Public attitudes about health information technology, and its relationship to health care quality, costs, and privacy.

OBJECTIVE: To understand Americans' attitudes concerning health information technology's (IT's) potential to improve health care and differences in those attitudes based on demographics and technological affinity. DATA SOURCES/STUDY SETTING: A random-digit-dial sample with known probability of selection for every household in the United States with a telephone, plus a supplemental sample of cell phone users. Telephone interviews were conducted from August 2009 through November 2009. STUDY DESIGN: Data were analyzed to present univariate estimates of Americans' opinions of health IT, as well as multivariate logistic regressions to assess hypotheses relating individuals' characteristics to their opinions. Characteristics used in our model include age, race, ethnicity, gender, income, and affinity to technology. FINDINGS: A large majority (78 percent) favor use of electronic medical records (EMRs); believe EMRs could improve care and reduce costs (78 percent and 59 percent, respectively); believe benefits of EMR use outweigh privacy risks (64 percent); and support health care information sharing among providers (72 percent). Regression analyses show more positive attitudes among those with higher incomes and greater comfort using electronic technologies. CONCLUSION: The findings suggest that Americans believe that health IT adoption is an effective means to improve the quality and safety of health care.

Using Nonmedically Trained Interviewers to Collect Biomeasures in a National In-Home Survey.

A key operational component of the National Social Life, Health, and Aging Project (NSHAP) is the use of nonmedically trained interviewers to collect biomeasures in a national in-home interview of health and aging. Few studies have integrated in-home biomeasure collection using nonmedically trained interviewers on a large scale. In this article, we discuss our approach to using nonmedically trained interviewers to collect biomeasures in the home. The article focuses on activities that impact the ability to integrate biomeasures into survey research, including developing field methods, recruiting and training interviewers, and monitoring data collection activities. In addition, cooperation rates and measures of interviewer productivity and data quality are provided to evaluate our approach.

Instrument development, study design implementation, and survey conduct for the national social life, health, and aging project.

The National Opinion Research Center, led by a team of investigators at the University of Chicago, conducted more than 3,000 in-person interviews with a nationally representative sample of adults aged 57-85 years. Data collection included in-person questionnaire items, an extensive array of biomeasures, and a postinterview self-administered questionnaire. The National Social Life, Health, and Aging Project (NSHAP) interview included the collection of 13 biomeasures: weight, waist circumference, height, blood pressure, smell, saliva collection, taste, a self-administered vaginal swab for female respondents, "Get Up and Go," distance vision, touch, oral mucosal transudate (Orasure) human immunodeficiency virus test, and blood spots. This article discusses the development of NSHAP's instruments and implementation of the study design. Measures, such as response and cooperation rates, are also provided to evaluate the effectiveness of the design and implementation.

Vaginal self-swab specimen collection in a home-based survey of older women: methods and applications.

OBJECTIVES: To describe the methods used for, cooperation with, assays conducted on, and applications of vaginal specimens collected by older women in their homes. METHODS: Community-residing women (N = 1,550), ages 57-85 years, participated in a nationally representative probability survey. Vaginal self-swab specimen collection and in-home interviews were conducted between 2005 and 2006. Specimens were analyzed for bacterial vaginosis (BV), vaginal candidiasis (VC), high-risk human papillomavirus (HR-HPV), and cytological characteristics. Field methods, consent procedures, the swab protocol, laboratory procedures, and results reporting are described. RESULTS: One thousand twenty-eight respondents (67.5% weighted) agreed to provide a vaginal specimen; 99.1% were successful. The specimen adequacy rates were BV and VC, 94.1%; HR-HPV, 99.7%; and cytology, 85.5%. The most common recorded reason for nonparticipation was a physical or health problem (38% of nonresponders). Responders were significantly more likely than nonresponders to be younger and more educated, and were more likely to report a recent pelvic examination, menopausal hormone use, and recent sexual activity. DISCUSSION: Collection of vaginal self-swab specimens from older women in a population-based study is feasible and provides novel data on microenvironmental characteristics of the female genital tract relevant to analyses of gynecologic health, sexual activity and problems, and immune and inflammatory function.