Differences in sociodemographic, health status, and lifestyle characteristics among American Indians by telephone coverage.
BACKGROUND
Telephone interviews are often used to obtain population-based estimates of health-related behaviors but they have serious limitations if phone coverage is poor and people without telephones differ from those with telephones. In this article we examine differences in selected sociodemographic, health status, and lifestyle factors among a sample of American Indian adults with and without telephones.


METHODS
In-person interviews were conducted with 410 adult residents of a Rocky Mountain state American Indian reservation. The interview included a question asking about telephone coverage. We compared respondents with and without telephones on demographics, health status, and lifestyle practices. The comparison was repeated for health status and lifestyle practices after adjusting for differences in demographic characteristics.


RESULTS
Residents without phones generally were less educated, had lower income and were more likely to be unemployed. The prevalence of unhealthful lifestyle practices/factors was consistently higher for residents without telephones. Many of the differences were reduced by adjusting for demographic characteristics, but significant differences remained for alcohol and marijuana use.


CONCLUSIONS
These results suggest that developing estimates of sociodemographic, health, and lifestyle characteristics on a Native American Indian reservation using a telephone survey method may result in significant noncoverage biases. Adjusting for demographic characteristics eliminated most of these differences. However, significant differences were still apparent with alcohol and marijuana use.
Pearson
D
D
Centers for Health Promotion, Group Health Cooperative of Puget Sound, Seattle, Washington 98101.
Cheadle
A
A
Wagner
E
E
Tonsberg
R
R
Psaty
B M
BM
D000293:Adolescent; D000328:Adult; D015982:Bias; D003710:Demography; D004522:Educational Status; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007182:Income; D007198:Indians, North American; D008019:Life Style; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012959:Socioeconomic Factors; D013689:Telephone