A discussion of chain referral as a method of sampling hard-to-reach populations

The utility of non-proportional quota sampling for recruiting at-risk women for microbicide research

In the context of a measurement development study designed to contextualize microbicide acceptability, a sample that represented a range of at-risk women and maintained the statistical power needed for validity analyses was required. A non-proportional quota sampling strategy focused on race/ethnicity and number of sexual partners was utilized. This strategy resulted in enrollment of approximately equal proportions of Latina (31%), Black (36%), and White (32%) women, and an approximately 1:2 ratio of single-partnered (29%) and multi-partnered (71%) women. About 17% of women screened were ineligible based on eligibility criteria; an additional 16% were ineligible based on quota closures. Most participants were recruited through word of mouth (39%), community-based organizations (19%), or media sources (19%). Women recruited through word of mouth had the highest screen-to-interview completion percentage (67%). Non-proportional quota sampling is a feasible option for ensuring adequate representation of sample characteristics in microbicide research, but this goal should be weighed against cost and staff burden.

First injection of ketamine among young injection drug users (IDUs) in three U.S. cities

Ketamine, a dissociative anesthetic, has emerged as an increasingly common drug among subgroups of young injection drug users (IDUs) in cities across the United States. In-depth qualitative interviews were conducted with 213 young IDUs aged 16-28 years recruited in New York, New Orleans, and Los Angeles between 2004 and 2006. While some initiated injection drug use with ketamine, the drug was more frequently injected by IDUs with extensive polydrug using histories. IDUs initiating with ketamine commonly self-injected via an intramuscular mode of administration. The injection group provided crucial knowledge and material resources that enabled the injection event to occur, including ketamine, syringes, and injection skills. Injection paraphernalia was commonly shared during the first injection of ketamine, particularly vials of pharmaceutically-packaged liquid ketamine. Injection events infrequently occurred in a rave or club and more typically in a private home, which challenges ketamine's designation as a 'club' drug. The first injection of ketamine was a noteworthy event since it introduced a novel drug or new mode of administration to be further explored by some, or exposed others to a drug to be avoided in the future. Risk reduction messages directed towards young IDUs should be expanded to include ketamine.

Patterns of ketamine use among young injection drug users

Ketamine is a dissociative anesthetic that has emerged as an increasingly popular choice among young drug users. Recent research indicates the presence of hidden populations of young people who inject ketamine in New York and other U.S. cities. Applying an ethno-epidemiological approach, the authors recruited 40 young injection drug users (IDUs) (< 25 years old) in New York City to explore health risks associated with ketamine use. This analysis looks at the varying patterns and frequencies of ketamine injection by examining personal, social, and cultural aspects of these young people's lives. We learned that drug-using histories, experiential dimensions, sociocultural characteristics, and associations with other young people help account for the different patterns of injecting ketamine within the sample. In particular, these findings indicate that young people who were more frequent ketamine injectors had the following characteristics: initiated injection drug use with ketamine; enjoyed the effects of ketamine, were stably housed; lived in the vicinity of New York City; and associated with others who also injected ketamine.

Lessons learned from a pilot study on the health status of children from itinerant populations

The pilot study is used to guide development of a research design or to test an already developed plan; however, results of pilot work often are not reported. Pilot work can yield many valuable lessons and provide investigative training to the principal investigator and as well as evidence to funding agencies that the research is feasible and worthwhile. The pilot study described here is preliminary work on health disparities in two itinerant populations: carnival and migrant farmworker children. This pilot study had three aims: (a) identify the most productive methods to recruit subjects from these two "invisible" populations; (b) test feasibility of the research protocol; and (c) collect preliminary data on the children's health status for future research proposals.

Reflections on cancer in the context of women's health: focus group discussions with Iranian immigrant women in Sweden

In cancer prevention, culture and ethnicity have often been considered in negative terms as a variable to explain "misconceptions" and "knowledge deficits." This study, based on data from nine focus groups with Iranian immigrant women of various ages residing in Sweden, was instead conducted to explore reasoning on cancer prevention and screening within a framework of beliefs on health, illness and sickness for women in general. Complex relationships and reasoning about health maintenance and disease prevention were found to be related to perceptions of body and self, and to the continual construction of social roles throughout the life span. Spontaneous discussion of relationships between stress, maintaining health and developing disease arose in all groups. Negative outcomes associated with stress have consequences for information provision, as focusing on the negative is viewed as leading to negative outcomes. "Cultural" differences appear to be as related to social roles and phases in the life cycle, as to ethnicity.