Self-administered questionnaires enhance emotion estimation of individuals with autism spectrum disorders in a robotic interview setting

Background

Robots offer many unique opportunities for helping individuals with autism spectrum disorders (ASD). Determining the optimal motion of robots when interacting with individuals with ASD is important for achieving more natural human-robot interactions and for exploiting the full potential of robotic interventions. Most prior studies have used supervised machine learning (ML) of user behavioral data to enable robot perception of affective states (i.e., arousal and valence) and engagement. It has previously been suggested that including personal demographic information in the identification of individuals with ASD is important for developing an automated system to perceive individual affective states and engagement. In this study, we hypothesized that assessing self-administered questionnaire data would contribute to the development of an automated estimation of the affective state and engagement when individuals with ASD are interviewed by an Android robot, which will be linked to implementing long-term interventions and maintaining the motivation of participants.

Methods

Participants sat across a table from an android robot that played the role of the interviewer. Each participant underwent a mock job interview. Twenty-five participants with ASD (males 22, females 3, average chronological age = 22.8, average IQ = 94.04) completed the experiment. We collected multimodal data (i.e., audio, motion, gaze, and self-administered questionnaire data) to train a model to correctly classify the state of individuals with ASD when interviewed by an android robot. We demonstrated the technical feasibility of using ML to enable robot perception of affect and engagement of individuals with ASD based on multimodal data.

Results

For arousal and engagement, the area under the curve (AUC) values of the model estimates and expert coding were relatively high. Overall, the AUC values of arousal, valence, and engagement were improved by including self-administered questionnaire data in the classification.

Discussion

These findings support the hypothesis that assessing self-administered questionnaire data contributes to the development of an automated estimation of an individual's affective state and engagement. Given the efficacy of including self-administered questionnaire data, future studies should confirm the effectiveness of such long-term intervention with a robot to maintain participants' motivation based on the proposed method of emotion estimation.

Escalation on Kihon Checklist Scores Preceding the Certification of Long-Term Care Need in the Older Population in Japan. A 9-Year Retrospective Study

Objectives

The Kihon Checklist (KCL) is valuable for predicting long-term care (LTC) certification. However, the precise association between KCL scores and the temporal dynamics of LTC need certification remains unclear. This study clarified the characteristic trajectory of KCL scores in individuals certified for LTC need.

Methods

The KCL scores spanning from 2011 to 2019 were obtained from 5630 older individuals, including those certified for LTC need in November 2020, in Iiyama City, Nagano, Japan. We analyzed the KCL score trajectories using a linear mixed model, both before and after propensity score matching.

Results

Throughout the 9-year observation period, the KCL scores consistently remained higher in the certified group compared to the non-certified group. Notably, a significant score increase occurred within the 3 years preceding LTC certification.

Discussion

Our findings highlight the effectiveness of continuous surveillance using the KCL in identifying individuals likely to require LTC within a few years.

[Development of the Japanese version of the 16-Item Informant Questionnaire on Cognitive Decline for the Elderly (J-IQCODE 16) for the Diagnosis of Prestroke Dementia]

The 16-Item Informant Questionnaire on Cognitive Decline for the Elderly (IQCODE 16) has been frequently used to diagnose prestroke dementia, an important determinant of stroke prognosis. We developed the Japanese version of the IQCODE 16 (J-IQCODE 16) using standardized translation methods. We applied the J-IQCODE 16 to 102 patients with stroke (19 with prestroke dementia diagnosed with DSM-5) admitted to the stroke care unit in our hospital. The cohort was randomly divided into a derivation cohort and a validation cohort containing 51 patients each. In the derivation cohort, the median J-IQCODE 16 score was 3.06, and the area under the receiver operating characteristic curve for prestroke dementia was 0.96, with an optimal cutoff value of 3.25 determined using the Youden index. When applied this cut-point to the validation cohort, the sensitivity and specificity of the J-IQCODE 16 for prestroke dementia were 90% and 85%, respectively. The J-IQCODE 16 is considered useful for the diagnosis of prestroke dementia.

