A collaborative approach to the recruitment and retention of minority patients with diabetes in rural community health centers.
BACKGROUND
Recruiting and retaining minorities from rural, community health centers is a challenge. Collaboration between the researchers and health center personnel and activities to enhance trust may improve results.


OBJECTIVE
To describe recruitment and retention strategies and report results of a 12-month clinical trial of a telemedicine-based diabetes self-management intervention, conducted within a rural community health center.


METHODS
Multi-level, multi-staged recruitment process including collaborative planning, data extraction, medical record review, telephone screen, 2 in-person enrollment visits and randomization. Target sample was adults >or=35 years of age with type 2 diabetes, glycated hemoglobin (GHb)>7% with no significant comorbidities to prevent safe participation. Follow-up visits occurred at 6 and 12 months post-randomization.


RESULTS
Of those eligible from medical record review, 65% were African-American(AA)/other and female. Approximately 33% of those successfully contacted by telephone were randomized (n=165), yielding a predominately AA/other (73.9%) and female (74.5%) sample. Among those eligible at the Telephone Screen, a greater percentage of Non-Hispanic Whites (NHW) refused participation than AA/other (54.2% vs 45.8%), while a greater percentage of women refused compared to men (64.4% vs 35.6%). Significant baseline differences were found by ethnicity for education, insurance, transportation and diastolic blood pressure; by gender for income, transportation, weight, and home monitoring of blood glucose. Overall 6 and 12 month retention rates were 90.9% and 82.4%, respectively, with a greater percentage of AA/Other and female participants retained.


CONCLUSIONS
Our collaborative approach was successful in recruiting and retaining ethnically diverse study participants who reside in a rural underserved area of South Carolina. Differences in baseline characteristics and retention by ethnicity and gender were found. Successful translational research must allow for a collaborative approach addressing factors at the level of the community health center, key personnel, and patients in an effort to build trust for the purpose of advancing the science of translating research to practice.
Davis
Richard M
RM
Department of Ophthalmology, University of South Carolina, School of Medicine, Columbia, SC 29203, USA. rdavis@uscmed.sc.edu
Hitch
Angela D
AD
Nichols
Michele
M
Rizvi
Ali
A
Salaam
Muhammad
M
Mayer-Davis
Elizabeth J
EJ
D015190:Blood Glucose Self-Monitoring; D001794:Blood Pressure; D001835:Body Weight; D003151:Community Health Centers / Q000458:organization & administration*; D003299:Cooperative Behavior; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006282:Health Personnel / Q000458:organization & administration; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D010353:Patient Education as Topic / Q000458:organization & administration; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012424:Rural Population; D012648:Self Care / Q000379:methods; D012737:Sex Factors; D012959:Socioeconomic Factors; D017216:Telemedicine / Q000458:organization & administration; D013997:Time Factors; D014186:Transportation