GOOD MORNING, EVERYONE.
WELCOME TO DAY 2 OF THE MEETING
AND OUR 20-YEAR ANNIVERSARY
CELEBRATION OF THIS WONDERFUL
SURVEY AND DATA COMMUNITY. I'M
ROBIN VANDERPOOL AND CURRENT
BRANCH CHIEF FOR HEALTH
COMMUNICATION AND INFORMATICS
RESEARCH AT THE NATIONAL CANCER
INSTITUTE AND HAPPY TO KICK OFF
DAY 2. WE HAD A REALLY TERRIFIC
DAY YESTERDAY AND HAD A GREAT
SET OF PRESENTATIONS THAT REALLY
COVERED THE HISTORY OF HINTS AND
HOW IT IS FOUNDATIONAL TO
RESEARCH AND POLICY EFFORTS WE
LEAD AT NATIONAL CANCER
INSTITUTE AS WELL AS OTHER PARTS
OF THE FEDERAL GOVERNMENT AND WE
HAVE A TERRIFIC PANEL
PRESENTATION FROM FEDERAL
PARTNERS THAT RUN SURVEYS AND
HAD AN OPPORTUNITY TO WORK
THROUGH CHALLENGES AND
OPPORTUNITIES THROUGH SURVEY
RESEARCH THAT ALL OF US CAN
LEARN FROM GOING FORWARD.
WE HAD REALLY IMPRESSIVE
PRESENTATIONS FROM YOU ALL, OUR
DATA USERS, ON IMPORTANT TOPICS
SUCH AS CANCER SURVIVORSHIP AND
HEALTH DISPARITIES AND HEALTH
EQUITY AND DIGITAL HEALTH AND
REALLY NEW AND EXCITING TOPICS
AND DISCUSSIONS AROUND SOCIAL
ISOLATION AND LONELINESS.
AGAIN, THANKS FOR BRINGING
RESEARCH PROJECTS TO US. I WAS
ESPECIALLY DELIGHTED TO SEE ALL
PRESENTATIONS FROM STUDENTS.
AND FROM EARLY-STAGE CAREER
INVESTIGATORS.
YESTERDAY, YOU ALL MAY RECALL
KELLY ASKED SOME OF US TO RAISE
OUR HANDS IF WE HAVE BEEN HINTS
DATA USERS SINCE THE VERY
BEGINNING SINCE 2003 AND LIKE
MANY PRESENTERS YESTERDAY, I WAS
ONE OF THE STUDENTS IN 2005 AND
2006 USING ORIGINAL HINTS
DATASET FOR OWN DOCTORATE OF
PUBLIC HEALTH CAPSTONE AT
UNIVERSITY OF KENTUCKY AND HAS
BEEN SUR REEL FOR ME IN THE PAST
FEW YEARS SINCE I JOINED THE NCI
TEAM TO SIT AT THE TABLE AS WE
ACTUALLY CURATE AND BRING
TOGETHER THE HINTS SEER SURVEY
AND HINTS 6 AND HAD A RETREAT TO
PLAN OUT THE HINTS 7 SURVEY. I
WAS THRILLED TO SEE, FOR
EXAMPLE, NEW TELEHEALTH ITEMS WE
ADDED THE PAST COUPLE YEARS.
YOU ARE DATA USERS COMMUNITY
USING THAT TO ANSWER IMPORTANT
QUESTIONS AROUND TELEHEALTH AND
AROUND RURAL AND URBAN HEALTH
DISPARITIES FOR EXAMPLE. PLEASE
KEEP USING THIS DATA. THIS IS
WHY WE DO THIS WORK TO BRING
IMPORTANT RESEARCH QUESTIONS TO
FRUITION.
I WANT TO, AGAIN, JUST GIVE A
BIG SHOUTOUT TO THE HINTS TEAM
LED BY KELLY BLAKE, HEATHER,
ANNA AND WONDERFUL COLLEAGUES AT
WESTAT AND ICF AND THANK ALL OF
THE HINTS CHAMPIONS PART OF THE
DIVISION OF CANCER CONTROL AND
POPULATION SCIENCES AND THEIR
CONTRIBUTION TO DEVELOPING THE
HINTS SURVEY AND THANKING THE
NATIONAL CANCER INSTITUTE FOR
THE SUPPORT OF THIS SURVEY FOR
THE PAST 20 YEARS AND HOPE
ANOTHER 20 OR 30 OR 40 YEARS TO
COME. TODAY, I WANT TO QUICKLY
COVER SOME LOGISTICS OF OUR TIME
TOGETHER HERE AT THE NATURE
CENTER. IF YOU HAVE SUITCASES,
YOU ARE WELCOME TO PUT THEM IN
ROOM J. PLEASE KNOW IT IS NOT
BEING ACTIVELY MONITORED. IF
YOU HAVE VALUABLES, YOU MIGHT
WANT TO KEEP THEM WITH YOU OR IF
YOU NEED HELP WITH TAXIS OR
INDICATING WHERE TO SEND A LYFT
OR UBER DRIVERS, EVENT STAFF IS
HAPPY TO HELP WITH THAT AS WELL.
CAFETERIA, IMPORTANT. THEY ARE
OPEN TODAY FROM 11:30 TO 1:30
PLEASE PATRONIZE THEIR SURVEYS.
FOR COLLEAGUES LISTENING
VIRTUALLY, LINES ARE MUTED AND
WE HAVE THE CHAT FEATURE OPEN.
PLEASE USE IT TO POST ANY
QUESTIONS. WE WILL TRY TO GET
TO THOSE IF TIME ALLOWS DURING
THE Q & A SESSION. IF YOU HAVE
QUESTIONS, PLEASE REACH OUT TO
ARIANA.
GOINS. WITH THAT, THAT IS ALL
OUR LOGISTICS FOR THE DAY. I
WANT TO WELCOME UP TO THE PODIUM
KELLY BLAKE AND RICK MOSER WHO
IS THE DIRECTOR OF HINTS
PROGRAM. THEY WILL START US OFF
WITH HINTS PROGRAM UPDATES AND
NEW DATA COLLECTION EFFORTS.
THANKS SO MUCH.
>> THANK YOU SO MUCH, ROBIN.
>> GOOD MORNING, EVERYBODY.
WELCOME BACK TO DAY 2 OF THE
HIPTS CONFERENCE. WE WILL START
THIS MORNING GIVING YOU A
LOOSELY STRUCTURED HODGE PODGE
OF UPDATES ON OUR DATA RESOURCES
AND DATA COLLECTION EFFORTS.
WE WILL BRIEFLY COVER THESE SIX
AREAS IN THE NEXT 20 MINUTES.
WE WILL GO OVER DATA MERGING
CODE TOOL AND DATA SUPPRESSION
RULES AND HINTS SEER AND TALKING
ABOUT DATA LINKAGE PROJECT AND
COME BACK TO TELL YOU WHAT IS ON
THE HORIZON FOR HINTS 7 AND OUR
LONGITUDINAL PANEL. FIRST, FOR
THOSE NEW TO HINTS OR THAT NEED
A REMINDER WE CREATED A DATA
MERGING CODE TOOL THAT LIVES ON
THE HINTS WEBSITE AND CREATED IT
WITH ICF AS A RESULT FROM
FEEDBACK FROM DATA USERS AND
HOPE IT WILL HELP MERGE
DIFFERENT ITERATIONS OF HINTS
FOR TREND ANALYSIS OR INCREASING
SAMPLE SIZES FOR ANALYSIS AND IT
PROVIDES CODE TO MERGE AND SET
UP REPLICATE WEIGHTS AND PROVIDE
CODES FOR STATISTICAL PROCEDURES
AND CROSS-TABULATION TABLE AND
CAI SQUARED TESTS AND THOSE ARE
CODES WE PROVIDE THAT IS
PROVIDED IN SAAS AND DATA AND
ARE DISCUSSING OUR CODE AND HOPE
TO MAKE THAT UPDATE RELATIVELY
SOON.
NEXT I WANTED TO MAKE YOU AWARE
OF DATA SUPPRESSION RULES
IMPLEMENTED STARTING IN 20202 IN
THE 2022 DATASET, HINTS 6 TO
MINIMIZE DISCLOSURE -- FOR
DEMOGRAPHIC AND GEOGRAPHIC
RESPONDENT CATEGORIES WITH FEWER
THAN 25 RESPONDENTS PER CELL AND
THIS RULE WAS IMPLEMENTED
STRICTLY FOR DISCLOSURE RISK NOT
FOR PRECISION. YOU MIGHT BE
AWARE THAT NCHS HAS SUPPRESSION
STANDARD FOR SAMPLE SIZES OF
LESS THAN 50 OR RELATIVE
STANDARD ERRORS LESS THAN OR
EQUAL TO 30% AND USERS DON'T
COMPLY PRESENTING RESULTS FOR
THAT. WE ACTUALLY LEAVE IT TO
YOU TO DO THAT.
YOU KNOW, TO IMPLEMENT
SUPPRESSION RULES YOU THINK ARE
NECESSARY FOR PRECISION. THERE
ARE METHODS OBTAINING CONFIDENCE
INTERVALS FOR SMALL PROPORTIONS
OR LIMITED SUBPOPULATIONS USING
STATISTICAL SOFTWARE AND LEAVE
THAT PART TO YOU. WHAT WE HAVE
DONE IN PUBLIC USE DATA SETS IS
HANDLE SUPPRESSION OF AS I SAID
CELLS FEWER THAN 25 RESPONDENTS
PER CELL ON DEMOGRAPHIC AND
GEOGRAPHIC CATEGORIES IN THREE
WAYS.
WE EITHER COLLAPSE RESPONSE
OPTIONS WITH ANOTHER RESPONSE
OPTION. IN OUR RURAL URBAN
CONTINUUM CODES WE MIGHT
COLLAPSE CODES 8 AND 9 IN THAT
IF CELL SIZES WERE TOO SMALL AND
IS WHAT IS ON OUR PUBLIC USE
DATA SET AND SET THE RESPONSE
OPTION TO MISSING OR VARIABLE
WITH RESPONSE OPTION MIGHT HAVE
BEEN SUPPRESSED ENTIRELY. YOU
CAN APPLY TO ACCESS RESTRICTED
USE DATA FILES THAT CONTAIN
VARIABLES WITH SMALL CELL SIZES
AND GEOCODES AND MAKING YOU
AWARE THIS IS A CHANGE
IMPLEMENTED IN 2022 AND WE WILL
BE DOING AND GOING FORWARD AS
WELL.
NOW, I WILL SWITCH GEARS AND
TALK ABOUT HINTS SEER.
THIS IS DATA WE COLLECTED IN
2021.
WE RELEASED IT LAST YEAR. YOU
HAVE A PREVIEW YESTERDAY DURING
ORAL SESSION FOCUSED ON CANCER
SURVIVORSHIP AND POSTERS LAST
NIGHT OF ANALYSIS THAT ARE USING
HINTS SEER. WE WANT TO PROMOTE
IT A BIT AND GIVE YOU AN
OVERVIEW TODAY.
SO, WHY DID WE DO THIS?
A LARGER SAMPLE OF CANCER
SURVIVORS HAVE BEEN THE MOST
COMMON REQUEST WE RECEIVE FROM
HINTS DATA USERS. ACROSS ANY
GIVEN CRICKLE OF HINTS WE HAVE 7
TO 11 RESPONDIENTS THAT REPORT
HAVING BEEN DIAGNOSED WITH
CANCER AND FRANKLY DATA USERS
NEED POWER TO DETECT DIFFERENCES
AND INFORMATION SUPPORT NEEDS
AND EXPERIENCES BY TIMES OF
DIAGNOSIS AND CANCER TYPE.
SO, WE -- OUR COLLEAGUE LILA DID
A REVIEW OF HINTS STUDIES FOR US
AND ABOUT 35 WERE FOCUSED ON
CANCER SURVIVORS AND PATIENTS.
WE NOTED A FEW GAPS FROM
STUDIES.
MAINLY THAT ANALYSIS WERE
LIMITED ONLY TO MOST COMMON
CANCERS AND ANWILLITYIC SAMPLES
FOR SINGLE SURVEY AND
ADMINISTRATIONS WERE PRETTY
SMALL AND WE HAD LIMITED DATA ON
CANCER SPECIFIC INFORMATION
SEEKING BEHAVIOR AND EXPERIENCES
AND BARRIERS, ET CETERA AND
WANTED TO CONDUCT THE PILOT
STUDY TO SEE IF WE COULD GET
MORE SURVIVORS FOR HINTS.
BEFORE I JUMP INTO HINTS SEER,
FAR RIGHT COLUMN OF THIS SLIDE
SHOWS NUMBER OF CANCER SURVIVORS
IN PREVIOUS ADMINISTRATIONS OF
HINTS WE GET RANDOMLY IN THE
GENERAL POPULATION SURVEYS.
IT RANGED FROM 44 SURVIVORS FROM
HINTS PUERTO RICO AND HINTS
CYCLE 2 UP TO 926 IN HINTSES 6,
2022. HINT SEER TO ADDRESS
NEEDS I MENTIONED PREVIOUSLY WE
CONDUCTED PILOT STUDY TO DO
SURVIVORS FOR HINTS SELECTED
REGISTRIES FOR EPIDEMIOLOGY AND
END RESULTS PROGRAM AS A
SAMPLING FRAME OF CANCER
SURVIVORS DRAWING FROM GREATER
BAY IOWA AND NEW MEXICO CANCER
ARE EDGETRIES TO OVERSAMPLE
SURVIVORS FOR HINTS 5 CYCLE 4
THAT WE DID A BIT LATER.
REGISTRIES WERE SELECTED WITH
GOAL OF ENSURING RACIAL AND
ETHNIC AND GEOGRAPHIC DIVERSITY.
WE DID EXCLUDE NONMALIGNANT
TUMORS, OBVIOUSLY AND NONMEL
GNOMA SKIN CANCERS AND WE DID
THAT BECAUSE IN GENERAL
POPULATION SURVEY 1/3 OF
RESPONDENTS REPORTING HISTORY OF
CANCER HAD BASIL CELL OR
SQUEEMOUS CARCINOMA AND
TREATMENT IS DIFFERENT FOR
SURVIVORS THAN PEOPLE DIAGNOSED
REPRESSED COLORECTAL THYROID AND
OTHER TYPES OF CANCER AND
INDIVIDUALS IN SAMPLE HAD TO BE
ALIVE AND 18 OR OLDER AS OF
DECEMBER 31ST, 2020 WITH LAST
DATE OF CONTACT NO EARLIER THAN
JANUARY OF 2016 THAT IS THE
LATEST DATE WE CAN GET.
WE TRIED TO DO, THAT YOU KNOW,
TO LESSEN THE LIKELIHOOD WE
WOULD EXCEPTED OUR SURVEY
MATERIALS TO HOMES WHERE PEOPLE
NO LONGER LIVED AND WE USE
STANDARD HINTS POSTAL
ADMINISTRATION PROCEDURES.
SO, THREE MAILINGS. WE FIELDED
SURVEYS WITH EACH REGISTRY
COHORT INDIVIDUALLY BETWEEN
JANUARY AND AUGUST OF 2021 AND
UNFORTUNATELY DID IT ENGLISH
ONLY FOR PLUS REASONS.
WHILE NOT NATIONALLY
REPRESENTATIVE, HINTS SEER
SAMPLES ARE PROBABILITY SAMPLES
FROM FRAMES FROM WHICH THEY WERE
DRAWN. CONTROL TOTALS REFLECT
THE DISTRIBUTIONS OF DEMOGRAPHIC
CHARACTERISTICS OF EACH ELIGIBLE
POPULATION PROVIDED BY EACH
REGISTRY AND WEIGHTS FOR EACH
REGISTRY SCALE UP TO THE
REGISTRY POPULATIONS AND HOPE
THAT MAKES SENSE.
SAMPLING FRAMES WERE STRATIFIED
BY TIMES FOR DIAGNOSIS. FEWER
THAN 5 YEARS 5 TO 10 YEARS OR
10 + YEARS AND BY RACE
ETHNICITY.
THE DATE OF DIAGNOSIS WAS PRIOR
TO 2018 BASED ON CERTIFIED DATA.
CANCER REGISTRY DATA HAS A
TWO-YEAR LAG PERIOD FOR
CERTIFICATION.
THE STRATIFICATION BY RACE AND
ETHNICITY WAS CONSISTENT WITH
HOW HINTS OVERSAMPLE AFRICAN
AMERICANS AND HISPANIC'S FOR
PROBABILITY SURVEY AND OVERALL
RESPONSE RATE WAS 12.6%
UNFORTUNATELY AND RESPONSE RATE
WAS EFFECTED BY THE CONSENTING
STAGE.
EACH CANCER REGISTRY HAD A
DIFFERENT IRB AND CONSENTING
PROCEDURE AND IN IOWA THEY
REQUIRED ACTIVE CONSENT TO BE
ABLE TO SHARE ADDRESSES TO BE ON
OUR FRAME.
SO, YOU CAN SEE THE VARYING
RESPONSE RATES FOR EACH OF THE
REGISTRIES AND THEN AS I SAID,
OUR OVERALL RESPONSE RATE WAS
12.6%.
ANDREW AND OTHERS AT WESTAT DID
A BRIEF NONRESPONSE BIAS
ANALYSIS FOR US THAT INDICATED
FEW DIFFERENCES IN DEMOGRAPHIC
COMPOSITION BETWEEN RESPONDENTS
AND POOL SAMPLE PATIENTS IN EACH
REGISTRY.
SO, IN TERMS OF CONTENT, MOST
ITEMS ON HINTS SEER WERE TAKEN
FROM HINTS CYCLE 42020 AND A FEW
UNIQUE ITEMS WERE ADDED AND SOME
MODIFIED TO MAKE THEM SALIENT TO
CANCER SURVIVORS.
SOME TOPICS ARE LISTED HERE.
EXAMPLES OF SOME OF THE NEW
ITEMS ARE THAT OUR IN HINTS SEER
BUT NOT IN GENERAL POPULATION
SURVEY ARE THOSE RELATED TO
CANCER TREATMENT AND COVID-19.
FOR EXAMPLE, IN CANCER
TREATMENT, WE HAVE QUESTIONS
ABOUT WHETHER THEY HAD TREATMENT
AND HOW LONG AGO IT WAS AND
QUALITY OF CARE THEY RECEIVED
AND SIDE-EFFECTS FROM TREATMENT
AND FINANCIAL BURDEN AND
DISCUSSIONS WITH PROVIDERS FOR
EXAMPLE ON EFFECTIVE TREATMENT
ON THEIR WORK LIFE AND COVID-19
ABLE TO ASK AND YOU SAW IN
PRESENTATIONS YESTERDAY
QUESTIONS ABOUT WHETHER
TREATMENTS OR APPOINTMENTS WERE
EFFECTED BY COVID OR WHETHER
TREATMENT PLANS CHANGED AND
THINGS LIKE THAT AS WELL AS
QUESTIONS WE HAD ON HINTS 6
ABOUT TRUSTED INFORMATION
SOURCES AND PERCEPTIONS THAT
WERE DIRECTLY RELATED TO
COVID-19 THAT MIRROR OUR CANCER
FATALISM QUESTIONS.
AND A REALLY SPECIAL COMPONENT
OF THIS DATA SET IS IT IS LINKED
TO SEER METADATA FOR EACH
RESPONDENT. EACH RESPONDENT HAS
LINKED DATA ON PRIMARY CANCER
SITE HADDISTOLOGY SUMMARY STAGE
AND DATE OF DIAGNOSIS AND DATA
SET INCLUDES RAW DATA AND CODES
THAT DERIVE VARIABLES LOOSELY
ALIGNING WITH SELF-REPORTED
CANCER SITES ON HINTS. ASK
ASHLEY MURRAY WHO DID A POSTER
FOR US SOMETIME LAST YEAR ABOUT
CONCORDANCE OF PEOPLE'S
SELF-REPORTED CANCER SITE AND
ACTUAL CANCER DIAGNOSIS FROM
SEER. LUCKILY IT WAS VERY HIGH.
IF INTERESTED IN SEEING SOME
NITTY GRITTY, YOU CAN LOOK AT
APPENDICIS IN METHODS REPORT AND
SECOND COLUMN IS SHOWING YOU
VARIABLE NAMES AND DESCRIPTIONS
OF THE SEER METADATA IN THIS
DATA SET.
TO GIVE YOU AN IDEA OF THE
SAMPLE CHARACTERISTICS, 60% OF
CANCER SAMPLE WAS DIAGNOSED 10
OR MORE YEARS AGO AND 30%, 5 TO
10 YEARS AGO.
10%, LESS THAN 5 YEARS AGO OR
RESPONDENTS WERE LESS THAN FIVE
YEARS POST DIAGNOSIS, I SHOULD
SAY. IN TERMS OF TUMOR
CHARACTERISTICS, I HOPE YOU CAN
SEE IT ON THE BIG SCREEN AND
DOESN'T LOOK SO SMALL AND
LARGELY ALIGN WITH SITE
PREVALENCES IN GENERAL
POPULATION AND BREAST PROSTATE
AND CANCER SURVIVORS YOU CAN SEE
OTHERS HERE IN UNWEIGHTED
FREQUENCIES.
YOU KNOW, 119 MELANOMA, SKIN
CANCERS.
68 URINARY TRACT CANCERS.
84 LYMPHOTHETIC LYMPHOMAS. YOU
SEE A RANGE OF CANCER SITES.
THIS NEXT SLIDE SHOWS STAGE OF
TUMORS REPRESENTED IN THE DATA
SET WITH ALMOST 68%, I'M SORRY,
BEING LOCALIZED TUMORS.
AND, YOU KNOW, THIS IS A PILOT
STUDY WE LEARN AID LOT FROM AND
WERE CHALLENGES TO DATA
COLLECTION EFFORT AND
CONSIDERATIONS FOR ITS USE FOR
YOU ALL.
NAMELY, AS I MENTIONED,
REGISTRIES HAVE INDIVIDUAL IRBS
AND CONSENTING PROCESSES TO
OBTAIN MAILING ADDRESSES.
SO, NONRESPONSE OF THE
CONSENTING STAGE DID EFFECT OUR
OVERALL RESPONSE RATE. AS I
SAID, LUCKILY, NONRESPONSE BIAS
ANALYSIS INDICATED A FEW
DIFFERENCES WE NEED TO BE
CONCERNED ABOUT. METHODOLOGICAL
SIDE, YOU KNOW, DESPITE
ESTABLISHED METHODS COMBINING
PROBABILITY AND NONPROBABILITY
SAMPLES, HINTS SEER SAMPLE WILL
LIKELY BE A STANDALONE DATA SET
WHEN YOU USE IT IS LIKELY
POSSIBLE TO STATISTICALLY
COMPARE HINTS SEER RESULTS
CAPTURED IN LARGER HINTS DATA
SETS LOOKING AT DEMOGRAPHIC
DISTRIBUTIONS AND CANCERS
RESPONSES TO HEALTH
COMMUNICATION ITEMS DOG IT BY
CONDUCTING SIGNIFICANCE TESTS
RUNNING MODELS SIMILAR TO DATA
COMPARISONS ACROSS DIFFERENT
HINTS AND POPULATION CYCLES AND
COMBINING SEER WITH HINTS TO
PRODUCE ESTIMATE GENERALLY NOT
RECOMMENDED AND WOULD REQUIRE
CAREFUL CONSIDERATION HOW THE
SAMPLES DIFFER GEOGRAPHICALLY
AND DEMOGRAPHICALLY AND ON SOME
OUTCOMES YOU WOULD BE INTERESTED
IN BEFORE YOU COULD ACTUALLY
MERGE THE DATASET TO GENERATE A
SINGLE ESTIMATE.
BUT WE HOPE THAT YOU ARE
INTERESTED IN THE HINTS SEER
DATA SET THAT IS A RESTRICTED
USE DATA FILE THAT CONTAINS
MEDICAL INFORMATION AND PII AND
REQUIRES YOU FILLING OUT A
REQUEST FORM AND USING STRINGENT
DATA USE AGREEMENT AND TO ACCESS
DATA YOU CAN GO TO THE
RESTRICTED USE DATA PAGE LINKED
HERE AND Q.R. CODE IS HERE AND
IS THE SAME FORM YOU WOULD FILL
OUT TO REQUEST GEOCODED DATA AS
WELL.
I THINK THAT IS ALL FOR HINTS
SEER AND WILL TURN IT TO RICK
FOR HINTS SEER DATA LINKAGE
PROJECT AND WE CAN ANSWER
QUESTIONS AT THE END SCOMBL
THANK YOU. I'M HERE TO TELL YOU
ABOUT THE HINTS DATA LINKAGE
PROJECT. IT IS A BABY OF MINE.
I FEEL LIKE A PROUD PARENT ABOUT
THIS AND TELLING YOU ABOUT IT
AND WHY WE ARE DOING
THESELINGAGES AND POINTING OUT
KELLY TALKED ABOUT HINTS SEER
PERSON TO PERSON LINKAGE PERSON
FROM HINTS AND LINK THEM UP WITH
SEER DATA. WE ARE TALKING ABOUT
GEOCODED LINKAGES HERE AND
POINTING THAT OUT AND WHY WE DO
THESE LINKAGES REGARDLESS OF
METHOD AND IDEA PROVIDING
PREDICTORS MODERATORS AND --
TYPICALLY NOT OUTCOMES
EXPLAINING WHAT WE ARE TALKING
ABOUT IS THIS IDEA WITH THIS
ILLUSTRATION THIS MULTILEVEL
INFLUENCES AND THINKING ABOUT
CANCER AND INFLUENCES ON CANCER
AND WE DO WANT TO DEFINITELY
THINK ABOUT THESE CELLS TO
SOCIETY KIND OF IDEA. THAT IS
WHAT WE ARE REALLY TRYING TO
SUPPORT HERE IN MANY WAYS AND
ULTIMATELY WE ARE TRYING TO
PROVIDE THE ABILITY TO ANSWER
NOVEL QUESTIONS YOU CAN'T ANSWER
WITH ANY ONE DATA SET. IT GETS
US TO HDLP AND HINTS DATA
LINKAGE PROJECT AND HINTS 5
CYCLE 4 DATA AND SEE WHAT IS
COLLECTED IN 2020 AND SEE THINGS
HERE AND CONTENT AND HOPEFULLY
ARE FAMILIAR WITH THAT
INTERESTED ITEMS CAREGIVING
CLINICAL TRIALS GENETIC TESTING
AND LINK IT AT A COUNTY LEVEL
WITH 70 VARIABLES FROM OTHER
SOURCES AND CAREFUL TO USE
TRUSTED SOURCED HR CENSUS AND
THOSE VARIABLES PUT IN FIVE
CATEGORIES SOCIAL AND ECONOMIC
FACTORS AND ONE THING TO POINT
OUT A LOT OF THE EXTERNAL
VARIABLES HAVE SOCIAL
DETERMINANTS OF HEALTH FOCUS
THAT IS SOMETHING WE
SPECIFICALLY WANTED TO DO.
THINKING ABOUT THE FIRST GROUP
THAT IS MORE SOCIAL AND ECONOMIC
FACTORS INCLUDING A COUPLE
INDICES AND INDEX OF INCOMING
INEQUALITY AND NEXT GROUP I CALL
DEMOGRAPHICS AND FOR EXAMPLE
PERCENT OF POPULATION OF AGES 65
OR OLDER OR SOMETHING LIKE THAT.
PERCENT OF DIFFERENT RACE
ETHNICITIES AT A COUNTY LEVEL
AND THIRD I WILL CALL
INFORMATION TECHNOLOGY THAT
INCLUDES PERCENT OF HOUSEHOLDS
WITH BROADBAND INTERNET OR
HOUSEHOLD WITH ONE OR MORE
COMPUTING DEVICES OR NO COMPUTER
THINK ABOUT THAT AND HOW IT
MIGHT EFFECT OUTCOMES AND THIRD
CATEGORY IS BUILT ENVIRONMENT
INCLUDING THINGS LIKE FAST FOOD
RESTAURANTS AND FITNESS CENTERS
AND NUMBER OF COMMUNITY HEALTH
CENTERS AND SHORTAGE OF PRIMARY
CARE PHYSICIANS AND MENTAL
HEALTH PROVIDERS AND FINALLY
PHYSICAL ENVIRONMENT THAT
INCLUDES PERCENTAGE OF DAYS WITH
GOOD AIR QUALITY OR AMOUNT OF
AIR PARTICULARATES MATTER AND
SAW IMPORTANCE OF AIR POLLUTION
ON HEALTH THAT IS A GREAT THING
TO INCLUDE OR AT LEAST WE HOPE
SO.
THE -- WE ARE GOING TO REPEAT
THIS WITH HINTS 6 DATA AND TAKE
DATA COLLECTED IN 20202 AND DO
THE SAME THING AND WE PLAN TO
PROVIDE THOSE DATA BY THE END OF
THE CALENDAR YEAR. IF YOU HAVE
SUGGESTIONS ON OTHER VARIABLES
WE SHOULD BE LINKING, PLEASE LET
ME KNOW. WE ARE REALLY LOOKING
AT THE COUNTY LEVEL THAT SEEMS
TO WORK BEST AND COUPLE THINGS
TO MENTION USING DATA HOPE YOU
DO AND STRONGLY ENCOURAGE YOU TO
DO THAT AND WAY THAT YOU USE
ANALYSIS YOU DO IS SIMILAR TO
USING ANY KINDS OF HINTS DATA
SET AND IN THIS SENSE FINAL
SAMPLE OF ESTIMATES AND VARIANCE
ESTIMATES OR YOU CAN USE
TAILORED LINEARIZATION EITHER
WAY. IT IS DOING REGULAR
ANALYSIS.
OF COURSE NOW YOU HAVE KROUNLTY
LEVEL VARIABLES TO INCLUDE IN
MODELS AND WE WILL MAKE SURE
THAT YOU THINK ABOUT ISSUES
AROUND PRECISION AND ACCURACY
AND SOME OF THE VARIABLES YOU
WILL SEE AND LINKED VARIABLES
HAVE MOES AND MARGINS OF RHO R
THAT IS WAY OF GETTING AT
PRECISION AND ACCURACY SIMILAR
TO CONFIDENCE INTERVAL AND WE
CAN INCLUDE THOSE WHERE WE CAN.
WHAT YOU WON'T SEE IS SAMPLE
SIZES AND SAY YOU SEE A COUNTY
LEVEL ESTIMATE OF WHATEVER AIR
PARTICULARATES MATTER YOU WON'T
KNOW HOW MANY UNITS WENT INTO
THAT TO FIGURE THAT OUT. YOU
MAY WANT TO LOOK AT THOSE MOES
AND MARGINS OF ERROR TO HELP
DECIDE YES THAT IS SEEMING
PRECISE AND ACCURATE ENOUGH AT
COUNTY LEVEL TO USE AND DATA SET
INCLUDES ZIP CODE AND STATE
INFORMATION FOR HINTS
RESPONDENTS MAYBE DOING DATA
LINKAGES OR OTHER VARIABLES TO
INCLUDE. IMPORTANTLY, THIS DATA
SET GETS TO FACT OF RESTRICTED
DATA SET AND SIMILARLY WE HAVE
OTHER HINTS DATA SETS THAT
INCLUDE GEOGRAPHIC CODES AND
STATE LEVEL COUNTY AND STATES,
COUNTY AND ZIP CODE. YOU CAN
REQUEST THOSE 2. AGAIN, DO YOUR
OWN THING. FOR THIS, WE HAVE
DONE THE HARD WORK. ASHLEY
MURRAY DID ALL OF THE HARD WORK
EMERGING DATA ALL TOGETHER TO
HELP YOU OUT AND WILL DO THE
SAME WITH HINTS 6 AND
IMPORTANTLY LIKE KELLY SAID IT
IS A RESTRICTED DATASET YOU HAVE
TO MAKE A REQUEST AND LOOK AT
YOUR APPLICATION AND BACK AND
FORTH SOME QUESTIONS AND IF IT
LOOKS GOOD WE APPROVE IT AND
SEND YOU DATA YOU AND THAT IS
Q.R. CODE AND ALL THESE GOOD
THINGS AND WILL STEP ASIDE AND
KELLY WILL COME BACK UP AND TELL
YOU ALL ABOUT THIS.
>> OKAY. SO, WE ARE GETTING
READY TO GO IN THE FIELD AGAIN
IN JANUARY OF 2024.
OUR GOALS REMAIN FAIRLY
CONSISTENT.
AS ALWAYS WITH HINTS. IT IS TO
ASK TIMELY AND IMPORTANT CANCER
COMMUNICATION QUESTIONS UNIQUE
TO FEDERAL SURVEYS AND MAINTAIN
ROBUST DATA USER COMMUNITY WE
HAVE AND INCREASE RESPONSE RATES
WE HOPE AND DATA QUALITY TO
REDUCE POTENTIAL FOR RESPONSE
BIAS AND STRENGTHEN METHODOLOGY
AND ANY IN THE TUTORIAL THIS
MORNING LEARNED AND MAYBE YOU
KNOW FROM LOOKING AT HINTS 6
DOCUMENTATION THAT RESPONSE RATE
IS HISTORICALLY LOW WHEN WE WERE
SLATED TO STOP THE DATA
COLLECTION EFFORT FOR HINTS 6
THAT REQUIRED A 4TH MAILING AND
INCREASED INCENTIVE TO SUBSAMPLE
OF NONRESPONDIENTS TO BRING UP
TO 28% RESPONSE RATE AND WE ARE
HOPING TO CONTINUE EFFORTS TO
INCREASE OUR RESPONSE RATE AND
HOPE TO CONTINUE TO RECRUIT
LONGITUDINAL SUBSAMPLE I WILL
TELL YOU ABOUT IN A MOMENT.
THIS IS JUST A QUICK SLIDE TO
SHOW, YOU KNOW, IT IS GOING TO
CONTINUE TO BE A BIENIAL
FIELDING AND WE HOPE TO GET
BETWEEN 6,000 TO 7,000
RESPONDENTS AND WILL BE
CROSS-SECTIONAL WITH SUBSECTION
THAT IS RECRUITED FOR PANEL AND
DUAL MODE AND POSTAL AND PUSH TO
WEB WITH SAMPLE OF AFRICAN
AMERICANS AND HISPANIC'S IN
RURAL I ZIP CODES WE STARTED TO
DO IN 2022 AND SAME AS HIBT 6 IS
INFORMATION SEEKING ITEMS FOCUS
ON CANCER ONLY INSTEAD OF HEALTH
INFORMATION SEEKING GENERALLY
AND ARE COMMITTED TO INCLUDING
MORE VALIDATED SCALES SUCH AS
INFORMATION SEEKING EXPERIENCES
SCALE AND PATIENT CENTERED
COMMUNICATION SCALE AND SOCIAL
ISOLATION SCALE AND OTHERS.
AS RICK SAID WE HOPE TO PROVIDE
LINKED DATA SETS WITH OR SOON
AFTER PUBLIC RELEASE OF HINTS 7
AND WE WILL CONTINUE OUR -- WHAT
WE THINK IS A STRONG PROTOCOL
FOR SPANISH INSTRUMENT MAILING
WHERE WE WILL MAIL BOTH ENGLISH
AND SPANISH INSTRUMENTS TO ALL
HOUSEHOLDS IN THE HIGH MINORITY
CENSUS TRACKS WE SAMPLE. IN
TERMS OF HINTS SEVEN CONSTRUCTS
THIS SLIDE HIGHLIGHTS NEW AREAS
WE WILL ASK. IN ADDITION TO
STANDARD HINTS CORE ITEMS AND
HEALTH BEHAVIOR ITEMS WE WILL
EXPAND TO CANNABIS USE AND RISK
PERCEPTIONS ON HINTS 7 AND
INTERSECTION OF SUN ALCOHOL AND
DIET MARKETING AND MORE
QUESTIONS ON CLIMATE CHANGE AND
QUESTIONS LED BY NICOLE AND ANNA
ON INFORMATION SEEKING IN THE
CLINICAL ENCOUNTER AND WHAT
EFFECT DOES PEOPLE'S INFORMATION
SEEKING ON THE INTERNET, FOR
EXAMPLE, HAVE IN THE CLINICAL
ENCOUNTER WITH THEIR PROVIDER.
WE WILL HAVE QUESTIONS ON NEW
MULTICANCER EARLY DETECTION
TESTS AND PEOPLE'S KNOWLEDGE
ABOUT THOSE.
AND SO IN TERMS OF OUR
LONGITUDINAL PANEL, THIS IS
REALLY EXCITING.
SO, STARTING WITH HINTS 6, WE
HAD A QUESTION FOR PEOPLE TO
CONSENT TO BE CONTACTED BY
E-MAIL TO PARTICIPATE IN FUTURE
SURVEYS.
