Blumenthal D S, Sung J, Coates R, Williams J, Liff J
Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310-1495, USA.
Health Serv Res. 1995 Apr;30(1 Pt 2):197-205.
Recruiting and retaining subjects for longitudinal prevention trials is challenging. The inherent difficulties are compounded when the trial is to take place in a low-income minority community, since prevention is a low priority among residents of such communities, and research is viewed with suspicion. We present our experiences in attempting to recruit and retain low-income black women living in inner-city Atlanta for a trial of an educational intervention to promote screening for cancer. The intervention was conducted in the home by trained lay health workers. We found that recruitment was more successful when we recruited directly from the community than when we recruited from the patient registry of a primary health care center. The attrition rate over an 18-month period was high. Among members of the intervention group, those retained in the study tended to be wealthier and better educated and were more likely to be married and employed than those who dropped out. It seems probable that women of lower socioeconomic status found our intervention to be intrusive or burdensome. Among the controls, socioeconomic factors did not discriminate between those who completed the study and those who did not; loss to follow-up in this group was associated only with younger age. In conducting research of this type in low-income minority communities, special attention must be given to issues of recruitment and retention if the validity of the study is to be preserved.
为纵向预防试验招募并留住受试者具有挑战性。当试验要在低收入少数族裔社区进行时，固有的困难会更加复杂，因为预防在此类社区居民的优先事项中处于较低位置，而且研究也遭到怀疑。我们介绍了我们在试图为一项促进癌症筛查的教育干预试验招募并留住居住在亚特兰大市中心的低收入黑人女性时的经历。该干预由训练有素的非专业健康工作者在受试者家中进行。我们发现，直接从社区招募比从初级医疗保健中心的患者登记册招募更成功。在18个月期间的损耗率很高。在干预组的成员中，留在研究中的人往往比退出的人更富有、受教育程度更高，而且更有可能已婚并有工作。社会经济地位较低的女性似乎觉得我们的干预具有侵扰性或负担过重。在对照组中，社会经济因素在完成研究的人和未完成研究的人之间没有起到区分作用；该组的失访仅与年龄较小有关。在低收入少数族裔社区进行此类研究时，如果要保持研究的有效性，就必须特别关注招募和留住受试者的问题。
