List-assisted Random Digit Dialing Research Articles

INTER-ARM BLOOD PRESSURE DIFFERENCE

Objective: An increased inter-arm systolic blood pressure difference (IBPD) is an easily determined physical examination finding and a significant IBPD has recently been associated with worse cardiovascular outcome. But the prevalence of IBPD in Asian population is unknown and the relationship between IBPD and blood pressure (BP) variability is not yet determined. This study was performed to describe the prevalence and clinical characteristics of the patients with increased IBPD and to examine the association between IBPD and BP variability.Design and method: A representative population (aged 20–65 years) was selected by list-assisted random-digit dialing method from a city with a population of one million. The BP of two arms was simultaneously measured using validated automatic BP measurement devices for 3 times and ambulatory blood pressure monitoring (ABPM) was performed in all included subjects. An increased IBPD was defined as > 10mmHg using the average of 3 BP differences obtained simultaneously in both arms. Results: Five hundreds of subjects were included in this study, and 13 subjects were excluded because of inadequate ABPM measurements. Mean age was 46.9 ± 9.4 years and 309 participants were female (63.4%). Overall systolic BP and diastolic BP were 118.5 ± 13.4 mmHg and 75.1 ± 10.3 mmHg and mean systolic IBPD was 5.7 ± 4.0mmHg. Of 487 subjects, 66 subjects (13.6%) had an increased systolic IBPD. Compared with those with normal IBPD, subjects with increased systolic IBPD showed higher clinic BP (127.2 ± 13.7 vs. 117.2 ± 12.8 mmHg in systolic BP, P < 0.001; 78.7 ± 11.2 vs. 74.6 ± 10.1 mmHg in diastolic BP, P = 0.002), higher 24-hour systolic BP (118.5 ± 12.0 vs. 115.6 ± 10.8 mmHg, P = 0.045) and higher 24-hour pulse pressure (42.4 ± 7.4 vs. 40.2 ± 6.5 mmHg, P = 0.012). The subjects with increased systolic IBPD showed higher 24-hour BP variability; increased standard deviation of daytime BPs, increased weighted standard deviation of BPs, increased coefficient of variation of daytime BPs and increased average real variability of both 24-hour BPs and daytime BPs (Table). There was no significant difference in nighttime dipping pattern of increased IBPD subjects. Conclusions: In this community-based cohort, an increased IBPD is common and associated with an increased short-term BP variability. Bilateral BP measurements should be emphasized in routine clinical practice.

Public perspectives toward long-term care staff's interventions in the sexual relationships of residents with dementia.

This study used a multiple segment factorial vignette to explore the attitudes of the public toward a dementia-caused non-spousal sexual relationship in a long-term care facility. Specific elements examined included the degree of intimacy, obligation of long-term care staff to intervene in the relationship, and the healthy spouse's disposition. Respondents ( N = 318) were contacted using a list-assisted random-digit dialing method and read a version of the vignette with the independent variables randomly generated. Two logistic regression models and one ordinal regression model were used to analyze the main effects of the independent design variables and respondent characteristics. Results The majority of respondents report the need for long-term care staff to intervene in sexual relationships and an obligation to inform the healthy spouse of a resident's sexual relationship. Results suggest differences of opinion exist based on respondent characteristics of education and religiosity. Discussion and implications: Public opinion is in favor of long-term care facilities incorporating spousal involvement into decisions regarding a cognitively impaired resident's ability to engage in an intimate relationship. Implications for long-term care policy focusing on staff training about sexual expression and intervention in addition to incorporating the spouse into decision-making processes are discussed.

