Main Article Content
This paper adds rich operational detail to the literature on recruiting older African American women, an underserved and at-risk population, for community-based research. Recruitment was undertaken for a study of cancer screening message contexts; that parent study comprised focus groups and a randomized trial. Social marketing perspectives informed the development of relatively low-cost recruitment strategies. GIS maps steered leaflet distribution and face-to-face outreach to individuals and organizations. African American churches were asked to serve as recruitment intermediaries, and the multiple steps in this process were outlined. The opportunity to participate was announced also through ethnic newspapers and other mass media channels, and the study participation experience itself was enhanced to increase the likelihood that early participants would encourage other women to participate. Recruitment and retention goals were met. In all, 867 women were added to a participant database. Participant reports of initial source of information about the study were kept for the 442 women in the trial phase of the parent study. Retention for a questionnaire mailed 30 days after immediate post-testing was 89%. Most participants said they had heard about the study via word-of-mouth (WOM), but in line with Diffusion of Innovation Theory, yields of WOM and other recruitment techniques fluctuated over time, and the recruitment strategy was adjusted accordingly. The perspectives and experiences described in this paper may help ensure successful recruitment in future community-based trials with older African American women and thus enlarge the arsenal of best practices for reducing gender and racial health disparities.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
2. Chen MS Jr, Lara PN, Dang JH, Paterniti DA, Kelly K. Twenty years post-NIH Revitalization Act: enhancing minority participation in clinical trials (EMPaCT):laying the groundwork for improving minority clinical trial accrual: renewing the case for enhancing minority participation in cancer clinical trials. Cancer. 2014 Apr 1;120 Suppl 7:1091-6. DOI:10.1002/cncr.28575
3. Nápoles AM, Chadiha LA; Resource Centers for Minority Aging Research. Advancing the science of recruitment and retention of ethnically diverse populations. Gerontologist. 2011 Jun;51 Suppl 1:S142-6. DOI:10.1093/geront/gnr019
4. Castillo-Mancilla JR, Cohn SE, Krishnan S, Cespedes M, Floris-Moore M, Schulte G, Pavlov G, Mildvan D, Smith KY, Actg Underrepresented Populations Survey Group. Minorities remain underrepresented in HIV/AIDS research despite access to clinical trials. HIV Clin Trials. 2014 Jan-Feb;15(1):14-26. DOI:10.1310/hct1501-14
5. Yancey AK, Ortega AN, Kumanyika SK. Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006;27:1-28. DOI:10.1146/annurev.publhealth.27.021405.102113
6. Corbie-Smith G, Thomas SB, St George DM. Distrust, race, and research. Arch Intern Med. 2002;162:2458–63.
7. Shavers VL, Lynch CF, Burmeister LF. Racial differences in factors that influence the willingness to participate in medical research studies. Ann Epidemiol. 2002;12:248–56.
8. Shapiro ET, Schamel JT, Parker KA, Randall LA, Frew PM. The role of functional, social, and mobility dynamics in facilitating older African Americans participation in clinical research. Open Access J Clin Trials. 2017;9:21-30. DOI:10.2147/OAJCT.S122422
9. Tanner A, Bergeron CD, Zheng Y, Friedman DB, Kim SH, Foster CB. Communicating Effectively About Clinical Trials With African American Communities: A Comparison of African American and White Information Sources and Needs. Health Promot Pract.
2016 Mar;17(2):199-208. DOI:10.1177/1524839915621545
10. Kreuter MW, Alcaraz KI, Pfeiffer D, et al. Using Dissemination Research to Identify Optimal Community Settings for Tailored Breast Cancer Information Kiosks. J Public Health Manag Pract. 2008; 14(2): 160-169. DOI:10.1097/01.PHH.0000311895.57831.02
11. Alcaraz KI, Weaver NL, Andresen EM, et al. The neighborhood voice: evaluating a mobile research vehicle for recruiting African Americans to participate in cancer control studies. Eval Health Prof. 2001; 34(3):336-48. DOI:10.1177/0163278710395933
12. Aguirre TM, Koehler AE, Joshi A, Wilhelm SL. Recruitment and retention challenges and successes. Ethn Health. 2016 Oct 21:1-9. DOI:10.1080/13557858.2016.1246427
13. Langford AT, Resnicow K, Beasley DD. Outcomes from the Body & Soul Clinical Trials Project: a university-church partnership to improve African American enrollment in a clinical trial registry. Patient Educ Couns. 2015;98(2):245-50. DOI:10.1016/j.pec.2014.10.018
14. Durant RW, Wenzel JA, Scarinci IC, Paterniti DA, Fouad MN, Hurd TC, Martin MY. Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: enhancing minority participation in clinical trials (EMPaCT). Cancer. 2014 Apr 1;120 Suppl 7:1097-105.
