Deconstructing the Complexity of Substance Use among Young Men Who have Sex with Men (YMSM) by Optimizing the Role of Qualitative Strategies in a Mixed Methods Study

Abstract

Qualitative data can be a powerful tool in developing interventions for substance use and other HIV-risk behaviors. Mixed methods design offers researchers the ability to obtain data that provides both breadth and depth to their research questions. However, the integration of qualitative data in mixed methods research has been limited. This paper describes the qualitative study design of the Healthy Young Men's Study, a longitudinal mixed method study with an ethnically diverse cohort of young men who have sex with men (YMSM) (N = 526) in Los Angeles. Integral to this discussion is how a mixed methods study can address common challenges such as sampling, representation and integration of both datasets.

RÉSUMÉ

Deùcomposition de la complexiteù d’usage de substance parmi les jeunes homes qui ont des relations sexuelles avec les hommes en optimisant le role des strateùgies qualitatives dans une eùtude aux meùthodes mixtes

Le modèle des meùthodes mixtes preùsente aux chercheurs la possibiliteù d’obtenir des donneùes qui fournissent a la fois la profondeur et la largeur aux questions de leurs recherches. Consideùrant que la donneùe qualitative pourrait eâtre un puissant outil dans le deùveloppement des interventions contre l’usage des substances et les comportements peùrilleux d’origine HIV, l’exploration des meùthodes pour integrer complètement les donneùes qualitatives dans les eùtudes aux meùthodes mixtes devient impeùrative. Cet article deùcrit un modèle d’eùtude qualitative de l’Etude Des Jeunes Hommes En Bonne Santeù (Healthy Young Men's Study), une eùtude longitudinale aux meùthodes mixtes d’un groupe, eùthniquement divers, de jeunes homes ayant des relations sexuelles avec les hommes (YMSM) (N = 526) aø Los Angeles. Au cours de cette discussion, on voit comment une eùtude aux meùthodes mixtes peut reùpondre aux communs deùfis dans l’invention du modèle tels que l’eùchantillonnage, la repreùsentation et l’inteùgration des deux ensembles de donneùes.

RESUMEN

Examinando la complejidad del uso de las drogas entre los hombres que tienen sexo con hombres por optimizar el papel de métodos cualitativos en una investigación cualitativa y cuantitativa

El uso de métodos de cualitativa y cuantitativa (“métodos mixtos”) se ofrecen la habilidad a obtener datos que proveen anchura y también profundidad para estudiar la hipótesis de una investigación. Considerando que datos cualitativos pueden ser eficaz para diseñar intervenciones para el uso de las drogas y otros riesgos asociado con la SIDA. Por eso, la integración completamente de métodos cualitativos en las investigaciones con diseños que combinan métodos cualitativa y cuantitativa es necesario. Este manuscrito describe el diseño cualitativa de la investigación “Jóvenes Sanos”, que usa métodos mixtos con un grupo de hombres que tienen sexo con hombres de grupos étnicos diferentes en Los Ángeles (N = 526). Importante a esto discusión es como este diseño de métodos mixtos se puede tratar retos comunes como muestreo, representación, y la integración o triangulación de los ambos métodos.

Keywords :

• mixed methods
• substance use
• HIV/AIDS
• young men who have sex with men (YMSM)

THE AUTHORS

Katrina Kubicek is the Ethnographer for the Healthy Young Men's Study and Senior Research Manager for the CHOIR Program at the Saban Research Institute at Children's Hospital Los Angeles. Her research interests include understanding how cultural and social factors influence risk and protective behaviors in young adults and adolescents as well as working in collaboration with community partners to design and adapt programs and interventions that are effective for the target populations and communities.

George Weiss is the Administrator for the CHOIR Program at the Saban Research Institute at Childrens Hospital Los Angeles. His primary area of interest is in integrating knowledge from diverse youth communities, researchers, and community leaders to develop meaningful and effective intervention strategies.

Ellen F. Iverson is an Assistant Research Professor in the Department of Pediatrics at the Keck School of Medicine, USC. She is currently the Deputy Director of the CHOIR Program at the Saban Research Institute at Children's Hospital Los Angeles. She also develops and conducts evaluation for multiple, community-based youth-focused programs and provides evaluation technical assistance and training to domestic violence agencies and programs in Southern California.

Michele D. Kipke, Ph.D., is a Professor in the Departments of Pediatrics and Preventive Medicine at the Keck School of Medicine, University of Southern California (USC). She is also the Director of the Community, Health Outcomes, and Intervention Research (CHOIR) Program at the Saban Research Institute and the Associate Director of the Saban Research Institute at Children's Hospital Los Angeles. Dr. Kipke has conducted research to examine HIV risk and prevention approaches among high-risk youth since the start of the epidemic in the mid-1980s, and she is engaged in research focused on outcomes and cost of pediatric care, research intended to promote community health, and research intended to prevent obesity and diabetes among children and families.

Notes

1 The term of YMSM is used in this paper, although it is important to note that the YMSM, as well as the adult MSM populations, are heterogeneous and not homogenous groups.

2 The three largest racial/ethnic groups in Los Angeles County include Caucasians, African Americans, and Latinos. Individuals classified as Latinos are a heterogeneous group including many different ethnicities (e.g., Mexican, Puerto Rican, Guatemalan), and each group differs in their experiences and cultures. Therefore, we wanted to focus on only one ethnic group within the Latino category. Individuals of Mexican descent make up the greatest proportion of Latinos in Los Angeles County and, therefore, were selected as the Latino group of interest of this study.

3 This study was funded by the National Institute of Drug Abuse for a total of 5 years, starting in the summer of 2003. Recruitment for the longitudinal study began in January 2005 and was completed over a 12-month period. Thus, longitudinal data collection began in January 2005 and ended in January 2008. Collecting five waves of data every 6 months was believed to be adequate to begin to understand how individuals’ behavior may evolve during this developmental period of “emerging adulthood” (Arnett, 2000).

4 Eligibility based on local residence was included to ensure that we obtained a sample of YMSM who could be tracked more easily rather than those who were on vacation or visiting Los Angeles for the summer months.

5 The survey itself collected data on lifetime, past 3 months, and past 30 days use of a number of substances including marijuana, cocaine, crack, heroin, ecstasy, methamphetamine, Ketamine, LSD, mushrooms, GHB, PCP, poppers, and prescription drugs without a prescription (e.g., anti-anxiety, depressants, Viagra, opiates, attention deficit medication).