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Challenges in Surveying Elderly African-American Men

Neal Simonsen, LSUHSC School of Public Health, Epidemiology Program 
Evrim Oral, LSUHSC School of Public Health, Biostatistics Program 
*Christine S Brennan, LSUHSC School of Public Health 
Jennifer Berken, LSUHSC School of Public Health, Biostatistics Program 
Jennifer Hayden, LSUHSC School of Public Health 
Elizabeth Fontham, LSUHSC School of Public Health, Epidemiology Program 

Keywords: Hard to reach subpopulation, Cancer research, Nonresponse rate, Accurint

Populations experiencing disproportionately poorer outcomes may benefit the most from health research, yet these groups are often identified as those among the hardest to reach in terms of enrollment in health-related research. It has been demonstrated that African American (AA) men have higher incidence and mortality rates for most major cancers, including prostate, lung, and colorectal cancer, compared to Caucasian American (CA) men, yet many studies are hampered by an insufficient number of AA men to adequately explore the reasons behind these differences. Multiple factors potentially contribute to this, including difficulties in obtaining valid contact information and in enrolling potential participants once contact is made. Once potential study participants have been identified, contact information remains incomplete for a substantial number of potential participants even after use of commercially available resources such as Accurint. Other reasons postulated to reduce AA enrollment in research studies is a greater distrust of medical researchers as well as socioeconomic and sociocultural factors in this population. While older AA men are not typically viewed as a hard to reach subpopulation, success in reaching this group is often problematic especially in cancer research. In this study, we define older AA men in cancer research as a harder to reach and persuade subpopulation. We assess contact and enrollment of this subpopulation compared to other groups using data from a population-based study of newly diagnosed prostate cancer conducted in Louisiana. Key barriers and contributors to specific components of successful enrollment are identified based on population comparisons and regression modeling with strategies to increase reach to potential participants proposed.