Research Designs

Is it true that hypertension and diabetes are widely distributed in community X?

Is it true that hypertension and diabetes are increasing in community X? Are obesity, positive family history and sedentary life positively associated with hypertension and diabetes? I think that antibiotics are not effective in acute tonsillitis. I dont believe that smoking is a CVD risk factor.

Related research: The three communities-based survey Blood pressure profile of school children and adolescents, Jordan Hypertension and associated factors among a recently urbanized community Hypertension and associated factors among a Bedouin community in North Jordan

1. Survey Designs
1.1 Purpose (objective) of Survey Research 1.1.1 Description
Making descriptive assertions about some population;
e.g. data from previous studies provide information on the distribution of certain attributes among the target population; age, sex, and level of education

Discovering the distribution of certain traits or attributes.

The researcher is not concerned with why the observed distribution exists, but merely what that distribution is. researcher often describes sub samples and compare them.

e.g. distribution of patients with DM, HBP, controlled and uncontrolled hypertension among age and sex groups.

1.1.2 Explanation
In studying hypertension, for example, the researcher may wish to explain why some people develop hypertension while others do not. An explanatory objective almost always requires multivariate analysis

1.2 Unit of Analysis (UA)

Typically, the UA for a survey is a person, but it could be families, hospitals, or health centers. Data are collected to describe the individual units of analysis; Those descriptions are aggregated and manipulated in order to describe the population represented by the units of analysis. There could be more than one UA in a survey. UA has to be identified in advance.

1.3 Basic Survey Designs

Once the objectives of survey and its unit of analysis are identified, the researcher has several different survey designs to choose from. A. B. Cross sectional surveys Longitudinal surveys.

A.

Cross-sectional Surveys
Data are collected at one point in time from a sample selected to describe some larger population at that time. Such a survey can be used for description and for explanation.

B. Longitudinal Surveys
Data are collected at different points in time, on a sample selected to describe some larger population. Permit the analysis of data over time. The researcher is able to report changes in descriptions and explanations

Types of longitudinal designs: a. Trend studies b. Cohort studies. c. Panel studies

a.

Trend studies A given general population may be sampled and studied at different points in time. e.g. Jordan Population & Family Health Survey (JPFHS) on Evermarried women of reproductive age taken every 5 years. Trend studies often involve data collection over a long period of time. Each time of data collection the sample and the general population are not the same .

B.

Cohort studies. A Cohort study focuses on the same specific population each time data are collected, although the samples studied may be different. e.g. a sample taken from 2010 JUST Medical Graduates (cohort) and 5 years later another sample is drawn from the 2010 JUST medical graduates. If 5 years later a sample was drawn from the 2015 JUST medical graduates we would have a trend study of graduating classes and not a cohort study of the 2010 graduates.

A variant of cohort is a cohort study of a given age group (twenties-thirties.)

C.

Panel studies

Panel studies involve the collection of data over time from the same sample of respondents. This sample is called panel e.g. Silent gallstone study

The logic of survey sampling

Survey= Sample Survey vs. All members of population survey (census). Why Survey? 1. Clearly less expensive. 2. Requires less time to complete the study. 3. Sample surveys are often more accurate than census. Why?

a.

Census requires a very large staff of interviewers thus jeopardize the quality of data.
Interviewing all members of large population require a lengthy interviewing period. Thus it would be difficult to specify the time to which the data refer. The managerial requirement of a very large survey would be far greater than normally faced survey researchers.

b.

c.

Types of survey methods 1. 2. Probability sampling Non-probability sampling.

Probability sampling is the most respected and useful method. Why ? Population of individuals vs. population of platelets heterogeneity vs. homogeneity

 A sample of individuals from the population, must contain the same variation as exists in the population.
A basic principle of probability sampling is the following: A

sample will be representative of the population from which it is selected, if all members of the population have an equal chance of being selected in the sample.

Although perfect representation is difficult to achieve yet probability sampling offers two special advantages:

i.

