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Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services

Celia Mason Orcid Logo, Lisa Moseley Orcid Logo, Steven Ariss, Tracy Collins Orcid Logo, Ashra Khanom, Gerlinde Pilkington, Alison Porter Orcid Logo, Sonia Saraiva Orcid Logo, Alan Watkins Orcid Logo, Jason Scott

International Journal of Qualitative Methods, Volume: 24

Swansea University Authors: Ashra Khanom, Alison Porter Orcid Logo, Alan Watkins Orcid Logo

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DOI (Published version): 10.1177/16094069251383463

Abstract

There is little understanding of challenges encountered when recruiting people who frequently use urgent and emergency care (UEC) services to qualitative research. This is despite considerable evidence that people who frequently use healthcare services are a heterogenous group, who are under-served...

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Published in: International Journal of Qualitative Methods
ISSN: 1609-4069 1609-4069
Published: SAGE Publications 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70848
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This is despite considerable evidence that people who frequently use healthcare services are a heterogenous group, who are under-served in qualitative research with voices that are seldom heard. This is particularly problematic when their use of healthcare services is often associated with unmet complex health or social care issues, chronic health conditions, and factors such as lower socioeconomic status; also associated with lack of involvement in health research and challenges to health status. This paper provides insight into recruiting this under-served and seldom-heard population to qualitative research studies and suggests how identified challenges could be overcome in future research. Using Rolfe et al.&#x2019;s Reflective Framework (2001), we examine processes and outcomes of five studies with differing methodological recruitment approaches to identify common challenges and facilitators of recruitment success. All studies aimed to recruit people who frequently used one or more UEC service. In comparing approaches, we identified two key stages of the research process that most contributed to difficulties and successes in recruitment of service users, and thus are deemed to be critical junctures: (1) Research Planning and Design, and (2) Research Delivery. The first contained themes around systems factors and study design factors, whilst the second included relational factors and personal factors. Recruitment was challenging across all studies due to unpredictable interplay of these four factors, indicating that there is no &#x2018;one size fits all&#x2019; approach for future research. This reflects the heterogeneous nature of the group, and suggests that multiple, targeted approaches to recruitment need to be co-designed with multiple service users from the outset. 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spelling 2026-01-08T15:51:52.3319443 v2 70848 2025-11-05 Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services 1f0f14742e3a36e8fd6d29f59374a009 Ashra Khanom Ashra Khanom true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 2025-11-05 MEDS There is little understanding of challenges encountered when recruiting people who frequently use urgent and emergency care (UEC) services to qualitative research. This is despite considerable evidence that people who frequently use healthcare services are a heterogenous group, who are under-served in qualitative research with voices that are seldom heard. This is particularly problematic when their use of healthcare services is often associated with unmet complex health or social care issues, chronic health conditions, and factors such as lower socioeconomic status; also associated with lack of involvement in health research and challenges to health status. This paper provides insight into recruiting this under-served and seldom-heard population to qualitative research studies and suggests how identified challenges could be overcome in future research. Using Rolfe et al.’s Reflective Framework (2001), we examine processes and outcomes of five studies with differing methodological recruitment approaches to identify common challenges and facilitators of recruitment success. All studies aimed to recruit people who frequently used one or more UEC service. In comparing approaches, we identified two key stages of the research process that most contributed to difficulties and successes in recruitment of service users, and thus are deemed to be critical junctures: (1) Research Planning and Design, and (2) Research Delivery. The first contained themes around systems factors and study design factors, whilst the second included relational factors and personal factors. Recruitment was challenging across all studies due to unpredictable interplay of these four factors, indicating that there is no ‘one size fits all’ approach for future research. This reflects the