An examination of how to engage young, underrepresented women in UK health surveys

An understanding of the health, health beliefs and health behaviours of young women is vital for primary and secondary prevention to reduce the impact of poor health on women’s own lives, their families, and future generations. However, young women from lower socioeconomic status (SES) categories are underrepresented in UK health surveys, limiting our understanding in this area. The aim of this thesis was to understand what encourages and discourages young women in lower SES categories to complete UK health surveys. A marketing framework was adopted to explore this across two studies. Study 1 employed focus groups across two phases. Phase 1 (49 women, 16-34 years) explored the first two stages of the framework (‘motivation’ and ‘perception’) through responses to recruitment materials. Qualitative data were compared across three life stage categories (education, work, and motherhood). In Phase 2, 45 Further Education (FE) students (16-24 years) participated to explore the remaining three stages of the framework (‘attitude formation’, ‘integration of intention and action’, ‘post-purchase learning’). In Study 2, 37/489 (7.6%) FE students returned a health questionnaire mailed to their homes. Reasons for responding or not were followed up with an in-class questionnaire with 188 of the students, and in interviews with 5 responders and 9 non-responders. Findings indicated that the women were in transition from adolescence to adulthood. They valued being treated as adults with choice and autonomy but could be easily distracted. A desire to help others encouraged response. Health information and opportunities to think and talk about health engaged participants; low self-esteem and pessimism were barriers. Some participants used cues such as amount of text and images to evaluate their eligibility for the study, and the importance and difficulty of the questionnaire. The application of a marketing framework challenges researchers to design health surveys to provide an equitable exchange. Participation may be encouraged by meeting participants’ pre-existing goals and responding to developing identities, lifestyles, and anxieties

Causal and Associational Language in Observational Health Research: A Systematic Evaluation.

We estimated the degree to which language used in the high profile medical/public health/epidemiology literature implied causality using language linking exposures to outcomes and action recommendations; examined disconnects between language and recommendations; identified the most common linking phrases; and estimated how strongly linking phrases imply causality. We searched and screened for 1,170 articles from 18 high-profile journals (65 per journal) published from 2010-2019. Based on written framing and systematic guidance, three reviewers rated the degree of causality implied in abstracts and full text for exposure/outcome linking language and action recommendations. Reviewers rated the causal implication of exposure/outcome linking language as None (no causal implication) in 13.8%, Weak 34.2%, Moderate 33.2%, and Strong 18.7% of abstracts. The implied causality of action recommendations was higher than the implied causality of linking sentences for 44.5% or commensurate for 40.3% of articles. The most common linking word in abstracts was "associate" (45.7%). Reviewers' ratings of linking word roots were highly heterogeneous; over half of reviewers rated "association" as having at least some causal implication. This research undercuts the assumption that avoiding "causal" words leads to clarity of interpretation in medical research

Causal and associational language in observational health research:a systematic evaluation

We estimated the degree to which language used in the high profile medical/public health/epidemiology literature implied causality using language linking exposures to outcomes and action recommendations; examined disconnects between language and recommendations; identified the most common linking phrases; and estimated how strongly linking phrases imply causality. We searched and screened for 1,170 articles from 18 high-profile journals (65 per journal) published from 2010-2019. Based on written framing and systematic guidance, three reviewers rated the degree of causality implied in abstracts and full text for exposure/outcome linking language and action recommendations. Reviewers rated the causal implication of exposure/outcome linking language as None (no causal implication) in 13.8%, Weak 34.2%, Moderate 33.2%, and Strong 18.7% of abstracts. The implied causality of action recommendations was higher than the implied causality of linking sentences for 44.5% or commensurate for 40.3% of articles. The most common linking word in abstracts was "associate" (45.7%). Reviewers’ ratings of linking word roots were highly heterogeneous; over half of reviewers rated "association" as having at least some causal implication