Random Digit Dialing Research Articles

The Prevalence of Chronic Obstructive Pulmonary Disease (COPD) and the Heterogeneity of Risk Factors in the Canadian Population: Results from the Canadian Obstructive Lung Disease (COLD) Study

PurposeTo determine the spirometric-based prevalence of COPD across different regions in Canada and to evaluate the site heterogeneity of risk factors.Patients and MethodsIn this cross-sectional, population-based study, random samples of non-institutionalized adults aged ≥40 years were generated by random digit dialling. Participants answered an interviewer-administered questionnaire and performed spirometry before and after bronchodilator administration. COPD was defined as post-bronchodilator FEV1/FVC <0.70 (fixed ratio, FR) and as FEV1/FVC <5th percentile (lower limits of normal, LLN). Separate logistic regression models were used to compute the risk (adjusted odds ratio, aOR) for COPD. I2 and Tau2 analyses were used to evaluate heterogeneity.ResultsOut of 5176 (95%) participants, 4893 (47% male with mean age 56.6 years (95% confidence interval, 56.0–57.2)) had spirometry that satisfied ATS criteria. The population prevalence of COPD was 16.2% (95% CI, 14.5–17.8) by FR and 11.2% (95% CI, 9.7–12.6) by LLN. Male predominance in prevalence was shown by FR but not by LLN criteria. Patient characteristics associated with an increased risk of COPD included: age (OR 1.56; 95% CI 1.33–1.84); history of physician-diagnosed asthma (OR 3.30; 95% CI 2.42–4.49); and childhood hospitalization for respiratory illness (OR 1.81; 95% CI 1.17–2.80). In terms of smoking-related risk factors, current smoking status had the highest odds ratio (OR 3.49; 95% CI 2.55–4.80). Variance in prevalence among sites was significantly reduced by adjusting for risk factors in Tau2 analyses. Higher odds of exposure for each risk factor was found in more severe COPD, suggesting that a higher risk could be linked to the development of severe disease.ConclusionThis study reports the population prevalence of COPD in nine urban cities which collectively represent the majority of the Canadian population and demonstrates that heterogeneity in prevalence among sites is substantially explained by variation in associated risk factors for COPD.

Relationship between Socioeconomic Factors and Incidence of Cosmetic Surgery in Tehran, Iran.

Background:Cosmetic surgery accompanied with high economic cost is increasing in Iran. It is necessary to be aware about factors affecting cosmetic surgery in order to control its increasing trend. Therefore, we aimed to determine the factors affecting the incidence of cosmetic surgery in Tehran, Iran.Methods:This survey was conducted on 2002 subjects between the ages of 15 to 60 yr using random digit dialing in Tehran, Iran 2015. Demographic data was collected from all of participants and in the presence of cosmetic surgery, the related cosmetic questions were asked in details. Cosmetic surgery was considered as an event and the incidence rate ratio for variables were estimated. For univariate analysis, Poisson regression was used as well as multi-level Poisson regression was used for multivariate analysis.Results:Totally, 224 participants (11%) undergone cosmetic surgery. There was a significant relationship between the age at surgery of participants with the incidence of cosmetic surgery (P<0.001). Cosmetic surgery in women was 1.9 times greater than in men (P <0.001). Incidence Rate Ratio (IRR) for the average and wealthy economic status in comparison to poor level was estimated (IRR=5.6, CI%95: 3.64,8.63) and (IRR=3.14, CI%95: 1.93,5.11), respectively. In addition, according to multivariate analysis all variables except the level of education and occupation, had significant relationship with the incidence of cosmetic surgery (P<0.001).Conclusion:Cosmetic surgery was related to socioeconomic and demographic factors. Given the high economic burden of this unnecessary surgery, it can be effective to emphasize on awareness-raising programs for those are more likely to undergo cosmetic surgery.

The use of an online survey for collecting food exposure information, Foodbook sub-study, February to April 2015.

