Scott D. Rhodes

Collecting behavioural data using the world wide web: considerations for researchers

Objective: To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. Methods: This discussion is based on the authors’ experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. Results: The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited “digital divide”, literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. Conclusions: Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.

Caffeinated Cocktails: Energy Drink Consumption, High‐risk Drinking, and Alcohol‐related Consequences among College Students

OBJECTIVES The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high-risk drinking behavior, and alcohol-related consequences. METHODS In Fall 2006, a Web-based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina. RESULTS A total of 697 students (24% of past 30-day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p < 0.001) and twice as many episodes of weekly drunkenness (1.4 days/week vs. 0.73 days/week; p < 0.001). Students who reported consuming AmED had significantly higher prevalence of alcohol-related consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p < 0.05). The effect of consuming AmED on driving while intoxicated depended on a students reported typical alcohol consumption (interaction p = 0.027). CONCLUSIONS Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol-related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk.

Photovoice as community-based participatory research: a qualitative review.

OBJECTIVE To explore the use of photovoice as a research methodology to identify and explore community health and disability priorities. METHODS Published studies (n = 31) that applied photovoice as a research methodology to promote and enhance individual and community change were identified and reviewed. RESULTS Findings are explored and organized by community concerns and priorities; participant recruitment, training, and camera instruction; identification of photo assignment; photo assignment discussion; data analysis; outcomes; and evaluation of program and policy changes. CONCLUSIONS Despite the limitations of the studies and/or how they are reported, findings from this review support further application of photovoice to facilitate community change.

The power and the promise: Working with communities to analyze data, interpret findings, and get to outcomes

Although the intent of community-based participatory research (CBPR) is to include community voices in all phases of a research initiative, community partners appear less frequently engaged in data analysis and interpretation than in other research phases. Using 4 brief case studies, each with a different data collection methodology, we provide examples of how community members participated in data analysis, interpretation, or both, thereby strengthening community capacity and providing unique insight. The roles and skills of the community and academic partners were different from but complementary to each other. We suggest that including community partners in data analysis and interpretation, while lengthening project time, enriches insights and findings and consequently should be a focus of the next generation of CBPR initiatives.

Community-based participatory research: a new and not-so-new approach to HIV/AIDS prevention, care, and treatment.

After nearly 30 years since the identification of HIV, a vaccine or effective cure still eludes us. Furthermore, our current challenges in providing access, and ensuring uptake and consistent adherence, to antiretroviral (ARV) medications indicate that the epidemic will continue to challenge educators and practitioners, clinicians and providers, and advocates and policy makers, even after a viable vaccine exists (Rhodes, Hergenrather, Wilkin, & Wooldredge, 2009). Currently, the most effective means to confront the HIV epidemic are to reduce (a) behavioral risk, (b) seropositive infectivity, and/or (c) biological vulnerability to infection. However, clearly our current arsenal of effective approaches to increase adherence to risk reduction strategies and treatment remains insufficient. This Theme Issue of AIDS Education and Prevention: An Interdisciplinary Journal explores how community members, organizational representatives, and academic researchers can combine their knowledge, perspectives, experiences, and resources to systematically inform and promote HIV prevention, care, and treatment in meaningful and effective ways through community-based participatory research (CBPR). We know that understanding and intervening upon complex health problems such as HIV/AIDS benefit from the multiple perspectives of community members, organizational representatives, and academic researchers (Agency for Healthcare Research and Quality, 2002; Centers for Disease Control and Prevention & Agency for Toxic Substances and Disease Registry Committee on Community Engagement, 1997; Green, 2001; Hergenrather & Rhodes, 2008; Institute of Medicine, 2000; Israel, Schulz, Parker, & Becker, 1998; Viswanathan, et al., 2004). Research aimed at understanding and promoting health has increasingly focused attention on CBPR (Eng, et al., 2005; Institute of Medicine, 2003; Israel, et al., 1998; Rhodes, et al., 2006; Viswanathan, et al., 2004; Wallerstein & Duran, 2003), recognizing that a community “outsider,” such as an academic researcher, can work best with community partners, who themselves are experts (Rhodes, et al., 2006; Rhodes, Hergenrather, Ramsey, Yee, & Wilkin, 2007). Blending lived experiences with sound science has the potential to develop deeper understandings of phenomena, and thus, produce more relevant and more likely successful and impactful interventions.

OUTCOMES FROM A COMMUNITY-BASED, PARTICIPATORY LAY HEALTH ADVISER HIV/ STD PREVENTION INTERVENTION FOR RECENTLY ARRIVED IMMIGRANT LATINO MEN IN RURAL NORTH CAROLINA

Latinos in the United States are at increased risk for HIV and sexually transmitted disease (STD) infection. We evaluated the efficacy of a pilot lay health adviser (LHA) intervention designed to increase condom use and HIV testing among Latino men. Fifteen LHAs (mean age = 35.6; range 23-60 years) from 15 Latino soccer teams were trained and worked with their teammates for 18 months. Another 15 teams served as the control group. Data were collected at baseline and at 18 months post-LHA training from a random sample of teammates from intervention and control teams. Data were collected from 222 men (mean age = 29 years) who participated in one of the 30 teams. Relative to the control condition, participants in the intervention reported more consistent condom use in the 30 days preceding follow-up (unadjusted analysis, intervention, 65.6% vs. control, 41.3%; p < .001). Participants in the intervention were more likely to report condom use (adjusted odds ratio [AOR] = 2.3; confidence interval [CI = 1.2-4.3) and HIV testing (AOR = 2.5; CI = 1.5-4.3). LHA interventions for Latino men that are developed in partnership with community members, rely on male-centered intrapersonal networks, and are culturally congruent can enhance preventive behaviors and may reduce HIV infection.

