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Table 7 Summary of the results from ‘ intervention fidelity ’ studies included in the review (n = 33 studies)

From: Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups

Barriers Strategies
Concerns regarding: Randomisation, i.e., not getting treatment Loss of control (re: allocation) Mistrust • Ensuring minimal standard of care for control group or minimal intervention for controls [29, 40] or alternatives to randomised controlled trials [27].
• Use trusted sources of information (e.g. doctor or family) [87].
• Participant education regarding the benefits of randomisation [73].
• Including peers and locals in intervention delivery [20, 55, 58, 82, 105, 108, 124].
Health intervention not culturally appropriate (with community values and beliefs) • Community involvement in development, action research method or ‘cultural immersion’ [27, 29, 31, 35, 56, 67, 70, 71],[74, 77, 80, 85, 107, 108, 113, 114],[118, 122].
• Culturally tailored programs [19, 29, 52, 58, 6870, 85, 88, 118].
Distance for delivery of intervention (rural groups) • Group-delivered (one-on-one) telephone intervention [88].
Negative framing of health information, emphasis on disparities • Positive and progress emphasised in health information [37]*.
  1. *Indicates good evidence from randomised controlled trial (see also Table 1).