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Aim: This study describes the study design, study participants, participation rate and underreporting in the Danish National Surveys of Diet and Physical Activity (DANSDA) from 1995 to 2011–2013. Methods: DANSDA are government-funded surveys of food and nutrient intake, physical activity and lifestyle, undertaken to support nutritional policy, risk assessment and public health research. The surveys are cross-sectional based on primarily simple random samples (ages 1–80 years in 1995, 4–75 years in 2000–2013) drawn from the Danish Civil Registration System. Approximately 4800 individuals in 1995, 8200 in 2000–2002, 8400 in 2003–2008 and 7300 in 2011–2013 were invited to participate. Participants completed a seven-day food diary, a physical activity questionnaire (2000–2008), a step diary (2011–2013) and a face-to-face interview. Self-reported anthropometrics (1995–2013) were supplemented with device-based measures (2011–2013). Pedometers were included in 2011–2013. Results: The number of participants included per survey round was 3100-4400. Participant rates decreased from 66% (1995) to 54% (2011–2013). Non-participation was primarily refusal. Ages 18–30 years, 61–75 years (2000–2013), 61–80 years (1995) and low educated and individuals living alone were underrepresented. Underreporting of energy intake among adults ranged from 14% (1995) to 26% (2008). Conclusions: The methods in DANSDA have been developed to include device-based measures on physical activity and anthropometrics. This has improved the applicability of the results of the survey. The participation rate has fallen, which has affected sample representativity, and underreporting has increased. Future DANSDA surveys should explore and consider new initiatives to counteract non-response and underreporting, with the aim of enhancing data representativeness and applicability. [ABSTRACT FROM AUTHOR] more...

Aims: This study aimed to describe the study design and respondent characteristics (including non-response analyses) of the Danish Health and Wellbeing Surveys in 2015 and 2019 and a follow-up survey that was carried out during the COVID-19 pandemic in 2020. Methods: The Danish Health and Wellbeing Survey is the Danish part of the European Health Interview Survey (EHIS). The samples in 2015 (N =12,000) and 2019 (N =14,000) were both based on a simple random selection of individuals aged ⩾15 years from the Danish Civil Registration System. All individuals from the sample in 2019 who were still alive and living in Denmark were reinvited for a follow-up survey in 2020 (N =13,474). Data in all surveys were collected via self-administered questionnaires (web or paper based). The questionnaires in 2015 and 2019 included the EHIS model questionnaire as well as national questions, whereas the questionnaire in 2020 mainly focused on physical and mental health, employment and working lives, and health behaviour. Results: The overall response proportion declined slightly between 2015 (48.4%) and 2019 (47.4%) but went up to 49.8% in the follow-up survey in 2020. Unit non-response was associated with, for example, male sex, younger age, being unmarried and lower educational level but not with degree of urbanisation. In all, 5000 individuals completed the questionnaire in both 2019 and 2020. Conclusions: The results are in line with most previous research on non-response in health surveys. However, an association between degree of urbanisation and non-response has been suggested in previous studies. This association was not found in our study. [ABSTRACT FROM AUTHOR] more...

The article presents a report on the birth cohort survey done on people and discusses the impact of its design and methodology. It states that hundred years old adults born in the period of 1911 and 1912 were measured separately on their functional ability, physical performance and participation. The survey used same assessment instruments in the process of data collection with the help of trained survey professionals with result conclusion including daily leaving, mental state and strength. more...

Objective: To investigate if the lower mortality among participants of a health check followed by lifestyle intervention of high risk persons is explained by self-selection.Methods: All persons residing in the study area (Copenhagen; Denmark) were randomized to intervention (n=11,629) or control group (n=47,987). Persons in the intervention group were invited for a health check and individual lifestyle counselling. At baseline, 52.5% participated. Differences between participants and control group in 10-year all-cause and disease specific mortality was assessed. In survival analyses we controlled for socio-demography and mental and physical health.Results: Mortality rates were highest among non-participants and lowest among participants in the intervention group, whereas mortality rates of controls were approximately the average of those of participants and non-participants. In adjusted analyses the difference in both all-cause mortality (HR 0.73, 95% CI 0.62-0.85) and disease specific mortality was diminished between participants and controls, and turning insignificant as regard cancer mortality. In total, 39% of the lower mortality among participants in the intervention group was explained by self-selection according to socio-demography and health.Conclusion: A substantial part of the lower mortality among participants in a preventive health check can be explained by confounding. The remaining lower mortality is most probably due to residual confounding, as the lower mortality was seen both for lifestyle related and non-lifestyle related diseases. [ABSTRACT FROM AUTHOR] more...