A self-administered questionnaire to measure Chinese smokers' cigarette dependence

A self-administered questionnaire for screening cigarette dependence was developed based on a set of 6335 Chinese adult smokers (termed the China Cigarette Dependence Test, CCDT). Both a 20-item version (CCDT-20) and a 7-item of the questionnaire (CCDT-7) were developed following 2-round of tests on their construct validity, test-retest reliability and internal consistency, covering seven dimensions (cigarettes per day, tolerance, withdrawal symptoms, craving, loss of control, regularity, and stereotypy). The results showed that the CCDT-20 and CCDT-7 scores were higher in daily smokers than in occasional smokers, and both were associated with self-rated nicotine dependence, exhaled carbon monoxide (CO), saliva cotinine, and DSM-V. The CCDT-20 and CCDT-7 scales were found to be easier to use by smokers in China and provided a more reliable measure of their cigarette dependence.

A Screening Tool for Self-Evaluation of Risk for Age-Related Macular Degeneration: Validation in a Spanish Population

Purpose

The objectives of this study were the creation and validation of a screening tool for age-related macular degeneration (AMD) for routine assessment by primary care physicians, ophthalmologists, other healthcare professionals, and the general population.

Methods

A simple, self-administered questionnaire (Simplified Théa AMD Risk-Assessment Scale [STARS] version 4.0) which included well-established risk factors for AMD, such as family history, smoking, and dietary factors, was administered to patients during ophthalmology visits. A fundus examination was performed to determine presence of large soft drusen, pigmentary abnormalities, or late AMD. Based on data from the questionnaire and the clinical examination, predictive models were developed to estimate probability of the Age-Related Eye Disease Study (AREDS) score (categorized as low risk/high risk). The models were evaluated by area under the receiving operating characteristic curve analysis.

Results

A total of 3854 subjects completed the questionnaire and underwent a fundus examination. Early/intermediate and late AMD were detected in 15.9% and 23.8% of the patients, respectively. A predictive model was developed with training, validation, and test datasets. The model in the test set had an area under the curve of 0.745 (95% confidence interval [CI] = 0.705-0.784), a positive predictive value of 0.500 (95% CI = 0.449-0.557), and a negative predictive value of 0.810 (95% CI = 0.770-0.844).

Conclusions

The STARS questionnaire version 4.0 and the model identify patients at high risk of developing late AMD.

Translational Relevance

The screening instrument described could be useful to evaluate the risk of late AMD in patients >55 years without having an eye examination, which could lead to more timely referrals and encourage lifestyle changes.

Attitudes of Company Executives toward a Comprehensive Workplace Health Management-Results of an Exploratory Cross-Sectional Study in Germany

Workplace health management (WHM) in Germany aims at maintaining and increasing the health and well-being of employees. Little is known about company executives’ attitudes toward WHM. To gain more insight, we conducted a large-scale survey in companies in the German county of Reutlingen in 2017. We sent a standardized questionnaire to 906 companies, containing inter alia 26 self-constructed declarative statements depicting company executives’ opinions on various WHM aspects; 222 questionnaires could be evaluated. By exploratory factor analysis we assigned the 26 items to six factors reflecting different attitudes toward WHM. Factor values were standardized to a scale from 0 to 10. The attitude ‘positive view of general health services in the company’, for example, achieved by far the lowest mean agreement (3.3 points). For the attitude ‘general skepticism toward WHM’, agreement and disagreement were balanced (5.0 points). Using multiple regression analyses, we searched for variables that could partially explain respondents’ agreement with attitudes. In conclusion, a general WHM skepticism was widespread, but not dominant. The idea that general health services should be offered in companies was predominantly rejected. Older respondents and respondents from smaller companies and craft enterprises were more skeptical than average about WHM and its possible extensions.

