Parenting is always an experiment so why not collect the data?
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Science is People – recruiting to the Baby Biome Cohort Study. A Q&A with Peter Brocklehurst

 

We were the experts for this Q&A! Prof Peter Brocklehurst joined us to pick our brains. How can you reach a large number of new mothers and what information do they need to encourage them to join a study such as the Baby Biome Cohort Study?

Peter:  We’ve got several challenges. The first is how to ensure that women know about the study before they turn up in labour. The second is how to gain consent for the study in a way which is manageable for such a large study which being as close to ideal as possible.

PSG X: Midwife appointments?

PSG I: I’ve heard lots of women complain that there isn’t enough time at these to discuss normal pregnancy questions, so probably not the best place to talk about the study in any depth. Although community midwives could hand out leaflets.

PSG F: Antenatal classes are likely to have the same problems I think. There was very little time and so many pressing questions. Again, where these still take place, leaflets could be available – a lot of women read everything that they are given at this time really carefully!

PSG J: Lots of leaflets in waiting room? That’s how I found out about the cord blood donation.

Peter:  Agree with this. Leaflets are good if people access them – and appointments usually entail lots of waiting around! Some antenatal clinics have TVs in and we could use them to mention the study as well. Reasonable?

PSG L: Yup. I watched that maternity tv thing on a loop…so irritating but I had nothing else to do so kept watching…

PSG J: Oh yes. Better than adverts for pushchairs etc!

PSG B: Or midwife introduces study at one appointment and gives leaflet and then signs up at next appointment one family have had chance to read the leaflet.

Peter:  That is one way we are planning. The problem is that midwife antenatal appointments are already pretty crammed for the midwives. Asking them to do even more is always challenging – and ensuring that 1000s of midwives know about the study in detail is a big job – but we will do it.

PSG B: Do you think that advertising through not just the Maternity Voices Partnerships but also the Local Maternity Service would be a good plan? This will allow women who cross borders to be captured. In my area (Walsall MVP) a lot of women give birth in Wolverhampton or Sandwell, so by targeting the LMS area you get a better range of recruits (in my area, the Black Country LMS consists of 4 hospital trusts and each area has its own demographic so creates a better sample).

PSG A: Could someone from the study be at the midwife clinic? In the appointment, midwife introduces it, and if you are interested you nip next door to talk to study person (but they need to be there – I wouldn’t have had time to come back another day).

PSG C: Scottish midwives are handing out baby boxes to new mothers. I’m not sure how these are distributed exactly – my wee one was born a few months before the scheme kicked in. But might be a way to get info out in one or two areas of Scotland at least.

PSG K: Our local hospitals community trust have paper newsletters that are free to pick up at pharmacies, doctors’ surgeries, leisure centres etc. Once we know the hospitals those magazines might do a story/ profile with info?

PSG N: Also, do you have pictures of cute babies on your literature? That and a really interesting fact (you just have to trump “Now your baby is the size of an avocado”) would make me look.

Peter:  Getting the information right is important as is the look of the information – all good points. Thanks.

PSG Q: Trying to think of other places I frequented as a pregnant woman – what about searching out local providers of pregnancy yoga, swimming or birth workshops. Providers like Birth light or similar? You could give them leaflets or ask if they can mention it to see if anyone is interested?

PSG G: Yoga classes are hugely popular.

PSG F: I’m pretty sure there is some sort of pregnancy yoga practitioners network. It must be massive. They would be good to have on board.

PSG P: Positive birth movement groups?

PSG I: Yes, our contacts there are really excited about the study.


Peter: What about local radio? Or local newspapers?

PSG J: I don’t think many people read or listen to these anymore!

Peter:  I thought that might be the case – but could this vary in different parts of the country?

PSG F: We have a local free magazine that comes through the door monthly. I’m always surprised how many people say that they’ve gone to events based on info in this magazine. It’s called Your Local Link. I wonder if similar publications exist in other areas – I bet it’s a franchise.

PSG W: NCT

PSG J: We have ‘insert borough name here’ Families magazine. Tends to have adverts for prep schools, council stuff, and a list of local events.

PSG J: Perhaps if there’s a popular local station? I wouldn’t have seen it in a local paper or heard on local radio.


Bounty Packs

PSG Q: Leaflets in the bounty pack?

PSG V: I didn’t do the bounty pack thing, but nearly everyone else I knew did, this sounds like a really good idea.

