Challenges and lessons learnt from conducting a health survey in an ethnically diverse population

2021 ◽  
pp. 140349482110546
Author(s):  
Siv Steffen Nygaard ◽  
Abirami Srivarathan ◽  
jimmi Mathisen ◽  
Maria Kristiansen ◽  
Ulla Christensen ◽  
...  
Keyword(s):  
Social Relations ◽  
Social Housing ◽  
Ethnically Diverse ◽  
Response Rates ◽  
Cultural Barriers ◽  
Third Wave ◽  
The Third ◽  
Language Groups ◽  
Lessons Learnt ◽  
Housing Area

Aim: To document the challenges of developing and executing an interviewer-driven survey questionnaire in an ethnically diverse and deprived social housing area undergoing reconstruction in Denmark. Methods: The survey was initially planned to be conducted in three waves (before, during and after reconstruction of the housing area), based on a questionnaire covering health, wellbeing and social relations. The first two waves took place in 2018 and 2019 (invited n=~600 per wave) and the third wave will be conducted once the reconstruction is finalised. The approach to the third wave is under revision by the research team. The questionnaire was translated from Danish into the seven most common languages in the housing area. A bilingual interview team went door to door interviewing residents. Field notes were collected systematically during each wave to document the process. Results: The response rates were 35% ( n=209) and 22% ( n=132) for waves 1 and 2, respectively. There was an overall decrease in response rates between waves 1 and 2 for all language groups, but particularly for Arabic and Turkish-speaking men. The most frequently stated reasons for non-participation included illness and language barriers. The key lessons learnt were that overcoming linguistic and cultural barriers to conducting research among residents in this social housing area requires time and resources. Conclusions: Several challenges are associated with conducting a survey in ethnically diverse and deprived social housing areas. Documenting the challenges and learning from experience are both important, in order to include this hard-to-reach population in health research.

scholarly journals Social relations and self-rated health in a multi-ethnic social housing area undergoing demolition

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M F Kvorning ◽  
A Srivarathan ◽  
S Nygaard ◽  
R Lund
Keyword(s):  
Social Relations ◽  
Social Housing ◽  
Structural Changes ◽  
Ethnically Diverse ◽  
Political Agenda ◽  
Residential Areas ◽  
Self Rated Health ◽  
Housing Area ◽  
Increased Risk ◽  
Contact Frequency

Abstract Background During the coming years, selected social housing areas in Denmark will undergo large structural changes as part of a political agenda. Previous studies on the effects of such interventions are inconclusive. Residential areas are important for the development of social relations and health. The aim of this study was to explore the associations between social relations and self-rated health (SRH) and the interaction with country of origin in an ethnically diverse social housing area undergoing demolition, and compare results with the municipality. Methods Data include multilingual interviewer driven surveys with residents aged 45+ years before demolition began in 2018 (N = 209) and during the demolition in 2019 (N = 132), and a health survey on municipality level (N = 1638). Information on social relations include contact frequency with and support from family, friends and neighbors. SRH was dichotomized into high/low. Descriptive and multivariate logistic regression analyses adjusted for age, sex and Western/non-Western origin are presented. Results In cross-sectional analyses from 2018, low contact frequency and low support increased the risk of low SRH, OR = 1.44 (0.63-3.29) and OR = 1.23 (0.62-2.48), especially when also having non-Western origin compared to having high contact frequency or support and Western origin, OR = 6.27 (1.80-21.84) and OR = 4.43 (1.68-11.69), respectively. The same association was seen in 2019 and on municipality level. Low contact frequency in 2018 was associated with higher risk of developing or maintaining low SRH in 2019 compared to the group with high contact frequency in 2018 in longitudinal analyses, OR = 3.04 (0.91-10.91). Conclusions Poor social relations increased the risk of low SRH, especially when also having non-Western origin. Having poor social relations before the demolition was associated with an increased risk of developing or maintaining low SRH during the demolition in an ethnically diverse social housing area. Key messages Having low contact frequency before area demolition in a social housing area in Denmark increased the risk of developing or maintaining low self-rated health after demolition had begun. Having poor social relations and non-Western origin is associated with a strong increased risk of low self-rated health in a deprived ethnic diverse social housing area in Denmark.

