Health and Technology

, Volume 5, Issue 2, pp 103–114 | Cite as

Recruiting rural and urban LGBT populations online: differences in participant characteristics between email and Craigslist approaches

  • Jacob C. Warren
  • K. Bryant Smalley
  • K. Nikki Barefoot
Original Paper


Current recruitment strategies to reach lesbian, gay, bisexual, and transgender (LGBT) groups typically yield highly localized, mostly urban samples. Online recruitment strategies hold much promise for engaging rural and other underrepresented LGBT individuals in health research, but little research has been conducted examining the relative strengths of differing online recruitment methods. The purpose of the current study was to explore the effectiveness of both email and Craigslist recruitment to access rural sexual and gender minorities, and to examine if individuals across modalities differ significantly from each other with regards to demographic and psychosocial characteristics. Participants for the study were recruited through two sequentially implemented online convenience sampling recruitment methods: listserv based and Craigslist based. Participants completed an online battery assessing demographic characteristics, disclosure of sexual orientation/gender identity, health behaviors, and various psychosocial characteristics. A total of 3279 LGBT-identified individuals were recruited, 980 through Listservs and 2299 through Craigslist. Participants came from all 50 US states and nearly 30 % reported living in a rural area. When comparing the Listserv and Craigslist recruits, the groups differed on nearly every demographic and psychosocial characteristic assessed, ranging from racial/ethnic diversity to levels of psychological distress. Online recruitment strategies are feasible for accessing both rural and urban LGBT populations, and are highly effective at doing so. These strategies yield samples with remarkable diversity geographically, demographically, and psychosocially. In addition, similar to comparisons between in-person and online recruitment, samples recruited through different online methods significantly differ from each other in demographic and psychosocial characteristics.


Rural LGBT Online recruitment Health disparities Technology 



This project was supported by seed funding from the Rural Health Research Institute.

Ethical statement

All research was reviewed and approved by the Institutional Review Board at Georgia Southern University. All participants completed an electronic informed consent process prior to participation in the study.

Conflict of interest

The authors have no conflicts of interest to disclose.