PSG U: Definitely in the bounty packs!

PSG Q: The first one was given to me at my ‘booking in’ appt with the midwife, I think that’s fairly common.

PSG V: Would skew to first time mums? I bet not many 2nd/3rd/4th time mums will read as mum bumpf as first timers.

PSG S: I didn’t find the information on the bounty packs that useful – lots of ads, little relevant info imho. could have missed something interesting in the middle of the ads. But worth trying lots of different things, you’ll reach different audiences.

PSG Q: Yeah lots of ads but I did sieve through them looking for useful stuff – there were some money off vouchers in mine though out of date!

PSG B: The packs are basically a way to get your personal data to sell on to other companies and most leaflets are irrelevant. I wouldn’t trust anything in the to be unbiased or without a big commercial interest.


Posters in Loos

PSG L: There were posters for studies in the loos in the hospital when I went for my appointments

PSG J: Good plan. Always need a trip to the loo for a sample! Ours had something about STIs

PSG J: See – 4 yrs on and I still remember! 😁

PSG D: Good idea!


Children’s Centres and NCT

PSG K: Or what about through children’s centres or NCT? I know I had a problem trying to do a baby study for a commercial organisation, but if it’s for academic science they’re usually more willing.

Peter:  Yes – NCT classes would be good and children’s centres. Thanks

PSG J: NCT will likely only hit a certain demographic. It’s really blooming expensive in my opinion!

PSG O: Agree about NCT being a certain demographic. Also, children’s centres (in my experience in my area) are not used by a broad demographic. Since the closure of many sure start centres, it seems that only the ones in areas with a great need have survived the cuts. Using both would perhaps start to make a representative sample.

PSG D: So many sure starts have been closed down 😞 would have been ideal.

PSG Q: Yeah I think you need to hit a wide range of places to try and get a good mixture of people – those two places will likely hit different groups. Though our local HV clinics were in children’s centres too.

PSG I: One thing to bear in mind is that the study will be recruiting in particular areas, not nationally. So we probably wouldn’t advertise it on the main NCT social media feed, for example, although we could do so through the branch network.

PSG Q: My local branch sent out emails and local magazines so that would be one way to get info out in certain areas.

PSG J: The reach of NCT emails has been really reduced with GDPR which they implemented over a year early…. our local branch was hit really hard.  However I think most have local Facebook groups or Twitter.


Online groups

PSG K: What about Mumsnet or Netmums? I get the impression the women running these are very good at getting publicity for their campaigns.

PSG U: Facebook groups? Thinking the big breastfeeding groups, natural parenting groups…

PSG L: Would that bias the study though?

PSG J: It would ensure a good number of longer-term breast feeders. Given that only 1% do bf only to 6 months.

PSG S: Communities in Mum/parent sites such as BabyCenter, Mumsnet, etc. I was part of several groups and we shared lots of info there. I’m still actively in my bumps group that started from a thread on moneysavingexpert.com.

PSG E: What about the due date groups on websites like Babycentre, and the sign up you get on the NHS website that sends you regular information? Prenatal classes?

PSG L: I think Facebook targeted adds would be a good way to go. Or the BabyCenter app.

PSG O: Social media is a must I think… It’s a quick and cheap way to get a far reach.

Peter:  Will need to explore Facebook groups! The problem is not to raise expectations for all women – if we can only recruit through specific hospitals we don’t want women wanting to take part and then not being able to let them.

PSG O: It is possible to target certain areas only with Facebook adverts. Groups can be set up for specific areas with entry questions into the group, e.g. Due date, postcode, admin then approve if women meet initial criteria.

Peter:  Great – I am a bit of a Facebook virgin, so this is good to know – sounds ideal.

PSG V: Facebook ads are fairly cheap, and can be super targeted, geographically and demographically.

PSG O: Also, I personally think print media is an inefficient and costly method of recruitment, it relies on so many factors to come together to work. Digital media is more personal and you can interact with a large group of people with one post.

PSG A: You just need to target ads and make it clear in them where and how you are recruiting.

PSG L: The BabyCenter app seemed to have a broad appeal too.

PSG I: I like the idea of apps. Are there any others we could advertise the study on?

PSG L: BabyCenter and Wonder Weeks were the ones I know of. I’m sure there must be others too.

PSG H: What to expect is one.

PSG G: Are there any apps that show how baby is developing in the womb? I guess you need apps for pregnancy rather than afterwards.

