Effective Recruitment Strategies Utilized to Examine Dietary Practices of Blacks in New York City in the Midst of the COVID-19 Pandemic

Journal of Racial and Ethnic Health Disparities · 4 authors, 4 centres

AI SUMMARY

FIDELITY 80%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This study describes effective recruitment strategies for engaging Black Americans in a colorectal cancer screening survey in New York City during the COVID-19 pandemic. A two-tiered approach combining consistent community engagement (e.g., barbershops, churches) with street canvassing yielded 504 completed surveys from 807 individuals engaged. Mistrust was less common than expected (0.02% of total engaged), but cultural differences emerged, with Caribbean participants more likely to decline due to comfort with home remedies, highlighting the need for tailored recruitment strategies.

Full summary

3,977 CHARS

**Background:** Black Americans have historically been considered a hard-to-reach population for research, with barriers including medical mistrust, time constraints, and socioeconomic stressors. However, most studies group all Black individuals together, ignoring within-race cultural differences. This paper addresses this gap by examining recruitment for a study on dietary practices and colorectal cancer (CRC) screening behavior among Black New Yorkers during the COVID-19 pandemic. CRC is the third most common cancer in Black men and women, and screening rates remain suboptimal. The study aimed to identify successful recruitment strategies and explore barriers to participation across diverse Black ethnic groups.

**Methods:** The study used a two-part recruitment process. Part one (November 2019–February 2020) involved building relationships with gatekeepers at churches, barbershops, and community centers in neighborhoods with large Black populations. The primary researcher (an African-American woman) established regular visitation schedules, prescreened interested individuals, and had them complete a survey on a tablet (paper copies available). Participants received $5 cash. Part two (late summer 2020, after COVID-19 shutdown) used availability sampling outside high-traffic subway stations (e.g., Atlantic Terminal-Barclays Center, 125th Street) and at community events. Eligibility: adults ≥18 years, self-identified as Black, willing to complete a survey with informed consent. Descriptive statistics were run on 497 subjects (after excluding 7 missing cases). Field notes and informal feedback from gatekeepers and participants were systematically reviewed.

**Key Results:** Total engagement was n=807. Of these, 14% (n=112) declined due to lack of time, 11% (n=85) because the $5 incentive was insufficient, 0.02% (n=23) due to distrust of research institutions, and 0.03% (n=27) due to language barriers. In part one (n=488 engaged), 29 (0.06%) declined due to lack of time, 11 (0.02%) due to distrust, and 24 (0.04%) due to insufficient incentive. After COVID-19 shutdown, of 424 who consented to recontact, 33 (78%) remained interested, 42 (0.099%) could not be reached, and 51 (12%) were uncomfortable coming to the site due to COVID. A total of 368 completed surveys from part one (331 pre-shutdown + 37 newly engaged post-shutdown). In part two (n=319 engaged), 83 (26%) declined due to lack of time, 61 (19%) due to insufficient incentive, 27 (0.084%) due to language barriers, and 12 (0.038%) due to distrust; 136 (43%) completed the survey. The final sample (n=497) was 46.1% male, 52.5% female; 38.4% African-American, 14.5% Caribbean, 9.3% African; 57.7% from Manhattan, 35.8% from Brooklyn; 23.1% aged 55–64, 22.1% aged 25–34; 38.4% had income under $20,999; 66.0% were single; 22.3% had some high school education, 19.5% had a bachelor's degree; 40.6% worked full-time, 40.8% were not working/retired. Mistrust was primarily expressed in Caribbean neighborhoods, where over 50 individuals informally mentioned comfort with home remedies and bush doctors over clinical screening.

**Clinical Implications:** The two-tiered model—combining sustained community engagement with street canvassing—proved effective for recruiting Black participants, even during a pandemic. Mistrust was a minor barrier overall (0.02%), contradicting the common narrative that historical mistrust is the primary obstacle for all Black populations. However, cultural differences emerged: Caribbean participants were more likely to decline due to language barriers and preference for traditional remedies. This suggests that future studies should develop tailored recruitment strategies (e.g., creole-language surveys, culturally sensitive messaging) and consider increasing incentives to address time and compensation concerns. The findings underscore the importance of within-race analysis to avoid overgeneralizing barriers and to improve recruitment equity.

