Recruitment strategies for minority participation: challenges and cost lessons from the POWER interview.
BACKGROUND
The importance of recruiting and retaining women from diverse populations is well recognized; however, the recruitment process often presents greater challenges at higher costs than initially anticipated.


OBJECTIVE
To describe recruitment strategies and costs from a study evaluating women's preferences regarding tamoxifen use for primary prevention of breast cancer.


METHODS
Description and analysis of recruitment strategies, outcomes, and costs for a cross-sectional interview study.


METHODS
University hospital and community sites.


METHODS
932 racially and ethnically diverse women respondents, of whom 771 completed the screening process (aged 27-87).


METHODS
Women were recruited and screened by using the Breast Cancer Risk Assessment Program (BCRA version 1, National Cancer Institute). Eligibility required an estimated five-year breast cancer risk of at least 1.7%. Recruitment goals targeted a high percentage of ethnic minorities.


METHODS
Recruitment strategies included direct mail, flyers, newspapers, media advertising, and community outreach.


RESULTS
Of the 771 screened women, 341 (44%) met eligibility criteria and 255 (33%) completed interviews (76.9% White, 10.6% Latina, 7.0% Asian, 3.9% African American, 1.6% Native American). Recruitment costs averaged US $113/screened participant. Direct mail and community contact yielded the largest number of participants (312 screened, 205 eligible). Radio advertising provided few participants (one screened, one eligible) at high cost.


CONCLUSIONS
Recruiting an ethnically diverse sample presented multiple challenges. We recommend that future studies budget adequately for recruitment time and costs, develop ongoing relationships with key community leaders, evaluate recruitment strategies closely, and report detailed recruitment findings to the research community.
Keyzer
Janet Fulton
JF
Center for Health Services Research in Primary Care, University of California, Davis, Sacramento, CA 95817, USA. janet.keyzer@ucdmc.ucdavis.edu
Melnikow
Joy
J
Kuppermann
Miriam
M
Birch
Stephen
S
Kuenneth
Christina
C
Nuovo
Jim
J
Azari
Rahman
R
Oto-Kent
Debra
D
Rooney
Mairin
M
D000328:Adult; D000329:Advertising; D000368:Aged; D000369:Aged, 80 and over; D016588:Anticarcinogenic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000517:prevention & control; D002140:California; D003159:Community-Institutional Relations; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008913:Minority Groups; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D018579:Patient Selection; D011177:Postal Service; D012106:Research / Q000191:economics / Q000458:organization & administration*; D013629:Tamoxifen / Q000627:therapeutic use
D016588:Anticarcinogenic Agents; D013629:Tamoxifen