Telephone Survey Respondents Research Articles

Individual-Level Cultural Factors and Use of Survey Response Styles Among Latino Survey Respondents

Acquiescent (ARS) and extreme response styles (ERS) can have detrimental effects on survey data and, for unknown reasons, are more frequently used by Latino than non-Latino white respondents. This exploratory study examined the influence of culture on these response styles by investigating their associations with individual-level cultural factors and ARS and ERS among 1,296 Mexican American, Puerto Rican, and Cuban American telephone survey respondents. Principal components representing stronger endorsement of marianismo/ machismo and social attentiveness ( simpatía, personalismo, respect for elders, value for sincerity, collectivism, individualism) were associated with higher ARS and ERS, while higher trust in strangers and more limited health literacy were associated with lower ERS. Findings from this study will enable survey designers to better anticipate ARS and ERS in surveys with Latino populations and, in turn, guide the selection of data collection and analysis methods to mitigate measurement error in the presence of these response styles.

Integrating Venezuelan Migrants into the Colombian Health System during COVID-19

ABSTRACT Colombia provides a unique setting to understand the complicated interaction between health systems, health insurance, migrant populations, and COVID-19 due to its system of Universal Health Coverage and its hosting of the second-largest population of displaced persons globally, including approximately 1.8 million Venezuelan migrants. We surveyed 8,130 Venezuelan migrants and Colombian nationals across 60 municipalities using a telephone survey during the first wave of the pandemic (September through November 2020). Using self-reported enrollment in one of the several Colombian health insurance schemes, we analyzed the access to and disparities in the use of health-care services for both Colombians and Venezuelan migrants by insurance status, including access to formal health services, virtual visits, and COVID-19 testing for both groups. We found that compared with 3.6% of Colombians, 73.6% of Venezuelan telephone survey respondents remain uninsured, despite existing policies that allow legally present migrants to enroll in national health insurance schemes. Enrolling migrants in either the subsidized or contributory regime increases their access to health-care services, and equality between Colombians and Venezuelans within the same insurance schemes can be achieved for some services. Colombia’s experience integrating Venezuelan migrants into their current health system through various insurance schemes during the first wave of their COVID-19 pandemic shows that access and equality can be achieved, although there continue to be challenges.

Expulsion of Immediate Postplacental Copper IUDs at Six Weeks: A Prospective Cohort Study [5A

INTRODUCTION: Postplacental intrauterine device (IUD) placement could improve contraceptive access and child spacing. We sought to report a precise point estimate of the proportion of TCu380A IUDs expelled 6 weeks after immediate postplacental placement, and to assess risk factors for expulsion. METHODS: We enrolled women who received a TCu380A IUD after vaginal delivery beyond 33 weeks gestation from April 2015-August 2016. A sample size of 195 enabled us to detect a 15% expulsion proportion with a 95% confidence interval of ±6%. Follow-up to determine IUD status occurred 6 weeks postpartum. RESULTS: 195 women enrolled. Six weeks postpartum, 155 of 171 (90.6%) telephone survey respondents believed their IUD was in place, and 136 (79.5%) reported high satisfaction. Of the 147 women who completed a pelvic exam, 104 had a correctly positioned IUD and continued its use (70.7% [95% CI 63.4-78.1%]). Mechanical IUD complications included: 10 complete expulsions (6.8%), 14 partial expulsions (IUD in cervix; 9.5%), 5 devices in the lower uterine segment (3.4%), and 8 rotated in the uterus (5.4%). IUD strings were visible on exam for 112 subjects (76.2%); of these, 90 (80.4%) had correctly positioned devices. There were no statistically significant associations between clinical covariates assessed and IUD continuation. CONCLUSION: In our cohort, continuation of a correctly positioned IUD was 71% at 6 weeks postpartum. Mechanical complications occurred in 25%, and visualization of IUD strings did not assure fundal placement. The significance of malpositioned IUDs requires further investigation. Participants were satisfied with postplacental IUD access.

