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RESEARCH ARTICLE

Comparing health survey data from Internet- and paper-based convenience samples of lesbian women in Germany

Oliver Hirsch A B , Karina Löltgen A and Annette Becker A
+ Author Affiliations
- Author Affiliations

A Department of General Practice/Family Medicine, Philipps University Marburg, D-35032 Marburg, Germany.

B Corresponding author. Email: oliver.hirsch@staff.uni-marburg.de

Sexual Health 11(4) 351-358 https://doi.org/10.1071/SH14041
Submitted: 1 May 2013  Accepted: 1 August 2014   Published: 4 September 2014

Abstract

Background: Members of populations that are measured online should be compared with paper-based samples in order to determine whether data from these different sources can be merged or must be analysed separately due to substantial differences. Methods: A sample of lesbian women recruited via the Internet were compared with a paper-based sample. Both groups used a questionnaire consisting of demographic variables, questions regarding dealing with homosexuality, psychological burden, access to care, and discrimination experience within the German healthcare system. Results: Only small differences emerged in dealing with homosexuality between both groups. Moderately more women in the Internet-based sample suffered from nervous tension and the impression of being out of balance. Moderately more women in the paper-based sample stated that their main contact person regarding health matters was informed about their sexual orientation. Most differences had small effect sizes. No substantial differences occurred between the two groups in the area of discrimination experience. No large differences in socioeconomic data, psychological burden, healthcare utilisation, or dealing with or experiences with homosexuality were found. Conclusions: Health survey data derived from Internet- and paper-based samples of lesbian women in Germany are not too dissimilar. Further research in additional contexts is needed to decide whether they can be merged for further analyses.

Additional keywords: female homosexuality, health surveys, Internet, questionnaires.


References

[1]  Strickland OL, Moloney MF, Dietrich AS, Myerburg S, Cotsonis GA, Johnson RV. Measurement issues related to data collection on the World Wide Web. ANS Adv Nurs Sci 2003; 26 246–56.
Measurement issues related to data collection on the World Wide Web.Crossref | GoogleScholarGoogle Scholar | 14674574PubMed |

[2]  Gosling SD, Vazire S, Srivastava S, John OP. Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. Am Psychol 2004; 59 93–104.
Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires.Crossref | GoogleScholarGoogle Scholar | 14992636PubMed |

[3]  Ekman A, Dickman PW, Klint A, Weiderpass E, Litton JE. Feasibility of using web-based questionnaires in large population-based epidemiological studies. Eur J Epidemiol 2006; 21 103–11.
Feasibility of using web-based questionnaires in large population-based epidemiological studies.Crossref | GoogleScholarGoogle Scholar | 16518678PubMed |

[4]  Mathy RM, Schillace M, Coleman SM, Berquist BE. Methodological rigor with internet samples: new ways to reach underrepresented populations. Cyberpsychol Behav 2002; 5 253–66.
Methodological rigor with internet samples: new ways to reach underrepresented populations.Crossref | GoogleScholarGoogle Scholar | 12123248PubMed |

[5]  Silenzio VM, Duberstein PR, Tang W, Lu N, Tu X, Homan CM. Connecting the invisible dots: reaching lesbian, gay, and bisexual adolescents and young adults at risk for suicide through online social networks. Soc Sci Med 2009; 69 469–74.
Connecting the invisible dots: reaching lesbian, gay, and bisexual adolescents and young adults at risk for suicide through online social networks.Crossref | GoogleScholarGoogle Scholar | 19540641PubMed |

[6]  Matsuo H, McIntyre KP, Tomazic T, Katz B. The online survey: its contributions and potential problems; 2004. Available from: http://www.amstat.org/sections/srms/proceedings/y2004f.html [verified 31 July 2014].

