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Strategies for recruiting representative samples of Asian Americans for a population-based case–control study
  1. Celeste K Wong1,2,
  2. Pamela L Horn-Ross1,
  3. Gilbert C Gee3,
  4. Salma Shariff-Marco1,4,5,
  5. Thu Quach4,5,6,1,
  6. Laura Allen1,
  7. Roxanna Bautista7,
  8. Patricia Quema La Chica7,
  9. Winston Tseng7,
  10. Pancho Chang8,
  11. Christina A Clarke1,4,5,
  12. Juan Yang1,
  13. Gem M Le9,
  14. Alison Canchola1,
  15. Melinda L Irwin2,
  16. Sandra Soo-Jin Lee10,
  17. Scarlett Lin Gomez1,4,5
  1. 1Cancer Prevention Institute of California, Fremont, California, USA
  2. 2School of Public Health, Yale University, New Haven, Connecticut, USA
  3. 3School of Public Health, University of California, Los Angeles, California, USA
  4. 4Stanford Cancer Institute, Stanford, California, USA
  5. 5Department of Health Research & Policy (Epidemiology), School of Medicine, Stanford, California, USA
  6. 6Asian Health Services, Oakland, California, USA
  7. 7Asian & Pacific Islander American Health Forum, San Francisco, California, USA
  8. 8Asian Americans for Community Involvement, San Jose, California, USA
  9. 9Division of General Internal Medicine, Center for Vulnerable Populations, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA
  10. 10Center for Biomedical Ethics, School of Medicine, Stanford, California, USA
  1. Correspondence to Dr Scarlett Lin Gomez, Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont 94538, CA, USA; scarlett{at}


Background Data are limited on effective methods for recruiting persons, especially from ethnically diverse populations, into population-based studies. The goal of this study was to evaluate the variation among and representativeness of controls identified using multiple methods for a population-based case–control study of breast cancer among Asian Americans, Native Hawaiians and Pacific Islanders (AANHPIs) in the San Francisco Bay Area.

Methods We used a unique combination of targeted recruitment strategies, including address-based sampling, community-based methods, and internet-based and media-based approaches for recruiting controls, frequency matched on age and ethnicity to a population-based sample of cases. To characterise the participating controls, we compared the distribution of sociodemographic characteristics and cancer risk factors between recruitment sources using χ2 tests. To ensure that the controls we recruited were representative of the underlying at-risk population, we compared characteristics of the controls, by ethnicity and in aggregate, to data from the California Health Interview Survey (CHIS), and adjusted the relative mix of recruitment strategies throughout the study as needed to achieve representativeness.

Results As expected, controls (n=483) recruited by any single method were not representative. However, when aggregated across methods, controls were largely representative of the underlying source population, as characterised by CHIS, with regard to the characteristics under study, including nativity, education, marital status and body mass index.

Conclusions A multimode approach using targeted recruitment strategies is an effective and feasible alternative to using a single recruitment method in identifying a representative, diverse control sample for population-based studies.

  • Cancer epidemiology
  • Epidemiological methods
  • Research Design in Epidemiology

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