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The challenge of cross-cultural collaborative research: lessons learnt from a pilot case–crossover study of severe occupational hand trauma in the People’s Republic of China
  1. Kezhi Jin1,2,
  2. David A Lombardi2,3,
  3. Theodore K Courtney2,3,
  4. Gary S Sorock4,
  5. Melissa J Perry3,
  6. Hong Chen5,
  7. Xin Wang5,
  8. Youxin Liang1
  1. 1School of Public Health, Fudan University, Shanghai, PRC
  2. 2Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA
  3. 3Harvard School of Public Health, Boston, Massachusetts, USA
  4. 4Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5Ningbo No 6 Hospital, Ningbo, Zhejiang Province, PRC
  1. Correspondence to:
 Dr K Jin
 Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748, USA;Jin.kezhi{at}


Objective: A pilot epidemiologic study was conducted in the People’s Republic of China to assess the feasibility of applying the study protocol from a US case–crossover study on transient work-related exposures and the risk of an acute occupational hand injury.

Design: Injured workers were recruited from a hand surgery center in Ningbo, Zhejiang, People’s Republic of China. A structured face-to-face interview questionnaire was administered.

Results: 156 workers with hand injury completed the study (73% men). The enrollment rate was 91%. Of those who refused participation, most indicated their reluctance was due to the requirement to sign the written consent form. Considerable variability was found among interviewers in ascertaining responses from participants to important exposure questions (21.3% v 97%).

Conclusions: Recommendations include the following: (1) exploring effective oral-consent protocols that reduce participant concern and still meet human participant protection requirements; (2) using non-physician interviewers; and (3) increasing the intensity and standardization of interviewer training.

  • PRC, People’s Republic of China

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  • Funding: This work was supported by the Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA and the Fudan University School of Public Health, Shanghai, PRC.

  • Competing interests: None.