Risky single-occasion drinking and disadvantaged men: will recruitment through primary care miss hazardous drinkers?

Background Men who are socially disadvantaged are at a substantially higher risk of developing alcohol-related diseases. People from deprived areas are known to be more difficult to recruit to research studies. As part of a feasibility assessment for an intervention study, 2 recruitment strategies were investigated. This article compares the drinking patterns of the disadvantaged men identified by the 2 strategies.

Methods A cross-sectional survey compared 2 strategies for recruiting disadvantaged men to a study on alcohol consumption: recruitment through general practice (GP) registers and through a community outreach strategy, respondent-driven sampling (RDS). Men aged 25 to 44years were recruited from deprived areas in the community. The entry criterion was binge drinking (8 units in a single session) at least twice in the previous 4weeks. Demographic characteristics, total consumption of alcohol, frequency of binge drinking (8 units in a session), and heavy binge drinking (16 units in a session) were measured.

Results Men recruited by RDS drank more than twice as much as the men recruited through GP (137 units in the previous 30days compared with 62 units; p=0.003). They also had many more binge drinking days: more than half (57%) of men from RDS had 6 or more binge drinking days in the previous 30days, whereas only 16% of the GP sample had 6 or more binge drinking days (p=0.001). Many more men recruited by RDS (37% vs. 5%; p=0.002) had more than 5 very heavy drinking sessions in the previous month (16 units in a session). The RDS group also had fewer alcohol-free days.

Conclusions The 2 sampling strategies recruited different types of drinkers. The men recruited through RDS were much more likely to engage in frequent harmful drinking. The results indicate that the 2 methods recruit different samples of disadvantaged men. Intervention studies that are only conducted through primary care may miss many harmful drinkers.