The Canterbury earthquake and aftershock sequence in New Zealand during 2010-2011 subjected the city’s structures to a significant accumulated cyclic demand and raised significant questions regarding the low-cycle fatigue demands imposed upon the structures. There is a significant challenge to quantify the level of cumulative demand imposed on structures and to assess the percentage of a structure's fatigue life that has been consumed as a result of this earthquake sequence. It is important to be able to quantify the cumulative demand to determine how a building will perform in a subsequent large earthquake and inform repair and re-occupancy decisions. This paper investigates the cumulative fatigue demand for a structure located within the Christchurch Central Business District (CBD). Time history analysis and equivalent cycle counting methods are applied across the Canterbury earthquake sequence, using key events from September 4th 2010 and February 22nd , 2011 main shocks. The estimate of the cumulative fatigue demand is then compared to the expected capacity of a case study reinforced concrete bridge pier, to undertake a structure-specific fatigue assessment. The analysis is undertaken to approximate the portion of the structural fatigue capacity that has been consumed, and how much residual capacity remains. Results are assessed for recordings at the four Christchurch central city strong motion recording sites installed by the GeoNet programme, to provide an estimate of variation in results. The computed cyclic demand results are compared to code-based design methods and as assessment of the inelastic displacement demand of the reinforcing steel. Results are also presented in a fragility context where a de minimis (inconsequential), irreparable damage and full fatigue fracture are defined to provide a probabilistic assessment of the fatigue damage incurred. This methodology can provide input into the overall assessment of fatigue demands and residual capacity.
The Christchurch memorial service, Japan's earthquake and tsunami, and compassion fatigue.
A video of a presentation by Jai Chung during the Staff and Patients Stream of the 2016 People in Disasters Conference. The presentation is titled, "A Systematic Review of Compassion Fatigue of Nurses During and After the Canterbury Earthquakes".The abstract for the presentation reads as follows: Limited research is currently available about compassion fatigue of health professionals during and after disasters in New Zealand. The purpose of this systematic literature review was to provide a comprehensive outline of existing research. National and international literature was compared and contrasted to determine the importance of recognising compassion fatigue during and after disasters. Health professionals responding to disasters have played an important role in saving lives. Especially, during and after the Canterbury earthquakes, many health professionals cared for the traumatized public of the region. When responding to and caring for many distressed people, health professionals - particularly nurses - may strongly empathise with people's pain, fear, and distress. Consequently, they can be affected both emotionally and physically. Nurses may experience intensive and extreme distress and trauma directly and indirectly. Physical exhaustion can arise quickly. Emotional exhaustion such as hopelessness and helplessness may lead to nurses losing the ability to nurture and care for people during disasters. This can lead to compassion fatigue. It is important to understand how health professionals, especially nurses, experience compassion fatigue in order to help them respond to disasters appropriately. International literature explains the importance of recognising compassion fatigue in nursing, and explores different coping mechanisms that assist nurses overcome or prevent this health problem. In contrast, New Zealand literature is limited to experiences of nurses' attitudes in responding to natural disasters. In light of this, this literature review will help to raise awareness about the importance of recognising and addressing symptoms of compassion fatigue in a profession such as nursing. Gaps within the research will also be identified along with recommendations for future research in this area, especially from a New Zealand perspective. Please note that due to a recording error the sound cuts out at 9 minutes.