WE WERE THRILLED WE RECEIVED
2009 E-MAILS IN RESPONSE TO THAT
QUESTION. ONLY ABOUT 100 OF
THEM WERE INVALID. TO RECRUIT
FOR THIS WE PROVIDED A 20 DLRDZ
INCENTIVE AND WHEN PEOPLE
RECEIVED THE E-MAIL FROM US,
THEY WOULD GET $5 FOR UPDATING
CONTACT INFORMATION AND $15 FOR
COMPLETING ENROLLMENT SURVEY
THAT WAS ONE CREATED WITH OLD
HINTS ITEMS THEY HADN'T JUST
ANSWERED ON HINTS 6 BUT WERE
ITEMS THAT HAD BEEN FIELDED
BEFORE AND WAY TO ENGAGE IN A
QUITE SHORT SURVEY AND SO FAR WE
HAVE ABOUT 432 RESPONDENTS THAT
FULLY CONSENTED AND UPDATED
CONTACT INFORMATION AND
COMPLETED ENROLLMENT SURVEY AND
WE HAVE 87 THAT ARE JUST
PARTIALLY ENROLLED AND WILL
CONTINUE TO RECRUIT NEW PANEL
MEMBERS WITH HINTS 7 AT OUR ITEM
DEVELOPMENT RETREAT. WE JUST
DECIDED HOW TO CHANGE WORDING OF
OUR QUESTION ON THE SURVEY A
LITTLE BETTER TO PERHAPS
INCREASE MORE INTERESTS.
WHAT WE ARE HOPING IS THIS
LONGITUDINAL PANEL WILL, YOU
KNOW, BE ABLE TO LAUNCH FUTURE
HINTS SURVEYS WITH IT AND
SUPPORT OUR FEDERAL PARTNERS AND
OTHER INVESTIGATORS TO LAUNCH
SURVEYS ON OWN PANEL TO DO TREND
ANALYSIS AND LOOK AT CHANGES
OVER TIME IN CERTAIN CONSTRUCTS.
THAT WAS A LOT TO SAY.
THANK YOU ALL FOR LISTENING. WE
ARE A LITTLE OVER TIME. HAPPY
TO TAKE A FEW QUESTIONS IF YOU
WOULD LIKE BEFORE WE MOVE ON TO
THE NEXT SESSION.
>> SOME QUESTIONS?
>> QUESTION ABOUT THE HINTS
SEER. I UNDERSTAND THAT DE
DEMOTICS IN HINTS SEER -- THERE
ARE FEW MINORITIES SPECIFICALLY
AFRICAN AMERICANS ARE THERE
PLANS FOR ADDITIONAL SAMPLING IN
FUTURE YEARS?
>> THIS WAS A PILOT STUDY. YOU
ARE RIGHT. IOWA IS VERY WHITE
AND YEAH. THE WHOLE SAMPLE
ENDED UP BEING FAIRLY WHITE. WE
WILL NEED TO TALK ABOUT IT.
RIGHT NOW, OUR FOCUS, YOU KNOW,
FOR AN ADDITIONAL STUDY OUT OF
OUR BACKBONE CROSS-SECTIONAL
SURVEY IS ON OUR PANEL GIVEN
WHERE WE ARE AT NCI AND INTEREST
IN DATA USE HINTS SEER WE WILL
HAVE TO SEE IF WE DO IT AGAIN
AND USE A PUBLIC SET DATASET FOR
LINKAGES AND SAMPLING. WE HAVE
NOT TALKED ABOUT IT YET. WE ARE
JUST TRYING TO GET IT OUT INTO
THE WORLDED. WE HAVE TO THINK
ABOUT IT AND SEE WHERE OUR
PRIORITIES ARE. CERTAINLY AS I
SAID, IT IS ONE OF THE MOST
REQUESTED THINGS WE GET FROM
DATA USERS AND WOULD LIKE TO
CERTAINLY IMPROVE SAMPLE OF
CANCER SURVIVORS WE USE FOR OUR
DATA.
>> GREAT PRESENTATION.
I HAD A QUESTION ABOUT THE
NUMBER LIKE $20 FOR THE AMAZON
GIFT CARDS AND HOW YOU ALL KIND
OF DECIDED ON THAT PARTICULAR
NUMBER.
BECAUSE THERE IS JUST ONGOING
CONVERSATION ABOUT WHAT IS AN
APPROPRIATE AMOUNT. IF YOU NEED
TO INCREASE IT FOR SOME
POPULATIONS TO GET MORE INTEREST
AND ALSO IF YOU KNOW ON AVERAGE
HOW LONG IT TAKES PEOPLE TO
COMPLETE SURVEYS, ESPECIALLY PEN
AND PAPER ONES IF YOU HAVE ANY
INFORMATION ABOUT THAT.
>> I HAVE TO DEFER TO WESTAT
COLLEAGUES ON BOTH THOSE
QUESTIONS AND FEEL CERTAIN THAT
DAVID AND ANDREW GROUNDED OUR
INCENTIVE AMOUNT IN THE
LITERATURE.
FOR BOTH, YOU KNOW, UPDATING
CONTACT INFORMATION AND WHAT WE
GIVE FOR FULL ENROLLMENT.
WHAT -- I CAN'T SEE YOU GUYS.
IS THAT RIGHT?
I'M SURE THERE IS SOME
LITERATURE TO INDICATE, THANKS,
ANDREW, FOR SAVING ME HERE.
>> I WOULD SAY THE DECISION IS
BASED ON THE AVAILABLE BUDGET.
WE ARE TRYING OWE BE PRETTY
ECONOMICALLY ABOUT IT AND BASED
ON EFFECTIVENESS OF PROMISED
INCENTIVES YOU GIVE CONTINGENT
OF COMPLETING SURVEY AND TEND TO
BE LARGER THAN PREPAID
INCENTIVES AND ARE THOSE TWO
CONSIDERATIONS THAT LED TO OUR
$20 DECISION.
>> THANK YOU ANDREW. WHAT IS
THE OTHER QUESTION?
I'M SORRY.
>> ON AVERAGE HOW LONG
[INDISCERNIBLE].
>> YEAH.
30 MINUTES.
FUNNY YOU SHOULD ASK. WE HAVE
LOOKED AT IT TO MAKE SURE WE
WERE UNDER OUR ORIGINAL GOAL AND
WE TRY TO KEEP THE SURVEY AT
20ZOITE EMS IN 30 MINUTES AND
HITITE EMS IN 30 MINUT200
ITE EMS IN 30 MINUTES AND HIT
THAT.
>> WHAT IS DATA PROCESS FOR
RESEARCHERS AND ARE THERE
DIFFERENT TIERS FOR HINTS SEER
DATA.
>> WHAT IS DATA ACCESS IN PLACE
FOR RESEARCHERS AND ARE THERE
DIFFERENT TIERS?
>> SURE. THERE ARE NOT
DIFFERENT TIERS. PROCESS IF YOU
GO TO THE WEBSITE WHERE THERE IS
A FORM FOR RESTRICTED USE DATA
FILES, TELL US WHAT YOUR GOALS
ARE. YOUR HYPOTHESES.
THE DEPENDENT AND INDEPENDENT
VARIABLES YOU PLAN TO USE AND
DEAL WITH SMALL CELL SIZES AND 8
TO 10 QUESTIONS YOU HAVE TO
ANSWER.
THOSE COME TO HINTS MANAGEMENT
TEAM AND FOLLOW UP WITH
REQUESTER TO ASK QUESTIONS AND
WHEN WE ARE SATISFIED WE FEEL WE
CAN RELEASE THE DATA SET WE SEND
OUT A STRINGENT DATA USE
AGREEMENT THAT HAS TO BE SIGNED
AND WE SEND DATA OFF.
ANY OTHER QUESTIONS?
OKAY. I THINK WE ARE WAY OVER.
I WILL TURN IT TO RICK TO
INTRODUCE THE NEXT PANEL. THANK
YOU ALL.
>> THANK YOU, THANK YOU, THANK
YOU, KELLY. ALL RIGHT. I WILL
ASK FOR THE TWO PRESENTERS TO
COME, PLEASE. WHILE THEY ARE
DOING THAT I WILL SAY A COUPLE
WORDS. I'M SUPER EXCITED ABOUT
THIS. THIS IS ABOUT MAXIMIZING
DATA QUALITY AND AS A
METHODOLOGIST THIS IS OUR
BIGGEST CONCERN AND WANT TO
REALLY TALK ABOUT DATA QUALITY
AND TALKING ABOUT THINGS LIKE
RELIABILITY AND REPRODUCIBILITY
AND REPRODUCING DATA IS IT VALID
WE ARE MEASURING WHAT WE THINK
WE ARE MEASURING? ARE MEASURES
PRECISE AND ACCURATE AND CAN WE
GENERALIZE FROM SAMPLE TO
POPULATION?
VERY IMPORTANT WE ARE ACHIEVING
ALL THESE ISSUES .
I'M REALLY PLEASED WE HAVE TWO
PRESENTERS THAT WILL TALK
EXACTLY ABOUT THAT AND HOW TO
MAXIMIZE DATA QUALITY AND TURNS
OUT THEY ARE BOTH NAMED ANDREW.
YOU DON'T HAVE TO BE NAMED
ANDREW TO BE PART OF THE PANEL
AND TURNS OUT IT WORKS PRETTY
WELL AND FIRST PRESENTER IS
ANDREW KAP AR ACEO SENIOR
METHODOLOGIST AT WESTAT THAT IS
MAIN CONTRACTOR FOR DATA
COLLECTION THAT WILL BE TALKING
ABOUT MAXIMIZING DATA QUALITY
FROM THE DATA COLLECTION
PERSPECTIVE. THAT WILL BE
GREAT. AFTER HE FINISHES ANDREW
WILL COME NEXT AND ANDREW IS
RESEARCH DIRECTOR AT TRUTH
INITIATIVE AND FORMER COLLEAGUE
THAT I'M VERY PROUD OF
LE TALK ABOUT FROM THE DATA
ANALYSIS SIDE AND DATA
COLLECTION AND DATA ANALYSIS
THINKING ABOUT IT AND HOW WE CAN
MAXIMIZE. I HEAR SOME VERY LOUD
NOISE. OKAY. MAYBE WE CAN KIND
OF FIGURE THAT OUT. PARDON FOR
THAT. ACTUALLY, ANDREW, WE WILL
FIGURE THAT OUT. YOU SHOULD
COME UP AND TALK.
ALL RIGHT. ANDREW, YOU ARE UP.
>> ALL RIGHT. HI, EVERYBODY.
THANK YOU FOR THE INTRODUCTION,
RICK. I'M ANDREW AND I WORKED
ON THE HINTS PROJECT OVER 10
YEARS AND OVER THAT TIME MY MAIN
ROLE IS TO OVERSEE VR EVOLVING
DATA INSTRUMENT IN DATA
COLLECTION PROCEDURES AND YOU
KNOW EVERY TIME HINTS GOES IN
FIELD SURVEY HAS UNIQUE MIX OF
CORE CONTENT THAT IS A LITTLE
DIFFERENT AND YOU ARE LESS
FAMILIAR WITH THE FACT THAT MOST
CYCLES IN MOST CYCLES WE ARE
ALSO EXPERIMENTING WITH HOW WE
DO DATA COLLECTION PROCEDURES TO
HELP INFORM BEST PRACTICES FOR
FUTURE DATA COLLECTION.
HINTS HAS A RICH HISTORY OF
EXPERIMENTATION DATING BACK TO
HINTS 1 AND IN ADDITION TO
TESTING AND ADOPTING NEW MODES
OF DATA COLLECTION WE
EXPERIMENTED WITH OTHER FACTORS
HOW TO DESIGN GRID QUESTIONS AND
WHAT IS BEST PROTOCOL FOR
DISTRIBUTING SPANISH LANGUAGE
MATERIALS AND MIGHT HAVE SEEN
PROJECT DIRECTOR TERRY
SUMMARIZING EXPERIMENTS WE HAVE
DONE THROUGHOUT THE YEARS AND
SHE PRESENTED IT YESTERDAY AND
ENCOURAGE YOU TO ASK HER
DETAILED QUESTIONS ABOUT THE
EXPERIMENTS AND IN THIS
PRESENTATION HOPING TO TELL YOU
ABOUT TWO LATEST EXPERIMENT
IMBEDDED INTO HINTS 6 AND WILL
SHARE WHAT WE DID AND FOUND AND
HOW FACTORS WE ARE TESTING
ULTIMATELY GO ON TO INFORM DATA
QUALITY AND IMPACT YOUR
ANALYSIS.
SO, JUST REAL QUICKLY, THESE ARE
-- WE HAD TWO EXPERIMENTS IN
HINTS 6. BOTH WHICH WERE
EXTENSIONS OF EXPERIMENTS WE
CONDUCTED IN HINTS 5 CYCLE 3
WHEN FIRST TESTED MIXED MODE
PAPER PLUS PUSH TO WEB DESIGN
AND EXPERIMENTS 1 I WILL CALL WE
COMPARED TWO WAYS DELIVERING
MULTIPLE MODES OF DATA
COLLECTION, EITHER CONCURRENT
SENT BOTH AT SAME TIME OR
SEQUENTIALLY MEANING WE OFFERED
WEB FIRST AND PAPER AND WEB AND
FUTURE MAILINGS AND SECOND
EXPERIMENT TESTED IMPACT OF
PROMPTING INTERVENTIONS KNOWN AS
POP-UPS APPEARING TO WEB
RESPONDENTS THAT RESPONDED TO
CERTAIN QUESTIONS TOO FAST OR
WHEN STRAITH LINING ANSWERING
CERTAIN QUESTIONS THAT I WILL DO
A VERY HIGH-LEVEL OVERVIEW OF
BOTH EXPERIMENTS AND TIE IT ALL
TOGETHER AT THE END.
HERE WE GO. FIRST, EXPERIMENT
ONE ABOUT MIXED MODE EXPERIMENT
AND SLIDESHOWS ARE RESEARCH
QUESTIONS IN THE EXPERIMENTAL
DESIGN FOR THIS EXPERIMENT THAT
WE ARE INTERESTED IN LEARNING
HOW CONTROL CONDITION OFFERING
WEB AND PAPER AT THE SAME TIME
AND INCENTIVIZING PEOPLE TO
RESPOND BY WEB AND HOW THAT
COMPARED TO A DESIGN WHERE
RESPONDENTS WERE ONLY OFFERED
WEB IN THE FIRST MAILING WITH NO
PARTICULAR INCENTIVE TO USE IT
BESIDES NORMAL PREPAID $2
INCENTIVE WE SENT TO EVERYBODY
AND AFTER THAT MAILING WE
FOLLOWED UP WITH WEB AND PAPER
IN PERSON THAT HOUSEHOLD DIDN'T
RESPOND TO THE INITIAL
INVITATION AND KNEW FROM PAST
EXPERIMENTS THAT CONCURRENT
APPROACH WORKED WELL AND
WOULDN'T UNDERSTAND WHETHER
SEQUENTIAL DESIGN COULD ACHIEVE
SIMILAR RESPONSE OUTCOMES MORE
AFFORDABLY AND IN PARTICULAR ARE
INTERESTED IN MAXIMIZING OUR WEB
RESPONSE THAT REDUCES PRINTING
AND SHIPPING AND DATA PROCESSING
THAT HAS TO DO MAKING HINTS
LANER AND GREENER.
OKAY.
WHAT DID WE FIND?
COMPARED TO CONTROL CONCURRENT
CONDITION, THE SEQUENTIAL DESIGN
THAT ACHIEVED AN OVERALL LOWER
RESPONSE RATE AND LOWER RESPONSE
-- LOWER PERCENT RESPONDING BY
WEB AND WE TOOK WEB FIRST AND
[INDISCERNIBLE] AND WE ALSO SAW
MORE PEOPLE DROP OUT EARLY.
THEY DIDN'T HAVE THAT PROMISED
INCENTIVE TO GO THROUGH THE WEB
SURVEY AND WE ALSO SAW THAT THEY
ARE IN THE SEQUENTIAL GROUP THAT
THERE ARE MORE OLDER RESPONDENTS
AND OTHERWISE TWO SAMPLES WERE
DEMOGRAPHICALLY PRETTY SIMILAR
AND WERE VERY FEW SIGNIFICANT
DIFFERENCES IN SURVEY ESTIMATES
BETWEEN PEOPLE THAT HAVE
CONCURRENT AND SEQUENTIAL DESIGN
AND ABOUT -- WE LOOKED AT ALL
DIFFERENT SURVEY QUESTIONS AND
ABOUT AS MANY CAME UP
SIGNIFICANT AS WOW EXPECT BY
CHANCE ALONE.
ULTIMATELY, SEQUENTIAL MIXED
MODE DESIGN HAD WORSE RESPONSE
OUTCOMES IN CONTROL CONDITION
AND LESS EXPENSIVE ACHIEVING
MOSTLY A COMPARABLE SAMPLE THAT
WAS EXPERIMENT 1. ON TO
EXPERIMENT 2.
EXPERIMENT 2 COMPARED THREE
DIFFERENT APPROACHES TO
INTERVENING WHEN WEB RESPONDENTS
EXHIBITED TWO BEHAVIORS
ASSOCIATED WITH POOR DATA
QUALITY. FIRST BEHAVIOR IS
SPEEDING ANSWERING QUESTION
FASTER THAN TIME IT TAKES TO
READ IT AND INCLUDED A PROMPT
APPEARING RESPONDENTS ON LESS
TIME ON CERTAIN PAGES EXPECTED
BASED ON NUMBER OF WORDS IN THE
PAGE AND EXPECTED READING SPEED
BASED ON THEIR AGE AND SECOND
BEHAVIOR WE TARGETED WITH
STRAITH LINING THAT WAS CHOOSING
SAME ANSWER FOR ALL ITEMS IN A
GRID WHEN WE EXPECT VARIATION IN
THE RESPONSE.
WE INCLUDED STRAITH LINING
PROMPTS ON 7 GRIDS THOUGHT IT
WAS UNLIKELY FOR RESPONDENTS TO
LJITY MEATALLY CHOOSE EXACT
RESPONSE FOR ALL SUBITEMS AND
EXPERIMENTED WITH HOW MANY
PROMPTS TO ADMINISTER 0 PROMPTS
ONE OF EACH PROMPT OR TWO OF
EACH PROMPT AND INTERESTED IN
WHETHER MORE PROMPTS WOULD
FURTHER LIMIT UNDESIRABLE
BEHAVIORS AND AT WHAT COST IT
MIGHT HAVE TO OUR RESPONSE RATE
IF WE POTENTIALLY ANNOY
RESPONDENTS TOO MUCH.
THIS IS WHAT THE PROMPT LOOKED
LIKE FOR STRAITH LINING PROMPTS
WHICH THIS IS THE EXAMPLE FROM
HINTS 5 AND DESIGN WAS SAME FOR
HINTS 6 AND SEE MY TIME HAS SHUT
DOWN AND WILL DESCRIBE THIS AND
TELLS IN NOTES THE RESPONDENT
STRAITH LINED AND ASKED WHAT IS
THE NOTE WE WOULD LIKE THEM TO
BE CONSIDERING ANSWERS
SEPARATELY AND ASKED IF THEY ARE
WILLING TO GO BACK AND
RECONSIDER ANSWERS. THEY CAN DO
THAT OR SAY NO. IF SAYING NO
THEY MOVE ON.
OKAY. ON TO RESULTS. THIS
TABLE OR CHART SHOWS OVERALL
RESPONSE RATE BY THREE TREATMENT
GROUPS AND YOU CAN SEE MORE
PROMPTS LED TO LOWER RESPONSE
RATES AND RESPONSE RATES ARE
SIGNIFICANTLY DIFFERENT FROM ONE
ANOTHER AND SUGGEST THAT SOME
RESPONDENTS WEREN'T PLEASED WITH
GETTING PROMPTED AND WE SORT OF
ANTICIPATED THIS IN ADVANCE AND
MADE SURE TO ALLOCATE A SMALL
PORTION OF RESPONDENTS TO TWO
PROMPTING CONDITIONS TO OFFSET
NEGATIVE EFFECTS WE POTENTIALLY
WERE ANTICIPATING ON THE
RESPONSE RATE.
HOW DID THE PROMPTS EFFECT THE
BEHAVIORS THAT THEY TARGETED?
FOR SPEAKING, FIRST TABLE SHOWS
WHAT KELLY MENTIONED BEFORE
OVERALL COMPLETION TIME BY
TREATMENT GROUP HERE IS ABOUT 30
MINUTES THAT WE TARGET FOR IRB
BURDEN CONSIDERATIONS.
AND WE CAN SEE THAT THOSE
PROMPTS RESPONDED SLOWER THAN
THOSE WITH TWO AND BOTH GROUPS
RESPONDED SLOWER THAN THOSE WITH
NO PROMPTS AND THESE PROMPTS
LOOKS LIKE WERE EFFECTIVE AT
SLOWING PEOPLE DOWN AND SECOND
TABLE SHOWS STRAIGHTLINING
RESULTS AND THIS IS MORE
COMPLICATED. I WILL BREAK IT
DOWN. FIRST HALF OF THE TABLE
SHOWS DIFFERENCES BY TREATMENT
GROUP IN PROPORTION OF
RESPONDENTS THAT STRAIGHTLINED
IN EACH OF THE GRIDS WITH
STRAIGHTLINING PROMPTS OF WHICH
THERE WERE 7. GROUP A IS NO
PROMPTS. B IS TWO PROMPTS AND C
IS 4 PROMPTS AND SECOND HALF OF
TABLE SHOWS P VALUE FOR
DIFFERENCES AND STATISTICALLY
SIGNIFICANT DIFFERENCES THAT ARE
HIGHLIGHTED IN RED AND RESULTS
SHOW THAT COMPARED TO NO PROMPTS
TWO PROMPTS AND FOUR PROMPTS
YIELDED STRAIGHTLINING IN MOST
GRIDS THAT WERE INVOKED AND
HOWEVER WERE NO SIGNIFICANT
DIFFERENCES WITH 2 OR 4 PROMPTS
AND ADDING ADDITIONAL PROMPTS
DIDN'T FURTHER DO STRAIGHTLINING
AND RESULTS INDICATE THAT
PROMPTS WERE EFFECTIVE
ADDRESSING BEHAVIORS THEY
TARGETED AND COST OF SLIGHT HINT
TO RESPONSE RATE I WILL SHOW IN
LAST SLIDE AND WILL ADD WE WILL
LOOK AT RESPONSE DISTRIBUTIONS
FOR KEY ESTIMATES ACROSS
PROMPTING CONDITION GROUPS THAT
WERE NOT SIGNIFICANT DIFFERENCES
IN THE OVERALL RESULT IN POINT
ESTIMATES THAT IS GOOD.
OKAY. ALL RIGHT. SO, THAT IS
THE CRASH COURSE IN THE TWO
EXPERIMENTS. I WOULD LIKE TO
CONCLUDE BY TALKING A LITTLE
MORE ABOUT HOW RESULTS RELATE TO
YOUR ANALYSIS. IN EXPERIMENT
ONE WE SAW CONTROL CONDITION AND
CONCURRENT MIX GROUP GOT AN
ACHIEVED MORE RESPONSES THAN THE
SEQUENTIAL GROUP AND IS
OBVIOUSLY IDEAL TO GO WITH THE
DESIGN THAT GARNERS THE MOST
RESPONSE. MORE RESPONSES MEANS
MORE POWER FOR ANALYSIS AND LESS
SCRUTINY FOR REVIEWERS ABOUT
POTENTIAL NONRESPONSE BIAS AND
-- RESPONDENTS WERE ULTIMATELY
NOT THAT DIFFERENT FROM THE
CONCURRENT GROUP.
SO, THIS TOPIC OF COST IS
ADMITTEDLY LESS RELEVANT FOR
ANALYSIS BUT IS IMPORTANT TO NCI
THAT HAS TO PAY FOR HINTS AND
WESTAT THAT HAS TO ADMINISTER IT
AND MORE PROMPTS HEARD RESULT
DATA AND LESS DATA YOU THAT
NOBODY LIKES AND EXPECT REDUCING
SPEEDING AND STRAIGHTLINING THAT
DATA YOU GET IS LESS NOISY AND
MORE VALID AND HARD TO SEE
DIFFERENCE BETWEEN DATA FROM
SPEEDER AND NONSPEEDER BUT WE
CAN UNDERSTAND THAT A PERSON WHO
SPENT TWO -- DID NOT SPEND
ENOUGH TIME ON THE QUESTION TO
FULLY READ IT IS NOT LIKELY TO
GIVE YOU HIGH-QUALITY DATA AND
STRAIGHTLINING ON OTHER HAND CAN
BE VISIBLE IN DATA.
AND RESULTS, YOU KNOW, IN -- IN
PEOPLE WHO -- IF YOU HAVE
STRAIGHTLINING GOING ON, THIS
RESULTS IN LESS VARIATION ACROSS
RESPONSES THAN MIGHT BE EXPECTED
AND DON'T WANT TO ARTIFICIALLY
INFLATE VARIANCE WHERE THERE
SHOULDN'T BE. YOU KNOW, SOME
PEOPLES STRAIGHTLINE
LEGITIMATELY AND WE WERE NOT
PUSHY ABOUT MAKING THEM CHANGE
ANSWERS AND WERE VERY SELECTIVE
ABOUT THE ACTUAL GRIDS THAT WE
INVOKED THE STRAIGHTLINE
RESULTS.
SO, THAT IS ALL MY TIME. I
WANTED TO HAVE ONE FINAL WORD
THAT IS THAT WE ULTIMATELY
DESIGN SURVEYS SO YOU AS
ANALYSTS DON'T NEED TO REALLY
PAY MUCH ATTENTION TO THEM. YOU
KNOW, WE KNOW YOU ARE NOT AS
INTERESTED IN METHODS AS WE ARE
AND ULTIMATELY IS VERY GOOD FOR
YOU TO BE AWARE OF EXPERIMENTS
THAT WERE HAPPENING AND HOW THEY
RELATE TO YOUR QUESTIONS AND SO
I HOPE THAT YOU ARE MORE AWARE
IN THE FUTURE IF YOU WEREN'T
ALREADY AND PRESUMABLY YOU
ALREADY KNEW ALL THIS. THANK
YOU FOR YOUR TIME THIS MORNING
AND LOOK FORWARD TO YOUR
QUESTIONS.
THA
THANKS.
>> ALL RIGHT. GOOD MORNING,
EVERYONE. I'M ANDREW AND REALLY
EXCITED TO HAVE THIS OPPORTUNITY
TO TALK TO ALL OF YOU ABOUT
PRICSSA A CHECKLIST DESIGNED BY
RESEARCHERS ANALYZING COMPLEX
SURVEY DATA YOU THAT IS ALL OF
YOU. HIRNTS IS EXAMPLE OF
COMPLEX SURVEY DATA SET AND WE
CREATED THE CHECKLIST TO HELP
REDUCE ANALYSIS ERRORS AND
INCREASE TRANSPARENCY AND IN MY
PRESENTATION I WILL GO THROUGH
ITEMS OF PRICSSA AND BEFORE I DO
THAT I WANT TO PROVIDE A LITTLE
BACKGROUND AND CONTEXT FOR WHY
WE CREATED PRICSSA. TO GIVE A
BRIEF DEFINITION, COMPLEX SURVEY
DATA AND FIRST TWO DATA COMING
FROM A PROBABILITY SAMPLE THAT
USES SAMPLING PROCEDURES
INCLUDING STRATIFICATION
[INDISCERNIBLE] UNEQUAL
PROBABILITY OF SELECTION AND USE
COMPLEX SAMPLING BECAUSE IT HAS
MANY ADVANTAGES OVER SIMPLE
RANDOM SAMPLING INCLUDING
REDUCING COSTS AND IMPROVING
STATISTICAL EFFICIENCY AND
SUBGROUP ESTIMATES AND WHEN
ANALYZED CORRECTLY WE CAN MAKE
INFERENCES TO A POPULATION OR
SUBPOPULATION OF INTERESTS.
THIS IS GREAT WITH THIS DATA WE
CAN THEN DO RESEARCH RELATED TO
SURVEILLANCE AND TRENDS AND
HEALTH DISPARITIES RESEARCH AND
POLICIES AND INTERVENTIONS AND
THIS IS R-' SEARCH YOU ARE ALL
DOING WITH HINTS DATA THAT IS
ALL GREAT. THERE IS ONE PROBLEM
THOUGH. THAT IS OUR STATS
SOFTWARE BY DEFAULT ASSUME DATA
COMES FROM A SIMPLE RANDOM
SAMPLE AND ONUS ON US TO ANALYZE
DATA CORRECTLY TO CAN THE FOR
COMPLEX DESIGN FEATURES.
IF USING THE CORRECT SOFTWARE
PROCEDURES TO ACCOUNT FOR
COMPLEX FEATURES AND FAILING TO
DO SO CAN PRODUCE WHAT IN THE
LITERATURE REFERRING TO AS
ANALYTIC ERROR THAT CAN LEAD TO
BIASED ESTIMATES AND INCORRECT
STANDARD ERRORS AND TYPE 1
ERRORS.
ANOTHER ISSUE IS REFERRED TO AS
REPORTING ERROR WHICH IS WHERE
AUTHORS FAIL TO ADEQUATELY
DESCRIBE DATA RESOURCES AND
PLANS FOR REPRODUCIBILITY BY
OTHERS AND UNFORTUNATELY BOTH OF
THE PROBLEMS ARE OCCURRING IN
THE LITERATURE AND THESE ARE
REFERENCES THAT THEY HAVE
DOCUMENTED THIS ISSUE.
SO, WE CREATED PRICSSA TO REDUCE
BOTH OF THESE PROBLEMS, ANALYTIC
ERROR AND REPORTING ERRORS AND
WANT TO GIVE A QUICK EXAMPLE OF
ANALYTIC ERROR. ANALYZING
COMPLEX SURVEY DATA THERE IS
REALLY TWO PARTS TO CONSIDER.
THERE IS WAITING AND VARIANCE
ESTIMATION. ONE COMMON MISTAKE
IS WHERE AUTHORS OR RESEARCHERS
WILL WAIVE DATA NOT ACCOUNTING
FOR CLUSTERING STRATIFICATION OF
COMPLEX DESIGN FEATURES THAT
LEADS TO INCORRECT VARIANCE
ESTIMATION AND EFFECTS STANDARD
ERRORS AND [INDISCERNIBLE] AND P
VALUES THAT I WANT TO GIVE A
QUICK EXAMPLE OF THIS FROM A
PAPER FROM BRIAN WARD AND
REFERENCE IS ON BOTTOM OF THE
SLIDE. IN THE EXAMPLE HE IS
ESTIMATING A PREVALENCE OF AN
OUTCOME AMONG NON-HISPANIC
WHITES AND HISPANICS AND REPORTS
IN THIS COLUMN LABELED SERIES 1
A PREVALENCE ESTIMATE AND
WEIGHTED PREVALENCE ESTIMATE AND
CONFIDENCE ERROR AND STANDARD
ERROR AND P VALUE COMPARING AND
TESTING IF TWO ESTIMATES ARE
EQUAL OR NOT AND FIRST EXAMPLE
DATA WAS WEIGHTED AND CLUSTERING
STRATIFICATION WAS NOT ACCOUNTED
FOR AND VARIANCE ESTIMATION WAS
INCORRECT.
IN THE COLUMN LABELED SERIES 2,
DATA WERE WEIGHTED WITH
CLUSTERING STRATIFICATION WORKED
DIRECTLY ACCOUNT FORD VARIANCE
ESTIMATION IS CORRECT AND NOTICE
THAT WEIGHTED ESTIMATES ARE THE
SAME AND COUNTING FOR CLUSTERING
STRATIFICATION DOESN'T EFFECT
ESTIMATES BUT STANDARD ERRORS
THAT THEY INCREASED AND DOUBLED
AND NOTICE THAT CONFIDENCE
INTERVALS GOT WIDER AND P VALUE
INCREASED FROM .02 TO .26 HERE
FAILING TO ACCOUNT FOR COMPLEX
DESIGN FEATURES WOULD HAVE LED
TO TYPE 1 ERROR AND AS A GENERAL
RULE THERE ARE EXCEPTIONS THAT
GENERALLY WAITING INCREASING
STANDARD ERRORS AND CONFIDENCE
INTERVALS WIDER AS THEY REDUCE
STANDARD ERRORS AND CONFIDENCE
INTERVALS GET NARROWER AND IS A
LITTLE CONTEXT AND WE CREATED
PRICSSA TO REDUCE THIS PROBLEM
AND INCREASE TRANSPARENCY AND
THE PRICSSA CHECKLIST IS NOW
PUBLISHED AND AVAILABLE OPEN
ACCESS GOOGLE PRICSSA REPORTING
ITEMS FOR COMPLEX SAMPLE SURVEY
ANALYSIS AND HIGHLIGHTING MY TWO
AUTHORS.
CHECKLIST HAS 14 ITEMS 5 OF
WHICH ARE RELATES TO SURVEY
CHARACTERISTICS AND 9 ANALYTIC
CHARACTERISTICS AND TLAE
ADDITIONAL ITEMS THAT ARE
OPTIONAL TO BE USED AS NEEDED
AND AGAIN THIS CHECKLIST WAS
CREATED TO REDUCE ANALYTIC
ERRORS AND REPORTING ERRORS WE
ARE SEEING AND THIS CHECKLIST IS
NOW PART OF THE EQUATOR NETWORK.
I WILL TRY TO GO QUICKLY THROUGH
THE CHECKLIST.
DATA COLLECTION DATES PROVIDES
HISTORICAL CONTEXT WHAT IS GOING
ON WHEN CHRIS WAS COMPLETING THE
SURVEY DATA COLLECTION MODE
SURVEYS CHANGES OVER TIME WITH
HINTS AND DURING COVID PEOPLE
HAD TO CHANGE MODE AND HOW
PEOPLE RESPOND TO SURVEY AND
NONRESPONSE IS IMPORTANT TO
REPORT THAT IN YOUR PAPER.
TARGET POPULATIONS WOULD BE US
ADULT AND HIGH SCHOOL STUDENTS
AND DESIGN TODAY REPRESENT AND
IMPORTANTLY CONDUCTING WEIGHTED
ANALYSIS YOU SHOULD INTERPRET
ESTIMATES WITH RESPECT TO TARGET
POPULATION AND SUB INTERINTERES
IT SHOULD BE US ADULTS WHATEVER
TARGET POPULATION IS. AUTHORS
SHOULD DESCRIBE SAMPLE OF DESIGN
AND IMPLICATIONS FOR ANALYSIS
AND VARIANCE ESTIMATION.
RESPONSE RATE AND HOW IT WAS
CALCULATED.
MISSINGNESS RATES AND ANYTHING
DONE TO ACCOUNT FOR MISSINGNESS
SUCH AS IMPUTATIONS.
OBSERVATION DELETION, DELETING
OBSERVATIONS AND THEY LEAD TO
INCORRECT VARIANCE ESTIMATION
AND IT DOESN'T HAPPEN WITH
REPLICATE WEIGHTS BUT TAILOR
SERIES -- GENERAL RULE OF THUMB
I ENCOURAGE YOU NEPHRTO DELETE
OBSERVATIONS ANALYZING COMPLEX
SURVEY DATA. IN SOME SITUATIONS
IT COULD LEAD TO INCORRECT
VARIANCE ESTIMATION.
BECAUSE OF THIS WE ARE ASKING
AUTHORS TO STATE IN METHODS
WHETHER OR NOT OBSERVATIONS WERE
DELE
DELETED.
INCLUDE UNWEIGHTED SAM SIZE FOR
ESTIMATES READER REVIEWERS
POPULATION ESTIMATE OFF SAMPLE
SIZE OF 6 PEOPLE OR 6,000.
ALL WEIGHTED ESTIMATES INCLUDE
STANDARD ERRORS THAT DOESN'T
HAVE TO BE IN TEXT BUT COULD BE
IN TABLE OR SUPPLEMENTARY TABLE.
X IS WEIGHTING SO DESCRIBE WHICH
ANALYSIS WERE WEIGHTED AND
COMMUNICATE WHICH VARIABLE WAS
USED IN WEIGHTING HINT DATA SET
THERE IS SAMPLE AND THIS COULD
BE CONFUSING AND PEOPLE USING
WRONG WEIGHT AND OTHER SURVEYS
LONGITUDINAL SURVEYS ARE
CONFUSING LONGITUDINAL AND
CROSS-SECTIONAL WEIGHTS THAT WE
FELT WAS IMPORTANT AUTHORS
SHOULD STATE IN METHOD SECTION
WHAT VARIABLES THEY USE TO
WEIGHT DATA AND IN E IS VARIANCE
ESTIMATION THAT MIGHT BE MOST
IMPORTANT ITEM IN THE CHECKLIST
GIVEN COMMON MISTAKE OF
INCORRECT VARIANCE ESTIMATION
AND IS IMPORTANT THIS AUTHORS
REPORT METHOD USED FOR VARIANCE
ESTIMATION AND WE RECOMMEND
LISTING VARIABLES USED COULD BE
REPLICATE WEIGHTS OR THERE IS
SOMETHING MISSING HERE. TAILOR
SERIES LINEARIZATION.
