***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We are conducting a community-based cluster-r and omized trial in rural Alabama , testing a peer-support intervention design ed to improve diabetes self-care behaviors . We describe recruitment and data collection approaches used , focusing on strategies that created community partnerships and facilitated recruitment in underserved , rural , largely minority communities . Key recruitment and data collection strategies included early community engagement ; pilot testing of procedures ; inclusion of community members as study team members , recruiters , and data collectors ; data collection at community venues to minimize participant travel requirements ; and provision of a multi-disciplinary diabetes education program to both intervention and control participants . A total of 424 participants were recruited and enrolled ( 400 targeted ) . Of the 759 referrals received , 78.9 % ( n=599 ) successfully completed telephone screening . Of these , 78.8 % ( n=472 ) were eligible and scheduled for a local enrollment day , and 81.4 % ( n=384 ) attended and enrolled in the study . In addition , community members who walked in and expressed interest were screened , and 40 eligible and willing individuals were consented and enrolled . We exceeded recruitment goals in underserved , rural communities in Alabama . This success was due in large part to community partnerships that facilitated community involvement on several levels : engaging the community early in study proposal and design ; hiring community members to fill various capacities as research team members , recruiters , and data collectors ; conducting data collection within communities ; and collecting additional contact information to maintain communication . Providing diabetes education to all participants , including intervention and control , helped ensure that everyone stood to benefit and likely enhanced overall participation Purpose To describe methods used to recruit and retain low-income Latinos in a r and omized clinical trial ( RCT ) of a diabetes self-management intervention at 5 community health centers ( CHCs ) in Massachusetts . Methods Consent from primary care providers ( PCPs ) was obtained to screen their patients . Trained site research coordinators ( SRCs ) screened , recruited , and enrolled participants following a multistep process ( medical record review s , PCP approval , a patient eligibility interview ) and provided support for retention efforts . Assessment staff were trained in motivational strategies to facilitate retention and received ongoing support from a retention coordinator . Electronic tracking systems facilitated recruitment and retention activities . Results Of an initial pool of 1176 patients , 1034 were active at the time of screening , 592 ( 57 % ) were eligible by medical record review , and 487 received PCP approval ( 92 % of review ed patients ) . Of these , 293 patients completed the  patient screening interview  ( 60 % of patients with PCP approval , and 76 % of those reached ) , and 276 were eligible . Sixteen percent of all active patients refused participation , and 8 % of contacted patients were unreachable . Two hundred fifty-two patients were r and omized after completion of baseline assessment s. Clinical , behavioral , and psychosocial assessment completion rates were 92 % , 77 % , and 86 % at 12-month follow-up , respectively , and 93 % of patients completed at least one study assessment at 12 months . Conclusions CHCs are a prime setting for translation research aim ed to eliminate diabetes health disparities . Successful recruitment and retention efforts must address institutional/organizational , research team , and patient-related challenges . References 1 . US Department of Health and Human Services , Centers for Disease Control and Prevention . Age-adjusted prevalence of diagnosed diabetes by race/ethnicity and sex in the United States , 1980 - 2005 . Available at : www.cdc.gov/diabetes/statistics/prev/ national/figraceethsex.htm . Accessed January 21 , 2010 . 2 . US Census Bureau . Annual estimates of the population by sex , race , and Hispanic or Latino origin for the United States : April 1 , 2000 to July 1 , 2006 . Available at : www.census.gov/popest/ national/asrh/NC-EST2006-srh.html . Accessed January 21 , 2010 . 3 . National Center for Health Statistics . Early release of selected estimates based on data from the January-September 2006 National Health Interview Survey . Available at : http://www . cdc.gov/nchs/about/major/nhis/released200703.htm . Accessed January 12 , 2010 . 4 . Centers for Disease Control and Prevention . Self-reported prevalence of diabetes among Hispanics : United States , 1994 - 1997 . MMWR . 1999;48:8 - 12 . 5 . Harris MI , Klein R , Cowie CC , Rowl and M , Byrd-Holt DD . Is the risk of diabetic retinopathy greater in non-Hispanic blacks and Mexican Americans than in non-Hispanic whites with type 2 diabetes ? A U.S. population study . Diabetes Care . 1998 ; 21:1230 - 1235 . 6 . Franklin GM , Kahn LB , Baxter J , Marshall JA , Hamman RF . Sensory neuropathy in non-insulin-dependent diabetes mellitus : the San Luis Valley Diabetes Study . Am J Epidemiol . 1990;131:633 - 643 . 7 . Agency for Healthcare Research and Quality . National Healthcare Disparities Report , 2006 . Rockville , MD : Agency for Healthcare Research and Quality ; 2006 . Available at : http://www.ahrq.gov/ qual/nhdr06/nhdr06.htm . Accessed January 12 , 2010 . 8 . National Institute of Diabetes and Digestive and Kidney Diseases , National Diabetes Information Clearinghouse ( NDIC ) . National diabetes statistics . Available at : http://diabetes.niddk.nih.gov/dm/ pubs/statistics/index.htm . Accessed January 12 , 2010 . 