Survey Completion Rate Research Articles

Assessment of country implementation of the WHO global health sector strategy on sexually transmitted infections (2016-2021).

BackgroundIn 2016, WHO launched the Global Health Sector Strategy on STIs, 2016–2021 (GHSS) to provide guidance and benchmarks for country achievement by 2020 and four global targets for achievement by 2030.MethodsA country survey jointly developed by experienced technical personnel at WHO Headquarters (HQ) and WHO regional offices was reviewed and distributed by WHO regional advisors to 194 WHO Member States in September-March 2020. The survey sought to assess implementation and prioritization of STI policy, surveillance, service delivery, commodity availability, and surveillance based on targets of the GHSS.ResultsA majority (58%, 112/194) of countries returned a completed survey reflecting current (2019) STI activities. The regions with the highest survey completion rates were South-East Asia Region (91%, 10/11), Region of the Americas (71%, 25/35) and Western Pacific Region (67%, 18/27). Having a national STI strategy was reported by 64% (72/112) and performing STI surveillance activities by 88% (97/110) of reporting countries. Availability of STI services within primary health clinics was reported by 88% of countries (99/112); within HIV clinics by 92% (103/112), and within reproductive health services by 85% (95/112). Existence of a national strategy to eliminate mother-to-child transmission of HIV and syphilis (EMTCT) was reported by 70% of countries (78/112). Antimicrobial resistance (AMR) monitoring for gonococcal infection (gonorrhoea) was reported by 64% (57/89) of reporting countries with this laboratory capacity. Inclusion of HPV vaccine for young women in the national immunization schedule was reported by 59% (65/110) and availability of cervical cancer screening was reported by 91% (95/104). Stockouts of STI medicines, primarily benzathine penicillin, within the prior four years were reported by 34% (37/110) of countries.ConclusionsMechanisms to support improvements to STI service delivery through national-level policy, commitment, programming and surveillance are needed to operationalize, accelerate and monitor progress towards achievement of the 2030 global STI strategy targets.

Validation and comparison of fall screening tools for predicting future falls among older adults

BackgroundFalls are the leading cause of injuries among older adults in the United States (US). Falls are preventable and clinicians are advised to screen for fall risk yearly. There are many falls screening tools and not all have been validated for their ability to predict future falls. MethodsWe enrolled 1905 community-dwelling older adults into a 13-month study using a probability-based representative panel of the US population recruited from NORC at the University of Chicago's National Frame. Respondents completed a baseline survey, 11 monthly fall calendars, and a final survey. The baseline survey included six falls screening tools (the Stay Independent, Three Key Questions (3KQ), a modified American Geriatric/British Geriatric tool, the short Falls Efficacy-1[FES-I]) and two single screening questions (“I have fallen in the past year” and “How many times did you fall in the past 12 months?”). The baseline and final survey collected demographic and health information, including falls. Sensitivity, specificity, positive and negative likelihood ratios, and corresponding 95% confidence intervals were calculated in SAS using weighted proportions. ResultsThere were 1563 respondents who completed the final survey (completion rate 82%). Sensitivity estimates ranged from 22.5% for the short FES-I to 68.7% for the 3KQ. Specificity estimates ranged from 57.9% for the 3KQ to 89.4% for the short FES-I. ConclusionsFalls screening tools have varying sensitivity and specificity for predicting the occurrence of a fall in the following 12 months.

Smartphone-based Ecological Momentary Assessment to study "scanxiety" among Adolescent and Young Adult survivors of childhood cancer: A feasibility study.

