The Effects of Tobacco Coverage in the Public Communication Environment on Young People’s Decisions to Smoke Combustible Cigarettes

In today’s complex media environment, does media coverage influence youth and young adults’ (YYA) tobacco use and intentions? We conceptualize the “public communication environment” and effect mediators, then ask whether over time variation in exogenously measured tobacco media coverage from mass and social media sources predicts daily YYA cigarette smoking intentions measured in a rolling nationally representative phone survey (N = 11,847 on 1,147 days between May 2014 and June 2017). Past week anti-tobacco and pro-tobacco content from Twitter, newspapers, broadcast news, Associated Press, and web blogs made coherent scales (thetas = 0.77 and 0.79). Opportunities for exposure to anti-tobacco content in the past week predicted lower intentions to smoke (Odds ratio [OR] = 0.95, p < .05, 95% confidence interval [CI] = 0.91–1.00). The effect was stronger among current smokers than among nonsmokers (interaction OR = 0.88, p < .05, 95% CI = 0.77–1.00). These findings support specific effects of anti-tobacco media coverage and illustrate a productive general approach to conceptualizing and assessing effects in the complex media environment.

Satisfaction and Experience of Palliative Patients with 24/7 Hotline Service During the COVID-19 Pandemic in Saudi Arabia

Background: The COVID-19 pandemic prompted a number of shifts on healthcare. Conventional face-to-face visits were shifted during lockdown to virtual ones. Palliative care (PC) virtual visits have had high satisfaction rates, especially with patients in remote areas. Due to a number of factors, further studies are needed to develop tools that can be helpful and cost effective in improving patient’s quality of life. Objective: Our aim is to learn the main reasons palliative patients in Saudi Arabia sought help via calling the free 24/7 hotline and to discuss the hotline’s satisfaction and effectiveness in solving the palliative patient’s concerns during COVID-19. Methods: A cross-sectional sample analysis was obtained from 214 patients from different regions in Saudi Arabia. A total number of 843 calls were made to the 24/7 PC hotlines from the period of 17 April 2020 to 28 February 2021, shortly after COVID-19 pandemic began. The purpose of the call, the caller's relationship to the patient, the status of the complaint, and the satisfaction rate were collected at the end of the call through a voluntary phone survey. Results: The primary reasons that palliative patients called the hotline were: 30% for medication refills, (n=247), 24.7% for medical complaints, (n=205), 15.8% were for booking a new appointment (n=131). Patients themselves accounted for 27.8% of the callers and patient’s sons/daughters accounted for 51.3%. 85% of patients said that their issue had been resolved by the end of the call and 89% of our sample were happy with the service provided through the hotline. Conclusion: The 24/7 hotline service for PC patients in Saudi Arabia was successful in its application and resulted in a high level of satisfaction among a wide sample of participants. The main reasons palliative patients reached out were to request medication refills, seek assistance with a medical complaint, and to book a new appointment. Our hotline service effectively solved 85% of patients' issues.

Covid-19, Rural Poverty, and Women’s Role in Decision-Making: Evidence from Khatlon Province in Tajikistan

The covid-19 pandemic has had devastating effects globally; it has caused health crises and economic recessions, leading unemployment to spike and disrupting food systems and supply chains. In the heavily remittance-dependent context of Tajikistan, however, migration has continued – and appears to have become increasingly dominated by men. In this context, what has happened to women’s perceptions of economic prospects, as well as the well-being of their households? How has women’s involvement in decision-making evolved? And to what extent do out-migration or in-migration of household members predict changes in women’s decision-making power? We consider these questions using a September – October 2020 phone survey deployed in Khatlon province, Tajikistan that successfully tracked 87% of households that had been surveyed in person in 2018. We find that both genders have similar expectations for their agricultural production (harvests), but women are slightly more likely to identify concerns with rising prices and a lack of access to financial services. Overall, we find little in the way of evidence that women’s involvement in intra-household decision-making declined as a result of the pandemic—though this is from a low base. However, we find that women are less likely than are men to report improvements in women’s decision-making authority. Further, we find that out-migration of household members, which is dominated by men, is associated with improvements in women’s decision-making power, particularly with respect to decisions about how to spend household income. Overall, our results point to the need for additional analyses of the gendered impacts of shocks on women in the Central Asia region.

