Thierry Gagné

How important are paper copies of questionnaires? Testing invitations modes when studying social inequalities in smoking among young adults

Using the internet to administer questionnaires for data collection has triggered interest in the past decade of survey research (Israel 2009). In Canada, the general population with access to the internet has grown from 60 % in 2005 to 80 % (Statistics Canada 2011), with young adults following the same trend (Lenhart et al. 2010). However, this trend is not evident across population subgroups as only 54 % of households in the lowest income quartile have access to the internet (Statistics Canada 2011). It is thought that web questionnaire administration can help in countering low response rates and growing research costs, but we were concerned that it should not create socio-economic selection bias problems. Researchers have questioned the influence of invitations that promote access to web versions of questionnaires only, hereby defined as ‘‘Web-only’’ invitations (Kwak and Radler 2002). Indeed, ‘‘Mixed-mode’’ invitations, hereby defined as invitations promoting additional modes of response (paper copy, phone or face-to-face interviews, etc.), have had relative success in increasing response rates (Shih and Fan 2007; Zuidgeest et al. 2011; Van den Berg et al. 2011). With the internet use trends changing rapidly, few recent studies have examined whether response rate and socio-economic status are associated with invitation methods in a population of young adults. In this paper, we report results from a study in which we tested whether adding a paper version of a questionnaire to a mailed invitation (a Mixed-mode invitation) will leads to a sample with different modes of response (i.e. telephone, mail or web), rates of response and socio-demographic characteristics when compared with a Web-only mailed invitation. This study was undertaken within the purview of a larger study entitled the Interdisciplinary Study of Inequalities in Smoking (ISIS), whose goal is to better understand the effects of neighbourhood and individual characteristics in the inequitable socio-economic distribution of smoking across Montreal neighbourhoods.

Rethinking the relationship between socioeconomic status and health: Challenging how socioeconomic status is currently used in health inequality research

Aims: The Scandinavian Journal of Public Health recently reiterated the importance of addressing social justice and health inequalities in its new editorial policy announcement. One of the related challenges highlighted in that issue was the limited use of sociological theories able to inform the complexity linking the resources and mechanisms captured by the concept of socioeconomic status. This debate article argues that part of the problem lies in the often unchallenged reliance on a generic conceptualization and operationalization of socioeconomic status. These practices hinder researchers’ capacity to examine in finer detail how resources and circumstances promote the unequal distribution of health through distinct yet intertwined pathways. As a potential way forward, this commentary explores how research practices can be challenged through concrete publication policies and guidelines. To this end, we propose a set of recommendations as a tool to strengthen the study of socioeconomic status and, ultimately, the quality of health inequality research. Conclusions: Authors, reviewers, and editors can become champions of change toward the implementation of sociological theory by holding higher standards regarding the conceptualization, operationalization, analysis, and interpretation of results in health inequality research.

Do social characteristics influence smoking uptake and cessation during young adulthood

ObjectivesThis study uses a Bourdieusian approach to assess young adults’ resources and examines their association with smoking initiation and cessation.MethodsData were drawn from 1450 young adults participating in the Interdisciplinary Study of Inequalities in Smoking, a cohort study in Montreal, Canada. We used logistic regression models to examine the association between young adults’ income, education, and peer smoking at baseline and smoking onset and cessation.ResultsYoung adults where most or all of their friends smoked had greater odds of smoking onset. Young adults that had completed pre-university postsecondary education also had higher odds of smoking onset after controlling for social support, employment status, and lacking money to pay for expenses. Income and the sociodemographic variables age and sex were not associated with smoking onset. Young adults where half of their friends smoked or where most to all of their friends smoked had lowers odds of smoking cessation. Men were more likely to cease smoking than women. Education, income and age were not associated with cessation.ConclusionsInterventions focusing on peer smoking may present promising avenues for tobacco prevention in young adults.

