Mixed Method Data Collection in Travel Surveys: Challenges and Opportunities

The Transport and Population Data Centre (TPDC) has been running the Sydney Household Travel Survey as a continuous survey since 1997/8. It collects information on day-to-day travel in the Greater Sydney Metropolitan Region. Based on the faceto- face personal interview method, it has been seen internationally as a leading example of achieving high quality results in terms of response rates and accuracy of trip reporting. Using this data collection method, the full response rate and part response rate are currently about 55% and 8% respectively. However, in line with recent trends, this rate has declined significantly over the years since 1981 when it was about 79% and since 1997/98 when it was still around 76%. This paper examines the issue of decreasing response rates and sets out to find if using mixed modes of data collection would produce better trip estimates and would be more cost effective. It begins by addressing the intuitive question (can we get a higher response by sampling more households) and explains why this is the wrong question. The correct question is whether new modes of data collection will achieve better response rates – and more importantly better trip estimates and cost efficiencies. By examining the limited existing evidence from both transport and other resources, the paper is able to show in which cases it is likely that multiple modes might make a difference, and when they might not. However, the paper clearly concludes that without some further information and research, it is not possible to make an informed decision on the usefulness of a multi-modal intervention. The report concludes by describing the parameters of a study that could answer the question of whether and what type of mixed mode surveys would improve trip estimates and cost efficiency of the current Sydney Household Travel Survey

Reducing Car Travel Through an ‘Individual Action’ Programme

This paper outlines a new approach to reducing car use in order to address environmental concerns. The individual action programme, known as travel blending, aims to encourage individuals to choose a mixture, or blend, of travel choices over time to satisfy their travel needs rather than being a captive of the private car. Participating households are sent a series of four kits, containing information booklets and travel diaries, over a nine week period. The travel diaries and vehicle log books are analysed and a summary of the household’s travel patterns, and the emissions produced by their vehicles, is sent back in a subsequent kit along with suggestions explaining how they could introduce travel blending into their travel patterns. Households complete another set of diaries and vehicle log books after four weeks and these are analysed so that a comparative summary can be returned to the household with the final kit. The paper describes results from a pilot study, involving about 50 individuals, undertaken in Sydney, Australia. The encouraging results from the pilot have resulted in preparations being made for a larger trial involving about 300 individuals

Households on the Move: Experiences of a New Approach to Voluntary Travel Behaviour Change

Voluntary travel behaviour change approaches have been used in most of the capital cities of Australia over the past few years. In a new approach to this strategy, Canberra carried out a pilot test of applying the strategy specifically to households as they undertake a move to a new residence. Clearly, households that are moving are in a much more flexible situation to adopt new travel habits. The idea of this application was, therefore, to intervene with households at a time when new habits are about to be formed. Two primary groups of households were targeted. The first was households that had just moved (i.e. in the past 4 to 6 weeks). The second was households that have committed to a move, but have not yet made the physical move to a new residence. In the paper, we describe the methods that have been tried to find and identify households in each of these groups and the success rates of the different approaches. Targeting households in this manner poses a number of new issues, with respect to the voluntary travel behaviour intervention, that do not arise in community or suburb applications. We explore a number of these issues in detail and discuss the ways in which these problems have been dealt with in the Canberra project. One of the key issues is to evaluate whether or not this intervention is effective. While evaluation of voluntary travel behaviour change is never easy, there are some very specific issues that arise with households that are moving or have just moved. We describe the issues relating to evaluation and then describe the procedures that have been tried in the Canberra case to overcome the problems

Ascertaining severe perineal trauma and associated risk factors by comparing birth data with multiple sources

