Abstract

Background: Recruitment of Black participants in research studies is challenging. Mistrust of academic and medical institutions due to historic mistreatment, medical racism, and lack of culturally tailored strategies to engage Black communities as partners, has led to under-representation of Black participants in studies. Black men have higher prevalence of hypertension (HTN) and worse outcomes than other groups. Yet, Black men are underrepresented in HTN clinical trials. The Community-to-Clinic Linkage Program to Prevent Hypertension (CLIP) is a community-engaged cluster randomized trial to test barbershop facilitation to prevent HTN among Black men residing in Staten Island (SI), New York City. Objective: To describe recruitment strategies to engage Black men in CLIP via an academic-community partnership. Methods and Results: Approximately 10% of SI residents identify as Black, of which ~ 90% live in 3 census tracts with the highest prevalence of HTN in the borough. The study team collaborates with Community Health Action of Staten Island (CHASI), a grassroots health organization with > 30 years of community focus on addressing the root causes of health disparities on SI, the Director of Health in SI, a community advisory council (CAC) comprised of local leaders and residents, and the New York American Heart Association providing HTN education materials in an academic-community partnership to implement CLIP. Our recruitment goal is to enroll 84 men across 4-5 Black-owned barbershops over 5 cycles (12 weeks each), total N=418. We did not meet recruitment goals for cycles 1 and 2, (~60% enrolled). In consultation with CHASI and the CAC we adjusted our recruitment strategies to: 1) host bi-monthly community events in or around participating barbershops; 2) offer study incentives at the time of enrollment; 3) leverage existing relationships with faith-based organizations and other stakeholders to promote CLIP; and 4) distribute co-branded promotional flyers with CHASI and other stakeholders to publicize events. Subsequently we exceeded recruitment goals in our last cycle (113% enrolled); current cycle recruitment is ongoing. Several strategies have been successful in improving recruitment of Black men for CLIP: 1) deep community ties of our community health partner; 2) enlisting local community health workers representative of the study population; 3) flexibility and open communication between academic and community staff; 4) trust in the competence of each partner; 5) mutual commitment to the mission of the study. Conclusion: Partnering with engaged and trusted community partners, stakeholders, and local leaders positively impacts recruitment of Black men participants in HTN research studies. Organizations with deep community ties are crucial for establishing trust and identifying flexible solutions to recruitment challenges.

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