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Presented by Connie L. Jacobs, LMSW

Factors Impacting Recruitment & Retention of African American Women in Breast Cancer Intervention Study. Presented by Connie L. Jacobs, LMSW. Objectives. Increase minority participation in clinical trials

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Presented by Connie L. Jacobs, LMSW

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  1. Factors Impacting Recruitment & Retention of African American Women in Breast Cancer Intervention Study Presented by Connie L. Jacobs, LMSW

  2. Objectives • Increase minority participation in clinical trials • Explore culturally competent approaches to recruit and retain African American women in clinical trials • Analyze factors impacting low retention rate • Address implications for future research

  3. Overview of A Nu-Life Study • Nutrition intervention study • Designed to examine effect of low fat, high fiber diet on breast cancer prevention • Focused on young pre-menopausal African American women

  4. Eligibility Criteria • African American women between 25 to 45 years old • Reside in Houston Metropolitan area • Not pregnant or taking birth control or hormonal therapy • Have regular monthly menstrual cycle • Have not undergone menopause • No personal history of diabetes or heart disease and no cancer diagnosis

  5. Breast Cancer Data References: American Cancer Society Cancer Facts & Figures for African Americans 2007-2008.

  6. Importance of Nu-Life Study • Breast cancer is the second leading cause of death among African American women • Pre-menopausal African American women have a higher incidence and death rate from breast cancer than women from any other ethnic group

  7. Study Design of Nu-Life • Focus Groups – Recruitment materials and nutrition perceptions • Study Recruitment – involved 3 phases • Study Randomization – (164 AA women) • Intervention Group – 27 nutrition classes (eating habits & cooking) • Control Group – 5 nutrition classes (ACS guidelines for cancer prevention) • Baseline, 6 & 12 month blood samples and body measurements taken on all participants

  8. Benefits to Participants • Increased knowledge about health, breast cancer awareness and detection • Free nutrition classes for one year • Accessibility to mammogram and pap smear as deemed medically appropriate • Informed of clinical trials • Monetary incentive upon completion

  9. A Nu-Life Recruitment Fliers

  10. Community Support of Recruitment Efforts • Churches • Health Fairs • Sororities • Civic Club Meetings • Local Cancer Organizations • Sister’s Network • Minority Physicians’ Groups • Minority Owned Businesses • Local Colleges/Universities

  11. Recruitment Methods

  12. Correlation of Recruitment Method versus Age of Participant • Recruitment efforts utilizing mass media were the most effective method regardless of age of participant • Distribution of flyers/brochures was an equally effective recruitment method among all participants • Community events were slightly more appealing to participants over 36 years of age

  13. Correlation of Recruitment Method versus Education of Participant • Mass media was most effective recruitment method for participants regardless of educational level • Community events were more effective with participants with high school education • Flyer/brochure distribution was slightly more effective than community events with participants with more than high school education

  14. Correlation of Recruitment Methods versus Income of Participant • Mass media was most effective method regardless of income of participant • Flyer/brochure distribution was slightly more effective for participants with income of less than 50K • Community events were equally effective as flyer/brochure distribution for participants with income greater than 50k

  15. Factors Contributing to Low Retention Rate • Pregnancy • Financial issues • Multiple responsibilities related to family and work demands • Physical and emotional fatigue • Forgetfulness • Inclement weather conditions

  16. Challenges of A Nu-Life • Recruitment and Retention • Study Population • Requirement of Blood Samples

  17. Discussion • Despite incorporating culturally competent approaches, creating trusting environment, incentives, flexible scheduling and frequent follow-up, study retention was lower (54%) than expected (75%)

  18. Implications for Future Research • Consider multiple factors impacting recruitment and retention and how this may affect participants remaining in study • Increase monitoring of recruitment and retention • Importance of training all staff on anticipating potential factors impacting recruitment and retention so these concerns can be proactively addressed • Evaluate the use of procedures that increase participants’ burden • Increase participants’ attachment to the study

  19. AcknowledgementsLovell Jones, PhDAbenaa Brewster, MDTanya Stephens, MDDenae King, PhDRichard Hajek, PhDBeverly Gor, EdDKelly Hodges, MSErica Givens, BSAmerican Cancer Society

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