Explore the vast range of titles available.

Paper questionnaires have traditionally been the first choice for data collection in research. However, declining response rates over the past decade have increased the risk of selection bias in cross-sectional studies. The growing use of the Internet offers new ways of collecting data, but trials using Web-based questionnaires have so far seen mixed results. A secure, online digital mailbox (e-Boks) linked to a civil registration number became mandatory for all Danish citizens in 2014 (exemption granted only in extraordinary cases). Approximately 89% of the Danish population have a digital mailbox, which is used for correspondence with public authorities. We aimed to compare response rates, completeness of data, and financial costs for different invitation methods: traditional surface mail and digital mail. We designed a cross-sectional comparative study. An invitation to participate in a survey on help-seeking behavior in out-of-hours care was sent to two groups of randomly selected citizens from age groups 30-39 and 50-59 years and parents to those aged 0-4 years using either traditional surface mail (paper group) or digital mail sent to a secure online mailbox (digital group). Costs per respondent were measured by adding up all costs for handling, dispatch, printing, and work salary and then dividing the total figure by the number of respondents. Data completeness was assessed by comparing the number of missing values between the two methods. Socioeconomic variables (age, gender, family income, education duration, immigrant status, and job status) were compared both between respondents and nonrespondents and within these groups to evaluate the degree of selection bias. A total 3600 citizens were invited in each group; 1303 (36.29%) responded to the digital invitation and 1653 (45.99%) to the paper invitation (difference 9.66%, 95% CI 7.40-11.92). The costs were €1.51 per respondent for the digital group and €15.67 for paper group respondents. Paper questionnaires generally had more missing values; this was significant in five of 17 variables (P<.05). Substantial differences were found in the socioeconomic variables between respondents and nonrespondents, whereas only minor differences were seen within the groups of respondents and nonrespondents. Although we found lower response rates for Web-based invitations, this solution was more cost-effective (by a factor of 10) and had slightly lower numbers of missing values than questionnaires sent with paper invitations. Analyses of socioeconomic variables showed almost no difference between nonrespondents in both groups, which could imply that the lower response rate in the digital group does not necessarily increase the level of selection bias. Invitations to questionnaire studies via digital mail may be an excellent option for collecting research data in the future. This study may serve as the foundational pillar of digital data collection in health care research in Scandinavia and other countries considering implementing similar systems.

Sufficient sample size and minimal sample bias are core requirements for empirical data analyses. Combining opportunistic recruitment with a Web-based survey and data-collection platform yields new benefits over traditional recruitment approaches. This paper aims to report the success of different recruitment methods and obtain data on participants' characteristics, participation behavior, recruitment rates, and representativeness of the sample. A longitudinal, Web-based survey was implemented as part of the European PASTA (Physical Activity through Sustainable Transport Approaches) project, between November 2014 and December 2016. During this period, participants were recruited from 7 European cities on a rolling basis. A standardized guide on recruitment strategy was developed for all cities, to reach a sufficient number of adult participants. To make use of the strengths and minimize weakness, a combination of different opportunistic recruitment methods was applied. In addition, the random sampling approach was applied in the city of Örebro. To reduce the attrition rate and improve real-time monitoring, the Web-based platform featured a participant's and a researchers' user interface and dashboard. Overall, 10,691 participants were recruited; most people found out about the survey through their workplace or employer (2300/10691, 21.51%), outreach promotion (2219/10691, 20.76%), and social media (1859/10691, 17.39%). The average number of questionnaires filled in per participant varied significantly between the cities (P<.001), with the highest number in Zurich (11.0, SE 0.33) and the lowest in Örebro (4.8, SE 0.17). Collaboration with local organizations, the use of Facebook and mailing lists, and direct street recruitment were the most effective approaches in reaching a high share of participants (P<.001). Considering the invested working hours, Facebook was one of the most time-efficient methods. Compared with the cities' census data, the composition of study participants was broadly representative in terms of gender distribution; however, the study included younger and better-educated participants. We observed that offering a mixed recruitment approach was highly effective in achieving a high participation rate. The highest attrition rate and the lowest average number of questionnaires filled in per participant were observed in Örebro, which also recruited participants through random sampling. These findings suggest that people who are more interested in the topic are more willing to participate and stay in a survey than those who are selected randomly and may not have a strong connection to the research topic. Although direct face-to-face contacts were very effective with respect to the number of recruited participants, recruiting people through social media was not only effective but also very time efficient. The collected data are based on one of the largest recruited longitudinal samples with a common recruitment strategy in different European cities.

