ArticleBMC medical research methodology2024
Evaluation of respondent-driven sampling in seven studies of people who use drugs from rural populations: findings from the Rural Opioid Initiative.
Article in BMC medical research methodology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 15 citations in OpenAlex.
- Can a participant-referred 'study buddy' increase retention of rural people who use drugs in research? A multi-site, randomized trial.Addiction (Abingdon, England) · 2026Trial
- Experiences of People Who Use Drugs in Rural Southeastern Ohio During the COVID-19 Pandemic: Harm Reduction, Substance Use Treatment, and Trusted Information Sources.Journal of studies on alcohol and drugs · 2026Article
- Medications for opioid use disorder, recovery supports, and overdose risk -- a database linkage study of a rural cohort of people who inject drugs and use opioids.BMC public health · 2026Article
- Drug Use and Social Connectivity Related to Hepatitis C Infection Among Rural People Who Use Drugs.Journal of viral hepatitis · 2026Article
- Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Willingness to use a mobile syringe service program among people who inject drugs in rural Appalachia.Harm reduction journal · 2026Article
- The Association Between Receiving Medications for Opioid Use Disorder and Human Immunodeficiency Virus Testing: Findings From the Rural Opioid Initiative.Journal of addiction medicine · 2026Article
- Resilience to Stigma in Medical, Social, and Employment Contexts Among People Who Inject Drugs in Rural Ohio: Adapting the 10-Item Connor-Davidson Resilience Scale.AIDS and behavior · 2026Article
- Patterns of Felt Stigma Among Rural-Dwelling People Who Use Drugs: A Latent Class Analysis.Substance use & misuse · 2026Article
- "Because we're the experts": centering the expertise of people who use drugs to identify and propose solutions for overdose prevention.Harm reduction journal · 2025Article
- Genomic surveillance uncovers regional variation in HCV transmission networks in rural United States.Nature communications · 2025Article
- Barriers to accessing medications for opioid use disorder among rural individuals.The International journal on drug policy · 2025Article
- Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.Journal of substance use and addiction treatment · 2025Article
- Influence of insurance type on healthcare utilization among rural people who use drugs.Drug and alcohol dependence · 2025Article
- Likelihood of using a harm reduction vending machine among rural people who inject drugs in Appalachian Kentucky.The International journal on drug policy · 2025Article
- Medicaid Policy and Hepatitis C Treatment Among Rural People Who Use Drugs.Medical care · 2025Article
- Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?Tropical medicine and infectious disease · 2025Article
- "I'm tired of seeing my friends die": Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Injection Drug Use and Sexual Behaviors Associated With Infection Transmission and Access to Harm Reduction for People Who Use Drugs and Sell Sex in the Rural US.Substance use : research and treatmentArticle
- Implementation Evaluation of a Multicomponent Intervention to Address the Infectious Disease and Overdose Syndemic Among People Who Use Drugs in Rural Settings.Journal of public health management and practice : JPHMPArticle
Corrections and comments
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Authors and funding
24 authors at 15 institutions in 2 countries.
Funding
Abstract
backgroundAccurate prevalence estimates of drug use and its harms are important to characterize burden and develop interventions to reduce negative health outcomes and disparities. Lack of a sampling frame for marginalized/stigmatized populations, including persons who use drugs (PWUD) in rural settings, makes this challenging. Respondent-driven sampling (RDS) is frequently used to recruit PWUD. However, the validity of RDS-generated population-level prevalence estimates relies on assumptions that should be evaluated.
methodsRDS was used to recruit PWUD across seven Rural Opioid Initiative studies between 2018-2020. To evaluate RDS assumptions, we computed recruitment homophily and design effects, generated convergence and bottleneck plots, and tested for recruitment and degree differences. We compared sample proportions with three RDS-adjusted estimators (two variations of RDS-I and RDS-II) for five variables of interest (past 30-day use of heroin, fentanyl, and methamphetamine; past 6-month homelessness; and being positive for hepatitis C virus (HCV) antibody) using linear regression with robust confidence intervals. We compared regression estimates for the associations between HCV positive antibody status and (a) heroin use, (b) fentanyl use, and (c) age using RDS-1 and RDS-II probability weights and no weights using logistic and modified Poisson regression and random-effects meta-analyses.
resultsAmong 2,842 PWUD, median age was 34 years and 43% were female. Most participants (54%) reported opioids as their drug of choice, however regional differences were present (e.g., methamphetamine range: 4-52%). Many recruitment chains were not long enough to achieve sample equilibrium. Recruitment homophily was present for some variables. Differences with respect to recruitment and degree varied across studies. Prevalence estimates varied only slightly with different RDS weighting approaches, most confidence intervals overlapped. Variations in measures of association varied little based on weighting approach.
conclusionsRDS was a useful recruitment tool for PWUD in rural settings. However, several violations of key RDS assumptions were observed which slightly impacts estimation of proportion although not associations.
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Registered trials
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