9 . US Department of Health and Human Services , Office of Minority Research . Diabetes and Hispanic Americans . Available at : http://www.omhrc.gov/templates/content.aspx?lvl=2&lvllD= 54&ID=3324 . Accessed December 10 , 2009 . 10 . The Diabetes Control and Complications Trial Research Group . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus . N Engl J Med . 1993;329 : 977 - 986 . 11 . UK Prospect i ve Diabetes Study ( UKPDS ) Group . Intensive blood-glucose control with  sulphonylureas  or  insulin  compared with conventional treatment and risk of complications in patients with type 2 diabetes ( UKPDS 33 ) . Lancet . 1998;352:837 - 853 . 12 . Norris SL , Engelgau MM , Narayan KM . Effectiveness of self-management training in type 2 diabetes : a systematic review of r and omized controlled trials . Diabetes Care . 2001;24:561 - 587 . 13 . Brown SA , Garcia AA , Kouzekanani K , Hanis CL . Culturally competent diabetes self-management education for Mexican Americans : the Starr County border health initiative . Diabetes Care . 2002;25:259 - 268 . 14 . Lorig K , Ritter PL , Villa F , Piette JD .  Spanish diabetes self-management with and without automated telephone reinforcement : two r and omized trials . Diabetes Care . 2008 ; 31:408 - 414 . 15 . Rosal MC , Olendzki B , Reed GW , Gumieniak O , Scavron J , Ockene IS . Diabetes self-management  among low-income Spanish speaking patients : a pilot study . Ann Behav Med . 2005;29:225 - 235 . 16 . Mauldon M , Melkus GD , Cagganello M. Tom and o Control : a culturally appropriate diabetes education program for Spanish-speaking individuals with type 2 diabetes mellitus . Evaluation of a pilot project . Diabetes Educ . 2006;32:751 - 760 . 17 . Centers for Disease Control and Prevention , National Center for Health Statistics . Age-adjusted percentage of civilian , noninstitutionalized population with diagnosed diabetes , Hispanics , United States , 1980 - 2007 . Available at : http://www.ced.gov/diabetes/ statistics/prev/national/figbyhispanic.htm . Accessed March 31 , 2010 . 18 . Flegal KM , Ezzati TM , Harris MI . Prevalence of diabetes in Mexican Americans , Cubans , and Puerto Ricans from the Hispanic health and nutrition examination survey 1982 - 1984 . Diabetes Care . 1991;14(7 Suppl):528 - 538 . 19 . Lemon SC , Zapka JG , Estabrook B , Benjamin E. Challenges to research in urban community health centers . Am J Public Health . 2006;96:626 - 628 . 20 . H and ley MA , Hammer H , Schillinger D. Navigating the terrain between research and practice : a Collaborative Research Network ( CRN ) case study in diabetes research . J Am Board Fam Med . 2006;19:85 - 92 . 21 . Piatt GA , Orchard TJ , Emerson S. Translating the chronic care model into the community : results from a r and omized controlled trial of a multifaceted diabetes care intervention . Diabetes Care . 2006;29:811 - 817 . 22 . Frayne SM , Burns RB , Hardt EJ , Rosen AK , Moskowitz MA . The exclusion of non-English-speaking persons from research . J Gen Intern Med . 1996;11:39 - 43 . 23 . Durant RW , Davis RB , St George M , Williams IC , Blumenthal C , Corbie-Smith GM . Participation in research studies : factors associated with failing to meet minority recruitment goals . Ann Epidemiol . 2007;17:634 - 642 . 24 . Centers for Disease Control and Prevention , Department of Health and Human Services . Diabetes data and trends . Available at : http : www.cdc.gov/diabetes/statistics/prev/national/. Accessed March 31 , 2010 . 25 . Surani S , Aguillar R , Komari V , Surani A , Subramanian S. Influence of Hispanic ethnicity in prevalence of  diabetes mellitus in sleep apnea and relationship to sleep phase  . Postgrad Med . 2009;121:108 - 112 . 26 . Link CL , McKinlay JB . Disparities in the prevalence of diabetes : is it race/ethnicity or socioeconomic status ? Results from the Boston Area Community Health ( BACH ) survey . Ethn Dis . 2009;19:288 - 292 . 27 . Bryson CL , Ross HJ , Boyko EJ , Young BA . Racial and ethnic variations in albuminuria in the US Third National Health and Nutrition Examination Survey ( NHANES III ) population : associations with diabetes and level of CKD . Am J Kidney Dis . 2006 ; 48:720 - 726 . 28 . Gross R , Olfson M , Gameroff MJ . Depression and glycemic control in Hispanic primary care patients with diabetes . J Gen Intern Med . 2005;20:460 - 466 . 29 . Trief PM , Morin PC , Izquierdo R. Depression and glycemic control in elderly ethnically diverse patients with diabetes : the IDEATel project . Diabetes Care . 2006 ; 29:830 - 835 . 30 . McCarthy CR . Historical background of clinical trials involving women and minorities . Acad Med . 1994;69:695 - 698 . 31 . Rosal MC , Benjamin EM , Pekow PS , Lemon SC , von Goeler D. Opportunities and challenges for diabetes prevention at two community health centers . Diabetes Care . 2008 ; 31:247 - 254 . 32 . Blumenthal DS , Sung J , Coates R , Williams J , Liff J. Recruitment and retention of subjects for a longitudinal cancer prevention study in an inner-city black community . Health Serv Res . 1995;30(1 Pt 2):197 - 205 . 33 . UyBico SJ , Pavel S , Gross CP . Recruiting vulnerable population s into research : a systematic review of recruitment interventions . J Gen Intern Med . 2007;22:852 - 863 . 34 . Corbie-Smith GM . Minority recruitment and participation in health research . N C Med J. 2004 ; 65:385 - 387 . 35 . Bruner DW , Jones M , Buchanan D , Russo J. Reducing cancer disparities for minorities 
    Output:
    
Multiple and flexible strategies targeting providers and participants at provider sites and within communities might be needed to enroll underrepresented population s into clinical trials