Skip to main content
SpringerLink
Log in

A Comparison of a Centralized Versus De-centralized Recruitment Schema in Two Community-Based Participatory Research Studies for Cancer Prevention

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Use of community-based participatory research (CBPR) approaches is increasing with the goal of making more meaningful and impactful advances in eliminating cancer-related health disparities. While many reports have espoused its advantages, few investigations have focused on comparing CBPR-oriented recruitment and retention. Consequently, the purpose of this analysis was to report and compare two different CBPR approaches in two cancer prevention studies. We utilized frequencies and Chi-squared tests to compare and contrast subject recruitment and retention for two studies that incorporated a randomized, controlled intervention design of a dietary and physical activity intervention among African Americans (AA). One study utilized a de-centralized approach to recruitment in which primary responsibility for recruitment was assigned to the general AA community of various church partners whereas the other incorporated a centralized approach to recruitment in which a single lay community individual was hired as research personnel to lead recruitment and intervention delivery. Both studies performed equally well for both recruitment and retention (75 and 88 % recruitment rates and 71 and 66 % retention rates) far exceeding those rates traditionally cited for cancer clinical trials (~5 %). The de-centralized approach to retention appeared to result in statistically greater retention for the control participants compared to the centralized approach (77 vs. 51 %, p < 0.01). Consequently, both CBPR approaches appeared to greatly enhance recruitment and retention rates of AA populations. We further note lessons learned and challenges to consider for future research opportunities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Freeman, H. P. (2003). Commentary on the meaning of race in science and society. Cancer Epidemiology, Biomarkers and Prevention, 12, 232s–236s.

    PubMed  Google Scholar 

  2. Freeman, H. P. (2004). Poverty, culture, and social injustice: Determinants of cancer disparities. CA: A Cancer Journal for Clinicians, 54, 72–77.

    Google Scholar 

  3. Freeman, H. P., & Chu, K. (2005). Determinants of cancer disparities: Barriers to cancer screening, diagnosis, and treatment. Surgical Oncology Clinics of North America, 14, 655–669.

    Article  PubMed  Google Scholar 

  4. Kerner, J., Guirguis-Blake, J., Hennessy, K., et al. (2005). Translating research into improved outcomes in comprehensive cancer control. Cancer Causes and Control, 16, 27–40.

    Article  PubMed  Google Scholar 

  5. Minkler, M., & Wallerstein, N. (2003). Community-based participatory research for health: From process to outcomes (2nd ed.). San Francisco, CA: Jossey-Bass.

  6. Viswanathan, M., Ammerman, A., Eng, E., et al. (2004). Community-based participatory research: Assessing the evidence. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Pub. No. 04-E022-1 AHRQ Pub. No. 04-E022-1.

  7. Wallerstein, N., & Duran, B. (2010). Community-based participatory research contributions to intervention research: The intersection of science and practice to improve health equity. American Journal of Public Health, 100, S40–S46.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Braun, K. L., Nguyen, T. T., Tanjasiri, S. P., et al. (2011). Operationalization of community-based participatory research principles: Assessment of the National Cancer Institute’s Community Network Programs. American Journal of Public Health, 102(6), 1195–1203.

    Article  PubMed  Google Scholar 

  9. Hebert, J. R., Brandt, H. M., Armstead, C. A., Adams, S. A., & Steck, S. E. (2009). Interdisciplinary, translational, and community-based participatory research: Finding a common language to improve cancer research. Cancer Epidemiology & Biomarkers Prevention, 18, 1213–1217.

    Article  Google Scholar 

  10. Casey, M. M., Call, K. T., & Klingner, J. M. (2001). Are rural residents less likely to obtain recommended preventive healthcare services? American Journal of Preventive Medicine, 21, 182–188.

    Article  CAS  PubMed  Google Scholar 

  11. Moscovice, I., & Rosenblatt, R. (2000). Quality-of-care challenges for rural health. Journal of Rural Health, 16, 168–176.

