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Background and Objectives Snowball sampling is applied when samples with the target characteristics are not easily accessible. This research describes snowball sampling as a purposeful method of data collection in qualitative research. Methods This paper is a descriptive review of previous research papers. Data were gathered using English keywords, including “review,” “declaration,” “snowball,” and “chain referral,” as well as Persian keywords that are equivalents of the following: “purposeful sampling,” “snowball,” “qualitative research,” and “descriptive review.” The databases included Google Scholar, Scopus, Irandoc, ProQuest, Science Direct, SID, MagIran, Medline, and Cochrane. The search was limited to Persian and English articles written between 2005 and 2013. Results The preliminary search yielded 433 articles from PubMed, 88 articles from Scopus, 1 article from SID, and 18 articles from MagIran. Among 125 articles, methodological and non-research articles were omitted. Finally, 11 relevant articles, which met the criteria, were selected for review. Conclusions Different methods of snowball sampling can be applied to facilitate scientific research, provide community-based data, and hold health educational programs. Snowball sampling can be effectively used to analyze vulnerable groups or individuals under special care. In fact, it allows researchers to access susceptible populations. Thus, it is suggested to consider snowball sampling strategies while working with the attendees of educational programs or samples of research studies.
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Strides Dev Med Educ. 2017 September; 14(3):e67670.
Published online 2017 September 30.
doi: 10.5812/sdme.67670.
Research Article
Snowball Sampling: A Purposeful Method of Sampling in Qualitative
Research
Mahin Naderifar,1Hamideh Goli,2and Fereshteh Ghaljaie3,*
1Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, IR Iran
2Department of Nursing, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
3Community Nursing Research Center, Faculty of Nursing and Midwifery,Zahedan University of Medical Sciences, Zahedan, Iran
*Corresponding author: Fereshteh Ghaljaie, Community Nursing Research Center, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.
E-mail: ghaljaei_f@yahoo.com
Received 2016 November 29; Revised 2017 May 03; Accepted 2017 June 25.
Abstract
Background and Objectives: Snowball sampling is applied when samples with the target characteristics are not easily accessible.
This research describes snowball sampling as a purposeful method of data collection in qualitative research.
Methods: This paper is a descriptive review of previous research papers. Data were gathered using English keywords, including “re-
view,” “declaration,” “snowball,” and “chain referral,” as well as Persian keywords that are equivalents of the following: “purposeful
sampling,” “snowball,” “qualitative research,” and “descriptive review.” The databases included Google Scholar,Scopus, Irandoc, Pro-
Quest, Science Direct, SID, MagIran, Medline, and Cochrane. The search was limited to Persian and English articles written between
2005 and 2013.
Results: The preliminary search yielded 433 articles from PubMed, 88 articles from Scopus, 1 article from SID, and 18 articles from
MagIran. Among 125 articles, methodological and non-research articles were omitted. Finally, 11 relevant articles, which met the
criteria, were selected for review.
Conclusions: Different methods of snowball sampling can be applied to facilitate scientific research, provide community-based
data, and hold health educational programs. Snowball sampling can be effectively used to analyze vulnerable groups or individ-
uals under special care. In fact, it allows researchers to access susceptible populations. Thus, it is suggested to consider snowball
sampling strategies while working with the attendees of educational programs or samples of research studies.
Keywords: Purposeful Sampling, Snowball, Qualitative Research, Descriptive Review
1. Background
Qualitative research is an organized method of de-
scribing people’s experiences and internal feelings (1). It
can be said that qualitative research provides a thorough
and deep overview of a phenomenon through data col-
lection and presents a rich description using a flexible
method of research. In this method, qualitative informa-
tion, which is gathered in the form of non-numerical data,
is presented (2).
There are different methods to collect the required
data, including interviews, observations, focus groups,
narratives, notes, reports, and review of archives. The
researcher chooses the information with respect to the
questions, sensitivity of the subject, research samples, and
availability of resources (3). To determine the characteris-
tics of a community, it is possible to gather data by sam-
pling or census reports.
Sampling is the process of choosing a part of the popu-
lation to represent the whole. If the researcher considers a
part of the population as a representation of the whole, the
analysis will be more comprehensive (4). In many research
studies, factors such as lack of human resources, lack of
precision, high expenses, inadequate equipment, and pop-
ulation dispersion prevent researchers from studying the
entire population. In this case, it is preferable to study only
a part of the population (5).
