Biosocial Surveys (2008) / Chapter Skim
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4 Elastic Powers: The Integration of Biomarkers into the Health and Retirement Study--David Weir
4 Elastic Powers: The Integration of Biomarkers into the Health and Retirement Study--David Weir
Pages 78-95
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From page 78... ...
. In his closing reflections on the biosocial opportunities for surveys, Kenneth Wachter quoted from a Matthew Arnold poem that described the aging process as exhaustion from the cumulation of shocks and change -- a literary anticipation of the concept of allostatic load that Wachter in turn stretched from a model of individual physiology in a social context into a model of paradigm shifts in the history of science (Wachter, 2001)
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From page 79... ...
Because the tests contemplated by HRS assess familiar risk factors and do not identify, for example, life-threatening cancers, the ethical conflict is not particularly difficult at this time. Biological material stored in repository for future use is governed by a separate IRB review.
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From page 80... ...
It includes anthropometrics, physical measures, blood spots, salivary DNA, and a self-administered psychosocial questionnaire. Most of the elements of this dramatically new development for the HRS were piloted in one way or another in smaller supplemental studies.
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From page 81... ...
This two-stage process worked against response rates in two ways. It extended the time interval between the HRS interview and the ADAMS visit, which resulted in loss due to mortality, and it provided respondents two opportunities to say no.
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From page 82... ...
Combined with the 56 percent response rate to the ADAMS study overall, however, only 55 percent of the HRS respondents approached for ADAMS ultimately provided a DNA sample. Diabetes Study In contrast to the ADAMS study, for which biomarker collection was a relatively small part of the overall assessment, the diabetes study was motivated in large part by the idea of collecting a clinically meaningful biomarker of the disease.
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From page 83... ...
Much of the nonbiological information about diabetes could easily be collected by a self-administered mail survey, which is far less expensive than even telephone interviews. The innovative aspect of the diabetes study was the attempt to gather dried blood spots (DBS)
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From page 84... ...
. In contrast to both the core HRS interviews and the ADAMS study, but quite consistent with other HRS mail surveys, there were substantial racial and ethnic differences in participation.
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From page 85... ...
Second, self-administration and mailback of blood spots, while inexpensive, is unlikely to yield high response rates and seems particularly ill-suited to maintaining high response rates of minorities. In-home requests, with a trained person present to take the sample, seemed to provide the best basis for administering biomarkers.
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From page 86... ...
SOURCE: HRS Diabetes Study. Face-to-Face Interviews In 2004, the HRS was given additional funding from the Social Secu Figure 4-3 rity Administration to use in-person interviewing to improve consent rates for linkage to Social Security records for two groups: all of the original 1992 HRS cohort (born 1931-1941, plus spouses)
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From page 87... ...
2006 Enhanced Face-to-Face Interview All the work of the various supplemental studies and pilot projects were brought together in the design of the enhanced face-to-face interview for 2006. The key elements of the 2006 HRS enhanced face-to-face interview are • measured height and weight and waist circumference, • blood pressure, • timed walk, grip strength, puff test, balance test, • dried blood spots for HbA1c, total cholesterol, high-density lipo protein cholesterol, C-reactive protein and repository, • salivary DNA for repository, and • self-administered mailback psychosocial questionnaire.
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From page 88... ...
At the same time, the laboratory technologies for using dried blood spots are advancing rapidly, making the scientific potential of this relatively inexpensive field collection protocol extremely attractive. At present, the HRS blood spots will be used to assay for HbA1c, total cholesterol, HDL cholesterol, and C-reactive protein.
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From page 89... ...
Interviewer Training The HRS was fortunate to follow, with about a year's lag, the development of in-home biomarker interviews in the National Social Life, Health, and Aging Project at the National Opinion Research Center and the University of Chicago. Their success set a high standard.
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From page 90... ...
In 2006 we therefore added self-rating questions on hand strength and on lung function to aid in understanding the functional abilities of those who do not do the measures. Table 4-2 shows that self-rated hand strength correlates very strongly with measured grip strength, and that persons reporting weakness in the hand had substantially lower completion rates on the grip strength test.
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From page 91... ...
TABLE 4-3 Self-Rated Shortness of Breath, Response Rate to Lung Test, and Measured Lung Function Self-Rated Expiratory Response Shortness of Breath Force Rate (%) N Measured Often 272.2 72.3 391 Sometimes 313.2 85.3 1,221 Rarely 367.2 87.7 2,134 Never 378.0 87.6 3,411 F-statistic 135.6 33.7 p-value < .0001 < .0001 SOURCE: Preliminary HRS 2006 production data, unweighted.
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From page 92... ...
The average differential is just Figure 4-4 under one inch. Measured heights are recorded to the nearest quarterinch, and self-reports are in round inches.
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From page 93... ...
Blood pressure data appear to be of good quality. The HRS protocol calls for three repeated measures, using an upper arm cuff with an automatic inflation device.
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From page 94... ...
Conclusion The integration of biomarkers into the HRS is very much a work in progress. The first big steps have been taken to transform a primarily telephone study into one using in-person interviewing to obtain direct physical measurements and collect biological samples in the home, challenging the "elastic powers" of the survey's designers and its funders.
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From page 95... ...
In National Research Council, Cells and surveys: Should biological measures be included in social science research?
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