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Community-Engaged Approaches for Minority Recruitment Into Clinical Research: A Scoping Review of the Literature

Published:September 28, 2020DOI:https://doi.org/10.1016/j.mayocp.2020.03.028

      Abstract

      Underrepresentation of racial and ethnic minority populations in clinical research persists in the United States, highlighting the unmet ideals of generalizability and equity of research findings and products. Previous systematic reviews exploring various facets of this phenomenon concluded that community engagement with minority groups may effectively promote recruitment and retention, but the ways in which community-engaged approaches have been used for recruitment have not been examined. We performed a scoping review of the literature to identify studies of community-engaged recruitment processes. The search resulted in 2842 articles, of which 66 met inclusion criteria. These articles demonstrated a relatively large literature base of descriptive studies conveying details of community engagement approaches to enhance recruitment of minority research participants. We summarize key aspects of current practices across the spectrum of community engagement. A gap in the literature is the relative lack of the comparative studies among different engagement strategies.

      Abbreviations and Acronyms:

      CAB (community advisory board), CBO (community-based organization), CBPR (community-based participatory research), CEnR (community-engaged research)
      Article Highlights
      • A relatively large number of descriptive studies identified by this scoping review suggest that community engagement approaches can improve the integration of minority populations into clinical trials.
      • The majority of studies engaged diverse community stakeholders in recruitment processes, often through study-specific or long-term community advisory boards.
      • Studies described recruitment activities across the spectrum of community engagement: informing communities, consulting with communities, involving communities, collaborating with communities, and co-leadership with communities.
      • There is a paucity of comparative studies on the effectiveness of the different levels of community engagement for research recruitment of racial and ethnic minority groups.
      Underrepresentation of racial and ethnic minority populations in clinical research has received considerable attention in the United States. Representative participation in research is important to address health inequities and to address gaps in the literature on effective prevention and treatment strategies for minority populations. The 1993 National Institutes of Health Revitalization Act required reporting of racial and ethnic demographic data to the extent that meaningful differences in outcomes may be explored while establishing mechanisms to enhance minority recruitment.

      National Institutes of Health Revitalization Act of 1993: Act to Amend the Public Health Service Act to Revise and Extend the Programs of the National Institutes of Health, and for Other Purposes. Pub L 103-43, 42 USC (1993).

      The US Food and Drug Administration implemented similar standards in 1997.
      Food and Drug Administration Modernization Act (FDAMA) of 1997. US Food and Drug Administration website.
      Despite these mandates, race and ethnicity are typically not reported in clinical trials.
      • Geller S.E.
      • Koch A.R.
      • Roesch P.
      • Filut A.
      • Hallgren E.
      • Carnes M.
      The more things change, the more they stay the same: a study to evaluate compliance with inclusion and assessment of women and minorities in randomized controlled trials.
      When reported, minority groups remain substantially underrepresented.
      • Chen Jr., M.S.
      • Lara P.N.
      • Dang J.H.
      • Paterniti D.A.
      • Kelly K.
      Twenty years post-NIH Revitalization Act: enhancing minority participation in clinical trials (EMPaCT): laying the groundwork for improving minority clinical trial accrual; renewing the case for enhancing minority participation in cancer clinical trials.
      ,
      • Guerrero S.
      • López-Cortés A.
      • Indacochea A.
      • et al.
      Analysis of racial/ethnic representation in select basic and applied cancer research studies.
      These stark differences persist despite willingness to participate in research among racial and ethnic minority groups that is generally comparable to white populations,
      • Katz R.V.
      • Kegeles S.S.
      • Kressin N.R.
      • et al.
      The Tuskegee Legacy Project: willingness of minorities to participate in biomedical research.
      ,
      • Wendler D.
      • Kington R.
      • Madans J.
      • et al.
      Are racial and ethnic minorities less willing to participate in health research?.
      reflecting a host of disproportionate structural barriers to research participation.
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      • Duran N.
      • Norris K.
      A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders.
      In response, there has been considerable research aimed at deriving optimal strategies for minority recruitment to clinical trials. Previous systematic reviews have assessed recruitment strategies for minority populations
      • Nicholson L.M.
      • Schwirian P.M.
      • Groner J.A.
      Recruitment and retention strategies in clinical studies with low-income and minority populations: progress from 2004-2014.
      ,
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      Effective recruitment and retention of minority research participants.
      and underrepresented populations more broadly.
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      Each of these reviews concluded that community engagement with minority groups may effectively promote recruitment and retention.
      Community-engaged research (CEnR) is “a process of working collaboratively with groups of people who are affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being,”
      Centers for Disease Control and Prevention
      Principles of Community Engagement.
      and it can be conceived as an umbrella term to include community participatory and CEnR.
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      • et al.
      Partnerships, processes, and outcomes: a health equity-focused scoping meta-review of community-engaged scholarship.
      The importance of CEnR was underscored by a 2013 Institute of Medicine report that recommended direct incorporation of community voice in all aspects of translational research.
      Committee to Review the Clinical and Translational Science Awards Program at the National Center for Advancing Translational Sciences; Board on Health Sciences Policy; Institute of Medicine
      The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research.
      Different CEnR approaches can be conceived as occurring across a continuum from low levels of engagement (eg, informing a community about an intervention) to co-ownership (eg, all facets of an intervention are co-led by community and academic partners).
      International Association for Public Participation
      IAP2 Spectrum of Public Participation.
      Participatory research approaches tend to involve high levels of engagement through equitable partnerships with community members throughout the research process and include the related disciplines of community-based participatory research (CBPR),
      • Israel B.A.
      • Schulz A.J.
      • Parker E.A.
      • Becker A.B.
      Review of community-based research: assessing partnership approaches to improve public health.
      participatory action research,
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      • Smith D.
      Participatory action research.
      community action research,
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      • Scharmer O.
      Community action research: learning as a community of practitioners, consultants and researchers.
      and community-partnered participatory research,
      • Wells K.
      • Jones L.
      Research" in community-partnered, participatory research.
      among others. A prior systematic review assessed the effectiveness of recruitment within CBPR trials and found that CBPR approaches were effective in increasing minority recruitment to research.
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      • Hacker K.
      • DiGirolamo A.
      • Hicks L.S.
      A systematic review of community-based participatory research to enhance clinical trials in racial and ethnic minority groups.
      Although CEnR is recognized as an important series of approaches for improving minority recruitment and participation in the research process, the ways in which these approaches have been successfully engaged have not been systematically examined. Therefore, we performed a scoping review of the literature to address this knowledge gap.

      Methods

      This scoping review was planned, conducted, and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).
      • Tricco A.C.
      • Lillie E.
      • Zarin W.
      • et al.
      PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation.
      Scoping reviews are a type of knowledge synthesis that “follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps.”
      • Tricco A.C.
      • Lillie E.
      • Zarin W.
      • et al.
      PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation.

       Eligibility Criteria

      In this review, we included articles that discussed recruitment of research participants to clinical research within the United States. Eligible articles must have referred to minority groups explicitly and a community engagement framework for recruitment or retention. No limit on study design was implemented.

       Information Sources and Literature Search

      We developed a literature search strategy in consultation with an expert reference librarian, who conducted the electronic search in March 2018. We searched the following databases: Ovid MEDLINE In-Process and Other Non-Indexed Citations and Ovid MEDLINE 1946 to March 2018; Cochrane Central Register of Controlled Trials; and Scopus 2005 to March 2018. We used a controlled vocabulary supplemented with key words for recruitment of minority research participants to clinical research as well as key words to include the full spectrum of CEnR approaches.

       Selection of Sources of Evidence

      Each item of the literature identified in the database search was screened by 2 independent reviewers in 2 phases. In the first phase, titles and abstracts were examined to exclude nonrelevant studies. Any discrepancies in this first screening phase were automatically deemed as included to avoid missing any relevant articles. In the second phase, the full-text version of each study was screened, taking into account the inclusion criteria. Discrepancies in the second screening phase were resolved by consensus. The screening phases utilized an online standardized and piloted form using DistillerSR software (Evidence Partners). Consistency among reviewers was monitored throughout the process to ensure a robust screening of the identified literature.

