Is the European Health Interview Survey online yet? Response and net sample composition of a web-based data collection

BACKGROUND: The European Health Interview Survey (EHIS) provides cross-national data on health status, health care and health determinants. So far, 10 of the 30 member states (MS) opted for web-based questionnaires within mixed-mode designs but none used it as the sole mode. In the context of future EHIS, the response rate and net sample composition of a web-only approach was&nbsp;tested. METHODS: A Belgian study with a target sample size of 1000 (age: 16-85) was organized using the EHIS wave 3 model questionnaire. The sample was selected according to a multistage, clustered sampling procedure with geographical stratification. Field substitution was applied; non-participating households were replaced by similar households regarding statistical sector, sex and age. There was one reminder letter and a €10 conditional&nbsp;incentive. RESULTS: Considering all substitutions, a 16% response rate was obtained after sending one reminder. Elderly, Brussels Capital inhabitants, people living without a partner and those with a non-Belgian nationality were less responding. By design, there were no differences between the initial and final net sample regarding substitution characteristics. Nevertheless, people living without a partner, non-Belgians and lower educated people remain&nbsp;underrepresented. CONCLUSION: There was a low response rate, particularly for some population groups. The response rate was lower than those of MS using mixed-mode designs including web, especially these comprising interviewer-based approaches. Despite the long and complex questionnaire, there was a low break off rate. So far, web-only data collection is not an acceptable strategy for population-based health surveys but efforts to increase the response should be further&nbsp;explored.</p

Determinants of unit nonresponse in multi-mode data collection: A multilevel analysis

BACKGROUND: Multi-mode data collection is widely used in surveys. Since several modes of data collection are successively applied in such design (e.g. self-administered questionnaire after face-to-face interview), partial nonresponse occurs if participants fail to complete all stages of the data collection. Although such nonresponse might seriously impact estimates, it remains currently unexplored. This study investigates the determinants of nonresponse to a self-administered questionnaire after having participated in a face-to-face interview. METHODS: Data from the Belgian Health Interview Survey 2013 were used to identify determinants of nonresponse to self-administered questionnaire (n = 1,464) among those who had completed the face-to-face interview (n = 8,133). The association between partial nonresponse and potential determinants was explored through multilevel logistic regression models, encompassing a random interviewer effect. RESULTS: Significant interviewer effects were found. Almost half (46.6%) of the variability in nonresponse was attributable to the interviewers, even in the analyses controlling for the area as potential confounder. Partial nonresponse was higher among youngsters, non-Belgian participants, people with a lower educational levels and those belonging to a lower income household, residents of Brussels and Wallonia, and people with poor perceived health. Higher odds of nonresponse were found for interviews done in the last quarters of the survey-year. Regarding interviewer characteristics, only the total number of interviews carried out throughout the survey was significantly associated with nonresponse to the self-administered questionnaire. CONCLUSIONS: The results indicate that interviewers play a crucial role in nonresponse to the self-administered questionnaire. Participant characteristics, interview circumstances and interviewer characteristics only partly explain the interviewer variability. Future research should examine further interviewer characteristics that impact nonresponse. The current study emphasises the importance of training and motivating interviewers to reduce nonresponse in multi-mode data collection.status: publishe

Effectiveness of local government actions targeting physical activity, sedentary behaviour, dietary behaviour and breastfeeding: a scoping review

This is a scoping review, taking a closer look at the evidence available of local governments (in high income countries) who have put in place certain policies aimed at contributing to a healthier diet, physical activity levels, exclusive breastfeeding and reducing sedentary behavior, and which of those are effectiv

Comparing web-based versus face-to-face and paper-and-pencil questionnaire data collected through two Belgian health surveys

Objectives Using the European Health Interview Survey (EHIS) questionnaire, a web-based survey was organized alongside a face-to-face (F2F) survey including a paper-and-pencil (P&amp;P) questionnaire for sensitive topics. Associated with these different modes, other design features varied too (e.g., recruitment, incentives, sampling). We assessed whether these whole data collection systems developed around the modes produced equivalent health&nbsp;estimates. Methods Data were obtained from two population-based surveys: the EHISWEB (web-administered,&nbsp;n = 1010) and the Belgian Health Interview Survey 2018 (BHIS2018) (interviewer-administered,&nbsp;n = 2748). Logistic regression analyses were used to assess mode system differences while adjusting for socio-demographic differences in the net&nbsp;samples. Results For the P&amp;P mode of the BHIS, significant mode system differences were detected for 2 of the 9 health indicators. Among the indicators collected via the F2F mode, 9 of the 18 indicators showed significant&nbsp;differences. Conclusions Indicators collected via the web-based and P&amp;P self-administered modes were generally more comparable than indicators collected via the web-based and F2F mode. Furthermore, fewer differences were detected for indicators based on simple and factual questions compared to indicators based on subjective or complex&nbsp;questions.</p

