Strategies for recruiting a sample of adults with type 2 diabetes from primary care clinics in rural Appalachia: Incorporating cultural competence

摘要

Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cultural competence in the overall design of clinical research.Objectives:The purpose of this paper is to describe culturally competent strategies used for recruitment and data collection with a sample of adults with type 2 diabetes from primary care settings in Appalachia.Design:The Purnell model of cultural competence and relevant literature served as a framework for study design.Four overarching approaches informed the organization of recruitment strategies and development of the data collection plan.Procedures:The approaches included selection of research sites,establishing collaborations,sustaining collaborative relationships,and enhancing understanding of benefits of participation.Four recruitment sites were selected based on potential to enhance diversification of participants;multiple steps were included in each of the three remaining approaches to build relationships and gain participation.A study log was maintained to provide evaluation data.Results:Recruitment took 14 months and a sample of 102 subjects provided consent with 101 participants providing complete data.Demographics were representative of the region except that African American participation was higher(6.9%)compared to current north central Appalachia(3%).Over 72%of participants indicated they would be interested in participating in future studies.Conclusions:These findings emphasize the importance of employing strategies for cultural competence in study design.Use of concepts from the Purnell model led to enhanced representativeness and potential for subsequent generalizability.