Table 3.

Community Leaders’ Focused Discussion Themes and Illustrative Quotes

Theme	Illustrative Quotes
Trust	“One of the other things is that people have to know about what it is what you are going to do, again that goes back to the trust issue because that’s a major problem in the Black community and stems from some earlier studies. The Tuskegee situation, I mean that is what people cite most often they don’t want to be used as guinea pigs, they can’t see benefits. They think that you are going to use them in a different way.”
	“So you’ll go in that community and recruit people you’ll be better able to do because they know that you’re there. But first of all you have to be in the community that people know who you are and what you plan to do. What are you going to do for me? What am I going to get out of this?”.
	“Because Latinos think that when you mention research study, you’re going to be the guinea pig, and there is no benefit for you, you’re going to be harmed. So, they’re afraid. As soon as you mention ‘research study,’ like oh-oh. No, thank you. They probably become very motivated but as soon as you mention research study, maybe if you just mention we’re doing a study to help the community, to help people in that community … I mean, if you don’t do it for your community, do it for your family. I always mention do it for your family because the family is very important for us.”
	“When you talk about doing research and Blacks have always been used as guinea pigs … So they’re not going to be rushing to go into any research. They do check with the ministers, the churches they go to. If they’re in organizations, depending on the social standing in the community, whether they do social clubs or whatever, you need to go where they go to have people where they trust and centers and what have you. The information can go a long way when the pastor gets up into the church and says ‘this is a program that I’ve been to’.”
	‘I think they need to see someone who looks like them doing a lot of the research. You know. And (someone) that can understand the language, their language, what they’re meaning.”
	“I think it depends a lot also on the group that you’re working with. With Latinos, there are many fears. Income is one of the things, but also the legal status. You never ask what’s your legal status, but some people ask like how long are you living in the United States. So, they start thinking why’s he asking me?”
Patient–Provider Relationship	“Patients want someone to spend time with them.”
	“I think is a lot with the providers and I think a lot is back to health care environment and people not having an opportunity to know their physician.”
	“A lot of that goes back to the personalities of the people how you project yourself to people.”
	“Attitude is the key of any success. Attitude. Because in my country I remember that they say there is not a medicine that could cure a patient but maybe a smile for that.”
Study Implementation Suggestions	“I’d say face-to-face (referring to paper and pencil vs. face-to-face interviews). It’s a trust factor, again. They get to put a face with the person who’s asking the questions. They get to dispel the fact that you may be using it to do something against them later on. They can see you, and again, giving them the options of having someone there with them, of their choosing when they do it. I think the face-to-face is better. Most people are going to ignore something that comes into the house, because, as I said, invasion of people’s privacy is so enormous nowadays. Nobody going to fill out something to send it back.”
Decreased Functional Capacity	“[F]ocus on medicine, but how about some of the things that they can do just to help themselves. How much exercise? And a lot of people think it has to be in a treadmill or in a gym, but it can just be walking, or, you know, sometimes they get up, they got little kids around the house, they can’t even get up.”
Access to Healthcare	“Health care system now managed care”
	“You’re in, you are out.”
	“Is like a revolving door.”
	“Five minutes later you’re walking out nobody’s talked to you. They give you some pills like you said “come back if it doesn’t work.” And the first question asked is, what kind of insurance do you have?”