Recruiting and retaining healthcare sites for research studies

Recent research has focused on characteristics of the healthcare environment that contribute to health disparities for racial/ethnic minorities and low-income individuals such as: structural barriers within the healthcare system, patient-provider communication problems, and cultural competence and/or cultural sensitivity issues. Training providers to deliver culturally sensitive healthcare will reduce health disparities. Although it is clear that providers, office staff, and administrators must all be invested in addressing contributors to health disparities, there is little research on facilitating involvement of healthcare sites in such initiatives. The present paper identifies challenges and recommendations for recruiting healthcare sites for health disparities research. The nationally-recruited healthcare sites included hospitals, health departments, community healthcare centers, and private clinics. The research participants were adult patients, providers, and office staff members. National organizations, organizations that provide healthcare services to specific populations, and collaborators in health sector fields were asked to post information about the study, and to identify potential sites. The posted information outlined the study purpose, participation benefits, and contact information for participation. Participation for sites involved identifying a data collection coordinator (DCC) to: identify community and/or staff members as data collectors (DCs). DCs recruited patient participants, disseminated questionnaires to participants, and returned all completed questionnaires to the researchers. All DCCs and DCs were trained by the researchers via phone. All participants were compensated via money orders. Of the 665 sites who were interested: 10.5% confirmed participation, 20.3% declined confirmed participation, and 69.2% were unresponsive. Recruitment barriers included: disinterest among site administrators (30%), time-consuming IRB approval (61%), and lack of DCs (46%). Retention barriers included: inability to meet data collection deadlines (100%), non-response to communication attempts (78.3%), and complaints regarding questionnaire length (100%). Fostering a relationship with the site administrators and staff members via conference calls and email greatly facilitated obtaining IRB approval and site involvement. Due to site input via constant correspondence, the questionnaires were shortened and translated resulting in more accessible and linguistically appropriate materials. Empowering sites in all aspects of planning and providing culturally sensitive materials aided communication and ultimately successful study completion. With the commitment of sites, a clinical tool inventory will be developed where patients can give feedback on what they find is most important to their healthcare experience, thus customizing culturally sensitive healthcare and ultimately reducing health disparities.