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BMC Public Health. 2007; 7: 233.
Published online Sep 6, 2007. doi:  10.1186/1471-2458-7-233
PMCID: PMC2020481
Recruitment and retention of low-income minority women in a behavioral intervention to reduce smoking, depression, and intimate partner violence during pregnancy
M Nabil El-Khorazaty,1 Allan A Johnson,2 Michele Kiely,corresponding author3 Ayman AE El-Mohandes,4 Siva Subramanian,5 Haziel A Laryea,6 Kennan B Murray,7 Jutta S Thornberry,8 and Jill G Joseph9
1Statistics and Epidemiology Unit, RTI International, 6110 Executive Blvd., Suite 902, Rockville, MD 20852-3903, US
2Division of Allied Health Sciences, College of Pharmacy, Nursing and Allied Health Sciences, Howard University, Washington, DC 20059, US
3Collaborative Studies Unit, DESPR/NICHD/NIH, 6100 Executive Blvd., Rm 7B05, Rockville, MD 20852-7510, US
4Department of Prevention and Community Health, School of Public Health and Health Services, The George Washington University Medical Center, 2175 K Street, NW, Washington, DC 20037, US
5Division of Neonatology, Georgetown University Hospital, 3800 Reservoir Road NW, Washington D.C. 20007, US
6c/o Allan A. Johnson, Division of Allied Health Sciences, College of Pharmacy, Nursing and Allied Health Sciences, Howard University, Washington, DC 20059, US
76537 Ashby Grove Loop, Haymarket, VA 20169
8Statistics and Epidemiology Unit, Research Triangle InstituteInternational, 6110 Executive Blvd., Suite 902, Rockville, MD 20852-3903, US
9Center for Health Services and Community Research, Children's National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, US
corresponding authorCorresponding author.
M Nabil El-Khorazaty: nek/at/rti.org; Allan A Johnson: ajohnson/at/Howard.edu; Michele Kiely: kielym/at/nih.gov; Ayman AE El-Mohandes: sphaxe/at/gwumc.edu; Siva Subramanian: SUBRAMAS/at/gunet.georgetown.edu; Haziel A Laryea: hlaryea/at/howard.edu; Kennan B Murray: kennan17/at/yahoo.com; Jutta S Thornberry: jps/at/rti.org; Jill G Joseph: JJoseph/at/cnmc.org
Received October 3, 2006; Accepted September 6, 2007.
Abstract
Background
Researchers have frequently encountered difficulties in the recruitment and retention of minorities resulting in their under-representation in clinical trials. This report describes the successful strategies of recruitment and retention of African Americans and Latinos in a randomized clinical trial to reduce smoking, depression and intimate partner violence during pregnancy. Socio-demographic characteristics and risk profiles of retained vs. non-retained women and lost to follow-up vs. dropped-out women are presented. In addition, subgroups of pregnant women who are less (more) likely to be retained are identified.
Methods
Pregnant African American women and Latinas who were Washington, DC residents, aged 18 years or more, and of 28 weeks gestational age or less were recruited at six prenatal care clinics. Potentially eligible women were screened for socio-demographic eligibility and the presence of the selected behavioral and psychological risks using an Audio Computer-Assisted Self-Interview. Eligible women who consented to participate completed a baseline telephone evaluation after which they were enrolled in the study and randomly assigned to either the intervention or the usual care group.
Results
Of the 1,398 eligible women, 1,191 (85%) agreed to participate in the study. Of the 1,191 women agreeing to participate, 1,070 completed the baseline evaluation and were enrolled in the study and randomized, for a recruitment rate of 90%. Of those enrolled, 1,044 were African American women. A total of 849 women completed the study, for a retention rate of 79%. Five percent dropped out and 12% were lost-to-follow up. Women retained in the study and those not retained were not statistically different with regard to socio-demographic characteristics and the targeted risks. Retention strategies included financial and other incentives, regular updates of contact information which was tracked and monitored by a computerized data management system available to all project staff, and attention to cultural competence with implementation of study procedures by appropriately selected, trained, and supervised staff. Single, less educated, alcohol and drug users, non-working, and non-WIC women represent minority women with expected low retention rates.
Conclusion
We conclude that with targeted recruitment and retention strategies, minority women will participate at high rates in behavioral clinical trials. We also found that women who drop out are different from women who are lost to follow-up, and require different strategies to optimize their completion of the study.
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