       Data Extraction

      Studies that were deemed relevant and included from the screening phase went into the data abstraction phase. The following items were extracted from these studies: study design, study focus (recruitment, retention, or both), study population(s), study setting(s), number of minority research participants recruited, study description, community engagement intervention for minority recruitment, level of community engagement, and major findings from the study. Levels of community engagement (inform, consult, involve, collaborate, co-lead) were adapted from the International Association for Public Participation’s Spectrum of Public Participation,
      International Association for Public Participation
      IAP2 Spectrum of Public Participation.
      variations of which are commonly employed to categorize community engagement more broadly.
      • Arnstein S.R.
      A ladder of citizen participation.
      The data extraction form was developed with consensus among the reviewers supported by methodology expertise and was adjusted in an iterative process. Although risk of bias assessment was built into the data extraction process, we do not report it in this review because nearly all of the included studies were descriptive.

       Synthesis of Results

      Overarching themes of the included studies were synthesized. We grouped studies and summarized them according to level of community engagement, main CEnR recruitment approaches, and key findings. Broad findings from each study were grouped under their respective theme.

      Results

       Search Results

      The search resulted in 2842 articles. Screening of abstracts excluded 2396, and full-text screening excluded an additional 380 articles. This process resulted in 66 articles that met inclusion criteria (Figure).
      Figure thumbnail gr1
      FigurePreferred Reporting Items for Systematic Reviews and Meta-Analyses study flowchart.

