When conducting research, something that often goes underestimated is the level of difficulty in recruitment of eligible participants. There are additional considerations when engaging minority participants, such as African Americans; particularly that researchers are sensitive to ethnic/cultural/political norms of the participants. By agreeing to participate in research, participants are sharing aspects of their lives with researchers, and it is paramount that research teams remain respectful to any concerns or skepticism that African Americans may have about participating in research. While recruitment of Black participants comes with certain challenges, it can be more challenging still to recruit multiple generations of participants, for example, a grandmother/mother/daughter triad. Developing methods to improve the process of building trusting relationships with minority participants would help to improve not just recruitment rates but retention of participants as well.
This study seeks to evaluate the effectiveness of multiple techniques used to recruit three generations of African American women into a genetics study. In the study, Hypertension and Heredity: Hypertension Genetic Polymorphisms in Three Generations of African American Women, three generations of maternally blood-related women were recruited to examine genetic risks for high blood pressure (hypertension). The principal investigator and research assistants who worked to recruit African American women into the three-generation genetic study were African Americans who lived in a large mid-western urban area. They were knowledgeable about the local health and university systems as well as the social climate and historical treatment of Blacks in a large urban city located in the mid-west. Forty-two triads (Grandmother/Mother/Daughter) of African American women from a larger metropolitan area in the mid-west where heart disease associated with hypertension is the most prevalent cause of death among this population. The average age for grandmothers in this study was 66 years, 42 years for mothers, and 17 years for granddaughters.
Recruiters utilized four major methods of recruitment including the use of 1) advertisements posted throughout the community, 2) local churches, 3) historically black sororities and other social networks, and 4) institution-based participant resource pools (mostly university-based registries that compile lists of local women who have expressed an interest in health-related research).
This study showed that engaging historically Black sororities was particularly successful because many have long histories of legacy, with multiple generations of the same family joining the same sorority. Two, three, or even four generations of women from the same family often attended regular scheduled meetings.
The use of the university-based health registries was more effective in enrolling three-generation families than recruitment via churches and community advertisements, most likely because the registries provided researchers with potential participants who had already expressed an interest in participating in research.
The churches contacted to help with recruitment varied in their preferred methods of disseminating information regarding the study. Some churches invited researchers to speak directly to the congregations, while some churches preferred that only the pastor speak on behalf of the research team, while some churches were only comfortable with the posting of fliers on church bulletin boards. Researchers were aware that they were guests at these facilities and understood that church leaders knew the best method for recruitment in their particular congregation.
The least effective method of recruitment was the posting of flyers in public areas. Either the flyers were placed in areas not frequented by people who were interested in research, or potential participants were skeptical of the offer and did not contact the research office.
Researchers also found it effective to conduct interviews during holidays, when families where scheduled to be together. Further, contacting the grandmother first was beneficial because in many African American families, the grandmother is often seen as the matriarch and head of the family, and therefore, after securing her trust and confidence in the research process, the mother and daughter were more likely to participate.
This study demonstrates the importance of utilizing non-traditional and innovative methods for recruitment of multigenerational participants and also demonstrates effective means of recruitment for African American populations.
Written by Buddy Toth, Visiting Student in Research.