Abstract
We compared strategies and costs associated with recruiting unmarried middle-aged and older women who partner with women (WPW) and women who partner with men (WPM) into an observational study about experiences with cancer screening. We used targeted and respondent-driven sampling methods to recruit potential participants. Comparable recruitment strategies were used for WPW and WPM. During 25 months (June 1, 2003, through June 30, 2005), 773 women were screened for study eligibility; 630 were enrolled (213 WPW, 417 WPM). Average staff time spent for recruitment was 100 min per participant. There were no differences by partner gender in average recruitment time (WPW, 90 min; WPM, 100 min). Print media was the most efficient recruitment mode (time per participant: 10 min for WPW, 15 min for WPM). Recruitment costs differed by partner gender ($140 for WPW, $110 for WPM). Costs associated with print media were $10 per WPW and $20 per WPM. Recruitment through community events had higher costs ($490 per WPW, $275 per WPM) but yielded more women with less education and lower incomes, who identified as a racial or ethnic minority, and self-reported a disability. Compared with WPM, WPW had more education and higher incomes, but were less likely to identify as a racial minority and self-report a disability. There was a trade-off between cost and sample diversity for the different recruitment methods. The per-person costs were lowest for print media, but recruitment through community events ensured a more diverse representation of unmarried heterosexual and sexual minority women.
Highlights
Since the 1994 NIH mandate for more diversity in research populations [1], the number of studies about strategies and costs associated with recruiting hard-toreach, underserved populations has increased
Results did not differ when we replicated the analyses after removing the six women who reported hearing about the study from more than one recruitment source. This is one of the first studies to describe strategies and costs associated with recruiting unmarried middle-aged and older sexual minority and heterosexual women. It contributes to other published reports documenting recruitment methods associated with an observational rather than clinical trial or intervention study
Direct costs per participant increased by $60 for previously married WPW but $30 or less for all other strata, assuming a 20% reduction in yield
Summary
Since the 1994 NIH mandate for more diversity in research populations [1], the number of studies about strategies and costs associated with recruiting hard-toreach, underserved populations has increased. The majority of these studies have focused on strategies for enrollment of racial and ethnic minorities [2], and focused on recruitment related to particular disease conditions. Fewer studies have focused on individuals without a specific health condition. Sexual minority (e.g., lesbian and bisexual) women are an important segment of the unmarried female population and represent another difficult-to-reach minority population [3]. Population prevalence estimates of middle-aged and older sexual minority women range from 1% to 5% in large community- and population-based studies [5,6,7]
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