Older People in Germany During the COVID-19 Pandemic:The Least, the More, and the Most Affected

Older people have been identified as a particularly vulnerable group during the COVID-19 pandemic. However, the question of how older people actually fared during the COVID-19 pandemic has only been sporadically addressed. This article aims to partly fill this gap by classifying subgroups of older people using Latent Class Analysis. Indicators used are: risk perception, safety behavior, and well-being. To predict subgroup membership, age, gender, living arrangement, children, chronic illness, conflict, socioeconomic status, and migration history are controlled for. The data analyzed stem from a phone survey among 491 older people (75–100 years) in Germany conducted in September/October 2020. Results show that three subgroups of older people – the least, the more and the most affected – can be formed based on their risk perception, safety behavior, and well-being, indicating the usefulness of these three constructs for identifying and studying older people particularly affected by the COVID-19 pandemic and the measures taken to contain it.

Effectiveness of WhatsApp for measuring migration in follow-up phone surveys - Lessons from a mode experiment in two low-income countries during COVID contact restrictions

Phone surveys have increasingly become important data collection tools in developing countries, particularly in the context of sudden contact restrictions due to the COVID-19 pandemic. Phone surveys offer particular potential for migration scholars aiming to study cross-border migration behavior. Geographic change of location over time complicates the logistics of face-to-face surveys and heavily increases costs. There is, however, limited evidence of the effectiveness of the phone survey modes in different geographic settings more generally, and in migration research more specifically. In this field experiment, we compared the response rates between WhatsApp—a relatively new but increasingly important survey mode—and interactive voice response (IVR) modes, using a sample of 8446 contacts in Senegal and Guinea. At 12%, WhatsApp survey response rates were nearly eight percentage points lower than IVR survey response rates. However, WhatsApp offers higher survey completion rates, substantially lower costs and does not introduce more sample selection bias compared to IVR. We discuss the potential of WhatsApp surveys in low-income contexts and provide practical recommendations for field implementation.

Default options: a powerful behavioral tool to increase COVID-19 contact tracing app acceptance in Latin America?

Given the rates of transmission of COVID-19, relying only on manual contact tracing might be infeasible to control the epidemic without sustained costly lockdowns or rapid vaccination efforts. In the first study of its kind in Latin America, we find through a phone survey of a nationally representative sample of ten countries that an opt-out regime (automatic installation) increases self-reported intention to accept a contact tracing app with exposure notification by 22 percentage points compared to an opt-in regime (voluntary installation). This effect is triple the size and of opposite sign of the effect found in Europe and the United States, potentially due to lower concerns regarding privacy and lower levels of interpersonal trust. We see that an opt-out regime is more effective in increasing willingness to accept for those who do not trust the government or do not use their smartphones for financial transactions. The local severity of the pandemic does not affect our results, but feeling personally at risk increases intent to accept such apps in general. These results can shed light on the use of default options not only for contact tracing apps but in public health overall in the context of a pandemic in Latin America.

Predictors of positive or negative reactions to learning Alzheimer’s biomarker results

With improved detection of Alzheimer’s disease and biomarker accessibility, more adults with no or mild symptoms may learn their AD biomarker results. Yet, potential psychosocial impact of learning AD biomarkers is not well understood. In a phone survey, we assessed potential reactions after learning about a hypothetical positive AD biomarker result. Data were collected from cognitively healthy participants (n=334, mean age=64.8±7.7) enrolled in longitudinal AD studies. Exploratory factor analysis identified five latent factors following a hypothetical positive biomarker result: advanced care planning, lifestyle changes to reduce dementia risk factors, psychological distress, subjective cognitive complaints, and stigma. Using linear regression, we found that predictors of potential pessimistic reactions (distress, cognitive complaints, stigma) included higher trust in research (Distress:b:0.04, p:0.04), no dementia family history (Stigma:b:-0.30,p:0.04), poorer memory self-rating (Cognitive complaints:b:-0.19,p:0.02), and Black racial identity (Cognitive complaints:b:0.30,p:0.02, Stigma:b:0.40,p:0.003). Predictors of potential optimistic reactions (advanced care planning, lifestyle changes) included more trust in research (Planning:b:0.07,p<0.0001) and Black racial identity (Planning:b:0.38,p:0.003), as well as younger age (Lifestyle:b:-0.02,p:0.02) and belief in AD controllability (Planning:b:0.22,p:0.003, Lifestyle:b:0.23,p:0.002). Concern about developing AD was associated with increased likelihood of all potential reactions. While AD concern associates with optimistic and pessimistic potential reactions, specific factors of family history, racial identity, trust, belief in AD controllability, and memory rating differentially predict each of the potential outcomes of learning AD biomarker results. These findings may help target education efforts to prepare and reduce risk of negative reactions for cognitively healthy adults who learn their AD biomarker results.