Walking for recreation and transport by geographic remoteness in South Australian adults.

To determine differences in walking for recreation and transport between Accessibility/Remoteness Index of Australia (ARIA) categories, in South Australian adults. Cross-sectional self-reported data from adult telephone survey respondents between April and May in 2012 and 2013. Population of South Australia. A total of 4004 adults (aged over 18years) participated: n=1956 men and n=2048 women. Area of residence was categorised using ARIA (major city, inner regional, outer regional and remote/very remote). Self-reported participation in walking for transport and recreation/exercise as the number of times and minutes per week. Data were analysed using Kruskal-Wallis test for median minutes and negative binomial regression for times walked with adjustment for socioeconomic status, age and body mass index. Average age was 47.8±18.5years, 51.1% were women, 70.9% lived in the major cities, 14.6% in inner regional, 10.8% in outer regional and 3.6% in remote/very remote areas. Relative to major city, times walked for recreation was lower for only remote/very remote residents (incidence rate ratio (IRR) 0.74 (95%CI 0.59-0.92), P=0.008). This difference was only observed for men (IRR 0.54 (95%CI 0.39-0.73), P<0.001). Relative to major city, times walked for transport was less for inner regional (IRR 0.74 (95%CI 0.67-0.85), P<0.001) and outer regional (IRR 0.64 (95%CI 0.56-0.74), P<0.001) only. This difference in transport walking was seen in both men and women. Frequency of walking varied by purpose, level of remoteness and sex. As walking is the focus of population-level health promotion, more detailed understanding of the aetiology of regular walking is needed.

Influenza and pneumococcal vaccination: do older people know if they have been vaccinated?

Objective:To estimate influenza and pneumococcal immunisation rates by self‐report and validate this with immunisation providers. Method:A random population telephone survey. This was followed by contacting immunisation providers of those reporting having an influenza vaccination (2009 or 2010 only) and/or pneumococcal vaccination to confirm vaccination or not. Results:A total of 680 people aged 65 and older responded to the telephone survey. Seventy‐five per cent of respondents self‐reported influenza vaccination in 2010 and 26% self‐reported having ever had the pneumococcal vaccination. Following up with immunisation providers, we found recall for influenza vaccination was confirmed in 96% of cases. For the pneumococcal vaccination, recall for vaccination was confirmed in 87% of cases. People saying they were not vaccinated for pneumococcal were subsequently confirmed as vaccinated in 77% of cases. Conclusions:In this study, self‐reported influenza vaccination was reliable. The term ‘pneumococcal vaccination or Pneumovax’ was poorly recognised by our telephone survey respondents as evident by the low rate of self‐reported pneumococcal vaccination compared to a much higher rate of pneumococcal vaccinations recorded by GPs. Implications:While pneumococcal vaccination is an accurate term, researchers should be aware of the terminology used in general practice and the community when designing their survey.

Proximity to Fast-Food Outlets and Supermarkets as Predictors of Fast-Food Dining Frequency

BackgroundThis study used cross-sectional data to test the independent relationship of proximity to chain fast-food outlets and proximity to full-service supermarkets on the frequency of mealtime dining at fast-food outlets in two major urban areas, using three approaches to define access. Interactions between presence of a supermarket and presence of fast-food outlets as predictors of fast-food dining were also tested. MethodsResidential intersections for respondents in point-of-purchase and random-digit-dial telephone surveys of adults in Philadelphia, PA, and Baltimore, MD, were geocoded. The count of fast-food outlets and supermarkets within quarter-mile, half-mile, and 1-mile street network buffers around each respondent’s intersection was calculated, as well as distance to the nearest fast-food outlet and supermarket. These variables were regressed on weekly fast-food dining frequency to determine whether proximity to fast food and supermarkets had independent and joint effects on fast-food dining. ResultsThe effect of access to supermarkets and chain fast-food outlets varied by study population. Among telephone survey respondents, supermarket access was the only significant predictor of fast-food dining frequency. Point-of-purchase respondents were generally unaffected by proximity to either supermarkets or fast-food outlets. However, ≥1 fast-food outlet within a 1-mile buffer was an independent predictor of consuming more fast-food meals among point-of-purchase respondents. At the quarter-mile distance, ≥1 supermarket was predictive of fewer fast-food meals. ConclusionsSupermarket access was associated with less fast-food dining among telephone respondents, whereas access to fast-food outlets were associated with more fast-food visits among survey respondents identified at point-of-purchase. This study adds to the existing literature on geographic determinants of fast-food dining behavior among urban adults in the general population and those who regularly consume fast food.

