Thunnissen Estrelle, Buffel Veerle, Campbell Linda, Vuylsteke Bea, Bos Philippe, Wouters Edwin
Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium.
Brussels Institute for Social and Population Studies, Vrije Universiteit Brussel, Brussel, Belgium.
J Med Internet Res. 2025 May 5;27:e60884. doi: 10.2196/60884.
Obtaining a representative sample is a substantial challenge when undertaking health research among hidden and hard-to-reach populations such as men who have sex with men Web-based respondent-driven sampling (WEB RDS) was developed to overcome such sampling challenges and to create population estimates based on network and sampling characteristics. Despite a decade of research, it remains unclear whether WEB RDS is suitable for sampling hidden populations such as men who have sex with men.
This study aims to evaluate how viable the WEB RDS methodology is for obtaining a nationwide sample of men who have sex with men, suitable for population inference of sexual health characteristics, in Belgium.
We adapted the Medical Resource Council process evaluation framework for interventions, to evaluate an empirical WEB RDS. Viewing "WEB RDS" as a complex intervention with respondent-driven recruitment as the aim, we evaluated indicators of context, implementation, mechanisms of impact, and performance. We analyzed the data using a mixed methods approach that integrated findings from quantitative analysis, such as RDS diagnostics, and qualitative thematic analysis.
Sampling did not reach a sufficient sample size (n=193) to compensate for an RDS design effect of 3 and the number of recruitment waves was low (waves=7). A visual examination of the convergence and bottleneck plots indicates that many more waves of recruitment would be needed for population estimates to become independent of the seeds. However, producing further waves was impeded by challenges inherent to the research context and process. Men who have sex with men and their community organization representatives indicated that, in Belgium, men who have sex with men are overresearched, with low motivation for the topic of sexual health and digital etiquette dictating not sharing survey links. A moderate reward of €10-€30 (US $11.2-$33.6) with a dual incentive structure was insufficient to overcome these barriers.
This study indicates that WEB RDS, even with a moderate incentive, is not a viable sampling strategy for obtaining valid population estimates of sexual health traits of men who have sex with men in Belgium. The study emphasizes the need to understand men who have sex with men research motivation and topic saliency. Additionally, the study highlights the importance of digital etiquette. Finally, the study showcases the use of the adapted Medical Research Council framework for evaluating WEB RDS methodology.
在男男性行为者等隐蔽且难以接触到的人群中开展健康研究时，获取具有代表性的样本是一项重大挑战。基于网络的应答驱动抽样（WEB RDS）应运而生，旨在克服此类抽样挑战，并根据网络和抽样特征进行总体估计。尽管经过了十年的研究，但尚不清楚WEB RDS是否适用于对男男性行为者等隐蔽人群进行抽样。
本研究旨在评估WEB RDS方法在比利时获取全国范围内男男性行为者样本的可行性，该样本适用于对性健康特征进行总体推断。
我们采用医学研究理事会的干预过程评估框架来评估一项实证性的WEB RDS。将“WEB RDS”视为以应答驱动招募为目标的复杂干预措施，我们评估了背景、实施、影响机制和绩效等指标。我们使用混合方法分析数据，该方法整合了定量分析（如RDS诊断）和定性主题分析的结果。
抽样未达到足够的样本量（n = 193）以补偿3的RDS设计效应，且招募轮次较少（轮次 = 7）。对收敛图和瓶颈图的直观检查表明，要使总体估计独立于种子样本，还需要更多轮次的招募。然而，研究背景和过程中固有的挑战阻碍了进一步的招募轮次。男男性行为者及其社区组织代表表示，在比利时，男男性行为者被过度研究，对性健康话题的积极性较低，且数字礼仪规定不能分享调查链接。10至30欧元（11.2至33.6美元）的适度奖励以及双重激励结构不足以克服这些障碍。
本研究表明，即使有适度激励，WEB RDS也不是在比利时获取男男性行为者性健康特征有效总体估计的可行抽样策略。该研究强调了理解男男性行为者研究动机和话题显著性的必要性。此外，该研究突出了数字礼仪的重要性。最后，该研究展示了采用改编后的医学研究理事会框架来评估WEB RDS方法。