    Article  CAS  PubMed  Google Scholar 

  12. Nemet, G. F., & Bailey, A. J. (2000). Distance and health care utilization among the rural elderly. Social Science and Medicine, 50, 1197–1208.

    Article  CAS  PubMed  Google Scholar 

  13. Bronstein, J. M., & Morrisey, M. A. (1990). Determinants of rural travel distance for obstetrics care. Medical Care, 28, 853–865.

    Article  CAS  PubMed  Google Scholar 

  14. Coughlin, S. S., Thompson, T. D., Seeff, L., Richards, T., & Stallings, F. (2002). Breast, cervical, and colorectal carcinoma screening in a demographically defined region of the southern U.S. Cancer, 95, 2211–2222.

    Article  PubMed  Google Scholar 

  15. Gamble, V. N. (1993). A legacy of distrust: African Americans and medical research. American Journal of Preventive Medicine, 9, 35–38.

    CAS  PubMed  Google Scholar 

  16. Gamble, V. N. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health, 87, 1773–1778.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Scharff, D. P., Mathews, K. J., Jackson, P., et al. (2010). More than Tuskegee: Understanding mistrust about research participation. Journal of Health Care for the Poor and Underserved, 21, 879–897.

    Article  PubMed  Google Scholar 

  18. Dancy, B. L., Wilbur, J., Talashek, M., Bonner, G., & Barnes-Boyd, C. (2004). Community-based research: Barriers to recruitment of African Americans. Nursing Outlook, 52, 234–240.

    Article  PubMed  Google Scholar 

  19. Wallerstein, N. B., & Duran, B. (2006). Using community-based participatory research to address health disparities. Health Promotion Practice, 7, 312–323.

    Article  PubMed  Google Scholar 

  20. Wallerstein, N. (2006). Commentary: challenges for the field in overcoming disparities through a CBPR approach. Ethnicity and Disease, 16, S146–S148.

    PubMed  Google Scholar 

  21. Cashman, S. B., Adeky, S., Allen, A. J., et al. (2008). The power and the promise: Working with communities to analyze data, interpret findings, and get to outcomes. American Journal of Public Health, 98, 1407–1417.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Fisher, T., Burnet, D., Huang, E., Chin, M., & Cagney, K. (2007). Cultural leverage: Interventions using culture to narrow racial disparities in health care. Medical Care Research and Review, 64, 243S–282S.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Friedman, D. B., Young, V. M., Freedman, D. A., et al. (2012). Reducing cancer disparities through innovative partnerships: A collaboration of the South Carolina cancer prevention and control research network and federally qualified health centers. Journal of Cancer Education, 27, 59–61.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Freedman, D. A., Whiteside, Y. O., Brandt, H. M., et al. (2012). Assessing readiness for establishing a farmers’ market at a community health center. Journal of Community Health, 37, 80–88.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Scarinci, I., Garcia, F. A. R., Kobetz, E., et al. (2010). Cervical cancer prevention: New tools and old barriers. Cancer, 116, 2531–2542.

    PubMed Central  PubMed  Google Scholar 

  26. Adams, S. A., Fleming, A., Brandt, H. M., et al. (2009). Racial disparities in cervical cancer mortality in an African American and European American cohort in South Carolina. Journal of South Carolina Medical Association, 105, 237–244.

    Google Scholar 

  27. Wright, M. S., Brandt, H. M., Corwin, S. J., Friedman, D., & Hebert, J. R. (2008). Assessing psychosocial, cultural, and system-level barriers to colorectal cancer screening among African Americans. Columbia: University of South Carolina, Arnold School of Public Health.

    Google Scholar 

  28. Wilcox, S., Sharpe, P. A., Parra-Medina, D., Granner, M., & Hutto, B. (2011). A randomized trial of a diet and exercise intervention for overweight and obese women from economically disadvantaged neighborhoods: Sisters Taking Action for Real Success (STARS). Contempory Clinical Trials, 32, 931–945.

