1
|
Nabe-Nielsen K, Garde AH, Gyntelberg F, Hansen ÅM, Prescott E, Laursen P, Holtermann A. Effects of Occupational and Leisure-Time Physical Activity on the Risk of Dementia: Results From the Copenhagen City Heart Study. Scand J Med Sci Sports 2024; 34:e14730. [PMID: 39318056 DOI: 10.1111/sms.14730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/30/2024] [Accepted: 09/02/2024] [Indexed: 09/26/2024]
Abstract
Leisure-time physical activity (LTPA) decreases the risk of dementia, whereas occupational physical activity (OPA) possibly increases the risk. Yet, previous findings are mixed. We therefore aimed to investigate the effect of LTPA and OPA, respectively, on dementia among men and women. In this observational, longitudinal study, we used data from the second wave of a population-based cohort from the municipality of Copenhagen as baseline. Data were collected in 1981-1983, and 10 343 participants were followed until the end of 2016. LTPA and OPA were self-reported, and information on dementia diagnoses and redemption of dementia medication was obtained at an individual level from national health registers. We used Poisson regression to analyze the association between LTPA/OPA and dementia and adjusted for self-reported age, socioeconomic factors, stress, and cardiovascular risk factors (smoking, alcohol, body mass index, and blood pressure). A higher level of LTPA was associated with a lower dementia risk among men, but we found no clear association among women. OPA and dementia were not associated among men, but occupationally active women who reported OPA in terms of walking, lifting, and heavy work had a higher risk of dementia than women with sedentary jobs. This study supported earlier findings of a protective effect of LTPA on dementia among men. Women in physically demanding jobs possibly have a higher risk of dementia, yet this finding warrants further investigation in future studies.
Collapse
Affiliation(s)
- K Nabe-Nielsen
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - A H Garde
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - F Gyntelberg
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - Å M Hansen
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - E Prescott
- Department of Cardiology, Bispebjerg Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - P Laursen
- Copenhagen City Heart Study, Bispebjerg Hospital, Copenhagen, Denmark
| | - A Holtermann
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| |
Collapse
|
2
|
Stolz E, Schultz A, Zuschnegg J, Großschädl F, Dorner TE, Roller-Wirnsberger R, Freidl W. Disability during the last ten years of life: evidence from a register-based study in Austria. Eur J Ageing 2024; 21:28. [PMID: 39340589 DOI: 10.1007/s10433-024-00823-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
Analyses of late-life disability based on survey data of the oldest old often suffer from non-representative samples due to selective participation and attrition. Here, we use register data on the Austrian long-term care allowance (ALTCA) as a proxy for late-life disability. In this retrospective mortality follow-back study, we analyze receipt of ALTCA, a universal cash benefit based on physician-assessed disability in activities of daily living during the last 10 years of life, among all decedents aged 65 years and over from 2020 in Austria (n = 76,781) and its association with sex, age at death, and underlying cause of death. We find that on average, ALTCA was received for 3.5 and 5.3 years in men and women. At 10 years before death, 10% of men and 25% of women received ALTCA, which increased to 56% and 77% at one year before death. Both the probability and duration of ALTCA increased with age at death and varied by cause of death: Those who died from cancer, myocardial infarction, and external causes of death were less likely to receive ALTCA and for shorter durations, while those who died from dementia, Parkinson's disease, chronic heart disease, or chronic lung disease were more likely to receive it and longer so. Overall, our register-based estimates of the prevalence of late-life disability were higher than previous survey-based estimates. Policy-makers should be aware that costs of long-term care will rise as life expectancy rises and deaths from dementia and chronic heart disease will likely increase in the rapidly aging European societies.
Collapse
Affiliation(s)
- Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.
| | - Anna Schultz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Julia Zuschnegg
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | | | - Thomas E Dorner
- Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
| | | | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| |
Collapse
|
3
|
Boekhout JM, Hut R, Lechner L, Peels DA. " I Don't Believe in Age; I Believe in Staying Enthusiastic": An Exploratory Qualitative Study into Recruitment Strategies Stimulating Middle-Aged and Older Adults to Join Physical Activity Interventions. Geriatrics (Basel) 2024; 9:80. [PMID: 38920436 PMCID: PMC11202473 DOI: 10.3390/geriatrics9030080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
Many middle-aged and older adults (MAOAs) do not engage in sufficient physical activity (PA), despite its well-documented benefits for healthy aging. Existing PA interventions often fail to reach or engage the target population effectively. This study investigates MAOAs' preferences for recruitment strategies to optimize the reach and uptake of PA interventions, thereby enhancing their impact on healthy aging and public health. Qualitative interviews were conducted with 39 MAOA participants (69% female, mean age = 69.46, SD = 7.07), guided by McGuire's Theory on Persuasive Communication. Factors related to the source, message content, channel, receiver characteristics and target behavior of recruitment strategies were analyzed. Our findings suggest a preference for trustworthy sources (e.g., healthcare professionals over commercial entities) and positive, non-ageist messaging. MAOAs vary in their channel preferences but emphasize the importance of personalization. Despite heterogeneity, MAOAs commonly perceive themselves as sufficiently active, indicating a need for improved knowledge on what constitutes sufficient PA, as well as easy enrollment or trying out interventions. Tailoring recruitment strategies to diverse MAOA segments based on age seems crucial for effective engagement. Future research could explore quantitative research into how communication factors relate to various target population characteristics.
Collapse
Affiliation(s)
- Janet M. Boekhout
- Department of Health Psychology, Faculty of Psychology, Open University of The Netherlands, 6401 DL Heerlen, The Netherlands; (R.H.); (L.L.); (D.A.P.)
| | | | | | | |
Collapse
|
4
|
Radley A, Lees JS, Stevens KI. Cardiovascular disease in older women with CKD. Clin Kidney J 2023; 16:2304-2308. [PMID: 38046012 PMCID: PMC10689181 DOI: 10.1093/ckj/sfad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 12/05/2023] Open
Affiliation(s)
- Alice Radley
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Jennifer S Lees
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Kate I Stevens
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| |
Collapse
|
5
|
Fuchs J, Gaertner B, Perlitz H, Kuttig T, Klingner A, Baumert J, Hüther A, Kuhnert R, Wolff J, Scheidt-Nave C. Study on Health of Older People in Germany (Gesundheit 65+): objectives, design and implementation. JOURNAL OF HEALTH MONITORING 2023; 8:61-83. [PMID: 37829118 PMCID: PMC10565879 DOI: 10.25646/11666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/07/2023] [Indexed: 10/14/2023]
Abstract
Background The longitudinal population-based study Gesundheit 65+ aimed to close data gaps on health and well-being of older adults in Germany in times of the COVID-19 pandemic. Methods The target population comprised persons 65 years and older permanently residing in Germany and with sufficient German language skills. Proxy interviews were possible and consent from legal representatives was obtained as necessary in order to enable participation of physically or cognitively impaired persons. A two-stage sampling process, was used to draw 128 primary sample points (PSUs) and within these PSUs sex- and age-stratified random samples were drawn from population registries. A mixed-mode design was applied to contact the study population and for data collection. Data were collected between June 2021 and April 2023. Participants were surveyed a total of four times at intervals of four months. At month 12 participants were offered a home visit including a non-invasive examination. Data on all-cause mortality and information on neighborhood social and built environment as well as health insurance data will be linked to primarily collected data at the individual level. Discussion Results will inform health politicians and other stakeholders in the care system on health and health care needs of older people in Germany.
Collapse
Affiliation(s)
- Judith Fuchs
- Corresponding author Dr Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Chatzi G, Whittaker W, Chandola T, Mason T, Soiland-Reyes C, Sutton M, Bower P. Could diabetes prevention programmes result in the widening of sociodemographic inequalities in type 2 diabetes? Comparison of survey and administrative data for England. J Epidemiol Community Health 2023; 77:565-570. [PMID: 37353312 PMCID: PMC10423529 DOI: 10.1136/jech-2022-219654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 05/16/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND The NHS Diabetes Prevention Programme (DPP) in England is a behavioural intervention for preventing type 2 diabetes mellitus (T2DM) among people with non-diabetic hyperglycaemia (NDH). How this programme affects inequalities by age, sex, limiting illnesses or disability, ethnicity or deprivation is not known. METHODS We used multinomial and binary logistic regression models to compare whether the population with NDH at different stages of the programme are representative of the population with NDH: stages include (1) prevalence of NDH (using survey data from UK Household Longitudinal Study (n=794) and Health Survey for England (n=1383)); (2) identification in primary care and offer of programme (using administrative data from the National Diabetes Audit (n=1 267 350)) and (3) programme participation (using programme provider records (n=98 024)). RESULTS Predicted probabilities drawn from the regressions with demographics as each outcome and dataset identifier as predictors showed that younger adults (aged under 40) (4% of the population with NDH (95% CI 2.4% to 6.5%)) and older adults (aged 80 and above) (12% (95% CI 9.5% to 14.2%)) were slightly under-represented among programme participants (2% (95% CI 1.8% to 2.2%) and 8% (95% CI 7.8% to 8.2%) of programme participants, respectively). People living in deprived areas were under-represented in eight sessions (14% (95% CI 13.7% to 14.4%) vs 20% (95% CI 16.4% to 23.6%) in the general population). Ethnic minorities were over-represented among offers (35% (95% CI 35.1% to 35.6%) vs 13% (95% CI 9.1% to 16.4%) in general population), though the proportion dropped at the programme completion stage (19% (95% CI 18.5% to 19.5%)). CONCLUSION The DPP has the potential to reduce ethnic inequalities, but may widen socioeconomic, age and limiting illness or disability-related inequalities in T2DM. While ethnic minority groups are over-represented at the identification and offer stages, efforts are required to support completion of the programme. Programme providers should target under-represented groups to ensure equitable access and narrow inequalities in T2DM.
