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

Abstract

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.