Objectives and methods:
A screening study using portable echocardiography was developed to determine the prevalence of Rheumatic Heart Disease (RHD) in children 10 -13 years in Counties Manukau, South Auckland. The study population consisted of seven socio-economically deprived schools, where the majority of students are Pacific Islanders or Maori. KidzFirst Public Health Nurses (KFPHN) deliver nursing services to these schools and have experience recruiting participants into community research programmes (eg Meningococcal B Vaccine Trials).

The KFPHN team, cultural advisors and investigators developed materials including information pamphlets, and consent forms. Pacific translations were produced. School principals were approached and educational talks to students delivered by nurses. Initially a two-stage process was used with families given an invitation flyer and responders then sent a consent form. After piloting this process in two schools a simplified single-stage process was adopted. Nurses worked in partnership with Community Workers making home visits, telephoning families and liaising with school staff.

Results:
1292 of the 1759 students returned consent forms: the overall response rate was 74%. 1158 consented: the overall consent rate was 66%. Using the two-step process the consent rate was 53%; consent increased to 79% using the one-step process. Consent rates at individual schools varied between 44% and 90%. Community Workers made 2050 phone calls and 491 home visits.

Conclusions:
Higher consent rates were achieved using the one-step process. Despite standardised methods variable consent rates were observed across the 7 study schools. Culturally-appropriate community workers appear to be essential for successful recruitment and community engagement.