Tone of Postcards in Increasing Survey Response Rates

2004 ◽  
Vol 94 (2) ◽  
pp. 444-448 ◽  
Author(s):  
James H. Price ◽  
Faith Yingling ◽  
Eileen Walsh ◽  
Judy Murnan ◽  
Joseph A. Dake
Keyword(s):  
Elementary School ◽  
Response Rates ◽  
Survey Response ◽  
Third Wave ◽  
Chi Square ◽  
Mail Surveys ◽  
The Third ◽  
Significant Difference ◽  
Chi Square Test ◽  
Second Wave

This study assessed differences in response rates to a series of three-wave mail surveys when amiable or insistently worded postcards were the third wave of the mailing. Three studies were conducted; one with a sample of 600 health commissioners, one with a sample of 680 vascular nurses, and one with 600 elementary school secretaries. The combined response rates for the first and second wave mailings were 65.8%, 67.6%, and 62.4%, respectively. A total of 308 amiable and 308 insistent postcards were sent randomly to nonrespondents as the third wave mailing. Overall, there were 41 amiable and 52 insistent postcards returned, not significantly different by chi-square test. However, a separate chi-square test for one of the three studies, the nurses' study, did find a significant difference in favor of the insistently worded postcards.

scholarly journals Social Relations, Community Engagement and Potentials: A Qualitative Study Exploring Resident Engagement in a Community-Based Health Promotion Intervention in a Deprived Social Housing Area

2020 ◽  
Vol 17 (7) ◽  
pp. 2341
Author(s):  
Abirami Srivarathan ◽  
Rikke Lund ◽  
Ulla Christensen ◽  
Maria Kristiansen
Keyword(s):  
Health Promotion ◽  
Social Relations ◽  
Ethnic Diversity ◽  
Social Housing ◽  
Local Context ◽  
Health Promotion Intervention ◽  
Community Based Interventions ◽  
Post Intervention ◽  
Community Based ◽  
Housing Area

Emerging evidence points towards a lower quality of life, fragile social relations and suboptimal health behavior and status of residents living in social housing areas characterized by ethnic diversity and socioeconomic deprivation. Community-based health promotion interventions developed in collaboration with the target group and adjusted to the local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in deprived social housing areas. This study explores residents’ perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analyzed with focuses on participation in an everyday life context, concepts of othering, and territorial stigmatization. Engagement in the intervention was motivated by the need to establish and enhance social relations, and to explore the world outside the housing area. However, barriers including cultural and language differences among residents, and competing contextual factors, challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in deprived social housing areas. However, adequate support and efforts to overcome the identified barriers are needed.

Effect on Survey Return Rates of Having a Signed or Unsigned Postcard as the Third-Wave Mailing

2003 ◽  
Vol 92 (3_suppl) ◽  
pp. 1099-1102 ◽  
Author(s):  
James H. Price ◽  
Sutoidem Akpanudo ◽  
Joseph A. Dake ◽  
Joann Kleinfelder
Keyword(s):  
Mail Survey ◽  
Response Rates ◽  
Third Wave ◽  
Chi Square ◽  
Return Rates ◽  
The Third ◽  
Chi Square Test

This study assessed differences in response rates to a three-wave mail survey when signed or unsigned postcards were the third wave of the mailing (after two mailings of the questionnaire). A total of 259 signed postcards and 259 unsigned postcards were mailed as the third-wave mailing. There were 34 signed postcards and 30 unsigned postcards returned, a not significantly different distribution by chi-square test.

scholarly journals Health, well-being and social relations in a changing neighbourhood: protocol for a prospective, multimethods study of the consequences of large structural changes in an ethnic diverse social housing area in Denmark

