SF-36 scores vary by method of administration: implications for study design.
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BACKGROUND: Previous research suggests that people respond differently to health status measures when data are collected by interview or self completion of a questionnaire. The objective of this study was to determine whether SF-36 health status scores differ systematically by method of administration. METHOD: A randomized cross-over study was carried out on 210 new attenders at general medicine, endocrinology, gastroenterology and urological out-patient departments. The outcome was the difference in SF-36 profiles comparing clinic based interviews with self completion at home by the same subjects. RESULTS: For seven of the eight variables of the SF-36 scores were lower in the self assessment, the differences being statistically significant in four of the eight comparisons. The largest differences were in role limitations due to emotional problems (difference 14.74, 95 per cent confidence interval (CI) 7.76-21.7) and social function (difference 7.21, 95 per cent CI 3.19-11.23). CONCLUSIONS: Clinic based interviews systematically exaggerate health status compared with self assessment. The difference is sufficiently large to underestimate the effectiveness of health service interventions when a clinic based pre-intervention and postal self completed follow-up design is used, unless adjustment is made for this systematic bias. (+info)
Correlates of physical activity in a sample of older adults with type 2 diabetes.
(34/8857)
OBJECTIVE: Physical activity is integral to the management of type 2 diabetes. Unfortunately, the majority of adults with type 2 diabetes do not regularly engage in physical activity. The purpose of this study was to assess physical activity behavior and its correlates (i.e., physical activity knowledge, barriers, and performance and outcome expectations) in older adults with type 2 diabetes. RESEARCH DESIGN AND METHODS: A subgroup of 260 adults with type 2 diabetes was identified from a larger stratified random sample of adults aged > or = 55 years. Participants completed an interviewer-administered survey designed from focus group findings and social learning theory. RESULTS: The majority of the respondents (54.6%) reported 0 min of weekly physical activity. This was especially true of older female respondents. Performance expectation scores were lower among respondents who were in the oldest age-group, namely, white women. Physical activity knowledge varied by age-group, and barriers to physical activity were prevalent in all groups. The following are significant correlates of reported weekly physical activity: younger age, more education, fewer motivational barriers, and greater perceived health and performance expectations. CONCLUSIONS: Given the importance of physical activity to diabetes management, the low prevalence of physical activity found in this and other studies should raise concerns among clinicians. Future research to identify predictors of physical activity is needed to guide clinicians in the promotion of physical activity. (+info)
Diabetes and automobile crashes in the elderly. A population-based case-control study.
(35/8857)
OBJECTIVE: The aim of this study was to estimate the association between diabetes and its complications and at-fault automobile crashes among older drivers. RESEARCH DESIGN AND METHODS: This was a population-based case-control study. Case subjects were drivers aged > or = 65 years who had been involved in a crash during 1996 in which they were at fault. Two control groups were selected: 1) crash-involved not-at-fault subjects and 2) non-crash-involved subjects. Telephone interviewers collected information on demographic characteristics, driving habits, diabetes sequelae and treatment, other chronic medical conditions, and visual function. RESULTS: Overall, there was no association between diabetes and at-fault crash involvement. The adjusted odds ratio (OR) for diabetes was 1.1 (CI 0.7-1.9) when case subjects were compared with either control group. However, the adjusted OR for diabetes was 2.5 (0.9-7.2) among subjects who had been involved in a crash in the 4 years preceding 1996, while it was only 0.9 (0.5-1.7) among those who had not. There was no evidence of an association between treatment modalities and at-fault crash involvement. Case subjects were, although not significantly (P = 0.25), more likely (OR 2.4) to report neuropathy compared with both control groups, and retinopathy was not associated with increased crash risk. CONCLUSIONS: This study provides no evidence that older drivers with diabetes are at increased risk for automobile crashes. There remains the possibility that those with diabetes who have more severe disease or have had multiple crashes are at increased risk. (+info)
Getting a high response rate of sexual behavior survey among the general population in Japan: three different methods of survey on sexual behavior.
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The purpose of this study was to specify the most accurate, reliable and valid technique for a general sexual behavioral survey in Japan. This pilot study was conducted to assure a high response rate and to keep respondents' privacy confidential by using an anonymous questionnaire survey technique. The sample (360 potential respondents) was selected randomly from basic resident registers in two geographically different areas. From the registries, 90 residents, aged 20 to 49 years old, were randomly selected to represent each sex from each area. The subjects were randomly assigned to three groups each having a different procedure of requesting the completion of the survey and providing the questionnaires: (1) Postal Group, (2) Telephone Group, and (3) Face-to-face Group. The survey was carried out from October 1995 to February 1996. Effective response rates for the above mentioned three groups were 69.2%, 69.2% and 55.8%, respectively. It is difficult to determine the best method when only considering the effective response rates. However, judging from our effort and expense, the mail survey is the best possible procedure and would be a reasonable method for a national sexual behavior survey. (+info)
Application of computer-assisted interviews to sexual behavior research.