Capacity design and hierarchy of strength philosophies at the base of modern seismic codes allow inelastic response in case of severe earthquakes and thus, in most traditional systems, damage develops at well-defined locations of reinforced concrete (RC) structures, known as plastic hinges. The 2010 and 2011 Christchurch earthquakes have demonstrated that this philosophy worked as expected. Plastic hinges formed in beams, in coupling beams and at the base of columns and walls. Structures were damaged permanently, but did not collapse. The 2010 and 2011 Christchurch earthquakes also highlighted a critical issue: the reparability of damaged buildings. No methodologies or techniques were available to estimate the level of subsequent earthquakes that RC buildings could still sustain before collapse. No repair techniques capable of restoring the initial condition of buildings were known. Finally, the cost-effectiveness of an eventual repair intervention, when compared with a new building, was unknown. These aspects, added to nuances of New Zealand building owners’ insurance coverage, encouraged the demolition of many buildings. Moreover, there was a perceived strong demand from government and industry to develop techniques for assessing damage to steel reinforcement bars embedded in cracked structural concrete elements. The most common questions were: “Have the steel bars been damaged in correspondence to the concrete cracks?”, “How much plastic deformation have the steel bars undergone?”, and “What is the residual strain capacity of the damaged bars?” Minimally invasive techniques capable of quantifying the level and extent of plastic deformation and residual strain capacity are not yet available. Although some studies had been recently conducted, a validated method is yet to be widely accepted. In this thesis, a least-invasive method for the damage-assessment of steel reinforcement is developed. Based on the information obtained from hardness testing and a single tensile test, it is possible to estimate the mechanical properties of earthquake-damaged rebars. The reduction in the low-cycle fatigue life due to strain ageing is also quantified. The proposed damage assessment methodology is based on empirical relationships between hardness and strain and residual strain capacity. If damage is suspected from in situ measurements, visual inspection or computer analysis, a bar may be removed and more accurate hardness measurements can be obtained using the lab-based Vickers hardness methodology. The Vickers hardness profile of damaged bars is then compared with calibration curves (Vickers hardness versus strain and residual strain capacity) previously developed for similar steel reinforcement bars extracted from undamaged locations. Experimental tests demonstrated that the time- and temperature-dependent strain-ageing phenomenon causes changes in the mechanical properties of plastically deformed steels. In particular, yield strength and hardness increases, whereas ductility decreases. The changes in mechanical properties are quantified and their implications on the hardness method are highlighted. Low-cycle fatigue (LCF) failures of steel reinforcing bars have been observed in laboratory testing and post-earthquake damage inspections. Often, failure might not occur during a first seismic event. However, damage is accumulated and the remaining fatigue life is reduced. Failure might therefore occur in a subsequent seismic event. Although numerous studies exist on the LCF behaviour of steel rebars, no studies had been conducted on the strain-ageing effects on the remaining fatigue life. In this thesis, the reduction in fatigue life due to this phenomenon is determined through a number of experimental tests.
One of the most controversial issues highlighted by the 2010-2011 Christchurch earthquake series and more recently the 2016 Kaikoura earthquake, has been the evident difficulty and lack of knowledge and guidelines for: a) evaluation of the residual capacity damaged buildings to sustain future aftershocks; b) selection and implementation of a series of reliable repairing techniques to bring back the structure to a condition substantially the same as prior to the earthquake; and c) predicting the cost (or cost-effectiveness) of such repair intervention, when compared to fully replacement costs while accounting for potential aftershocks in the near future. As a result of such complexity and uncertainty (i.e., risk), in combination with the possibility (unique in New Zealand when compared to most of the seismic-prone countries) to rely on financial support from the insurance companies, many modern buildings, in a number exceeding typical expectations from past experiences at an international level, have ended up being demolished. This has resulted in additional time and indirect losses prior to the full reconstruction, as well as in an increase in uncertainty on the actual relocation of the investment. This research project provides the main end-users and stakeholders (practitioner engineers, owners, local and government authorities, insurers, and regulatory agencies) with comprehensive evidence-based information to assess the residual capacity of damage reinforced concrete buildings, and to evaluate the feasibility of repairing techniques, in order to support their delicate decision-making process of repair vs. demolition or replacement. Literature review on effectiveness of epoxy injection repairs, as well as experimental tests on full-scale beam-column joints shows that repaired specimens have a reduced initial stiffness compared with the undamaged specimen, with no apparent strength reduction, sometimes exhibiting higher displacement ductility capacities. Although the bond between the steel and concrete is only partially restored, it still allows the repaired specimen to dissipate at least the same amount of hysteretic energy. Experimental tests on buildings subjected to earthquake loading demonstrate that even for severe damage levels, the ability of the epoxy injection to restore the initial stiffness of the structure is significant. Literature review on damage assessment and repair guidelines suggests that there is consensus within the international community that concrete elements with cracks less