Methods and strategies to recruit African Americans into cancer prevention surveillance studies

Recruitment of African Americans into health research studies is a major challenge. This report describes a study of different methods and strategies to recruit African Americans into a population-based assessment of cancer behavioral risk factors.

African Americans ages 18 to 70 years in North Carolina (n = 5,000) were randomly selected from the Department of Motor Vehicle rosters and assigned at random to one of five different recruitment strategies based on variations of approach letters (generic versus culturally sensitive) and inclusion, exclusion, or promise of a small incentive. Prospective participants were sent an 11-page questionnaire by mail but could complete it by telephone or Internet as well as by mail.

The overall response rate was 17.5% (747 completed surveys of 4,276 delivered): 655, 84, and 8 by mail, Internet, and telephone, respectively. Among eligible respondents, response was significantly higher for incentive-based than nonincentive strategies; 23.9% for the generic letter plus incentive compared with 15.8% for the generic letter only (P < 0.001). The culturally sensitive letter had little effect on participation (15.8% for both the generic and culturally sensitive letters). The mean age of eligible respondents was 43.9 years, 41% were male, 37% were college graduates, and 75% were overweight/obese. There were no differences in respondent characteristics by assigned recruitment strategy.

Incentive-based strategies yielded the highest survey responses, whereas a culturally sensitive letter did not appreciably increase participation among African Americans in North Carolina. This study adds to what is known about culturally sensitive recruitment strategies for African Americans and challenges their usefulness in survey-based studies.