AHS-2 is one of very few large health studies of Black/African Americans (Blacks) with nearly 26,000 Black participants. As such, it is specially positioned to help answer why Blacks have different risks of certain diseases. AHS-2 is also positioned to examine how best to overcome historical barriers in working with the Black community in a research setting. Here is what we have learned so far:
Profile of Black Study Members
- Compared to the rest of the AHS-2 study members, the Black cohort included more females and younger individuals. Fewer were currently married and more were never married, divorced or separated.
- The average age of baptism was 24.3 years.
- Compared to non-Adventist Blacks, rates of smoking, drinking and meat consumption were lower, and rates of vegetarianism and water consumption were higher for Black study members.
- The education level was higher for Black study members (35% hold a bachelor’s degree or higher) than for Blacks nationally (15% hold a bachelor’s degree or higher).
- Compared to other Adventists, Black Adventists have more cases of type 2 diabetes, stroke and high blood pressure, but fewer cases of emphysema, myocardial infarction, heart attacks, fibromyalgia and high cholesterol.
- Black females had significantly less cancer than did non-Black females.
- Black males had 47% higher prevalence of prostate cancer than did non-Black males.
- Obesity was more prevalent among Blacks than non-Blacks (35% vs. 22%). For Body Mass Index (BMI), 42% of non-Blacks had normal weight, and 28% of Blacks had normal weight.
More: Regional breakdown of BMI levels for Black participants [PDF]
- 53% of Blacks reported sleeping six or fewer hours per night.
- Overall, Black Adventist study participants reported better physical and mental quality of life than the U.S. norm.
More: Physical and Mental Quality of Life Data [PDF]
- Cases of hypertension and diabetes were lower for Black Adventists than comparable national rates for both Blacks and non-Blacks, a noteworthy finding. This may be explained by the fact that Black Adventists reported better health habits than Black non-Adventists.
Research in the Black Community
Background: Blacks have been under-represented in scientific studies for several reasons. From the Black community’s fear of exploitation based on mistreatment in the past, to researchers’ failure to recruit Blacks through targeted strategies, much work is needed to improve the representation of Blacks in medical/scientific research. AHS-2 has documented the methods involved in recruiting 26,000 Black Adventists in order for future researchers to achieve better representation also.
- The local Adventist churches were the main area for recruitment to AHS-2, as this is the center for community life and activity.
- Focus groups in three churches revealed several areas of concern, including:
- Use of Social Security numbers
- Respectful and culturally appropriate treatment
- Meaningful and motivating incentives
- On-going sharing of results
- The recruitment personnel were Loma Linda University (LLU) Black researchers familiar with the church structure and obstacles in recruitment. They partnered with church officials, specifically the pastor and his volunteers, for recruitment. Additionally, LLU formed a partnership with Oakwood University in Alabama, a historically Black Adventist institution, by establishing a research support office there.
- Tailored promotional materials were printed, and the pastor’s volunteers were trained by the same researchers who recruited the pastor.
- Recruitment included pre-enrollment activities and a special Sabbath “Celebration Day” that for many churches included a health sermon and a special potluck where enrollees were encouraged to bring the questionnaire.
- In 2004, AHS-2 promoted the study nationally through church publications and Adventist television.
- AHS-2 found that the degree of participation of the pastor and church recruiters made a difference in the churches’ response rates. For example, when the pastor and recruiter both fully participated, an average of 67.3% of those requesting questionnaires returned them, compared to a 35.8% return rate for churches where neither the pastor nor the recruiter retuned the questionnaire.
AHS-2 has shown that through tailored methods, it is possible to recruit a large number of Blacks, in spite of the challenges mentioned above.
Related publications from AHS-2:
- Recruiting Black Americans in a large cohort study: the Adventist Health Study-2 (AHS-2) design, methods and participant characteristics.
- Cohort profile: The biopsychosocial religion and health study (BRHS).
- Comparing self-reported disease outcomes, diet, and lifestyles in a national cohort of Black and White Seventh-day Adventists.
- Understanding the challenges in recruiting Blacks to a longitudinal cohort study: the Adventist health study.