Table 3

Recommended Strategies for Recruiting and Retaining Diverse Communities in Research

Views/StrategyAfrican Americans (SOAR-Net)Arab Americans (MetroNet)Chinese Americans (SF Bay CRN)Hispanic Americans (SPUR-Net)Navajo (RIOS Net)
General Views of Research ParticipationImplicit distrust in research enterprise
High level of suspicion in “the system”
Sense that research hasn’t been beneficial
Desire to learn is a potent motivator
Recognition of value of prevention—supports research involvement
Perceive benefits in gaining knowledge and advancing science
Some fear and uncertainty, and concern about scams
Generally positive connotation surrounding research
Desire to help family members and future generations as motivators
Desires to learn about health topics and to help people and communities are motivators
Concern about being mistreated as research participants
Strategy 1: Trust With Targeted PartnersTuskegee study a legacy of distrust (of the government and health research)
Importance of being honest up front and throughout projects
Suspicion of outsiders—need to establish trust
Key community figures (doctors and religious leaders) influential in brokering trust
Credibility of the researcher and/or the research institution important
Leverage trust through doctors or other authority figures
High level of trust in credible doctors and community clinics
Fears about immigration status makes trust building essential
Initial distrust of researchers (historical legacy of abuse)
Visit to communities is imperative to introduce researchers/projects and establish trust
Strategy 2: Relevant Topic and Feasible Study DesignThe same general principles apply across groups:
Community
 Focus projects on specific topics of relevance to community members (eg, diabetes, hypertension)
 Consider community members’ motivations for research participation (eg, desire to learn, advance science, help one’s family)
 Make research participation accessible and convenient to a wide spectrum of community members
Clinical
 Ensure studies are of clinical importance
 Identify clinician allies and collaborate with them
 Clinicians with strong relationships with patients best suited to recruit
 Reduce the burden of participation for clinicians and clinical staff
Strategy 3: A Competent Research TeamTeam members should be relatable people
Transparency in communication is important—research team should be forthcoming with information
Knowing a community member on research team is helpful—people are not as open with strangers
Language ability is important
Staff should not push too hard— people should be allowed to make their own decisions
Staff professionalism is important for ensuring privacy
Recruiters must be fluent unless participants are acculturated
Staff should have good and regular communication with participants
Breaching privacy was a concern when local community residents are part of research team
Local research team member is ultimately held more responsible for the project than the PI
Strategy 4: Tailored Recruitment StrategiesRecruitment should be personalized
Patient navigators can be used to adapt language in study materials and to successfully recruit families
Person-to-person/word-of-mouth recruitment preferred
Sex concordance between recruiters and participants is important— husbands may have to give wives permission
Good bilingual marketing materials are essential
Emphasize family values (highlight benefits of research to family and community)
Tap into social networks (family and community)
Personal touch is important (ie, telephone calls from trusted organizations or contacts)
Easier to recruit from within clinic than off the street (minimizes suspicion)
Oral communications are important—word of mouth or radio advertisements
Pamphlets with pictures are useful
Expectation that researchers participate in local events
Strategy 5: Study ImplementationThe same general principles apply across groups:
Buy-in of clinic staff can influence the success of the study
Have a designated research person to contact when study-related problems arise
Obtain feedback from clinic staff on study processes
Keep clinicians in the loop (even if not actively part of project)
Find out clinic’s approach to recontacting patients
Strategy 6: Tailored Retention StrategiesImportant to maintain relationships with families (through personal calls)
Participants need to see progress/change
Ongoing involvement of leaders is important in interventions
Experiential learning and active participation help keep people engaged
Contact participants regularly and offer practical help
Show participants appreciation and respect
Staff continuity throughout project is important
Staff relationships with participants are important (need to have good and regular communication)
Need alternative contact information (many migrate during year)
Projects may need to be adaptable to local events and instabilities
Inquire about overall health— not just project focus
Strategy 7: Closing the Loop and Sowing the Seeds of Future Research ProjectsNeed to do continuous follow-up, including years beyond the end of the project
Desire for the next generation to know about research results
Make sure results matter and benefit the community
Attend festivals and religious celebrations
Help community members access the university
Important to disseminate research results to maintain one’s reputation
Have an end-of-study event to recognize clinical staff
Highlight Chinese populations’ needs to the government
Desire for progress reports/regular updates
Results need to be disseminated beyond the clinical setting
Help people improve their well-being—including beyond the end of the study
Hold local meetings to present meaning of results
Involve community members in dissemination of materials
  • SOAR-Net = Southwestern Ohio Ambulatory Research Network; SF Bay CRN = San Francisco Bay Collaborative Research Network; SPUR-Net = Southern Primary-care Urban Research Network; RIOS Net = Research Involving Outpatient Settings Network; PI = principal investigator.