       Characteristics of Included Studies

      The vast majority of studies were descriptive (n=62), ie, they documented observations or lessons learned about minority recruitment to clinical research studies. The remaining 4 studies were analytic observational studies or mixed-methods studies of recruitment processes. The studies outlined details of CEnR strategies for recruitment to randomized trials (n=24),
      • Adams S.A.
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      A comparison of a centralized versus de-centralized recruitment schema in two community-based participatory research studies for cancer prevention.
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      • Mitrani V.B.
      Increasing minority research participation through community organization outreach.
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      Recruitment of a rural, southern, predominantly African-American population into a diabetes self-management trial.
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      The AAKOMA Project Adult Advisory Board
      The significance of strategic community engagement in recruiting African American youth & families for clinical research.
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      Recruitment strategies to engage African American men in HIV testing randomized controlled trials in the rural southern United States.
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      Effective recruitment and retention strategies for older members of rural minorities.
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      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
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      Apoyo con cariño: strategies to promote recruiting, enrolling, and retaining Latinos in a cancer clinical trial.
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      Addressing cultural sensitivity in a smoking cessation intervention: development of the Kick It at Swope project.
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      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
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      Case study: community engagement and clinical trial success; outreach to African American women.
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      Latina recruitment for cancer prevention education via Community Based Participatory Research strategies.
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      Recruiting African American churches to participate in research: the Learning and Developing Individual Exercise Skills for a Better Life study.
      observational studies (n=25),
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      Recruiting and retaining indigenous farmworker participants.
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      Recruitment, enrollment and retention of young black men for HIV prevention research: experiences from The 411 for Safe Text project.
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      Developing partnerships and recruiting dyads for a prostate cancer informed decision making program: lessons learned from a community-academic-clinical team.
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      HPTN 061 Study Group
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      • et al.
      Leveraging community-based participatory research capacity to recruit Pacific Islanders into a genetics study.
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      • Mangione C.M.
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      • et al.
      "It takes a village": multilevel approaches to recruit African Americans and their families for genetic research.
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      Successful recruitment and retention of Latino study participants.
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      Lessons learned regarding recruitment to the National African American Alzheimer Disease Health Literacy Program.
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      Overcoming recruitment barriers in urban older adults residing in congregate living facilities.
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      Project Sugar: a recruitment model for successful African-American participation in health research.
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      Methods to optimize recruitment and retention to an exercise study in Chinese immigrants.
      or mixed-methods/qualitative studies (n=2)
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      Experiences and lessons learned in using community-based participatory research to recruit Asian American immigrant research participants.
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      Recruiting Chinese- and Korean-Americans in cancer survivorship research: challenges and lessons learned.
      ,
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      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
      ; 8 articles highlighted lessons learned from recruitment to more than one study,
      • Tiwari T.
      • Casciello A.
      • Gansky S.A.
      • et al.
      Recruitment for health disparities preventive intervention trials: the Early Childhood Caries Collaborating Centers.
      ,
      • Mendez-Luck C.A.
      • Trejo L.
      • Miranda J.
      • Jimenez E.
      • Quiter E.S.
      • Mangione C.M.
      Recruitment strategies and costs associated with community-based research in a Mexican-origin population.
      ,
      • Adderley-Kelly B.
      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
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      • Larios S.
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      Increasing ethnic minority participation in substance abuse clinical trials: lessons learned in the National Institute on Drug Abuse's Clinical Trials Network.
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      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
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      • et al.
      Enrolling minority and underserved populations in cancer clinical research.
      and other studies described the development of a registry (n=4),
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      • Gwyther L.P.
      • et al.
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      Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).
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      • Morris J.C.
      An interdisciplinary outreach model of African American recruitment for Alzheimer's disease research.
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      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
      a community advisory board (CAB) (n=3),
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      • Moua M.
      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
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      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
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      • Bowers B.J.
      A case study of engaging hard-to-reach participants in the research process: Community Advisors on Research Design and Strategies (CARDS)®.
      or multifaceted community infrastructure (n=2)
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      • Chen T.
      • Chung H.
      Engaging Asian Americans for mental health research: challenges and solutions.
      ,
      • Sankaré I.C.
      • Bross R.
      • Brown A.F.
      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      for future recruitment efforts. In this context, studies sometimes used qualitative and/or quantitative approaches to evaluate the recruitment strategies. Several studies noted initial difficulties with minority recruitment that improved after CEnR approaches were used.
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      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Whitt-Glover M.C.
      • Borden S.L.
      • Alexander D.S.
      • Kennedy B.M.
      • Goldmon M.V.
      Recruiting African American churches to participate in research: the Learning and Developing Individual Exercise Skills for a Better Life study.
      ,
      • Wallington S.F.
      • Dash C.
      • Sheppard V.B.
      • et al.
      Enrolling minority and underserved populations in cancer clinical research.
      ,
      • Flores E.
      • Espinoza P.
      • Jacobellis J.
      • Bakemeier R.
      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      Other studies used multiple recruitment strategies and described CEnR approaches as most successful.
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      • Thomas P.
      • Willis L.A.
      • Sutton M.Y.
      Recruitment strategies to engage African American men in HIV testing randomized controlled trials in the rural southern United States.
      ,
      • Farquhar S.
      • de Jesus Gonzalez C.
      • Hall J.
      • et al.
      Recruiting and retaining indigenous farmworker participants.
      ,
      • Mendez-Luck C.A.
      • Trejo L.
      • Miranda J.
      • Jimenez E.
      • Quiter E.S.
      • Mangione C.M.
      Recruitment strategies and costs associated with community-based research in a Mexican-origin population.
      • Ochs-Balcom H.M.
      • Jandorf L.
      • Wang Y.
      • et al.
      "It takes a village": multilevel approaches to recruit African Americans and their families for genetic research.
      • Raymond-Flesch M.
      • Siemons R.
      • Brindis C.D.
      Research and engagement strategies for young adult immigrants without documentation: lessons learned through community partnership.
      ,
      • Lim J.W.
      • Paek M.S.
      Recruiting Chinese- and Korean-Americans in cancer survivorship research: challenges and lessons learned.
      However, only one study compared the effects of different community engagement approaches on recruitment outcomes, finding that incorporating sociocultural values into recruitment was superior to nonsociocultural strategies and that recruitment through community partnerships led to the highest recruitment of target populations.
      • Huffman L.E.
      • Wilson D.K.
      • Kitzman-Ulrich H.
      • Lyerly J.E.
      • Gause H.M.
      • Resnicow K.
      Associations between culturally relevant recruitment strategies and participant interest, enrollment and generalizability in a weight-loss intervention for African American families.
      All of the studies described recruitment efforts; 20 studies described both recruitment and retention of research participants.
      • Adams S.A.
      • Heiney S.P.
      • Brandt H.M.
      • et al.
      A comparison of a centralized versus de-centralized recruitment schema in two community-based participatory research studies for cancer prevention.
      ,
      • Burns D.
      • Soward A.C.
      • Skelly A.H.
      • Leeman J.
      • Carlson J.
      Effective recruitment and retention strategies for older members of rural minorities.
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      • Falcon R.
      • Bridge D.A.
      • Currier J.
      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      • Fischer S.M.
      • Kline D.M.
      • Min S.J.
      • Okuyama S.
      • Fink R.M.
      Apoyo con cariño: strategies to promote recruiting, enrolling, and retaining Latinos in a cancer clinical trial.
      • Hanza M.M.
      • Goodson M.
      • Osman A.
      • et al.
