Best Practices

South Asians are under-represented in research, resulting in healthcare practice based on research with limited external validity for the South Asian context. In addition, the lack of representation of Asians and Asian subgroups in medical research conducted in North America leaves this community vulnerable to inaccurate generalizations that may perpetuate disparities in health outcomes. Below is a list of preliminary findings from a qualitative study completed with members of research teams who conducted health research with folks of South Asian ancestry. The lead author of this study is Zeina el Karsh, a practicum student who worked with SARHC in 2023.

Background

  • People of south Asian descent constitute approximately 7.1% percent of the total population in Canada – and 25% of the total population of Asia

  • Fastest growing immigrant population in Canada

  • SA is the largest visible minority group in Canada

  • SA people represent 14.2% of BC’s total population

  • Nearly 1 in 8 Fraser Health residents identify as South Asian

  • Burden of disease

  • South Asian seniors (65 years of age and over) were significantly less likely to report excellent or very good health and mental health compared to seniors in Fraser Health overall.

  • SAs living in Canada have a higher prevalence of diabetes than the majority of the Canadian population (have 2-3 times the rate of diabetes compared to the overall population)

  • Analysis of Canadian mortality data found that South Asian Canadians have higher rates of cardiovascular disease than Canadians of European or Chinese origin 

  • SA are under-represented in research, resulting in healthcare practice based on research with limited external validity for the South Asian context

  • Lack of representation of Asians and Asian subgroups in medical research conducted in North America leaves this community vulnerable to inaccurate generalizations that may perpetuate disparities in health outcomes

 Methods

  • A brief review of the literature was conducted using the following databases: PubMed, CINAHL, PsycINFO and Cochrane Library

  • 5 Canadian Research teams that covered different areas in health research (mental health, dementia and older adults, general population health, chronic disease management, health education/promotion) were contacted and asked to participate in a 30-60 min Zoom interview

  • Interview guide was developed based on findings from review of the literature. Our research team aimed to identify the barriers, facilitators, and future direction of SA participation in health research through hearing about the experiences of the interviewees. 

  • Knowledge gained through the interviews, coupled with the compiled literature were used to develop a comprehensive list of important consideration for SA health research

 Results

·    Barriers 

  • Person-based: help-seeking attitude, conception of research, hesitancy toward technology use

  • Practical: lack of transportation (especially for seniors), location and timing of events

  • Community-based: lack of involvement/inclusion of non-Indian/non-Pakistani SAs, lack of community awareness of research significance

  • Institutional: lack of funding, lack of political activity (in UK)

  • Research-based: use of research tools incompatible with Punjabi/Hindi translations, concrete/discrete approach to complex topics, background of research staff/recruiters

·    Facilitators

  • High social capital presence among SA community members relative to other minority groups

  • Use of personal connections to community/consultation of trusted insiders

  • Research staff being themselves members of the community and capable of speaking the language

  • Establish consistent connections with local community centre, community leaders, and places of worship

  • “Train the trainer” approach: training community staff that is already connected/familiar with the community member to conduction research procedures (i.e. facilitate focus groups)

  • Delivering research protocols and materials in appropriate SA languages

  • Include patient-partners in the steps of developing/conducting/analyzing the research OR verify with community member the relevance and appropriateness of research

  • Allow for flexibility in timing/location