A Comparison of a Centralized Versus De-centralized Recruitment Schema in Two Community-Based Participatory Research Studies for Cancer Prevention

Abstract

Use of community-based participatory research (CBPR) approaches is increasing with the goal of making more meaningful and impactful advances in eliminating cancer-related health disparities. While many reports have espoused its advantages, few investigations have focused on comparing CBPR-oriented recruitment and retention. Consequently, the purpose of this analysis was to report and compare two different CBPR approaches in two cancer prevention studies. We utilized frequencies and chi-squared tests to compare and contrast subject recruitment and retention for two studies that incorporated a randomized, controlled intervention design of a dietary and physical activity intervention among African Americans. One study utilized a de-centralized approach to recruitment in which primary responsibility for recruitment was assigned to the general AA community of various church partners whereas the other incorporated a centralized approach to recruitment in which a single lay community individual was hired as research personnel to lead recruitment and intervention delivery. Both studies performed equally well for both recruitment and retention (75 and 88% recruitment rates and 71 and 66% retention rates) far exceeding those rates traditionally cited for cancer clinical trials (~5%). The de-centralized approach to retention appeared to result in statistically greater retention for the control participants compared to the centralized approach (77 vs 51%, P<0.01). Consequently, both CBPR approaches appeared to greatly enhance recruitment and retention rates of AA populations. We further note lessons learned and challenges to consider for future research opportunities.

Predictors of Retention Among African Americans in a Randomized Controlled Trial to Test the Healthy Eating and Active Living in the Spirit (HEALS) Intervention

“…11,13,14 CBPR-based recruitment strategies involve community engagement in the development and implementation of culturally appropriate interventions as well as the involvement of members of the target population in all aspects of the research (ie, study design, recruitment, implementation, evaluation, and reporting of findings). 11 Decentralized forms of CBPR involve recruitment of participants into the study and implementation of the intervention by the retention rates as high as 77%, although there were still many "missed" assessment sessions. 11 This finding led to the hypothesis that individuallevel factors might affect retention in RCTs among participants, particularly AAs.…”

“…11 Decentralized forms of CBPR involve recruitment of participants into the study and implementation of the intervention by the retention rates as high as 77%, although there were still many "missed" assessment sessions. 11 This finding led to the hypothesis that individuallevel factors might affect retention in RCTs among participants, particularly AAs. The main objective of this study was to identify individual characteristics associated with study retention among AA study participants.…”

“…Details of the recruitment of participants, using a CBPR approach have been reported previously. 11,13,21 Individuals eligible to enroll in the study were AAs aged ≥30 years with no previous cancer diagnosis, or other unstable comorbidities. Participants in churches assigned to the intervention group engaged in 12 weekly then 9 monthly classes lasting about 1.5 hours per class.…”

“…Individuals were, on average, obese (mean partnering site and not study staff. 11 Factors that have been identified as influencing retention in weightloss trials include age, sex, race, distance to intervention site, cognitive impairment, occupational status, education, socioeconomic status, smoking, physical activity level and depression. 9,[16][17][18][19] A review of 50 studies of AAs in clinical trials identified barriers to retention including lack of a study partner, lower educational level, and lack of compensation.…”

“…Previous studies showed that community-based participatory research (CBPR) approaches lead to increased recruitment and retention rates. [11][12][13][14][15] In fact, use of CBPR approaches to promote health is recognized as a critical strategy in addressing health inequities among socially disadvantaged and Predictors of retention among african americans in a randomized controlled trial to test the healthy eating and active living in the sPirit (heals) intervention Oluwole A. Babatunde, MPH 1,3 ; Swann Arp Adams,PhD [1][2][3] ; Michael D. Wirth, PhD 1,3,4 ; Jan M. Eberth,PhD 1,3 ; Jameson Sofge, MPH 1,3 ; Seul Ki Choi, PhD 3,5 ; Brook E. Harmon,PhD 3,6 ; Lisa Davis, MS 3 ; Ruby Drayton, MS 3 ; Thomas G. Hurley, MS 3 ; Heather M. Brandt, PhD 3,5 ; Cheryl A. Armstead,PhD 3,7 ; James R. Hébert, ScD 1,3,4,8 Introduction: Retention of racial/ethnic minority groups into research trials is necessary to fully understand and address health disparities. This study was conducted to identify participants' characteristics associated with retention of African Americans (AAs) in a randomized controlled trial (RCT) of a behavioral intervention.…”