Dillman's Total Design Method Research Articles

Health Care Provider Stigma Toward Patients With Substance Use Disorders: Protocol for a Nationally Representative Survey.

The US overdose epidemic is an escalating public health emergency, accounting for over 100,000 deaths annually. Despite the availability of medications for opioid use disorders, provider-level barriers, such as negative attitudes, exacerbate the treatment gap in clinical care settings. Assessing the prevalence and intensity of provider stigma, defined as the negative perceptions and behaviors that providers embody and enact toward patients with substance use disorders, across providers with different specialties, is critical to expanding the delivery of substance use treatment. To thoroughly understand provider stigma toward patients with substance use disorders, we conducted a nationwide survey of emergency medicine and primary care physicians and dentists using a questionnaire designed to reveal how widely and intensely provider attitudes and stigma can impact these providers' clinical practices in caring for their patients. The survey also queried providers' stigma and clinical practices toward other chronic conditions, which can then be compared with their stigma and practices related to substance use disorders. Our cross-sectional survey was mailed to a nationally representative sample of primary care physicians, emergency medicine physicians, and dentists (N=3011), obtained by American Medical Association and American Dental Association licensees based on specified selection criteria. We oversampled nonmetropolitan practice areas, given the potential differences in provider stigma and available resources in these regions compared with metropolitan areas. Data collection followed a recommended series of contacts with participants per the Dillman Total Design Method, with mixed-modality options offered (email, mail, fax, and phone). A gradually increasing compensation scale (maximum US$250) was implemented to recruit chronic nonresponders and assess the association between requiring higher incentives to participate and providers stigma. The primary outcome, provider stigma, was measured using the Medical Condition Regard Scale, which inquired about participants' views on substance use and other chronic conditions. Additional survey measures included familiarity and social engagement with people with substance use disorders; clinical practices (screening, treating, and referring for a range of chronic conditions); subjective norms and social desirability; knowledge and prior education; and descriptions of their patient populations. Data collection was facilitated through collaboration with the National Opinion Research Center between October 2020 and October 2022. The overall Council of American Survey Research Organizations completion rate was 53.62% (1240/2312.7; physicians overall: 855/1681.9, 50.83% [primary care physicians: 506/1081.3, 46.79%; emergency medicine physicians: 349/599.8, 58.2%]; dentists: 385/627.1, 61.4%). The ineligibility rate among those screened is applied to those not screened, causing denominators to include fractional numbers. Using systematically quantified data on the prevalence and intensity of provider stigma toward substance use disorders in health care, we can provide evidence-based improvement strategies and policies to inform the development and implementation of stigma-reduction interventions for providers to address their perceptions and treatment of substance use. DERR1-10.2196/47548.

Perceptions of FASD by Minnesota public defenders

PurposePersons diagnosed with fetal alcohol spectrum disorder (FASD) are more likely to come into contact with the criminal justice system than general population controls. Although previous survey evidence has suggested that federal district attorneys are limited in their knowledge of the psycholegal impairments presented by defendants with this condition, such research has yet to have been conducted with state-specific public defenders. The paper aims to discuss these issues.Design/methodology/approachThe Dillman Total Design Method was used to disseminate an electronic survey to public defenders in Minnesota. The survey included questions designed to measure their knowledge bases on and legal experiences with FASD. Surveys were completed by 135 respondents (nMen=63; nWomen=72) with an average of 16.22 years (SD=11.34) of legal experience.FindingsRespondents varied in their knowledge bases on the cognitive impairments, social deficits, and physical complications characteristic of FASD. Less than 20 percent of respondents reported having received training on the psycholegal impairments experienced by individuals diagnosed with FASD from arrest until the start of adjudication, during adjudication, or during incarceration. Over 95 percent of respondents reported that they could benefit from a Continuing Legal Education course on the psycholegal impairments of individuals diagnosed with FASD, and over 90 percent reported that they could benefit from being provided the findings of a screening tool for FASD in their daily practice.Originality/valueFirst survey of state public defenders’ perceptions of FASD.

