Community health worker perspectives on recruitment and retention of recent immigrant women in a randomized clinical trial

Objective/Purpose: Based on a strong partnership built over the past ten years, this community-academic collaborative team implemented a cluster-randomized trial designed to test a community health worker (CHW)-led intervention program to promote breast and cervical cancer screening among Korean American (KA) women. The purpose of this paper is to report on the recruitment and retention success and specific strategies used by CHWs. Methods: We used prescreening forms, meeting logs, and interview data from four focus groups with CHWs. Descriptive statistics and content analysis were used to summarize our findings. Results: 28 CHWs from 23 churches screened 782 KA women and enrolled 560 eligible women in the trial (intervention, n=278; control, n=282). Over the 6-month of intervention period, 31 women dropped from the study, resulting in 94.5% retention rate. CHWs used a variety of methods to advertise the study and enroll participants such as church bulletin board and/or newsletters, telephone contacts using church membership list, and verbal persuasion at varying venues (e.g., lunch meeting in and outside of the church). While the majority of enrolled participants were recruited through CHWs' own church network, most successful retention strategies were: “not rushing it,” genuine attention and care about the participant, trust, and peer support (and competition among participants). Conclusion: CHWs successfully recruited KA women in a large-scale randomized trial and were able to retain most of them over the study period. Motivated and well-trained CHWs may be used to facilitate participation of hard-to-reach communities in a randomized trial.