Skip to main content
SpringerLink
Log in

Privacy, Confidentiality, and Safety Considerations for Conducting Geographic Momentary Assessment Studies Among Persons Who Use Drugs and Men Who Have Sex with Men

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Geographic momentary assessments (GMA) collect real-time behavioral data in one’s natural environment using a smartphone and could potentially increase the ecological validity of behavioral data. Several studies have evaluated the feasibility and acceptability of GMA among persons who use drugs (PWUD) and men who have sex with men (MSM), but fewer have discussed privacy, confidentiality, and safety concerns, particularly when illegal or stigmatized behavioral data were collected. This study explores perceptions regarding privacy, confidentiality, and safety of GMA research among PWUD and MSM recruited in three different settings (rural Appalachia, a mid-sized city in the South, and a mid-Atlantic city). Between November 2014 and April 2017, we recruited 35 PWUD from rural Appalachian Kentucky (N = 20) and Baltimore, Maryland (N = 15) and 20 MSM from Lexington, Kentucky to complete semi-structured qualitative interviews. Through thematic analyses, we identified and compared privacy, confidentiality, and safety concerns by demographic characteristics, risk behaviors, and setting. Privacy, confidentiality, and safety concerns varied by setting, age, smartphone ownership, use of illegal drugs, and history of drug-related arrests. Among those who used drugs, participants reported concerns with being tracked and burden associated with carrying and safeguarding study phones and responding to survey prompts. Privacy and confidentiality concerns were noted in each setting, but tracking concerns were greatest among Baltimore participants and led many to feel that they (or others) would be unwilling to participate or comply with study procedures. While locations considered to be sensitive varied by setting, participants in all settings said they would take measures to prevent sensitive information from being collected (i.e., intentionally disable devices, leave phones at home, alter response times). Privacy, confidentiality, and safety concerns may limit the accuracy of risk location information, study compliance, and participation. As concerns were often greatest among those engaging in illegal behaviors and with the highest risk behaviors, selection bias and non-response bias could negatively influence the representativeness and validity of study findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

EMA:

ecological momentary assessment

GMA:

geographical momentary assessments

GPS:

Global Positioning System

MSM:

men who have sex with men

PWUD:

persons who use drugs

TGW:

transgender women

References

  1. Chakrapani V, Newman PA, Shunmugam M, Dubrow R. Social-structural contexts of needle and syringe sharing behaviours of HIV-positive injecting drug users in Manipur, India: a mixed methods investigation. Harm Reduction Journal. 2011;8(1):9.

    Article  Google Scholar 

  2. Grund JPC, Stern LS, Kaplan CD, Adriaans NFP, Drucker E. Drug-use contexts and HIV-consequences—the effect of drug policy on patterns of everyday drug-use in Rotterdam and the Bronx. Br J Addict. 1992;87(3):381–92.

    Article  CAS  Google Scholar 

  3. Hien NT, Giang LT, Binh PN, Wolffers I. The social context of HIV risk behaviour by drug injectors in Ho Chi Minh City, Vietnam. Aids Care-Psychological and Socio-Medical Aspects of Aids/Hiv. 2000;12(4):483–95.

    CAS  Google Scholar 

  4. Rhodes T. Risk environments and drug harms: a social science for harm reduction approach. Int J Drug Policy. 2009;20(3):193–201.

    Article  Google Scholar 

  5. Rhodes T, Mikhailova L, Sarang A, Lowndes CM, Rylkov A, Khutorskoy M, et al. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Soc Sci Med. 2003;57(1):39–54.

    Article  Google Scholar 

  6. Singer M, Jia Z, Schensul JJ, Weeks M, Page JB. AIDS and the i.v. drug user: the local context in prevention efforts. Med Anthropol. 1992;14(2–4):285–306.

    Article  CAS  Google Scholar 

  7. Rudolph A, Tobin K, Rudolph J, Latkin C. Web-based survey application to collect contextually relevant geographic data with exposure times: application development and feasibility testing. JMIR Public Health and Surveillance. 2018;4(1).

  8. Kirchner TR, Shiffman S. Spatio-temporal determinants of mental health and well-being: advances in geographically-explicit ecological momentary assessment (GEMA). Soc Psychiatry Psychiatr Epidemiol. 2016;51(9):1211–23.

    Article  Google Scholar 

  9. Watkins KL, Regan SD, Nguyen N, et al. Advancing cessation research by integrating EMA and geospatial methodologies: associations between tobacco retail outlets and real-time smoking urges during a quit attempt. Nicotine Tob Res 2013 ntt135.

  10. Stahler GJ, Mennis J, Baron DA. Geospatial technology and the “exposome”: new perspectives on addiction. Am J Public Health. 2013;103(8):1354–6.

    Article  Google Scholar 

  11. Kirk GD, Linas BS, Westergaard RP, Piggott D, Bollinger RC, Chang LW, et al. The exposure assessment in current time study: implementation, feasibility, and acceptability of real-time data collection in a community cohort of illicit drug users. AIDS research and treatment. 2013;2013:1–10.

    Google Scholar 

  12. Phillips KA, Epstein DH, Mezghanni M, Vahabzadeh M, Reamer D, Agage D, et al. Smartphone delivery of Mobile HIV risk reduction education. AIDS research and treatment. 2013;2013:1–9.

    Article  Google Scholar 

  13. Yang C, Linas B, Kirk G, et al. Feasibility and acceptability of smartphone-based ecological momentary assessment of alcohol use among African American men who have sex with men in Baltimore. Jmir Mhealth and Uhealth 2015;3(2).