PSG I: Any idea how much it costs to develop an app? I’m wondering if we could do an app version of ‘What’s in a Nappy’, to cover the first year….

PSG K: Depends how sophisticated the app, how many operating systems you need it to work on etc.


Where will recruitment take place?

PSG U: What sort of scale are we thinking? Throughout the whole of the uk?

PSG I: Baby Biome will be recruiting in four areas – two in England, one in Scotland and one in Wales. These are yet to be determined.

Peter: Current plans are for 25 hospitals throughout the country – not all of the UK.

PSG E: Oh, disappointed you won’t be including NI 🙁

PSG U: I’m in South Wales, so hoping a nearby hospital will be included. Not that I’m planning any more babies, but can help recruit in my area.


Who should be recruited?

PSG L: What about bias? Are you looking to get a representative sample?

Peter:  The more representative the better – but it’s not essential for looking at the microbiome work. But the cohort will be able to answer lots of other questions over many years, so representativeness would be good if possible.

PSG L: I think you want to try and recruit as broadly as possible- children’s centres (where they still exist) seem to do a good job of reaching a cross section of people near me.


Baby Biome Ambassadors

PSG F: How about a series of ambassadors – enthusiastic volunteers that go to the local bumps and babies groups and talk to people about the study?

PSG I: I’m going to be running the Patient and Public Involvement (PPI) groups for the study, and it would be great to equip the members of those groups to go out and talk to more parents. What sort of support do you think they would need to do so?

PSG F: Enough background info about the microbiome itself to be excited about the study, lots of bumph to give away both in terms of leaflets and stickers.

PSG G: Cards with website where you can sign up / find out more. A leaflet & that NCT baby poo leaflet to enable them to add some humour if appropriate.

PSG G: I love microbiome stickers might be amusing.

PSG U: I’d be more than happy to talk to groups of they are accessible transport-wise to me.

PSG D: I love these ideas.


Other professionals

PSG H: Might the MVPs if the hospitals you’re recruiting from be able to help?

PSG L: MVPs?

PSG I: Maternity Voices Partnerships. Formerly known as Maternity Services Liaison Committees, and they still go under that name in Scotland.

Peter:  We will be keeping these groups informed – asking them to disseminate information through their population is also a great idea – they will know what is likely to work locally.

PSG L: I had no idea such a thing existed (not sure if that makes a difference to how useful they might be…).

PSG I: The coverage is patchy in places. Every trust is supposed to have one but they haven’t always been a priority for managers, especially when budgets are tight. There’s been a big push on them lately though, as part of the Better Births implementation.

PSG J: Our Trust just ceased these meetings 🙁 Not sure why.

PSG B: They should be setting MVPs up! Can you contact your local maternity service and enquire?

PSG J: I can ask around.


Preschools and Nurseries

PSG G: If it’s in a specific geographic area then how about targeting pre-schools, nurseries and primaries with posters, as mums there might be having another baby & get involved?

PSG F: That’s a really good point. Mums with small children are very likely to be going to groups with their existing kids, and by targetting groups with kids from 1-3ish, there is likely to be a good proportion of people having second children.

And I think that women having their second child might well be more likely to get involved in something like this. They are more likely to be a bit more relaxed about the whole process having done it once before and have a bit more headspace.

PSG T: And libraries.


Other websites

PSG L: I’d also think about digital marketing- targeted adverts on baby websites that a served to people in the areas you are working in- you can be really specific and target by demographic too.

Peter:  What impact do you think professional bodies support for the study – such as the Royal College of Midwives or Obstetricians and Gynaecologists would have? Do pregnant mums ever look at these websites?

PSG G: It would be good to have their endorsement / support on things but don’t think many people look specifically there.

PSG S: I don’t think most would look at the websites but knowing the study is endorsed/supported by them might be a good thing.

PSG L: I didn’t. I was looking at the websites that told me what piece of fruit my baby was the size of or where to buy baby stuff…

Peter:  Useful – thanks.

PSG E: I didn’t look at them and don’t think they’d influence me. I’d be much more swayed by my midwife speaking to me about it, or a short talk at the prenatal class with a real person, to be honest.

PSG D: Knowing they are in support would be important to me. So much bumph in the baby packs/Midwife packs/bounty etc was simply data mining for advertising purposes. Their stamp would add legitimacy.

PSG O: Agree that it validates the study and it would influence me because it would make me think it’s an important piece of research.


