Ahlmark Nanna, Algren Maria Holst, Holmberg Teresa, Norredam Marie Louise, Nielsen Signe Smith, Blom Astrid Benedikte, Bo Anne, Juel Knud
a National Institute of Public Health , University of Southern Denmark , Copenhagen K , Denmark.
Ethn Health. 2015;20(6):611-32. doi: 10.1080/13557858.2014.979768. Epub 2014 Nov 20.
The participation rate in the Danish National Health Survey (DNHS) 2010 was significantly lower among ethnic minorities than ethnic Danes. The purpose was to characterize nonresponse among ethnic minorities in DNHS, analyze variations in item nonresponse, and investigate barriers and incentives to participation.
This was a mixed-method study. Logistic regression was used to analyze nonresponse using data from DNHS (N = 177,639 and chi-square tests in item nonresponse analyses. We explored barriers and incentives regarding participation through focus groups and cognitive interviews. Informants included immigrants and their descendants of both sexes, with and without higher education.
The highest nonresponse rate was for non-Western descendants (80.0%) and immigrants 25 (72.3%) with basic education. Immigrants and descendants had higher odds ratios (OR = 3.07 and OR = 3.35, respectively) for nonresponse than ethnic Danes when adjusted for sex, age, marital status, and education. Non-Western immigrants had higher item nonresponse in several question categories. Barriers to non-participation related to the content, language, format, and layout of both the questionnaire and the cover letter. The sender and setting in which to receive the questionnaire also influenced answering incentives. We observed differences in barriers and incentives between immigrants and descendants.
Nonresponse appears related to linguistic and/or educational limitations, to alienation generated by the questions' focus on disease and cultural assumptions, or mistrust regarding anonymity. Ethnic minorities seem particularly affected by such barriers. To increase survey participation, questions could be sensitized to reflect multicultural traditions, and the impact of sender and setting considered.
在2010年丹麦国家健康调查（DNHS）中，少数族裔的参与率显著低于丹麦族裔。目的是描述DNHS中少数族裔的无应答情况，分析项目无应答的差异，并调查参与的障碍和激励因素。
这是一项混合方法研究。使用逻辑回归分析来自DNHS的数据（N = 177,639）以分析无应答情况，并在项目无应答分析中使用卡方检验。我们通过焦点小组和认知访谈探讨了参与的障碍和激励因素。受访者包括有或没有高等教育的移民及其后代，男女皆有。
未接受过高等教育的非西方后裔（80.0%）和移民（72.3%）的无应答率最高。在对性别、年龄、婚姻状况和教育进行调整后，移民及其后代无应答的优势比（OR）分别高于丹麦族裔（分别为OR = 3.07和OR = 3.35）。非西方移民在几个问题类别中的项目无应答率更高。不参与的障碍与问卷和附信的内容、语言、格式及布局有关。问卷的发送者和接收问卷的环境也影响回答的积极性。我们观察到移民及其后代在障碍和激励因素方面存在差异。
无应答似乎与语言和/或教育限制、问题关注疾病和文化假设所产生的疏离感或对匿名性的不信任有关。少数族裔似乎特别受这些障碍的影响。为提高调查参与率，问题可以更具敏感性以反映多元文化传统，并考虑发送者和环境的影响。
