Nonresponse bias in a national study of dentists' infection control practices and attitudes related to HIV.
The aim was to investigate late response and nonresponse bias in a survey related to HIV and infection control. Questionnaires with ID numbers were mailed to a stratified random sample of dentists in Canada with additional mailings 4 and 7 weeks later (n = 6444). We compared responses received after < 4 weeks, 4-7 weeks, > 7 weeks. Extrapolation was used to estimate nonresponse bias. Univariate analyses showed significant differences between responses received < 4 weeks after initial mailing and those received later for items on sociodemographics, knowledge, infection control practices and attitudes: late responders were more likely to report that they would refuse to treat any patients with HIV (P < 0.01). Multiple logistic regression indicated that the best predictors of responses received > or = 4 weeks were disagreement that HBV is more infectious than HIV (OR = 1.7); unwillingness to attend a dentist who treats HIV/AIDS patients (OR = 1.3); incorrect perception of the risk of HIV infection after an HIV-contaminated needlestick injury (OR = 1.2); and sometimes or never heat-sterilizing handpieces after each patient (OR = 1.2). Extrapolation indicated that the percentage of all respondents who reported refusal to treat (15.2%) would have been 17.1% if a 100% response rate had been obtained. We found significant evidence of late response and nonresponse bias primarily in knowledge and fears related to HIV infectivity; however, the impact on the final results was small and we concluded that additional follow-up to improve response rates would not be worthwhile.
McCarthy
G M
GM
Faculty of Dentistry, University of Western Ontario, London, Canada. gmccarth@julian.uwo.ca
MacDonald
J K
JK
D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D015982:Bias; D002170:Canada / Q000453:epidemiology; D002983:Clinical Competence; D003815:Dentists / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D005544:Forecasting; D015658:HIV Infections / Q000635:transmission; D006509:Hepatitis B / Q000635:transmission; D006358:Hot Temperature; D006801:Humans; D019552:Infection Control, Dental / Q000706:statistics & numerical data; D017758:Infectious Disease Transmission, Patient-to-Professional; D016015:Logistic Models; D016602:Needlestick Injuries / Q000209:etiology; D009784:Occupational Diseases / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D016079:Refusal to Treat; D012307:Risk Factors; D012959:Socioeconomic Factors; D013242:Sterilization; D011795:Surveys and Questionnaires; D013997:Time Factors