Linking Data

Peter:  These have all been really helpful suggestions – thanks. Can I ask about data linkage in the study?

In order to obtain clinical data form hospital records and GP records for both mum and baby, we are asking participants permission to access their routinely held data. We undertake never the share these data and to keep them completely confidential. This did not seem to be a problem in our pilot of 3500 women but recent events may have altered public views about this. It would be great to hear your thoughts and what we could do to allay fears that we will ‘sell the data’ or misuse it in some way.

PSG L: I wouldn’t be worried about that personally. There’s such a big push with GDPR at the moment everyone has to be transparent with what they do with your data- I think people are used to being told whether or not it can be passed to 3rd parties etc.

Peter:  Even with consent from women in the pilot study we still have to jump through lots of hoops before we can get access to the data – not quite signing in blood – but close!

PSG E: As long as you were connected to a reputable university and funder, with clearly well set out terms and conditions I would not have a problem with this.

PSG G: Think you just need to ensure you have robust privacy procedures in place & you can say the pilot information all held securely. Ithink people do still trust the medical profession. Clarity about what will be done with the data is essential.

PSG A: Make your NHS approval very obvious on your website /sign up page – people know and trust NHS more than random researchers.

PSG D: Honestly? Not being tied to the fairly unethical Bounty pack would be a good start.

PSG P: Honestly I would happily sign for you to access my records if the information about what I was consenting to was clear about exactly what would / would not be done with it – if I’m left uncertain about what something means I won’t consent, and it’s surprising how many consent forms are actually quite unclear.

PSG A: The main thing is clarity and things written in plain English. Ask representatives of your target audience and point out jargon / anything that is unclear, before you roll it out more generally. What makes sense to you may not make sense to others.

Peter:  Agree – one huge difficulty we have is that NHS Digital, who hold the data, insist we have to use their exact wording before the consent is considered valid. We have tried – and will try again, to make this more understandable. What we currently do is write it clearly, and then add in the required text from NHS Digital. Not very satisfactory.

PSG A: How long will you access data for – one off, 1 year, 5 years etc?

Peter: The plan is to ask for consent to seek data until the child becomes old enough that we ask then – so until age 16. However, we make it very clear that women can withdraw their consent at any time, without having to give any reason.

PSG S: I think you need to be really clear on what data you need, why it’s needed, how you’ll treat it and keep it confidential. Will you anonymise the data? How? which protocols would you use? I personally would be asking those questions and I think techy mums would too.

Peter:  We will not anonymise the data because we will need identifiers to link with the routine data sources. but when other researchers ask to access the data through a data access committee, data will only be provided in anonymised way.

Peter:  We need to make the consent forms as clear as possible then. Rachel Plachcinski from the NCT is helping us with this – and we will ask lots of women to sense check and make sure it is as good as it can be.

PSG A: I think it might be helpful for people to see an example of how the data look when researchers get it (i.e. What does anonymised data look like? Really it is just a bunch of numbers on a very long spreadsheet).

How do researchers work with it? (I.e. they use statistics and modelling, they don’t manually look at data).

Peter:  It is boring to look at! long rows of codes and numbers with a key to indicate that, for example. 1 equals caesarean section, 2 means ventouse, 3 means forceps etc. Anonymised means that no one can use the data to work backwards and find out which women it came from – so no dates of birth, just ages, no addresses, just parts of the country etc.

Peter:  No one will know about who participated in the study apart from the core group of researchers who need to link the sample data and questionnaires to the clinical data. Maintaining confidentiality is absolutely critical – and is one of the hoops that NHS Digital insist on before providing us with data. The University systems have to be airtight. Explaining this clearly but comprehensively will be key.

PSG S: Agree! that was a good start 😉 But you also need to word it for less tech-savvy mums so they are reassured about their info. Getting a group of mums to read/comment/improve is a good idea.

 

 

PSG F: I think that the future use of the data is the bit that some people worry about – other researchers who may ask to access it for their own work. Although most people understand that requests have to go through a committee before they are approved, I think that many people don’t feel comfortable that businesses may apply and then make sure of their data. There’s nothing you can do about this, but I guess that it’s important that the information about how carefully screened these requests are is really clear.

PSG S: I understand the need to link data, but knowing those details about other researchers access request might be important. It comes down to “who will know what about me and my baby” and you need to be clear about that.

PSG O: I agree, I don’t think this will be a big problem as long as it’s clear how the data will be used.

