Tuesday 16th July
Wednesday 17th July
Thursday 18th July
Friday 19th July
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Collection and analysis of biological data in health surveys: developing best practice 2 |
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| Convenor | Miss Samantha Clemens (Head of the Health and Wellbeing Team) |
| Coordinator 1 | Miss Barbara Schaan (Munich Center for the Economics of Aging, Max Planck Institute for Social Law and Social Policy) |
| Coordinator 2 | Mrs Heidi Guyer (Survey Research Center, University of Michigan) |
Biological measures can add a lot to survey data, enabling us to find out things about participants that cannot be collected through survey questions. These biomeasures encompass a range of biological, anthropometric, functional, and sensory measurements. Examples are height, weight or blood pressure. There have been innovative developments in the collection of biomeasures for example in the study of epigenectics. Integrating biomeasures into surveys has great potential including the estimation of prevalence of disease in a non-clinical population, the detection of undiagnosed conditions, and provision of objective measures compared with self-reported measures.
The collection of biomeasures often involves the development of detailed protocols about when, where, how and by whom the measurements can be taken to ensure that the resulting data are of good quality. Measures may be carried out in participants' homes or at a clinic and they may be collected by a survey interviewer or a trained medical specialist. Often, multiple approaches are used taking into consideration the requirements of the study, measures of interest, cost, and demographics of the study population. Researchers must consider the implications of taking biomeasures at every stage of the survey including ethical implications and the impact on training, pretesting, data collection, data quality, sample shipment, informed consent and response rates.
This session aims to share best practice and explore challenges in collecting biological data in health surveys. We invite papers which describe (but need not be restricted to) the following related to health surveys with biological measurements:
1. Innovations in collecting and analysing biomeasures
2. The design of protocols for complex biomeasures
3. Evaluations of using different protocols
4. Collecting biomeasures for special populations
5. Using biomeasures to validate self-reported health measurements
6. Applying biomeasures for the analysis of social gradients in health and cross-country comparisons in health
The Health and Retirement Study (HRS) is a longitudinal study that conducts biennial interviews with over 20,000 adults aged 50 and older in the United States. Beginning in 2006, HRS initiated an enhanced face-to-face interview with an alternating half of all study participants each wave. In addition to the regular interview, respondents who received the enhanced interview were asked to complete a series of physical measurements and provide biological samples including dried blood spots, collected via a finger stick, and saliva samples from which DNA is extracted. Participants are asked to complete the enhanced interview every four years. 2010 marked the first wave in which we returned to panel members to ask for their participation in the physical measures and biomarkers again. Additionally, a subgroup of panel members was asked for consent to participate in a pilot study to collect whole blood. A phlebotomist contacted consenting respondents to schedule the in-home whole blood draw. Participation in all measures is high each wave. In 2006, 94% of respondents asked to complete a series of physical measures agreed to do so compared to 92% in 2010. Conversely, the rate of participation in providing dried blood spot samples increased from 80% in 2006 to 86% in 2010. The results of longitudinal participation in the various physical measures and biomarkers in 2006 and 2010, as well as results of the whole blood draw pilot, will be presented. Additionally, we will examine some of the correlates of participation in these components.
The integration of physical measures and biomarkers in population-based surveys has become increasingly common in recent years. These measures are considered to be an important complement to self-reported health measures that are typically collected in large surveys. Yet the value of these measures has not yet been fully demonstrated. This paper assesses the importance of three physical performance measures (grip strength, lung function and walking speed) as predictors of self-rated health and physical functioning, and change in these health outcomes, among older adults. Data come from the 2006-2010 waves of the Health and Retirement Study (HRS), the 2004-2008 waves of the English Longitudinal Study of Ageing (ELSA), and the 2004-2008 waves of the Survey of Health, Aging and Retirement in Europe (SHARE). We use ordered probit models to predict self-rated health and logistic regression models to predict ADL, IADL and Nagi limitation among men and women age 65 or over. The base model for each outcome includes the physical performance measures and basic sociodemographic factors. The full model adds measures of self-reported disease and other health indicators. Preliminary results from the HRS suggest that the performance measures are strongly associated with self-rated health and functioning after controlling for sociodemographic and other health factors, suggesting that the performance measures capture a unique component of health that is not explained by the self-reported measures. The presentation will focus on comparisons across the three studies.