Researchers should plan the sampling process and de-
termine the method of study. Sampling is performed in
two general ways: probability and nonprobability. In prob-
ability sampling methods, the rules of probability are ap-
plied, and as their main feature, each sample has a chance
to be selected. In these methods, the researcher’s opin-
ion or community members do not influence the selection
of samples. The selected sample is a representative of the
population, and the researcher can generalize the findings
to the whole population. Probability sampling methods
include simple random sampling, systematic sampling,
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Naderifar M et al.
stratified sampling, and cluster sampling.
On the other hand, nonprobability methods of sam-
pling involve samples that are available to the researcher
or are selected by the researcher. In these methods, not ev-
eryone has an equal chance of being selected, and it is not
clear who will be included in the final sample. Regarding
the sampling method, generalization of the findings to the
entire population is not clear either, and one cannot calcu-
late the rate of error in the sampling. Different methods of
nonprobability sampling include convenience, purpose-
ful, and quota sampling. In quantitative research, proba-
bility sampling is normally applied, whereas in qualitative
research, nonprobability sampling is selected (1).
The convenience sampling method includes members
of the population who are available to the researcher. For
instance, a lecturer who distributes questionnaires among
students has in fact used this method. Asking questions
from passers-by on the street is another example of this
method of sampling. This method is also called “acciden-
tal sampling” (1). Snowball sampling is a convenience sam-
pling method. This method is applied when it is diffi-
cult to access subjects with the target characteristics. In
this method, the existing study subjects recruit future sub-
jects among their acquaintances. Sampling continues un-
til data saturation (6).
As stated by Polit-O’Hara and Beck, this method, which
is also called the “chain method,” is efficient and cost-
effective to access people who would otherwise be very
difficult to find. In this method, the researcher asks the
first few samples, who are usually selected via convenience
sampling, if they know anyone with similar views or situ-
ations to take part in the research. The snowball method
not only takes little time but also provides the researcher
with the opportunity to communicate better with the sam-
ples, as they are acquaintances of the first sample, and the
first sample is linked to the researcher (7). This type of net-
working is particularly useful for finding people who are
not willing to reveal their identities (e.g., addicts and crim-
inals) (4).
In another definition, snowball sampling may be less
reliant on a reference sample, but it is still suitable to find
unattainable populations. For example, when the research
is aimed at a group of illegal immigrants or addicts, meet-
ing the first group of samples will probably lead to other
samples; thus, the study sample grows like a rolling snow-
ball (5).
Generally, snowball sampling is a gradual process, and
time influences the selection of samples. Sampling usu-
ally continues until data saturation. On the other hand,
convenience sampling is the weakest method of sampling.
The risk of bias is low when the population is homoge-
neous in terms of the target characteristic under question,
whereas in nonhomogeneous populations, this method of
sampling has a higher risk of error (1).
In recent decades, qualitative research has become
more popular in nursing studies. Despite the growing
body of qualitative research in the past few decades, there
have been debates about these types of studies due to lack
of detailed information on the methods and processes.
Most published qualitative papers do not provide enough
information about the characteristics of the samples, re-
search, and sampling methods. In qualitative research,
sampling is determined by the type of research, while most
published literature has not determined the type of re-
search (8).
Consecutive sampling is one method of purposeful
sampling in qualitative research. In this method, instead
of selecting a fixed sample, every subject who meets the cri-
teria is selected until the required sample size is achieved.
This method is classified into three types, one of which is
snowball sampling. This type of sampling is a nonprob-
ability method, which involves random selection of sub-
jects. This method is most effective when the members
of the population are not easily accessible (e.g., homeless
people, illegal immigrants, and addicts). The researcher
first identifies a group of people, and after gathering data,
he/she asks them to recommend similar cases for the study.
The purpose of qualitative research is to gain a deeper
understanding of a phenomenon, rather than to general-
izing the findings. Therefore, careful selection of research
samples can help us conduct a more thorough evaluation.
The purpose of this study was to review the available qual-
itative research in nursing, which applied the snowball
sampling method.
2. Methods
This research is a thorough and descriptive review of
the snowball sampling method, based on articles pub-
lished in national and international journals, as well as dis-
sertations. The articles were selected from Cochrane, Pro-
Quest, Science Direct, SID, MagIran, Medline, Irandoc, Sco-
pus, and Google Scholar databases in both Persian and En-
glish languages between 2005 and 2013. Data were gath-
ered using English keywords, including “review,” “declara-
tion,” “snowball,” and “chain referral,” as well as Persian
keywords that are equivalents of the following: “purpose-
ful sampling,” “snowball,” “qualitative research,” and “de-
scriptive review.”
