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ESRA 2023 Glance Program

All time references are in CEST

Improvement of measurements in health research 2

Session Organisers Mrs Sandra Jaworeck (TU Chemnitz)
Mr Philip Adebahr (TU Chemnitz)
Professor Peter Kriwy (TU Chemnitz)
TimeThursday 20 July, 16:00 - 17:30
Room U6-28

All scientific disciplines have an interest in improving both measurement instruments and measurement strategies. This is especially pertinent to empirical social science health research. It may be possible to extend measurement beyond the perception of individuals to a broader basis of content.
Results of quantitative empirical health research shape the everyday life of actors in the health care system. Quantitative empirical measures support indices of, for example, health, health care systems, and socioeconomic status. Knowledge of the background of measurements, assessment of measurement quality, and content validity should be critically examined as well as response behavior in terms of social desirability. Changes in response behavior are also evident with different survey modes. Which means that respondent behavior could make a decisive difference in results.
Health is neither a purely objective nor a strictly subjective concept. But in social science surveys, subjective information about health is usually the central element of health measurements. What thresholds, if any, must be exceeded for individuals to respond to stimuli? Once stimuli have been perceived, they are evaluated by the observer (also unconsciously) and classified into contexts as well as learned structures. These processes are shaped by the functioning of the human organs and, above all, by previous individual experiences.
Measurements are often made at the objective level, as in the case of socioeconomic status, which is determined from objective indicators (education, occupation, income). In addition, subjective social status (SSS) has increasingly been measured in recent years. The subjective level is present in pretty much all areas of health research.
This session deals with improvements of objective and subjective health measurements that will enhance and simplify the field in the future.

Keywords: measurements, methods, health research


Can the Lifecourse of Long COVID be Predicted?: Harnessing Organic Data to Advance Evidence-Based Health Policymaking

Professor Asaph Young Chun (Seoul National University) - Presenting Author
Ms Seyoung Kim (Seoul National University)
Dr Minjung Han (Seoul National University)
Dr Su Jin Park (Seoul National University)
Professor Sungil Cho (Seoul National University)

Nowcasting the course of Long COVID, the post-acute effects of COVID-19 infection, faces a Herculean task as challenging as forecasting the 1918 Spanish flu that claimed over 55 million lives across continents. In the case of Korea, science-and-data-based modeling has been a cornerstone of policymaking since the COVID-19 infected the Korean population in February, 2019. The purpose of this paper is to unravel the coevolution of forecasting science and public policy throughout the course of COVID-19 pandemic in South Korea, which has recently extended to develop prediction modeling of Long COVID particularly among children and adolescents.

We initially used the model of Incidence Decay with Exponential Adjustment (IDEA) based on a well-established model that classifies population into the three groups: Susceptibles, Infected, and Recovered (SIR). The IDEA model outcomes have guided Korea to develop and adjust measures of non-pharmaceutical interventions (NPI), such as masking, social distancing, and business and school closures. The paper will show the extent to which model outcomes have been aligned with people’s compliance with social distancing as well as COVID-19 transmission speed and scope in a number of crucial junctures, and point out the nature of gaps between prediction science and policy implementation. The paper will turn to discussing alternative prediction models that are grounded on forecasting methodology and big data science in a transdisciplinary manner. The data used in modeling included official organic data and commercial big data, both of which enhanced the rigor of prediction modeling. The paper extends nearcasting models to Long COVID in children and adolescents, estimating the impact on Long COVID of various levels of COVID19 infection, including the impact on hospital admission, ICU treatment, and mortality associated with Long COVID. The paper points out conditions for further innovation.

Measuring the impact of deliberative dialogues on citizens’ beliefs and risk assessment

Dr Sophia McDonnell (Kantar Public) - Presenting Author
Ms Elke Himmelsbach (Kantar Public)
Dr Corinna Lüthje (Bundesamt für Strahlenschutz (BfS))

To inform about radiation risks, the Federal Office for Radiation Protection (BfS) funded “citizen workshops” where randomly selected citizens listened to lectures by experts and discussed them in small groups. To measure the effectiveness of such events in iterms of knowledge enhancement and individual risk assessment, we developed an empirical, theory-based evaluation design.

In June 2022, citizens in four German cities were randomly contacted with an invitation to a citizen workshop on 5G and health. We then reached out to those who signed up with a quantitative telephone survey measuring attitudes towards 5G and health, risk assessments and other general values. Everyone who completed the survey was invited to take part in in-person citizen workshops in September 2022. In total, 134 citizens took part. Two weeks later, we conducted another telephone survey testing some of the attitudinal factors measured earlier and asking respondents to evaluate the events. Consequently, we could measure within-person differences and between-person differences. To measure whether changes in beliefs were sustainable, we carried out another telephone survey two months after and are preparing a third wave four months after.