  1. 1.
    Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington DC: Institute of Medicine.Google Scholar
  2. 2.
    Bayer R. Homosexuality and American psychiatry: the politics of diagnosis (Revised Edition). Princeton, NJ: Princeton University Press; 1987.Google Scholar
  3. 3.
    Minton HL. Departing from deviance: a history of homosexual rights and emancipatory science in America. Chicago: University of Chicago Press; 2002.Google Scholar
  4. 4.
    NOLO. Health care antidiscrimination laws protecting gays and lesbians: can doctors withhold treatment because of a patient’s sexual orientation or gender identity? 2013. Retrieved from
  5. 5.
    Brotman S, Ryan B, Jalbert Y, Rowe B. The impact of coming out on health and health care access: the experiences of gay, lesbian, bisexual, and two-spirit people. J Health Soc Policy. 2002;15(1):1–29.CrossRefGoogle Scholar
  6. 6.
    Carroll NM. Optimal gynecologic and obstetric care for lesbians. Obstet Gynecol. 1999;93(4):611–3.CrossRefGoogle Scholar
  7. 7.
    Daley A. Lesbian invisibility in health care services—Heterosexual hegemony and strategies for change. Can Soc Work Rev. 1998;15(1):57–71.MathSciNetGoogle Scholar
  8. 8.
    Reyes M. Latina lesbians and alcohol and other drugs: social work implications. Alcohol Treat Q. 1998;6(1/2):179–92.CrossRefGoogle Scholar
  9. 9.
    Warren JC, Smalley KB. What is rural? In: Warren JC, Smalley KB, editors. Rural public health. New York: Springer Publishing Company; 2014. p. 1–10.Google Scholar
  10. 10.
    U.S. Census Bureau. American FactFinder. 2010. Retrieved from
  11. 11.
    Hart LG, Larson EH, Lishner DM. Rural definitions for health policy research. Am J Public Health. 2005;95(7):1149–55.CrossRefGoogle Scholar
  12. 12.
    Warren JC, Smalley KB. Rural public health. New York: Springer Publishing Company; 2014.Google Scholar
  13. 13.
    Smalley KB, Yancey CT, Warren JC, Naufel K, Ryan R, Pugh JL. Rural mental health and psychological treatment: a review for practitioners. J Clin Psychol. 2010;66(5):479–89.Google Scholar
  14. 14.
    Robertson AE. The mental health experiences of gay men: a research study exploring gay men’s health needs. J Psychiatr Ment Health Nurs. 1998;5(1):33–40.CrossRefGoogle Scholar
  15. 15.
    Brown J, Tracy J. Lesbians and cancer: an overlooked health disparity. Cancer Causes Control. 2008;19(10):1009–20.CrossRefGoogle Scholar
  16. 16.
    Carroll N, Goldstein RS, Lo W, Mayer KH. Gynecological infections and sexual practices of Massachusetts lesbian and bisexual women. J Gay Lesbian Medical Assoc. 1997;1:15–23.CrossRefGoogle Scholar
  17. 17.
    Case P, Austin B, Hunter DJ, Manson JE, Malspeis S, Willet WC, Spiegelman D. Sexual orientation, health risk factors, and physical functioning in the Nurses’ Health Study II. 2004;13(9):1033–1047.Google Scholar
  18. 18.
    Preston D, D’Augelli AR, Kassab CD, Starks MT. The relationship of stigma to the sexual risk behavior of rural men who have sex with men. AIDS Educ Prev. 2007;19(3):218–30.CrossRefGoogle Scholar
  19. 19.
    Tiemann KA, Kennedy SA, Haga MP. Rural lesbians’ strategies for coming out to health care professionals. J Lesbian Stud. 1998;2(1):61–75.CrossRefGoogle Scholar
  20. 20.
    Barefoot KN, Rickard A, Smalley KB, Warren JC. Rural lesbians: Unique challenges and implications for mental health providers. J Rural Mental Health; in press.Google Scholar
  21. 21.
    Fernández MI, Warren JC, Varga LM, Prado G, Hernandez N, Bowen GS. Cruising in cyber space: comparing internet chat room versus community venues for recruiting Hispanic men who have sex with men to participate in prevention studies. J Ethn Subst Abus. 2007;6(2):143–62.CrossRefGoogle Scholar
  22. 22.
    Grov C. HIV risk and substance use in men who have sex with men surveyed in bathhouses, bars/clubs, and on venue of recruitment matters. AIDS Behav. 2012;16(4):807–17.CrossRefGoogle Scholar
  23. 23.
    Grov C, Ventuneac A, Rendina HJ, Jimenez RH, Parsons JT. Recruiting men who have sex with men on for face-to-face assessments: implications for research. AIDS Behav. 2013;17(2):773–8.CrossRefGoogle Scholar
  24. 24.
    Oswald R, Culton L. Under the rainbow: rural gay life and its relevance for family providers. Fam Relat. 2003;52:72–9.CrossRefGoogle Scholar
  25. 25.
    Jamison J. Psychometric validation of the Multidimensional Disclosure to Health Care Providers Scale (MD-HCPS). Dissertation Abstracts International. 2011. Available at:
  26. 26.
    Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behav Res Ther. 1997;35(1):79–89.CrossRefGoogle Scholar
  27. 27.
    Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–43.CrossRefGoogle Scholar
  28. 28.
    Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample. Psychol Assess. 1998;10:176–81.CrossRefGoogle Scholar
  29. 29.
    Babor TF, la Fuente JR, Sauders J, Grant M. AUDIT, the Alcohol Use Disorders Identification Test: guidelines for use in primary care. Geneva: World Health Organization; 1992.Google Scholar
  30. 30.
    de Meneses-Gaya C, Zuardi A, Loureiro S, Crippa JS. Alcohol Use Disorders Identification Test (AUDIT): an updated systematic review of psychometric properties. Psychol Neurosci. 2009;2(1):83–97.CrossRefGoogle Scholar
  31. 31.
    Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess. 1990;55:610–7.CrossRefGoogle Scholar
  32. 32.
    Smalley KB, Warren JC, Klibert J. Health risk behaviors in insured and uninsured community health center patients in the rural US South. Rural Remote Health. 2012;12(2123):1–8.Google Scholar
  33. 33.
    Rosenberg M. Society and the adolescent self-image. Princeton: Princeton University Press; 1965.Google Scholar
  34. 34.
    Warren JC, Smalley KB, Klibert J, Denmark JW. Access to emerging technologies and telehealth intervention modality preferences in rural patients. Health Technol. 2011;1(2):99–105.CrossRefGoogle Scholar

Copyright information

© IUPESM and Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Jacob C. Warren
    • 1
    • 2
  • K. Bryant Smalley
    • 3
    • 4
  • K. Nikki Barefoot
    • 3
  1. 1.Center for Rural Health and Health DisparitiesMercer University School of MedicineMacon31207 USA
  2. 2.Department of Community MedicineMercer University School of MedicineMaconUSA
  3. 3.Rural Health Research InstituteGeorgia Southern UniversityStatesboroUSA
  4. 4.Department of PsychologyGeorgia Southern UniversityStatesboroUSA

Personalised recommendations