Implications of the COVID-19 pandemic on self-reported health status and noise annoyance in rural and non-rural Canada | Scientific Reports -…

Sample designSample recruitment and response rate

A detailed presentation of CPENS methodology is provided by Michaud et al.1. Briefly, a general population probability-based random sample (GPRS) from all provinces was used to recruit respondents via telephone to the online survey. For this study, the sample was created using two approaches. A random digit dialing approach (i.e., GPRS) for the general population across the country where the sample was pulled randomly by province proportionally to their size nationally, and by postal codes of the First Nations and remote areas in order to oversample those specific groups. Non-respondents that did not complete the survey were sent a reminder message at 3 and 6days after the initial recruitment. Of the 22,892 potentially eligible participants, 11,492 were recruited to the survey, for a recruitment rate of 50.6%. Of the 11,492 recruited participants, 6647 completed the online survey, for an overall response rate among eligible respondents of 29.0%. To achieve a representative sample of rural, urban, and suburban areas, survey data were weighted with the most recent Statistics Canada census data. This also corrected for over and under sampled groups in certain geographic locations. There was no evidence of extreme values in the weighted data that would indicate a sampling bias. The margin of error for the study was1.2%, at a 95% confidence level (i.e., 19 times out of 20).

The sampling frame was set to target respondents from remote/rural, suburban and urban areas in all ten Canadian provinces using the forward sortation area (FSA) postal code information22. Respondents indicated the geographic region that best corresponded to the area in which they lived based on population size. Because some postal codes can be both rural and urban, geographic region in the statistical analysis was based on self-reported geographic region.

The questionnaire included content to evaluate noise perception, annoyance, and expectations of quiet, health-related and socio-demographic variables. The average length of time to complete the online questionnaire was just under 10min. The questionnaire was designed by Health Canada and pre-tested in both English and French. For the pretesting, 299 people were recruited by phone (212 in English and 87 in French). This led to 72 completed online surveys (61 English, and 11 French). Minor changes made to the survey after pre-testing did not affect the pre-test data, allowing results collected during the pre-test to be included in the final analysis. The English and French versions of the survey are available through Libraryand Archives Canada23.

In CPENS, participants were asked to indicate how they have been personally affected by the COVID-19 pandemic with respect to physical health, mental health, annoyance toward environmental noise, annoyance toward indoor noise, stress in their life, and overall well-being. Response categories for these six outcome variables were as follows: much worse, somewhat worse, unchanged, somewhat improved, and much improved. For modelling, the responses were grouped as: somewhat/much worse and unchanged/somewhat/much improved. When reporting prevalence rates the responses were grouped into the three following categories: somewhat/much worse, unchanged and somewhat/much improved. A number of other variables were collected in CPENS that were considered to be potentially associated to the six evaluated outcomes. These included the demographic variables such as age, gender, education, income and Indigenous status. Age in years was divided into three groups (1834, 3554, 55 +). The following gender categories were defined (female, male, other/prefer not to say). Education was rated as: up to high school diploma or equivalent, certificate or diploma, bachelor's degree or post graduate degree. A certificate or diploma could be from a registered apprenticeship, or other trade, college, CEGEP (i.e., Quebec College) or other non-university, university below bachelor's level. Total household income in Canadian dollars was grouped as follows: under $40K, $40K to just under $80K, $80K to just under $150K, $150K and above. Indigenous status was grouped as follows: Self identify as First Nation/ Mtis/Inuk (Inuit), or Do not self identify. Province of residence as well as geographic region were also considered as potential predictor variables since the response to the pandemic differed by province as well as geographic region. Due to the smaller sample sizes, the Prairie Provinces (i.e., Manitoba and Saskatchewan), were grouped together as were the Atlantic Provinces (i.e., New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland & Labrador). The remaining provinces (British Columbia, Alberta, Ontario and Quebec) were classified independently. Self-reported geographic region was defined as rural/remote (i.e.,<1000 to 10,000 inhabitants), suburban (i.e., a mixed-use or residential area, existing either as part of a city or urban area, or as a separate residential community within commuting distance of a city) and urban (i.e., 10,000+ inhabitants).

A respondents current work or school situation was also considered. Respondents self-identified as follows: working or attending school outside their home; working or attending school inside their home; retired; unemployed; and a portion of those indicating other could be grouped as on paid leave (i.e., sick, maternity, and disability). More than one option could be selected; therefore, each situation was considered separately as a Yes/No response.

Other variables considered included, sleep disturbance (for any reason at home over the previous 12months), classified as highly sleep disturbed (rating 8 to 10) versus not highly sleep disturbed (rating 0 to 7). Similarly, sensitivity to noise was defined as highly sensitive to noise (rating 8 to 10) versus not highly sensitive to noise (rating 0 to 7). Participants were asked to rate their overall physical health relative to someone of their age, and their overall mental health (no reference to age). For both of these questions the responses included the following: poor; fair; good; very good; and excellent. These were collapsed as: poor/fair and good/very good/excellent. Heart disease including high blood pressure, anxiety or depression, sleep disorder, and hearing loss were also evaluated as diagnosed by a healthcare professional, not diagnosed but suffer from the condition, or does not apply. Affirming a diagnosis was assumed to indicate the condition was current, and not one that historically existed, but no longer current.

Weighted frequencies and cross-tabulations were used to explore the distribution of demographics and characteristics of the population by Indigenous status and geographic region. Cross-tabulations of each of the health-related outcomes and noise annoyance variables affected by the pandemic with Indigenous status and geographic region were also considered. Chi-square tests of independence compared Indigenous status to non-Indigenous respondents, as well as geographic regions.

Initial univariate logistic regression models were used to investigate the relationship between each of the health-related outcomes, including noise annoyance variables and other variables of interest, as mentioned above. Unadjusted odds ratios (ORs) are reported for each relationship in Supplemental Material (see Table S1). Finally, a multivariate logistic regression model was developed using stepwise regression techniques with a significance level of the chi-square for entering an effect into the model equal to 20% and the significance level of the chi-square for an effect to remain in the model of 5%. Adjusted ORs are reported for the final models for each evaluated outcome affected by the pandemic. Confidence intervals (CI) of ORs including the value 1 indicate insufficient evidence to observe an association between the outcome evaluated and variable under investigation.

Statistical analysis was performed using SAS Enterprise Guide 7.15 (SAS Institute Inc., Cary, NC). A 0.05 statistical significance level was implemented throughout unless otherwise stated. In addition, Bonferroni corrections were made to account for all pairwise comparisons to ensure that the overall Type I (false positive) error rate was less than 0.05. Estimates with a coefficient of variation (CV) between 16.6 and 33.3% were designated E and must be interpreted with caution due to the high sampling variability associated with it; CV estimates that exceeded 33.3% were designated F indicating that these data could not be released due to questionable validity. No results are reported for cell frequencies less than 10.

This study was approved by the Health Canada and Public Health Agency of Canada Review Ethics Board (Protocol no. REB 2020-038H). Informed consent is implied in the voluntary response to the survey questionnaire. This research was conducted in accordance with all relevant Government of Canada guidelines and regulations for conducting online surveys.

Continued here:

Implications of the COVID-19 pandemic on self-reported health status and noise annoyance in rural and non-rural Canada | Scientific Reports -...