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1 Questionnaire Design K Alpers C Campese, P McKeown, V Bremer, V Prikazsky EPIET Introductory Course Lazareto, Menorca 6 October 2011.

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Presentation on theme: "1 Questionnaire Design K Alpers C Campese, P McKeown, V Bremer, V Prikazsky EPIET Introductory Course Lazareto, Menorca 6 October 2011."— Presentation transcript:

1 1 Questionnaire Design K Alpers C Campese, P McKeown, V Bremer, V Prikazsky EPIET Introductory Course Lazareto, Menorca 6 October 2011

2 2 What is a questionnaire? A tool for data collection A series of written questions in a fixed, rational order

3 3 A well designed questionnaire Good appearance (easy for the eye) Short and simple Relevant and logical High response Easier to collect to summarize to analyse Minimises potential sources of bias

4 4 Bias Systematic difference in the response measurement Recall bias –Cases more likely to remember than controls Observer bias –Different interviewers – different interpretations –Different interpretation of similar questions Non-response bias –telephone interviews: more females, elderly

5 5 How to reduce bias Structured questionnaire Ensure high response rate Random choice of interview partners Training of interviewers

6 6 Advantages of questionnaires Can reach a large number of people Relatively easy and economic Relate directly to study question Provide quantifiable answers Relatively easy to analyse

7 7 Disadvantages of questionnaires Provide only limited insight into a problem –the range of possible responses is limited –the question maybe misleading Varying response –Unclear question can lead to misunderstanding misinterpretation Do not allow for mistakes –must be right from the beginning –missing data hard to chase

8 8 Types of Questionnaires Interviewer-administered –face to face

9 9 Types of Questionnaires Interviewer-administered –face to face –telephone

10 10 Types of Questionnaires Interviewer-administered –face to face –telephone Self-administered –by post

11 11 Types of Questionnaires Interviewer-administered –face to face –telephone Self-administered –by post – –Internet –Social Networks

12 12 Self-administered questionnaire Advantages cheap and easy to administer –preserves confidentiality –completed at respondent's convenience –not influenced by interviewer

13 13 Self-administered questionnaire Advantages –cheap and easy to administer –preserves confidentiality –completed at respondent's convenience –not influenced by interviewer Disadvantages –low response –questions can be misunderstood –no control by interviewer –only literate persons –time delay (post) – /internet: need computer access/software

14 14 Interviewer-administered questionnaire Advantages –participation of illiterate people –clarification of ambiguities –quick answers

15 15 Interviewer-administered questionnaire Advantages –participation of illiterate people –clarification of ambiguities –quick answers Disadvantages –interviewer bias –needs more staff resources –only short questionnaires possible especially on telephone –difficult for sensitive issues

16 16 Before starting to design a questionnaire Write a study protocol! define objectives define study questions Risk factors for being stung by jellyfish at Lazareto (Menorca), October 2011 Study protocol Prepared by cohort 17 Menorca, 6 October 2011

17 17 Study protocol and questionnaire Definition of objectives List of variables to collect Analysis plan Study protocol Design questions Control and reading Pilot test questionnaire questions must relate to objectives collect appropriate information for analyses

18 18 Use existing questionnaires As an inspiration Don´t need to re-invent the wheel Have been tested BUT: adapt to present situation!

19 19 Questionnaires for outbreak investigations Exploratory –Generate hypotheses –Detailed –Only some cases –Based on existing questionnaires –Open questions Analytical study –Testing hypothesis –Focus on possible vehicles

20 20 Questionnaire needs to be adapted to study population Know the respondents –language –education –occupation –ethnic group –sensitive issues

21 21 Structure of a questionnaire 1Identification 2Interview introduction 3Instructions on how to answer 4Questions 5Conclusion

22 Identification On first page –Return address –Study title On all pages –Identifyer –Page numbers Data protection: Identifiers kept separately from names

23 Introduction Covering letter/ interview introduction –Who are you / you work for –Why are you investigating –Where did you obtain the respondents name –How and where can you be contacted –Guarantee of confidentiality –Length of interview (be honest) Usefulness of study should be clear to all respondents

24 24 Example of introduction Good morning, My name is....., I work for …….. You may have been already informed that a survey on risk factors for being stung by a jellyfish will be done this week in Mahon. This study has been approved by the national ethical committee. Only anonymized data will be analysed. You have been randomly selected to participate in this study. Your participation is voluntary. The interview will take about 10 minutes. I will start with the first question.....

25 Instructions Minimise potential sources of bias Guide for Interviewers Guide for Respondents in self-administered questionnaires –Which questions can be skipped => where to jump to –Selection of multiple answers possible Use different fonts (e.g. bold or italics) Example: I will ask you a few questions about your contacts with jellyfish. You will answer by yes or no If no, go to question 27

26 Questions 1.Content 2.Order 3.Format 4.Coding 5.Pitfalls

27 Content of questions Clear focus on research question –avoid sidetracking –avoid unnecessary information

28 Question order Decide on the order of items/questions –easy difficult –general particular –factual abstract Group questions by topic Be aware of ordering effects Dont put the most important items last Where to place sensitive questions?

