1 Health Surveys January 2008 Diane Martin, MA, PhD

2 Why Surveys? Answer important questions Learn new skills, especially in measurement Self admin. relatively inexpensive Complete fairly quickly Write one results paper and/or one methods paper

3 Survey Research Large body of scientific evidence Art of survey design, practical experience Tradeoff between methodological rigor and cost Two major types of res. questions –Describe (estimation) –Explain associations (hyp. testing)

4 Advantages of Surveys Collect information only respondent can answer Good for attitudes, beliefs, expectations, personal behaviors, subjective measures, individual experiences Information society (culturally defined)

5 Disadvantages of Surveys Respondent burden Nonresponse Negative influence of gov’t/privacy/telemarketing Poor survey techniques, everyone thinks they can do this

6 Survey - Last Resort Are existing data sufficient? Can secondary data be abstracted? Can observations be made?

7 Most Important Survey Principles Minimize errors throughout process Encourage response, decrease respondent burden Use tailored design Define measures carefully Pay attention to detail

8 Scientific Integrity Responsible conduct of research AAPOR code of ethics Conflicts of interest Elements of disclosure Human subject issues Interviewer falsification Data mashing

9 Ethical Principles Respect for the person: informed consent, rights respected Beneficence: subjects’ well-being, risks vs benefits Justice: benefits & burdens distributed fairly across people

10 UW IRB Exempt, ‘no risk’, anonymous, limited publication Minimal risk, expedited review (maybe) Full review

11 Survey Content Don’t reinvent the wheel Keep it simple, short Move from a conceptual model with major variables to operational definitions of variables (measurement matrix) Consider measurement issues Aday LA, Designing and Conducting Surveys, 1996

12 Single Questions versus Scale or Index Advantages of scale or index –Increases sensitivity –Decreases number of variables for analysis Consider the scale validity, reliability, measurement error Obtain help if constructing new scale

13 Survey Mode Choose mode appropriate for content and population Know mode advantages and disadvantages Interviews: in person, telephone, ACASI Self administered: in clinic, mail, computer/internet

14 Total Survey Error Overall goal: decrease study error Know different types of errors Anticipate errors in all phases of study!! Understand how errors affect results Take errors into account in analysis and discussion Groves RM et al, Survey Methodology, 2004

15 Tailored Survey Design Survey response is explained by Social Exchange Theory –Actions of individuals motivated by expected return on their actions Create respondent trust, perceived rewards > costs Use health marketing and communication Format for print or web Qs is crucial Pretest Dillman DA, Mail and Internet Surveys, 2007

16 Analysis Know unit of analysis Write hypotheses a priori, with clear definitions of outcome variable and independent (predictor) variables Write plan of analysis and make mock tables Use Epi Info to analyze data

17 Disseminate Results Feedback results to respondents, community, gov’t MOH (presentations, one page summary) Write articles for newspapers Find a journal article that reports on a study similar to yours – mimic it

18 Summary Survey - last resort Don’t reinvent the wheel Keep it short, simple Maximize social exchange Minimize errors and respondent burden