Web-based and telephone surveys to assess public perception toward the national health insurance in taiwan: a comparison of cost and results.

BackgroundNumerous studies have examined the impact of global budget payment systems of health insurance on patient access to medical care. In order to monitor the population’s accessibility to health services, a series of survey are often used to understand public perceptions of the health care provider. Taiwan implemented the single-payer National Health Insurance in 1995 and has been conducting a series of surveys to monitor public perception of the NHI after adopting a global budget payment system in 2002. Although telephone surveys are commonly used in obtaining public opinions on various public health issues, limitations such as higher cost and influence of interviewers do raise some concerns. Web-based surveys, one of the alternative methods, may be free from these problems.ObjectiveOur aim was to examine the difference of sociodemographic characteristics, satisfaction of NHI and NHI-contracted health care providers, attitude toward NHI-related issues, behavior in seeking medical advice and self-reported health status between those who completed Web-based surveys and those reached by telephone.MethodsThis study compared the demographic factors of participants who took either a Web-based survey (1313 participants) or random digit dialing telephone survey (2411 participants) that contained identical questions.ResultsCompared to telephone survey respondents, Web-based respondents tended to be younger (P<.001), unmarried (P<.001), non-smokers (P<.001), with a higher education (P<.001), and a higher monthly household income (P<.001) and worse self-reported health status (P=.008); however, they were less likely to report suffering from a chronic disease (P<.001). Despite these differences in background characteristics, no significant differences were observed in their answers related to the seeking of medical care or NHI-related issues. Telephone survey respondents reported greater satisfaction with NHI services. Web-based surveys were also shown to provide a lower average cost per sample (US$0.71) compared to telephone surveys (US$3.98).ConclusionsWeb-based surveys provide a low-cost alternative method for the polling of public attitudes toward NHI-related issues. Despite general similarities between the two polling methods with regard to responses, respondents to telephone surveys reported a stronger agreement with regard to satisfaction with NHI services and a more positive self-reported health status.

Who reports noticing and using calorie information posted on fast food restaurant menus?

Objective: Identify consumer characteristics that predict seeing and using calorie information on fast food menu boards. Methods: Two separate data collection methods were used in Philadelphia during June 2010, several weeks after calorie labeling legislation went into effect: (1) point-of-purchase survey and receipt collection conducted outside fast food restaurants (N = 669) and (2) a random digit dial telephone survey (N = 702). Logistic regressions were used to predict the odds of reporting seeing, and of reporting seeing and being influenced by posted calorie information. Results: Approximately 35.1% of point-of-purchase and 65.7% of telephone survey respondents reported seeing posted calorie information, 11.8% and 41.7%, respectively, reported that the labels influenced their purchasing decisions, and 8.4% and 17% reported they were influenced in a healthful direction. BMI, education, income, gender, consumer preferences, restaurant chain, and frequency of visiting fast food restaurants were associated with heterogeneity in the likelihood of reporting seeing and reporting seeing and using calorie labels. Conclusion: Demographic characteristics and consumer preferences are important determinants in the use of posted calorie information. Future work should consider the types of consumers this information is intended for, and how to effectively reach them.

