In total, 182 individuals responded to the survey, of whom, two did not provide consent for their data to be analysed and a further six participants had first part postcodes which indicated they were not living in the designated study area. These eight individuals were excluded from the analysis, providing a final sample of 174 participants.
Sample characteristics:
The majority of participants were female (69%) (Table 2, Fig. 1). The majority of the sample was represented by younger age groups, in particular 25–34 year olds (36.2% of the total), with 89.6% being < 55 years, and only 2.9% being > 65 years. Ethnicity in the sample was approximately representative of the wider Liverpool region (Table 1), with 89% identifying as White (including British, Irish, Gypsy or Irish Traveller, Other). More socioeconomically advantaged groups were over-represented, with 70.7% of the sample having attained a Degree or higher and 32.8% having a household income of greater than £60,000 per annum. The entire sample owned a smartphone. Over a third (37.9%) of the sample did not access their GP online for any service. In those that did access their GP online, the most common causes for accessing their GP online were, booking appointments (76.9%) and requesting prescriptions (65.7%).
The majority of the sample responded as being either ‘comfortable’ or ‘very comfortable’ (74.8%) with reporting an episode of illness to a non-GP based, technology-mediated service (Table 3). A similar proportion was either ‘comfortable’ or ‘very comfortable’ with answering additional questions related to their symptoms (78.8%).
Table 2
Survey Participant demographics.
Demographic Variables
|
Overall (N = 174)
|
Gender
|
(N = 174)
|
|
Female
|
120 (69.0%)
|
|
Male
|
53 (30.5%)
|
|
Prefer not to say
|
1 (0.6%)
|
|
Age
|
(N = 174)
|
|
16–17
|
1 (0.6%)
|
|
18–24
|
19 (10.9%)
|
|
25–34
|
63 (36.2%)
|
|
35–44
|
38 (21.8%)
|
|
45–54
|
35 (20.1%)
|
|
55–64
|
13 (7.5%)
|
|
65+
|
5 (2.9%)
|
|
Household Income
|
(N = 172)
|
|
<£10,000
|
9 (5.2%)
|
|
£10,001–20,000
|
10 (5.7%)
|
|
£20,001–30,000
|
32 (18.4%)
|
|
£30,001–45,000
|
29 (16.7%)
|
|
£45,001–60,000
|
35 (20.1%)
|
|
>£60,000
|
57 (32.8%)
|
|
Educational Attainment
|
(N = 173)
|
|
A levels/BTEC/level 3 diploma
|
36 (20.7%)
|
|
Degree/PGDips
|
68 (39.1%)
|
|
Masters
|
35 (20.1%)
|
|
NVQ/GCSE/O Level
|
12 (6.9%)
|
|
Other
|
2 (1.1%)
|
|
PhD
|
20 (11.5%)
|
|
Ethnicity
|
(N = 174)
|
|
BAME
|
19 (10.9%)
|
|
White British
|
141 (81.0%)
|
|
White Other
|
14 (8.0%)
|
|
Number of Children
|
(N = 168)
|
|
0
|
102 (58.6%)
|
|
1 to 2
|
59 (33.9%)
|
|
3 or more
|
7 (4.0%)
|
|
Proportions expressed as percentages account for (include) missing data from survey.
*White Other: included those who identified as; Irish, Gypsy or Irish Traveller, Other,
* BAME: included those who identified as; ‘Mixed/Multiple Ethnic Groups’; White and Asian, White and Black African, White and Black Caribbean, Other; ‘Asian British/Asian’; Chinese, Pakistani, Indian, Bangladeshi, Other; ‘Black British/Black’; African, Caribbean, Other; ‘Other Ethnic Group’; Arab, Other
Over three quarters (77.6%) of the sample said they would provide a stool sample if prompted (Table 3). Method A was the preferred method of stool sample collection (66.1%). This was the method that involved direct sampling of stool, rather than utilising a ‘poo hammock’ as in Method B (Appendix 1). Among those who stated that they would refuse to provide a stool sample, more than 40% said that they could change their mind, most commonly through being provided with a ‘diagnosis’ of causative microbes.
Table 3
Participant responses to each of the survey’s main outcomes.