PSG A: For a lot of us, it is formula companies that are viewed as the big ‘threat’ and someone we wouldn’t want to have access to our data. Is there any way to firmly exclude them from making access requests.

PSG A: Would it be feasible to have a list on your website of who has been granted access?

Peter:  The access committee – modelled on the one for UK Biobank would only allow data to be shared with legitimate researchers, who provide a protocol for what analysis they plan to undertake, sign a contract stating that they will not use the data for any other purpose and will not share the data with any third party. So far this is working really well for UK Biobanks, and for the existing birth cohorts.

PSG N: I can see people being twitchy about this. I think a one sentence super concise description with a link to fuller information would cover those who are mildly and more seriously concerned.

PSG L: Personally I’d want formula companies to access the data if it could improve health outcomes for children who need formula.

PSG A: The access model sounds good, but you may want an FAQ which addresses specific concerns of mothers about baby/gut data, which would seem of particular interest to formula companies (who may legitimately want to research the effect of their formula on the gut).

Peter:  I think this will be of less interest to companies but of real interest to doctors eg neonatologists who are keen to ensure that all infant feeding optimises infant health. but I may be too cynical.

PSG A: Legitimate university researchers could equally do this research in a much less biased way than formula companies (i.e. university researchers would hopefully publish results that were both pro and against formula. There is a danger that the commercial interests would lead formula companies to hide any results that were less positive about formula).

Peter:  I agree with this. but the contract for data sharing would include a clause about making the analysis publicly available regardless of the results. And current systems police this i.e. check that it has been done. so there are ways to try and make sure data are not supressed – not perfect, but going in the right direction.

PSG N: Is it fair to say that we in this group are likely to be a fairly twitchy bunch (no to Bounty! No to formula companies! etc.) compared to the general population of mums?

PSG J: Quite possibly. Though quite a few people boycott Nestle? That might only be middle class mums of a certain persuasion? 😉

PSG N: I just guess that some of these concerns, while important to people here, are quite possibly rather niche and wouldn’t constitute major forces in persuading/dissuading the bulk of mums. A tweak which catches a small percentage of most of the mums may be worth more gain than one which addresses a concern shared by even most of us here, iykwim.

PSG J: Totally agree.

PSG B: Being tied to bounty would be a huge red flag for me when being asked about data sharing and I would likely say no following the fairly aggressive selling of my data that happened after getting my bounty packs with my first child.

PSG D: My bumps and babies group has a wide economic and geographic (and class?) basis… and almost all of us hated bounty for one reason or another.

PSG D: Me too! And it was far from just me pushing an agenda. Other mums saw harassment & disrespect from the new-born photographers etc.

PSG A: At a basic level, it seemed wrong that bounty were allowed by the NHS to push information about overpriced and unnecessary baby items into unsuspecting hands at a routine appointment. I had the sense to chuck the majority of it in the bin (I used the laundry samples when I went on holiday). However, I can’t imagine how guilt inducing it would be for people who were struggling to afford baby basics. I’m assuming this bag doesn’t have to go through any ethical clearance?!


Peer Support

PSG I: How many of you have peer support projects running locally? Those generally reach a wider demographic but there’s no central register so researchers have to look hard for them.

PSG J: For breastfeeding yes. However, funding has been slashed everywhere.

PSG D: If you mean community groups? Our Sure Starts all shut down. That provided an amazing support system and wide demographic appeal. We have nothing like that left now.

PSG J: Depends how wealthy the local council is.

PSG D: I do part run a peer support babywearing group.

PSG F: We have breastfeeding and babywearing peer support, but I don’t know how many people they see during pregnancy. I think that many people only access this after the birth.

Peter:  This all speaks to working with the participating hospitals to develop processes that work in that local area – and keeping on top of this because the situation may change over the course of the study i.e. Sure Start centres closing.

PSG I: Local authorities generally fund them, the most common are breastfeeding but there are also groups working with refugees, asylum seekers and women with mental health issues. My local project, Auntie Pam’s, provides pregnancy support for any mum who attends.

PSG J: Agreed – if you can get local public health on board it’s a good start as they can give details of their providers who will not necessarily be hospitals.

PSG D: In our county even the breastfeeding support is hugely diminished from even 3 years ago and what’s left Is under current threat.

PSG K: Yes, we have breastfeeding and post-natal depression, as we still have a children’s centre and motivated staff are still running them.


