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As survey methods evolve, researchers require a comprehensive understanding of the error sources in their data. Comparative studies, which assess differences between the estimates from emerging survey methods and those from traditional surveys, are a popular tool for evaluating total error; however, they do not provide insight on the contributing error sources themselves. The Total Survey Error (TSE) framework is a natural fit for evaluations that examine survey error components across multiple data sources. In this article, we present a case study that demonstrates how the TSE framework can support both qualitative and quantitative evaluations comparing probability and nonprobability surveys. Our case study focuses on five internet panels that are intended to represent the US population and are used to measure health statistics. For these panels, we analyze the total survey error in two ways: (1) using a qualitative assessment that describes how panel construction and management methods may introduce error and (2) using a quantitative assessment that estimates and partitions the total error for two probability-based panels into coverage error and nonresponse error. This work can serve as a “proof of concept” for how the TSE framework may be applied to understand and compare the error structure of probability and nonprobability surveys. For those working specifically with internet panels, our findings will further provide an example of how researchers may choose the panel option best suited to their study aims and help vendors prioritize areas of improvement.

Background Influenza vaccination has been recommended for all persons aged ≥6 months since 2010. Methods Data from the 2016 National Internet Flu Survey were analyzed to assess provider vaccination recommendations and early influenza vaccination during the 2016–17 season among adults aged ≥18 years. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with early vaccine uptake by provider vaccination recommendation status. Results Overall, 24.0% visited a provider who both recommended and offered influenza vaccination, 9.0% visited a provider who only recommended but did not offer, 25.1% visited a provider who neither recommended nor offered, and 41.9% did not visit a doctor from July 1 through date of interview. Adults who reported that a provider both recommended and offered vaccine had significantly higher vaccination coverage (66.6%) compared with those who reported that a provider only recommended but did not offer (48.4%), those who neither received recommendation nor offer (32.0%), and those who did not visit a doctor during the vaccination period (28.8%). Results of multivariable logistic regression indicated that having received a provider recommendation, with or without an offer for vaccination, was significantly associated with higher vaccination coverage after controlling for demographic and access-to-care factors. Conclusions Provider recommendation was significantly associated with influenza vaccination. However, overall, 67.0% of adults did not visit a doctor during the vaccination period or did visit a doctor but did not receive a provider recommendation. Evidence-based strategies such as client reminder/recall, standing orders, provider reminders, or health systems interventions in combination should be undertaken to improve provider recommendation and influenza vaccination coverage. Other factors significantly associated with a higher level of influenza vaccination included age ≥50 years, being Hispanic, having a college or higher education, having a usual place for medical care, and having public health insurance.

Text messaging interventions may offer promise for health systems, but we need more evidence. We investigated efficacy of three text messaging programs in helping smokers quit. Arm 1 had cessation assessment and quit date reminder messages. Arm 2 had Arm 1 messages plus quit date preparation messages. Arm 3 had Arm 1 and Arm 2 messages plus 6 weeks of post-quit date messaging. Smokers aged 18–29 interested in quitting were randomly assigned to a study arm. We surveyed participants at baseline, and at 3, 8, 20, and 32 weeks (n = 4,027). At 8 weeks, scores on psychological measures were higher in Arm 3 than in Arm 2 or Arm 1. Seven-day smoking abstinence was higher in Arms 3 and 2 than in Arm 1 after controlling for background and psychological measures. Arm 3 affected quitting the most, suggesting motivational text messages before, on, and after an individual’s quit date may increase quitting.

Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended that all persons aged ≥6months receive annual influenza vaccination.We analyzed data from the 2015 National Internet Flu Survey (NIFS), to assess knowledge and awareness of the influenza vaccination recommendation and early influenza vaccination coverage during the 2015-16 season among adults. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with adults' knowledge and awareness of the vaccination recommendation and early vaccine uptake during the 2015-16 influenza season.Among the 3301 respondents aged ≥18years, 19.6% indicated knowing that influenza vaccination is recommended for all persons aged ≥6months. Of respondents, 62.3% indicated awareness that there was a recommendation for influenza vaccination, but did not indicate correct knowledge of the recommended age group. Overall, 39.9% of adults aged ≥18years reported having an influenza vaccination. Age 65years and older, being female, having a college or higher education, not being in work force, having annual household income ≥$75,000, reporting having received an influenza vaccination early in the 2015-16 season, having children aged ≤17years in the household, and having high-risk conditions were independently associated with a higher correct knowledge of the influenza vaccination recommendation.Approximately 1 in 5 had correct knowledge of the recommendation that all persons aged ≥6months should receive an influenza vaccination annually, with some socio-economic groups being even less aware. Clinic based education in combination with strategies known to increase uptake of recommended vaccines, such as patient reminder/recall systems and other healthcare system-based interventions are needed to improve vaccination, which could also improve awareness.

Background: A case definition of Gulf War illness with 3 primary variants, previously developed by factor analysis of symptoms in a US Navy construction battalion and validated in clinic veterans, identified ill veterans with objective abnormalities of brain function. This study tests prestated hypotheses of its external validity. Methods: A stratified probability sample (n = 8,020), selected from a sampling frame of the 3.5 million Gulf War era US military veterans, completed a computer-assisted telephone interview survey. Application of the prior factor weights to the subjects’ responses generated the case definition. Results: The structural equation model of the case definition fit both random halves of the population sample well (root mean-square error of approximation = 0.015). The overall case definition was 3.87 times (95% confidence interval, 2.61–5.74) more prevalent in the deployed than the deployable nondeployed veterans: 3.33 (1.10–10.10) for syndrome variant 1; 5.11 (2.43–10.75) for variant 2, and 4.25 (2.33–7.74) for variant 3. Functional status on SF-12 was greatly reduced (effect sizes, 1.0–2.0) in veterans meeting the overall and variant case definitions. Conclusions: The factor case definition applies to the full Gulf War veteran population and has good characteristics for research.