First, all articles related to qualitative research in Iran
were gathered. The articles, which contained the afore-
mentioned keywords in the abstract, were included in our
preliminary list, while the rest of the articles were dis-
carded. Then, a checklist was used to document all the
2Strides Dev Med Educ. 2017; 14(3):e67670.
Naderifar M et al.
required information, including the title, location, time,
scope, and method of sampling; this checklist was used for
the final evaluation. Two individuals separately searched
and gathered the data.
3. Results
In the preliminary search, 423 articles from PubMed,
88 articles from Scopus, 1 article from SID, and 18 articles
from MagIran were selected. Dissertations approved be-
tween 2005 and 2013 were also reviewed. After limiting the
search to articles with full text, the total number of the ar-
ticles reached 125. In addition, dissertations that were not
available to the researchers were eliminated.
The remaining articles were reviewed, and those with
a theoretical framework, as well as non-research articles,
were omitted. Finally, 11 articles were found eligible for the
review and were selected for their relevance to the purpose
of this study. The methods and content of these papers
were thoroughly reviewed to determine the characteristics
of snowball sampling and methods of implementation (Ta-
ble 1).
4. Discussion and Conclusions
One main challenge of qualitative research is selecting
the samples, determining the sufficient sample size, and
explaining the sampling procedure. Although many quali-
tative research experts believe that data saturation is a sub-
jective phenomenon, there is also the view that more ob-
servations and interviews do not affect the interpretation
of the results.
Review of the literature showed that a few research
studies have accurately explained the snowball sampling
method. In most of them, the main method of sampling
was sufficient, and they have not presented clear expla-
nations about its implementation. On the other hand, in
some studies, the snowball sampling method did not suf-
fice and was only used to complete the data. It should be
mentioned that the snowball sampling method is fully ex-
plained in only one study, which has fully clarified its dif-
ferent aspects.
Different variations of snowball sampling can be ap-
plied in the development of community-based informa-
tion, dissemination efforts related to health education pro-
grams, and research studies. These methods can be effec-
tively used to choose samples from fragile populations or
people under specialized care. Adaptation of the snowball
sampling method helps researchers gain access to the tar-
get population.
Adaptations of snowball sampling strategies should be
considered when recruiting participants for educational
programs or research studies. In snowball sampling, the
fragile population is selected in a social context and in a
multi-stage process. After gaining access to the prelimi-
nary samples, the samples begin to introduce other people
to take part in the research. This process will continue in
a semi-automatic and chain-like manner until data satura-
tion (9).
Nurses have different responsibilities, including clini-
cal care, education, and research. In many cases, it is dif-
ficult to identify or contact care-seekers. Human immun-
odeficiency virus (HIV) positive patients, abused women,
drug addicts, sex workers, and people with homosexual
or asexual tendencies are examples of these fragile popu-
lations (10). The snowball sampling method has been de-
rived from different concepts of social marketing. How-
ever, people who are involved in research studies and have
educational opportunities should always consider individ-
ual rights and privacy.
Snowball sampling is a method of gathering informa-
tion to access specific groups of people. The advantages
and limitations of this research method should be eval-
uated to select the best strategy. A researcher aiming to
perform health interventions should consider people’s pri-
vacy concerns (both for preliminary samples and samples
in the target community). Additionally, anonymity and
confidentiality of the data should be guaranteed by the re-
searcher (11).
The limitations of this study, which are mostly related
to its design (review study), include lack of homogeneity in
the measurement methods and lack of explanation about
the exact sampling method in most papers. Researchers
interested in qualitative research are recommended to
choose a method of sampling that is not only more accu-
rate but also saves time and money.
Supplementary Material
Supplementary material(s) is available here [To read
supplementary materials, please refer to the journal web-
site and open PDF/HTML].
Acknowledgments
The researchers would like to thank our research col-
leagues in Zabol University of Medical Sciences and Za-
hedan University of Medical Sciences, for their coopera-
tion.
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4Strides Dev Med Educ. 2017; 14(3):e67670.
Naderifar M et al.
Table1. General Data Gathered from the Selected Articles on the Snowball Sampling Method
Reference Title Data Collection Method Findings
Walsh et al. (12)Attitudes and subjective norms:
Determinants of parents’ intentions to
reduce childhood fever with
medications
Three methods: newspaper
advertisement, face-to-face interview,
and snowball sampling
The snowball method was implemented
by a network of researchers and
respondents. All the attendees were
given a package containing an
introduction letter, information
overview sheet, questionnaire, and
return envelope. After completing the
forms, the information was collected.
