Fieldworker effects on substance use reporting in a rural South African setting

Abstract

Aims: Fieldworkers capturing reports of sensitive behaviors, such as substance use, may influence survey responses and represent an important factor in response validity. We explored the effects and interaction of fieldworker and respondent characteristics (age and gender) in substance (tobacco and alcohol) use reporting. We aim to further the literature on conditional social attribution effects on substance use reporting in the context of South Africa, where accurate estimates of modifiable risk factors are critical for medical and public health practitioners and policy-makers in efforts to reduce chronic disease burden and mortality. Design: We modeled substance use reporting using binary logistic regression. We also tested if fieldworker effects remained, allowing for correlation in reporting for respondents with the same fieldworker using multi-level logistic regression. Setting: Agincourt Health and Socio-Demographic Surveillance System site, rural South Africa. Participants: We used data from a 2010–2011 study on HIV and cardiometabolic risk, ages 15+ (N = 4,684). Measures: Lifetime and current alcohol and tobacco use. Findings: Respondents reported higher lifetime smoking use to older fieldworkers. Male respondents reported higher lifetime alcohol use to older fieldworkers. No fieldworker effects were significant on reports of current smoking. An older, male fieldworker increased the probability of reports of current alcohol use. Adjusting for intra-fieldworker correlation explained many of the observed fieldworker effects. Conclusions: Our results highlight the importance of adjusting for interviewer characteristics to improve the accuracy of chronic disease risk factor estimates and validity of inferred associations. We recommend that surveys collecting information that may be subject to response bias routinely include anonymized fieldworker identifiers and demographic information. Analysts can then use these additional fieldworker data as a tool in evaluating probable bias in respondent reporting.

Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015

“… 27 While we showed no association with alcohol use, our sample also had low self-reported use of alcohol, with 80% reporting not drinking in the past month, which may be due to response bias. 49 Given the limited employment opportunities in our setting, 28 a higher risk of hypertension among employed individuals may represent those more likely to be exposed to workplace-related stress and other behavioural factors such as diet 50 51 that may differ from those not employed.…”

The Impact of the Older Person’s Grant Expansion on Hypertension Among Older Men in Rural South Africa: Findings From the HAALSI Cohort

“…We also did not have data on parental history of hypertension to use in our hypertension probability model, which may have reduced the discriminatory capability of our model ( 28 ). In addition, we only had a binary alcohol consumption measure, which may be subject to reporting error or bias that could have affected the predictive capability of the Wand et al model used in this analysis ( 57 ). Future studies should address how to minimize error and biases in the measurement of alcohol consumption in this study context.…”

Language analysis of spontaneous descriptions of restless legs syndrome: Gender differences?

“…Another strength is the inclusion of a large sample of consecutive RLS patients, with a sex ratio similar to the one reported for RLS prevalence in epidemiological data (Berger et al, 2004 ; Didriksen et al, 2017 ; Hening et al, 2004 ; Högl et al, 2005 ; Kim et al, 2019 ). A possible limitation is that all patients were interviewed by a female investigator: interviewer’s gender has been reported to cause a bias in responses about sensitive experiences or behaviours (which are reported more frequently to women by women (Harling et al, 2019 ) and to female voices by men (Dykema et al, 2012 )), or substance abuse (which seems to be reported more often to men by both women and men; Heeb & Gmel, 2001 ; Houle et al, 2019 )). Although men and women talk about the same when in same‐gender dyads, women talk less while talking to men, whereas men talk more when talking to women than when talking to men (Mulac, 1989 ).…”