Perceptions of FASD by United States District Attorneys

Purpose The majority of individuals diagnosed with fetal alcohol spectrum disorder (FASD) will become involved with the criminal justice system during their lifetime. Due to the signs and symptoms of their illness, the psycholegal impairments presented by such alleged offenders pose unique challenges for the attorneys tasked with prosecuting their crimes. That said, little is known about the training and courtroom background of district attorneys with this population. The paper aims to discuss these issues. Design/methodology/approach A web-based survey was developed to investigate the knowledge bases and legal experiences of US District Attorneys concerning FASD, and to compare these across sexes, legal experience levels, as well as geographical regions. The survey was distributed electronically to all US District Attorneys following the Dillman Total Design Method. Surveys were completed by 216 respondents (men, n=166; women, n=50; Northeast, n=32; South, n=102; Midwest, n=36; West, n=46) with an average of 25.03 years (SD=10.71) of legal experience. Findings Participants displayed variable levels of knowledge concerning the signs and symptoms of FASD and underestimated how often persons with FASD become involved in the criminal justice system. The majority of participants had never received training on the psycholegal impairments of individuals diagnosed with FASD and reported that they would benefit from a Continuing Legal Education course on the subject. Participants also reported that they would benefit from seeing the findings of an FASD screening tool in daily practice. Originality/value First survey of legal professionals’ perceptions of FASD.

Enablers of Six Sigma: contextual framework and its empirical validation

The aim of the paper is to identify the enablers for the successful implementation of Six Sigma. None of the existing frameworks provides any clear understanding related to linkages between, and hierarchical relationships among, the constructs of Six Sigma implementation. Our study has both inductive and deductive elements. We identified enablers of Six Sigma implementation from existing research, and we developed a contextual framework using the interpretive structural modelling technique. We further studied enablers based on their driving power and dependence using MICMAC analysis to categorise the enablers into four clusters. In order to validate the ISM model statistically we developed and pre-tested a structured questionnaire before using it for a survey. Data were collected using a split survey method using a modified version of Dillman's total design method. We performed non-response bias before checking assumptions such as constant variance and normality. We further checked the reliability and construct validity using confirmatory factor analysis. We find that constructs and indicators of our theoretical framework meet the criteria, and find them to be a good fit based on confirmatory factor analysis. We draw conclusions based on statistical analyses and our study limitations, and suggest further research directions.

Child Care Provider Awareness and Prevention of Cytomegalovirus and Other Infectious Diseases

Child care facilities are prime locations for the transmission of infectious and communicable diseases. Children and child care providers are at high risk for cytomegalovirus (CMV) infection which causes severe birth defects and developmental delays. The goals of study were: (1) to determine the level of cytomegalovirus awareness and other infectious diseases among child care providers, and (2) to determine what measures providers are taking to prevent the spread of infectious disease. This is a descriptive study. We used the Dillman total design method to survey a random sample of licensed family and residential child care providers. We used a 29-item questionnaire to ask about awareness of cytomegalovirus and other infectious diseases, knowledge of how to control spread of these diseases, sources of information, personal hand hygiene behaviors, and demographics. The response rate was 68.6 %. Awareness of infectious diseases ranged from 12.8 to 99.4 %; 18.5 % ‘had’ heard of CMV. Respondent’s primary sources of information were health care providers and the Internet. Self-report of hand hygiene behavior was high. Providers do not know how to appropriately sanitize surfaces to reduce spread of disease. Awareness of CMV and how to prevent transmission of infectious disease is low. Intervening with child care providers and parents through child care facilities are key opportunities to reduce prevalence of CMV infection and other diseases.

