ESRA 2025 Preliminary Glance Program

All time references are in CEST

Health research
Session Organiser	Dr Daniel Seddig (KFN)
Time	Tuesday 15 July, 09:00 - 10:30
Room	Ruppert 134

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Papers

Collecting national sexual health data in the post COVID-19 pandemic era: experiences of Natsal-4

Mrs Katharine Sadler (University College London and National Centre for Social Research) - Presenting Author
Miss Rebecca Light (University College London and National Centre for Social Research)
Miss Ellen Randall (National Centre for Social Research)
Mrs Soazig Clifton (University College London and National Centre for Social Research)
Miss Anne Conolly (National Centre for Social Research)
Mr Curtis Jessop (National Centre for Social Research)
Mrs Margaret Blake (Ipsos)
Professor Catherine Mercer (University College London)
Professor Pam Sonnenberg (University College London)

Great Britain’s fourth National Survey of Sexual Attitudes and Lifestyles (Natsal-4) was designed to provide high quality representative data on the sexual and reproductive health, attitudes and lifestyles of people aged 16-59 years. The study included the option for all consenting participants to self-collect either three vaginal swab samples or one urine sample, for testing of sexually transmitted infections and the microbiome. Participants were also asked to give consent to link their data to health, education and/or administrative records.

Originally designed to be hour-long, face-to-face interviews with a probability sample of participants drawn from an address-based sample frame, the emergence of the COVID-19 pandemic meant a remote data collection option was needed. The study was adapted to enable telephone interviewing with an embedded online self-completion, while retaining face-to-face as the preferred mode. Biosampling and data linkage protocols were revised and fieldwork resumed. However, given the loss of an experienced survey fieldforce and changes in the general public’s willingness to participate in research studies, data collection was challenging.

To compensate for the predicted shortfall in the target number of interviews, while retaining a probability sample design, data collection with NatCen probability panel members aged 18-59 years was implemented. Those who did not take part in the hour-long telephone interview, were invited to take part in a shorter (~20 minute) online version of the survey. In addition, an Ipsos non-probability (quota) online panel survey was conducted. Biosampling and data linkage consent were included in all data collection arms.

Carried out between 2022 and 2024, 18,961 Natsal-4 interviews were achieved. We discuss the challenges and success of strategies adopted to address these, while reflecting on lessons learnt for future general population sexual health surveys.

Multi-mode survey on the health impacts of the Lacq industrial basin

Miss Aude D'Arco (Santé publique France) - Presenting Author
Mrs Sandrine Coquet (Santé publique France)
Mrs Anna Siguier (Santé publique France)
Mr Abdelkrim ZEGHNOUN (Santé publique France)
Mr Marc Ruello (Santé publique France)
Mr Jean-Baptiste Richard (Santé publique France)

The Lacq industrial basin, located northwest of Pau in the Pyrénées-Atlantiques, has been a major industrial hub for 60 years. This complex brings together numerous companies specializing in natural gas extraction, thiochemistry, fine chemistry, and green chemistry. Santé Publique France was tasked with evaluating the relevance and feasibility of implementing epidemiological health monitoring in the Lacq basin. The response to this request included a perceived health survey conducted among residents of 99 municipalities surrounding this industrial basin.
For this survey, the sample was randomly drawn from health insurance databases and stratified into three exposure levels to the industrial basin. Data collection relied on an increasingly common method for surveys: multi-mode data collection. This methodological choice aimed to maximize participation from a diverse range of profiles (in terms of age, gender, place of residence, personal sensitivity to the topic, etc.) by combining several collection modes: an online questionnaire, telephone interviews, and face-to-face interviews.
The survey was conducted from October 2023 to January 2024 and resulted in 2,043 responses. The overall participation rate was 49.0%, ranging from 14.93% for face-to-face interviews to 64.37% for the online questionnaire. In this analysis, we examine the profile of respondents by collection mode, focusing on socio-economic characteristics, health status, and perceived exposure to industrial basin pollution.

Correlates of Internal Migration and Other Contributing Factors on Utilizing and Accessing Healthcare Services of Women in Bangladesh

Dr Md Atiqul Islam (Jagannath University) - Presenting Author
Mr Emon Mitra (Dept. of Statistics, Jagannath University)
Miss Most Sarmin Akter Rini (Dept. of Statistics, Jagannath University)
Miss Monisha Talukder (Dept. of Statistics, Jagannath University)
Miss Tania Akter Dina (Dept. of Statistics, Jagannath University)
Mr Shahadat Hossain Mehedi (Dept. of Statistics, Jagannath University)

Background: Individuals who relocate within the boundaries of a country have difficulty accessing healthcare facilities. The objective was to correlate internal migration and other contributing factors to utilizing and accessing healthcare service outcomes of women in Bangladesh, considering division as a cluster effect.

Methods: Data were extracted from the nationwide Bangladesh Demographic Health Survey (BDHS) 2022 survey. A total of 3,997 women's data on migration, socio-demographic and health indicator factors were used. Four separate generalized linear mixed models (GLMMs) were fitted to see the impact of internal migration and other factors on ANC visits, modern contraceptive use, problems accessing medical care due to getting money for treatment, and problems accessing medical care due to distance to the facility. Later, a joint multilevel model was fitted to see the joint inter-correlation among the four healthcare service outcomes.

Results: The rural to urban migrants within nine years had experienced more problems accessing care due to money. The urban to rural migrants within nine years reduced ANC visits from 48% to 52%, and modern contraceptive use reduced from 12% to 30%. The urban to rural migrants experienced more problems accessing care within nine years due to distance. Apart from migration status, other factors such as place of previous residence, education, work status, wealth index, and number of living children also influenced women's utilizing and accessing healthcare service outcomes.

