Barriers and recruitment strategies for precarious status migrants in Montreal, Canada

BMC Med Res Methodol. 2019 Feb 26;19(1):41. doi: 10.1186/s12874-019-0683-2.


Background: Precarious status migrants are a group of persons who are vulnerable, heterogeneous, and often suspicious of research teams. They are underrepresented in population-based research projects, and strategies to recruit them are described exclusively in terms of a single cultural group. We analyzed the recruitment strategies implemented during a research project aimed at understanding precarious status migrants' health status and healthcare access in Montreal, Canada. The research sample consisted of 854 persons recruited from a variety of ethnocultural communities between June 2016 and September 2017. This article analyzes the strategies implemented by the research team to respond to the challenges of that recruitment, and assess the effectiveness of those strategies. Based on the results, we share the lessons learned with a view to increasing precarious status migrants' representation in research.

Method: A mixed sequential design was used to combine qualitative data gathered from members of the research team at a reflexive workshop (n = 16) and in individual interviews (n = 15) with qualitative and quantitative data collected using the conceptual mapping method (n = 10).

Results: The research team encountered challenges in implementing the strategies, related to the identification of the target population, the establishment of community partnerships, and suspicion on the part of the individuals approached. The combination of a venue-based sampling method, a communications strategy, and the snowball sampling method was key to the recruitment. Linking people with resources that could help them was useful in obtaining their effective and non-instrumental participation in the study. Creating a diverse and multicultural team helped build trust with participants. However, the strategy of matching the ethnocultural identity of the interviewer with that of the respondent was not systematically effective.

Conclusion: The interviewers' experience and their understanding of the issue are important factors to take into consideration in future research. More over, the development of a community resource guide tailored to the needs of participants should be major components of any research project targeting migrants. Finally, strategies should be implemented as the result of a continuous reflexive process among all members of the research team.

Keywords: Hard to reach population; Precarious status migrants; Recruitment strategies; Research method; Research participation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Canada
  • Communication
  • Female
  • Health Personnel / psychology
  • Health Personnel / statistics & numerical data
  • Health Services Accessibility / legislation & jurisprudence
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand / legislation & jurisprudence
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Selection*
  • Qualitative Research*
  • Research Design*
  • Surveys and Questionnaires
  • Transients and Migrants / legislation & jurisprudence
  • Transients and Migrants / psychology
  • Transients and Migrants / statistics & numerical data*