Jackson Heart StudyJackson Heart StudySonja R. Fuqua, PhD, RN

Director of Clinical Quality

MS Primary Health Care Association

**********

JHS Manager of Recruitment and Retention (1999-2009)

JHS: TimelineJHS: Timeline

Planning Phase - 1996-1997Feasibility Phase - 1998-1999JHS - began full study - 2000

– recruitment began August, 2000– examinations September, 2000-2004– annual follow up began September, 2001– surveillance continuous

DesignDesign

Prospective population-based epidemiology study--also incorporating families

Expansion of the current ARIC study (Atherosclerosis Risks in Communities)

Projected study population: 6500

ARICARIC

Atherosclerosis Risk in Communities StudyGoal: study risk factors for CVD in

European-Americans and African-Americans

4 centersJackson, MS Forsyth Co, NC

Minneapolis, MN Washington Co, MD

JHS: Family ComponentJHS: Family Component

Family members were included to permit studies of familial/genetic contributions to CVD

Size: 2,000 of the 6,500 JHS cohort sampleEligibility: Index family member has 2 full

siblings and a minimum of 9 first degree, age eligible relatives in study area

Content for JHS ExamContent for JHS Exam

Medical and family history

Medications Lifestyle factors Sociocultural factors Anthropometry BP, ECG Echocardiography

Carotid Ultrasound Brachial Reactivity Pulmonary Function Extensive Blood work Long-term storage of

frozen specimens and DNA extractions

JHS: Interview ComponentsJHS: Interview Components

Demographic information Personal and family health history Medical history (stroke & reproductive) Medication use history Smoking and alcohol use history Nutrition Physical activity Sociocultural

JHS: Sociocultural JHS: Sociocultural ComponentsComponents

SES Health Care Access Stress Coping Religion and religious

coping Social support and

integration

Depression Anger & Hostility Optimism John Henryism Job Latitude Discrimination

ParticipantsParticipants

6,500 participants 2,000 ARIC 2,000 Family Study 2,500 Randomized sample

African American 35-84 years of age Residents of Hinds, Madison, or Rankin

county

Cost to ParticipateCost to Participate

FREE Time expenditure

Home Induction Interview---1 hour Clinic Examination—4 ½ hours 24-hour AMBP and urine—24 hours Annual Follow-up—30 minutes

BENEFITSBENEFITS

Comprehensive medical exam ($4000) Assist in understanding the problem of

African Americans and CVD Build a healthier tomorrow “Friendship” network

Recruitment ProcessRecruitment Process

Contact letter—invitation to participate Three attempts for home contact

Alternate: daytime, evening, weekend First attempt—door-hanger with business card Second attempt—add “happy”

Two attempts either home or phone contact May suspend efforts after five attempts

Recruitment RevisionsRecruitment Revisions

To meet the demands of recruitment goals: Five recruiters became 11 Allowed phone calls Increased--focused community activities Accepted volunteers

Randomized Per demographics and county

Jackson Heart Study Recruitment Jackson Heart Study Recruitment ChallengesChallenges

– Awareness-Improved in recent

months

– Contact challenges-Imperfections in list-Caller I.D./Telemarketer

and junk mail aversion-Avoidance due to

negative expectations/suspicion

-“Random approach”

Recruitment ChallengesRecruitment Challenges

– Acceptance

-70-80% once contact is made

– Clinic appointments

-80% keep appointment after initial home interview

-Transportation issues;other barriers

-Change of heart

-Compensation/incentive

JHS Recruitment:JHS Recruitment:Ended March 31, 2004Ended March 31, 2004

TOTAL Recruited: 5302TOTAL Recruited: 5302

JHS RecruitersJHS Recruiters

JHS RETENTIONJHS RETENTION

Annual Follow-Up Interviews Participant Birthday Cards, Newsletters,

Volunteer Opportunities JHS Annual Family Reunion Community Health Advisors Network

(CHAN) Community Partnerships and Outreach

JHS Exam 2JHS Exam 2

September 2004—December 2008 85% returned for the second exam

JHS Exam 3JHS Exam 3

February 2009—March 2013

Ancillary StudiesAncillary Studies Ancillary studies added

Peripheral Arterial Tonometry (PAT), which looks at the health of your blood vessels

A study that is looking for a relationship between heart disease and hearing loss;

MRI (Magnetic Resonance Imaging) of your heart

Health Promotion Study (Yoga Study) Sleep Study

Where do we go from Here?Where do we go from Here?

Ongoing Retention Efforts Community Partnerships and Outreach Community Health Advisor Education and

Activities TRIPP

Translating Research Into Practice and Prevention

Building a

Legacyof

Health...

To be a “Professional”To be a “Professional”

How do you put a giraffe into a refrigerator?

Open the refrigerator, put in the giraffe and close the door.

This question tests whether you tend to do simple things in an overly complicated way.

Professional………Professional………

How do you put an elephant into a fridge?Open the refrigerator, put in the elephant

and close the door. (WRONG)

Open the refrigerator, take out the giraffe, put in the elephant and close the door.

Test the ability to think through the repercussions of your actions.

Professional…………Professional…………

The Lion King is hosting an animal conference. All the animals attend except one. Which animal does not attend?

The Elephant. Its in the refrigerator.

This tests your memory

Professional………..Professional………..

There is a river you must cross, but it is inhabited by crocodiles. How do you manage it?

You swim across. All the Crocodiles are attending the Animal Conference.

This tests whether you learn quickly from your mistakes.