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Reaching Out to Seniors in Rural Appalachia

October 5, 2010

Appalachia mapLillybrook No. 1 sat in Stonecole Holler, down from Princewick Hill in Raleigh County.  Like most West Virginia coal camps in the 1940s, the miners and their families lived in the terraced rows of tiny wood frame houses that the company bosses erected along the slope of the hill.  Life was hard, but folks in Lillybrook No. 1 pulled together and looked out for each other.  “When a worker got hurt or sick and could not work, a ritual took place called ‘passing the paper around,’” recalled a former resident.  “Most of the workers would sign to give the worker a dollar or more.  This was taken out of their pay and was presented to the injured worker.” 

In 1954, Lillybrook No. 1 shut down, and most residents headed north for factory jobs.  For the few who stayed behind, their lives remained hardscrabble while their mountain worlds grew more remote.  Now battling the chronic aches and pains of old age, few have neighbors or family members left to “pass the paper around” and travelling to the closest town or city to see a dentist or physician can be a financial and logistical challenge. For most, the thought of enrolling in a long-term clinical study seems more burden than benefit. 

Further complicating matters, researchers lack a reproducible approach to reach out to senior citizens in remote parts of Appalachia like Stonecole Holler. In the September issue of Special Care Dentistry, a team of NIDCR grantees offers its lessons learned while recruiting rural and cognitively impaired older adults in central West Virginia to participate in a clinical study. 

Starting with a multi-pronged recruitment strategy, including pitches to local media and primary-care clinics, the group soon turned much of its energy toward proactive outreach within individual communities.  That especially included gaining the support of staff at community senior centers. 

“Most of the staff members were very involved within their respective facilities and trusted by elders, and thus were a major asset in assisting with recruitment,” they noted.  “The value of building relationships with these individuals cannot be overstated.” 

The researchers also found themselves bumping up against a traditional underappreciation for the value of good oral health.  To overcome this barrier, they found help already residing within their communities of interest.  “In our experience, having someone with strong credentials (e.g., a well respected dentist with a strong tie to community) who was an engaging and dynamic speaker deliver educational presentations in various prospective recruitment locations greatly facilitated recruitment.”  They explained further, “By piquing older adults’ interests through community presentations delivered by dental experts in the field, prospective participants were better able to see how their participation in a research project could have practical and translational implications.”  Indeed, by keeping things simple and their data collection flexible, 93 percent of enrollees reported that they would likely participate again if contacted about a future follow-up study.

  • Recruitment of rural and cognitively impaired older adults for dental research, Wu B, Goedereis EA, Crout RJ, Plassman BL, DiNapoli EA, McNeil DW, Wiener M, Boone ML, Wiener RC, Kao E, Bai L. Spec Care Dentist, Sept 2010:30(5),193-9.




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This page last updated: February 26, 2014