CBPR-Informed Recruitment and Retention Adaptations in a Randomized Study of XXXX Testing Among Pacific Islanders in Southern California.

@entity5 @entity1 @entity975
BACKGROUND: Pacific Islanders (PIs) experience high cervical @entity5 rates in the United States. Stage of diagnosis is also later for PIs than non-Hispanic Whites. The @entity975 test is severely underutilized among PIs: only 71% of Asian American and Pacific Islander @entity1 age 25 years or older received a @entity975 test within the last 3 years (U.S. average, 82%). Community-based participatory research (CBPR) is increasingly seen as an essential approach in designing and conducting culturally relevant and appropriate studies that reduce @entity5 incidence and other health disparities among minority and other medically underserved populations. PURPOSE: The purpose of this article is to describe the lessons learned thus far regarding the identification, recruitment, and retention of PI community organizations and members into a CBPR-informed, randomized, community trial promoting @entity975 testing. METHODS: This 5-year study used CBPR to develop and test the efficacy of a social support intervention for Chamorro, Samoan, and Tongan @entity1 to increase @entity975 testing in southern California. Eligible @entity1 were between the ages of 21 and 65, and married or in a long-term relationship with a @entity1 for at least 5 years. @entity1 and their husbands or significant others received a 2-hour, culturally tailored workshop that include a group activity, information on @entity975 testing, a video, and corresponding materials. Comparison @entity1 received a brochure about @entity975 testing. Three waves of data are collected from all @entity1 : pretest (before workshop or brochure), posttest 1 (immediately after workshop or brochure), and posttest 2 (6 months follow-up). RESULTS: Of the 76 organizations approached to participate in the study, 67 (88.2%) eventually agreed to participate. Thus far, 473 @entity1 and 419 @entity1 completed the study pretest, post-test, education, and 6-month follow-up. Only 242 @entity1 and 204 @entity1 of the eligible @entity1 have completed the follow-up survey (63.5% of @entity1 and 60.5% of @entity1 retained after 6 months). LESSONS LEARNED: The main strategy to overcome initial recruitment challenges was study staff persistence, because they averaged five contacts with each church or clan leader before receiving confirmation that an educational session can be scheduled. Personal connections provided an introduction to the most appropriate church or clan leader. Other efforts for retention include creation of an online version of the survey, re-attending church services, and creating special events organized around clan activities. CONCLUSIONS: Although CBPR improves the cultural competence and relevance of study activities for ethnically diverse populations, selected past research shows that it does not ensure that such designs overcome all of the unique challenges in ethnically diverse communities. PI-specific organizational recruitment and individual retention is influenced by study issues and cultural factors in each community.
