Lessons Learned from Recruiting Socially Isolated Older Immigrants for a Survey-based Study in Toronto

The COVID-19 pandemic brought to the forefront the detrimental health and social consequences of social isolation (Hosseinzadeh et al., 2022). For many older immigrant adults, these consequences are all too familiar. The loss of familiar social networks that resulted from immigrating to and settling in a new country coupled with systemic racism, language discordance, financial precarity, acculturation stress, limited mobility during winter months, costs of or lack of (accessible) transportation, and a lack of access to information and community resources, among other factors, contribute to their social isolation (Guruge et al., 2019; Sidani et al., 2022). Even though COVID-related public health restrictions have been lifted and there is return to ‘normalcy,’ older immigrant adults continue to experience social isolation. In this paper, opportunities, and challenges of reaching out to socially-isolated older immigrant adults in a research context are presented.

The Inclusive Communities for Older Immigrants (ICOI) is a 7-year multi-provincial, multi-sectoral, multidisciplinary project that aims to generate knowledge about social isolation and connectedness among older immigrants to improve their lives and support multidirectional knowledge exchange. The multi-phase, mixed-methods study is currently underway in nine cities and four provinces in Canada. In Toronto – one such city, a total of six research assistants (RAs) were involved, from October 2022 to January 2023, to recruit (n = 204) study participants who self-reported social isolation. Data were collected from Punjabi (n = 50), Arabic (n = 39), and Mandarin-speaking (n = 115) older immigrant adults. Once data collection was complete, the RAs were asked to reflect on their experience in recruiting research participants. RAs were posed the following questions: What successes and challenges did you experience when recruiting participants and collecting data for your language group? Based on the lessons learned, what approaches would you use in future data collections within these communities and why? This commentary presents a critical analysis of the consolidated responses with the intention to aid future researchers who hope to engage in research with similar populations.

Four RAs, one Arabic, one Punjabi, and two Mandarin-speaking, who are immigrants themselves, participated in this joint reflection activity. Thematic analysis (Braun & Clarke, 2006) was used to identify patterns and common relationships emergent from the data. Three key themes were identified: (1) importance of cultural humility; (2) consideration of contextual factors; and (3) attention to the development of data collection tools.

The importance of cultural humility cannot be underscored in the process of participant recruitment. Even though the RAs were much younger than the older adults they recruited, they had an appreciation for the cultural and religious beliefs and practices and were able to relate to the participants in terms of common language, cultural understanding of aging, and familiarity with the community. Bi-weekly communication with the RAs was also important for bridging some of the theoretical and methodological points for recruiting participants from their own ethnocultural and language groups in light of the limited research experience the RAs possessed.

Among the contextual factors that were considered flexibility in time for participant recruitment, having location and stakeholder knowledge, building in opportunities for social connection, and targeted project information-sharing, were of utmost importance. Recruitment of the first few participants was the most challenging and time-consuming. Next, word of mouth or snowball sampling became very useful in recruiting the subsequent participants. In addition, building connections with community leaders in organizations, such as cultural centres, and places of worship, and having the location knowledge aided with recruitment because they had often already developed trusting relationships with the potential study participants or had knowledge of the isolated older immigrants in their communities. Next, as the RAs became more familiar with their recruitment locations and were more and consistently visible to their respective community members, the potential participants also became more familiar with the RAs allowing further trust development to occur. The RAs also noted the importance of extending the interview time anywhere between 30 min to one hour (which can be costly for studies with limited budget), to engage in dialogue with the socially-isolated participants beyond the study requirements. This is because the study participants often wanted to stay and talk with the RAs well after the data collection portion was completed as they used this as an opportunity to connect socially. Finally, ensuring that information about the study is shared in a manner that can be reached by the target population is key. Any recruitment material should be translated into the languages with careful attention to the various dialects of the target populations.

In terms of paying attention to how data collection tools are developed, survey length and translation of the documents were key. While the focus of this study was on three specific language groups, there was variation in dialects. For example, translating study documents for the Arabic participants in this study was particularly challenging because of the many dialects.

In conclusion, there is a dearth of research that addresses social isolation for older immigrants, partially because of the challenges with recruitment. The insights garnered through this study's recruitment and data collection processes, as presented through the three key themes, have applications for future research that seeks to recruit hard-to-reach populations.