Jackson Heart StudyJackson Heart StudySonja R. Fuqua, PhD, RN
Director of Clinical Quality
MS Primary Health Care Association
**********
JHS Manager of Recruitment and Retention (1999-2009)
JHS: TimelineJHS: Timeline
Planning Phase - 1996-1997Feasibility Phase - 1998-1999JHS - began full study - 2000
– recruitment began August, 2000– examinations September, 2000-2004– annual follow up began September, 2001– surveillance continuous
DesignDesign
Prospective population-based epidemiology study--also incorporating families
Expansion of the current ARIC study (Atherosclerosis Risks in Communities)
Projected study population: 6500
ARICARIC
Atherosclerosis Risk in Communities StudyGoal: study risk factors for CVD in
European-Americans and African-Americans
4 centersJackson, MS Forsyth Co, NC
Minneapolis, MN Washington Co, MD
JHS: Family ComponentJHS: Family Component
Family members were included to permit studies of familial/genetic contributions to CVD
Size: 2,000 of the 6,500 JHS cohort sampleEligibility: Index family member has 2 full
siblings and a minimum of 9 first degree, age eligible relatives in study area
Content for JHS ExamContent for JHS Exam
Medical and family history
Medications Lifestyle factors Sociocultural factors Anthropometry BP, ECG Echocardiography
Carotid Ultrasound Brachial Reactivity Pulmonary Function Extensive Blood work Long-term storage of
frozen specimens and DNA extractions
JHS: Interview ComponentsJHS: Interview Components
Demographic information Personal and family health history Medical history (stroke & reproductive) Medication use history Smoking and alcohol use history Nutrition Physical activity Sociocultural
JHS: Sociocultural JHS: Sociocultural ComponentsComponents
SES Health Care Access Stress Coping Religion and religious
coping Social support and
integration
Depression Anger & Hostility Optimism John Henryism Job Latitude Discrimination
ParticipantsParticipants
6,500 participants 2,000 ARIC 2,000 Family Study 2,500 Randomized sample
African American 35-84 years of age Residents of Hinds, Madison, or Rankin
county
Cost to ParticipateCost to Participate
FREE Time expenditure
Home Induction Interview---1 hour Clinic Examination—4 ½ hours 24-hour AMBP and urine—24 hours Annual Follow-up—30 minutes
BENEFITSBENEFITS
Comprehensive medical exam ($4000) Assist in understanding the problem of
African Americans and CVD Build a healthier tomorrow “Friendship” network
Recruitment ProcessRecruitment Process
Contact letter—invitation to participate Three attempts for home contact
Alternate: daytime, evening, weekend First attempt—door-hanger with business card Second attempt—add “happy”
Two attempts either home or phone contact May suspend efforts after five attempts
Recruitment RevisionsRecruitment Revisions
To meet the demands of recruitment goals: Five recruiters became 11 Allowed phone calls Increased--focused community activities Accepted volunteers
Randomized Per demographics and county
Jackson Heart Study Recruitment Jackson Heart Study Recruitment ChallengesChallenges
– Awareness-Improved in recent
months
– Contact challenges-Imperfections in list-Caller I.D./Telemarketer
and junk mail aversion-Avoidance due to
negative expectations/suspicion
-“Random approach”
Recruitment ChallengesRecruitment Challenges
– Acceptance
-70-80% once contact is made
– Clinic appointments
-80% keep appointment after initial home interview
-Transportation issues;other barriers
-Change of heart
-Compensation/incentive
JHS Recruitment:JHS Recruitment:Ended March 31, 2004Ended March 31, 2004
TOTAL Recruited: 5302TOTAL Recruited: 5302
JHS RETENTIONJHS RETENTION
Annual Follow-Up Interviews Participant Birthday Cards, Newsletters,
Volunteer Opportunities JHS Annual Family Reunion Community Health Advisors Network
(CHAN) Community Partnerships and Outreach
JHS Exam 2JHS Exam 2
September 2004—December 2008 85% returned for the second exam
JHS Exam 3JHS Exam 3
February 2009—March 2013
Ancillary StudiesAncillary Studies Ancillary studies added
Peripheral Arterial Tonometry (PAT), which looks at the health of your blood vessels
A study that is looking for a relationship between heart disease and hearing loss;
MRI (Magnetic Resonance Imaging) of your heart
Health Promotion Study (Yoga Study) Sleep Study
Where do we go from Here?Where do we go from Here?
Ongoing Retention Efforts Community Partnerships and Outreach Community Health Advisor Education and
Activities TRIPP
Translating Research Into Practice and Prevention
To be a “Professional”To be a “Professional”
How do you put a giraffe into a refrigerator?
Open the refrigerator, put in the giraffe and close the door.
This question tests whether you tend to do simple things in an overly complicated way.
Professional………Professional………
How do you put an elephant into a fridge?Open the refrigerator, put in the elephant
and close the door. (WRONG)
Open the refrigerator, take out the giraffe, put in the elephant and close the door.
Test the ability to think through the repercussions of your actions.
Professional…………Professional…………
The Lion King is hosting an animal conference. All the animals attend except one. Which animal does not attend?
The Elephant. Its in the refrigerator.
This tests your memory
Professional………..Professional………..
There is a river you must cross, but it is inhabited by crocodiles. How do you manage it?
You swim across. All the Crocodiles are attending the Animal Conference.
This tests whether you learn quickly from your mistakes.