      Lessons learned from community-led recruitment of immigrants and refugee participants for a randomized, community-based participatory research study [published correction appears in J Immigr Minor Health. 2016;18(5):1246].
      • Harris K.J.
      • Ahluwalia J.S.
      • Okuyemi K.S.
      • et al.
      Addressing cultural sensitivity in a smoking cessation intervention: development of the Kick It at Swope project.
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
      ,
      • Johnson D.A.
      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Parra-Medina D.
      • D'Antonio A.
      • Smith S.M.
      • Levin S.
      • Kirkner G.
      • Mayer-Davis E.
      Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medically underserved counties of South Carolina: the POWER study.
      ,
      • Stoy D.B.
      • Curtis R.C.
      • Dameworth K.S.
      • et al.
      The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience.
      ,
      • Vincent D.
      • McEwen M.M.
      • Hepworth J.T.
      • Stump C.S.
      Challenges and success of recruiting and retention for a culturally tailored Diabetes Prevention Program for adults of Mexican descent.
      ,
      • Dreer L.E.
      • Weston J.
      • Owsley C.
      Strategic planning for recruitment and retention of older African Americans in health promotion research programs.
      • Ejiogu N.
      • Norbeck J.H.
      • Mason M.A.
      • Cromwell B.C.
      • Zonderman A.B.
      • Evans M.K.
      Recruitment and retention strategies for minority or poor clinical research participants: lessons from the Healthy Aging in Neighborhoods of Diversity across the Life Span study.
      • Farquhar S.
      • de Jesus Gonzalez C.
      • Hall J.
      • et al.
      Recruiting and retaining indigenous farmworker participants.
      • Fortune T.
      • Wright E.
      • Juzang I.
      • Bull S.
      Recruitment, enrollment and retention of young black men for HIV prevention research: experiences from The 411 for Safe Text project.
      ,
      • Magnus M.
      • Franks J.
      • Griffith S.
      • Arnold M.P.
      • Goodman K.
      • Wheeler D.P.
      HPTN 061 Study Group
      Engaging, recruiting, and retaining black men who have sex with men in research studies: don't underestimate the importance of staffing—lessons learned from HPTN 061, the BROTHERS study.
      ,
      • Redwood D.
      • Lanier A.
      • Kemberling M.
      • Klejka J.
      • Sylvester I.
      • Lundgren K.
      Community-based participatory research in a large cohort study of chronic diseases among Alaska native adults.
      ,
      • Reidy M.C.
      • Orpinas P.
      • Davis M.
      Successful recruitment and retention of Latino study participants.
      ,
      • Taylor-Piliae R.E.
      • Froelicher E.S.
      Methods to optimize recruitment and retention to an exercise study in Chinese immigrants.
      Minority groups recruited included black or African American (n=46),
      • Adams S.A.
      • Heiney S.P.
      • Brandt H.M.
      • et al.
      A comparison of a centralized versus de-centralized recruitment schema in two community-based participatory research studies for cancer prevention.
      • Alvarez R.A.
      • Vasquez E.
      • Mayorga C.C.
      • Feaster D.J.
      • Mitrani V.B.
      Increasing minority research participation through community organization outreach.
      • Andreae S.J.
      • Halanych J.H.
      • Cherrington A.
      • Safford M.M.
      Recruitment of a rural, southern, predominantly African-American population into a diabetes self-management trial.
      • Breland-Noble A.M.
      • Bell C.C.
      • Burriss A.
      • Poole H.K.
      The AAKOMA Project Adult Advisory Board
      The significance of strategic community engagement in recruiting African American youth & families for clinical research.
      • Brown E.J.
      • Thomas P.
      • Willis L.A.
      • Sutton M.Y.
      Recruitment strategies to engage African American men in HIV testing randomized controlled trials in the rural southern United States.
      • Burns D.
      • Soward A.C.
      • Skelly A.H.
      • Leeman J.
      • Carlson J.
      Effective recruitment and retention strategies for older members of rural minorities.
      ,
      • Falcon R.
      • Bridge D.A.
      • Currier J.
      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      ,
      • Hanza M.M.
      • Goodson M.
      • Osman A.
      • et al.
      Lessons learned from community-led recruitment of immigrants and refugee participants for a randomized, community-based participatory research study [published correction appears in J Immigr Minor Health. 2016;18(5):1246].
      • Harris K.J.
      • Ahluwalia J.S.
      • Okuyemi K.S.
      • et al.
      Addressing cultural sensitivity in a smoking cessation intervention: development of the Kick It at Swope project.
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
      • Hood S.
      • Hall M.
      • Dixon C.
      • Jolly D.
      • Linnan L.
      Organizational-l evel recruitment of barbershops as health promotion intervention study sites: addressing health disparities among Black men.
      • Horowitz C.R.
      • Brenner B.L.
      • Lachapelle S.
      • Amara D.A.
      • Arniella G.
      Effective recruitment of minority populations through community-led strategies.
      • Huffman L.E.
      • Wilson D.K.
      • Kitzman-Ulrich H.
      • Lyerly J.E.
      • Gause H.M.
      • Resnicow K.
      Associations between culturally relevant recruitment strategies and participant interest, enrollment and generalizability in a weight-loss intervention for African American families.
      • Johnson D.A.
      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Parra-Medina D.
      • D'Antonio A.
      • Smith S.M.
      • Levin S.
      • Kirkner G.
      • Mayer-Davis E.
      Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medically underserved counties of South Carolina: the POWER study.
      • Slade J.L.
      • Holt C.L.
      • Bowie J.
      • et al.
      Recruitment of African American churches to participate in cancer early detection interventions: a community perspective.
      • Stoy D.B.
      • Curtis R.C.
      • Dameworth K.S.
      • et al.
      The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience.
      ,
      • Whitt-Glover M.C.
      • Borden S.L.
      • Alexander D.S.
      • Kennedy B.M.
      • Goldmon M.V.
      Recruiting African American churches to participate in research: the Learning and Developing Individual Exercise Skills for a Better Life study.
      • Abernethy A.D.
      • Magat M.M.
      • Houston T.R.
      • Arnold Jr., H.L.
      • Bjorck J.P.
      • Gorsuch R.L.
      Recruiting African American men for cancer screening studies: applying a culturally based model.
      • Brewer L.C.
      • Jenkins S.
      • Lackore K.
      • et al.
      mHealth intervention promoting cardiovascular health among African-Americans: recruitment and baseline characteristics of a pilot study.
      • Burroughs A.R.
      • Visscher W.A.
      • Haney T.L.
      • et al.
      Community recruitment process by race, gender, and SES gradient: lessons learned from the Community Health and Stress Evaluation (CHASE) Study experience.
      • Ceasar J.
      • Peters-Lawrence M.H.
      • Mitchell V.
      • Powell-Wiley T.M.
      The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model: an effective tool for engaging urban communities in community-based participatory research.
      • Dennis B.P.
      • Neese J.B.
      Recruitment and retention of African American elders into community-based research: lessons learned.
      ,
      • Dreer L.E.
      • Weston J.
      • Owsley C.
      Strategic planning for recruitment and retention of older African Americans in health promotion research programs.
      ,
      • Ejiogu N.
      • Norbeck J.H.
      • Mason M.A.
      • Cromwell B.C.
      • Zonderman A.B.
      • Evans M.K.
      Recruitment and retention strategies for minority or poor clinical research participants: lessons from the Healthy Aging in Neighborhoods of Diversity across the Life Span study.
      ,
      • Fortune T.
      • Wright E.
      • Juzang I.
      • Bull S.
      Recruitment, enrollment and retention of young black men for HIV prevention research: experiences from The 411 for Safe Text project.
      • Friedman D.B.
      • Johnson K.M.
      • Owens O.L.
      • et al.
      Developing partnerships and recruiting dyads for a prostate cancer informed decision making program: lessons learned from a community-academic-clinical team.
      • Magnus M.
      • Franks J.
      • Griffith S.
      • Arnold M.P.
      • Goodman K.
      • Wheeler D.P.
      HPTN 061 Study Group
      Engaging, recruiting, and retaining black men who have sex with men in research studies: don't underestimate the importance of staffing—lessons learned from HPTN 061, the BROTHERS study.
      ,
      • Ochs-Balcom H.M.
      • Jandorf L.
      • Wang Y.
      • et al.
      "It takes a village": multilevel approaches to recruit African Americans and their families for genetic research.
      ,
      • Rexroth D.F.
      • Friedland R.P.
      Lessons learned regarding recruitment to the National African American Alzheimer Disease Health Literacy Program.
      • Samus Q.M.
      • Amjad H.
      • Johnston D.
      • Black B.S.
      • Bartels S.J.
      • Lyketsos C.G.
      A multipronged, adaptive approach for the recruitment of diverse community-residing elders with memory impairment: the MIND at Home experience.
      • Simning A.
      • van Wijngaarden E.
      • Conwell Y.
      Overcoming recruitment barriers in urban older adults residing in congregate living facilities.
      • Souder E.
      • Terry T.L.
      Use of lay educators to overcome barriers to research with Black older adults: a case study using Alzheimer's Disease Center.
      • Spruill I.
      Project Sugar: a recruitment model for successful African-American participation in health research.
      • Spruill I.J.
      Enhancing recruitment of African-American families into genetic research: lessons learned from Project SuGar.
      ,
      • Adderley-Kelly B.
      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
      • Burlew K.
      • Larios S.
      • Suarez-Morales L.
      • Holmes B.
      • Venner K.
      • Chavez R.
      Increasing ethnic minority participation in substance abuse clinical trials: lessons learned in the National Institute on Drug Abuse's Clinical Trials Network.
      • Dancy B.L.
      • Wilbur J.
      • Talashek M.
      • Bonner G.
      • Barnes-Boyd C.
      Community-based research: barriers to recruitment of African Americans.
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      ,
      • Wallington S.F.
      • Dash C.
      • Sheppard V.B.
      • et al.
      Enrolling minority and underserved populations in cancer clinical research.
      • Chadiha L.A.
      • Washington O.G.
      • Lichtenberg P.A.
      • Green C.R.
      • Daniels K.L.
      • Jackson J.S.
      Building a registry of research volunteers among older urban African Americans: recruitment processes and outcomes from a community-based partnership.
      • Romero H.R.
      • Welsh-Bohmer K.A.
      • Gwyther L.P.
      • et al.
      Community engagement in diverse populations for Alzheimer disease prevention trials.
      • Samuel T.
      Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).
      • Williams M.M.
      • Meisel M.M.
      • Williams J.
      • Morris J.C.
      An interdisciplinary outreach model of African American recruitment for Alzheimer's disease research.
