Well-constructed epidemiologic studies provide information about environmental risks and inform interventions and public health policies. Using focus groups, this pilot project examined the attitudes, beliefs, and concerns of rural-dwelling adults toward participating in a longitudinal cohort study. Focus group participants who were 40 years or older, residents in the Grants Mining District, and had no previous diagnosis of diabetes (except gestational diabetes) were recruited from a local physician’s office in the Grants Mining District. Participants provided insight into local health concerns, willingness to participate in long-term research and to provide biological specimens, and consent form expectations. For this population, the uranium mining legacy in the Grants Mining District is a contextual factor that can be addressed via community engagement and in the study design to minimize misinterpretation or bias and to maximize the ability to detect causal risk factors for health outcomes.