ObjectiveScan‐related anxiety (“scanxiety”) refers to the fear, stress, and anxiety in anticipation of tests and scans in follow‐up cancer care. This study assessed the feasibility of Ecological Momentary Assessment (EMA) for real‐world, real‐time capture of scanxiety using patients' personal smartphone.MethodsAdolescent and Young Adult survivors of childhood cancer were prompted to complete EMA surveys on a smartphone app three times per day for 11 days (33 surveys total) around their routine surveillance scans. Participants provided structured feedback on the EMA protocol.ResultsThirty out of 46 contacted survivors (65%) enrolled, exceeding the preregistered feasibility cutoff of 55%. The survey completion rate (83%) greatly exceeded the preregistered feasibility cutoff of 65%. Participants generally found the smartphone app easy and enjoyable to use and reported low levels of distress from answering surveys. Participants reported significantly more daily fear of cancer recurrence (FCR) and negative affect in the days before compared to the days after surveillance scans, aligning with the expected trajectory of scanxiety. Participants who reported greater FCR and scanxiety using comprehensive measures at baseline also reported significantly more daily FCR around their surveillance scans, indicating validity of EMA items. Bodily threat monitoring was prospectively and concurrently associated with daily FCR, thus warranting further investigation as a risk factor for scanxiety.ConclusionsFindings indicate the feasibility, acceptability, and validity of EMA as a research tool to capture the dynamics and potential risk factors for scanxiety.

Characterization of Near-Infrared Imaging and Indocyanine-Green Use Amongst General Surgeons: A Survey of 263 General Surgeons

BackgroundNear-infrared fluorescence imaging (NIRFI) is an increasingly utilized imaging modality, however its use amongst general surgeons and its barriers to adoption have not yet been characterized.MethodsThis survey was sent to Canadian Association of General Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons members. Survey development occurred through consensus of NIRFI experienced surgeons.ResultsSurvey completion rate for those opening the email was 16.0% (n = 263). Most respondents had used NIRFI (n = 161, 61.2%). Training, higher volumes, and bariatric, thoracic, or foregut subspecialty were associated with use (P < .001).Common reasons for NIRFI included anastomotic assessment (n = 117, 72.7%), cholangiography (n = 106, 65.8%), macroscopic angiography (n = 66, 41.0%), and bowel viability assessment (n = 101, 62.7%). Technical knowledge, training and poor evidence were cited as common barriers to NIRFI adoption.ConclusionsNIRFI use is common with high case volume, bariatric, foregut, and thoracic surgery practices associated with adoption. Barriers to use appear to be lack of awareness, low confidence in current evidence, and inadequate training. High quality randomized studies evaluating NIRFI are needed to improve confidence in current evidence; if deemed beneficial, training will be imperative for NIRFI adoption.

An analysis of missed injuries at a level 1 trauma center with a tertiary survey protocol

BackgroundTertiary surveys can help identify missed injuries, but how and when to conduct them remains uncertain. This study aimed to evaluate the outcomes of a policy requiring tertiary survey completion within 24 h post-admission. MethodsA retrospective review was performed with a pre-intervention time-period of 8/1/2019-1/31/2020, where tertiary surveys were performed prior to discharge (n = 762). During the post-intervention time-period of 8/1/2020-1/31/21 tertiary surveys were performed within 24 h of admission (n = 651). ResultsMissed injury (1.6% [n = 12] vs. 1.5% [n = 10]; p = 0.953) and mortality rates (3.1% vs. 3.7%, p = 0.579) were similar between the pre- and post-intervention groups. Tertiary survey completion rates were higher (86.8% vs. 80.2%; p = 0.001) and exams performed earlier (1[1-1] vs. 1 [1–2] day, p < 0.001) in the post-intervention group. For those with missed injuries, time to injury identification and number of injuries identified on tertiary survey was unchanged. ConclusionRequiring tertiary surveys within 24 h of admission can help identify and correct missed injuries, but standardization of the tertiary survey process and documentation may be as important as the timing.

Social Determinants of Health Data Availability for Patients with Eye Conditions.

Purpose:To quantify and characterize social determinants of health (SDoH) data coverage using single-center electronic health records (EHRs) and the National Institutes of Health All of Us research program.Design:Retrospective cohort study from June 2014 through June 2021.Participants:Adults 18 years of age or older with a diagnosis of diabetic retinopathy, glaucoma, cataracts, or age-related macular degeneration.Methods:For All of Us, research participants completed online survey forms as part of a nationwide prospective cohort study. In local EHRs, patients were selected based on diagnosis codes.Main Outcome Measures:Social determinants of health data coverage, characterized by the proportion of each disease cohort with available data regarding demographics and socioeconomic factors.Results:In All of Us, we identified 23 806 unique adult patients, of whom 2246 had a diagnosis of diabetic retinopathy, 13 448 had a diagnosis of glaucoma, 6634 had a diagnosis of cataracts, and 1478 had a diagnosis of age-related macular degeneration. Survey completion rates were high (99.5%–100%) across all cohorts for demographic information, overall health, income, education, and lifestyle. However, health care access (12.7%–29.4%), housing (0.7%–1.1%), social isolation (0.2%–0.3%), and food security (0–0.1%) showed significantly lower response rates. In local EHRs, we identified 80 548 adult patients, of whom 6616 had a diagnosis of diabetic retinopathy, 26 793 had a diagnosis of glaucoma, 40 427 had a diagnosis of cataracts, and 6712 had a diagnosis of age-related macular degeneration. High data coverage was found across all cohorts for variables related to tobacco use (82.84%–89.07%), alcohol use (77.45%–83.66%), and intravenous drug use (84.76%–93.14%). However, low data coverage (< 50% completion) was found for all other variables, including education, finances, social isolation, stress, physical activity, food insecurity, and transportation. We used chi-square testing to assess whether the data coverage varied across different disease cohorts and found that all fields varied significantly (P < 0.001).Conclusions:The limited and highly variable data coverage in both local EHRs and All of Us highlights the need for researchers and providers to develop SDoH data collection strategies and to assemble complete datasets.

Abstract P050: Transcending The Geographical Barrier: Design And Preliminary Findings From The Mhealth Component Of The Rural Study

Background: The rural population in the Southeastern United States has been historically understudied despite an elevated risk of cardiovascular disease. Mobile technology can help elucidate the epidemiology of cardiovascular disease in rural areas when deployed in a culturally appropriate manner. Objectives: To describe the design of a mobile health (mHealth) electronic cohort embedded in a longitudinal cohort study, the Risks Underlying Rural Areas Longitudinal (RURAL), evaluate the feasibility, and report preliminary findings on survey completion and smartwatch adherence rates. Methods: Eligible and consenting participants were mailed a wearable activity tracker and, if needed, a smartphone. Participant-reported outcomes were collected using the RURAL smartphone app that deployed validated instruments at 24-hours, 7-days, 1-month, 3-month, and 6-month intervals. Remote support was provided when participants had not completed their surveys or their activity tracker data were not passively collected over the previous seven days. Results: Participants (N=52) were enrolled between February and June of 2021 over a teleconference “setup” call; among them, 11 requested a study smartphone. Participants were on average 50.9 ± 10.4 years of age, nearly a third were men (n=18), and approximately two-thirds (n=34) were Black. We contacted 41 participants due to overdue surveys and lack of smartwatch syncing in the previous 7 days. Nearly all participants completed the surveys at 24-hours (48/52), at 7-days (49/52), 1-month (47/52), and 3-months (47/52). Participants, on average, had nearly 1 day of missing smartwatch data over at least three months of observed data; average wear-time was 83%. Data stratified by participants’ use of study smartphones are described in Table 1. Conclusions: Although previous mHealth research has demonstrated challenges working in rural populations without consistent access to smartphones, we have demonstrated high adherence and participation by providing frequent support.

Quantifying Contact Patterns: Development and Characteristics of the British Columbia COVID-19 Population Mixing Patterns Survey

