Comparing two sampling methods to engage hard-to-reach communities in research priority setting

BMC Medical Research Methodology, Oct 2016

Background Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. Methods In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1) snowball sampling, a chain- referral method or 2) purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community). Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities’ stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Results Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 %) consented, 52 (95 %) attended the first meeting, and 36 (65 %) attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 %) consented, 36 (58 %) attended the first meeting, and 26 (42 %) attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P < 0.05). Despite differing recruitment strategies, stakeholders from the two communities identified largely similar ideas for research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045) which was higher for the purposive/convenience sampling group and for city improvements/transportation services (P = 0.004) which was higher for the snowball sampling group. Conclusions In each of the two similar hard-to-reach communities, a community advisory board partnered with researchers to implement a different sampling method to recruit stakeholders. The snowball sampling method achieved greater participation with more Hispanics but also more individuals with disabilities than a purposive-convenience sampling method. However, priorities for research on chronic pain from both stakeholder groups were similar. Although utilizing a snowball sampling method appears to be superior, further research is needed on implementation costs and resources.

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Comparing two sampling methods to engage hard-to-reach communities in research priority setting

Valerio et al. BMC Medical Research Methodology Comparing two sampling methods to engage hard-to-reach communities in research priority setting Melissa A. Valerio 3 Natalia Rodriguez 0 Paula Winkler 0 2 Jaime Lopez 6 Meagen Dennison 5 Yuanyuan Liang 0 4 Barbara J. Turner 0 1 0 Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio (UTHSCSA) , 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 , USA 1 Department of Medicine , UTHSCSA, 7703 Floyd Curl Drive, San Antonio, TX 78229 , USA 2 South Central Area Health Education Center (AHEC), UTHSCSA , 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229 , USA 3 Department of Health Promotion and Behavioral Science, University of Texas School of Public Health in San Antonio , 7411 John Smith Drive, Suite 1100, San Antonio, TX 78229 , USA 4 Department of Epidemiology and Biostatistics, UTHSCSA , 7703 Floyd Curl Drive, San Antonio, TX 78229 , USA 5 Karnes County AgriLife Extension , 115 N. Market Street, Karnes City, TX 78118 , USA 6 Frio County AgriLife Extension , 400 S. Pecan Street, Pearsall, TX 78061 , USA Background: Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. Methods: In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1) snowball sampling, a chain- referral method or 2) purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community). Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities' stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Results: Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 %) consented, 52 (95 %) attended the first meeting, and 36 (65 %) attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 %) consented, 36 (58 %) attended the first meeting, and 26 (42 %) attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P < 0.05). Despite differing recruitment strategies, stakeholders from the two communities identified largely similar ideas for research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045) which was higher for the purposive/convenience sampling group and for city improvements/transportation services (P = 0.004) which was higher for the snowball sampling group. (Continued on next page) © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. - (Continued from previous page) Conclusions: In each of the two similar hard-to-reach communities, a community advisory board partnered with researchers to implement a different sampling method to recruit stakeholders. The snowball sampling method achieved greater participation with more Hispanics but also more individuals with disabilities than a purposive-convenience sampling method. However, priorities for research on chronic pain from both stakeholder groups were similar. Although utilizing a snowball sampling method appears to be superior, further research is needed on implementation costs and resources. Background A key feature of community-based and patient-centered outcomes research is partnering with community stakeholders from a project’s inception to ensure that it offers value to the community, is culturally appropriate, and is likely to yield sustainable improvements in prioritized outcomes [1]. Engaging persons from hard-to-reach or vulnerable communities has high priority, given evidence that lack of engaging racial-ethnic minorities and lower socioeconomic populations in research and decisionmaking contributes to disparities in enrollment in randomized cli (...truncated)


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Melissa Valerio, Natalia Rodriguez, Paula Winkler, Jaime Lopez, Meagen Dennison, Yuanyuan Liang, Barbara Turner. Comparing two sampling methods to engage hard-to-reach communities in research priority setting, BMC Medical Research Methodology, 2016, pp. 146, 16, DOI: 10.1186/s12874-016-0242-z