Development and initial psychometric evaluation of a radiotherapy-related symptom assessment tool, based on data from patients with brain tumours undergoing proton beam therapy

BACKGROUND

Currently, no available tool easily and effectively measures both the frequency, intensity and distress of symptoms among patients receiving radiotherapy. A core symptom set (fatigue, insomnia, pain, appetite loss, cognitive problems, anxiety, nausea, depression, constipation, diarrhoea and skin reaction) has been identified and assessed across oncology research to better understand the pattern of symptoms and treatment side effects.

AIM

The aim was to develop a tool measuring the multiple-symptom experience in patients undergoing radiotherapy and evaluate its psychometric properties (validity, reliability and responsiveness).

DESIGN

This study has a prospective, longitudinal and quantitative design.

METHODS

We developed a patient-reported outcome questionnaire, the Radiotherapy-Related Symptoms Assessment Scale to assess the frequency, intensity and distress associated with symptoms. Patients (n = 175) with brain tumours undergoing proton beam therapy completed the Radiotherapy-Related Symptoms Assessment Scale and the health-related quality of life questionnaire (EORTC QLQ-C30) during treatment. We assessed the validity, reliability and responsiveness of the Radiotherapy-Related Symptoms Assessment Scale and evaluated the validity against QLQ-C30.

RESULTS

There were significant questionnaire-questionnaire correlations regarding selected items, primarily fatigue, insomnia and pain, indicating satisfactory criterion-related validity. The Radiotherapy-Related Symptoms Assessment Scale had fair to good retest reliability.

CONCLUSION

The Radiotherapy-Related Symptoms Assessment Scale is a valid instrument for assessing symptom intensity and distress in patients with brain tumour undergoing PBT, with psychometric properties within the expected range. The Radiotherapy-Related Symptoms Assessment Scale provides nurses with substantial information on symptom experience but requires little effort from the patient. Additional studies are required to further assess the psychometric properties in patients with different cancer diagnoses receiving conventional radiotherapy.

Impact of Self-Reported Sitting Time and Transtheoretical Model Based on Exercise Behavior Change on Glycemic and Weight Control in Japanese Adults with Type 1 Diabetes: A Cross-Sectional Study

This cross-sectional study aimed to examine the associations among self-reported sitting time (ST), transtheoretical model (TTM) based on exercise behavior change, and glycemic and weight control in Japanese adults with type 1 diabetes (T1D). Forty-two adults (age, 44.0 (33.3–56.8) years) with uncomplicated T1D answered questions regarding their lifestyles, including ST per day, and TTM using self-administered questionnaires. The glycated hemoglobin (HbA1c) level correlated with age and ST (p < 0.05, p < 0.01, respectively), whereas body mass index correlated with duration of T1D and TTM (p < 0.05, p < 0.01, respectively). Logistic regression analysis showed that poor glycemic control (HbA1c, >7%) was associated with ST (odds ratio, 3.53 (95% confidence interval, 1.54–8.11), p < 0.01). In addition, the cut-off points for quartiles of ST were 4.6, 6.0, and 8.0 h/day, and the HbA1c level in the lowest quartile was 15% lower than that in the highest quartile (p < 0.01). Although further studies with larger samples are needed, these results implied that expanded self-reported ST might be related to poor glycemic control in Japanese T1D adults, most of whom were lean, young and middle-aged, regardless of TTM based on exercise behavior change.

Validation of self-reported medication use for hypertension, diabetes, and dyslipidemia among employees of large-sized companies in Japan

OBJECTIVE

The aim of this study was to evaluate the validity of self-reported medication use for hypertension, diabetes, and dyslipidemia by comparison with health insurance claims among employees of large-sized companies in Japan.

METHODS

Participants were 61 676 participants of 13 large-sized companies in Japan. Self-reports on medication use were obtained through web- or paper-based questionnaires conducted at the annual health checkup in fiscal year 2016. Health insurance claims for medication were obtained from corporate health insurance associations from April 1, 2016, to March 31, 2017. Agreement rate, sensitivity, specificity, positive and negative predictive values (PPV and NPV), and kappa statistics of self-reporting were examined for different reference periods (1-, 2-, and 3- months, and 1-year). Subgroup analysis was conducted stratified by sex, age, body mass index, smoking, alcohol drinking, blood pressure, hemoglobin A1c, and low-density lipoprotein cholesterol.

