Too few women and minorities in addiction studies

Researchers provide tips on recruiting and retaining underrepresented groups in research on addiction.

By Beth Azar
Monitor staff

Congress recently mandated that researchers include more women and ethnic minorities in their studies. And most researchers agree it?s good science to do so. But it?s also easier said than done, said a group of researchers who study addiction in traditionally understudied populations. Researchers who try to include women and minorities in their studies often find it difficult to recruit and retain participants, they said.

In fact, researchers should be prepared to spend most of their time on the front end of their study, identifying and recruiting participants and designing measurement tools appropriate for the population, said Laurie Roehrich, PhD, of Pacific Graduate School of Psychology, in a symposium on underserved populations at APA?s 1998 Annual Convention. The session was part of the National Institute on Alcohol Abuse and Alcoholism Miniconvention and was a tutorial for researchers trying to include more women and ethnic minorities in their studies.

Roehrich and Sharon Wilsnack, PhD, of the University of North Dakota School of Medicine and Health Sciences, shared their experience recruiting, retaining and studying special populations in studies of addiction.

Barriers

Roehrich acknowledged several significant barriers to attracting special populations to addiction studies, most of which pertain to the general population as well:

? Because drugs are illegal, people may not want to enter a study for fear of exposing themselves to the law.

? A stigma of addiction exists in many communities so people may be afraid to enter a study for fear of being exposed.

? Many special populations are outside of the health-care system and so difficult to locate.

? Some populations have little or no access to transportation to get to a study site.

? Women may need childcare in order to participate in a study.

? Some immigrant and poverty populations may have poor language or reading skills.

Recruitment and retention

Once researchers understand the barriers to study participation, they must design strategies to recruit and retain participants. Wilsnack and her colleagues have had success recruiting and retaining women in a 20-year study of women?s drinking. And she credits her success to her willingness to think of her study participants as partners. Her recruitment and retention strategies include:

? Communicating the project?s significance 'woman to woman,' emphasizing the benefits the study will have to other women.

? Locating and retaining a group of highly committed women to conduct face-to-face interviews and to track down women for follow-up portions of the study.

? Recognizing potential barriers to participation such as the potential influence of partners who might not approve of the study.

Measurement strategies

Researchers may obtain unusable data or lose participants if they try to use the same measurement tools with all populations?a technique common in behavioral research, said Wilsnack. Once researchers recruit participants, they need to tailor questionnaires and surveys to their study population, she said. Several strategies she and her colleagues use are:

? Including questions specific to women?s alcohol-related problems and contexts, such as drinking-related problems with children.

? Wording and sequencing questions to be sensitive to women. For example, they worded alcohol consumption questions to make it seem as if reporting high levels of drinking is normal and acceptable, so women would feel comfortable answering honestly. They also let them answer sensitive questions on self-report forms that they could seal into envelopes to ensure confidentiality.

? Adding protocols relevant to subgroups, such as lesbians.

Researchers should also design measures that are accessible to the population in question?written at the appropriate grade level and with a realistic number of items, said Roehrich. And it?s important to take time to conduct focus groups and pilot research projects to test research designs and measures.

Data collection

To ensure that researchers retain participants over the course of a longitudinal study, they should design data collection techniques that put participants at ease and build a sense of commitment to the study, said Wilsnack. Some strategies include:

? Building a rapport with participants with face-to-face, at- home interviews.

? Selecting and training interviewers carefully. For example, Wilsnack rejected any interviewer who abstained completely from drinking alcohol or who had a negative attitude about drinking.

? Maximizing privacy and confidentiality.