Objective: The purpose of this paper is to present a review of the empirical literature on recruitment and retention of racial/ethnic children, adolescents and families. Facilitators and barriers to successful recruitment and retention in research will be addressed for this population. Racially/ethnically diverse children, adolescents, and their families are rapidly growing segment of the population (U. S. Bureau of Census, 2000). Growing acceptance of health disparities within the diverse racial/ethnic populations, NIH ethical guidelines, and increasing evidence of cultural, racial and ethnic differences challenge investigators to spend more time planning and evaluating their recruitment and retention strategies. Research designs must reflect an understanding of the cultural context and its' influence on beliefs, values and expectations of adolescents from their point of view (NINR, 1993; Peterson & Sterling, 1999; Villarruel, 1999). While all populations experiencing health distress or disease of any kind may be labeled vulnerable, historically, racial/ethnic groups have been more vulnerable to the negative conduct and outcomes of research. Hence, members of these groups are more cautious and less willing to engage in research.
Findings: Empirical evidence suggests promising strategies for recruiting and retaining children, adolescents and families in research studies. Focus group interviews were used by Jones and Broome(2000) to obtain perspectives of adolescents in order to identify specific incentives, conditions , strategies and investigator characteristics adolescents viewed as necessary to recruit and retain themselves and other adolescent in a year-long intervention study. The findings of that study suggest that some of the factors identified as important for recruitment of adolescents were also equally important for retention (e.g. straightforward honest communication, autonomy, explanation of benefits, desire to learn, opportunities for relationships, involvement of other peers, and incentives, such as fun, food, and money. Holder, Turner-Musa, Alleyne, Kobrin, Simmens, Cruz, & Reiss (1998) discuss a multisystem recruitment approach to engage African Americans in research including the need for: 1. poistive beliefs and experiences, trust in professionals and institutions, 2. protection of family members, 3. bonding and shared beliefs with health care team about the research, 4. morale and empathy in members of the research team (i.e. ability to interact with families), 5. unrealistic expectations, and 6. fears. Their research teams used a combination of three strategies: Define and engage families, engage health care, build and maintain skills and morale of research staff. Fitzbgibbon, Prewitt, Blackman, Simon, Luke, Keys, Avellone, Singh (1998) found that differing demographics between populations of two African American groups with comparable cardiovascular disease necessitated the use of different recruitment and retention strategies including direct presentation, telephone recruitment and neighborhood canvassing. These investigators concluded that researchers studying racial/ethnic populations, must be willing to spend the time to develop successful, culturally sensitive strategies. Successful recruitment requires strategies tailored to the needs, experiences and environment of the target group. While these efforts may be labor-intensive they are often successful (Fitzbgibbon, Prewitt, Blackman, Simon, Luke, Keys, Avellone, Singh,1998). Examples from two community-based research studies conducted by the author will be used to illustrate concepts relevant to recruitment and retention of children and adolescents. These and other issues related to gaining access, specific researcher-participant relationship issues (i.e. culture, communication, researcher/team biases), ethics and informed consent, developmental and disease specific considerations will be discussed in relation to development and implementation of practical strategies to recruit and retain racially/ethnically children, adolescent, & families.
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