534 Ethnicity & Disease, Volume 13, Autumn 2003 COMMENTARY BARRIERS AND STRATEGIES FOR SUSTAINED PARTICIPATION OF AFRICAN-AMERICAN MEN IN COHORT STUDIES Gail D. Hughes, DrPH, MPH; Denethia B. Sellers, MSW, PhD; Lionel B. Fraser Jr., MD; Bern’Nadette Knight, MSPH; Gloria A. Areghan, MSN, CSNP (Ethn Dis. 2003;13:534–536) Key Words: African American, Prostate Cancer, Cohort Studies The article by Hoyo and colleagues entitled, Barriers and Strategies for Sustained Participation of African-American Men in Cohort Studies, used focus groups to determine the feasibility of recruiting and retaining African-American men in cohort studies, especially those collecting both biological and ques- tionnaire data from a study conducted in the Durham, NC metropolitan area. 1 Several strategies were used to recruit study participants representing a broad educational and socio-eco- nomic cross-section of African-American men between the ages of 40 and 64, including targeting college campus sports events, local community businesses, as well as high- and low-employ- ment geographic locations with predominantly African-Amer- ican employees. 1 A total of 46 African-American men and 9 African-American women were recruited through this process. 1 The article raises many similar issues researchers have faced while attempting to recruit and sustain participation of African Americans in clinical trials. 2 Since barriers to participation like mistrust are commonly reported in the context of clinical 3,4 and community trials, 5 Hoyo and colleagues reported the results of a focus group study regarding barriers and facilitators of sus- tained participation in prostate cancer research studies among African-American men. 1 Specifically, focus groups in their study addressed the following topics: strategies for minimizing bar- riers, the feasibility of their participation in a study collecting biological specimen and questionnaire data, feelings and per- ceptions of prostate cancer, as well as their risk factors, study participation and design, and sources of outreach and recruit- ment. 1 Similarly, our study in the Jackson, Mississippi metropolitan area conducted a series of 10 focus groups with homogeneous groupings (6 male and 4 female) from a urology clinic patient From the Department of Preventive Medicine-Epidemiology (GDH, GAA), Department of Surgery (Urology) and Metropolitan Urology, PA (LBF), Division of General Internal Medicine (BK), Uni- versity of Mississippi Medical Center, Jackson, Mississippi; Florida A+M University; Department of Health, Physical Education and Rec- reation; Tallahassee, Florida. Address correspondence and reprint requests to Denethia B. Sell- ers, MSW, PhD; Florida A+M University; HPER-206 Gaither’s Gym Office Complex; Tallahassee, FL 32307; dbs1to10@aol.com population to investigate perceived barriers to participation, perceptions of cancer and cancer research, factors that may in- crease the probability of sustained participation, health aware- ness, social support, and coping strategies. Participants were also asked about the feasibility of their participation in a long- term follow-up study where biological specimens and interview data would be collected in regularly defined intervals. Participants eligible for the study were African-American patients between the ages of 40–75 years who were diagnosed with prostate cancer (with an ICD-9 code of 185) within the past 10 years and seen in the local urology clinic. Female par- ticipants were partners/spouses of African-American males di- agnosed with prostate cancer from the recruitment clinic. Po- tential participants who met the inclusion criteria were ran- domly selected from lists generated by the urology clinic. Those recruited to participate in the study were contacted initially by phone by clinic staff and informed of their eligibility to par- ticipate in the study. Each person contacted then received a follow-up letter and phone call to be scheduled to participate in a focus group. The spouses/partners of potential participants were contacted once the male participants had been selected and scheduled to participate in the focus group. Similarities and differences exist between the respective fo- cus group results from these 2 studies according to the cate- gories addressed (Tables 1–3). In our study, we found that Af- rican Americans were more likely to participate in long-term prostate cancer studies if the recruitment source provided en- couragement and followup from resources within the com- munity, such as church supporters, gate-keepers, or key infor- mants. Providing information, education, and periodic feed- back also encouraged continued participation. Utilizing re- search institutions or community-based organizations that participants perceived as trustworthy, competent, credible and well known was also important to encourage participation in trials. 6 Participants stated that if prostate cancer survivors were used as recruiters they would be more encouraged to participate in research. They wanted to be kept informed of progress/out- comes from the research conducted through either newsletters or mailings. An acknowledgment of participant (geographic lo- cale, socioeconomic status, education, occupation) diversity and a comprehensive community approach to study involvement was also important to our participants.