Deborah Bray Preston

A Discussion of Chain Referral As a Method of Sampling Hard-to-Reach Populations

Nursing research often requires inquiry into sensitive topics that involve hidden or hard-to reach populations. However, identifying and sampling these populations for research purposes is often fraught with difficulties. Barriers include society’s lack of tolerance of diverse groups, social stigma, concern for issues of confidentiality, and fear of exposure because of possible threats to security. Chain referral sampling techniques are proposed to minimize bias while maintaining privacy and confidentiality. Techniques of chain referral sampling are detailed for use in researching sensitive topics and hidden populations. When carefully planned and executed, this sampling design offers transcultural nurse researchers a reasonable method for accessing and studying special populations that are particularly hard-to-reach.

Issues in the Development of HIV-Preventive Interventions for Men Who Have Sex with Men (MSM) in Rural Areas

Interventions aimed at reducing HIV-related sexual risk behaviors among men who have sex with men (MSM) have been highly successful in urban areas in reducing the incidence of new cases of HIV infection. In rural areas, where the rates of infection are increasing, issues of culture, population density, isolation, and lack of access to health care services present different challenges for the design and dissemination of preventive interventions. In this paper, we will discuss the issues related to the development of preventive interventions for rural MSM, and propose a model of intervention based on preliminary findings from a recent study of rural MSM.

Marital status, gender roles, stress, and health in the elderly

A model of the relationship between the social context effects of marital status and gender role differences in health was tested in a sample of noninstitutionalized elderly. The conceptual model assumed that (a) marital status is a social context; (b) social contexts give rise to social interactions; (c) social interactions result in the assumption or modification of gender roles; and (d) gender roles determine the behavior of elderly individuals with regard to health, stress, coping, and social support. A random telephone survey of 6,585 households in six northeastern states resulted in a sample of 900 elderly 65 years of age or older. Hierarchical regression analysis was used to test the main effects, the joint effects, and the combined effects of gender and marital status on the independent variables as they related to health. Findings suggested that of the four marital contexts studied (married men and married women and unmarried men and unmarried women), married women were in the poorest health and most vulnerable to stress. For them, social support in terms of both number of confidantes and access to helping networks was not protective. These findings suggest that social context affects elderly womens health. The potential for expanding theories of womens health to include the social conditions in which they live is discussed.

Rural‐urban differences in women's psychological well‐being

The psychological well‐being of rural women has been a neglected research topic. This paper begins to fill that gap by reporting a study of the emotional well‐being of 75 women in a highly rural Pennsylvania county and a comparable urban group (N = 78) from Philadelphia. Results indicated few differences between the groups in any of the indicators of well‐being (stress, tension, strain, exhaustion, and life satisfaction); both groups reported relatively low stress and rather high life satisfaction. For both groups, stress related to family and friendship matters was most significant, followed by job‐related stress. Lifestyle factors (SES level, young children at home) were important predictors of stress for rural but not urban women, while poor health predicted stress for both groups. Findings are discussed in terms of the social, cultural, and economic characteristics of rural and urban life.

Developing a partnership for HIV primary prevention for men at high risk for HIV infection in rural communities

This paper identifies a collaborative approach used to access a difficult-to-reach population of men who have sex with men (MSM) at risk for HIV infection in a rural area of the US. To develop and implement an HIV prevention program the approach needed an HIV prevention educator networked through social political and institutional structures by emphasizing the involvement of a state government district health department a community-based AIDS agency MSM gatekeepers gay bars and informal groups of rural MSM. The goal of the intervention was to lower unnecessary HIV incidence through building HIV-related support and partnership. Several model approaches have been used by program planners to develop the goal of the planning process. These include the Program Evaluation and Review Technique the PRECEDE model the PROCEED model and the Planned Approach to Community Health model. Lastly project strategy included the seven principles such as planning the process planning with people planning with data planning for permanence planning for priorities planning for measurable outcomes and planning for evaluation.