The participation of hard-to-reach older people in the research and development process of health technologies from the perspective of multipliers—A qualitative analysis

Alexander Pauls, F. Koppelin, Hajo Zeeb
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Abstract

The participation of older people in research and development processes has long been called for but has not been sufficiently put into practice. In addition, participation is often late and not particularly intensive, so that certain older groups of people are underrepresented in the development of health technologies (HT). Heterogeneity, e.g., between urban and rural populations, in access to and motivation for participation is also rarely taken into account. The aim of this study was to investigate form and phases of participation for hard-to-reach older people in the research and development process of HT.The qualitative study among multipliers was conducted using focus groups and telephone interviews and took place in a city and an adjacent rural area in northwestern Lower Saxony, Germany. A content analysis of the data was undertaken using deductive-inductive category formation.Seventeen participants (13 female) took part in the study (median age 61, 33–73). Participants from both areas identified particular forms and phases of participation in the research and development process. Longer forms of participation for hard-to-reach groups and the development process of technologies for older people from the rural area were viewed as challenges. Passive and active access strategies are needed to achieve sufficient heterogeneity in the research and development process. Trusted multipliers can play an important role in gaining access to hard-to-reach older people, but also during the research process. Apart from facilitating factors (e.g., age-specific study materials), inhibiting factors such as contact anxieties are also indicated. Only urban participants mention financial/material incentives and community as possible motivations.The results provide important insights from the perspective of multipliers. They show specificities in access and participation for rural areas and for hard-to-reach older people. Many older people may have uncertainties about research projects and HT. Multipliers can assume a key role to help reduce these uncertainties in the future.
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从乘数的角度看难以接触到的老年人参与保健技术研发过程--定性分析
让老年人参与研究和开发进程的呼声由来已久,但却没有得到充分落实。此外,老年人的参与往往较晚,而且参与程度不高,因此某些老年群体在卫生技术(HT)的开发中代表性不足。城市和农村人口在参与机会和动机方面的异质性也很少得到考虑。本研究的目的是调查难以接触到的老年人参与健康技术研发过程的形式和阶段。这项针对乘数的定性研究采用焦点小组和电话访谈的方式,在德国下萨克森州西北部的一个城市和邻近农村地区进行。17 名参与者(13 名女性)参加了研究(中位年龄 61 岁,33-73 岁)。来自两个地区的参与者确定了参与研发过程的特定形式和阶段。对于难以接触到的群体来说,较长的参与形式以及针对农村地区老年人的技术开发过程都被视为挑战。要在研发过程中实现充分的异质性,需要采取被动和主动的参与战略。受信任的倍增效应在接触难以接触到的老年人方面可以发挥重要作用,但在研究过程中也是如此。除了促进因素(如针对特定年龄段的研究材料)外,还有一些抑制因素,如接触焦虑。只有城市参与者提到经济/物质奖励和社区是可能的动机。这些结果从乘数的角度提供了重要的见解,显示了农村地区和难以接触到的老年人在获取和参与方面的特殊性。许多老年人可能对研究项目和 HT 存在不确定性。乘数可以在未来发挥关键作用,帮助减少这些不确定性。
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