The OBS UK Dashboard: an interactive tool for representative trial site selection to facilitate equality and diversity in maternity research

Elsmore, Amy; Rai, Tanvi; Pallmann, Philip; Townson, Julia; Kotecha, Sarah; Black, Mairead; Sanders, Julia; Collis, Rachel; Collins, Peter; Karunakaran, Bala; Wu, Pensee; Bell, Sarah; Parry-Smith, William

Abstract

Background: Obstetric Bleeding Study UK (OBS UK) (award ID: 152057) is a National Institute for Health and Care Research (NIHR)-funded stepped wedge cluster randomised controlled trial of a complex intervention for postpartum haemorrhage. This was developed in Wales and evaluated in a feasibility study, with improvements in maternal outcomes observed. Generalisability of the findings is limited by lack of control data and limited ethnic diversity in the Welsh obstetric patient population compared to the United Kingdom (UK): 94% of the Welsh population identifies as White, versus 82% in the UK. Non-White ethnicity and socioeconomic deprivation are linked to increased risk of adverse maternal outcomes. Traditionally, decisions regarding site selection are based on desire to complete trials on target in ‘tried and tested’ research active institutions. To ensure widespread applicability of the results and investigate the impact of ethnicity and social deprivation on trial outcomes, maternity units were recruited that represent the ethnic diversity and social deprivation profiles of the UK. Method: Using routinely collected, publicly available data, an interactive dashboard was developed that demonstrates the demographics of the population served by each maternity unit in the UK, to inform site recruitment. Data on births per year, ethnic and socioeconomic group of the population for each maternity unit, across the UK, were integrated into the dashboard. Results: The dashboard demonstrates that OBS UK trial sites reflect the ethnic and socioeconomic diversity of the UK (study vs UK population ethnicity: White 79.2% vs 81.7%, Asian 10.5% vs 9.3%, Black 4.7% vs 4.0%, Mixed 2.5% vs 2.9%, Other 3.0% vs 2.1%) with variation in site demography, size and location. Missing data varied across sites and nations and is presented. Conclusion: The NIHR equality, diversity and inclusion strategy states studies must widen participation, facilitating individuals from all backgrounds to engage. The development of this novel interactive dashboard demonstrates an innovative way of achieving this. National Health Service (NHS) maternity researchers should consider using this tool to enhance diversity in research, address health disparities and improve generalisability of findings. This approach could be applied to healthcare settings beyond maternity care and across different global populations. Trial registration: ISRCTN 17679951. Registered on August 30, 2023.

Citation

Elsmore, A., Rai, T., Pallmann, P., Townson, J., Kotecha, S., Black, M., …Parry-Smith, W. (in press). The OBS UK Dashboard: an interactive tool for representative trial site selection to facilitate equality and diversity in maternity research. Trials, 25(1), Article 629. https://doi.org/10.1186/s13063-024-08487-x

• Journal Article Type: Article
• Acceptance Date: Sep 20, 2024
• Online Publication Date: Sep 27, 2024
• Deposit Date: Sep 30, 2024
• Journal: Trials
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 1
• Article Number: 629
• DOI: https://doi.org/10.1186/s13063-024-08487-x
• Keywords: Health inequalities, Index of Multiple Deprivation, Trial site selection, Equality and diversity in research, Maternity care
• Public URL: https://keele-repository.worktribe.com/output/926481
• Publisher URL: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-024-08487-x