Mixing mixed-mode designs in a national health interview survey: a pilot study to assess the impact on the self-administered questionnaire non-response

Elise Braekman,Guido Van Hal,Stefaan Demarest,Lydia Gisle,Finaba Berete,Jean Tafforeau,Sabine Drieskens,Johan Van Der Heyden,Rana Charafeddine

doi:10.1186/s12874-019-0860-3

Elise Braekman, Guido Van Hal + Show 7 more

Open Access

https://doi.org/10.1186/s12874-019-0860-3

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Abstract

BackgroundMany population health surveys consist of a mixed-mode design that includes a face-to-face (F2F) interview followed by a paper-and-pencil (P&P) self-administered questionnaire (SAQ) for the sensitive topics. In order to alleviate the burden of a supplementary P&P questioning after the interview, a mixed-mode SAQ design including a web and P&P option was tested for the Belgian health interview survey.MethodsA pilot study (n = 266, age 15+) was organized using a mixed-mode SAQ design following the F2F interview. Respondents were invited to complete a web SAQ either immediately after the interview or at a later time. The P&P option was offered in case respondents refused or had previously declared having no computer access, no internet connection or no recent usage of computers. The unit response rate for the web SAQ and the overall unit response rate for the SAQ independent of the mode were evaluated. A logistic regression analysis was conducted to explore the association of socio-demographic characteristics and interviewer effects with the completed SAQ mode. Furthermore, a logistic regression analysis assessed the differential user-friendliness of the SAQ modes. Finally, a logistic multilevel model was used to evaluate the item non-response in the two SAQ modes while controlling for respondents’ characteristics.ResultsOf the eligible F2F respondents in this study, 76% (107/140) agreed to complete the web SAQ. Yet among those, only 78.5% (84/107) actually did. At the end, the overall (web and P&P) SAQ unit response rate reached 73.5%. In this study older people were less likely to complete the web SAQ. Indications for an interviewer effect were observed as regard the number of web respondents, P&P respondents and respondents who refused to complete the SAQ. The web SAQ scored better in terms of user-friendliness and presented higher item response than the P&P SAQ.ConclusionsThe web SAQ performed better regarding user-friendliness and item response than the P&P SAQ but the overall SAQ unit response rate was low. Therefore, future research is recommended to further assess which type of SAQ design implemented after a F2F interview is the most beneficial to obtain high unit and item response rates.

Highlights

Many population health surveys consist of a mixed-mode design that includes a face-to-face (F2F) interview followed by a paper-and-pencil (P&P) self-administered questionnaire (SAQ) for the sensitive topics
This SAQ is only addressed to the participants of 15 years and older who do not have their F2F interview completed by proxy
Taking advantage of the technological advancements applied to data collection, a web SAQ to be completed after the F2F interview was pilot tested in the framework of the Belgian health interview survey (BHIS) under the assumption that it reduces the burden for the F2F respondents and improves the data quality with regard to the traditional P&P SAQ

Summary

Introduction

Many population health surveys consist of a mixed-mode design that includes a face-to-face (F2F) interview followed by a paper-and-pencil (P&P) self-administered questionnaire (SAQ) for the sensitive topics. A number of national health interview surveys (HISs) such as those carried out in Belgium, Denmark, the United Kingdom and France included, in addition to a face-to-face (F2F) interview, a paper-and-pencil (P&P) self-administered questionnaire (SAQ) for a specific subsection of the questionnaire [1,2,3,4] In this type of mixedmode design the SAQ is typically used for sensitive topics such as substance use and mental health in order to reduce potential social desirability bias and to enhance the respondents’ privacy [5]. Completing a P&P SAQ immediately after a long and fatiguing F2F session can seem too burdensome for the respondents and cause a drop in the response rate of the SAQ Both the Belgian health interview survey (BHIS) and the Danish HIS report a substantial portion of respondents that fail to complete this additional P&P SAQ [2, 6]. The declining response rates and the growing complexity regarding the reasons for non-responding challenge the ability to confidently obtain populationrepresentative net samples that provide estimates that are generalizable for the whole population [9]

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