This thesis was written by Ke Zhou as part of his Master’s Degree in Public Health at the École des Hautes Etudes en Santé Publique (EHESP) in Rennes, France, carried out between 2014 and 2016. This report comes from his Development and implementation of recruitment strategies with hard-to-reach communities, conducted under the tutelage of Valéry Ridde at the Institute of Public Health Research at the University of Montreal (IRSPUM), as part of the research project on access to healthcare for migrants without medical insurance in Montreal.


Background: Universal Health Coverage (UHC) provides access to key health interventions for all at an affordable cost for achieving equity in health. Nevertheless, it is also a source of health inequity. In fact, it offers a benefits package including financial protection for people. For immigrants arrived in the province of Quebec, Canada, most types of their visa do not allow them to have access to provincial health insurance programs. They need to opt for private insurance to cover health risks. Some immigrants cannot pay or do not have any valid private insurance. Therefore, they become excluded from any financial health protection. In the fist stage of the research project “How to improve health and access to healthcare of immigrants without health insurance in Montreal”, a quantitative survey will be conducted for recruiting 400 immigrants in their communities.

Objective: This paper proposes a respondent recruitment strategy for the project by using the case of the Chinese community in Montreal.

Methods: A conceptual framework and a logic model were used for organizing the works that have been done for the strategy development process. Cultural validation of survey tools and design of communication campaign were used for reducing recruitment barriers and adding incentives. Qualitative analysis was used for understanding migratory profiles and organizations regarding research question. Geographic information system method has been used for understanding the distribution of the target population and for gathering information on places of their activities and organizations.

Results: Key features of the preliminary strategy include: Considering the dimensions of heterogeneity of the target population and addressing these in sampling; Adopting a multiple pathways recruitment approach and an operational plan; Addressing barriers to recruitment and add incentives for participants.

Conclusion: The strategy proposed in this paper considered the heterogeneity of the target population of which no registry, prevalence, and distribution information exist. With multiple recruitment pathways, communication campaign and cultural adaptation, it theoretically allows attaining a relatively good response rate with valid results.

Article download and suggested citation:

Zhou, K. (2016). Development of participant recruitment strategy in the project “How to improve health and access to health care of migrants without medical coverage in Montreal” - the case of the Chinese community. [Master of Public Health]. Ecole des hautes études en santé publique (EHESP), France. Download