AHS-2 is one of very few large health studies of black Americans, with nearly 26,000 black participants. As such, it is specially positioned to help answer why this group faces different risks of certain diseases. AHS-2 is also positioned to examine how best to overcome historical barriers in working with the black community in a research setting. Here is what we have learned so far:

Profile of Black Study Members

  • Compared to the rest of the AHS-2 study members, this cohort included more females and younger individuals.
  • Fewer were currently married and more were never married, divorced or separated.
  • The average age of baptism was 24.3 years.
  • Rates of smoking, drinking and meat consumption were lower, and rates of vegetarianism and water consumption were higher, for black Adventist participants.
  • The education level was higher for black study members (35% hold a bachelor’s degree or higher) than for black Americans nationally (15% hold a bachelor’s degree or higher).

Health Overview

  • Compared to other Adventists, black Adventists have more cases of Type 2 diabetes, stroke and high blood pressure.
  • However, the same group has fewer cases of emphysema, myocardial infarction, heart attacks, fibromyalgia and high cholesterol.
  • Black females had significantly less cancer than did non-black females.
  • Black males had 47% higher prevalence of prostate cancer than did non-black males.
  • Obesity was more prevalent among black participants vs. non-black participants (35% vs. 22%).
  • For BMI, 42% of non-blacks had normal weight, and 28% of blacks had normal weight. More: Regional breakdown of BMI levels for black participants
  • 53% of black participants reported sleeping six or fewer hours per night.
  • Overall, black Adventist study participants reported better physical and mental quality of life than the U.S. norm. More: Physical and Mental Quality of Life Data
  • Cases of hypertension and diabetes were lower for black Adventists than comparable national rates for both blacks and non-blacks, a noteworthy finding. This may be explained by the fact that black Adventists reported better health habits than black non-Adventists.

Research in the Black Community

Black Americans have been under-represented in scientific studies for several reasons. From the black community’s fear of exploitation based on mistreatment in the past, to researchers’ failure to recruit blacks through targeted strategies, much work is needed to improve black representation in medical/scientific research. AHS-2 has documented the methods involved in recruiting 26,000 black Adventists in order for future researchers to achieve better representation also.

Methods

  • Local Adventist churches were the main recruitment area, as this is the center for community life and activity.
  • Focus groups in three churches revealed several areas of concern, including:
    • Confidentiality
    • Use of Social Security numbers
    • Respectful and culturally appropriate treatment
    • Meaningful and motivating incentives
    • Ongoing sharing of results
  • The recruitment personnel were Loma Linda University (LLU) black researchers familiar with the church structure and obstacles in recruitment. They partnered with church officials for recruitment. Additionally, LLU formed a partnership with Oakwood University in Alabama, a historically black Adventist institution, by establishing a research support office there.
  • Tailored promotional materials were printed and volunteers were trained by researchers.
  • Recruitment included pre-enrollment activities and a special Sabbath “Celebration Day” that included a health sermon and a special potluck where enrollees were encouraged to bring the questionnaire.
  • In 2004, AHS-2 promoted the study nationally through church publications and Adventist television.
  • AHS-2 found that the degree of participation of the pastor and church recruiters made a difference in the churches’ response rates. For example, when the pastor and recruiter both fully participated, 67.3% of those requesting questionnaires returned them, compared to 35.8% for churches where neither the pastor nor the recruiter returned the questionnaire.

Despite the challenges of the past, AHS-2 has shown that it is possible to recruit a large number of black participants through tailored methods.