      ,
      • Kaiser B.L.
      • Thomas G.R.
      • Bowers B.J.
      A case study of engaging hard-to-reach participants in the research process: Community Advisors on Research Design and Strategies (CARDS)®.
      ,
      • Sankaré I.C.
      • Bross R.
      • Brown A.F.
      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      Hispanic or Latino (n=20),
      • Alvarez R.A.
      • Vasquez E.
      • Mayorga C.C.
      • Feaster D.J.
      • Mitrani V.B.
      Increasing minority research participation through community organization outreach.
      ,
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      • Falcon R.
      • Bridge D.A.
      • Currier J.
      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      • Fischer S.M.
      • Kline D.M.
      • Min S.J.
      • Okuyama S.
      • Fink R.M.
      Apoyo con cariño: strategies to promote recruiting, enrolling, and retaining Latinos in a cancer clinical trial.
      • Hanza M.M.
      • Goodson M.
      • Osman A.
      • et al.
      Lessons learned from community-led recruitment of immigrants and refugee participants for a randomized, community-based participatory research study [published correction appears in J Immigr Minor Health. 2016;18(5):1246].
      • Harris K.J.
      • Ahluwalia J.S.
      • Okuyemi K.S.
      • et al.
      Addressing cultural sensitivity in a smoking cessation intervention: development of the Kick It at Swope project.
      ,
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
      ,
      • Horowitz C.R.
      • Brenner B.L.
      • Lachapelle S.
      • Amara D.A.
      • Arniella G.
      Effective recruitment of minority populations through community-led strategies.
      ,
      • Larkey L.K.
      • Gonzalez J.A.
      • Mar L.E.
      • Glantz N.
      Latina recruitment for cancer prevention education via Community Based Participatory Research strategies.
      ,
      • Tiwari T.
      • Casciello A.
      • Gansky S.A.
      • et al.
      Recruitment for health disparities preventive intervention trials: the Early Childhood Caries Collaborating Centers.
      ,
      • Vincent D.
      • McEwen M.M.
      • Hepworth J.T.
      • Stump C.S.
      Challenges and success of recruiting and retention for a culturally tailored Diabetes Prevention Program for adults of Mexican descent.
      ,
      • Farquhar S.
      • de Jesus Gonzalez C.
      • Hall J.
      • et al.
      Recruiting and retaining indigenous farmworker participants.
      ,
      • Mendez-Luck C.A.
      • Trejo L.
      • Miranda J.
      • Jimenez E.
      • Quiter E.S.
      • Mangione C.M.
      Recruitment strategies and costs associated with community-based research in a Mexican-origin population.
      ,
      • Raymond-Flesch M.
      • Siemons R.
      • Brindis C.D.
      Research and engagement strategies for young adult immigrants without documentation: lessons learned through community partnership.
      ,
      • Reidy M.C.
      • Orpinas P.
      • Davis M.
      Successful recruitment and retention of Latino study participants.
      ,
      • Simning A.
      • van Wijngaarden E.
      • Conwell Y.
      Overcoming recruitment barriers in urban older adults residing in congregate living facilities.
      ,
      • Burlew K.
      • Larios S.
      • Suarez-Morales L.
      • Holmes B.
      • Venner K.
      • Chavez R.
      Increasing ethnic minority participation in substance abuse clinical trials: lessons learned in the National Institute on Drug Abuse's Clinical Trials Network.
      ,
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      ,
      • Larkey L.K.
      • Ogden S.L.
      • Tenorio S.
      • Ewell T.
      Latino recruitment to cancer prevention/screening trials in the Southwest: setting a research agenda.
      ,
      • Flores E.
      • Espinoza P.
      • Jacobellis J.
      • Bakemeier R.
      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      ,
      • Sankaré I.C.
      • Bross R.
      • Brown A.F.
      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      Asian (n=6),
      • Dong X.
      • Wong E.
      • Simon M.A.
      Study design and implementation of the PINE study.
      ,
      • Taylor-Piliae R.E.
      • Froelicher E.S.
      Methods to optimize recruitment and retention to an exercise study in Chinese immigrants.
      • Katigbak C.
      • Foley M.
      • Robert L.
      • Hutchinson M.K.
      Experiences and lessons learned in using community-based participatory research to recruit Asian American immigrant research participants.
      • Lim J.W.
      • Paek M.S.
      Recruiting Chinese- and Korean-Americans in cancer survivorship research: challenges and lessons learned.
      ,
      • Culhane-Pera K.A.
      • Straka R.J.
      • Moua M.
      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
      ,
      • Chen H.
      • Kramer E.J.
      • Chen T.
      • Chung H.
      Engaging Asian Americans for mental health research: challenges and solutions.
      American Indian or Alaskan Native (n=3),
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      ,
      • Tiwari T.
      • Casciello A.
      • Gansky S.A.
      • et al.
      Recruitment for health disparities preventive intervention trials: the Early Childhood Caries Collaborating Centers.
      ,
      • Redwood D.
      • Lanier A.
      • Kemberling M.
      • Klejka J.
      • Sylvester I.
      • Lundgren K.
      Community-based participatory research in a large cohort study of chronic diseases among Alaska native adults.
      and Native Hawaiian or other Pacific Islander (n=2).
      • Tanjasiri S.P.
      • Weiss J.W.
      • Santos L.
      • et al.
      CBPR-informed recruitment and retention adaptations in a randomized study of Pap testing among Pacific Islanders in southern California.
      ,
      • McElfish P.A.
      • Narcisse M.R.
      • Long C.R.
      • et al.
      Leveraging community-based participatory research capacity to recruit Pacific Islanders into a genetics study.
      Eleven studies targeted more than one population.
      • Alvarez R.A.
      • Vasquez E.
      • Mayorga C.C.
      • Feaster D.J.
      • Mitrani V.B.
      Increasing minority research participation through community organization outreach.
      ,
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      ,
      • Falcon R.
      • Bridge D.A.
      • Currier J.
      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      ,
      • Hanza M.M.
      • Goodson M.
      • Osman A.
      • et al.
      Lessons learned from community-led recruitment of immigrants and refugee participants for a randomized, community-based participatory research study [published correction appears in J Immigr Minor Health. 2016;18(5):1246].
      ,
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
      ,
      • Horowitz C.R.
      • Brenner B.L.
      • Lachapelle S.
      • Amara D.A.
      • Arniella G.
      Effective recruitment of minority populations through community-led strategies.
      ,
      • Tiwari T.
      • Casciello A.
      • Gansky S.A.
      • et al.
      Recruitment for health disparities preventive intervention trials: the Early Childhood Caries Collaborating Centers.
      ,
      • Simning A.
      • van Wijngaarden E.
      • Conwell Y.
      Overcoming recruitment barriers in urban older adults residing in congregate living facilities.
      ,
      • Burlew K.
      • Larios S.
      • Suarez-Morales L.
      • Holmes B.
      • Venner K.
      • Chavez R.
      Increasing ethnic minority participation in substance abuse clinical trials: lessons learned in the National Institute on Drug Abuse's Clinical Trials Network.
      ,
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      ,
      • Sankaré I.C.
      • Bross R.
      • Brown A.F.
      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      Study settings included community-based organizations (CBOs) (n=30),
      • Breland-Noble A.M.
      • Bell C.C.
      • Burriss A.
      • Poole H.K.
      The AAKOMA Project Adult Advisory Board
      The significance of strategic community engagement in recruiting African American youth & families for clinical research.
      ,
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      ,
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
      ,
      • Horowitz C.R.
      • Brenner B.L.
      • Lachapelle S.
      • Amara D.A.
      • Arniella G.
      Effective recruitment of minority populations through community-led strategies.
      ,
      • Huffman L.E.
      • Wilson D.K.
      • Kitzman-Ulrich H.
      • Lyerly J.E.
      • Gause H.M.
      • Resnicow K.
      Associations between culturally relevant recruitment strategies and participant interest, enrollment and generalizability in a weight-loss intervention for African American families.
      ,
      • Larkey L.K.
      • Gonzalez J.A.
      • Mar L.E.
      • Glantz N.
      Latina recruitment for cancer prevention education via Community Based Participatory Research strategies.
      ,
      • Tiwari T.
      • Casciello A.
      • Gansky S.A.
      • et al.
      Recruitment for health disparities preventive intervention trials: the Early Childhood Caries Collaborating Centers.
      ,
      • Dong X.
      • Wong E.
      • Simon M.A.
      Study design and implementation of the PINE study.
      • Dreer L.E.
      • Weston J.
      • Owsley C.
      Strategic planning for recruitment and retention of older African Americans in health promotion research programs.
      • Ejiogu N.
      • Norbeck J.H.
      • Mason M.A.
      • Cromwell B.C.
      • Zonderman A.B.
      • Evans M.K.
      Recruitment and retention strategies for minority or poor clinical research participants: lessons from the Healthy Aging in Neighborhoods of Diversity across the Life Span study.
      • Farquhar S.
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      • et al.
      Recruiting and retaining indigenous farmworker participants.
      • Fortune T.
      • Wright E.
      • Juzang I.
      • Bull S.
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      • Friedman D.B.
      • Johnson K.M.
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      • et al.
      Developing partnerships and recruiting dyads for a prostate cancer informed decision making program: lessons learned from a community-academic-clinical team.
      • Magnus M.
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      • Goodman K.
      • Wheeler D.P.
      HPTN 061 Study Group
      Engaging, recruiting, and retaining black men who have sex with men in research studies: don't underestimate the importance of staffing—lessons learned from HPTN 061, the BROTHERS study.
      ,
      • Mendez-Luck C.A.
      • Trejo L.
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      • Quiter E.S.
      • Mangione C.M.
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      ,
      • Ochs-Balcom H.M.
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      • et al.
      "It takes a village": multilevel approaches to recruit African Americans and their families for genetic research.
      ,
      • Samus Q.M.
      • Amjad H.
      • Johnston D.
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      • Bartels S.J.
      • Lyketsos C.G.
      A multipronged, adaptive approach for the recruitment of diverse community-residing elders with memory impairment: the MIND at Home experience.
      ,
      • Simning A.
      • van Wijngaarden E.
      • Conwell Y.
      Overcoming recruitment barriers in urban older adults residing in congregate living facilities.
