title: It Could Be a Pearl to You: Exploring Recruitment and Retention of the Program to Encourage Active, Rewarding Lives (PEARLS) With Hard-to-Reach Populations.
abstract: OBJECTIVE
  We partnered with 3 social service organizations to identify hard-to-reach populations, barriers to reach, and strategies for improving recruitment and retention for Program to Encourage Active, Rewarding Lives (PEARLS), a home-based depression-care management program for elders.
  
  
  METHODS
  We conducted semistructured interviews with staff and former PEARLS participants. All interviews were transcribed verbatim and thematically analyzed.
  
  
  RESULTS
  Veterans, African Americans, Filipino men, other immigrants and English-language learners, old-older adults, rural communities, and people with limited education were identified as hard to reach. The themes of trust, cultural appropriateness, meet them where they are, and framing and reframing, cut across barriers to participation in PEARLS and approaches for overcoming these barriers.
  
  
  CONCLUSIONS
  Research findings will be used to inform technical assistance activities with PEARLS providers, changes to PEARLS program and training materials, and future PEARLS research activities.
authors.affiliation: Health Promotion Research Center, University of Washington School of Public Health, Seattle. lesles@uw.edu.
authors.forename: Lesley
authors.initials: L
authors.lastname: Steinman
authors.affiliation: Health Promotion Research Center, University of Washington School of Public Health, Seattle.
authors.forename: Kristen
authors.initials: K
authors.lastname: Hammerback
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle. Harborview Medical Center, University of Washington Medical Center, Seattle.
authors.forename: Mark
authors.initials: M
authors.lastname: Snowden
mesh_terms: D001741:Black or African American / Q000523:psychology; D000368:Aged; D002986:Clinical Trials as Topic / Q000523:psychology*; D054521:Cultural Competency; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D018579:Patient Selection; D036301:Qualitative Research; D012424:Rural Population; D035502:Trust; D014728:Veterans / Q000523:psychology
keywords: Implementation; Mental health; Reach; Recruitment; Retention; Underserved