Chronic conditions and lifestyle behavior after cancer: The differences between 2,103 cancer cases and 4,185 age and gender matched controls.

9585 Background: Weight gain and inactivity after cancer are associated with poorer cancer outcomes and may predispose to chronic conditions but the prevalence of these among cancer survivors is not well defined. The objectives of this cross-sectional study were to determine whether those with history of cancer have a greater prevalence of chronic conditions and whether their lifestyle behaviours differ from cancer free controls. Methods: Cross-sectional self-reported data were obtained from adult telephone survey respondents between January 2010 and March 2012. Age and gender matched individuals who did not report a cancer diagnosis were randomly selected from the same data source as controls. Data reported included rates of cardiovascular disease, hypertension, hyperlipidaemia, diabetes, and osteoporosis, lifestyle behaviours (diet, physical activity and smoking), obesity, psychological distress and self-reported health. Between-group differences were assessed using McNemar’s test. Results: 2,103 cases and 4,185 controls were included in the analyses. Cancer cases had a higher prevalence than controls for all chronic conditions: cardiovascular disease 22.1% vs 18.4%, p=0.001; hypertension 53.3% vs 50%, p=0.015; hyperlipidaemia 47.8% vs 41.8%, p&lt;0.001; diabetes 16% vs 13%, p=0.006; osteoporosis 13% vs 11%, p=0.013. There were no differences in diet, exercise or obesity. Cancer cases were more likely to report “very high” psychological distress (2.9% vs 1.7%, p=0.005) and “poor-fair” self-rated health (33.5% vs 22.9%, p&lt;0.001). Conclusions: Despite similar diet and exercise habits and levels of obesity the prevalence of chronic conditions was significantly higher amongst those with history of cancer compared to controls. Further research is warranted to explain this increased predisposition to chronic conditions.

Abstract WP174: Public Perceived Risk of Stroke, Myocardial Infarction, and Cancer

Introduction: Stroke is the fourth leading cause of death in the United States, yet community stroke awareness remains low. Perceptions of individual risk prompt changes in health behavior. Previous reports show community awareness is higher for heart disease than stroke. We hypothesized that public perception of their personal risk of MI and cancer would be significantly higher than stroke. Methods: Telephone survey respondents were drawn from our biracial population of 1.3 million using random-digit dialing in 2010 to reflect the age, race, and gender distribution of stroke patients, based an ongoing stroke incidence study in the same region.Respondents were asked to rate their risk of having a stroke, heart attack, cancer, and for women, breast cancer on a scale of 0-10. Analysis was restricted to 1959 of 2036 respondents who were of black or white race. Comparisons were made using analysis of covariance to adjust for age, education, hypertension, diabetes, smoking, coronary artery disease (CAD) and prior stroke. Results: Respondents were well-matched to previous descriptions of ischemic stroke populations: 28% black, 61% female, with a mean age of 66.3((±14.7). Overall, respondents thought they had the highest risk of MI, followed by stroke and cancer. However, blacks had a significantly lower perceived risk of stroke, MI, and cancer, after adjusting for confounders. Discussion: Perceived risk of stroke was higher than we expected compared to other common diseases, second only to heart attack. Blacks had significantly lower perceived risks than whites for stroke, MI, and cancer. Future public awareness campaigns should consider linking risks of stroke with risks of MI, especially as MI and stroke share many preventative strategies. Racial differences in perceived risk should be evaluated as a target for intervention as perceived risk is associated with changes in health behavior.

