Recruitment of New Immigrants Into a Randomized Controlled Prevention Trial: The Live Well Experience

Abstract

Minority populations are hard to reach with prevention interventions because of cultural and logistical barriers to recruitment. Understanding how to overcome these barriers is pertinent to reducing the elevated burden of obesity within these underserved communities. To inform this literature gap, we explore the processes and outcomes of recruitment for Live Well-a randomized controlled obesity prevention intervention targeting new immigrant mothers and children from Brazil, Latin America, and Haiti who were residing in the greater Somerville, MA area. We employed community-based participatory research principles to develop and implement five culturally-adapted recruitment activities (posters and flyers, media announcements, church outreach, participant referrals, and community organization partnerships) and tracked enrollment for the total and stratified samples of 406 dyads (37% Brazilian, 29% Latino, 33% Haitian). We describe how strategic partnerships were built and sustained within the intervention community, and detail the key adjustments that contributed to our success. Ultimately, community organization partnerships and participant referrals enrolled a collective majority of participants (34% and 25%, respectively); however, stratified analyses revealed variation by ethnicity: Haitian immigrants responded best to ethnic-based media announcements (44%), whereas Latino and Brazilian immigrants were most responsive to community organization outreach (45% and 38%, respectively). Implications from our findings enhance the literature on recruiting hard-to-reach communities into prevention research: some less integrated communities may respond more to grassroots activities with direct engagement, whereas communities with more social capital may be more responsive to top-down, community-wide collaborations. Furthermore, we suggest that strategic and trusting partnerships are key facilitators of recruitment, and future researchers must understand communities' culture and social networks when building relationships. Our analyses provide rare insight into best practices to overcome specific cultural barriers to recruitment which future investigators can use to better reach underserved communities with prevention research.

Keywords: Community-based participatory research; Immigrants; Obesity prevention; Randomized controlled trial; Recruitment; Underserved.