During foodborne illness outbreak investigations, comparing food exposure frequencies of cases to those of a control population can help identify suspect food sources. The Public Health Agency of Canada (PHAC) conducted an online survey between February and April 2015 to collect seven-day food exposures from a convenience sample. The study period overlapped with a national, population-based exposure survey being conducted via telephone using random digit dialling. A subset of the food exposure questions from the telephone-based survey was included in the online survey. The online survey study objectives were to: 1) describe the survey methodology, survey respondents and response behaviour; and 2) determine if the online methodology is an appropriate alternative to telephone surveys by comparing food exposures. The online survey link was distributed via email to employees and public health partners, and was promoted on the PHAC website and social media channels. In total 2,100 surveys were completed. The majority of respondents were female, with high income and education, aged 30 to 39 years. The proportion reporting consuming the food items in the online survey was generally higher than those reported in the telephone survey, with a mean difference of 6.0% (95% CI: 4.2, 7.8). In an outbreak investigation, the 6.0% bias could make it more difficult to detect a difference between the case and control food exposures. Nevertheless, given the speed of response and lower resource expenditure of online surveys as well as the willing, able and convenient sample, a bias of 6.0% is considered small enough to be acceptable for future surveys.

Measuring Preferences and Behaviours in the 2019 Canadian Election Study

AbstractThe 2019 Canadian Election Study (CES) consists of two separate surveys with campaign-period rolling cross-sections and post-election follow-ups. The parallel studies were conducted online and through a random-digit-dial (RDD) telephone survey. Both continue the long tradition of gathering information about the attitudes, opinions, preferences and behaviours of the Canadian public. The online survey, in particular, introduces some important innovations that open up the potential for exciting new research on subgroups in the electorate.

Intentions to reduce sugar-sweetened beverage consumption: the importance of perceived susceptibility to health risks.

There are numerous health effects associated with excess sugar-sweetened beverage (SSB) consumption. Interventions aimed at reducing population-level consumption require understanding of the relevant barriers and facilitators. This study aimed to identify the variables with the strongest relationship with intentions to reduce SSB consumption from a suite of variables derived from the literature. Random-digit dialling of landline and mobile phones was used to survey adults using computer-assisted telephone interviews. The outcome variable was 'likelihood of reducing SSB consumption in next 6 months', and the predictor variables were demographics, SSB attitudes and behaviour, health risk perceptions and social/environmental exposure. Australia. A subsample of 1630 regular SSB consumers from a nationally representative sample of 3430 Australian adults (38 % female, 51 % aged 18-45 years, 56 % overweight or obese). Respondents indicated that they were 'not at all' (30·1 %), 'somewhat' (43·9 %) and 'very likely' (25·3 %) to reduce SSB consumption. Multivariate nominal logistic regressions showed that perceiving future health to be 'very much' at risk was the strongest predictor of intention to reduce SSB consumption (OR = 8·1, 95 % CI 1·8, 37·0, P < 0·01). Other significant predictors (P < 0·01) included self-perceptions about too much consumption, habitual consumption, difficulty reducing consumption and likelihood of benefitting from reduced consumption. Health risk perceptions had the strongest relationship with intentions to reduce consumption. Age and consumption perceptions were also predictors in the multivariate models, whereas social/environmental exposure variables were not. Interventions may seek to incorporate strategies to denormalise consumption practices and increase knowledge about perceived susceptibility to health risks.

Terminology Change for Small Low-Risk Papillary Thyroid Cancer As a Response to Overtreatment: Results from Three Australian Community Juries.