Abstract TMP108: Ongoing Use and Withdrawal of Antithrombotic Medication for Medical Procedures in the Greater Cincinnati population

Introduction: Withdrawal of antithrombotic medication for medical procedures is a potentially important cause of ischemic stroke (Broderick, Stroke, 2011). However, population estimates of how commonly persons in the general population withdraw from antithrombotic medication during a given year are not available. Methods: Telephone survey respondents were drawn from our biracial population of 1.3 million using random-digit dialing in 2011 to reflect the age, race, and gender distribution of stroke patients, based on an ongoing stroke incidence study in the same region. In addition to demographic and medical history questions, we also asked if they had stopped the medication on request of their physician for scheduled surgery or other procedure during the past 60 days. Results: There were a total of 2036 surveyed, 1959 self-identified as either black (544) or white (1415) race. 62% were on antithrombotic medication overall of which 7% were on an anticoagulant and 58% were on an antiplatelet medication and 4% on both (Table 1). Use of antithrombotic medication increased with advancing age (p&lt;0.0001) and was more common in men (64%) than women (60%), p=0.09 and whites (64%) than blacks (55%), p=0.0003. Of those persons 75 years or older, 72% were taking an antithrombotic medication: an antiplatelet agent alone in 60%, anticoagulant alone in 6% and both in 6%. Of those using an antithrombotic medication, 10% indicated that they had stopped the medication in the past 60 days prior to interview. Of those that stopped the meds, 27/134 (20%) were on anticoagulants, and 101/1144 (9%) were on antiplatelet agents. Conclusions: Use of antithrombotic medication is widely prevalent in the population as is discontinuance of such medication for medical procedures, particularly warfarin. Withdrawal of anti-thrombotic medications for surgical procedures and diagnostic testing is a potential risk factor for ischemic stroke and is an important area for ongoing study.

Abstract WP176: Racial Differences in Perceived Risk, Self-efficacy, and Fear of Stroke

Introduction: Stroke is the fourth leading cause of death in the United States, yet awareness of stroke risk factors, warning signs and symptoms remain low. Perceptions of risk affect health behavior: higher perceived risk leads to increased behavioral change to lower risk. Within a population representative of ischemic stroke patients, we sought to evaluate racial differences in perceived risk and fear of stroke, as well asself-efficacy to modify risk. Methods: Telephone survey respondents were drawn from our biracial population of 1.3 million using random-digit dialing to reflect the age, race, and gender distribution of stroke patients, based an ongoing stroke incidence study in the same region. Selected questions from the validated Risk Behavior Diagnosis Scale assessed respondents’ perception of personal risk, self-efficacy, and fear of stroke, using a modified Likert scale assigning 1 point for strongly agree and 5 points for strongly disagree. Results: Analysis was restricted to1959 of 2036 respondents contacted in 2010 who were of black or white race. Respondents were matched to previous descriptions of ischemic stroke populations: 28% black, 61% female, with a mean age of 66.3(± 14.7). Overall, respondents thought controlling blood pressure reduces stroke risk and they had the skills to reduce their blood pressure. However, fear and perceived risk of stroke was significantly lower among blacks than whites, after adjusting for age, education, hypertension, diabetes, smoking, coronary artery disease and prior stroke. Discussion: The general public believes stroke is a severe condition, and they have the skills to control blood pressure and lower their risk for stroke. Blacks were less likely to believe stroke is extremely harmful and had lower personal risk of stroke compared to whites after adjusting for confounders. Future public awareness campaigns should focus on communicating personal risk and severity of stroke, especially to black communities.

Survey Response Styles, Acculturation, and Culture Among a Sample of Mexican American Adults

A number of studies have investigated use of extreme (ERS) and acquiescent (ARS) response styles across cultural groups. However, due to within-group heterogeneity, it is important to also examine use of response styles, acculturation, and endorsement of cultural variables at the individual level. This study explores relationships between acculturation, six Mexican cultural factors, ERS, and ARS among a sample of 288 Mexican American telephone survey respondents. Three aspects of acculturation were assessed: Spanish use, the importance of preserving Mexican culture, and interaction with Mexican Americans versus Anglos. These variables were hypothesized to positively associate with ERS and ARS. Participants with higher Spanish use did utilize more ERS and ARS; however, value for preserving Mexican culture and interaction with Mexican Americans were not associated with response style use. In analyses of cultural factors, endorsement of familismo and simpatia were related to more frequent ERS and ARS, machismo was associated with lower ERS among men, and la mujer was related to higher ERS among women. Caballerismo was marginally associated with utilization of ERS among men. No association was found between la mujer abnegada and ERS among women. Relationships between male gender roles and ARS were nonsignificant. Relationships between female gender roles and ARS were mixed but trended in the positive direction. Overall, these findings suggest that Mexican American respondents vary in their use of response styles by acculturation and cultural factors. This usage may be specifically influenced by participants' valuing of and engagement with constructs directly associated with social behavior.

