Recruiting and motivating black subjects to complete a lengthy survey in a large cohort study: An exploration of different strategies

Background: The effectiveness of multiple innovative recruitment strategies for enrolling Black/African American participants to the Adventist Health Study-2 (AHS-2) is described. The study's focus is diet and breast, prostate and colon cancer. Methods. Promotions centered on trust, relationship building and incentives for increasing enrollment and questionnaire return rate. Of the sub-studies described, one had a randomized control group, and the others, informal controls. The subjects are from all states of the U.S. and some provinces of Canada. The offer of a Black art piece, follow-up calls, a competitive tournament as well as other strategies accounted for nearly 3,000 additional returns even though they were often used in small subsets. Results: Flexibility and multiple strategies proved advantageous in gaining the cooperation of Blacks, who are usually reluctant to participate in research studies. Conclusions: Lessons learned during initial enrollment should help us retain our final Black cohort of 26,000, and obtain new information when required.