Hispanic Retention Research Articles

Culturally Sensitive Approaches to Recruitment and Retention of Hispanics in the National Lung Screening Trial

Hispanics are underrepresented in medical research. At the National Lung Screening Trial's University of Colorado Denver screening center, traditional recruitment methods resulted in enrollment of few Hispanics. In response, the center adopted culturally sensitive recruitment techniques, including use of carefully-crafted bilingual materials. Bilingual interviewers were hired, and persons familiar with culture and language of groups of different Hispanic origin were consulted. Representation of Hispanics among participants enrolled at the Colorado center increased nearly threefold, from 3.3 to 9.4 %, after adoption of these methods. In this manuscript, we report on the specialized recruitment methods that were developed and how they were used to address known barriers to Hispanic recruitment.

Attrition and retention in clinical trials by ethnic origin

Context Common perceptions exist within the medical community that retention of Hispanics in clinical trials is difficult, albeit little data is available to support this conviction. Methods A total of 541 randomly selected charts from closed clinical trials between 2000 and 2006 were reviewed. Records were from participating institutions in Texas Medical Center, Houston, and targeted diseases of high prevalence, specifically, breast cancer, prostate cancer, and chronic obstructive pulmonary disease (COPD)/asthma. Findings Overall, 259 participants (48%) completed the trial they were enrolled in (44% whites, 69% Hispanics, 51% blacks; p < .05). Within pediatric trials, whom all were pulmonary patients, retention rates were higher among Hispanics than whites (adjusted odds ratio [OR] = 7.49, 95% confidence interval [CI] = 1.15–58.03, p = .04). Among adults, patient's ethnicity was unrelated to study completion. All associations were adjusted for possible confounders. Reasons for not completing a trial varied by ethnicity: “patient withdrawing consent” was more common among whites (51.4%) than Hispanics (21.7%) or blacks (26.2%) ( p < .05). Hispanics were more inclined to be withdrawn from the trial by the investigator (43.5%) than were whites (24%, p = .04), mostly due to non-compliance with the study protocol. Conclusions Hispanic parents of children with COPD may be more likely to complete a trial than parents of non-Hispanic whites. Among adults, Hispanics had similar completion rates as compared to whites. Culturally sensitive, multi-factorial approaches maybe imperative to increasing patient engagement in clinical trials.

The recruitment and participation of Hispanic women in nursing research: a learning process.

Limited information is available regarding the selection of culturally appropriate methods for obtaining data from the Hispanic population, which is currently the largest and fastest growing ethnic minority in the United States. Due to this lack of knowledge which would guide the investigator in the recruitment and retention of Hispanics in research studies, the Hispanic population remains understudied and underserved. This article describes the numerous challenges that were encountered in the actual process of recruiting Hispanic women into a research study which examined adjustment among breast cancer survivors. The rate of refusal to participate was unexpectedly high, which necessitated additional recruitment strategies, including a renewed emphasis on the importance of the study and the option of meeting with other members of the community in a group. Women who refused to participate in the study stated concerns related to a loss of health benefits, the influence of family members, and a recurrence of emotional stress. Instrument issues are also addressed. This learning process of developing, refining, and testing effective methods for recruiting Hispanic women in research studies remains an ongoing endeavor; through these efforts it is hoped that culturally competent health care can become a reality.

Gender and Racial/Ethnic Differences in the Affirmative Action Attitudes of U.S. College Students

Most of the literature on affirmative action focuses on European American adults' opposition to it. This study extends that focus by investigating gender and racial/ethnic differences in college students' support for affirmative action in higher education. Multivariate analysis of data from a diverse sample (N = 290) found greater differences along racial/ethnic than gender lines. European and Asian American students expressed greater opposition to affirmative action; African and Hispanic American students were more supportive. Asian Americans shared with Whites racerelated orientations that predisposed them to their oppositional views. Hispanics shared orientations with African Americans that predisposed their support of affirmative action. The need to clarify the multiracial/ethnic context of the debate over higher education affirmative action is supported. INTRODUCTION Higher education in the United States currently exists in a state of paradox. On the one hand, U.S. institutions of higher education want to appear to be strongly egalitarian. Yet, the nation's colleges and universities have played a significant role in historically discriminating against women, Blacks, and other people of color (Altbach, 1991; Anderson, 1988; Darder, Torres, & Gutierrez, 1997). These institutions continue to struggle with how to become more liberal, inclusive, and tolerant of women and racial/ethnic minorities. For their part, African Americans overwhelmingly have considered a college degree to be an important vehicle for self-determination and upward social mobility (Anderson, 1988). Blacks have been as determined as any other racial / ethnic group to struggle through societal barriers to achieve the American dream of equal opportunity and success through education and hard work (Feagin, Vera, & Imani, 1996). Despite this strong determination, Black students are not promised that the fruits of their preparation and hard work will be realized on majority White college campuses without having to endure a hostile racial climate. Black students often report a sense of insensitivity among Whites toward the issue of student diversity. They also often indicate the belief that their racial and cultural backgrounds are invalidated by White students, faculty, administrators, and staff on traditionally White college campuses (Feagin et al., 1996; Smith, 1998). However, as Smith (1996) contends, when the campus environment is racially hostile, or specifically antiBlack, learning for all students becomes impaired, and the overall educational process may stall or cease. During the 1980s and 1990s, college and university campuses in the U.S. have been plagued with incidents of racial intolerance toward Blacks, race-targeted programs, and multicultural curricula (Botstein, 1991; Feagin et al., 1996). More recently, legislation and official enactments have caused higher education to move away from its commitment to affirmative action and racially targeted programs. When these types of programs are threatened or eliminated, the college transition, retention, and performance patterns of African and Hispanic American students are jeopardized (Gossman, Dandridge, Nettles, & Thoeny, 1983). Two decades of research has supported the contention that both African American (Altbach, 1991; Babbit, Burbach, & Thompson, 1975; Jones, Harris, & Hauck, 1975) and Hispanic American (Burbach & Thompson, 1971; Munoz, 1986; Olivas, 1986) college students face greater academic difficulty, financial hardship, social isolation, and cultural conflicts. These academic and non-academic stressors are critical variables in the higher risks for Black and Hispanic retention and performance problems at traditionally White institutions of higher education (TWIs). Hence, beyond preparing themselves for the academic rigors of higher education, Black and Hispanic students must also cope with non-academic sources of stress in the TWI environment noted by Pascarella and Terenzini (1991) and Sedlacek (1988, 1991, 1993, 1995). …

Retention of Hispanics in public sector mental health services.

Hispanic underutilization of mental health facilities extends to lowered retention rates among the chronically mentally ill. A theoretical model of retention was developed with four domains of variables: personal traits, accessibility of social support, treatment characteristics, and facility characteristics. Using data collected from CMHC clinical charts in 1983 and 1984, the model was tested using multiple regression and commonality analysis. The model was tenable (R = .59). However, the commonality analysis suggested that most of the unique variance was contributed by the treatment domain. The social support domain made negligible unique contribution. Implications of the model are discussed.