Health disparities continue to pose significant challenges to achieving health equity, undermining the well-being of individuals and communities. To ensure the validity and fairness of research outcomes, it is essential to include representation across areas such as race and ethnicity, age, gender, and socioeconomic conditions. When research neglects the experiences and health needs of under-represented groups, it risks missing insights that could drive progress toward health equity.
Recognizing this need, the Recruitment and Retention Shared Facility (RRSF), a service of the Minority Health & Health Equity Research Center (MHERC), at the University of Alabama at Birmingham (UAB), has a history of supporting health disparities and health equity research in studies and clinical trials.
As one of the longest-standing activities of the MHERC, the RRSF provides a recruitment infrastructure for investigators that includes participant recruitment and retention, telephone interviews, data collection services, customized survey modules, reporting, and more. RRSF faculty and staff have unique expertise in reaching populations that are typically under-represented in biomedical research.
Set apart by its unique ability to reach certain demographics, the RRSF was established in 1997 as part of the Women’s Health Initiative. While the RRSF has evolved significantly over the years, by 2003, it became a funded shared facility core of the UAB O’Neal Cancer Center. The group’s mission was two-fold—to support both cancer-related and non-cancer-related research. This expansion was driven by the visionary efforts of Mona Fouad, M.D., Director of the MHERC, whose commitment to community engagement and health equity has been instrumental in the RRSF’s evolution and success over the years.
Visionary Leadership and Passionate Commitment
Fouad’s vision for the RRSF was rooted in her dedication to engaging under-represented populations in Jefferson County and surrounding areas. Her efforts have ensured that these communities receive vital health information, guidance, and equitable access in research arenas previously untapped. The RRSF relies on trusted community members and leaders to provide guidance, consulting, and transparent information to their communities. Knowing the RRSF team by name has fostered rapport with community members, a sense of familiarity that has built upon itself and continues to benefit the core and the programs/projects it supports.
The RRSF team is co-directed by Cynthia Y. Johnson and Julie Schach, whose personal experiences and commitment to the community inspire their work. After retiring from the corporate sector, Johnson discovered a new calling at the RRSF. Her motivation and passion stem from her role as a caregiver for her immunocompromised son. When learning how she can best serve her son, Johnson experienced first-hand the challenges community members have seeking and finding reliable information. Empathizing with those she serves; this perspective allows her to represent the community effectively and advocate for their needs in the RRSF’s initiatives. Johnson’s nearly 24 years of experience at the RRSF have been marked by her commitment to being a reliable resource and an example for others.
“Research makes such a profound difference in our lives. It’s not just a job for me; it’s a wholehearted passion.” --- Cynthia Y. Johnson
Schach’s motivation stems from her early experiences as a caregiver alongside her supportive family. Her grandfather’s battle with Alzheimer’s and her grandmother’s stroke inspired her to pursue a research career to help play a part in advancing better health outcomes through research for all communities. Schach first entered the field of research as a Data Entry Operator and then as a Data Coordinator for The National Lung Screening Trial (NLST), a study led by Dr. Fouad in preventive medicine. This experience connected her with communities in Birmingham, allowing her to learn about their distinct challenges. With 16 years in research under Dr. Fouad, Schach’s focus has always been on building bridges to support those who are struggling, emphasizing her heartfelt commitment to serving the community.
“Even on the hardest days, the common goal is to help others. This work is an opportunity to meet people where they are; it’s a mission to make a real difference.” -- Julie Schach
Finding Success with a Community-Centric Approach
Community engagement lies at the core of the RRSF’s recruitment strategy. The RRSF team consists of staff members who represent the communities they serve, which helps build trust and credibility. This engagement is crucial for recruitment efforts, as it strengthens the relationship between researchers and the populations they intend to study. By involving community members and leaders in the research process, the RRSF ensures that its recruitment strategies are culturally relevant and address the unique needs and concerns of each population. This proactive approach not only increases participation rates but also results in more meaningful and representative research outcomes.
One of the RRSF’s most notable achievements is its involvement in “All of Us,” a National Institutes of Health research program aimed at collecting and analyzing diverse data from over one million individuals in the United States. Since early 2023, the RRSF has enrolled nearly 43,000 participants for the study; achieving a remarkable 92% enrollment rate of under-represented populations, well above the 40% goal for the Southern All of Us Network. This initiative seeks to accelerate health research and drive medical breakthroughs for improved health outcomes for everyone. Now in its seventh year with the All of Us study, the RRSF has supported recruitment strategies at nine different institutions—University of Alabama at Birmingham, Cooper Green, University of Alabama Tuscaloosa, University of Alabama Huntsville, Louisiana State University, Tulane University, University of Mississippi Medical Center, University of South Alabama, University of Alabama Selma & Montgomery. This success is attributed to the RRSF’s innovative enrollment models, which include community engagement and partnerships.
Comprehensive Services and Future Initiatives
The RRSF offers a wide range of services to support researchers in developing effective recruitment and retention plans. These services include tailored population and clinic-based recruitment strategies, phone or in-person study eligibility screenings, and the development of customized participant retention plans. The RRSF’s specialized database enhances participant recruitment, ensuring researchers can reach their target populations effectively.
The RRSF continues to develop and implement new practices, as well as expand its services. Future initiatives include focusing on customizable participant recruitment strategies that use multimedia, traditional mail, and social media to broaden the pool of individuals interested in research. Additionally, they aim to expand their offerings by strengthening their Spanish-speaking core and extending engagement efforts to other Alabama cities like Selma and Dothan.
Sustained Excellence and Building Trust
Over the past 25 years, the RRSF has worked with numerous investigators on a wide variety of studies, building trust with each successful project. That success is built on a commitment to innovation and continuous learning and adaptation.
Dr. Lori Bateman, a researcher who has collaborated extensively with the RRSF, praised the team’s dedication and expertise. “Johnson and Schach’s authentic understanding of the communities we serve and their expertise in recruitment and data collection always reassures me that my goals will be met at the proposal, data collection, and analysis stages of my projects,” Dr. Bateman stated.
The RRSF core has contributed to more than 100 studies, enrolling nearly 150,000 participants to date. In 2024 alone, they have successfully recruited just over 4,130 participants for 14 different investigators.
Recruitment of participants can seem like a simple process, but depending on the study and the population needed, it can be difficult to reach recruitment goals. For researchers new to working with recruitment and retention services, Schach recommends that they consult with the RRSF during the initial grant-writing process rather than waiting until after a study is funded. RRSF develops custom plans based on budget, target population, and deadlines. The experienced staff implements strategies quickly, allowing them to pivot and adapt efficiently if needed. “The earlier we can get involved in talking to the investigator, the better we can customize a plan and write a strategy. If we can’t anticipate challenges, we risk starting from scratch—and that’s simply not in our DNA”, said Schach.
As a service core of the MHERC, a university-wide interdisciplinary research center, the RRSF can provide its cost-effective, centralized service to researchers throughout UAB. For more information, contact Co-Directors CY Johnson or Julie Schach.