It is typically more representative than any other types of samples.

probability theory permits researcher to estimate the accuracy or representativeness of his sample

ii.

Sampling Concepts and Terminology

1.

Element An element is that unit about which information is collected and which provides the basis of analysis= unit of analysis. Sampling Unit A sampling unit is that element or set of elements considered for selection in some stage of sampling. In Single stage sample, sampling units are the same as the elements. primary sampling units", "secondary sampling units", and "final sampling units" would be used to designate the successive stages. E.g sample of census blocks-sample of households from all households of selected blocks sample of members from all members of selected households (elements)

2.

3.

Sampling frame It is the actual list of sampling units from which the sample, or some stage of the sample, is selected . Sampling frame define the survey populationE.g. (telephone directory, electricity bills, municipality's list of voters).
Observation Unit An observation unit, or the unit of data collection, is an element or aggregation of elements from which information is collected. e.g. heads of households (the observation units) to collect information about every member of the household (the units of analysis).

4.

6.

Variable A variable is a set of mutually exclusive characteristics such as sex, age, employment status N.B.: a variable, by definition, must possess a variation, otherwise it is constant. Parameter It is the summary description of a given variable in the population. e.g. mean income, age distribution

7.

8.

Statistic It is the summary description of a given variable in a survey sample. Sample statistics are used to make estimates of population parameters.

9.

Standard Error It is a measure of spread and indicates the extent to which the sample estimates will be distributed around the population parameter.
Probability sampling methods seldom, if ever, provide statistics exactly equal to the parameters that they are used to estimate. Probability theory, however, permits us to estimate the degree of error to be expected for a given sample design.

Probability sampling theory

The ultimate purpose of survey sampling is to select a set of elements from a population in such a way that descriptions of those elements (statistics) accurately describe the total population from which they are selected. Probability sampling provides a method for - enhancing the likelihood of accomplishing this aim, and - estimating the degree of probable success.

Random selection (equal chance) is the key for this process. Computer programs/random tables are used to select a random sample.

Types of sampling designs

1. Simple Random Sampling (SRS) Start by establishing the sampling frame Assign A number to each element Use Tables of random numbers to generate the sample

2.

Systematic sampling

Start by establishing the sampling frame

Assign A number to each element, then

Every Kth element in the total list is chosen (systematically) for inclusion in the sample. e.g. to draw a sample of 1,000 from a list of 10,000 then every 10th element will be selected. Systematic sampling is superior to SRS in convenience if nothing else. Caution should be paid to the arrangement of the list.

3.

Stratified Sampling Starts by organizing the population into homogeneous subsets and to select the appropriate number of elements from each. The researcher insures that appropriate number of elements is drawn from homogeneous subsets. e.g. university students, may first be organized by college and appropriate number of first year, second year, third yearare drawn. Has the advantage of reducing the standard error

4.

Multistage cluster sampling Starts by sampling of groups of elements-clusters; listing of elements within each of the selected clusters. Sample each list and then add them to form the study sample. May be used when can not generate an exhaustive list of the target population. involves the repetition of two basic steps: listing and sampling. e.g. sampling school teachers.

Design the survey Instrument

The types of data to be gathered during the survey could be: 1. Information: age, education, whether the person has history of diabetes and so on. This kind of data is usually gathered through an instrument called "questionnaire". 2. Physical measures such as blood tests, blood pressure measure, and measures of weight and height.

Data collection:
The data will then be collected using the above instruments (questionnaire, weighing scale, measuring tape, blood pressure machine.

Data processing. Once collected, the data is then entered in the computer to make a spread sheet file that contains all the data collected. The data in the file are entered according to what is called "the coding manual". e.g. For instance males are given number "1" and females are given number"2.

Data analysis. Using the statistical packages available to you, you can Generate frequencies study variables, Perform t-tests, Chi squares, and any other statistical analysis needed by the researcher.

Report findings.
The results that you generate out of the analysis will then be transformed into a report to be used by interested groups; scholars in the field, scientists, decision-makers, health planners, etc.