than 0.2 mm wide only require cosmetic repairs; epoxy injection repairs of cracks less and 2.0 mm wide and concrete patching of spalled cover concrete (i.e., minor to moderate damage) is an appropiate repair strategy; and for severe damaged components (e.g., cracks greater than 2.0 mm wide, crushing of the concrete core, buckling of the longitudinal reinforcement) local replacement of steel and/or concrete in addition to epoxy crack injection is more appropriate. In terms of expected cracking patterns, non-linear finite element investigations on well-designed reinforced concrete beam-to-column joints, have shown that lower number of cracks but with wider openings are expected to occur for larger compressive concrete strength, f’c, and lower reinforcement content, ρs. It was also observed that the tensile concrete strength, ft, strongly affects the expected cracking pattern in the beam-column joints, the latter being more uniformly distributed for lower ft values. Strain rate effects do not seem to play an important role on the cracking pattern. However, small variations in the cracking pattern were observed for low reinforcement content as it approaches to the minimum required as per NZS 3101:2006. Simple equations are proposed in this research project to relate the maximum and residual crack widths with the steel strain at peak displacement, with or without axial load. A literature review on fracture of reinforcing steel due to low-cycle fatigue, including recent research using steel manufactured per New Zealand standards is also presented. Experimental results describing the influence of the cyclic effect on the ultimate strain capacity of the steel are also discussed, and preliminary equations to account for that effect are proposed. A literature review on the current practice to assess the seismic residual capacity of structures is also presented. The various factors affecting the residual fatigue life at a component level (i.e., plastic hinge) of well-designed reinforced concrete frames are discussed, and equations to quantify each of them are proposed, as well as a methodology to incorporate them into a full displacement-based procedure for pre-earthquake and post-earthquake seismic assessment.
The assessment of damage and remaining capacity after an earthquake is an immediate measure to determine whether a reinforced concrete (RC) building is usable and safe for occupants. The recent Christchurch earthquake (22 February 2011) caused a uniquely severe level of structural damage to modern buildings, resulting in extensive damage to the building stock. About 60% of damaged multistorey concrete buildings (3 storeys and up) were demolished after the earthquake, and the cost of reconstruction amounted to 40 billion NZD. The aftermath disclosed issues of great complexities regarding the future of the RC buildings damaged by the earthquakes. This highlighted the importance of post-event decision-making, as the outcome will allow the appropriate course of action—demolition, repair or acceptance of the existing building—to be considered. To adopt the proper strategy, accurate assessment of the residual capacity and the level of damage is required. This doctoral dissertation aims to assess the damage and remaining capacity at constituent material and member level (i.e., concrete material and beams) through a systematic approach in an attempt to address part of an existing gap in the available literature. Since the residual capacity of RC members is not unique and depends on previously applied loading history, post-event residual capacity in this study was assessed in terms of fraction of fatigue life (i.e., the number of cycles required to failure). This research comprises three main parts: (1) residual capacity and damage assessment at material level (i.e., concrete), (2) post-yield bond deterioration and damage assessment at the interface of steel and concrete, and, finally, (3) residual capacity and damage assessment at member level (i.e., RC beam). The first part of this research focused on damage assessment and the remaining capacity of concrete from a material point of view. It aimed to employ appropriate and reliable durability-based testing and image-detection techniques to quantify deterioration in the mechanical properties of concrete on the basis that stress-induced damage occurred in the microstructural system of the concrete material. To this end, in the first phase, a feasibility study was conducted in which a combination of oxygen permeability, electrical resistivity and porosity tests were assessed to determine if they were robust and reliable enough to reveal damage which occurred in the microstructural system of concrete. The results, in terms of change in permeability, electrical resistivity and porosity features of disk samples taken from the middle third of damaged concrete cylinders (200 mm × 100 mm) monotonically pre-loaded to 50%, 70%, 90% and 95% of the ultimate strength (f′c), showed the permeability test is a reliable tool to identify the degree of damage, due to its high sensitivity to the load-induced microcracking. In parallel, to determine the residual capacity, the companion damaged concrete cylinders already loaded to the same level of compressive strength were reloaded up to failure. Comparing the stress–strain relationship of damaged concrete with intact material, it was also found that the strain capacity of the reloaded pre-damaged concrete cylinders decreases while strength remained virtually unchanged. In the second phase of the first part, a fluorescent microscopy technique was used to assess the damage and develop a correlation between material degradation, by virtue of the geometrical features, and damage to the concrete. To account for the effect of confinement and cyclic loading, in the third phase, the residual capacity and damage assessment of unconfined and GFRP confined concrete cylinders subjected to low-cycle fatigue loading, was investigated. Similar to the first phase, permeability testing technique was used to provide an indirect evaluation of fatigue damage. Finally, in the fourth phase of the first part, the suitability of permeability testing technique to assess damage was evaluated for cored concrete taken from three types of RC members: columns, beams and a beam-column joint. In view of the fact that the composite action of an RC member is highly dependent on the bond between reinforcement and surrounding concrete, understanding the deterioration of the bond in the post-yield range of strain in steel was crucial to assess damage at member level. Therefore, in the second phase of this research, a state-of-the- art distributed fibre optic strain sensor system (DFOSSS) system was used to evaluate bond deterioration in a cantilever RC beam subjected to monotonic lateral loading. The technology allowed the continuous capture of strain, every 2.6 mm along the length, in both reinforcing bars and cover concrete. The strain profile provided a basis by which the slip, axial stress and bond stress distributions were then established. In the third part, the study focused on the damage assessment and residual capacity of seven half-scale RC beams subjected to a constant-amplitude cyclic loading protocol. In the first stage, the structural performances of three specimens under constant-amplitude fatigue at 1%, 2% and 4% chord rotation (drift) were examined. In parallel, the number of cycles to failure, degradation in strength, stiffness and energy dissipation were characterized. In the second stage, four RC beams were subjected to loading up to 70% and 90% of their fatigue life, at 2% and 4% drift, and then monotonically pulled up to failure. To determine the residual flexural capacity, the lateral force–displacement results of pre-damaged specimens were compared with an undamaged specimen subjected to only monotonic loading. The study showed significant losses in strength, deformability, stiffness and energy dissipation capacity. A nonlinear finite element analysis (FEA) using concrete damage plasticity (CDP) model was also conducted in ABAQUS to numerically investigate the behaviour of the tested specimen. The results of the FE simulations indicated a reasonable response compared with the behaviour of the test specimen in terms of force–displacement and cracking pattern. During the Christchurch earthquake it was observed that the loading history has a significant influence on structural responses. While in conventional pseudo-static loading protocol, internal forces can be redistributed along the plastic length: there is little chance for structures undergoing high initial loading amplitude to redistribute pertinent stresses. As a result, in the third phase of this part, the effect of high rate of loading on the behaviour of seismically designed RC beams was investigated. Two half-scale cantilever RC beams were subjected to similar constant-amplitude cyclic loading at 2% and 4% drifts, but at a rate of 500 mm/s. Due to the incapability of conventional measuring techniques, a motion-tracking system was employed for data acquisition with the high-speed tests. The effect of rate of loading on the fatigue life of specimens (i.e., the number of cycles required to failure), secant stiffness, failure mode, cracking pattern, beam elongations and bar fracture surface were analysed. Integrating the results of all parts of this research has resulted in a better understanding of residual capacity and the development of damage at both the material and member level by using a low-cycle fatigue approach.
Reinforced concrete buildings that satisfied modern seismic design criteria generally behaved as expected during the recent Canterbury and Kaikoura earthquakes in New Zealand, forming plastic hinges in intended locations. While this meant that life-safety performance objectives were met, widespread demolition and heavy economic losses took place in the aftermath of the earthquakes.The Christchurch central business district was particularly hard hit, with over 60% of the multistorey reinforced concrete buildings being demolished. A lack of knowledge on the post-earthquake residual capacity of reinforced concrete buildings was a contributing factor to the mass demolition.Many aspects related to the assessment of earthquake-damaged reinforced concrete buildings require further research. This thesis focusses on improving the state of knowledge on the post earthquakeresidual capacity and reparability of moderately damaged plastic hinges, with an emphasis on plastic hinges typical of modern moment frame structures. The repair method focussed on is epoxy injection of cracks and patching of spalled concrete. A targeted test program on seventeen nominally identical large-scale ductile reinforced concrete beams, three of which were repaired by epoxy injection following initial damaging loadings, was conducted to support these objectives. Test variables included the loading protocol, the loading rate, and the level of restraint to axial elongation.The information that can be gleaned from post-earthquake damage surveys is investigated. It is shown that residual crack widths are dependent on residual deformations, and are not necessarily indicative of the maximum rotation demands or the plastic hinge residual capacity. The implications of various other types of damage typical of beam and column plastic hinges are also discussed.Experimental data are used to demonstrate that the strength and deformation capacity of plastic hinges with modern seismic detailing are often unreduced as a result of moderate earthquake induced damage, albeit with certain exceptions. Special attention is given to the effects of prior yielding of the longitudinal reinforcement, accounting for the low-cycle fatigue and strain ageing phenomena. A material-level testing program on the low-cycle fatigue behaviour of grade 300E reinforcing steel was conducted to supplement the data available in the literature.A reduction in stiffness, relative to the initial secant stiffness to yield, occurs due to moderate plastic hinging damage. This reduction in stiffness is shown to be correlated with the ductility demand,and a proposed model gives a conservative lower-bound estimate of the residual stiffness following an arbitrary earthquake-type loading. Repair by epoxy injection is shown to be effective in restoring the majority of stiffness to plastic hinges in beams. Epoxy injection is also shown to have implications for the residual strength and elongation characteristics of repaired plastic hinges.