[7]  Riggle ED, Rostosky SS, Reedy CS. Online surveys for BGLT research: issues and techniques. J Homosex 2005; 49 1–21.
Online surveys for BGLT research: issues and techniques.Crossref | GoogleScholarGoogle Scholar | 16048891PubMed |

[8]  Hirsch O, Hauschild F, Schmidt MH, Baum E, Christiansen H. Comparison of web-based and paper-based administration of ADHD questionnaires for adults. J Med Internet Res 2013; 15 e47
Comparison of web-based and paper-based administration of ADHD questionnaires for adults.Crossref | GoogleScholarGoogle Scholar | 23518816PubMed |

[9]  Shindel AW, Rowen TS, Lin TC, Li CS, Robertson PA, Breyer BN. An internet survey of demographic and health factors associated with risk of sexual dysfunction in women who have sex with women. J Sex Med 2012; 9 1261–71.
An internet survey of demographic and health factors associated with risk of sexual dysfunction in women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 22375801PubMed |

[10]  Sanchez DT, Moss-Racusin CA, Phelan JE, Crocker J. Relationship contingency and sexual motivation in women: implications for sexual satisfaction. Arch Sex Behav 2011; 40 99–110.
Relationship contingency and sexual motivation in women: implications for sexual satisfaction.Crossref | GoogleScholarGoogle Scholar | 20174863PubMed |

[11]  Fikar CR, Keith L. Information needs of gay, lesbian, bisexual, and transgendered health care professionals: results of an Internet survey. J Med Libr Assoc 2004; 92 56–65.
| 14762463PubMed |

[12]  Peel E. Pregnancy loss in lesbian and bisexual women: an online survey of experiences. Hum Reprod 2010; 25 721–7.
Pregnancy loss in lesbian and bisexual women: an online survey of experiences.Crossref | GoogleScholarGoogle Scholar | 20023293PubMed |

[13]  Riggle ED, Rostosky SS, Horne SG. Psychological distress, well-being, and legal recognition in same-sex couple relationships. J Fam Psychol 2010; 24 82–6.
Psychological distress, well-being, and legal recognition in same-sex couple relationships.Crossref | GoogleScholarGoogle Scholar | 20175612PubMed |

[14]  Bjorkman M, Malterud K. Lesbian women coping with challenges of minority stress: a qualitative study. Scand J Public Health 2012; 40 239–44.
Lesbian women coping with challenges of minority stress: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 22637362PubMed |

[15]  Vrangalova Z, Savin-Williams RC. Mostly heterosexual and mostly gay/lesbian: evidence for new sexual orientation identities. Arch Sex Behav 2012; 41 85–101.
Mostly heterosexual and mostly gay/lesbian: evidence for new sexual orientation identities.Crossref | GoogleScholarGoogle Scholar | 22327566PubMed |

[16]  Brooks KD, Quina K. Women’s sexual identity patterns: differences among lesbians, bisexuals, and unlabeled women. J Homosex 2009; 56 1030–45.
Women’s sexual identity patterns: differences among lesbians, bisexuals, and unlabeled women.Crossref | GoogleScholarGoogle Scholar | 19882425PubMed |

[17]  Averett P, Yoon I, Jenkins CL. Older lesbians: experiences of aging, discrimination and resilience. J Women Aging 2011; 23 216–32.
Older lesbians: experiences of aging, discrimination and resilience.Crossref | GoogleScholarGoogle Scholar | 21767086PubMed |

[18]  Averett P, Yoon I, Jenkins CL. Older lesbian sexuality: identity, sexual behavior, and the impact of aging. J Sex Res 2012; 49 495–507.
Older lesbian sexuality: identity, sexual behavior, and the impact of aging.Crossref | GoogleScholarGoogle Scholar | 21707407PubMed |

[19]  Birnholz JL, Young MA. Differential item functioning for lesbians, bisexual, and heterosexual women in the center for epidemiological studies depression scale. Assessment 2012; 19 502–5.
Differential item functioning for lesbians, bisexual, and heterosexual women in the center for epidemiological studies depression scale.Crossref | GoogleScholarGoogle Scholar | 22399328PubMed |

[20]  Sell RL, Petrulio C. Sampling homosexuals, bisexuals, gays, and lesbians for public health research: a review of the literature from 1990 to 1992. J Homosex 1996; 30 31–47.
Sampling homosexuals, bisexuals, gays, and lesbians for public health research: a review of the literature from 1990 to 1992.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28zltlSntQ%3D%3D&md5=cab2b007c34b41005ff6d3acf4035cc4CAS | 8738743PubMed |

[21]  Meads C, Buckley E, Sanderson P. Ten years of lesbian health survey research in the UK West Midlands. BMC Public Health 2007; 7 251
Ten years of lesbian health survey research in the UK West Midlands.Crossref | GoogleScholarGoogle Scholar | 17880702PubMed |