Collapse
Affiliation(s)
- Georgia Chatzi
- Cathie Marsh Institute for Social Research, Department of Social Statistics, School of Social Sciences, The University of Manchester, Manchester, UK
| | - William Whittaker
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Tarani Chandola
- Cathie Marsh Institute for Social Research, Department of Social Statistics, School of Social Sciences, The University of Manchester, Manchester, UK
- Faculty of Social Sciences, HKU, Hong Kong, Hong Kong
| | - Thomas Mason
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Claudia Soiland-Reyes
- Research and Innovation Department, Northern Care Alliance NHS Foundation Trust, Salford, UK
- North West Ambulance Service NHS Trust, Bolton, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics, Centre for Primary Care and Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - Peter Bower
- Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK
| |
Collapse
|
7
|
Gaertner B, Scheidt-Nave C, Koschollek C, Fuchs J. Health status of the old and very old people in Germany: results of the Gesundheit 65+ study. JOURNAL OF HEALTH MONITORING 2023; 8:7-29. [PMID: 37829119 PMCID: PMC10565703 DOI: 10.25646/11663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/12/2023] [Indexed: 10/14/2023]
Abstract
Background The demographic change makes comprehensive health reporting on health at older age an important topic. Methods Gesundheit 65+ is a longitudinal epidemiological study on the health status of persons aged 65 and older in Germany. Based on a two-stage stratified random sample from 128 local population registers, 3,694 persons participated in the baseline survey between June 2021 and April 2022 (47.9 % women, mean age 78.8 years). Weighted prevalences for 19 indicators of the baseline survey are presented overall and by age, sex, education and region of residence. Results Overall, 52.0 % of all participants of the baseline survey reported to be in good or very good health, and 78.5 % reported high or very high satisfaction with their life. This was in contrast to the large number of health/functional limitations whose prevalences ranged from 5.3 % for severe visual limitations to 69.2 % for multimorbidity. The health status of women was clearly worse than that of men, and the health status of persons aged 80 and older was worse than between 65 and 79 years of age. There was a clear educational gradient evident in the health status, but there were no differences between West and East Germany. Conclusions Gesundheit 65+ provides a comprehensive database for description of the health status of old and very old people in Germany, on the basis of which recommendations for action for policy and practice can be derived.
Collapse
Affiliation(s)
- Beate Gaertner
- Robert Koch Institute, Berlin, Germany Department of Epidemiology and Health Monitoring
| | | | | | | |
Collapse
|
8
|
Platt JR, Todd OM, Hall P, Craig Z, Quyn A, Seymour M, Braun M, Roodhart J, Punt C, Christou N, Taieb J, Karoui M, Brown J, Cairns DA, Morton D, Gilbert A, Seligmann JF. FOxTROT2: innovative trial design to evaluate the role of neoadjuvant chemotherapy for treating locally advanced colon cancer in older adults or those with frailty. ESMO Open 2023; 8:100642. [PMID: 36549127 PMCID: PMC9800329 DOI: 10.1016/j.esmoop.2022.100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 12/24/2022] Open
Abstract
Treating older adults with cancer is increasingly important in modern oncology practice. However, we currently lack the high-quality evidence needed to guide optimal management of this heterogeneous group. Principally, historic under-recruitment of older adults to clinical trials limits our understanding of how existing evidence can be applied to this group. Such uncertainty is particularly prevalent in the management of colon cancer (CC). With CC being most common in older adults, many patients also suffer from frailty, which is recognised as being strongly associated with poor clinical outcomes. Conducting clinical trials in older adults presents several major challenges, many of which impact the clinical relevance of results to a real-world population. When considering this heterogeneous group, it may be difficult to define the target population, recruit participants effectively, choose an appropriate trial design, and ensure participants remain engaged with the trial during follow-up. Furthermore, after overcoming these challenges, clinical trials tend to enrol highly selected patient cohorts that comprise only the fittest older patients, which are not representative of the wider population. FOxTROT1 was the first phase III randomised controlled trial to illustrate the benefit of neoadjuvant chemotherapy (NAC) in the treatment of CC. Patients receiving NAC had greater 2-year disease-free survival compared to those proceeding straight to surgery. Outcomes for older adults in FOxTROT1 were similarly impressive when compared to their younger counterparts. Yet, this group inevitably represents a fitter subgroup of the older patient population. FOxTROT2 has been designed to investigate NAC in a full range of older adults with CC, including those with frailty. In this review, we describe the key challenges to conducting a robust clinical trial in this heterogeneous patient group, highlight our strategies for overcoming these challenges in FOxTROT2, and explain how we hope to provide clarity on the optimal treatment of CC in older adults.
Collapse
Affiliation(s)
- J R Platt
- Department of Oncology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds. https://twitter.com/Jplatt_19
| | - O M Todd
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds. https://twitter.com/ToddOly
| | - P Hall
- University of Edinburgh Cancer Research Centre, Edinburgh
| | - Z Craig
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds
| | - A Quyn
- The John Goligher Colorectal Surgery Unit, St James's University Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds
| | - M Seymour
- Department of Oncology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds
| | - M Braun
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester; School of Medical Sciences, University of Manchester, Manchester, UK
| | - J Roodhart
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht
| | - C Punt
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - N Christou
- Department of Digestive Surgery, University Hospital of Limoges, Limoges. https://twitter.com/CNikinc
| | - J Taieb
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance publique-Hôpitaux de Paris, Sorbonne Paris Cité, University Paris-Cité (Paris Descartes), Paris
| | - M Karoui
- Department of Digestive and Oncological Surgery, Georges Pompidou European Hospital, Assistance publique-Hôpitaux de Paris, Paris Cité University, Paris, France
| | - J Brown
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds
| | - D A Cairns
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds. https://twitter.com/kennycairns
| | - D Morton
- Institute of Cancer and Genomic Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - A Gilbert
- Department of Oncology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds
| | - J F Seligmann
- Department of Oncology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds.
| |
Collapse
|
9
|
Fuchs J, Gaertner B, Rommel A, Starker A. Informal caregivers in Germany - who are they and which risks and resources do they have? Front Public Health 2023; 11:1058517. [PMID: 36875417 PMCID: PMC9978811 DOI: 10.3389/fpubh.2023.1058517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Abstract
Background The aim of this study is to describe the social characteristics, the health and living situation and the prevalence of behavioral risk factors of adult informal caregivers compared to non-caregivers in Germany. Methods We used data from the German Health Update (GEDA 2019/2020-EHIS survey) which is a cross-sectional population-based health interview survey conducted between 04/2019 and 09/2020. The sample comprised 22,646 adults living in private households. Three mutually exclusive groups of providing informal care or assistance were differentiated: intense caregivers (informal care ≥10 h/week), less-intense caregivers (informal care<10 h/week) and non-caregivers. For the three groups weighted prevalences of social characteristics, health status (self-perceived health, health-related activity limitations, chronic diseases, low back disorder or other chronic back defect, depressive symptoms), behavioral risk factors (at-risk drinking, current smoking, insufficient physical activity, non-daily fruit and vegetable consumption, obesity) and social risk factors (single household, low social support) were calculated and stratified by gender. Separate regression analyses adjusted for age-group were conducted to identify significant differences between intense and less-intense caregivers vs. non-caregivers, respectively. Results Overall, 6.5% were intense caregivers, 15.2% less-intense caregivers and 78.3% non-caregivers. Women provided care more often (23.9%) than men (19.3%). Informal care was most frequently provided in the age group of 45 to 64 years. Intense caregivers reported worse health status, were more often current smokers, physical inactive, obese and lived less often alone than non-caregivers. However, in age-group adjusted regression analyses only few significant differences were seen: Female and male intense caregivers had more often a low back disorder and lived less often alone compared to non-caregivers. In addition, male intense care-givers reported more often worse self-perceived health, health-related activity limitation, and the presence of chronic diseases. In contrast, less-intense caregivers and non-caregivers differed in favor of the less-intense caregivers. Discussion A substantial proportion of the adult German population provides informal care regularly, especially women. Intense caregivers are a vulnerable group for negative health outcomes, especially men. In particular measures to prevent low back disorder should be provided. As the necessity of providing informal care will probably increase in the future, this will be important for the society and public health.
