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Koschollek C, Gaertner B, Geerlings J, Kuhnert R, Mauz E, Hövener C. Recruiting people with selected citizenships for the health interview survey GEDA Fokus throughout Germany: evaluation of recruitment efforts and recommendations for future research. BMC Med Res Methodol 2024; 24:200. [PMID: 39266952 DOI: 10.1186/s12874-024-02328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 09/02/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND Germany is the second most common country of immigration after the US. However, people with own or familial history of migration are not represented proportionately to the population within public health monitoring and reporting. To bridge this data gap and enable differentiated analyses on migration and health, we conducted the health interview survey GEDA Fokus among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship living throughout Germany. The aim of this paper is to evaluate the effects of recruitment efforts regarding participation and sample composition. METHODS Data collection for this cross-sectional and multilingual survey took place between 11/2021 and 5/2022 utilizing a sequential mixed-mode design, including self-administered web- and paper-based questionnaires as well as face-to-face and telephone interviews. The gross sample (n = 33436; age range 18-79 years) was randomly drawn from the residents' registers in 120 primary sampling units based on citizenship. Outcome rates according to the American Association for Public Opinion Research, the sample composition throughout the multistage recruitment process, utilization of survey modes, and questionnaire languages are presented. RESULTS Overall, 6038 persons participated, which corresponded to a response rate of 18.4% (range: 13.8% for Turkish citizenship to 23.9% for Syrian citizenship). Home visits accounted for the largest single increase in response. During recruitment, more female, older, as well as participants with lower levels of education and income took part in the survey. People with physical health problems and less favourable health behaviour more often took part in the survey at a later stage, while participants with symptoms of depression or anxiety more often participated early. Utilization of survey modes and questionnaire languages differed by sociodemographic and migration-related characteristics, e.g. participants aged 50 years and above more often used paper- than web-based questionnaires and those with a shorter duration of residence more often used a translated questionnaire. CONCLUSION Multiple contact attempts, including home visits and different survey languages, as well as offering different modes of survey administration, increased response rates and most likely reduced non-response bias. In order to adequately represent and include the diversifying population in public health monitoring, national public health institutes should tailor survey designs to meet the needs of different population groups considered hard to survey to enable their survey participation.
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Affiliation(s)
- Carmen Koschollek
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany.
| | - Beate Gaertner
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Julia Geerlings
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Ronny Kuhnert
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Elvira Mauz
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Claudia Hövener
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
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Nykänen S, García-Velázquez R, E Castaneda A, Koponen P, Musta L, Skogberg N. Psychosocial and economic impact of COVID-19 pandemic by sex among migrant populations compared with general Finnish population: a population-based study. Scand J Public Health 2024; 52:360-369. [PMID: 38544303 PMCID: PMC11067388 DOI: 10.1177/14034948241235245] [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: 06/22/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 05/04/2024]
Abstract
AIMS To study sex differences in the psychosocial and economic impact of the restrictive measures during the COVID-19 pandemic in 2020 among the migrant origin and the general population in Finland. METHODS Cross-sectional MigCOVID Survey data (10/2020-2/2021; n=3668) were used. FinHealth 2017 Follow-up Study participants constituted the general population reference group (n=3490). Sex differences in self-perceived impact of the restrictive measures during the COVID-19 pandemic in 2020 on the psychosocial and economic situation were examined with multivariate logistic regression, adjusting for sociodemographics and self-rated health. RESULTS The migrant origin population had higher odds for reporting weakened economic situation (odds ratio (OR) 5.41; 95% confidence interval (CI) 3.96-7.39), increased loneliness (OR 1.75; 95% CI 1.35-2.28), decrease in feelings of hope for the future (OR 1.70; 95% CI 1.33-2.19) and increased sleeping difficulties and nightmares (OR 1.98; 95% CI 1.34-2.92) than the general population. While the psychosocial and economic impact of COVID-19 was higher in women compared with men in the general population, findings were not fully replicated in the migrant origin population. CONCLUSIONS Individuals of migrant origin faced a higher likelihood of experiencing adverse changes in both psychosocial and economic aspects during the pandemic, suggesting increased vulnerability linked to migrant origin. Additional research is required to delve into the intricate connections among gender, migrant origin, and the impact of COVID-19, aiming to enhance comprehensive understanding of the contributing factors. Vulnerabilities of different population groups should be identified and addressed when planning measures to reduce adverse societal impact in future crises.