Identifying Aspects of Pharmacists' Attitudes and Barriers toward Health Literacy: A Factor Analytic Study

Health literacy has gained prominence since the Institute of Medicine Report publicized the widespread prevalence of low health literacy. Pharmacists play an important role in enhancing health literacy as a result of their proximity to patients. Literature about pharmacists' perceptions and barriers in incorporating health literacy interventions is lacking. To develop an instrument to measure pharmacists' attitudes and barriers toward health literacy. A survey instrument assessing attitudes and barriers was designed based on a pharmacist focus group. The instrument was pretested among a sample of pharmacists from Illinois. The final instrument was administered to a systematic sample of 1500 pharmacists who were members of the Illinois Pharmacists Association. Dillman's 5-step total design method was followed to maximize survey responses. Exploratory principal components analysis with varimax rotation was performed on attitudes and barriers items to identify underlying components. Internal consistency of the components was determined using the Cronbach α and corrected item-total correlations. Overall, usable responses were received from 701 respondents, yielding a 48.1% response rate. Exploratory principal components analysis of the attitudes subscale produced a 5-factor solution that explained 55.87% of the variance. The 5 components included (1) low health literacy (LHL) situations, (2) LHL reasons, (3) LHL patient characteristics, (4) medication-related factors, and (5) LHL patient-interaction factors. The barriers subscale produced 3 components: (1) practice-related barriers, (2) knowledge and interaction-related barriers, and (3) process barriers, all of which explained 53.74% of the variance. Cronbach α values for the 5 attitudes subscales ranged from 0.33 to 0.78 and, for the 3 barriers, subscale values ranged from 0.56 to 0.71, offering evidence of internal consistency. Identification of components of pharmacists' attitudes and barriers toward health literacy will be useful to managers interested in incorporating health literacy interventions in their practice.

Using cervical spine clearance guidelines in a pediatric population: a survey of physician practices and opinions

Unlike in adults, there are currently no standardized, validated guidelines to aid practitioners in clearing the pediatric cervical spine (C-spine). Many pediatric centres in Canada have locally produced, adult-modified guidelines, but the extent to which these or other guidelines are used is unknown. The purpose of this study was to determine if Canadian physicians are using either locally produced or adult C-spine guidelines to clear the C- spines of patients < 16 years of age. The study also characterized the common methods used by physicians to clear pediatric C-spine injuries in terms of clinical examination and radiologic imaging. A 20-question survey was distributed to 240 Canadian pediatric emergency physicians and trauma team leaders using the Dillman Total Design Method. The response rate was 68%. The results showed that 61% of physicians currently use guidelines to assist in the clearance of pediatric C-spines. Of those physicians not using guidelines, 85% stated that they would use them if they were available. The clinical criteria most often used to clear pediatric C-spines were a normal neurologic examination (97%) and the absence of C-spine tenderness (95%), intoxication (94%), and distracting injuries (87%). Guidelines are commonly used by Canadian physicians when clearing the pediatric C-spine, yet few are validated in children. Those most commonly used are locally developed guidelines, the Canadian C-spine guidelines, or National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria.

Nonresponse Error in Mail Surveys: Top Ten Problems

Conducting mail surveys can result in nonresponse error, which occurs when the potential participant is unwilling to participate or impossible to contact. Nonresponse can result in a reduction in precision of the study and may bias results. The purpose of this paper is to describe and make readers aware of a top ten list of mailed survey problems affecting the response rate encountered over time with different research projects, while utilizing the Dillman Total Design Method. Ten nonresponse error problems were identified, such as inserter machine gets sequence out of order, capitalization in databases, and mailing discarded by postal service. These ten mishaps can potentiate nonresponse errors, but there are ways to minimize their frequency. Suggestions offered stem from our own experiences during research projects. Our goal is to increase researchers' knowledge of nonresponse error problems and to offer solutions which can decrease nonresponse error in future projects.