Collapse
Affiliation(s)
- Judith Fuchs
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Beate Gaertner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Alexander Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anne Starker
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
10
|
Lyshol H, Gil AP, Tolonen H, Namorado S, Kislaya I, Barreto M, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Dias CM. Local problem solving in the Portuguese health examination survey: a mixed method study. Arch Public Health 2022; 80:198. [PMID: 36002860 PMCID: PMC9400230 DOI: 10.1186/s13690-022-00939-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe how local teams of survey personnel conducted the survey, describing strategies used to solve practical survey problems and to try to increase the participation rate.
Methods
After a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. Forty-one of the local staff members (survey personnel) also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.
Results
The local teams believed that the detailed manual, described as a “cookbook for making a health examination survey”, made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process.
Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.
Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.
Conclusions
The theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.
A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.
Collapse
|
11
|
Geigl C, Loss J, Leitzmann M, Janssen C. Social Factors of Dietary Risk Behavior in Older German Adults: Results of a Multivariable Analysis. Nutrients 2022; 14:1057. [PMID: 35268032 PMCID: PMC8912758 DOI: 10.3390/nu14051057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/19/2022] [Accepted: 02/28/2022] [Indexed: 12/10/2022] Open
Abstract
With this analysis, we aimed to examine the associations between social factors and dietary risk behavior in older adults. Data were collected through a full-population postal survey of German adults aged 65 years or older (n = 1687, 33% response proportion, 52% female, mean age = 76 years). Using principal component analysis (PCA), a data-driven Dietary Risk Behavior Index (DRB) was computed. Dietary risk behavior was defined as consumption frequencies of vegetables/fruit, whole grains, and dairy products below national dietary recommendations. By performing a multiple linear regression, we analyzed associations between sociodemographic, socioeconomic, psychosocial, and behavioral factors and dietary risk behavior. Physical activity, female gender, socioeconomic status, social support, and age (in the male sample) were negatively associated with dietary risk behavior. Alcohol consumption and smoking were positively associated with dietary risk behavior. A group-specific analysis revealed a higher goodness-of-fit for the low socioeconomic status group, older adults aged 65-79 years, and women. A comprehensive understanding of the relationships between social factors and dietary risk behavior in older adults assists the group-specific targeting of dietary-related interventions. Demand-oriented dietary interventions should account for underlying social conditions to reduce inequity in dietary risk behavior among older adults. The results of this work may be transferable to municipalities in high-income European countries.
Collapse
Affiliation(s)
- Christoph Geigl
- Department of Applied Social Sciences, Munich University of Applied Sciences, 81243 Munich, Germany
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93053 Regensburg, Germany;
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13353 Berlin, Germany;
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93053 Regensburg, Germany;
| | - Christian Janssen
- Department of Applied Social Sciences, Munich University of Applied Sciences, 81243 Munich, Germany
| |
Collapse
|
12
|
Seibel V, Haan M. Survey research among older migrants: Age-related differences in contact and cooperation. THE GERONTOLOGIST 2022; 62:842-854. [PMID: 35092439 PMCID: PMC9295202 DOI: 10.1093/geront/gnac017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives Given the increasing academic interest in older migrants, this study aims at examining the likelihood of establishing contact and cooperation in a survey among first-generation migrants in Germany, comparing migrants of age 50 and older with younger migrants (aged 16–49). Research Design and Methods We analyze data from the Migrants’ Welfare State Attitudes (MIFARE) study collected in Germany, which contains information about first-generation migrants from 9 different origin groups living in private households. Potential survey participants were contacted via mail and invited to participate in a paper- or online-based survey. In addition, an incentive experiment was implemented and age-dependent response rates were analyzed. Using logistic regression analyses, we compare older and younger migrants with regard to their likelihood of contact, cooperation, reaction to incentives, and mode choice. Results Within the MIFARE study, older migrants are more likely to be contacted than younger ones. Older migrants are also more likely to cooperate in survey research than younger migrants. Both groups respond equally positively to the use of unconditional incentives. Lastly, older migrants show a strong preference to fill out the questionnaire on paper, rather than online. Discussion and Implications Older first-generation migrants living in private households are easier to contact and are more likely to cooperate in survey research than younger first-generation migrants. Offering unconditional incentives and surveys on paper are likely to increase response rates among older migrants.
Collapse
Affiliation(s)
- Verena Seibel
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marieke Haan
- Sociology Department, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
13
|
Old-age diversity is underrepresented in digital health research: findings from the evaluation of a mobile phone system for post-operative progress monitoring in Sweden. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Much research is conducted to evaluate digital-based solutions for health-care services, but little is known about how such evaluations acknowledge diversity in later life. This study helps fill this gap and analyses participation in the evaluation of a web-based mobile phone system for monitoring the post-operative progress of patients after day surgery. Participation is conceptualised as resulting from three processes: pre-screening, recruitment and self-selection. Based on field information and survey data, this study models (a) the (non-)participation in a sample of 498 individuals aged 60 and older that includes non-screened, non-recruited, decliners and participants in the evaluation, and (b) the individual decision to participate in a sample of 210 individuals aged 60 and older who were invited to take part in the evaluation. Increasing age enhances the likelihood of not being screened, not being recruited or declining the invitation. Those not recruited were most often ineligible because of technology-related barriers. Decliners and participants differed by age, gender, job, health status, digital skills, but not by social participation. Results suggest that highly specific groups of older people are more likely to be involved than others. Old-age diversity is not properly represented in digital health research, with implications for the inclusivity of new digital health technologies. This has implications for increased risks of old-age exclusion and exacerbation of social and digital inequalities in ageing societies.
Collapse
|
14
|
Neumann S, Bamford A, Lithander FE, Tenison E, Henderson EJ. Public attitudes to the use of remote data collection in clinical research. Contemp Clin Trials 2021; 111:106595. [PMID: 34653652 PMCID: PMC8511885 DOI: 10.1016/j.cct.2021.106595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 11/28/2022]
Abstract
Background/aims Coronavirus Disease 2019 (COVID-19) has presented an unprecedented challenge for delivering clinical research. The use of technology-assisted data collection for clinical research is desirable for many practitioners, but the acceptability of use in the general population has not been assessed. The aim of the study was to assess attitudes towards using technology-assisted remote methods in the delivery of clinical research in the UK and to understand the barriers to taking part in research with respect to both remote assessments and traditional research methods across different age ranges. Methods The study was conducted as an online anonymous survey with a 4-part questionnaire, between August 2020 and December 2020. Participants living in the UK aged 18 years and above were eligible to take part. Results A total 351 completed the survey and are included in the data analysis. In all age groups, participants identified that use of online assignments, video calls and telephone calls would make them more likely to take part in clinical research. Overall, the largest barrier to taking part in research was time commitments and timing of the appointment. COVID-19 has had a small, positive influence on the confidence of using technology in the general population. Conclusions The study found that there is a large interest in taking part in research using online, telephone and video call appointments, which could facilitate research delivery in light of ongoing COVID-19-related restrictions and also improve the accessibility and inclusivity of research.
Collapse
Affiliation(s)
- S Neumann
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK.
| | - A Bamford
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK
| | - F E Lithander
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK
| | - E Tenison
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK; Royal United Hospitals Bath NHS Foundation Trust, Older Peoples Unit, Bath, UK
| | - E J Henderson
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK; Royal United Hospitals Bath NHS Foundation Trust, Older Peoples Unit, Bath, UK
| |
Collapse
|
15
|
De Rosis S, Pennucci F, Lungu DA, Manca M, Nuti S. A continuous PREMs and PROMs Observatory for elective hip and knee arthroplasty: study protocol. BMJ Open 2021; 11:e049826. [PMID: 34548358 PMCID: PMC8458328 DOI: 10.1136/bmjopen-2021-049826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Scholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). This protocol describes the methodology behind an innovative observatory implemented in Tuscany, Italy, aiming at continuously and longitudinally collecting PROMs and PREMs for elective hip and knee total replacement. METHODS AND ANALYSIS The Observatory is digital. Enrolled patients are invited via SMS or email to online questionnaires, which include the Oxford Hip Score or the Oxford Knee Score. Data are real-time reported to healthcare professionals and managers in a raw format, anonymised and aggregated on a web platform. The data will be used to investigate the relationship between the PROMs trend and patients' characteristics, surgical procedure, hospital characteristics, and PREMs. Indicators using patient data will be computed, and they will integrate the healthcare performance evaluation system adopted in Tuscany. ETHICS AND DISSEMINATION The data protection officers of local healthcare organisations and the regional privacy office framed the initiative referring to the national and regional guidelines that regulate patient surveys. The findings will be reported both in real time and for publication in peer-reviewed journals.