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e030936 ◽  
Author(s):  
Rikke Lund ◽  
Ulla Christensen ◽  
Jimmi Mathisen ◽  
Kristine S Sørensen ◽  
Abirami Srivarathan ◽  
...  
Keyword(s):  
Social Relations ◽  
Social Housing ◽  
Large Scale ◽  
Structural Changes ◽  
Personal Data ◽  
Well Being ◽  
User Engagement ◽  
Structural Interventions ◽  
Residential Areas ◽  
Housing Area

IntroductionResidential areas constitute an important arena for health, well-being and social relations. Structural interventions such as demolition and area renewal have been used to reduce inequality in health and well-being in disadvantaged areas. However, the effects of larger structural interventions are inconclusive. In a longitudinal perspective, this study aims to analyse how large-scale structural changes in an ethnic diverse social housing area are associated with the residents’ health, well-being and social relations.Methods and analysisIn this multimethods study, we examine this aim among middle-aged and older residents in a multiethnic social housing area in a Danish municipality by the inclusion of comprehensive survey (in 2018, 2019 and 2020), register (yearly 2015–2025) and qualitative (2018–2020) data. Municipal Health Profile survey data from 2017 and 2021 will be used for comparison. The area will undergo large structural changes in the built environment during 2018–2021. A ‘natural experiment’ (n=6000) compares differences in health and social outcomes across the study period between the study area and a similar neighbouring area not undergoing structural changes. Through user engagement in the design of the study, throughout the different phases of the study and in the two co-created interventions embedded in the study design, a focus on empowerment and recognition of the resources and perspectives of residents are encouraged.Ethics and disseminationThe study is registered in the University of Copenhagen’s record of biobanks and research projects containing personal data and will be conducted in accordance with the principles of the Helsinki Declaration. Residential and municipal representatives and local non-governmental organisations are engaged in the design and execution of the study to ensure the usefulness, reflexive interpretation of data, and relevance of interventions. Results will be published in international peer-reviewed scientific journals, presented at conferences and as short reports through the use of both written and visual outputs.

scholarly journals Health, well-being and social relations in a changing neighbourhood

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Lund ◽  
U Christensen ◽  
J Mathisen ◽  
A Srivarathan ◽  
D Molbo ◽  
...  
Keyword(s):  
Social Relations ◽  
Social Housing ◽  
Structural Changes ◽  
Intervention Development ◽  
Well Being ◽  
Control Area ◽  
User Engagement ◽  
Communication Tool ◽  
Non Governmental Organizations ◽  
Housing Area

Abstract The main purpose of the study is to examine the development in health, wellbeing and social relations among middle-aged and older residents during a four-year period from 2018-2021 in a Danish multi-ethnic social housing area undergoing large structural changes in the built environment. In addition, to develop two interventions with a focus on ensuring social cohesion in the area during the study period. This presentation will provide an overview of the study outline. The presentation will include a description of the study area, the political decisions that have led to the structural changes, the study population and a short overview of the aims and planned sub-studies. To prepare for the workshop discussion of the challenges, advantages and possibilities with the multi-methods approach this is followed by a short introduction to the different methods applied (a three-wave survey and qualitative data as well as two co-created interventions). The study is furthermore including a 'natural experiment' (N∼6.000) with a neighbouring non-profit social housing area not undergoing structural changes as the control area based on register data. The user-engagement in the design of study will be shortly described for example by their involvement in intervention development and by the involvement of citizen representatives and representatives from the Municipality and local non-governmental organizations in the design and execution of the study. Finally, the inclusion of graphical facilitation as a communication tool will be introduced.

scholarly journals 30.M. Workshop: Experiences using a multi-methods study in an ethnic diverse deprived social housing area in Denmark

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Social Relations ◽  
Social Cohesion ◽  
Social Housing ◽  
Large Scale ◽  
Structural Changes ◽  
Synergistic Effects ◽  
Well Being ◽  
Socioeconomic Background ◽  
User Engagement ◽  
Housing Area