Community-based natural resources management (CBNRM) in Xinhui, Guangdong Province, China

Using institutional appraisal focused groups (FG) and participatory appraisals with Dillman Total Design Method (TDM), this study examines community interaction with and utilization of wetland resources in Xinhui, Guangdong Province, China. Field results show high commercial activities and corresponding impacts on coastal environment. Other interacting factors identified include: legislation and ecosystem management, stakeholders’ participation, international guidelines criteria, and utilization of mangrove resources in the region. Sensitivity index and community-based natural resources management collaboration comparison percentile showed significant differences between cumulative distributions of respondents (D = 0.2568, P = 0.078). Likert statement of 11 sensitivity optional indexes in EMS of K–S test at 0.05 level of P = 0.078 also show significant differences in interaction between respondent groups and sensitivity factors. This indicates a dysfunction between regional environmental management systems and CBNRM in Xinhui coastal district. Considering the high tourism potential and economic quest of the region, there is the need for coordinated community enlightenment and further studies on the social, ecological and economic value of wetland resources.

Looking inside the black box: a theory-based process evaluation alongside a randomised controlled trial of printed educational materials (the Ontario printed educational message, OPEM) to improve referral and prescribing practices in primary care in Ontario, Canada

BackgroundRandomised controlled trials of implementation strategies tell us whether (or not) an intervention results in changes in professional behaviour but little about the causal mechanisms that produce any change. Theory-based process evaluations collect data on theoretical constructs alongside randomised trials to explore possible causal mechanisms and effect modifiers. This is similar to measuring intermediate endpoints in clinical trials to further understand the biological basis of any observed effects (for example, measuring lipid profiles alongside trials of lipid lowering drugs where the primary endpoint could be reduction in vascular related deaths).This study protocol describes a theory-based process evaluation alongside the Ontario Printed Educational Message (OPEM) trial. We hypothesize that the OPEM interventions are most likely to operate through changes in physicians' behavioural intentions due to improved attitudes or subjective norms with little or no change in perceived behavioural control. We will test this hypothesis using a well-validated social cognition model, the theory of planned behaviour (TPB) that incorporates these constructs.Methods/designWe will develop theory-based surveys using standard methods based upon the TPB for the second and third replications, and survey a subsample of Ontario family physicians from each arm of the trial two months before and six months after the dissemination of the index edition of informed, the evidence based newsletter used for the interventions. In the third replication, our study will converge with the "TRY-ME" protocol (a second study conducted alongside the OPEM trial), in which the content of educational messages was constructed using both standard methods and methods informed by psychological theory. We will modify Dillman's total design method to maximise response rates. Preliminary analyses will initially assess the internal reliability of the measures and use regression to explore the relationships between predictor and dependent variable (intention to advise diabetic patients to have annual retinopathy screening and to prescribe thiazide diuretics for first line treatment of uncomplicated hypertension). We will then compare groups using methods appropriate for comparing independent samples to determine whether there have been changes in the predicted constructs (attitudes, subjective norms, or intentions) across the study groups as hypothesised, and will assess the convergence between the process evaluation results and the main trial results.Trial registration numberCurrent controlled trial ISRCTN72772651

What Do Adults in Prince Edward Island: Know About Nutrition?

To assess adults' knowledge of dietary recommendations, food sources of key nutrients, food choices, and diet-disease relationships. A previously validated survey, designed to assess nutrition knowledge, was adapted for use in Prince Edward Island and mailed to a random sample of 3,500 adults (aged 18 to 74). Dillman's Total Design Method was followed and a response rate of 26.4% achieved. Mean scores and 95% confidence intervals (CIs) were calculated for the overall survey and for each section. Demographic variations were assessed by univariate analysis. Of an overall possible score of 110 points, the mean score with 95% CI was 71.0 (70.1, 71.9). Respondents scored higher on the sections on dietary recommendations, food sources, and food choices than diet-disease relationships. Demographic differences existed in gender, age, education, and income. Findings suggest that adults have good general knowledge of dietary recommendations, but lack knowledge about how to make healthier food choices and the impact of diet on disease risk. When designing intervention strategies, dietitians should consider targeted messages to provide adults with the information they need to make healthy food choices.

