This paper describes the methods used to recruit
American Indian (AI) populations for the Strong Heart Study
(SHS), a community-based study of cardiovascular disease
(CVD) and its risk factors in AI men and women.
Recruitment strategies included personal contact by
recruiters and drivers/recruiters in remote areas, SHS staff
participation in community activities, and mass media. A
total of 4,549 participants aged 45-74 years were recruited
from 13 American Indian tribes and communities. Overall
participation rates were 72%, 55%, and 62%, respectively,
for the three study centers (Arizona, the Dakotas, and
Oklahoma). Participant feedback and educational material
related to risk factor reduction and promoting a healthy
lifestyle were emphasized. Participants were likely to be
female, young, and nonsmokers. Barriers to recruitment
included lack of telephones in a large proportion of
households, conflicting beliefs about health/health care/
research, fears, taboos, and occasional rumors about study
examination procedures. Participants were referred for
follow-up of health problems detected by the study. The
strong commitment of the participating communities
helped to insure the success of the SHS, which can be
considered a model for recruitment in future American
Indian population-based studies. Success was facilitated by
the use of a variety of recruitment techniques.