Barriers and strategies for sustained participation of African-American men in cohort studies.
BACKGROUND
Prostate cancer incidence is about 70% higher among African Americans compared to Whites. Factors associated with this differential remain unclear, although several studies suggest that genetic factors may play a role. Before epidemiologic research can adequately identify factors associated with this differential, we need studies to determine the feasibility of recruiting and retaining African-American men in cohort studies, especially those that collect biological and questionnaire data.


METHODS
We conducted 4 focus group discussions among African-American men aged 40 to 64 years in North Carolina, and an additional group comprised of their partners, using a semi-structured interview protocol (total N=55 subjects). Data were analyzed with QRS NU*DIST to identify themes.


RESULTS
Participants' willingness to participate in cohort studies seemed to be motivated by a perceived risk of prostate cancer. Barriers to participation included mistrust of the research community, poor knowledge of cancer-site specific heterogeneity, anticipated time commitment, and the invasive nature of disease detection procedures. To foster trust and increase disease knowledge, recommended strategies included: partnering with known civic organizations that provide education on risk factors; discussing early signs and symptoms at the point of recruitment; recruiting participants from community clusters; and providing periodic feedback on biologic samples (if collected) to reassure participants of their proper usage.


CONCLUSIONS
Observational cohort studies focused on African-American men are feasible if certain barriers to participation are addressed.
Hoyo
Cathrine
C
Department of Health Education, North Carolina Central University, Durham 27707, USA. hoyo0001@mc.duke.edu
Reid
M LaVerne
ML
Godley
Paul A
PA
Parrish
Theodore
T
Smith
Lenora
L
Gammon
Marilie
M
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D044383:Black People; D015331:Cohort Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D018579:Patient Selection; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016312:Treatment Refusal; D035502:Trust; D001741:Black or African American