RESULTS

Agreement, sensitivity, specificity, PPV, and NPV were 0.98, 0.90, 0.98, 0.87, and 0.99 for hypertension, 0.99, 0.89, 1.00, 0.89, and 1.00 for diabetes, and 0.98, 0.86, 0.99, 0.83, and 0.99 for dyslipidemia, respectively, between self-reports and claims data for 3 months. Kappa statistics were highest with the 3-month reference period of claims data for hypertension, diabetes, and dyslipidemia. No major concordance was observed between the subgroups.

CONCLUSION

This validation of self-reported medication use for hypertension, diabetes, and dyslipidemia showed almost perfect reliability among employees of large-sized companies in Japan.

Short Assessment of Health Literacy (SAHL) in Portugal: development and validation of a self-administered tool

The goal of this study was to adapt, improve and validate a short, self-administered health literacy assessment tool for European Portuguese-speaking adults. Health literacy tools are of great importance to health authorities and professionals, as low or inadequate health literacy, that is, a limited capacity to handle health-related information, is associated with higher morbidity and mortality. The 18-item Short Assessment of Health Literacy for Brazilian Portuguese-speaking adults (SAHLPA-18) was adapted into European Portuguese. The European Portuguese tool (SAHLPA-23) includes five additional items. The SAHLPA-23 was tested in a convenience sample of 503 participants from two Portuguese regions. Socio-demographic data, literacy and cognitive indicators were collected. Participants also completed a questionnaire on comprehension of written health materials. Construct validity was assessed through correlations between SAHLPA-23 scores and education, literacy, and cognitive variables and score on the comprehension questionnaire. The psychometric properties of the new tool were compared with those of the SAHLPA-18. The mean SAHLPA-18 and SAHLPA-23 scores were 13.9 (77.2%; SD=2.9) and 18.3 (79.6%; SD=3.8), respectively. Both tools showed adequate reliability (Cronbach’s α>0.7). SAHLPA-23 was more highly correlated with all study variables than SAHLPA-18. Although both instruments displayed acceptable discriminative power, SAHLPA-23 had better accuracy than SAHLPA-18 (DeLong’s method: ΔAUC=0.09, Z=3.36; P<0.001). The SAHLPA-23 is an independent, feasible and innovative tool for estimation of health literacy in the Portuguese adult population.

Clinical utility of a self-administered questionnaire for assessment of hereditary gynecologic cancer

Background

A patient's medical history and familial cancer history are important information for assessing the risk of hereditary cancer. We have generated a self-administered questionnaire for patients with gynecologic cancer. This pilot study analyzed the usefulness of this questionnaire and the rates of patients that meet the Society of Gynecologic Oncology criteria in ovarian cancer and endometrial cancer patients.

Method

Ovarian or endometrial cancer patients were recruited for this study. After informed consent was obtained, participants completed the questionnaire. Genetic risks were assessed from the data of each patient's questionnaire by Society of Gynecologic Oncology guideline. Clinical and pathological findings were compared between the genetic risk groups.

Results

A total of 105 patients were identified with ovarian cancer and 56 patients with endometrial cancer eligible for this study. According to the Society of Gynecologic Oncology guideline, of the 105 ovarian cancer patients, 25 patients (23%) had a 20–25% risk and three patients (2.9%) had a 5–10% risk of hereditary breast and ovarian cancer syndrome. A further 22 patients (21%) had a 5–10% risk of Lynch syndrome. Two patients (1.9%) met the Amsterdam criteria II. Of 56 endometrial cancer patients, 24 patients (42.9%) had a 5–10% risk of Lynch syndrome. The endometrial cancer patients with genetic risk of Lynch syndrome were younger (mean age: 47.79) at diagnosis compared to patients without a genetic risk of Lynch syndrome (mean age: 57.91).

