Deck 13 Flashcards
Identify the importance of data collection mode when conducting a study design.
While a respondent’s words taken during phone surveys or in-person interviews take more importance given the conversational format, online surveys’ visual design elements have a bigger impact on how questions are read and interpreted. When designing a survey online, it is important to be aware of the question types that are a good fit.
Identify the importance of respondent effort when undertaking survey design.
There are questions that put a heavier burden on the respondent’s working memory and comprehension or are likely to elicit higher non-response if asked in different data collection modes.
Identify the importance of question wording when conducting a survey design.
Formulating questions with the right wording so it accurately reflects the issue of interest is one of the hardest parts in writing questionnaires.
Data errors can sift through a survey if you use unfamiliar, complex, or technically inaccurate words, ask more than one question at a time, use incomplete sentences, use abstract or vague concepts, make the questions too wordy, ask questions without a clear task or ask questions that lead respondents to a particular answer.
Identify the importance of question sequence when conducting a survey design, as well as question format.
Questions should follow a logical flow. Order inconsistencies can confuse respondents and bias the results.
Questions can be closed-ended or open-ended. Closed-ended questions provide answer choices, while open-ended questions ask respondents to answer in their own words. Each type of question serves different research objectives and has its own limitations. The key issues here are related to the level of detail and information richness we need, our previous knowledge about the topic, and whether to influence respondents’ answers.
Identify the importance of information accuracy when conducting a study design.
Some questions yield more accurate information than others. Respondents can answer questions about their gender and age pretty accurately, but when it comes to attitudes and opinions in a particular issue, many may not have a clear answer. Overall, attitudes and opinion questions should be worded in a way that best reflects how respondents think and talk about a particular issue.
Identify the importance of measured behaviours when conducting a study design.
People tend to have less precise memories of mundane behaviors they engage in on a regular basis, and usually they do not categorize events by periods of times (e.g. week, month, and year). We need to consider appropriate reference periods for
the type of behavior we want to measure. Measured behavior should be relevant to the respondent and capture his or her potential state of mind.
Identify the importance of question structure when conducting a study design.
Questions have different parts that must work in harmony to capture
high-quality data. These are the question stem (e.g. what is your age?), additional instructions (e.g. select one answer) and response options, if any (e.g. Under 18, 19 to 24, 25 +). The wrong combination can leave respondents baffled about how to answer a question.
Identify the importance of visual layout and analytical plan when conducting a survey design.
Using design elements in an inconsistent way can increase the burden put on the respondent in trying to understand the meaning of what is asked. Different font sizes, colors, and strengths across questions, forces the respondent to relearn their meaning every time they are used. Also presenting scales with different directions (positive to negative or vice versa) in rating questions within the same survey increases measurement error as respondents often assume all rating questions have the same scale direction even when the instructions explain the meaning of the end points of the scale.
Analytical plan - Based on the research object, both the type of information requested and the question format are important for the type of analysis we plan to perform once the data is collected. There is also the question of whether you want to replicate the results, track certain events or just run a one-time ad-hoc analysis. If the goal is to track certain metrics, time and care should be dedicated to craft tracking questions, as slight changes in wording can change the meaning of a question and thus its results.
The stages of change model was created to observe the stages people would go through to help them quit smoking. What are the stages of this model?
Precontemplation – During the precontemplation stage, people are not considering a change. People in this stage are often described as “in denial” due to claims that their behavior is not a problem. If you are in this stage, you may feel resigned to your current state or believe that you have no control over your behaviour. In some cases, people in this stage do not understand that their behaviour is damaging or are under-informed about the consequences of their actions.
Contemplation – During this stage, people become more and more aware of the potential benefits of making a change, but the costs tend to stand out even more. This conflict creates a strong sense of ambivalence about changing. Because of this uncertainty, the contemplation stage of change can last months or even years. In fact, many people never make it past the contemplation phase.
Preparation – During the preparation stage, you might begin making small changes to prepare for a larger life change. For example, if losing weight is your goal, you might switch to lower-fat foods. You might also take some sort of direct action such as consulting a therapist, joining a health club, or reading self-help books.
Action – People begin taking direct action in order to accomplish their goals. Oftentimes, resolutions fail because the previous steps have not been given enough thought or time.
Maintenance – The maintenance phase of the Stages of Change Model involves successfully avoiding former behaviours and keeping up new behaviours. During this stage, people become more assured that they will be able to continue their change. If you are trying to maintain a new behaviour, look for ways to avoid temptation.
Relapse – In any behavior change, relapses are a common occurrence. When you go through a relapse, you might experience feelings of failure, disappointment, and frustration.
How would you discriminate between causal and non-causal association?
Temporality: Does the presumed cause precede the effect? Obviously a cause must precede its effect. However that is as far as can be said with any degree of certainty. It does not follow that if exposure to a postulated causative agent precedes an effect that the latter is the direct consequence of the former.
