title: Respondent-driven sampling for an adolescent health study in vulnerable urban settings: a multi-country study.
abstract: The global adolescent population is larger than ever before and is rapidly urbanizing. Global surveillance systems to monitor youth health typically use household- and school-based recruitment methods. These systems risk not reaching the most marginalized youth made vulnerable by conditions of migration, civil conflict, and other forms of individual and structural vulnerability. We describe the methodology of the Well-Being of Adolescents in Vulnerable Environments survey, which used respondent-driven sampling (RDS) to recruit male and female youth aged 15-19 years and living in economically distressed urban settings in Baltimore, MD; Johannesburg, South Africa; Ibadan, Nigeria; New Delhi, India; and Shanghai, China (migrant youth only) for a cross-sectional study. We describe a shared recruitment and survey administration protocol across the five sites, present recruitment parameters, and illustrate challenges and necessary adaptations for use of RDS with youth in disadvantaged urban settings. We describe the reach of RDS into populations of youth who may be missed by traditional household- and school-based sampling. Across all sites, an estimated 9.6% were unstably housed; among those enrolled in school, absenteeism was pervasive with 29% having missed over 6 days of school in the past month. Overall findings confirm the feasibility, efficiency, and utility of RDS in quickly reaching diverse samples of youth, including those both in and out of school and those unstably housed, and provide direction for optimizing RDS methods with this population. In our rapidly urbanizing global landscape with an unprecedented youth population, RDS may serve as a valuable tool in complementing existing household- and school-based methods for health-related surveillance that can guide policy.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: mdecker@jhsph.edu.
authors.forename: Michele R
authors.initials: MR
authors.lastname: Decker
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Beth Dail
authors.initials: BD
authors.lastname: Marshall
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Mark
authors.initials: M
authors.lastname: Emerson
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Amanda
authors.initials: A
authors.lastname: Kalamar
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Laura
authors.initials: L
authors.lastname: Covarrubias
authors.affiliation: Urban Institute, Washington, DC.
authors.forename: Nan
authors.initials: N
authors.lastname: Astone
authors.affiliation: Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China.
authors.forename: Ziliang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China.
authors.forename: Ersheng
authors.initials: E
authors.lastname: Gao
authors.affiliation: Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Mashimbye
authors.affiliation: Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Sinead
authors.initials: S
authors.lastname: Delany-Moretlwe
authors.affiliation: Population Council, New Delhi, India.
authors.forename: Rajib
authors.initials: R
authors.lastname: Acharya
authors.affiliation: Institute of Child Health, College of Medicine, University of Ibadan/ University College Hospital Ibadan, Ibadan, Nigeria.
authors.forename: Adesola
authors.initials: A
authors.lastname: Olumide
authors.affiliation: Institute of Child Health, College of Medicine, University of Ibadan/ University College Hospital Ibadan, Ibadan, Nigeria.
authors.forename: Oladosu
authors.initials: O
authors.lastname: Ojengbede
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Blum
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Freya L
authors.initials: FL
authors.lastname: Sonenstein
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D005260:Female; D005783:Gender Identity; D014943:Global Health; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D011204:Poverty Areas; D012494:Sampling Studies; D013019:South Africa / Q000453:epidemiology; D013334:Students / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000191:economics*; D014507:Urbanization / Q000639:trends; D055815:Young Adult
keywords: Adolescent health; Gender differences; Respondent-driven sampling