Objective:To assess the effectiveness of the National Death Index (NDI) in identifying participants in the oldest cohort of the Australian Longitudinal Study on Women's Health (ALSWH) who had died between 1996 and 1998. Methods:Identifying information for each woman was matched with the NDI using a probabilistic algorithm and clerical review. Differences in full name, date of birth, State of residence and date of last contact were used to assess the probability of a true match. Results:NDI identified 410 matches of death records for 409 women; 386 were categorised as true matches and 23 were doubtful matches. Responses to the follow‐up survey confirmed that for six of the doubtful matches the women had died, 16 were alive and the vital status of one woman remained unconfirmed at 30 June 1998. Twelve deaths, known to have occurred before July 1998, were not identified through NDI. The sensitivity of the NDI for identifying known deaths was 95%. Detailed identifying information, particularly the middle name, was important for accurate identification of the vital status. Conclusions:Using surname, all given names, gender, date of birth, State of residence and age at last contact as matching variables, the NDI was an effective tool for identifying women who had died. Implications:Routinely collected mortality data in the NDI are useful for the practice of epidemiology.
Women's Health Australia research teamomen's Health Australia (WHA) is a large-scale multidisciplinary project which aims to explore W the health of Australia's women over twenty years. The overall goal is to clarify relationships between women's health and use of health services and biological, psychological, social and lifestyle factors. It involves collection of quantitative and qualitative data, as well as record linkage with other data sources. The participants for the main part of the study are three age cohorts of women, selected by the Health Insurance Commission (HIC) through Medicare records, to represent young (aged 18-23 in 1996), mid-age (45-50) and older women (70-75). Stratified random sampling was used, with over-sampling of women in rural and remote areas. The study design involves surveying each main cohort every three years for twenty years as well as conducting nested sub-studies. More than 41,000 women (14,792 young women, 14,200 mid-age women and 12,624 older women) responded to baseline surveys in 1996. Comparisons with 1996 census data suggest that the participants are reasonably representative of Australian women as a whole. ' Clearly, maintaining contact with participants is essential to the quality of any longitudinal project. A populationbased survey of women ranging in age from 18 to (eventually) 95 years raises particular problems for maintaining contact. Young women frequently move location (our 1999 pilot survey showed that 35% of respondents had moved house three or more times in the past three years), and many of them change their surnames when they marry. While the mid-age women move less often, similar problems arise when they divorce or separate. Younger women may not be registered on the electoral roll, and if they are, their addresses there may be out of date. In tracking older women, the main problems occur when they move to a retirement village or nursing home, or to live with a relative; the identification of those who have died is also important. How to avoid losing contact with participantsThe most important and cost-effective strategy for cohort maintenance is, obviously, to avoid losing contact with participants in the first place. The following strategies are generally well recognised? but are worth reiterating in this context.
Telephone interviews have practical advantages, b ut with specif ic par ticipation criteria one cannot know w hether respondents phoned at random will be eligible. The more specific the criteria, the lower the recr uitment rate; eligibility rates may be as low as 2% if several conditions must be met, making 'cold calling' expensive and time-consuming. 1 An alternative telephone-based recr uitment strategy involves selecting, from an existing database, individuals who meet criteria. A US study was able to contact 83% of older people from a hospital database, and recruited 45% of them for a nutrition education program, requiring a mean of 5.97 phone calls per recruitment. 2 We examined the response rate obtained when calling y oung participants in the Australian Longitudinal Study on Women's Health (ALSWH), who had responded to two main surveys four years apart, ag reed to be contacted for additional substudies, and met specif ic criteria (never -smokers, recent adopters, continuing smokers, and ex-smokers).The ALSWH surveys a representative sample of Australian women in three age groups. Surveys collect information on physical and emotional health, use of services, health behaviours, demographics, and major life e vents. 3 Young women pose particular difficulties for longitudinal research. They have high levels of mobility, are likely to live in shared accommodation, may not have telephone listings, and are likely to rely on mobile phones. 4 A signif icant proportion of young women change their surnames when they marry.In August 2002, a letter was sent to 180 young par ticipants, inviting them to participate in a 20-minute telephone interview about smoking. Recruitment phone calls were made at varying times of day and days of the week, over a period of four months; if the target person was not known to the person answering the phone, tracking procedures 4 were used to locate new contact details and repeat the procedure.Of 180 letters, six were returned to sender. From these, five women were re-located and three inter viewed. During phoning, active tracking became necessary for another 45 women (25%), of whom 21 were re-located. Another 42 (23%) provided new contact details when contacted. Thus, 93 women (51.7%) had changed contact details over the year since previous contact. In this analysis, calls required for locating new details are not included.Eight-four interviews were completed (46.7%). Another 29 (16.1%) refused to participate. Of the remaining 67 women, 22 have not yet been re-located. For 17 women (9.4%), we spoke to someone who conf irmed that she lived at that address, but was not then available (despite up to nine calls). For another 15 (8.3%), we spoke to the target person (up to three times in the course of up to 11 phone calls) but were asked to call back because the respondent was "too b usy" to make an appointment, but were unable to arrange an appointment time on callback. For another eight (4.4%), an interview time was arranged but the participant was not available at that time; in three ca...
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