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Affiliation(s)
- Sanna Nykänen
- Department of Public Health and Welfare, Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Regina García-Velázquez
- Department of Public Health and Welfare, Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anu E Castaneda
- Department of Public Health and Welfare, Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Laura Musta
- Department of Public Health and Welfare, Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Natalia Skogberg
- Department of Public Health and Welfare, Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Kieseppä V, García Velázquez R, Vehko T, Castaneda A, Kuusio H. Satisfaction With Primary Care Among the Foreign-Born and the General Population in Finland: A Survey-Based study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241252567. [PMID: 38708687 DOI: 10.1177/00469580241252567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Foreign-born people have been found to be less satisfied with health care than native populations across countries. However, studies on differences in satisfaction with treatment between different foreign-born groups are lacking. This study explores differences in satisfaction with primary health care between the foreign-born population from different regions of origins and the general population of Finland. The study uses survey data on foreign-born population (n = 2708) and general population (n = 6671) living in Finland who report using health services. Satisfaction with experienced respect for privacy during treatment, benefit of treatment and smoothness of treatment are predicted by region of origin using logistic regression. Almost all foreign-born groups were less likely to consider treatment appointments beneficial as compared to the general population. Some foreign-born groups (people from Southeast Asia and South and Central Asia) were more satisfied with smoothness of care compared to general population. People from East Asia were less likely than the general population to consider that their privacy had been respected during the examinations and treatment. While we made the positive finding of high overall satisfaction with treatment, we also found important differences between groups. In particular, appointments were found less useful among the foreign-born population. Perceived unusefulness of treatment might lead to underuse of health care, which might result in accumulation of untreated health problems. The results point toward potential development points in the health care system. Addressing these issues might help decrease health disparities between population groups.
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Affiliation(s)
- Valentina Kieseppä
- Finnish Institute for Health and Welfare, Public Health and Welfare, Helsinki, Finland
- University of Oulu, Faculty of Medicine, Research Unit of Clinical Medicine, Oulu, Finland
- University of Edinburgh, Centre for Clinical Brain Sciences, Edinburgh, UK
| | | | - Tuulikki Vehko
- Finnish Institute for Health and Welfare, Public Health and Welfare, Helsinki, Finland
| | - Anu Castaneda
- Finnish Institute for Health and Welfare, Public Health and Welfare, Helsinki, Finland
| | - Hannamaria Kuusio
- Finnish Institute for Health and Welfare, Public Health and Welfare, Helsinki, Finland
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Robertsson T, Kokko S, Lilja E, Castañeda AE. Prevalence and risk factors of psychological distress among foreign-born population in Finland: A population-based survey comparing nine regions of origin. Scand J Public Health 2023:14034948221144660. [PMID: 36600449 DOI: 10.1177/14034948221144660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS Previous research indicates that foreign-born populations experience more psychological distress than general populations. However, it remains unclear how prevalence varies between regions of origin. The role of socio-demographic and migration-related factors also needs to be further investigated. We aimed to (a) compare the prevalence of psychological distress in foreign-born and general Finnish populations, (b) investigate differences in prevalence between nine regions of origin and (c) examine which socio-demographic and migration-related factors are associated with distress among foreign-born populations. METHODS The study used data from the Survey on Well-Being among Foreign Born Population (FinMonik), a population-based survey (n=6312) of foreign-born populations living in Finland collected between 2018 and 2019 by the Finnish Institute for Health and Welfare. Psychological distress was measured using the Mental Health Inventory-5 (MHI-5), with a cut-off point of 52. Logistic regression was used to adjust analyses by age and sex to determine the prevalence of psychological distress and the associated socio-demographic factors. RESULTS Psychological distress was more prevalent among those who were foreign born (17.4%) than among the general population (12.9%). Migrants from the Middle East and North Africa had the highest prevalence (29.7%) compared to other regions of origin. Unemployment or economic inactivity, international protection as a reason for migration and beginner-level language proficiency were the main factors increasing the odds for distress among foreign-born populations. CONCLUSIONS
Foreign-born populations experience more psychological distress than the general population, but prevalence varies between regions of origin. Future efforts should aim at a better understanding of the mental health risk factors and the development of targeted interventions for these subpopulations.
