Factors affecting study efficiency and item non-response in health surveys in developing countries: the Jamaica national healthy lifestyle survey

• Published in: BMC medical research methodology Vol. 7; no. 1; p. 13
• Main Authors: Wilks, Rainford, Younger, Novie, Mullings, Jasneth, Zohoori, Namvar, Figueroa, Peter, Tulloch-Reid, Marshall, Ferguson, Trevor, Walters, Christine, Bennett, Franklyn, Forrester, Terrence, Ward, Elizabeth, Ashley, Deanna
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28.02.2007; BioMed Central; BMC
• Subjects: Adolescent; Adult; Age Distribution; Aged; Confidence Intervals; Developing Countries; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Female; Health Surveys; Humans; Hypertension - diagnosis; Hypertension - epidemiology; Incidence; Jamaica - epidemiology; Life Style; Male; Middle Aged; Multivariate Analysis; Reproducibility of Results; Risk Factors; Sex Distribution; Surveys and Questionnaires; Treatment Refusal - statistics & numerical data; Jamaica
• ISSN: 1471-2288; 1471-2288
• DOI: 10.1186/1471-2288-7-13

Health surveys provide important information on the burden and secular trends of risk factors and disease. Several factors including survey and item non-response can affect data quality. There are few reports on efficiency, validity and the impact of item non-response, from developing countries. This report examines factors associated with item non-response and study efficiency in a national health survey in a developing Caribbean island. A national sample of participants aged 15-74 years was selected in a multi-stage sampling design accounting for 4 health regions and 14 parishes using enumeration districts as primary sampling units. Means and proportions of the variables of interest were compared between various categories. Non-response was defined as failure to provide an analyzable response. Linear and logistic regression models accounting for sample design and post-stratification weighting were used to identify independent correlates of recruitment efficiency and item non-response. We recruited 2012 15-74 year-olds (66.2% females) at a response rate of 87.6% with significant variation between regions (80.9% to 97.6%; p < 0.0001). Females outnumbered males in all parishes. The majority of subjects were recruited in a single visit, 39.1% required multiple visits varying significantly by region (27.0% to 49.8% [p < 0.0001]). Average interview time was 44.3 minutes with no variation between health regions, urban-rural residence, educational level, gender and SES; but increased significantly with older age category from 42.9 minutes in the youngest to 46.0 minutes in the oldest age category. Between 15.8% and 26.8% of persons did not provide responses for the number of sexual partners in the last year. Women and urban residents provided less data than their counterparts. Highest item non-response related to income at 30% with no gender difference but independently related to educational level, employment status, age group and health region. Characteristics of non-responders vary with types of questions. Informative health surveys are possible in developing countries. While survey response rates may be satisfactory, item non-response was high in respect of income and sexual practice. In contrast to developed countries, non-response to questions on income is higher and has different correlates. These findings can inform future surveys.