Collapse
Affiliation(s)
- Sabina De Rosis
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesca Pennucci
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Daniel Adrian Lungu
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Mario Manca
- Department of Orthopaedic Surgery, Versilia Hospital, Lido di Camaiore, Italy
| | - Sabina Nuti
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| |
Collapse
|
16
|
Gaertner B, Fuchs J, Möhler R, Meyer G, Scheidt-Nave C. Older people at the beginning of the COVID-19 pandemic: A scoping review. JOURNAL OF HEALTH MONITORING 2021; 6:2-37. [PMID: 35586562 PMCID: PMC8832372 DOI: 10.25646/7857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/12/2021] [Indexed: 12/23/2022]
Abstract
This scoping review focuses on evidence gaps regarding the effects on health, social participation and life contexts of older people at the beginning of the COVID-19 pandemic. It is based on a systematic search strategy of the international literature covering a period between December 2019 and June 2020. The review is supplemented by a search of the websites of selected organisations in Germany (cut-off date: 29 June 2020). Search hits were differentiated by types of publication (empirical study, review, discussion paper). The contents were summarised in tabular form according to topic. The publications mainly discussed the high risks of suffering severe courses of COVID-19 faced by older people, specifically those belonging to certain subgroups. In addition, further main topics were the pandemic’s indirect impacts on physical and mental health, physical and cognitive functions and participation in society. Social isolation, loneliness, reduced levels of physical activity and difficulties in maintaining care were discussed as major health risks. Ageism was an issue that was addressed across all of the identified topics. The publications highlighted the need, but also the opportunity, for raising public awareness of the needs of older people in various life contexts. Publications pointed to the urgent need for research into the biological and social causes of older peoples’ high infection risk and how measures could be adapted in a differentiated manner (infection prevention and control measures, social support, medical and nursing care).
Collapse
Affiliation(s)
- Beate Gaertner
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ralph Möhler
- Heinrich Heine University Düsseldorf, Institute for Health Services Research and Health Economics.,Bielefeld University, School of Public Health, Department of Health Services Research and Nursing Science
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Science
| | | |
Collapse
|
17
|
Ramsay JE, Hogan CK, Janevic MR, Courser RR, Allgood KL, Connell CM. Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results From Take Heart. J Gerontol A Biol Sci Med Sci 2021; 75:922-928. [PMID: 31046117 DOI: 10.1093/gerona/glz112] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few published studies report lessons learned for recruiting older adults from racial/ethnic minority, low SES communities for behavioral interventions. In this article, we describe recruitment processes and results for Take Heart, a randomized controlled trial testing the effectiveness of an adapted heart disease self-management program for primarily African American, urban, low SES adults 50 years or older living in Detroit. METHODS Older adults were recruited via community-based (CB), electronic medical record (EMR), and in-person hospital clinic (HC) methods. Recruitment processes, demographic characteristics of enrolled participants, yield and cost, lessons learned, and best practices for each method are described. RESULTS Within 22 months, 1,478 potential participants were identified, 1,223 were contacted and 453 enrolled, resulting in an overall recruitment yield of 37%. The CB method had the highest yield at 49%, followed by HC at 36% and EMR at 16%. Of six CB approaches, information sessions and flyers had the highest yields at 60% and 59%, respectively. The average cost of recruiting and enrolling one participant was $142. CONCLUSIONS CB, EMR, and HC methods each made important contributions to reaching our recruitment goal. The CB method resulted in the highest recruitment yield, while EMR had the lowest. Face-to-face interaction with community members and hiring a community health worker were particularly useful in engaging this population. Further research is needed to confirm these findings in urban, minority, low SES populations of older adults.
Collapse
Affiliation(s)
- Jessica E Ramsay
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Cainnear K Hogan
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Mary R Janevic
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Rebecca R Courser
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Kristi L Allgood
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Cathleen M Connell
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| |
Collapse
|
18
|
Ferrè F, De Rosis S, Murante AM, Gilmore KJ, Ghilli M, Mariniello D, Nuti S, Roncella M. Systematic and continuous collection of patient-reported outcomes and experience in women with cancer undergoing mastectomy and immediate breast reconstruction: a study protocol for the Tuscany Region (Italy). BMJ Open 2021; 11:e042235. [PMID: 33431493 PMCID: PMC7802685 DOI: 10.1136/bmjopen-2020-042235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/29/2020] [Accepted: 12/10/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Monitoring how patients feel and what they experience during the care process gives health professionals data to improve the quality of care, and gives health systems information to better design and implement care pathways. To gain new insights about specific gaps and/or strengths in breast cancer care, we measure patient-reported outcomes (PROs) and patient-reported experiences (PREs) for women receiving immediate breast reconstruction (iBR). METHODS AND ANALYSIS Prospective, multicentre, cohort study with continuous and systematic web-based data collection from women diagnosed with breast cancer, who have an indication for iBR after mastectomy treated at any Breast Unit (BU) in Tuscany Region (Italy). Patients are classified into one of two groups under conditions of routine clinical practice, based on the type of iBR planned (implant and autologous reconstruction). Patient-reported information are obtained prior to and after surgery (at 3-month and 12-month follow-up). We estimate that there are around 700 annual eligible patients.Descriptive analyses are used to assess trends in PROs over time and differences between types of iBR in PROs and PREs. Additionally, econometric models are used to analyse patient and BU characteristics associated with outcomes and experiences. PREs are evaluated to assess aspects of integrated care along the care pathway. ETHICS AND DISSEMINATION The study has been reviewed and obtained a nihil obstat from the Tuscan Ethics Committees of the three Area Vasta in 2017. Dissemination of results will be via periodic report, journal articles and conference presentations.
Collapse
Affiliation(s)
- Francesca Ferrè
- Department EMbeDS, Institute of Management, MeS Management and Health Laboratory, Sant'Anna School of Advanced Studies, Pisa, Toscana, Italy
| | - Sabina De Rosis
- Department EMbeDS, Institute of Management, MeS Management and Health Laboratory, Sant'Anna School of Advanced Studies, Pisa, Toscana, Italy
| | - Anna Maria Murante
- Department EMbeDS, Institute of Management, MeS Management and Health Laboratory, Sant'Anna School of Advanced Studies, Pisa, Toscana, Italy
| | - Kendall Jamieson Gilmore
- Department EMbeDS, Institute of Management, MeS Management and Health Laboratory, Sant'Anna School of Advanced Studies, Pisa, Toscana, Italy
| | - Matteo Ghilli
- Breast Cancer Centre, Azienda Ospedaliero Universitaria Pisana, Pisa, Toscana, Italy
| | - Donatella Mariniello
- Breast Cancer Centre, Azienda Ospedaliero Universitaria Pisana, Pisa, Toscana, Italy
| | - Sabina Nuti
- Department EMbeDS, Institute of Management, MeS Management and Health Laboratory, Sant'Anna School of Advanced Studies, Pisa, Toscana, Italy
| | - Manuela Roncella
- Breast Cancer Centre, Azienda Ospedaliero Universitaria Pisana, Pisa, Toscana, Italy
| |
Collapse
|
19
|
Todd OM, Burton JK, Dodds RM, Hollinghurst J, Lyons RA, Quinn TJ, Schneider A, Walesby KE, Wilkinson C, Conroy S, Gale CP, Hall M, Walters K, Clegg AP. New Horizons in the use of routine data for ageing research. Age Ageing 2020; 49:716-722. [PMID: 32043136 PMCID: PMC7444666 DOI: 10.1093/ageing/afaa018] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/02/2019] [Accepted: 01/16/2020] [Indexed: 12/14/2022] Open
Abstract
The past three decades have seen a steady increase in the availability of routinely collected health and social care data and the processing power to analyse it. These developments represent a major opportunity for ageing research, especially with the integration of different datasets across traditional boundaries of health and social care, for prognostic research and novel evaluations of interventions with representative populations of older people. However, there are considerable challenges in using routine data at the level of coding, data analysis and in the application of findings to everyday care. New Horizons in applying routine data to investigate novel questions in ageing research require a collaborative approach between clinicians, data scientists, biostatisticians, epidemiologists and trial methodologists. This requires building capacity for the next generation of research leaders in this important area. There is a need to develop consensus code lists and standardised, validated algorithms for common conditions and outcomes that are relevant for older people to maximise the potential of routine data research in this group. Lastly, we must help drive the application of routine data to improve the care of older people, through the development of novel methods for evaluation of interventions using routine data infrastructure. We believe that harnessing routine data can help address knowledge gaps for older people living with multiple conditions and frailty, and design interventions and pathways of care to address the complex health issues we face in caring for older people.