  14. Duncan DT, Kapadia F, Regan SD, Goedel WC, Levy MD, Barton SC, et al. Feasibility and acceptability of global positioning system (GPS) methods to study the spatial contexts of substance use and sexual risk behaviors among young men who have sex with men in New York City: a p18 cohort sub-study. PLoS One. 2016;11(2):e0147520.

    Article  Google Scholar 

  15. Rudolph AE, Bazzi AR, Fish S. Ethical considerations and potential threats to validity for three methods commonly used to collect geographic information in studies among people who use drugs. Addict Behav. 2016;61:84–90.

    Article  Google Scholar 

  16. Ramanathan N, Swendeman D, Comulada WS, Estrin D, Rotheram-Borus MJ. Identifying preferences for mobile health applications for self-monitoring and self-management: focus group findings from HIV-positive persons and young mothers. Int J Med Inform. 2013;82(4):e38–46.

    Article  Google Scholar 

  17. Roth AM, Rossi J, Goldshear JL, Truong Q, Armenta RF, Lankenau SE, et al. Potential risks of ecological momentary assessment among persons who inject drugs. Subst Use Misuse. 2017;52(7):840–7.

    Article  Google Scholar 

  18. Mirzazadeh A, Grasso M, Johnson K, Briceno A, Navadeh S, McFarland W, et al. Acceptability of Global Positioning System technology to survey injecting drug users’ movements and social interactions: a pilot study from San Francisco, USA. Technol Health Care. 2014;22(5):689–700.

    Article  CAS  Google Scholar 

  19. Rudolph AE, Young AM, Havens JR. A rural/urban comparison of privacy and confidentiality concerns associated with providing sensitive location information in epidemiologic research involving persons who use drugs. Addict Behav. 2017;74:106–11.

    Article  Google Scholar 

  20. Young AM, Rudolph AE, Quillen D, Havens JR. Spatial, temporal and relational patterns in respondent-driven sampling: evidence from a social network study of rural drug users. J Epidemiol Community Health. Aug 2014;68(8):792–8.

    Article  Google Scholar 

  21. Sciences CfIOoM. International ethical guidelines for biomedical research involving human subjects. Bull Med Ethics. 2002(182):17.

  22. Software for qualitative data analysis [computer program]. Version. Berlin, Germany; 1989–2016.

  23. Goedel WC, Reisner SL, Janssen AC, Poteat TC, Regan SD, Kreski NT, et al. Acceptability and feasibility of using a novel geospatial method to measure neighborhood contexts and mobility among transgender women in New York City. Transgender Health. 2017;2(1):96–106.

    Article  Google Scholar 

  24. Zenk SN, Schulz AJ, Odoms-Young AM, Wilbur JE, Matthews S, Gamboa C, et al. Feasibility of using global positioning systems (GPS) with diverse urban adults: before and after data on perceived acceptability, barriers, and ease of use. J Phys Act Health. 2012;9(7):924–34.

    Article  Google Scholar 

  25. Freedman MJ, Lester KM, McNamara C, Milby JB, Schumacher JE. Cell phones for ecological momentary assessment with cocaine-addicted homeless patients in treatment. J Subst Abus Treat. 2006;30(2):105–11.

    Article  Google Scholar 

  26. Epstein DH, Preston KL. Daily life hour by hour, with and without cocaine: an ecological momentary assessment study. Psychopharmacology. 2010;211(2):223–32.

    Article  CAS  Google Scholar 

  27. Mitchell JT, Schick RS, Hallyburton M, Dennis MF, Kollins SH, Beckham JC et al. Combined ecological momentary assessment and global positioning system tracking to assess smoking behavior: a proof of concept study. J Dual Diagnosis. 2013;10(1):19–29.

Download references

Acknowledgements

This research was funded by the Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute and National Institutes of Drug Abuse Grants R25DA031608 (Director, Celia B. Fisher), K01DA033879 (PI: Abby E. Rudolph) and R21AI131979 (PI: Abby E. Rudolph). The rural Appalachian study was funded by R01DA024598 and R01DA033862 (PI: Jennifer R. Havens). The MSM study in Lexington was funded by R03DA039740 (PI: April M. Young). We would also like to acknowledge (in alphabetical order by last name) Erin Martinez, Madelyn McDonald, Teddy Medina, Marissa Lawrence, Connor Smith, and Seung Yeon Song for their help with transcribing the Lexington interviews.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA

    Abby E. Rudolph

  2. Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B. Moore Avenue, Ritter Annex 905, Philadelphia, PA, 19122, USA

    Abby E. Rudolph

  3. Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, 40536, USA

    April M. Young

  4. Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, 405308, USA

    April M. Young & Jennifer R. Havens

Authors
  1. Abby E. Rudolph
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. April M. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer R. Havens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abby E. Rudolph.

Ethics declarations

All study procedures and materials were reviewed and approved by the Institutional Review Boards at Boston University and the Pacific Institute for Research and Evaluation.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rudolph, A.E., Young, A.M. & Havens, J.R. Privacy, Confidentiality, and Safety Considerations for Conducting Geographic Momentary Assessment Studies Among Persons Who Use Drugs and Men Who Have Sex with Men. J Urban Health 97, 306–316 (2020). https://doi.org/10.1007/s11524-018-0315-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-018-0315-x

Keywords

Search

Navigation