The use of biomarkers in survey research is increasing, but the measurements are usually done by nurses or trained interviewers. It would be more efficient if respondents could themselves perform simple measurements, especially when it involves respondents who are members of an online survey panel. In this research, we report the results of a study using self-administered objective measures of activity: accelerometers (actigraphs).
1200 members of the LISS household panel of CentERdata, who normally fill in online questionnaires, were asked to wear an accelerometer to measure their activity level. The measures were stored on the device, which had to be placed in a charger/reader to transfer the data to a computer. The accelerometers were send to the panel members and they were asked to wear it for 8 days and then send it back. Hence, no help of an interviewer or nurse was available or needed so instructions needed to be clear.
To compare objective measures with self-reported physical activity levels or sedentary behavior and to asses affect and time-use, respondents also filled in questionnaires reporting their daily activity, location, social context, associated mood, sedentary time and sleep time.
We report the feasability of collecting self-administered measures of activity within the framework of an online panel, the response rates obtained, and the data quality. Moreover, we focus on the selectivity in the response: which panel members are or are not willing and able to participate in this type of study.
Since its inception in 1995, the Scottish Health Survey (SHeS) has collected biological samples and measurements from its participants. Prior to 2012 these measurements were collected by nurse fieldworkers but in recent years there has been a move to making greater use of non-medically trained field interviewers to collect a wide range bio-measures. In 2012, SHeS became the first of the UK's major health surveys to make the transition from nurse to interviewer administered bio-measure data collection. Such a move poses a number of important challenges and has implications for comparability over time.
As part of the transition, the survey team carried out a validation study to assess the impact of this switch in relation to two measures: blood pressure and waist measurement. The research objectives were:
(1) To establish the degree of agreement between interview and nurse measurements
(2) To generate calibration equations that allow for statistics based on data collected by interviewers to be 'converted' to the equivalent statistics had a nurse collected the data and vice versa.
In addition, evidence suggests that blood pressure is systematically lower when measured by nurses than by doctors ("white coat" effect). As a secondary aim, the research team was interested in exploring whether there was any evidence of "white coat" effect when non-medically trained interviewers take measures instead of medically trained nurses?
This presentation discusses the design and conduct of the validation study in addition to the key findings (and their implications) that emerged.
To improve population-based monitoring of health related-issues, different access strategies are applied by the Robert Koch Institute. Target specific low-threshold surveys are needed to assess knowledge, attitude and behavior of young women, the target population for HPV-vaccination in Germany. We conducted a feasibility study to investigate if a social media site like Facebook may be a prudent choice for study recruitment of young women.
We aimed to include approximately 1,000 women aged 18 to 25 years in the survey. Continuously optimized Facebook ads were published from Dec. 2012 to Jan. 2013. Different targeting strategies were tested to improve participation. By clicking on the ads, interested women were directed to the web-based questionnaire in the technical environment of the Robert Koch Institute. The questionnaire focused on items like vaccination status, knowledge on HPV, informational behavior and socio-demographics. As an incentive women with a completed questionnaire were able to participate in a raffle of online vouchers.
We will present sample quality issues like nonresponse, drop-out rates, as well as the sample distribution according to demographic characteristics of survey participants. Regression analysis will provide information about the characteristics of study participants in regards of sample representativity and factors for study participation. Survey results will provide valuable knowledge if recruitment via a social media site will permit convenient and cost effective access to difficult to reach target groups and will provide important information on HPV vaccination practices in Germany.