# Improving Reproducibility of Respondent Driven Sampling through Adaptive Design - Diversity Supplement

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $12,579

## Abstract

The COVID-19 pandemic has drawn much attention from the public in 2020. Since restrictions related to
COVID-19 took place, troubling news about an increase in overdose-related fatalities emerged. In fact, 2021
saw a record high number of overdose death. Because those who are already subject to the negative effects of
social and economic determinants of health (e.g., older persons, racial/ethnic minorities) are also affected by
both COVID-19 and fatal overdose disproportionately, this collision between the COVID-19 pandemic and the
overdose epidemic is creating a syndemic. Because the pandemic has been associated with an increase in
substance use for racial/ethnic minorities, existing health disparities are expected to exacerbate. A clear
example is the City of Detroit, where 90% of the residents are racial/ethnic minorities. As of May 2022, Detroit’s
COVID-19 mortality rate is 522 per 100k residents, and its fatal overdose rate is 77 per 100k, each two to three
times higher than the national average, while the COVID-19 confirmation rate is lower. Another concerning
observation is Detroit’s vaccination rate of 41.4%, which is lower by over 20 % point than the national average.
This syndemic, combined with low vaccination rates, is likely to produce negative impacts beyond health,
including the economy through the lost opportunity costs. Despite this concerning trend, little is known about
the effect of the syndemic on communities of persons who inject drugs (PWID), including basic statistics about
COVID-19 vaccination and harm reduction practices. The mechanisms behind these preventive practices are
complicated, involving not only PWID’s own behaviors but also influences from their social networks.
Moreover, the mechanism may differ by age and race/ethnicity. Therefore, it is critical to examine the syndemic
with social networks, particularly for older and racial/ethnic minority PWID who are at a greater risk.
 This diversity supplement study builds on a parent R01 grant that currently is in the field collecting data
from PWID using respondent driven sampling (RDS) in Southeast Michigan. Based on our prior work, a
majority of PWID from this area are older and racial/ethnic minorities, implying robust statistical power for the
analysis that provides insights into older PWID and racial/ethnic minority PWID. Thanks to the RDS method,
innovative social network measures beyond ego-centric self-reports will be introduced in understanding
PWID’s vaccination and harm reduction practices. The proposed research has strong potential to address the
urgent need to assess the syndemic and its effect on older PWID. Specifically, the study aims to describe the
extent of COVID-19 vaccination, overdose incidence and preventive practices among PWID and analyze them
as a function of social networks with specific considerations given to age and race/ethnicity. This diversity
supplement is uniquely positioned to provide a trainee-candidate, a doctoral student in survey...

## Key facts

- **NIH application ID:** 10631522
- **Project number:** 3R01AG060936-04S1
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Sung-Hee Lee
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $12,579
- **Award type:** 3
- **Project period:** 2019-02-15 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10631522

## Citation

> US National Institutes of Health, RePORTER application 10631522, Improving Reproducibility of Respondent Driven Sampling through Adaptive Design - Diversity Supplement (3R01AG060936-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10631522. Licensed CC0.

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