Inflow Angle of Small Paraophthalmic Aneurysms Is a Determinant of Adjacent Sphenoid Bone Remodeling

Objective Large internal carotid artery aneurysms can cause remodeling of the sphenoid bone with subsequent hemorrhage into the sinus. No reports have demonstrated small unruptured lesions causing similar bone remodeling. The purpose of this study was to demonstrate our experience with small unruptured paraophthalmic aneurysms causing sphenoid bone remodeling, specifically when the optimal aneurysm inflow angle is present. Methods We searched our database for computed tomography angiography studies of small paraophthalmic aneurysms and assessed adjacent sphenoid bone remodeling and inflow angle. Results We found that aneurysms causing sphenoid remodeling represent 19.51% of all small paraophthalmic aneurysms at our institution and that the average inflow angle for these aneurysms was 94.38 degrees, significantly greater than for those not causing remodeling. Conclusions Our findings add support to using computed tomography angiography in the follow-up of aneurysms to assess surrounding bone changes and to the development of a more evidence-based approach in the management of small paraophthalmic aneurysms, which currently may be managed conservatively.

Letter to the Editor - The implications of the professionalization of health promotion in Canada: a response to JR Graham’s letter to the editor

This letter is in response to the following Letter to the Editor: http://www.phac-aspc.gc.ca/publicat/hpcdp-pspmc/37-1/ar-04-eng.php.

Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income

A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001-2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (ORHT = .98, 95% CI (.97, .99); ORDM = .93, 95% CI (.92, .94)) and White women (ORHT = .95, 95% CI (.95, .96); ORDM = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (ORHT = .99, 95% CI (.92, 1.06); ORDM = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (ORHT = .86, 95% CI (.80, .92); ORDM = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.

Trashing bibliometry? In defence of a unique approach for disciplinary development

The present letter is in response to the IJPH Editorial published on September 16, 2015, ‘‘Trashing epidemiology and public health with bibliometry? In defence of science in Germany (and elsewhere)’’ (Künzli 2015). In this editorial, Dr. Künzli questioned the methodological validity of the bibliometric analysis of a recent report produced by the German Academy of Sciences regarding the state of German public health research. In essence, this report’s restrictive methodology excluded some of the highest ranking journals where public health research is often published. This restrictive inclusion criterion vastly underestimated the reality of German public health institutions’ research production. Although it is surprising that this report excluded such important journals, the report’s misrepresentation is also said to be in strong part due to the inherent multidisciplinary nature of public health (and in a lesser way, epidemiology) and to the large quantity of peer-review journals that this multidisciplinarity entails. While this editorial strongly defends German public health institutions, its concluding argument questions the need for bibliometry: ‘‘Bibliometric methods must comply with basic standards just like any other science. Else, instead of ridiculing the output of public health research and epidemiology, one may need to dump bibliometry’’. We believe that the editorial was too quick to discredit bibliometry, an analytic approach that we argue is quite useful in providing a complementary perspective to review public health research produced. The editor claimed ‘‘it is a challenge to properly define the borders and bibliometric space’’ of a discipline such as public health yet, we believe that bibliometry is uniquely placed to shed light on this question. Examples of such endeavours include projects that explored core topics and trends within disciplines such as medical sociology (Seale 2008) and epidemiology (Oakes 2005, Trinquart and Galea 2015) or within more specific concepts in the public health literature such as health inequalities (Bouchard et al. 2015). We argue that one of the central traits grounding the validity of these bibliometric projects, contrary to the Leopoldina report (Leopoldina 2015), is that they were either: (a) produced by public health experts who had tacit knowledge of what data sources and analyses were needed to answer their research questions; and (b) designed so that experts who recognized limits to their knowledge could find out the most relevant data to examine. Our own work (in submission) is a suitable example: we used a bibliometric analysis of journal references and abstracts to describe the breadth and heterogeneity of disciplines among health promotion research. Knowing the multidisciplinarity of health promotion and public health, our methodology was designed to ensure that no relevant health promotion journals were excluded. This methodology included (1) an international sample of health promotion scholars who were surveyed on the most relevant journals to their work (for publishing and consulting); and (2) the top 25 most frequently cited journals in one of the core journals in health promotion research, Health Promotion International. We were surprised to find that health promotion research included disciplines and journals that we had not considered. Thus, these results vastly changed our research questions and our interpretation of the current research space in health promotion. In essence, we wholeheartedly agree that bibliometry, like any research, is not to be taken lightly and requires tacit knowledge of the research field of interest. We agree T. Gagné (&) J. Lapalme Université de Montréal, Montreal, QC, Canada e-mail: thierry.gagne@umontreal.ca Int J Public Health (2015) 60:879–880 DOI 10.1007/s00038-015-0752-1