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

Abstract

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. Electronic supplementary material The online version of this article (10.1186/s12874-019-0683-2) contains supplementary material, which is available to authorized users.

The negative self-perceived health of migrants with precarious status in Montreal, Canada: A cross-sectional study

“…There were two distinct recruitment processes. The first was a venue-based community sampling methodology, snowball sampling and an active campaign in social media, communities, and the local press were undertaken, as described elsewhere [53]. A formative assessment took place prior to the study [54].…”

“…However, there remains a dearth of information about the health impact of the absence of health insurance for migrants with precarious status in Canada, despite the fact that it seems their number is rising [21]. Furthermore, migrants with precarious status often express a fear of research teams and are consequently underrepresented in population-based research [53]. Considering this, the objective of this article is to examine the association between precarious migration status and self-perceived health in Montreal.…”

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

“…Our sample is not representative of all Pakistani migrants, but rather represents Pakistanis affected by chronic hepatitis and/or HIV, living in precarious conditions in Seine-St-Denis. Our sample does however represent the most vulnerable ones, the undocumented migrants, who are tremendously difficult to study [49], due to fears of the French administration and language barriers. The very mobility of Pakistani migrants on the move mean that contact tracing can only be of limited effectiveness.…”

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

“…Our sample is not representative of all Pakistani migrants, but rather represents Pakistanis affected by chronic hepatitis and/or HIV, living in precarious conditions in Seine-St-Denis. Our sample does however represent the most vulnerable ones, the undocumented migrants, who are tremendously difficult to study (49), due to fears of the French administration and language barriers. Moreover, these might represent a significant number, given IOM unofficial research on the Eastern Mediterranean route.…”