heterogeneous nature of the group, and suggests that multiple, targeted approaches to recruitment need to be co-designed with multiple service users from the outset. We make further recommendations that may also be transferred to other under-served and seldom-heard populations. Journal Article International Journal of Qualitative Methods 24 SAGE Publications 1609-4069 1609-4069 research; recruitment; under-served in research; qualitative; high intensity users 1 12 2025 2025-12-01 10.1177/16094069251383463 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This study was supported by FUsED NIHR HS & DR Reference Number: NIHR132852. HEAR: NIHR ARC NENC Reference number: NIHR200173. InFORM: Health and Care Research Wales: Health Fellowship Award: HCRW HF-17-1420. THeN: NIHR CRN NENC Targeting Health Needs Award Reference: 179695242. STRETCHED and STRETCH-UP: NIHR HDSR Reference: NIHR180302. 2026-01-08T15:51:52.3319443 2025-11-05T18:02:59.7402447 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Celia Mason 0000-0001-7053-871x 1 Lisa Moseley 0009-0007-8119-4626 2 Steven Ariss 3 Tracy Collins 0000-0002-9512-6241 4 Ashra Khanom 5 Gerlinde Pilkington 6 Alison Porter 0000-0002-3408-7007 7 Sonia Saraiva 0000-0002-2305-9246 8 Alan Watkins 0000-0003-3804-1943 9 Jason Scott 10 70848__35935__433a18371c4f4f9586ac668e3937fdf1.pdf 70848.VoR.pdf 2026-01-08T15:46:39.2761959 Output 718925 application/pdf Version of Record true © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License. true eng https://creativecommons.org/licenses/by/4.0/
title Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
spellingShingle Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
Ashra Khanom
Alison Porter
Alan Watkins
title_short Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
title_full Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
title_fullStr Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
title_full_unstemmed Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
title_sort Under-Served in Qualitative Health Research: Overcoming Challenges to Recruiting People Who Frequently Use Urgent and Emergency Care Services
author_id_str_mv 1f0f14742e3a36e8fd6d29f59374a009
fcc861ec479a79f7fb9befb13192238b
81fc05c9333d9df41b041157437bcc2f
author_id_fullname_str_mv 1f0f14742e3a36e8fd6d29f59374a009_***_Ashra Khanom
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
author Ashra Khanom
Alison Porter
Alan Watkins
author2 Celia Mason
Lisa Moseley
Steven Ariss
Tracy Collins
Ashra Khanom
Gerlinde Pilkington
Alison Porter
Sonia Saraiva
Alan Watkins
Jason Scott
format Journal article
container_title International Journal of Qualitative Methods
container_volume 24
publishDate 2025
institution Swansea University
issn 1609-4069
1609-4069
doi_str_mv 10.1177/16094069251383463
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description There is little understanding of challenges encountered when recruiting people who frequently use urgent and emergency care (UEC) services to qualitative research. This is despite considerable evidence that people who frequently use healthcare services are a heterogenous group, who are under-served in qualitative research with voices that are seldom heard. This is particularly problematic when their use of healthcare services is often associated with unmet complex health or social care issues, chronic health conditions, and factors such as lower socioeconomic status; also associated with lack of involvement in health research and challenges to health status. This paper provides insight into recruiting this under-served and seldom-heard population to qualitative research studies and suggests how identified challenges could be overcome in future research. Using Rolfe et al.’s Reflective Framework (2001), we examine processes and outcomes of five studies with differing methodological recruitment approaches to identify common challenges and facilitators of recruitment success. All studies aimed to recruit people who frequently used one or more UEC service. In comparing approaches, we identified two key stages of the research process that most contributed to difficulties and successes in recruitment of service users, and thus are deemed to be critical junctures: (1) Research Planning and Design, and (2) Research Delivery. The first contained themes around systems factors and study design factors, whilst the second included relational factors and personal factors. Recruitment was challenging across all studies due to unpredictable interplay of these four factors, indicating that there is no ‘one size fits all’ approach for future research. This reflects the heterogeneous nature of the group, and suggests that multiple, targeted approaches to recruitment need to be co-designed with multiple service users from the outset. We make further recommendations that may also be transferred to other under-served and seldom-heard populations.
published_date 2025-12-01T05:33:54Z
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score 11.096068

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