Community recruitment process by race, gender, and SES gradient: Lessons learned from the community health and stress evaluation (CHASE) study experience

Recruitment of community participants for clinical research studies is a challenging task. When possible, community-based recruitment efforts should involve members of the targeted community in the planning, community preparation, and actual recruitment process. It becomes even more difficult to recruit study participants from the community when the research involves an invasive procedure, or when diverse target groups require that a variety of recruitment methods be used. The Community Health and Stress Evaluation (CHASE) Study was designed to determine the role of psychosocial and biobehavioral factors in the etiology of coronary heart disease. It involved both an invasive medical procedure (a spinal tap) and the collection of survey and medical information from Black and White persons in different socioeconomic status (SES) groups. Interestingly, we experienced the greatest difficulty in recruiting lower SES white persons, while groups that typically are "difficult to find" (such as Blacks) were actually easiest to recruit for the study. This paper describes the background of the CHASE study, the community recruitment methods used, and the results of the recruitment efforts by race, gender and SES gradient. We present an evaluation of the community recruitment component, why we think differences occurred, and the lessons learned from the experiences that may be applied to similar studies.