15. Levkoff S, Sanchez H. Lessons learned about minority recruitment and retention from the Centers on Minority Aging and Health Promotion. Gerontologist. 2003;43:18–26.
16. Fouad M, Corbie-Smith G, Curb D, et al. Special populations recruitment for the Women’s Health Initiative: Successes and limitations. Controlled Clin Trials. 2004;25: 335–352. DOI:10.1016/j.cct.2004.03.005
17. McCaskill-Stevens W, McKinney MM, Whitman CG, Minasian LM. Increasing minority participation in cancer clinical trials: the minority-based community clinical oncology program experience. J Clin Oncol. 2005 Aug 1;23(22):5247-54. DOI:10.1200/JCO.2005.22.236
18. Singhal A, Cody MJ, Rogers, EM, Sabido M. Entertainment-Education and Social Change: History, Research and Practice. Mahwah NJ:Erlbaum, 2004.
19. Brown SD, Lee K, Schoffman DE, King AC, Crawley LM, Kiernan M. Minority recruitment into clinical trials: experimental findings and practical implications. Contemp Clin Trials. 2012 Jul;33(4):620-3. DOI:10.1016/j.cct.2012.03.003
20. Barnard KD, Dent L, Cook A. A systematic review of models to predict recruitment to multicentre clinical trials. BMC Med Res Methodol. 2010 Jul 6;10:63. DOI:10.1186/1471-2288-10-63
21. Derrick JL, Eliseo-Arras RK, Hanny C, Britton M, Haddad S. Comparison of internet and mailing methods to recruit couples into research on unaided smoking cessation. Addict Behav. 2017 Dec;75:12-16. DOI:10.1016/j.addbeh.2017.06.012
22. Frierson GM, Morrow JR Jr, Vidales A. Successful minority recruitment and adherence in physical activity Internet-based research: the WIN study. J Natl Med Assoc. 2012 Nov-Dec;104(11-12):544-54.
23. UyBico SJ, Pavel S, Gross CP. Recruiting vulnerable populations into research: a systematic review of recruitment interventions. J Gen Intern Med, 2007;22(6): 852-863. DOI:10.1007/s11606-007-0126-3
24. Cabral DN, Nápoles-Springer AM, Miike R, et al. Population- and community-based recruitment of African Americans and Latinos: the San Francisco Bay Area Lung Cancer Study. Am J of Epid. 2003;158(3): 272-279.
25. Liljas AEM, Walters K, Jovicic A, Iliffe S, Manthorpe J, Goodman C, Kharicha K. Strategies to improve engagement of 'hard to reach' older people in research on health promotion: a systematic review. BMC Public Health. 2017 Apr 21;17(1):349. DOI:10.1186/s12889-017-4241-8
26. Johnson NB, Hayes LD, Brown K, Hoo EC, Ethier KA. CDC National Health Report: Leading Causes of Morbidity and Mortality and Associated Behavioral Risk and Protective Factors-United States, 2005-2013. MMWR Surveill Summ. 2014 Oct
27. Belgrave FZ, Abrams JA. Reducing disparities and achieving equity in African American women's health. Am Psychol. 2016 Nov;71(8):723-733. DOI:10.1037/amp0000081
28. Dancy B, Wilbur J., Talashek M, et al. Community-based research: Barriers to recruitment of African Americans. Nurs Outlook. 2004; 52: 234-40. DOI:10.1016/j.outlook.2004.04.012
29. Escobar-Chaves S, Tortolero S, Masses L, et al. Recruiting and retaining minority women: Findings from the Women on the Move Study. Ethn Dis. 2002;12:242–251.