NEXT IS SUBPOPULATION ANALYSIS.
WHEN CONDUCTING SUBPOPULATION
ANALYSIS IT IS STRONGLY
RECOMMENDED YOU USE CORRECT
SUBPOP COMMANDS WHEN USING
TAILOR SERIES LINEARIZATION
VARIANCE ESTIMATION THERE IS
SPECIAL CODE NEEDED FOR
SUBPOPULATION LEVEL ANALYSIS
USING INCORRECT CODE WILL LEAD
TO INCORRECT [INDISCERNIBLE]
ESTIMATION AND THIS DOESN'T
HAPPEN WITH REPLICATE WEIGHTS
BUT STRONGLY RECOMMENDED YOU USE
CORRECT SUBPOP COMMANDS
REGARDLESS OF METHOD OF
VARIANCE.
NEXT IS SUPPRESSION RULE. KELLY
TALKED ABOUT THIS EARLIER.
PRICSSA CHECKLIST DOESN'T
REQUIRE TO USE SUPPRESSION RULE.
HINTS DATA SET DOESN'T HAVE.
I WORK WITH HINTS DATA ALL THE
TIME AND FOLLOW SUPPRESSION RULE
AND USE ONE RECOMMENDED BY
NATIONAL CENTER FOR HEALTH
STATISTICS. I CAN TALK ABOUT IT
DURING THE Q & A IF YOU HAVE
QUESTIONS AND THIS PUBLISHED
FROM NWR THERE ARE CELLS THAT
ARE BLANK AND AT BOTTOM SAID
THAT DATA WAS UNRELIABLE THAT IS
EXAMPLE OF SUPPRESSION RULE.
LAST ITEM IS SOFTWARE AND CODE.
THERE IS SOME SMALL DIFFERENCES
BETWEEN SOFTWARES ANALYZING
COMPLEX SURVEY DATA THAT IS
SMALL AND IMPORTANT FOR AUTHORS
TO DISCLOSE WHAT SOFTWARE
VERSION THEY USE AND THAT
AUTHORS MAKE CODE PUBLICLY
AVAILABLE TO MAXIMIZE
TRANSPARENCY. IF YOU HAVE NOT
DONE IT BEFORE IT IS EASY AND
THERE IS SEVERAL FREE ONLINE
REPOSITORIES CREATING ACCOUNT
AND UPLOADING CODE AND WILL
CREATE A SHAREABLE LINK YOU CAN
PUT IN YOUR PAPER.
>> CHECKLIST 14 ITEMS -- ALL OF
THE ESSENTIAL PRICSSA
INFORMATION THAT AUTHORS NEED IN
THAT IS A EXAMPLE FROM THE PAPER
AND EXCITED THAT HIBTS HAS
CREATED A PRICSSA PAGE TO MAKE
IT EASY TO COMPLY AND IT IS ON
THE HINT WEBSITE DATA TAB AND
DROPDOWN AND FROM HERE YOU CAN
DOWNLOAD AN EXCEL SPREADSHEET
AND PRICSSA INFORMATION FOR ALL
WAVES OF HINTS AND THANK YOU TO
THE PRICSSA TEAM FOR DOING THAT
AND HAPPY TO ANSWER ANY
QUESTIONS.
I HAVE A QUESTION YOU MENTIONED
FOR SUBGROUP ANALYZES WE HAVE TO
USE [INDISCERNIBLE] DOMAIN THAT
IT ANALYZES AND FOR EXAMPLE ON
CAREGIVERS I NEED TO USE THAT
DOMAIN COMMENT FOR SAAS.
>> I'M HAPPY TO CHAT WITH YOU
AFTER INDIVIDUALLY AND WE CAN
GET INTO A LENGTHY DISCUSSION OF
THE CODE. ANALYZING COMPLEX
SURVEY DATA IS STRONGLY
RECOMMEND TODAY USE CORRECT
SUBPOP CODE FOR SAAS USERS IS A
DOMAIN CO-MANNED AND THAT ENSURE
VARIANCE ESTIMATION IS CORRECT.
I -- IT MIGHT BE BEST IF WE
CHATTED ONE ON ONE AFTERWARDS.
>> SURE.
>> I CAN HELP WITH THAT.
>> THANK YOU.
>> GOOD MORNING. NOT SURE IF
TRUE FOR HINTS BUT OTHER COMPLEX
SURVEYS. THERE ARE MULTIPLE
RESPONSE RATES YOU CAN FIND IF
YOU GO THROUGH METHODOLOGY.
WHICH ONE SHOULD WE BE LOOKING
FOR?
>> REALLY GOOD QUESTION THAT I
DON'T THINK I HAVE A GREAT
ANSWER RIGHT NOW.
IT WILL DEPEND WHAT ANALYSIS
AND POPULATION YOU ARE WORKING
WITH AND WHAT DATA SET AND MORE
INFORMATION THE BETTER. I --
YEAH. I CAN'T REALLY GIVE A
SPECIFIC ANSWER THAT IT WILL
DEPEND.
>> OKAY.
>> SOMETHING WE COULD INCLUDE IN
OUR MANUSCRIPT. GREAT QUESTION.
>> NEXT MODERATOR IS NEWEST TEAM
MEMBER MARIA WHO WILL MODERATE
THE NEXT PANEL, I BELIEVE. COME
ON UP.
>> HELLO AND GOOD MORNING,
EVERYBODY. CLOSE TO LUNCH. IF
ALL PANELISTS COULD COME UP FOR
SESSION NO. 3 FOR MEASURE
METHODS AND DATA LINKAGES. I
WILL DO A COUPLE OVERALL NOTES.
LUNCH WILL BE RIGHT AFTER THIS
UPSTAIRS AND WE CAN COME BACK BY
1 O'CLOCK PROMPTLY TO START THE
SESSION -- UNDERSCORING THE
POTENTIAL FOR USING HINTS DATA
IN INNOVATIVE WAYS FOR LINKING
TO OTHER TYPES OF DATA SETS THAT
IS REGISTRY DATA TO ASSESSING
ITEMS AND MEASURES THROUGHOUT
DIFFERENT HINTS CYCLES THAT IS
VERY MUCH LOOKING FORWARD TO
HEARING FROM OUR PRESENTERS THAT
I WILL QUICKLY INTRODUCE. THEY
WILL EACH HAVE UP TO 12 MINUTES
TO DO PRESENTATIONS AND AT END
WHATEVER REMAINING TIME WE WILL
HAVE WE WILL OPEN THE FLOOR FOR
QUESTIONS.
FIRST, HEARING FROM DR. MARK WHO
IS THE DEVELOPMENT DIMENSIONS
INTERNATIONAL ENDOWED PROFESSOR
OF HEALTH BEHAVIOR AND SOCIETY
IN COLLEGE OF PUBLIC HEALTH AT
UNIVERSITY OF KENTUCKY AND
SECONDARY WILL HEAR FROM KAIYI
WEN DATA PRACTICE AREA AT RT
INTERNATIONAL AND LASTLY WE WILL
HEAR FROM CELESTE CAMPOS
CASTILLO WHO IS AT MICHIGAN
STATE UNIVERSITY.
WITHOUT FURTHER ADO.
>> THANK YOU. GOOD MORNING,
EVERYBODY. FOR THE MOST PART
WHEN WE ASK PEOPLE ABOUT THEIR
PERCEIVED RISK FOR CANCER WE DO
IT WITH A QUESTION THAT LOOKS
LIKE THIS. MIGHT LOOK FAMILIAR
AND HAS BEEN IN MANY HINTS
ITERATIONS.
BEHAVIORALLY WHEN WE GIVE PEOPLE
THAT KIND OF QUESTION, MOST GIVE
US AN ANSWER THAT IS A
SCALE-POINT RESPONSE THAT TELLS
US SOMETHING ABOUT THEIR LEVEL
OF RISK.
PAINFULLY OBVIOUS IT SEEMS FOR
COMFORTS AS FANCY AS HINTS.
IF YOU MAKE A VERY SMALL CHANGE
IN WAY THAT YOU ASK ABOUT
PERCEIVED RISK, ADD THE OPTION
FOR PEOPLE TO SAY THAT THEY
DON'T KNOW WHAT THEIR RISK FOR
CANCER IS.
YOU GET VERY DIFFERENT DATA THAT
IS NATIONALLY REPRESENTATIVE
SURVEY OUR GROUP DID SIX MONTHS
BEFORE THE ADMINISTRATION THAT I
JUST SHOWED YOU. WHAT WE FOUND
IS THAT ALMOST HALF OF AMERICAN
ADULTS SAID THAT THEY DIDN'T
KNOW THEIR RISK FOR COLON
CANCER.
NOW, I HAVE TO SAY BECAUSE
OTHERWISE THAT ONE PERSON IN THE
AUDIENCE WILL ASK THE QUESTION
AND I KNOW QUESTIONS ARE NOT
DIRECTLY COMPARABLE THAT WE WILL
GET TO IN A MINUTE. THERE IS A
REALLY IMPORTANT IMPLICATION
THAT COMES UP FROM DATA AND
QUESTION WE NEED TO ADDRESS THAT
IS A QUESTION OF WHAT HAPPENS
WHEN SOMEBODY CAN'T TELL YOU
THEY DON'T KNOW THEIR RISK FOR
CANCER BECAUSE YOU DON'T ASK THE
QUESTION?
IMPLICATION WHAT I JUST SHOWED
YOU IS THERE IS A MEANINGFUL
PORTION OF THE US POPULATION
THAT WOULD SAY THEY DON'T KNOW
THEIR RISK IF GIVEN OPPORTUNITY
TO DO SO YET IF YOU DON'T GIVE
THEM THAT OPPORTUNITY THEY
GENERATE A SCALE POINT RESPONSE
SURVEY METHODOLOGY PERSPECTIVE
BECOMES REALLY IMPORTANT TO
UNDERSTAND WHAT THEY ARE DOG AND
WHAT SCALE POINT RESPONSE THEY
ARE GENERATING AND WHAT THAT
MEANS FOR THE WAY THAT WE THINK
ABOUT AND UNDERSTAND PERCEIVED
RISK AND RELATION TO OTHER
CONSTRUCTS.
WITH A BIG THANK YOU TO THE
HINTS STAFF WE CAN ANSWER THAT
QUESTION NOW.
MOST RECENT ITERATION OF HINTS,
HINTS 6 FIRST TIME KEY PERCEIVED
RISK OPTION RESPONSE OPTION AND
THANKS TO THE HINTS STAFF. IT
IS GREAT IT IS THERE.
IMPORTANTLY FOR US AND ALMOST
IDENTICAL QUESTION WAS INCLUDED
IN THREE OF CYCLES OF HINTS 4.
ALBEIT OUT A RESPONSE OPTION
THAT LET'S US LOOK DIRECTLY AT
THAT QUESTION OF WHAT IS
HAPPENING WHEN YOU DO OR DON'T
GIVE PEOPLE THAT OPPORTUNITY TO
SAY THEY DON'T KNOW.
LET'S LOOK AT WHAT HAPPENS.
BEFORE I DO, THAT I WILL GIVE
YOU A LITTLE BIT OF A FRAMEWORK
FOR WHAT I WILL DO THAT WILL
KEEP THINGS FROM GETTING MUDDY
IN RESULTS.
FOR MOST PART I WILL SHOW YOU
DATA COMPARING SURVEY
ADMINISTRATIONS WHEN RISK
QUESTION HAS A RESPONSE OPTION,
HINTS 6 TO SURVEY
ADMINISTRATIONS WHERE IT DOESN'T
IN HINTS 4 AND WILL SHOW YOU A
FEW THINGS WHERE WITHIN HINTS 6
WE COMPARE PEOPLE WHO GAVE ONE
OF WHAT I WILL CALL SCALE POINT
RESPONSES THAT VARY LIKELY TO
UNLIKELY RELATIVE TO PEOPLE THAT
SAID THEY DON'T KNOW THEIR RISK
AND WILL MAKE CLEAR DOING THAT
AND KEEPING THAT DIFFERENCE IN
MIND WHAT WILL HELP AS WE GO
THROUGH. LOOKING AT TWO
QUESTIONS THAT WE PLAYED WITH A
LITTLE BIT. HOW DOES THE
PRESENCE OR ABSENCE OF ABILITY
TO SAY DON'T KNOW EFFECT
ANSWERING QUESTIONING BEHAVIOR
AND TO EXTENT IT ANSWERS
QUESTIONING BEHAVIOR WITH HINT
IT DOES WHAT ARE EFFECTS ON
RELATION BETWEEN PERCEIVED RISKS
AND CONSTRUCTS WE MIGHT BE
INTERESTED IN?
COUPLE METHODS NOTES WE DID ALL
THINGS ANDREW TOLD US WE SHOULD
DO IN TERMS OF PRICSSA CHECKLIST
AND CREATED DATA STRUCTURE
COMBINING HINTS DATA SETS AND
WILL SHOW YOU ANALYSIS THAT
COMPARE WITH I DON'T KNOW
RESPONSE TO ALL HINTS LUMPED
TOGETHER WITHOUT. I WILL TELL
YOU A COUPLE PLACES WE ARE
LOOKING AT INDIVIDUALLY MATTERS
COMBINED WEIGHTS FOR HINTS
GUIDELINES AND ANALYSIS ARE
LOOKING AT REPLICA WEIGHTS AND
STATE 18 AND EXCLUDED TWO GROUPS
AND FIRST OF ALL EXCLUDED PEOPLE
WITH FAMILY HISTORY OF CANCER
AND ACROSS SURVEY ADMINISTRATION
CYCLES THERE WERE A COUPLE WHERE
CANCER HISTORY WAS INCLUSION
CRITERIA FOR THE RISK QUESTION
AND MAKING SURE WE COMPARE
APPLES TO APPLES WE EXCLUDED
HISTORY ACROSS THE BOARD AND
PEOPLE THAT HAD MISSING DATA YOU
FOR A REASON THAT WASN'T RELATED
TO THEIR BEHAVIOR AND SOMEBODY
THAT DID A WEB SURVEY AND
SOMETHING HAPPENED AND THEY
DIDN'T GET THE QUESTION.
WITH THAT, WE WILL SEE WHAT
HAPPENS.
SO, WHEN YOU GIVE PEOPLE THE
ABILITY TO SAY THEY DON'T KNOW
THEIR LIFETIME RISK FOR CANCER,
ABOUT A QUARTER OF US ADULTS
WITHOUT CANCER USE THAT OPTION
AND SAY THEY DON'T KNOW WHAT
THEIR RISK IS.
IF YOU DON'T GIVE THEM THAT
OPTION, 97% OF, AGAIN,
NATIONALLY REPRESENTED SAMPLE OF
US ADULTS GIVE YOU A SCALE-POINT
RESPONSE OPTION.
THEN YOU HAVE TO ASK WHAT IS
HAPPENING TO 23.7% OF PEOPLE AND
WHERE THEY ARE GOING AND IN
SURVEY VERSIONS THEY DON'T KNOW
WHERE OPTION IS PROVIDED AND WE
CAN GET A SENSE OF THAT LOOKING
AT DISTRIBUTIONS OF RESPONSES.
X AXIS HERE WE HAVE VARIETY OF
DIFFERENT WAYS TO ANSWER THAT
PERCEIVED RISK QUESTION AND WHAT
I CALL SCALE POINT RESPONSES
FROM VERY LIKELY TO UNLIKELY AND
DON'T KNOW OPTION FOR HINTS 6
AND MISSING DATA.
WHEN I DON'T KNOW RESPONSE
OPTION IS GIVEN AS IN HINTS 6,
WE HAVE SEEN YOU HAVE 25% OF
SAMPLES SAYING THEY DON'T KNOW
AND YOU WILL SEE THERE IS A
REASONABLY NORMAL DISTRIBUTION
OF RESPONSES ACROSS THE SCALE
POINT.
WHEN YOU DO A SURVEY
ADMINISTRATION THAT DOES NOT
PROVIDE THAT OPTION, YOU GET A
VERY DIFFERENT PATTERN. I WANT
YOU TO LOOK AT TWO THINGS IN
PARTICULAR ABOUT THIS PATTERN.
FIRST OF ALL, THERE IS MORE THAN
FOUR TIMES AS MUCH MISSING DATA
IN THE ADMINISTRATIONS WITHOUT A
DON'T KNOW RESPONSE OPTION.
IN OTHER WORDS SOME OF 23.7% OF
PEOPLE ARE SKIPPING THE ITEM OR
CIRCLING MULTIPLE ITEMS IN ERROR
OR SOMETHING LIKE THAT INSTEAD
OF BEING ABLE TO SAY THAT THEY
DON'T KNOW THE RISK.
THE OTHER INTERESTING THING IS
THE VAST MAJORITY OF THEM THOUGH
ARE PICKING THAT MIDDLE RESPONSE
OPTION AND NEITHER LIKELY NOR
UNLIKELY.
THIS IS A PRIMARILY METHODS TALK
I WON'T SAY A THINK ABOUT WHY
THAT IS THE CASE I WILL TALK A
LOT MORE ABOUT IT AT LUNCH IF
ANYBODY IS INTERESTED AND I
WON'T TALK ABOUT IT NOW BECAUSE
I WANT TO SHOW YOU SECOND
IMPORTANT THING ABOUT THIS DATA
THAT IS WHAT EFFECT IS THAT
CHANGE IN THE DISTRIBUTION AND
QUESTION ANSWERING BEHAVIOR HAVE
ON RELATION BETWEEN PERCEIVED
RISK AND OTHER CONSTRUCTS OF
INTEREST?
SO, WE IDENTIFIED 8 DIFFERENT
PSYCHOSOCIAL OR BEHAVIORAL
CONSTRUCTS THAT ARE ALL THINGS
WE KNOW ARE RELATED PERCEIVED
RISK AND ARE THINGS ASKED IN
HINTS 6 AND ASKED IN AT LEAST
ONE OF THE HINTS 4 CYCLES. 12
MINUTES ONLY GOES SO FAR AND I
WILL SHOW YOU IN DETAIL RESULTS
JUST FOR PERCEIVED WORRY
QUESTION AND TELL YOU ABOUT
PATTERNS FOR OTHER THINGS IN A
MINUTE.
WHEN YOU START TO LOOK AT THIS
AND YOU LOOK AT IN THIS CASE A
REGRESSION OF PERCEIVED RISK AS
A PREDICTOR LOOKING AT CANCER
WORRY IS AN OUTCOME AND SLOPE
ESTIMATE LEVEL PREDICTION THING
DOESN'T LOOK TOO BAD AND SCALE
POINT INCREASE IN PERCEIVED
WORRY AND EACH INCREASE IN
PERCEIVED RISK WHICH IS GREAT
UNTIL YOU REMEMBER THAT A POINT
ESTIMATE IS ONE THING WE CARE
ABOUT WITH REGRESSION ANALYSIS.
REGRESSION SLOPE IS THE BEST FIT
LINE FOR THE DATA.
THAT DOESN'T NECESSARILY MEAN IT
IS A GOOD FIT LINE FOR THAT
DATA.
RIGHT?
WE ARE FITTING THE LINE THAT
MINIMIZES DISTANCE BETWEEN
PEOPLE'S ACTUAL DATA AND BEST
PREDICTION WE CAN COME AND HAVE
A SLOPE DOING THAT WITH
RELATIVELY SMALL DEGREE OF RHO R
THAT IS PREDICTED IN NATURALLY
CLOSE TO EACH OTHER AND HAVE
EXACTLY SAME SLOPE WITH MUCH
GREATER DEGREE OF ERROR.
THAT DISTANCE BETWEEN PREDICTED
AND ACTUAL, THAT ERROR BECOMES
REALLY IMPORTANT AND FACTORS
INTO OUR CONCLUSIONS ABOUT
STATISTICAL SIGNIFICANCE. IN
OTHER WORDS, IS THERE ACTUALLY
RELATION BETWEEN PERCEIVED RISK
AND SOMETHING ELSE AND FACTORS
INTO VARIANCE ACCOUNTED FOR
DOING THINGS EXCITING IF
SOMETHING IS IMPORTANT ENOUGH TO
INTERVENE ON AND HOW MUCH
VARIANCE DOES IT ACCOUNT FOR?
THIS IS WHERE THINGS GET
STICKIER FOR US.
COMPARED TO WHEN THERE IS NOT --
WHEN YOU GIVE I DON'T KNOW
RESPONSE OPTION AND PEOPLE DON'T
KNOW RISK STANDARD ERROR GOES UP
IN SURVEY ADMINISTRATIONS WHERE
YOU DON'T.
THIS IS ONE PLACE WHERE LUMPING
TOGETHER HINTS 4 MUDDIES THINGS
A BIT AND PART OF DENOMINATOR
STANDARD ERROR IS SAMPLE SIZE
INCREASING IT YOU DO STANDARD
ERROR AND ALL THINGS BEING EQUAL
AND BREAKING IT SEPARATELY 1 IN
HINTED 4 STANDARD ERROR GOES UP
26% RELATIVE TO HINT 6 WITH
DON'T KNOW RESPONSE OPTION AND
HINTS 3 MORE THAN DOUBLES 110%
GREATER.
VARIANCE ACCOUNTED FOR DROPS BY
40% WORRIED RELATIVE TO CYCLES
DON'T KNOW RESPONSE OPTION GIVEN
AND COLLECTIVELY ACROSS
CONSTRUCTS FOR HINTS 4
ADMINISTRATION WE LOOKS AT 15
DIFFERENT COMPARISONS FOR
STANDARD ERRORS AND 13 OF 15
WERE INCREASED 5 TO 110% AND 10
OF 12 WERE R2 COMPARISONS
ANYWHERE FROM 6 TO 86% REDUCTION
AND ROBUST PATTERN AND IN MANY
CASES IS A VERY LARGE PATTERN.
WHAT IS GOING ON?
LAST THING I WILL SHOW YOU IS A
LITTLE BIT OF A LOOK AT THE
CROSS-TABS TABLES FOR
INTERSECTION OF PEOPLE'S ANSWERS
TO CANCER RISK AND ANSWERS TO
CANCER WORRY.
THIS IS THE PERCENTAGE OF THE
POPULATION THAT ANSWERED EACH OF
THE COMBINATIONS.
THINKING ABOUT STATS.
TO THE EXTENT THERE IS RELATION
WE SHOULD SEE MOST RESPONSES
FALL SOMEWHERE ON THIS UPPER
DIAGONAL. CANCER RISKS GO UP
AND CANCER WORRY ANSWERS SHOULD
ALSO GO UP.
WE WILL DO A REALLY
SOPHISTICATED STATISTICAL
ANALYSIS TO LOOK AT THIS WHEN A
DON'T KNOW RESPONSE OPTION IN
HINTS 6 TAKE YOUR EYES AND LOOK
ACROSS EACH OF THE ROWS FOR
CANCER WORRY AND SEE WHERE MOST
RESPONSES ARE.
FOR EXAMPLE, OREGON NOT AT ALL
MOST RESPONSES ARE THERE WITH
VERY UNLIKELY.
WHEN YOU HAVE AN I DON'T KNOW
RESPONSE OPTION AS YOU DO IN
HINTS 6 WHAT YOU SEE WHEN YOU DO
THAT IS A FAIRLY NICE UPWARD
PROGRESSION WE GO TO. ONE CELL
DOESN'T WORK. DATA IS NOT
PERFECT. BY AND LARGE YOU SEE
RELATION YOU WOULD EXPECT. WHEN
DON'T KNOW RESPONSE OPTION IS
PROVIDED AND AND 27.3% OF PEOPL
SAID THEY DON'T KNOW FOR. SAME
EXERCISE SURVEY THEY DON'T KNOW
WHAT RESPONSE OPTION IS NOT
PROVIDED YOU GET A VERY
DIFFERENT PATTERN.
THERE, AGAIN, WITH ONE
EXCEPTION, DATA IS NEVER
PERFECT. REGARDLESS OF LEVEL OF
CANCER WORRY, MOST COMMON
RESPONSE THAT PEOPLE ARE GIVING
FOR CANCER RISK IS A MIDPOINT
RESPONSE OPTION THAT IS NEITHER
LIKELY NOR UNLIKELY AND IS
CHANGE IN VARIANCE AND
COVARIANCE PATTERNS INCREASING
PERCEIVED RISK AND THEREFORE
DECREASING THE -- OUR ABILITY TO
PREDICT RESPONSES.
SO, THAT CHANGE IN PEOPLE'S
ANSWERING BEHAVIOR AND FORCING
PEOPLE TO NOT BE ABLE TO SAY
THAT THEY DON'T KNOW THEIR RISK
BUT HAVING TO FIGURE OUT A WAY
TO DO IT HAS REALLY IMPORTANT
IMPLICATIONS FOR US IN TERMS OF
SURVEY METHODOLOGY.
MY TEENAGE SON WAS LOOKING AT
THIS GRAPH. HE MADE EXACTLY THE
OBSERVATION ABOUT ITS LOOK YOU
WOULD EXPECT A 14-YEAR-OLD BOY
TO MAKE THAT MAKES OR MAY
SUGGEST SOMETHING ABOUT WHAT
HAPPENS TO OUR ABILITY TO
UNDERSTAND PERCEIVED RISK AND TO
REALLY HONOR WHAT PEOPLE ARE OR
ARE NOT TELLING US WITH
PERCEIVED RISK ANSWERS AND
FAILED TO ACCOUNT WE DON'T KNOW
RESPONSES AND NOT ONLY DOES IT
PROVIDE IMPORTANT INFORMATION
ABOUT PEOPLE'S KNOWLEDGE OR LACK
THEREOF. IF WE DON'T ACCOUNT
FOR THE IMPORTANT FACT THERE ARE
PEOPLE THAT LACK KNOWLEDGE OF
THEIR RISK, WE ARE LOOKING AT
RELATION BETWEEN RISK AND OTHER
CONSTRUCTS A LITTLE LIKE LOOKING
AT EYE CHART WITHOUT GLASSES
LOSING -- AND DRAWING ERRONEOUS
CONCLUSIONS ABOUT WHAT PERCEIVED
RISK IS DOG FOR IMPORTANT
PHENOMENA FOR CANCER PREVENTION
AND THANK YOU AND LOOK FORWARD
TO ANSWERING QUESTIONS AND
TALKING MORE LATER.
>> GOOD MORNING, EVERYONE.
[INDISCERNIBLE] I'M GOING TO
TALK ABOUT MY PAPER WITH MY
ADVISOR. MENTAL HEALTH CRISIS
AND [INDISCERNIBLE]. LET'S GET
STARTED WITH BACKGROUND
INFORMATION. ACCORDING TO 2021
NATIONAL SURVEY ON DRUG USE AND
HEALTH, MORE THAN 1/5 OF US
ADULTS EXPERIENCE MENTAL ILLNESS
AND MENTAL HEALTH ISSUES ARE
BECOMING MORE PREFL LEBT AND
SERIOUS IN RECENT YEARS AND DATA
IN TWENTD 11 AROUND 6.6% OF
ADULTS WITH -- FRACTION OF
PEOPLE WITH MENTAL HEALTH
PROBLEMS IN US IS HIGHER AND
DEVELOPED COUNTRIES IN ENGLAND
AND SWITER LOINTD IS 1 IN 7
PEOPLE IN FRANCE AND MENTAL
ILLNESS IS COSTLY TO SOCIETY
IMPOSING MULTIBILLION DOLLAR
BURDEN ON US ECONOMY EACH YEAR
AND POOR MENTAL HEALTH HARMS
EDUCATIONAL OUTCOMES FOR
CHILDREN AND BRINGS LARGE
PRODUCTIVITY AND EARNING
PENALTIES FOR ADULTS FURTHER
IMPACTING SOCIABILITY.
WHAT IS MENTAL HEALTH AND NOISE
POLLUTION AND -- COMPARED TO
SECOND AND THIRD LARGEST COUNTRY
CHINA AND INDIA, US HAS HUGE
NETWORK AROUND THE WORLD AND 20
TIMES THAT OF THE WHOLE EUROPEAN
UNION. ACROSS THE COUNTRY,
AMERICAN DRIERNS SPENT MORE THAN
84 BILLION HOURS DRIVING DURING
2015 ON AVERAGE AMERICAN DRIVERS
SPEND JUST UNDER AN HOUR DRIVING
EVERY DAY.
I EXPENSIVE USAGE OF PRIVATE
VEHICLES FOR TRANSPORTATION AND
FROM HOME IS PRODUCED FROM
HIGHWAYS COULD BE IMPORTANT
FACTOR FOR COMMON MENTAL HEALTH
PROBLEMS IN THE US. IN THIS
STUDY WE WANT TO KNOW WHAT IS
CAUSAL EFFECT OF NOISE
POLLUTION.
MORE SPECIFIC WE USE
[INDISCERNIBLE] BECAUSE ALL
THESE FIVE ITERATIONS OFFER
VALUABLE ZIP-9 INFORMATION FOR
RANDOM RESPONDENTS AT A NATIONAL
LEVEL AND UNIQUE FEATURE OF
HINTS DATA THAT WE CAN LINK
INDIVIDUAL MENTAL HEALTH
OUTCOMES TO HIGHWAY AND
AVIATION. LET'S LOOK AT THIS IS
THE SCREENSHOT OF THE NATIONAL
NOISE MAP AND SHADED AREAS ARE
HIGHWAYS AND ORANGE IS AVIATION
NOISE.
MORE SPECIFIC LOOK AT LOCAL AREA
TO SEE MAJOR HIGHWAYS IN PINK
AND BLUE AREAS MEANING MORE
NOISE POLLUTION AND
[INDISCERNIBLE] ARE LOCAL AIR
THAT IS OUT OF THE SCREEN AND
AVIATION NOISE EXPOSURE. AFTER
DEMOGRAPHIC AND OTHER VARIABLES
THAT EFFECT MENTAL HAEMTH WE
HAVE [INDISCERNIBLE] RESPONDENTS
IN THE SAMPLE AND KEY OUTCOME
VARIABLE IN SUMMARY MENTAL
HEALTH STUDY IS [INDISCERNIBLE]
AND THIS INDEX RANGES 0 TO 12
WITH LARGER NUMBER INDICATING
WORSE MENTAL HEALTH AND SPECIFIC
OTHER RESPONDENTS WILL BE ASKED
IN PAST TWO WEEKS HOW OFTEN HAVE
YOU BEEN BOTHERED BY ANY OF THE
FOLLOWING SYMPTOMS AND WE HAVE
FOUR DESIGNATIONS TO KNOW OF
MENTAL HEALTH CONDITIONS AND
WILL GET INDEX IN THE END.
MORE SPECIFIC NUMBER OF AVERAGE
HOUSEHOLD YOU SEE ON ZIP-9 IS 5.
THIS IS VALUABLE PROCESS TO
ADDRESS THIS AND HOW TO MEASURE
NOISE.
HERE, ALL OF THE POINTS ARE
[INDISCERNIBLE] FOR HINTS
RESPONDENTS DATA USE AGREEMENT
SHOWING INFORMATION FOR ALL
RESPONDENTS AND POINTS ARE
[INDISCERNIBLE] SURROUNDING MY
HOME.
WE SEE EACH BUFFER IS BUFFER I
CREATED [INDISCERNIBLE] WE ARE
ASSUMING THAT EACH RESPONDENTS
ARE [INDISCERNIBLE] WITHIN EACH
WE CAN CALCULATE AVERAGE PIXEL
VALUE OF NOISE POLLUTION FROM
[INDISCERNIBLE] AND GET AVERAGE
NOISE BUFFER TO [INDISCERNIBLE]
HINT RESPONDENTS TO APPROXIMATE
LOCAL EXPOSURE TO AVIATION NOISE
AND BLACK AND WHITE LINES HERE
ARE LOCAL HEAVY HERE FROM THE
CITY.
WE ACCOUNT FOR INDIVIDUAL
DEMOGRAPHIC INFORMATION LIKE
GRENDER, RACE, EDUCATION AND
INCOME. WE INCLUDE OTHER
FACTORS LIKE INDIVIDUAL PHYSICAL
HEALTH CONDITIONS AND LOCAL
ENVIRONMENTAL CONDITIONS SUCH AS
EXTREME TEMPERATURE AND AIR
QUALITY AND HINTS DATA HAD THIS
AND ENVIRONMENTAL AND
DEMOGRAPHIC INFORMATION FROM
OTHER DATA SETS WE HAVE VALUABLE
INFORMATION FROM HINTS DATA. WE
WILL LOOK AT STATISTICS.
THIS IS DISTRIBUTION OF ROAD
NOISE. YOU SEE PEOPLE EXPOSED
TO NO ROAD NOISE BECAUSE NOW
MOST PEOPLE ARE LIVING IN URBAN
CITY AND LOTS OF HIGHWAYS ARE
SURROUNDING US. MOST PEOPLE
EXPOSURE TO ROAD NOISE IS
BETWEEN 52 TO 53 DECIBELS.
HOWEVER, AVIATION NOISE
OBVIOUSLY A LOT OF PEOPLE ARE
LIVING NEAR AIR PORTS NOT
EXPOSED TO AVIATION NOISE AND
THOSE EXPOSED TO IT 45 TO 50
DECIBELS AND GAP IS HUGE BLANK
AREA LOWEST DETECTIBLE NOISE
VALUE FROM DEPARTMENT OF
TRANSPORTATION IS
[INDISCERNIBLE] WHICH
CONTRIBUTES TO THE BLANK AREA IN
THE MIDDLE. WE HAVE STATISTICS
FOR RESPONDENTS AND AVERAGE AGE
IS AROUND 55 AND FRACTION FOR
DIFFERENT RACIAL GROUPS HERE WE
SEE AROUND 61 PEOPLE ARE FROM
BIG CITY AND FROM MIDDLE CITY
AND WE HAVE STATISTICS FOR OTHER
CONTROL VARIABLES AND OUTCOME
VARIABLE WE HAVE THESE.
WE HAVE THESE BECAUSE WE ARE
USING FIVE ITERATIONS AND
SYSTEMATIC CHANGE AS CROSS
DIFFERENT WAVES AND CREATED Z
SCORE AND STANDARDIZED INDEX FOR
THIS INDEX AND USE THIS AS OUR
MAIN OUTCOME VARIABLES AND WE
HAVE [INDISCERNIBLE] FOR CONTROL
VARIABLES THAT MEASURE FSIS AND
LOCAL ENVIRONMENTAL FACTORS LIKE
THIS INDEX AND TOTAL ONSITE
EMISSIONS TO APPROXIMATE LOCAL
EXPOSURE FOR TRADITIONAL AIR
POLLUTANTS.
AND HERE IS OUR MAIN RESULTS .
HERE, REMINDER IS POSITIVE CO
EFFICIENTS ON THIS TABLE
REPRESENT NEGATIVE EFFECTS OF
MENTAL HEALTH. ORIGINAL INDEX
IS INDEX THAT HAS LARGER VALUE
THAT IS WORSE MENTAL HEALTH.
COLUMN 1 AND 2 THIS CASE ARE
CORRELATIONS
SO, THE 0.02, IT MEANS THE NOISE
WHERE IT WILL INCREASE AND I'M
SORRY RESPONDENTS WILL HAVE
WORSE MENTAL HEALTH BETWEEN
STANDARD DEVIATIONS THAT IS VERY
SIGNIFICANT AND COLUMNS 3 AND 4
ARE BASICALLY USING
[INDISCERNIBLE] METRIC WAYS TO
USE RANDOM VARIATIONS IN
ENVIRONMENTAL FACTORS USING WIND
DIRECTION AND WIND SPEED IN THE
STUDY TO TELL CAUSALITY BETWEEN
NOISE AND CORRELATION AND THIS
IS ANOTHER LEVEL BEYOND SIMPLE
CORRELATION AND SIMILARLY WE
HAVE THESE EFFECTS OF NOISE OF
MENTAL HEALTH HERE.
WE WANT TO KNOW WHY AND NOISE
THAT EFFECT MENTAL HEALTH AND
THERE IS EVIDENCE IN
[INDISCERNIBLE] STRESSING
INDIVIDUAL RESPECT TO NOISE WILL
BE THROUGH ACTIVATION OF
[INDISCERNIBLE] PART IN OUR
GRANT AND HPA AXIS AND WE FIND
THAT AVERAGE NOISE HAS
SIGNIFICANT EFFECTS -- BECAUSE
THE DATA THAT WE HAVE ARE SLEEP
OTHER FROM THE FIRST
[INDISCERNIBLE].
SO, WE CAN'T GET ZIP-9 LEVEL
NOISE FOR THREE WEEKS. WE DON'T
HAVE INFORMATION FOR THESE THREE
WEEKS AND AT [INDISCERNIBLE]
LEVEL WE SEE THAT OUR MECHANISM
WORKS HERE AND [INDISCERNIBLE]
BE REDUCED IF EXPOSED TO MORE
ROAD NOISE.