Collapse
Affiliation(s)
- Oliver M Todd
- Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Trust, University of Leeds, Bradford, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Jennifer K Burton
- Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G4 OSF, UK
| | - Richard M Dodds
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Joe Hollinghurst
- Health Data Research UK (HDR-UK), Swansea University, Swansea, UK
| | - Ronan A Lyons
- Health Data Research UK (HDR-UK), Swansea University, Swansea, UK
| | - Terence J Quinn
- Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G4 OSF, UK
| | - Anna Schneider
- School of Health & Social Care, Scottish Centre for Administrative Data Research, Edinburgh Napier University, Edinburgh, UK
| | - Katherine E Walesby
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Chris Wilkinson
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Conroy
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Chris P Gale
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Marlous Hall
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Kate Walters
- Centre for Ageing Population Studies, Department of Primary Care & Population Health, Institute of Epidemiology & Health Care, University College, London, UK
| | - Andrew P Clegg
- Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Trust, University of Leeds, Bradford, UK
| |
Collapse
|
20
|
Chung PC, Chan TC. Association between periodontitis and all-cause and cancer mortality: retrospective elderly community cohort study. BMC Oral Health 2020; 20:168. [PMID: 32517780 PMCID: PMC7285774 DOI: 10.1186/s12903-020-01156-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/01/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Periodontal infection induces inflammation, which may increase the risk of tumor-promoting effects. The aim of this study was to assess the association between periodontitis and all-cause mortality, and all-cancer and specific cancers' mortality in a health examination cohort of the elderly in the communities. METHODS A dataset of health examinations for the elderly with cause of death from 2005 to 2012 was obtained from the Department of Health, Taipei City Government. We enrolled 82,548 study participants with 262,035 visits. A Cox proportional hazards model and Cox frailty model were used for calculating the hazard ratios under different periodontal status by using SAS and Rstudio. RESULTS Being male, elderly, having a low education level, and smoking were risk factors for mortality in this retrospective elderly community cohort study. Participants with periodontitis followed across time had significantly higher hazard ratios (HRs) for all-cause mortality and all-cancer mortality (HR = 1.092, 95% confidence interval (CI):1.038 to 1.149, HR = 1.114, 95% CI:1.032 to 1.203, respectively) in the Cox frailty models after adjusting for age, marital status, education level, sex, and smoking status. After adjusting for age and sex, the hazard ratio was 1.185 (95% CI: 1.027 to 1.368) for lung cancer mortality, and 1.340 (95% CI: 1.019 to 1.762) for prostate cancer mortality in the periodontitis group with each visit. CONCLUSIONS The findings indicated that being male, having a low education level, and daily smoking were risk factors for mortality, and showed mixed evidence that periodontal disease is associated with all-cause, all-cancer and specific-cancer mortality including lung and prostate cancer. We suggest the importance of regular health screening in order to achieve early disease detection and lower mortality risk.
Collapse
Affiliation(s)
- Ping-Chen Chung
- Department of Dentistry, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 115, Taiwan. .,Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
21
|
Nguyen D, Hautekiet P, Berete F, Braekman E, Charafeddine R, Demarest S, Drieskens S, Gisle L, Hermans L, Tafforeau J, Van der Heyden J. The Belgian health examination survey: objectives, design and methods. ACTA ACUST UNITED AC 2020; 78:50. [PMID: 32514346 PMCID: PMC7268416 DOI: 10.1186/s13690-020-00428-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 05/13/2020] [Indexed: 12/21/2022]
Abstract
Background In 2018 the first Belgian Health Examination Survey (BELHES) took place. The target group included all Belgian residents aged 18 years and older. The BELHES was organized as a second stage of the sixth Belgian Health Interview Survey (BHIS). This paper describes the study design, recruitment method and the methodological choices that were made in the BELHES. Methods After a pilot period during the first quarter of the BHIS fieldwork, eligible BHIS participants were invited to participate in the BELHES until a predefined number (n = 1100) was reached. To obtain the required sample size, 4918 eligible BHIS participants had to be contacted. Data were collected at the participant’s home by trained nurses. The data collection included: 1) a short set of questions through a face-to-face interview, 2) a clinical examination consisting of the measurement of height, weight, waist circumference, blood pressure and for people aged 50 years and older handgrip strength and 3) a collection of blood and urine samples. The BELHES followed as much as possible the guidelines provided in the framework of the European Health Examination Survey (EHES) initiative. Finally 1184 individuals participated in the BELHES, resulting in a participation rate of 24.1%. Results for all the core BELHES measurements were obtained for more than 90% of the participants. Conclusion It is feasible to organize a health examination survey as a second stage of the BHIS. The first successfully organized BELHES provides useful information to support Belgian health decision-makers and health professionals. As the BELHES followed EHES recommendations to a large extent, the results can be compared with those from similar surveys in other EU (European Union) member states.
Collapse
Affiliation(s)
- Diem Nguyen
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Pauline Hautekiet
- Department of Chemical and physical health risks, Sciensano, Brussels, Belgium.,Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Finaba Berete
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Elise Braekman
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.,Unit of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Stefaan Demarest
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Sabine Drieskens
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Lydia Gisle
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Lize Hermans
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Jean Tafforeau
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Johan Van der Heyden
- Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| |
Collapse
|
22
|
Linnenkamp U, Gontscharuk V, Brüne M, Chernyak N, Kvitkina T, Arend W, Fiege A, Schmitz-Losem I, Kruse J, Evers SMAA, Hiligsmann M, Hoffmann B, Andrich S, Icks A. Using statutory health insurance data to evaluate non-response in a cross-sectional study on depression among patients with diabetes in Germany. Int J Epidemiol 2020; 49:629-637. [PMID: 31990354 PMCID: PMC7266537 DOI: 10.1093/ije/dyz278] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Low response rates do not indicate poor representativeness of study populations if non-response occurs completely at random. A non-response analysis can help to investigate whether non-response is a potential source for bias within a study. METHODS A cross-sectional survey among a random sample of a health insurance population with diabetes (n = 3642, 58.9% male, mean age 65.7 years), assessing depression in diabetes, was conducted in 2013 in Germany. Health insurance data were available for responders and non-responders to assess non-response bias. The response rate was 51.1%. Odds ratios (ORs) for responses to the survey were calculated using logistic regression taking into consideration the depression diagnosis as well as age, sex, antihyperglycaemic medication, medication utilization, hospital admission and other comorbidities (from health insurance data). RESULTS Responders and non-responders did not differ in the depression diagnosis [OR 0.99, confidence interval (CI) 0.82-1.2]. Regardless of age and sex, treatment with insulin only (OR 1.73, CI 1.36-2.21), treatment with oral antihyperglycaemic drugs (OAD) only (OR 1.77, CI 1.49-2.09), treatment with both insulin and OAD (OR 1.91, CI 1.51-2.43) and higher general medication utilization (1.29, 1.10-1.51) were associated with responding to the survey. CONCLUSION We found differences in age, sex, diabetes treatment and medication utilization between responders and non-responders, which might bias the results. However, responders and non-responders did not differ in their depression status, which is the focus of the DiaDec study. Our analysis may serve as an example for conducting non-response analyses using health insurance data.
Collapse
Affiliation(s)
- Ute Linnenkamp
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Manuela Brüne
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Nadezda Chernyak
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Tatjana Kvitkina
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Werner Arend
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Annett Fiege
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Johannes Kruse
- Clinic for Psychosomatic and Psychotherapy, University Clinic Gießen, Gießen, Germany
| | - Silvia M A A Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Silke Andrich
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
23
|
Poli A, Kelfve S, Motel-Klingebiel A. A research tool for measuring non-participation of older people in research on digital health. BMC Public Health 2019; 19:1487. [PMID: 31703655 PMCID: PMC6842243 DOI: 10.1186/s12889-019-7830-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 10/22/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Healthcare services are being increasingly digitalised in European countries. However, in studies evaluating digital health technology, some people are less likely to participate than others, e.g. those who are older, those with a lower level of education and those with poorer digital skills. Such non-participation in research - deriving from the processes of non-recruitment of targeted individuals and self-selection - can be a driver of old-age exclusion from new digital health technologies. We aim to introduce, discuss and test an instrument to measure non-participation in digital health studies, in particular, the process of self-selection. METHODS Based on a review of the relevant literature, we designed an instrument - the NPART survey questionnaire - for the analysis of self-selection, covering five thematic areas: socioeconomic factors, self-rated health and subjective overall quality of life, social participation, time resources, and digital skills and use of technology. The instrument was piloted on 70 older study persons in Sweden, approached during the recruitment process for a trial study. RESULTS Results indicated that participants, as compared to decliners, were on average slightly younger and more educated, and reported better memory, higher social participation, and higher familiarity with and greater use of digital technologies. Overall, the survey questionnaire was able to discriminate between participants and decliners on the key aspects investigated, along the lines of the relevant literature. CONCLUSIONS The NPART survey questionnaire can be applied to characterise non-participation in digital health research, in particular, the process of self-selection. It helps to identify underrepresented groups and their needs. Data generated from such an investigation, combined with hospital registry data on non-recruitment, allows for the implementation of improved sampling strategies, e.g. focused recruitment of underrepresented groups, and for the post hoc adjustment of results generated from biased samples, e.g. weighting procedures.