The objective of this study is to examine the influence of near-fault motions on liquefaction triggering in Christchurch and neighboring towns during the 2010-2011 Canterbury earthquake sequence (CES). The CES began with the 4 September 2010, Mw7.1 Darfield earthquake and included up to ten events that triggered liquefaction. However, most notably, widespread liquefaction was induced by the Darfield earthquake and the Mw6.2, 22 February 2011 Christchurch earthquake. Of particular relevance to this study is the forward directivity effects that were prevalent in the motions recorded during the Darfield earthquake, and to a much lesser extent, during the Christchurch earthquake. A 2D variant of the Richart-Newmark fatigue theory was used to compute the equivalent number of cycles (neq) for the ground motions, where volumetric strain was used as the damage metric. This study is unique because it considers the contribution and phasing of both the fault-normal and fault-parallel components of motion on neq and the magnitude scaling factor (MSF). It was found that when the fault-normal and fault-parallel motions were treated individually, the former yielded a lower neq than the latter. Additionally, when the combined effects of fault-normal and fault-parallel components were considered, it was found that the MSF were higher than those commonly used. This implies that motions containing near-fault effects are less demanding on the soil than motions that do not. This may be one of several factors that resulted in less severe liquefaction occurring during the Darfield earthquake than the Christchurch earthquake.
A video of a presentation by Garry Williams during the fourth plenary of the 2016 People in Disasters Conference. Williams is the Programme Manager of the Ministry of Education's Greater Christchurch Education Renewal Programme. The presentation is titled, "Education Renewal: A section response to the February 2011 Christchurch earthquake".The abstract for this presentation reads as follows: The Canterbury earthquakes caused a disaster recovery situation unparalleled in New Zealand's history. In addition to widespread damage to residential dwellings and destruction of Christchurch's central business district, the earthquakes damaged more than 200 schools from Hurunui in the north, to the Mackenzie District in the east, and Timaru in the south. The impact on education provision was substantial, with the majority of early childhood centres, schools and tertiary providers experiencing damage or subsequent, with the majority of early childhood centres, schools and tertiary providers experiencing damage or subsequent operational issues caused by the ensuing migration of people. Following the February earthquake, over 12,000 students had left the school they had been attending and enrolled elsewhere - often at a school outside the region. Shortened school days and compression of teaching into short periods meant shift-sharing students engaged in the curriculum being delivered in more diverse ways. School principals and staff reported increased fatigue and stress and changes in student behaviours, often related to repeated exposure to and ongoing reminders of the trauma of the earthquakes. While there has been a shift from direct, trauma-related presentations to the indirect effects of psychological adversity and daily life stresses, international experiences tells us that psychological recovery generally lags behind the immediate physical recovery and rebuilding. The Ministries of Health and Education and the Canterbury District Health Board have developed and implemented a joint action plan to address specifically the emerging mental health issues for youth in Canterbury. However, the impact of vulnerable and stressed adults on children's behaviour contributes to the overall impact of ongoing wellbeing issues on the educational outcomes for the community. There is substantial evidence supporting the need to focus on adults' resilience so they can support children and youth. Much of the Ministry's work around supporting children under stress is through supporting the adults responsible for teaching them and leading their schools. The education renewal programme exists to assist education communities to rebuild and look toward renewal. The response to the earthquakes provides a significant opportunity to better meet the needs and aspirations of children and youth people. All the parents want to see their children eager to learn, achieving success, and gaining knowledge and skills that will, in time, enable them to become confident, adaptable, economically independent adults. But this is not always the case, hence our approach to education renewal seeks to address inequities and improve outcome, while prioritising actions that will have a positive impact on learners in greatest need of assistance.