Conclusions

In this study, we were able to show that the newly designed questionnaire is a useful tool for evaluating cancer family history along with Society of Gynecologic Oncology criteria or Amsterdam criteria II. When considering the risk of Lynch syndrome for a patient with ovarian cancer, it is important to collect a second and third relative's family history.

Content Validity of the Credibility and Expectancy Questionnaire in a Pain Rehabilitation Setting

BACKGROUND

Content validity, the proper reflection of the concept to be measured, is yet unknown for the Credibility and Expectancy Questionnaire (CEQ). It is frequently used in pain rehabilitation because treatment expectancy is influential on the outcome.

OBJECTIVE

To test and improve the content validity of the CEQ in a sample of patients with chronic pain in different phases of their treatment.

METHODS

A qualitative observational study design using the Three-Step Test-Interview method was used. Therein, data collection, analyses, and adaptations occur iteratively.

RESULTS

Seventeen patients with chronic pain in different stages of treatment participated through convenience sampling from the mother sample of a randomized controlled trial. The main study parameter is content validity, which is defined as (1) interpretations and responses of the participants and (2) the identification of response problems operationalized, and resulting in changes in the CEQ. For patients waiting for treatment, the written instruction of the CEQ allowed different interpretations. After changing the instructions, the CEQ became an easy-to-understand and content-valid questionnaire. For patients who had already undergone treatment, changes regarding time frame and recall period were necessary to overcome interpretation and response problems to the CEQ.

DISCUSSION

After small changes, the CEQ appeared to be a content-valid measurement instrument for patients waiting for treatment. However, for patients who had already undergone treatment, the content validity of the CEQ was less, and considerable changes were necessary.

Impact of caries prevalence on oral health-related quality of life among police personnel in Virajpet, South India

OBJECTIVE

The objective of this study is to assess the impact of caries prevalence on oral health-related quality of life among police personnel in Virajpet, South India.

MATERIALS AND METHODS

Police personnel were randomly selected from the 296 police staff working in Virajpet, India. They were invited for a dental examination and a questionnaire survey. A self-administered questionnaire was used to collect their demographic information, and to determine the oral health-related quality of life (OHRQoL). Caries experiences of the participants were recorded as per the World Health Organization (WHO) criteria (1997). The analysis of variance (ANOVA) was used to compare within-group differences of the selected sociodemographic factors and the Chi-square analysis was used to explore the association between the variables.

RESULTS

All the 172 invited participants joined this study. Their mean age was 38.02 ± 9.08 years. There was no significant difference in oral health-related quality of life scores according to gender and age. The prevalence of dental caries was found to be 78% in the current study. Data analysis showed that there was no statistically significant association between the oral health-related quality of life scores and caries prevalence.

CONCLUSION

The present study showed that there was no association between the oral health-related quality of life and caries prevalence among the police personnel in Virajpet.

Lumbar spinal stenosis-specific symptom scale: validity and responsiveness

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

To test the validity and responsiveness of the lumbar spinal stenosis (LSS)-specific symptom scale (FLS-25 [Fukushima LSS Scale 25]).

SUMMARY OF BACKGROUND DATA

The FLS-25, a self-administered questionnaire designed to comprehensively cover various symptoms of LSS, has been developed to address the need to measure symptoms specific to this disorder.

METHODS

One hundred sixty-seven patients with confirmed LSS who required conservative therapy were asked to complete a questionnaire including questions regarding walking capacity and the FLS-25. These patients also underwent a lumbar extension test and a walking stress test, which are stress tests designed to objectively evaluate LSS symptoms, to measure standing time, walking distance, and walking time. Relationship between the FLS-25 scores and these external standards was analyzed to evaluate the criterion validity of the FLS-25. The patients underwent the same evaluations after 8 weeks of conservative therapy. The relationship between changes from baseline to week 8 in FLS-25 scores and changes in the 3 external standards was analyzed to evaluate the responsiveness of the FLS-25.