Exploring Latino men's HIV risk using community-based participatory research.

OBJECTIVES To explore sociocultural determinants of HIV risk and identify potential intervention approaches among adult Latino men. METHODS Using community-based participatory research for study design and implementation and data analysis, 7 focus groups were conducted with members of a soccer league in central North Carolina. RESULTS Five themes emerged, including perceived barriers to accessing health care, the role of hegemonic masculinity in risk, and potentially effective intervention approaches to health promotion and disease prevention. CONCLUSIONS Latino soccer leagues may provide an effective social network with which to partner to design, implement, and evaluate interventions to reduce sexual risk among Latino men, who have been inaccessible in conventional HIV/ STD prevention programs.

Exploring Undergraduate Student Attitudes Toward Persons With Disabilities Application of the Disability Social Relationship Scale

The Disability Social Relations Generalized Disability (DSRGD) Scale was used to explore the influence of the social context on attitudes toward persons with disabilities. The DSRGD Scale was based on the Disability Social Relationship (DSR) Scale (Grand, Bernier, & Strohmer, 1982; Strohmer, Grand, & Purcell, 1984). A sample of 1,013 undergraduate students completed the DSRGD. Principal axis factoring yielded three factors representing the three contextual subscales of Dating, Marriage, and Work. The study findings identified a significant effect of context on attitudes toward persons with disabilities. A significant effect of gender across social context was identified, with females scoring higher than males on the subscales of Dating, Marriage, and Work.

Boys Must Be Men, and Men Must Have Sex With Women: A Qualitative CBPR Study to Explore Sexual Risk Among African American, Latino, and White Gay Men and MSM

Men who have sex with men (MSM) continue to be disproportionately affected by HIV and sexually transmitted diseases. This study was designed to explore sexual risk among MSM using community-based participatory research (CBPR). An academic—community partnership conducted nine focus groups with 88 MSM. Participants self-identified as African American/Black (n = 28), Hispanic/Latino (n = 33), White (n = 21), and biracial/ethnic (n = 6). The mean age was 27 years (range = 18-60 years). Grounded theory was used. Twelve themes related to HIV risk emerged, including low knowledge of HIV and sexually transmitted diseases, particularly among Latino MSM and MSM who use the Internet for sexual networking; stereotyping of African American MSM as sexually “dominant” and Latino MSM as less likely to be HIV infected; and the eroticization of “barebacking.” Twelve intervention approaches also were identified, including developing culturally congruent programming using community-identified assets, harnessing social media used by informal networks of MSM, and promoting protection within the context of intimate relationships. A community forum was held to develop recommendations and move these themes to action.

Still a hard-to-reach population? Using social media to recruit latino gay couples for an HIV intervention adaptation study

Background Online social networking use has increased rapidly among African American and Latino men who have sex with men (MSM), making it important to understand how these technologies can be used to reach, retain, and maintain individuals in care and promote health wellness. In particular, the Internet is increasingly recognized as a platform for health communication and education. However, little is known about how primarily Spanish-speaking populations use and engage with each other through social media platforms. Objective We aimed to recruit eligible couples for a study to adapt “Connect ‘n Unite” (an HIV prevention intervention initially created for black gay couples) for Spanish-speaking Latino gay couples living in New York City. Methods In order to successfully design and implement an effective social media recruitment campaign to reach Spanish-speaking Latino gay couples for our ongoing “Latinos en Pareja” study, our community stakeholders and research team used McGuire’s communication/persuasion matrix. The matrix guided our research, specifically each marketing “channel”, targeted “message”, and target population or “receiver”. We developed a social media recruitment protocol and trained our research staff and stakeholders to conduct social media recruitment. Results As a result, in just 1 month, we recruited all of our subjects (N=14 couples, that is, N=28 participants) and reached more than 35,658 participants through different channels. One of the major successes of our social media recruitment campaign was to build a strong stakeholder base that became involved early on in all aspects of the research process—from pilot study writing and development to recruitment and retention. In addition, the variety of “messages” used across different social media platforms (including Facebook, the “Latinos en Pareja” study website, Craigslist, and various smartphone applications such as Grindr, SCRUFF, and Jack’d) helped recruit Latino gay couples. We also relied on a wide range of community-based organizations across New York City to promote the study and build in the social media components. Conclusions Our findings highlight the importance of incorporating communication technologies into the recruitment and engagement of participants in HIV interventions. Particularly, the success of our social media recruitment strategy with Spanish-speaking Latino MSM shows that this population is not particularly “hard to reach”, as it is often characterized within public health literature.