Recruitment Methods For Epidemiologic Research On Hepatitis C Among Rural Young Adults Who Inject Drugs

Author: Young AM, Ballard AM, Haardörfer R, Cooper HLF

Theme: Epidemiology & Public Health Research Year: 2018

Rural communities in the U.S. are epicenters of Hepatitis C (HCV), fueled by opioid injection,
syringe sharing, and a historically weak harm reduction infrastructure. However, methods for
epidemiologic research on HCV among PWUD were developed predominantly in urban
contexts. This study explores the feasibility of using web-based strategies to recruit rural,
young adult PWUD into epidemiologic research.
Recruitment occurred from August 2017 to April 2018 in a rural Appalachian Kentucky
community using a combination of WebRDS and outreach strategies tailored to rural areas
(i.e., community cookouts held in gas station and grocery parking lots). Inclusion criteria
included being age 18–35, recent (past 6 month) opioid use to get high, and living in the 5-
county study area. Prospective participants completed an extensive online eligibility
screening (e.g., quizzes assessing knowledge of the local community and opioids to verify
residence and substance use, respectively) which underwent cognitive testing with PWUD.
Preliminary data were analyzed to determine yield of recruitment methods.
As of April 2018, 243 people were screened for eligibility; 99 were eligible and 84
participated. Project cookouts were most effective in enrolling people into the online
screening (25.5% of those screened); however, a substantial proportion of these were
ineligible (64.5%). Of the 22 eligible PWUD recruited via cookouts, 19 completed the survey
and referred a total of 27 others into the screening using WebRDS; 92.6% of whom were
eligible. Thus, 48.8% of the sample was directly or indirectly attributable to recruitment
cookouts. Other more traditional recruitment strategies (e.g., flyers posted in health and
social service agencies) have yielded relatively few eligible participants (n=7).
Though web-based recruitment methods have successfully recruited marginalized
populations in urban areas, our study indicates that web-based methods need to be
complemented by context-tailored, street-outreach activities such as cookouts to recruit rural
Disclosure of Interest Statement:
This research was funded by a grant from the National Institutes of Health (NIH R21
DA042727) to Drs. Cooper and Young.

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