Papers by Kirk Dombrowski
Social Science & Medicine, 2019
Rationale-This study evaluates the process and preliminary outcomes of Promoting Community Conver... more Rationale-This study evaluates the process and preliminary outcomes of Promoting Community Conversations About Research to End Suicide (PC CARES), an intervention that brings key stakeholders together so they can discuss suicide prevention research and find ways to put it into practice. Originally piloted in remote and rural Alaskan communities, the approach shows promise. Method-Using a multi-method design, the study describes a series of locally-facilitated "learning circles" over 15 months and their preliminary results. Sign-in sheets documented participation. Transcriptions of audio-recorded sessions captured facilitator fidelity, accuracy, and the dominant themes of community discussions. Linked participant surveys (n=83) compared attendees' perceived knowledge, skills, attitudes, and their 'community of practice' at baseline and * Corresponding
Journal of Racial and Ethnic Health Disparities, 2018
We reviewed 27 studies on adults with a refugee background resettled from Africa published betwee... more We reviewed 27 studies on adults with a refugee background resettled from Africa published between 1999 and 2017 to appraise their methodological issues for survey research. Out of 27 studies, eleven used a single sampling method (referral = 1, convenience = 10), and 16 relied on multiple sampling methods, many of which were combinations of referral and convenience. The two most salient recruitment strategies found were building trusted relationships with the community (n = 15), and using recruiters who were culturally and linguistically matched to the refugee communities of interest (n = 14). Fifteen studies used existing data collection instruments, while in 13 studies, researchers developed their own data collection instruments. In-person or phone interviews using bilingual interviewers (n = 21) were the most frequently used mode of data collection, followed by a self-administered survey (n = 7). Our review presents methodological gaps in current refugee health studies, such as limited use of probability sampling approach due to system barriers, lack of information in community engagement and recruitment processes, and insufficient considerations of unique culture and experiences of refugee communities when developing or adapting the instruments. Efforts can be made to guide and facilitate appropriate reporting and development of more scientifically robust survey methodologies for refugee health studies, as well as to improve registration system infrastructure that may help identify these hidden populations more effectively.
Bulletin of Latin American Research, 2009
North American Dialogue, 2004
In a small Tlingit village in 1992, newly converted members of an all‐native church started a bon... more In a small Tlingit village in 1992, newly converted members of an all‐native church started a bonfire of "non‐Christian" items, including, reportedly, native dancing regalia. The burnings recalled an earlier century in which church converts in the same village burned totem poles. This book traces the years leading up to the most recent burnings and reveals the multiple strands of social tension defining Tlingit and Haida life in Southeast Alaska today.
Clinical Infectious Diseases, Aug 11, 2019
BackgroundThere are too many plausible permutations and scale-up scenarios of combination hepatit... more BackgroundThere are too many plausible permutations and scale-up scenarios of combination hepatitis C virus (HCV) interventions for exhaustive testing in experimental trials. Therefore, we used a computer simulation to project the health and economic impacts of alternative combination intervention scenarios for people who inject drugs (PWID), focusing on direct antiviral agents (DAA) and medication-assisted treatment combined with syringe access programs (MAT+).MethodsWe performed an allocative efficiency study, using a mathematical model to simulate the progression of HCV in PWID and its related consequences. We combined 2 previously validated simulations to estimate the cost-effectiveness of intervention strategies that included a range of coverage levels. Analyses were performed from a health-sector and societal perspective, with a 15-year time horizon and a discount rate of 3%.ResultsFrom a health-sector perspective (excluding criminal justice system–related costs), 4 potential strategies fell on the cost-efficiency frontier. At 20% coverage, DAAs had an incremental cost-effectiveness ratio (ICER) of $27 251/quality-adjusted life-year (QALY). Combinations of DAA at 20% with MAT+ at 20%, 40%, and 80% coverage had ICERs of $165 985/QALY, $325 860/QALY, and $399 189/QALY, respectively. When analyzed from a societal perspective (including criminal justice system–related costs), DAA at 20% with MAT+ at 80% was the most effective intervention and was cost saving. While DAA at 20% with MAT+ at 80% was more expensive (eg, less cost saving) than MAT+ at 80% alone without DAA, it offered a favorable value compared to MAT+ at 80% alone ($23 932/QALY).ConclusionsWhen considering health-sector costs alone, DAA alone was the most cost-effective intervention. However, with criminal justice system–related costs, DAA and MAT+ implemented together became the most cost-effective intervention.