RESULTS

The distribution of FLS-25 scores among patients was symmetric, and there were no ceiling or floor effects. FLS-25 scores increased as self-reported walking capacity decreased (P=0.006). The mean standing time in the lumbar extension test was 165 (SD=109) seconds, and FLS-25 scores increased as standing time decreased (P=0.003). In the walking stress test, mean walking distance and mean walking time were 213 (SD=154) m and 236 (SD=114) seconds. FLS-25 scores increased as walking distance (P=0.002) and walking time (P=0.054) decreased. Changes from baseline to week 8 in FLS-25 scores correlated with changes in the stress test standing time (P=0.014), walking distance (P<0.001), and walking time (P<0.001).

CONCLUSION

The criterion validity and responsiveness of the FLS-25 were confirmed. The use of FLS-25 in clinical and investigational settings is warranted to monitor patients and evaluate therapeutic efficacy.

LEVEL OF EVIDENCE

3.

Exercise counseling of primary care physicians in metabolic syndrome and cardiovascular diseases is associated with their specialty and exercise habits

Background

We investigated the practice of exercise counseling of primary care physicians in metabolic syndromes and cardiovascular diseases and its association with their age class, specialty, work place, and their own exercise habits.

Subjects and methods

The subjects were 3,310 medical doctors who had graduated from Jichi Medical University in Japan. The study instrument was a self-administered questionnaire to investigate their age class, specialty, workplace, exercise habits, and exercise counseling for their patients.

Results

Overall, 839 completed responses were analyzed from a total of 933 that were received (28.2%). The primary care physicians whose specialties were internal medicine and general medicine significantly more often recommended exercise in diabetes mellitus, hyperlipidemia, heart failure, and hypertension cases than those whose specialties were surgery and pediatrics. The primary care physicians whose specialty was pediatrics recommended exercise less often in apoplexia cases than those whose specialties were internal medicine, general medicine, and surgery. Their exercise habits were positively associated with their recommendation of exercise in hyperlipidemia, heart failure, and hypertension cases; however, these associations were not observed in diabetes mellitus and apoplexia. The primary care physicians’ age class and work place showed no association with their exercise recommendations in metabolic syndrome and cardiovascular diseases.

Conclusion

The primary care physicians whose specialties were internal medicine and general medicine significantly more often recommended exercise in diabetes mellitus, hyperlipidemia, heart failure, and hypertension cases. In addition, their own exercise habits were positively associated with their recommendation of exercise in hyperlipidemia, heart failure, and hypertension cases.

Association of primary care physicians' exercise habits and their age, specialty, and workplace

Background

In this study, we investigated primary care physicians’ exercise habits, and the association of this variable with their age, specialty, and workplace.

Methods

The population of this cross-sectional study comprised 3,310 medical doctors who graduated from Jichi Medical University in Japan between 1978 and 2012. The study instrument was a self-administered questionnaire mailed in August 2012 to investigate primary care physicians’ exercise habits, age, specialty, and workplace.

Results

The 896 available primary care physicians’ responses to the self-administered questionnaire were analyzed. Their exercise frequency was as follows: daily, 104 (11.6%); at least 2–3 times per week, 235 (26.2%); no more than once a week, 225 (25.1%); no more than once a month, 278 (31.0%); and other, 52 (5.8%). Their exercise intensity was as follows: high (≥6 Mets), 264 (29.5%); moderate (4–6 Mets), 199 (22.2%); mild, (3–4 Mets), 295 (32.9%); very mild (<3 Mets), 68 (7.6%); none, 64 (7.1%); and other, 6 (0.7%). Their exercise volume was calculated to represent their exercise habits by multiplying score for exercise frequency by score for intensity. Multivariate linear regression analyses showed that the primary care physicians’ exercise volumes were associated with their age (P<0.01) and workplace (P<0.01), but not with their specialty (P=0.37). Primary care physicians in the older age group were more likely to have a higher exercise volume than those in the younger age groups (50–60 years > older than 60 years >40–50 years >30–40 years >24–30 years). Primary care physicians working in a clinic were more likely to have a higher exercise volume than those working in a university hospital, polyclinic hospital, or hospital.

