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Abstract #159982
Audio (mp3) recordingDonna H. Odierna, DrPH, MS, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California St,. Suite 265, San Francisco, CA 94118, 510 531-5303, Donna.Odierna@ucsf.edu and Laura A. Schmidt, PhD, Institute for Health Policy Studies and Department of Anthropology, History and Social Medicine, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118.
Objectives: In longitudinal studies, it may be difficult to retain hard-to-reach populations, including welfare recipients, the poor, the unstably housed, and other vulnerable and economically or socially marginalized groups. Differential attrition of hard-to-reach respondents may lead to biased and inaccurate results.
Methods: We report findings from a nonresponse simulation of a survey of 498 female cash aid recipients in a California county. Hard-to-reach respondents were reinterviewed 12 months after baseline only after extended tracking efforts. A simulation based on a study previously published in The American Journal of Public Health examined the consequences of failure to include these hard-to-reach respondents.
Results: Standard bivariate comparisons of baseline characteristics revealed few apparent differences between hard- and easy-to-reach respondents. However, a deeper exploration through simulation analyses showed that failure to include hard-to-reach respondents would have decreased response rates from 89% to 71%, and to well below 70% in important subgroups, as well as biasing and nullifying results of the original, published study.
Conclusions: The effects of failure to include hard-to-reach respondents in public health research are not necessarily predicable based on simple non-response comparisons. The pursuit of more effective strategies for tracking and retaining hard-to-reach respondents should become a priority in public health research, particularly research that includes members of vulnerable or hard-to-reach populations.
Learning Objectives:
- Describe two ways to define hard-to-reach groups and individuals
- Evaluate the possible consequences of failure to retain the hard-to-reach in longitudinal studies
- Articulate the importance of providing adequate resources for follow-up of hard to reach individuals in studies that include members of vulnerable, marginalized, or hard-to-reach populations.
Keywords: Vulnerable Populations, Public Health Research
Presenting author's disclosure statement:
Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA