The impact of survey length, interactivity and participant involvement on intentions and satisfaction across multiple panels

This study examines how survey design characteristics impact on participant satisfaction, future intentions to complete surveys, and intention to recommend the survey to others, based on panel members, extracted from three different panels, who randomly received one out of eight developed surveys, varying length, involvement and interactivity. The experiment was designed for an Australian industry client. The multivariate analysis of covariance (MANCOVA hereafter) results suggest that there are differences based on the panels used, and longer surveys are viewed more positively. Interaction occurs between panels and involvement, but other two way interaction effects are insignificant. Implications for survey design and future research are discussed.<br /

Understanding settlement services literacy and the provision of settlement services for humanitarian migrants in Australia : a service provider perspective

Over the past 40 years, successive Australian Governments have developed a comprehensive programme of settlement services (SS) designed to improve settlement outcomes for humanitarian migrants. Many humanitarian migrants do not arrive with the appropriate skills and abilities to fully benefit from available SS. “Settlement services literacy” (SSL) has been proposed as a framework to contextualise factors that may enable or constrain humanitarian migrants' utilisation of SS. The aim of this study was to investigate the provision of SS in relation to SSL, that is humanitarian migrants' ability to effectively access information and services, to critically assess services, and to politically mobilise and effect change. Qualitative interviews were conducted with 26 service providers representing 19 organisations in Greater Western Sydney (n = 8) and Melbourne (n = 11). The study found that SS programmes address many of the indicators that promote SSL acquisition. However, this is not achieved systematically, nor do the programmes reflect all indicators across the three SSL levels. This study provides new insights into various factors impacting the effectiveness of SS provision and SSL acquisition. These insights can inform future programme policy reforms and contribute to more effective and responsive service systems that meet the diverse and complex needs of humanitarian migrants

The effects of a culturally-tailored campaign to increase blood donation knowledge, attitudes and intentions among African migrants in two Australian States: Victoria and South Australia

Research suggests that African migrants are often positively predisposed towards blood donation, but are under-represented in participation. A culturally-tailored intervention targeting the African migrant community in Australia was developed and implemented, to enhance knowledge about blood donation, improve attitudes towards donating, increase intentions to donate blood, and increase the number of new African donors in Australia. Four weeks after a targeted campaign, a survey evaluation process commenced, administered face-to-face by bilingual interviewers from the African community in Melbourne and Adelaide, Australia (community survey). The questionnaires covered demographics, campaign awareness, blood donation knowledge and intentions, medical mistrust and perceived discrimination, and were analysed to evaluate changes in knowledge and intention. Sixty-two percent of survey participants (n = 454) reported being aware of the campaign. With increasing campaign awareness, there was a 0.28 increase in knowledge score (p = .005); previous blood donation was also associated with an increased blood donation knowledge score. Blood donation intention scores were not associated with campaign awareness (p = 0.272), but were associated with previous blood donation behaviour and a positive blood donation attitude score. More positive scores on the blood donation attitude measure were associated with increasing blood donation intentions, self-efficacy and campaign awareness (score increases of 0.27, 0.30 and 0.04, respectively, all p&lt;0.05). Data were collected on the ethnicity of new blood donors in six blood collection centres before and after the intervention, and independent of the intervention evaluation survey. These data were also used to assess behavioural changes and the proportions of donors from different countries before and after the survey. There was no difference in the number of new African migrant donors, before and after the intervention. The culturally-relevant marketing campaign was associated with improved blood donation knowledge and attitudes, but there was no short-term change in blood donation intentions or the number of African donors

Establishing the psychometric properties of constructs from the conceptual 'settlement services literacy' framework and their relationship with migrants' acculturative stress in Australia

Background: Effective migration often requires supports for new arrivals, referred to as settlement services. Settlement services literacy (SSL) is key to ensuring new migrants have the capability to access and utilise the information and services designed to support the resettlement process and achieve positive settlement outcomes. To date, however, no research has sought to empirically validate measures of SSL or to assess individual migrants' levels of SSL. The aim of this study was to establish the psychometric properties of constructs from the conceptual SSL framework. Design Using a snowball sampling approach, trained multilingual research assistants collected data on 653 participants. The total sample was randomly divided into two split-half samples: one for the exploratory factor analysis (EFA; N = 324) and the other for the confirmatory factor analysis (CFA; N = 329) and scale validation. The final SSL scale included 30 questions. The full data set was used to test the nomological validity of the scale regarding whether the components of SSL impact on migrants' level of acculturative stress. Results: The EFA yielded five factors: knowledge (eight items, α = 0.88), empowerment (five items, α = 0.89), competence (four items, α = 0.86), community influence (four items, α = 0.82), and political (two items, α = 0.81). In the CFA, the initial model demonstrated a poor to marginal fit model. Its re-specification by examining modification indices resulted in a good model fit: CMIN/DF = 3.07, comparative fit index = 0.92, root mean square error of approximation = 0.08 and standardised root mean square residual = 0.07, which are consistent with recommendations. All the path coefficients between the second-order construct (SSL) and its five dimensions (knowledge, empowerment, competence, community influence and political) were significant at an α = .05 level, giving evidence for the validity of different SSL dimensions. We found that SSL is significantly related to migrants' acculturative stress (β = - 0.39, p < 0.05) in the nomological model. Conclusions The study provides evidence of the construct validity and reliability of the SSL tool. It provides the basis for integrating the measures of SSL into evaluation of settlement services. This will allow for more effective decision-making in designing and implementing settlement services as well as funding and service agreements to address any deficiencies