PurposeSeveral non-pharmaceutical interventions such as physical distancing, self-isolation, a stay-at-home order, hand washing, and schools and businesses closures were implemented in British Columbia (BC) following the first lab-tested case of COVID-19 on January 26, 2020. These interventions were aimed at minimizing in-person contacts that could potentially lead to new COVID-19 infections. The BC COVID-19 Population Mixing Patterns survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. We describe the BC-Mix survey design and the demographic characteristics of respondents.Methods & MaterialsThe ongoing repeated online survey was launched in September 2020. Participants are recruited through a variety of social media platforms including Instagram, Facebook, YouTube, and community group mailing lists. A follow up survey is sent to participants two to four weeks after completing the first iteration. Survey responses are weighted to BC's population by age, sex, geography, and ethnicity to obtain generalizable estimates. A survey completion rate of at least 33% AND a valid response for the sex questionnaire item AND a valid response for age questionnaire item were required for inclusion in weighting and further analysis. Additional indices such as material and social deprivation index, and residential instability are generated using census and location data.ResultsAs of June 14, 2021, over 58,000 residents of BC had participated in the survey of which 31,007 survey responses were eligible for analysis. Of the eligible participants, about 60% provided consent for monthly follow up and about 26% provided their personal health numbers for linkage with other healthcare utilization databases. Approximately 51% were females 39% were 55 years or older, 63% identified as white or not a visible minority and 48% had at least a university degree.ConclusionThe pandemic response is best informed by surveillance systems capable of timely assessment of behaviour patterns. BC-Mix survey respondents represented a large cohort of British Columbians providing near real-time information on behavioural and contact patterns in BC. Data from the BC-Mix survey continues to inform provincial COVID-19-related control measures.

A Feasibility Study: Testing Whether a Sleep Application Providing Objective Sleep Data to Physicians Improves Patient-Physician Communication Regarding Sleep Experiences, Habits, and Behaviors.

IntroductionSleep tracker data have not been utilized routinely in sleep-related disorders and their management. Sleep-related disorders are common in primary care practice and incorporating sleep tracker data may help in improving patient care. We conducted a pilot study to assess the feasibility of a sleep program using the Fitbit Charge 2™ device and SleepLife® application. The main aim of the study was to examine whether a program using a commercially available wearable sleep tracker device providing objective sleep data would improve communication in primary care settings between patients and their providers. Secondary aims included whether patient satisfaction with care would improve as result of the program.MethodsA prospective, randomized, parallel group, observational pilot study was conducted in 20 primary care clinics in Indianapolis, IN from June 2018 to February 2019. Inclusion criteria included patients over the age of 18, have a diagnosis of insomnia identified by electronic medical record and/or a validated questionnaire, and were on a prescription sleep aid. The study was not specific to any sleep aid prescription, branded or generic, and was not designed to evaluate a drug or drug class. Each primary care clinic was randomized to either the SleepLife® intervention or the control arm. All patients were provided with a Fitbit Charge 2™ device. Only patients in the intervention arm were educated on how to use the SleepLife® application. Physicians in the intervention arm were set up with the SleepLife® portal on their computers.ResultsForty-nine physicians and 75 patients were enrolled in the study. Patients had a mean age of 57 (SD 12.8) years and 61% were female. Mean age of physicians was 47 (SD 10.6) years. Patients showed high rates of involvement in the program with 83% completing all survey questions. Physician survey completion rate was 55%. Only one physician logged into the SleepLife portal to check their patients’ sleep status. At the end of the 6-week intervention, patients’ composite general satisfaction scores with sleep health management decreased significantly in the intervention arm when compared to controls (p = 0.03). Patients’ satisfaction with communication also decreased significantly in the intervention group (p = 0.01). The sleep outcomes, which were calculated on the basis of study questionnaire answers, improved significantly in the intervention group as compared to the control group (p = 0.04). Physician communication satisfaction scores remained unchanged (p = 0.12).ConclusionsSleepLife® and its related physician portal can facilitate physician–patient communication, and it captures patient sleep outcomes including behaviors and habits. Patients were highly engaged with the program, while physicians did not demonstrate engagement. The study design and questionnaires do not specifically address the reasons behind the decreased patient satisfaction with care and communication, but it was perceived to be a result of physician non-responsiveness. Sleep quality scores on the other hand showed an improvement among SleepLife® users, suggesting that patients may have implemented good sleep practices on their own. Given that it was a feasibility study, and the sample size was small, we were not able to make major inferences regarding the difference between sleep disorder types. Additionally, we excluded patients with a history of alcohol use, substance abuse, or depression because of concerns that they may affect sleep independently. To promote the growth of technology in primary care, further research incorporating results from this study and physician engagement techniques should be included.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-021-02013-0.