Objectives Population data are often used to monitor severe perineal trauma trends and association of risk factors. Within NSW, two different datasets can be used; the Perinatal Data Collection (‘birth’ data), or a linked dataset combining birth data with the Admitted Patient Hospital Data Collection (‘hospital’ data). Severe perineal trauma can be ascertained by birth data alone, or by hospital ICD-10-AM diagnosis and procedure coding in the linked dataset. The aim of this study is to compare rates and risk factors for severe perineal trauma using birth data alone, with those using linked data. Methods The study population consisted of all vaginal births in NSW 2001-2011. As perineal injury coding in birth data was revised in 2006, data were analysed separately for 2 ‘earlier data’ and ‘more recent data’. Rates of severe perineal injury over time were compared in birth data alone, and in linked data. Kappa and agreement statistics were calculated. Risk factor distributions (primiparity, instrumental birth, birthweight≥4kg, Asian country of birth and episiotomy) were compared between women with severe perineal trauma identified by birth data alone, and identified by linked data. Multivariable logistic regression was used to calculate the adjusted odds ratios of severe perineal trauma. Results Among 697,202 vaginal births, 2.1% were identified with severe perineal trauma by birth data alone, and 2.6% by linked data. The rate discrepancy was higher among earlier data (1.7% for birth data, 2.4% for linked data). Kappa for earlier data was 0.78 (95% CI 0.78, 0.79), and 0.89 (95% CI 0.89, 0.89) for more recent data. With the exception of episiotomy, differences in risk factor distributions were small, with similar adjusted odds ratios. Adjusted odds ratio of severe perineal trauma for episiotomy was higher (1.34 95% CI 1.27, 1.41) using linked data compared with birth data (1.03 95% CI 0.97, 1.09). Conclusions While discrepancies in ascertainment of severe perineal trauma improved after revision of birth data coding in 2006, higher ascertainment by linked data was still evident for recent data. There were also higher risk estimates of severe perineal trauma with episiotomy by linked data than by birth data.Australian Research Council; Dr Albert S McKern Research Scholarshi

Obstetric anal sphincter injury rates among primiparous women with different modes of vaginal delivery

Objective: To determine whether OASI rates are increasing at equal rates among different vaginal birth modes. Methods: Using New South Wales (NSW) linked population data, the overall yearly OASI rates were determined among the 261,008 primiparous vertex singleton term births which occurred from 2001-2011. OASI rates among non-instrumental, forceps and vacuum births with and without episiotomy were also determined. Multivariable logistic regression was used to ascertain the adjusted odds ratios (aORs) for each birth category by year. The trends of the aORs over time for each birth category were compared. Results: The overall OASI rate was 4.1% in 2001 and 5.9% in 2011. The highest OASI rates were among forceps births without episiotomy (12.2% in 2001, 14.8% in 2011), and lowest for non-instrumental births without episiotomy (2.6% in 2001, 4.4% in 2011). After adjustment for known risk factors, the only birth categories to show significant increases with OASI over the study period were non-instrumental without episiotomy and forceps with episiotomy (linear trend p<0.01). Conclusion: Overall OASI rates have continued to increase. Known risk factors do not fully explain the increase for non-instrumental births without episiotomy and forceps with episiotomy. Changes in clinical management and/or reporting may be contributing.Australian National Health and Medical Research Council; Australian Research Council; Dr Albert S McKern Research Scholarshi

Vulvoplasty in NSW 2001-2013: A population-based record-linkage study

Objectives: To compare characteristics of women who have vulvoplasty procedures with other women; quantify short-term adverse events and complications; and determine any association of vulvoplasty on future births. Design, setting and participants: A population-based record-linkage study was undertaken using the New South Wales (NSW) Admitted Patient Data Collection and NSW Perinatal Data Collection. All women who had vulvoplasties in hospital during 2001 - 2013 were identified, and their characteristics compared with all women of reproductive age (reference population). Main outcome measures: Admissions for vulvoplasty and repeat vulvoplasties; serious complications or adverse events following vulvoplasty procedures; birth mode and perineal outcomes for primiparous women with and without prior vulvoplasty. Results: There were 4,592 vulvoplasty procedures performed on 4,381 women, increasing by 64.5% over the study period. Compared to the reference population, women who had vulvoplasty were more likely to be Australian born (74.6% vs 67.6%); have other cosmetic surgery (10.1% vs 1.7%); and never been married (43.1% vs 33.1%). The serious adverse event/complication rate was 7.2%. Of those with a subsequent first birth, 40.0% had a caesarean section, compared with 30.3% of other women (p<0.001); while among vaginal births, perineal outcomes including tears and episiotomies were not significantly different (p=0.87; p=0.20). Conclusions: Since 2001, the number of vulvoplasties performed in NSW has increased dramatically, with no obvious biological reason for the rise. The procedure was not without serious complications necessitating hospital readmission in some instances. This study provides objective outcome information for counselling women who are contemplating vulvoplastyNHMR