Data collection in pandemic times: the case of the Belgian COVID-19 health surveys

Abstract Background Survey data were needed to assess the mental and social health, health related behaviors and compliance with preventive measures of the population during the COVID-19 pandemic. Yet, the pandemic challenged classical survey methods. Time and budgetary constraints at the beginning of the pandemic led to ad hoc recruitment of participants and easily manageable data collection modes. This paper describes the methodological choices and results in terms of participation for the COVID-19 health surveys conducted in Belgium. Methods The COVID-19 health surveys refer to a series of ten non-probability web surveys organized between April 2020 and March 2022. The applied recruitment strategies were diverse including, amongst others, a launch through the website and the social media of the organizing research institute. In addition, the survey links were shared in articles published in the national press and participants were requested to share the surveys in their network. Furthermore, participants were asked consent to be re-contacted for next survey editions using e-mail invitations. Results These mixed approaches allowed to reach a substantial number of participants per edition ranging from 49339 in survey 1 to 13882 in survey 10. In addition, a longitudinal component was created; a large share of the same individuals were followed up over time; 12599 participants completed at least 5 surveys. There were, however, sex, age, educational level and regional differences in participation. Post-stratification weighting on socio-demographic factors was applied to at least partly take this into account. Conclusion The COVID-19 health surveys allowed rapid data collection after the onset of the pandemic. Data from these non-probability web surveys had their limitations in terms of representativeness due to self-selection but were an important information source as there were few alternatives. Moreover, by following-up the same individuals over time it was possible to study the effect of the different crisis phases on, amongst others, the mental health. It is important to draw lessons from these experiences: initiatives in order to create a survey infrastructure better equipped for future crises are needed

Anxiety and Depression in Belgium during the First 15 Months of the COVID-19 Pandemic: A Longitudinal Study

The COVID-19 pandemic and policy measures enacted to contain the spread of the coronavirus have had nationwide psychological effects. This study aimed to assess the impact of the first 15 months of the COVID-19 pandemic on the level of anxiety (GAD-7 scale) and depression (PHQ-9 scale) of the Belgian adult population. A longitudinal study was conducted from April 2020 to June 2021, with 1838 respondents participating in 6 online surveys. Linear mixed models were used to model the associations between the predictor variables and the mental health outcomes. Results showed that the prevalence of symptoms of anxiety and depression was higher in times of stricter policy measures. Furthermore, after the initial stress from the outbreak, coping and adjustment were observed in participants, as symptoms of anxiety and depression decreased during times of lower policy restrictions to almost the same level as in pre-COVID times (2018). Though time trends were similar for all population subgroups, higher levels of both anxiety and depression were generally found among women, young people, people with poor social support, extraverts, people having pre-existing psychological problems, and people who were infected/exposed to the COVID-19 virus. Therefore, investment in mental health treatment programs and supports, especially for those risk groups, is crucial

Mixing mixed-mode designs in a national health interview survey : a pilot study to assess the impact on the self-administered questionnaire non-response

BACKGROUND: Many population health surveys consist of a mixed-mode design that includes a face-to-face (F2F) interview followed by a paper-and-pencil (P&amp;P) self-administered questionnaire (SAQ) for the sensitive topics. In order to alleviate the burden of a supplementary P&amp;P questioning after the interview, a mixed-mode SAQ design including a web and P&amp;P option was tested for the Belgian health interview&nbsp;survey. METHODS: A pilot study (n = 266, age 15+) was organized using a mixed-mode SAQ design following the F2F interview. Respondents were invited to complete a web SAQ either immediately after the interview or at a later time. The P&amp;P option was offered in case respondents refused or had previously declared having no computer access, no internet connection or no recent usage of computers. The unit response rate for the web SAQ and the overall unit response rate for the SAQ independent of the mode were evaluated. A logistic regression analysis was conducted to explore the association of socio-demographic characteristics and interviewer effects with the completed SAQ mode. Furthermore, a logistic regression analysis assessed the differential user-friendliness of the SAQ modes. Finally, a logistic multilevel model was used to evaluate the item non-response in the two SAQ modes while controlling for respondents’&nbsp;characteristics. RESULTS: Of the eligible F2F respondents in this study, 76% (107/140) agreed to complete the web SAQ. Yet among those, only 78.5% (84/107) actually did. At the end, the overall (web and P&amp;P) SAQ unit response rate reached 73.5%. In this study older people were less likely to complete the web SAQ. Indications for an interviewer effect were observed as regard the number of web respondents, P&amp;P respondents and respondents who refused to complete the SAQ. The web SAQ scored better in terms of user-friendliness and presented higher item response than the P&amp;P SAQ. CONCLUSIONS: The web SAQ performed better regarding user-friendliness and item response than the P&amp;P SAQ but the overall SAQ unit response rate was low. Therefore, future research is recommended to further assess which type of SAQ design implemented after a F2F interview is the most beneficial to obtain high unit and item response&nbsp;rates.</p