Does Primary Care Fill the Gap in Access to Specialty Mental Health Care? A Mixed Methods Study.

BackgroundBroad consensus supports the use of primary care to address unmet need for mental health treatment.ObjectiveTo better understand whether primary care filled the gap when individuals were unable to access specialty mental health care.Design2018 mixed methods study with a national US internet survey (completion rate 66%) and follow-up interviews.ParticipantsPrivately insured English-speaking adults ages 18–64 reporting serious psychological distress that used an outpatient mental health provider in the last year or attempted to use a mental health provider but did not ultimately use specialty services (N = 428). Follow-up interviews were conducted with 30 survey respondents.Main MeasuresWhether survey respondents obtained mental health care from their primary care provider (PCP), and if so, the rating of that care on a 1 to 10 scale, with ratings of 9 or 10 considered highly rated. Interviews explored patient-reported barriers and facilitators to engagement and satisfaction with care provided by PCPs.Key ResultsOf the 22% that reported they tried to but did not access specialty mental health care, 53% reported receiving mental health care from a PCP. Respondents receiving care only from their PCP were less likely to rate their PCP care highly (21% versus 48%; p = 0.01). Interviewees reported experiences with PCP-provided mental health care related to three major themes: PCP engagement, relationship with the PCP, and PCP role.ConclusionsPrimary care is partially filling the gap for mental health treatment when specialty care is not available. Patient experiences reinforce the need for screening and follow-up in primary care, clinician training, and referral to a trusted specialty consultant when needed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-07260-z.

Cannabis Use among Patients with Alopecia Areata: A Cross-Sectional Survey Study.

Importance:Little is known about cannabis use among patients with alopecia areata (AA). These patients often experience significant psychosocial burden and may seek alternative therapies beyond that of traditional medical treatments, such as cannabis.Objective:To characterize cannabis use among patients with AA.Design:This was a cross-sectional study conducted from March 9, 2021, to March 22, 2021, using a web-based survey distributed to adult patients with AA using the National AA Foundation's email listserv and social media platforms.Results:1,087 participants completed the survey (completion rate: 88.1%). Most participants were female (n = 870, 83.3%) and Caucasian (n = 771, 73.8%), with a mean age of 47.6 ± 15.5 years. 65.9% (n = 689) of participants with AA had a history of cannabis use and among those, 51.8% (n = 357) were current cannabis users. The most common reason for cannabis use among current users was for AA-related symptoms (n = 199, 55.7%), with the greatest perceived improvement in symptoms of stress (n = 261, 73.1%) and anxiety, sadness, and depression (n = 234, 65.6%). 80.4% (n = 287) indicated that cannabis had no impact on their hair loss.Conclusion:Cannabis use is common among patients with AA and is often used to alleviate the psychosocial symptoms related to AA, despite the lack of perceived improvement in hair regrowth.

Crowd-sourced web survey for household travel diaries

This study presents an open-source, web-based, self-completion and/or personal-interview survey platform, namely Travel Survey as a Service (TSaaS), which currently hosts three different survey types. This study proposes to use the TSaaS platform as the crowd-sourced data collection approach for household travel diaries. The TSaaS provides flexibility to conduct multiple surveys for different purposes/locations simultaneously using a web survey format. For better control of the data collection process, multiple survey links for household travel diaries (or any other survey) in a region can be created. Eventually, collected data can be processed jointly or separately as per the requirements. The data is recorded in an efficient data structure. Personal information and location are neither asked nor tracked using devices or otherwise. To assist in recalling the activity locations, a location-search field is provided and integrated with a map. The permanent address, trip origin, and destination are recorded as the nearest landmark on the map, and the location is shown as a marker on the map. The marker on the map can be adjusted to correct the location if required. A pilot study was conducted in Jaipur, and three different data collection approaches are attempted. The approaches are compared in terms of survey completion rate, survey completion time, and time-cost of each approach. The crowd-sourced web survey turns out to be the most efficient in terms of the time-cost per completed survey record and most suitable to collect a large number of survey records in an urban agglomeration.