PS 11-05 INTER-ARM BLOOD PRESSURE DIFFERENCE

Objective: An increased inter-arm systolic blood pressure difference (IBPD) is an easily determined physical examination finding and a significant IBPD has recently been associated with worse cardiovascular outcome. But the prevalence of IBPD in Asian population is unknown and the relationship between IBPD and blood pressure (BP) variability is not yet determined. Design and Method: A representative population was selected by list-assisted random-digit dialing method from a city. The BP of two arms was simultaneously measured using validated automatic BP measurement devices for 3 times and an increased IBPD was defined as ≥10mmHg using the average of 3 BP differences obtained simultaneously in both arms. Results: We recruited 497 subjects in this study, and 10 subjects were excluded because of inadequate ABPM measurements. Mean age was 46.9 ± 9.4 years and 309 participants were female (63.4%). Overall systolic BP and diastolic BP were 118.5 ± 13.4 mmHg and 75.1 ± 10.3 mmHg and mean systolic IBPD was 5.7 ± 4.0 mmHg. Of the 487 subjects, 66 subjects (13.6%) had an increased systolic IBPD. Compared with those with normal IBPD, subjects with increased systolic IBPD showed higher clinic BP (127.2 ± 13.7 vs. 117.2 ± 12.8 mmHg in systolic BP, P < 0.001; 78.7 ± 11.2 vs. 74.6 ± 10.1 mmHg in diastolic BP, P = 0.002), higher 24-hour systolic BP (118.5 ± 12.0 vs. 115.6 ± 10.8 mmHg, P = 0.045) and higher 24-hour pulse pressure (42.4 ± 7.4 vs. 40.2 ± 6.5 mmHg, P = 0.012). The subjects with increased systolic IBPD showed higher 24-hour BP variability; increased standard deviation of daytime BPs, increased weighted standard deviation of BPs, increased coefficient of variation of daytime BPs and increased average real variability of both 24-hour BPs and daytime BPs (Table). There was no significant difference in nighttime dipping pattern of increased IBPD subjects. Conclusions: In this community-based cohort, an increased IBPD is common and associated with an increased short-term BP variability.

Simultaneous versus concurrent use of alcohol and cannabis in the National Alcohol Survey.

Cannabis is the most commonly used drug among those who drink, yet no study has directly compared those who use cannabis and alcohol simultaneously versus concurrently (i.e., separately) in the adult general population. Here, we assess differences in demographics, alcohol-related social consequences, harms to self, and drunk driving across simultaneous, concurrent, and alcohol-only using groups. Secondary analyses of the 2005 and 2010 National Alcohol Survey (N=8,626; 4,522 female, 4,104 male), a Computer Assisted Telephone Interview survey of individuals aged 18 and older from all 50 states and DC. Blacks and Hispanics are over-sampled. Data were collected using list-assisted Random Digit Dialing. Multinomial and multivariable logistic regressions were used for analyses. The prevalence of simultaneous use was almost twice as high as concurrent use, implying that individuals who use both cannabis and alcohol tend to use them at the same time. Furthermore, simultaneous use was associated with increased frequency and quantity of alcohol use. Simultaneous use was also the most detrimental: compared to alcohol only, simultaneous use approximately doubled the odds of drunk driving, social consequences, and harms to self. The magnitudes of differences in problems remained when comparing drunk driving among simultaneous users to concurrent users. The overall set of results is particularly important to bear in mind when studying and/or treating problems among alcohol/cannabis co-users because they demonstrate that in the general population, co-users are a heterogeneous group who experience different likelihoods of problems relative to co-use patterns.

Patient Perspectives on Psoriasis Management: U.S. Results of the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey

Background Psoriasis and psoriatic arthritis are associated with a high disease burden, underdiagnosis, and undertreatment. Objective To further understand unmet needs in patients with psoriasis and psoriatic arthritis. Methods The population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey included psoriasis and/or psoriatic arthritis patients selected by list-assisted random digit dialing. We report results from the United States. Results 52,926 households in the United States were screened; 1,005 adults completed the survey. Of these, 73.1% of patients reported a psoriasis diagnosis alone and 26.9% reported psoriatic arthritis (with/without a separate psoriasis diagnosis). Approximately 22% of patients reported no current treatment; &lt;10% of psoriasis and 50% of psoriatic arthritis patients were receiving systemic therapy. Perceived treatment burden, safety and tolerability concerns, and lack of effectiveness were commonly reported as reasons for treatment dissatisfaction and discontinuation. Conclusions Psoriasis and psoriatic arthritis remain undertreated in the United States, marked by high treatment dissatisfaction and discontinuation.

Patient perspectives in the management of psoriasis: Results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey

Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements. To further the understanding of the unmet needs of psoriasis and PsA patients. This was a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe. Patients were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment; 139,948 households were screened and 3426 patients completed the survey. The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA. When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Psoriasis patients indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%). Of psoriasis patients, 45% had not seen a physician in a year; >80% of psoriasis patients with ≥ 4 palms body surface area and 59% of PsA patients were receiving no treatment or topical treatment only. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety/tolerability reasons and a lack/loss of efficacy. The survey lacked a control group, did not account for ethnic and health care system differences across countries, and was limited by factors associated with any patient survey, including accurate recall and interpretation of questions. Several identified unmet needs warrant additional attention and action, including improved severity assessment, PsA screening, patient awareness, and treatment options.