[22]  Schwarcz S, Spindler H, Scheer S, Valleroy L, Lansky A. Assessing representativeness of sampling methods for reaching men who have sex with men: a direct comparison of results obtained from convenience and probability samples. AIDS Behav 2007; 11 596–602.
Assessing representativeness of sampling methods for reaching men who have sex with men: a direct comparison of results obtained from convenience and probability samples.Crossref | GoogleScholarGoogle Scholar | 17436073PubMed |

[23]  Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 2007; 146 317–25.
Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.Crossref | GoogleScholarGoogle Scholar | 17339617PubMed |

[24]  Löwe B, Kroenke K, Gräfe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res 2005; 58 163–71.
Detecting and monitoring depression with a two-item questionnaire (PHQ-2).Crossref | GoogleScholarGoogle Scholar | 15820844PubMed |

[25]  Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care 2003; 41 1284–92.
The Patient Health Questionnaire-2: validity of a two-item depression screener.Crossref | GoogleScholarGoogle Scholar | 14583691PubMed |

[26]  Gräfe K, Zipfel S, Herzog W, Löwe B. Screening psychischer Störungen mit dem “Gesundheitsfragebogen für Patienten (PHQ-D)”. Ergebnisse der deutschen Validierungsstudie. Diagnostica 2004; 50 171–81. [Screening of psychological disorders with the “Patient Health Questionnaire (PHQ-D)”. Results of the German validation study].
Screening psychischer Störungen mit dem “Gesundheitsfragebogen für Patienten (PHQ-D)”. Ergebnisse der deutschen Validierungsstudie.Crossref | GoogleScholarGoogle Scholar |

[27]  Löwe B, Spitzer RL, Zipfel S, Herzog W. PHQ-D. Gesundheitsfragebogen für Patienten. Manual. Komplettversion und Kurzform. Autorisierte deutsche Version des “Prime MD Patient Health Questionnaire (PHQ)”. Berlin: Pfizer; 2002.

[28]  Han C, Pae CU, Patkar AA, Masand PS, Kim KW, Joe SH, et al Psychometric properties of the Patient Health Questionnaire-15 (PHQ-15) for measuring the somatic symptoms of psychiatric outpatients. Psychosomatics 2009; 50 580–5.
| 19996228PubMed |

[29]  Kroenke K, Spitzer RL, Williams JB, Lowe B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry 2010; 32 345–59.
The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.Crossref | GoogleScholarGoogle Scholar | 20633738PubMed |

[30]  Körber S, Frieser D, Steinbrecher N, Hiller W. Classification characteristics of the Patient Health Questionnaire-15 for screening somatoform disorders in a primary care setting. J Psychosom Res 2011; 71 142–7.
Classification characteristics of the Patient Health Questionnaire-15 for screening somatoform disorders in a primary care setting.Crossref | GoogleScholarGoogle Scholar | 21843748PubMed |

[31]  Steinbrecher N, Koerber S, Frieser D, Hiller W. The prevalence of medically unexplained symptoms in primary care. Psychosomatics 2011; 52 263–71.
The prevalence of medically unexplained symptoms in primary care.Crossref | GoogleScholarGoogle Scholar | 21565598PubMed |

[32]  Donner-Banzhoff N, Maisel P, Baum E, Dörr C. DEGAM-Leitlinie Nr. 2: Müdigkeit [Guideline 2 “Fatigue” of the German Association of General Practice/Family Medicine]. Düsseldorf: Omikron Publishing; 2011.

[33]  Volker MA. Reporting effect size estimates in school psychology research. Psychol Sch 2006; 43 653–72.
Reporting effect size estimates in school psychology research.Crossref | GoogleScholarGoogle Scholar |

[34]  Huber PJ, Ronchetti EM. Robust Statistics. Hoboken, NJ: John Wiley & Sons; 2009.

[35]  Grissom RJ, Kim JJ. Effect sizes for research. Univariate and multivariate applications. New York: Routledge; 2012.

[36]  Rhodes SD, Bowie DA, Hergenrather KC. Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health 2003; 57 68–73.
Collecting behavioural data using the world wide web: considerations for researchers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3s%2FitlegtQ%3D%3D&md5=234dd009d4343a2ac9a533849c0a4a9aCAS | 12490652PubMed |

[37]  McDermott E, Roen K. Youth on the virtual edge: researching marginalized sexualities and genders online. Qual Health Res 2012; 22 560–70.
Youth on the virtual edge: researching marginalized sexualities and genders online.Crossref | GoogleScholarGoogle Scholar | 22068038PubMed |

[38]  Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988.

