Women's Representation in Clinical Research in State of Qatar – Findings from PERCEPTIONS Study

Objective To explore the trends in clinical research participation of women living in State of Qatar. Background Women's participation in clinical studies has been a dilemma for the researchers worldwide as they have been ‘under represented’ in research [1]. This is particularly of concern when findings specific to females for any disease are extracted from a study that has males recruited in majority [1]. Although studies have shown increased likelihood of females to participate in research [2,3] the real question is whether their participation is enough to reflect this preference in tangible study samples? Some well recognized barriers to female participation in research include child-care, poverty and transport [4]. There are certain patriarchal cultures in which women are either not fully empowered to take decisions arbitrarily [5] or require consultation with a family member before committing to a study [6]. Literature endorses that female representation be ensured in clinical research [1]. Not much is known about patterns of female participation in clinical studies in the State of Qatar. PERCEPTIONS Study (Perceptions about Enrollment and Recruitment in Clinical rEsearch PrevalenT In State of Qatar): PERCEPTIONS Study is an elaborate, three phased, mixed design research project. This Phase was conducted to explore the existing attitudes and behaviours prevalent in the population in Qatar. With the dynamic National Vision 2030, Qatar is set to become world leader in health care research. Diabetes, hypertension, cancer and personalized medicine are some of the projected research goals therefore it is essential to gain an insight about the thoughts, beliefs and concerns of people that this research is meant to thrive with and eventually benefit. Methods A survey was conducted at two large-scale public events held within the State of Qatar between December 2014 and February 2015. Residents of Qatar above or equal to 18 years of age were surveyed following a verbal consent. Those visiting/touring Qatar or under 18 years were excluded from the survey. Filled surveys were entered in Microsoft Excel and analyzed on SPSS version 23. Results Of the total surveyed population 37.5% (n = 51) women reported they were approached for consent. Of these 64.7% (n = 33) agreed to participate while the rest [35.3% (n = 18)] refused. All the women who were invited into a research previously were well educated with only one reporting elementary level of education. The rest had achieved secondary education and above. Only 20% (n = 10) were unemployed. They were mostly between 25–44 years of age and a slightly higher proportion had spent ten years or less in Qatar. Reasons for refusal among the females in our survey included: time constraint, fear and mistrust, lack of awareness and lack of interest. Proportion of Qatari females who participated in research was equal to Qatari men (50%, n = 4) while those who refused were thrice as much as the male respondents (n = 3). Women from other Arab or Non Arab nationalities (38.8% and 37.5% respectively) who agreed to participate formed one third of the total number of respondents in each group. They displayed similar proportions in the group that declined consent. Non-Arab females however were the least likely to refuse participation in research. Conclusion Women in Qatar are twice more likely to participate in a clinical study than to decline consent. They are however half as likely to enroll as compared to the men. None of the female participants in our survey reported any of the reasons demonstrated throughout existing literature for refusal to participate. In fact their reasons to decline or accept participation were similar to those reported by the male respondents. Women's participation is crucial in research. These preliminary findings mandate an in depth understanding of female recruitment trends in State of Qatar. Women, Female, Recruitment, Clinical Research, State of Qatar References [1] Cooley ME, Sarna L, Brown JK, Williams RD, Chernecky C, Padilla G, et al. Challenges of recruitment and retention in multisite clinical research. Cancer Nurs 2003 Oct;26(5):376–84; quiz 385–6. [2] Tariq S, Goddard CA, Elkum N. Barriers in participant recruitment of diverse ethnicities in the state of Kuwait. Int J Equity Health 2013 Nov 20;12:93–9276–12–93. [3] Dunn KM, Jordan K, Lacey RJ, Shapley M, Jinks C. Patterns of consent in epidemiologic research: evidence from over 25,000 responders. Am J Epidemiol 2004 Jun 1;159(11):1087–1094. [4] Gilliss CL, Lee KA, Gutierrez Y, Taylor D, Beyene Y, Neuhaus J, et al. Recruitment and retention of healthy minority women into community-based longitudinal research. J Womens Health Gend Based Med 2001 Jan–Feb;10(1):77–85. [5] Daunt DJ. Ethnicity and recruitment rates in clinical research studies. Appl Nurs Res 2003 Aug;16(3):189–195. [6] Killawi A, Khidir A, Elnashar M, Abdelrahim H, Hammoud M, Elliott H, et al. Procedures of recruiting, obtaining informed consent, and compensating research participants in Qatar: findings from a qualitative investigation. BMC Med Ethics 2014 Feb 4;15:9–6939–15–9.