    Article  Google Scholar 

  29. Sharpe, P. A., Wilcox, S., Rooney, L. J., et al. (2011). Adherence to accelerometer protocols among women from economically disadvantaged neighborhoods. Journal of Physical Activity & Health, 8, 699–706.

    Google Scholar 

  30. Bynum, S. A., Brandt, H. M., Sharpe, P. A., Williams, M. S., & Kerr, J. C. (2011). Working to close the gap: Identifying predictors of HPV vaccine uptake among young African American women. Journal of Health Care for the Poor and Underserved, 22, 549–561.

    Article  PubMed  Google Scholar 

  31. Bynum, S. A., Brandt, H. M., Annang, L., et al. (2011). Do health beliefs, health care system distrust, and racial pride influence HPV vaccine acceptability among African American college females? Journal of Health Psychology. (Published online before print July 8, 2011). doi:10.1177/1359105311412833.

  32. Sharpe, P. A., Burroughs, E. L., Granner, M. L., et al. (2010). Impact of a community-based prevention marketing intervention to promote physical activity among middle-aged women. Health Education & Behavior, 37, 403–423.

    Article  Google Scholar 

  33. Peck, L. E., Sharpe, P. A., Burroughs, E. L., & Granner, M. L. (2008). Recruitment strategies and costs for a community-based physical activity program. Health Promotion Practice, 9, 191–198.

    Article  PubMed  Google Scholar 

  34. Ureda, J. R., Byrd, T. L., Calderon-Mora, J. A., et al. (2011). The use of illustrated story mapping to enhance focus group discussion. Health Promotion Practice, 12, 74–78.

    Article  PubMed  Google Scholar 

  35. McFall, S. L., Ureda, J., Byrd, T. L., Valdes, A., Morales, P., et al. (2009). What is needed for informed decisions about prostate cancer screening: Perspectives of African-American and Hispanic men. Health Education Research, 24, 280–291.

    Article  PubMed  Google Scholar 

  36. De Las Nueces, D., Hacker, K., DiGirolamo, A., & Hicks, L. S. (2012). A systematic review of community-based participatory research to enhance clinical trials in racial and ethnic minority groups. Health Services Research, 47, 1363–1386.

    Article  PubMed Central  Google Scholar 

  37. Shadish, W. (2001). Experimental and quasi-experimental designs for generalized causal inference. Boston: Houghton Mifflin.

    Google Scholar 

  38. Greiner, K. A., Friedman, D. B., Adams, S. A., et al. (2014). Effective recruitment strategies and community-based participatory research: Community networks program centers’ recruitment in cancer prevention studies. Cancer Epidemiology, Biomarkers and Prevention, 23, 416–423.

    Article  PubMed  Google Scholar 

  39. Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27, 1–28.

    Article  PubMed  Google Scholar 

  40. Burns, D., Soward, A. C. M., Skelly, A. H., Leeman, J., & Carlson, J. (2008). Effective recruitment and retention strategies for older members of rural minorities. Diabetes Educator, 34, 1045–1052.

    Article  PubMed  Google Scholar 

  41. Schlueter, D. F., Thompson, W. W., Mason, T. A., Rayton, M., & Arriola, K. J. (2010). A qualitative evaluation of the avon foundation community education and outreach initiative patient navigation program. Journal of Cancer Education, 25, 571–576.

    Article  PubMed  Google Scholar 

  42. Larkey, L. K., Gonzalez, J. A., Mar, L. E., & Glantz, N. (2009). Latina recruitment for cancer prevention education via community based participatory research strategies. Contemporary Clinical Trials, 30, 47–54.

