Advertisement

Journal of Immigrant and Minority Health

, Volume 12, Issue 1, pp 74–82 | Cite as

Comparing Two Approaches to Acquiring HIV-Risk Data from Puerto Rican Women with Severe Mental Illness

  • Emily L. G. HeaphyEmail author
  • Sana Loue
ORIGINAL PAPER

Abstract

Renewed interest has been expressed by researchers in mixed-method assessment that employs both quantitative and qualitative techniques in an expansive style that utilizes a variety of tactics to address research questions. Participants consisted of Puerto Rican women with severe mental illness living in Cuyahoga County, Ohio. The women were shadowed over a 2-year period to observe and verify behaviors that were self-reported using standardized instruments in semi-structured interviews. Concurrent criterion-related validity was employed to determine the extent of the correlation between responses obtained from the two approaches. Forty-four percent of the women were diagnosed with major depression and the mean overall GAF score was 58.5 ± 14.5. A comparison of the data collected using the different methodologies revealed that inconsistent and contradictory responses are not uncommon. The mixed-method design provided a more complete way of obtaining HIV-risk behavior data. Researchers and clinicians could benefit from mixed methods research that can provide greater opportunities to obtain data of a sensitive nature.

Keywords

Mixed methods research Severe mental illness Puerto Rican HIV-risk behaviors 

Notes

Acknowledgements

This research was supported by a grant from the National Institute of Mental Health R01 MH-63016. We thank Nancy Mendez, Ingrid Vargas, and Jenice Contreras for their efforts in recruiting, interviewing, and shadowing the study participants; Martha Sajatovic, Daniel Tisch, and Leslie Heinberg for their review of this manuscript; and our study participants.

