Tuning Clinical Recruitment around Cultural Taboos in a Human Microbiome Study

ABSTRACT

Human microbial communities are bodies of microorganisms that reside in or on different body parts. Importantly, they have been found to affect human health. However, scientific research on human microbial communities has created new challenges for human subject recruitment. First, individuals are asked to collect samples of bodily substances that can be seen as repulsive (e.g. feces and urine). Second, because scientists want to understand how human microbial communities evolve over time, individuals are asked to commit to a regular sample collection for extended periods of time. A longitudinal qualitative study of the work of scientists, physicians, research staff, and study coordinators involved in a human microbiome research project has found that these actors can bypass some aspects of these recruitment and retention challenges through ‘tuning work’. Tuning work is a collaborative process where professionals agree to adjust their practices towards shared goals. Such professionals reconfigure their work practices, personal routines, and the study protocol in an effort to obviate cultural taboos against handling bodily substances. The burden of long-term participation provides fewer opportunities for tuning work for these professionals, however. As such, long-term commitment by human subjects remains a recruitment and retention obstacle.

KEYWORDS:

• Human microbiome
• human subject recruitment
• recruitment practices
• cultural taboo
• fecal habitus
• tuning

Acknowledgements

I am grateful to the reviewers and the editors for their detailed feedback, as well as to Dan McFarland, Woody Powell, John Willinsky, and Karen Cook for their comments on the very first draft. I would also like to thank the members of my wonderful online writing group: Charles Gomez, Benjamin Keep, and Sebastian Munoz-Najar Galvez.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Elina I. Mäkinen is an organizational researcher specializing in collaboration and innovation in the life sciences. Dr. Mäkinen received her Ph.D. in Stanford University’s organizational studies doctoral programme. She was recently appointed as an Associate Professor in the New Social Research Programme at the University of Tampere, Finland.

ORCID

Elina I. Mäkinen http://orcid.org/0000-0003-2340-7252