Table 2.

Summary of challenges faced by researchers studying stress and health mechanisms in diverse communities and proposed solutions

Challenges	Solutions
Recruitment and Retention
• Mistrust of researchers and research institutions especially in racial/ethnic minority communities	• Develop a written memorandum of understanding with local clinics and community centers to create continuity within the research relationship
	• Create a way to show your investment in using your research findings to better meet community’s needs (e.g., present results of studies to the community with an emphasis on its contribution to our understanding)
	• Utilize data to help fund health initiatives needed by the community
	• Provide information to prospective participants about the role of the IRB and steps taken to assure the security of their information
	• Share results of research studies using biological samples with the community through local media and other sources trusted by the community as a demonstration of how data is used
• Cost and inconvenience of travel for participants to and from the research institution	• Develop partnerships to conduct the work in community sites where target participants live and work
	• Write salary support for local clinic/community center staff into grants to help recruit and conduct study
	• Reimburse participants for transportation costs to and from research visits or provide transportation vouchers
	• Develop complimentary programs to provide childcare during parent participation
• Mismatch in language between research materials and preferred language of prospective participant	• Work with community partners or focus groups to anticipate any common language or literacy issues that may emerge with research materials and translate or edit as needed
• Commonly used and passive recruitment strategies such as mass mailings, newspaper and online advertisements, fliers that tend to under-recruit members of racial/ethnic minority participants	• Use active recruitment methods especially face-to-face interactions within community settings to recruit participants and community members as partners in recruitment
• Strict health-related inclusion criteria often exclude individuals from racial/ethnic minority groups	• Power studies to account for comorbidities rather than exclude them where possible
• Study procedures are or are perceived to be invasive, excessively long, or uncomfortable	• Design research procedures from the perspective of the participant’s comfort (e.g., build breaks into long protocols, offer snacks if possible)
Collecting biological samples
• Collecting biological specimens inherently requires participants to change their behavior	• Use existing research on behavior change to identify ways to increase participant motivation, capability, and opportunity to participate and comply with the study protocol
• Adhering to sample collection protocols requires new skills and knowledge about how to correctly collect specimens and why adherence to collection protocols is important	• Engage participants in active rather than passive training (e.g., detailed in-person explanation and demonstration of sampling in the location where samples will be collected such as the participants’ homes)
	• Share results of previous research using similar samples to demonstrate how samples will be used
	• Conduct focus groups to identify parts of protocol that are confusing or unlikely to be adhered to
	• Provide multiple forms of information including, in person demonstration, written, illustrated, and video training on sample collection to emphasize the importance of timing and adherence to protocols and honest reporting of collection times
• Biological sample collection procedures interfere with participants’ daily routines	• Incorporate discussion of barriers to compliance in sample collection into in-home trainings and how to proactively minimize them (e.g., identify physical cues and set reminders)
• Interpersonal contexts may interfere with participant motivation to adhere to study protocols (e.g., expectation to collect samples before dinner even though not all family dinners are at home)	• Consider engaging social groups in sample collection (e.g., families, teams)
• Diminished participant engagement across time in longitudinal studies	• Hire enthusiastic, friendly, committed, and diverse staff (preferably that come from the target community) that develop rapport with the participants
	• Create staff consistency for participants (e.g., assign one well-chosen staff person to participant contact or use the same person to maintain the participant connection throughout the project as much as possible)
Data analysis, interpretation, and dissemination
• Small study sample sizes with more limited options for data analysis	• Use blocking, planned missingness, and borrow from larger datasets when power is low
	• Use bootstrapping techniques when assumptions of normality cannot be met
	• Contribute to data sharing / pooling initiatives that harness the strengths of diverse samples across multiple studies
	• Use large, publicly-available datasets to test research questions if possible
• Rejection of papers from target journals	• Provide strong rationale in manuscripts about the importance of biopsychosocial processes in the target population including both basic and translational rationales where relevant
• Obstacles to tenure and promotion	• Assert importance of your research in target communities within a translational science framework, details on difficulty of the recruitment, retention, and procedural work involved in studying your target population, as well as the long-term benefits of working relationships with community partners to long-term projects in promotion materials