Web-based questionnaire (WBQ) surveys are popular, but the quality of reporting WBQ survey research is uneven and unsatisfactory worldwide. Education and training on WBQ methodology may be necessary. However, the current knowledge, attitudes, and practices (KAP) of its methodology remain unknown. We investigated the KAP of WBQ methodology among Chinese health workers for the first time to clarify the possible reasons for the unsatisfactory reporting quality of WBQ survey research from China's experience, aiming to provide a basis for improvement. We developed a structured WBQ based on the current recommendations and knowledge and investigated 458 health workers from June 7 to July 6, 2022. A total of 381 valid questionnaires were analyzed after data processing. We defined 50% and 75% as \"qualified\" and \"satisfactory\" in knowledge and practice topics to describe the results and analyzed the basic characteristics of the participants who had difficulties in conducting WBQ survey research. A total of 215 (56.4%) participants had used WBQs for investigation, mostly more than 2 times (88.3%), but only 95 (44.2%) of them had ever received methodological training. A total of 134 (62.3%) users believed that WBQs were practical, but 126 (58.6%) had doubts about the reliability of the results. Most of the knowledge and practice topics did not reach a satisfactory level, and some even did not reach a qualified level. A total of 95 (44.2%)-136 (63.3%) of the users had reported difficulties in conducting WBQ survey research, and different participants could have different difficulties according to their characteristics. In addition, 191 (88.8%) users believed training was necessary. We found that Chinese health workers seriously underestimated and neglected the importance of the WBQ methodology, which may be an important reason for the reduced reporting quality of WBQ survey research. Medical educators need to strengthen methodological training on WBQs, which may help to improve the quality of WBQ survey research.

The widespread availability of internet-based pornography has led to growing concerns about its impact on mental health, particularly among young adults. Despite increasing recognition of problematic pornography use, standardized diagnostic criteria for pornography addiction are lacking. This study aimed to address this gap by applying adapted DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) criteria to evaluate \"pornography-watching disorder\" (PWD) in a large sample of young adults in Hungary. The primary objective was to assess the prevalence of PWD among young adults and identify key risk factors associated with its development using DSM-5 criteria adapted for pornography use. It also aimed to advance the understanding of PWD as a potential behavioral addiction. A cross-sectional web-based survey was conducted between September and December 2018, targeting young adults aged 18-35 years in Hungary. Participants were recruited through social media and the University of Szeged Albert Szent-Györgyi Medical School's web page. Of the 9397 respondents, 7187 (76.5%) had previously consumed pornography and were included in the analysis. PWD was measured using 10 statements adapted from the DSM-5 substance use disorder criteria. Multivariable binary logistic regression was used to identify significant predictors of PWD. The prevalence of PWD in the sample was 4.4% (n=315). Frequent pornography consumption was a significant risk factor, with weekly users (odds ratio [OR] 0.45, 95% CI 0.33-0.62, P<.001), monthly users (OR 0.18, 95% CI 0.11-0.28, P<.001), and less than monthly users (OR 0.05, 95% CI 0.03-0.10, P<.001) showing significantly lower odds compared with daily users as a reference category. Male sex was associated with a higher risk (OR 0.53, 95% CI 0.39-0.72, P<.001), as were early exposure to pornography (OR 0.94, 95% CI 0.90-0.98, P=.006), paraphilia (OR 3.95, 95% CI 2.37-6.56, P<.001), dissatisfaction with sexual life (OR 0.94, 95% CI 0.90-0.98, P=.006), difficulty forming personal relationships (OR 0.93, 95% CI 0.88-0.98, P=.005), and strong adherence to religious norms (OR 1.12, 95% CI 1.06-1.19, P<.001). Protective factors included adequate sexual education (OR 0.67, 95% CI 0.53-0.87, P=.02) and residing in the capital (OR 0.52, 95% CI 0.30-0.91, P=.02). The use of an anonymous web-based questionnaire likely reduced the influence of stigma, resulting in more accurate self-reporting of sensitive behaviors. This study is among the first to apply DSM-5 criteria to evaluate PWD, providing important insights into its prevalence and associated risk factors in young adults. The findings highlight the need for standardized diagnostic tools for PWD and suggest targeted interventions, particularly for high-risk groups. These results contribute to the ongoing discussion about whether pornography addiction should be recognized as a distinct behavioral disorder.