Analysis of the first post-event survey shows significant shifts in several attitudes and health risk assessment towards 5G. Concerns have decreased considerably, while knowledge about the topic in general has increased. The analysis of the quantitative surveys, qualitative observation and qualitative interviews with some participants revealed that particularly the echange with credible experts and peer discussions contributed to this. We plan to use statistically advanced methods to isolate the impact of intervening factors.

We consider this project valuable because to our knowledge, few citizens’ dialogue events have been empirically validated. We employed an ambitious survey design consisting of a quantitative baseline measurement and several directly comparable follow-up measurements supplemented by qualitative data.

Understanding the Influence of Health-Related Information in Online Searches on Online Behavior and Attitudes

Dr Franziska Pradel (Technical University of Munich) - Presenting Author
Dr Sebastian Sattler (Bielefeld University)

In the context of health information search, this web-based survey investigates how people's intended click behavior, health-related attitudes, and attitudes towards regulating online content are affected by their search results and how they perceive these results. Specifically, in the context of drug use to improve cognitive performance without medical necessity, this 2x2 between-subjects experiment examines the impact of information source (established vs. unknown source) and type of information (single case reports, so-called exemplars vs. a scientific study). We also explore the mediating role of information perception (i.e., trustworthiness, affect, informativeness) as well as the moderating role of prior experiences and attitudes regarding such drug use. The results of this study provide insight into how people interact with different search results sources on health-related online information and how their attitudes and experiences play a role in their evaluation of online information. Thereby, they can help improve our understanding of online search behavior and, thus, can be used to inform strategies for regulating online content.

Attitudes Towards Pregnancy Programs During the Covid-19 Pandemic - May Vignette Studies Illustrate Increasing Demands?

Ms Rebecca Ney (Sociology with focus on health research) - Presenting Author

Between 2019 and 2021, live births have increased from 46.0 to 47.7 per 1,000 women. Concomitant health problems during pregnancy and premature births have also been rising, stronger than before the start of the pandemic. Health literacy programs are available for prevention, strengthening health skills of pregnant women as well as development opportunities for children to circumvent the negative trend. However, such programs are less frequently used by women with limited socio-demographic status and health resources, although they are vulnerable for health risks during pregnancy and birth. The pandemic was reinforcing this trend. Organization pregnancy programs, which doesn’t consider aging effects, socio-economic status and health literacy, often reduce equal opportunities concerning access and attractiveness of services. Declining uptake highlights the need for prevention during pregnancy and accessibility.
Thus, an online vignette study examines effects of age, socioeconomic status, and health-related behaviours on the use of pregnancy programs to deduce structural conditions that improve access and motivation to use them. In eight fictitious case studies (vignettes), pregnant and nonpregnant women aged 15-49 were asked about their likelihood of using pregnancy programs.
Age-based and socioeconomic-related effects are associated to low-threshold access conditions, like financial support, short distance and different information channels on health programs, which might promote equal opportunities in pregnancy prevention. Comparing the results with a vignette study in 2019, stronger effects clarified the increasing need for pregnancy programs.
Unequal utilization of pregnancy programs as a function of personal determinants underscores the importance of sustainable pregnancy prevention, which is an important finding for improving access, needs and attitudes in pregnancy care.

Is a picture worth a thousand words? Potentials and challenges of the non-verbal assessment of psychological constructs.

Professor Patrick Brzoska (Witten/Herdecke University, Faculty of Health, School of Medicine) - Presenting Author

Introduction: Psychological constructs such as health-related quality of life (HRQOL) and anxiety are commonly assessed by means of standardized self- or interviewer-administered questionnaires such as the WHOQOL, the SF-36 or the GAD-7. Such questionnaires usually need to be properly readapted prior to their application to vulnerable populations such as migrants and other communities. Because of limited financial and time resources, this is usually not possible in population-based research. Consequently, the quality of data collected among these population groups is limited or they are excluded from studies altogether. One strategy to address this limitation can be the use of language-independent questionnaires which are based on pictures. Using a scoping review of literature, the present study examines potentials and challenges of the nonverbal assessment of psychological constructs.

Methods: A scoping review was conducted in English and German using the databases PubMed, PsycInfo, CINAHL and SSCI. Additionally, reference lists of studies identified were scanned manually for relevant sources.

Results: Sixteen questionnaires, e.g., assessing HRQOL, anxiety and intelligence, were identified that are at least partially based on pictures. Their layouts as well as type and degree of pictorial items vary from drawings illustrating endpoints of Likert scales to the use of picture stories with little text. Few studies provide sufficient information on the reliability and validity of the questionnaires.

Discussion: Pictorial questionnaires can allow a more accessible assessment of psychological constructs across different population groups independent of their language proficiency and general reading and writing skills. While being potentially superior to existing verbal instruments for routine use in health research and practice, representing complex items by means of pictures may be challenging. Oftentimes, the evidence on the psychometric performance of pictorial questionnaires is also lacking and studies particularly need to examine their convergent and factorial validity.