Standardization of ileoanal J-pouch surgery technique: Quality assessment of minimally invasive ileoanal J-pouch surgery videos

BackgroundIleal pouch anal anastomosis is a complex procedure associated with significant morbidity, with several complications after ileal pouch anal anastomosis surgery leading to pouch failure. The aim of the study is to evaluate the heterogeneity surrounding the technique of ileoanal J-pouch surgery by assessing the safety and quality of published online peer-reviewed surgical videos. MethodsIleal pouch anal anastomosis videos published on peer-reviewed surgical journals and video channels were edited and anonymized to demonstrate specific steps of the surgical procedure: mobilization and division of the rectum, formation of the ileoanal J-pouch reservoir, anastomosis, and lengthening techniques. The anonymized videos were presented to a group of reviewers with expertise in ileal pouch anal anastomosis blinded to the names and affiliations of the surgeons performing the procedure. Primary outcome was the rate of interobserver variability in the assessment of specific technical steps of the ileal pouch anal anastomosis surgery procedure. Secondary outcome was the appropriateness of the use of surgical videos review as an assessment tool for ileal pouch anal anastomosis surgery, measured as rate of reviewers being unable to answer for poor video quality. ResultsIn total, 29 video fragments were distributed, and 13 assessors completed a 60-item survey, organized in 7 major domains. The survey completion rate was 93.4%. Out of a total 729 answers, in 23 (3.2%) the reviewers indicated they were unable to comment due to poor video image, and in 48 (6.5%) were unable to comment due to the particular step not being shown in the procedure. The proportion of assessors rating rectal mobilization technically appropriate ranged from 30.7% to 92.3% and from 7.7% to 69.2% for safety. The level of rectal division was considered appropriate in 0 to 53.8% of the videos, whereas the stapling technique used for rectal division was appropriate in 0 to 70% of the videos. ConclusionOur study assessed published peer-reviewed videos on ileal pouch anal anastomosis surgery and reported heterogeneity in the safety of the demonstrated techniques. Blind assessment of published peer-reviewed ileal pouch anal anastomosis videos reported a high rate of unsafe or inappropriate technique for rectal mobilization and transection in the reviewed videos, with fair interobserver agreement among reviewers. There is a need for consensus on what is considered safe and appropriate in ileal pouch anal anastomosis surgery. Peer review of ileal pouch anal anastomosis surgery videos could facilitate training and accreditation in this complex procedure.

A Study Looking at the Teaching of Peripheral Arterial Disease to Medical Personnel in Nepal: How well are we doing and how might we be able to improve?

Background There is currently no data showing the prevalence of peripheral arterial disease in Nepal, although they have a high incidence of risk factors in their population such as diabetes, hypertension, and high volume of smoke inhalation.&#x0D; Objective To quantify a gap in medical education curriculum in Nepal as it pertains to medical trainees that have a lack of exposure to peripheral arterial disease (PAD) in a clinical setting as well as improve lecture quality on peripheral arterial disease.&#x0D; Method A survey was sent out to 615 medical trainees in Nepal with a survey completion rate of 44%. The results indicate that both medical students and intern doctors feel most confident in their ability to diagnose peripheral arterial disease and comfortable ordering a workup for peripheral arterial disease when their education includes both a dedicated lecture and care of a patient.&#x0D; Result The self-reported ability to diagnose peripheral arterial disease increased in medical students from 21.9% in the lecture only group to 44.4% in the group who had both lecture and cared for a patient. The current curriculum at the Kathmandu University School of Medical Sciences only allows two hours in the medical school to cover all vascular topics and is taught with a traditional PowerPoint method.&#x0D; Conclusion To improve this area of curriculum, we recommend increasing the allotted time for lectures as well as demonstrate on live patients the evaluation for peripheral arterial disease.

