marginalized communities in environmental health pregnancy cohort studies, our findings suggest that applying a health equity and social justice lens to research may help address barriers that exist at the individual, interpersonal, community, institutional, and policy levels. Findings from this review may have important implications for planning future pregnancy cohort studies and ensuring that communities who are disproportionately affected by environmental chemical exposures may be better represented in research and considered in policy decisions.

Keywords: Cohort; Engagement; Environmental chemicals; Marginalized; Pregnancy; Recruitment; Retention.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: GF received a contract from Health Canada to conduct the scoping review.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flowchart. Adapted from: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71
Fig. 2
Fig. 2
Mapping barriers to research participation among marginalized population. Adapted from: Socio-ecological model: framework for prevention, Centers for Disease Control. Available from: https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html
Fig. 3
Fig. 3
Barriers and strategies to engaging, recruiting and retaining pregnant people from marginalized communities in environmental health cohort studies
See this image and copyright information in PMC

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