Our multisystem approach addressed the recruitment of African American families with a chronically, physically ill member. The approach focused on the social transactions between the family, the healthcare team, and the research staff, and the influence of these transactions on family recruitment. This multisystem approach included three core strategies: defining the membership of families in a culturally appropriate fashion and engaging those members; engaging the healthcare team; and building and maintaining the skills and morale of the research staff. A description of a longitudinal family health study and potential sources of recruitment biases is provided. Descriptive and bivariate analyses examined the effectiveness of the recruitment approach. A focus group explored the reciprocal process of family protectiveness that both facilitated and hindered family recruitment and the research staff's alliance with families and the dialysis staff. Discussion focuses on the family health study's recruitment rate, sampling biases, and methods for improving the effectiveness of the multisystem recruitment approach.