LGBTQ+ Voices in Evaluation TIG Week: Reaching Rural LGBTQ+ Communities: Lessons from a Montana PrEP Needs Assessment by McKenzie Javorka, Patrick Boise, and Kaitlin Fertaly

Date: Wednesday, December 24, 2025

Hello! We’re McKenzie Javorka, Patrick Boise, and Kaitlin Fertaly, evaluators at the University of Montana’s Rural Institute for Inclusive Communities.

Montana has major gaps in pre-exposure prophylaxis (PrEP) uptake among people who could benefit from it, especially men and people assigned male at birth (AMAB) who have sex with men/AMAB individuals. To understand why, we partnered with our state public health department to conduct a statewide PrEP needs assessment.

Lessons Learned

We’ve done plenty of needs assessments in Montana, but this one challenged us in new ways, especially when it came to recruiting participants.

Our original plan was straightforward: run a statewide online survey, then invite a subsample of respondents to do follow-up interviews. Given Montana’s size and rurality, an online survey seemed like the most efficient and affordable option. But soon after launching, our survey was flooded with bots and fake responses. Sorting through what was real versus fake or invalid became a major task.

Even the next step, inviting survey participants to follow-up interviews, was tricky. Some scammers went as far as completing phone interviews with false information to earn incentives. It quickly became clear we needed a new approach.

We pivoted and instead began recruiting through community-based organizations, health clinics, and word-of-mouth networks. We distributed flyers, partnered with trusted LGBTQ+ and harm reduction groups, and tabled at a drag show to connect directly with potential participants. It took longer than expected and skewed more urban than we hoped, but these efforts finally got us the participation we needed.

Hot Tips

• Expect bots, AI, and scammers in online surveys. We built in checks like requiring a valid Montana zip code and logic questions, but they weren’t enough. AI-generated and falsified responses can easily slip through. In the end, we had to apply multiple filters after data collection and still had lingering concerns about data validity.
• Be cautious about advertising incentives. Incentives can help with recruitment but publicizing them online can also attract bots and scammers. If you must mention them, consider mailing physical incentives (which require a real address in the study area) or using verification systems before sending digital rewards.
• Partner with trusted organizations and “study champions.” Our most effective recruitment came through LGBTQ+ and harm reduction organizations that directly shared our study with clients. We also relied on highly connected community members who spread the word through social media and personal networks. However, these tactics may not be the most effective for reaching people in the most remote areas or those who aren’t openly LGBTQ+.
• Offer flexible participation options. There is no one-size-fits-all approach for interviewing – different groups prefer different formats. For example, people who use injection drugs were easiest to reach in person at harm reduction sites, while most other participants preferred scheduled Zoom or phone interviews. Flexibility helped us meet people where they were, literally and figuratively.

Despite the bumps along the way, we ultimately met our study goals by staying persistent, flexible, and community-centered. However, reaching LGBTQ+ participants in rural areas may take more time- and resource-intensive methods, such as traveling to recruit at in-person events or building relationships with trusted community gatekeepers. These methods were beyond our budget and timeframe for the current PrEP needs assessment; however, we now know to plan for more intensive outreach in future projects focused on rural LGBTQ+ populations.

What strategies have worked for you in reaching LGBTQ+ people in rural areas? We’d love to hear your thoughts in the comments!

The American Evaluation Association is hosting LGBTQ+ Voices in Evaluation TIG Week with our colleagues in the LGBTQ+ Voices in Evaluation Topical Interest Group. The contributions all this week to AEA365 come from our LGBTQ+ Voices in Evaluation TIG members. Do you have questions, concerns, kudos, or content to extend this AEA365 contribution? Please add them in the comments section for this post on the AEA365 webpage so that we may enrich our community of practice. Would you like to submit an AEA365 Tip? Please send a note of interest to AEA365@eval.org. AEA365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators. The views and opinions expressed on the AEA365 blog are solely those of the original authors and other contributors. These views and opinions do not necessarily represent those of the American Evaluation Association, and/or any/all contributors to this site.