Using Concept Mapping to Explore and Engage Parent and Youth Residents of an Economically Underserved Minority Community around Children's Asthma.

BACKGROUND: Asthma continues to disproportionately impact children living in economically underserved urban neighborhoods, and contributes to persistent racial and economic disparities in health. Furthermore, asthma is often exacerbated by the presence of social and environmental factors that are prevalent in, and sometimes particular to, these communities. OBJECTIVES: The present study uses a community-based participatory research (CBPR) approach to explore and define the experience and issues around children's asthma in an economically underserved community. These findings will be used to inform the design of a community intervention. METHODS: Through a community and academic partnership called Healthy Living, Healthy Learning, Healthy Lives (HL3), we engaged neighborhood youth and adult residents (N = 21) in a concept mapping activity to identify triggers and health care-related factors that influence children with asthma. RESULTS: Findings highlight that the most important triggers of asthma included indoor and outdoor irritants and allergens, as well as violence and fear-related emotions. The most important factors perceived to influence the care of asthma included medical relievers such as asthma medication, appliances such as a humidifier, and supports for asthma like the school nurse. Differences between adults and youth perceptions of factors triggering and influencing asthma are highlighted. CONCLUSIONS: Engaging community residents as experts provided a deeper understanding of the issues around children's asthma in the community, which can contribute to the design of a more effective intervention.

How much of the cocaine market are we missing? Insights from respondent-driven sampling in a mid-sized American city.

BACKGROUND: Studying markets for illegal drugs is important, but difficult. Data usually come from a selected subset of consumers, such as arrestees, treatment clients, or household survey respondents. There are rarely opportunities to study how such groups may differ from other market participants or how much of total consumption they represent. METHODS: This paper uses respondent-driven sampling (RDS) of drug users in a mid-sized American city to estimate the shares of cocaine (powder and crack) users and expenditures that are attributable to different combinations of these groups. RESULTS: We find that those arrested in the last year accounted for 34% of past-month cocaine users and 40% of past-week cocaine spending in the RDS sample. Augmenting past-year arrestees with those who received treatment in the past year increases these values to 44% (users) and 55% (spending). CONCLUSIONS: Our results suggest that estimates based only on people who were arrested and/or treated in the past year would have to be inflated by 100-200% to capture the market totals. Adding those who own or rent their place of residence increased coverage in this study to 76% (users) and 81% (spending), suggesting that in theory the inflation factor could be reduced to 23-32% by supplementing data on arrestees and treatment populations with household data, although in practice rates of under-reporting by survey respondents may make coverage (sampling frame) a secondary concern for household surveys.