Gaining and sustaining minority participation in longitudinal research projects

African-Americans are often not enthusiastic about participating in Alzheimer disease research due to past exploitation from medical and public health studies. To assure adequate representation from the African-American community, and to investigate the health needs of this population, strategies to recognize the problems and address the issues have been developed. The recruitment approach used existing connections in an urban community using culturally sensitive strategies. These strategies recruited elderly patients from an existing relationship with the Boston University Medical Center Geriatric Service. They built on the researchers' association with a neighborhood health center located in one of the Boston communities and utilized the services of an outreach worker. The outreach worker was from the community, aware of the health care needs of the elderly, and had a relationship with existing elderly community groups. Several methods were used to recruit patients. These included one-on-one discussions, posters, existing relationships with elderly groups, and direct phone calls. To develop trust carefully with the community's elders, multiple trust-building strategies were used. A multifaceted recruitment approach and strong linkages between the research team and the community were essential to successful recruitment and retention of participants.