Selected Health Outcomes Research Articles

Applying arts to health interventions and health research in Ghana: a scoping review.

This review documents arts applied to health interventions and health research in Ghana, examines evidence of their impact on health outcomes, and identifies research and practice gaps. Eight databases (MEDLINE, Academic Search Complete, CINAHL, Health Source: Nursing/Academic Edition, Humanities International Complete, Scopus, African Journals Online and PsycINFO) were searched for articles published between 2000 and 2022. Following screening, seventeen articles reporting sixteen eligible studies were selected. Ten art forms (including comedy, music, theatre) were applied to eight health conditions (including HIV/AIDS, mental illness, COVID-19). Most studies involved artists and artist-researchers. The majority of studies were cross-sectional. Impact was reported on health education, illness management and community health development. Some studies engaged with health policy communities, but none reported impact on health policy change. Creative arts have a reported measurable impact on selected health outcomes in Ghana. Participatory arts-based projects have the greatest potential for sustainable and transformational social health impact.

Hip fracture in elderly: malnutrition and health outcomes. A systematic review and meta-analysis

Abstract Background Hip fracture is a common condition among elderly and one of the leading causes of disability. Malnutrition is widely present in older patients and has been identified in several studies as an important and modifiable prognostic factor for several medical conditions, including hip fracture. The aim of the present study is to evaluate the association between malnutrition, assessed by validated tools, and selected health outcomes for different follow-up intervals from hip fracture, in particular: mortality, changes in mobility/living arrangements and postoperative delirium. Methods A literature search on PubMed, Web of Science and Scopus databases up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT score and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR/OR/HR) extracted from 14 eligible selected studies. Results Malnutrition significantly increased the risk of any adverse outcome by 70% at 1 month, and up to 250% at 1 year, showing an increasing trend with longer follow-up periods. One month after hip fracture, malnutrition significantly increased the risk of postoperative delirium by 275% (OR = 2.75; 95% CI 1.80-4.18; p ≤ 0.05), mortality by 342% (OR = 3.42; 95% CI 2.14-5.48; p ≤ 0.05) and mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63-7.55; p ≤ 0.05). One year after hip fracture, malnutrition significantly increased the risk of transfer to more supported living arrangements by 218% (OR = 2.18; 95% CI 1.58-3.01; p ≤ 0.05), declined mobility by 41% (OR = 1.41; 95% CI 1.14-1.75; p ≤ 0.05), mortality by 368% (OR = 3.68; 95% CI 3.00-4.52; p ≤ 0.05) and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91-2.87; p ≤ 0.05). Conclusions These findings underscore that malnutrition worsens outcomes after hip fracture in elderly, emphasizing the importance of nutritional assessment to mitigate potential adverse consequences. Key messages • The results of the present study underscore that malnutrition increases the risk of death and worsens mobility and independence after hip fracture in older adults. • Routine nutritional status evaluation could prove beneficial in the management of hip fracture older patients in order to prevent potential adverse outcomes.

How can exposure assessment for pesticides in epidemiological studies be improved? Insights from the IMPRESS project

The IMPRoving Exposure aSSessment Methodologies for Epidemiological Studies on Pesticides (IMPRESS) project (http://www.impress-project.org/) aimed to further the understanding of the performance of pesticide exposure assessment methods (EAMs). To achieve this the IMPRESS project used two approaches to assess EAM performance, using existing and newly collected data from five studies from three different countries and use of published secondary data to undertake three meta-analyses for selected chronic health outcomes. Based on the findings of the IMPRESS project we provide in this paper insights on the overarching research question “How can exposure assessments for pesticides in epidemiological studies be improved”? Exposure assessment is a critical component of pesticide epidemiological studies. EAMs used and epidemiological practices employed need to reflect the changing nature and complexities of pesticide exposure in various occupational settings. To properly assess the association between exposure and selected health outcomes, the choice of EAM should provide a clear exposure contrast within the study population. Acquiring a practical understanding of the pesticide use practices is crucial to determine whether factors such as frequency or intensity of exposure have to be considered in planned analyses. Biomonitoring may be more beneficially applied intensively in a focussed exposure assessment analysis of a particular cohort, which can be used to determine the most relevant exposure factors within that cohort-specific context. Overall, improving pesticide exposure assessment in epidemiological studies requires a multi-disciplinary approach. A next step for the wider scientific community may be to consider the development of a decision tree to aid the selection of suitable EAMs. Such a decision tree would need to consider and be based on multiple parameters including, but not limited to, study type, health endpoint, socio-demographic context, farming system, pesticide used, and application methods.

