Survey response inducements for registered nurses.

The past 20 years have seen an overall decline in survey response rates and an even more pronounced decline in samples of health care professionals. The authors tested the use of a "thank you" or "reminder" postcard as a method by which to stem the tide of declining response rates. The authors conducted a mail and telephone survey of 49,605 registered nurses for the 2000 National Sample Survey of Registered Nurses and sent an extra mailing to a random subsample (n = 4,968). They then compared response rates for both groups. Contrary to prior research, this study found that reminder postcards did not improve response rates or rates of return. There may be several reasons for this finding, including the general familiarity with, and high saliency of, this research project for the nursing community. These results suggest that even widely accepted best practices for survey methods deserve scrutiny when applied to special subpopulations.

Regional differences in alcohol use among U. S. military personnel.

OBJECTIVE: The purpose of this study was to examine differences in heavy alcohol use and alcohol-related negative effects among U.S. military personnel stationed in different world regions and to examine factors that may account for regional differences. METHOD: Data were drawn from the 1998 Department of Defense Survey of Health Related Behaviors among Military Personnel, which had a large representative sample of active-duty U.S. forces. Heavy alcohol use and related negative effects (severe consequences, productivity loss and alcohol overuse) were examined in four regions (Asia, Europe, Hawaii and continental United States; N = 17,154; 86% men) using multivariate logistic regression models that controlled for demographic factors. RESULTS: U.S. military personnel stationed in Asia were significantly more likely to be heavy alcohol users than personnel stationed in the other regions. Productivity loss was also significantly greater in Asia, whereas severe consequences and alcohol overuse were not. Possible explanations for the findings include local regional culture, availability of alcohol, freedom from restraints, response to stress, military culture and selection effects. CONCLUSIONS: Heavy alcohol use of military personnel varies by region of assignment and may be attributable to a variety of factors. Future studies need to examine regional alcohol use in greater detail and to include measures specific to potential explanatory domains to permit a more complete understanding of underlying causal mechanisms of heavy drinking by U.S. forces in Asia. Current findings suggest that alcohol use prevention and early intervention programs should be tailored to take account of regional differences.

Smoking and functional status among Medicare managed care enrollees.

BACKGROUND: Smoking is a major determinant of health status and outcomes. Current smoking has been associated with lower scores on the Short Form-36 Health Survey (SF-36). Whether this occurs among the elderly and disabled Medicare populations is not known. This study assessed the relationships between smoking status and both physical and mental functioning in the Medicare managed-care population. METHODS: During the spring of 1998, data were collected from 134309 elderly and 8640 disabled Medicare beneficiaries for Cohort 1, Round 1 of the Medicare Health Outcomes Survey. We subsequently used these data to calculate mean standardized SF-36 scores, self-reported health status, and prevalence of smoking-related illness, by smoking status, after adjusting for demographic factors. RESULTS: Among the disabled, everyday and someday smokers had lower standardized physical component (PCS) and mental component (MCS) scores than never smokers (-2.4 to -4.5 points; p <0.01 for all). Among the elderly, the lowest PCS and MCS scores were seen among recent quitters (-5.1 and -3.7 points, respectively, below those for never smokers; p <0.01 for both), but current smokers also had significantly lower scores on both scales. For the elderly and disabled populations, MCS scores of long-term quitters were the same as nonsmokers. Similar patterns were seen across all eight SF-36 scales. Ever smokers had higher odds of reporting both less-than-good health and a history of smoking-related chronic disease. CONCLUSIONS: In the elderly and disabled Medicare populations, smokers report worse physical and mental functional status than never smokers. Long-term quitters have better functional status than those who still smoke. More effort should be directed at helping elderly smokers to quit earlier. Smoking cessation has implications for improving both survival and functional status.