PhD Project - Azar Alexander-Sefre
Trial participants need to represent those in society who are intended to benefit from the outcomes of the trial. The groups needing representation most will vary from trial to trial, and an under served group for one type of trial may be very different to that of another. Reasons for why under served groups are not included in research can be complex, but solutions are easier to identify when inclusion is considered from the outset of a trial.
Intersectionality goes a step further in recognising that there may be multiple factors (for example ethnicity and gender) that combine and lead to disadvantage or discrimination. This theory describes how individuals may be affected by a range of different interlocking systems of power at the same time, which shape unique experiences and barriers, including barriers to health and to research participation.
Azar’s PhD explored what it means to take an intersectional lens when designing and delivering clinical trials to be more inclusive, and why this can be challenging in practice. The PhD used a staged approach. First, Azar completed a scoping review to map evidence on whether overlapping social factors are linked to health outcomes and health inequalities. Azar then conducted qualitative interviews with people involved in trial design and delivery, alongside patient and public involvement contributors, to explore how intersectionality is understood in trial settings and what helps or hinders its use. A participatory workshop was then used to explore these challenges further and identify practical ways forward.
The PhD findings were translated into a practical suite of resources to support trial teams to take proportionate steps towards applying intersectionality in real trial settings. The resources are available via Trial Forge: Intersectionality: looking beyond single identities to make trials more inclusive • Trial Forge
Supervisors: Shaun Treweek, Heidi Green (Couch Health), Vicky Shepherd (Cardiff University) and Fran Sherratt (University of Liverpool)
Contact: azar.alexander-sefre@abdn.ac.uk
Contacts
- Azar Alexander-Sefre; a.alexander-sefre.22@abdn.ac.uk