AND EVEN GOING FROM
[INDISCERNIBLE] DEPRESSIVE
SYMPTOMS TO LOWER LABOR INCOMES
AND [INDISCERNIBLE] AND FINDINGS
FOR THIS EFFECT IS EQUIVALENT TO
THOSE THAT HAVE MENTAL HEALTH
PROBLEMS DESCRIBED AT FIELDING
[INDISCERNIBLE] AND WE HAVE
LITTLE INTEREST OF DOING THIS
FOR SEVERAL DAYS [INDISCERNIBLE]
AND NOT BEING ABLE TO CONTROL
THIS AT SAME TIME AND
[INDISCERNIBLE] NOISE ADVISEMENT
OF POLICY TO PROTECT PEOPLE FROM
NEGATIVE EFFECTS OF NOISE
POLLUTION.
TO CONCLUDE WE ASK ABOUT CAUSAL
EFFECT OF NOISE SOLUTION MENTAL
HEALTH USING RESTRICTED
INDIVIDUAL LEVEL DATA WITH
[INDISCERNIBLE] ZIP-9 LEVEL AND
WE FIND THAT SLEEP DEPRIVATION
IS SIGNIFICANTLY LOW EXPANDING
HOW NOISE EFFECTS MENTAL HEALTH
AND APPRECIATE DR. MOSER FOR
USAGE OF HINTS DATA AND
APPRECIATE MY DEPARTMENT ADVISOR
GETTING US ZIP-9 INFORMATION.
[INDISCERNIBLE] I'M REALLY
WILLING TO HEAR [INDISCERNIBLE]
IN THE ECONOMIC WORLD AND
LOOKING FOR TO ANY
INCORPORATION. THIS IS MY
CONTACT INFORMATION. THANK YOU
VERY MUCH.
>> HI, EVERYBODY. I'M ASHLEY
MURRAY AND REALLY EXCITED TO
PRESENT SOME ANALYSIS THAT WE
CONDUCTED ON THE HINTS
SEER-LINKED DATA SET THAT KELLY
ELUDED TO EARLIER. ALL THIS
WORK WAS CONDUCTED WHILE I WAS A
FELLOW AT NCI.
NOW, I CONSIDER MYSELF PART OF
THE FAN CLUB. I'M EXCITED TO BE
HERE TODAY.
HERE IS A QUICK OUTLINE WHAT I
WILL DISCUSS.
SELF-REPORT SURVEYS PARTICULARLY
THOSE ASKING ABOUT HEALTH AND
MEDICAL INFORMATION AND
BEHAVIORS ARE PRONE TO ERROR
THAT MAY BE PARTICULARLY TRUE
FOR SOME MEDICAL HISTORIES .
WE HAVE KNOWN IT FOR QUITE SOME
TIME AND FOR EXAMPLE RESEARCH
HAS FOUND THAT SELF-REPORTED
MAMMOGRA OFFY MIGHT BE MORE --
SELF REPORTED PROSTATE AND
COLORECTAL CANCER SCREENING
MIGHT BE USED AND CLINICAL
HEALTH RECORDS IS EMERGING WAY
TO ADDRESS THIS ISSUE AND ONE IN
THE UNITED STATES IS THE SEER
PROGRAM. SEER PROGRAM WAS
INTRODUCED EARLIER. SEER IS
SURVEILLANCE EPIDEMIOLOGY AND
END RESULT PROGRAM A REGISTRY OF
CANCER SURVIVORS AIMING TO TRACK
CANCER STATISTICS AND REDUCING
CANCER BURDEN IN THE UNITED
STATES -- DATA ON CANCER
SURVIVORS ARE COLLECTED FROM 22
POPULATION BASED GEOGRAPHIC
REGIONS IN THE UNITED STATES AND
REPRESENT 48% OF THE UNITED
STATES POPULATION APPROXIMATELY.
HINTS IS A BIENNIAL DUAL MODES
SURVEY OF NONINSTITUTIONALIZED
ADULTS IN THE UNITED STATES
CONDUCTED BY NATIONAL CANCER
INSTITUTE. HINTS TYPICALLY
MEASURES AND TRACKS TRENDS
RELATED TO CANCER AND CANCER
COMMUNICATION AND HEALTH
BEHAVIORS. HINTS SEER WAS
CONDUCTED FROM RESPONDENTS FROM
THREE SEER REGISTRIES CONDUCTED
AS PILOT STUDY TO SAMPLE CANCER
SURVIVORS FOR ADMINISTRATION OF
THE HINTS SURVEY AND THREE
CANCER REGISTRIES WERE GREATER
BAY AREA CANCER REGISTRY IOWA
CANCER REGISTRY AND NEW MEXICO
TUMOR REGISTRY.
BY SAMPLING CANCER SURVIVORS
FROM SEER REGISTRIES PROVIDING
LINKED CLINICAL HEALTH RECORDS
USING SEER REGISTRY WE WERE ABLE
TO ASK A FEW UNIQUE QUESTIONS
AND PRIOR ADMINISTRATION OF HINT
AND RESEARCH FOR TODAY'S
PRESENTATION WERE TO WHAT EXTENT
DO SELF REPORT ITEMS MATCH
RECORDS FOR CANCER SURVIVORS AND
CANCER SURVIVORS ACCURATELY
SELF-REPORT CANCER TYPE AND DO
THEY SELF-REPORT THEIR YEAR OF
CANCER DIAGNOSIS?
DELVING MORE INTO METHODS OF
HINTS SEER IN 2021 THE
INFORMATION FROM SURVEY FIELDED
WITH RANDOM SAMPLE OF CANCER
SURVIVORS FROM THREE REGISTRIES
I MENTIONED EARLIER AND
PROCEDURES REQUIRED BY SEER ARE
EDGETRIES RESPONSE RATES WERE
CALCULATED IN TWO STAGES FIRST
OF WHICH ACCOUNTED FOR CONSENT
RATES AND SECOND STAGE THAT
ACCOUNTED FOR SURVEY COMPLETION
RATE.
LIKE KELLY DISCUSSED EARLIER
THERE WERE DIFFERENT RESPONSE
RATES BY EACH OF THE SIERRA
REGISTRIES YOU CAN SEE UP ON THE
SCREEN.
WE CONDUCTED OR SORRY ANDREW
CONDUCTED AN OVERALL RESPONSE
RATE.
BIAS ANALYSIS, WHICH INDICATED
TWO DIFFERENCES IN DEMOGRAPHIC
COMPOSITION BETWEEN RESPONDENTS
AND POOL OF SAMPLED PATIENTS IN
EACH REGISTRY AND HINTS SEER
ACHIEVED RESPONSE RATE OF 12.6%.
SO, HINTS SEER IS
SELF-ADMINISTERED QUESTIONNAIRE
THAT USING HINT 5 CYCLE 4
SURVEY. HOWEVER, WE WERE ABLE
TO UPDATE THE SURVEY TO HAVE
MODIFIED QUESTIONS TO BE MORE
SALIENT TO CANCER SURVIVORS.
FOR EXAMPLE AS WE HEARD FROM A
COUPLE OTHER PRESENTERS THERE
WERE QUESTIONS ASKING ABOUT RISK
FOR GETTING ADDITIONAL CANCER
AND ABLE TO FIELD ALSO SOME
ITEMS RELATED TO THE COVID-19
PANDEMIC BECAUSE OF TIMING
WHENEVER WE FIELDED THE SURVEY
AND TWO QUESTIONS MOST
INTERESTED IN FOR TODAY'S
ANALYSIS ARE WHAT TYPES OF
CANCER HAVE YOU BEEN DIAGNOSED
WITH AND AT WHAT AGE WERE YOU
TOLD YOU HAD CANCER?
1,213 RESPONDENTS SELF-REPORTED
CANCER DIAGNOSIS USING
CATEGORICAL VARIABLE YOU CAN SEE
UP ON THE SCREEN THAT INCLUDED
AND OTHER SPECIFY OPTION AND
SELF-REPORTED CANCER DIAGNOSIS
INCLUDING THOSE IN OTHER
RESPONSES THAT WERE RECODED
USING SEER SITE RECODES OR ICD03
CODES IF YOU HEARD OF THEM
BEFORE AND SELF-REPORTED CANCER
DIAGNOSIS WAS CROSSED WITH
REGISTRY-RECORDED CANCER
DIAGNOSIS FROM THE SEER REGISTRY
AND A FEW RESPONDENTS WROTE A
RESPONSE UNABLE TO BE
CATEGORIZED COLLAPSED THEM WITH
RESPONDENTS WHO REPORTED
REGISTRY RECORDED CANCER
DIAGNOSIS THAT DIDN'T MATCH AND
96.5% OF RESPONDENTS REPORTED
CANCER DIAGNOSIS MATCHING SEER
REGISTRY LINKED CANCER DIAGNOSIS
INDICATING HIGH ACCURACY IN
SELF-REPORTED CANCER DIAGNOSIS.
NEXT, WE WERE INTERESTED IN THE
HINTS SEER ITEM AT WHAT AGE WERE
YOU FIRST TOLD YOU HAD A CANCER
DIAGNOSIS?
THIS ITEM MATCHED THE SEER ARE
EDGETRY AND REPORTED DATE OF
YEAR OF CANCER DIAGNOSIS.
HOWEVER, WE HAD TO GO THROUGH A
SERIES OF CALCULATIONS TO BE
ABLE TO CREATE A HINTS SEER
VARIABLE THAT COULD BE COMPARED
WITH THE SEER ARE EDGETRY
REPORTED DATA.
USING AGE AT FIRST CANCER
DIAGNOSIS, RESPONDENT'S CURRENT
AGE AND YEAR OF SURVEY
COMPLETION, WE WERE ABLE TO
COMPUTE AN ESTIMATED YEAR OF
CANCER DIAGNOSIS, WHICH THEN IF
WE CALCULATE THE YEAR OF CANCER
DIAGNOSIS THIS WAY, THIS IS
UNFORTUNATELY CREATING AN
OPPORTUNITY FOR ERROR.
WE DON'T KNOW WHEN THE
RESPONDENT'S BIRTHDAY IS ONLY
THE YEAR THEY COMPLETED THE
SURVEY AND HOW OLD THEY REPORTED
THEY WERE WHENEVER THEY
COMPLETED THE SURVEY.
ADDITIONALLY, BECAUSE WE ASKED
WHEN THE RESPONDENT WAS FIRST
TOLD THEY HAD CANCER, WE COULD
ONLY CONDUCT ANALYSIS ON THOSE
WHOSE SEER ARE EDGETRY LINKED
CANCER DIAGNOSIS CORRESPONDED
WITH FIRST CANCER DIAGNOSIS.
TO ACCOUNT FOR THE ERROR
PRODUCED BY HAVING TO CALCULATE
YEAR OF CANCER DIAGNOSIS USING
RESPONDENT SELF-REPORTED AGE AND
SELF-REPORTED AGE AT FIRST
CANCER DIAGNOSIS WE ANALYZE
CORRESPONDIENTS OF -- WE ANALYZE
CORRESPONDENTS TO ASSESS WHETHER
CALCULATED YEAR OF DIAGNOSIS
MATCHED SEER ARE EDGETRY
REPORTED YEAR OF DIAGNOSIS AND
34.7% OF ELIGIBLE RESPONDENTS
HAD MATCHING CALCULATED YEAR OF
CANCER DIAGNOSIS AND SEER
REGISTRY REPORTED YEAR OF CANCER
DIAGNOSIS. 39.1% HAD CALCULATED
YEAR OF CANCER DIAGNOSIS THAT
MATCHED WITHIN PLUS OR MINUS ONE
YEAR OF SEER REGISTRY REPORTED
CANCER DIAGNOSIS AND 9.7% HAD
CALCULATED YEAR OF CANCER
DIAGNOSIS MATCHING WITHIN PLUS
OR MINUS 2 YEARS OF SEER ARE
EDGETRY REPORTED YEAR OF CANCER
DIAGNOSIS.
FINALLY, ONLY 16.5% HAD A
CALCULATED YEAR OF CANCER
DIAGNOSIS THAT HAD A GREATER
THAN PLUS OR MINUS TWO YEARS OF
THE SEER ARE EDGETRY REPORTED
YEAR OF CANCER DIAGNOSIS.
IF WE COMBINE FIRST THREE GROUPS
I TALKED ABOUT RESPONDENTS THAT
HAD CALCULATED YEAR OF CANCER
DIAGNOSIS THAT MATCHED THEIR
REGISTRY REPORTED YEAR OF CANCER
DIAGNOSIS WITHIN PLUS OR MINUS
TWO YEARS OR LESS, 83.5% OF
SAMPLE FIT WITHIN THAT CATEGORY
AND ONLY 16.5% HAD GREATER THAN
2 YEAR DIFFERENCE INDICATING
THAT MOST CANCER SURVIVORS HAD
AN ACCURATE CALCULATED YEAR OF
CANCER DIAGNOSIS.
TO SUM UP, 96.5% OF RESPONDENTS
REPORTED CANCER DIAGNOSIS THAT
MATCHED THE SEER REGISTRY LINKED
CANCER DIAGNOSIS AND 83.5% OF
SAMPLE HAD CALCULATED YEAR OF
CANCER DIAGNOSIS WITHIN ACING
CREPTABLE MARGIN OF ERROR OF
AGREEMENT WITH REGISTRY LINKED
CANCER DIAGNOSIS AND FOUND A
HIGH AGREEMENT BETWEEN CANCER
TYPE INDICATORS AND SLIGHTLY
LOWER AGREEMENT OF CANCER
DIAGNOSIS INDICATORS AND PART OF
THIS LOWER AGREEMENT FOR AGE AT
FIRST CANCER DIAGNOSIS COULD BE
BECAUSE OR COULD BE ATTRIBUTED
TO US HAVING TO CALCULATE YEAR
OF CANCER DIAGNOSIS.
PART MIGHT BE DUE TO DIFFICULTY
IN REMEMBERING EXACTLY WHEN A
DIAGNOSIS HAPPENED THAT I'M SURE
THAT MANY OF US HAVE GONE TO
HEALTH CHECK-UPS AND STRUGGLED
TO REMEMBER WHEN THINGS HAPPENED
ON MEDICAL HISTORY FORM AND I
FIND MYSELF CONSTANTLY DOING
MENTAL GYMNASTICS TRYING TO
REMEMBER WHAT YEAR MEDICAL
PROCEDURE HAPPENED AND HOW OLD
WAS I IN THAT GRADE? SOMETIMES
THIS CAN BE OR MAKE THINGS MORE
DIFFICULT FOR PEOPLE TO
REMEMBER.
HOWEVER, BECAUSE CANCER
SURVIVORS HAVE LOTS OF
INTERACTION WITH MEDICAL SYSTEM
THEY MIGHT HAVE AN EASIER TIME
REMEMBERING AND SELF-REPORTING
CERTAIN ASPECTS OF THEIR
DIAGNOSIS. FUTURE RESEARCH
COULD EXPLORE OTHER RESPONDENTS
WITH OTHER MEDICAL DIAGNOSIS ARE
MORE OR LESS ACCURATE IN
SELF-REPORTING THEIR MEDICAL
HISTORY AND RESEARCH FOR EXAMPLE
IS FOUND THAT IF MORE SPECIFIC
INFORMATION ABOUT CANCER
DIAGNOSIS AND TREATMENT SUCH AS
STAGE CANCER DIAGNOSIS, THOSE
TYPES OF HEALTH HISTORIES MIGHT
BE MORE PRONE TO ERROR.
FINALLY, BECAUSE LINKAGES MIGHT
BE A WAY TO REDUCE OR ESTIMATE
ERROR IN SELF-REPORT
QUESTIONNAIRES, THINKING ABOUT
LINKAGES WHEN DESIGNING
QUESTIONNAIRES IS IMPORTANT
PRIOR TO FIELDING THE SURVEY AND
IMPORTANT TO NOTE THAT TESTING
FOR ACCURACY OF SELF-REPORT IS
NOT PRIMARY GOAL OF HINTS SEER
AND TEAM WAS CAUTIOUS ABOUT
MAKING CHANGES TO HINT
INSTRUMENT LIMITING ABILITY TO
COMPARE TO GENERAL POPULATION
ADMINISTRATION OF HINTS.
BASED ON FINDINGS FROM CURRENT
ANALYSIS, WHEN POSSIBLE
QUESTIONNAIRES SHOULD TAKE INTO
CONSIDERATION WHETHER TO BE
DESIGNED IN A WAY THAT LINKAGES
COULD BE CREATED TO REDUCE OR
ESTIMATE ERROR IN SELF-REPORT
QUESTIONNAIRES TO INCREASE THE
QUALITY OF A- NAL SEIZE.
HERE ARE MY WORKS CITED AND
THANK YOU TO MY COLLEAGUES AT
WESTAT ICF, NCI, AND THANK YOU
TO EVERYBODY HERE ON THE HINTS
TEAM.
>> HI, EVERYONE. SO, THE
CURRENT PAPER IS SITUATED IN THE
VAST LITERATURE ON TRUST AND
HEALTHCARE PROVIDERS, WHICH
FAIRLY CONSISTENTLY FINDS THAT
BLACK ADULTS TEND TO CITE LOWER
LEVELS OF TRUST IN PROVIDERS
THAN WHITE ADULTS.
REASONS FOR THIS ARE A MYRIAD.
THERE IS A VAST, VAST LITERATURE
HERE ALSO DOCUMENTING WHAT ARE
MECHANISMS BEHIND DIFFERENCES.
VERY, VERY BRIEFLY, THIS
INCLUDES SYSTEMIC DISCRIMINATION
INSIDE OF HEALTHCARE AND
EXPERIENCING FOR EXAMPLE
MISTREATMENT OR MALTREATMENT BY
CLINICIANS AND OTHER HEALTH
PROVIDERS AND DISCRIMINATION
OUTSIDE OF HEALTHCARE AND ONE
EXAMPLE IS RESIDENTIAL
SEGREGATION THAT MEANS THAT
BLACK HOUSEHOLDS ARE LESS LIKELY
TO LIVE NEAR GREEN SPACES AND
RISK OF HEART DISEASE DIABETES
AND OBESITY AND POOR HEALTH
OUTCOMES IN TURN LEAD TO
MISMANAGEMENT FOR CLINICIANS AND
FUELS IDEA THAT CLINICIANS ARE
NOT TO BE TRUSTED. AN EXAMPLE
HERE IS INTERGENERATIONAL
TRANSMISSION. BLACK CHILDREN
FOR EXAM WILL GROW UP SEEING
ADULTS AND FAMILIES GET
MISTREATED BY CLINICIANS AND
LEARN FROM EARLY AGE THAT
CLINICIANS ARE NOT FOLKS THAT
SHOULD BE TRUSTED.
CITIES IN THE AREA TEND TO BE
CROSS-SECTIONAL.
WE AS A SOCIETY HAVE TRIED OUR
BEST TO RECTIFY THE SITUATION
AND LONGITUDINAL STUDIES HERE
WOULD BE IDEAL AS A CHECK TO SEE
IF THINGS WE ARE DOING TO
IMPROVE THE SITUATION FOR BLACK
ADULTS, IF THAT IS EFFECTING
DIFFERENCES IN TRUST.
AND THEY SAID NO. VERY FEW
STUDIES LIKE THIS EXIST. THIS
IS WHERE HINTS COMES IN.
HINTS HAS ASKED A QUESTION ABOUT
TRUST AND HEALTHCARE PROVIDERS
AND I HAVE HERE IN THE BLACK
DOTS THE DIFFERENT ITERATIONS
THAT THIS QUESTION HAS BEEN
ASKED IN.
YOU SEE THAT IT COVERS ABOUT 15
YEARS.
LOTS OF INTERESTING CHANGES HAVE
HAPPENED IN THE 15 YEAR INSIDE
OF HEALTHCARE. FOR EXAMPLE,
PASSAGE OF ACA AND PASSAGE OF
HIGH TECH AND OUTSIDE OF
HEALTHCARE OTHER CHANGES HAVE
HAPPENED AS WELL POLITICALLY
INCLUDING PRESIDENT BARACK OBAMA
BEING ELECTED AND PRESIDENT
DONALD TRUMP ALSO BEING ELECTED
AND MAINLY CHANGES THAT YOU CAN
THEORIZE IMPACTING LEVELS OF
TRUST AND HEALTHCARE PROVIDERS
THAT THERE ARE ALSO OTHER
EXTRANEOUS CHANGES THAT HAPPEN
DURING THIS TIME THAT HAVE TO DO
WITH THE DESIGN OF HINTS.
AND SO, FOR EXAMPLE, WE HAVE
SURVEY MODE EFFECTS AND I JUST
-- I -- AFTER I SENT SLIDES TO
ANNA IS WHERE I DISCOVERED THIS
PARTICULAR MISTAKE THAT IS THE
FIRST TWO YEARS THERE AND 2005
AND 2007 THAT ARE THE FILM
SURVEY.
AND THEN 2007 IS ALSO THAT
MAIL-IN SURVEY AND EDIT AND OF
COURSE THEY ARE DISCOVERING TO
THESE SLIDES TO ANNA AND THANK
YOU ANNA FOR HERDING CATS. MY
MISTAKE, OBVIOUSLY. WE HAVE
DIFFERENCES IN SURVEY MODE THAT
COULD IMPACT LEVELS OF TRUST IN
PROVIDERS THAT PEOPLE REPORT AND
FOR EXAMPLE IF TALKING ON PHONE
TO A FELLOW HUMAN BEING AND
ASKED IF YOU TRUST DOCTORS YOU
KNOW DOCTORS ARE REVERED IN
SOCIETY AND MIGHT BE INCLINED TO
SAY YES AND I TRUST THEM A LOT
EVEN THOUGH YOU MAY NOT AND
VERSUS A MAIL-IN SURVEY AND PEN
AND PAPER-BASED SURVEY YOU MIGHT
BE INCLINED TO BE HONEST IN
DISTRUST IN CLINICIANS AND ARE
OTHER CHANGES HERE TO THE DESIGN
OF HINTS THAT ARE NOTEWORTHY
THAT IS THE FDA ITERATIONS WHERE
THEY OVERSAMPLED SMOKERS USING
STRATEGIES AND END GAME IS
OVERSAMPLE SMOESHGS AND IMPACT
TO MAKE IT INTO THE DATA SETS
AND ONE THING HERE TO NOTE IS
YOU WILL SEE YEAR 2017 HERE
APPEARS TWICE THERE AND ONE IS
AN FDA CYCLE WHERE THEY
OVERSAMPLE SMOKERS AND ONE
NON-FDA CYCLE USING FAIRLY
TRADITIONAL SAMPLING METHODS
THEY USE IN OTHER HINTS
CONSIDERATIONS.
I WILL COMPARE DEMOGRAPHICS OF
THE TWO 2017 ITERATIONS THAT
FROM MY READ OF THE METHODOLOGY
REPORTS THOSE TWO ITERATIONS
WERE FIELDED SIMULTANEOUSLY IN
THE EXACT SAME MONTHS OF THE
YEAR 2017. ONE WAS FDA CYCLE
AND ONE WAS NON-FDA CYCLE. YOU
SEE SHOWING RAW FREQUENCIES FOR
ETHNO RACIAL DEMOGRAPHIC
RESPONDENTS HERE OF FDA CYCLE
AND NON-FDA CYCLE GREATER
PERCENTAGE OF WHITE ADULTS MADE
IT INTO FDA CYCLE VERSUS NON-FDA
CYCLE AND SMALLER OF BLACK
ADULTS MADE IT IN FDA CYCLE THAN
NON-FDA CYCLE. YOU SEE THESE
DIFFERENCES IN THE CHI-SQUARED
TEST. WE SHOULD BE ABLE TO
ACCOUNT FOR DIFFERENCES IN RAW
FREQUENCIES IN THEORY. NEXT I
WILL SHOW YOU PERCENTAGE OF
ADULTS SAYING THEY TRUST
HEALTHCARE PROVIDERS A LOT USING
SURVEY WEIGHTS UNADJUSTED
MEANING NO CO-VARIATES AND
ATTEMPT TO ACCOUNT FOR
DIFFERENCES IN SURVEY DESIGN OF
HINTS ATTEMPTING TO ACCOUNT FOR
SURVEY MODE AND OVERSAMPLING OF
SMOKERS IN FDA CYCLES THAT IS
FIRST YEAR FOR EVERYBODY THAT IS
65 TO 68% THAT IS A THEY TRUST
IN HEALTHCARE PROVIDERS A LOT.
WHITES COMPARED TO AVERAGE FOR
SAMPLE SLIGHTLY HIGHER AND BLACK
ADULTS ARE SIGNIFICANTLY LOWER
AND CONSISTENT WITH TRENDS IN
OTHER LITERATURES THAT IS
PERCENTAGE FOR LATINO AS WELL AS
OTHERS AND IN THE NEXT YEAR A
VERY SIMILAR PATTERN THAT WE SAW
IN 2005 AND IN 2011, WE START TO
SEE THINGS LEVEL OUT AND STILL
SEE THOSE DISPARITIES THAT
APPEAR IN OTHER LITERATURES AND
2013, WE HAVE THE 2015 FIRST FDA
CYCLE.
WE SEE HERE BLACK ADULTS NOW
REPORT SLIGHTLY HIGHER LEVELS OF
TRUST IN HEALTHCARE PROVIDERS
THAT IS NOT SIGNIFICANT.
WE SEE THE OTHER TWO GROUPS.
NOW THAT 2017 ITERATION, FIRST
THE FDA CYCLE. WE HAVE GOT FOR
THE ENTIRE SAMPLE THAT PRESENTS
AS WELL AS FOR WHITE ADULTS.
NOW, FOR BLACK ADULTS THAT
PERCENTAGE SHOOTS UP INDEED IT
IS STATISTICALLY SIGNIFICANT
HERE THIS DIFFERENCE IN THIS
PARTICULAR ITERATION, THE
PERCENTAGE OF BLACK ADULTS THAT
IS A THAT THEY TRUST IN
PROVIDERS A LOT IS SIGNIFICANTLY
GREATER THAN PERCENT FOR WHITE
ADULTS THAT DEPARTS FROM THAT
VAST LITERATURE I MENTIONED IN
THE VERY BEGINNING THAT DEPARTS
FROM THE EXPLANATIONS I WAS
SAYING FOR WHY WE WOULD EXPECT
BLACK ADULTS TO REPORT LOWER
LEVELS OF TRUST THAN WHITE
ADULTS.
AND THEN EVERYBODY ELSE.
NOW, WE HAVE THAT OTHER DATA
POINT FROM 2017. WHAT I SHOWED
YOU FOR FDA CYCLE COULD VERY
WELL BE PART OF THE TREND THAT
WE ARE STARTING TO SEE FROM THE
PREVIOUS ITERATIONS AND HERE IS
THE NON-FDA CYCLE FROM 2017 THAT
IS WHAT PATTERNS LOOK FOR AND
LOOK LIKE.
AND THEY ARE STATISTICALLY
DIFFERENT FROM EACH OTHER.
THEY DO NOT MATCH VERY WELL.
FDA CYCLE AND NON-FDA CYCLE THAT
WAS FIELDED IN THE EXACT SAME
YEAR AND MONTHS.
WE HAVE 2019 YEAR HERE TOO.
LOOKING AT PATTERNS, THEY
SUGGEST THAT THEY SHOULD ACCOUNT
FOR CO-VARIATES AS WELL AS
SURVEY DESIGN EFFECTS AND WHAT
WE DID.
SO, WHAT I WILL SHOW YOU HERE IS
THE ADJUSTED DIFFERENCES FOR
PERCENTAGE OF BLACK ADULTS
VERSUS WHITE RESPONDENTS
SPECIFICALLY PERCENTAGE FOR
WHITE ADULTS MINUS PERCENTAGE
FOR BLACK ADULTS THAT SAY THEY
TRUST IN DOCTORS AND HEALTHCARE
PROVIDERS A LOT. THIS IS
WEIGHTED AND ADJUSTED FOR
CO-VARIATES AND SURVEY DESIGN
EFFECTS AND CATEGORICAL
INDICATORS FOR SURVEY MODE AND
WHETHER OR NOT IT WAS FDA CYCLE
THAT IS PERCENT FROM 2 THOUGH
YOU 5 THAT IS SIGNIFICANTLY
DIFFERENT AND ABOUT A 12%
DIFFERENCE.
2007, THAT PERCENTAGE IS 6%. IT
IS NOW HALF AND STILL
STATISTICALLY DIFFERENT AND 2011
YOU START TO SEE NONSIGNIFICANT
DIFFERENCES BETWEEN TWO GROUPS.
13, PRACTICALLY THE SAME.
15, 2015 IS ALSO PRACTICALLY THE
SAME.
NOW, FOR 2017 YEAR. AND
NONSIGNIFICANCE, 2019, IT SHOOTS
BACK UP.
NOT QUITE STATISTICALLY
DIFFERENT, BUT THIS IS PROBABLY
SOMETHING THAT SHOULD BE
EXAMINED IN FURTHER ITERATIONS
OF HINTS DATA TO SEE IF
BLACK/WHITE DIFFERENCES IN
LEVELS OF TRUST DO COME BACK AND
YOU SEE HERE AFTER ACCOUNTING
AND ADJUSTING FOR CO-VARIATES
AND SURVEY DESIGN EFFECTS.
DIFFERENCES DID DISAPPEAR OVER
TIME AND LOOK AS IF THEY
REAPPEAR IN MOST RECENT
ITERATION THAT THIS IS
AVAILABLE.
SO, AS I JUST SAID, THAT IS MY
SUMMARY THAT DISAPPEARED OVER
TIME AND INCONSISTENCY OF
CROSS-SURVEY STUDIES THAT
SOMETIMES DO HAPPEN IN THIS
LITERATURE AND SHOULD TAKE INTO
ACCOUNT OTHER FACTORS THAT
PRESENT HERE THAT SHAPE THAT
BLACK LIGHT DIFFERENCE SUCH AS
SURVEY YEARS AND SURVEY MODE
THAT WAS INSIDE OF THE SAMPLE
AND JUST IN GENERAL THESE ISSUES
ARE TO BE CONSIDERED WHEN
ANALYZING HINTS DATA.
AS I MENTIONED IN ANALYSIS THIS
IS A CATEGORICAL INDICATOR OF
SURVEY DESIGN EFFECTS THAT I'M
INTERESTED IN SOME FEEDBACK AND
ADDITIONAL METHODS THAT COULD BE
USED.
THANK YOU VERY MUCH.
>> THANK YOU.
>> IT IS GREEN.
THANK YOU TO PRESENTERS IF YOU
HAVE QUESTIONS WE HAVE TIME FOR
A COUPLE.
>> VERY GOOD TALKS. VERY GOOD
JOB, ALL OF YOU. I HAVE MANY
QUESTIONS AND WILL ASK ONE. DR.
CAMPOS CASTILLO, YOU SAW THAT
U-SHAPED TREND, WHY? ANY
HYPOTHESES?
>> TESTING? OKAY. GOOD.
YEAH. SO, AS BEST AS WE CAN
TELL HERE BECAUSE, YOU KNOW,
WHEN I STARTED OFF SETTING UP
THE STAGE, THERE WERE LOTS OF
THINGS THAT PRIOR LITERATURES DO
SHOW SHAPED LEVELS OF TRUST IN
HEALTHCARE PROVIDERS AND WE
CAN'T TEST OUT ALL OF THE
DIFFERENT MECHANISMS.
BEST AS WHAT WE CAN TELL FROM
CO-VARIATES AVAILABLE IN EACH OF
THE ITERATIONS IS THAT BLACK
ADULTS, THEIR EDUCATIONAL
ATTAINMENT HAS INCREASED OVER
TIME AND EDUCATION WILL BE
ASSOCIATED WITH LEVELS OF TRUST
IN HEALTHCARE PROVIDERS AND THAT
EDUCATION CANNOT EXPLAIN THE
2019 SHOOTING BACK UP THE WAY
THAT IT DID. IT IS NOT LIKE
THEY ALL OF A SUDDEN, YOU KNOW,
STOPPED GOING TO SCHOOL.
SOMETHING ELSE IS GOING ON
THERE.
LY SUGGEST IT IS PROBABLY MAYBE
ELECTION OF PRESIDENT TRUMP. IT
IS HARD TO DIRECTLY TEST SOME OF
THOSE THINGS AND AS FAR AS I CAN
TELL FROM CO-VARIATES THAT
APPEAR IN ALL ITERATIONS WE CAN
INCLUDE INTO THE MODEL IS THAT
BLACK ADULTS ARE LEVEL OF
EDUCATIONAL ATTAINMENTS INCREASE
OVER TIME.
>> THIS IS MY QUESTION FOR MARK.
YOU TALKED ABOUT OBVIOUSLY GIVEN
OPTION OF DON'T KNOW PROPENSITY
OF CERTAIN PEOPLE TO ANSWER
THAT. CAN YOU TELL US ANYTHING
ABOUT THESE FOLKS? PEOPLE THAT
IS A THEY DON'T KNOW DO THEY
HAVE DIFFERENT BEHAVIORS OR
PERCEPTIONS? WHY SHOULD WE BE
CONCERNED?
VERY GOOD QUESTION I CAN TALK
ABOUT FOR A LONG TIME AND COUPLE
TEASERS I WILL TALK MUCH MORE
ABOUT IT WITH FOLKS INTERESTED
IN LATER AND COUPLE THINGS
GROUPS DON'T SHOW OVER TIME AND
LOOKING AT WHO IS LIKELY TO SAY
THEY DON'T KNOW RISKS IT IS
FOLKS WITH LOWER EDUCATION AND
LOWER HEALTH LITERACY AND EVERY
ONCE IN A WHILE MINORITY -- LOTS
OF THE DISPARITIES WE CARE ABOUT
FOR CANCER PREVENTION WE THINK
IS PRIMARILY PHENOMENA ABOUT
LACK OF KNOWLEDGE AND HEALTH
RELATED LITERACY AND INFORMATION
TO UNDERSTAND AND BE ABLE TO
ANSWER RISKS AND OTHER THING
INTERESTED IN TERMS OF BEHAVIOR
IS WE HAVE A COUPLE PAPERS WE
HAVE SHOWN WHEN YOU LOOK AT
VARIOUS CANCER PREVENTION
BEHAVIORS FOR EXAMPLE COAL OE
RECTAL CANCER SCREENING PEOPLE
THAT DON'T KNOW THEIR RISKS HAVE
LOIER LEVELS OF BEHAVIOR AND
THAN PEOPLE THAT ANSWER
QUESTIONS SAYING RISK IS VERY
LOW AND IMPLICATIONS THERE ARE
FOR CANCER PREVENTION AND IN
TERMS OF ADVICE THIS IS ALL
METHODOLOGICAL WHY YOU SHOULD
MEASURE IT TO GET EXACT ANSWERS
AND PHENOMENA PEOPLE LACKING
RISK TO BE INCREDIBLY UNCERTAIN
IS IMPORTANT PHENOMENA IN OWN
RIGHT FOR HEALTH AND CANCER
PREVENTION.
>> TWO QUESTIONS. ONE FOR THE
FIRST PERSON WHO WAS JUST
SPEAKING. YEAH. THERE IS HUGE
LITERATURE I DIDN'T SEE YOU SAY
ANYTHING ABOUT. I MEAN, IN THE
SURVEY METHODS LITERATURE THIS
IS DEBATE FOR THE LAST 50 YEARS.
SO, ONE QUESTION IS TAKING
PEOPLE OUT. YOU HAVE A
RELATIONSHIP WITH PEOPLE WHO
HAVE VERY DEFINITE USE. IS THAT
WHAT YOU ARE REALLY INTERESTED
IN IF YOU WANT TO GENERALIZE THE
GENERAL POPULATION?
>> YEAH. THAT IS ANOTHER ONE
THAT IS MORE THAN A 30 SECOND
ANSWER. 30 SECOND START TO IT.
ARE YOU RIGHT. FOLKS HAVE DONE
A LOT OF THIS IN SURVEY
LITERATURE AND MOST OF THE
ADVICE IS UNFORTUNATELY TO NOT
OFFER A NO RESPONSE OPTION THAT
I ARGUE IS BAD VICE BY AND LARGE
WE CAN TALK ABOUT IT MORE LATER.
IF YOU -- WHAT I WOULD ARGUE IS
YOU ARE NOT EXCLUDING THOSE
FOLKS BY MEASURING DON'T KNOW
AND THEN USING IT AS
INFORMATION. IT IS THAT IF YOU
WANT TO THINK ABOUT RISK
PERCEPTION AS MULTI-FACETED
PHENOMENA, KNOWLEDGE OF RISK IS
PART OF THE PHENOMENA AND LEVEL
OF KNOWLEDGE IS A SEPARATE AND
DISTINCT PART OF IT.
>> COUNTERARGUMENT FOR THAT IS
-- COUNTERARGUMENT TO THAT IS
PEOPLE TEND TO USE DON'T KNOW
CATEGORY AS A [INDISCERNIBLE]
DEVICE. THEY DON'T WANT TO
EXERT A LOT OF EFFORT TO THINK
ABOUT IT. THEY ARE A LITTLE
UNCERTAIN AND PICK THE DON'T
KNOW OPTION. YOU ARE MISSING
SOME OF THOSE PEOPLE.