      ,
      • Spruill I.J.
      Enhancing recruitment of African-American families into genetic research: lessons learned from Project SuGar.
      • Taylor-Piliae R.E.
      • Froelicher E.S.
      Methods to optimize recruitment and retention to an exercise study in Chinese immigrants.
      • Katigbak C.
      • Foley M.
      • Robert L.
      • Hutchinson M.K.
      Experiences and lessons learned in using community-based participatory research to recruit Asian American immigrant research participants.
      • Lim J.W.
      • Paek M.S.
      Recruiting Chinese- and Korean-Americans in cancer survivorship research: challenges and lessons learned.
      ,
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      ,
      • Chadiha L.A.
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      • Lichtenberg P.A.
      • Green C.R.
      • Daniels K.L.
      • Jackson J.S.
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      • Romero H.R.
      • Welsh-Bohmer K.A.
      • Gwyther L.P.
      • et al.
      Community engagement in diverse populations for Alzheimer disease prevention trials.
      • Samuel T.
      Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).
      • Williams M.M.
      • Meisel M.M.
      • Williams J.
      • Morris J.C.
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      • Culhane-Pera K.A.
      • Straka R.J.
      • Moua M.
      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
      • Flores E.
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      • Jacobellis J.
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      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      ,
      • Sankaré I.C.
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      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      places of worship (n=27),
      • Adams S.A.
      • Heiney S.P.
      • Brandt H.M.
      • et al.
      A comparison of a centralized versus de-centralized recruitment schema in two community-based participatory research studies for cancer prevention.
      ,
      • Brown E.J.
      • Thomas P.
      • Willis L.A.
      • Sutton M.Y.
      Recruitment strategies to engage African American men in HIV testing randomized controlled trials in the rural southern United States.
      ,
      • Burns D.
      • Soward A.C.
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      • Leeman J.
      • Carlson J.
      Effective recruitment and retention strategies for older members of rural minorities.
      ,
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
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      ,
      • Johnson D.A.
      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Larkey L.K.
      • Gonzalez J.A.
      • Mar L.E.
      • Glantz N.
      Latina recruitment for cancer prevention education via Community Based Participatory Research strategies.
      ,
      • Slade J.L.
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      Recruitment of African American churches to participate in cancer early detection interventions: a community perspective.
      • Stoy D.B.
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      • Tanjasiri S.P.
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      ,
      • Vincent D.
      • McEwen M.M.
      • Hepworth J.T.
      • Stump C.S.
      Challenges and success of recruiting and retention for a culturally tailored Diabetes Prevention Program for adults of Mexican descent.
      • Whitt-Glover M.C.
      • Borden S.L.
      • Alexander D.S.
      • Kennedy B.M.
      • Goldmon M.V.
      Recruiting African American churches to participate in research: the Learning and Developing Individual Exercise Skills for a Better Life study.
      • Abernethy A.D.
      • Magat M.M.
      • Houston T.R.
      • Arnold Jr., H.L.
      • Bjorck J.P.
      • Gorsuch R.L.
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      • Brewer L.C.
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      ,
      • Ceasar J.
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      • Mitchell V.
      • Powell-Wiley T.M.
      The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model: an effective tool for engaging urban communities in community-based participatory research.
      ,
      • Dennis B.P.
      • Neese J.B.
      Recruitment and retention of African American elders into community-based research: lessons learned.
      ,
      • Friedman D.B.
      • Johnson K.M.
      • Owens O.L.
      • et al.
      Developing partnerships and recruiting dyads for a prostate cancer informed decision making program: lessons learned from a community-academic-clinical team.
      ,
      • Mendez-Luck C.A.
      • Trejo L.
      • Miranda J.
      • Jimenez E.
      • Quiter E.S.
      • Mangione C.M.
      Recruitment strategies and costs associated with community-based research in a Mexican-origin population.
      ,
      • Rexroth D.F.
      • Friedland R.P.
      Lessons learned regarding recruitment to the National African American Alzheimer Disease Health Literacy Program.
      ,
      • Spruill I.
      Project Sugar: a recruitment model for successful African-American participation in health research.
      ,
      • Spruill I.J.
      Enhancing recruitment of African-American families into genetic research: lessons learned from Project SuGar.
      ,
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      ,
      • Larkey L.K.
      • Ogden S.L.
      • Tenorio S.
      • Ewell T.
      Latino recruitment to cancer prevention/screening trials in the Southwest: setting a research agenda.
      ,
      • Chadiha L.A.
      • Washington O.G.
      • Lichtenberg P.A.
      • Green C.R.
      • Daniels K.L.
      • Jackson J.S.
      Building a registry of research volunteers among older urban African Americans: recruitment processes and outcomes from a community-based partnership.
      • Romero H.R.
      • Welsh-Bohmer K.A.
      • Gwyther L.P.
      • et al.
      Community engagement in diverse populations for Alzheimer disease prevention trials.
      • Samuel T.
      Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).
      • Williams M.M.
      • Meisel M.M.
      • Williams J.
      • Morris J.C.
      An interdisciplinary outreach model of African American recruitment for Alzheimer's disease research.
      ,
      • Flores E.
      • Espinoza P.
      • Jacobellis J.
      • Bakemeier R.
      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      clinical settings (n=26),
      • Alvarez R.A.
      • Vasquez E.
      • Mayorga C.C.
      • Feaster D.J.
      • Mitrani V.B.
      Increasing minority research participation through community organization outreach.
      • Andreae S.J.
      • Halanych J.H.
      • Cherrington A.
      • Safford M.M.
      Recruitment of a rural, southern, predominantly African-American population into a diabetes self-management trial.
      • Breland-Noble A.M.
      • Bell C.C.
      • Burriss A.
      • Poole H.K.
      The AAKOMA Project Adult Advisory Board
      The significance of strategic community engagement in recruiting African American youth & families for clinical research.
      ,
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      • Falcon R.
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      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      • Fischer S.M.
      • Kline D.M.
      • Min S.J.
      • Okuyama S.
      • Fink R.M.
      Apoyo con cariño: strategies to promote recruiting, enrolling, and retaining Latinos in a cancer clinical trial.
      ,
      • Harris K.J.
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      Addressing cultural sensitivity in a smoking cessation intervention: development of the Kick It at Swope project.
      ,
      • Parra-Medina D.
      • D'Antonio A.
      • Smith S.M.
      • Levin S.
      • Kirkner G.
      • Mayer-Davis E.
      Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medically underserved counties of South Carolina: the POWER study.
      ,
      • Vincent D.
      • McEwen M.M.
      • Hepworth J.T.
      • Stump C.S.
      Challenges and success of recruiting and retention for a culturally tailored Diabetes Prevention Program for adults of Mexican descent.
      ,
      • Friedman D.B.
      • Johnson K.M.
      • Owens O.L.
      • et al.
      Developing partnerships and recruiting dyads for a prostate cancer informed decision making program: lessons learned from a community-academic-clinical team.
      ,
      • McElfish P.A.
      • Narcisse M.R.
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      • et al.
      Leveraging community-based participatory research capacity to recruit Pacific Islanders into a genetics study.
      ,
      • Mendez-Luck C.A.
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      • Miranda J.
      • Jimenez E.
      • Quiter E.S.
      • Mangione C.M.
      Recruitment strategies and costs associated with community-based research in a Mexican-origin population.
      ,
      • Redwood D.
      • Lanier A.
      • Kemberling M.
      • Klejka J.
      • Sylvester I.
      • Lundgren K.
      Community-based participatory research in a large cohort study of chronic diseases among Alaska native adults.
      ,
      • Souder E.
      • Terry T.L.
      Use of lay educators to overcome barriers to research with Black older adults: a case study using Alzheimer's Disease Center.
      • Spruill I.
      Project Sugar: a recruitment model for successful African-American participation in health research.
      • Spruill I.J.
      Enhancing recruitment of African-American families into genetic research: lessons learned from Project SuGar.
      ,
      • Lim J.W.
      • Paek M.S.
      Recruiting Chinese- and Korean-Americans in cancer survivorship research: challenges and lessons learned.
      ,
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      • Larkey L.K.
      • Ogden S.L.
      • Tenorio S.
      • Ewell T.
      Latino recruitment to cancer prevention/screening trials in the Southwest: setting a research agenda.
      • Wallington S.F.
      • Dash C.
      • Sheppard V.B.
      • et al.
      Enrolling minority and underserved populations in cancer clinical research.
      ,
      • Romero H.R.
      • Welsh-Bohmer K.A.
      • Gwyther L.P.
      • et al.
      Community engagement in diverse populations for Alzheimer disease prevention trials.
      ,
      • Williams M.M.
      • Meisel M.M.
      • Williams J.
      • Morris J.C.
      An interdisciplinary outreach model of African American recruitment for Alzheimer's disease research.
      • Culhane-Pera K.A.
      • Straka R.J.
      • Moua M.
      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
      • Flores E.
      • Espinoza P.
      • Jacobellis J.
      • Bakemeier R.
      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      • Kaiser B.L.
      • Thomas G.R.
      • Bowers B.J.
      A case study of engaging hard-to-reach participants in the research process: Community Advisors on Research Design and Strategies (CARDS)®.
      • Chen H.
      • Kramer E.J.
      • Chen T.
      • Chung H.
      Engaging Asian Americans for mental health research: challenges and solutions.
      schools (n=6),
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      ,
      • Larkey L.K.
      • Gonzalez J.A.
      • Mar L.E.
      • Glantz N.
      Latina recruitment for cancer prevention education via Community Based Participatory Research strategies.
      ,
      • Fortune T.
      • Wright E.