References

  1. 1.
    Johnson RB, Onwuegbuzie AJ. Mixed methods research: a research paradigm whose time has come. Educ Res. 2004;33:14–26.Google Scholar
  2. 2.
    Greene JC, Caracelli VJ, Graham WF. Toward a conceptual framework for mixed-method evaluation designs. Educ Eval Policy Anal. 1989;11:255–74.Google Scholar
  3. 3.
    Rossman GB, Wilson BL. Numbers and words: combining quantitative and qualitative methods in a single large-scale evaluation study. Eval Rev. 1985;9:627–43.CrossRefGoogle Scholar
  4. 4.
    Madey DL. Some benefits of integrating qualitative and quantitative methods in program evaluation, with illustrations. Educ Eval Policy Anal. 1982;4:223–36.Google Scholar
  5. 5.
    Robins CS, Ware NC, dosReis S, Willging CE, Chung JY, Lewis-Fernandez R. Dialogues on mixed-methods and mental health services research: anticipating challenges. Build Solut Psychiatr Serv. 2008;59:727–31.Google Scholar
  6. 6.
    Onwuegbuzie AJ, Teddlie C. A framework for analyzing data in mixed methods research. In: Tashakkori A, Teddlie C, editors. Handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage; 2003. p. 351–83.Google Scholar
  7. 7.
    Tashakkori A, Teddlie C. Mixed methodology: combining qualitative and quantitative approaches. Applied Social Research Methods Series, vol. 46. Thousand Oaks, CA: Sage; 1998.Google Scholar
  8. 8.
    Mathison S. Why triangulate? Educ Res. 1988;17:13–7.Google Scholar
  9. 9.
    Hopson RK, Peterson JA, Lucas KJ. Tales from the ‘hood’: framing HIV/AIDS prevention through intervention ethnography in the inner city. Addict Res Theory. 2001;9:339–63.CrossRefGoogle Scholar
  10. 10.
    Sivaram S, Srikrishnan AK, Latkin CA, Johnson SC, Go VF, Bentley ME, et al. Development of an opinion leader-led HIV prevention intervention among alcohol users in Chennai, India. AIDS Educ Prev. 2004;16:137–49.CrossRefPubMedGoogle Scholar
  11. 11.
    Castro FP, Barrera M, Martinez CR. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5:41–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Bauman LJ, Stein REK, Ireys HT. Reinventing fidelity: the transfer of social technology among settings. Am J Community Psychol. 1991;19:619–39.CrossRefPubMedGoogle Scholar
  13. 13.
    Parker R, Ehrhardt AA. Through an ethnographic lens: ethnographic methods, comparative analysis, and HIV/AIDS research. AIDS Behav. 2001;5:105–10.CrossRefGoogle Scholar
  14. 14.
    Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990;108:339–62.CrossRefPubMedGoogle Scholar
  15. 15.
    Weinhardt LS, Forsyth AD, Carey MP, Jaworski BC, Durant LE. Reliability and validity of self-report measures of HIV-related sexual behavior: progress since 1990 and recommendation for research and practice. Arch Sex Behav. 1998;27:155–80.CrossRefPubMedGoogle Scholar
  16. 16.
    Schroder KEE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. accuracy of self-reports. Ann Behav Med. 2003;26:104–23.CrossRefPubMedGoogle Scholar
  17. 17.
    Ochs EP, Binik YM. The use of couple data to determine the reliability of self-reported sexual behavior. J Sex Res. 1999;36:374–84.CrossRefGoogle Scholar
  18. 18.
    Schrimshaw EW, Rosario M, Meyer-Bahlburg HFL, Scharf-Matlick AA. Test-retest reliability of self-reported sexual behavior, sexual orientation, and psychosexual milestones among gay, lesbian, and bisexual youths. Arch Sex Behav. 2006;35:225–34.CrossRefPubMedGoogle Scholar
  19. 19.
    Carmines EG, Zeller RA. Reliability and validity assessment. Newbury Park: Sage Publications; 1991.Google Scholar
  20. 20.
    Wainberg ML, Gonzalez MA, McKinnon K, Elkington KS, Pinto D, Mann CG, et al. Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness. Soc Sci Med. 2007;65:296–308.CrossRefPubMedGoogle Scholar
  21. 21.
    Klein H, Elifson KW, Sterk CE. Childhood neglect and adulthood involvement in HIV-related risk behaviors. Child Abuse Negl. 2007;31:39–53.CrossRefPubMedGoogle Scholar
  22. 22.
    VanDorn RA, Mustillo S, Elbogen EB, Dorsey S, Swanson JW, Swartz MS. The effects of early sexual abuse on adult risk sexual behaviors among persons with severe mental illness. Child Abuse Negl. 2005;29:1265–79.CrossRefGoogle Scholar
  23. 23.
    Parillo KM, Freeman RC, Collier K, Young P. Association between early sexual abuse and adult HIV-risky sexual behaviors among community-recruited women. Child Abuse Negl. 2001;25:335–46.CrossRefPubMedGoogle Scholar
  24. 24.
    Mullings JL, Marquart JW, Hartley DJ. Exploring the effects of childhood sexual abuse and its impact on HIV/AIDS risk-taking behavior among women prisoners. Prison J. 2003;83:442–63.CrossRefGoogle Scholar
  25. 25.
    Saewyc E, Skay C, Richens K, Reis E, Poon C, Murphy A. Sexual orientation, sexual abuse, and HIV-risk behaviors among adolescents in the Pacific Northwest. Am J Public Health. 2006;96:1104–10.CrossRefPubMedGoogle Scholar
  26. 26.
    Meade CS, Kershaw TS, Hansen NB, Sikkema KJ. Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior. AIDS Behav. 2007;13(2):207–16.Google Scholar
  27. 27.
    Devieux JG, Malow R, Lerner BG, Dyer JG, Baptista L, Lucenko B, et al. Triple jeopardy for HIV: substance using severely mentally ill adults. J Prev Interv Community. 2007;33:5–18.CrossRefPubMedGoogle Scholar
  28. 28.