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Affiliation(s)
- Tessa Robertsson
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Sami Kokko
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Eero Lilja
- Migration and Cultural Diversity Team, Finnish Institute for Health and Welfare, Finland
| | - Anu E Castañeda
- Migration and Cultural Diversity Team, Finnish Institute for Health and Welfare, Finland
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Bastola K, Nohynek H, Lilja E, Castaneda AE, Austero S, Kuusio H, Skogberg N. Incidence of SARS-CoV-2 Infection and Factors Associated With Complete COVID-19 Vaccine Uptake Among Migrant Origin Persons in Finland. Int J Public Health 2023; 68:1605547. [PMID: 37206095 PMCID: PMC10189547 DOI: 10.3389/ijph.2023.1605547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/20/2023] [Indexed: 05/21/2023] Open
Abstract
Objective: We examined incidence of SARS-CoV-2 infection, COVID-19 vaccine uptake and factors associated with complete COVID-19 vaccine uptake among persons of migrant origin in Finland. Methods: Data on laboratory-confirmed SARS-CoV-2 infection and COVID-19 vaccine doses between March 2020 and November 2021 were linked to FinMonik register sample (n = 13,223) and MigCOVID (n = 3,668) survey data using unique personal identifier. Logistic regression was the main method of analyses. Results: Among FinMonik sample, complete COVID-19 vaccine uptake was lower among persons of Russia/former Soviet Union, Estonia, and rest of Africa and higher among persons of Southeast Asia, rest of Asia, and the Middle East/North Africa than among persons originating from Europe/North America/Oceania. Male sex, younger age, migration age (<18 years) and shorter length of residence were associated with lower vaccine uptake among FinMonik sample, whereas younger age, being economically inactive, poorer language skills, experiences of discrimination and psychological distress were associated with lower vaccine uptake among MigCOVID sub-sample. Conclusion: Our Findings point to a further need of tailored and targeted communication and community outreach strategies to increase vaccine uptake among persons of migrant origin.
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García-Velázquez R, Kieseppä V, Lilja E, Koponen P, Skogberg N, Kuusio H. A multisource approach to health care use: concordance between register and self-reported physician visits in the foreign-born population in Finland. BMC Med Res Methodol 2022; 22:309. [PMID: 36460964 PMCID: PMC9717412 DOI: 10.1186/s12874-022-01780-w] [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: 08/11/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Reliable information on the use of health services is important for health care planning, monitoring and policy. It is critical to assess the validity of the sources used for this purpose, including register and survey-based data. Studies on foreign-born populations' health care use have usually implemented either survey or register data. The concordance of such data among groups of different cultural background remains largely unknown. In this study, we presented an approach to examine routinely how survey and register-related characteristics may explain disagreement found between the two information sources. METHODS We linked register- and survey-based data pertaining to the Finnish Register of Primary Health Care general physician visits and the Survey on Well-Being among Foreign Born Population (FinMonik, 2018-2019), a nationally representative survey. The sample comprised n = 5,800 informants for whom registered general physician visits were tracked in the 12-month period preceding their participation in the survey. Cohen's kappa was used as measure of multisource concordance, hierarchical loglinear models for the association between single predictors and multisource discrepancy, and a logistic regression model for examining source-related predictors of source discrepancy. Survey weights were used in all sample analyses. RESULTS Source concordance was poor. When dichotomizing general physician visits (zero vs one or more), 35% of informants had reported one or more visits while none were found from register. Both register- and informant-related predictors were associated to this discrepancy (i.e. catchment area, private health care use, inability to work, region of origin and reason for migration). CONCLUSIONS We found high discrepancy between the reported and the registered physician visits among the foreign-born population in Finland, with a particularly high number of reported physician visits when none were found in the register. There was a strong association between the specific catchment area and mismatch, indicating that both register under-coverage and survey over-report are plausible and may coexist behind the discrepancy. However, associations of informant's characteristics and mismatch were less pronounced. Implications on the validity of medical information sources are discussed.
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Affiliation(s)
- Regina García-Velázquez
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Valentina Kieseppä
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Eero Lilja
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Päivikki Koponen
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Natalia Skogberg
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
| | - Hannamaria Kuusio
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Mannerheimintie 166, PL/PB/P.O. Box 30, FI-00271 Helsinki, Finland
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Kieseppä V, García Velázquez R, Vehko T, Kuusio H. Satisfaction with access to health services among foreign-born population in Finland: a survey-based study. BMC Health Serv Res 2022; 22:781. [PMID: 35701765 PMCID: PMC9199131 DOI: 10.1186/s12913-022-08155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many European studies have shown migrants to be less satisfied with health care and find it less accessible than the general populations. The aim of this study was to compare satisfaction with access to health care between migrants from different regions of origin and the general population of Finland. METHODS This study uses data from two comprehensive survey samples on health and wellbeing of the foreign-born and the general population living in Finland. Three aspects of satisfaction with health care access were measured and predicted by region of origin using logistic regression. RESULTS Foreign-born population was slightly more dissatisfied with all aspects of the access to health care as compared to the general population. In all aspects of access, migrants from the Middle East and Africa were least likely to be satisfied. CONCLUSIONS As the satisfaction with access was lowest among migrant groups which are likely to have higher needs for at least some health services in comparison to the general population, these results are alarming. More research is needed to identify the potential development points in the health care system of Finland.
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Affiliation(s)
- Valentina Kieseppä
- Finnish Institute for Health and Welfare, Public Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Regina García Velázquez
- Finnish Institute for Health and Welfare, Public Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare, Public Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Hannamaria Kuusio
- Finnish Institute for Health and Welfare, Public Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
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