Charkazi et al. (13)Explaining smoking among students at
Golestan University of Medical Sciences
based on BASNEF model
Snowball sampling (The researcher
identified some smoking students, and
after explaining the purpose of the study
and obtaining oral consent, they were
asked to introduce some other smoker
students to recruit a larger sample.)
Abstract norms and enabling factors are
among the most important factors in
smoking. Therefore, these points should
be considered for preventing and
organizing recovery programs.
Heshmati Nabavi et al. (14)Barrier to forming and implementing
academic service partnership in
nursing: A qualitative study
Purposeful sampling, snowball
sampling, and interview (First,
purposeful sampling was applied, and
then more samples were identified
using the snowball method. This process
continued until data saturation.)
The identified themes were
“organizational divergence,” “invisible
wall,” and “overemphasis on theoretical
knowledge.” The most important
barriers impeding cooperation between
educational and clinical institutes are
ambiguities in the organizational
structure of institutes, responsibilities
of employees of each institute in
relation to others, overemphasis on
theoretical knowledge, and ignoring of
practical knowledge and clinical
performance of nurses. Development of
academic service partnership can be
facilitated by defining a formal
organizational relationship between
academic and service institutes,
clarifying roles and responsibilities of
each institute regarding clinical
education, defining clinical practice
roles for nursing faculty members, and
emphasizing the importance of nursing
clinical practice.
Swallow et al. (15)Pan-Britain, mixed-methods study of
multidisciplinary teams teaching
parents to manage children’s long-term
kidney conditions at home: Study
protocol
Purposeful sampling was applied
considering the child’s age, diagnosis,
ethnicity,and need for clinical care.
Snowball sampling was implemented to
identify staff members who were
involved in the care of the child.
It is essential to educate the parents on
long-term care for children at home. It is
also essential to understand that parents
of children with chronic renal diseases
need to receive specialized education.
Sasson et al. (16)A qualitative study to identify barriers to
local implementation of pre-hospital
termination of resuscitation protocols
First, a focus group was determined, and
then using snowball sampling, more
samples entered the study. Emergency
room doctors, paramedics, emergency
room authorities, and nurses were also
invited.
A method Focus group was used instead
of a response package to have a better
understanding of how emergency
systems manage resuscitation protocols
and which practical factors impede the
implementation of resuscitation
protocols.
Zaghloul and Alsokair (17)Constructing a nurse appraisal form: A
Delphi technique study
Delphi technique and snowball
sampling method
A standardized nurse appraisal form was
designed and implemented in the
hospitals of the eastern states of Saudi
Arabia, which are covered by health
organizations. The nurses’ ideas about
the appraisal form were used to
determine different aspects of a nurse’s
performance. In each hospital, the first
head nurse was introduced to other
head nurses to participate in the study.
This process continued until enough
head nurses and supervisors were
recruited.
Strides Dev Med Educ. 2017; 14(3):e67670. 5
Naderifar M et al.
Zareipour et al. (18)Effective factors on smoking based on
BASNEF model in male students in
Tehran Medical Sciences University in
2009
Snowball sampling method (The
researcher met a smoking person, and
after attaining oral consent, he was
asked to complete a questionnaire.
Then, he was asked to invite other
smoker friends to take part in the study.
The researcher recruited the samples
and collected the questionnaires.)
Based on this model, the importance of
normative, enabling, and observational
factors in smoking behaviors was
determined, and the need for
authorities’ attention was highlighted.
Improvement of social and life skills,
including resistance against peer
pressure (saying “no”), and of the sense
of responsibility and self-confidence in
the youth can be effective. The youth
smoke out of fear of humiliation and
shame. However, through building
confidence, they can influence their
peers.
Lagu et al. (19)Content of weblogs written by health
professionals
Modified snowball sampling method The domain and content of medical
weblogs were reviewed to determine
how much the writer of these posts had
revealed facts about the patient,
breached the doctor-patient
confidentiality,or outlined the
shortcomings of care for the patient. The
researchers defined medical weblogs as
web pages, which have medical content
and are written by healthcare
professionals. Weblogs are a developing
part of the medical profession’s public
face. In these weblogs, doctors and
nurses can share their opinions.
However, they can also jeopardize their
career by revealing confidential
information in their content.
