A Systematic Review of Recruitment for Older Chinese Immigrants into Clinical Trials

Posted: Aug 23, 2016
Asian Pacific Island Nursing Journal. 1. 2. 35-45.
KEYWORDS: Knowledge/Attitudes/Beliefs, Language or Cultural Barriers, Logistics/Transportation, Underserved, Low Literacy, Non-English Speaking, Older Adults, Minority Groups, Asian, Letter, Behavioral


Researchers analyze previous studies to gain big picture understanding about the barriers and potential improvement in the accrual of elderly Chinese immigrants for clinical trials.

Why this item may be useful

Older Chinese Immigrants are often poorly represented in clinical trials, especially compared to younger Chinese immigrants, and US-born elderly of Chinese descent. Specific barriers and potential strategies for improvement of accrual in this demographic are discussed in this systematic review of the thirteen studies that passed through the researchers' selection process. Both qualititative and quantitative data from these studies proved useful in analyzing what has historically worked most effectively and efficiently in the accrual of elderly Chinese immigrants. The researchers conclude that convenience sampling may be a more cost effective approach than random sampling because random mailings are not required. The random mailings were considered to be less effective due to the high mobility of this specific demographic, the presence of outdated information in the yellow pages that were utilized, and surname confusion with other ethnic minorities. 


  • From this review there were ten major barriers that appeared to be hindering accrual of elderly Chinese immigrants for clinical trials.
  • These ten barriers include younger Chinese elderly status (ie 60-70 years old), low health literacy, longer LOS in the United States, limited English speaking ability, low acculturation, time constraints, inadequate treansportation, social stigma about disease in Chinese culture, and mistrust of researchers. 
  • The discussed strategies for improving the accrual of older Chinese immigrants include using convenience recruitment methods, particularly using personal referals; using specific techniques to accrue younger Chinese elders; communicating effectively using participants' native language; exercising cultural competancy; and establishing relationships of trust with participants and community leaders.