Baseline participation in a health examination survey of the population 65 years and older: who is missed and why?
Baseline participation in a health examination survey of the population 65 years and older: who is missed and why?
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DOI：
10.1186/s12877-016-0185-6
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发表时间：
2016-01-19
期刊：
影响因子：
4.1
通讯作者：
Scheidt-Nave, Christa
中科院分区：
文献类型：
--
作者：
Gaertner, Beate;Seitz, Ina;Scheidt-Nave, Christa
背景：公共卫生监测取决于 65 岁以上人口的有效健康和残疾估计。这一年龄组的不参与率较高，阻碍了这一目标的实现。对潜在基线选择偏差的大小和方向的了解有限。方法：我们对 1481 名 65 岁以上内城居民进行的基于登记的随机样本分析了基线不参与情况，根据整个样本的可用人口统计数据、可用的自我报告信息以及不参与的原因，这些居民被邀请参加健康检查调查。招募一年后，重新访问未答复者以评估其原因。 结果：根据参与状态定义了五个群体：参与者（N = 299）、已死亡或搬家者（N = 173）、拒绝参与但回答简短问卷的人（N = 384）、拒绝参与和简短问卷的人（N = 324）和无答复者（N = 301）。结果证实存在显着的基线选择偏差，85 岁以上的人、居住护理人员或来自贫困社区、教育程度较低、外国公民或健康相关生活质量较低的人的代表性显着不足。最后，可以确定 78% 的非参与者的不参与原因，其中包括 183 名无反应者。结论：非参与者中存在多种健康问题和参与障碍。老龄化人口的公共卫生监测需要创新的研究设计。
Background: Public health monitoring depends on valid health and disability estimates in the population 65+ years. This is hampered by high non-participation rates in this age group. There is limited insight into size and direction of potential baseline selection bias.Methods: We analyzed baseline non-participation in a register-based random sample of 1481 inner-city residents 65+ years, invited to a health examination survey according to demographics available for the entire sample, self-report information as available and reasons for non-participation. One year after recruitment, non-responders were revisited to assess their reasons.Results: Five groups defined by participation status were differentiated: participants (N = 299), persons who had died or moved (N = 173), those who declined participation, but answered a short questionnaire (N = 384), those who declined participation and the short questionnaire (N = 324), and non-responders (N = 301). The results confirm substantial baseline selection bias with significant underrepresentation of persons 85+ years, persons in residential care or from disadvantaged neighborhoods, with lower education, foreign citizenship, or lower health-related quality of life. Finally, reasons for non-participation could be identified for 78 % of all non-participants, including 183 non-responders.Conclusion: A diversity in health problems and barriers to participation exists among non-participants. Innovative study designs are needed for public health monitoring in aging populations.