The Health of Children in U.S. Military Families: Evaluation of the 2020-21 National Survey of Children's Health.

The health of children and adolescents, particularly children of military families, is instrumental for military departments; yet, there has not been an examination on the overall physical health status, or access to health care, among children of military families compared to children of civilian families. This study used the 2020-2021 National Survey of Children's Health, children aged 0-17 years, to examine the association between military status of the caregiver of the child and the child's health status, financial stability, and health care access via health insurance coverage (n = 90,711 children). Bivariate analyses used Pearson's chi-squared tests and were weighted to be nationally representative. Multivariable regression analyses were used to examine the association between military status and selected health outcomes. In unadjusted analyses, we found that children who had ever had a caregiver serve on active duty were overall more financially stable than children with a civilian caregiver, with children of military families less likely to reside below the federal poverty level and more likely to have continuous health insurance coverage. We also found that children with a caregiver who has ever been on active duty were more likely to have reported mental health needs and more likely to have special health care needs than their civilian counterparts. In adjusted analyses, children with a caregiver who has ever been on active duty were more likely to have special health care needs (adjusted odds ratio [aOR] 1.22; 95% confidence interval [CI] 1.10-1.36) and mental health needs (aOR 1.22; 95% CI 1.10-1.35). This is the first study, to our knowledge, to do a national examination of overall physical and mental health, as well as specific health conditions and access to health care, among children of military families compared to their civilian counterparts. The findings from this study may be instructive for policymakers and stakeholders in evaluating special needs and mental health resources for military families and improve continuity of health care access through insurance coverage to improve the health of all U.S. children and adolescents.

Regional variation in prevalence of frailty in India: Evidence from longitudinal ageing study in India (LASI) wave-1.

Background & objectives Frailty is a geriatric syndrome with clinical and public health implications. It represents the state of increased vulnerability. This study aimed to estimate the prevalence of frailty and pre-frailty by demographic characteristics and geographical regions in India. Furthermore, it also aimed to examine the association of this prevalence with selected health outcomes using data from the Longitudinal Ageing Study of India (LASI). Methods This is a secondary analysis of LASI wave-1 data. A total of 26,058 respondents aged ≥60 yr were included for analysis. Frailty was assessed using Fried's frailty phenotype, including slowness, shrinking, low physical activity, weakness, and low endurance. Descriptive statistics were used to study frailty distribution. The odds ratio (OR) of health events across the frailty categories was computed using ordinal logistic regression. Results The findings of this study suggest that the prevalence of frailty and pre-frailty was 29.2 and 58.8 per cent, respectively. The prevalence of frailty was higher among women (37.3%), illiterate (37%) and rural residents (31%). It ranged between 14.5 per cent in Uttarakhand and 41.3 per cent in Arunachal Pradesh. Frailty was strongly associated with depression [OR: 2.09, Confidence Interval (CI): 1.98-2.21] and activities of daily living (ADL) difficulty (OR: 1.75, CI: 1.64-1.86). Higher odds were reported for fracture (OR: 1.24, CI: 1.01-1.51) and multimorbidity (OR: 1.18, CI: 1.04-1.33) among frailty. Interpretation & conclusions The heterogeneity of frailty prevalence across States indicates the need for population-specific strategies. A sharp age-related increase in prevalence highlights the need for preventive measures. Furthermore, the high prevalence of frailty among women, illiterate and rural residents indicates the target population for receiving preventive interventions. Lastly, a heterogeneity in frailty prevalence across different States indicates the scope for region-specific programmes.

Prospective cohort study on non-specific symptoms, cognitive, behavioral, sleep and mental health in relation to electronic media use and transportation noise among adolescents (HERMES): study protocol

