Preventive Oncology & Epidemiology (Dec 2024)
The Together for Health – Virginia Research Program: A multi-modal approach for population health assessment
Abstract
Background:The Together for Health-Virginia (T4H-VA) Research Program aimed to advance cancer prevention, education, and outreach in Virginia. Creating a representative and inclusive cohort is critical to the program’s mission and quality of outcomes. The T4H-VA Research Program utilized a multi-modal sampling approach to improve population health assessment. The current study describes the technology-based, non-probability platform developed for this purpose and compares differences between the probability-based (mail-based) and non-probability-based (e-cohort) methods with respect to participant demographics, health characteristics, and health information and technology use.Methods:T4H-VA is a research registry focusing on 54 counties within the Massey Comprehensive Cancer Center (MCCC) catchment area in Richmond, VA. Adult residents proficient in English were eligible. For the probability-based sampling, surveys were mailed to residents within the catchment area. For the non-probability sampling, an online study platform was developed and surveys were completed through the web/mobile app.Result:Both cohorts fell short of recruitment goals. The study yielded 1158 participants (M = 57, SD = 16 years; 55.0% female; 72.1% White); 899 (77.6%) were sampled through the probability, mail-based approach. Participants who identified as ‘other' race were significantly less likely to be sampled by the non-probability method. Significant differences emerged, including health protective (greater moderate and high physical activity) and risk factors (greater alcohol consumption and personal history of cancer) in the non-probability, e-cohort relative to the probability sample. E-Cohort participants were significantly more likely to report using electronic health records.Discussion:Overall difficulties in recruiting were caused, at least in part, by the onset of the COVID-19 pandemic and related factors. The e-cohort, which used exclusively digital recruitment strategies, fell significantly short of recruitment goals. This suggests in-person and mail-based strategies remain important for recruitment. Moreover, instead of favoring a singular approach, a combined approach to survey sampling may capitalize on the strengths of each sampling mode to increase diversity in sociodemographic and health risk characteristics.Abbreviations:ABS: address-based sample; BRFSS: Behavioral Risk Factor Surveillance System; BMI: body mass index; CI: confidence interval; COVID-19: coronavirus disease 2019; e-cohort: electronic cohort; EHR: electronic health record; eConsent: electronic consent; HINTS: Health Information National Trends Survey; HIT: health information technology; HOP: Healthy Oregon Project; MCC: Massey Cancer Center; NCI: National Cancer Institute; NIH: National Institute of Health; OR: odds ratio; REDCap: Research electronic data capture; T4H-VA: Together for Health-Virginia; VCU: Virginia Commonwealth University.
Keywords