Management of anticoagulation in pregnant women with venous thromboembolism: An international survey of clinical practice

IntroductionVenous thromboembolism (VTE) is an important cause of maternal morbidity and mortality. During pregnancy, VTE is treated with low-molecular-weight-heparin (LMWH). Studies assessing the optimal duration and peripartum management of therapeutic anticoagulation are lacking. This survey aimed to assess clinician practices for the management of anticoagulation in pregnant women with acute VTE. MethodsAn electronic survey consisting of clinical scenarios addressing anticoagulation management for VTE in pregnancy was created. The target sample was clinicians likely to be involved in the management of pregnant women with acute VTE. The survey completion rate and proportion of individuals selecting a response were determined. Results96 respondents completed the survey including general internists (56.3%), hematologists (21.9%), and obstetricians (6.3%). In the management of a VTE in first or second trimester, most respondents preferred therapeutic LMWH until 6 weeks postpartum. In the first and second trimester, 48.0% and 37.5% of respondents, respectively, opted to reduce the dose of anticoagulation after 3 or 6 months. 29.2% of physicians opted for bridging with intravenous heparin around delivery when treating a VTE in the third trimester. 73.0% perceived an increased risk of clinically relevant non-major bleeding associated with the use of therapeutic anticoagulation in the peripartum and postpartum periods. ConclusionsThe survey highlights a wide variability of practice in the management of therapeutic anticoagulation in pregnancy. Larger scale studies with relevant clinical outcomes including thrombosis and bleeding risks are needed to inform clinical practice.

The experience of remote recruitment for Essential Coaching for Every Mother during the coronavirus disease 2019 pandemic.

ABSTRACTIntroduction and aims:Due to physical distancing recommendations because of the COVID-19 pandemic, recruitment approaches for perinatal research needed to shift from in-person to remote. The purpose of this study is to describe the recruitment and retention of women for an mHealth intervention study for Essential Coaching for Every Mother.Methods:Three methods were used for recruitment: social media, posters in hospital, and media outreach. First time mothers were eligible for enrollment antenatally (37+ weeks) and postnatally (<3 weeks). Eligibility screening occurred remotely via text message. Outcomes were days to recruit 75 participants, eligibility vs. ineligibility rates, dropout and exclusion reasons, survey completion rates, perinatal timing of enrollment, and recruitment sources.Results:Recruitment ran from 15 July to 19 September 2020 (67 days) with 200 potential participants screened and 88 enrolled. It took 50 days to enroll 75 participants. Women recruited antenatally were more likely to receive all intervention messages (68 vs. 19%) and miss fewer messages (6.4 vs. 13.8) than women enrolled postnatally. Participants heard about the study through family/friends (31%), news (20%), Facebook groups/ads (30%), posters (12%), or other (7%).Conclusion:Antenatal recruitment resulted in participants enrolling earlier and receiving more messages. Remote recruitment was a feasible way to recruit, with word of mouth and media outreach being most successful, followed by Facebook.

Strategies to Estimate Prevalence of SARS-CoV-2 Antibodies in a Texas Vulnerable Population: Results From Phase I of the Texas Coronavirus Antibody Response Survey

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and immunity remains uncertain in populations. The state of Texas ranks 2nd in infection with over 2.71 million cases and has seen a disproportionate rate of death across the state. The Texas CARES project was funded by the state of Texas to estimate the prevalence of SARS-CoV-2 antibody status in children and adults. Identifying strategies to understand natural as well as vaccine induced antibody response to COVID-19 is critical.Materials and Methods: The Texas CARES (Texas Coronavirus Antibody Response Survey) is an ongoing prospective population-based convenience sample from the Texas general population that commenced in October 2020. Volunteer participants are recruited across the state to participate in a 3-time point data collection Texas CARES to assess antibody response over time. We use the Roche Elecsys® Anti-SARS-CoV-2 Immunoassay to determine SARS-CoV-2 antibody status.Results: The crude antibody positivity prevalence in Phase I was 26.1% (80/307). The fully adjusted seroprevalence of the sample was 31.5%. Specifically, 41.1% of males and 21.9% of females were seropositive. For age categories, 33.5% of those 18–34; 24.4% of those 35–44; 33.2% of those 45–54; and 32.8% of those 55+ were seropositive. In this sample, 42.2% (89/211) of those negative for the antibody test reported having had a COVID-19 test.Conclusions: In this survey we enrolled and analyzed data for 307 participants, demonstrating a high survey and antibody test completion rate, and ability to implement a questionnaire and SARS-CoV-2 antibody testing within clinical settings. We were also able to determine our capability to estimate the cross-sectional seroprevalence within Texas's federally qualified community centers (FQHCs). The crude positivity prevalence for SARS-CoV-2 antibodies in this sample was 26.1% indicating potentially high exposure to COVID-19 for clinic employees and patients. Data will also allow us to understand sex, age and chronic illness variation in seroprevalence by natural and vaccine induced. These methods are being used to guide the completion of a large longitudinal survey in the state of Texas with implications for practice and population health.