Atopic dermatitis (AD) is a chronic inflammatory cutaneous disease that affects 30.48% of young children; thus, there is a need for epidemiological studies in community settings. Web-based questionnaires (WBQs) are more convenient, time-saving, and efficient than traditional surveys, but the reliability of identifying AD through WBQs and whether AD can be identified without the attendance of doctors, especially in community or similar settings, remains unknown. This study aimed to develop and validate a web-based instrument for infantile AD identification (electronic version of the modified Child Eczema Questionnaire [eCEQ]) and to clarify the possibility of conducting WBQs to identify infantile AD without the attendance of doctors in a community-representative population. This study was divided into 2 phases. Phase 1 investigated 205 children younger than 2 years to develop and validate the eCEQ by comparison with the diagnoses of dermatologists. Phase 2 recruited 1375 children younger than 2 years to implement the eCEQ and verify the obtained prevalence by comparison with the previously published prevalence. In phase 1, a total of 195 questionnaires were analyzed from children with a median age of 8.8 (IQR 4.5-15.0) months. The identification values of the eCEQ according to the appropriate rules were acceptable (logic rule: sensitivity 89.2%, specificity 91.5%, positive predictive value 97.1%, and negative predictive value 72.9%; statistic rule: sensitivity 90.5%, specificity 89.4%, positive predictive value 96.4%, and negative predictive value 75%). In phase 2, a total of 837 questionnaires were analyzed from children with a median age of 8.4 (IQR 5.2-14.6) months. The prevalence of infantile AD obtained by the eCEQ (logic rule) was 31.9% (267/837), which was close to the published prevalence (30.48%). Based on the results of phase 2, only 20.2% (54/267) of the participants identified by the eCEQ had previously received a diagnosis from doctors. Additionally, among the participants who were not diagnosed by doctors but were identified by the eCEQ, only 6.1% (13/213) were actually aware of the possible presence of AD. Infantile AD can be identified without the attendance of doctors by using the eCEQ, which can be easily applied to community-based epidemiological studies and provide acceptable identification reliability. In addition, the eCEQ can also be applied to the field of public health to improve the health awareness of the general population.

Study aim was to determine the levels and barriers of the Nutrition Care Process (NCP), a practical method of individualized nutrition support. Delegate of registered dietitians (RDs) from acute-care hospitals answered our nationwide web-based questionnaire (April-June, 2023) to determine the implementation status of screening, assessment, intervention (including planning), and monitoring (components of the NCP). Of 5,378 institutions contacted, 905 (16.8%) responded. For Screening, 80.0% screened all inpatients: primary personnel in charge were RDs (57.6%); the most used screening tool was Subjective Global Assessment (SGA) (49.2%). For Assessment, 66.1% assessed all inpatients: food intake (93.3%) was most evaluated whereas muscle mass and strength (13.0%, 8.8%) were least evaluated. For Intervention, 43.9% did so within 48h of hospital admission: oral nutritional supplement (92.9%) was the most common RDs intervention and parenteral nutrition (29.9%) was used less. For Monitoring, 18.5% of institutions had monitoring frequency of ≥ 3 times/week whilst 23.0% had monitoring less than once a week for severely malnourished patients. Energy and protein intake (93.7%, 84.3%) were most monitored and lipid intake (30.1%) was less monitored. Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening, inaccurate patient targeting and lack of important evaluation items in Assessment, delayed timing and incomplete contents in Intervention, and inadequate fre-quency and lack of important evaluation items in Monitoring. An increase in RDs staffing in acute-care general wards, widespread NCP instruction manuals, and education about the tools and evaluation items utilized in nutritional management are possible solutions.

Sample size in surveys with open-ended questions relies on the principle of data saturation. Determining the point of data saturation is complex because researchers have information on only what they have found. The decision to stop data collection is solely dictated by the judgment and experience of researchers. In this article, we present how mathematical modeling may be used to describe and extrapolate the accumulation of themes during a study to help researchers determine the point of data saturation. The model considers a latent distribution of the probability of elicitation of all themes and infers the accumulation of themes as arising from a mixture of zero-truncated binomial distributions. We illustrate how the model could be used with data from a survey with open-ended questions on the burden of treatment involving 1,053 participants from 34 different countries and with various conditions. The performance of the model in predicting the number of themes to be found with the inclusion of new participants was investigated by Monte Carlo simulations. Then, we tested how the slope of the expected theme accumulation curve could be used as a stopping criterion for data collection in surveys with open-ended questions. By doubling the sample size after the inclusion of initial samples of 25 to 200 participants, the model reliably predicted the number of themes to be found. Mean estimation error ranged from 3% to 1% with simulated data and was <2% with data from the study of the burden of treatment. Sequentially calculating the slope of the expected theme accumulation curve for every five new participants included was a feasible approach to balance the benefits of including these new participants in the study. In our simulations, a stopping criterion based on a value of 0.05 for this slope allowed for identifying 97.5% of the themes while limiting the inclusion of participants eliciting nothing new in the study. Mathematical models adapted from ecological research can accurately predict the point of data saturation in surveys with open-ended questions.