Electronic media (eMedia) devices along with exposure to transportation noise are integral to the daily routines of adolescents. The concerns associated with excessive eMedia usage extend beyond sleep deprivation to include the heightened exposure to radiofrequency electromagnetic fields (RF-EMF) emitted by these wireless devices. The aim of HERMES (Health Effects Related to Mobile PhonE Use in AdolescentS) study is to better understand biophysical and psychological pathways in relation to eMedia, RF-EMF exposure use and transportation noise that may effect on cognitive, behavioral, sleep and mental health, as well as non-specific symptoms. Following two previous HERMES cohorts conducted between 2012 and 2015 we have initiated the third wave of HERMES study as a prospective cohort with intermediate (every four months) and one year follows-up. Eligible participants are adolescents attending 7th or 8th school grades in Northwest and Central Switzerland. Baseline examinations are a questionnaire on eMedia usage and selected health outcomes, as well as computerized cognitive tests. In addition, parents/guardians are asked to fill in a questionnaire about their child’s health and potential eMedia use determinants. Far-field RF-EMF exposure and transportation noise at the place of residence and school are predicted based on a propagation model. Cumulative RF-EMF brain dose is calculated based on self-reported eMedia use, mobile phone operator data, and RF-EMF modelling. A follow-up visit is conducted one year later, and two interim questionnaires are sent to adolescents to be completed at home. Between baseline and 1-year follow-up, a subsample of 150 study participants is invited to collect personal RF-EMF measurements as well as sleep and physical activity data using accelerometers. This new recruitment wave of HERMES study provides a greater understanding of causal pathways between eMedia, RF EMF, and transportation noise exposure and their effects on health outcomes, with relevant implications for both governmental health policy and lay people alike.

Effectiveness of Tailored Self-Management Interventions for People with Chronic Musculoskeletal Conditions: a Systematic Review and Meta-Analysis

Purpose: To evaluate the effectiveness of tailored self-management interventions to improve health and behavioural outcomes for individuals living with chronic musculoskeletal (MSK) conditions. Methods: We searched relevant databases and grey literature on January 27, 2022 (CRD42022297624). We included English language randomized controlled trials and quasi-experimental trials that assessed the effect of tailored self-management on health and behavioural outcomes for individuals living with chronic MSK conditions. Eligible studies included: Individually prescribed components based on subjective and/or objective assessments; usual care or non-tailored controls; ≥1 health and behavioural outcome(s). Methodological quality was evaluated using the Cochrane Risk of Bias (RoB 2) tool and certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. Results: Our search yielded 1558 articles, and 21 studies were included in the review. Compared with usual care/non-tailored controls, positive effects were detected in favour of tailored interventions for pain (standardized mean difference [SMD] = 0.35; 95% CI: 0.20, 0.50; moderate certainty) and quality of life, SF-12/36, (SMD = 0.22; 95% CI: 0.08, 0.37; high certainty) in people with inflammatory arthritis (IA) and chronic pain conditions. Similar effects were detected for pain self-efficacy (SMD = 0.40; 95% CI: 0.20, 0.62; moderate certainty) and quality of life, index score (SMD = 0.19; 95% CI: 0.00, 0.38; moderate certainty) across chronic MSK conditions. Conclusion: Tailored self-management interventions offer modest benefits for select health outcomes; however, clinical significance remains unclear.

The Emerging Importance of Sleep Regularity on Cardiovascular Health and Cognitive Impairment in Older Adults: A Review of the Literature.

The regularity of sleep/wake patterns across multiple days is emerging as an important determinant of health. However, the association between sleep regularity and health outcomes in the aging population is not well understood. The current systematic review identified 22 publications that examined the relationship between sleep regularity and selected health outcomes: cardiovascular risk, cognitive impairment, and mortality. All studies were published after 2010, reflecting a growing research interest in daily sleep regularity. Low sleep regularity was consistently associated with higher cardiovascular risk and elevated risk of all-cause mortality. Results on cognitive impairment are mixed, with inconsistency likely attributed to small sample sizes and differences in sleep regularity assessment. Overall, regularity in sleep carries important information about health and should be included in future studies that collect daily sleep measures. Gaps in literature and methodological shortcomings are discussed.

Health benefits of pedestrian and cyclist commuting: evidence from the Scottish Longitudinal Study

BackgroundDespite active travel investment increasing, evidence of benefit is often limited to selected health outcomes and a short follow-up period, and cyclists and pedestrians are often analysed together. We aimed...