Main Survey Outcomes
|
Overall N = 174
|
Comfortability Reporting Illness Online
|
N = 173
|
|
Very Comfortable
|
61 (35.1%)
|
|
Comfortable
|
69 (39.7%)
|
|
Neither Comfortable or Uncomfortable
|
22 (12.6%)
|
|
Uncomfortable
|
20 (11.5%)
|
|
Very Uncomfortable
|
1 (0.6%)
|
|
Comfortability Describing Symptoms Online
|
N = 172
|
|
Very Comfortable
|
64 (36.8%)
|
|
Comfortable
|
73 (42.0%)
|
|
Neither Comfortable or Uncomfortable
|
21 (12.1%)
|
|
Uncomfortable
|
14 (8.0%)
|
|
Would provide a stool sample if asked
|
N = 174
|
|
No
|
39 (22.4%)
|
|
Yes
|
135 (77.6%)
|
|
If No to stool; what factor might change your mind? (multi-response)
|
N = 39
|
|
Being provided with ‘diagnosis’ of causative microbes
|
16 (41%)
|
|
Helping to aid in scientific research
|
6 (15.4%)
|
|
Helping to identify disease outbreaks
|
11 (28.2%)
|
|
Other
|
1 (2.6%)
|
|
Chosen Stool Collection Method
|
N = 169
|
|
Method A
|
115 (66.1%)
|
|
Method B
|
54 (31.0%)
|
|
Wanted Informing of Test Outcome
|
N = 173
|
|
No
|
3 (1.7%)
|
|
Yes
|
170 (97.7%)
|
|
Wanted further information on microbes
|
N = 173
|
|
No
|
5 (2.9%)
|
|
Yes
|
168 (96.6%)
|
|
Proportions expressed as percentages account for (include) missing data from survey. |
Almost all (97.7%) of respondents indicated that they would want to be informed of the results of the tests carried out on their stool sample. Similarly, almost all (96.6%) respondents said they would want more information about the microbe if one was identified. Generally, the number of respondents (N) to questions throughout the survey was relatively consistent.
In descriptive analysis of stool sample provision, men were less likely to provide a stool sample than women (Table 4). When compared with those who identified as White British, those who identified with BAME ethnicities were less likely to provide a stool sample and those who identified as other White ethnicities were more likely to provide a stool sample. Additionally, those with the highest educational attainment were more likely to provide a stool sample
Upon univariable logistic regression, only age and income were associated with agreeing to provide a stool sample if asked (Table 4). The variable with the strongest association was age, with those more than 55 years old having more than 6 times the odds of providing a stool sample compared to those aged 25–34 (OR 6.28, 95% CI 1.15-117.48). Those with a household income less than £30,000 (OR 2.5, 95% CI 1.02–6.6) and those with a household income of more than £60,000 (OR 2.28, 95% CI 0.98–5.58), had more than twice the odds of providing a stool sample than those whose household income was £30,000-£60,000.
Table 4
Univariable analysis of the association between demographic factors and providing a stool sample.
Independent variable
|
Would provide a stool sample
|
Univariable Analysis
|
No (%)
|
Yes (%)
|
OR
|
95% CI
|
P value
|
Age (25–34)
|
17 (43.6%)
|
46 (34.1%)
|
Ref
|
NA
|
NA
|
Age (16–24)
|
7 (17.9%)
|
13 (9.6%)
|
0.8
|
0.27–2.58
|
0.696
|
Age (35–44)
|
9 (23.1%)
|
29 (21.5%)
|
1.19
|
0.48–3.12
|
0.713
|
Age (45–54)
|
5 (12.8%)
|
30 (22.2%)
|
2.22
|
0.78–7.32
|
0.155
|
Age (55+)
|
1 (2.6%)
|
17 (12.6%)
|
6.28
|
1.15-117.48
|
0.085
|
Gender (Female)
|
24 (61.5%)
|
96 (71.1%)
|
Ref
|
NA
|
NA
|
Gender (Male)
|
14 (35.9%)
|
39 (28.9%)
|
0.7
|
0.33–1.51
|
0.349
|
Income (£30,001–60,000)
|
21 (53.8%)
|
43 (31.9%)
|
Ref
|
|
|
Income (<£30,000)
|
8 (20.5%)
|
43 (31.9%)
|
2.50
|
1.02–6.6
|
0.052
|
Income (>£60,000)
|
10 (25.6%)
|
47 (34.8%)
|
2.28
|
0.98–5.58
|
0.061
|
Education (Degree/HND PGDips)
|
17 (43.6%)
|
53 (39.3%)
|
REF
|
NA
|
NA
|
Education (< Degree)
|
14 (35.9%)
|
34 (25.2%)
|
0.84
|
0.36–1.97
|
0.682
|
Education (Masters/PhD)
|
8 (20.5%)
|
47 (34.8%)
|
1.88
|
0.76–4.99
|
0.181
|
Ethnicity (White British)
|
31 (79.5%)
|
110 (81.5%)
|
REF
|
NA
|
NA
|
Ethnicity (BAME)
|
6 (15.4%)
|
13 (9.6%)
|
0.61
|
0.22–1.86
|
0.355
|
Ethnicity (White Other)
|
2 (5.1%)
|
12 (8.9%)
|
3.38
|
0.63–62.8
|
0.251
|
No. of Children (0)
|
21 (53.8%)
|
81 (60.0%)
|
REF
|
NA
|
NA
|
No. of Children (1–2)
|
15 (38.5%)
|
44 (32.6%)
|
0.72
|
0.34–1.57
|
0.723
|
No. of Children (3+)
|
1 (2.6%)
|
6 (4.4%)
|
1.48
|
0.23–28.81
|
0.408
|
OR odds ratio; CI confidence interval |