Maximizing respondent-driven sampling field procedures in the recruitment of sexual minorities for health research.

OBJECTIVES: Research to address the significant health burden experienced by sexual minority populations remains hampered by a lack of appropriate sampling methods to support evidence-based studies. Respondent-driven sampling offers one viable strategy to recruit these hidden populations. Because few studies systematically report their experiences using respondent-driven sampling to recruit sexual minorities, this article aligns with recent recommendations for the standardization of reporting and transparency in studies utilizing respondent-driven sampling. We (1) provide detailed descriptions about the successful execution of respondent-driven sampling in two community-based studies of sexual minority individuals, (2) outline procedures to enhance the effectiveness of respondent-driven sampling referral processes, (3) present mixed-methods results regarding the effectiveness of respondent-driven sampling in our studies, and (4) offer recommendations for other researchers when using respondent-driven sampling. METHODS: We successfully recruited 655 sexual minority men and women for two studies using respondent-driven sampling. RESULTS: Resulting metrics indicate the successful achievement of equilibrium in each study. In addition, exit interviews elucidated strategies to effectively target referrals who meet the study criteria and procedures to promote the study that will maximize referral chains and ensure attainment of equilibrium. CONCLUSION: Mixed-methods results suggest that respondent-driven sampling can be an effective means of recruiting a community-based sample of sexual minorities in smaller urban regions. Limitations are presented and suggestions are offered to researchers utilizing respondent-driven sampling in future studies.

Reconsidering adulthood: Relative constructions of adult identity during the transition to adulthood.

This article explores how peers influence the process of adult identity development during the transition to adulthood. The influence of peers leads to similar individuals adopting differing definitions of adulthood. Utilizing data from interviews with 60 young adults who are all exactly 30 years old, findings indicate that peer groups can partly explain variation in self-perceived definitions of adulthood. Respondents described how peers influence the transition to adulthood in two ways. First, they measure the timing of their transitions relative to their peers. Second, they assess the nature of their transitions relative to what they perceive to be the normative nature of that transition within their peer group. While this process was reported by respondents across gender and education level, the outcomes varied between individuals who are demographically similar. Variation in self-perceived status is due in part to the differences between peer groups, as the reference point for each individual varies from one peer group to another. These findings suggest that norms about adulthood are perceived at the group level, which can explain why differing feelings of adulthood exist among individuals who have completed comparable transitions and share similar status characteristics. As previous research has focused on adulthood norms that exist primarily at the societal level, this study expands on that work by suggesting that salient adulthood norms may be developed and referenced at multiple levels.

The architecture of support: The activation of preexisting ties and formation of new ties for tailored support.

This study examines differences in the resources, information, and support parents coping with pediatric cancer accessed from different types of network contacts. Using interviews with parents of childhood cancer patients (N = 80 parents), we examine (1) if parents rely on different types of network ties to access tailored information, resources or support; (2) differences in the nature or utility of information, resources, and support offered by different types of network contacts; and (3) the role of health-related professionals in brokering new network ties. Findings show that after a child's cancer diagnosis, parents received support from a broad portfolio of network members, which included preexisting network ties to friends and families as well as the formation of new ties to other cancer families and health-related professionals. Family, friends, and neighbors offered logistical support that aided balancing preexisting work and household responsibilities with new obligations. Parents formed new ties to other families coping with cancer for tailored health-related emotional and informational support. Health-related professionals served as network brokers, who fostered the development of new network ties and connected parents with supportive resources.

The devil you know: parents seeking information online for paediatric cancer.

There is a growing interest in understanding the effect that online information-seeking has on patients' experiences, empowerment and interactions with healthcare providers. This mixed-methods study combines surveys and in-depth interviews with 41 parents of paediatric cancer patients in the USA to examine how parents think about, evaluate, access and use the internet to seek information related to their child's cancer. We find that, during the acute crisis of a child being diagnosed with cancer, parents preferred to receive information related to their child's diagnosis, prognosis and treatment options from a trusted healthcare provider rather than through the internet. We find that access to medically related cancer information through the internet was deemed to be untrustworthy and frightening. Parents' reasons for avoiding online information-seeking included fear of what they might find out, uncertainty about the accuracy of information online, being overloaded by the volume of information online and having been told not to go online by oncologists. Some parents also had logistical barriers to accessing the internet. While most parents did not turn to the internet as a source of health-related information, many did use it to connect with sources of social support throughout their child's illness.

Structuring survivorship care: discipline-specific clinician perspectives.

INTRODUCTION: Several models for survivorship care are prominent within the cancer literature; however, there is little empirical research that examines what oncology clinicians perceive to be the best approach to caring for cancer survivors, what services survivorship programs should include, and how prepared they feel to care for cancer survivors. METHODS: An IRB approved web-based survey of all clinical staff was conducted at a NCI designated comprehensive cancer center with a 49.8% response rate (N = 377). Data were summarized using frequencies and relative frequencies, and pairwise tests of statistical significance were utilized to evaluate differences between clinician type groups. RESULTS: Overall, the largest proportion of respondents preferred a disease-specific survivorship model (37.6%). This preference was specifically observed in oncology physicians and nurses. When asked where specific survivorship services should be provided, respondents indicated a preference for services directly related to survivors' medical treatment (i.e. information about late effects) to be delivered in a disease-specific survivorship clinic, and ancillary services (i.e. nutrition and fertility counseling) to be housed in a centralized comprehensive survivorship clinic. Physicians felt that they have significantly more information, training, and resources to care for cancer survivors than did oncology nurses. DISCUSSION/CONCLUSION: These results indicate that oncology clinicians prefer a combination of survivorship care delivery models where continuing medical needs are met in disease-specific clinics, and comprehensive wellness services are offered in a centralized comprehensive survivorship clinic. Results also suggest that planning for survivorship initiatives should include additional resources, education, and training for clinical staff. IMPLICATIONS FOR CANCER SURVIVORS: These findings underscore the need for a universally accepted definition of cancer survivorship, and support a model for delivering care to cancer survivors that is a blend of the disease-specific and comprehensive survivorship programs.