Research article

Sampling 'hard-to-reach' populations in health research: yield from a study targeting Americans living in Canada

Danielle A Southern¹ , Steven Lewis^1,2 , Colleen J Maxwell¹ , James R Dunn^4,5 , Tom W Noseworthy^1,3 , Gail Corbett⁶ , Karen Thomas⁶ and William A Ghali^1,3

¹  Centre for Health and Policy Studies & Dept. of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada

²  Access Consulting Ltd, Access Consulting Ltd., 211-4th Ave. S, Saskatoon SK S7K 1N1, Canada

³  Department of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada

⁴  Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada

⁵  Department of Geography, University of Toronto, Ontario M5S 1A8, Canada

⁶  Office of Communications, Faculty of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada

author email corresponding author email

BMC Medical Research Methodology 2008, 8:57doi:10.1186/1471-2288-8-57

Published:	18 August 2008

Abstract

Background

Some populations targeted in survey research can be hard to reach, either because of lack of contact information, or non-existent databases to inform sampling. Here, we present a methodological "case-report" of the yield of a multi-step survey study assessing views on health care among American emigres to Canada, a hard-to-reach population.

Methods

To sample this hard-to-reach population, we held a live media conference, supplemented by a nation-wide media release announcing the study. We prepared an 'op-ed' piece describing the study and how to participate. We paid for advertisements in 6 newspapers. We sent the survey information to targeted organizations. And lastly, we asked those who completed the web survey to send the information to others. We use descriptive statistics to document the method's yield.

Results

The combined media strategies led to 4 television news interviews, 10 newspaper stories, 1 editorial and 2 radio interviews. 458 unique individuals accessed the on-line survey, among whom 310 eligible subjects provided responses to the key study questions. Fifty-six percent reported that they became aware of the survey via media outlets, 26% by word of mouth, and 9% through both the media and word of mouth.

Conclusion

Our multi-step communication method yielded a sufficient sample of Americans living in Canada. This combination of paid and unpaid media exposure can be considered by others as a unique methodological approach to identifying and sampling hard-to-reach populations.