Measure and control of non‐response in a mail survey

PurposeThis paper shows several results obtained from the first investigation made in Spain using Dillman's total design method for mail surveys. In the spring of 1998 a survey was carried out on consumer behaviour in one particular Spanish region (Navarra). The response rate was 68.3 percent. One month later, a team of professional interviewers interviewed the people who did not respond to the mail survey. The objective is to compare the results obtained by these interviewers with an estimation of the non‐response after using several different methods and a group of adjustment procedures.Design/methodology/approachThe total design method (TDM) for mail surveys has produced some wonderful results in several countries in Northern and Central Europe, but as far as one can gather it has never been used in any of the countries of Southern Europe surrounding the Mediterranean. The excellent results obtained from mail surveys in the USA, and some of the findings confirmed by disciples of Dillman in several European countries, led to carrying out the first investigation in Spain using TDM through mail surveys. With the aim of resolving some of the above‐mentioned questions, it was decided to make the first‐ever investigation using TDM within Spanish society.FindingsThe results obtained by applying the total design method to a Mediterranean country do not differ greatly from data obtained by other researchers on the efficiency of mailing surveys in other countries. This fact forces one to have serious doubts about the declarations of some experts who place the response rate for mailing surveys at 40 percent in Spain. In this paper, different strategies to reduce the impact of non‐response in a mail survey are outlined. First, a second interview was carried out with a subsample of the interviewees who were non‐responders, with the aim of finding out more about the characteristics of those who do not respond. Later, a strategy of weighting was used using CHAID to identify the best predictors from among the set of variables available.Originality/valueIn the South of Europe there is very sparse use of mail surveys, while there is great use of face‐to‐face surveys: this is the opposite of the tendency in other countries, where telephone surveys are supplanting the face‐to‐face interview. This is the first research about non‐response in mail surveys in the South of Europe.

Oropharyngeal dysphagia: surveying practice patterns of the speech-language pathologist.

The present study was designed to obtain a comprehensive view of the dysphagia assessment practice patterns of speech-language pathologists and their opinion on the importance of these practices using survey methods and taking into consideration clinician, patient, and practice-setting variables. A self-administered mail questionnaire was developed following established methodology to maximize response rates. Eight dysphagia experts independently rated the new survey for content validity. Test-retest reliability was assessed with a random sample of 23 participants. The survey was sent to 50 speech-language pathologists randomly selected from the Canadian professional association database of members who practice in dysphagia. Surveys were mailed according to the Dillman Total Design Method and included an incentive offer. High survey (64%) and item response (95%) rates were achieved and clinicians were reliable reporters of their practice behaviors (ICC>0.60). Of all the clinical assessment items, 36% were reported with high (>80%) utilization and 24% with low (<20%) utilization, the former pertaining to tongue motion and vocal quality after food/fluid intake and the latter to testing of oral sensation without food. One-third (33%) of instrumental assessment items were highly utilized and included assessment of bolus movement and laryngeal response to bolus misdirection. Overall, clinician experience and teaching institutions influenced greater utilization. Opinions of importance were similar to utilization behaviors (r = 0.947, p = 0.01). Of all patients referred for dysphagia assessment, full clinical assessments were administered to 71% of patients but instrumental assessments to only 36%. A hierarchical model of practice behavior is proposed to explain this pattern of progressively decreasing item utilization.