Utility of Nontraditional Risk Markers in Atherosclerotic Cardiovascular Disease Risk Assessment

AbstractBackgroundThe improvement in discrimination gained by adding nontraditional cardiovascular risk markers cited in the 2013 American College of Cardiology/American Heart Association cholesterol guidelines to the atherosclerotic cardiovascular disease (ASCVD) risk estimator (pooled cohort equation [PCE]) is untested.ObjectivesThis study assessed the predictive accuracy and improvement in reclassification gained by the addition of the coronary artery calcium (CAC) score, the ankle–brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) levels, and family history (FH) of ASCVD to the PCE in participants of MESA (Multi-Ethnic Study of Atherosclerosis).MethodsThe PCE was calibrated (cPCE) and used for this analysis. The Cox proportional hazards survival model, Harrell’s C statistics, and net reclassification improvement analyses were used. ASCVD was defined as myocardial infarction, coronary heart disease–related death, or fatal or nonfatal stroke.ResultsOf 6,814 MESA participants not prescribed statins at baseline, 5,185 had complete data and were included in this analysis. Their mean age was 61 years; 53.1% were women, 9.8% had diabetes, and 13.6% were current smokers. After 10 years of follow-up, 320 (6.2%) ASCVD events occurred. CAC score, ABI, and FH were independent predictors of ASCVD events in the multivariable Cox models. CAC score modestly improved the Harrell’s C statistic (0.74 vs. 0.76; p = 0.04); ABI, hsCRP levels, and FH produced no improvement in Harrell’s C statistic when added to the cPCE.ConclusionsCAC score, ABI, and FH were independent predictors of ASCVD events. CAC score modestly improved the discriminative ability of the cPCE compared with other nontraditional risk markers

Early insights from statistical and mathematical modeling of key epidemiologic parameters of COVID-19

We report key epidemiologic parameter estimates for coronavirus disease identified in peer-reviewed publications, preprint articles, and online reports. Range estimates for incubation period were 1.8–6.9 days, serial interval 4.0–7.5 days, and doubling time 2.3–7.4 days. The effective reproductive number varied widely, with reductions attributable to interventions. Case burden and infection fatality ratios increased with patient age. Implementation of combined interventions could reduce cases and delay epidemic peak up to 1 month. These parameters for transmission, disease severity, and intervention effectiveness are critical for guiding policy decisions. Estimates will likely change as new information becomes available

Does self monitoring of blood glucose as opposed to urinalysis provide additional benefit in patients newly diagnosed with type 2 diabetes receiving structured education? The DESMOND SMBG randomised controlled trial protocol

BackgroundThe benefit of self-monitoring of blood glucose (SMBG) in people with type 2 diabetes on diet or oral agents other than sulphonylureas remains uncertain. Trials of interventions incorporating education about self-monitoring of blood glucose have reported mixed results. A recent systematic review concluded that SMBG was not cost-effective. However, what was unclear was whether a cheaper method of self-monitoring (such as urine glucose monitoring) could produce comparable benefit and patient acceptability for less cost.Methods/DesignThe DESMOND SMBG trial is comparing two monitoring strategies (blood glucose monitoring and urine testing) over 18 months when incorporated into a comprehensive self-management structured education programme. It is a multi-site cluster randomised controlled trial, conducted across 8 sites (7 primary care trusts) in England, UK involving individuals with newly diagnosed Type 2 diabetes.The trial has 80% power to demonstrate equivalence in mean HbA1c (the primary end-point) at 18 months of within &plusmn; 0.5% assuming 20% drop out and 20% non-consent. Secondary end-points include blood pressure, lipids, body weight and psychosocial measures as well as a qualitative sub-study.Practices were randomised to one of two arms: participants attend a DESMOND programme incorporating a module on self-monitoring of either urine or blood glucose. The programme is delivered by accredited educators who received specific training about equipoise. Biomedical data are collected and psychosocial scales completed at baseline, and 6, 12, and 18 months post programme. Qualitative research with participants and educators will explore views and experiences of the trial and preferences for methods of monitoring.DiscussionThe DESMOND SMBG trial is designed to provide evidence to inform the debate about the value of self-monitoring of blood glucose in people with newly diagnosed type 2 diabetes. Strengths include a setting in primary care, a cluster design, a health economic analysis, a comparison of different methods of monitoring while controlling for other components of training within the context of a quality assured structured education programme and a qualitative sub-study

Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized?

Data show that the insights that improve obesity prevention and treatment will almost certainly benefit the incidence and care of type 2 diabetes

A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings

BackgroundA composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.MethodsWe assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation.ResultsThe analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals.ConclusionThe GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments