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Edwards PJ, Roberts I, Clarke MJ, DiGuiseppi C, Woolf B, Perkins C. Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev 2023; 11:MR000008. [PMID: 38032037 PMCID: PMC10687884 DOI: 10.1002/14651858.mr000008.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Self-administered questionnaires are widely used to collect data in epidemiological research, but non-response reduces the effective sample size and can introduce bias. Finding ways to increase response to postal and electronic questionnaires would improve the quality of epidemiological research. OBJECTIVES To identify effective strategies to increase response to postal and electronic questionnaires. SEARCH METHODS We searched 14 electronic databases up to December 2021 and manually searched the reference lists of relevant trials and reviews. We contacted the authors of all trials or reviews to ask about unpublished trials; where necessary, we also contacted authors to confirm the methods of allocation used and to clarify results presented. SELECTION CRITERIA Randomised trials of methods to increase response to postal or electronic questionnaires. We assessed the eligibility of each trial using pre-defined criteria. DATA COLLECTION AND ANALYSIS We extracted data on the trial participants, the intervention, the number randomised to intervention and comparison groups and allocation concealment. For each strategy, we estimated pooled odds ratios (OR) and 95% confidence intervals (CI) in a random-effects model. We assessed evidence for selection bias using Egger's weighted regression method and Begg's rank correlation test and funnel plot. We assessed heterogeneity amongst trial odds ratios using a Chi2 test and quantified the degree of inconsistency between trial results using the I2 statistic. MAIN RESULTS Postal We found 670 eligible trials that evaluated over 100 different strategies of increasing response to postal questionnaires. We found substantial heterogeneity amongst trial results in half of the strategies. The odds of response almost doubled when: using monetary incentives (odds ratio (OR) 1.86; 95% confidence interval (CI) 1.73 to 1.99; heterogeneity I2 = 85%); using a telephone reminder (OR 1.96; 95% CI 1.03 to 3.74); and when clinical outcome questions were placed last (OR 2.05; 95% CI 1.00 to 4.24). The odds of response increased by about half when: using a shorter questionnaire (OR 1.58; 95% CI 1.40 to 1.78); contacting participants before sending questionnaires (OR 1.36; 95% CI 1.23 to 1.51; I2 = 87%); incentives were given with questionnaires (i.e. unconditional) rather than when given only after participants had returned their questionnaire (i.e. conditional on response) (OR 1.53; 95% CI 1.35 to 1.74); using personalised SMS reminders (OR 1.53; 95% CI 0.97 to 2.42); using a special (recorded) delivery service (OR 1.68; 95% CI 1.36 to 2.08; I2 = 87%); using electronic reminders (OR 1.60; 95% CI 1.10 to 2.33); using intensive follow-up (OR 1.69; 95% CI 0.93 to 3.06); using a more interesting/salient questionnaire (OR 1.73; 95% CI 1.12 to 2.66); and when mentioning an obligation to respond (OR 1.61; 95% CI 1.16 to 2.22). The odds of response also increased with: non-monetary incentives (OR 1.16; 95% CI 1.11 to 1.21; I2 = 80%); a larger monetary incentive (OR 1.24; 95% CI 1.15 to 1.33); a larger non-monetary incentive (OR 1.15; 95% CI 1.00 to 1.33); when a pen was included (OR 1.44; 95% CI 1.38 to 1.50); using personalised materials (OR 1.15; 95% CI 1.09 to 1.21; I2 = 57%); using a single-sided rather than a double-sided questionnaire (OR 1.13; 95% CI 1.02 to 1.25); using stamped return envelopes rather than franked return envelopes (OR 1.23; 95% CI 1.13 to 1.33; I2 = 69%), assuring confidentiality (OR 1.33; 95% CI 1.24 to 1.42); using first-class outward mailing (OR 1.11; 95% CI 1.02 to 1.21); and when questionnaires originated from a university (OR 1.32; 95% CI 1.13 to 1.54). The odds of response were reduced when the questionnaire included questions of a sensitive nature (OR 0.94; 95% CI 0.88 to 1.00). Electronic We found 88 eligible trials that evaluated over 30 different ways of increasing response to electronic questionnaires. We found substantial heterogeneity amongst trial results in half of the strategies. The odds of response tripled when: using a brief letter rather than a detailed letter (OR 3.26; 95% CI 1.79 to 5.94); and when a picture was included in an email (OR 3.05; 95% CI 1.84 to 5.06; I2 = 19%). The odds of response almost doubled when: using monetary incentives (OR 1.88; 95% CI 1.31 to 2.71; I2 = 79%); and using a more interesting topic (OR 1.85; 95% CI 1.52 to 2.26). The odds of response increased by half when: using non-monetary incentives (OR 1.60; 95% CI 1.25 to 2.05); using shorter e-questionnaires (OR 1.51; 95% CI 1.06 to 2.16; I2 = 94%); and using a more interesting e-questionnaire (OR 1.85; 95% CI 1.52 to 2.26). The odds of response increased by a third when: offering survey results as an incentive (OR 1.36; 95% CI 1.16 to 1.59); using a white background (OR 1.31; 95% CI 1.10 to 1.56); and when stressing the benefits to society of response (OR 1.38; 95% CI 1.07 to 1.78; I2 = 41%). The odds of response also increased with: personalised e-questionnaires (OR 1.24; 95% CI 1.17 to 1.32; I2 = 41%); using a simple header (OR 1.23; 95% CI 1.03 to 1.48); giving a deadline (OR 1.18; 95% CI 1.03 to 1.34); and by giving a longer time estimate for completion (OR 1.25; 95% CI 0.96 to 1.64). The odds of response were reduced when: "Survey" was mentioned in the e-mail subject (OR 0.81; 95% CI 0.67 to 0.97); when the email or the e-questionnaire was from a male investigator, or it included a male signature (OR 0.55; 95% CI 0.38 to 0.80); and by using university sponsorship (OR 0.84; 95%CI 0.69 to 1.01). The odds of response using a postal questionnaire were over twice those using an e-questionnaire (OR 2.33; 95% CI 2.25 to 2.42; I2 = 98%). Response also increased when: providing a choice of response mode (electronic or postal) rather than electronic only (OR 1.76 95% CI 1.67 to 1.85; I2 = 97%); and when administering the e-questionnaire by computer rather than by smartphone (OR 1.62 95% CI 1.36 to 1.94). AUTHORS' CONCLUSIONS Researchers using postal and electronic questionnaires can increase response using the strategies shown to be effective in this Cochrane review.
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Affiliation(s)
- Philip James Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Roberts
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Mike J Clarke
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Benjamin Woolf
- School of Psychological Science, University of Bristol, Bristol, UK
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Iwai Y, Yu AYL, Thomas SM, Fayanju OA, Sudan R, Bynum DL, Fayanju OM. Leadership and Impostor Syndrome in Surgery. J Am Coll Surg 2023; 237:585-595. [PMID: 37350479 PMCID: PMC10846669 DOI: 10.1097/xcs.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine. STUDY DESIGN A cross-sectional survey was distributed to US physicians from June 2021 to December 2021 through medical schools and professional organizations. Differences were tested with the chi-square test and t -test for categorical and continuous variables, respectively. Logistic regression was used to identify factors associated with holding leadership positions and experiencing impostor syndrome. RESULTS A total of 2,183 attending and retired physicians were included in the analytic cohort; 1,471 (67.4%) were in leadership roles and 712 (32.6%) were not. After adjustment, male physicians were more likely than women to hold leadership positions (odds ratio 1.4; 95% CI 1.16 to 1.69; p < 0.001). Non-US citizens (permanent resident or visa holder) were less likely to hold leadership positions than US citizens (odds ratio 0.3; 95% CI 0.16 to 0.55; p < 0.001). Having a leadership position was associated with lower odds of impostor syndrome (odds ratio 0.54; 95% CI 0.43 to 0.68; p < 0.001). Female surgeons were more likely to report impostor syndrome compared to male surgeons (90.0% vs 67.7%; p < 0.001), an association that persisted even when female surgeons held leadership roles. Similar trends were appreciated for female and male nonsurgeons. Impostor syndrome rates did not differ by race and ethnicity, including among those underrepresented in medicine, even after adjustment for gender and leadership role. CONCLUSIONS Female physicians were more likely to experience impostor syndrome than men, regardless of specialty or leadership role. Although several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.
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Affiliation(s)
- Yoshiko Iwai
- From the University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Iwai)
| | - Alice Yunzi L Yu
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL (Yu)
| | - Samantha M Thomas
- Duke Cancer Institute (Thomas), Duke University School of Medicine, Durham, NC
- Departments of Biostatistics and Bioinformatics (Thomas), Duke University School of Medicine, Durham, NC
| | - Oluseyi A Fayanju
- Department of Medicine, Stanford University, Palo Alto, CA (QA Fayanju)
| | - Ranjan Sudan
- Surgery (Sudan), Duke University School of Medicine, Durham, NC
| | - Debra L Bynum
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Bynum)
| | - Oluwadamilola M Fayanju
- Department of Surgery, Perelman School of Medicine (OM Fayanju), The University of Pennsylvania, Philadelphia, PA
- Penn Center for Cancer Care Innovation (PC3I) (OM Fayanju), The University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics (LDI) (OM Fayanju), The University of Pennsylvania, Philadelphia, PA
- Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, PA (OM Fayanju)
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Chen AC, Epstein AM, Joynt Maddox KE, Grabowski DC, Orav EJ, Barnett ML. Care delivery approaches and perceived barriers to improving quality of care: A national survey of skilled nursing facilities. J Am Geriatr Soc 2023. [PMID: 36918371 PMCID: PMC10363227 DOI: 10.1111/jgs.18331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Nursing home quality of care is a persistent challenge, with recent reports calling for increased reforms to improve quality and safety. Less is known about the clinical approaches currently used and the barriers perceived by skilled nursing facilities (SNFs) to provide care for their short-stay residents. METHODS We conducted a nationally representative survey of SNFs from October 2020 to May 2021 to understand their care delivery approaches and perceived barriers. Our primary outcomes were the reported number of 23 separate care delivery approaches and the reported number of 12 separate barriers to reduce spending or improve care for SNF short-stay residents. We also performed stratified analyses by facility participation in bundled payments and other SNF characteristics. RESULTS We received 377 responses from 693 SNFs contacted (response rate = 54%). SNFs reported an average of 16.8 care delivery approaches and an average of 5.0 barriers. While there were some differences observed in SNF characteristics, such as by bundled payments participation or ownership type, there were common care delivery approaches and barriers shared by most facilities. Care management practices, including reviewing the patient census and medication reconciliation on discharge, were the most common delivery approaches reported. SNFs were less likely to ensure the completion of a follow-up appointment with a primary care provider or track repeat emergency room visits. Issues concerning staffing, such as staff turnover and/or burnout, and lack of resources to provide patients social support, mental health, and substance use services, were the most cited barriers to care delivery. CONCLUSIONS Nationally, SNFs implemented a wide array of care delivery approaches, but challenges with staffing and limited resources to address patients' social and mental health needs were dominant. Individual SNFs may have limited ability to address these key barriers, so the involvement of many stakeholders across the entire healthcare system may be necessary.
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Affiliation(s)
- Amanda C Chen
- Harvard Graduate School of Arts and Sciences, Boston, Massachusetts, USA
| | - Arnold M Epstein
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karen E Joynt Maddox
- Center for Economics and Policy, Institute of Public Health at Washington University, St. Louis, Missouri, USA
| | - David C Grabowski
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - E John Orav
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michael L Barnett
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Kahwati LC, Kelly BJ, Johnson M, Clark RT, Viswanathan M. End-user understanding of qualitative comparative analysis used within evidence synthesis: A mixed-methods study. Res Synth Methods 2023; 14:180-192. [PMID: 36175386 DOI: 10.1002/jrsm.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 08/09/2022] [Accepted: 09/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Enhanced uptake of systematic reviews that use qualitative comparative analyses (QCA) requires knowing how end-users interpret such findings. The study purpose was to identify effective approaches to communicating results from a QCA within a systematic review. METHODS Sequential exploratory mixed methods design; thematic analysis of interviews with 11 end-users followed by a randomized experiment with 254 participants that provided QCA results for a hypothetical review presented through three formats (text, table, and figure). A survey administered after the experiment assessed subjective and objective comprehension of QCA results. RESULTS Interview themes included use of jargon; appropriate use of appendices, tables, figures; and integration of QCA results within the systematic review. In the experiment, we observed a significant difference (p = 0.035) in subjective comprehension across the three presentation formats. Participants randomized to the figure and text formats scored higher compared to the table. No significant differences were observed for objective comprehension overall (p = 0.11). However, for parameter interpretation (a unique component of QCA results), scores among participants that received the figure format were significantly higher than scores for participants who received the text (p = 0.001) or table (p = 0.004). No significant differences (p = 0.09) were observed in objective comprehension for configuration interpretation. CONCLUSIONS End-users of systematic reviews saw value in the use of QCA, but unfamiliar methods and terminology were barriers to full understanding of the findings. When presenting results, a figure format appears to be superior to text or table formats based on measures of subjective comprehension and some measures of objective comprehension.
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Affiliation(s)
- Leila C Kahwati
- RTI-University of North Carolina Evidence Based Practice Center, Research Triangle Park, Durham, North Carolina, USA.,RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Bridget J Kelly
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Mihaela Johnson
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Rachel T Clark
- RTI International, Research Triangle Park, Durham, North Carolina, USA.,Komodo Health, San Francisco, California, USA
| | - Meera Viswanathan
- RTI-University of North Carolina Evidence Based Practice Center, Research Triangle Park, Durham, North Carolina, USA.,RTI International, Research Triangle Park, Durham, North Carolina, USA
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Chiu AS, Saucke MC, Bushaw K, Voils CI, Sydnor J, Haymart M, Pitt SC. The relative importance of treatment outcomes to surgeons' recommendations for low-risk thyroid cancer. Surgery 2023; 173:183-188. [PMID: 36182602 DOI: 10.1016/j.surg.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/20/2022] [Accepted: 05/03/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The treatment of low-risk thyroid cancer is controversial. We evaluated the importance of treatment outcomes to surgeons' recommendations. METHODS A cross-sectional survey asked thyroid surgeons for their treatment recommendations for a healthy 45-year-old patient with a solitary, low-risk, 2-cm papillary thyroid cancer. The importance of the 10 treatment outcomes (survival, recurrence, etc.) to their recommendation was evaluated using constant sum scaling, a method where 100 points are allocated among the treatment outcomes; more points indicate higher importance. The distribution of points was compared between surgeons recommending total thyroidectomy and surgeons recommending lobectomy using Hottelling's T2 test. RESULTS Of 165 respondents (74.3% response rate), 35.8% (n = 59) recommended total thyroidectomy and 64.2% (n = 106) lobectomy. The importance of the 10 treatment outcomes was significantly different between groups (P < .05). Surgeons recommending total thyroidectomy were most influenced by the risk of recurrence (19.1 points; standard deviation 16.5) and rated this 1.6-times more important than those recommending lobectomy. Conversely, surgeons recommending lobectomy placed high emphasis on need for hormone replacement (14.3 points; standard deviation 15.4), rating this 3.1-times more important than those recommending total thyroidectomy. CONCLUSION Surgeons who recommend total thyroidectomy and those who recommend lobectomy differently prioritize the importance of cancer recurrence and thyroid hormone replacement. Understanding how surgeons' beliefs influence their recommendations is important for ensuring patients receive treatment aligned with their values.
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Affiliation(s)
- Alexander S Chiu
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
| | - Megan C Saucke
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Kyle Bushaw
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Corrine I Voils
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Justin Sydnor
- University of Wisconsin School of Business, Madison, WI
| | - Megan Haymart
- Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI
| | - Susan C Pitt
- Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI
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Abdelazeem B, Hamdallah A, Rizk MA, Abbas KS, El-Shahat NA, Manasrah N, Mostafa MR, Eltobgy M. Does usage of monetary incentive impact the involvement in surveys? A systematic review and meta-analysis of 46 randomized controlled trials. PLoS One 2023; 18:e0279128. [PMID: 36649255 PMCID: PMC9844858 DOI: 10.1371/journal.pone.0279128] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Surveys are an effective method for collecting a large quantity of data. However, incomplete responses to these surveys can affect the validity of the studies and introduce bias. Recent studies have suggested that monetary incentives may increase survey response rates. We intended to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of monetary incentives on survey participation. METHODS A systematic search of electronic databases was conducted to collect studies assessing the impact of monetary incentives on survey participation. The primary outcome of interest was the response rates to incentives: money, lottery, and voucher. We used the Cochrane Collaboration tool to assess the risk of bias in randomized trials. We calculated the rate ratio (RR) with its 95% confidence interval (95% CI) using Review Manager Software (version 5.3). We used random-effects analysis and considered the data statistically significant with a P-value <0.05. RESULTS Forty-six RCTs were included. A total of 109,648 participants from 14 countries were involved. The mean age of participants ranged from 15 to more than 60 years, with 27.5% being males, 16.7% being females, and the other 55.8% not reported. Our analysis showed a significant increase in response rate in the incentive group compared to the control group, irrespective of the incentive methods. Money was the most efficient way to increase the response rate (RR: 1.25; 95% CI: 1.16,1.35; P = < 0.00001) compared to voucher (RR: 1.19; 95% CI: 1.08,1.31; P = < 0.0005) and lottery (RR: 1.12; 95% CI: 1.03,1.22; P = < 0.009). CONCLUSION Monetary incentives encourage the response rate in surveys. Money was more effective than vouchers or lotteries. Therefore, researchers may include money as an incentive to improve the response rate while conducting surveys.
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Affiliation(s)
- Basel Abdelazeem
- McLaren Health Care, Flint, Michigan, United States of America
- Michigan State University, East Lansing, Michigan, United States of America
| | | | | | | | | | - Nouraldeen Manasrah
- Detroit Medical Center/Sinai Grace Hospital, Detroit, Michigan
- Wayne State University, Detroit, Michigan, United States of America
| | - Mostafa Reda Mostafa
- Rochester Regional/Unity hospital, Rochester, New York, United States of America
| | - Mostafa Eltobgy
- The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
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7
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Dudley CM, Stankowski TJ, Tucholka JL, Schumacher JR, Poore SO, Neuman HB. Perspectives of Wisconsin Providers on Factors Influencing Receipt of Post-Mastectomy Breast Reconstruction. Clin Breast Cancer 2022; 22:840-846. [PMID: 36008204 PMCID: PMC10684062 DOI: 10.1016/j.clbc.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The objective is to determine perspectives of general surgeons, plastic surgeons, and cancer navigators on factors contributing to breast cancer patients' decision for post-mastectomy reconstruction, especially for women facing financial hardship. METHODS We mailed Wisconsin general and plastic surgeons who performed >5 breast cancer procedures annually a survey, including a postcard inviting cancer navigators to participate. Descriptive statistics summarize item responses. McNemar's chi-squared tests evaluated surgeons' perspectives of factors influencing reconstruction for all women compared to women facing financial hardship. RESULTS Respondents include 70 general surgeons, 18 plastic surgeons, and 9 navigators. Respondents perceived preference-related factors as important, including "does not want more surgery" (85% reported it important overall and 77% for financial hardship women) and "reconstructed breast is not important to her" (77% vs. 61%). Surgeons perceived logistical factors were more important for women facing financial hardship, including "capacity to be away from work or home responsibilities for recovery" (30% reported important overall and 60% for financial hardship women), "concerned about out-of-pocket costs" (26% vs. 57%), and "frequent visits to complete reconstruction too burdensome" (27% vs. 49%). CONCLUSION Our findings demonstrate Wisconsin surgeons and cancer navigators perceive logistical concerns influence reconstruction decisions for women facing financial hardship.
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Affiliation(s)
- Christina M Dudley
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | | | - Jessica R Schumacher
- University of Wisconsin School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Samuel O Poore
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Heather B Neuman
- University of Wisconsin School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI.
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Woolf B, Edwards P. Does advance contact with research participants increase response to questionnaires: an updated systematic review and meta-analysis. BMC Med Res Methodol 2021; 21:265. [PMID: 34837965 PMCID: PMC8627623 DOI: 10.1186/s12874-021-01435-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background Questionnaires remain one of the most common forms of data collection in epidemiology, psychology and other human-sciences. However, results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. The last systematic review to examine the effect of questionnaire pre-notification on response is 10 years old, and lacked a risk of bias assessment. Objectives Update the section of the Cochrane systematic review, Edwards et al. (2009), on pre-notification to include 1) recently published studies, 2) an assessment of risk of bias, 3) Explore if heterogeneity is reduced by: delay between pre-contact and questionnaire delivery, the method of pre-contact, if pre-contact and questionnaire delivery differ, if the pre-contact includes a foot-in-the-door manipulation, and study’s the risk of bias. Methods Inclusion criteria: population: any population, intervention: comparison of some type of pre-notification, comparison group: no pre-notification, outcome: response rates. Study design: randomised controlled trails. Exclusion criteria: NA. Data sources: Studies which cited or were included in Edwards et al. (2009); We additionally searched: CINAHL, Web of Science, PsycInfo, MEDLINE, EconLit, EMBASE, Cochrane Central, Cochrane CMR, ERIC, and Sociological Abstracts. The searches were implemented in June 2018 and May 2021. Study screening: a single reviewer screened studies, with a random 10% sample independently screened to ascertain accuracy. Data extraction: data was extracted by a single reviewer twice, with a week between each extraction. Risk of Bias: within studies bias was assessed using the Cochrane Risk of Bias tool (ROB1) by a single unblinded reviewer, across studies bias was assessed using funnel plots. Synthesis Method: study results were meta-analysed with a random effects model using the final response rate as the outcome. Evaluation of Uncertainty: Uncertainty was evaluated using the GRADE approach. Results One hundred seven trials were included with 211,802 participants. Over-all pre-notification increased response, OR = 1.33 (95% CI: 1.20–1.47). However, there was a large amount of heterogeneity (I2 = 97.1%), which was not explained by the subgroup analyses. In addition, when studies at high or unclear risk of bias were excluded the effect was to reduced OR = 1.09 (95% CI: 0.99–1.20). Because of the large amount of heterogeneity, even after restricting to low risk of bias studies, there is still moderate uncertainty in these results. Conclusions Using the GRADE evaluation, this review finds moderate evidence that pre-notification may not have an effect on response rates. Funding Economic and Social Research Council. Preregistration None. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01435-2.
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Affiliation(s)
- Benjamin Woolf
- Department of Psychological Science, University of Bristol, 5 Priory Road, Bristol, UK. .,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK. .,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Phil Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Hickey M, McIntyre L, Taljaard M, Abdulaziz K, Yadav K, Hickey C, Perry JJ. Effect of prenotification on the response rate of a postal survey of emergency physicians: a randomised, controlled, assessor-blind trial. BMJ Open 2021; 11:e052843. [PMID: 34556517 PMCID: PMC8461690 DOI: 10.1136/bmjopen-2021-052843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Response rates to physician surveys are typically low. The objective of this study was to determine the effect of a prenotification letter on the response rate of a postal survey of emergency physicians. DESIGN This was a substudy of a national, cross-sectional postal survey sent to emergency physicians in Canada. We randomised participants to either receive a postal prenotification letter prior to the survey, or to no prenotification letter. PARTICIPANTS A random sample of 500 emergency physicians in Canada. Participants were selected from the Canadian Medical Directory, a national medical directory which lists more than 99% of practising physicians in Canada. INTERVENTIONS Using computer-generated randomisation, physicians were randomised in a concealed fashion to receive a prenotification letter approximately 1 week prior to the survey, or to not receive a prenotification letter. All physicians received an unconditional incentive of a $3 coffee card with the survey instrument. In both groups, non-respondents were sent reminder surveys approximately every 14 days and a special contact using Xpresspost during the final contact attempt. OUTCOME The primary outcome was the survey response rate. RESULTS 201 of 447 eligible physicians returned the survey (45.0%). Of 231 eligible physicians contacted in the prenotification group, 80 (34.6%) returned the survey and among 237 eligible physicians contacted in the no-prenotification group, 121 (51.1%) returned the survey (absolute difference in proportions 16.5%, 95% CI 2.5 to 30.5, p=0.01). CONCLUSION Inclusion of a prenotification letter resulted in a lower response rate in this postal survey of emergency physicians. Given the added costs, time and effort required to send a prenotification letter, this study suggests that it may be more effective to omit the prenotification letter in physician postal surveys.
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Affiliation(s)
- Michael Hickey
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Lauralyn McIntyre
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kasim Abdulaziz
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Krishan Yadav
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Carly Hickey
- Intensive Care Unit, Queensway Carleton Hospital, Ottawa, Ontario, Canada
| | - Jeffrey J Perry
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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10
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Sammut R, Griscti O, Norman IJ. Strategies to improve response rates to web surveys: A literature review. Int J Nurs Stud 2021; 123:104058. [PMID: 34454334 DOI: 10.1016/j.ijnurstu.2021.104058] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The development of the web survey has led to significant strides in questionnaire survey methodology, including its potential to substantially increase sample sizes at minimal costs. Despite its advantages, web surveys typically achieve lower response rates from participants compared to more conventional survey methods. OBJECTIVE The aim of this review was to evaluate strategies to increase the response rate to web surveys. METHODS CINAHL (EBSCO), MEDLINE Complete, the Cochrane database of systematic reviews, the Cochrane central register of controlled trials and Psych Info were searched, from inception to the 24th of June, 2021. The Boolean search phrase (Ti: Web survey* OR online survey* OR internet survey*) AND (Ti: response rate* OR nonresponse* or participation rate*) was used. This was supplemented by a secondary search of the reference lists. To be eligible for inclusion in the review, papers had to evaluate one or more strategies to improve response rates to web surveys. Experimental and quasi experimental studies were included in the review. RESULTS A total of 159 papers were identified. Following removal of duplicates, and further screening by two independent reviewers, 45 papers met the inclusion and exclusion criteria, and were included in the final review. The use of e-mail pre-notification, email invitation and two reminders were found to increase response rates to web surveys as do the use of a semi-automatic log-in, a simple design and a short survey which takes around 10 min to complete. Incentives, including entry into a prize draw with a cash prize considered to be of value to the participants also increase response rates. CONCLUSION Research studies are needed to explore whether the different strategies used by researchers with the intent to improve response rates are acceptable to potential participants and to evaluate the potential synergistic effect of combinations of several strategies identified in this review. Tweetable abstract: Email prenotification, email invitation, 2 reminders, simple 10 min design and lottery incentives improve response rates to web surveys.
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Affiliation(s)
- Roberta Sammut
- Department of Nursing, Faculty of Health Sciences, University of Malta, Tal-Qroqq, Msida MSD2080, Malta.
| | - Odette Griscti
- Nursing Department, Cape Breton University, Office A231H, P.O. Box 5300, 1250 Grand Lake Road, Sydney, Nova Scotia B1P 6L2, Canada.
| | - Ian J Norman
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom.
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Dykema J, Stevenson J, Assad N, Kniss C, Taylor CA. Effects of Sequential Prepaid Incentives on Response Rates, Data Quality, Sample Representativeness, and Costs in a Mail Survey of Physicians. Eval Health Prof 2020; 44:235-244. [PMID: 32924566 DOI: 10.1177/0163278720958186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While collecting high quality data from physicians is critical, response rates for physician surveys are frequently low. A proven method for increasing response in mail surveys is to provide a small, prepaid monetary incentive in the initial mailing. More recently, researchers have begun experimenting with adding a second cash incentive in a follow-up contact in order to increase participation among more reluctant respondents. To assess the effects of sequential incentives on response rates, data quality, sample representativeness, and costs, physicians (N = 1,500) were randomly assigned to treatments that crossed the amount of a first ($5 or $10) and second ($0, $5, or $10) incentive to form the following groups: Group $5/$5; Group $5/$10; Group $10/$0; Group $10/$5; and Group $10/$10. Overall, second incentives were associated with higher response rates and lower costs per completed survey, and while they had no effect on item nonresponse, they increased sample representativeness.
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Affiliation(s)
- Jennifer Dykema
- University of Wisconsin Survey Center, 5228University of Wisconsin-Madison, WI, USA.,Department of Sociology, 5228University of Wisconsin-Madison, WI, USA
| | - John Stevenson
- University of Wisconsin Survey Center, 5228University of Wisconsin-Madison, WI, USA
| | - Nadia Assad
- University of Wisconsin Survey Center, 5228University of Wisconsin-Madison, WI, USA
| | - Chad Kniss
- University of Wisconsin Survey Center, 5228University of Wisconsin-Madison, WI, USA
| | - Catherine A Taylor
- Department of Global Community Health and Behavioral Sciences, 5783Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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Choueiry J, Reszel J, Hamid JS, Wilding J, Martelli B, Harrison D. Development and Pilot Evaluation of an Educational Tool for the FLACC Pain Scale. Pain Manag Nurs 2020; 21:523-529. [PMID: 32682637 DOI: 10.1016/j.pmn.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/29/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The FLACC (Face, Legs, Activity, Cry, Consolability) pain scale is commonly used for pediatric pain assessment; however, no online educational tool exists to facilitate the use of the scale. AIMS This study aimed to develop an online educational tool and evaluate its effect on nurse knowledge, user confidence, and scoring accuracy. DESIGN AND METHODS In phase 1, semistructured interviews were conducted to identify preferred educational features and content. Eight informants were interviewed in phase 1. Recommendations informed the development of the educational tool. Data were analyzed via conventional content analysis. Phase 2 involved a pre-post evaluation of the tool through online surveys. Posteducational data were collected immediately after the tool was completed. Wilcoxon signed rank and McNemar-Bowker tests were used to compare pre- and post-training knowledge, confidence, and FLACC scores. Scoring accuracy was examined using percentage agreement and consensus analysis. RESULTS Thirty-four nurses participated in phase 2. The educational tool significantly improved knowledge (p < .0001) and increased user confidence, although not to a significant level (p = .06). There was a significant improvement in correct assessment of moderate pain (p = .04). Almost all nurses correctly assessed severe pain before and after education (91%). However, there was a decrease in accurate assessment of mild pain (p = .01). CONCLUSIONS Because the intervention improved knowledge, user confidence, and assessment accuracy of moderate pain, it would be useful to implement such a tool as part of clinician education. However, further modifications will be needed to improve assessment of mild pain.
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Affiliation(s)
- Juliana Choueiry
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | - Jessica Reszel
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Jemila S Hamid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Population Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jodi Wilding
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Brenda Martelli
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Denise Harrison
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
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13
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Patient Reported Outcomes in Surgical Research. Health Serv Res 2020. [DOI: 10.1007/978-3-030-28357-5_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Pignatiello A, Stasiulis E, Solimine C, Ayad O, Boydell KM. Lessons Learned in a Physician Referral to Pediatric Telemental Health Services Program. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2019; 28:99-104. [PMID: 31798648 PMCID: PMC6863575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 07/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study explores the physician referral and engagement process of a pediatric telemental health program based in a large urban teaching children's hospital, and identifies the processes, strengths and challenges from the perspectives of Primary Care Physicians (PCPs) and telepsychiatrist consultants. METHODS A mixed methods approach was used. This included an online survey completed by 43 PCPs in Ontario rural communities who had referred patients to the telemental health program. Qualitative interviews were conducted with 11 child/adolescent telepsychiatrists who provide consultations via teleconferencing. RESULTS The majority of PCPs (61%) reported somewhat to moderate satisfaction with referral experiences. Challenges identified by physicians were related to communication and administration issues including: lack of timely follow-up appointments and continuity of care; lengthy referral forms; and recommendations for mental health services not accessible in their communities. Similarly, psychiatrist consultants expressed frustration with the sparse information they received from referring physicians and most significantly, the absence of appropriate service providers/professionals during the consultation to provide collateral information and ensure uptake of recommendations. CONCLUSION Telemental health programs provide a valuable service to PCPs and their child and youth clients that could be significantly enhanced with a different consultation model. Such models of service delivery require protocols to educate PCPs, improve communication and information sharing and establish clear expectations between PCPs and telepsychiatry consultants.
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Affiliation(s)
- Antonio Pignatiello
- Associate Psychiatrist-in-Chief; Medical Director, TeleLink Mental Health Program, The Hospital for Sick Children; Associate Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Associate Dean, Health Professions Student Affairs, MD Program, University of Toronto, Toronto, Ontario
| | - Elaine Stasiulis
- Research Fellow, Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, Ontario
| | - Carmela Solimine
- Research Manager (at time of writing), Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
| | - Omar Ayad
- Project Manager, TeleLink Mental Health Program, The Hospital for Sick Children, Toronto, Ontario
| | - Katherine M Boydell
- Professor of Mental Health, Black Dog Institute, University of New South Wales, New South Wales, Australia
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Hill EK, Stuckey A, Fiascone S, Raker C, Clark MA, Brown A, Gordinier M, Robison K. Gender and the Balance of Parenting and Professional Life among Gynecology Subspecialists. J Minim Invasive Gynecol 2019; 26:1088-1094. [DOI: 10.1016/j.jmig.2018.10.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 10/28/2022]
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Sack DI, Woodruff SI, McCabe CT, Galarneau MR, Han PP. Evaluation of Three Postal Invitational Strategies to Increase Survey Response Rates in a Combat-Injured U.S. Military Population: Findings From the Wounded Warrior Recovery Project. Mil Med 2019; 184:521-528. [PMID: 30901447 DOI: 10.1093/milmed/usy374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/07/2018] [Indexed: 11/12/2022] Open
Abstract
The survival rate of those injured in combat in overseas contingency operations is higher than in previous conflicts. There is a need to assess the long-term psychosocial and quality of life outcomes of those injured in combat, yet surveying this population presents inherent challenges. As part of a large-scale, longitudinal examination of patient-reported outcomes of service members injured on deployment, the present manuscript evaluated the effectiveness of three postal strategies on response rates: (1) mailing a study prenotification postcard, (2) mailing the survey invitation in a larger envelope, and (3) including a small cash preincentive ($2). Evaluation of these strategies yielded mixed results in this population. Neither the prenotification postcard nor inclusion of a $2 cash preincentive significantly increased response rates. However, use of a larger envelope to mail the survey invitation significantly increased the response rate by 53.1%. Researchers interested in collecting patient-reported outcomes among military populations, including those with combat-related injuries, may find that increasing the visibility of recruitment materials is more effective for improving response rates than attempting to cognitively prime or offer prospective participants preincentives.
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Affiliation(s)
| | | | | | - Michael R Galarneau
- Naval Health Research Center, Department of Medical Modeling, Simulation, and Mission Support, 140 Sylvester Rd., San Diego, CA
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Pak DJ, Gruber J, Deer T, Provenzano D, Gulati A, Xu Y, Tangel V, Mehta N. Spinal cord stimulator education during pain fellowship: unmet training needs and factors that impact future practice. Reg Anesth Pain Med 2019; 44:407-414. [DOI: 10.1136/rapm-2018-100065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 09/07/2018] [Indexed: 11/04/2022]
Abstract
Background and objectivesWith a growing need for non-opioid chronic pain treatments, pain physicians should understand the proper utilization of neuromodulation therapies to provide the most comprehensive care. We aimed to identify the unmet training needs that deter physicians from using spinal cord stimulation (SCS) devices.MethodsInternet-based surveys were fielded to fellows enrolled in pain fellowships during the 2016–2017 academic year accredited by the Accreditation Council for Graduate Medical Education and past pain fellows identified through pain medicine societies and SCS manufacturers.ResultsCurrent fellows were more likely to have received SCS training during fellowship compared with past fellows (100.0% vs 84.0%), yet there was variability in fellows’ SCS experiences with a wide range of trials and implants performed. Forty-six percent of current fellows felt there was an unmet training need regarding SCS. Deficiency in SCS case volume was the most common barrier that was noted (38.5%), followed by lack of SCS curriculum (30.8%) and lack of faculty with SCS expertise (23.1%). Lack of training was a predominant reason for past fellows choosing not to use SCS devices postfellowship. The majority of current and past fellows (79.5% and 55.4%, respectively) strongly supported direct training of fellows by SCS manufacturers.ConclusionsWhile SCS training during pain fellowship has become more universal, the experiences that fellows receive are highly variable, and most rely on industry-sponsored programs to supplement training deficiencies. Standardization of SCS procedures may also enable less experienced providers to navigate the SCS treatment algorithm.
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Dubois L, Marsh T, Demers LB. Program Coordinator Professional Development: Definition, Perception of Importance, Motivating Factors, and Barriers. Am J Med 2019; 132:114-118. [PMID: 30240687 DOI: 10.1016/j.amjmed.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/13/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Lauralee Dubois
- Boston Medical Center and Boston University School of Medicine, Mass.
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If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers. J Am Board Fam Med 2018; 31:774-782. [PMID: 30201674 PMCID: PMC6170156 DOI: 10.3122/jabfm.2018.05.180045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/17/2018] [Accepted: 04/22/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI. METHODS We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment. RESULTS Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%; P < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI (P < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9-26.0; P < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2-90.0; P = .01); screening verbally (OR, 3.9; 95% CI, 1.9-8.0; P < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8-7.4; P < .001); using the term, "accidental bowel leakage" (OR, 2.9; 95% CI, 1.2-6.7; P = .02) or "bowel control issues" (OR, 2.2; 95% CI, 1.1-4.5; P = .03); and being a resident (OR, 0.37; 95% CI, 0.16-0.82; P = .02). PCPs reported high interest in patient and provider educational materials about UI and FI. CONCLUSIONS Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment.
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Brtnikova M, Crane LA, Allison MA, Hurley LP, Beaty BL, Kempe A. A method for achieving high response rates in national surveys of U.S. primary care physicians. PLoS One 2018; 13:e0202755. [PMID: 30138406 PMCID: PMC6107210 DOI: 10.1371/journal.pone.0202755] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022] Open
Abstract
Physician questionnaires are commonly used in health services research; however, many survey studies are limited by low response rate. We describe the effectiveness of a method to maximize survey response without using incentives, the effectiveness of survey reminders over time, and differences in response rates based on survey mode and primary care specialty. As part of a study to assess vaccine policy issues, 13 separate surveys were conducted by internet and mail over the period of 2008 to 2013. Surveys were conducted among pre-recruited networks of pediatricians, family physicians and general internists. Each network was active for 2 years and responded to 3–6 surveys. Physicians who indicated preference to respond through an online survey received up to 9 e-mailed requests to complete the questionnaire and up to 2 mailed questionnaires. Physicians who chose to respond by mail received up to 3 mailed questionnaires and a reminder postcard. For 6 of the 13 surveys conducted over the 6 year period, an additional mailing using a hand-addressed envelope was mailed to non-responders at the end of the usual protocol. Effectiveness of survey methods was measured by response rates. The overall response rates varied from 66‒83%. Response rates declined 17 percentage-points on average between the first and last surveys administered within each physician network. The internet group consistently had higher response rates than the mail group (74% vs. 62% on average). An additional mailing in a hand-written envelope boosted the final response rate by 11 percentage-points. Self-selection of survey mode, multiple reminders, and hand-written envelopes are effective methods for maximizing response rates in physician surveys.
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Affiliation(s)
- Michaela Brtnikova
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
- * E-mail:
| | - Lori A. Crane
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
- Department of Community and Behavioral Health, Colorado School of Public Health, Denver, CO, United States of America
| | - Mandy A. Allison
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
| | - Laura P. Hurley
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
- Division of General Internal Medicine, Denver Health, Denver, CO, United States of America
| | - Brenda L. Beaty
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
| | - Allison Kempe
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO, United States of America
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Kaplan SE, Raj A, Carr PL, Terrin N, Breeze JL, Freund KM. Race/Ethnicity and Success in Academic Medicine: Findings From a Longitudinal Multi-Institutional Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:616-622. [PMID: 29068820 PMCID: PMC5916738 DOI: 10.1097/acm.0000000000001968] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE To understand differences in productivity, advancement, retention, satisfaction, and compensation comparing underrepresented medical (URM) faculty with other faculty at multiple institutions. METHOD A 17-year follow-up was conducted of the National Faculty Survey, a random sample from 24 U.S. medical schools, oversampled for URM faculty. The authors examined academic productivity, advancement, retention, satisfaction, and compensation, comparing white, URM, and non-URM faculty. Retention, productivity, and advancement data were obtained from public sources for nonrespondents. Covariates included gender, specialty, time distribution, and years in academia. Negative binomial regression was used for count data, logistic regression for binary outcomes, and linear regression for continuous outcomes. RESULTS In productivity analyses, advancement, and retention, 1,270 participants were included; 604 participants responded to the compensation and satisfaction survey. Response rates were lower for African American (26%) and Hispanic faculty (39%) than white faculty (52%, P < .0001). URM faculty had lower rates of peer-reviewed publications (relative number 0.64; 95% CI: 0.51, 0.79), promotion to professor (OR = 0.53; CI: 0.30, 0.93), and retention in academic medicine (OR = 0.49; CI: 0.32, 0.75). No differences were identified in federal grant acquisition, senior leadership roles, career satisfaction, or compensation between URM and white faculty. CONCLUSIONS URM and white faculty had similar career satisfaction, grant support, leadership, and compensation; URM faculty had fewer publications and were less likely to be promoted and retained in academic careers. Successful retention of URM faculty requires comprehensive institutional commitment to changing the academic climate and deliberative programming to support productivity and advancement.
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Affiliation(s)
- Samantha E Kaplan
- S.E. Kaplan is assistant professor of obstetrics and gynecology and assistant dean for diversity and multicultural affairs, Boston University School of Medicine, Boston, Massachusetts. A. Raj is professor of medicine and global public health and director, Center on Gender Equity and Health, Division of Global Public Health, School of Medicine, University of California, San Diego, San Diego, California. P.L. Carr is associate physician, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. N. Terrin is professor of medicine and director of biostatistics, epidemiology, and research design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. J.L. Breeze is instructor of medicine and epidemiologist in biostatistics, epidemiology, and research design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. K.M. Freund is professor and vice chair of medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts
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Using a Small Cash Incentive to Increase Survey Response. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 45:813-819. [DOI: 10.1007/s10488-018-0866-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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23
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Beebe TJ, Jacobson RM, Jenkins SM, Lackore KA, Rutten LJF. Testing the Impact of Mixed-Mode Designs (Mail and Web) and Multiple Contact Attempts within Mode (Mail or Web) on Clinician Survey Response. Health Serv Res 2018; 53 Suppl 1:3070-3083. [PMID: 29355920 DOI: 10.1111/1475-6773.12827] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare response rate and nonresponse bias across two mixed-mode survey designs and two single-mode designs. DATA SOURCES This experiment was embedded in a clinician survey of knowledge and attitudes regarding HPV vaccination (n = 275). STUDY DESIGN Clinicians were randomly assigned one of two mixed-mode (mail/web or web/mail) or single-mode designs (mail-only/web-only). Differences in response rate and nonresponse bias were assessed. PRINCIPAL FINDINGS Using a multiple-contact protocol increased response, and sending a web survey first provided the more rapid response. Overall, the mixed-mode survey designs generated final response rates approximately 10 percentage points higher than their single-mode counterparts, although only the final response differences between the mail-only and web/mail conditions attained statistical significance (32.1 percent vs. 48 percent, respectively; p = .005). Observed differences did not result in nonresponse bias. CONCLUSIONS Results support mixing modes of survey administration and web-based data collection in a multiple contact survey data collection protocol.
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Affiliation(s)
- Timothy J Beebe
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Robert M Jacobson
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Sarah M Jenkins
- Survey Research Center, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Kandace A Lackore
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Lila J Finney Rutten
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Hurlimann T, Jaitovich Groisman I, Godard B. The elusive ideal of inclusiveness: lessons from a worldwide survey of neurologists on the ethical issues raised by whole-genome sequencing. BMC Med Ethics 2017; 18:28. [PMID: 28399922 PMCID: PMC5389086 DOI: 10.1186/s12910-017-0187-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/04/2017] [Indexed: 12/20/2022] Open
Abstract
The anticipation of ethical issues that may arise with the clinical use of genomic technologies is crucial to envision their future implementation in a manner sensitive to local contexts. Yet, populations in low- and middle-income countries are underrepresented in studies that aim to explore stakeholders’ perspectives on the use of such technologies. Within the framework of a research project entitled “Personalized medicine in the treatment of epilepsy”, we sought to increase inclusiveness by widening the reach of our survey, inviting neurologists from around the world to share their views and practices regarding the use of whole-genome sequencing in clinical neurology and its associated ethics. We discuss herein the compelling scientific and ethical reasons that led us to attempt to recruit neurologists worldwide, despite the lack, in many low- or middle-income countries, of access to genomic technologies. Recruitment procedures and their results are presented and discussed, as well as the barriers we faced. We conclude that inclusive recruitment remains a challenging, albeit necessary and legitimate, endeavour.
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Affiliation(s)
- Thierry Hurlimann
- Institut de recherche en santé publique (IRSPUM), Omics-Ethics Research Group, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, QC, H3C 3 J7, Canada
| | - Iris Jaitovich Groisman
- Institut de recherche en santé publique (IRSPUM), Omics-Ethics Research Group, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, QC, H3C 3 J7, Canada
| | - Béatrice Godard
- Institut de recherche en santé publique (IRSPUM), Omics-Ethics Research Group, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, QC, H3C 3 J7, Canada.
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Primary Care Physicians' Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs. AIDS Behav 2017; 21:1025-1033. [PMID: 27896552 DOI: 10.1007/s10461-016-1612-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pre-exposure prophylaxis for HIV (PrEP) is recommended for people who inject drugs (PWID). Despite their central role in disease prevention, willingness to prescribe PrEP to PWID among primary care physicians (PCPs) is largely understudied. We conducted an online survey (April-May 2015) of members of a society for academic general internists regarding PrEP. Among 250 respondents, 74% (n = 185) of PCPs reported high willingness to prescribe PrEP to PWID. PCPs were more likely to report high willingness to prescribe PrEP to all other HIV risk groups (p's < 0.03 for all pair comparisons). Compared with PCPs delivering care to more HIV-infected clinic patients, PCPs delivering care to fewer HIV-infected patients were more likely to report low willingness to prescribe PrEP to PWID (Odds Ratio [95% CI] = 6.38 [1.48-27.47]). PCP and practice characteristics were not otherwise associated with low willingness to prescribe PrEP to PWID. Interventions to improve PCPs' willingness to prescribe PrEP to PWID are needed.