Mail Surveys Can Achieve High Response Rates in a Dermatology Patient Population

In order to understand the burden of skin disease on patient populations, researchers need to be able to measure exposures and outcomes of interest in a population-based study. One method of obtaining such information is mailed patient surveys. This method of obtaining information, however, raises concerns regarding possible low response rates, and to the best of our knowledge, this method has not been attempted in large dermatology patient populations with a high response rate. We sought to determine whether using a slightly modified version of the Dillman Total Design Method as a mailed survey protocol would result in a high response rate in a dermatology population. A mail survey was sent using a slightly modified version of Dillman's Total Design Method to 4894 patients seen in the Dermatology Department of the University of Pennsylvania, who were diagnosed with nonmelanoma skin cancer, dermatophytosis, acne rosacea, seborrheic keratosis, or warts; 74.1% of the subjects responded to the mailings; 69.8% (n=3203) of patients returned a completed survey. Response rates (both as overall response and as survey completers only) were high across a wide spectrum of dermatologic illnesses and did not vary significantly by entry diagnosis. Dillman's Total Design Method appears to be an effective tool for researchers studying the burden of skin disease in a large sample of dermatology patients.

Comparison of Triage Assessments among Pediatric Registered Nurses and Pediatric Emergency Physicians

Objectives: To compare triage level assignments, using simulated written case scenarios, in a pediatric emergency department (ED) among registered nurses (RNs) and pediatric emergency physicians (PEPs) and to compare the triage level assignments among RNs and PEPs with a consensus criterion standard. Methods: This was a cross‐sectional mailed questionnaire survey. The study was conducted at a pediatric tertiary care center with more than 65,000 annual patient visits. Participants were PEPs and RNs working in the ED. Dillman's Total Design Method, with three mailouts, was used for questionnaire construction and implementation. The survey included 55 case scenarios of patients presenting to the ED. Participants were instructed to assign triage level on each case, using the following four‐level triage scale: 1 = resuscitation / emergent, 2 = urgent, 3 = less‐urgent, and 4 = non‐urgent. A priori, all cases were assigned a triage level by consensus agreement of three PEPs, using established triage guidelines from the RNs' teaching manual. Kappa statistics (95% CI) and the mean percentage of correct responses (±1 SD) were calculated. Results: There was a 100% response rate (39 RNs, 24 PEPs). The kappa level of agreement (95% CI) was 0.453 (0.447 to 0.459) among the RNs and was 0.419 (0.409 to 0.429) among the PEPs. The mean percentage of correct responses (±1 SD) for the RNs was 64.2% (±8.0%) and for the PEPs was 53.5% (±8.1%, p &lt; 0.01). There was no significant difference within groups by experience level (&lt;10 vs. ≥10 years) or by the type of work schedule (day vs. evening vs. overnight) or full‐time vs. part‐time status. Conclusions: The level of agreement and accuracy of triage assignment was only moderate for both RNs and PEPs. Triage, a crucial step in emergency care, requires improved measurement.

Providing Sexual Education to Victims of Child Sexual Abuse: What Is a Clinician to Do?

ABSTRACT Despite the large body of research on childhood sexual abuse, virtually no one has examined the coverage of sexual education in treatment. Agencies from across the United States that specialize in treating child and adolescent victims of sexual abuse were surveyed. The results indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not based on gender or treatment modality. Parents are often included in treatment; however, the amount of parental involvement varies. Published materials, such as children's books and videos, are frequently used. Participants (i.e., clinicians) are satisfied with their coverage of sexual education in treatment even though clients often experience negative reactions. Results suggest that covering sexual education in treatment helps decrease some of the negative effects of sexual abuse. This study also serves as a test of Dillman's Total Design Method of conducting mail surveys.

Use of the Health Belief Model to Examine Older Adults' Food-Handling Behaviors

Objective To measure the association among Health Belief Model (HBM) variables and safe food-handling behaviors among older adults. Design A mail survey using Dillman's Total Design Method. Setting In October 1999, a survey was sent to volunteers from a preexisting cohort of noninstitutionalized older adults living throughout Nevada. Data collection continued through January 2000. Participants With a 56% response rate, the sample (n = 266) was composed mainly of women (73%) and individuals from urban counties (74%). The mean age was 68.09 years (SD = 8.27). Except for gender, sample characteristics were similar to those of the preexisting cohort. Variables Measured Perceived threat of foodborne illness (ie, perceived severity and perceived susceptibility), cues to action (ie, media cues and educational cues), and safe food-handling behaviors (ie, sanitation and cross-contamination). Analysis Rank order correlation coefficients were computed to measure the association among variables. Significance was set at P < .05. Results Cues to action were positively related to perceived threat of foodborne illness and safe food-handling behaviors. Perceived severity of foodborne illness was positively related to one dimension of safe food-handling behaviors (ie, sanitation). Conclusions and Implications The HBM is a useful framework for examining food-handling behaviors among older adults.