      • Juzang I.
      • Bull S.
      Recruitment, enrollment and retention of young black men for HIV prevention research: experiences from The 411 for Safe Text project.
      ,
      • Adderley-Kelly B.
      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
      ,
      • Romero H.R.
      • Welsh-Bohmer K.A.
      • Gwyther L.P.
      • et al.
      Community engagement in diverse populations for Alzheimer disease prevention trials.
      ,
      • Culhane-Pera K.A.
      • Straka R.J.
      • Moua M.
      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
      senior centers (n=4),
      • Stoy D.B.
      • Curtis R.C.
      • Dameworth K.S.
      • et al.
      The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience.
      ,
      • Taylor-Piliae R.E.
      • Froelicher E.S.
      Methods to optimize recruitment and retention to an exercise study in Chinese immigrants.
      ,
      • Adderley-Kelly B.
      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
      ,
      • Flores E.
      • Espinoza P.
      • Jacobellis J.
      • Bakemeier R.
      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      other specific locations (barber shop, grocery store, community center) (n=3),
      • Cruz T.H.
      • Davis S.M.
      • FitzGerald C.A.
      • Canaca G.F.
      • Keane P.C.
      Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children.
      ,
      • Hood S.
      • Hall M.
      • Dixon C.
      • Jolly D.
      • Linnan L.
      Organizational-l evel recruitment of barbershops as health promotion intervention study sites: addressing health disparities among Black men.
      ,
      • Rexroth D.F.
      • Friedland R.P.
      Lessons learned regarding recruitment to the National African American Alzheimer Disease Health Literacy Program.
      and various community-based locations (n=16)
      • Brown E.J.
      • Thomas P.
      • Willis L.A.
      • Sutton M.Y.
      Recruitment strategies to engage African American men in HIV testing randomized controlled trials in the rural southern United States.
      ,
      • Hanza M.M.
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      • Osman A.
      • et al.
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      ,
      • Johnson D.A.
      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Burroughs A.R.
      • Visscher W.A.
      • Haney T.L.
      • et al.
      Community recruitment process by race, gender, and SES gradient: lessons learned from the Community Health and Stress Evaluation (CHASE) Study experience.
      ,
      • Dennis B.P.
      • Neese J.B.
      Recruitment and retention of African American elders into community-based research: lessons learned.
      ,
      • Farquhar S.
      • de Jesus Gonzalez C.
      • Hall J.
      • et al.
      Recruiting and retaining indigenous farmworker participants.
      ,
      • Ochs-Balcom H.M.
      • Jandorf L.
      • Wang Y.
      • et al.
      "It takes a village": multilevel approaches to recruit African Americans and their families for genetic research.
      • Raymond-Flesch M.
      • Siemons R.
      • Brindis C.D.
      Research and engagement strategies for young adult immigrants without documentation: lessons learned through community partnership.
      • Redwood D.
      • Lanier A.
      • Kemberling M.
      • Klejka J.
      • Sylvester I.
      • Lundgren K.
      Community-based participatory research in a large cohort study of chronic diseases among Alaska native adults.
      • Reidy M.C.
      • Orpinas P.
      • Davis M.
      Successful recruitment and retention of Latino study participants.
      ,
      • Samus Q.M.
      • Amjad H.
      • Johnston D.
      • Black B.S.
      • Bartels S.J.
      • Lyketsos C.G.
      A multipronged, adaptive approach for the recruitment of diverse community-residing elders with memory impairment: the MIND at Home experience.
      ,
      • Souder E.
      • Terry T.L.
      Use of lay educators to overcome barriers to research with Black older adults: a case study using Alzheimer's Disease Center.
      ,
      • Katigbak C.
      • Foley M.
      • Robert L.
      • Hutchinson M.K.
      Experiences and lessons learned in using community-based participatory research to recruit Asian American immigrant research participants.
      ,
      • Adderley-Kelly B.
      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
      ,
      • Dancy B.L.
      • Wilbur J.
      • Talashek M.
      • Bonner G.
      • Barnes-Boyd C.
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      ,
      • Sankaré I.C.
      • Bross R.
      • Brown A.F.
      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      ; 35 studies recruited participants from more than one setting.
      • Breland-Noble A.M.
      • Bell C.C.
      • Burriss A.
      • Poole H.K.
      The AAKOMA Project Adult Advisory Board
      The significance of strategic community engagement in recruiting African American youth & families for clinical research.
      ,
      • Brown E.J.
      • Thomas P.
      • Willis L.A.
      • Sutton M.Y.
      Recruitment strategies to engage African American men in HIV testing randomized controlled trials in the rural southern United States.
      ,
      • Falcon R.
      • Bridge D.A.
      • Currier J.
      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      ,
      • Hippolyte J.M.
      • Phillips-Caesar E.G.
      • Winston G.J.
      • Charlson M.E.
      • Peterson J.C.
      Recruitment and retention techniques for developing faith-based research partnerships, New York City, 2009-2012.
      ,
      • Johnson D.A.
      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Larkey L.K.
      • Gonzalez J.A.
      • Mar L.E.
      • Glantz N.
      Latina recruitment for cancer prevention education via Community Based Participatory Research strategies.
      ,
      • Stoy D.B.
      • Curtis R.C.
      • Dameworth K.S.
      • et al.
      The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience.
      ,
      • Vincent D.
      • McEwen M.M.
      • Hepworth J.T.
      • Stump C.S.
      Challenges and success of recruiting and retention for a culturally tailored Diabetes Prevention Program for adults of Mexican descent.
      ,
      • Ceasar J.
      • Peters-Lawrence M.H.
      • Mitchell V.
      • Powell-Wiley T.M.
      The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model: an effective tool for engaging urban communities in community-based participatory research.
      • Dennis B.P.
      • Neese J.B.
      Recruitment and retention of African American elders into community-based research: lessons learned.
      • Dong X.
      • Wong E.
      • Simon M.A.
      Study design and implementation of the PINE study.
      ,
      • Farquhar S.
      • de Jesus Gonzalez C.
      • Hall J.
      • et al.
      Recruiting and retaining indigenous farmworker participants.
      • Fortune T.
      • Wright E.
      • Juzang I.
      • Bull S.
      Recruitment, enrollment and retention of young black men for HIV prevention research: experiences from The 411 for Safe Text project.
      • Friedman D.B.
      • Johnson K.M.
      • Owens O.L.
      • et al.
      Developing partnerships and recruiting dyads for a prostate cancer informed decision making program: lessons learned from a community-academic-clinical team.
      ,
      • Mendez-Luck C.A.
      • Trejo L.
      • Miranda J.
      • Jimenez E.
      • Quiter E.S.
      • Mangione C.M.
      Recruitment strategies and costs associated with community-based research in a Mexican-origin population.
      ,
      • Ochs-Balcom H.M.
      • Jandorf L.
      • Wang Y.
      • et al.
      "It takes a village": multilevel approaches to recruit African Americans and their families for genetic research.
      ,
      • Redwood D.
      • Lanier A.
      • Kemberling M.
      • Klejka J.
      • Sylvester I.
      • Lundgren K.
      Community-based participatory research in a large cohort study of chronic diseases among Alaska native adults.
      ,
      • Rexroth D.F.
      • Friedland R.P.
      Lessons learned regarding recruitment to the National African American Alzheimer Disease Health Literacy Program.
      ,
      • Samus Q.M.
      • Amjad H.
      • Johnston D.
      • Black B.S.
      • Bartels S.J.
      • Lyketsos C.G.
      A multipronged, adaptive approach for the recruitment of diverse community-residing elders with memory impairment: the MIND at Home experience.
      ,
      • Souder E.
      • Terry T.L.
      Use of lay educators to overcome barriers to research with Black older adults: a case study using Alzheimer's Disease Center.
      • Spruill I.
      Project Sugar: a recruitment model for successful African-American participation in health research.
      • Spruill I.J.
      Enhancing recruitment of African-American families into genetic research: lessons learned from Project SuGar.
      • Taylor-Piliae R.E.
      • Froelicher E.S.
      Methods to optimize recruitment and retention to an exercise study in Chinese immigrants.
      • Katigbak C.
      • Foley M.
      • Robert L.
      • Hutchinson M.K.
      Experiences and lessons learned in using community-based participatory research to recruit Asian American immigrant research participants.
      • Lim J.W.
      • Paek M.S.
      Recruiting Chinese- and Korean-Americans in cancer survivorship research: challenges and lessons learned.
      • Adderley-Kelly B.
      • Green P.M.
      Strategies for successful conduct of research with low-income African American populations.
      ,
      • Greiner K.A.
      • Friedman D.B.
      • Adams S.A.
      • et al.
      Effective recruitment strategies and community-based participatory research: Community Networks Program Centers' recruitment in cancer prevention studies.
      ,
      • Larkey L.K.
      • Ogden S.L.
      • Tenorio S.
      • Ewell T.
      Latino recruitment to cancer prevention/screening trials in the Southwest: setting a research agenda.
      ,
      • Chadiha L.A.
      • Washington O.G.
      • Lichtenberg P.A.
      • Green C.R.
      • Daniels K.L.
      • Jackson J.S.
      Building a registry of research volunteers among older urban African Americans: recruitment processes and outcomes from a community-based partnership.
      • Romero H.R.
      • Welsh-Bohmer K.A.
      • Gwyther L.P.
      • et al.
      Community engagement in diverse populations for Alzheimer disease prevention trials.
      • Samuel T.
      Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).
      • Williams M.M.
      • Meisel M.M.
      • Williams J.
      • Morris J.C.
      An interdisciplinary outreach model of African American recruitment for Alzheimer's disease research.
      • Culhane-Pera K.A.
      • Straka R.J.
      • Moua M.
      • et al.
      Engaging Hmong adults in genomic and pharmacogenomic research: toward reducing health disparities in genomic knowledge using a community-based participatory research approach.
      • Flores E.
      • Espinoza P.
      • Jacobellis J.
      • Bakemeier R.
      • Press N.
      The greater Denver Latino Cancer Prevention/Control Network: prevention and research through a community-based approach.
      ,
      • Sankaré I.C.
      • Bross R.
      • Brown A.F.
      • et al.
      Strategies to build trust and recruit African American and Latino community residents for health research: a cohort study.
      Characteristics of every included study are presented in Supplemental Table 1 (available online at http://www.mayoclinicproceedings.org).

