) African American women are twice as likely as Caucasian women to develop cervical cancer and almost three times as likely to suffer mortality. Therefore, attention to methods that enhance the cancer-screening behaviors of African American women is paramount to the Healthy People 2000 goals of reducing cancer rates in special populations. General recruitment and retention of minority populations into clinical trials has recently come under scrutiny by researchers. Scientific testing of strategies to enhance recruitment and retention is scarce in the literature. This study will test whether an additional intervention in the form of a peer advocate from the African American community affects recruitment and retention rates of African Americans in a large trial of cervical cancer screening and triage techniques (the ALTS trial). Three hundred eligible women with a Pap smear diagnosis of LSIL will be randomized into special intervention and control groups. A peer advocate clinical assistant will interact closely with the intervention group in addition to regular follow-up; follow-up for the control group will be according to the ALTS protocol. Recruitment and retention rates for the two groups will be compared. Barriers to recruitment and retention will be identified. An index to measure anxiety states in the participants will be administered to determine the effect of the intervention on anxiety levels in women referred for an abnormal Pap smear. This index will also be used to assess the relationship between anxiety state and retention rate. It is hoped that a better understanding of the specific factors that influence general minority recruitment and retention will be realized through this trial. It is also hoped that the results may lead future investigators in research staff selection and recruitment and retention planning.
