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S8 D. Dingoyan et al. / European Psychiatry 27 (2012) / supplement n°2 / S4-S9
him/herself. Moreover, all of the focus groups mentioned that
women with Turkish migration backgrounds are not allowed
to invite a male interviewer into their home without the presence
of a male family member. Such an invitation could lead
to confl icts with the social environment of the women, such as
defamations. It was also repeatedly stated that the interviewer
should be able to speak the Turkish language.
3.5. Tangible incentives
For a three- hour interview, the overall mean tangible incentive
was 29 € (range: 20- 45; n=36). One participant refused to
specify an amount (“To me, it is more important if I will be helped
at that moment. So, I will not name a sum.”)
3.6. Key fi gures
Thirty- six participants stated that well- known public fi gures
would positively affect participation in research studies. Only
one participant expressed that there would not be a relation
between participation willingness and well- known fi gures. On
the basis of the questionnaire concerning the relevance of key
fi gures, public fi gures from various social areas were identifi ed.
Table 4 shows the top ten named fi gures and their degree of
popularity. An internationally known fi lm director and a local
hairdresser with Turkish migration backgrounds were most
frequently mentioned.
4. Discussion
Regarding the sample characteristics (e.g., age, country of
birth, nationality, year of migration, school and professional
qualifi cation), with the exception of gender, the sample composition
is diverse and widely ranged (Table 1). As all participant
statements were included in the content analysis, it can be
assumed that the results of the focus groups are not distorted
fundamentally by the smaller number of male participants.
An exception is the category “role of women”, which will be
Table 4
Top ten frequently mentioned key fi gures and their degree
of popularity on a 0- 10 scale.
well known key fi gures gender n popularity ø
1 Turkish buisnessman male 30 8
2 Turkish fi lm director male 27 7
3 Turkish physician male 23 7
4 Turkish federal politician male 22 7
5 German mayor male 22 7
6 Turkish local politician female 20 7
7 Turkish hairdresser male 20 4
8 Turkish local politician male 19 6
9 Turkish sportsman male 15 8
10 Turkish tv presenter male 15 7
discussed later. Moreover, it is not clear whether the low level
of male participants is due to a generally lower willingness of
men with Turkish migration backgrounds to participate in health
research studies, or whether other factors (e.g. time- related or
personal reasons, various factors infl uencing the recruitment
process) may have played a role. Overall, the enrolment of
participants with Turkish migration backgrounds into the focus
groups was associated with several challenges. For the majority
of invitees, the issue of “to know each other” was a motivating
factor for their participation. Being accompanied by friends or
relatives was the most often expressed condition for attendance.
Furthermore, the feedback indicated that many participants
had concerns about the research staff’s expectations of them
and whether they would be able to meet them. In this context,
some participants also reported concerns of being examined
and providing incorrect answers. For these reasons, it seems
adequate not to have audio and video taped the participants, so
as not to excite their fears of being controlled or examined. These
factors and the need to be accompanied by a trusted person
may also be related to previously mentioned reasons for lower
participation rates (perceived barriers), such as anxiety, mistrust
and negative experiences in the interactions with the majority
population. Considering the fi ndings of the perceived barriers, it
is striking that most of the documented statements were related
to the fi rst category, which refers to the traditional role of women.
This result was not merely due to the large number of female
participants. The women became increasingly conversational
with each other, which led to more differentiated statements.
Therefore, care should be taken in drawing conclusions that
could result in unfounded generalisations or the stigmatisation
of women and men with Turkish migration backgrounds.
The results provide a wide range of potential participation
barriers that should be considered in the process of study
planning. Of note, some of the stated reasons for the lower
participation rates were also reported in other studies, such as
lack of knowledge, anxiety and mistrust of scientifi c institutions
and the government. An extreme example of negative experiences
with health research studies is the Tuskegee Syphilis
Study. Many authors point out that this study became a symbol
of research subject abuse of African Americans. It is discussed
that these experiences affect the willingness to participate in
health research studies until today [4,5,25]. The present study
did not demonstrate such a clear association between a specifi c
traumatic event and the willingness to participate. However,
focus group participants mentioned negative experiences with
governmental institutions (such as national authorities) as
possible reasons for mistrust of health research studies. Thus,
trust building through diverse resources is a key aspect that has
been indicated in the literature [11,19,25] and by focus group
participants (recommendations). When the participants were
asked to name motivating factors for participation in future
research, word- of- mouth promotion of the research project and
the involvement of well- known key fi gures were mentioned as
trust building methods. The importance of key fi gures and the
social networking of the Turkish community should be considered
to be a relevant resource to build trust and to enhance
participation rates in health research studies [2,3,26]. As also
mentioned in the focus groups, the transparent communication
of the study objectives, interview conditions and relevance of
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