    Article  PubMed  Google Scholar 

  43. Horowitz, C. R., Brenner, B. L., Lachapelle, S., Amara, D. A., & Arniella, G. (2009). Effective recruitment of minority populations through community-led strategies. American Journal of Preventive Medicine, 37, S195–S200.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Hebert, J. R., Wirth, M., Davis, L., et al. (2013). C-reactive protein levels in African Americans: a diet and lifestyle randomized community trial. American Journal of Preventive Medicine, 45, 430–440.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Doctors, patients face different barriers to clinical trials 2001; 1–3. http://www.cancer.gov/clinicaltrials/developments/doctors-barriers0401. Accessed 18 Jan 2008.

  46. Motzer, S. A., Moseley, J. R., & Lewis, F. M. (1997). Recruitment and retention of families in clinical trials with longitudinal designs. Western Journal of Nursing Research, 19, 314–333.

    Article  CAS  PubMed  Google Scholar 

  47. Corbie-Smith, G., Goldmon, M., Isler, M. R., et al. (2010). Partnerships in health disparities research and the roles of pastors of black churches: Potential conflict, synergy, and expectations. Journal of the National Medical Association, 102(9), 823–831.

    PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We wish to acknowledge the contributions of Ms. Ernie Weisner and Ms. Kendrea Knight to participant and church recruitment. The authors also wish to acknowledge the community partners who made significant contributions to the conduct of the study including Maureen Byrd, McLeod Hospital, Cumberland United Methodist Church, Mt. Zion African Methodist Episcopal Church, Monumental Baptist Church, Majority Missionary Baptist Church, Trinity Baptist Church, Levi Park Community Center, and Florence County Parks and Recreation. Funding was provided by the National Cancer Institute, National Institute on Minority Health and Health Disparities (NIMHD) for the HEALS study [R24 MD002769 Hebert, JR (PI)]. The SISTAS study was funded by the National Cancer Institute for the South Carolina Cancer Disparities Community Network-II [U54CA153461 Hébert, JR (PI)]. Dr. Hébert also was supported by an Established Investigator Award in Cancer Prevention and Control from the Cancer Training Branch of the National Cancer Institute [K05 CA136975 Hébert, JR (PI)]. Dr. Wirth’s participation was supported through an ASPIRE-II Grant from the University of South Carolina, Office of Research and by the South Carolina Cancer Prevention and Control Research Network funded under Cooperative Agreement Number 3U48DP001936-01 from the Centers for Disease Control and Prevention and the National Cancer Institute. Ms. Farr’s participation was supported by a Research Supplement to Promote Diversity in Health Related Research from the Center to Reduce Cancer Health Disparities of the National Cancer Institute (3U54CA153461-04S2 PI: Hebert/PD: Farr). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflict of interest

All authors do not have conflicts of interest.

Author information

Authors and Affiliations

  1. College of Nursing, University of South Carolina, Columbia, SC, 29208, USA

    Swann Arp Adams, Sue P. Heiney & Tisha M. Felder

  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Swann Arp Adams, Michael D. Wirth & James R. Hébert

  3. Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Swann Arp Adams, Heather M. Brandt, Michael D. Wirth, Samira Khan, Hiluv Johnson, Lisa Davis, Cassandra M. Wineglass, Tatiana Y. Warren-Jones, Tisha M. Felder, Ruby F. Drayton, Briana Davis, Deeonna E. Farr & James R. Hébert

  4. Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Heather M. Brandt & Deeonna E. Farr

  5. Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Tatiana Y. Warren-Jones

Authors
  1. Swann Arp Adams
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sue P. Heiney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heather M. Brandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael D. Wirth
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Samira Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiluv Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lisa Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cassandra M. Wineglass
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tatiana Y. Warren-Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tisha M. Felder
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ruby F. Drayton
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Briana Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Deeonna E. Farr
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. James R. Hébert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Swann Arp Adams.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adams, S.A., Heiney, S.P., Brandt, H.M. et al. A Comparison of a Centralized Versus De-centralized Recruitment Schema in Two Community-Based Participatory Research Studies for Cancer Prevention. J Community Health 40, 251–259 (2015). https://doi.org/10.1007/s10900-014-9924-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-014-9924-9

Keywords

Search

Navigation