Background: The majority of small papillary thyroid cancers (sPTCs) are treated surgically, rather than by active surveillance. Patient and clinician preference for surgery may be partially driven by the use of cancer terminology. Some experts propose that changing terminology would better communicate the indolent nature of sPTCs and improve uptake of active surveillance. Others argue that terminology that includes "cancer" correctly reflects the biological nature of these tumors. The views of informed lay publics can provide value-based perspectives on complex issues and guide policy discussions. Methods: We recruited 40 people for three community juries, held in Sydney, Wodonga, and Cairns, Australia. Participants were of diverse backgrounds and ages, recruited through random digit dialing and a topic-blinded social media strategy. Juries were informed about thyroid cancer, overdiagnosis, and overtreatment, and heard arguments for and against terminology change before deliberation. The deliberative process in Jury 1 led to a refinement of jury charge, the updated version that was then used in Juries 2 and 3. Results: Jury 1 favored no terminology change, and Juries 2 and 3 were divided on the topic. Key reasons for opposing terminology change included a strong desire to retain terminology that aligns with the pathological definition of cancer, and to avoid even a minimal risk of harm that could arise if patients became complacent in follow-up. Key reasons to support terminology change included a desire to reduce psychological distress, stigma, and discrimination associated with a cancer diagnosis, and an argument that terminology change may be a more effective trigger for health system reform compared with other options. The juries unanimously recommended community education and health system reforms to reduce harms of overtreatment, and expressed an expectation that clinicians and researchers reach agreement on clinical guidelines to promote better uptake of active surveillance. Conclusions: The conceptual tension between a pathological and an outcome-based understanding of cancer was apparent in deliberation. This highlights an ongoing challenge for those advocating changing disease terminology. Regardless of action on terminology, jurors shared a strong expectation that practical changes would be made to respond to the harms of overtreatment.

Assessing Repeated and Rescheduled Attempts in Random Digit Dial Surveys

A central challenge to telephone surveys is low response rates. This is particularly true for random digit dial (RDD) surveys, which have especially low response rates. For researchers designing RDD survey protocols, there is a clear tradeoff between effort and composition, where surveys can achieve a higher response rate by calling fewer numbers repeatedly or by calling more numbers less intensively. This brief explores this tradeoff by measuring the effects of (i) repeated attempts per case, and (ii) rescheduling a call, on completion rates and sample composition. Using data from nine low- and middle-income countries (LMICs), we find that repeated and rescheduled attempts result in lower completion rates than new attempts, on average. However, the respondents who complete the survey in later attempts or after rescheduling have statistically significant differences in observable characteristics. This suggests that more call attempts may be needed to adequately represent the respondents who are harder to interview, even if those call attempts produce fewer completions per case.

Cleveland City: Policy and Budget Reallocation Analysis

The City of Cleveland in Ohio has endured suffering from detrimental budgeting and policy issues. The city’s monetary forecasts utilize internal recorded information, National and State economic indicators, and cost and income projections to appraise the city’s future monetary condition, including choices for controlling costs and expanding income (City of Cleveland, 2021). The purpose of this research paper is to examine the top five low-income and high-income areas in Cleveland. These low-income areas include Youngstown (Poverty rate of 36.2), East Cleveland (Poverty rate of 38.9), Warren (Poverty rate of 35.6), Fostoria (Poverty rate of 31.1), and Cambridge (Poverty rate of 33.2) (Exner, 2020). The high-income areas include Kamm's Corner, Riverside, Tremont, Old Brooklyn, and Jefferson (Kolmar, 2020). This project will discuss the background of Cleveland, Ohio, its budget allocation in previous years, the methods in which budget and allocation are chosen, and the contrast of methods to other cities in the US. A random digit dialing (RDD) survey will be distributed amongst residents in Cleveland, Ohio. The data will be processed in software including JASP and RStudio. Furthermore, the team will be specifically working with Cleveland City Council member Honorable Jasmine Santana.

American Rescue Plan and the Effects of Stimulus Checks - New York City

In 2020, the COVID-19 pandemic caused mass devastation, drastically impacting the United States economy. As a result, despite severe political polarization the year before, the Biden administration attempted to make progress to ease the country into economic recovery by stimulating the economy which suffered an economic plunge at the fastest rate in its history. In March of 2021, the American Rescue Plan (ARP), a $1.9 trillion stimulus package, was passed by Congress and signed into law. Although major components of the ARP included extended unemployment benefits, emergency paid leave, expanded welfare, support for small businesses, additional funding, and various tax provisions, a crucial element of the plan was individual direct payments in the form of stimulus checks, making the ARP particularly unique. It is important to examine the effects of stimulus payments as well as improvements in healthcare, housing, and other areas. Using in-person fieldwork, online surveys, and the Pew Research Center’s Random Digit Dialing (RDD) method, this paper will be summarizing primary data from Americans nationwide to identify patterns that may exist between various socioeconomic groups, geographical regions, and similar demographics. Conducting evidence-based research, the paper will analyze correlational relationships between consumer spending, inflation, and unemployment due to fiscal policy.

