Behavioural Surveillance Surveys - The Wisdom of Whores
Behavioural Surveillance Surveys - The Wisdom of Whores Behavioural Surveillance Surveys - The Wisdom of Whores
Targeted (snowball) sampling The rationale for preferring probability over non-probability sampling methods for BSS was outlined earlier in this section. Non-probability sampling methods are a last resort. They are used in situations where probability methods are not feasible because it is not possible to construct an adequate sampling frame of sites or locations where members of a sub-population of interest congregate. Groups for which non-probability sampling methods may have to be used include injecting drug users, some types of sex workers, and possibly men-whohave-sex-with-men. The basic form of non-probability sampling recommended for BSS is a modified form of snowball sampling referred to as targeted sampling. The basic idea in snowball sampling is to compensate for the lack of a sampling frame by learning the identities of members of a given “network” of persons who engage in a given risk behavior through key informants and respondent group members themselves. Snowball sampling is an iterative process. Typically, the data collection process begins by interviewing key informants and subpopulation members known to the researchers in order to learn the identities of other group members and to gather information on where other members might be found. These persons are then contacted, data are collected, and these sub-population members are asked to provide information on how and where additional sub-population members might be found. “Leads” from each wave of referrals are followed-up until a sample of pre-determined size has been reached. An important limitation of snowball sampling is that “lead” sub-population members are more likely to provide information on other group members who are in their own social, economic, and/or sexual network. To the extent that risk-taking and/or protective behaviors differ across networks, this poses a potential bias problem for sub-population surveys. Research in the United States (San Francisco), for example, revealed the existence of different social networks in terms of racial, ethnic and drug-type among drug-users, even in relatively small geographic areas. In order for the snowball sampling approach to yield meaningful monitoring data, it is therefore necessary to ensure individuals from different networks are included in the sample. The targeted sampling approach extends the ideas of snowball sampling to include an initial ethnographic assessment aimed at identifying the various networks or sub-groups that might exist in a given setting. The sub-groups so identified are then treated as sampling strata, and quota samples are chosen within each stratum using snowball sampling techniques. More information about targeted sampling can be found in a paper by John Watters and Patrick Biernacki: “Targeted sampling: options for the study of hidden populations”, published in the journal Social Problems (Vol.36, No.4, 1989). B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 4 45
Implications of alternative sampling strategies for analysis The choice of sampling method has important implications for data analysis. More can be done during analysis to compensate for potential biases in survey data when probability sampling methods have been used than when non-probability methods have been used. For example, the fact that some respondent group members may have had a greater chance of being included in a survey than others can be taken into account in probability samples by introducing sampling weights. These procedures are described in Chapter 5. Such adjustments are not possible with nonprobability sampling schemes. The use of conventional statistical procedures to determine the statistical significance of observed changes in indicators is also on more solid theoretical grounds when probability sampling methods are used. Probability sampling methods often imply a greater investment in developing sampling frames, and complex fieldwork. The trade off between complexity of fieldwork and precision of results should be taken into account when choosing a sampling approach. In general, more reliable survey results are more likely to lead to more appropriate decisions about investment in effective HIV prevention efforts, so where probability designs are possible, they are usually worth the effort. Sample size requirements One of the key design parameters for any survey is, of course, the sample size needed to satisfy the survey’s measurement objectives. In this section, procedures are presented for calculating sample size requirements for repeated rounds of BSS. Several points should be borne in mind when reviewing the material below. First, the procedures presented are intended for surveys whose primary objective is to measure changes in selected behavioral indicators over time. The sample sizes required to measure changes in indicators over time are larger than those required to measure a variable or indicator at a single point in time, and this must be taken into account in order to ensure sufficient statistical power. Secondly, sample size requirements are addressed here with respect to indicators measured as proportions. This is the type of indictor most commonly used in behavioral surveillance for HIV. Examples might include the proportion of respondents who used a condom the last time they had sex with a sex worker, or the proportion of respondents who shared injecting equipment the last time they injected drugs. 46 C H A PTER 4 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S
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Implications <strong>of</strong> alternative sampling strategies<br />
for analysis<br />
<strong>The</strong> choice <strong>of</strong> sampling method has important<br />
implications for data analysis. More can be<br />
done during analysis to compensate for<br />
potential biases in survey data when probability<br />
sampling methods have been used than when<br />
non-probability methods have been used.<br />
For example, the fact that some respondent<br />
group members may have had a greater<br />
chance <strong>of</strong> being included in a survey than<br />
others can be taken into account in probability<br />
samples by introducing sampling weights.<br />
<strong>The</strong>se procedures are described in Chapter 5.<br />
Such adjustments are not possible with nonprobability<br />
sampling schemes. <strong>The</strong> use <strong>of</strong><br />
conventional statistical procedures to determine<br />
the statistical significance <strong>of</strong> observed changes<br />
in indicators is also on more solid theoretical<br />
grounds when probability sampling methods<br />
are used.<br />
Probability sampling methods <strong>of</strong>ten imply<br />
a greater investment in developing sampling<br />
frames, and complex fieldwork. <strong>The</strong> trade<br />
<strong>of</strong>f between complexity <strong>of</strong> fieldwork and<br />
precision <strong>of</strong> results should be taken into<br />
account when choosing a sampling approach.<br />
In general, more reliable survey results are<br />
more likely to lead to more appropriate<br />
decisions about investment in effective HIV<br />
prevention efforts, so where probability<br />
designs are possible, they are usually worth<br />
the effort.<br />
Sample size requirements<br />
One <strong>of</strong> the key design parameters for any<br />
survey is, <strong>of</strong> course, the sample size needed to<br />
satisfy the survey’s measurement objectives.<br />
In this section, procedures are presented for<br />
calculating sample size requirements for<br />
repeated rounds <strong>of</strong> BSS. Several points should<br />
be borne in mind when reviewing the material<br />
below. First, the procedures presented are<br />
intended for surveys whose primary objective<br />
is to measure changes in selected behavioral<br />
indicators over time. <strong>The</strong> sample sizes required<br />
to measure changes in indicators over time<br />
are larger than those required to measure a<br />
variable or indicator at a single point in time,<br />
and this must be taken into account in<br />
order to ensure sufficient statistical power.<br />
Secondly, sample size requirements are<br />
addressed here with respect to indicators<br />
measured as proportions. This is the type <strong>of</strong><br />
indictor most commonly used in behavioral<br />
surveillance for HIV. Examples might include<br />
the proportion <strong>of</strong> respondents who used a<br />
condom the last time they had sex with a sex<br />
worker, or the proportion <strong>of</strong> respondents who<br />
shared injecting equipment the last time they<br />
injected drugs.<br />
46<br />
C H A PTER 4 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S