Subject recruitment issues in African Americans

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Subject recruitment issues in African Americans

• Keith E. Whitfield, Ph.D.
• Department of Biobehavioral Health
• The Pennsylvania State University

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Overview

• Basis for issues
• Subject Recruitment
• Measurement Issues

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Baltimore Study of Black Aging

• Began in 1997
• Mission To explore psychosocial and health
  factors
• related to cognitive functioning in African
  Americans
• Six Waves of Data Collection
• Everyday Problem Solving 249
• Cognition and Health 502
• Personality and Health 343
• Arthritis and Depression 200
• Context and Health Care Access 50
• Cognition and Desegregation 201
• Longitudinal follow-up 100

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Carolina African American Twin Study of Aging
(CAATSA)

• Keith Whitfield-Principal Investigator
• Gerry McClearn-Investigator
• David Vandenburg-Investigator
• Sebrina Wiggins-Asst Project Director
• Santiba Cambell-Project Coordinator
• Dwayne Brandon-Data Entry Coordinator
• Coren Burton Jaroah Carter
• Letanya Love Kimya Jackson
• Laurel McKie Kim Newsome
• Mattie Richmond Corey Wright

Funded by the National Institute on Aging Grant
1RO1-AG13662-01A2
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• 285 Twin Pairs
• Singletons/Sibling
• 25-85 yrs old
• North Carolina
• Home Interviews

• Health-
• Cardiovascular Disease Risk Factors
• Memory
• Physical Functioning
• Mental Health
• Personality
• Social Factors

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Final Sample
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Subject Recruitment

• Personnel
• Finding Subjects
• Retention and Tracking
• Testing Site
• First Contact

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Personnel

• Community Liaison
• Project Coordinator
• Senior Aids
• Community Leaders (Clergy)
• Minority Investigator

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Finding Subjects

• Health Care Providers
• Community Liaison
• Naturalistic Observation
• Informal Conversations
• Census Data

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of Baltimore Population over 50 that is Black
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of African Americans over 50 in Baltimore
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Retention and Tracking

• Birthday Cards
• Go to Church
• Family/Friends/Community Gossip

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Testing Site

• Clinic
• Church
• Local Community Site
• Home

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First Contact

• Through powerful others
• Church
• Community icon
• Family Member
• Personal appeals
• Presentations to small groups
• Based on positive personal attribute
• (e.g., being a twin)

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Measurement

• Selection of Measures
• Equivalence of Measures
• Reliability and Validity

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Measure Selection

• Focus group
• Pilot measure and assess its validity from
  subjects comments
• Find out what subjects view as important aspects
  of aging.
• Previous Use
• 1-Used in African American Populations
• 2-Previous cross-cultural use
• 3-Well accepted measure

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Equivalence of Measures
Cauce, A.M., Coronado, N., Watson, J. (1998).
Conceptual, methodological and statistical issues
in culturally competent research (pp305-331). In
M. Hernandez M.R. Isaacs (Eds.), Promoting
cultural competence in childrens mental health
services. Baltimore MD Paul H. Brookes
Publishing Co.

• Cultural Equivalence
• Extent the measure has same internal structure
  and meanings within and across groups
• Conceptual Equivalence
• Content of items is defined similarly across
  groups
• Items are equally familiar across groups

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Equivalence of Measures (cont.)

• Linguistic Equivalence
• Language of items is understood the same across
  groups (e.g. Blue)
• Functional Equivalence
• Scores have similar correlates across groups
• Scalar Equivalence
• Scores reflect the same level of the construct
  across groups

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Reliability and Validity

• Use focus groups for validity
• Small pilot studies
• Always re-calculate reliability
• Cross-validate new measures with old

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Summary

• No easy answers and perfect strategies
• Add human component
• Utilize community and form long term
  relationships
• Give as much as you get