Survey of Occupational Therapy Practitioners in Southwestern Schools

Purpose: The purpose of this study was to identify current practice in assessment useof school-based occupational therapy practitioners and to identify their expectations of student performance in assessment upon completion of the pediatric Fieldwork II experience. A survey of school-based occupational therapists in the southwestern states was conducted to answer three research questions: (1) what standardized assessments are currently used frequently and occasionally by occupational therapy practitioners in the school setting, (2) what level of competency in assessment administration by Fieldwork II students is expected by supervising occupational therapists, and (3) what educational preparation did the practitioners receive prior to their employment in schools and what professional support is currently available to them? Method: A five page questionnaire was mailed to 406 practicing thera-pists in four southwestern states with a response rate of 74.1 percent using Dillman's Total Design Method. Results: Respondents reported use of motor and visual perception tests most frequently in their practice. When trends of this survey were compared to previous surveys, practitioners reported similar use of motor and visual perception tests, a decreased use of sensory integration measures, and an increasein the use of function-based assessments.

Influencing local computer technology policy via a K-12/University Collaboration

This article discusses a district-wide study conducted in collaboration with local officials and researchers from a nearby university. The goals of the study were collaboratively derived by university and representatives of K-12 education (i.e. from kindergarten to completing compulsory education) and included: (1) determining how teachers in the district were using computers in instruction, (2) determining factors that influenced these uses and (3) developing a local policy agenda from the results of the study. Survey methodology was implemented using Dillman's (1978) Total Design Method and a 92% response rate was obtained. The study suggests that teachers are primarily using computers for drill and practice or as rewards for completing work, that teachers lack confidence in meeting many of the state technology standards and that teachers are not satisfied with the support they receive. The study also suggests that systemic teacher preparation efforts focused on developing teachers' instructional computer efficacy with multiple applications, coupled with efforts to improve districtwide support, may enable this district to facilitate effective instructional computer use. Local consequences and the broader significance of the study are discussed.

SURVEY METHODOLOGY IN THE DEVELOPMENT OF A FOOD WASTE/RESIDUE DATABASE1

Survey research was used to obtain data from food processors to develop a wastes/residues database. The general principles of Dillman's Total Design Method of survey administration were followed with the exception that telephone follow-ups replaced a third mailing five weeks after the initial mailing. The purpose of this article is to discuss survey methodology and responses in one facet of the food industry. Food processors were asked to provide a company profile and information about food wastes/residues generated in the facility and to indicate that perceived barriers to source reduction or recycling activities and willingness to provide waste samples for proximate analysis. Questionnaires were mailed to 444 food processing companies with 10 or more employees in the state of Iowa. The response rates were traced for each contact [initial mailing, post-card follow-up, second survey, and telephone calls] and for each Standard Industrial Codes (SIC) and total response rates were determined. Factors influencing response rate were identified. The overall response rate was 82.2% (365), but only 250 of the questionnaires contained data other than company profiles. Data were obtained from companies in over 37 different SICs. Factors influencing response rates included: perception among some of the companies classified by SIC codes as food manufacturing that they were not food processors; timing of survey; perceived confidentiality of data requested; and availability of the correct contact person. Knowledge of how to obtain data from this segment of the food chain will assist other researchers and businesses as they seek information from food processors about their wastes/residues and other trends that will impact other segments of the food chain.