Paul Ritvo

Impact of participant incentives and direct and snowball sampling on survey response rate in an ethnically diverse community: results from a pilot study of physical activity and the built environment.

Community-wide efforts to encourage healthy behaviours must respond to the needs of existing neighbourhoods, especially those where low physical activity (PA) is associated with social, economic, and cultural challenges. This study reports on the effect of direct and snowball sampling strategies and financial incentive levels on the response rates of a built environment and PA survey in a predominately urban, low-SES new-immigrant community. Women residing in the Jane-Finch neighbourhood of Toronto, Ontario were selected to participate by quasi-random sampling, yielding a response rate of 41.5%. The survey completion rate per contact attempt increased 2-fold when incentives were increased from

The feasibility of assessing women's perceptions of the risks and benefits of fertility drug therapy in relation to ovarian cancer risk

10 to

Health risk behaviour change and adaptation in cardiac patients

20 and a further threefold following the increase from

Canadian national surveys on pandemic influenza preparations: pre-pandemic and peri-pandemic findings

20 to

Responsiveness of disease-specific and generic utility instruments in prostate cancer patients

30. Snowball sampled respondents were older, less likely to have full-time employment, and had lower educational attainment than directly sampled participants. With appropriate incentives, face-to-face contact, and snowball sampling, survey-based research is feasible within a low-SES, high minority population.

Cancer patients' preferences for communicating clinical trial quality of life information: A qualitative study

OBJECTIVE To determine the feasibility of asking women undergoing fertility treatment the maximum increased risk of ovarian cancer they would be willing to tolerate in order to take ovulation-induction drugs. DESIGN A prospective pilot study of women attending fertility clinics over a 2-month period. SETTING Two tertiary care fertility clinics in Toronto. PATIENT(S) Sixty-one English-speaking women were approached and 85% (n = 52) were enrolled. INTERVENTION(S) A self-administered questionnaire with fertility-specific questions. Thirty-eight women also were asked to complete standardized scales of anxiety and optimism. MAIN OUTCOME MEASURE(S) Womens report of the maximum level of lifetime risk of ovarian cancer they were willing to tolerate in order to undergo fertility treatment. RESULT(S) Seventy-nine percent were willing to accept an increased risk of ovarian cancer. Only 24% understood that treatment for ovarian cancer usually was not curative. CONCLUSION(S) A majority of patients were willing to tolerate a modest increase in their lifetime risk of ovarian cancer because of fertility treatment, most basing their estimate of acceptable risk on limited awareness of the issue.

A survey of attitudes towards paediatric vaccinations amongst Canadian naturopathic students

Integrating much from the health belief model, the precaution–adoption model, self-efficacy theory, expectancy theory, and the trans-theoretical model of behaviour change, a cognitive-behavioural model for assessment and intervention in cardiac patients is presented in which health risk appraisal is seen as the central construct. Specifically, we hypothesize that peoples beliefs regarding the seriousness of their health risk, the modifiability of their health risk, and their confidence in the risk-reduction methods and in their ability to employ these methods, will influence their adoption of and adherence to health risk-reduction behaviours as well as influencing their psychological adjustment. Furthermore, attentional processes such as ruminative states or avoidance are seen to play a pivotal role in facilitating or impeding cognitive appraisal processes and behaviour change. Dispositional expectancy styles (e.g. optimism versus pessimism) are seen to shape beliefs regarding the modifiability of health risk via their effects on appraisals of self-efficacy and appraisals of the effectiveness of risk-reduction methods. Finally, clinical scenarios are presented to illustrate the utility of the model in guiding assessment and intervention in patients with medical problems.

Parental views on pediatric vaccination : the impact of competing advocacy coalitions

BackgroundPrior to the 2009 H1N1 Influenza pandemic, public health authorities in Canada and elsewhere prepared for the future outbreak, partly guided by an ethical framework developed within the Canadian Program of Research on Ethics in a Pandemic (CanPREP). We developed a telephone-based survey based on that framework, which was delivered across Canada in late 2008. In June, 2009, the WHO declared pandemic Phase 6 status and from the subsequent October (2009) until May 2010, the CanPREP team fielded a second (revised) survey, collecting another 1,000 opinions from Canadians during a period of pre-pandemic anticipation and peri-pandemic experience.MethodsSurveys were administered by telephone with random sampling achieved via random digit dialing. Eligible participants were adults, 18 years or older, with per province stratification approximating provincial percentages of national population. Descriptive results were tabulated and logistic regression analyses used to assess whether demographic factors were significantly associated with outcomes, and to identify divergences (between the pre-pandemic and intra-pandemic surveys).ResultsN = 1,029 interviews were completed from 1,986 households, yielding a gross response rate of 52% (AAPOR Standard Definition 3). Over 90% of subjects indicated the most important goal of pandemic influenza preparations was saving lives, with 41% indicating that saving lives solely in Canada was the highest priority and 50% indicating saving lives globally was the highest priority. About 90% of respondents supported the obligation of health care workers to report to work and face influenza pandemic risks excepting those with serious health conditions which that increased risks. Strong majorities favoured stocking adequate protective antiviral dosages for all Canadians (92%) and, if effective, influenza vaccinations (95%). Over 70% agreed Canada should provide international assistance to poorer countries for pandemic preparation, even if resources for Canadians were reduced.ConclusionsResults suggest Canadians trust public health officials to make difficult decisions, providing emphasis is maintained on reciprocity and respect for individual rights. Canadians also support international obligations to help poorer countries and associated efforts to save lives outside the country, even if intra-national efforts are reduced.