Schreiber and MacDonald (20)Keeping vigil over the profession: A
grounded theory of the context of nurse
anesthesia practice
Purposeful and snowball sampling
methods
Management of registered anesthesia
nurses in different cultural-political
backgrounds of patient care was
studied. The grounded theory was used
to observe the performance of
registered and certified anesthetic
nurses. The grounded theory was used
to find procedures in different social
backgrounds. The grounded theory was
used since the researchers were
interested to show the process using
which the nurses performed their role.
Mishima et al. (21)Assistance in family health from the
perspective of users
Snowball sampling method (chain
sampling) according to the location of
the original interviewed group that met
the inclusion criteria
Family health services were evaluated
from the perspective of clients in San
Paolo and Riviera Porto, Brazil, in a wide
range of primary healthcare services
and specialized care services at different
levels.
Cataldo and Malone (22)False promises: The tobacco industry,
“low-tar” cigarettes, and older smokers
Snowball sampling The role of tobacco industries in
marketing and damage from tobacco
addiction were assessed among old
smokers and infants. The researcher
sought to find documents from the
tobacco industry,which was
unsuccessful.
Sadler et al. (9)Recruiting hard-to-reach United States
population sub-groups via adaptations
of snowball sampling strategy
Snowball sampling to recruit subgroups
that were not easily accessible
Variations of the snowball sampling
strategy can be applied in the
development of community-based
information, health education
programs, and research studies. This
strategy is effective in enlisting the
involvement of members from
vulnerable populations. These strategies
find individuals, who have the desired
characteristics, and use that person’s
social networks to recruit similar
subjects in a multi-stage process. This
semi-automatic process continues until
enough samples have been recruited.
6Strides Dev Med Educ. 2017; 14(3):e67670.
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The study was conducted with the aim to construct a unified nurse appraisal format to be used at hospitals performing under different healthcare organizations in the Eastern Province in the Kingdom of Saudi Arabia. The study included hospitals representing different healthcare organizations within the Eastern Province. The target population included Hospital head nurses and nurse supervisors and the snowball sampling technique was employed to select the panel subjects. The final draft resulted into the agreed upon performance dimensions which included namely; quality standards, work habits, supervision/leadership, staff relations and interpersonal skills, attendance and punctuality, problem solving, oral communication, productivity results, coordination, innovation, record keeping. Nurse managers have to continuously assess competence of practicing nurses to assure qualified and safe patient care. A nurse appraisal form was constructed concurrently with this study results and was proposed to be used at all Eastern Region hospitals. This study is considered an initial step for further efforts and studies to be conducted to reach both national and international nursing appraisal dimensions and unify them for the sake of best health promotion.
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Background & Aims: Smoking as a health risk behavior endangers not only the individual but also community health and is one of the preventable causes of death. This risk behavior is growing among educated young people. This study was aimed to investigate effective factors leading to smoking based on BASNEF Model in male students in Tehran Medical Sciences University in 2009. Materials & Methods: This descriptive analytical study was performed on 200 male students that were selected by snowball sampling method. The data were collected using a questionnaires based on BASNEF Model. The data were analyzed by Chi-square tests, and Pearson correlation coefficient. Results: The survey results showed that the most frequent causes of smoking were easy access to cigarettes (80%) and peers smoking (82%). Considering the attitude of the samples 33.5% had a positive, 19.5% neutral and 47% had a negative attitude toward smoking. There was a significant association between positive attitude to smoking and students’ years of study or parental education. There also was a significant relationship between age at onset of smoking with either parents or peers smoking. There was a relationship between low price cigarettes and the number of cigarettes smoked per day. The average number of cigarettes smoked per day and students age and cigar costs per month showed a positive correlation. Conclusion: The importance of attitudes, subjective norms, and factors affecting smoking are highlighted in the study and health officials must urge to pursue structural interventions to prevent them.
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Nurse researchers and educators often engage in outreach to narrowly defined populations. This article offers examples of how variations on the snowball sampling recruitment strategy can be applied in the creation of culturally appropriate, community-based information dissemination efforts related to recruitment to health education programs and research studies. Examples from the primary author's program of research are provided to demonstrate how adaptations of snowball sampling can be used effectively in the recruitment of members of traditionally underserved or vulnerable populations. The adaptation of snowball sampling techniques, as described in this article, helped the authors to gain access to each of the more-vulnerable population groups of interest. The use of culturally sensitive recruitment strategies is both appropriate and effective in enlisting the involvement of members of vulnerable populations. Adaptations of snowball sampling strategies should be considered when recruiting participants for education programs or for research studies when the recruitment of a population-based sample is not essential.