title: Using mail to reach patients seen at an urban health care facility.
abstract: Urban American Indians/Alaska Natives (AI/ANs) are highly mobile, and little is known about ways to include them in research or clinical activities. We evaluated postal mailings as a means of reaching patients seen at an urban Indian health care facility (60% of whom were AI/AN) and identified factors associated with receipt of mail. As part of a clinical trial, a Native art calendar was sent via first class mail to 5,633 clients seen at the urban Indian clinic during the prior two years. A multi-step address verification process was conducted, including telephone contacts, Web searches, and in-person visits. Logistic regressions examined the association of client characteristics with accurate addresses. Based on initial mailings and in-person location efforts, we estimated that only 61% of clients actually received the calendars. The multi-step address verification process was significantly less likely to identify working addresses for clients who were AI/AN and clients who were seen more than 3 months before the study. Reaching urban AI/ANs for research activities and health care is difficult. Innovative strategies are needed to locate this highly mobile and understudied population.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Duffy
authors.forename: Jack
authors.initials: J
authors.lastname: Goldberg
authors.forename: Dedra
authors.initials: D
authors.lastname: Buchwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011177:Postal Service; D014481:United States; D016549:United States Indian Health Service / Q000458:organization & administration*; D019037:Urban Health Services / Q000458:organization & administration*