Understanding Response Rates in Random Digit Dial Surveys

This research methods brief presents data from random digit dial (RDD) surveys in nine countries. We show that response rates to such surveys are typically below 60 percent and can be as low as 7 percent. We also show that most of the sample is lost at two points in the survey: non-contact, where respondents do not pick up the phone, and early refusal, where respondents terminate the interview before the survey begins. Beyond that point, cooperation is relatively high, with breakoffs during the interview ranging from effectively 0 to 10 percent across the nine countries. This evidence suggests that the most promising ways to increase response rates are strategies that increase pick-up rates and improve the first impression respondents have of the interviewer. While increasing contact and consent rates should logically improve response rates, it is not a guarantee. Future research would be needed to confirm whether respondents who are newly induced to answer and consent to the survey would be just as cooperative as those who would have consented without further intervention.

Messaging to Improve Response Rates: Effectiveness of Pre-Survey SMS Messages

Response rates remain low in phone surveys compared to face-to-face data collection (see here for a similar brief on response rates). This is especially true for random digit dial (RDD) or similar “cold call” phone surveys, which are necessary in the absence of a sample frame of reliable phone numbers. This brief presents early evidence from a series of experiments IPA conducted in 4 countries during 2020 to learn whether pre-survey messages, typically SMS texts, improve the rates at which respondents answer the phone, and complete the interview, with the ultimate goal of increasing the productivity of phone surveys. We find that, on average, SMS messages improve the rate at which respondents complete the survey relative to no message. This change is not driven by the rate at which respondents answer the phone, but by survey completion conditional on starting the survey. Random variation in message content had no significant effect on the rate at which respondents answer and complete phone surveys. The sample that resulted from the SMS message treatment had a composition that was on average younger and less likely to be predicted to be in poverty than the other treatment and control groups.

Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic.

To investigate the prevalence of suicidal thoughts and behaviours (STB; i.e. suicidal ideation, plans or attempts) in the Spanish adult general population during the first wave of the Spain coronavirus disease 2019 (COVID-19) pandemic (March-July, 2020), and to investigate the individual- and population-level impact of relevant distal and proximal STB risk factor domains. Cross-sectional study design using data from the baseline assessment of an observational cohort study (MIND/COVID project). A nationally representative sample of 3500 non-institutionalised Spanish adults (51.5% female; mean age = 49.6 [s.d. = 17.0]) was taken using dual-frame random digit dialing, stratified for age, sex and geographical area. Professional interviewers carried out computer-assisted telephone interviews (1-30 June 2020). Thirty-day STB was assessed using modified items from the Columbia Suicide Severity Rating Scale. Distal (i.e. pre-pandemic) risk factors included sociodemographic variables, number of physical health conditions and pre-pandemic lifetime mental disorders; proximal (i.e. pandemic) risk factors included current mental disorders and a range of adverse events-experiences related to the pandemic. Logistic regression was used to investigate individual-level associations (odds ratios [OR]) and population-level associations (population attributable risk proportions [PARP]) between risk factors and 30-day STB. All data were weighted using post-stratification survey weights. Estimated prevalence of 30-day STB was 4.5% (1.8% active suicidal ideation; n = 5 [0.1%] suicide attempts). STB was 9.7% among the 34.3% of respondents with pre-pandemic lifetime mental disorders, and 1.8% among the 65.7% without any pre-pandemic lifetime mental disorder. Factors significantly associated with STB were pre-pandemic lifetime mental disorders (total PARP = 49.1%) and current mental disorders (total PARP = 58.4%), i.e. major depressive disorder (OR = 6.0; PARP = 39.2%), generalised anxiety disorder (OR = 5.6; PARP = 36.3%), post-traumatic stress disorder (OR = 4.6; PARP = 26.6%), panic attacks (OR = 6.7; PARP = 36.6%) and alcohol/substance use disorder (OR = 3.3; PARP = 5.9%). Pandemic-related adverse events-experiences associated with STB were lack of social support, interpersonal stress, stress about personal health and about the health of loved ones (PARPs 32.7-42.6%%), and having loved ones infected with COVID-19 (OR = 1.7; PARP = 18.8%). Up to 74.1% of STB is potentially attributable to the joint effects of mental disorders and adverse events-experiences related to the pandemic. STB at the end of the first wave of the Spain COVID-19 pandemic was high, and large proportions of STB are potentially attributable to mental disorders and adverse events-experiences related to the pandemic, including health-related stress, lack of social support and interpersonal stress. There is an urgent need to allocate resources to increase access to adequate mental healthcare, even in times of healthcare system overload. NCT04556565.