The experiences and perceptions of people with chronic and rare diseases during political-economic sanctions in Iran: a qualitative study

BackgroundEconomic sanctions aim to exert pressure on political and economic foundations. Hypothesizing that sanctions might affect various aspects of population health, this study, as a component of a broader investigation to ascertain the trend effects of sanctions on selected health outcomes in Iran, seeks to explore the experiences of Iranian citizens associated with the imposed sanctions.MethodsThis is a qualitative study. We conducted 31 semi-structured interviews with randomly selected patients diagnosed with at least one chronic and rare disease from diverse backgrounds across four provinces in Iran. We analyzed data using an inductive content analysis approach, facilitated by the MAXQDA10 software.ResultsWe identified three primary themes: direct effects, side effects, and coping strategies. The immediate effects were perceived to be manifested through the restriction of healthcare service availability and affordability for citizens. The side effects included the economic hardships experienced in individuals’ lives and the perceived devastation caused by these difficulties. Some coping mechanisms adopted by patients or their families/relatives included prioritizing comorbidities, prioritizing health needs within families with multiple ill members, and readjusting health/illness requirements in light of daily living needs.ConclusionIn addition to the inherent burden of their illness, patients faced substantial healthcare costs as a result of sanctions, restricted access to medications, and availability of low-quality medications. We advocate considering these challenges within the healthcare system resilience framework as a crucial first step for policymakers, aiming to determine actionable measures and mitigate the adverse effects of sanctions on citizens, particularly the most vulnerable groups.

Instructional Guidelines on Selected Health Outcomes among Elderly with Knee Osteoarthritis

Instructional Guidelines on Selected Health Outcomes among Elderly with Knee Osteoarthritis

Effects of symptom management program on selected health outcomes among older people with chronic obstructive pulmonary disease: a quasi-experimental study

Older adults have limitations from their aging process and chronic disease, so developed interventions must pay attention and concern to their aging degeneration and needs. This study aims to study the effects of a symptom management program on selected health outcomes among older people with chronic obstructive pulmonary disease. The quasi-experimental research included the 15 older patients in the control group receiving routine nursing care, while the other 15 in the experimental group received a 4-week symptom management program. First, the general information was analyzed using descriptive statistics. Next, the average health outcomes were analyzed using independent and dependent t-tests, Mann–Whitney U Test, and Wilcoxon Signed Ranks Test. In addition, the readmission rate was compared using Fisher’s Exact Test. Results revealed that most of the older patients were men (96.7%), aged 60–88 years (Mean = 71.57, SD = 7.75), with a smoking history (93.3%). The improvements were found in dyspnea (p < .01), its severity during activities (p < .01), and the quality of life (p = .04) among patients who attended the program. However, both groups did not have a different pulmonary function (p = .25) and the proportion of readmission within 28 days (p = .50). This study shows that the symptom management program can reduce dyspnea and severity during activities and improve the quality of life. Older people suffer from chronic obstructive pulmonary disease, especially when experiencing dyspnea. Therefore, it is crucial to have a symptom management program for older patients, especially a program developed to respond to changes in the aging process and the limitations of older people. This developed program was age-friendly to deal with symptoms and improve quality of life. However, this program should be explored in typical situations without the effects of the coronavirus disease (COVID-19) pandemic. In addition, more extensive population-based studies and randomized controlled trials should be adopted to increase credibility and ensure generalization.Clinical Trial Registration Number: https://osf.io/6sj7y (October 4, 2021).

Ukumela impilo randomised trial: preliminary findings of height-adjustable sit-to-stand workstations on health outcomes of South African office workers

BackgroundThe prevalence of sedentary behaviour has concurrently risen with multiple cardiometabolic risk markers independent of physical activity levels. Office-based workers accumulate the highest levels of sitting time during occupational times. This study aims to investigate the short-term effects of using height-adjustable sit-to-stand workstations on cardiometabolic risk markers of office-based workers in South Africa.ResultsSixty-two office-based workers were randomized into intervention (n = 44), and the control group (n = 18). Small improvements were observed in BMI, blood pressure, and cholesterol levels in this cohort.ConclusionThis preliminary investigation confirms that short-term height-adjustable sit-stand interventions are effective in reducing workplace sitting time and selected health outcomes. South Africa has been attributed with the highest burden of obesity in Sub-Saharan Africa, as a result, there is a need to implement long-term workplace intervention to reverse these implications.Trial registrationPan African Clinical Trial Registry, PACTR201911656014962 on the 12th of November 2019.