Background: Preventive primary care programs that aim to reduce morbidity and mortality from lifestyle-related diseases are often affected by low-to-moderate participation rates. Improving participation rates is essential for clinical effectiveness and cost-effectiveness. In 2016-2017, we conducted a pilot study (TOF pilot1) for a preventive primary care intervention (TOF is the Danish abbreviation for "Early Detection and Prevention"). Among 8814 invited patients, 3545 (40.22%) consented to participate, with the highest participation rates among women and patients with higher income, education, and employment., Objective: The aim of this study was to evaluate the effects of a revised invitation strategy on invitation comprehensibility, the overall participation rate, and participant demography. The new strategy specifically targeted men and patients of low educational attainment., Methods: This study was embedded in the second TOF pilot study (TOF pilot2, initiated in October 2018) that tested an adjusted intervention. The revised invitation strategy comprised a prenotification postcard and a new invitation that specifically targeted men and patients of low educational attainment. The new invitation was developed in a co-design process that included communication professionals and target-group representatives. The study sample consisted of 4633 patients aged between 29 and 59 years, who resided in one of two municipalities in the Region of Southern Denmark. Eligible patients were randomly assigned to one of four invitation groups. The control group (Group 1) received the original invitation used in TOF pilot1. The intervention groups received the original invitation and the prenotification postcard (Group 2), the new revised invitation and the prenotification postcard (Group 3), or the new invitation but no prenotification postcard (Group 4)., Results: Overall, 2171 (46.86%) patients consented to participate. Compared to the control group, participation rates increased significantly in all three intervention groups (all P<.001). Participation across the three intervention groups increased for women and men, as well as for patients with high and low educational attainment and high and low family income. The largest relative increase in participation rates occurred among men, patients with low educational attainment, and patients with low family income. No increase in participation was detected for unemployed patients or patients of non-Danish origin. Most participants found the original (813/987, 82.37%) and new (965/1133, 85.17%) invitations easy to understand with no significant difference (P=.08) in comprehensibility between invitations., Conclusions: The results suggest that participation in preventive primary care interventions can be greatly increased by implementing a co-design-based invitation strategy that includes prenotification postcards and targeted invitations. Although firm conclusions cannot be made from this study, the observed increased participation rates for men and patients of low socioeconomic status may be relevant in programs that aim to reduce social inequality in health., Trial Registration: ClinicalTrials.gov NCT03913585; https://clinicaltrials.gov/ct2/show/NCT03913585., (©Trine Thilsing, Lars Bruun Larsen, Anders Larrabee Sonderlund, Signe Skaarup Andreassen, Jeanette Reffstrup Christensen, Nanna Herning Svensson, Marie Dahl, Jens Sondergaard. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 10.03.2021.) more...

Objectives: The aim was to study whether the effects of a population-based health check and lifestyle intervention differed according to study participation rate., Methods: All persons living in 73 areas of Copenhagen County, Denmark, were included in the Inter99 randomized trial in 1999 (intervention group n = 11,483; control group n = 47,122). All persons in the intervention group were invited for health checks and were offered lifestyle counseling if they were at high risk of ischemic heart disease. Areas were divided into low 35-49%, middle 50-54% and high ≥ 55% health check participation. All persons were followed in registers for 10-year cause-specific mortality., Results: In high-participation areas, there was a significantly higher risk of lifestyle-(HR 1.37 [1.04, 1.79]) and cancer-related deaths (HR 1.47 [1.08, 2.02]) among women in the intervention group than control group. Regarding smoking-related cancer deaths, differences were even more pronounced. Among men, no significant difference in mortality was seen between control and intervention groups., Conclusions: The results of this paper suggest that among women, the health check and lifestyle intervention may increase the risk of lifestyle and cancer-related deaths. more...