Conducting community research in rural China: Addressing the methodological challenges of recruiting participants in rapidly changing social environments

Introduction The present paper addresses a unique challenge for public health and community research in rural China, i.e. the very large percentage of young adults that comprises a highly mobile working population that has been an essential component of the country's economic transformation. Fluid local demographic patterns potentially have a substantial impact on sample representativeness and data validity. Methods This report is based upon a cross-sectional survey with face-to-face interviews of residents aged 1634 years in rural communities of Mianyang, Sichuan Province, China. Two waves of fieldwork and other strategies were adopted in response to recruitment challenges. Results 1654 of 3008 potential participants took part in the study; this constituted 98% of those individuals approached and 55% of the persons enumerated in the local household registration system (hukou). Analyses revealed substantial differences among those who were interviewed during September and October 2005, versus those seen during the Chinese Lunar New Year of 2006 when many migrant workers and students returned to their homes. Both groups together differed from those who were unavailable during either recruiting episode. Discussion We discuss potential responses to associated methodological challenges, including (i) permanent hukou mismatches; (ii) temporary hukou mismatches; (iii) difficulties faced by potential participants to fully understand the purpose of research, the informed consent process, and specific research questions; and (iv) appreciation of the importance of local social networks, as they pertain in particular to rural China. These findings underscore that there may be a need to make on-the-ground adjustments to varying local conditions to maximize sample representativeness and data validity.