Evaluation of the cost and effectiveness of diverse recruitment methods for a genetic screening study

Purpose: Recruitment of participants from diverse backgrounds is crucial to the generalizability of genetic research, but has proven challenging. We retrospectively evaluated recruitment methods used for a study on return of genetic results. Methods: The costs of study design, development, and participant enrollment were calculated, and the characteristics of the participants enrolled through the seven recruitment methods were examined. Results: A total of 1118 participants provided consent, a blood sample, and questionnaire data. The estimated cost across recruitment methods ranged from $579 to$1666 per participant and required a large recruitment team. Recruitment methods using flyers and staff networks were the most cost-efficient and resulted in the highest completion rate. Targeted sampling that emphasized the importance of Latino/a participation, utilization of translated materials, and in-person recruitments contributed to enrolling a demographically diverse sample. Conclusions: Although all methods were deployed in the same hospital or neighborhood and shared the same staff, each recruitment method was different in terms of cost and characteristics of the enrolled participants, suggesting the importance of carefully choosing the recruitment methods based on the desired composition of the final study sample. This analysis provides information about the effectiveness and cost of different methods to recruit adults for genetic research

HIV-infected women: Barriers to AZT use

AZT has become a mainstay drug in efforts to slow disease progression in HIV-infected individuals. Further, recent evidence indicates that AZT use by pregnant infected women and their neonates may reduce the risk of vertical transmission. In a study of HIV-infected women's treatment-related behavior, attitudes toward the use of this drug were examined. Data were gathered through unstructured interviewing techniques. The data from the first 71 women accrued revealed that negative attitudes towards its use were widely prevalent. Women viewed the drug as highly toxic, prescribed indiscriminately, inadequately tested in women and minorities, promoted for the wrong reasons and inappropriate while they were feeling well. The findings suggest that removing attitudinal barriers to the use of AZT will be important to both primary and secondary prevention efforts.HIV/AIDS HIV-infected women AZT

Perceiving benefits in adversity: stress-related growth in women living with HIV/AIDS

This study examines perceptions of illness-related positive of change or stress-related growth among a sample of African American, Puerto Rican, and non-Hispanic White women (n=54) living with HIV/AIDS in New York City, USA. While these women acknowledged the negative stresses of living with HIV/AIDS, 83% reported at least one positive change in their lives that they attributed to their illness experience. A number of different domains of potential growth were identified including: health behaviors, spirituality, interpersonal relationships, view of the self, value of life, and career goals. While growth was reported by nearly all the women, some variation was found in the forms of growth reported in relation to the women's ethnic/racial background, class, and IV drug use history. These data suggest an expanded conceptualization of stress-related growth that includes behavioral aspects of growth in response to stress and illness, and which takes into account the diverse ways in which growth may be experienced.Stress-related growth Coping HIV/AIDS Women New York City

Factors distinguishing homosexual males practicing risky and safer sex

A longitudinal study of patterns of sexual behavior among asymptomatic, homosexual males in New York City was conducted. Participants were interviewed at two time points, 6 months apart. Based on their reports of sexual behavior during a recent 'typical' month, respondents were classified at each time point as engaging in safer (or low-risk) sexual practices versus high-risk sexual behaviors. Discriminant analysis was employed to distinguish the 53 males classified as risky at both time 1 and time 2 from the 47 males classified as safer in both periods. Statistically significant discrimination was achieved with 10 psychosocial predictor variables, four of which were significant while controlling for all other variables in the model. Of these predictors, drug use within sexual contexts was particularly noteworthy, since it provided the greatest relative contribution to the discriminant function and appears to be an important candidate for educational intervention. Other significant variables included perceived adequacy of emotional support, number of years engaged in regular sexual intercourse with other males, and perceived difficulty in modifying sexual behavior. Self-esteem and alcohol consumption approached significance.AIDS homosexual behavior sexual behavior AIDS prevention