STUDY TYPE

other

SPECIALTY

public_health

SUMMARISED BY

AI pipeline

FIDELITY CHECK

80% · B

ORIGINAL PAPER

PMC10019415

Effective Recruitment Strategies Utilized to Examine Dietary Practices of Blacks in New York City in the Midst of the COVID-19 Pandemic

Journal of Racial and Ethnic Health Disparities

READ THE FULL PAPER

ABSTRACT

Abstract Background Black Americans have long been considered a hard-to-reach population for research studies, whether quantitative surveys or for clinical research. Studies have explored multiple rationales for why Blacks are hard to reach, and the explanations have included historical mistrust, the need to assess the benefits from participating in research, and the expense of spending time participating in research, among others. What has not been explored is the continuous merging of all individuals who identify as Black, particularly when exploring reasonings for a lower interest in participating in research. This paper addresses this issue by investigating the participation rate of individuals identifying as Black in New York City in a study exploring dietary practices as a predictor of colorectal cancer screening behavior. Participants were asked to self-report screening behavior, intent to screen, and dietary and other lifestyle practices. In this analysis, we discuss the unique experience encountered in recruiting Black American participants to participate in this study, particularly amid a worldwide pandemic of COVID-19. Methods The methodology for this study included a systematic review of the literature, a two-part recruitment process, and data analysis. The first part of the recruitment process involved registering individuals who were interested in participating in the study and consented to be contacted and reminded to come to the location where they were recruited on a scheduled date to complete the actual survey. With this part of the recruitment process, we engaged with n = 488 Black men and women between November 2019 and February 2020. The second part of the recruitment process utilized availability sampling outside of NYC subway stations and other high traffic areas as well as large community events. We engaged with n = 319 individuals. Total engagement with n = 807 individuals yielded a sample size for the survey of 504 completed surveys. Results Of the total engaged ( n = 807), 14% declined to participate due to a lack of time, 11% chose not to participate in the study because the incentive was not enough to compensate for their time 0.02% declined due to not trusting institutions conducting research, and 0.03% did not feel comfortable understanding the questions due to a language barrier. We had a sample size of ( n = 504) of the total 807 individuals engaged. Conclusions Recruiting Black Americans into our colorectal cancer study did not prove to be challenging with the two-tiered model of recruitment that involved consistent engagement and having the primary researcher lead this recruitment process. Extracting within race differences is critical in demystifying the conclusion of numerous studies that African Americans specifically are hesitant to participate due to historical mistrust related to tragedies such as the Tuskegee Experiment and numerous other occurrences of African Americans being treated as guinea pigs for the advancement of research. This data contributes knowledge to this field regarding understanding recruitment challenges in the Black population, but further work needs to be conducted. Mistrust in this study primarily came from the individuals engaged in Caribbean neighborhoods, where many expressed more comfort with home remedies and bush doctors when asked about colorectal cancer screening and declined to participate. Innovative communication, qualitative research, and recruitment strategies tailored to the Caribbean population are needed in future studies to address this recruitment challenge that we experienced.

CITATION EXPORT

Cicely K Johnson, May May Leung, Grace X Ma et al.. Effective Recruitment Strategies Utilized to Examine Dietary Practices of Blacks in New York City in the Midst of the COVID-19 Pandemic. Journal of Racial and Ethnic Health Disparities. (2023). https://doi.org/10.1007/s40615-023-01559-9

AUTHORS

4 · 4 CENTRES

Cicely K Johnson, May May Leung, Grace X Ma, Olorunseun O Ogunwobi

1Hunter College Center for Cancer Health Disparities Research, Hunter College of the City University of New York, New York, NY USA
2Nutrition Program, School of Urban Public Health, Hunter College of the City University of New York, New York, NY USA
3Center for Asian Health, Temple University, Philadelphia, PA USA
4Department of Biological Sciences, Hunter College of the City University of New York, New York, NY USA