title: Cultural and ethnic barriers in conducting research. Factors influencing menarche in the United Arab Emirates.
abstract: OBJECTIVE
  The objective of this cross sectional survey was to study the feasibility of conducting research on issues related to physical and sexual maturation in a predominantly Islamic society and to identify the factors influencing menarche in this multi ethnic community.
  
  
  METHODS
  This study was conducted in Al-Ain, United Arab Emirates (UAE) between January 1999 through to February 1999. Fifteen female secondary schools located in different geographical regions in Al-Ain were chosen in consultation with the District Education Department. All girls aged 12-16-years were selected. Information regarding whether they had attained menarche including month and the year, age at menarche and the factors influencing it such as height and weight, diet, physical activity were gathered. Univariate and multiple linear regressions were used in analysis.
  
  
  RESULTS
  Of the 1500 questionnaires distributed, 1416 questionnaires were returned but only 890 had the required information and were used in the analysis. Ninety-three (10.4%) had not attained menarche and as expected these girls were younger (p<0.0001) than those who had attained menarche. Mean age at menarche was 12.68 (SD 1.27) years. In the univariate analysis UAE nationality, vegetarians (p=0.001), higher income group (p=0.008), low body weight (p=0.009) and a diagnosis of anemia (p<0.05) in the year before menarche were all positively associated with the age at menarche. Only anemia achieved borderline significance (p=0.056) in multivariate analysis and no other variables were significant.
  
  
  CONCLUSIONS
  This study highlights the difficulties of conducting research on issues considered to be sensitive by the community and provide data on factors influencing menarche in a multi ethnic community.
authors.affiliation: Department of Public Health and Epidemiology, Southend Primary Care Trust and University of Cambridge, England.
authors.forename: Padmanabhan
authors.initials: P
authors.lastname: Badrinath
authors.forename: Saad
authors.initials: S
authors.lastname: Ghazal-Aswad
authors.forename: Daniel
authors.initials: D
authors.lastname: Parfitt
authors.forename: Nawal
authors.initials: N
authors.lastname: Osman
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D035843:Biomedical Research; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007514:Islam; D008572:Menarche / Q000208:ethnology*; D015999:Multivariate Analysis; D012068:Religion and Medicine; D012529:Saudi Arabia; D012741:Sexual Maturation; D011795:Surveys and Questionnaires