Strategies for recruiting African-American residents of public housing developments into a randomized controlled trial

Objectives: Two community-based strategies used to implement a clinical trial within public housing developments are discussed: 1) hiring and training community outreach residents (CORE) team members to recruit and retain primarily African-American participants; and 2) conducting health fairs to recruit participants into a trial examining the effects of nicotine gum and motivational interviewing on smoking cessation rates. Design: A cluster randomized, community-based clinical trial. Setting: This trial was conducted in housing developments within a metropolitan area in the Midwest. Participants: Over a period of 20 months, the research team recruited 813 residents, 80% of whom were African-American, to attend health fairs. Of this number, 273 (33%) smokers were identified, and 173 were ultimately enrolled into the study. Results: Attendance at health fairs of public housing development residents ranged from 8%-66% across the housing developments, with an average of 21%. A brief survey was conducted at the health fair to assess smoking status, fruit/vegetable consumption, and physical activity. Conclusions: A number of possible explanations for the relatively high participation rates among a community-based trial include engaging the community in the research process, offering free health screening services, building recruitment incentives for the CORE, and tailoring health education/promotion materials according to the demographic make-up of the developments. Details regarding the development of recruitment strategies that may boost recruitment rates in community-based clinical trials with predominantly ethnic minorities are provided.