29 29 Starting questions –Door-opener –Simple –Closed format –Relevant to main subject –Non-offending –Neither demographic nor personal questions

30 Format of questions Adjust to responding audience –professionals vs. public –middle class vs. prisoners Keep sentences simple and short Define key words (fully vaccinated) Remember options –dont know –dont want to answer

31 31 Ask one thing at a time 7 - Do you like to go swimming and do you mind to be stung by jellyfish? Yes No Ask for one information at a time Answer options – Mutually exclusive and exhaustive – Vertical order of answer options

32 32 Be accurate 8 – What is the jellyfish situation? Good Bad Versus 8 - How often did you see jellyfish during the last week? Once Twice Three times or more Never Don´t know

33 33 Be objective 10 - Do you agree that jellyfish are annoying? Yes No versus 10 - According to you, jellyfish in Lazareto are… not at all a public health problem not a major public health problem a potential public health problem an important public health problem no opinion/don´t know

34 34 Be simple 11- Did you see more than an average of 33 jellyfish/m 2 salt water surface on more than 3 occasions that you went swimming in the morning last week? Yes No versus 11- Have you seen jellyfish on more than 3 mornings last week? Yes No Don´t know

35 35 Two main question formats Closed format forced choice Yes Always No Sometimes Dont know Never Open format free text 12 – What did you do to avoid being stung by jellyfish? Please describe : __________________________________________ ________________________________________

36 36 Advantages of open questions not directive detailed and unexpected answers possible –> allow exploration of issues to generate hypotheses useful for exploring knowledge and attitudes qualitative research focus groups trawling questionnaires

37 37 Disadvantages of open questions interviewer bias time-consuming coding problems difficult to analyse difficult to compare groups

38 38 Advantages of closed questions Straightforward response Simple Quick Less discrimination against less verbally expressive people Easy to code, record, analyse Easy to compare Easy to report

39 39 Disadvantages of closed questions restricted number of possible answers Possible loss of additional information Compromise –insert field others, if yes specify : __________

40 40 Examples for closed questions 2 - What is your age in years? ___ years 3 - How long have you stayed at Lazareto? ___ days 4 - What is your sex (gender)? Male Female 5 - Did you go swimming on 4 October 2010? Yes No Dont know

41 Which of the following beaches have you visited during your stay in Menorca? Lazareto beach Calan Porter Rafalet Macarella SaMesquida Closed questions: Checklist

42 Which of the following beaches have you visited during your stay in Menorca? Lazareto beach Yes No Don´t know Calan Porter Yes No Don´t know Rafalet Yes No Don´t know Macarella Yes No Don´t know Sa Mesquida Yes No Don´t know Checklist

43 43 Rating scale 15 – How often did you see jellyfish during the past weeks? Always Sometimes Seldom Never Mornings Lunchtime Evenings

44 44 Rating scale Numerical 16 - How severe was your pain after you were stung? (please circle) Not painful at all Very painful Analogue 17- How severe is your pain (put the tick on the line) 010

45 45 Likert Scale Rensis Likert, Psychometric scale Five (or more) ordered response levels 18 – Jellyfish also have the right to swim in the Mediterranean sea I strongly disagree I disagree I neither agree or disagree I agree I strongly agree

46 Coding Answers can be pre-coded Quicker and easier data entry Examples: Male 1 Ill 1 Female 0 Not ill 0 Dont know 9 Lazareto beach 1 Harbour 2 Es Castel 3 Mahón 4

47 Avoid pitfalls jargon/abbreviations/slang 21- Should jellyfish victims receive a PEP? (post exposure prophylaxis) not mutually exclusive options 22 - What is your age ?

48 48 Avoid…. Leading questions 23 - Do you think we should forbid EPIET-fellows to go swimming in the mornings? Making the questionnaire too long Typographical / spelling errors

49 Conclusion Dont forget to thank the interviewed persons Tell them when the results will be available and where

50 50 Example of conclusion This is the end of the interview. Thanks for answering this questionnaire. The result of this study will be available on the ECDC website in six weeks. Do you have any others questions you wish to ask ? We are still in a very early phase of our investigation. Would you agree to be contacted again in case further questions arise? In some outbreak investigations you might want to add:

51 51 Presentation and layout Clear and consistent adequate space to answer – large font size – appropriate page breaks avoid messy layouts too many and fancy logos printing questionnaire on coloured paper may help

52 52 Pilot your questionnaire! Pilot with a group of people -> similar to your target subjects Highlight problems before starting –Misunderstandings –Look for alternative wording –Final polishing

53 53 Summary A well designed questionnaire: collects appropriate data -> to answer your research question minimises potential sources of bias -> increases the validity of the replies Will much more likely be completed


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