Economic Burden of Health Conditions Associated With Adverse Childhood Experiences Among US Adults

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events in childhood, such as experiencing abuse or neglect, witnessing violence, or living in a household with substance use disorder, mental health problems, or instability from parental separation or incarceration. Adults who had ACEs have more harmful risk behaviors and worse health outcomes; the economic burden associated with these issues is uncertain. To estimate the economic burden of ACE-associated health conditions among US adults. In this economic evaluation, regression models of cross-sectional survey data from the 2019-2020 Behavioral Risk Factor Surveillance System (BRFSS) and previous studies were used to estimate ACE population-attributable fractions (PAFs) (ie, the fraction of total cases associated with a specific exposure) for selected health outcomes (anxiety, arthritis, asthma, cancer, chronic obstructive pulmonary disease, depression, diabetes, heart disease, kidney disease, stroke, and violence) and risk factors (heavy drinking, illicit drug use, overweight and obesity, and smoking) among the 2019 US adult population. Adverse childhood experience PAFs were used to calculate the proportion of total condition-specific medical spending and lost healthy life-years related to ACEs using Global Burden of Disease Study data. Data analysis was performed from September 10, 2021, to November 29, 2022. Adverse childhood experiences (age <18 years). Monetary valuation of ACE-associated morbidity and mortality using standard US value of statistical life methods and presented in terms of annual and lifetime per affected person and total population estimates at the national and state levels. A total of 820 673 adults, representing 255 million individuals, participated in the BRFSS in 2019 and 2020. An estimated 160 million of the total 255 million US adult population (63%) had 1 or more ACE, associated with an annual economic burden of $14.1 trillion ($183 billion in direct medical spending and $13.9 trillion in lost healthy life-years). This was $88 000 per affected adult annually and $2.4 million over their lifetimes. The lifetime economic burden per affected adult was lowest in North Dakota ($1.3 million) and highest in Arkansas ($4.3 million). Twenty-two percent of adults had 4 or more ACEs and comprised 58% of the total economic burden-the estimated per person lifetime economic burden for those adults was $4.0 million. In this cross-sectional analysis of the US adult population, the economic burden of ACE-related health conditions was substantial. The findings suggest that measuring the economic burden of ACEs can support decision-making about investing in strategies to improve population health.

Charting the Chronology of Research on Added Sugars: A Scoping Review and Evidence Map

The objective of this study was to conduct a scoping review and produce a publicly available database characterizing the design and reporting elements of the literature on dietary added sugars and select health outcomes. Relevant studies published from 1990 to 2021 were identified to create a database containing information on study and population characteristics, reported added sugars source and concentrations, dietary energy balance, total energy intake, and outcome measures related to body composition, obesity, cardiovascular disease, and diabetes mellitus. There were 245 publications identified, 22% of which describe interventions, and 78% describe observational studies. Publications pertaining to added sugars have risen dramatically since 2010, led by studies primarily assessing body composition (36%) or cardiovascular health (32%), including adults (65%), measuring liquid-only sources of added sugars (56%). Over 65% of studies reported total energy intake, 61% controlled for total energy intake in the design and analysis, and fewer than 5% of studies reported the energy balance of subjects. There has been a significant increase in research on added sugars since 2010, with substantial heterogeneity across all facets of methodology—study designs, exposures and outcomes of interest, terminology, and reporting of dietary intake data—thus limiting the ability to synthesize evidence in this scope of the literature. This evidence map highlights gaps and important areas for improvement to strengthen the state of research and better inform future policies and dietary recommendations on added sugars.

The Effects of an Anti-inflammatory Dietary Consultation on Self-efficacy, Adherence and Selected Health Outcomes: A Randomized Control Trial

Research has shown that an anti-inflammatory diet can reduce inflammation and improve health outcomes in individuals with neurological disability, however, long term adherence is challenging. This study aimed to determine the effects of a 2-part dietary consultation, targeted at identified barriers for adherence in this population, on self-efficacy for adhering to an anti-inflammatory diet, as well as adherence and health outcomes one-month post-intervention. Eleven individuals (10 female, age 51.5±12.6 years) with neurological disability (7 multiple sclerosis, 3 spinal cord injury, 1 muscular dystrophy; 20.5 ± 10.6 years post-injury/diagnosis) participated. The intervention group (n = 7) received recipes for an anti-inflammatory diet and the consultation, while controls (n = 4) received the recipes only. The consultation included a home-visit involving cooking and accessible kitchen equipment demonstrations, and an accompanied trip to the grocery store. Task and barrier self-efficacy improved immediately following the consultation with trends for improvement one-month post-intervention. The consultation was also associated with increased dietary adherence one-month post-intervention and decreased depressive symptoms. Changes in dietary adherence (r = −.61; P = .045), and barrier self-efficacy (r = −.77; P = .009) were negatively correlated to changes in depression. Thus, a consultation targeted at barriers related to anti-inflammatory eating can improve self-efficacy for adherence as well as actual adherence and depressive symptomology one-month later.