Language and Love

Social networking sites (SNS) provide adolescents with opportunities for content generation on a wide range of social issues, providing unique insight into the psychosocial development of adolescence. We explored SNS webpages viewed by a random sample of adolescents during the initial uptake of SNS use (2005) to describe their general language use. Adolescents aged 14 to 17 with home Internet access were recruited using list-assisted random digit dialing methods. All SNS (MySpace) webpages viewed by participants were captured, and a large, structured set of texts (text corpus) was created from the profiles and message boards therein. Using concordance software, word frequency and keyword associations were analyzed. The 346 participants viewed approximately 28,000 MySpace pages, yielding a 1,147,432-word text corpus. Profile sections presented information about the content creator, while message boards focused more on short conversations with recipients. The most common content word was the term love. Profile owners would profess their love for activities, such as dancing, partying, or shopping, followed by their love for family, friends, and significant others. SNS offer teens an opportunity to describe and share feelings about people, places, and things connected to a range of activities and social contacts within their online and offline environments. Better understanding of SNS can offer strategies to adolescents and health care providers for insight into what connects young people in a community.

Sodium intake of a city population in Korea estimated by 24-h urine collection method

Accurate estimation of sodium intake by a precise and reproducible method is crucial in sodium intake reduction policy. This study tested the feasibility of 24-h urine (24HU) collection method and estimated sodium intake of a major city population from a representative adult sample. A representative population (aged 20-65 years) was selected by list-assisted random-digit dialing method from a city with a population of one million. Sodium and potassium intakes (24HUNa and 24HUK, respectively) were measured with 24HU collection. Of those 496 individuals recruited, 24HU samples from 368 participants were determined to be properly collected and analyzed. The weighted mean of 24HUNa was 166.4 ± 68.1 mmol per day, much lower than 208.2 mmol of 24HUNa measured in Pusan (Korea; 1988 INTERSALT). The 24HUNa was highest in population aged 40-49 years, with a decrease after 50 years. Men had higher 24HUNa than women (182.0 ± 77.6 vs 151.4 ± 55.0 mmol per day). The sodium intake is higher than that found in survey conducted in the United Kingdom/Scotland and Finland, similar to that of Spain and lower than that of Portugal, Slovenia and Turkey. In contrast to 24HUNa, 24HUK increased continuously as age increased. This study enables us to compare sodium intake with the results of other surveys even from other countries, and reinforce the recommended introduction of the 24HU collection method in Korea. Sodium intake of the studied population was higher than the World Health Organization recommendation, suggesting the needs for further efforts to reduce sodium intake.

Noncoverage Errors in Travel Surveys Due to Mobile Phone–Only Households

National and regional household travel surveys have conventionally sampled landline telephone households through list-assisted random digit dialing. However, recent increases in “mobile phone-only” households result in either noncoverage or undercoverage of a growing segment of the population. This result could cause a substantial bias in the representativeness of travel behavior toward the target population. To cover mobile phone-only households, an address-based sampling method is of interest. This study explores whether the characteristics and travel behavior of mobile phone-only households differ from those of households with landline telephones. In addition, this study quantifies the extent of noncoverage errors in the surveys in respondents’ travel behavior. Along with census data, the mobile phone-only sample (N = 2,988) was compared with the landline telephone sample (N = 7,774) drawn from the 2008 National Capital Region Household Travel Survey. Results show that the mobile phone-only sample consisted of relatively more single-person households; younger individuals; and Blacks, Asians, and Hispanics, who were generally identified as hard-to-reach groups. Statistical models were estimated to examine differences in travel behavior and suggested that the mobile phone-only households made more transit (41%) and walking (29%) trips. This study shows that the inclusion of the mobile phone-only households can reduce the noncoverage errors, especially for alternative modes. The implications for travel survey methods are discussed.

A regression-based study using jackknife replicates of HINTS III data: Predictors of the efficacy of health information seeking

The current study determines and assesses the effects of the statistically significant predictors of the efficacy of health information seeking through a regression-based analysis of the 2007 edition of the Health Information National Trends Survey (HINTS) data. The HINTS III data were collected through list-assisted random digit dialing and mail-in questionnaire with a natural corresponding unstratified and cluster sampling design with jackknife replicates and were analyzed using generalized linear models with jackknife parameter estimation based on the complete and 50 jackknife replicate datasets. The resampling-based analytic approaches, such as the jackknife and bootstrap, generally provide unbiased parameter estimates and are the preferred methods for complex survey data analyses. We implemented an exhaustive search through all potential predictors of the efficacy in health information seeking combined with model building based on forward selection and backward elimination of covariates to derive the best predictive model. This model-based and data-driven approach to detect and assess the relative effects of the significant predictors of the aforesaid outcome variable of interest is a greatly advantageous alternative to the common hypotheses-based analyses. Our results show that numeracy, education, patient health care satisfaction (with the health information given by their health provider), health information dissatisfaction, general health, and psychological distress are the optimal covariates significantly associated with the efficacy of health information seeking. Interestingly, many usually important background covariates such as race, income, gender, geographical location, and others were not significant predictors of the outcome variable of interest. The conclusions of our analysis reveal new insights into the complexity of the efficacy of health information seeking and will undoubtedly have important implications on the design and success of future health care messages and campaigns.