Reversibility: Does removal of a presumed cause lead to a reduction in the risk of ill-health? Reduction in a particular exposure if followed by a reduced risk of a particular disease may strengthen the presumption of a real cause-effect relationship. This reversibility of association may suffer from similar fallacies as temporality.
Strength of Association: Is the exposure associated with a high relative risk of acquiring the disease? The concept of “risk” and its measurement also features elsewhere. programme. How does the strength of association between a risk and a possible causal factor influence the weight of evidence for a causal association?
Exposure-response: Is increased exposure to the possible cause associated with an increased response (i.e. an increased likelihood of an effect)?
Consistency: Have similar results been shown in other studies? Elsewhere you can learn how to critically appraise literature. It follows that if a number of good studies using different approaches lead to the same interpretation of a cause-effect relationship it is more likely to be a valid one.
Biologic plausibility: Is there a reasonable postulated biologic mechanism linking the possible cause and the effect?
Analogy: Can parallels be drawn with examples of other well established cause-effect relationships?
Specificity: Does the cause lead to a specific effect? (i.e. one cause - one effect) Many diseases and symptoms can be the result of a number of causes. Similarly many causes of ill- health can have different effects on the body. Only rarely is specificity demonstrable in environmental cause-effect relationships (other than in infectious diseases). Thus for example mesothelioma of the pleura (or peritoneum) is a relatively specific consequence of asbestos exposure. {However this criterion has to be treated with some caution: for example we know that tobacco smoking can cause many diseases ranging from lung cancer to chronic bronchitis to bladder cancer, and that asthma can be caused by many occupational causes - i.e. a single cause does not necessarily equal a single effect}.
Describe the link between health and gender.
Throughout entire industrial world men live shorter lives
Men more likely to die at any given age than women of the same age.
BUT females are more likely to experience high morbidity rates
women are far more likely to visit the doctor than men
men generally underepresented in health statistics
Mortality….
over the last 100 years, in all contemporary advanced industrial societies, life expectancy has
increased for both men and women
but higher for women.
(1994) average female life expectancy was approximately 78 years compared to 72 years for
men.
Major causes of death among British men heart disease, lung cancer, bronchitis, accidents
and other violent deaths
For women cancers of the breast cervix and uterus are major causes of mortality.
coronary heart disease now a major cause of female deaths
Morbidity….
Women more likely to report both physical and psychological problems to their GP.
higher rates of chronic disease such as strokes, rheumatoid arthritis, diabetes and varicose
veins for women women also constitute two thirds of those with a disability.
Women more likely to have been hospitalized
women constitute the majority of those suffering from neurosis, psychosis, dementia and
depressive disorders.
women also more likely to suffer from Iatrogenic disease
Describe the link between health and ethnicity.
Groups from India, Pakistan and Bangladesh - more likely than white population to die from heart disease.
Groups from India, Pakistan and Bangladesh, Africa and the Caribbean - more likely than white population to suffer from a stroke (esp Africans and Afro-Caribbean’s).
Africans and Afro-Caribbean’s suffer from very high rates of hypertension, liver cancer, TB, diabetes and maternal mortality.
Afro-Caribbean’s and ‘Asians’ (problematic category) suffer disproportionately from accidental and violent death, and poisonings.
Mortality rates for obstructive lung infections such as bronchitis and many types of cancer esp. lung cancer lower among Afro-Caribbean’s and ‘Asians’.
All ethnic minorities have higher rates of still births, perinatal moralities (death within 1 week), and neo-natal mortality (within 1 month).
Afro-carribeans more likely to be admitted to mental health units, men more so than women and more likely to be sectioned
Explanation? - Poverty, Stress of Migration & Racism, Anomic Explanations, Cultural Deficit Models.
What is Prognosis?
An assessment of the future course and outcome of a patient’s disease, based on knowledge of the course of disease in other patients together with the general health, age, and sex of the patient
Why is Prognosis important?
Knowledge of prognosis with or without treatment can help diagnostic and treatment decisions
Important for patients to know the likely course of their disease
Different patients will value outcomes of disease process differently, which may need to be
taken into account during decision making.
Doctors are not always accurate in their prognostic judgements*
Some characteristics of the patient can be used to predict outcomes more accurately, known as prognostic factors. They can be..
Demographic (e.g. age, gender)
Disease specific (e.g. grade of tumour)
Co-morbid (other coexisting disease conditions)
Prognostic factors are not the same as risk factors. Risk factors are patient characteristics associated with the development of the disease in the first place.
• An example
o Being overweight is generally considered to be a risk factor for type 2 diabetes (i.e. if you are obese you are more likely to develop type 2 diabetes than someone who isn’t obese).
o If you are a type 2 diabetic, having higher blood glucose levels is a prognostic factor for increased risk of mortality (i.e. the higher your blood sugar, the higher your risk of dying)