Collapse
Affiliation(s)
- Arianna Poli
- Division Ageing and Social Change (ASC), Linköping University, Kungsgatan 40, 601 74 Norrköping, Sweden
| | - Susanne Kelfve
- Division Ageing and Social Change (ASC), Linköping University, Kungsgatan 40, 601 74 Norrköping, Sweden
- Aging Research Center (ARC), Karolinska Institutet & Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Andreas Motel-Klingebiel
- Division Ageing and Social Change (ASC), Linköping University, Kungsgatan 40, 601 74 Norrköping, Sweden
| |
Collapse
|
24
|
Arts MH, Benraad CE, Hanssen D, Hilderink P, de Jonge L, Naarding P, Lucassen P, Oude Voshaar RC. Frailty and Somatic Comorbidity in Older Patients With Medically Unexplained Symptoms. J Am Med Dir Assoc 2019; 20:1150-1155. [DOI: 10.1016/j.jamda.2019.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 12/22/2022]
|
25
|
Dahlin-Ivanoff S, Sterner TR, Blennow K, Skoog I, Erhag HF. Was it worth it? Older adults' experiences of participating in a population-based cohort study - a focus group study. BMC Geriatr 2019; 19:224. [PMID: 31426756 PMCID: PMC6700766 DOI: 10.1186/s12877-019-1238-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 07/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND At present, we know relatively little about priorities and problems with topics that older adults experience when completing different examinations in longitudinal population-based studies. To examine these topics, research must be adapted to investigate the meanings, motivations, and interpretations of the individual participants themselves. Therefore, the present study aimed to explore older adults' motives, understandings and experiences regarding participating in the Gothenburg H70 Birth Cohort Studies (the H-70 study). METHODS Focus group discussions were used. A total of thirty-eight persons, 19 women and 19 men participated in nine focus groups. A strategic sampling technique was used to ensure that the focus group participants represented the larger population. RESULTS The results supported the overall theme: "It was well worth the effort," which summarized how the participants felt about the population health study. The following specific themes were also identified: an intense event, for the benefit of oneself and others, confidence in health research and the researcher, key decisions about test outcomes and the survey raising questions and providing few answers. CONCLUSIONS Knowledge of priorities and problems with topics experienced by older adults completing different examinations when participating in longitudinal population-based studies is crucial for research to improve the health and wellbeing of older people. To date, older people's involvement in population-based cohort studies has largely been as research subjects. This study is a first step toward the participants taking a more active part by allowing them to share their experiences which can be used to improve the research procedures. This requires the participation of older adults in collaboration with the researchers, to ensure the quality of longitudinal studies of older adults. Therefore, our intention when it comes to future research will be to involve older adults-the target group-in the research procedure.
Collapse
Affiliation(s)
- Synneve Dahlin-Ivanoff
- Center for Ageing and Health – AGECAP, Gothenburg University, Sahlgrenska Academy, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Sahlgrenska Academy at the University of Gothenburg, P.O. Box 455, SE- 405 30 Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Center for Ageing and Health – AGECAP, Gothenburg University, Sahlgrenska Academy, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| | - Kaj Blennow
- Center for Ageing and Health – AGECAP, Gothenburg University, Sahlgrenska Academy, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Clinical Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, SE-431 80 Mölndal, Sweden
| | - Ingmar Skoog
- Center for Ageing and Health – AGECAP, Gothenburg University, Sahlgrenska Academy, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| | - Hanna Falk Erhag
- Center for Ageing and Health – AGECAP, Gothenburg University, Sahlgrenska Academy, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
- Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
| |
Collapse
|
26
|
Enzenbach C, Wicklein B, Wirkner K, Loeffler M. Evaluating selection bias in a population-based cohort study with low baseline participation: the LIFE-Adult-Study. BMC Med Res Methodol 2019; 19:135. [PMID: 31262266 PMCID: PMC6604357 DOI: 10.1186/s12874-019-0779-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/18/2019] [Indexed: 12/30/2022] Open
Abstract
Background Participation in epidemiologic studies is steadily declining, which may result in selection bias. It is therefore an ongoing challenge to clarify the determinants of participation to judge possible selection effects and to derive measures to minimise that bias. We evaluated the potential for selection bias in a recent population-based cohort study with low baseline participation and investigated reasons for nonparticipation. Methods LIFE-Adult is a cohort study in the general population of the city of Leipzig (Germany) designed to gain insights into the distribution and development of civilisation diseases. Nine thousand one hundred forty-five participants aged 40–79 years were randomly sampled in 2011–2014. We compared LIFE-Adult participants with both the Leipzig population and nonparticipants using official statistics and short questionnaire data. We applied descriptive statistics and logistic regression analysis to evaluate the determinants of study participation. Results Thirty-one percent of the invited persons participated in the LIFE-Adult baseline examination. Study participants were less often elderly women and more often married, highly educated, employed, and current nonsmokers compared to both the Leipzig population and nonparticipants. They further reported better health than nonparticipants. The observed differences were considerable in education and health variables. They were generally stronger in men than in women. For example, in male study participants aged 50–69, the frequency of high education was 1.5 times that of the general population, and the frequency of myocardial infarction was half that of nonparticipants. Lack of time and interest, as well as health problems were the main reasons for nonparticipation. Conclusions Our investigation suggests that the low baseline participation in LIFE-Adult is associated with the typical selection of study participants with higher social status and healthier lifestyle, and additionally less disease. Notably, education and health status seem to be crucial selection factors. Consequently, frequencies of major health conditions in the general population will likely be underestimated. A differential selection related to sex might also distort effect estimates. The extent of the assessment, the interest in the research topic, and health problems of potential participants should in future be considered in LIFE-Adult and in similar studies to raise participation and to minimise selection bias. Electronic supplementary material The online version of this article (10.1186/s12874-019-0779-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Cornelia Enzenbach
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany. .,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Barbara Wicklein
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Kerstin Wirkner
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| |
Collapse
|
27
|
Abstract
Very old people are known to participate less often in social surveys than younger age-groups. However, survey participation among very old people in institutional settings is understudied. Additionally, the focus of the literature is on response rates, which neglects the complexity of the process of survey participation. The present study uses standard definitions of the American Association for Public Opinion Research to give a detailed description of survey participation among very old people, including those in institutional settings. Data come from a German survey on quality of life and subjective well-being of persons aged 80-84, 85-89, and 90+ (N = 1800). The present study (a) estimates contact, cooperation, response, and refusal rates and (b) identifies associations of age, sex, and type of residence with each of these rates. Weighted outcome rates for the survey were: contact = 66.0%, cooperation = 39.6%, response = 26.1%, and refusal = 26.9%. Age, sex, and type of residence were not associated with the contact, cooperation, and response rate. Lower refusal rates were found for people aged 90+, men, and institutionalized people. Additional analyses showed higher rates of non-interviews due to health-related reasons for institutionalized people and those aged 90+. Overall, results indicate that institutionalized and non-institutionalized people showed similar levels of survey participation. Willingness to participate is a key factor for women and people in private households, while the ability to participate is more important for institutionalized people.
Collapse
Affiliation(s)
- Michael Wagner
- 1Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Matthias Kuppler
- 1Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Christian Rietz
- 2Institute for Educational Science, Heidelberg University of Education, Heidelberg, Germany
| | - Roman Kaspar
- 3Ceres - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
| |
Collapse
|
28
|
Schätzung kleinräumiger Krankheitshäufigkeiten für die deutsche Bevölkerung anhand von Routinedaten am Beispiel von Typ-2-Diabetes. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s11943-019-00241-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
29
|
Raheja D, Davila EP, Johnson ET, Deović R, Paine M, Rouphael N. Willingness to Participate in Vaccine-Related Clinical Trials among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081743. [PMID: 30110896 PMCID: PMC6121248 DOI: 10.3390/ijerph15081743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/09/2018] [Accepted: 08/11/2018] [Indexed: 11/23/2022]
Abstract
The purpose of this study is to understand among a convenience sample of 400 adults aged 60 years of age or older (1) reasons for being willing or unwilling to participate in a vaccine clinical research study and (2) overall perceptions about vaccine clinical research. A cross-sectional study using a sample of older adults residing in the metro-Atlanta area and surrounding neighborhoods was conducted. The study questionnaire contained 37 questions, including questions about socio-demographics and perceptions about clinical trial processes. Statistical analysis was conducted using logistic regression. The adjusted modeling results indicated that sex, distance to research clinic, and being informed about the research findings played a role in the likelihood of an elderly person participating in a vaccine study. Males were more likely to participate in clinical trials as compared to females (OR: 2.486; CI: 1.042–5.934). Most participants were willing to travel up to 25 miles from the research clinic. Of the respondents, 45% were unlikely to participate if the results of the current trial are not shared. Improving access to clinical trials in terms of distance traveled and ensuring streamlined processes to inform participants about the results of the trial in the future would increase willingness to participate in vaccine clinical trials. The survey could serve as a useful tool for conducting vaccine studies and other clinical trials by understanding the barriers specific to the elderly.