1696. The Black Box of Using Health Claims-Based Analyses to Estimate UTI Prevalence in Community-Dwelling Women

BackgroundUrinary tract infections (UTIs) are common in women but most epidemiology studies occurred in specialized settings (university health clinics) or used outdated methods (random digit dialing). Currently, women receive UTI care in systems with electronic health records (EHR), thus documenting care of a wider female demographic in real-world settings. We estimated the prevalence of acute, uncomplicated UTIs in community-dwelling women in a health claims database using various operational definitions of UTI.MethodsWe conducted a retrospective analysis of claims data from the OptumLabs® Data Warehouse (OLDW), a de-identified claims and clinical information repository for privately insured and Medicare Advantage enrollees in a large, private US health plan. Non-pregnant female patients ≥ 15 years of age with two years of continuous enrollment between 2007-2015 and a visit encounter in an outpatient office, urgent care, or emergency department were included. Women with lower urinary tract disease/abnormalities, neurological disease, urological treatment, procedures or urinary catheter use, cancer or HIV treatment were excluded. Decision rules for identifying UTIs were derived using one or more combinations of: relevant ICD-9 codes, UTI symptom diagnosis codes, positive urine test results, and/or antibiotic prescription recorded in the EHR and claims. Prevalence rates were calculated for each decision rule.ResultsOf the 7,337,700 females in the claims database, 947,041 (12.97%) had an index UTI diagnosis or symptoms and met eligibility criteria. The table below illustrates prevalence rates according to each decision rule. As shown, applying decision rules based on common UTI definitions resulted in large differences in prevalence rates.Table ConclusionUsing common definitions for UTI to analyze claims data from an insurer of large proportions of the US, we obtained significantly different prevalence rates. This study highlights major limitations in using EHR and claims data for UTI quality initiatives such as tracking of practices associated with antimicrobial stewardship and lends credibility to proposals to track these infections as a reportable disease.Disclosures All Authors: No reported disclosures

Change Over Time in Linguistic Acculturation: A Comparison Between Cuban and Non-Cuban Hispanic Immigrants

While acculturation and its implications for mental health have received extensive attention in studies with older immigrant populations, change over time in acculturation less so. This paper examines change over a two-year period in levels of linguistic acculturation among Cuban (n = 186) and non-Cuban Hispanic (n = 116) immigrants living in Florida. Data came from the waves of the Survey of Older Floridian (SOF), conducted using a statewide sampling frame based on population densities, with a computer-assisted telephone interview strategy. Calls were initiated through random digit dialing, and a follow-up interview was added approximately two years later. Measures included six acculturation items, one dealing with the participant’s language preference for the interview itself and five items dealing with language ability and usage. Results indicated that non-Cuban Hispanics were significantly more acculturated than Cuban Hispanics, and that at least 75% of Wave 2 acculturation was accounted for by Wave 1 status. After controlling for initial levels of acculturation, those who at first interview reported more economic problems and those reporting fewer depressive symptoms were more acculturated at follow-up. It was concluded that while linguistic acculturation is relatively stable, interventions to increase acculturation have implications for mental health service utilization.

