Olsen Sara H, Roh Esther J, Syakayuwa Tandwa, Chola Mumbi, Agbakwuru Chinedu, Stafford Kristen A, Stoebenau Kirsten, Dzekedzeke Kumbutso, Charurat Manhattan
Department of Behavioral and Community Health, University of Maryland School of Public Health, Maryland, USA.
Center for International Health, Education, and Biosecurity, Zambia.
Health Promot Perspect. 2022 May 29;12(1):67-76. doi: 10.34172/hpp.2022.09. eCollection 2022.
Nationally representative, household-based, health-related surveys are an invaluable source of health information, but face implementation challenges. In sub-Saharan Africa, these challenges are exacerbated when surveys include the collection of biological specimens. In this study, we describe the potential implementation challenges identified during field practice leading up to the 2020 Zambia Population-based HIV Impact Assessment (ZAMPHIA) survey, and explore the role of two crises on community mistrust of, and apprehension to, participate in the survey. Using focus group methodology to better understand the influence of crises on ZAMPHIA participation, we conducted 12 focus group discussions (FGDs) in five districts across two provinces. FGDs were conducted with three purposively sampled study groups: recognized household heads, community leaders, and young adults aged 18-24 years. We used reflexive thematic analysis to develop themes from across the FGDs. We identified two key themes: the ever-present threat a stranger posed to the community is enhanced by crises, and endorsement of community awareness through sensitization can mitigate outsider challenges in medical research. We argue that these crises emphasized underlying mistrust that can only be addressed with substantial investment in community engagement efforts to build trust and partnership in medical research endeavors. Our findings underline the importance of prioritizing community engagement through substantial investment in varied and extensive approaches to sensitization to facilitate community engagement toward community acceptance of ZAMPHIA and similar studies.
全国代表性的、基于家庭的、与健康相关的调查是健康信息的宝贵来源，但面临实施挑战。在撒哈拉以南非洲，当调查包括生物样本采集时，这些挑战会加剧。在本研究中，我们描述了在2020年赞比亚基于人群的艾滋病毒影响评估（ZAMPHIA）调查之前的实地实践中发现的潜在实施挑战，并探讨了两场危机对社区参与调查的不信任和担忧的影响。我们采用焦点小组方法以更好地理解危机对ZAMPHIA参与的影响，在两个省份的五个地区进行了12次焦点小组讨论（FGD）。FGD是与三个有目的抽样的研究群体进行的：公认的户主、社区领袖以及18至24岁的年轻人。我们使用反思性主题分析从FGD中提炼出主题。我们确定了两个关键主题：危机加剧了陌生人对社区构成的持续威胁，以及通过宣传提高社区意识可以减轻医学研究中的外来者挑战。我们认为，这些危机凸显了潜在的不信任，只有通过大量投资于社区参与努力，在医学研究工作中建立信任和伙伴关系才能解决。我们的研究结果强调了通过大量投资于各种广泛的宣传方法来优先考虑社区参与的重要性，以促进社区参与，使社区接受ZAMPHIA及类似研究。