Conclusion: Internal migration significantly impacts women's utilization and access to healthcare services by affecting their socioeconomic conditions and cultural practices related to health. Relocating can enhance healthcare access or pose challenges, ultimately influencing healthcare service outcomes and general well-being. The government should implement policies that increase access to health care services for migrant women from the specific division, ensuring they receive comprehensive reproductive and mental health support.

End-of-Life Cancer Care Costs: Out-of-Pocket Expenditure and Financial Impact on Israeli Families

Professor Aviad Tur-Sinai (University of Haifa) - Presenting Author
Professor Netta Bentur (Tel-Aviv University)

In most countries, including those with national health insurance or comprehensive public insurance, cancer treatment involves out-of-pocket (OOP) expenses for patients and their families. This study aims to identify areas and extent of OOP spending in cancer patients' last half-year of life, examine the probability of OOP spending based on patient characteristics, and assess the financial burden on families. 491 first-degree relatives of cancer patients (average age: 70) who were hospitalized and died 3–6 months before the study were interviewed by telephone. They were asked about their OOP payments during the last-half year of the patient's life, the nature of each payment, and whether it had imposed a financial burden on them. A logistic regression and ordered logit models were used to estimate the probability of OOP expenditure financial burden. The study found that 84% of the patients and their relatives incurred OOP expenses during the last half-year of life. Average expenditures were US$5,800 for medicines, $8,000 for private caregivers, and $2,800 for private nurses. The probability of OOP medication expenses was significantly higher among patients unable to remain alone at home and those struggling financially. OOP spending on private caregivers or nurses was significantly higher among incapacitated, older patients who couldn't remain alone and lacked nursing-care insurance. Financial burden was higher among those unable to remain alone, the incapacitated, and uninsured patients, while being lower among those with above-average income, better education, and patients who died home. The study recommends that oncology services provide detailed information about patient entitlements and referrals to the National Insurance Institute, that oncologists consider end-of-life care financial burden, and that maintain annual increases in technology and pharmaceutical budgets, particularly for new cancer treatments, to reduce financial burden.

Phenotyping equity for population health research: a scoping review

Dr Claudine Kraan (Murdoch Children's Research Institute)
Dr Susan Clifford (Murdoch Children's Research Institute) - Presenting Author
Dr Will Siero (Murdoch Children's Research Institute)
Dr Meredith O'Connor (Murdoch Children's Research Institute)
Dr Kate Paton (Murdoch Children's Research Institute)
Miss Tehani Paiva (Murdoch Children's Research Institute)
Dr Helene Kammoun (Murdoch Children's Research Institute)
Dr Suzanne Mavoa (Murdoch Children's Research Institute)
Professor Melissa Wake (Murdoch Children's Research Institute)

BACKGROUND: Childhood longitudinal cohorts, regardless of size, have long faced challenges in fully representing the diversity not only of who signs up, but of the participants’ physical, mental, cognitive and molecular phenotypes – all essential to precision population health and policy. Fortunately, accelerating advances in digital epidemiology, low-burden assessment tools and app-based data collection are transforming this landscape. This study explores barriers and opportunities to phenotyping with equity (hereafter ‘phenotyping equity’) in Generation Victoria’s (GenV’s) 2028/29 Early School Gateway for 50,000 children and 70,000+ parents. GenV (GenV, genv.org.au) is Australia’s largest and most inclusive child and parent longitudinal cohort.

METHOD: We are conducting scoping research to map methodologies aiming for phenotyping equity as it applies to disease burden, both current (eg mental health, chronic illness, autism) and future (eg cardiovascular, lung, hearing, vision). Phenotyping equity focusses on measures selection and delivery, preferencing robust, multi-modal, brief measures and indicators that are low- or no-cost, universal-capable and inclusive of disability, neurodiversity, mental health, languages spoken and rurality. We will use the Joanna Briggs institute framework and PCC (Population/Concept/Context).

RESULTS: Robust, brief, low to no cost, multi-modal and inclusive measures of phenotypes do exist. In this presentation we present our scoping results and our plans to further develop the protocol with: (a) qualitative research to understand the strengths and weaknesses of our proposed approach as perceived by parents; and (b) feasibility testing using a learning systems approach to improve and optimize measures and their integration.

CONCLUSION: Phenotyping equity is a way forward to conceptualize the complexities of measures selection for vulnerable groups. Our innovative methods will drive practical solutions for cohort research methodologies and impact health policy and care for all.

Do individuals follow their peers? Evidence from the Covid-19 pandemic

Professor Gil S. Epstein (Bar-Ilan University)
Dr Odelia Heizler (Tel-Aviv-Yaffo Academic College) - Presenting Author
Dr Osnat Israeli (Ashkelon Academic College)

Vaccinations played an important role in mitigating death from COVID-19. This study aims to examine how the vaccination decision of an individual is affected by the decisions of individuals who are similar to himself. Previous studies show the importance of herd behavior (or information cascade) on the decision to be vaccinated against Covid-19, controlling for socio-economics variables. In the present paper, we assume that individuals have stronger social networks with people who are similar to them. Moreover, their cost-benefit analysis would be closer to that of their peers. The current research makes use two datasets: the 10th round of European Social Survey (ESS) dataset for individual data and the organization Our World in Data (OWID) for measure the herding behavior and Covid-19 variables. We investigate whether the effect of the herd of similar people (for example, of a similar age group or similar residence) is higher than the effect of the herd of different people. Controlling for sociodemographic characteristics, health status, COVID-19 illness history, and pandemic-related features, the results suggest that people tend to imitate people who live close to them even if information is published about the behavior of people who live further away.