Background The 2010/2011 Canterbury earthquakes and aftershocks in New Zealand caused unprecedented destruction to the physical, social, economic, and community fabric of Christchurch city. The recovery phase in Christchurch is on going, six years following the initial earthquake. Research exploring how disabled populations experience community inclusion in the longer-term recovery following natural disasters is scant. Yet such information is vital to ensure that recovering communities are inclusive for all members of the affected population. This thesis specifically examined how people who use wheelchairs experienced community inclusion four years following the 2010/2011 Canterbury earthquakes. Aims The primary research aim was to understand how one section of the disability community – people who use wheelchairs – experienced community inclusion over the four years following the 2010/2011 Canterbury earthquakes and aftershocks. A secondary aim was to test a novel sampling approach, Respondent Driven Sampling, which had the potential to enable unbiased population-based estimates. This was motivated by the lack of an available sampling frame for the target population, which would inhibit recruitment of a representative sample. Methodology and methods An exploratory sequential mixed methods design was used, beginning with a qualitative phase (Phase One), which informed a second quantitative phase (Phase Two). The qualitative phase had two stages. First, a small sample of people who use wheelchairs participated in an individual, semi-structured interview. In the second stage, these participants were then invited to a group interview to clarify and prioritise themes identified in the individual interviews. The quantitative phase was a cross-sectional survey developed from the findings from Phase One. Initially, Respondent Driven Sampling was employed to conduct a national, electronic cross-sectional survey that aimed to recruit a sample that may provide unbiased population-based estimates. Following the unsuccessful application of Respondent Driven Sampling, a region-specific convenience sampling approach was used. The datasets from the qualitative and quantitative phases were integrated to address the primary aim of the research. Results In Phase One 13 participants completed the individual interviews, and five of them contributed to the group interview. Thematic analysis of individual and group interview data suggested that participants felt the 2010/11 earthquakes magnified many pre-existing barriers to community inclusion, and also created an exciting opportunity for change. This finding was encapsulated in five themes: 1) earthquakes magnified barriers, 2) community inclusion requires energy, 3) social connections are important, 4) an opportunity lost, and 5) an opportunity found. The findings from Phase One informed the development of a survey instrument to investigate how these findings generalised to a larger sample of individuals who use wheelchairs. In Phase Two, the Respondent Driven Sampling approach failed to recruit enough participants to satisfy the statistical requirements needed to reach equilibrium, thereby enabling the calculation of unbiased population estimates. The subsequent convenience sampling approach recruited 49 participants who, combined with the 15 participants from the Respondent Driven Sampling approach that remained eligible for the region-specific sample, resulted in the total of 64 individuals who used wheelchairs and were residents of Christchurch. Participants reported their level of community inclusion at three time periods: the six months prior to the first earthquake in September 2010 (time one), the six months following the first earthquake in September 2010 (time two), and the six months prior to survey completion (between October 2015 and March 2016, (time three)). Survey data provided some precision regarding the timing in which the magnified barriers developed. Difficulty with community inclusion rose significantly between time one and time two, and while reducing slightly, was still present during time three, and had not returned to the time one baseline. The integrated findings from Phase One and Phase Two suggested that magnified barriers to community inclusion had been sustained four years post-earthquake, and community access had not returned to pre-earthquake levels, let alone improved beyond pre-earthquake levels. Conclusion Findings from this mixed methods study suggest that four years following the initial earthquake, participants were still experiencing multiple magnified barriers, which contributed to physical and social exclusion, as well as fatigue, as participants relied on individual agency to negotiate such barriers. Participants also highlighted the exciting opportunity to create an accessible city. However because they were still experiencing barriers four years following the initial event, and were concerned that this opportunity might be lost if the recovery proceeds without commitment and awareness from the numerous stakeholders involved in guiding the recovery. To truly realise the opportunity to create an accessible city following a disaster, the transition from the response phase to a sustainable longer-term recovery must adopt a new model of community engagement where decision-makers partner with people living with disability to co-produce a vision and strategy for creating an inclusive community. Furthermore, despite the unsuccessful use of Respondent Driven Sampling in this study, future research exploring the application of RDS with wheelchair users is recommended before discounting this sampling approach in this population.
