Maximizing participation by black Americans in population-based diabetes research: the Project DIRECT pilot experience.

Diabetes and its associated complications and risk factors have a higher prevalence among blacks than whites. To reduce the burden of diabetes within the black community, research is needed to assess the behavioral, social, and environmental correlates associated with this disproportionate burden. Because of some well known instances of historical exploitation and abuse from medical and public health research conducted in black communities, this population has little enthusiasm for additional research, despite pressing health needs. This paper describes the process used to eliminate barriers and enhance trust between the target community and the researchers conducting a population survey of diabetes in Wake County, North Carolina. A community advisory board was organized to (1) review the survey instruments and methodologies, (2) identify persons from the community to serve as interviewers, and (3) promote the survey using the major local communication channels. The response rate to both the household survey and the comprehensive medical exam was 77%. Eighty-one percent of eligible black respondents completed the household exam and 80% completed the comprehensive medical exam. Advantages of building collaborative relationships between the community and research team are discussed.