Collapse
Affiliation(s)
- Divyanshu Raheja
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30329, USA.
| | - Evelyn P Davila
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30329, USA.
| | - Eric T Johnson
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30329, USA.
| | - Rijalda Deović
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30329, USA.
| | - Michele Paine
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30329, USA.
| | - Nadine Rouphael
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30329, USA.
| |
Collapse
|
30
|
Hoebel J, Rommel A, Schröder SL, Fuchs J, Nowossadeck E, Lampert T. Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1127. [PMID: 28954436 PMCID: PMC5664628 DOI: 10.3390/ijerph14101127] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/18/2017] [Accepted: 09/21/2017] [Indexed: 11/24/2022]
Abstract
Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived from the Robert Koch Institute's cross-sectional German Health Update study. The sample was restricted to participants aged 50-85 years (n = 11,811). Socioeconomic status (SES) was measured based on education, (former) occupation, and income. Odds ratios and prevalence differences were estimated using logistic regression and linear probability models, respectively. Our results show that self-reported health problems were more prevalent among men and women with lower SES. The extent of SES-related health inequalities decreased at older ages, predominantly among men. Although the prevalence of perceived unmet needs for healthcare was low overall, low SES was associated with higher perceptions of unmet needs in both sexes and for several kinds of health services. In conclusion, socioeconomic inequalities in health exist in a late working age and early retirement but may narrow at older ages, particularly among men. Socially disadvantaged elderly people perceive greater barriers to accessing healthcare services than those who are better off.
Collapse
Affiliation(s)
- Jens Hoebel
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
| | - Alexander Rommel
- Division of Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
| | - Sara Lena Schröder
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle, Germany.
| | - Judith Fuchs
- Division of Physical Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
| | - Enno Nowossadeck
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
| | - Thomas Lampert
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
| |
Collapse
|
31
|
Heerman WJ, Jackson N, Roumie CL, Harris PA, Rosenbloom ST, Pulley J, Wilkins CH, Williams NA, Crenshaw D, Leak C, Scherdin J, Muñoz D, Bachmann J, Rothman RL, Kripalani S. Recruitment methods for survey research: Findings from the Mid-South Clinical Data Research Network. Contemp Clin Trials 2017; 62:50-55. [PMID: 28823925 DOI: 10.1016/j.cct.2017.08.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE The objective of this study was to report survey response rates and demographic characteristics of eight recruitment approaches to determine acceptability and effectiveness of large-scale patient recruitment among various populations. METHODS We conducted a cross sectional analysis of survey data from two large cohorts. Patients were recruited from the Mid-South Clinical Data Research Network using clinic-based recruitment, research registries, and mail, phone, and email approaches. Response rates are reported as patients who consented for the survey divided by the number of eligible patients approached. RESULTS We contacted more than 90,000 patients and 13,197 patients completed surveys. Median age was 56.3years (IQR 40.9, 67.4). Racial/ethnic distribution was 84.1% White, non-Hispanic; 9.9% Black, non-Hispanic; 1.8% Hispanic; and 4.0% other, non-Hispanic. Face-to-face recruitment had the highest response rate of 94.3%, followed by participants who "opted-in" to a registry (76%). The lowest response rate was for unsolicited emails from the clinic (6.1%). Face-to-face recruitment enrolled a higher percentage of participants who self-identified as Black, non-Hispanic compared to other approaches (18.6% face-to-face vs. 8.4% for email). CONCLUSIONS Technology-enabled recruitment approaches such as registries and emails are effective for recruiting but may yield less racial/ethnic diversity compared to traditional, more time-intensive approaches.
Collapse
Affiliation(s)
- William J Heerman
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA; Department of Medicine, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA.
| | - Natalie Jackson
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Christianne L Roumie
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA; Department of Medicine, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA; Veterans Health Administration, Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, 1310 24th Ave S, Nashville, TN 37212, USA
| | - Paul A Harris
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA; Department of Medicine, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA
| | - S Trent Rosenbloom
- Department of Medicine, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA; Department of Biomedical Informatics, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA
| | - Jill Pulley
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Consuelo H Wilkins
- Veterans Health Administration, Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, 1310 24th Ave S, Nashville, TN 37212, USA; Meharry-Vanderbilt Alliance, 1005 Dr. D.B. Todd Jr. Blvd., Biomedical Building, Nashville, TN 37208, USA; Meharry Medical College, Department of Medicine, 1005 Dr. D.B. Todd Jr. Blvd., Biomedical Building, Nashville, TN 37208, USA
| | | | - David Crenshaw
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Cardella Leak
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Jon Scherdin
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Daniel Muñoz
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Justin Bachmann
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA
| | - Russell L Rothman
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA; Department of Medicine, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA
| | - Sunil Kripalani
- Center for Health Services Research, Institute for Medicine and Public Health, Vanderbilt University, 2525 West End Ave, Nashville, TN 37232, USA; Department of Medicine, School of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37232, USA
| |
Collapse
|
32
|
Liljas AEM, Walters K, Jovicic A, Iliffe S, Manthorpe J, Goodman C, Kharicha K. Strategies to improve engagement of 'hard to reach' older people in research on health promotion: a systematic review. BMC Public Health 2017; 17:349. [PMID: 28431552 PMCID: PMC5399821 DOI: 10.1186/s12889-017-4241-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 04/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This systematic review aimed to identify facilitators, barriers and strategies for engaging 'hard to reach' older people in research on health promotion; the oldest old (≥80 years), older people from black and minority ethnic groups (BME) and older people living in deprived areas. METHODS Eight databases were searched to identify eligible studies using quantitative, qualitative, and mixed research methods. Using elements of narrative synthesis, engagement strategies, and reported facilitators and barriers were identified, tabulated and analysed thematically for each of the three groups of older people. RESULTS Twenty-three studies (3 with oldest-old, 16 with BME older people, 2 within deprived areas, 1 with both oldest-old and BME, 1 with both BME and deprived areas) were included. Methods included 10 quantitative studies (of which 1 was an RCT), 12 qualitative studies and one mixed-methods study. Facilitators for engaging the oldest old included gaining family support and having flexible sessions. Facilitators for BME groups included building trust through known professionals/community leaders, targeting personal interests, and addressing ethnic and cultural characteristics. Among older people in deprived areas, facilitators for engagement included encouragement by peers and providing refreshments. Across all groups, barriers for engagement were deteriorating health, having other priorities and lack of transport/inaccessibility. Feeling too tired and lacking support from family members were additional barriers for the oldest old. Similarly, feeling too tired and too old to participate in research on health promotion were reported by BME groups. Barriers for BME groups included lack of motivation and self-confidence, and cultural and language differences. Barriers identified in deprived areas included use of written recruitment materials. Strategies to successfully engage with the oldest old included home visits and professionals securing consent if needed. Strategies to engage older people from BME groups included developing community connections and organising social group sessions. Strategies to engage with older people in deprived areas included flexibility in timing and location of interventions. CONCLUSIONS This review identified facilitators, barriers and strategies for engaging 'hard to reach' older people in health promotion but research has been mainly descriptive and there was no high quality evidence on the effectiveness of different approaches.
Collapse
Affiliation(s)
- Ann E. M. Liljas
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Kate Walters
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Ana Jovicic
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Steve Iliffe
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King’s College London, London, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, Hatfield, UK
| | - Kalpa Kharicha
- Research Department of Primary Care and Population Health, University College London, London, UK
| |
Collapse
|
33
|
Akmatov MK, Riese P, May M, Jentsch L, Ahmed MW, Werner D, Rösel A, Tyler M, Pessler K, Prokein J, Bernemann I, Klopp N, Prochnow B, Trittel S, Tallam A, Illig T, Schindler C, Guzmán CA, Pessler F. Establishment of a cohort for deep phenotyping of the immune response to influenza vaccination among elderly individuals recruited from the general population. Hum Vaccin Immunother 2017; 13:1630-1639. [PMID: 28394705 DOI: 10.1080/21645515.2017.1299300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Elderly individuals have the highest burden of disease from influenza infection but also the lowest immune response to influenza vaccination. A better understanding of the host response to influenza vaccination in the elderly is therefore urgently needed. We conducted a biphasic prospective, population-based study from Dec. 2014 to May 2015 (pilot study) and Sept. 2015 to May 2016 (main study). Individuals 65-80 y of age were randomly selected from the residents' registration office in Hannover, Germany, for the pilot (n = 34) and main study (n = 200). The pilot study tested recruitment for study arms featuring 2, 4, or 5 visits/blood draws. The 5-visit (day 0, 1/3, 7, 21, 70 with respect to vaccination) study arm was selected for the main study. Both studies featured vaccination with Fluad™ (Novartis, Italy), a detailed medical history, a physical exam, recording of adverse events, completion of a questionnaire on common infections and an end-of-study questionnaire, and blood samples. Response rates in the pilot and main studies were 3.7% and 4.0%, respectively. Willingness to participate did not differ among the study arms (Fisher's exact test, p = 0.44). In both studies, there were no losses to follow-up. Compliance with study visits, blood sampling and completion of the questionnaires was very high (100%, >97%, 100%, respectively), as were participants' acceptance of and satisfaction with both phases of the study. The low response rates indicate the need for optimized recruitment strategies if the study population is to be representative of the general population. Nonetheless, the complex prospective study design proved to be highly feasible.