(37/8857)
Collection of sensitive data with the use of video-enhanced, computer-assisted, self-administered interviews (V-CASI) has the potential to reduce interview bias and improve the validity of the study. The purpose of this study was to compare responses to sensitive questions elicited by V-CASI and by face-to-face interview (FTFI) methods. Women attending a New Orleans, Louisiana, public family planning or sexually transmitted disease clinic from July 1995 to July 1996, diagnosed with a Chlamydia trachomatis infection responded to eight close-ended behavioral questions (four socially undesirable, two socially desirable, and two neutral behaviors) using both FTFI and V-CASI techniques in a randomized crossover design. Of the 280 women included, the mean age was 23 years, 95 percent were African American, and 71 percent felt comfortable using computers. While kappa scores indicated good-to-excellent agreement between interview techniques, women tended to admit to socially undesirable behaviors more often on V-CASI compared with FTFI. Thirty percent of the women gave a discrepant response between V-CASI and FTFI toward social desirability. Women who reported a socially undesirable behavior in V-CASI (i.e., more than two sex partners and infrequent condom usage) were more likely to have a discrepant response. Utilization of the same logistic regression model to predict condom use yielded different results when data from V-CASI were used compared with data from FTFI. The V-CASI technique can reduce social desirability bias and improve validity in research requiring information on sensitive sexual behaviors. (+info)
The hidden cost of 'free' maternity care in Dhaka, Bangladesh.
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We studied the cost and affordability of 'free' maternity services at government facilities in Dhaka, Bangladesh, to assess whether economic factors may contribute to low utilization. We conducted a questionnaire survey and in-depth interviews among 220 post-partum mothers and their husbands, selected from four government maternity facilities (three referral hospitals and one Mother and Child Health hospital) in Dhaka. Mothers with serious complications were excluded. Information was collected on the costs of maternity care, household income, the sources of finance used to cover the costs, and the family's willingness to pay for maternity services. The mean cost for normal delivery was 1275 taka (US$31.9) and for caesarean section 4703 taka (US$117.5). Average monthly household income was 4933 taka (US$123). Twenty-one per cent of families were spending 51-100% of monthly income, and 27% of families 2-8 times their monthly income for maternity care. Overall, 51% of the families (and 74% of those having a caesarean delivery) did not have enough money to pay; of these, 79% had to borrow from a money lender or relative. Surprisingly, 72% of the families said they were willing to pay a government-levied user charge, though this was less popular among low-income families (61%). 'Free' maternity care in Bangladesh involves considerable hidden costs which may be a major contributor to low utilization of maternity services, especially among low-income groups. To increase utilization of safer motherhood services, policy-makers might consider introducing fixed user charges with clear exemption guidelines, or greater subsidies for existing services, especially caesarean section. (+info)
Cross-sectional comparison of live and interactive voice recognition administration of the SF-12 health status survey.
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OBJECTIVE: To compare interactive voice recognition (IVR) and live telephone methods for administering the SF-12 health status survey (SF-12). STUDY DESIGN: Patients with low back pain received either IVR or live interviews in a cross-sectional design with partial randomization. The interviews consisted of the SF-12 and some additional questions specific to low back pain. PATIENTS AND METHODS: Complete findings were obtainable from 229 patients. Summary scales were compared by using multivariate analysis of variance with mean comparisons for continuously scored items. Response frequencies for categorically scored items were compared by using the chi-square test. RESULTS: The 2 methods produced similar results on the Physical Component Summary scale but not the Mental Component Summary scale. Compared with patients who had a live telephone interview, the patients using IVR acknowledged significantly greater overall mental interference, greater general emotional concerns, and poorer mood and overall health. CONCLUSIONS: Because IVR eliminates the demand characteristics of responding to a personal interviewer, it may be a desirable way to evaluate sensitive topics. It also may reduce costs of data entry, labor, and measurement error. (+info)
Activity patterns in very old people: a survey of cognitively intact subjects aged 90 years or older.
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AIM: to measure activity patterns in very old people, the factors related to this and the association of different types of activity with well-being. METHODS: a study of 105 people, aged 90 years or older, who were not cognitively impaired, living in Stockholm. The activities carried out during the previous day were recorded and each activity was rated. RESULTS AND CONCLUSIONS: the degrees of intellectual, social and physical activity are independent of each other. Very elderly people tended to have variable but relatively low activity levels over a day. Good health and not moving home were associated with greater intellectual activity. Extraversion and negative life events (such as death of close friend or family member) were associated with greater social activity, while relatively younger age and better health were associated with greater physical activity. There was positive association between physical activity and well-being. (+info)