The impact of non-response bias due to sampling in public health studies: A comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health.
The impact of non-response bias due to sampling in public health studies: A comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health.
复制标题
DOI：
10.1186/s12889-017-4189-8
复制
发表时间：
2017-03-23
影响因子：
4.5
通讯作者：
Pieterse ME
中科院分区：
文献类型：
--
作者：
Cheung KL;Ten Klooster PM;Smit C;de Vries H;Pieterse ME
在对年轻人进行公共卫生监测时，了解选择性不回应的影响至关重要，特别是当涉及药物滥用或性行为等有争议的话题时。依赖于受试者自愿参与的研究特别容易受到抽样偏差的影响。由于那些最难在自愿基础上参与调查的答卷人也更有可能报告风险行为，这可能导致低估风险因素的普遍性。邀请青少年参加一个家庭邮寄的调查是一个典型的自愿招募策略，没有答复率很高，而不是在上学期间强制参加。本研究探讨了青少年健康相关特征的患病率估计值由于不同的抽样方法而存在偏差的程度，以及这是否也会导致受试者内分析的偏差。使用了2011年在荷兰两个相似和相邻地区Twente和IJsselland收集的横截面数据集。总共有9360名青少年在一个强制性的样本（特文特）和1952名青少年在一个自愿的样本（艾瑟尔兰）参加了这项研究。为了检验样本在健康相关变量上是否存在差异，我们进行了单变量和多变量逻辑回归分析，控制了样本之间的任何人口统计学差异。进行了额外的多变量logistic回归，以检查抽样方法对健康相关变量之间关联的调节作用。正如预期的那样，与强制性抽样相比，女性、老年人以及教育程度较高的人在自愿抽样中所占比例过高。志愿样本中的受访者倾向于吸烟较少，饮酒较少（曾经，一生和过去四周），心理健康状况更好，主观健康状况更好，有更积极的学校经历，比强制性样本中的受访者更少性交。抽样方法对变量之间的关联没有调节作用。这是首批提供有力证据的研究之一，证明与强制招募相比，自愿招募可能导致青少年健康相关流行率估计数出现严重的无应答偏倚。由此造成的健康行为和福祉措施普遍程度的低估似乎很大，自我报告的饮酒比例低了四倍。然而，变量之间的相关性似乎对抽样偏差不敏感。
In public health monitoring of young people it is critical to understand the effects of selective non-response, in particular when a controversial topic is involved like substance abuse or sexual behaviour. Research that is dependent upon voluntary subject participation is particularly vulnerable to sampling bias. As respondents whose participation is hardest to elicit on a voluntary basis are also more likely to report risk behaviour, this potentially leads to underestimation of risk factor prevalence. Inviting adolescents to participate in a home-sent postal survey is a typical voluntary recruitment strategy with high non-response, as opposed to mandatory participation during school time. This study examines the extent to which prevalence estimates of adolescent health-related characteristics are biased due to different sampling methods, and whether this also biases within-subject analyses. Cross-sectional datasets collected in 2011 in Twente and IJsselland, two similar and adjacent regions in the Netherlands, were used. In total, 9360 youngsters in a mandatory sample (Twente) and 1952 youngsters in a voluntary sample (IJsselland) participated in the study. To test whether the samples differed on health-related variables, we conducted both univariate and multivariable logistic regression analyses controlling for any demographic difference between the samples. Additional multivariable logistic regressions were conducted to examine moderating effects of sampling method on associations between health-related variables. As expected, females, older individuals, as well as individuals with higher education levels, were over-represented in the voluntary sample, compared to the mandatory sample. Respondents in the voluntary sample tended to smoke less, consume less alcohol (ever, lifetime, and past four weeks), have better mental health, have better subjective health status, have more positive school experiences and have less sexual intercourse than respondents in the mandatory sample. No moderating effects were found for sampling method on associations between variables. This is one of first studies to provide strong evidence that voluntary recruitment may lead to a strong non-response bias in health-related prevalence estimates in adolescents, as compared to mandatory recruitment. The resulting underestimation in prevalence of health behaviours and well-being measures appeared large, up to a four-fold lower proportion for self-reported alcohol consumption. Correlations between variables, though, appeared to be insensitive to sampling bias.