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Paul CL, Piterman L, Shaw JE, Kirby C, Forshaw KL, Robinson J, Thepwongsa I, Sanson-Fisher RW. Poor uptake of an online intervention in a cluster randomised controlled trial of online diabetes education for rural general practitioners. Trials 2017; 18:137. [PMID: 28335809 PMCID: PMC5364574 DOI: 10.1186/s13063-017-1869-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/01/2017] [Indexed: 11/20/2022] Open
Abstract
Background In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control. Method Trial design: the cluster randomised controlled trial involved towns as the unit of allocation and analysis with outcomes assessed by de-identified pathology data (not reported here). The intervention programme consisted of an online active learning module, direct electronic access to specialist advice and performance feedback. Multiple rounds of invitation were used to engage GPs with the online intervention content. Evidence-based strategies (e.g. pre-notification, rewards, incentives) were incorporated into the invitations to enrol in the programme. Recruitment to the programme was electronically monitored through the hosting software package during the study intervention period. Results Eleven matched pairs of towns were included in the study. There were 146 GPs in the 11 intervention towns, of whom 34 (23.3%) enrolled in the programme, and 8 (5.5%) completed the online learning module. No town had more than 10% of the resident GPs complete the learning module. There were no contacts made by GPs regarding requests for specialist advice. Consequently, the trial was discontinued. Conclusion There is an ongoing need to engage primary care physicians in improving diabetes monitoring and management in rural areas. Online training options, while notionally attractive and accessible, are not likely to have high levels of uptake, even when evidence-based recruitment strategies are implemented. Trial registration Australian New Zealand Clinical Trials Registry, identifier: ACTRN12611000553976. Retrospectively registered on 31 May 2011.
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Affiliation(s)
- Christine L Paul
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia. .,University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia. .,W4 HMRI Building, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Leon Piterman
- Monash University, School of Rural Health, Churchill, VIC, Australia.,Eastern Victoria General Practice Training, Churchill, VIC, Australia
| | - Jonathan E Shaw
- Baker IDI Heart and Diabetes Institute, Clinical Diabetes and Epidemiology Group, Melbourne, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Catherine Kirby
- Monash University, School of Rural Health, Churchill, VIC, Australia.,Eastern Victoria General Practice Training, Churchill, VIC, Australia
| | - Kristy L Forshaw
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia.,University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia
| | - Jennifer Robinson
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia
| | - Isaraporn Thepwongsa
- Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Robert W Sanson-Fisher
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW, Australia.,University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia
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Sebo P, Maisonneuve H, Cerutti B, Fournier JP, Senn N, Haller DM. Rates, Delays, and Completeness of General Practitioners' Responses to a Postal Versus Web-Based Survey: A Randomized Trial. J Med Internet Res 2017; 19:e83. [PMID: 28330830 PMCID: PMC5382256 DOI: 10.2196/jmir.6308] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 12/15/2016] [Accepted: 12/22/2016] [Indexed: 11/13/2022] Open
Abstract
Background Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). Objective Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs’ preventive practices. Methods This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study. Results Among the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P<.001), but median response time was much shorter (1 day vs 1-3 weeks, P<.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P<.001). Conclusions Web-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs’ participation in surveys while reducing costs.
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Affiliation(s)
- Paul Sebo
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Maisonneuve
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Bernard Cerutti
- Unit of Research and Development in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jean Pascal Fournier
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Nicolas Senn
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians. J Gen Intern Med 2017; 32:62-70. [PMID: 27778215 PMCID: PMC5215171 DOI: 10.1007/s11606-016-3903-z] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/29/2016] [Accepted: 10/05/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN Cross-sectional online survey conducted in April and May 2015. RESPONDENTS Members of a national professional organization for academic primary care physicians (n = 266). MAIN MEASURES PrEP awareness, PrEP adoption (ever prescribed or referred a patient for PrEP [yes/no]), provider and practice characteristics, and self-rated knowledge, attitudes, and beliefs associated with adoption. KEY RESULTS The survey response rate was 8.6 % (266/2093). Ninety-three percent of respondents reported prior awareness of PrEP. Of these, 34.9 % reported PrEP adoption. In multivariable analysis of provider and practice characteristics, compared with non-adopters, adopters were more likely to provide care to more than 50 HIV-positive patients (vs. 0, aOR = 6.82, 95 % CI 2.06-22.52). Compared with non-adopters, adopters were also more likely to report excellent, very good, or good self-rated PrEP knowledge (15.1 %, 33.7 %, 30.2 % vs. 2.5 %, 18.1 %, 23.8 %, respectively; p < 0.001) and to perceive PrEP as extremely safe (35.1 % vs. 10.7 %; p = 0.002). Compared with non-adopters, adopters were less likely to perceive PrEP as being moderately likely to increase risk behaviors ("risk compensation") (12.8 % vs. 28.8 %, p = 0.02). CONCLUSIONS While most respondents were aware of PrEP, only one-third of PrEP-aware PCPs reported adoption. Adopters were more likely to have experience providing HIV care and to perceive PrEP as extremely safe, and were less likely to perceive PrEP use as leading to risk compensation. To enhance PCP adoption of PrEP, educational efforts targeting PCPs without HIV care experience should be considered, as well as training those with HIV care experience to be PrEP "clinical champions". Concerns about safety and risk compensation must also be addressed.
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Cook DA, Wittich CM, Daniels WL, West CP, Harris AM, Beebe TJ. Incentive and Reminder Strategies to Improve Response Rate for Internet-Based Physician Surveys: A Randomized Experiment. J Med Internet Res 2016; 18:e244. [PMID: 27637296 PMCID: PMC5045523 DOI: 10.2196/jmir.6318] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 11/13/2022] Open
Abstract
Background Most research on how to enhance response rates in physician surveys has been done using paper surveys. Uncertainties remain regarding how to enhance response rates in Internet-based surveys. Objective To evaluate the impact of a low-cost nonmonetary incentive and paper mail reminders (formal letter and postcard) on response rates in Internet-based physician surveys. Methods We executed a factorial-design randomized experiment while conducting a nationally representative Internet-based physician survey. We invited 3966 physicians (randomly selected from a commercial database of all licensed US physicians) via email to complete an Internet-based survey. We used 2 randomly assigned email messages: one message offered a book upon survey completion, whereas the other did not mention the book but was otherwise identical. All nonrespondents received several email reminders. Some physicians were further assigned at random to receive 1 reminder via paper mail (either a postcard or a letter) or no paper reminder. The primary outcome of this study was the survey response rate. Results Of the 3966 physicians who were invited, 451 (11.4%) responded to at least one survey question and 336 (8.5%) completed the entire survey. Of those who were offered a book, 345/2973 (11.6%) responded compared with 106/993 (10.7%) who were not offered a book (odds ratio 1.10, 95% CI 0.87-1.38, P=.42). Regarding the paper mail reminder, 168/1572 (10.7%) letter recipients, 148/1561 (9.5%) postcard recipients, and 69/767 (9.0%) email-only recipients responded (P=.35). The response rate for those receiving letters or postcards was similar (odds ratio 1.14, 95% CI 0.91-1.44, P=.26). Conclusions Offering a modest nonmonetary incentive and sending a paper reminder did not improve survey response rate. Further research on how to enhance response rates in Internet-based physician surveys is needed.
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Affiliation(s)
- David A Cook
- Mayo Clinic Online Learning, Mayo Clinic College of Medicine, Rochester, MN, United States.
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Freund KM, Raj A, Kaplan SE, Terrin N, Breeze JL, Urech TH, Carr PL. Inequities in Academic Compensation by Gender: A Follow-up to the National Faculty Survey Cohort Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:1068-73. [PMID: 27276007 PMCID: PMC4965349 DOI: 10.1097/acm.0000000000001250] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
PURPOSE Cross-sectional studies have demonstrated gender differences in salaries within academic medicine. No research has assessed longitudinal compensation patterns. This study sought to assess longitudinal patterns by gender in compensation, and to understand factors associated with these differences in a longitudinal cohort. METHOD A 17-year longitudinal follow-up of the National Faculty Survey was conducted with a random sample of faculty from 24 U.S. medical schools. Participants employed full-time at initial and follow-up time periods completed the survey. Annual pretax compensation during academic year 2012-2013 was compared by gender. Covariates assessed included race/ethnicity; years since first academic appointment; retention in academic career; academic rank; departmental affiliation; percent effort distribution across clinical, teaching, administrative, and research duties; marital and parental status; and any leave or part-time status in the years between surveys. RESULTS In unadjusted analyses, women earned a mean of $20,520 less than men (P = .03); women made 90 cents for every dollar earned by their male counterparts. This difference was reduced to $16,982 (P = .04) after adjusting for covariates. The mean difference of $15,159 was no longer significant (P = .06) when adjusting covariates and for those who had ever taken a leave or worked part-time. CONCLUSIONS The continued gender gap in compensation cannot be accounted for by metrics used to calculate salary. Institutional actions to address these disparities include both initial appointment and annual salary equity reviews, training of senior faculty and administrators to understand implicit bias, and training of women faculty in negotiating skills.