30. Derose KP, Hawes-Dawson J, Fox SA, et al. Dealing with diversity: recruiting churches and women for a randomized trial of mammography promotion. Health Ed Behav. 2000;27:632–48. DOI:10.1177/109019810002700508
31. Markens S., Fox SA, Taub B, et al. Role of Black churches in health promotion programs: lessons from the Los Angeles Mammography Promotion in Churches Program. American J Public Health. 2002; 92:805–10.
32. Goldmon M, Roberson JT, Carey T, et al. The data collection/data distribution center: Building a sustainable African-American church-based research network. Prog Commun Health Partnersh. 2008:2(3):205-224. DOI:10.1353/cpr.0.0023
33. Carter-Edwards L, Fisher JT, Vaughn BJ, et al. Church rosters: Is this a viable mechanism for effectively recruiting African Americans for a community-based survey? Ethn Health. 2002; 7:41–5525. DOI:10.1080/13557850220146984
34. Whitt-Gover MC, Borden SL, Alexander DS, Kennedy BM, Goldmon MV. Recruiting African American churches to participate in research: The learning and developing individual exercise skills for a better life study. Health Promot Pract. 2016 Mar;17(2):297-306. DOI: 10.1177/152483991
35. Kotler P, Zaltman G. Social marketing: An approach to planned social change. J Mark. 1971 Jul;3-12.
36. Rogers EM. Diffusion of Innovations, 5th Edition. New York: Free Press, 2003.
37. U.S. Census Bureau. Census 2000 Summary File 3. http://factfinder.census.gov/servlet/DatasetMainPageServlet?_program=DEC&_submenuId=datasets_1&_lang=en. Accessed Sept 26, 2017.
38. U.S. National Institutes of Health, National Cancer Institute website. Surveillance Epidemiology and End Result (SEER) Fast Stats. http://seer.cancer.gov/faststats/selections.php?series=race,sex for demographic calculator. Accessed Sept 26, 2017.
39. National Medical Association website. https://nmanet.site-ym.com/page/About_Us. Accessed Sept 26, 2017.
40. National Black Nurses Association website. http://www.nbna.org/. Accessed Sept 26, 2017.
41. U.S. Preventive Services Task Force (USPSTF), 2009. Clinical Guidelines: Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med;151:716-726. DOI:10.7326/0003-4819-151-10-200911170-00008
42. Centers for Disease Control (CDC) website. BRFSS Prevalence and Trends Data.- Virginia 2010. https://www.cdc.gov/brfss/annual_data/annual_2010.htm. Accessed Sept 26, 2017.
43. Wilbur J, Buchholz SW, Ingram DM, Braun LT, Johnson TJ, Fogg L, Miller AM, Volgman AS, McDevitt J. Effectiveness, efficiency, duration, and costs of recruiting for an African American women's lifestyle physical activity program. Res Nurs Health. 2013 Oct;36(5):487-99. DOI:10.1002/nur.21550
44. Haidich AB, Ioannidis JP. Determinants of patient recruitment in a multicenter clinical trials group: trends, seasonality and the effect of large studies. BMC Med Res Methodol. 2001;1:4.
45. World Council of Churches website. National Baptist Convention USA, Inc., membership statistics. http://www.oikoumene.org/en/member-churches/national-baptist-convention-usa-inc. Accessed Sept 26, 2017.
46. Nichols L, Martindale-Adams J, Burns R, et al. Winter L. Social marketing as a framework for recruitment: illustrations from the REACH study. J Aging Health. 2004 Nov;16(5 Suppl):157S-76S. DOI:10.1177/0898264304269727
47. Sundstrom B. Breaking women’s health taboos: Integrating diffusion of innovations with social marketing. Soc Mark Q. 2014;20(2): 87-102. DOI:10.1177/1524500414525774
48. Brown B, Long H, Gould H, et al. A conceptual model for the recruitment of diverse women into research studies. J Womens Health Gend Based Med. 2000; 9(6): 625-632. DOI:10.1089/15246090050118152