Collapse
Affiliation(s)
- Manas K Akmatov
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany.,b Helmholtz Centre for Infection Research , Braunschweig , Germany.,c Centre for Individualized Infection Medicine , Hannover , Germany
| | - Peggy Riese
- d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Marcus May
- e Clinical Research Center Hannover , Hannover Medical School , Hannover , Germany
| | - Leonhard Jentsch
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Malik W Ahmed
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Damaris Werner
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Anja Rösel
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Megan Tyler
- e Clinical Research Center Hannover , Hannover Medical School , Hannover , Germany
| | - Kevin Pessler
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Jana Prokein
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Inga Bernemann
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Norman Klopp
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Blair Prochnow
- d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Stephanie Trittel
- d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Aravind Tallam
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany
| | - Thomas Illig
- f Hannover Unified Biobank , Hannover Medical School , Hannover , Germany
| | - Christoph Schindler
- e Clinical Research Center Hannover , Hannover Medical School , Hannover , Germany
| | - Carlos A Guzmán
- c Centre for Individualized Infection Medicine , Hannover , Germany.,d Department of Vaccinology and Applied Microbiology , Helmholtz Centre for Infection Research , Braunschweig , Germany
| | - Frank Pessler
- a TWINCORE, Centre for Experimental and Clinical Infection Research , Hannover , Germany.,b Helmholtz Centre for Infection Research , Braunschweig , Germany.,c Centre for Individualized Infection Medicine , Hannover , Germany
| |
Collapse
|
34
|
Walters K, Kharicha K, Goodman C, Handley M, Manthorpe J, Cattan M, Morris S, Clarke CS, Round J, Iliffe S. Promoting independence, health and well-being for older people: a feasibility study of computer-aided health and social risk appraisal system in primary care. BMC FAMILY PRACTICE 2017; 18:47. [PMID: 28340553 PMCID: PMC5366113 DOI: 10.1186/s12875-017-0620-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 03/20/2017] [Indexed: 11/13/2022]
Abstract
Background With population ageing, research is needed into new low-cost, scalable methods of effective promotion of health and wellbeing for older people. We aimed to assess feasibility, reach and costs of implementing a new tailored computer-aided health and social risk appraisal system in primary care. Methods Design: Feasibility study. Setting: Five General Practices in London (Ealing) and Hertfordshire, United Kingdom (UK) Participants: Random sample of patients aged 65 + years. Intervention: The Multi-dimensional Risk Appraisal for Older people (MRA-O) system includes: 1) Postal questionnaire including health, lifestyle, social and environmental domains; 2) Software system generating a personalised feedback report with advice on health and wellbeing; 3) Follow-up of people with new concerning or complex needs by GPs or practice nurses. Evaluation: Feasibility of implementation; participant wellbeing, functional ability and quality of life; social needs, health risks, potential lifestyle changes; and costs of implementation. Results Response rates to initial postal invitations were low (526/1550, 34%). Of these, 454/526 (86%) completed MRA-O assessments. Compared to local UK Census data on older people, participants were younger, more were owner-occupiers and fewer were from ethnic minority groups than expected. A range of problems was identified by participants, including pain in last week (269/438, 61.4%), low physical activity (173/453, 38.2%), sedentary lifestyle (174/447, 38.3%), falls (117/439, 26.7%), incontinence (111/441 25.2%), impaired vision 116/451 (25.7%), impaired hearing (145/431, 33.6%), depressed mood (71/451, 15.7%), impaired memory (44/444 9.9%), social isolation (46/449, 10.2%) and loneliness (31/442, 7.0%). Self-rated health was good/excellent in 312/437 (71.4%), and quality of life and well-being were slightly above age-specific population norms. Implementation costs were low. Practices reviewed medical records of 143/454 (31.5%) of participants as a consequence of their responses, and actively followed up 110/454 (24.2%) of their patients. Conclusions A computer-aided risk appraisal system was feasible for General Practices to implement, yields useful information about health and social problems, and identifies individual needs. Participation rates were however low, particularly for the oldest old, the poorest, and ethnic minority groups, and this type of intervention may increase inequalities in access. Widespread implementation of this approach would require work to address potential inequalities.
Collapse
Affiliation(s)
- Kate Walters
- Department Primary Care & Population Health, University College London (UCL), Royal Free Campus, Rowland Hill St, London, NW3 2PF, UK.
| | - Kalpa Kharicha
- Department Primary Care & Population Health, University College London (UCL), Royal Free Campus, Rowland Hill St, London, NW3 2PF, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, AL10 9AB, Hertfordshire, UK
| | - Melanie Handley
- Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, AL10 9AB, Hertfordshire, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King's College London, Strand, London, WC2B 4LL, UK
| | - Mima Cattan
- University of Northumbria, Sutherland Building Newcastle-upon-Tyne, Newcastle, NE1 8ST, UK
| | - Steve Morris
- Department of Applied Health Research, UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Caroline S Clarke
- Department Primary Care & Population Health, University College London (UCL), Royal Free Campus, Rowland Hill St, London, NW3 2PF, UK
| | - Jeff Round
- Department of Applied Health Research, UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Steve Iliffe
- Department Primary Care & Population Health, University College London (UCL), Royal Free Campus, Rowland Hill St, London, NW3 2PF, UK
| |
Collapse
|
35
|
Akmatov MK, Jentsch L, Riese P, May M, Ahmed MW, Werner D, Rösel A, Prokein J, Bernemann I, Klopp N, Prochnow B, Illig T, Schindler C, Guzman CA, Pessler F. Motivations for (non)participation in population-based health studies among the elderly - comparison of participants and nonparticipants of a prospective study on influenza vaccination. BMC Med Res Methodol 2017; 17:18. [PMID: 28148221 PMCID: PMC5288977 DOI: 10.1186/s12874-017-0302-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/24/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Participation in epidemiological studies has strongly declined in recent years. We examined the reasons for (non)participation in population-based health studies among participants and nonparticipants of a prospective study on influenza vaccination among the elderly. METHODS Males and females between 65 and 80 years of age (N = 5582) were randomly selected from the residents' registration office in Hannover, Germany, and were invited to participate in a study featuring vaccination with a seasonal adjuvanted influenza vaccine (Fluad™, Novartis) including five follow-up visits (day 0, 1/3, 7, 21, 70 with respect to vaccination). A 24-item nonresponder questionnaire, including 10 items on reasons for participating in a hypothetical health study, was mailed to 1500 randomly selected nonparticipants. The same 10 items were included in the end-of-study questionnaire administered to the participants in the vaccination study (n = 200). Logistic regression analysis with backward elimination was used to identify the reasons most strongly associated with nonparticipation. RESULTS Five hundred thirty-one (35%) nonparticipants and 200 participants (100%) returned the respective questionnaires. Nonparticipation was associated with a lower interest in obtaining personal health information (OR = 3.32) and a preference for less invasive (OR = 3.01) and less time-demanding (OR = 2.19) studies. Responses to other items, e.g. regarding altruistic motives, monetary compensation, general interest of the study, or study approval through ethics committee and data security authority, did not differ between participants and nonparticipants. CONCLUSIONS Participation rates in health studies among elderly individuals could potentially be improved by reducing interventions and time demand, for instance by implementing methods of self-sampling and remote data collection. TRIAL REGISTRATION No. 1100359 (ClinicalTrials.gov, date of registration: 09.02.2015).
Collapse
Affiliation(s)
- Manas K Akmatov
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany. .,Helmholtz Centre for Infection Research, Braunschweig, Germany. .,Centre for Individualized Infection Medicine, Hannover, Germany. .,Research Group "Biomarkers for Infectious Diseases", TWINCORE, Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Str. 7, Hannover, 30625, Germany.
| | - Leonhard Jentsch
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Peggy Riese
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Marcus May
- MHH CRC Core Facility, Hannover Medical School, Hannover, Germany
| | - Malik W Ahmed
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Damaris Werner
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Anja Rösel
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Jana Prokein
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Inga Bernemann
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Norman Klopp
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Blair Prochnow
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Thomas Illig
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | | | - Carlos A Guzman
- Helmholtz Centre for Infection Research, Braunschweig, Germany.,Centre for Individualized Infection Medicine, Hannover, Germany
| | - Frank Pessler
- TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany.,Helmholtz Centre for Infection Research, Braunschweig, Germany.,Centre for Individualized Infection Medicine, Hannover, Germany
| |
Collapse
|