1053 Estimated dietary sodium intake among adults in Korean general population by 24 hour urine samples

Objectives: Korean government has started sodium intake reduction policy since 2005. The present study was performed to test the feasibility of 24 urine collection method and List-assisted random-digit dialing method (LARDD) in a population based survey (granted by Korea FDA, 11162KFDA162, NCT01438619). Methods: Representative population (aged 20 between 65 years) was selected by LARDD from a city with one million population. Sodium and potassium intake (24HUNa, 24HUK, respectively) were measured with 24 hour urine collection. Out of 1623 telephone interviews, 496 adults (30.6%, age range 20 - 65 years) were recruited by LARDD. Results: Of those recruited, 368 subjects completed 24 hour urine sampling, determined by creatinine method. The estimated mean 24HUNa was 166.4 mmol/day, much lower than 208.2 mmol estimated at 1988 (INTERSALT). 24HUNa was highest in population aged 30 to 49 years, and decreased after 50 years. Men had higher 24HUNa than women (182.0 vs. 151.4 mmol/day). The estimated sodium intake is higher than that reported from UK, Scotland, and Finland, and similar to that of Spain. In contrast to 24HUNa, 24HUK was increasing continuously as age increasing, which is different from low potassium intake of population above 50 years in national health survey 2009. Conclusion: In the estimation of sodium intake, 24 hour urine collection method is feasible, and enables comparing sodium intake to the other countries. High sodium intake is a significant problem in population below 50 years, although potassium intake in elderly subjects is high.

Differences Between RDD Telephone and ABS Mail Survey Design: Coverage, Unit Nonresponse, and Measurement Error

Using list-assisted random digit dialing (RDD) with telephone data collection and address-based sampling (ABS) with mail questionnaires are two survey designs that yield probability based inference, yet they are so different that they can yield entirely different results. The 2007 Health Information National Trends Survey (HINTS) provides a unique opportunity to evaluate the effect of these different designs on a variety of survey estimates and, even more importantly, the effect on individual sources of survey error. Understanding the difference in error structure between the two designs is important to survey practitioners in order to select the optimum design, and to data users who can anticipate which results may be affected and how. We first compared estimates between the two designs and then estimated the different sources of error. In addition to identified differences in estimates, we found that for some estimates the two designs can yield similar results merely due to the effect of similar biases. The error components were quite different between the two designs––while the ABS design yields almost complete coverage of the population compared to the RDD design, it was subjected to substantially higher nonresponse bias.

Family Members' Reports of Abuse in Michigan Nursing Homes

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.

Zero Banks

List-assisted random digit dialing (RDD) is commonly used for sampling telephone households in the United States. The sampling frame is landline one hundred-series banks with one or more listed tele- phone numbers. The exclusion of banks without listed numbers from this truncated design has been justified by a 1995 study which found only 3.7 percent of working household numbers in unlisted banks with

Household Pesticides and the Risk of Wilms Tumor

BackgroundPrevious epidemiologic studies have suggested that exposure to pesticides in utero and during early childhood may increase the risk for development of childhood cancer, including Wilms tumor, a childhood kidney tumor.ObjectivesIn this analysis we evaluated the role of residential pesticide exposure in relation to the risk of Wilms tumor in children using data from a North American case–control study.MethodsThe National Wilms Tumor Study Group (NWTSG) collected information on exposure to residential pesticides from the month before pregnancy through the diagnosis reference date using detailed phone interviews from 523 case mothers and 517 controls frequency matched on child’s age and geographic region and identified by list-assisted random digit dialing. Pesticides were grouped according to type of pesticide and where they were used.ResultsA slightly increased risk of Wilms tumor was found among children of mothers who reported insecticide use [odds ratio (OR) = 1.4, 95% confidence interval (CI), 1.0–1.8; adjusted for education, income, and the matching variables]. Results from all other categories of pesticides were generally close to the null.ConclusionsThis study is the largest case–control study of Wilms tumor to date. We were unable to confirm earlier reports of an increased risk for Wilms tumor among those exposed to residential pesticides during pregnancy through early childhood.