Abstract Structural changes are commonly used as a political tool to improve health and wellbeing and reduce health disparities in deprived social housing areas. However, the evidence of effect is limited and ambiguous. Potential consequences are both positive (increasing heterogeneity in socioeconomic background of residents, better overall health) and negative (poorer social cohesion, stress due to relocation of residents). In Denmark, a number of social housing areas have recently been selected for large structural changes based on a politically defined list of indicators related to the socio-economic status and ethnicity of the residents. The setting for the workshop is a prospective multi-methods study of health, wellbeing and social relations among residents in one of the selected social housing areas in the period 2015-2025 with a focus on middle-aged and older residents, 'Health, Well-being and Social Relations in a Changing Neighbourhood'. Twenty percent of the apartment blocks in the area will be demolished in the period 2019-2020. This study provides a unique opportunity to explore the effects of large-scale structural changes in a longitudinal and multi-methods perspective. Thus, the study aims to increase our understanding of how changes affect the health, well-being and social relations among residents from different perspectives. Through user engagement in the design of the study and in particular in the two co-created interventions embedded in the study design, a focus on empowerment and recognition of the resources and perspectives of residents is encouraged. The main objectives of this workshop is to present and discuss the advantages and challenges with the different methodological approaches and communicative tools and how to gain synergistic effects of this approach within the setting of the research project. The workshop will include five presentations followed by a discussion. A focus on the multiple methods employed in the project and how they interact and supplement each other will bind the presentations together. The purpose is to share and discuss with the public health research community the experienced advantages as well as challenges with this approach. The project includes: A three wave survey (before, during and after the structural changes) (target population N∼600 in each wave). A needs assessment based on 31 qualitative interviews and results from the first survey wave. Two co-created interventions with a main purpose of ensuring social cohesion in the community during the structural changes. Register-based information on health and social factors in the period 2015-2025 on all residents living in the social housing area as well as in a similar neighbouring control social housing area not undergoing structural changes until 2023 (natural experiment approach). Novel in this area, graphic illustrative methods will be included as an instrument for increasing communication success and as part of the interventions. Key messages The workshop offers insight on synergistic effects of a longitudinal, multi-methods study exploring health and social effects of large-scale structural changes in an ethnic diverse social housing area. Offers a discussion of the challenges with data collection in a period with Danish state level political decisions leading to significant structural changes in deprived social housing areas.

Experiences and challenges in collecting survey data in an ethnically diverse social housing area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Nygaard ◽  
A Srivarathan ◽  
J Mathisen ◽  
M Kristiansen ◽  
R Lund
Keyword(s):  
Health Disparities ◽  
Health Research ◽  
Social Housing ◽  
Economically Disadvantaged ◽  
Ethnically Diverse ◽  
Recruitment Strategy ◽  
Social Mechanisms ◽  
Disadvantaged Groups ◽  
Housing Area ◽  
New Challenges

Abstract Socio-economically disadvantaged groups are characterised by a higher burden of disease than the background population. Paradoxically, they are often underrepresented in health research. Failing to include socio-economically disadvantaged groups in research impairs the ability to address the social mechanisms creating health disparities. The study describes how we have tried to accommodate identified challenges from the literature in conducting a questionnaire survey in a socio-economically deprived and ethnically diverse social housing area, and which new challenges we identified. The survey is planned before, during and after the structural changes take place. Through innovative approaches, we sought to accommodate identified barriers to reaching participants. The questionnaire was translated from Danish to the seven most prevalent languages in the area, based on data from the national register. A survey corps of native speaking interviewers went door-to-door to perform face-to-face interviews. To encourage participation, we used a recruitment strategy inspired by ethnographic data collection traditions, such as local presence, participation in local activities, and graphic facilitation on invitation letters. Wave 1 and 2 had a response rate of 35% (N = 209) and 22% (N = 132), respectively. 79 respondents participated in both waves. Despite our efforts to accommodate identified challenges such as language, illiteracy, and mistrust, the response rates are low. We identified new challenges in recruiting participants including participation fatigue, frustration with the restructure process, and a feeling of limited individual gain from participation. Many challenges are associated with conducting research among socio-economically disadvantaged groups. Documenting processes and learning from experiences are important steps in including groups with lower socio-economic status in health research in order to address the underlying social mechanisms creating health disparities.

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