Recruitment and Retention of Low‐SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood

• Author: Astrid Reina,Kaddy Y. Revolorio,Katherine J. W. Baucom,Xiao S. Chen,Nicholas S. Perry,Andrew Christensen
• DOI: http://doi.org/10.1111/famp.12287
• Date: 01 June 2018
• Published date: 01 June 2018

Recruitment and Retention of Low-SES Ethnic

Minority Couples in Intervention Research at the

Transition to Parenthood

KATHERINE J. W. BAUCOM*

XIAO S. CHEN

†

NICHOLAS S. PERRY*

KADDY Y. REVOLORIO

†

ASTRID REINA

‡

ANDREW CHRISTENSEN

§

To read this article in Simplified Mandarin, please see the article’s Supporting Information on Wiley

Online Library (wileyonlinelibrary.com/journal/famp).

Low-SES couples have limited resources to manage the chronic and acute stressors with

which theyare disproportionately faced.Although these couplesare at greater risk fornegative

individual and relationship outcomes, evaluations of the impact of couple relationship educa-

tion (CRE) in low-SES couples have been plagued by methodological problems, most notably

challenges associated with recruitment and retention. We review the literature on challenges

couples face associated with low-SES, as well as on recruitment, retention, and CRE in low-

SES, ethnic minority populations. We illustrate some of thes e challenges in a case study of CRE

for low-SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited

from a community health clinic and randomized to either an experimental treatment condition

(EXP; N=11) or a treatment-as-usual control condition (TAU; N=10). This study sought to

mitigate documented challenges with recruitment and retention: We leveraged community

partnerships, attempted to build and maintain strong relationships with study participants,

provided incentives for assessments as well as intervention meetings, and attempted to reduce

potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment

and retention. We integrate these findings and experiences with our review of previous work in

this area. We make recommendations for future CRE research and practice that have potential

implications for public policy in this area.

*Department of Psychology, University of Utah, Salt Lake City, UT.

†

Graduate School of Education and Psychology, Pepperdine University, Malibu, CA.

‡

Department of Psychiatry, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,

Torrance, CA.

§

Department of Psychology, University of California, Los Angeles, Los Angeles, CA.

Correspondence concerning this article should be addressed to Katherine J. W. Baucom, Department of

Psychology, University of Utah, 380 South 1350 East, BEHS 502, Salt Lake City, UT 84112. E-mail:

katherine.baucom@psych.utah.edu.

We thank our research assistants Jackie Diaz, Farrah Khaleghi, Christina Khong, Sravya Mallam, Luiz

Mendoza, Naseem Morid, Lisbeth Pacheco, Lizeth Pimentel, Mayra Quezada, Jennifer Ray, Roby Shamas,

Diana Solis, and Daniela Vosti; trainers Lisa Benson, Najwa Culver, Aurora Farias, Lizbeth Gaona, Suha-

dee Henriquez, Kate Humphreys, Maria Jalbrzikowski, Elizabeth Thompson, and Shu-Wen Wang; and

other collaborators including Jen Ngo, Pat Carney, Dr. Griselda Gutierrez, and Dr. Siri Kjos. Thisresearch

was supported by a fellowship awarded to Katherine J. W. Baucom from the Eunice Kennedy Shriver

National Institute of Child Health & Human Development (F31HD062168), as well as by the Tamar Diana

Wilson Grant from theUCLA Chicano Studies Research Center and the Randy Gerson MemorialGrant from

the American Psychological Foundation.The content is solely the responsibility of the authors and does not

necessarilyrepresent the official views of the National Institutesof Health or other funding agencies.

308

Family Process, Vol. 57, No. 2, 2018 ©2017 Family Process Institute

doi: 10.1111/famp.12287

Keywords: Couple Relationship; Prevention; Socioeconomic Status; Ethnic Minority;

Recruitment; Retention

Fam Proc 57:308–323, 2018

Couples’ socioeconomic context determines the availability of resources to cope with

stressful life events (Story & Bradbury, 2004). Despite the unique challenges with

which low-SES ethnic minority couples are faced, relationship research has been largely

unsuccessful at recruiting representative samples (Karney, Kreitz, & Sweeney, 2004).

Furthermore, low-SES and ethnic minority participants successfully recruited into longi-

tudinal relationship studies are more likely to drop out (Karney & Bradbury, 1995) . In this

paper, we describe basic research findings from low-SES and ethnic minority samples that

point to the potential utility of intervention, as well as translational work in low-SES pop-

ulations. We then review challenges with, and recommendations for, successful recruit-

ment and retention of ethnically diverse samples. Finally, we illustrate many of these

challenges with data from a pilot preventive intervention study with low-SES ethnic

minority couples transitioning to parenthood, and place the results in the context of

previous work in this area.

Stress Associated with Low-SES and Ethnic Minority Status

Low-SES couples are at disproportionate risk for a number of negative outcomes. Stress

levels are higher in low-income households, and the discrepancy in stress levels between

lower and higher income households is growing (APA, 2015). Lower weekly wages are asso-

ciated with poorer maternal physical and mental health (Coley & Lombardi, 2014). One

mechanism for these effects is the influence of low-SES on couples’ relationship functioning .

Low-SES may impose significant social challenges that function as external stressors on

the relationship, such as reduced access to resources (e.g., transportation), neighborhood

disadvantage (Berkulk-Silberman, Dreyer, Huberman, Klass, & Mendelsohn, 2010), and a

tendency for lower earning shift work (Perry-Jenkins, Goldberg, Pierce, & Sayer, 2007).

Consistent with the notion of SES as an external stressor (e.g., Story & Bradbury, 2004),

SES moderates associations between stressful life events, mental health, and relationship

satisfaction, with stressful events and mental health concerns explaining greater variance

in relationship satisfaction for low-income couples (Maisel & Karney, 2012). Although low-

SES couples are generally at a disadvantage relative to their middle- and upper-SES coun-

terparts, these effects appear to be even more pronounced for ethnic minority couples. For

example, studies have demonstrated poorer mental health in low-income Hispanic com-

pared with low-income White or Black mothers (Coley & Lombardi, 2014), and low-income

Black couples have smaller social support networks relative to low-income White couples

(Jackson, Kennedy, Bradbury, & Karney, 2014). Thus, stress is prominent in the lives of

low-SES couples, and may be heightened in ethnic minority couples.

Low-SES couples’ experience of stress is exacerbated at certain life transitions, such as

the transition to parenthood (TTP). For example, low-SES parents have reduced access to

sources of parenting information compared to higher earning parents (Berkulk-Silberman

et al., 2010). Research has linked SES to poorer outcomes in the early years of parenthood,

with lower income parents being more likely to use harsh parenting styles (Callahan, Scar-

amella, Laird, & Sohr-Preston, 2011) and to be more permissive of child behavior problems

(Bluestone & Tamis-LeMonda, 1999). Multiple theories (e.g., family stress, investment

model) have attempted to explain the links between SES and relationship functioning. In

their review of the literature on associations between SES and family outcomes, Conger,

Fam. Proc., Vol. 57, June, 2018

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