COVID-19 research has relied heavily on convenience-based samples, which—though often necessary—are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended. Supplementary Information The online version contains supplementary material available at 10.1007/s10654-022-00932-y.
The aim was to explore the factors associated with the financial burden (FB) of medical care, dental care, and medicines among older-aged people in Slovenia, Serbia, and Croatia using EU-SILC 2017. The highest frequency of FB of medical care and medicines was in Croatia (50% and 69.1%, respectively) and of dental care in Slovenia (48.5%). The multivariate logistic regression analysis with FB as an outcome variable showed that the FB of medical care was associated with being married (OR: 1.54), reporting not severe (OR: 1.51) and severe limitations in daily activities (OR: 2.05), having higher education (OR: 2.03), and heavy burden of housing costs (OR: 0.51) in Slovenia, with very bad self-perceived health (OR: 5.23), having the slight (OR: 0.69) or heavy (OR: 0.47) burden of housing costs, making ends meet fairly easily or with some difficulty (OR: 3.58) or with difficulty or great difficulty (OR: 6.80) in Serbia, and with being married (OR: 1.43), having heavy burden of housing costs (OR: 0.62), and making ends meet fairly easily or with some difficulty (OR: 2.08) or with difficulty or great difficulty (OR: 2.52) in Croatia. The older-aged have the FB of healthcare, especially the poorest or those with health problems.
Background/Aim. Cervical cancer is still an important public health problem in Belgrade. The aim of this study was to explore spatial patterns of cervical cancer, provision and accessibility of women's health service on the primary health care level in Belgrade, as well as the needs for improving cancer surveillance and preventive programs. Methods. This study applied a descriptive epidemiological method and a geographic information system based on data on cervical cancer diagnosed among female residents of Belgrade in 2006 and 2011. A map of the density of cases, with precise and complete data on the address of residence at the time of diagnosis, and a map of the distribution of gynecological practices in the primary health care in Belgrade, were generated through the process of georeferencing. Results. A total of 569 cases of cervical cancer were registered in 2006 and 2011, without significant differences. Significant associations were noticed for municipality of residence and year of diagnosis (χ 2 = 42.99, df = 16, p = 0.000), and year of diagnosis and age groups 30-34 (р = 0.038, f = 3.998, df = 11, ANOVA), 40-44 (р = 0.001, f = 7.545 df = 13, ANOVA) and 45-49 (р = 0.046, f = 2.679, df = 15, ANOVA). The process of georeferencing covered a total of 466 (81.8%) cases with 97.4% of all cases diagnosed in 2006 and 68.6% in 2011. The generated maps showed similar spatial patterns of cases for both years: a higher density of cases with addresses in central parts of urban and suburban municipalities, as well as in parts of densely populated areas of urban municipalities. There was no regularity of grouping found for the cases in relation to the provision of women's health service, or of distance from the place of residence of cases to gynecological practices. Conclusion. Our results indicate possibilities for the perception of the spatial distribution of cervical cancer and needs for improving cancer surveillance and preventive programs on small geographical areas.
Background Changes in the health insurance law in 2005 led to the changes in the organization of the provision of dental health care in Serbia. Prior to this law, dental health care was available for every resident covered by mandatory health insurance without additional out-of-pocket payments. Now the dental health care is available only for children under the age of 18, students under the age of 26, pregnant women and for emergency dental care. The aim of this study was to assess the prevalence of unmet dental health care needs among adults and to assess the factors associated with unmet dental health care needs. Methods The study was the secondary analysis of the data from the Survey on income and Living conditions in Serbia, conducted during 2017. Multivariate logistic regression analysis was used to assess the association of unmet dental health care needs and socio-demographic and socio-economic factors. Results Total of 1718/12437 (12.1%) adults reported unmet dental health care needs. The main reason reported was not being able to afford it (1014/1718, 59.0%), along with the fear of doctors or hospitals (260/1718, 15.5%). Multivariate logistic regression analysis showed the association of unmet dental health care needs and being employed (OR: 1.50, 95% CI: 1.24-1.80), unemployed (OR: 1.96, 95% CI: 1.65-2.33), having primary (OR: 1.47, 95% CI: 1.16-1.86), or secondary education (OR: 1.43, 95% CI: 1.21-1.69), being divorced (OR: 1.47, 95% CI: 1.17-1.85), having good (OR:1.44, 95% CI: 1.20- 1.74), average (OR: 2.36, 95% CI: 1.91-2.92), poor (OR: 2.29, 95%CI: 1.77-2.97), or very poor general health (OR: 2.42, 95% CI: 1.68-3.48), having limitation in daily activities (OR: 0.66, 95% CI: 0.60-0.77) and being materially deprived (OR: 1.67, 95% CI: 1.46-1.90). Conclusions The prevalence of unmet dental health care needs in high among adults in Serbia. There is an association between social characteristics and health status with unmet dental health care needs in Serbia. Key messages There is a high prevalence of unmet dental health care needs in Serbia. Unmet dental health care needs are associated with social characteristics and health status.
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