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Affiliation(s)
- Karen M Freund
- K.M. Freund is professor and vice chair of medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts. A. Raj is professor of medicine and global public health and director, Center on Gender Equity and Health, School of Medicine, University of California, San Diego, La Jolla, California. S.E. Kaplan is assistant professor and assistant dean for diversity, Boston University School of Medicine, Boston, Massachusetts. N. Terrin is director, Biostatistics, Epidemiology and Research Design Center, Tufts Clinical and Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. J.L. Breeze is epidemiologist, Biostatistics, Epidemiology and Research Design Center, Tufts Clinical and Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. T.H. Urech is a research heath science specialist, VA HSR&D Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, California. P.L. Carr is a faculty member, Department of Medicine at Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Moysidou A, Farsalinos KE, Voudris V, Merakou K, Kourea K, Barbouni A. Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050514. [PMID: 27213421 PMCID: PMC4881139 DOI: 10.3390/ijerph13050514] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 12/28/2022]
Abstract
Introduction. The purpose of this study was to evaluate the knowledge and perceptions of Greek healthcare professionals about nicotine, nicotine replacement therapies and electronic cigarettes. Methods. An online survey was performed, in which physicians and nurses working in private and public healthcare sectors in Athens-Greece were asked to participate through email invitations. A knowledge score was calculated by scoring the correct answers to specific questions with 1 point. Results. A total of 262 healthcare professionals were included to the analysis. Most had daily contact with smokers in their working environment. About half of them considered that nicotine has an extremely or very important contribution to smoking-related disease. More than 30% considered nicotine replacement therapies equally or more addictive than smoking, 76.7% overestimated their smoking cessation efficacy and only 21.0% would recommend them as long-term smoking substitutes. For electronic cigarettes, 45.0% considered them equally or more addictive than smoking and 24.4% equally or more harmful than tobacco cigarettes. Additionally, 35.5% thought they involve combustion while the majority responded that nicotine in electronic cigarettes is synthetically produced. Only 14.5% knew about the pending European regulation, but 33.2% have recommended them to smokers in the past. Still, more than 40% would not recommend electronic cigarettes to smokers unwilling or unable to quit smoking with currently approved medications. Cardiologists and respiratory physicians, who are responsible for smoking cessation therapy in Greece, were even more reluctant to recommend electronic cigarettes to this subpopulation of smokers compared to all other participants. The knowledge score of the whole study sample was 7.7 (SD: 2.4) out of a maximum score of 16. Higher score was associated with specific physician specialties. Conclusions. Greek healthcare professionals appear to overestimate the adverse effects of nicotine, and many would not recommend any nicotine-containing product as a long-term smoking substitute. Additionally, they have poor knowledge about the function and characteristics of electronic cigarettes.
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Affiliation(s)
- Anastasia Moysidou
- National School of Public Health, Alexandras Av. 196, Athens 11521, Greece.
| | | | - Vassilis Voudris
- Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece.
| | - Kyriakoula Merakou
- National School of Public Health, Alexandras Av. 196, Athens 11521, Greece.
| | - Kallirrhoe Kourea
- National School of Public Health, Alexandras Av. 196, Athens 11521, Greece.
| | - Anastasia Barbouni
- National School of Public Health, Alexandras Av. 196, Athens 11521, Greece.
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Baker EH, Dowden JE, Cochran AR, Iannitti DA, Kimchi ET, Staveley-O'Carroll KF, Jeyarajah DR. Qualities and characteristics of successfully matched North American HPB surgery fellowship candidates. HPB (Oxford) 2016; 18:479-84. [PMID: 27154813 PMCID: PMC4857058 DOI: 10.1016/j.hpb.2015.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 12/09/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepato-pancreato-biliary (HPB) fellowships in North America are difficult to secure with an acceptance rate of 1 in 3 applicants. Desirable characteristics in an HPB surgery applicant have not been previously reported. This study examines the perceptions of trainees and HPB program directors with regards to positive attributes in applicants for HPB fellowships. METHODS Parallel surveys were distributed by email with a web-link to current and recent HPB fellows in North America (from the past 5 years) with questions addressing the following domains: surgical training, research experience, and mentorship. A similar survey was distributed to HPB fellowship program directors in North America requesting their opinion as to the importance of these characteristics in potential applicants. RESULTS 32 of 60 of surveyed fellows and 21 of 38 of surveyed program directors responded between November 2014-February 2015. Fellows overall came from fairly diverse backgrounds (13/32 were overseas medical graduates) about one third of respondents having had some prior research experience. Program directors gave priority to the applicant's interview, curriculum vitae, and their recommendation letters (in order of importance). Both the surveyed fellows and program directors felt that the characteristics most important in a successful HPB fellowship candidate include interpersonal skills, perceived operative skills, and perceived fund of knowledge. CONCLUSION Results of this survey provide useful and practical information for trainees considering applying to an HPB fellowship program.
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Affiliation(s)
- Erin H Baker
- Department of General Surgery, Division of Hepatobiliary and Pancreas Surgery, Carolinas Medical Center, Charlotte, NC, USA
| | - Jacob E Dowden
- Department of General Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Allyson R Cochran
- Department of General Surgery, Division of Hepatobiliary and Pancreas Surgery, Carolinas Medical Center, Charlotte, NC, USA
| | - David A Iannitti
- Department of General Surgery, Division of Hepatobiliary and Pancreas Surgery, Carolinas Medical Center, Charlotte, NC, USA
| | - Eric T Kimchi
- Department of General Surgery, Medical University of South Carolina, Charleston, SC, USA
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Chen JS, Sprague BL, Klabunde CN, Tosteson ANA, Bitton A, Onega T, MacLean CD, Harris K, Schapira MM, Haas JS. Take the money and run? Redemption of a gift card incentive in a clinician survey. BMC Med Res Methodol 2016; 16:25. [PMID: 26911445 PMCID: PMC4766634 DOI: 10.1186/s12874-016-0126-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. METHODS Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women's primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177). An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. RESULTS 63.5% of clinicians who responded to the survey used the gift card, and only one provider who didn't participate used the gift card (1.6%). Many of those who participated did not redeem their gift cards (36.5% of respondents). The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. CONCLUSIONS Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.
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Affiliation(s)
- Jane S Chen
- Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA.,Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Carrie N Klabunde
- Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Anna N A Tosteson
- Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA
| | - Asaf Bitton
- Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA.,Harvard Medical School, Boston, MA, USA
| | - Tracy Onega
- Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA
| | | | - Kimberly Harris
- Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA
| | - Marilyn M Schapira
- University of Pennsylvania and the Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Jennifer S Haas
- Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA. .,Harvard Medical School, Boston, MA, USA. .,Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Morrison W, Womer J, Nathanson P, Kersun L, Hester DM, Walsh C, Feudtner C. Pediatricians' Experience with Clinical Ethics Consultation: A National Survey. J Pediatr 2015. [PMID: 26210945 DOI: 10.1016/j.jpeds.2015.06.047] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To conduct a national survey of pediatricians' access to and experience with clinical ethics consultation. STUDY DESIGN We surveyed a randomly selected sample of 3687 physician members of the American Academy of Pediatrics. We asked about their experiences with ethics consultation, the helpfulness of and barriers to consultation, and ethics education. Using a discrete choice experiment with maximum difference scaling, we evaluated which traits of ethics consultants were most valuable. RESULTS Of the total sample of 3687 physicians, 659 (18%) responded to the survey. One-third of the respondents had no experience with clinical ethics consultation, and 16% reported no access to consultation. General pediatricians were less likely to have access. The vast majority (90%) who had experience with consultation had found it helpful. Those with fewer years in practice were more likely to have training in ethics. The most frequently reported issues leading to consultation concerned end-of-life care and conflicts with patients/families or among the team. Intensive care unit physicians were more likely to have requested consultation. Mediation skills and ethics knowledge were the most highly valued consultant characteristics, and representing the official position of the hospital was the least-valued characteristic. CONCLUSION There is variability in pediatricians' access to ethics consultation. Most respondents reported that consultation had been helpful in the past. Determining ethically appropriate end-of-life care and mediation of disagreements are common reasons that pediatricians request consultation.
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Affiliation(s)
- Wynne Morrison
- Pediatric Advanced Care Team, Department of Medical Ethics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
| | - James Womer
- Pediatric Advanced Care Team, Department of Medical Ethics, The Children's Hospital of Philadelphia, Philadelphia, PA; Temple University School of Medicine, Philadelphia, PA
| | - Pamela Nathanson
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Leslie Kersun
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - D Micah Hester
- Division of Medical Humanities, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Corbett Walsh
- New York University School of Medicine, New York, NY
| | - Chris Feudtner
- Pediatric Advanced Care Team, Department of Medical Ethics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Watters AL, Stabulas-Savage J, Toppin JD, Janal MN, Robbins MR. Incorporating Experiential Learning Techniques to Improve Self-Efficacy in Clinical Special Care Dentistry Education. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.9.tb05994.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Amber L. Watters
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry, and Oral, Head, and Neck Cancer Clinic; Providence Cancer Center; Providence Portland Medical Center; Portland OR
| | - Jeanine Stabulas-Savage
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry
| | - James D. Toppin
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry and Director of Dental Services; Damian Family Care Centers; Queens NY
| | - Malvin N. Janal
- Department of Epidemiology and Health Promotion; New York University College of Dentistry
| | - Miriam R. Robbins
- Special Needs Clinic, Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry
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Lee S, Dowshen N, Matone M, Mollen C. Variation in Practice of Expedited Partner Therapy for Adolescents by State Policy Environment. J Adolesc Health 2015; 57:348-50. [PMID: 26299562 DOI: 10.1016/j.jadohealth.2015.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 05/26/2015] [Accepted: 05/26/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to assess provider practice of expedited partner therapy (EPT) for adolescents with chlamydial infection across varying state policy environments and compare provider practice in a parallel treatment scenario for a nonsexually transmitted disease. METHODS Anonymous survey of randomly selected providers in one of three state EPT policy environments: EPT is (A) explicitly legal; (B) permissible, but not directly referenced in law; or (C) potentially allowable. RESULTS Of 195 respondents, only 20% reported ever practicing EPT. Group A providers were more likely to have used EPT than Groups B and C. Commonly cited barriers included missed opportunity to counsel partners and ensuring medication delivery. In parallel hypothetical scenarios, providers were more likely to offer prophylactic antibiotics to a patient's mother for pertussis exposure without a face-to-face visit than the sexual partner of an adolescent with chlamydia. CONCLUSIONS Further investigation is needed to better understand provider and policy factors that may facilitate EPT provision to adolescents.
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Affiliation(s)
- Susan Lee
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Nadia Dowshen
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Meredith Matone
- PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Cynthia Mollen
- PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
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Abstract
INTRODUCTION Smokers are likely asking their physicians about the safety of e-cigarettes and their potential role as a cessation tool; however, the research literature on this communication is scant. A pilot study of physicians in the United States was conducted to investigate physician-patient communication regarding e-cigarettes. METHODS A total of 158 physicians were recruited from a direct marketing e-mail list and completed a short, web-based survey between January and April 2014. The survey addressed demographics, physician specialty, patient-provider e-cigarette communication, and attitudes towards tobacco harm reduction. RESULTS Nearly two-thirds (65%) of physicians reported being asked about e-cigarettes by their patients, and almost a third (30%) reported that they have recommended e-cigarettes as a smoking cessation tool. Male physicians were significantly more likely to endorse a harm reduction approach. DISCUSSION Physician communication about e-cigarettes may shape patients' perceptions about the products. More research is needed to explore the type of information that physicians share with their patients regarding e-cigarettes and harm reduction.
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Affiliation(s)
- Michael B. Steinberg
- Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Daniel P. Giovenco
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Cristine D. Delnevo
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, USA
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Keusch F. Why do people participate in Web surveys? Applying survey participation theory to Internet survey data collection. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s11301-014-0111-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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David MC, Ware RS. Meta-analysis of randomized controlled trials supports the use of incentives for inducing response to electronic health surveys. J Clin Epidemiol 2014; 67:1210-21. [PMID: 25216899 DOI: 10.1016/j.jclinepi.2014.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 07/02/2014] [Accepted: 08/01/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The objective of this meta-analysis was to assess incentive effectiveness on response to electronic health surveys. STUDY DESIGN AND SETTING A systematic literature search of PubMed, Web of Science, CINAHL, EMBASE, and the Cochrane Library was performed from 1970 to March 2013. Two authors independently selected the trials, assessed methodological quality, and extracted data. Original authors were contacted for the missing information. RESULTS The search strategy yielded nine trials (including 29,463 participants in total) that met eligibility criteria. For each of the incentive strategies examined, a random-effects model was used because of significant heterogeneity, and results were summarized as pooled odds ratios (ORs). Compared with no incentive, the offer of an incentive was seen to have a beneficial effect on response (OR, 1.48; 95% CI: 1.29, 1.71). Specifically, the odds of response were more than doubled when a monetary incentive was used (OR, 2.43; 95% CI: 1.60, 3.69) and increased when nonmonetary incentives were used (OR, 1.33; 95% CI: 1.17, 1.51). CONCLUSION These findings indicate that health researchers using electronic surveys can improve the quality of their research by offering incentives to potential participants.
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Affiliation(s)
- Michael C David
- School of Population Health, The University of Queensland, Herston Road, Herston 4006, Queensland, Australia.
| | - Robert S Ware
- School of Population Health, The University of Queensland, Herston Road, Herston 4006, Queensland, Australia
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Stenne R, Hurlimann T, Godard B. Benefits associated with nutrigenomics research and their reporting in the scientific literature: researchers' perspectives. Account Res 2014; 20:167-83. [PMID: 23672589 DOI: 10.1080/08989621.2013.788381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Nutrigenomics and nutrigenetics (NGx) are fields of research that have raised significant expectations about their potential benefits. This article presents empirical data from an online survey seeking the opinions of NGx researchers (n=126) regarding the achievability of the potential benefits of NGx, the time envisioned for their realization, the motives that may lead to their explicit mention in scientific peer-reviewed articles and the audience(s) targeted by NGx researchers when reporting their results in such articles. Results show that caution should be taken to avoid the risks associated with biohype and the premature dissemination of the potential benefits of NGx among various audiences.
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Affiliation(s)
- R Stenne
- OMICS-ETHICS, Research Group, Department of Social and Preventive Medicine, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada
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Hurlimann T, Menuz V, Graham J, Robitaille J, Vohl MC, Godard B. Risks of nutrigenomics and nutrigenetics? What the scientists say. GENES AND NUTRITION 2013; 9:370. [PMID: 24293399 DOI: 10.1007/s12263-013-0370-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/18/2013] [Indexed: 01/12/2023]
Abstract
Nutrigenomics and nutrigenetics (hereafter NGx) have stimulated expectations for beneficial applications in public health and individuals. Yet, the potential achievability of such promise is not without socioethical considerations that challenge NGx implementation. This paper focuses on the opinions of NGx researchers about potential risks raised by NGx. The results of an online survey show that these researchers (n = 126) are fairly confident about the potential benefits of NGx, and that most downplay its potential risks. Researchers in this field do not believe that NGx will reconfigure foods as medication or transform the conception of eating into a health hazard. The majority think that NGx will produce no added burden on individuals to get tested or to remain compliant with NGx recommendations, nor that NGx will threaten individual autonomy in daily food choice. The majority of researchers do not think that NGx will lead to discrimination against and/or stigmatization of people who do not comply with NGx dietary recommendations. Despite this optimism among NGx researchers, we suggest that key risk factors raised by the socioethical context in which NGx applications will be implemented need to be considered.
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Affiliation(s)
- T Hurlimann
- Department of Social and Preventive Medicine, Bioethics Programmes, School of Public Health (ESPUM), University of Montreal, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada
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Abstract
Surveys involving health care providers are characterized by low and declining response rates (RRs), and researchers have utilized various strategies to increase survey RRs among health professionals. Based on 48 studies with 156 subgroups of within-study conditions, a multilevel meta-regression analysis was conducted to summarize the effects of different strategies employed in surveys of health professionals. An estimated overall survey RR among health professionals was 0.53 with a significant downward trend during the last half century. Of the variables that were examined, mode of data collection, incentives, and number of follow-up attempts were all found to be significantly related to RR. The mail survey mode was more effective in improving RR, compared to the online or web survey mode. Relative to the non-incentive subgroups, subgroups receiving monetary incentives were more likely to respond, while nonmonetary incentive groups were not significantly different from non-incentive groups. When number of follow-ups was considered, the one or two attempts of follow-up were found to be effective in increasing survey RR among health professionals. Having noted challenges associated with surveying health professionals, researchers must make every effort to improve access to their target population by implementing appropriate incentive- and design-based strategies demonstrated to improve participation rates.
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Affiliation(s)
- Young Ik Cho
- Joseph J. Zilber School of Public Health, University of Wisconsin–Milwaukee, Milwaukee, WI, USA
| | - Timothy P. Johnson
- Survey Research Laboratory, College of Urban Planning and Public Affairs, University of Illinois at Chicago, Chicago, IL, USA
| | - Jonathan B. VanGeest
- Department of Health Policy and Management, College of Public Health, Kent State University, Kent, OH, USA
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Abstract
The versatility, speed, and reduced costs with which web surveys can be conducted with clinicians are often offset by low response rates. Drawing on best practices and general recommendations in the literature, we provide an evidence-based overview of methods for conducting online surveys with providers. We highlight important advantages and disadvantages of conducting provider surveys online and include a review of differences in response rates between web and mail surveys of clinicians. When administered online, design-based features affect rates of survey participation and data quality. We examine features likely to have an impact including sample frames, incentives, contacts (type, timing, and content), mixed-mode approaches, and questionnaire length. We make several recommendations regarding optimal web-based designs, but more empirical research is needed, particularly with regard to identifying which combinations of incentive and contact approaches yield the highest response rates and are the most cost-effective.
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Affiliation(s)
| | | | - Tara Piché
- University of Wisconsin–Madison, WI, USA
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Measuring and Monitoring ICP in Neurocritical Care: Results from a National Practice Survey. Neurocrit Care 2013; 20:15-20. [DOI: 10.1007/s12028-013-9847-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Paul CL, Piterman L, Shaw J, Kirby C, Sanson-Fisher RW, Carey ML, Robinson J, McElduff P, Thepwongsa I. Diabetes in rural towns: effectiveness of continuing education and feedback for healthcare providers in altering diabetes outcomes at a population level: protocol for a cluster randomised controlled trial. Implement Sci 2013; 8:30. [PMID: 23497486 PMCID: PMC3600674 DOI: 10.1186/1748-5908-8-30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 03/04/2013] [Indexed: 01/09/2023] Open
Abstract
Background Type 2 diabetes is one of the fastest growing chronic diseases internationally. The health complications associated with type 2 diabetes can be prevented, delayed, or improved via early diagnosis and effective management. This research aims to examine the impact of a primarily web-based educational intervention on the diabetes care provided by general practitioners (GPs) in rural areas, and subsequent patient outcomes. A population-level approach to outcome assessment is used, via whole-town de-identified pathology records. Methods/design The study uses a cluster randomised controlled trial with rural communities as the unit of analysis. Towns from four Australian states were selected and matched on factors including rurality, population size, proportion of the population who were Indigenous Australians, and socio-economic status. Eleven pairs of towns from two states were suitable for the trial, and one town from each pair was randomised to the experimental group. GPs in the towns allocated to the experimental group are offered an intervention package comprising education on best practice diabetes care via an on-line active learning module, a moderated discussion forum, access to targeted and specialist advice through an on-line request form, and town-based performance feedback on diabetes monitoring and outcomes. The package is offered via repeated direct mail. Discussion The benefits of the outcomes of the trial are described along with the challenges and limitations associated with the methodology. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12611000553976
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Affiliation(s)
- Christine L Paul
- Health Behaviour Research group, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, HMRI Building, Callaghan, NSW 2308, Australia.
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