       Community Advisory Boards

      Most of the studies engaged diverse community stakeholders in recruitment processes, referred to in most studies as CABs. The role of CABs ranged from providing advice to the study team about recruitment strategies (consult) to direct participation in recruitment of participants or stakeholders (involve) to decision-making capacity (collaboration) and co-leadership of activities. In all of the included studies, CAB composition included members of the population targeted for recruitment, both in terms of racial/ethnic group and disease group, if applicable. This typically took the form of community members from the specific location targeted for recruitment, eg, clergy members or lay leaders from a place of worship. Some CABs also included representatives from CBOs representing important stakeholders. Compensation of CAB members was not typically discussed; those articles that did described hourly or project-based remuneration to individual CAB members or to the organization they represented.

       Levels of Community Engagement

      Levels of community engagement, their definitions, and themes for how CEnR was operationalized at each level for recruitment of minority research participants are presented in the Table. The full description of community-engaged activities for recruitment and retention of every study is summarized in Supplemental Table 2 (available online at http://www.mayoclinicproceedings.org).
      TableLevels of Community Engagement for Recruitment
      Level of community engagementDefinitionRecruitment approachesRecruitment findings
      InformCommunities are provided with information about research opportunitiesStudy team conducts outreach activities in community locations to promote the studyOnsite activities allow members of target population to learn about the study and to establish relationships with the study team
      ConsultFeedback is solicited from communities for research procedure(s)CAB consulted about recruitment strategy, materials, and incentives

      CABs utilized as “gatekeepers” for access to registry of minority participants interested in research
      CAB input substantially changes initial recruitment plan

      CAB brings community voice to the research and recruitment process

      CAB facilitates connection with difficult to reach stakeholders
      InvolveCommunities informed and participate in research proceduresCAB directly participates in recruitment through social networks and by applying sociocultural knowledge. Besides direct recruitment, this may include connection to key stakeholdersInvolvement of trusted community members and leaders is essential for reaching target populations

      Incorporates contextual factors that may impact recruitment
      CollaboratePartnerships are formed with communities to work together on all proceduresPartnerships with CBOs and/or unaffiliated community members who work with target populations; typically take the lead on recruitment efforts, sometimes with help of research training

      Strategic planning with community partners around recruitment

      Community partners guide health- (and disease-) related education/advocacy activities that also promote research participation
      Collaboration fosters trust between community and academic partners, thereby breaking down a key barrier to recruitment

      Recruitment is successful when CBOs are the “face” of the research project

      Recruitment is successful when there are specific targeted benefits to community partners, often beyond the research

      Partnerships often precede funding
      Co-leadRobust partnership with communities who hold decision-making power over all research proceduresEstablished partnership norms and principles guide co-ownership of processes and resources by community and academic partners

      Community partners lead recruitment through integration of local knowledge

      Development of a long-term community-based research and recruitment infrastructure
      Community partners and participants become advocates for the study

      Participatory partnerships that extend beyond individual studies can lead to sustainable recruitment efforts

      Recruitment strategies emerge from communities

      Reliance on community strengths and resources

      Often mutual benefits beyond research

      Partnership often precedes project conception
      CAB = community advisory board; CBO = community-based organization.

       Inform

      Only 2 studies conducted a CEnR strategy through information/outreach alone.
      • Simning A.
      • van Wijngaarden E.
      • Conwell Y.
      Overcoming recruitment barriers in urban older adults residing in congregate living facilities.
      ,
      • Larkey L.K.
      • Ogden S.L.
      • Tenorio S.
      • Ewell T.
      Latino recruitment to cancer prevention/screening trials in the Southwest: setting a research agenda.
      The study teams conducted outreach activities in community locations to promote the study. Findings were that on-site activities allowed members of the target population to learn about the study and to establish relationships with the study team.

       Consult

      Consultation was classified as the CEnR strategy for recruitment of minority participants in 13 studies.
      • Falcon R.
      • Bridge D.A.
      • Currier J.
      • et al.
      GRACE Study Group
      Recruitment and retention of diverse populations in antiretroviral clinical trials: practical applications from the Gender, Race And Clinical Experience study.
      ,
      • Fischer S.M.
      • Kline D.M.
      • Min S.J.
      • Okuyama S.
      • Fink R.M.
      Apoyo con cariño: strategies to promote recruiting, enrolling, and retaining Latinos in a cancer clinical trial.
      ,
      • Harris K.J.
      • Ahluwalia J.S.
      • Okuyemi K.S.
      • et al.
      Addressing cultural sensitivity in a smoking cessation intervention: development of the Kick It at Swope project.
      ,
      • Hood S.
      • Hall M.
      • Dixon C.
      • Jolly D.
      • Linnan L.
      Organizational-l evel recruitment of barbershops as health promotion intervention study sites: addressing health disparities among Black men.
      ,
      • Johnson D.A.
      • Joosten Y.A.
      • Wilkins C.H.
      • Shibao C.A.
      Case study: community engagement and clinical trial success; outreach to African American women.
      ,
      • Stoy D.B.
      • Curtis R.C.
      • Dameworth K.S.
      • et al.
      The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience.
      ,
      • Burroughs A.R.
      • Visscher W.A.
      • Haney T.L.
      • et al.
      Community recruitment process by race, gender, and SES gradient: lessons learned from the Community Health and Stress Evaluation (CHASE) Study experience.
      ,
      • Rexroth D.F.
      • Friedland R.P.
      Lessons learned regarding recruitment to the National African American Alzheimer Disease Health Literacy Program.
      ,
      • Souder E.
      • Terry T.L.
      Use of lay educators to overcome barriers to research with Black older adults: a case study using Alzheimer's Disease Center.
      ,
      • Chadiha L.A.
      • Washington O.G.
      • Lichtenberg P.A.
      • Green C.R.
      • Daniels K.L.
      • Jackson J.S.
      Building a registry of research volunteers among older urban African Americans: recruitment processes and outcomes from a community-based partnership.
      ,
      • Samuel T.
      Standardizing a process to engage African Americans in health research: the Community Research Outreach Workers' Network (CROWN).