Engaging African American breast cancer survivors in an intervention trial: culture, responsiveness and community

Abstract

Introduction: Younger breast cancer survivors often lead extremely busy lives with multiple demands and responsibilities, making them difficult to recruit into clinical trials. African American women are even more difficult to recruit because of additional historical and cultural barriers. In a randomized clinical trial of an intervention, we successfully used culturally informed, population-specific recruitment and retention strategies to engage younger African-American breast cancer survivors.

Methods: Caucasian and African American breast cancer survivors were recruited from multiple communities and sites. A variety of planned recruitment and retention strategies addressed cultural and population-specific barriers and were guided by three key principals: increasing familiarity with the study in the communities of interest; increasing the availability and accessibility of study information and study participation; and using cultural brokers.

Results: Accrual of younger African-American breast cancer survivors increased by 373% in 11 months. The steepest rise in the numbers of African-American women recruited came when all strategies were in place and operating simultaneously. Retention rates were 87% for both Caucasian and African American women. DISCUSSSION/CONCLUSIONS: To successfully recruit busy, younger African American cancer survivors, it is important to use a multifaceted approach, addressing cultural and racial/ethnic barriers to research participation; bridging gaps across cultures and communities; including the role of faith and beliefs in considering research participation; recognizing the demands of different life stages and economic situations and the place of research in the larger picture of peoples' lives. Designs for recruitment and retention need to be broadly conceptualized and specifically applied.

Implications for cancer survivors: For busy cancer survivors, willingness to participate in and complete research participation is enhanced by strategies that address barriers but also acknowledge the many demands on their time by making research familiar, available, accessible and credible.

Fig. 1

Timeline of activities and accrual. * Note: 1 Posters, PSA, 2 Stopped Caucasian recruitment, Emailed listservs, 3 Tumor registry queries at 7 sites, 9 events, Intramural grant, Meetings with organizations, 4 CRA training