Experiences and Lessons Learned in Using Community-Based Participatory Research to Recruit Asian American Immigrant Research Participants

Community based participatory research (CBPR) is a collaborative, action-oriented research approach that seeks to address health disparities through aligning community members' insider knowledge of their communities with academic researchers' methodological expertise (Minkler, 2005; Wallerstein & Duran, 2010). CBPR draws on critical and social theory to promote equal partnership and decision making. This collaboration minimizes the hierarchy traditionally found in research (Minkler & Wallerstein, 2003). The CBPR approach is applicable to many health conditions in a variety of contexts, and has been primarily employed with low-income groups and communities of color (Israel et al., 2010). Core values of this approach include partnership and collaboration between communities and researchers, equitable power distribution, trust and mutual commitment, and an openness to knowledge acquired from participants' experiences (Israel, Schulz, Parker, & Becker, 1998). These values are the basis for collaborative research partnerships focused on alleviating complex health problems.Health Disparities Among Immigrant GroupsIn many countries, ethnic minority immigrants are a growing segment of the population who are likely to experience health disparities (Miramontes et al., 2015; Pottie et al., 2011). Over the past 20 years, increasing numbers of migrants from middle-income countries in Asia, Latin America, and Eastern Europe have settled in high-income countries such as the United States, Australia, Great Britain, and Canada (Connor, Cohn, & Gonzalez-Barrera, 2013). As an example, by 2050, the population in the United States-which is the world's top immigration destination-is expected to grow from 320 million to 458 million people (Colby & Ortman, 2015), of which 136 million will be immigrants (Ortman & Guarneri, 2009). Similarly, Germany, which ranks second in terms of migrant-receiving countries (Organisation for Economic Cooperation and Development, 2015), is presently experiencing a large and sudden migration wave as a result of the Syrian refugee crisis. A recent analysis of global migration trends notes that African migrants from sub-Saharan Africa move primarily within Africa; the biggest migration flows from West Africa are to Western Europe; Latin Americans move predominantly to North America and Europe; while South Asians and South-East Asians migrate to Western Asia, North America, and less frequently to Europe (Abel & Sander, 2014). These migration trends highlight the fluid changes occurring in host countries. Furthermore, they underscore the salience of broadly understanding CBPR and how it may be employed to better understand the health needs of ethnic minorities to better develop "migrant-sensitive health systems" (World Health Organization, 2010, p. 4).Immigrants are a subset of the ethnic minority population with myriad health risks and health needs that are poorly understood. For example, Asians represent the fastest growing proportion of newcomers to the United States (Hoeffel, Rstogi, Kim, & Shahid, 2012). Composed of more than 14 subgroups, they are tremendously diverse in geographic origin, language, religious affiliation, immigration status, and cultural beliefs and practices (Tseng, 2009). Historically, Asian Americans have been under-represented in health research, and many studies that do include Asian Americans present aggregated data, masking critical health differences between ethnic subgroups. Disaggregated data demonstrate health disparities among subgroups on a number of chronic conditions, including cancer, heart disease, and mental health problems (Nadimpalli & Hutchinson, 2012). Factors contributing to deleterious health outcomes include limited health literacy, cultural and linguistic factors, and perceived discrimination (Clough, Lee, & Chae, 2013; Harris, 2012; Kandula, Kersey, & Lurie, 2004). Failure to address these factors presents tremendous costs on an already strained healthcare system. …