>> I AGREE THAT IS AN ARGUMENT
MADE BY FOLKS THAT ARGUE AGAINST
DON'T KNOW RESPONSE OPTION AND
SAY THAT BY AND LARGE OUR DATA
DOESN'T SUPPORT THAT ARGUMENT
AND GIVING ONE DATA POINT FOR IT
AND WOULD LOVE TO TALK TO YOU
MORE LATER. IF YOU GIVE PEOPLE
MULTIPLE RISK PERCEPTION
QUESTIONS VERY FEW PEOPLE USE
THE DON'T KNOW RESPONSE MULTIPLE
TIMES NOT PEOPLE ARE GOING
THROUGH CHECKING DON'T KNOW AND
EASIER THAN NOT AND SEEMS TO BE
SPECIFIC TO DIFFERENT KINDS OF
RISK QUESTIONS AND DEGREE OF
KNOWLEDGE AND SENSITIVE TO HOW
COMMON HEALTH PROBLEM IS AND
RELATED TO EDUCATION AND OTHER
THINGS YOU WOULDN'T NECESSARILY
EXPECT FROM A PURELY SATISFYING
ANSWER AND WOULD LOVE TO TALK
MORE. BY AND LARGE OUR DATA
DOESN'T SUPPORT DATA THAT IT IS
SATISFYING.
>> IT IS VERY QUESTION-SPECIFIC
AND COULD BE FOR THIS PARTICULAR
QUESTION THE DON'T KNOW ONGS IS
BETTER. GENERALLY LITERATURE
SAYS IF INTERESTED IN ISOLATING
DON'T KNOW GROUP PUT IN DON'T
KNOW ANSWER AND FOR VERY LAST
SPEAKER, I GUESSSAYS IF INTERES
DON'T KNOW GROUP PUT IN DON'T
KNOW ANSWER AND FOR VERY LAST
SPEAKER, I GUESS ONE THING THAT
TROUBLES ME ABOUT LAST PART AND
IN THE VERY LAST YEARS YOU ARE
CONTROLLING FOR MODE MODE WASN'T
RANDOMLY ASSIGNED TO PEOPLE AND
IT REPRESENTS A LOT BESIDES MODE
LIKE AGE, GENDER, EDUCATION,
INCOME. NOT CLEAR WHAT MODELS
MEAN IF YOU PUT MODE IN AS A
CO-VARIATE.
>> FOR THE SAKE OF TIME, I
FOCUSED ON BLACK LIGHT
DIFFERENCE IN THE LEVELS OF
TRUST IN HEALTHCARE PROVIDERS
AND I DIDN'T TOUCH ON WHAT
HAPPENS WITH THE ESTIMATES FOR
THE LATINO RESPONDENTS. IN
EARLY YEARS WHEN THEY HAD FILM
SURVEY EARLY YEARS WHEN THIS HE
FILM SURVEY, THAT IS WHERE YOU
DO SEE DIFFERENCES IN LATINO
WHITE RESPONDENTS THAT IS
BECAUSE OF THE LANGUAGE OF THE
SURVEY.
WHEN I DID THE MAIL IN SURVEY
THEY WERE ABLE TO PROVIDE
SPANISH LANGUAGE OF MATERIALS AT
WHICH IT WAS A LITTLE MORE
DIFFICULT, I GUESS, IN THE
MAIL-IN SURVEY THAT IS SOMETHING
I CAN'T SPEAK TO. ALL I KNOW IS
THAT IS WHAT I SEE WHEN I'M
CALCULATING ESTIMATES THAT IS
MUCH LESS ACCOUNTING FOR SURVEY
MODE AND IS MUCH LESS ABOUT
ADJUSTING ESTIMATES FOR BLACK
AND WHITE DIFFERENCES AND MORE
FOR LATINO WHITE DIFFERENCES.
>> FOR EARLY YEARS AND
CONTROLLING PROMOTERS IT IS
ACTUALLY RECOMMENDED AND IN 2019
AND 2021, MODE DOESN'T REALLY
REPRESENT ANYTHING EXCEPT SOME
CONGLOMERATION OF PEOPLE THAT
LIKE TO USE THOSE MODES THAT IS
NOT REALLY RANDOMLY ASSIGNED AND
CONTROLLING FOR IT, I'M NOT
QUITE SURE WHAT IT MEANS IN THAT
CONTEXT. YOU ARE RIGHT. I
THINK WHEN HINTS WENT FROM PHONE
TO MAIL THERE WERE ISSUES WITH
GETTING SPANISH SPEAKERS.
>> RIGHT.
>> THAT IS DEFINITELY TRUE.
>> OKAY.
>> THANK YOU. WE HAVE TIME FOR
A QUICK QUESTION.
>> THIS QUESTION IS FOR ASHLEY.
I'M CURIOUS ABOUT THE
IMPLICATIONS OF THE -- FOR THE
16% OR SO THAT YOU SAID WERE
MISESTIMATING THEIR AGE OF
DIAGNOSIS.
ONE WAY I PERSONALLY SEE THAT
VARIABLE TO CALCULATE TIME TO
CANCER SURVIVORSHIP. I'M
PERSONALLY CURIOUS ABOUT
IMPLICATIONS FOR THAT VARIABLE
AND PEOPLE MISESTIMATING AGE
WERE THEY MORE LIKELY TO BE
PEOPLE FURTHER OUT IN CANCER
SURVIVORSHIP OR FURTHER AWAY
FROM CANCER TREATMENT? IF YOU
CAN SPEAK TO THAT, THAT WOULD BE
HELPFUL. THANK YOU.
>> YEAH. THANKS FOR YOUR
QUESTION. THAT IS SOMETHING WE
HAVE DISCUSSED LOOKING INTO BUT
HAVEN'T DELVED TOO FAR INTO
QUITE YET. THERE IS A LOT OF
OPPORTUNITIES TO DIG MORE INTO
DATA SET TO SEE IF THERE IS
ANYTHING LIKE TIME-SENSE
DIAGNOSIS THAT COULD HELP TO
EXPLAIN SOME OF THE DIFFERENCES.
ALSO, THERE IS THE OPPORTUNITY
FOR THE ERROR IN HOW WE HAD TO
CALCULATE THE TIME-SENSE
DIAGNOSIS AND AGE DIAGNOSIS IN
COMPARISON TO HOW SEER
REGISTERED AND REPORTED THE
VARIABLE.
THANK YOU, AGAIN, EVERYONE,
FOR YOUR WONDERFUL
PRESENTATIONS. ENJOY YOUR
LUNCH. THANK YOU.
SYLVIA CHOU WILL MODERATE THE
NEXT POSTER SESSION -- OF.
WHEN WE WERE HIGHLIGHTING THE
MOST CITED HINTS PAPERS AND
SYLVIA'S IS THE MOST CITED HINTS
PAPER AT OVER 1500 CITATIONS FOR
A 2009 PAPER THAT WAS PUBLISHED
IN JMIR TITLED SOCIAL MEDIA USE
AND US IMPLICATIONS FOR HEALTH
PROMOTION AND CO-AUTHORS WERE
YVONNE HUNT AND ELLEN AND JOE.
I WANTED TO SAY THAT. IT WAS A
REALLY IMPORTANT PAPER. HINTS
WAS ONE OF THE FIRST SURVEYS
THAT STARTED TO LOOK AT SOCIAL
MEDIA USE IN THE US AND
FOUNDATIONAL PAPER THAT SYLVIA
LED THAT IS A BIG PART OF HER
CAREER AND REALLY SORRY I DIDN'T
MENTION IT YESTERDAY OR IT
DIDN'T SHOW UP IN OUR ANALYSIS.
WITH THAT, HERE IS SYLVIA TO
MODERATE THE NEXT SESSION.
>> THANK YOU, KELLY AND EVERYONE
FOR COMING BACK AVERAGE LUNCH
FOR WHAT IS GOING TO BE A VERY
EXCITING PANEL. I'M SYLVIA CHOU
AND WILL SAY ONE REASON WHY I
THINK HINTS HAS A VALUABLE
INSIGHT IS TRYING TO MEET
PEOPLE'S COMMUNICATION NEEDS OR
UNDERSTAND THEIR NEED WHERE'S
THEY LIVE AND WORK AND PLAY AND
IS ONE OF THE FIRST SURVEYS THAT
INTRODUCED SOCIAL MEDIA RELATED
ITEMS NOT JUST HOW YOU USE
SOCIAL MEDIA BUT HEALTH RELATED
SOCIAL MEDIA USE WHETHER
PARTICIPATION IN ONLINE SUPPORT
GROUPS OR WATCHING YOUTUBE
VIDEOS ABOUT HEALTH THAT GIVES A
LOT TO THINK ABOUT IN MATERIALS
OF EVOLVING AND CHANGING
LANDSCAPE THAT IS CHARACTERIZED
BY USER GENERATED CONTENT THAT
CONNECTS TO WAY WE COMMUNICATE
ABOUT HEALTH AND THIS PANEL HAS
FOUR PRESENTATIONS ABOUT
DIFFERENT ASPECTS OF SOCIAL
MEDIA.
BY WAY OF INTRODUCTION THE FEEL
THE FIRST DECADE OF SOCIAL MEDIA
THERE WAS EXCITEMENT AND
PROMISES THINKING ABOUT HOW IT
HELPS SUPPORT COMMUNICATION
EFFORTS AND BIG QUESTION OF
MISINFORMATION THAT BECOMES TOO
BIG TO IGNORE AND WE THINK
OPENING UP PEER-TO-PEER
COMMUNICATION LET'S US HAVE LESS
CONTROL OF CONTENT AND BEGIN
ASKING QUESTIONS OF PEOPLE'S
PERCEPTIONS AND QUALITY OF
INFORMATION THEY SEE ON SOCIAL
MEDIA THAT YOU WILL SEE IN AT
LEAST TWO PRESENTATIONS TODAY.
LET'S GET STARTED. WE WILL
START WITH OUR FIRST SPEAK ER.
DR. MING WONG AND YONAIRA AND
PRATHYUSHA.
THANK YOU SO MUCH.
>> THANK YOU, EVERYONE, FOR
STAYING THIS AFTERNOON.
MY RESEARCH FOCUSES ON IMPACT OF
NEW COMMUNICATION TECHNOLOGIES
ON HEALTH COMMUNICATIONS THAT
I'M TRYING TO IDENTIFY
STRATEGIES FOR SOCIAL MEDIA
INTERVENTIONS IN ANTIRAPING
CAMPAIGNS IN THE STUDY.
VAPING HAS SURPASSED CIGARETTES
BECOMING THE MOST PREVALENT
TOBACCO USE BY US USE AND 6% OF
HIGH SCHOOL STUDENTS AND 4.7% OF
STUDENTS REPORTED -- MAY SERVE
AS A GATEWAY TO CIGARETTE
SMOKING AND MARIJUANA AND OTHER
SUBSTANCE USE. FACEBOOK
INSTAGRAM AND TIKTOK AND YOUTUBE
WHERE THEY ARE MORE LIKELY TO
SEARCH FOR AND SHARE INFORMATION
ABOUT [INDISCERNIBLE] AND
INTERNET VENDORS MARKET PRODUCTS
AND NONCOMMERCIAL VENDORS THAT
SHARE COUPONS PROMOTIONS AND
PRODUCT USE.
COMMON PROMOTIONAL STRATEGIES
INCLUDE PRICE PROMOTIONS BETWEEN
FLAVORS FEATURING PRODUCT
CHARACTERISTICS THAT USE
YOUTH-APPEALING THEMES AND
CELEBRITY INFLUENCER MARKETING
BUILDING PROVAPE COMMUNITIES AND
IDENTITIES AND INCENTIVIZING
FRIEND TAGGING LIKE THE ICE
BUCKET CHALLENGE VIRAL CAMPAIGNS
WE HAVE SEEN BEFORE. VISUALS
OFTEN PORTRAY A SAFE YOUTH
HEALTHY INDEPENDENT NATURAL AND
COOL THEMES AND WE SEE USERS
POST VERY COOL VAPING TRICKS AND
PROMOTE VAPING PRODUCTS ON
INSTAGRAM AND TIKTOK AND
EXPOSURE TO PROMOTION MESSAGES
WE KNOW AS RISK FACTOR FOR USE
PARTICULARLY AMONG ADOLESCENTS
BEING SHOWN TO SHOW INCREASED
[INDISCERNIBLE] AND REDUCED
SMOKING CESSATIONS AND IN
ADDITION TO PROVAPING MESSAGES
ON SOCIAL MEDIA WE KNOW PUBLIC
HEALTH PROFESSIONALS ARE POSTING
ANTIRAPING MESSAGES ON SOCIAL
MEDIA SUCH AS REAL COST
E-CIGARETTE CAMPAIGN AND NEW
EVIDENCE SUGGESTS THAT ENGAGING
YOUTH OF HARMS OF E-CIGARETTE
USE HAVE SOME EFFECT. QUESTIONS
I'M TRYING TO ASK HERE IS HOW DO
SOCIAL MEDIA EXPERIENCES EFFECT
VAPOR'S PERCEPTIONS OF
E-CIGARETTE [INDISCERNIBLE].
AS WE TALK AND WE HEARD EARLIER
THAT WE KNOW THAT HEALTH
MISINFORMATION IN PARTICULAR HAS
BEEN PREVALENT ON SOCIAL MEDIA
AND WENT THROUGH THOSE AND
PARTICULARLY IS ON SOCIAL MEDIA
THAT SOCIAL MEDIA USERS HEAR
MESSAGES SUCH AS NICO TEEN IS
NOT ADDICTIVE AND NEVER HARMFUL
AND [INDISCERNIBLE] THAT TOUT
UNPROVEN HEALTH BENEFITS I HAVE
SEEN [INDISCERNIBLE] FOR
INSTANCE E-CIGARETTES COMPLETELY
HEALTHY AND SYNTHETIC NICOTINE
DOESN'T CAUSE CANCER AND
E-CIGARETTES CAN PROMOTE SMOKING
CESSATION AND STARTED TO WORK
WITH A COLLEAGUE WHO USED TO
MANAGE ESPORTS TEAMS AND TALK
ABOUT E-CIGARETTE USE IN SPORTS
COMMUNITY AND FOUND THERE IS A
LOT OF MISINFORMATION ABOUT
ESPORTS AND SOME CLAIM THIS IS A
PARTICULAR PAIR.
VAPE WILLING DURING GAMING HELPS
RELAX NERVES AND PERFORM BETTER
AND HELPS YOU SOCIALIZE.
I TALKED WITH MI COLLEAGUE.
I'M INTERESTED IN LOOKING AT
WHETHER EXPOSURE TO HEALTH
MISINFORMATION ON SOCIAL MEDIA.
SO, I HYPOTHESIZED THAT VAPING
FREQUENCY IS ASSOCIATED WITH
PERCEIVED E-CIGARETTE HARM AND
MORE IMPORTANTLY I EXPECT THIS
RELATIONSHIP TO BE AMPLIFIED
WHEN INDIVIDUALS ARE EXPOSED TO
TOBACCO ADVERTISING ON SOCIAL
MEDIA AND EXPOSE TODAY HEALTH
INFORMATION ON SOCIAL MEDIA
MEANING THEY ARE LESS LIKELY TO
PERCEIVE HARM WHEN EXPOSED TO
THESE SOURCES AVEND THIS EFFECT
IS ATTENUATED WHEN INDIVIDUALS
ARE EXPOSED TO ANTI-VAPING AND
ANTITOBACCO ADVERTISING ON
SOCIAL MEDIA MEANING WHEN THEY
SEE THESE MESSAGES THIS ARE MORE
LIKELY TO SEE HARM.
DATA SET I USED IS THIS DATA
THAT E-CIGARETTE HARM IS
MEASURED BY 5-POINT SCALE I
RECODED SO HIGHER VALUE
INDICATES MORE PERCEIVED HARM
AND E-CIGARETTE FREQUENCY THAT
IS USED TO USERS THOSE REPORTED
USING E-CIGARETTES BEFORE AND 6%
IN THE DATASET AND NOT LOOKING
AT SOCIAL MEDIA EFFECTS OF THOSE
USED ON E-CIGARETTES BEFORE AND
OTHER MEASURES I USED DURING
TOBACCO EXPOSURE ADVERTISING IN
PAST THREE MONTHS AND TOBACCO
ADVERTISING SOCIAL MEDIA AND
SIMILAR QUESTION WAS ASKED ABOUT
ANTITOBACCO ADVERTISING AND
ASKED HOW MUCH OF THE HEALTH
INFORMATION YOU SEE ON SOCIAL
MEDIA YOU THINK IS FALSE OR
MISLEADING AND CONTROLLED A HOST
OF DEMOGRAPHICS THIS WAS A
SURVEY PACKAGE IN R.
SO S
SO, RESULTS SHOW FREQUENCY IS
ASSOCIATED WITH PERCEIVED
E-CIGARETTE HARM AND
[INDISCERNIBLE] IS NOT
SURPRISING AND I'M NOT TRYING TO
SORT OF CLAIM CAUSATION HERE AND
RELATIONSHIP COULD BE REVERSED
LOOKING AT CORRELATION HERE AND
MORE IMPORTANTLY THERE IS A
SIGNIFICANT TWO-WAY INTERACTION
BETWEEN VAPING FREQUENCY AND
EXPOSURE TO TOBACCO ADVERTISING
ON SOCIAL MEDIA SHOWING THAT
FREQUENT VAPORS ARE LESS LIKELY
TO PERCEIVE -- GIVEN PREVALENCE
OF VAPING FREQUENCY AMONG YOUTH
ALSO FOLLOWED UP WITH A
THREE-WAY INTERACTION THAT WE
KNOW THAT AGE MATTERS HERE AND
DID ANALYSIS WITH THREE WAY
INTERACTION BETWEEN VAPING
FREQUENCY EXPOSURE AND THIS
TELLS US THAT THIS EFFECT IS
STRONGER ON YOUTH.
UNFORTUNATELY OTHER TWO
MODERATION HYPOTHESES WEREN'T
SUPPORTED AND EFFECT AND
RELATIONSHIP BETWEEN VAPING
FREQUENCY AND PERCEIVED
E-CIGARETTE HARM DIDN'T VARY
SIGNIFICANTLY BETWEEN THOSE THAT
WERE EXPOSED TO HEALTH
MISINFORMATION AND THOSE THAT
WERE NOT AND THEY DID NOT VARY
BETWEEN THOSE THAT WERE EXPOSED
TO ANTITOBACCO ADVERTISING ON
SOCIAL MEDIA VERSUS THOSE THAT
WERE NOT EXPOSED TO THOSE.
WHAT ARE IMPLICATIONS?
WE KNOW THAT TOBACCO ADVERTISING
IS EFFECTIVE PARTICULARLY AMONG
YOUTH AND SEE STRONG INTERACTION
AMONG RESULTS AND WE HAVE TO BE
PROACTIVE IN STRATEGIC
COUNTERACT TOBACCO ADVERTISING
EFFECTS.
WE KNOW PUBLIC HEALTH, PUBLIC IS
EXPOSED TO HEALTH MISINFORMATION
ONLINE AND RESEARCH IS SHOWING
IMPACT.
ANNA'S PRESENTATION NEXT WILL
LOOK AT PREVALENCE PREDICTORS
AND ASSOCIATED BEHAVIOR WITH
EXPOSURE TO HEALTH
MISINFORMATION ON SOCIAL MEDIA
AND DIDN'T FIND EFFECT IN STUDY
REGARDING E-CIGARETTE USE.
THINKING ABOUT RESULTS AND
THINKING ABOUT THIS MEASURE, THE
ONE THAT I USED HERE IS A
SELF-REPORTED MEASURE TO HEALTH
MISINFORMATION ON SOCIAL MEDIA
AND PROBLEM THINKING ABOUT THIS
MEASURE IS THOSE EXPOSED TO
HEALTH INFORMATION THAT MAY NOT
KNOW OR THINK INFORMATION THEY
SEE IS MISINFORMATION. TO THEM,
MISINFORMATION IS ACTUALLY THE
TRUTH AND WHAT THEY BELIEVE IN
AND THAT MIGHT BE A CONCERTIVE
MEASURE OF EFFECT OF
MISINFORMATION. I THOUGHT OF
ANOTHER POSSIBILITY WHEN LOOKING
AT SOCIAL MEDIA INSTAGRAM DATA
SET I COLLECTED I SEE SOME
VAPORS CLAIM ANTI-VAPING
MESSAGES TO BE MISINFORMATION
AND MESSAGES THEY THOUGHT WERE
ACTUALLY FALSE. IN THAT SENSE
WHEN WE FIND EFFECTS FROM
PERCEIVED EFFECTS ON
MISINFORMATION OF VAPORS ARE
EFFECT OF TRUE ARNTI VAPING
MESSAGE AND THINKING ABOUT THIS
I THINK THERE COULD BE MORE
NUANCE TO MEASURE EXPOSURE TO
HEALTH MISINFORMATION ONLINE.
WE KNOW THAT WE NEED TO DEVELOP
MORE EFFECTIVE ANTI-VAPING
ADVERTISING CAMPAIGNS AND NULL
EFFECT IN THE STUDY SUGGESTS WE
HAVE TO DEVELOP MORE EFFECTIVE
CAMPAIGN COMMUNICATION TO
COMMUNICATE HARMS OF E-CIGARETTE
USE TO VAPORS.
THERE HAS BEEN RESEARCH ON HOW
TO DESIGN ANTI-VAPING CAMPAIGNS
ON SOCIAL MEDIA IN THE
LITERATURE AND GRANTED WE NEED
MORE RESEARCH ON THAT. I WANTED
TO SHARE RECENT DIRECTIONS I HAD
TAKEN BY RESEARCH OF LOOKING AT
ARTIFICIALLY DRIVEN AND
ARTIFICIAL INTELLIGENCE DRIVEN
ALGORITHMS ON SOCIAL MEDIA AND
ESPECIALLY ON TIKTOK.
SO, I WORKING WITH A LOCAL
NON-PROFIT WHOSE AIM IS TOBACCO
CONTROL AND NOTICED AN
INTERESTING PHENOMENON POSTING
ANTI-VAPING MESSAGES ON TIKTOK.
WHEN WE CLICKED ON ANTI-VAPING
MESSAGE WE GET RECOMMENDED THESE
ARE RELATED VIDEOS YOU SHOULD
WATCH AND KEEP CLICKING ON
MESSAGES, WE WERE DIRECTED TO
MORE AND MORE PROVAPING MESSAGES
ON SOCIAL MEDIA.
IMAGINE A CURRENT VAPOR WHO
WANTS TO QUIT VAPING SEES
CAMPAIGN MESSAGE GOING TO
ORGANIZATION'S WEBSITE AND
CLICKS ANTI-VAPING MESSAGE AND
SLOWLY STARTS TO SEE
ATTITUDE-RE-ENFORCING MESSAGES
THAT PROMOTE VAPING AND IS NOT
WHAT WE WANTED.
WHAT ARE SOLUTION SNZ.
MORE RESEARCH I THINK INTO
ALGORITHMIC IMPACT WORKING IN
SOCIAL MEDIA PLATFORMS IS
IMPORTANT AND FROM OUR
PERSPECTIVE LOOKING AT MAYBE WE
NEED TO THINK ABOUT AT RISK
LITERACY AND SOCIAL MEDIA
LITER
LITERACY.
WE HAVE DONE RESEARCH THAT
DEVELOPED VAPING SOCIAL MEDIA
LITERACY PROGRAM AND FOUND THAT
INCREASED PERCEIVED HARM OF
E-CIGARETTES AND SEEING THIS
LITERACY IN TOBACCO CONTROL
ENDEAVORS.
THANK YOU.
>> HI. GOOD AFTERNOON,
EVERYONE. I WILL PRESENT ON
SOME OF THE NEW SOCIAL MEDIA
MISINFORMATION ITEMS FROM HINT 6
AND RELATIONSHIP TO
COMMUNICATION BEHAVIORS
INVOLVING SHARING AND USING
SOCIAL MEDIA HEALTH INFORMATION.
OKAY OUR TEAM STARTED TO WORK ON
HEALTH MISINFORMATION BACK IN
2017 AND BACK THEN FELT WE HAD
TO DO A LOT OF WORK TO CONVINCE
PEOPLE THAT HEALTH
MISINFORMATION WAS SOMETHING
THAT NEEDED URGENT ATTENTION.
MADE IT CLEAR TO EVERYONE THIS
IS A SERIOUS PROBLEM TO HINDER
PUBLIC HEALTH RESPONSE AND
IMPORTANT TO NOTE THAT
MISINFORMATION AS A CONCEPT IS
NOT NEW BUT IS A BIGGER THREAT
IN THE CURRENT -- THEREBY
EXACERBATING NEGATIVE EFFECT OF
MISINFORMATION ON INDIVIDUAL AND
POPULATION HEALTH AND MANY
STUDIES TO DATE DOCUMENTED
EXISTENCE OF SUBSTANTIAL AMOUNTS
OF HEALTH-RELATED MISINFORMATION
ON SOCIAL MEDIA PLATFORMS ACROSS
A WIDE RANGE OF TOPICS AND
EXPERIMENTAL RESEARCH SUGGESTS
THAT SOCIAL MEDIA MISINFORMATION
COULD HAVE NEGATIVE IMPACT ON
HEALTH RELATED ATTITUDES
BEHAVIORS AND OUTCOMES AND
GROWING INFORMATION SUGGESTS
MISINFORMATION IS WIDESPREAD ON
SOCIAL MEDIA AND RELATIONSHIP
BETWEEN SOCIAL MEDIA EXPOSURE
AND HEALTH RELATED OUTCOMES AND
LITTLE WORK TO DATE -- PERCEIVE
MISINFORMATION ON SOCIAL MEDIA
OR PERCEPTIONS THAT IMPACT
BEHAVIOR THAT IS A POTENTIALLY
SIGNIFICANT GAP IN THE
LITERATURE AND EVIDENCE TO
SUGGEST THAT PERCEPTIONS COULD
IMPACT ATTITUDES AND BEHAVIORS
OVER AND ABOVE -- OVER AND ABOVE
THE IMPACT OF ACTUAL EXPOSURE OR
MISINFORMATION ENDORSEMENT. FOR
EXAMPLE A STUDY CONDUCTED IN
2020 FOUND PERCEPTIONS OF HIGH
MISINFORMATION PREVALENCE IN
SOCIAL MEDIA WERE CORRELATED
WITH WORRY ABOUT COVID-19 AND
ACTUAL OBJECTIVE PREVALENCE OF
MISINFORMATION AND WORRY ABOUT
COVID-19 SUGGESTING THAT
MISINFORMATION PERCEPTIONS MIGHT
HAVE UNIQUE EFFECTS.
IN ADDITION TO ASSESSING
PERCEPTIONS WITH MISINFORMATION
PREVALENCE ASSESSING PEOPLE'S
CONFIDENCE IN ABILITY TO DETECT
MISINFORMATION IS IMPORTANT AND
CONFIDENCE CAN EFFECT HOW PEOPLE
MAKE SUBSEQUENT JUDGMENTS --
ABILITY TO MANAGE AND MAKE
HEALTH DECISIONS AND PERCEPTIONS
RELATED TO MISINFORMATION MIGHT
IMPACT COGNITIONS AND BEHAVIORS
IN IMPORTANT WAYS IT IS CRITICAL
TO ASSESS MISINFORMATION
PERCEPTIONS ASSOCIATED BY OTHER
CHARACTERISTICS TO IDENTIFY
GROUPS VULNERABLE TO
MISINFORMATION AND MIGHT BE A
NEED OF TARGETED EFFORTS AND
LIGHT OF FACT THAT LITTLE WORK
TO DATE EXPLORED PUBLIC
PERCEPTION MISINFORMATION AND
EVIDENCE SUGGESTS THAT
PERCEPTIONS CAN EFFECT REAL
WORLD ATTITUDES AND BEHAVIORS
UNDERTOOK A STUDY -- IDENTIFY
SOCIO DEMOGRAPHIC FACTORS
ASSOCIATED WITH PERCEPTIONS AND
EXPLORE MISINFORMATION
PERCEPTIONS AND HEALTH
COMMUNICATION BEHAVIORS AND
DISCUSSING HEALTH INFORMATION
FROM SOCIAL MEDIA WITH PROVIDERS
AND USING SOCIAL MEDIA
INFORMATION TO MAKE HEALTH
DECISI
DECISIONS.
RESPONDENTS SELECTING I DO NOT
USE SOCIAL MEDIA WERE EXCLUDED
FROM ANALYSIS. LACK OF
CONFIDENCE DISCERNING TRUTH OF
FALSE INFORMATION ON SOCIAL
MEDIA WAS ASSESSED BY RESPONDENT
AS GREEMENT WITH STATEMENT I
FIND IT HARD TO TELL WHETHER
HEALTH INFORMATION ON SOCIAL
MEDIA IS TRUE OR FALSE AND
INFORMATION SHARING BEHAVIOR ON
SOCIAL MEDIA WAS ASSESSED ASKING
RESPONDENTS HOW OVRN THEY SHARED
PERSONAL OR GENERAL HEALTH
INFORMATION ON SOCIAL MEDIA IN
THE PAST 12 MONTHS ITEMS ASKING
ABOUT USE OF INFORMATION FROM
SOCIAL MEDIA IN DISCUSSION WITH
PROVIDERS AND USE OF INFORMATION
FROM SOCIAL MEDIA MAKING HEALTH
DECISIONS THIS SLIDE SHOWS SOCIO
DEMOGRAPHIC -- INCLUDING
EDUCATION SEX AGE RACE ETHNICITY
INCOME GEOGRAPHIC RESIDENCE
HEALTH LITERACY AND DIGITAL
LITERACY AND CALCULATED
FREQUENCIES AND UNADJUSTED
PROPORTIONS TO DESCRIBE
DISTRIBUTION OF RESPONSES TO TWO
MISINFORMATION PERCEPTION ITEMS
RUNNING TWO LOGISTIC REGRESSION
MODELS EXAMINING ASSOCIATION OF
SOCIO DEMOGRAPHIC
CHARACTERISTICS WITH TWO MAIN
PERCEPTION ITEMS AND SEPARATE
SET OF LOGISTIC REGRESSION
MODELS USED TO TEST ASSOCIATION
BETWEEN TWO MAIN PERCEPTION
ITEMS AND COMMUNICATION
BEHAVIORS RELATED TO SHARING USE
OF SOCIAL MEDIA INFORMATION.
OVERALL, WE FOUND THAT OVER
1/3US SOCIAL MEDIA USERS REPORT
HIGH PERCEIVED MISINFORMATION
AMOUNT.
-- WE ALSO FOUND CERTAIN SOCIO
DEMOGRAPHIC CHARACTERISTICS AND
LITERACY MEASURES TO BE -- FOR
EXAMPLE HISPANIC AND
NON-HISPANIC BLACK AND
AFRICAN-AMERICAN INDIVIDUALS
WERE LESS LIKELY TO PERCEIVE
HIGH LEVELS OF MISINFORMATION AS
WERE THOSE WITH SUBJECTIVE
HEALTH LITERACY AND OTHER HAND
THOSE WITH LOWER DIGITAL
LITERACY -- IN TERMS OF
PERCEIVED DIFFICULTY -- WE FOUND
DIFFERENCES BASED ON AGE
ETHNICITY AND WILLITY TRASCY AND
ADULTS 25 TO 34 AND -- WERE LESS
LIKELY TO REPORT HIGH
DISCERNMENT DIFFICULTY COMPARED
TO THOSE WITH AGE 18 TO 24 AND
HISPANIC INDIVIDUALS WERE LESS
LIKELY TO REPORT HIGH
DISCERNMENT DIFFICULTY AND THOSE
WITH LOWER DIGITAL LITERACY AND
LOWER -- FINALLY WE FOUND
DISTINCT COMMUNICATION BEHAVIOR
PATTERNS ASSOCIATED WITH TWO
PERCEPTIONS AND WERE LESS LIKELY
TO REPORT SHARING GENERAL HEALTH
INFORMATION ON SOCIAL MEDIA AND
USING SOCIAL MEDIA INFORMATION
AND DISCUSSIONS WITH HEALTHCARE
PROVIDERS AND INDIVIDUALS WITH
HIGH PERCEIVED DISCERNMENT
DIFFICULTY WERE MORE LIKELY TO
REPORT USING INFORMATION FROM
SOCIAL MEDIA MAKING HEALTH
DECISIONS AND DISCUSSIONS WITH
HEALTH PROVIDERS AND OVERALL SEE
1/3 OF AMERICAN SOCIAL MEDIA
USERS REPORT THAT HEALTH
INFORMATION THEY SEE ON SOCIAL
MEDIA IS FALSE OR MISLEADING AND
PERCEPTION VARIES BY RACE
ETHNICITY AND NONSUBJECTIVE
LITERACY AND -- LESS LIKELY TO
SAY LOTS OF THE HEALTH
INFORMATION THEY SEE ON SOCIAL
MEDIA IS FALSE OR MISLEADING
THESE ARE SELF-REPORT MEASURES
NOT POSSIBLE TO REPORT IF THESE
GROUPS -- DUE TO NATURE OF
ONLINE NETWORKS OR IF LESS AWARE
OF THE FACT THAT THE INFORMATION
THEY ARE SEEING IS ACTUALLY
FALSE.
IT WILL BE IMPORTANT TO FURTHER
EXAMINE REASONS BEHIND FINDINGS
GIVEN THAT BLACK AND HISPANIC
INDIVIDUALS REPORT USING SOCIAL
MEDIA AT HIGHER RATES THAN
WHITES AND SUBSTANTIAL
PROPORTIONS OF INDIVIDUALS IN
GROUPS REPORT REGULARLY GETTING
NEWS FROM SOCIAL MEDIA PLATFORMS
AND SAW THOSE ARE LOWER
SUBJECTIVE HEALTH LITERACY
PERCEIVED LOWER LEVELS OF HEALTH
MISINFORMATION AND CONCERNING
THAT SUMMARY RESEARCH SUGGESTS
THAT INDIVIDUALS WITH -- QUALITY
ISSUES AND MAY BE LESS LIKELY TO
USE ESTABLISHED INFORMATION
EVALUATION CRITERIA. OVERALL,
FINDINGS INDICATE A NEED FOR
TARGETED EFFORTS TO RAISE
AWARENESS ABOUT MISINFORMATION
AND PROVIDE INFORMATION
EVALUATION TRAINING TO AT-RISK
GROUPS AND FOUND THAT
APPROXIMATELY 2/3 OF US SOCIAL
MEDIA USERS FIND IT HARD TO TELL
WHETHER HEALTH INFORMATION ON
SOCIAL MEDIA IS TRUE OR FALSE
AND HIGH DISCERNMENT DIFFICULTY
AMONG THE PUBLIC ARE CONCERNING
SINCE LOW CONFIDENCE IN ONE'S
ABILITY TO DISTINGUISH TRUE FROM
FALSE INFORMATION COULD RESULT
IN LOWER MOTIVATION TO SEEK
INFORMATION, APATHY AND
CONFUSION THAT COULD HAVE
NEGATIVE HEALTH OUTCOMES NO THE
BECAUSE PEOPLE MIGHT ACT ON
MISINFORMATION BUT FAIL TO ACT
ON ACCURATE INFORMATION BECAUSE
THEY ARE CONFUSED ABOUT WHAT TO
BELIEVE. ADDITIONALLY THERE
WERE DIFFERENCES IN DISCERNMENT
DIFFICULTY BASED ON DEMOGRAPHIC
CHARACTERISTICS BASED ON AGE AND
ETHNICITY AND SOME GROUPS THAT
IS MISPLACED COULD BE A PROBLEM
AS INDIVIDUALS MAY NOT FEEL THE
NEED TO FURTHER VERIFY
INFORMATION THAT THEY FIND FOR
EXAMPLE BY DOING ADDITIONAL
RESEARCH OR BY TALKING TO
PROVIDERS POTENTIALLY PUTTING
THEM AT GREATER RISK ASKING ON
FALSE INFORMATION AND FOUND
INTERESTING PATTERNS BETWEEN
MISINFORMATION PERCEPTIONS AND
COMMUNICATION BEHAVIORS FOR
EXAMPLE PERCEIVING HIGH LEVELS
OF MISINFORMATION WAS ASSOCIATED
WITH LOWER ODDS SHARING GENERAL
HEALTH INFORMATION ON SOCIAL
MEDIA AND PERHAPS PEOPLE --
PLATFORMS ARE HESITANT TO
FURTHER CONTRIBUTE TO THE
PROBLEM SHARING INFORMATION THAT
MAY TURN OUT TO BE FALSE.