Using risk factor surveillance as a basis for mixed-methodology research: an example from Australia using food intake and anthropometric measures

Risk factor surveillance is an integral part of public health, and can provide a ready-made sample for further research. This study assessed the utility of mixed-methodology research using telephone and postal surveys. Adult respondents to telephone surveys in South Australia and Western Australia were recruited to a postal survey about food consumption, in particular, relating to fruit and vegetables. Responses to the two surveys were compared. Around 60% of eligible telephone survey respondents participated in the postal survey. There was fair to poor agreement between the results from the two methods for serves of fruit and vegetables consumed. There was excellent agreement between the two methods for self-reported height and weight. The telephone survey was a useful way to recruit people to the postal survey; this could be due to the high level of trust gained through the telephone interview, or social desirability bias. It is difficult to ascertain why different results on fruit and vegetable intake were obtained, but it may be associated with understanding of the parameters of a 'serve', recall bias or the time taken to calculate an answer.

Testing survey methodology to measure patients' experiences and views of the emergency and urgent care system: telephone versus postal survey

BackgroundTo address three methodological challenges when attempting to measure patients' experiences and views of a system of inter-related health services rather than a single service: the feasibility of a population survey for identifying system users, the optimal recall period for system use, and the mode of administration which is most feasible and representative in the context of routine measurement of system performance.MethodsPostal survey of a random sample of 900 members of the general population and market research telephone survey of quota sample of 1000 members of the general population.ResultsResponse rates to the postal and market research telephone population surveys were 51% (457 out of 893 receiving the questionnaire) and 9% (1014 out of 11924 contactable telephone numbers) respectively. Both surveys were able to identify users of the system in the previous three months: 22% (99/457) of postal and 15% (151/1000) of telephone survey respondents. For both surveys, recall of event occurrence reduced by a half after four weeks. The telephone survey more accurately estimated use of individual services within the system than the postal survey. Experiences and views of events remained reasonably stable over the three month recall time period for both modes of administration. Even though the response rate was lower, the telephone survey was more representative of the population, was faster and cheaper to undertake, and had fewer missing values.ConclusionsIt is possible to identify users of a health care system using a population survey. A recall period of three months can be used to estimate experiences and views but one month is more accurate for estimating use of the system. A quota sample market research telephone survey gives a low response rate yet is more representative and accurate than a postal survey of a random sample of the population.

A comparison of web-based and telephone surveys for assessing traffic safety concerns, beliefs, and behaviors

Introduction The purpose of this investigation was to compare the results of a web-based and a telephone interview survey measuring driver concerns about a variety of traffic safety issues, their beliefs, and specific driving behaviors. Method State-wide, annual random digit-dial telephone surveys and web-based surveys were conducted in Maryland. A total of 1,700 drivers were surveyed by telephone and 6,806 took a web survey. Results Telephone respondents were more likely to be female and older. Web respondents were more likely to be white and not Latino/Hispanic. After controlling for demographic differences, telephone survey respondents were more likely to be concerned about traffic safety. They were more likely to believe that sobriety checkpoints reduce drunk driving (OR = 2.18, 95% CI 1.94, 2.45), they would be ticketed for not wearing a seat belt (OR = 1.26, 95% CI 1.12, 1.43), and they would be stopped by the police if they drove after drinking too much (OR = 1.17, 95% CI 1.03, 1.32). They were less likely to report a variety of risky behaviors including using a cell phone while driving (OR = .54, 95% CI .48, .61) and driving 10+ mph over the speed limit (OR = .81, 95% CI .72, .91), but were more likely to report having been ticketed for a moving violation in the last month (OR = 2.22, 95% CI 1.70, 2.90). Suggestions are offered for overcoming potential sources of sampling bias. Impact on Industry Web-based surveys produce substantially different results than random-digit-dial telephone surveys, when used for public assessments of traffic safety concerns and behaviors.

