Using Visual Analogue Scales in eHealth: Non-Response Effects in a Lifestyle Intervention.

Tim Kuhlmann,Julian Wienert,Ulf-Dietrich Reips,Sonia Lippke

doi:10.2196/jmir.5271

Tim Kuhlmann, Julian Wienert + Show 2 more

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https://doi.org/10.2196/jmir.5271

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Abstract

BackgroundVisual analogue scales (VASs) have been shown to be valid measurement instruments and a better alternative to Likert-type scales in Internet-based research, both empirically and theoretically [1,2]. Upsides include more differentiated responses, better measurement level, and less error. Their feasibility and properties in the context of eHealth, however, have not been examined so far.ObjectiveThe present study examined VASs in the context of a lifestyle study conducted online, measuring the impact of VASs on distributional properties and non-response.MethodA sample of 446 participants with a mean age of 52.4 years (standard deviation (SD) = 12.1) took part in the study. The study was carried out as a randomized controlled trial, aimed at supporting participants over 8 weeks with an additional follow-up measurement. In addition to the randomized questionnaire, participants were further randomly assigned to either a Likert-type or VAS response scale version of the measures.ResultsResults showed that SDs were lower for items answered via VASs, 2P (Y ≥ 47 | n=55, P=.5) < .001. Means did not differ across versions. Participants in the VAS version showed lower dropout rates than participants in the Likert version, odds ratio = 0.75, 90% CI (0.58-0.98), P=.04. Number of missing values did not differ between questionnaire versions.ConclusionsThe VAS is shown to be a valid instrument in the eHealth context, offering advantages over Likert-type scales. The results of the study provide further support for the use of VASs in Internet-based research, extending the scope to senior samples in the health context.Trial RegistrationClinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6h88sLw2Y)

Highlights

Internet- and eHealth-Based Health PromotionInternet-based health promotion targeting health behavior change is a promising approach for health behavior change and aftercare programs [3]
We argue that the progression in technology has widely eliminated technical difficulties when using visual analogue scale (VAS), and a main effect on less dropout and missing data remains, even with cardiac patients who otherwise may not be routinely confronted with computerized VASs
The results from the analyses of item properties, dropout, and missing values are presented

Summary

Introduction

Internet-based health promotion targeting health behavior change is a promising approach for health behavior change and aftercare programs [3] It offers a number of advantages over traditional health promotion methods, most notably, the possibility of taking part anywhere at any time, as long as an Internet-connected device is available. The field of Internet-based health promotion is in its early stages and guidelines for designing such programs optimally are sparse This is of crucial importance because the development of eHealth programs is time consuming and the outcome, for example, less mortality due to a healthier lifestyle, of high value [5]. In addition to the randomized questionnaire, participants were further randomly assigned to either a Likert-type or VAS response scale version of the measures. Trial Registration: Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6h88sLw2Y)

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