The impact of COVID-19 on teachers' mental health

PurposeThe purpose of this paper is to examine teachers’ experiences with mental health during the COVID-19 pandemic.Design/methodology/approachThe authors administered an online survey to full-time public school teachers simultaneously enrolled in a master’s degree program in education. Out of 455 teachers who were sent the survey, 96 completed it, resulting in a 21.1% survey completion rate. The survey was composed of both quantitative and qualitative items which assessed teachers’ self-perceptions about their mental health before and during the COVID-19 pandemic, as well as their use of mental health resources. Most questions were drawn from the Patient Health Questionnaire-4 (PHQ-4), so focused primarily on symptoms of depression and anxiety.FindingsThe results of the survey indicated that overall, teachers felt an increase in symptoms of anxiety and depression between March 2020 and February 2021. A noteworthy percentage of participants said they were seeking mental health supports.Research limitations/implicationsThis study was conducted with teachers in an alternative certification program, so their experiences might not be widely generalizable to teachers enrolled in traditional pathways to certification.Originality/valueWhile some research has been conducted on mental health, less has been conducted with public school teachers and even less has assessed the impact of the COVID-19 pandemic. This study aims to add to the existing literature about teachers' experiences with anxiety and depression, as well as the specific impact of COVID-19.

Data Collection Smart and Simple: Evaluation and Metanalysis of Call Data From Studies Applying the 5Q Approach

Agricultural development projects often struggle to show impact because they lack agile and cost-effective data collection tools and approaches. Due to the lack of real-time feedback data, they are not responsive to emerging opportunities during project implementation and often miss the needs of beneficiaries. This study evaluates the application of the 5Q approach (5Q). It shows findings from analyzing more than 37,000 call log records from studies among five countries. Results show that response rate and completion status for interactive voice response (IVR) surveys vary between countries, survey types, and survey topics. The complexity of question trees, the number of question blocks in a tree, and the total call duration are relevant parameters to improve response and survey completion rate. One of the main advantages of IVR surveys is low cost and time efficiency. The total cost for operating 1,000 calls of 5 min each in five countries was 1,600 USD. To take full advantage of 5Q, questions and question-logic trees must follow the principle of keeping surveys smart and simple and aligned to the project's theory of change and research questions. Lessons learned from operating the IVR surveys in five countries show that the response rate improves through quality control of the phone contact database, using a larger pool of phone numbers to reach the desired target response rate, and using project communication channels to announce the IVR surveys. Among other things, the respondent's first impression is decisive. Thus, the introduction and the consent request largely determine the response and completion rate.

Depression Level Prediction in People with Parkinson's Disease during the COVID-19 Pandemic.

Many recent studies show that the COVID-19 pandemic has been severely affecting the mental wellness of people with Parkinson's disease. In this study, we propose a machine learning-based approach to predict the level of anxiety and depression among participants with Parkinson's disease using surveys conducted before and during the pandemic in order to provide timely intervention. The proposed method successfully predicts one's depression level using automated machine learning with a root mean square error (RMSE) of 2.841. In addition, we performed model importance and feature importance analysis to reduce the number of features from 5,308 to 4 for maximizing the survey completion rate while minimizing the RMSE and computational complexity.