Representativeness of individual-level data in COVID-19 phone surveys: Findings from Sub-Saharan Africa

The COVID-19 pandemic has created urgent demand for timely data, leading to a surge in mobile phone surveys for tracking the impacts of and responses to the pandemic. Using data from national phone surveys implemented in Ethiopia, Malawi, Nigeria and Uganda during the pandemic and the pre-COVID-19 national face-to-face surveys that served as the sampling frames for the phone surveys, this paper documents selection the biases in individual-level analyses based on phone survey data. In most cases, individual-level data are available only for phone survey respondents, who we find are more likely to be household heads or their spouses and non-farm enterprise owners, and on average, are older and better educated vis-a-vis the general adult population. These differences are the result of uneven access to mobile phones in the population and the way that phone survey respondents are selected. To improve the representativeness of individual-level analysis using phone survey data, we recalibrate the phone survey sampling weights based on propensity score adjustments that are derived from a model of an individual’s likelihood of being interviewed as a function of individual- and household-level attributes. We find that reweighting improves the representativeness of the estimates for phone survey respondents, moving them closer to those of the general adult population. This holds for both women and men and for a range of demographic, education, and labor market outcomes. However, reweighting increases the variance of the estimates and, in most cases, fails to overcome selection biases. This indicates limitations to deriving representative individual-level estimates from phone survey data. Obtaining reliable data on men and women through future phone surveys will require random selection of adult interviewees within sampled households.

Population Health Surveillance Using Mobile Phone Surveys in Low- and Middle-Income Countries: Methodology and Sample Representativeness of a Cross-sectional Survey of Live Poultry Exposure in Bangladesh

Background Population-based health surveys are typically conducted using face-to-face household interviews in low- and middle-income countries (LMICs). However, telephone-based surveys are cheaper, faster, and can provide greater access to hard-to-reach or remote populations. The rapid growth in mobile phone ownership in LMICs provides a unique opportunity to implement novel data collection methods for population health surveys. Objective This study aims to describe the development and population representativeness of a mobile phone survey measuring live poultry exposure in urban Bangladesh. Methods A population-based, cross-sectional, mobile phone survey was conducted between September and November 2019 in North and South Dhaka City Corporations (DCC), Bangladesh, to measure live poultry exposure using a stratified probability sampling design. Data were collected using a computer-assisted telephone interview platform. The call operational data were summarized, and the participant data were weighted by age, sex, and education to the 2011 census. The demographic distribution of the weighted sample was compared with external sources to assess population representativeness. Results A total of 5486 unique mobile phone numbers were dialed, with 1047 respondents completing the survey. The survey had an overall response rate of 52.2% (1047/2006) and a co-operation rate of 89.0% (1047/1176). Initial results comparing the sociodemographic profile of the survey sample to the census population showed that mobile phone sampling slightly underrepresented older individuals and overrepresented those with higher secondary education. After weighting, the demographic profile of the sample population matched well with the latest DCC census population profile. Conclusions Probability-based mobile phone survey sampling and data collection methods produced a population-representative sample with minimal adjustment in DCC, Bangladesh. Mobile phone–based surveys can offer an efficient, economic, and robust way to conduct surveillance for population health outcomes, which has important implications for improving population health surveillance in LMICs.

Mobile phone surveys: The Slovenian case study

In 2004, the number of mobile phone subscriptions in Slovenia reached the total number of inhabitants. Consequently, the fixed telephone coverage has started to decline; almost 10% of households are now available only over the mobile phone. With this, Slovenia positions itself as a typical EU country and can serve as a case study for issues related to mobile phone interview surveys. The paper addresses the general context of mobile phone usage and the calculations of mobile phone coverage rates. It also discusses the non-coverage problems related to mobile and mobile-only households. It is shown, that even with a relatively small non-coverage the corresponding estimates can be considerably biased, as in the case of the unemployment rate in the Slovenian Labour Force Survey. There are severe methodological problems with mobile phone interview surveys. In particular, a pilot mobile phone survey confirmed the disadvantages of costs, frames and response rates, at least when compared to fixed telephone surveys. In addition, the response rates are dramatically lower for less intensive mobile phone users. The comparisons of respondents in mobile phone surveys with the corresponding sub-samples in Labour Force Surveys and in fixed telephone surveys revealed some specific discrepancies in the socio-demographic structure. Due to non-coverage, the respondents in the mobile phone survey tend to be younger, higher educated, from larger households and are represented by a larger share of males. The non-response mechanism can additionally reinforce these effects (e.g, gender), however it can also cancel them (e.g., age, household size). Special complexity arises from the diverse effects of the non-response components (refusal vs. non-contact). According to their attitudes towards mobile phone use, mobile phone users compose three distinct segments (intensive pragmatic and emotional users, less intensive users) that may behave differentially also during the mobile phone survey process.