Community Health Worker Perspectives on Recruitment and Retention of Recent Immigrant Women in a Randomized Clinical Trial

Purpose: Based on a strong partnership built over the past ten years, this community-academic research team implemented a cluster-randomized trial designed to test a multi-faceted community health worker (CHW) intervention to promote cancer screening among Korean American (KA) women. The purpose of this paper is to report on the recruitment and retention success and specific strategies used by CHWs.

Methods: We used prescreening forms, participant logs, short CHW surveys, and interview data from focus groups with CHWs. Descriptive statistics and content analysis were used to summarize our findings.

Results: 28 CHWs from 23 ethnic churches screened 782 KA women and enrolled 560 eligible women in the trial (intervention, n=278; control, n=282), with direct and indirect personal and formal contacts within church being the most common recruitment sources utilized. Over the 6-month of intervention period, 31 women dropped from the study, resulting in a 94.5% retention rate. Four focus group interviews were conducted with 23 CHWs. Four themes were identified in relation to recruitment: building on trust and respect, use of formal network at the church, use of personal network, and facilitating non-threatening environment. The themes identified for retention were: trust, realizing benefits, and peer support.

Conclusions: Trust was a key strategy to successful recruitment and retention of KA women and it was the cornerstone for other strategies. CHWs should be ensured of core competencies for practice including recruitment and retention. Qualified and well-trained CHWs can recruit and retain hard-to-reach recent immigrant women in a randomized trial utilizing multiple culturally-sensitive strategies.