Q: Will the study information be available in different languages? Definitely relevant if Leicester and London are used again!

Peter:  Yes


Q: I wonder how keen you are to recruit mothers who won’t be birthing at hospital or may choose to opt out of the standard medical contacts during pregnancy? I’m thinking about the mothers who decline scans / decline midwife appointments / opt for home births or free births etc.

When thinking about how to recruit participants it will be more challenging to recruit these ‘outliers’ to the norm, but potentially rewarding as these may also be the mothers who are more likely to steer clear of antibiotics and over-the-counter medications so could give a good range of data.

PSG F: Any idea what sort of numbers of women are in these groups?

PSG I: UK home birth rate is 2.3%, so freebirth rate will be very small.

PSG G: Might these mums use a Doula? I think they have a network online & association – they might publicise the study?

PSG I: We could contact doulas via DoulaUK and a couple of other organisations.

PSG L: Would you need to recruit really large numbers of this group to be able to claim any statistical significance?

PSG F: I guess it all depends on the areas involved. The home birth groups round here are really well attended by parents who would love this sort of thing and would be more likely to get talking about it at a home birth group rather than at a rushed midwife appointment. But they don’t tend to be very diverse.

PSG D: FB groups might be good to target this demographic. Though I know a few Mothers who would fit bit do not engage in this kind of social media.

PSG I: According to this paper, freebirths are often counted as Born Before Arrival (BBAs) and the proportion of BBAs in all births is between 0.14 and 0.44%. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0847-6

PSG P: Yes I think that these groups of mothers are very likely to be keen to participate if they can be reached, and Facebook groups are probably a key way to reach them as well as through local doulas and independent midwives.

I guess a question is whether non-hospital birth settings would be workable for the study as I think a cord blood sample is needed?

PSG I: If I’ve got my mental arithmetic right, less than 200 births in the sample are likely to be BBAs, and I don’t know what proportion of those will be planned freebirths.


Q: What do you think would be more effective in persuading you to take part in this sort of study – a leaflet/poster/written info that you can read at leisure or a personal interaction, where someone tells you about it?

PSG O: Personal interaction for sure. How will people actually sign up? Leaflets and posters may advertise, but what will the next step be? People in general are lazy, so while seeing a poster makes pregnant mothers aware, what will induce them to make the next step?

PSG G: Ideally for me, I would hear about it from someone involved & then be able to easily find out more about it online. That hearing about it could be from a conversation on a Facebook group, or outside school waiting to collect the kids. Online is easier because you can get a link & keep it rather than having to do your own search.

PSG N: I’m a reader.

PSG M: I’m a bit of a mix, hearing about something then wanting read/research before making a decision.

Peter:  Clearly we need to cover all bases – leaflets, posters, YouTube clips, word of mouth, social media, loo doors- everything we can think of!

PSG G: Yes – they say when you think you have seen it everywhere & told everyone several times then you may just be beginning to get your message across!

PSG L: Definitely a range of options and an online link would be really important.


Q: Do you know whether (exact week, not range of) gestational age will also be recorded? And will you be track whether antibiotics were given to the mother in both e&p, caesarean and vaginal birth? Is maternal weight (at birth & infant age 5) also available? And any data on maternal request caesarean?

Peter:  Gestational age: yes, antibiotics: yes, maternal weight during pregnancy: yes (not at age 5) and indications for CS as recorded in the electronic record: yes.

PSG I: Does the electronic record collect data on maternal request caesarean? That is, whether it’s a maternal request CS as opposed to emergency or planned due to medical advice.

Peter:  Only if this is recorded accurately – but indication is recorded.


Peter:  As before – this has been hugely helpful. Some of these ideas we have thought of, but lots we haven’t. So a huge thanks for being so generous with your contributions. We will take all these thoughts away and fortunate our plans in much more detail.

PSG A: There is not going to be one magic bullet to get a diverse number of people to sign up, I think you will need to work hard and use lots of different networks /methods simultaneously.

It will also take time – word of mouth is hugely powerful if you can give it the time to work (6 months – 3 years).


Curious about the Baby Biome Cohort Study and want to know more? Read all about it in our other Q&A sessions with Peter Brocklehurst and Nigel Field where we ask all about it:

Want to know more about Parenting Science Gang? You can find out about what we are up to in the About section of our site, and read our Q&As with lots of different scientists about a massive range of topics that interest parents.

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