Regular dental visits and dental anxiety in an adult dentate population

The objective of this study was to investigate factors associated with regular dental visits in an adult population. A representative sample of non-institutionalized dentate adults (aged 18 through 69 years) from the Detroit tricounty area (Wayne, Macomb and Oakland counties) was randomly selected using list-assisted random digit dialing. The authors collected the data through a self-administered questionnaire that asked for information about regular dental visits, private dental insurance, perceived oral health status and dental treatment experience. The authors used Corah's Dental Anxiety Scale to measure respondents' dental anxiety level. They also conducted a descriptive analysis and a logistic regression analysis. A final sample of 630 adults who resided in 368 households participated in this study. Seventy-two percent of respondents had dental insurance (excluding Medicaid). About 63 percent reported that they visited a dentist regularly. About 12 percent of adults had high dental anxiety (a score of 13 or higher on the Corah scale). A logistic regression model found that dental anxiety, dental insurance status and perceived oral health status were significantly associated with regular dental visits after accounting for sociodemographic factors such as sex, age and income. Among those who had dental insurance, dentally anxious adults were significantly less likely to visit dentists regularly. However, this association was not significant among respondents without dental insurance. Dental insurance, perceived oral health status and dental anxiety were associated with regular dental visits. Dental anxiety was an influencing factor in regular dental visit behavior, especially among adults who had private dental insurance. Practitioners need to be educated about the causes of dental anxiety and receive training in how to treat the problem.

Commentary: Trade-offs in the development of a sample design for case-control studies.

The recent article, "Comparison of Telephone Sampling and Area Sampling: Response Rates and Within-Household Coverage" (Am J Epidemiol 2001;153:1119-27), raised a number of issues related to two sampling methodologies that can be used for selecting population-based controls for case-control studies: random digit dialing (RDD) and area probability sampling. Some of these issues are discussed in this commentary in more detail to help in making sample design decisions, including the need to take the analysis plan into account when developing a sample design. Data from the paper are used to illustrate how the choice of sample design can affect analyses. Relative costs associated with the two methodologies as well as variance and bias concerns are also discussed in detail. Sample coverage issues, including those associated with list-assisted RDD, are considered, as are some advantages of the list-assisted approach. A discussion of the use of concurrent screening and sampling with an RDD approach as an alternative to periodically selecting fixed sample sizes is provided.

The Current Efficiency of List-Assisted Telephone Sampling Designs

List-assisted random digit dialing (RDD) designs became popular in the late 1980s and early 1990s. Work done by the Bureau of Labor Statistics and the University of Michigan in 1993 resulted in the development of the underlying theory for these designs as well as the evaluation of various alternative sampling plans to optimize the method. Recent research to reevaluate these designs in light of the significant changes in the telephone system over the past decade is presented in this article. The article provides background on the development of list-assisted designs, and recent changes in the U.S. telephone system are reviewed. Using 1999 data from Survey Sampling, Inc., an analysis of the current state of the telephone system is presented, and a reoptimization of the earlier designs is undertaken. Results from the earlier work are compared with findings from the 1999 data.

The Use of Telephone Interview Methodology to Obtain 24-hour Dietary Recalls

Objective To compare 24-hour dietary recalls collected over the telephone to in-person recalls collected in the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). Design Trained interviewers collected 24-hour dietary recalls over the telephone using the multiple-pass approach. These results were compared to in-person interviews from a pooled subsample of CSFII respondents. Subjects/setting List-assisted random-digit dialing was used to identify 700 women between the ages of 20 and 49 years. One eligible woman per household was selected to participate. Statistical analyses Approximate t tests to examine differences in average nutrient and energy intakes were conducted on weighted data. Results The reported intakes of most nutrients in the current 24-hour dietary recalls collected over the telephone were significantly higher than those reported in the 1994 and 1995 CSFII, but there were no significant differences between the telephone survey and 1996 CSFII results. The 24-hour dietary recalls collected over the telephone yielded consistently greater mean nutrient intake per respondent compared with a comparable pooled subsample from the 1994,1995, and 1996 CSFII. Generally, no significant differences were found in the food group data between the telephone survey and the CSFII survey. Mean dietary intakes reported by the comparable CSFII subsample increased from 1994 to 1996. Applications Collecting 24-hour dietary recalls over the telephone is a practical and valid data collection tool for use in national food consumption surveys. J Am Diet Assoc. 1999;99:1406–1411.