INDIVIDUALS PERCEIVING HIGH
LEVELS OF MISINFORMATION WERE
LESS LIKELY TO USE SOCIAL MEDIA
INFORMATION IN MAKING HEALTH
DECISIONS OR IN DISCUSSIONS WITH
HEALTH PROVIDERS THEY ARE
SKEPTICAL OF INFORMATION THEY
ARE FINDING ON PLATFORMS AND IN
CONTRAST INDIVIDUALS REPORTING
ON SOCIAL MEDIA WERE LIKELY TO
REPORT THEY USE INFORMATION FROM
THESE PLATFORMS MAKING HEALTH
DECISIONS AND IN DISCUSSIONS
WITH PROVIDERS BECAUSE THEY SEEK
ASSISTANCE FROM PROVIDERS
ASSESSING CREDIBILITY OF THE
INFORMATION THEY FIND AND
RESEARCH SUGGESTS THAT PROVIDERS
ARE NOT CURRENTLY INITIATING
CONVERSATIONS ABOUT ONLINETH
INFORMATION -- COULD BE HELPFUL
TO INCORPORATE INTO PATIENT
PROVIDER CONVERSATIONS.
SO, BEFORE I WRAP UP I WANT TO
QUICKLY NOTE SOME LIMITATIONS OF
THE STUDY INCLUDING THE FACT
THAT HINTS DATA IS
CROSS-SECTIONAL AND FACT THAT
MEASURES USED WERE SUBJECTIVE
SELF-REPORT ITEMS AND SINCE
PRIOR RESEARCH SUGGESTS
MISINFORMATION PERCEPTIONS COULD
HAVE UNIQUE EFFECTS ON ATTITUDES
AND BEHAVIORS SEPARATE FROM
OBJECTIVE EXPOSURE TO
MISINFORMATION CURRENT STUDY
NONETHELESS MAKES IMPORTANT
CONTRIBUTION TO BROADER HEALTH
MISINFORMATION LITERATURE AND
ENDING BY ACKNOWLEDGING
WONDERFUL COLLABORATORS ON THIS
ANALYSIS. NICOLE, SYLVIA AND
KATIE. THANK YOU.
>> HI, EVERYONE. I DON'T HAVE
TO GO THROUGH THREE OF MY SLIDES
ALREADY. IT WAS A WONDERFUL
PRESENTATION. SO, I'M JENNA AND
SKIELT TODAY BE HERE AND BEFORE
I START I WANT TO THANK CATRINA
CORPUS A FELLOW WORKING WITH ME
IN MY RESEARCH TEAM FOR A YEAR
NOW WHO HELPED OUT WITH
ANALYSIS.
I WILL HONE IN ON A SPECIFIC
SUBSET OF THIS DATA SET OF T202
HINTS DATA SET FOCUSING ON
LATINOS AND LOOKING AT
ENGAGEMENT WITH AND UTILIZATION
OF HEALTH INFORMATION ON SOCIAL
MEDIA AMONG US LATINOS.
SO, I WANT TO START OFF TALKING
ABOUT ENGAGEMENT TALK BEING
SOCIAL MEDIA AND ENGAGEMENT
MEASURES WE TEND TO THINK OF
LIKES, COMMENTS, SHARES AND
THOSE THINGS ARE VERY IMPORTANT
AND I ALWAYS LIKE TO ROUND
DEFINING ENGAGEMENT BY WHAT IS A
COMPREHENSIVE -- THEY DEFINE AS
USER -- INTERACT WITH AND CREATE
AND SHARE CONTENT.
VERY IMPORTANT FROM PUBLIC
HEALTH AND CANCER PREVENTION
PERSPECTIVE THAT IS
INCERTIFIMENTAL REACHING
AUDIENCES ON PLATFORMS THESE ARE
PREDICTORS FOR INCREASED
KNOWLEDGE AND AWARENESS AND
USING INFORMATION; RIGHT?
PEOPLE ARE ABSORBING INFORMATION
AND USING THEM OFFLINE
POTENTIALLY. THANK YOU, ANNA,
FOR GOING OVER A LOT OF THESE.
ONLY THING I WANT TO HIGHLIGHT
IN ADDITION TO WHAT ANNA WAS
SAYING AND RESULT SHEZ REPORTED
IS A REALLY GREAT SYSTEMATIC
REVIEW BY DR. HER AND IN THAT
WAS LOOKING AT DIFFERENT
PREDICTORS FOR HEALTH
MISINFORMATION AND ENGAGEMENT
AND UTILIZATION ON SOCIAL MEDIA
AND TWO THINGS THAT THEY FOUND
IS THAT BEING OF RACIAL MINORITY
STATUS AS WELL AS USING SOCIAL
MEDIA HAVE BEEN ASSOCIATED WITH
GREATER SUSCEPTIBILITY TO HEALTH
MISINFORMATION IN GENERAL.
WHEN WE START THINKING ABOUT
THIS CASE IN LAT TOONO COMMUNITY
COVID SHOWED ALL OF US AND
RAMIFICATIONS OF HEALTH
MISINFORMATION AND LATINOS IN
PARTICULAR WONDERFUL KEYNOTE
MENTIONED WE ARE LARGEST
MINORITY GROUP IN THE UNITED
STATES AND NIELSEN REPORTED THIS
WAS AUGUST-ISH OF 2020 THAT
REPORTED THAT REGARDING TO COVID
AND CORONAVIRUS RELATED
INFORMATION LAT TEENIAS WERE 22%
MORE LIKELY TO USE SOCIAL MEDIA
AS PRIMARY SOURCE OF INFORMATION
ON THESE TOPICS THAT IS A
POPULATION DEFINITELY THAT NOT
ONLY IS IT A BIG AND YOUNGER
POPULATION BUT THEY APPEAR TO
USE SOCIAL MEDIA TO LEARN ABOUT
HEALTH INFORMATION.
LATINOS STREAM MORE AND WATCH
MORE CONTENT ON SMARTPHONES, ET
CETERA.
WE CAN SEE HERE THAT THEY USE
SOCIAL MEDIA IN DIFFERENT RATES
AS WELL.
LATINOS USE FACEBOOK A LOT AND
USE WHATSAPP AT A MUCH HIGHER
PROPORTION THAN OTHER SUBGROUPS
IN THE UNITED STATES.
SO, IT IS REALLY IMPORTANT TO
THINK ABOUT WHAT PEOPLE ARE
ENCOUNTERING ON PLATFORMS AND
HOW THEY ARE MAKING SENSE OF
INFORMATION THEY MIGHT BE
ENGAGING WITH GIVEN THAT A
PLATFORM LIKE WHATSAPP IS A
LITTLE MORE INTERPERSONAL;
RIGHT?
PEOPLE ON THERE YOU ALREADY
TRUST AND THEY MIGHT SEND YOU A
VIDEO OR SOMETHING ELSE.
AND AS ANNA ALSO MENTIONED, THIS
IS NOT NEW.
SYLVIA LEADED A PAPER ON JAMA IN
2018 TALKING ABOUT IMPORTANCE OF
ADDRESSING HEALTH MISINFORMATION
AND MOVING RESEARCH AGENDA
TOWARDS THERE AND SOME WORK
REALLY FROM THOSE CALLS AND
PREVIOUS WORK LOOKED AT
SPECIFICALLY LATINOS AND HOW
THEY ARE ENGAGING WITH
INFORMATION AND ABOUT CANCER IN
PARTICULAR. WHAT THEY DO WITH
IT.
THIS IS IF IN-DEPTH QUALITATIVE
WORK THAT I SIT DOWN AND TALK TO
PEOPLE ABOUT WHAT THEY ARE
ACTUAL WILL ENCOUNTER ON THEIR
FACEBOOK PLATFORMS AND SOCIAL
MEDIA FEEDS AND TALKING THROUGH
WHY THEY ARE ENGAGING WITH
SPECIFIC CONTENT AND WHAT THEY
DO WITH IT OUTSIDE OF THIS
PLATF
PLATFORM.
A LOT OF IT RELATES TO PARTS OF
THEIR CULTURE AND IDENTITY AND
MAYBE IT IS IN SPANISH OR
BILINGUAL AND LOTS OF VIDEOS.
ALSO A LOT OF CONTENT THEY
ENGAGED WITH WAS WITH LOCI
CREDIBILITY WHEN WE DID CONTENT
ANALYSIS OF CONTENT THEY SHARED
WITH US THAT IS QUALITATIVE AND
EXPLORATORY AND WAS THRILLED TO
SEE THAT HINTS INCLUDED ITEMS
THAT CAN GIVE US INSIGHTS
WHETHER THIS HOLDS IN A BIGGER
POPULATION AND WITH THAT IN MIND
MY SLIDES ARE OFF. APOLOGIES.
WITH THAT IN MIND I WAS LOOKING
AT THE SUBSET OF HINTS USERS
THAT USE SOCIAL MEDIA SAME WAY
THAT WAS PREVIOUSLY DESCRIBED
AND REALLY HONING IN ON
CENTERING MY ANALYSIS AROUND
LATINOS AND COMPARING TO
NON-LATINO WHITES.
SAMPLE IS ANYONE THAT IDENTIFIED
AS EITHER LATINO OR NON-HISPANIC
WHITE AND USED SOCIAL MEDIA. I
WANTED TO EXPLORE DIFFERENCES
WITH ENGAGEMENT AND UTILIZATION
OF HEALTH INFORMATION AND THINK
ALSO ABOUT PERCEPTIONS THAT ANNA
WAS MENTIONING.
RIGHT? . WHEN YOU HAVE AN
AUDIENCE THAT IS PREDOMINANTLY
USING THESE PLATFORMS TO
COMMUNICATE TO GET ACCESS TO
DIFFERENT TYPES OF INFORMATION
IT BEGS THE QUESTION HOW DO THEY
PERCEIVE THAT THIS CONTENT IS
BEING EXPLORED PRACH WHAT ARE
THEY SEEING? WE DIDN'T SEE
LITERATURE THAT WAS TALKING
ABOUT PERCEPTIONS AND PREDICTORS
AND WANTED TO DO A FEW THINGS TO
ASSESS DIFFERENCES IN
PERCEPTIONS AND ENGAGEMENT AND
UTILIZATION OF HEALTH
INFORMATION AND DETERMINE IF
PERCEPTIONS WERE PREDICTIVE.
ALSO, EXPLORING THIS WITHIN
THESE SUBETHNIC DIFFERENCES.
IN MATERIALS OF OUTCOMES I WANT
TO POINT OUT MY -- I ACTUALLY
USED FOUR DIFFERENT OUTCOME
MEASURES AND USED TWO FOR
ENGAGEMENT AND DIDN'T AGGREGATE
THEM AND ONE IS SHARING GENERAL
HEALTH INFORMATION.
OTHER ONE I WANTED TO REALLY
LOOK AT BECAUSE OF THIS VISUAL
COMPONENT I WAS MENTIONING
EARLIER IS WATCHING OF
HEALTH-RELATED VIDEOS ON SOCIAL
MEDIA AND I DICHOTOMIZED
RESPONSES TO INDIVIDUALS THAT
REPORTED EITHER SHARING GENERAL
HEALTH INFORMATION OR WATCHING
VIDEOS LESS THAN ONCE A MONTH
VERSUS THOSE THAT REPORTED
HIGHER FREQUENCIES. SEVERAL
TIMES A MONTH OR MORE. IN TERMS
OF UTILIZATION, I LOOKED AT
MAKING DECISIONS WITH
INFORMATION THAT THEY ARE
ENCOUNTERING AS WELL AS TALKING
TO THEIR PROVIDER POTENTIALLY.
THOSE WERE DICHOTOMIZED AS AGREE
AND DISAGREE AS A WAY THAT A
PREVIOUS PRESENTER WAS SAYING
AND LOOKED AT PERCEIVED AMOUNT
OF HEALTH MISINFORMATION ON
SOCIAL MEDIA AND KEPT THEM AS
THREE RESPONSE OPTIONS AND DID A
LITTLE AND NO MISINFORMATION AND
INDIVIDUALS THAT PERCEIVED A
LITTLE OR NO MISINFORMATION AND
MAINLY BECAUSE OF SKEWEDNESS AND
NO RESPONSES.
I WANTED ALSO TO MAKE SURE THAT
SOCIAL MEDIA UTILIZATION
FREQUENCY WAS TAKEN CARE OF HERE
AND PEOPLE ARE USING SOCIAL
MEDIA MORE OR DIFFERENCES
REGARDING THAT AND RACIAL/ETHNIC
CATEGORIZATIONS THAT I
MENTIONED.
I ALSO INCLUDED A FEW EXTRA
DEMOGRAPHIC VARIABLES AND
ANALYZED THIS ON SPSS AND
REPORTED CHI SQUARES FOR
LOGISTICAL REGRESSIONS AND THIS
IS SOMETHING I DIDN'T WEIGHT AND
I'M VERY THANKFUL FOR TODAY'S
MORNING PRESENTATION AND GOT
RESOURCES TO APPLY WEIGHTS AND
SPS THAT I HAD NOT DONE BEFORE.
WHAT I WILL REPORT IS THE ACTUAL
SAMPLE.
HERE, THE MAIN THING THAT I
WANTED TO HIGHLIGHT IS THE
DIFFERENCES IN NON-HISPANIC
WHITES AND LAT TOONOS AND
POPULATION OF SOCIAL MEDIA USERS
WERE HEAVILY FEMALE AND YOUNGER
IN LATINO POPULATION AND HAD
LESS EDUCATION LEVEL AND LOWER
HOUSEHOLD INCOMES AND WHEN WE
LOOK AT SOCIAL MEDIA UTILIZATION
FREQUENCY THEY ARE USING SOCIAL
MEDIA PLATFORMS IN SAME RATES AS
NON-HISPANIC WHITES.
I HIGHLIGHTED A FEW MAIN POINTS
I WANT TO MAKE HERE AND FIRST
BEING WHEN WE LOOK AT
PERCEPTIONS OF THE AMOUNT OF --
SORRY LOOKING AT PERCEPTIONS WE
SEE THAT LATINOS WERE MORE
LIKELY TO PERCEIVE LITTLE TO NO
OR FALSE HEALTH INFORMATION ON
SOCIAL MEDIA.
--
WHEN LOOKING AT HOW THEY REPORT
ENGAGEMENT, AGAIN, WE SEE THAT
LATINOS REPORT HIGHER AND MORE
ENGAGEMENT BY SHARING OR
WATCHING VIDEOS THAN
NON-HISPANIC WHITES AND THINK
THE BIGGEST THING I WANT TO SHOW
HERE IS IN VIDEO WATCHING THAT
48.2% VERSUS 26% WE ALSO SEE
THEY ARE USING THE INFORMATION
TO EITHER MAKE DECISIONS OR
DISCUSS INFORMATION WITH THEIR
PROVIDER.
ONCE WE RAN LOGISTIC REGRESSIONS
TO SEE ODDS, WE SEE THAT LATINOS
AND WHEN WE CONTROL FOR A FEW OF
THE CO-VARIATE AS WELL AS
PERCEIVED HEALTH MISINFORMATION
WE SEE LATINOS ARE 62% MORE
LIKELY TO REPORT SHARING GENERAL
HEALTH INFORMATION SEVERAL TIMES
A MONTH OR MORE COMPARED TO
NON-LATINO WHITES AND ARE 66%
MORE LIKELY TO WATCH VIDEOS AND
ARE ALSO REPORTING HIGHER
UTILIZATION AND HAVE HIGHER ODDS
OF MAKING DECISIONS AND HIGHER
ODDS OF DISCUSSING THE
INFORMATION WITH THEIR
PROVIDERS.
I WILL JUMP THIS AND ACTUALLY GO
OVER TO THIS LAST SLIDE THAT WE
SEE THAT. YES. AS ANNA WAS
MENTIONING PERCEPTIONS OF HEALTH
MISINFORMATION WAS A PREDICTOR
OF ENGAGEMENT AND UTILIZATION.
I THINK THAT IS IMPORTANT,
AGAIN, GOING TO SOME OF THE WORK
THAT SYLVIA HAS DONE AND AGE APH
SPECIAL ISSUE ON SOCIAL MEDIA
THAT CALLED FOR REALLY HONING IN
ON VULNERABLE POPULATIONS AND
IDENTIFYING WHO IS VULNERABLE IN
SOME OF THOSE REASONS AND WHEN I
SEE THIS I THINK, GREAT.
LATINOS ARE USING MORE AND THERE
IS ALSO A GROUP OF INDIVIDUALS
THAT PERCEIVE THERE IS LESS
MISINFORMATION AND MAYBE
INTERFACING AND ENGAGING WITH
CONTENT AT HIGHER RAYS.
HOW DOES IT LOOK HONING IN ON
THAT GROUP AND SEEING WHETHER
BEING LATINO IS PREDICTIVE ALSO
AND ARE THEY ENGAGING MORE AND
USING MORE?
WE SEE IT WITHIN INDIVIDUALS
THAT PERCEIVE THERE IS LITTLE TO
NO MISINFORMATION AND LATINOS
ARE TWO TIME MONTHS R LIKELY TO
SHARE INFORMATION AND 2.3 TIMES
MORE LIKELY TO WATCH VIDEOS AND
58% MORE LIKELY TO MAKE
DECISIONS WITH THAT INFORMATION;
RIGHT?
REALLY IMPORTANT GROUP TO HONE
IN ON AND THIS IS ALSO SOMETHING
THAT ALIGNS WITH SOME WORKING I
WAS MENTIONING EARLIER.
ONE OF THE MOST IMPACTFUL
INTERVIEWS I HAVE DONE IS WHEN
TALKING TO A PORTO WREAK AN
WOMAN SOMEONE CLAIMING TO BE
PHYSICIAN THAT MAMMOGRAMS CAUSE
BREAST CANCER AND CANCELLED HER
MAMMOGRAM AND SHARED THAT WITH
ME. WE ARE SEEING RAMIFICATIONS
AND THIS WORK IS SHOWING THAT
THIS IS NOT -- POTENTIALLY THIS
IS AN ISOLATED CASE THAT IS
HIGHLIGHTING AND ALIGNING WITH
SUGGESTIONS OF HIGHER ENGAGEMENT
AND POTENTIAL SUBSEQUENT ACTIONS
TAKEN AMONG LATINOS WHEN
DISCUSSING CANCER INFORMATION.
IT ALSO PROVIDES MORE EVIDENCE
FOR STRONGER VISUAL FORMAT THAT
MIGHT BE IMPACTING AND WE TEND
TO TALK ABOUT MISINFORMATION
WORK AND FACT CHECKING AND SEE
LOTS OF TEXT-BASED DATA. SPACES
ARE ALLOWING FOR OTHER VISUAL
FORMS OF DATA INCLUDING MEMES,
ET CETERA, TO BE SHARING THIS
KIND OF INFORMATION AND WE SEE
THAT HIGHER PERCEPTIONS OF
LITTLE TO NO MISINFORMATION ARE
PREVALENT AMONG LATINOS AND ARE
ALSO ENGAGING WITH CONTENT AND
HIGHER RATES.
AGAIN, THIS IS REALLY
EMPHASIZING NEED FOR TAILORED
DIGITAL HEALTH INTERVENTIONS AND
REALLY HONING IN ON HOW THIS IS
MANIFESTING WHAT WE CAN DO ABOUT
IT.
OF COURSE, LIMITATIONS.
ONE THING I WANT TO ADD TO WHAT
ANNA WAS SAYING IS THE ITEMS
THAT ARE ASKING ENGAGEMENT AND
UTILIZATION ARE FOR ANY KIND OF
HEALTH INFORMATION; RIGHT?
WE DON'T -- WE CAN'T REALLY
INFER ON ACCURACY OR QUALITY
WHAT PEOPLE ARE ENGAGING WITH
AND HOW THEY PERCEIVE IT.
ANOTHER THING WE WERE NOT ABLE
TO DO IS EXPLORE DIFFERENCES
WITHIN LATINO SUBGROUPS BY
LANGUAGE PREFERENCES AND
SUBETHNICITY GIVEN TO SAMPLE
SIZE LIMITATIONS AND ALSO THE
INABILITY TO EXPLORE HOW
ENGAGEMENT AND UTILIZATION
RELATE TO SPECIFIC SOCIAL MEDIA
PLATFORMS.
I WOULD ENCOURAGE TO THINK ABOUT
MAYBE ADDING SOME ITEMS THAT
ALLOW US TO SEE WHAT PLATFORMS
PEOPLE ARE ACTUALLY USING AND
THERE ARE CERTAIN PLATFORMS WITH
SPECIFIC CERTAIN AFFORDANCES
THAT MAY BE MORE -- THAT A
CERTAIN GROUP MIGHT BE MORE
LIKELY TO USE THAT WE NEED TO BE
LOOKING AT.
REALLY, IN TERM OF THE FUTURE,
THIS IS ALLOWING FOR MORE
CENTERING OF ANALYSIS OF
DIFFERENT POPULATIONS AND IN
MANY CASE LATINO SOCIAL MEDIA
USERS THIS IS A REALLY IMPORTANT
WORK TO EXPLORE IMPORTANT
PREDICTORS OF ENGAGEMENT
UTILIZATION AND FURTHER EXPLORE
ROLES OF CULTURE AND IDENTITY
AND HOW THESE DYNAMICS TAKE
PLACE AND TO REALLY DEVELOP
FUTURE THEORETICAL FRAMEWORKS
AND MODELS THAT ARE INTEGRATING
ENGAGEMENT UTILIZATION AND
CREDIBILITY ASSESSMENTS.
I'M VERY EXCITED TO BE HERE.
THANK YOU VERY MUCH.
>> THANK YOU SO MUCH. OUR LAST
SPEAKER I'M VERY EAGER AND
EXCITED TO HEAR THE TALK ABOUT
RESPONSIBILITY AND HOW PEOPLE
ARE RESPONSIBLE FOR SOME ISSUES
WE HAVE BEEN DISCUSSING HERE.
TAKE IT AWAY.
>> HELLO. HI, EVERYONE. GOOD
AFTERNOON. I'M A FIRST-YEAR
MASTERS STUDENT IN DEPARTMENT OF
MEDIA AND INFORMATION AT
MICHIGAN STATE UNIVERSITY. THIS
IS MY FIRST TIME PRESENTING IN A
CONFERENCE. JUST BEAR WITH ME.
MY NAME IS PRATHYUSHA.
IF I [INDISCERNIBLE] PLEASE
EXCUSE ME.
BEFORE I BEGIN MY PRESENTATION,
I WOULD LIKE EVERYONE TO THINK
ABOUT HOW HAVE WE EVER WONDERED
ABOUT WHO SHOULD BEAR THE
RESPONSIBILITY IN REDUCING OR
MAYBE THIS IS A MORE BROADER
WORD AND REDUCING HEALTH-RELATED
FALSEHOODS ONLINE AND FOR OLD
RIDDLES AND GENERATION THAT
DIDN'T GROW UP WITH DIGITAL
TECHNOLOGY.
LET'S DIVE DEEPER INTO THE
SCENARIO.
THIS IS JUST A SMALL ATTEMPT
FROM ME OF UNDERSTANDING WHAT
EXACTLY OLD RIDDLES MIGHT MEAN
AND IS A KIND INFERENCE.
LET'S START THIS OBJECTIVE.
DESPITE OF GROWING CONCERNS OR
OLDER ADULTS EXPOSURE TO FALSE
HEALTH INFORMATION ON SOCIAL
MEDIA, LITTLE RESEARCH EXAMINES
BELIEFS OVER HOW AND WHO SHOULD
BE HELD RESPONSIBLE IN REMOVING
HEALTH-RELATED FALSEHOODS THAT
IS UNFORTUNATE THERE IS VERY
LIMITED RESEARCH BEING DONE ON
OLDER PERCEPTIONS ON THEIR WAY
OF THINKING AND EXACTLY WHAT
THEY WANT TO DO AND WHAT THEY
WANT FROM DIGITAL MEDIA AND
STUFF.
THE FIRST QUESTION IS WHY SHOULD
WE STUDY OLD RIDDLES?
WHAT IS THE NEED?
AS WE ALL KNOW, THERE IS A HEAVY
DEMOGRAPHIC SHIFT GOING ON IN US
ALONE WE HAVE ALMOST 56 MILLION
OLD RIDDLES AND STARTING ABOUT
OLD RIDDLES GIVING DIFFERENT
INFORMATION ABOUT LIKE WE CAN
COME UP WITH NEW POLICIES AND
NEW TECHNOLOGIES AND WE CAN HELP
THEM TO KEEP THEM ENGAGED NO THE
TO MAKE THEM FEEL ISOLATED AND
HELP THEM HAVE BETTER MENTAL
HEALTH AND WELLBEING AND ALSO ON
THE OTHER SIDE SOCIAL MEDIA OR
DIGITAL PLATFORMS CAN BE
[INDISCERNIBLE] FROM THIS THING
AND WHEREIN AGAIN COME IN WITH
NEW TOOLS OR PORTALS AND
WHATEVER IT IS THAT IS TO MAKE
LIFE OF OLD RIDDLES EASIER TO
COME UP AND [INDISCERNIBLE] OR
WHOEVER IT IS THAT CAN COME UP
WITH BETTER POLICIES AND BETTER
RECOMMENDATIONS TO MAKE LIVES OF
OLD RIDDLES BETTER AND MATERIALS
AND METHODS.
HERE WE USED ABOUT HINTS 20202
DATA ACROSS CROSS-SECTIONAL DATA
AND SURVEY FIELDED FROM MARCH TO
NOVEMBER OF 2022 INCLUDING 6
THOUSAND 244 RESPONDENTS AND
28.1%.
IN THIS PARTICULAR RESEARCH WE
HAVE FULL SAMPLE THAT CONSISTS
OF 6 THOUSAND 252 RESPONSES.
OUT OF WHICH ONLY 4 THOUSAND 415
ARE DAILY SOCIAL MEDIA USERS
THAT WE DIDN'T INCLUDE OTHER
18-27 PEOPLE AS THEY DIDN'T USE
SOCIAL MEDIA ON A DAILY BASIS
AND THOUGHT MAYBE IT IS NOT
RELATABLE TO RESEARCH WE HAVE
DONE27 PEOPLE AS THEY DIDN'T US
SOCIAL MEDIA ON A DAILY BASIS
AND THOUGHT MAYBE IT IS NOT
RELATABLE TO RESEARCH WE HAVE
DONE1827 PEOPLE AS THEY DIDN'T
SOCIAL MEDIA ON A DAILY BASIS
AND THOUGHT MAYBE IT IS NOT
RELATABLE TO RESEARCH WE HAVE
DO
DONE.
WE ANALYZED 3 THOUSAND,499 RESP
THIS STUDY AND WILL COME BACK TO
RESPONSES AND ANALYZED FOUR MAIN
ITEMS BEING ASKED. ONE IS IF
THEY ARE DAILY SOCIAL MEDIA
USERS OR NOT AND HEALTH RELATED
FALSEHOODS AND HEALTH
INFORMATION YOU SEE ON SOCIAL
MEDIA DO YOU THINK IS FALSE OR
MISLEADING AND DISCUSSIONS OF
SOCIAL MEDIA WITH MEDICAL
PROVIDERS ON LEVEL OF AGREEMENT
WITH ITEM AND I USE INFORMATION
FROM SOCIAL MEDIA IN DISCUSSIONS
WITH HEALTHCARE PROVIDERS AND
LIKE REGARDING ANALYSIS AND
RESOURCES AFTER CHARACTERIZING
SAMPLE BY EXAMINING FREQUENCIES
AND PROPORTIONS WE HAVE
ESTIMATED 8 BINARY LOGIC
REGRESSIONS TO UNDERSTAND HOW
RESPONDENTS AGE IS ASSOCIATED
WITH OUTCOMES OF INTEREST.
OKAY. SORRY.
IF YOU CAN SEE HERE OUT OF THE
SAMPLE, WE HAVE 18 TO 30 AGE
GROUP THAT HAS MORE LIKE --
ALMOST 85% OF THEM ARE DAILY
SOCIAL MEDIA USERS.
AGE GROUP 31 TO 50 WE HAVE
ALMOST 70% AND [INDISCERNIBLE]
IS MORE OR LESS THE SAME AND
COMING TO 65 AND 74 AND WE HAVE
ALMOST AROUND 60% OF THEM ARE
DAILY SOCIAL MEDIA USE HERBS AND
OUT OF THESE PEOPLE OUT OF THEM
LIKE THE OLD THER ARE IT DOES
NOT AGREE TO DISCUSS WHATEVER
INFORMATION THEY SEE ON SOERNL
MEDIA WITH MEDICAL PROFESSIONALS
AND SELF-REPORTING AND AGING
75 + DID NOT MENTION THEY COME
ACROSS MORE FALSE RELATED
MISINFORMATION ONLINE AND
BECAUSE FACT OLD RIDDLES CAN'T
DISTINGUISH WHAT IS TRUE AND
MISINFORMATION AND IF YOU CAN
SEE BINARY LOGIC RESGREGS
EVERYONE WILL HAVE DIFFERENT
PERCEPTIONS AND IDEAS HERE AND
FEW MENTIONED NEWS MEDIA AND
SOCIAL MEDIA PLATFORMS AND
SURVEY DONE IN 2022 PEER
RESEARCH IN WHICH RIDDLES
MENTIONED LEAST LIKELY TO HAVE
SOCIAL MEDIA PLATFORMS AND WE
CAN'T REALLY BELIEVE THAT
RIDDLES IN THIS SURVEY NO
RELATION AND IT KEPT INCREASING
AS AGE INCREASES AND SO HERE WE
CAN SEE THAT EMPHASIS THUS FAR
HAS BEEN ON SOCIAL MEDIA REFORMS
REGULATING BY FINDINGS THAT
SUGGEST AN ALTERNATIVE OR
ALTERNATE OPPORTUNITIES TO FIX
THIS ISSUE FOR OLD RIDDLES THAT
IS FOCUSING ON MEDICAL PROVIDERS
AND AS WE HAVE LIMITED RESEARCH
OR LIMITED EQUATIONS BEING ASKED
IN THE SURVEY, WE NEVER KNOW
WHAT EXACTLY OLD RIDDLES NEED.
INSTEAD MAYBE IF THERE IS A WHY
OPTION INCLUDED IN CASE WHOEVER
HAS SELECTED ANY PARTICULAR
OPTION IF THERE IS A DEPENDENT
WHY QUESTION THAT WE CAN SERVE
THEN MAYBE WE CAN GET A BETTER
PERSPECTIVE WHAT EXACTLY OLD
RIDDLES OR AGE GROUP THAT PEOPLE
PREFER AND CURRENT SOCIAL MEDIA
USERS PREVENTING INSIGHTS TO
[INDISCERNIBLE] NONUSERS WHO MAY
ADOPT IT LATER AND SURVEY IS
CONDUCTS ONLY ENGLISH AND
SPANISH IGNORING OTHER LANGUAGES
THAT MIGHT BE PEOPLE COMING FROM
DIFFERENT LANGUAGES AND A FEW
THINGS MIGHT GET LOST IN
TRANSLATION AND BETTER TO HAVE
MAYBE MORE THAN TWO LANGUAGES
INCLUDING FRENCH OR WHATEVER
LANGUAGE IS MOST SPOKEN HERE IN
AMERICA THAT MIGHT GIVE A NEW
PERSPECTIVE POLICY IMPLICATIONS
LIKE AFTER CONNECTING THIS STUDY
DESPITE LIMITATIONS STUDY
FINDING SHED LIGHT ON TARGETED
INTERVENTIONS ASSISTING OLD
RIDDLES AND [INDISCERNIBLE]
COUNTER ON SOCIAL MEDIA AND
PLATFORMS HAVE SOUGHT FALSEHOOD
IMPLEMENTING ALGORITHMS AND
DIFFERENT MODERATION TEAMS AND
OPTIONS FOR USERS TO REPORT
[INDISCERNIBLE] AND FALSEHOOD
STILL PERSISTS AND FEW PEOPLE
REPORTED DISCUSSING WHAT THEY
FOUND ON SOCIAL MEDIA WITH
MEDICAL PROVIDERS AS CLINICAL
VISITS ARE KIND OF TIME MEDICAL
PROVIDERS ALL PATIENTS NEED TO
HAVE MORE TIME WITH EACH TO
DISCUSS THESE THINGS AND AS
FIRST OPTION IS NOT KIND OF
FEASIBLE SECOND IS MEDICAL
PROVIDERS ENTERING ON SOCIAL
MEDIA FOR EXAMPLE IF ANY NEW OR
PRIOR TO COVID-19 THAT IS ONE
SUCH SITUATION THAT HAS MADE
EVERYONE REALIZE THAT
CIRCULATING FALSE INFORMATION
OVER SOCIAL MEDIA IS A THREAT TO
SOCIETY AND MEDICAL PROVIDERS
WOULD HAVE VOLUNTARIED
THEMSELVES TO BE HANDLED IN
BETTER WAY MAYBE AND I'M A UK
DESIGNER AND MAYBE WE CAN COME
UP WITH NEW TECHNOLOGICAL TOOLS
KEEPING IN MIND WITH OLD RIDDLES
AND BUILDING OR DEVELOPING OR
DESIGNING SUCH TOOLS MAYBE
CONDUCT MUCH MORE SERIOUS
SERVICE ABOUT ONLY TO OLD
RIDDLES THAT WAY WE MAYBE KIND
OF AT LEAST RESTRICT SPREAD
OFHOOF
FALSEHOODS WE ARE SEEING TODAY
AND I WOULD LIKE TO THANK MY
PROFESSOR WHO HAS ADVISED AND
HELPED ME TO STEER MY RESEARCH
IN THIS DIRECTION AND ELYSE AND
MY COLLEAGUES SO THAT IS IT
ABOUT -- FROM MY END. THANK
YOU.
>> THANK YOU SO MUCH TO ALL OF
THE SPEAKERS FOR A WONDERFUL SET
OF PRESENTATIONS AND I WELCOME
PEOPLE WITH QUESTIONS TO COME
UP.
AS A WAY TO START PLEASE LINE
UP. NO RUSH. I HAVE A QUESTION
THAT IS REALLY I THINK THERE IS
A LOT OF INTEREST IN SORT OF
PERCEPTIONS AND AWARENESS OF
MISINFORMATION AND INFORMATION
OF MIXED QUALITY ONLINE AND WE
HAVE AN IDEA THAT HEALTHY
SKEPTICISM WOULD BE GOOD; RIGHT?
PEOPLE SHOULD HAVE A SENSE OR
SLIGHTLY WEARY OF WHAT THEY SEE.
BUT, I THINK IT IS A SLIPPERY
SLOPE. WE ALSO WANT CERTAIN
INSTITUTIONS AND TYPES OF
INFORMATION TO BE TRUSTED AND
DON'T WANT SO MUCH SKEPTICISM IT
BECOMES APATHY OR CONFUSION OR I
JUST DON'T KNOW WHO TO TRUST
ANYMORE AND WONDER IF ANY OF YOU
HAVE IN YOUR RESEARCH SORT OF
THOUGHT ABOUT THIS BALANCING
ACT. I THINK WE ARE AWARE THAT
THERE ARE LIMITATIONS FOR HOW WE
CAN MEASURE THESE THINGS THROUGH
SELF-REPORTED SURVEY THAT I
THINK WILL BE A POINT PROBABLY
THAT EVERYONE AGREES ON.
JUST IN TERMS OF CREDIBILITY
ASSESSMENT AND SKEPTICISM AND
TRUST IF ANYBODY HAS ANY
THOUGHTS.
>> OKAY.
>> PLEASE, ANNA.
>> HELLO?
>> YES.
>> OKAY. THIS IS NOT FROM MY
RESEARCH BUT FROM SOMEONE ELSE'S
RESEARCH THAT I WILL JUST STEAL
WHAT THEY SAID.
THERE WAS A PRESENTATION THAT I
SAW A COUPLE OF MONTHS AGO WHERE
THE PRESENTER WAS MAKING THE
POINT THAT ADDRESSING
MISINFORMATION WOULD HAVE A VERY
SMALL EFFECT ON OVERAULT
PEOPLE'S ATTITUDES OR HEALTH
BELIEFS OR BEHAVIORS WHEREAS
GETTING PEOPLE TO BELIEVE TRUE
INFORMATION WOULD HAVE A MUCH
GREATER EFFECT ON OVERALL HEALTH
AND WELLBEING.
THIS POINT OF SKEPTICISM IS --
IS YOU KNOW A VERY IMPORTANT
ONE.
ALTHOUGH WE DO PROBABLY WANT
PEOPLE TO BE SKEPTICAL OF
INFORMATION THEY FIND ON SOCIAL
MEDIA PEOPLE ARE SKEPTICAL OF
INFORMATION COMING FROM
LEGITIMATE SOURCES AND PROVIDERS
AND NEWS SOURCES AND JOURNALISTS
AND REALLY BECAUSE OF COVID-19
THERE HAS BEEN A LOT OF
ATTENTION ON MISINFORMATION AND
ON SOCIAL MEDIA BUT HASN'T BEEN
A LOT OF ATTENTION BEING PAID TO
THE FACT THAT PEOPLE ARE NOT
TRUST
TRUSTING ACCURATE INFORMATION
THAT IS A FLIPSIDE OF THE COIN
AND THEIR PRESENTATION WAS
SAYING THAT YOU KNOW INCREASING
TRUST AND TRUE INFORMATION WOULD
ACTUALLY BE A POSSIBLY MORE
EFFECTIVE WAY TO HANDLE THIS
SITUATION THAN JUST TRYING TO
REDUCE BELIEF IN FALSE
INFORMATION.