[39]  Boehmer U, Clark M, Timm A, Ozonoff A. Two means of sampling sexual minority women: how different are the samples of women? J LGBT Health Res 2009; 4 143–51.
Two means of sampling sexual minority women: how different are the samples of women?Crossref | GoogleScholarGoogle Scholar |

[40]  Dennert G. Die gesundheitliche Situation lesbischer Frauen in Deutschland [Health issues in lesbian women in Germany]. Herbolzheim: Centaurus; 2005.

[41]  Austin EL, Irwin JA. Age differences in the correlates of problematic alcohol use among southern lesbians. J Stud Alcohol Drugs 2010; 71 295–8.
| 20230728PubMed |

[42]  Bowen DJ, Bradford JB, Powers D, McMorrow P, Linde R, Murphy BC, et al Comparing women of differing sexual orientations using population-based sampling. Women Health 2005; 40 19–34.
Comparing women of differing sexual orientations using population-based sampling.Crossref | GoogleScholarGoogle Scholar |

[43]  Malterud K, Bjorkman M, Flatval M, Ohnstad A, Thesen J, Rortveit G. Epidemiological research on marginalized groups implies major validity challenges; lesbian health as an example. J Clin Epidemiol 2009; 62 703–10.
Epidemiological research on marginalized groups implies major validity challenges; lesbian health as an example.Crossref | GoogleScholarGoogle Scholar | 19070465PubMed |

[44]  Bowen DJ, Bradford J, Powers D. Comparing sexual minority status across sampling methods and populations. Women Health 2007; 44 121–34.
Comparing sexual minority status across sampling methods and populations.Crossref | GoogleScholarGoogle Scholar |

[45]  Groves RM. Nonresponse rates and nonresponse bias in household surveys. Public Opin Q 2006; 70 646–75.
Nonresponse rates and nonresponse bias in household surveys.Crossref | GoogleScholarGoogle Scholar |

[46]  Johnson TP, Wislar JS. Response rates and nonresponse errors in surveys. JAMA 2012; 307 1805–6.
Response rates and nonresponse errors in surveys.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xms1ajtb4%3D&md5=502249d74ffeab7d4009eb60c96c8722CAS | 22550194PubMed |

[47]  McCreesh N, Frost SD, Seeley J, Katongole J, Tarsh MN, Ndunguse R, et al Evaluation of respondent-driven sampling. Epidemiology 2012; 23 138–47.
Evaluation of respondent-driven sampling.Crossref | GoogleScholarGoogle Scholar | 22157309PubMed |

[48]  White RG, Lansky A, Goel S, Wilson D, Hladik W, Hakim A, et al Respondent driven sampling–where we are and where should we be going? Sex Transm Infect 2012; 88 397–9.
Respondent driven sampling–where we are and where should we be going?Crossref | GoogleScholarGoogle Scholar | 23012492PubMed |

[49]  Goel S, Salganik MJ. Assessing respondent-driven sampling. Proc Natl Acad Sci USA 2010; 107 6743–7.
Assessing respondent-driven sampling.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXltFSjtL4%3D&md5=f2bcc3df758f35b1f1c67ab60b62658eCAS | 20351258PubMed |

[50]  Wejnert C, Heckathorn DD. Web-based network sampling: efficiency and efficacy of respondent-driven sampling for online research. Sociol Methods Res 2008; 37 105–34.
Web-based network sampling: efficiency and efficacy of respondent-driven sampling for online research.Crossref | GoogleScholarGoogle Scholar |

[51]  Johnston LG, Trummal A, Lohmus L, Ravalepik A. Efficacy of convenience sampling through the internet versus respondent driven sampling among males who have sex with males in Tallinn and Harju County, Estonia: challenges reaching a hidden population. AIDS Care 2009; 21 1195–202.
Efficacy of convenience sampling through the internet versus respondent driven sampling among males who have sex with males in Tallinn and Harju County, Estonia: challenges reaching a hidden population.Crossref | GoogleScholarGoogle Scholar | 20024780PubMed |