    McLellan AT, Luborsky L, Cacciola J, Griffith J, Evans F, Barr HL, et al. New data from the Addiction Severity Index. Reliability and validity in three centers. J Nerv Ment Dis. 1985;173:412–23.PubMedGoogle Scholar
  29. 29.
    Hodgins DC, el-Gyebaly N. More data on the Addiction Severity Index. Reliability and validity with the mentally ill substance abuser. J Nerv Ment Dis. 1992;180:197–201.PubMedCrossRefGoogle Scholar
  30. 30.
    Malow RM, Devieux JG, Martinez L, Peipman F, Lucenko BA, Kalichman SC. History of traumatic abuse and HIV risk behaviors in severely mentally ill substance abusing adults. J Fam Violence. 2006;21:127–35.CrossRefGoogle Scholar
  31. 31.
    Loue S, Sajatovic M. Spirituality, coping, and HIV risk and prevention in a sample of severely mentally ill Puerto Rican women. J Urban Health. 2006;83:1168–82.CrossRefPubMedGoogle Scholar
  32. 32.
    CDC. HIV/AIDS Surveillance Report, 2005;17:Tables 3&7 (Revised June 2007).Google Scholar
  33. 33.
    Suarez-Al-Adam M, Raffaelli M, O’Leary A. Influence of abuse and partner hypermasculinity on the sexual behavior of Latinas. AIDS Educ Prev. 2000;12:263–74.PubMedGoogle Scholar
  34. 34.
    Peragallo N, DeForge BR, Khoury Z, Rivero R, Talashek M. Latinas’ perspectives on HIV/AIDS: cultural issues to consider in prevention. Hisp Health Care Int. 2002;1:11–22.Google Scholar
  35. 35.
    Nyamathi A, Bennett C, Leake B, Lewis C, Flaskerud J. AIDS-related knowledge, perceptions, and behaviors among impoverished minority women. Am J Public Health. 1993;83:65–71.PubMedGoogle Scholar
  36. 36.
    Amaro H, Raj A. On the margin: power and women’s HIV risk reduction strategies. Sex Roles. 2000;42:723–49.CrossRefGoogle Scholar
  37. 37.
    Reyes JC, Robles RR, Colon HM, Marrero CA, Matos TD, Calderon JM, et al. Severe anxiety symptomatology and HIV risk behavior among Hispanic injection drug users in Puerto Rico. AIDS Behav. 2007;11:145–50.CrossRefPubMedGoogle Scholar
  38. 38.
    Armistead SG. Pan-hispanic oral tradition. Oral Tradit. 2003;18:154–6.CrossRefGoogle Scholar
  39. 39.
    deArellano MA. Trauma among Hispanic/Latino populations. 2006.Google Scholar
  40. 40.
    Tucker JS, Kanouse DE, Miu A, Koegel P, Sullivan G. HIV risk behaviors and their correlates among HIV-positive adults with serious mental illness. AIDS Behav. 2003;7:29–40.CrossRefPubMedGoogle Scholar
  41. 41.
    Carey MP, Carey KB, Maisto SA, Schroder KE, Vanable PA, Gordon CM. HIV risk behavior among psychiatric outpatients: association with psychiatric disorder, substance use disorder, and gender. J Nerv Ment Dis. 2004;192:289–96.CrossRefPubMedGoogle Scholar
  42. 42.
    Chandra PS, Carey MP, Carey KB, Prasada Rao PS, Jairam KR, Thomas T. HIV risk behaviour among psychiatric inpatients: results from a hospital-wide screening study in southern India. Int J STD AIDS. 2003;14:532–8.CrossRefPubMedGoogle Scholar
  43. 43.
    Brown LK, Lourie KJ, Zlotnick C, Cohn J. Impact of sexual abuse on the HIV-risk-related behavior of adolescents in intensive psychiatric treatment. Am J Psychiatry. 2000;157:1413–5.CrossRefPubMedGoogle Scholar
  44. 44.
    Meade CS, Sikkema KJ. Psychiatric and psychosocial correlates of sexual risk behavior among adults with severe mental illness. Community Ment Health J. 2007;43:153–69.CrossRefPubMedGoogle Scholar
  45. 45.
    McKinnon K, Cournos F, Herman R. A lifetime alcohol or other drug use disorder and specific psychiatric symptoms predict sexual risk and HIV infection among people with severe mental illness. AIDS Behav. 2001;5:233–40.CrossRefGoogle Scholar
  46. 46.
    Rosenberg SD, Trumbetta SL, Mueser KT, Goodman LA, Osher FC, Vidaver RM, et al. Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness. Compr Psychiatry. 2001;42:263–71.CrossRefPubMedGoogle Scholar
  47. 47.
    Carey MP, Carey KB, Gleason JR, Gordon CM, Brewer KK. HIV-risk behavior among outpatients at a state psychiatric hospital: prevalence and risk modeling. Behav Ther. 1999;30:389–406.CrossRefPubMedGoogle Scholar
  48. 48.
    McDermott BE, Sautter FJ Jr, Winstead DK, Quirk T. Diagnosis, health beliefs, and risk of HIV infection in psychiatric patients. Hosp Community Psychiatry. 1994;45:580–5.PubMedGoogle Scholar
  49. 49.
    Volavka J, Convit A, Czobor P, Douyon R, O’Donnell J, Ventura F. HIV seroprevalence and risk behaviors in psychiatric inpatients. Psychiatry Res. 1991;39:109–14.CrossRefPubMedGoogle Scholar
  50. 50.
    Kelly JA, Murphy DA, Bahr GR, Brasfield TL, Davis DR, Hauth AC, et al. AIDS/HIV risk behavior among the chronic mentally ill. Am J Psychiatry. 1992;149:886–9.PubMedGoogle Scholar
  51. 51.
    Cournos F, Guido JR, Coomaraswamy S, Meyer-Bahlburg H, Sugden R, Horwath E. Sexual activity and risk of HIV infection among patients with schizophrenia. Am J Psychiatry. 1994;151:228–32.PubMedGoogle Scholar
  52. 52.
    Banks-Wallace J. Talk that talk: storytelling and analysis rooted in African American oral tradition. Qual Health Res. 2002;12:410–26.CrossRefPubMedGoogle Scholar
  53. 53.
    Schneider W. The search for wisdom in native American narratives and classical scholarship. Oral Tradit. 2003;18:268–9.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Center for Minority Public HealthClevelandUSA
  2. 2.Department of Epidemiology and BiostatisticsCase Western Reserve UniversityClevelandUSA

Personalised recommendations