Conclusion

Primary care physicians’ exercise habits were associated with their age and workplace, but not with their specialty.

A comparative analysis of monthly out-of-pocket costs for patients with breast cancer as compared with other common cancers in Ontario, Canada

BACKGROUND

Monthly out-of-pocket costs (oopc) for Ontario patients with cancer have previously been reported, but little detail has been provided on differences based on tumour type.

METHODS

A questionnaire administered in cancer clinics in the province of Ontario, with a mix of urban and rural patients, was analyzed using descriptive statistics and a regression analysis of cross-sectional data. The dependent variable was oopc (Canadian dollars), analyzed separately for total oopc (excluding imputed travel costs), and for each of the individual cost categories.

RESULTS

Compared with colorectal, lung, and prostate cancer patients combined, breast cancer patients had statistically significantly higher total oopc ($393 vs. $149, p = 0.02), device costs ($142 vs. $12, p = 0.018), and family care costs ($38 vs. $3, p = 0.01). By contrast, they trended toward lower costs for travel ($225 vs. $426, p = 0.055) and had lower costs for parking ($32 vs. $53, p = 0.0198). Compared with non-breast cancer patients, patients with breast cancer reported a greater perceived financial burden (31% vs. 17% p = 0.0133).

INTERPRETATION

These findings highlight that financial burden for cancer patients can vary by tumour type, and that patients with breast cancer may require a different mix of supportive services than do patients with other common tumour types. Supportive care programs related to financial burden should consider the likelihood and nature of financial burden when counselling breast cancer patients.

Reliability of retrospective self-reports of sexual and nonsexual health behaviors among women

The accuracy of self-reports regarding sexual health behavior has been questioned. To investigate whether sexual health behaviors are uniquely difficult to report, we asked 185 college women to answer behavioral frequency questions about sexual and nonsexual health behaviors for an 8-week interval. Women either took part in a face-to-face interview or completed a self-administered questionnaire. One week later, the women returned and responded to the same questions in the same mode of assessment conditions. The test-retest intraclass correlations showed that all health behaviors, sexual and nonsexual, were reported reliably. There was a trend for lower-frequency reports to yield more-stable estimates of behavioral frequency. These findings converge with other methodological investigations to indicate that socially sensitive health behaviors are not more difficult to assess reliably.

Short- and long-term reliability of information on previous illness and family history as compared with that on smoking and drinking habits in questionnaire surveys

To assess the reliability of responses to questionnaires regarding previous illness, family history of cancer, and smoking and drinking habits, we repeated questionnaire surveys four times at intervals of 2 weeks and 1 year (short-term), and 4.5 years (long-term) among 440 subjects aged 40-69. The reliability was assessed using kappa statistic. Kappa was calculated both for complete data and data including missing values. The changes of mode of pre-after paired responses were also investigated. Our results from complete data showed both short- and long-term reliabilities of replies regarding smoking or drinking were excellent (mean kappa 0.85-0.99). The reliability of previous illness was excellent except for stroke for short-term intervals (mean kappa 0.85-1.00), but varied depending on the kinds of illness with long-term intervals (mean kappa -0.01-0.75). Responses to family history had fair to excellent short-term reliability (mean kappa 0.54-0.85). Inclusion of missing value as an independent category reduced reliability remarkably. Subjects stating absence of medical history were more likely to have missing values for this item than subjects with some history. In conclusion, the reliability for information given on previous illness was as good as that on smoking and drinking for a short interval, but was lower for a long-interval probably due to the development of new cases. The reliability of a family history on cancer was slightly poorer than that of individual's previous cancer or other illnesses and that of smoking and drinking even for a short interval.