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Background  The effectiveness of multiple innovative recruitment strategies for enrolling Black/African American participants to the Adventist Health Study-2 (AHS-2) is described. The study’s focus is diet and breast, prostate and colon cancer.    Methods  Promotions centered on trust, relationship building and incentives for increasing enrollment and questionnaire return rate. Of the sub-studies described, one had a randomized control group, and the others, informal controls. The subjects are from all states of the U.S. and some provinces of Canada. The offer of a Black art piece, follow-up calls, a competitive tournament as well as other strategies accounted for nearly 3,000 additional returns even though they were often used in small subsets.    Results  Flexibility and multiple strategies proved advantageous in gaining the cooperation of Blacks, who are usually reluctant to participate in research studies.    Conclusions  Lessons learned during initial enrollment should help us retain our final Black cohort of 26,000, and obtain new information when required.

Recruiting and motivating black subjects to complete a lengthy survey in a large cohort study: an exploration of different strategies