Recruitment experience in a clinical trial to improve HBP care in young urban African American men

A 12 month clinical trial was undertaken to improve HBP care in young African American men, the age/race/sex group with the lowest rates of diagnosis, treatment and control of HBP. To accrue a sample a three phase recruitment process was undertaken by nurse supervised community health workers (CHW). African American men, ages 18-49 years, residing near the Johns Hopkins Hospital, with BP ≥ 140 and/or 90 mm Hg (average of 2 measurements on > 2 occasions) or on HBP medication, and able to give verified names, addresses and telephone numbers for 2 or 3 contact persons were eligible. Incentives of $10 were paid at the completion of the eligibility review process. Tracking efforts included mailing birthday cards and pre-appointment reminders, telephone calls, and home visits to the participant and/or contact persons. In phase 1, 1,391 potentially eligible men were identified. In phase 11, 803 (58%) responded to an invitation to be screened and made an appointment. Of those, 528 (66%) kept the appointment; 207 (39%) were BP eligible and 204 (99%) consented to be enrolled. Three men declined because they did not want to have blood drawn. The Emergency Department provided the largest number of men identified (N = 858) and enrolled (N = 96), an 11% yield. Through word-of-mouth 234 men were identified and 74 were enrolled, a 32% yield. Through advertising 40 men were identified and 13 were enrolled, a 33% yield. The recruitment effort intensity varied widely: 1.9 (sd 1.9; range 0-11) telephone calls were made and 0.7 (sd 0.9; range 0-5) letters were sent. Up to 6 appointments were made, however of 803 men invited 73% (N = 583) kept 1 of 3 scheduled appointments. The number of appointments made was associated with enrollment (P < .001) but not with phone calls or letters sent (P = 0.06). Recruitment can be successfully carried out by trained members of the sampleʹs community using multiple strategies. Concerns about being exploited as a research subject were not a barrier to enrollment.