Effective recruitment strategies: Experience from the carbohydrate and related biomarkers (CARB) feeding study

B56

Purpose: Individuals from underrepresented minority groups are thought to be difficult to recruit into cancer prevention research trials. This is may be due, in part, to a low level of trust in scientific research, competing demands for time, and limited English proficiency. Using data from a Seattle-based randomized, controlled feeding study, Carbohydrates and Related Biomarkers (CARB), which aims to recruit 88 participants (22 Hispanics and 22 African Americans), we examined strategies for recruiting underrepresented individuals into prevention trials. The overall goal of the CARB study is to understand the relationship between physiologic response to specific dietary patterns and mechanisms related to carcinogenesis. The study aims to recruit two groups of participants; those who are normal weight and those who are overweight; and examine biomarkers of insulin, glucose, IGF1, IGFBP3, leptin, adiponectin, interleukin-6, C-reactive protein and serum amyloid A.
 Methods: Study eligibility criteria were: 1) 18-45 years of age; 2) BMI = 18-24.9 or BMI = 28.0-40.0; 3) no preexisting health conditions; 4) non-smoking; and 5) normal fasting blood glucose (< 100 mg/dl). Participants receive all meals and beverages for two 28-day feeding periods, complete blood draws, urine and feces collections, and complete questionnaires on appetite, depression, mood and satiety. Participants visit the project Human Nutrition Laboratory every weekday evening, where they are fed, weighed, and given breakfast, lunch and a snack for the following day. On Fridays, participants receive food for the entire week-end. Participants were recruited by posting announcements in local newspapers and on email list serves, posting flyers in community organizations, in-person recruitment at community events that targeted Hispanics and African Americans and presentations at ethnic studies classes and student groups at local universities. A compensation of $750.00 is provided upon study completion.
 Results: To date, 521 individuals (all races and ethnicities) have requested study information and 238 (144 females, 91 males) completed a pre-enrollment screening questionnaire. Of those, 36 were Hispanic and 35 were African-American. A total of 126 were determined to be eligible based on screening data (17 were Hispanic and 19 were African-American) and were invited to attend a screening visit. A total of 64 (51%) attended the screening visit (15 Hispanics and 12 African Americans) and to-date 42 (48% of our recruitment goal) have enrolled in the study (6 are Hispanic and 10 are African American). Among those who completed the pre-enrollment screening questionnaire, 72 (30%) individuals were recruited by newspaper advertisements, 61 (26%) by word of mouth, 44 (18%) by flyers or posters, 26 (11%) by in-person recruitment, and 20 (8%) by other strategies. Among African-Americans, the most commonly cited recruitment methods were newspaper announcements (35%) and word of mouth (26%). Among Hispanics, the most common recruitment methods were in-person recruitment (31%) and word of mouth (28%).
 Discussion: Proactive in-person approaches appear to be the most effective methods for successful recruitment of underrepresented populations into prevention studies.