Background/Objectives: To assess the validity and the reproducibility of a newly developed web-based, self-administered food frequency questionnaire (web-FFQ). Subjects/Methods: A total of 74 healthy subjects (34 men and 40 women) from the Québec City metropolitan area were asked to complete, in random order, the web-FFQ, a validated interviewer-administered FFQ (IA-FFQ) and a 3-day food record (3-day FR). Results: Mean intakes of 17/22 nutrients assessed between the web-FFQ and the 3-day FR were not significantly different (differences <10%, P ⩾0.11). Sex and energy-adjusted de-attenuated Pearson correlation coefficients for each nutrient varied from 0.12–0.98 (mean R =0.55, 95% confidence interval 0.46; 0.63) between the web-FFQ and the 3-day FR. All correlations were significant ( P ⩽0.01) and above 0.34 (mean R =0.59, 95% confidence interval 0.54; 0.65) between the web-FFQ and the IA-FFQ, except for sodium ( R =0.17, P =0.14). Cross-classification analysis revealed that on average, 77% of subjects were classified in the same or adjacent quartile of nutrient intake between the web-FFQ and the 3-day FR. Correlation coefficients for reproducibility of the web-FFQ tested 4–6 weeks apart in the same individuals were all equal or above 0.48 ( P ⩽0.0001; mean R =0.72, 95% confidence interval 0.68; 0.76). More than 90% of the subjects were classified in the same or adjacent quartile between the two administrations of the web-FFQ, while only 0.8% was misclassified. Conclusions: These data demonstrate that the newly developed web-based FFQ appears to have reasonable validity and good reproducibility for assessing nutrient intakes at the group and individual levels in a population of healthy adults.

To develop and validate a web-based self-diagnostic questionnaire on school food service offer aimed at food service managers (FSM) by: (i) identifying relevant indicators of school food offer, developing a questionnaire and validating the concept using an expert panel; (ii) validating the questions by comparing the FSM's responses with observations by dietitians and (iii) undergoing a qualitative evaluation of the tool through direct observation and short interviews. Mixed methods. Quebec, Canada. Nine experts validated the theoretical constructs and indicators on which the questionnaire was based. Inter-rater reliability tests were conducted with thirty-nine FSM, who then participated in interviews about platform functionality satisfaction. Twenty school stakeholders participated in the survey pertaining to their use of the personalised report. The questionnaire focused on the main school food service's lunchtime offer and comprised twenty-six questions. The overall strength of agreement was good, and all questions' strengths of agreement were fair to excellent except for one question. Qualitative data reached saturation and showed that navigation through the questionnaire was fluid. Improvements were suggested to increase user-friendliness and simplicity of both the platform and questionnaire. Results from the survey showed that all respondents were either satisfied or very satisfied with their personalised report. We successfully developed and validated a web-based self-diagnostic questionnaire. The final version facilitates knowledge mobilisation with school stakeholders and offers a new opportunity for the assessment and surveillance of school food offer.

Online data collection could advantageously replace paper-and-pencil questionnaires in epidemiological studies by reducing the logistic burden, the cost and the duration of data processing. However, there is a need for studies comparing these new instruments to traditional ones. Our objective was to compare the web-based version of the NutriNet-Santé self-administered anthropometric questionnaire to the paper-based version. The questionnaire included 17 questions divided into subquestions (55 variables in all) dealing with height, weight, hip and waist circumferences, weight history, restrictive diet and weight self-perception. Both versions of the questionnaire were filled out by 147 volunteers (paper version first,  = 76, or web-based version first,  = 71) participating in the SU.VI.MAX (“Supplémentation en VItamines Minéraux et AntioXydants”) cohort (age-range: 49–75 years; men: 46.3%). At the end of the test, subjects filled in a “satisfaction” questionnaire giving their opinions and feelings about each version. Agreement was assessed by intraclass correlation coefficients (ICCs) and kappas. We also quantified the number of errors inherent in the paper version. Agreement between the two versions was high. ICCs ranged from 0.86 to 1.00. Kappas ranged from 0.69 to 1.00 for comparable variables. A total of 82 data entry mistakes (1.5% of total entries), 60 missing values (1.1%), 57 inconsistent values (1.1%) and 3 abnormal values (0.1%) were counted in the paper version (non-existent in the web-based version due to integrated controls). The web-based version was preferred by 92.2% of users. In conclusion, the quality of information provided by the web-based anthropometric questionnaire used in the NutriNet-Santé Study was equal to, or better than, that of the paper version, with substantial logistic and cost advantages.