Comparison of enrollment rates of African-American families into a school-based tobacco prevention trial using two recruitment strategies in urban and rural settings

Purpose. This study evaluated similarities and differences of enrollment rates using two different recruitment strategies for a tobacco control trial in rural and urban African-American (AA) elementary school families. Design. A comparative study, nested within a larger randomized controlled trial, was used to test the effectiveness of two recruitment approaches on enrollment rates in rural and urban AA families. Setting. The study was conducted in 14 Title 1 elementary schools in the southeastern United States: 7 rural and 7 urban. Subjects. There were 736 eligible AA families, and 332 (45%) completed informed consent and were enrolled into the study. Intervention. The Facilitate, Open and transparent communication, Shared benefits, Team and tailored, Educate bilaterally, and Relationships, realistic and rewards (FOSTER) approach guided the two recruitment strategies: (1) written informational packets provided to fourth graders to take home to parents; and (2) proactive, face-to-face family information sessions held at schools. Measures. Enrollment rates were based on responsiveness to the two recruitment strategies and completion of the informed consent process. Analysis. Chi-square, Cochran-Mantel-Haenszel, and Breslow-Day tests were performed. Results. Higher enrollment rates occurred during the family session for both rural and urban families (100% rural, 93.6% urban; p = .0475) than informational packets alone (28.7% rural, 22% urban; p < .0001). Rural family enrollment rates were overall higher than urban rates regardless of recruitment strategy (52.0% rural vs. 39.6% urban; p = .0008). Conclusion. The findings suggest the FOSTER approach, although effective in both rural and urban settings, was more successful in recruiting rural families.