Robin Lin Miller

A Venue-Based Method for Sampling Hard-to-Reach Populations

Constructing scientifically sound samples of hard-to-reach populations, also known as hidden populations, is a challenge for many research projects. Traditional sample survey methods, such as random sampling from telephone or mailing lists, can yield low numbers of eligible respondents while non-probability sampling introduces unknown biases. The authors describe a venue-based application of time-space sampling (TSS) that addresses the challenges of accessing hard-to-reach populations. The method entails identifying days and times when the target population gathers at specific venues, constructing a sampling frame of venue, day-time units (VDTs), randomly selecting and visiting VDTs (the primary sampling units), and systematically intercepting and collecting information from consenting members of the target population. This allows researchers to construct a sample with known properties, make statistical inference to the larger population of venue visitors, and theorize about the introduction of biases that may limit generalization of results to the target population. The authors describe their use of TSS in the ongoing Community Intervention Trial for Youth (CITY) project to generate a systematic sample of young men who have sex with men. The project is an ongoing community level HIV prevention intervention trial funded by the Centers for Disease Control and Prevention. The TSS method is reproducible and can be adapted to hard-to-reach populations in other situations, environments, and cultures.

Advancing the Science of Community-Level Interventions

Community interventions are complex social processes that need to move beyond single interventions and outcomes at individual levels of short-term change. A scientific paradigm is emerging that supports collaborative, multilevel, culturally situated community interventions aimed at creating sustainable community-level impact. This paradigm is rooted in a deep history of ecological and collaborative thinking across public health, psychology, anthropology, and other fields of social science. The new paradigm makes a number of primary assertions that affect conceptualization of health issues, intervention design, and intervention evaluation. To elaborate the paradigm and advance the science of community intervention, we offer suggestions for promoting a scientific agenda, developing collaborations among professionals and communities, and examining the culture of science.

Identity and Agency: The Meaning and Value of Pregnancy for Young Black Lesbians

Young sexual minority women disproportionately experience pregnancy, repeat pregnancy, and become parents, when compared with their heterosexual peers. Black sexual minority women who are socioeconomically disadvantaged are a part of three demographic groups likely to experience adolescent pregnancy. A paucity of research has examined why these young women become pregnant. The authors begin to address this gap by examining the meaning of pregnancy from young women’s perspective. Modified grounded theory was used to analyze data from interviews with 14 young Black sexual minority women, aged 16–24. Pregnancies, intentional and unintentional, were common among the participants and within their sexual minority community. Pregnancy affirmed sexual identity and same-sex relationships as well as garnered sexual and reproductive agency. Participants’ pregnancy experiences contradicted the belief that young women sought or valued pregnancy because it provided access to heterosexual privilege. Although the main functions of intentional pregnancies did not differ drastically from those of young heterosexual women, we argue that these young women’s pregnancy and parenting desires may be magnified because of the particular realities they face as sexual minority women. Further, we situate our analysis within the context of a Black cultural environment and argue that pregnancy and motherhood may be adaptive subsistence strategies for women who are largely socially devalued.

Taking Stock of Empowerment Evaluation: An Empirical Review

Empowerment evaluation entered the evaluation lexicon in 1993. Since that time, it has attracted many adherents, as well as vocal detractors. A prominent issue in the debates on empowerment evaluation concerns the extent to which empowerment evaluation can be readily distinguished from other approaches to evaluation that share with it an emphasis on participatory and collaborative processes, capacity development, and evaluation use. A second issue concerns the extent to which empowerment evaluation actually leads to empowered outcomes for those who have participated in the evaluation process and those who are the intended beneficiaries of the social programs that were the objects of evaluation. The authors systematically examined 47 case examples of empowerment evaluation published from 1994 through June 2005. The results suggest wide variation among practitioners in adherence to empowerment evaluation principles and weak emphasis on the attainment of empowered outcomes for program beneficiaries. Implications for theory and practice are discussed.

Strategies for Managing Heterosexism Used among African American Gay and Bisexual Men

Oppression and oppression management are focal topics of inquiry in research on African Americans’ social behaviors. Previous research has failed to investigate the methods that African Americans who are also bisexual and gay use to cope with oppressive experiences associated with their status as sexual minorities. In the current study, the authors use in-depth interviews with gay and bisexual African American men (n = 37) to examine the strategies that they employ to manage their sexual minority status. Six minority status management strategies for coping with heterosexism and the contexts in which these strategies are used are identified. The functions these strategies serve, such as avoiding stigma or building support systems, are also identified. The data suggest similarities among the strategies these men use to cope with heterosexism and the strategies that theorists have identified for coping with racism. Implications for research and theory about dual oppression management are discussed.

Attention deficit hyperactivity disorder in African American children: what can be concluded from the past ten years?