Evaluating Voluntary Travel Behaviour Interventions

Considerable interest in the policy of voluntary travel behaviour change interventions, known as by the generic name of TravelSmart®, has emerged. Measuring its effectiveness and determining its cost-benefit ratios is a major issue. Several difficulties arise in this process. First, it requires both a before and an after survey, sufficiently far apart to detect stable change in household travel behaviour. Second, it requires estimates of numbers of trips and activities, distance travelled by mode, time spent travelling by mode, and the modes of travel used. These are poorly reported in household travel surveys, introducing serious potentials for error in evaluation. Third, are issues relating to sample sizes to detect changes of the order of 5 to 10 percent in various travel behaviours, with acceptable accuracy. After discussing these issues in some detail, we describe a potential survey process, using GPS devices, that can overcome a number of the problems. We describe the information that can be obtained through the GPS and its associated prompted recall survey, demonstrating some of the benefits associated with this procedure. We conclude that evaluation is a significant issue that requires substantial funding to be done effectively, but that the GPS survey offers a high level of reliability in the information obtaine

Knowledge, attitude and experience of episiotomy use among obstetricians and midwives in Viet Nam

Background: Episiotomy remains a routine procedure at childbirth in many South-East Asian countries but the reasons for this are unknown. The aim of this study was to determine the knowledge of, attitudes towards and experience of episiotomy use among clinicians in Viet Nam. Methods: All obstetricians and midwives who provide delivery care at Hung Vuong Hospital were surveyed about their practice, knowledge and attitudes towards episiotomy use. Data were analysed using frequency tabulations and contingency table analysis. Results: 148 (88%) clinicians completed the questionnaire. Fewer obstetricians (52.2%) than midwives (79.7%) thought the current episiotomy rate of 86% was about right (P<0.01). Most obstetricians (82.6%) and midwives (98.7%) reported performing episiotomies on nulliparous women over 90% of the time. Among multipara, 24.6% of obstetricians reported performing episiotomy less than 60% of the time compared with only 3 (3.8%) midwives (P<0.01). Aiming to reduce 3rd-4th degree perineal tears was the most commonly reported reason for performing an episiotomy by both obstetricians (76.8%) and midwives (82.3%), and lack of training in how to minimize tears and keep the perineum intact was the mostly commonly reported obstacle (obstetricians 56.5%, midwives 36.7% P=0.02) to reducing the episiotomy rate. Conclusion: Although several factors that may impede or facilitate episiotomy practice change were identified by our survey, training and confidence in normal vaginal birth without episiotomy is a priority.The authors would like to acknowledge the midwives and obstetricians at Hung Vuong Hospital who gave generously of their time in completing the questionnaire. Christine Roberts is supported by an Australian National Health and Medical Research Council Senior Research Fellowship (APP1021025). Amanda Ampt is supported by the Albert S McKern Research Scholarship

From importing innovations to co-producing them: Transdisciplinary approaches to the development of online land management tools

While traditional approaches to innovation diffusion often assume that innovations come from outside a local system, transdisciplinary co-production offers an alternative paradigm in which local stakeholders are engaged as co-producers of innovations. The use of digital online tools for agriculture, conservation, and citizen science is an area of expanding opportunities, but landholders are often dependent on tools developed outside their local communities. This article looks at the potential for transdisciplinary co-production to be used as a framework for more participatory development of digital online land management tools, with a case study from the Central Tablelands of New South Wales, Australia. This research has implications beyond rural land management to other industries and contexts where reflexive and integrative strategies are needed to overcome barriers to stakeholder participation and engagement with new technologies