Journal of drug abuse, 2016
In the face of the exponential growth of Internet of Things (IoT) devices, the limited capacity o... more In the face of the exponential growth of Internet of Things (IoT) devices, the limited capacity of radio spectrum is likely to reach saturation. Cognitive Radio technology has been proposed to relieve over-saturated channels by allowing for licensed channels to be opportunistically accessed by unlicensed users during periods of time when the license holder is absent from its channel. Un-coordinated competition over a limited number of resources among unlicensed spectrum users leads to complex co-existence challenges. Here we present a new bio-social inspired paradigm for cognitive radio, extending our previous work where we showed a plausible evolutionary trajectory of intra-groups dynamics over time as groups abide by two social behavioral rules, in-group deference and out-group avoidance. In this paper, we relax these social behavior rules in order to allow groups to organize into different social structures. More specifically, we observe how a hierarchical society compares to a classless society. We show that as the system scales, the hierarchical social structure is more likely to emerge in a distributed cognitive radio network. The bio-social paradigm presented here has consequences both in suggesting potential improvements for dynamic spectrum access, and in understanding the natural evolvement of social structures as cognitive radio devices form groups to gain advantage in the competition over resources.
arXiv (Cornell University), Jan 31, 2017
Estimates of population size for hidden and hard-to-reach individuals are of particular interest ... more Estimates of population size for hidden and hard-to-reach individuals are of particular interest to health officials when health problems are concentrated in such populations. Efforts to derive these estimates are often frustrated by a range of factors including social stigma or an association with illegal activities that ordinarily preclude conventional survey strategies. This paper builds on and extends prior work that proposed a method to meet these challenges. Here we describe a rigorous formalization of a one-step, network-based population estimation procedure that can be employed under conditions of anonymity. The estimation procedure is designed to be implemented alongside currently accepted strategies for research with hidden populations. Simulation experiments are described that test the efficacy of the method across a range of implementation conditions and hidden population sizes. The results of these experiments show that reliable population estimates can be derived for hidden, networked population as large as 12,500 and perhaps larger for one family of random graphs. As such, the method shows potential for cost-effective implementation health and disease surveillance officials concerned with hidden populations. Limitations and future work are discussed in the concluding section.
Frontiers in Psychiatry
BackgroundRespondent Driven Sampling (RDS) is an effective sampling strategy to recruit hard-to-r... more BackgroundRespondent Driven Sampling (RDS) is an effective sampling strategy to recruit hard-to-reach populations but the impact of the COVID-19 pandemic on the use of this strategy in the collection of data involving human subjects, particularly among marginalized and vulnerable populations, is not known. Based on an ongoing study using RDS to recruit and study the interactions between HIV infection, injection drug use, and the microbiome in Puerto Rico, this paper explores the effectiveness of RDS during the pandemic and provided potential strategies that could improve recruitment and data collection.ResultsRDS was employed to evaluate its effectiveness in recruiting a group of people who inject drugs (PWID) and controls (N = 127) into a study in the midst of the COVID-19 pandemic. The participants were distributed among three subsets: 15 were HIV+ and PWID, 58 were HIV- PWID, and 54 were HIV+ and not PWID.FindingsResults show that recruitment through peer networks using RDS was p...
Journal of Leukocyte Biology
Antiretroviral therapy has been effective in suppressing HIV viral load and enabling people livin... more Antiretroviral therapy has been effective in suppressing HIV viral load and enabling people living with HIV to experience longer, more conventional lives. However, as people living with HIV are living longer, they are developing aging-related diseases prematurely and are more susceptible to comorbidities that have been linked to chronic inflammation. Coincident with HIV infection and aging, drug abuse has also been independently associated with gut dysbiosis, microbial translocation, and inflammation. Here, we hypothesized that injection drug use would exacerbate HIV-induced immune activation and inflammation, thereby intensifying immune dysfunction. We recruited 50 individuals not using injection drugs (36/50 HIV+) and 47 people who inject drugs (PWID, 12/47 HIV+). All but 3 of the HIV+ subjects were on antiretroviral therapy. Plasma immune profiles were characterized by immunoproteomics, and cellular immunophenotypes were assessed using mass cytometry. The immune profiles of HIV+/...
Journal of Applied Communication Research
Community-based participatory research (CBPR) has been shown to improve health and social well-be... more Community-based participatory research (CBPR) has been shown to improve health and social well-being by including diverse, marginalized community voices within academic-community partnerships. Although CBPR has gained in popularity, an explicit examination and evaluation of communication processes and outcomes throughout an entire CBPR project is lacking. Here, we analyze interviews with 10 stakeholders (i.e. 4 academic and 6 community partners) about their experiences in a three-phase, mixed-methods project exploring Hispanic and Somali community members' perceptions of healthcare needs and access in a rural U.S. community. Results reflect that CBPR endeavors include communication challenges, successes, and ongoing tensions not simply between the academic group and community partners but also within these groups. We encourage academic-community research partners to devote considerable efforts to strengthening effective communication between and within multiple identity groups throughout an entire CBPR project (including evaluation) as they work to create, complete, and sustain project goals and outcomes.
