Interventions to Increase the Reachability of Migrants in Germany With Health Interview Surveys: Mixed-Mode Feasibility Study

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Germany is a popular country for immigration, and migration has increased in recent years. It is therefore important to collect reliable data on migrants’ health. The Robert Koch-Institute (RKI) has launched the “Improving Health Monitoring in Migrant Populations” (IMIRA) project to sustainably integrate migrant populations into health monitoring in Germany. Objective: One of IMIRA’s objectives is the implementation of a feasibility study (the “IMIRA survey”) that focuses on testing different interventions to increase the reachability of migrants with health interview surveys. Possible causes of non-response should be identified so as to increase participation in future surveys. Methods: The IMIRA survey was conducted from January to May 2018. The target populations were Turkish, Polish, Romanian, Syrian and Croatian migrants, who represent the biggest migrant groups living in Germany. Probability sampling was used, utilising data from the registration offices in two states (Berlin and Brandenburg); 9,068 persons were randomly selected by nationality in seven sample points. Age (three categories: 18-44, 45-64 and 65+ years) and gender strata were applied. Different modes and methods were used to test their usability: culturally-sensitive materials, online questionnaires, telephone interviews, personal contact and personal interviews, using multilingual materials and interviewers. To evaluate the effectiveness of the interventions there was an intervention group A and a control group B. The European Health Interview Survey (EHIS) was used, with additional instruments on religious affiliation, experience with discrimination and subjective social status. Results: Data collection took place from January to May 2018 in Berlin and Brandenburg, Germany. The results are published in the online journal ‘Survey Methods: Insights from the Field’ in 2019, focusing on mode-specific response rates, potential issues with the use of modes, and the effectiveness of interventions (such as personal contact). Conclusions: The IMIRA survey appraised the usability of mixed-mode/method approaches among migrant groups with a probability sample in two German states. When conducting the survey we were confronted with issues regarding the translation of the questionnaire as well as the validity of some instruments within the survey languages. As a major result it can be stated, that personal face-to-face contact was the most effective intervention to recruit our participants. The findings will be implemented in the upcoming health monitoring study at the RKI.