When conducting research on understanding and mitigating health inequities specific to Black families during pregnancy, recruitment and retention can be especially challenging. A group of Michigan-based researchers have conducted several studies that only include Black women.
“Through our experience, we feel that we have gained knowledge on successful recruitment and retention [tactics]. It is important to share these [tactics] with others in order to continue to include people of color in research and make research more generalizable and representative of different populations,” says Sarah Vaughan, PhD, MPH, a research associate in the department of epidemiology and biostatistics at Michigan State University College of Human Medicine.
Recently, Vaughan and colleagues authored a paper outlining effective approaches to recruit and retain pregnant Black women for a study of preterm birth.1 They reported tactics that worked on the participant level (matching recruiters by gender and race when possible), the clinical level (prioritizing clinical care over research activities), and protocol level (maintaining a wide enrollment window and compensating participants for their time).
In addition to their primary function of making sure the proposed research is safe and ethical, IRBs should consider how the research affects the community with which investigators want to engage.
“It is important that the research portrays positive feelings within and about the community, rather than negative attitudes. This is especially important for pregnant participants, as there is often ‘mother blaming’ when there are complications with a pregnancy,” Vaughan says.
Overall, the research should be positive for the community participating. Vaughan says investigators should think about the questions they are asking and to whom those questions apply.
“For example, we don’t include white women in our studies because it is well-documented that health disparities surrounding pregnancy exist between white women and women of color,” Vaughan explains. “We want to know what is affecting birth outcomes specifically in the Black community because that’s where the interventions will need to be implemented in order to improve outcomes.”
Additionally, the aim of the research should appeal to the engaged population. “The research should address issues that are important, on a personal level, to the population being studied,” Vaughan says.
One of the most successful tools to recruit African American women in clinical trials is “visiting minority communities, speaking with community leaders, and building relationships,” according to Christina Brennan, MD, vice president of clinical research at the Feinstein Institutes for Medical Research in Manhasset, NY.
Working with churches or attending community events can build trust within the neighborhood. “As researchers and clinicians, we need to show our commitment to these communities,” Brennan says. “Being visible, sharing educational materials, and being a part of our neighbors’ everyday lives is key.”
Translating study materials, advertisements, and brochures into the predominant languages in the community is helpful.
“One other often-overlooked approach to reach diverse communities is to deploy culturally concordant staff — for example, Hispanic staff in Hispanic-dominant communities,” Brennan says.
Researchers also must address financial assistance. “This has demonstrated the ability to improve trial equity and participation,” Brennan says.
When designing trials, investigators should select trial sites based on the geographical distribution of ethnic/racial minority patients and physicians.
“It all goes back to trust, communication, education, and building a presence within the community,” Brennan says.
REFERENCE
- Vaughan SE, Misra DP, Wong AC, et al. Successful recruitment strategies for engaging pregnant African American women in research. West J Nurs Res 2022;44:94-100.