Author's Note All authors contributed to the development of the concepts used in this article. Ce... more Author's Note All authors contributed to the development of the concepts used in this article. Celia contributed to the study design and commented on drafts of the article. Kirk contributed to the conceptual analysis of the article and commented on drafts of the article. Roberto contributed to the study design, conducted the interviews, analyzed the research data, and wrote the first draft of the article.
Harm Reduction Journal, 2020
Background Sharing drug injection equipment has been associated with the transmission of HCV amon... more Background Sharing drug injection equipment has been associated with the transmission of HCV among PWID through blood contained in the cooker and cotton used to prepare and divide up the drug solution. While epidemiologists often subsume this practice under the sharing of “ancillary equipment,” more attention should be paid to the fact that indirect sharing takes place within the process of joint drug acquisition and preparation. Methods We employed an ethnographic approach observing active PWID (N = 33) in four rural towns in Puerto Rico in order to document drug sharing arrangements involved in “caballo”, as this practice is locally known. We explored partners’ motivation to engage in drug sharing, as well as its social organization, social roles and existing norms. Findings Findings suggest that drug sharing, is one of the main drivers of the HCV epidemic in this population. Lack of financial resources, drug packaging, drug of choice and the desire to avoid the painful effects of...
Journal of Rural Mental Health, 2020
Perceived social support has been correlated with refugees' positive mental health outcomes; yet,... more Perceived social support has been correlated with refugees' positive mental health outcomes; yet, little is known about the perceived sources of support after secondary migration to new-destination rural towns. Somali refugee men (n _ 49) residing in a rural Midwest United States community were recruited using respondent-driven sampling to complete a self-administered structured survey in English or Somali using audio computer-assisted self-interview software. Questions assessed perceived digitalcommons.unl.edu
The study was conducted to provide information about markets for, distribution of, and use of met... more The study was conducted to provide information about markets for, distribution of, and use of methamphetamine in New York City, both inside and outside of the MSM (men who have sex with men)/gay community. The study used Respondent Driven Sampling to recruit 132 methamphetamine market participants. Each respondent participated in a one to two hour structured interview combining both qualitative and quantitative responses. Each respondent was invited to recruit three additional eligible participants. Data collected included demographics, social network data, the respondent's market participation in obtaining and providing methamphetamine, consumption of methamphetamine, and experience with the criminal justice system and crime associated with participation in methamphetamine markets.
This multi-method project sought to gain a better understanding of the commercial sexually exploi... more This multi-method project sought to gain a better understanding of the commercial sexually exploited children (CSEC) population, particularly its size, characteristics, needs, and geographic spread in New York City. It represents a first attempt to understand the CSEC population in a major metropolitan area and to examine a concerted institutional effort to meet its needs. Three forms of data were collected in the project: questionnaire data, interview data, and network data. The project used Respondent Driven Sampling (RDS) to identify commercial sexually exploited children (CSEC) in New York City. Interviews were conducted with 230 youths between January 2006 and December 2007. Quantitative surveys regarding the frequency and quality of cross-stakeholder communication were administered at the beginning of the evaluation and one year later. For the purpose of trend analysis of CSEC related offenses, research staff obtained citywide arrest and prosecution data on child prostitution,...
Puerto Rico health sciences journal, 2019
OBJECTIVE This study aimed to determine the association between years of drug injection and homel... more OBJECTIVE This study aimed to determine the association between years of drug injection and homelessness among drug users in rural Puerto Rico. METHODS Respondent-driven sampling methods allowed us to obtain a sample of 315 intravenous drug users (IDUs) in rural Puerto Rico. Information about sociodemographic characteristics, drug use patterns, homelessness and risk behaviors was obtained through structured interviews. HIV and HCV statuses were assessed via rapid antibody tests. Frequency distributions were used to describe the study sample. Bivariate analysis and multivariate logistic regressions were used to assess covariates of homelessness. The study received IRB approval through the University of Nebraska-Lincoln and the University of Puerto Rico. RESULTS Almost 91% of the study participants were males. The mean age was 41.7 years and the majority of the participants had not completed high school (47.6%). The prevalence of current homelessness was 21.9%. After controlling for s...
ArXiv, 2018
Prevention and intervention work done within community settings often face unique analytic challe... more Prevention and intervention work done within community settings often face unique analytic challenges for rigorous evaluations. Since community prevention work (often geographically isolated) cannot be controlled in the same way other prevention programs and these communities have an increased level of interpersonal interactions, rigorous evaluations are needed. Even when the `gold standard' randomized control trials are implemented within community intervention work, the threats to internal validity can be called into question given informal social spread of information in closed network settings. A new prevention evaluation method is presented here to disentangle the social influences assumed to influence prevention effects within communities. We formally introduce the method and it's utility for a suicide prevention program implemented in several Alaska Native villages. The results show promise to explore eight sociological measures of intervention effects in the face of ...
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Papers by Kirk Dombrowski