Phase I testing of investigational drugs relies on healthy volunteers as research participants. Many U.S. healthy volunteers enroll repeatedly in clinical trials for the financial compensation. Serial participants are incentivized to ignore restrictions on their participation, and no centralized clinical trial registry prevents dual enrollment. Little is currently known about how healthy volunteers participate in studies over time, hampering the development of policies to protect this group. We detail a methodology developed as part of a longitudinal study to track in real-time healthy volunteers’ Phase I participation. Illustrating these data through three case studies, we document how healthy volunteers use strategies, such as qualifying for studies at more than one clinic and traveling significant distances, to maximize their participation. Our findings suggest that “clinical trial diaries” can generate critical information about serial research participation and point to ethical issues unique to healthy volunteers’ involvement in Phase I clinical trials.
We draw on unique data on communication flows between migrants and non-migrants in a bi-national, cross-border social network to test competing theories of the process of social incorporation. While advocates of the assimilation perspective argue that social incorporation is largely a one-way street, a recent literature on immigrant transnationalism challenges this view by arguing that changes in communication technologies and reductions in travel costs have made it possible for migrants to retain meaningful connections to their origin communities. In the context of this debate, we argue that communication flows-as measured by a combination of the number of social ties and the frequency of communication with them-provide an empirical test of the potential durability of cross-border networks. In our analysis, we find mixed support for both transnationalism and assimilation: while the classic assimilation perspective is correct that the strength of migrants' ties to origin attenuates as time in the destination increases, we also find evidence of a striking persistence in cross-border communication that is reinvigorated by migrant return visits, consistent with an attenuated view of transnationalism.
While the concept of transnationalism has gained widespread popularity among scholars as a way to describe immigrants’ long-term maintenance of cross-border ties to their origin communities, critics have argued that the overall proportion of immigrants who engage in transnational behavior is low and that, as a result, transnationalism has little sustained effect on the process of immigrant adaptation and assimilation. In this paper, we argue that a key shortcoming in the current empirical debate on transnationalism is the lack of data on the social networks that connect migrants to each other and to non-migrants in communities of origin. To address this shortcoming, our analysis uses unique bi-national data on the social network connecting an immigrant sending community in Guanajuato, Mexico, to two destination areas in the United States. We test for the effect of respondents’ positions in cross-border networks on their migration intentions and attitudes towards the United States using data on the opinions of their peers, their participation in cross border and local communication networks, and their structural position in the network. The results indicate qualified empirical support for a network-based model of transnationalism; in the U.S. sample we find evidence of network clustering consistent with peer effects, while in the Mexican sample we find evidence of the importance of cross-border communication with friends.
The migration of working-aged men from Mexico to the United States fractures the family-centered support structures typical of Latin America and contributes to high levels of depression in women left behind in migratory sending communities in Mexico. Mujeres en Solidaridad Apoyandose (MESA) was developed to improve depression in women through social support in a resource poor setting. MESA is a promotora intervention that trains women in the community to lead social support groups over a five-week period. The MESA curriculum uses a combination of cognitive behavioral theory techniques, psychoeducation, and social support activities aimed at alleviating or preventing depression in women. Results from this pilot efficacy study (n = 39) show that depressed participants at baseline experienced declines in depression as measured by the Center for Epidemiologic Studies Depression Scale at follow-up. Other findings demonstrate the complexity behind addressing social support and depression for women impacted by migration in different ways.
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