>> THANK YOU, ANNA.
>> I WATCHED THE SAME TALK AND
THOUGHT THAT RESEARCHER WAS
MAKING VALID POINTS THAT TO YOUR
POINT OF SKEPTICISM, THAT IS
SOMETHING THAT MY CURRENT
INTERVIEWS ARE ALSO IT IS A
THEME THAT IS COMING UP WHEN WE
TALK TO LATINA HEALTH EDUCATORS
AND CANCER SURVIVORS ABOUT HOW
THEY ARE NAVIGATING WHATSAPP AND
FACEBOOK INFORMATION RELATED TO
CANCER AND COVID ON THESE SPACES
AND THERE IS HEALTHY LEVEL OF
SKEPTICISM IT HAS EMERGING IN
SOME OF THOSE CONVERSATIONS THAT
WE ARE ACTUALLY CURRENTLY
STARTING TO EXPLORE HOW THAT
RELATES MAYBE TO HOW THEY ARE
DISSEMINATING AND IF THEY ARE
DISSEMINATING THE CONTENT MORE
AND ROLE IT IS PLAYING AND I
DON'T HAVE ANSWERS BUT IS
SOMETHING THAT I THINK IS
IMPORTANT TO THINK ABOUT WHEN WE
THINK OF WHO PEOPLE TRUST AND
HOW DIFFERENT GROUPS TRUST
DIFFERENT INDIVIDUALS AND HOW TO
BETTER TOOEZ IT OUT TO LEVERAGE
THAT INFORMATION GOING FORWARD.
>> THANK YOU.
>> I THINK WE CAN AGREE I USED
TO BE POLITICAL INFORMATION
RESEARCH AND TALKING ABOUT
CYNICISM AND HOW DO WE ADDRESS
CYNICISM? ONE SOLUTION IS TO
CULTIVATE SKEPTICISM.
>> YEAH.
>> EXACTLY. BUT I THINK THAT AT
LEAST AT THIS PHASE A MORE
IMPORTANT ISSUE IS A LOT OF WORK
WE DO IS ASKING PEOPLE TO BE
MORE CRITICAL AND BY DEFAULT WE
ARE COGNITIVE MISERS AND MOST OF
US DON'T TAKE TIME TO EVALUATE
EVERY PIECE OF INFORMATION WE
GET AND THAT EXTREME WE ARE
TALKING ABOUT HERE AND MORE
IMPORTANTLY WE LOOK AT WHETHER
PEOPLE START TO VERIFY
INFORMATION WE NOTICE DIFFERENT
MOTIVATIONS AND DUE PROCESSING
MODEL THAT OFTEN TIMES PEOPLE
RELY ON HEURISTICS AND OFTEN
TIMES PEOPLE RELY ON HEURISTICS
WHEN THEY SHOULD BE MORE
CRITICAL AND WHEREAS FOR OTHER
SOURCES IF WE TRUST A SOURCE AND
AUTHORITY OF SOURCE THAT NEED TO
BE CRITICAL MORE AND BE KIND OF
LAID BACK AND NOT JUST ONE
[INDISCERNIBLE] AND DUE
PROCESSING MODEL AND IMPORTANT
THING IS WHEN SHOULD PEOPLE BE
MORE CRITICAL GIVEN RESOURCES WE
HAVE AND TRUSTWORTHY SOURCES
THAT COULD BE LAID BACK AND
THINK THAT IT MAY BE MORE
NUANCED THAT WAY AND FOR DEFAULT
WE DON'T REALLY WANT TO BE
SKEPTICAL AND THINK THAT
INTERESTING WORK WE DO IS TO
ENCOURAGE PEOPLE TO BE SKEPTICAL
AND MORE WHEN THEY SHOULD BE
SKEPTICAL.
>> SKEPTICAL AND NOT CYNICAL.
>> YES.
>> YES. WE HAVE ABOUT THREE
MINUTES AND WOULD LOVE FOR
PEOPLE TO GET AT LEAST A CHANCE
TO MAKE A COMMENT IF WE CAN'T
FULLY ADDRESS QUESTIONS.
>> THANK YOU ALL FOR TACKLING
THIS IMPORTANT TOPIC THAT MAKES
ME FEEL OLD AND OUT OF TOUCH. I
HAVE NO IDEA WHAT WHATSAPP IS
AND QUESTION IS FOR DR. WANG AND
YOU ARE STUDYING [INDISCERNIBLE]
AND YOUR DEPENDENT VARIABLE IS
NOT PERCEIVED ECIG HARM BUT
RELATION TO E-CIGARETTES THEY
COULD BE HARMFUL BUT ANSWER IS
NOT MORE HARMFUL MAKE SENSE?
WANT YOUR THOUGHTS AND HOW IT
MIGHT IMPACT YOUR ANALYSIS FACT
IT IS NOT ACTUALLY ECIG HARM BUT
IN RELATION TO E-CIGARETTE
SMOKING.
>> WE LOOKED AT THIS RELATED TO
OTHER RESEARCH WHAT IS ROLE OF
PERCEPTIONS AND THIS DATA SET
DIDN'T REALLY GIVE US AND WAY OF
NOT LOOKING AT KIND OF IT IS NOT
REALLY PERCEIVED BUT IT IS MAYBE
THE ACTUAL HARM.
I THINK THERE IS A DIFFERENCE
THERE AND OPPORTUNITY TO LOOK
MORE INTO DATA AND NOW MEASURES
LOOKING AT IN STUDY ARE THESE
AND THERE ARE MORE VARIABLES IN
DATA SET WE COULD LOOK AT MORE
AND IS A GOOD SUGGESTION.
>> THANKS SO MUCH.
>> MORE COMMENTS FROM THAT?
PLEASE GO AHEAD.
>> IN RELATION TO E-CIGARETTES
AND WAY TO SPEAK TO YOUTH ABOUT
POTENTIAL HARM, I WANT YOUR
THOUGHTS ABOUT LESSONS LEARNED
FROM THE D.A.R.E. PROGRAM THAT
IS A FAMOUS FAILURE TO EDUCATE
YOUTH ABOUT POTENTIAL HARM AND
DANGERS OF SUBSTANCE ABUSE AND
HOW IT MIGHT BE APPLIED AS WE
TRY TO DISSEMINATE PUBLIC HEALTH
INFORMATION ABOUT E-CIGARETTES?
>> THERE IS A LOT OF LESSONS
LEARNED FROM THAT WE LEARNED TO
ENGAGE MORE WITH YOUTH FROM THAT
CAMPAIGN AND MORE TO BE TAILORED
TO YOUTH AND SOURCES THAT THEY
TRUST AND FORMS THEY USE MOST
OFTEN. WE ALSO FIND THAT WITH
KIND OF WITH E-CIGARETTES, THERE
ARE UNIQUE CHARACTERISTICS.
ONE THING WE ARE LOOKING AT IS
FLAVORS THAT I THINK IS WITH
PREVIOUS CAMPAIGNS AND LOOKING
AT OTHER SIDE THAT IS
[INDISCERNIBLE] STARTS TO TALK
ABOUT E-CIGARETTE USE AND TALK
ABOUT SUBSTANCE ANDIN TRAEGS
PEOPLE AND WE CAN SEE WITH
E-CIGARETTES TOO WE ARE
STRUGGLING TO TALK ABOUT FLAVORS
AND WANT TO PERSUADE PEOPLE NOT
TO USE E-CIGARETTES BUT FLAVORS
PEOPLE START TO GET INTERESTED
AND ENGAGED IN IT. WE HAVE THAT
ISSUE WITH HEALTH COMMUNICATION
CAMPAIGNS THAT HAVE DONE BEFORE
AND HOW TO DEAL WITH THOSE
ISSUES WHEN WE NEED TO TALK
ABOUT TALKING ABOUT RISKY
BEHAVIOR AND INTRODUCING TYPES
OF PRODUCTS GETTING SOME PEOPLE
INTRIGUED AND INTERESTED AND
THERE ARE LESSONS THERE AND NEW
TOPICS AND PHENOMENON WITH NEW
E-CIGARETTES AND DIFFERENT TYPES
OF HEALTH CAMPAIGNS.
>> THANK YOU.
>> THANK YOU. LAST QUESTION.
>> THESE WERE GREAT
PRESENTATIONS AND I HEARD
INCREASED SOCIAL MEDIA USE AND
SPECIFIC DEMOGRAPHIC GROUPS AND
CREATE LACK OF AWARENESS AND
PERCEPTIONS OF MISINFORMATION
AND INCREASEDUTE LIZ DECISION OF
SOCIAL MEDIA AND HEALTH RELATED
DECISION MAKING AND WANTED TO
THINK ABOUT IN TERMS OF
TRANSLATING EVIDENCE IN
INTERVENTIONS AND PROGRAMS THAT
HEALTHCARE PROVIDERS WHILE YOU
KNOW HOPING TO ACT ALWAYS IN
BEST INTENTIONS OF PATIENTS AND
THEY THEMSELVES PERHAPS BEING
CREDIBLE AND ABLE TO DISCERN
MISINFORMATION AND CONSUMERS OF
CREDIBLE INFORMATION MIGHT BE
ILL-EQUIPPED TO COMBAT
MISINFORMATION AND TO MY
KNOWLEDGE IS NOT SOMETHING THEY
ARE TEACHING IN MEDICAL SCHOOL
CURRENTLY AND TALKING ABOUT
AWARENESS OF INITIATIVES AND HOW
TO THINK ABOUT TRANSLATING THIS
INTO INTERVENTIONS TARGETED
TOWARDS HEALTHCARE PROVIDERS
LEVERAGING PATIENT PROVIDER
RELATIONSHIP TO BE BETTER ABLE
TO COMBAT MISINFORMATION AND
EITHER INITIATIVES AND WHAT
TOOLS PROVIDERS MIGHT NEED TO DO
THIS WORK. THANKS.
>> THIS IS NOT SOCIAL MEDIA
SPECIFIC AND IN SOME WORK WE ARE
DOG LOOKING AT PROVIDER
REACTIONS BRINGING IN ONLINE
INFORMATION AND REACTIONS WAY
THEY ADDRESS IT TENDS TO BE
DISMISSIVE AND DON'T KNOW IF IT
IS SUPER HELPFUL AND IT MAKES
PEOPLE NOT -- IT DOESN'T STOP
PEOPLE NECESSARILY FROM LOOKING
OR USING THAT INFORMATION BUT
MAKES THEM MORE HESITANT TO GO
TO THEIR PROVIDER TO GET ADVISE
OR VERIFY THAT INFORMATION.
I DO THINK THAT RIGHT NOW EVEN
THOUGH WE SAW IN THE LAST
PRESENTATION THAT PEOPLE THINK
THAT PROVIDERS ARE BEST PEOPLE
TO ADDRESS MISINFORMATION
PROBLEMS.
THEY ARE MAYBE NOT DOING IT IN
THE BEST WAY RIGHT NOW.
THEY ARE EITHER IGNORING IT OR
PEOPLE BRINGING IT UP AND SOCIAL
MEDIA TALKING ABOUT THIS AND
DON'T LOOK AT IT. I THINK THAT
MAYBE INTERVENTIONS TO TEACH
PROVIDERS HOW TO SORT OF
RESPECTFULLY ACCEPT THAT PEOPLE
ARE BRINGING INFORMATION TO THEM
AND ARE FINDING HOW TO SORT OF
BEST NAVIGATE PEOPLE THROUGH
THAT, THAT COULD BE HELPFUL.
>> PLEASE JOIN ME IN THANKING
SPEAKERS FOR A GREAT PANEL.
AND BY THE NEXT AND LAST PANEL
ON DISPARITIES AND HEALTH
OUTCOMES REALLY AND ALL OF THE
SPEAKERS.
>> VARIETY OF DIFFERENT HEALTH
OUTCOMES ACROSS THE CONTINUUM
AND EVERYTHING FROM PREVENTIVE
BEHAVIORS ROUTINE SKIN CHECKS
AND GUIDELINES TO DELAYS IN
MEDICAL CARE AND WOULD LIKE TO
INVITE DR. ADAEZE FROM SLIPPERY
ROCK UNIVERSITY TO GIVE HER
PRESENTATION.
>> HELLO, EVERYONE. IT IS GOOD
TO BE HERE.
TODAY, WE WILL BE TALKING ABOUT
THE ROLE OF SOCIAL DETERMINANCE
OF HEALTH ON SCREENING
GUIDELINES FOR WOMEN AGE 21 TO
64 YEARS.
WE USE DATA FROM HAYNES 22
SURVEY.
WE KNOW CANCER IS A SECOND
LEADING CAUSE OF DEATH OF WOMEN
IN THE US.
FOR 2023 THERE IS EXPECTED
13,960 NEW CASES OF CANCER IN US
AND 4,310 DEATHS OF
[INDISCERNIBLE] IN THE UNITED
STATES.
[INDISCERNIBLE] IS FREQUENTLY
DIAGNOSED [INDISCERNIBLE]
CERVICAL CANCER IS HIGHLY
PREVENTABLE AND WOMEN NOT UP TO
DATE WITH SCREENING GUIDELINES
HEALTH 2023 TARGETS SET CERVICAL
CANCER SCREENING FOR WOMEN AND
CURRENTLICENING IS --
WHAT IS THE PROBLEM?
PROBLEM IS SOCIAL DETERMINANCES
OF HEALTH HAVE BEEN INFLUENCE
ADHERENCE TO CERVICAL CANCER
SCREENING GUIDELINES.
UNFORTUNATELY, FORMER RESEARCH
OR PREVIOUS RESEARCH HAVEN'T
BEEN ABLE TO STAND OUT WHICH ARE
DOMAINS OF SOCIAL DETERMINANCE
OF HEALTH. WE CAN'T LUMP
EVERYTHING TOGETHER BUT KNOW
WHICH PARTICULAR DOMAIN SOCIAL
DETERMINANTS OF HEALTH WE ARE
TARGETING AS RESEARCHERS.
THIS IS THE FOCUS OF OUR STUDY
TO FIND OUT IMPACT OF SOCIAL
DETERMINANCE OF HEALTH ON
SCREENING ADHERENCE AND FIND OUT
WHICH OF THE DOMAINS THAT IS OR
INFLUENCES CERVICAL CANCER
SCREENING IN WOMEN.
AMERICAN CANCER SOCIETY HAS FIVE
DOMAINS OF SOCIAL DETERMINANTS
OF HEALTH TO CLASSIFY ON
ECONOMIC STABILITY THAT MEASURES
EMPLOYMENT STATUS FOR SECURITY
AND INCOME STATUS EDUCATIONAL
LEVEL HEALTH CARE ACCESS BUILT
ENVIRONMENT SOCIAL COMMUNITY
CONTEXT AND LOTS OF PEOPLE LOOK
AT SOCIAL SUPPORT AND SOCIAL
COMMUNITY CONTEXT.
OUR METHODS WE -- SAMPLE
CONSISTS OF 200,337 RESPONDENTS
WOMEN AGE 21 TO 64 YEARS MEAN
AGE IS 43.5 AND MEASURES WE
LOOKED AT WAS CERVICAL CANCER
CO-VARIATES AGE BMI MARITAL
STATUS KNOWLEDGE OF CERVICAL
CANCER AND [INDISCERNIBLE] WE
USED WEIGHTED MULTIVARIATE
LOGISTIC REGRESSION AND
EXAMINING RELATIONSHIP BETWEEN
[INDISCERNIBLE] DOMAINS AND
ADHERENCE TO CANCER -- CERVICAL
CANCER SCREENING.
SO, IN OUR ANALYSIS, CO-VARIATES
WERE NOT -- DIDN'T HAVE POSITIVE
-- NEGATIVE INFLUENCE ON
CERVICAL CANCER SCREENING AND
FOLLOWING -- THE FOLLOWING
SOCIAL DETERMINELENANTS OF
HEALTH DOMAIN ACTUALLY HAD
POSITIVE OR NEGATIVE INFLUENCE
ON CERVICAL CANCER SCREENING.
ONE, EMPLOYMENT. WHICH SHOWED
THAT PEOPLE THAT WERE
UNDEREMPLOYED ACTUALLY HAS MORE
ODDS OF NOT BEING ADHERIENT TO
CERVICAL CANCER SCREENING AND
THOSE THAT LIVED ALONE AND
WASN'T CLASSIFIED IN ANY OTHER
DOMAINS BUT WAS INTERESTING TO
SEE THAT SOCIALIZATION AMONG
FIVE DOMAINS AND SOCIAL
ISOLATION AND EMPLOYMENT STATUS
HAD MOST ODDS OF INFLUENCING
PEOPLE AND NOT BEING ADHERIENT
TO CERVICAL CANCER SCREENING.
SO, WHAT IS THE IMPLICATION OF
THIS STUDY?
PREVIOUSLY SOCIAL ISOLATION HAD
BEEN LINKED TO HAVE DISEASE AND
MEVEN TAL HEALTH ISSUES AND
INTERESTINGLY IN STUDY WE ARE
FINDING OUT SOCIAL ISOLATION IS
RELATED TO NOT BEING ADHERIENT
TO CERVICAL CANCER SCREENING AND
WHY IS THIS INTERESTING? SOCIAL
ISOLATION IS ACTUALLY ON
INCREASE IN THE UNITED STATES.
THIS CALLS FOR MORE ATTENTION.
WHAT WE ARE LOOKING AT OR
ADVOCATING IS TO LOOK AT NEW
SURGEON GENERAL'S FRAMEWORK THAT
HAS SIX CONCEPTS. ONE, STRENGEN
SOCIAL INFRASTRUCTURE AND
CONNECTION OF PUBLIC POLICIES
MOBILIZING HEALTH SECTOR
REFORMING DIGITAL ENVIRONMENTS
AND KNOWLEDGE TO CULTIVATE A
CULTURE OF CONNECTION. WHY DO
WE NEED TO DO THIS?
BECAUSE IF YOU LOOK AT WHAT IS
GOING ON IN THE US, LOTS OF
PEOPLE NOW ARE FEELING
DISCONNECTED WITH THEIR
COMMUNITIES AND DISCONNECTED
WITH HEALTH SYSTEMS AND IS
REALLY PLACING A LOT OF STRESS
ON PEOPLE BEING ADHERIENT TO
CERVICAL CANCER NOT ONLY
CERVICAL CANCER SCREENING BUT IS
GOOD TO LOOK AT OTHER TYPES OF
CANCERS OR HEALTH SCREENINGS.
WHAT WE CAN DO AS HEALTH
EDUCATORS OR HEALTH RESEARCHERS
IS MIGHT NOT BE ABLE TO EFFECT
SOCIAL INFRASTRUCTURE RIGHT AWAY
BUT CAN START TO CREATE
AWARENESS EVEN IN IMMEDIATE
COMMUNITIES ABOUT SOCIAL
CONNECTEDNESS.
WE CAN ALSO START TO EDUCATE
HEALTH CARE PROVIDERS ON HOW TO
DETERMINE SOCIAL DISCONNECT IN
PATIENTS WHO COME IN AND MAKE
THEM FEEL AWARE OF WHERE TO GET
THIS SCREENING AND ALL THAT.
THANK YOU.
>> THANK YOU. OUR NEXT
PRESENTER IS JEREMY MARTINA FROM
HARVARD MEDICAL SCHOOL
PRESENTING ON -- UNDERGOING
ROUTINE SKIN CHECKS.
>> THANK YOU FOR THAT. BRIEFLY
BEFORE I GET STARTED ON THIS
TALK ABOUT LANGUAGE FLUENCY AND
ASPECTS OF ACCESSIBILITY QUICK
MOMENT TO ACKNOWLEDGE THE ASL
INTERPRETERS WHO DO A FANTASTIC
JOB NOT JUST HOW IMPRESSIVE IT
IS TO SEE BUT AS FAR AS WHAT
THEY DO FOR EQUITY AND
ACCESSIBILITY.
THANK YOU FOR THAT.
SO, I'M JEREMY MARTINEZ AND
TITLE OF PRESENTATION IS ENGLISH
PROFICIENCY AND SOCIO
DEMOGRAPHIC PREDICTOR OF
UNDERGOING SKIN CANCER
SCREENING. BACKGROUND, SKIN
CANCER IS MOST PREVALENT
MALIGNANCY IN UNITED STATES AND
SKIN CANCER HAS BEEN INCREASING
IN RECENT YEARS AND SIGNIFICANT
SOCIO DEMOGRAPHIC DISPARITIES
EXIST WITH REGARDS -- HEALTH
LITERACY AND CANCER PROGNOSIS
AND THESE DISPARITIES EXTEND
INTO THE FIELD OF DERMATOLOGY AS
WELL AND LINGUISTIC DISPARITIES
ARE OFTEN OVERLOOKED AND NOT
CAPTURED BY RACIAL/ETHNIC
IDENTIFIERS WE FOCUS ON IN
LARGE-SCALE DATA SETS AND SKIN
EXAMS ARE PRIMARY METHOD OF SKIN
CANCER DETECTION AND EARLY
INTERVENTION IS CRITICAL FOR
MORBIDITY AND MORTALITY AND GOAL
OF STUDY FIRST TO
[INDISCERNIBLE] ASSOCIATION
ENGLISH PROFICIENCY AND
UNDERGOING ROUTINE SKIN CHECK
AND SECONDARY WILL I TO ATTEMPT
TO RECOVER A POSSIBLE CAUSAL
EFFECT OF LIMITED ENGLISH
PROFICIENCY UNDERGOING ROUTINE
SKIN CHECKS AND DATA I USED YOU
ARE FAMILIAR WITH AT THIS POINT
HEALTH INFORMATION NATIONAL
TREND SURVEY NATIONAL
REPRESENTED SURVEY YOU KNOW AND
PURPOSES OF THIS STUDY USED
HINTS 5 CYCLE 1 AND 2017 VERSION
I DUG INTO ARCHIVES A BIT AND
SIMPLE REASON BEING THAT IS ONLY
ONE I FOUND WITH RELEVANT
QUESTIONS ABOUT SKIN CANCER.
AS FAR AS METHODS AS YOU KNOW
THIS IS A COMPLEX SURVEY THAT
HINTS DATASET AND HAD TO
INCORPORATE KNACK KNIFE
REPLICATE WEIGHTS TO DRAW
INFERENTIAL STATISTICS AND USED
MULTIVARIABLE LOGISTIC
REGRESSION ASSOCIATED FOR
DEMOGRAPHIC CHARACTERISTICS WITH
PRIMARY ONE BEING THAT I CREATED
THAT WAS PROFICIENT AND TOOK ON
A VALUE OF 1 IF RESPONDENTS
LISTING HIGHEST LEVEL ENGLISH
PROFICIENCY AND ZERO OTHERWISE
AND OUTCOME WAS SKIN CHECK AND
IS A VARIABLE I CREATED BINARY
TAKING ON VALUE OF 1 IF SOMEBODY
REPORTED HAVING REGULAR SKIN
CHECKS PERFORMED AND ZERO
OTHERWISE AND CO-VARIATES ARE
CORRECTED FOR STANDARD SOCIO
DEMOGRAPHIC CHARACTERISTICS WE
LOOK AT COMMONLY THAT INCLUDE
THINGS LIKE AGE, INSURANCE
STATUS GENDER EDUCATION RACE
ETHNICITY US RESIDENT AND INCOME
AND PERFORMED LOGISTIC
REGRESSION ANALYSIS UTILIZING
PROPENSITY SCORE MATCH COHORT
DONE TO DRAW CAUSAL EFFECT FROM
THIS RELATIONSHIP USING
SPECIFICALLY ONE TO ONE OPTIMAL
MATCHING THAT IS A NICE AND
CLEAN WAY TO SAY MATCHING
PROCEDURE WAS CRAFTED SUCH
MINIMIZING SUM OF PAIRWISE
DISTANCES BETWEEN MATCHING
COHORTS AND FELL INTO SIMPLE
LOGISTIC REGRESSION WITHOUT
ADJUSTING ADDITIONAL CO-VARIATES
NO THE A DOUBLY ROBUST ANALYSIS.
AND METHODS USED I USED R
VERSION 4.2 THAT IS REALLY FUN
FOR INSTRUCTIONS OF R WERE
LISTED ON THE WEBSITE FOR HINTS
BUT SHOULD BE EASIER AND PACKAGE
USED WAS TIDY VERSE NICE WAY TO
WORK WITH R THAT IS EASIER TO
READ AND SURVEY PACKAGE USED FOR
COMPLEX SURVEY DESIGNS SURVEYOR
THAT IS A NICE PACKAGE TO ALLOW
TO USE DEPLIER OR TIDY VERSE
SYNTAX WORKING WITH POWERFUL
SURVEY DATA PACKAGE GT SUMMARY
RESPONSIBLE FOR NICE PLOTS YOU
WILL SEE AND MATCH IT WHICH IS
WHAT I USE FOR PROPENSITY SCORE
MATCHING PROCEDURE.
SOMETHING INTERESTING TO NOTE IS
BASELINE CHARACTERISTICS BETWEEN
TWO GROUPS WERE VERY DIFFERENT.
ACTUALLY, IN EVERY ONE OF THE
CO-VARIATES I LOOKED AT WITH
EXCEPTION BEING US REGION THAT
IS COMPARE ENGLISH PROFICIENT TO
ENGLISH NONPROFICIENT GROUPS AND
INCOME AND INSURANCE STATUS AND
SEX AND AGE GROUP AND
EDUCATIONAL ATTAINMENT
RACE/ETHNICITY AND HISPANIC
IDENTITY, ALL THESE WERE
SIGNIFICANTLY DIFFERENT ACROSS
TWO GROUPS INDICATED BY P VALUE
OF LESS THAN .5 AND THIS IS NOT
CASE FOR REGION WITH P VALUE OF
.2.
FOR ONE-TO-ONE MATCH COHORT I
CREATED WE CAN SEE THAT AFTER
THE MATCHING PROCEDURE WE HAVE A
SIGNIFICANTLY MORE COMPARABLE
GROUP OF ENGLISH PROFICIENT AND
ENGLISH NONPROFICIENT SUBGROUPS
THAT THAT IS SHOWN WITH BLUE
DOTS BEING ASKED FOR MATCHING
PROCEDURE AND BLUE DOTS BEFORE
AND RESULTS WE CAN SEE THAT IN
UNADJUSTED MODEL AND AGAIN
SIMPLE LOGISTIC REGRESSION
LOOKING AT ENGLISH PROFICIENCY
AS A PREDICTOR ODDS RATIO
UNDERGOING SKIN ROUTINE CHECKS
-- WITH 90% CONFIDENCE INTERVAL
LISTED IN ROW BELOW THAT DOESN'T
CONTAIN 1 THAT SUGGESTS
SIGNIFICANT ASSOCIATION AND
IMPORTANTLY WHEN WE ADJUST FOR
COMMON SOCIO OR COMMON
CO-VARIATES I LISTED BEFORE WE
SEE IT DROPS AND IS SIGNIFICANT
AT 3.24.
AGAIN, 95% CONFIDENCE INTERVAL
DOESN'T CONTAIN ONE SIGNIFYING A
STATISTICALLY SIGNIFICANT
ASSOCIATION.
MATCHED MODEL WE SEE THERE IS
MAYBE EVIDENCE OF INCREASED ODDS
RATIO UNDERGOING SKIN ROUTINE
CHECKS AMONG SUFFICIENT SUBJECTS
AND [INDISCERNIBLE] AND THIS 95%
CONFIDENCE INTERVALE IS WIDE
0.55 TO 5.4 AND CONTAINING ONE
AND LIMITING HOW MUCH STOCK WE
CAN PUT INTO THAT ANALYSIS.
AGAIN, IN SUMMARY ENGLISH
PROFICIENCIES ASSOCIATED WITH
3.24 TIMES HIGHER ODDS
UNDERGOING SKIN ROUTINE CHECKS
THAT IS STATISTICALLY
SIGNIFICANT AND PROPENSITY
ANALYSIS -- LANGUAGE PROFICIENCY
AND UNDERGOING ROUTINE SKIN
CHECKS THAT IS IMPORTANT TO
THINK ABOUT IN CONTEXT OF
LIMITATIONS IN MY STUDY AND FOR
ONE, UNOBSERVED CONFOUNDING IS
SOMETHING WE COULD NEVER SORT OF
ACCOUNT FOR HAVING CORRECTED
FOR.
THERE WAS ALSO SIGNIFICANT LACK
OF STATISTICAL POWER AFTER THE
MATCHING PROCEDURE BECAUSE OF
WAY IT WORKS IS THAT YOU NEED TO
FIND ONE TO ONE PERFECT MATCHES
AND YOU END UP THROWING AWAY
LOTS OF DATA POINTS.
NEXT STEPS COULD BE USEFUL TO
CONSIDER INSTEAD USING INVERSE
PROPENSITY SCORE WEIGHTING THAT
IS ANOTHER WAY TO MATCH TWO
GROUPS TOGETHER AND WOULD GIVE
ME A LITTLE BIT OF A BOOST IN
STATISTICAL POWER FOR SIMPLE
REASON WE HAVE MORE DATA YOU TO
WORK WITH.
THANK YOU ALL FOR YOUR ATTEN
ATTENTION.
>> THANK YOU JEREMY. LAST
PRESENTER IS DR. MARK PI ELA WHO
WILL PRESENT ON ASSOCIATIONS
BETWEEN DISCRIMINATION MEDICAL
MISTRUST AND DELAYING NEEDED
CARE.
>> THANKS FOR STICKING THROUGH
WITH US, GUYS.
WE ARE ALMOST DONE AND FEELS
LIKE GRADUATION DAY OR
SOMETHING.
ALL RIGHT.
SO, BEFORE WE JUMP INTO MY
DISCUSSION, I THINK IT IS
IMPORTANT WE DISCUSS WHAT
MEDICAL MISTRUST IS. IT IS A
CONSTRUCT THAT WE ALL HAVE A
PICTURE OF BUT CAN'T REALLY
DEFINE AND I WON'T DO A GOOD JOB
IN NEXT TWO MINUTES DEFINING IT
ANYWAY AND AT LEAST WE CAN GET
ON SAME PAGE AND THINGS TO
CONSIDER IS WELL, WHAT IS IT?
IF I WAS TO DIVE INTO LITERATURE
AND TRY TO GIVE THIS A JUST
ANSWER WE WOULD BE HERE FOR THE
NEXT SEVERAL HOURS AND SUGGEST
THAT YOU GO DOWN THAT RABBIT
HOLE IF YOU HAVE INTEREST.
LITERATURE DISTINGUISHES BETWEEN
MEDICAL MISTRUST THAT IS A
GENERAL MISTRUST OF THE HEALTH
CARE SYSTEM VERSUS INTERPERSONAL
DISTRUST THAT IS MORE DISTRUST
WITH PROVIDERS OR SPECIFIC
PROVIDER AND THINGS LIKE
CONSPIRACY THEORIES ARE
TECHNICALLY A DIFFERENT PART OF
MEDICAL MISTRUST AND FOR
PURPOSES OF THIS ONE I SAID
MEDICAL MISTRUST THAT IS GENERAL
MISTRUST IN THE HEALTHCARE
SYSTEM.
SO, WHO IS SUSCEPTIBLE TO IT?
DR. CASTILLO'S DATA SHOWED
EARLIER THAT HISTORICALLY WE
THOUGHT OF IT TO BE MARGINALIZED
GROUPS AND PEOPLE LIKE
RACIAL/ETHNIC MINORITIES AND
LGBTQ INDIVIDUALS AND PEOPLE
FROM RURAL RESIDENTS AS DATA
SHOWED US AND LOTS OF FAMILY AND
FRIEND'S FACEBOOK PAGES OVER THE
PANDEMIC SHOWED US FACE OF
MEDICAL MISTRUST IS CHANGING
TODAY.
IN REALITY ANYBODY COULD BE
SUSCEPTIBLE TO IT. PEOPLE ARE
MORE LIKELY TO EXPERIENCE IT.
WHAT CAUSES IT? I HOPE TO SHOW
TODAY THAT SOME OF IT IS RELATED
TO DISCRIMINATION IN THE
HEALTHCARE SYSTEM THAT IS ALSO
THINGS RELATED TO, YOU KNOW,
THINGS PASSED ON TO YOU BY
EXPERIENCES BY FAMILY FRIENDS
AND HISTORICAL CONTEXTS OF
ATROCITIES THAT HEALTHCARE
SYSTEM HAS CAUSED CERTAIN PEOPLE
THAT SEEMS TO BE A VERY COMPLEX
MATTER.
AND NOT ONE OR EVEN A HANDFUL OF
INDIVIDUAL CAUSES.
WHAT ARE NEGATIVE EFFECTS?
MEDICAL MISTRUST IN A VACUUM
DOESN'T MEAN ANYTHING AND YOU
DON'T TRUST HEALTHCARE SYSTEM
AND NOTHING HAPPENS, WHY DOES
THAT REALLY MATTER?
WHAT HAPPENS IS PEOPLE WITH LESS
TRUST IN MEDICAL SYSTEM ARE LESS
LIKELY TO USE IT AND GET
PREVENTIVE CARE AND DELAYED CARE
THEY NEED AND HAVE WORSENED
HEALTH OUTCOMES AND THAT IS WHAT
OF MEDICAL MISTRUST WE ARE
TRYING TO ALLEVIATE.
HISTORICALLY AS I SAID WE HAVE
TENDED TO LOOK AT MARGINALIZED
GROUPS AS BEING A CAUSE OF
MEDICAL MISTRUST. REALLY, IT IS
AN ASSOCIATION BETWEEN THE TWO.
AS THIS MODEL DEPICTS THAT
RESULTS IN DELAYED CARE.
WHAT I HAVE INTEREST IN AND
SHOWED TODAY IS PERSONAL HISTORY
OF DISCRIMINATION MIGHT MEDIATE
THAT RELATIONSHIP BETWEEN
MINORITY RAISED MEDICAL MISTRUST
AND ON THIS VALUE SEEMS
SELF-EVIDENT AND HAS BEEN TESTED
IN LITERATURE AND MOST DATA SETS
DON'T INCLUDE CONSTRUCTS IN ONE
SIMPLE DATA SET TO TEST
HYPOTHESISES LIKE THIS AND NOT
MENTIONING VARIOUS CO-VARIATES
THAT MIGHT IMPACT THIS
RELATIONSHIP ALSO. THIS IS AN
OPPORTUNITY WHERE YOU COME
ACROSS A GREAT RESEARCH QUESTION
BY EXTENT. ACTUALLY IN HINT'S
DATA SET I'M A PRIOR USER AS
WELL AND PULLING DATA FROM
POSTER PRESENTATION THAT I
PRESENTED LAST NIGHT AND SAW
THESE THREE QUESTIONS IN SAME
DATA SET AND SECTION OF THE
SURVEY AND OKAY THEY ARE
AVAILABLE. I CAN ANSWER THIS
QUESTION I'M VERY INTERESTED IN.
AS FAR AS MEDICAL MISTRUST AS A
VARIABLE ASKING HOW MUCH DO YOU
TRUST HEALTHCARE SYSTEM
HOSPITALS AND PHARMACIES AND
ORGANIZATIONS INVOLVED IN
HEALTHCARE WITH LIKERT SCALE
FROM NOT AT ALL TO A LOT AND
VARIABLE REGARDING
DISCRIMINATION YES OR NO. THERE
IS A VARIABLE WHETHER OR NOT YOU
DELAYED MEDICAL CARE IN THE PAST
12 MONTHS ALSO.
THESE WERE USED FOR THESE
ANALYSIS.
THIS USED 2022 WAVE 6 OF HINTS
AND HAD TO EXCLUDE INDIVIDUALS
INCLUDING INCOMPLETE SURVEYS AND
PEOPLE WITH MISSING RACE OR
ETHNICITY THIS IS PRIMARY AND
INDEPENDENT VARIABLE AND WERE
SOME MISSING DATA POINTS AND 6%
OF CASES HAD NO DATA REGARDING
MEDICAL MISTRUST THAT WERE
DROPPED FROM THAT ANALYSIS.
ON -- IN MODELS OF DELAYED
MEDICAL CARE ABOUT 14% OF CASES
WERE DROPPED FROM THAT AND MOST
NOT MISSING DATA AND MOST PEOPLE
DIDN'T NEED HEALTHCARE IN PAST
12 MONTHS THAT COULD BE INCLUDED
IN ANALYSIS AND USED
MULTIVARIABLE LOGISTIC
REGRESSION ANALYSIS AND SAAS AND
SHOWING DATA REGARDING TRUST IN
HEALTHCARE SYSTEM BY RACE.
WHAT WE SEE IS THAT ONLY ABOUT
40% OF INDIVIDUALS REPORTED A
LOT OF TRUST IN THE HEALTHCARE
SYSTEM THAT SEEMED TO BE RELATED
WITH RACE MEANING 41% OF
NON-HISPANIC WHITE COMPARED TO
36% OF AFRICAN AMERICAN OR BLACK
AND TLE 3% OF HISPANIC AND 38%
OF OTHER.
I DEFINED ANYTHING THAT IS NOT A
LOT AS MEDICAL MIS TRTRUST.
LOOKING AT A LITTLE OR NOT AT
ALL, WE SEE DISPARITY
DIFFERENCES BASED ON
CATEGORIZATION.
AT END OF THE DAY WHETHER OR NOT
YOU CONSIDER MEDICAL MISTRUST
SOMEWHAT VERSUS A LITTLE I THINK
IS YOU KNOW A LITTLE THAT WE CAN
ALL QUIBBLE ABOUT THAT. TO ME,
I COULDN'T COMPREHEND DIFFERENCE
BETWEEN A LITTLE AND SOMEWHAT IF
ANSWERING THAT QUESTION AND WHY
BOTH WERE INCLUDED IN DEFINITION
OF MEDICAL MISTRUST.
ONE POINT OF CONTENTION MAYBE
FOR THIS ANALYSIS IS I LUMPED
ALL RACIAL AND ETHNIC MINORITIES
TOGETHER FOR SAKE OF ANALYSIS TO
SIMPLIFY IT.
BECAUSE OF ASSOCIATION THAT HAS
RACE AND MEDICAL MISTRUST THAT
SEEMS TO BE FAIRLY EQUAL AMONG
GROUPS AND OBVIOUSLY WILL BE
INTRAGROUP HETEROGENEITY THAT
WOULD COME TO PLAY AND WHEN I
DID THIS THERE WAS 41% HAVING NO
MEDICAL MISTRUST AMONG
NON-HISPANIC WHITE COMPARED TO
35%.
JUSTING AT BIVARIATE
CHARACTERISTICS BY RACE AND
ETHNICITY GROUP, WHAT WE SEE IS
THAT MINORITY PARTICIPANTS WERE
YOUNGER.
THEY WERE MORE LIKELY TO BE
FEMALE AND WERE LESS LIKELY TO
HAVE COLLEGE DEGREE AND MORE
LIKELY TO HAVE HOUSEHOLD INCOME
OF LESS THAN 50,000 AND LESS
LIKELY TO HAVE HEALTH INSURANCE
AND MORE LIKELY TO REPORT
DISCRIMINATION BASED ON RACE AND
HEALTHCARE SYSTEM AND SLIGHTLY
MORE LIKELY TO REPORT DELAY IN
MEDICAL CARE AND SAME THING WHEN
YOU BREAK DOWN BY THOSE WITH
MEDICAL MISTRUST VERSUS THOSE
WITHOUT WE SEE SAME TREND THAT
THESE ARE OVERLAPPING
CONSTRUCTS.
SO, IF IN THE MEDIATION
ANALYSIS, FIRST THING THAT I DID
WAS LOOK AT RELATIONSHIP THAT
WAS BETWEEN BEING A MINORITY
RACE AND ETHNICITY AND MISTRUST
AND CONTROLLING FOR CO-VARIATES
AGE GENDER AND SOCIOECONOMIC
STATUS THAT IS INCOME AND
EDUCATION LEVEL AS WELL PEOPLE
THAT WERE MINORITIES WERE AT --
SORRY 14% MORE LIKELY TO REPORT
MEDICAL MISTRUST AND WERE OVER
FIVE TIMES MORE LIKELY TO REPORT
DISCRIMINATION IN THE HEALTHCARE
SYSTEM AS WELL.
WE LOOKED AT DISCRIMINATION IN
THE HEALTHCARE SYSTEM AND THOSE
REPORTING THAT WERE OVER 3 TIMES
AS LIKELY TO REPORT MEDICAL
MISTRUST.
WHEN YOU DO MEDIATION ANALYSIS I
FOUND THAT THERE WAS NO LONGER
STATISTICALLY SIGNIFICANT
ASSOCIATION BETWEEN RACE MEDICAL
MISTRUST THAT COMPLETELY
ATTENUATED THIS RELATIONSHIP AND
MEDIATED IT.
I WILL ALLOW CHANGE OVER HERE
AND LOOKING AT HOW IT RELATES TO
DELAYED CARE AND AGAIN IS DATA
SHOWING ASSOCIATION BETWEEN RACE
ETHNICITY AND MEDICAL MISTRUST
AND THE ODDS RATIO IS SLIGHTLY
DIFFERENT BECAUSE OF DIFFERENT
SAMPLE SIZE AND SAME TREND HERE
AND WE SEE MEDICAL MISTRUST IS
ASSOCIATED WITH TWICE AS
LIKELIHOOD TO DELAY MEDICAL CARE
AND INTERESTINGLY I FOUND NO
ASSOCIATION BETWEEN RACE AND
ETHNICITY IN DELAYING MEDICAL
CARE.
DOING MEDIATION ANALYSIS I FOUND
ACTUALLY RACIAL AND ETHNIC
MINORITIES WERE LESS LIKELY TO
DELAY MEDICAL CARE THAN WHITE
PEERS AND IS ACTUALLY MEDICAL
MISTRUST THAT MAKES IT NOT
STATISTICALLY SIGNIFICANT.
THERE IS STILL A MEDIATION GOING
THERE BUT NO THE IN MANNER THAT
I EXPECTED IT TO BE AND OBVIOUS
LIMITATIONS AND MEASURES I USED
AND MEDICAL MISTRUST AND USED A
SINGLE VARIABLE THAT IS COMPLETE
MMPI AND IT IS A MEASURE THAT IS
USED FOR MEDICAL MISTRUST
SPECIFICALLY AND USING THAT
WOULD HAVE FOUND DIFFERENT
RESULTS AND OPERATIONAL
DEFINITIONS I USED AGAIN AND
LOOKED AT A LOT OF TRUST VERSUS
ANYTHING ELSE AND COULD DEFINE
AS A LOT OR SOMEWHAT VERSUS NOT
A LOT AND COULD CHANGE MY RESULT
AS WELL WHICH IS FAIRLY SMALL
THAN LESS THAN 1% OF EVERY OTHER
VARIABLE OTHER THAN RACE WHICH
IS 6%.
KEY TAKEAWAYS, FIRST OFF, LESS
THAN 40% OF PARTICIPANTS
REPORTED A LOT OF TRUST IN THE
HEALTH CARE SYSTEM THAT IS
MINDBLOWING TO ME AND THOUGHT IT
WOULD BE MUCH HIGHER THAT IS A
PRECEDENT FOR THAT AND STUDY
ONGOING SINCE 1972 THAT IS 50
YEARS OF DATE THAW IS SHOWING
THAT A VERY SIMILAR QUESTION
THAT PEOPLE ASK I WILL NAME
INSTITUTIONS IN COUNTRY AS FAR
AS PEOPLE RUNNING INSTITUTIONS
ARE CONCERNED WOULD YOU SAY
GREAT DEAL OF CONFIDENCE SOME
CONFIDENCE OR HARDLY ANY
CONFIDENCE AT ALL AND THIS IS
FOR HEALTHCARE SYSTEM AND SEE IN
70S IT PEAKED ABOUT 60% AND
DECLINING AND LESS THAN 40% IN
RECENT YEARS THAT IS SURPRISING
TO ME AND TO SOME OF YOU MIGHT
BE PRECEDENT TO IT.
SECONDLY MINORITY PATIENTS MORE
LIKELY TO REPORT MEDICAL
MISTRUST IN THE HEALTHCARE
SYSTEM AND MEDIATED BY PERSONAL
[INDISCERNIBLE] IN HEAL J CARE
SYSTEM THAT IS CONSISTENT WITH
SOME CONCEPTUAL MODELS OF
MEDICAL MISTRUST BUT NOT ALWAYS.
THEY WERE LOOKING AT MEDICAL
MISTRUST AND CONCEPTUALIZATIONS
WHETHER RELATIONSHIP WAS
BIDIRECTIONAL UNIDIRECTIONAL AND
WHICH WAY IT POINTED AND IS UP
TO DEBATE DEFINITELY AND IS
ANOTHER STAGE RECENTLY LOOKING
AT AND THEY SAW THESE AT TWO
CONCEPTUALLY DIFFERENT
CONSTRUCTS.
AND NOT EVEN RELATED AT ALL.
TAKE AWAY NO. 3 MINORITY
PATIENTS [INDISCERNIBLE] AND
NON-HISPANIC WHITES NOT
SOMETHING I SUSPECTED BUT SEEMS
TO BE CONSISTENT WITH DATA OUT
THERE AND PARTICULARLY OVER THE
COVID PANDEMIC IF YOU LOOK AT
THOSE DELAYING MEDICAL CARE FROM
2020 ONWARDS IT HAS BEEN MORE
LIKELY TO BE NON-HISPANIC WHITE
PEOPLE AND DUE TO CONCERNS
RELATED TO COVID OR OTHER
MEASURES THERE.
THANK YOU FOR ALL OF YOU FOR
STICKING AROUND.
>> THANK YOU TO PRESENTERS.
GOOD NEWS WE HAVE QUESTIONS AND
FOR QUESTIONS FOR EITHER OR
SPECIFIC PRESENTERS TO PLEASE
COME TO THE MIC. PLEASE GO
AHEAD.
MAYBE IF YOU CAN PROJECT I CAN
REPEAT THE QUESTION FOR THOSE ON
ZOOM.
THE OTHER QUESTION TO REPEAT FOR
THOSE ON ZOOM IS FOR THE LAST
PRESENTER THAT IS REGARDING
CONSIDERATIONS OF CONSIDERING
GENDER IDENTITY AS A MODERATOR
RATHER THAN A CONFOUNDER TO BE
ABLE TO LOOK AT EXPERIENCES OF
MEDICAL MISTRUST BY RACE
ETHNICITY AND GENDER IDENTITY.
>> AS I DISCUSSED, THERE IS MANY
WAYS TO CONCEPTUALIZE THAT IS
VERY IMPORTANT AND OPAQUE
CONCEPTUAL MODEL AND DIDN'T FIND
THAT GENDER WAS ASSOCIATED WITH
MEDICAL MISTRUST IN THIS. I
DON'T KNOW THAT INCLUDING IT AS
A MODIFIER WOULD HAVE MADE A
DIFFERENCE AND SOMETHING TO LOOK
AT, YEAH. WHETHER OR NOT THAT
DO
DOES.
THE DATA IS PRETTY SCANT
REGARDING GENDER AND
RELATIONSHIP WITH RESPECT TO
MEDICAL MISTRUST AND WOULD BE
HAPPY TO HEAR YOUR
CONCEPTUALIZATION OF THAT. I
DIDN'T CHECK IT BECAUSE I DIDN'T
HAVE DATA TO SUPPORT THAT.
IT WASN'T PART OF MY CONCEPTUAL
MODEL.
>> WE WILL ALTERNATE MICS.
IF YOU CAN GO AHEAD WITH YOUR
QUEST
QUESTION.
>> I WILL START WITH
[INDISCERN
[INDISCERNIBLE].
>> [INDISCERNIBLE].
>> I WAS ATTENDING
[INDISCERNIBLE] MEETING AND ALL
OF A SUDDEN I SAW COMING DOWN
HEALTH AND DISPARITY TO YOUR
KNOWLEDGE I WORK WITH HEALTH AND
HEALTH DISPARITY WITH AFRICAN
AMERICANS FOR LAST 15 YEARS AND
GIVEN A TASK BY NIH TO SEE WHAT
IS HAPPENING IN LOCAL AFRICAN
AMERICANS AND WHAT IS REASON
THAT BELIEFS ARE HIGH AND I'M
NOT SOCIAL EPIGENETICS PEOPLE
AND CLINICAL SCIENTIST AND
LOOKING AT GENE TRANSCRIPTION
AND GETTING WORSE AND WITH MY
EXPERIENCE I SEE THAT DISPARITY
IN MY EYES THAT I CAN'T EXPLAIN
PROPERLY AND NOT IN MY AREA AND
QUESTION FROM LEARNED PRESENTERS
AND I'M SEEING KEY QUESTIONS AND
EDUCATION AND SMOKING IS
IMPORTANT AND NEED TO CONNECT
WITH DISEASES OUTCOME AND
TRANSCRIPT I'M TALKING ABOUT.
WHAT IS YOUR ADVICE TO ME AS A
CLINICAL RESEARCHER AND WHICH
AREA REALLY ASKING TO SOCIAL
DETERMINANTS OF HEALTH IN
AFRICAN AMERICANS OR HEALTH OR
DESPAIRED PEOPLE AND WHICH AREA
SHOULD I CONSENT MORE TO CONNECT
DISEASE OUTCOME?
>> IT SAID INDICATION AND SOCIAL
LIFESTYLE WHATEVER YOU WANT ME
TO.
>> FROM MY EXPERIENCE I WOULD
SAY DON'T CONCENTRATE ON JUST
ONE ASPECT. WHAT WE SAW DOING
ANALYSIS AND IF YOU GROUP THEM
AS SOCIAL DETERMINANCE OF HEALTH
GROUPING THEM AND SOMETIMES THEY
DON'T GIVE YOU ANSWERS WHAT YOU
ARE LOOKING FOR. WHAT YOU DO
AND WHAT WE HAVE DONE IS LOOKING
AT THESE DOMAINS THAT I WOULD
SAY FROM MY EXPERIENCE NOW, TAKE
A SERIOUS LOOK AT THE SOCIAL
CONNECTION AND SOCIAL ISOLATION
BECAUSE RECENTLY WE ARE SEEING
THAT PEOPLE LOOK AT JUST
EDUCATION AND EMPLOYMENT AND ALL
THAT.
PEOPLE, WE ARE NOT LOOKING SO
MUCH INTO THE CONNECTEDNESS OF
THE COMMUNITIES AND HOW DO WE
SUPPORT PEOPLE WHO ARE THE
BOTTOM TO GET HEALTHCARE HELP
THAT THEY NEED?
SOMETIMES MEDICAL CARE THEY NEED
AND SOCIAL SUPPORT IS THE AREA
THAT THEY DEFINE THEMSELVES AND
IN THE ENVIRONMENT THAT THEY
DEFINE THEMSELVES AND WE PROVIDE
THESE THINGS TO COME WHEN WE
PROVIDE THESE THINGS TALKING
ABOUT MEDICAL MISTRUST DO THEY
TRUST US MEDICAL PROVIDERS DO
THEY TRUST US WELL ENOUGH TO
COME SEEK HELP THEY NEED THAT IS
A MULTIDIMENSIONAL THEME YOU
SHOULD LOOK AT. IF YOU LOOK AT
MULTIDIMENSIONAL THING AND STICK
TAKE THEM APART ONE-BY-ONE AND
SEE WHICH OF THOSE.
DON'T JUST LOOK AT EDUCATION OR
JUST EMPLOYMENT. YOU KNOW, LOOK
AT DIFFERENT ALL TOGETHER AND
WHAT WE SAID ABOUT LANGUAGE.
YOU KNOW?
THAT COULD BE SOMETHING TO
INTEREST YOU.
>> MY EXPERIENCE IN LAST 20
YEARS AND MY UNIVERSITY AND
HARVARD UNIVERSITY, 15 YEARS AGO
WAS 100% BLACK THE OUTPATIENT
AND NOW IS BECOMING 64. I SAW
LOCAL ADULTS AROUND COMMUNITY IS
CHANGED AND IS ALL ECONOMICS AND
SOCIAL AND HOW IT CONNECTS DOT
AND IT IS VERY WHAT IS IT
CALLED? A VERY TOUGH JOB. I
NEED MORE PEOPLE LIKE YOU BEHIND
ME TO SUPPORT MY CONCEPT AND
FIND THE CLUE. THINGS ARE GOING
BETTER TO MY EXPERIENCE AND
SHOULD HAVE GONE BETTER BY THE
TIME THAT WE INTERVENE OR LOOK
AT THE MATTER.
DEFINITELY THERE IS SOME MISSING
DOTS THAT WE CAN CONNECT.
>> YES.
>> THAT COULD BE A -- I MEAN,
KEY TO SUCCESS MAYBE ARE GETTING
OUT OF THAT.
>> THANK YOU.
>> THANK YOU FOR YOUR ADVICE.
THANK YOU.
>> THANK YOU.
>> MY QUESTION IS FOR THE LAST
PRESENTER THAT PIGGYBACKS ON THE
FIRST PRESENTER QUESTION.
I DON'T KNOW IF YOU ARE FAMILIAR
WITH DAVID WILL &S EVERY DAY
DISCRIMINATION SCALE AND CURIOUS
IN YOUR ANALYSIS IN ADDITION TO
LOOKING AT GENDER IF YOU CONTROL
FOR OBESITY AND OTHER THINGS IN
EVERY DAY DISCRIMINATION SCALE
IT ASKS BASICALLY WERE YOU
DISCRIMINATED IN VARIOUS
CONTEXTS AND PEOPLE'S PERCEPTION
OF WHY AND RACE IS ONE OF THEM.
IT IS ALSO GENDER AND OBESITY
AND OTHER THINGS AND CURIOUS IF
YOU CAN'T REALLY DUPLICATE IT.
QUESTIONS ARE NOT ASKED IN
HINTS.
COULD YOU KIND OF LOOK AT OTHER
FACTORS FROM THAT PARTICULAR
SCALE AS PROXIES TO HELP MAYBE
EXPLAIN THE MEDICAL MISTRUST?
>> VERY GOOD QUESTION.
AGAIN, WE ARE KIND OF LIMITED TO
VARIABLES IN THERE AND VARIABLES
SPECIFICALLY WERE YOU
DISCRIMINATED ON BASED ON YOUR
RACE THAT IS SURPRISING THAT 3%
OF WHITE PEOPLE ACTUALLY
REPORTED YES TO THAT. SO, YEAH.
IT IS NOT GENERAL DISCRIMINATION
THAT WOULD BE DEFINITELY MORE
MISLEADING.
>> RIGHT.
>> IF THAT IS HOW VARIABLE IS
LAID OUT.
>> YEAH. I UNDERSTAND THAT IS
THE ACTUAL QUESTION AND JUST
WONDERING IF YOU WERE ABLE TO
CONTROL FOR IT AND OTHER THINGS
THAT COULD POTENTIALLY GO ON TO
THAT LIKE OBESITY AND AGAIN AS
CONTROLLED FACTORS, I GUESS.
>> I DIDN'T BECAUSE YOU KNOW I
ALWAYS START WITH CONCEPTUAL
MODEL.
SO, IF IT DOESN'T FIT MY MODEL
IT DOESN'T GO INTO MY STATS
PROGRAM IS MY RULE.
QUESTION SPECIFICALLY BASED ON
RACE AND MEDICAL MISTRUST THERE
IS NOT A LINK TO ME FOR OBESITY.
I WOULDN'T CONTROL FOR IT. YOU
COULD ARGUE THERE IS. AND
CERTAINLY THAT IS OPEN FOR
DEBATE AND WHY I DIDN'T CONTROL
FOR OTHER FACTORS RELATED TO
THIS AND HOW VARIABLES WERE LAID
OUT AND CONCEPTUALLY, YOU WOULD
ONLY CONTROL FOR THEM IF THEY
WERE ASSOCIATED WITH THE OUTCOME
AND THE INDEPENDENT VARIABLE.
>> >> HI.
>> YES. GO AHEAD.
>> MY QUESTION IS FOR THE FIRST
PRESENTER.
I THINK I SAW CORRECTLY THAT
YOUR ANALYSIS FOUND THAT LIVING
ALONE WAS STATISTICALLY A
SIGNIFICANT PREDICTOR BUT NOT
THE PERCEIVED SELF-REPORTED
SOCIAL ISOLATION AND I'M CURIOUS
AND WOULD LOVE FOR YOU TO -- DI
INTERPRET IT CORRECTLY FROM YOUR
SLIDE?
>> SAY THAT AGAIN.
>> I SAW THAT LIVING ALONE WAS A
PREDICTOR OF YOUR OUTCOME BUT
NOT SELF-REPORT OF SOCIAL
ISOLATION THAT WAS MEASURED IN.
>> THAT IS NOT A PREDICTOR OF
SELF-ISOLATION AND LIVING ALONE
IS NOT A DOMAIN OF SOCIAL
DETERMINANTS OF HEALTH THAT WE
PUT THERE TO SEE VARIABLES THAT
WOULD PREDICT YOUR ADHERENCE TO
CERVICAL CANCER SCREENING AND
WHAT WE USE FOR SOCIAL ISOLATION
IS [INDISCERNIBLE] IS WHAT WE
USED.
>> RIGHT.
>> TO DETERMINE SOCIAL ISOLATION
FOR THIS STUDY, ACTUALLY.
SO, THE LIVING ALONE IS ACTUALLY
UNDER MARITAL STATUS.
>> RIGHT.
>> IT SHOWED BUT WAS NOT PART OF
THE DOMAINS. OKAY?
WE HAD TO INCLUDE IT IN THE
RESULT.
>> WHAT I WOULD LOVE TO HEAR
MORE ABOUT IS WHAT YOU THINK
THOSE DIFFERENT WAYS OF KIND OF
MEASURING OR THINKING ABOUT OR
ASSESSING SOCIAL ISOLATION
SUGGEST FOR HOW WE INTERVENE TO
SUPPORT PEOPLE WHO ARE
EXPERIENCING IT. IF YOU COULD.
>> SORRY COULD YOU REPHRASE THE
QUESTION AGAIN?
>> SO, THE -- SORRY.
>> UH-HUH.
>> IT SEEMS AS THOUGH THERE ARE
DIFFERENT WAYS OF ASSESSING
SOCIAL ISOLATION.
>> YES.
>> OBJECTIVE MEASURES AND LIVING
ALONE AND MARITAL STATUS AND
MORE SUBJECTIVE EXPERIENCE
MEASURES AND PROMISE SCALE OF
SELF-REPORTED AND SOCIAL
ISOLATION AND WOULD LOVE TO HEAR
MORE ABOUT THOUGHTS ABOUT HOW
POTENTIALLY DIFFERENT
ASSOCIATIONS OF LIKE THESE
DIFFERENT WAYS OF MEASURING
SOCIAL ISOLATION COULD HAVE
DIFFERENT ASSOCIATIONS WITH
OUTCOMES WE CARE ABOUT AND WHAT
IT MEANS HOW TO INTERVENE TO
SUPPORT PEOPLE THAT ARE
EXPERIENCING SOCIAL ISOLATION.
>> IF I UNDERSTAND YOUR
QUESTION, YOU ARE SAYING WHAT IS
THE IMPLICATION AND HOW DO WE
INTERVENE ON THE SOCIAL
ISOLATION NOW NOT LIKE ON LIVING
ALONE VARIABLE. IS THAT WHAT
YOU ARE ASKING?
>> DEPENDING HOW WE
CONCEPTUALIZE SOCIAL ISOLATION
THROUGH OBJECTIVE MEASURES
LIVING ALONE IN MARITAL STATUS
AND SUBJECTIVE MEASURES LIVING
IN USE OF PROMISE SCALE AND HOW
WE MEASURE SOCIAL ISOLATION THAT
INFLUENCES HOW WE SHOULD
INTERVENE ON IT.
>> OKAY. YOU KNOW THAT THERE
ARE VARIOUS WAYS TO LOOK AT
SOCIAL ISOLATION AND LOOKING AT
ONE SOCIAL SUPPORT AND MARITAL
STATUS ON LIVING ALONE CAN ALSO
BE PART OF YOUR WHAT IS IT
CALLED?
SOCIAL SUPPORT; RIGHT?
WAY THAT WE LOOKED AT IT WE ARE
LOOKING AT IT MORE FROM A
COMMUNITY LEVEL AND WHO IN YOUR
COMMUNITY OR HOW DOES YOUR
COMMUNITY HELP YOU OR HOW
CONNECTED DO YOU FEEL IN YOUR
COMMUNITY?
>> I WOULD SAY IF YOU WANT TO --
I WOULD SAY OR SUGGEST THAT IN
YOUR INTERVENTION I WOULD LOOK
AT REALLY NOT DIRECTLY ON FAMILY
LEVEL NOW GO BEYOND THE FAMILY
LEVEL AND MAKING PEOPLE AWARE
BECAUSE SOMETIMES PEOPLE ARE NOT
AWARE THEY ARE SOCIALLY ISOLATED
AND MAKE PEOPLE AWARE WHAT IS
GOING ON AROUND THEM. OKAY?
MAKE THE MEDICAL PRACTITIONERS
AWARE TO CHECK WHEN PEOPLE COME
IN OR YOU ARE TALKING TO PEOPLE
ABOUT SCREENING ARE THEY AWARE
THEY ARE DISCONNECTED FROM WHAT
IS HAPPENING IN THEIR IMMEDIATE
COMMUNITY?
OKAY?
ARE THERE SOCIAL OUT THERE
INFRASTRUCTURE THAT HELP PEOPLE
LOOK AT -- WE LOOK AT THIS NOT
FROM THE PERSONAL PERSPECTIVE
BUT LOOKING AT IT FROM THE
COMMUNITY AND POLICY PERSPECTIVE
AND FROM A LARGER PICTURE. YOU
KNOW?
>> THANK YOU.
>> THAT IS THE WAY I WOULD LOOK
AT IT.
>> THANK YOU.
>> I HAVE A QUESTION FOR ALL OF
THE PRESENTERS AND GREAT TO SEE
DIFFERENT CONCEPTUAL MODELS AND
DIFFERENT DOMAINS AND LEVELS OF
INFLUENCE AND INCORPORATING
SOCIAL AND CULTURAL FACTORS AND
STRUCTURAL DETERMINANCE AND
THINK IN ONE OF THE
OPPORTUNITIES AND CHALLENGE WITH
DOING WORK AND SECONDARY DATA
ANALYSIS IS THAT PERHAPS THERE
ARE ALWAYS SOME QUESTIONS THAT
YOU JUST WISH THAT HINTS WHO
HAVE HAD TO ADVANCE YOUR
RESEARCH QUESTIONS AND IN
THINKING ABOUT THE WORK AND NEXT
STEPS IF YOU COULD PINPOINT IF
THERE HAD JUST BEEN A QUESTION
OR ANOTHER DOMAIN THAT WAS
REALLY TIED INTO THE QUESTION
THAT YOUR RESEARCH QUESTION AND
WHAT YOU WOULD HAVE WANTED THAT
TO BE.
WE WILL START. JEREMY?
>> I WILL ANSWER THIS WITH A
SORT OF BIAS THAT I'M APPLYING
TO DERMATOLOGY AND MEDICAL
SCHOOL NOW AND MENTIONING
DIGGING BACK TO 2017 TO FIND
ANYTHING ABOUT SKIN CANCER AND
IS SOMETHING THAT I HOLD VERY
SERIOUSLY. SKIN CANCER RISK OF
SKIN CANCER DISPARITIES AND
REGARDING SKIN CANCER MORTALITY.
QUESTIONS KIND OF COUCHED IN
DERMATOLOGY WOULD HAVE BEEN
HELPFUL FOR ME.
I WILL SAY I REALLY APPRECIATE
THE FACT THAT LINGUISTIC
DIVERSITY OR QUESTIONS REGARDING
LINGUISTIC DIVERSITY CAN BE
ANSWERED THROUGH HINTS DATASET
THAT IS SOMETHING I COULDN'T
FIND IN SEVERAL OTHERS AND I
REALLY APPRECIATE THAT.
>> I THINK WE WILL NEED A BETTER
WAY TO MEASURE THE CONCEPT OF
SOCIAL DETERMINANTS OF HEALTH
AND THINGS LIKE SOCIAL ISOLATION
THAT WASN'T VERY EASY TO JUST
THERE WERE THINGS COULDN'T
MEASURE USING [INDISCERNIBLE]
AND ALL THAT THAT WOULD HAVE
BEEN GOOD TO ASK MAYBE MORE OPEN
QUESTIONS ON LIKE, YOU KNOW,
SOCIAL SUPPORT YOU KNOW LIKE
COMMUNITY SUPPORT AND ALL THAT.
YEAH.
>> MINE WAS ACTUALLY A SUCCESS
STORY. I WROTE A PAPER ABOUT A
YEAR OR TWO AGO RELATING TO
MEDICAL MISTRUST USING HINTS
DATA AND TRUSTED INFORMATION
ABOUT CANCER AND INTERPERSONAL
TRUST AND WISH THEY WOULD ASK
MORE SPECIFIC QUESTIONS ABOUT
MEDICAL MISTRUST AND NEXT WAY
SURE ENOUGH THEY DID AND DIDN'T
KNOW WHAT WOULD BE ON THERE
UNTIL I RAN ACROSS IT.
CERTAINLY MORE -- I'M INTERESTED
IN SOCIOECONOMIC STATUS AND VERY
IMPORTANT CONSTRUCT IN MOST OF
MY RESEARCH THAT IS ANOTHER ONE
OF THE CONSTRUCTS WE KNOW WHAT
IT IS AND NO ONE KNOWS WHAT IT
MEANS AND YOU KNOW WE USE
EDUCATION AND INCOME AS PROXIES
AND AREA-BASED INFORMATION I
THINK IS REALLY HELPFUL FOR
THAT. DATA LINKAGE THAT IS IN
THE PRIOR WAVE. ONCE THAT GETS
INTEGRATED AND MAYBE IF A PLEA
TO GIVE IT BELOW A COUNTY LEVEL
AND COUNTY THAT I LIVE IN IS
SUCH -- IT HAS SO MUCH
DISPARITIES IN IT AND GET IT HAS
TO DO WITH STATES AND STUFF AND
MOST STATE DATA COMES FROM THE
COUNTY LEVEL AND IN MY COUNTY
THAT I LIVE IN, I HAVE MILLION
DOLLAR HOMES AND HALF OF THE
COUNTY LIVES BELOW THE POVERTY
THAT GETS MUTED OUT LOOKING AT
DATA AT THE COUNTY LEVEL.
I UNDERSTAND LIMITATIONS.
PLEASE, IF POSSIBLE, SOMETHING
THAT IS BELOW COUNTY-LEVEL DATA.
>> WE WILL THANK PANELISTS FOR
REALLY EXCITING PRESENTATIONS TO
WRAP UP THIS CONFERENCE.
I WOULD LIKE TO INVITE KELLY
BLAKE TO GIVE CLOSING REMARKS
AND ANNOUNCE TRAINEE AWARDS.
VERY EXCITING.
>> THANK YOU, MARLENE AND SYLVIA
FOR THE GREAT PANELS.
FUNNY STORY. I HAVE BEEN THE
HINTS DIRECTOR FOR FOUR YEARS
NOW AND BEEN INVOLVED WITH HINTS
SINCE ITS INCEPTION AND WILLIAMS
EVERY-DAY DISCRIMINATION SCALE I
HAVE TRIED TO DO ON THE SURVEY
FOR THE PAST THREE ITERATIONS
AND DESPITE IT BEING A VALIDATED
SCALE WE CAN'T GET IT OUT OF
COGNITIVE TESTING AND I CAN'T
GET MY ITEMS OUT OF HINTS AND
THOSE WISHING TO HAVE ITEMS ON
OR PARTICULAR RESPONSE OPTION ON
AN ITEM, PLEASE AT LEAST TAKE
THAT, YOU KNOW, WITH SOME
COMFORT THAT I EVEN HAVE TROUBLE
GETTING ITEMS ON HIPTS.
I WILL START WITH SOME AWARDS.
AT THE LAST HINTS MEETING THAT
WAS FIVE YEARS AGO WE
ESTABLISHED W BRADFORD
COMMENDATION FOR OUTSTANDING
STUDENT ABSTRACT AND HAVE
[INDISCERNIBLE] IN THE AUDIENCE
THAT I WOULD LIKE HIM TO COME
UP.
BRAD WAS ONE OF THREE NOW HINTS
DIRECTORS IN SO FAR THE LONGEST
STANDING ONE 12 OR 13 YEARS OF
PAST 20 YEARS THAT WE
ESTABLISHED THIS AWARD BEFORE
BRAD RETIRED IN RECOGNITION OF
STEADFAST COMMITMENT TO TRAINEES
AND JUNIOR INVESTIGATORS AND
STUDENTS THAT USE HINTS. WE ARE
AWARDING TWO STUDENTS WITH THIS
COMMENDATION THIS YEAR AND PAID
FOR THEIR TRAVEL TO THE
CONFERENCE AND HAVE NICE PLAQUES
FOR THEM AND [INDISCERNIBLE]
COULDN'T STAY WITH US THIS
AFTERNOON. WE WILL MAIL HIS
CERTIFICATE TO HIM. HE WAS PART
OF THE FIRST PANEL YESTERDAY AND
OTHER PRESENTER THIS AFTERNOON
IT WAS HIS FIRST CONFERENCE
PRESENTATION. WE ARE THRILL
TODAY BE ABLE TO GIVE HIM THIS
AWARD AND WOULD LIKE TO CALL UP
KRISTEN FROM UNIVERSITY OF
TENNESSEE WHO IS ALSO GETTING
THIS AWARD FOR HER ABSTRACT AND
PRESENTATION ON DIFFERENCES ON
TRUST SOURCES AND VIRALITY. IF
YOU CAN SHAKE [INDISCERNIBLE]'S
HAND I WILL GIVE YOU YOUR
PLAQUE.
>> NICE TO MEET YOU.
>> CONGRATULATIONS.
>> THANK YOU.
>> ALSO, NOT HERE WITH US TODAY
IS DR. GORDON WILLIS WHO IS
RECEIVING THIS YEAR'S 2023
OUTSTANDING SERVICE AWARD FOR
VALUED CONTRIBUTIONS TO HINTS
MANAGEMENT TEAM BEFORE HIS
RETIREMENT AND LAST YEAR MANY
KNOW GORDON ALONG WITH PAUL
BEATTY ON THE PANEL YESTERDAY
WROTE THE BOOK ON COGNITIVE
TESTING THAT WAS AN INSTRUMENTAL
PART OF HINTS MANAGEMENT TEAM
FOR MANY YEARS AND WILL MAIL HIS
PLAQUE TO HIM WHERE HE IS
RETIRED IN FLORIDA.
CONGRATULATIONS TO GORDON.
THEN I WANT TO JUST THANK ALL OF
YOU FOR STICKING WITH US FOR THE
LAST TWO DAYS.
I WANT TO EXPRESS GRATITUDE FOR
EVERYONE INVOLVED IN THIS
CONFERENCE AND ALSO IN HINTS.
AGAIN, ANNA SINGLE-HANDEDLY
PLANNED THIS MEETING.
LET'S THANK ANNA AND STAFF NIH
EVENTS MANAGEMENT STAFF AND
DIVISION OF AMENITIES AND
TRANSPORTATION SERVICES AND
WONDERFUL ASL INTERPRETERS THAT
THE SPEAKER ACKNOWLEDGED EARLIER
AND ICS STAFF THAT WAS HERE
EARLIER AND WHAT YOU SEE ON
WEBSITE CODE MERGING TOOLS AND
BRIEFS AND THOSE MATERIALS COME
FROM ICF AND BRIAN'S TEAM.
REALLY THANK THEM. I FEEL WE
HAVE BEEN REMISED AT THIS
CONFERENCE TO ACKNOWLEDGE WESTAT
STAFF AND WANT TO DO THAT.
DAVID AND TERRY AND ANDREW AND
LLOYD HICKS AND OTHERS WHO YOU
KNOW ARE THE BREAD AND BUTTER OF
HINTS WHO HAVE BEEN WITH US
SINCE THE BEGINNING AND THEY ARE
ONES THAT ADMINISTER THE SURVEY
AND IS THEIR BRAINS THAT PUT THE
SURVEY OUT AND GET DATA TO US.
I CAN'T THANK THEM ENOUGH FOR 20
YEARS OF SERVICE TO HINTS.
I WANT TO ALSO THANK MY HINTS
MANAGEMENT TEAM AND RICK AND
HEATHER AND ROBIN AND DCCPS
LEADERSHIP AND CATRINA GODDARD
THAT CONTINUES TO SUPPORT HINTS
SURVEY AND [INDISCERNIBLE] WHO
SERVED ADS WONDERFUL CONFERENCE
CHAIR FOR THE CONFERENCE AND
MODERATORS BRAD AND MICHELE AND
SYLVIA AND OTHERS AND TO YOU OUR
HINTS DATA USERS. THANK YOU.
WE HOPE TO HAVE ANOTHER
CONFERENCE IN FIVE YEARS AND
DON'T HESITATE TO REACH OUT TO
ANY OF US WITH QUESTIONS.
WE HOPE NOT TO BE, YOU KNOW, A
WHITE IVORY TOWER BUREAUCRACY
THAT WE WANT TO BE REALLY
ACCESSIBLE TO ALL OF YOU FOR
YOUR QUESTIONS AND PLEASE REACH
OUT. THANK YOU, ALL!