low-wage hourly positions. The names of all participants discussed
have been changed to pseudonyms.
Recruitment was based on a theoretical sampling frame, or
recruitment for the purpose of theory development. My research
assistants and I recruited healthcare professionals from online
clinic directories (7 professionals) and from the author's social
networks (8 professionals) based on their answers to simple
questions about their ability to offer substantive feedback
regarding the healthcare issues of their patients.
Patients and caregivers were recruited using three strategies:
recruiting from the research team's social networks, “cold approaches”
and snowball sampling from the social networks of cold
approaches (immediate family and close friends). Recruitment was
based on the potential participants' answers to basic questions
about their or their close family members' ability to access
healthcare in the U.S. and in Mexico. Just under half of the patient/
caregiver sample was recruited by approaching unknown individuals
in community clinic waiting rooms and in public downtown
areas. Roughly one third of the patient/caregiver sample was
recruited from relatives and close friends of cold approach participants,
and the remaining participants are individuals from the
research team's social networks (e.g. neighbors and friends). This
latter strategy was important for recruiting unauthorized immigrants,
who required higher levels of trust with the research team
before agreeing to participate due to deportation fears. Early
recruitment efforts did not target immigrants, but later recruitment
did seek immigrants of any status (unauthorized, naturalized, etc.)
in order to understand unique healthcare barriers and strategies
not shared by U.S.-born participants. The University of WisconsineMadison
IRB approved all study activities. Participants were
not recruited on the basis of race, ethnicity, or socioeconomic status
at any stage of the research process. The predominantly Mexican
American and low-middle income status of the sample reflects the
larger demographics of South Texas border areas, where 89% of
residents are Latino/a and 34% of the population lives below the
poverty line (U.S. Census Bureau, 2009).
The guiding methodology for data collection and analysis is
constructivist grounded theory (Charmaz, 2006), which draws on
Glaser and Strauss' grounded theory methodology (1967).
Constructivist grounded theory is a systematic approach to qualitative
research emphasizing building theories through
simultaneous data collection and analysis. As I collected interviews
and field observations, these data were coded into the most
frequent and significant themes (Charmaz, 2006). Analysis also
included “memoing,” or writing short analytic documents, to
further refine theoretical explanations of the field processes. While
the preliminary interview guide drew sensitizing concepts from
research on cross-border healthcare (e.g. Bastida et al., 2008; Byrd
and Law, 2009), subsequent guides focused on emerging themes
surrounding prescription drug access strategies.