Intention to Receive Cognitive Screening for Alzheimer’s Disease in Nondemented Older Adults

The study explored factors associated with intention to receive cognitive screening for Alzheimer’s disease (AD). It also examined whether self-efficacy mediates the relationship between knowledge about screening and the intention to be screened. A population-based, random-digit dialing survey was performed; 1,043 responses were collected from a sample of nondemented older adults living in urban, suburban, and rural areas. A majority were female (66.8%, n = 697) and White (82.7%, n = 863) with a mean age 62.6 years (SD = 10.2). Findings from regression analysis identified that being female (β = .080), being depressed (β = .149), and having a positive life orientation (β = .120) were significantly associated with the intention to receive cognitive screening, p < .05. Results indicated that older adults with a positive life orientation reported greater intention to be screened for AD, whereas depressed participants were more likely to plan to be screened for AD. Bootstrapping results identified a mediating effect of self-efficacy (β = .2668, t = 7.3137, p < .0005). Self-efficacy mediated the relationship between knowledge about screening and intention to be screened. Using self-efficacy as a mediation effect indicated that older adults with knowledge about screening understand the benefits of early screening and diagnosis and are more likely to have self-efficacy (i.e., confidence to consult with a physician), and thus are more likely to show intention to be screened. Intention to be screened for AD could increase public awareness by defining effective ways to assist older adults to seek a cognitive screen.

Priority allocation of pandemic influenza vaccines in Australia – Recommendations of 3 community juries

BackgroundPandemic planning has historically been oriented to respond to an influenza virus, with vaccination strategy being a key focus. As the current COVID-19 pandemic plays out, the Australian government is closely monitoring progress towards development of SARS-CoV2 vaccines as a definitive intervention. However, as in any pandemic, initial supply will likely be exceeded by demand due to limited manufacturing output. MethodsWe convened community juries in three Australian locations in 2019 to assess public acceptability and perceived legitimacy of influenza pandemic vaccination distribution strategies. Preparatory work included literature reviews on pandemic vaccine allocation strategies and on vaccine allocation ethics, and simulation modelling studies. We assumed vaccine would be provided to predefined priority groups. Jurors were then asked to recommend one of two strategies for distributing remaining early doses of vaccine: directly vaccinate people at higher risk of adverse outcomes from influenza; or indirectly protect the general population by vaccinating primary school students, who are most likely to spread infection. ResultsThirty-four participants of diverse backgrounds and ages were recruited through random digit dialling and topic-blinded social media advertising. Juries heard evidence and arguments supporting different vaccine distribution strategies, and questioned expert presenters. All three community juries supported prioritising school children for influenza vaccination (aiming for indirect protection), one by 10–2 majority and two by consensus. Justifications included that indirect protection benefits more people and is likely to be more publicly acceptable. ConclusionsIn the context of an influenza pandemic, informed citizens were not opposed to prioritising groups at higher risks of adverse outcomes, but if resources and epidemiological conditions allow, achieving population benefits should be a strategic priority. These insights may inform future SARS-CoV-2 vaccination strategies.

Nationwide Survey in Greece about Knowledge, Risk Perceptions, and Preventive Behaviors for COVID-19 during the General Lockdown in April 2020.

Background: The aim of this study was to investigate the knowledge, attitudes, and practices of the Greek general population toward coronavirus disease 2019 (COVID-19) during the lockdown period in April 2020, to examine factors associated with misperceptions and to determine behavioral patterns that may require interventions. Methods: A cross-sectional study of the general Greek population (N = 1858) was conducted. A geographically stratified cluster sampling was implemented. A questionnaire was composed consisting of 35 questions. Data collection took place from 15 April to 2 May 2020. A random-digit dialing survey was conducted by 29 interviewers. Results: The majority of respondents (62.7%) answered ≥12/17 questions correctly. Participants aged 18–44 years, male gender, specific occupations (freelancer, unemployed, housewife, retiree) and those who sought information about COVID-19 from less than two sources received lower aggregated scores on knowledge questions. Regarding attitudes toward future vaccination, 18.9% declared that were against it, while 81.1% that they may consider or will be vaccinated. About 40% were not using a face mask and only 42% washed their hands appropriately. Conclusion: Adjusting information campaigns targeting especially people below 45 years of age can help to sensitize them and realise their role to control the spread. Further targeted surveys are needed to adjust/design prevention campaigns.

