Cross-cultural research: Trying to do it better. 1. Issues in study design

Abstract

Objective: To discuss a range of strategies to address the methodological and practical challenges in designing cross-cultural public health studies. Method: The Mothers in a New Country (MINC) Study was an interview study of 318 Vietnamese, Turkish and Filipino recent mothers exploring their views of maternity care and the early months of motherhood. It was carried out in Melbourne between 1994 and 1997. Sampling, recruitment, retention and representativeness all pose problems for studies involving non-English-speaking background immigrant populations, as do selection, training and support processes for bicultural interviewers. These issues are discussed with reference to the strategies undertaken to tackle them in the MINC Study. Results: In the MINC Study, a systematic approach to sampling and recruitment, combined with a flexible and sensitive study protocol were largely successful both in achieving an adequate sample size and a largely representative study sample. Similarly, paying significant attention to the selection, training and ongoing support of the bicultural interviewers employed on the study contributed greatly to its successful completion and enhanced confidence in the study findings. Implications: Both researchers and funders need to take seriously the implications of the many methodological and practical issues involved in designing sound cross-cultural public health studies. In particular, there are major implications for study costs and timelines. However, the benefits to be gained are significant.