Incidence and persistence of post-COVID condition in children – a matched cohort study in Germany

Abstract Introduction Long-term health effects of COVID-19 have been investigated by several large cohort studies. As most of these studies have been conducted in adults, data on the incidence and persistence of post-COVID-19 condition (PCC) among children and adolescents are still limited. Methods Using routine healthcare data from statutory health insurance in Germany, children and adolescents with laboratory-confirmed COVID-19 in 2020 were matched to controls (neither documented nor clinically suspected COVID-19) and followed for incident health conditions until 2021-09-30. To study PCC in children we considered selected health outcomes including malaise/fatigue (R53), dyspnea (R06.0), and cognitive dysfunction (F06.7, U51, R41), developmental delay (F80-89), adjustment disorder (F43), chronic fatigue syndrome (CFS; G93.3), and altered smell/anosmia (R43). The incidence of PCC was determined based on the lack of related diagnoses in the 12 months preceding the index quarter. For each outcome incidence rate ratios (IRR) were estimated using Poisson regression. Results At 3-month-follow-up, about 40% more individuals with COVID-19 suffered from at least one of the specified health conditions compared to controls. IRR were highest for smell/anosmia and CFS. IRR were generally higher among adolescents (≥12 years) than among younger children. Only a minority of PCC diagnoses persisted for 12 months within the COVID cohort. Diagnoses were more frequently persistent in the younger age group after one year. Conclusions Despite that long-term consequences of COVID-19 are less common and usually less severe in children, a considerable share of those diagnosed with PCC still suffered from specific symptoms 12 months after acute infection. Considering the high number of infected persons our findings suggest a relevant PCC related burden for health care even among children and adolescents. Key messages • In routine healthcare data adolescents showed stronger associations between COVID-19 and post COVID-19 related ICD-10 diagnoses than children &amp;lt; 12 years of age. • Serious ICD-10 diagnoses persisted for a longer time in younger children than adolescents.

How a “Something Else” Response Option for Sexual Identity Affects National Survey Estimates of Associations Between Sexual Identity, Reproductive Health, and Substance Use

This randomized experiment tested whether the inclusion of a “something else” response option for a question about sexual identity in a national health survey would significantly moderate estimated differences between sexual identity subgroups in terms of various health outcomes, including substance use and reproductive health. We conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (NSFG; 2015–2019), where two large national half-samples were randomly assigned to receive one of two different versions of a question about sexual identity (a four-category version that included a “something else” response option or a three-category version omitting this option). We focused on national estimates of differences between subgroups defined by sexual identity. Multivariable models indicated that the estimated subgroup differences changed in a statistically significant fashion when using the four-category version of the sexual identity question for several measures, including 16% of male measures (household size, past-year cigarette use, and past-year illicit drug use) and 15% of female measures (wanting a/another child, ever had a sexually transmitted disease, and past-year marijuana use). The absence of a “something else” response option for questions about sexual identity in national health surveys may cause respondents to select options that do not accurately describe their identities, and this can have a significant effect on national estimates of differences between sexual identity subgroups in terms of selected health outcomes.

Effect of Yakson Touch Technique on Selected Health Outcomes among Preterm Neonates in the Neonatal Intensive Care Units

Effect of Yakson Touch Technique on Selected Health Outcomes among Preterm Neonates in the Neonatal Intensive Care Units

Mail to One or Mail to All? An Experiment (Sub)Sampling Drop Point Units in a Self-Administered Address-Based Sampling Frame Survey

Practitioners utilizing an address-based sampling frame for a self-administered, mail contact survey must decide on how to handle drop points, which are single delivery points or receptacles that service multiple households. A variety of strategies have been adopted, including sampling all units at the drop point or subsampling just one (or a portion) of them. This paper reports results from an experiment fielded during the 2021 Healthy Chicago Survey aimed at providing insight into whether there are any substantive differences between these approaches. We find that a subsampling strategy in which a single mailing is sent produces a roughly 3 percentage point higher response rate relative to a strategy sending multiple mailings concurrently to the drop point. While base-weighted distributions of gender and age differed enough to be statistically significant, there were no noteworthy differences across other demographics or across the base-weighted distributions of select key health outcomes measured by the survey. Taken together, these results provide some evidence that a “mail to one” drop point strategy is more efficient than a “mail to all” drop point strategy.