Developing a Spatially Enabled Inventory of Recreational Boats Using Vessel Registration Data

Effective waterway management requires information on the characteristics and locations of boats. A field-based boat census—a traditional method to obtain spatially accurate information—is relatively expensive, time-consuming, and restrictive in scope. Vessel registration data, maintained by all U.S. states, is potentially a more robust information source. This research evaluated the accuracy and reliability of vessel registration data to supply location and attribute information for boats. The study premise was to use vessel registration data, which includes the mailing address of registered boat owners, to develop a spatially enabled inventory of boats. The study area comprised 12,064 salt-water accessible property parcels in two Florida counties. An on-water census (OWC) provided location and characteristics for 5,023 vessels, which were compared to 8,681 vessel registration records linked to the study area. Discrepancies between the OWC and vessel registration data were explained by a stratified, random sample of 485 telephone survey respondents. Study results show that vessel registration data accurately located and characterized roughly 81% of the boat population; in contrast, the OWC accurately located less than 56%. A conclusion is that state vessel registration data is a better alternative than an OWC for locating and characterizing boats kept along waterways.

Internet Connectedness and its Social Origins: An Ecological Approach to Postaccess Digital Divides

This study examines the influence of sociocultural factors on the level of “Internet connectedness.” The Internet Connectedness Index (ICI), composed of five items, is modified and applied to measure disparities in the ways in which people use the Internet. With a dataset of 384 randomly selected telephone survey respondents, the ICI is regressed on various social indicators. The result indicates that technological environments, social environments, and the scope and intensity of Internet-related goals significantly influence individuals' Internet connectedness. This finding highlights that even after people gain access to the Internet, the ways they incorporate the Internet into their everyday lives differ, and that the differences reflect disparities in the multiple dimensions of the social context in which individuals are situated.

Opinions as Norms

This research investigates the impact of normative intensity (i.e., strength of feeling) and crystallization (i.e., level of agreement) regarding communication behaviors and perceptions of social sanctions. By adapting the return potential model originally set forth by Jay Jackson, the authors examine perceptions of communication behaviors as a normative opinion process. Telephone survey respondents were asked to offer their own personal opinions regarding several communicative behaviors. By calculating the normative power (NP = Normative Intensity × Crystallization) associated with each of these behaviors, predictions were made regarding the frequency of behavior. The authors also connect normative power with the social costs ascribed to acts falling outside the accepted realm of behavior. Results indicate that public opinion can be seen as a normative process in which the intensity and crystallization of the climate of opinion exert influence on behavior in various communication situations.

New Challenges for Telephone Survey Research in the Twenty-First Century

Telephone surveys are critical for examining cross-sectional characteristics of population subgroups, tracking trends in prevalence of conditions and risk behaviors over time, identifying risk factors associated with multiple health conditions, and assessing the effects of interventions. Technology has aided telephone research through advances such as computer-assisted telephone interviewing. However, technology such as answering machines and caller ID has contributed to declines in response rates and has increased costs of conducting telephone surveys. The exponential increase in cell phone utilization presents a challenge to the tradition of random digit dial (RDD) surveys of households. Because telephone surveys are used by other industries such as marketing and public opinion polling, the marketplace may help drive innovation and adaptation. Cell phones have made telephone communication an even greater part of the everyday culture and could make potential telephone survey respondents even more accessible to public health researchers.