The challenges of recruiting African American subjects and entry strategies used in northeast Ohio.

Abstract: This article focuses on the recruitment of African American subjects because there are wide gaps in health outcomes within African American communities. Historical occurrences have contributed to the distrust of the motives of researchers about the purposes and credibility of research studies. Commonly acknowledged challenges include researchers' lack of sensitivity and understanding of minority subjects (Fujimoto, 1989; El-Sadr & Capps, 1992; Pletsch, Howe & Tenney, 1995). This paper discusses some of the challenges encountered by an African American researcher in North East Ohio in recruiting mothers and adolescent daughters, with and without a child, for a community-based communication intervention entitled: Mission Possible: Parents and Kids Who Listen (Riesch, Tosi, Thurston, Forsyth, Kuenning, & Kestly, 1993). This paper also suggests strategies and makes recommendations for researchers, who must recruit African American subjects. Researchers will need to examine their role in increasing the credibility of research within minority communities and develop innovative recruitment strategies. Key Words: Recruitment of African American Subjects Entry Strategies to recruit African American Subjects Challenges in Recruitment Historically, African Americans have been under represented in research. The National Institute of Health (NIH) Revitalization Act (1993) mandated that African American and other individuals from minority groups be included in research to prevent findings from majority populations being generalized to minority populations (Mastroianni, Faden, & Federman, 1994; DHHS, 1994). NIH requirements insured that no extramural funding would be awarded to bio-behavioral researchers that did not comply with the recruitment of under represented minorities in research. The requirements also stipulated that researchers report annually on gender and race and ethnicity of research participants. The implementation of the Act caused consternation among researchers because of their perceived difficulty in recruiting and retaining minority subjects from all groups (El-Sadr & Capps, 1992; Mastroianni, Faden, & Federman, 1994; Ness, Nelson, Kumanyika & Grisso, 1997). Commonly acknowledged challenges to the recruitment and retention of minority subjects have included researchers' lack of cultural sensitivity and understanding of the targeted population and a generalized distrust of researchers and the research process by minority populations, and their formal and informal leaders (Fujimoto, 1998; El-Sadr & Capps, 1992; Pletsch, Howe & Tenney, 1995). This article focuses on the recruitment of African American subjects because compared to European Americans there are wide gaps in health outcomes within African American communities. The health disparities result in an increase in morbidity and mortality rates among African Americans (Pacquiao, 1995; Murdaugh, 1990; Svensson, 1989). Historical occurrences have contributed to the distrust of the motives of researchers about the purposes and credibility of research studies. For example, most African Americans are aware of the Tuskegee Syphilis Study and its medical neglect of ill African Americans. In that study, researchers deceptively denied African American men treatment that resulted in chronic illness and death, without consideration of the impact of the lack of treatment on their health (Kleinman, Eisenbereg, & Good, 1978; Scott-Jones, 1994). Other examples that fuel the distrust of research are related to community anecdotes about the care and medical treatment of African Americans in hospitals. There is wide spread belief that African Americans are "experimented on" and used as "guinea pigs." The Tuskegee Syphilis Study supports this belief that has resulted in the strong disbelief in the integrity of the medical system. It is believed to be an integral component of the society that has dehumanized and discriminated against them (Jencks & Paul, 1991; Taylor, Chatters, Tucker, & Lewis, R. …