Samuel et al. [Samuel, V. J., Curtis, S., Thornell, A., George, P., Taylor, A., Brome, D. R., et al. (1997). The unexplored void of ADHD and African-American research: A review of the literature. Journal of Attention Disorders, 1(4), 197-207.] reviewed the literature on Attention Deficit Hyperactivity Disorder (ADHD) in African Americans, and found a paucity of research. The present review of 73 articles updates this assessment of available research and presents the current understanding of ADHD symptoms, assessment, diagnosis, and treatment in African American children ages 3-18. The authors conducted a qualitative review, as well as a mini meta-analysis of 5 studies of ADHD symptoms and 5 studies of ADHD diagnosis to clarify the question of racial differences in prevalence. African American youth had more ADHD symptoms (Cohens d=0.45, p<.001), yet were diagnosed with ADHD only two-thirds as often as Caucasian youth (OR=.66, p<.001). This pattern was not explained by teacher rating bias or by SES, but may be influenced by parent beliefs about ADHD, higher rates of risk, and lack of treatment access and utilization. Lower treatment rates may be related to high rates of classroom behavior problems among African American youth. Findings also suggest that existing assessment tools may not adequately capture ADHD manifestation in African Americans. Findings highlight the need for more investigation and awareness of relevant cultural issues to inform a culturally competent approach to assessment, diagnosis, and treatment of ADHD in African Americans.

Assessing Organizational Capacity to Deliver HIV Prevention Services Collaboratively: Tales from the Field

Collaborative efforts between university researchers and community entities such as citizen coalitions and community-based organizations to provide health prevention programs are widespread. The authors describe their attempt to develop and implement a method for assessing whether community organizations had the organizational capacity to collaborate in a national study to prevent HIV infection among young men who have sex with men and what, if any, needs these institutions had for organizational capacity development assistance. The Feasibility, Evaluation Ability, and Sustainability Assessment (FEASA) combines qualitative methods for collecting data (interviews, organizational records, observations) from multiple sources to document an organizations capacity to provide HIV prevention services and its capacity-development needs. The authors describe experiences piloting FEASA in 13 communities and the benefits of using a systematic approach to partnership development.

Developing Standards for Empirical Examinations of Evaluation Theory

Evaluation scholars have long called for research on evaluation (Mark, 2001, 2003; Shadish, Cook, & Leviton, 1991; Smith, 1993; Worthen, 2001) to provide an empirical basis for improving its theory and practice. Although calls to investigate evaluation have struck a chord in some quarters of the evaluation community, with the exception of research in the area of evaluation use, these calls have been infrequently answered. Specific frameworks and guidance on how to study evaluation have seldom been offered, which may contribute to the relative dearth of research on evaluation. This article will focus on one area in which research on evaluation is sorely needed, the relationship between theory and practice. In this article, I develop a preliminary framework for studying critical aspects of the value of theory to practice.

Risk and protective factors related to HIV-risk behavior: A comparison between HIV-positive and HIV-negative young men who have sex with men

Abstract The objective of this study was to assess and compare the prevalence of high-risk sexual behaviors among young HIV-negative (n=8064) and HIV-positive (n=171) men who have sex with men (MSM) on predictors of unprotected anal intercourse (UAI). Using venue-based time-space sampling, 8235 MSM aged 15–25 were anonymously surveyed as a part of the Community Intervention Trial for Youth (CITY). The Project was conducted in 13 communities across the USA from 1999 to 2002. Forty percent of HIV-positive men and 34% of HIV-negative men reported that they had UAI in the previous 3 months. HIV-positive MSM were more likely than their uninfected peers to have traded sex within the previous year, to have had sex while high during their last sexual encounter, and to have UAI with a greater number of partners. Multivariate analyses indicated that for HIV-negative men, positive peer norms regarding safer sex and being Black or Latino predicted avoidance of UAI. Among HIV-positive men, having social support for safer sex and positive peer norms predicted avoidance of UAI. Young HIV-positive MSM are a relevant subgroup for prevention because they constitute a significant source from which future infections could be generated.

Identifying HIV prevention service needs of African American men who have sex with men: an application of spatial analysis techniques to service planning.

BACKGROUND Black men who have sex with men (MSM) are a priority population for HIV prevention. METHOD We applied spatial analysis techniques to map the availability of HIV prevention services to young black MSM in Chicago to guide prevention planning. GIS was used to map characteristics of ZIP codes in Chicago. Choropleth maps and descriptive statistics were used to visualize and analyze the data. RESULTS Areas where young black MSM reside typically have low HIV service densities. HIV service density also corresponds poorly to some ZIP codes in which young black MSM who report high rates of unprotected sexual behavior reside. CONCLUSION Spatial analysis can show whether services are located near specific populations of interest. Data from multiple sources can be integrated to explore relationships among characteristics of geographic zones.