Double Whammy: Accessing, Recruiting And Retaining The Hidden Of The Hidden

Recruitment of women who use crack is challenging in any environment, but especially in rural environments. The nature of rural environments, which limits confidentiality; coupled with conservative views and stigma associated with drug use, contributes to the difficulty of access to rural residents who use illicit drugs if one only uses traditional recruitment strategies. This ethnographic study among rural black women who use powder and crack cocaine, however, implemented effective recruitment and retention strategies. Recruitment strategies included: concealing the nature of the study from all residents in the county with the exception of the participants, recruiting potential participants into one or more health prevention programs sponsored by a local community-based organization as well as the current research study, modifying traditional participant observation and ethnographic mapping techniques, using snowball sampling technique, and employing two indigenous women to serve as cultural brokers. Retention strategies focused primarily on maintaining a personal relationship with the participants by visiting them in their homes, at hangouts, in jail and correctional facilities, and providing incentives and favors. These strategies made it possible to recruit rural black women who use powder and crack cocaine for participation in drug-use research and to retain the majority of recruits. © 2003 by the Haworth Press, Inc. All rights reserved