Characteristics of Mutual Fund Investors, 2020

Each year, the Investment Company Institute (ICI) conducts a telephone survey of US households to track households’ ownership of mutual funds and to gather information on their demographic and financial characteristics. The most recent survey was conducted from May to June 2020 and was based on a dual-frame telephone sample of 3,001 US households. Of these, 1,350 households were from a landline random digit dial (RDD) frame, and 1,651 households were from a cell phone RDD frame. Of the households contacted, 1,372 households, or 45.7 percent, owned mutual funds. This paper presents results from the survey, highlighting the demographic and financial characteristics of mutual fund–owning households, where they purchase their funds, and their financial goals. In 2020, most households that owned mutual funds were headed by individuals in their peak earning and saving years. Many mutual fund owners were employed and had moderate household incomes. Mutual fund–owning households often held several funds, and equity funds were the most commonly owned type of mutual fund. Among households owning mutual funds in 2020, 82 percent held more than one fund, and 90 percent owned equity funds. Almost all mutual fund investors were focused on retirement saving. Saving for retirement was a financial goal for 94 percent of mutual fund–owning households, and 75 percent indicated that retirement saving was the household’s primary financial goal. Incidence of mutual fund ownership was the highest among Generation X. The largest portion of mutual fund assets held by households are held by Baby Boomers. Generation Z and Millennial households owning mutual funds are more likely to hold funds only inside employer-sponsored retirement plans, compared with older generations.

Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey

BackgroundFew studies have examined public opinion about the health care system in the former Soviet region. The objective of our study was to evaluate the population’s satisfaction with the health care system and identify factors associated with it in Armenia.MethodsWe conducted a cross-sectional telephone survey among 576 adult residents of the capital Yerevan using Random Digit Dialing technique. Simple and multivariate logistic regression explored associations between potential determinants and satisfaction.ResultsA substantial proportion of respondents (45.5%) were dissatisfied or very dissatisfied with the health system. About 49% of respondents negatively evaluated the ability of the system to provide equal access to care. About 69% of respondents thought that the responsibility for an individual’s health should be equally shared between the individual and the government or that the government’s share should be larger. The adjusted odds of satisfaction were higher among individuals with better health status, those who positively rated equal access and respect to patients in the system, those thinking that the responsibility for health should be equally shared between the individual and the government, and those who tended to trust the government.ConclusionsThis study enriched our understanding of factors that shape the population’s satisfaction with the health care system in different cultural and political environments. We recommend further exploration of public opinion about those system attributes that are not directly linked to patient experiences with care, but might be equally important for explaining the phenomenon of satisfaction.

Feasibility and Quality of a National RDD Smartphone Web Survey: Comparison With a Cell Phone CATI Survey

Internet-enabled smartphones and wireless communication technologies are opening new ways to conduct web-based self-administered data collection for academic or nonacademic research. Considering the relative advantages of self-administration such as the low cost, overall convenience, and collection of better data about sensitive topics, survey researchers are eager to explore conducting national web surveys of the general population via smartphones, especially if they can use probability-based random-digit-dialing (RDD) sampling methods. But questions about the feasibility of such surveys remain. We conducted an experiment using national samples drawn from an RDD wireless sampling frame to compare two administration methods: a smartphone web survey using SMS (text messages) invitations and a cell phone (smartphone or feature phone) survey through computer-assisted telephone interviewing (CATI). This study was conducted using the National Survey of Smoking and Health in South Korea, a country with a very high rate of smartphone ownership. The geographic and demographic representativeness of respondents in the smartphone web mode (self-administered mode) was similar to that of the cell phone CATI survey (interviewer-administered mode), although the completion rate in the former was nearly half that of the latter. A majority of demographic variables and measures of experiences, attitudes, and perceptions of cigarettes or smoking showed significant mode differences for both unweighted and weighted estimates. The total cost of the web survey was about one fifth that of the telephone survey. The results demonstrate the potential of a smartphone web survey as a stand-alone or primary mode of data collection, if carefully designed and implemented.