Web-based Participants Research Articles

Lessons Learned From a Sequential Mixed-Mode Survey Design to Recruit and Collect Data From Case-Control Study Participants: Formative Evaluation.

Sequential mixed-mode surveys using both web-based surveys and telephone interviews are increasingly being used in observational studies and have been shown to have many benefits; however, the application of this survey design has not been evaluated in the context of epidemiological case-control studies. In this paper, we discuss the challenges, benefits, and limitations of using a sequential mixed-mode survey design for a case-control study assessing risk factors during the COVID-19 pandemic. Colorado adults testing positive for SARS-CoV-2 were randomly selected and matched to those with a negative SARS-CoV-2 test result from March to April 2021. Participants were first contacted by SMS text message to complete a self-administered web-based survey asking about community exposures and behaviors. Those who did not respond were contacted for a telephone interview. We evaluated the representativeness of survey participants to sample populations and compared sociodemographic characteristics, participant responses, and time and resource requirements by survey mode using descriptive statistics and logistic regression models. Of enrolled case and control participants, most were interviewed by telephone (308/537, 57.4% and 342/648, 52.8%, respectively), with overall enrollment more than doubling after interviewers called nonresponders. Participants identifying as female or White non-Hispanic, residing in urban areas, and not working outside the home were more likely to complete the web-based survey. Telephone participants were more likely than web-based participants to be aged 18-39 years or 60 years and older and reside in areas with lower levels of education, more linguistic isolation, lower income, and more people of color. While there were statistically significant sociodemographic differences noted between web-based and telephone case and control participants and their respective sample pools, participants were more similar to sample pools when web-based and telephone responses were combined. Web-based participants were less likely to report close contact with an individual with COVID-19 (odds ratio [OR] 0.70, 95% CI 0.53-0.94) but more likely to report community exposures, including visiting a grocery store or retail shop (OR 1.55, 95% CI 1.13-2.12), restaurant or cafe or coffee shop (OR 1.52, 95% CI 1.20-1.92), attending a gathering (OR 1.69, 95% CI 1.34-2.15), or sport or sporting event (OR 1.05, 95% CI 1.05-1.88). The web-based survey required an average of 0.03 (SD 0) person-hours per enrolled participant and US $920 in resources, whereas the telephone interview required an average of 5.11 person-hours per enrolled participant and US $70,000 in interviewer wages. While we still encountered control recruitment challenges noted in other observational studies, the sequential mixed-mode design was an efficient method for recruiting a more representative group of participants for a case-control study with limited impact on data quality and should be considered during public health emergencies when timely and accurate exposure information is needed to inform control measures.

Comparison of the responses of cross-sectional web- and paper-based surveys on lifestyle behaviors of Japanese adolescents

ObjectiveIn Japan, paper-based surveys are currently more effective than web-based surveys. This study compared the response rates and lifestyle behaviors between paper- and web-based surveys conducted among Japanese junior and senior high schools. MethodsIn total, there were 42 and 64 junior and senior high schools, respectively, for the web-based surveys and 20 and 27 junior and senior high schools, respectively, for the paper-based surveys. The questionnaire covered lifestyle behaviors (e.g., alcohol consumption, smoking, exercise, eating, and sleep status), mental health, and plans to attend college. School- and student-level response rates by survey method were assessed, and so was the effect on the reporting of each lifestyle behavior using logistic regression models. ResultsThe school response rates were 16.0% and 38.3% for web- and paper-based surveys, respectively. The student response rates were 88.7% and 77.2%, respectively. The web-based group had significantly more female participants and lower response rates for higher grades in senior high schools. The odds of lifetime and current alcohol consumption and poor mental health were lower, whereas those of lifetime use of conventional cigarettes, shorter sleep duration, and plans to continue attending college were higher among web-based (vs. paper-based) participants. ConclusionsThe school response rate was poor in the web-based survey. However, whether the differences in lifestyle behavior are attributed to selection bias or the survey method remains unclear.

Web-Based Return of Individual Patient-Reported Outcome Results Among Patients With Lymphoma: Randomized Controlled Trial.

BackgroundThere has been a cultural shift toward patient engagement in health, with a growing demand from patients to access their results.ObjectiveThe Lymphoma Intervention (LIVE) trial is conducted to examine the impact of return of individual patient-reported outcome (PRO) results and a web-based self-management intervention on psychological distress, self-management, satisfaction with information, and health care use in a population-based setting.MethodsReturn of PRO results included comparison with age- and sex-matched peers and was built into the Patient-Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship registry. The self-management intervention is an adaptation of a fully automated evidence-based intervention for breast cancer survivors. Patients with lymphoma who completed the web-based questionnaire were equally randomized to care as usual, return of PRO results, and return of PRO results plus self-management intervention. Patients completed questionnaires 9 to 18 months after diagnosis (T0; n=227), 4 months (T1; n=190), 12 months (T2; n=170), and 24 months (T3; n=98).ResultsOf all invited patients, 51.1% (456/892) responded and web-based participants (n=227) were randomly assigned to care as usual (n=76), return of PRO results (n=74), or return of PRO results and access to Living with lymphoma (n=77). Return of PRO results was viewed by 76.7% (115/150) of those with access. No statistically significant differences were observed for psychological distress, self-management, satisfaction with information provision, and health care use between patients who received PRO results and those who did not (P>.05). Use of the self-management intervention was low (2/76, 3%), and an effect could therefore not be determined.ConclusionsReturn of individual PRO results seems to meet patients’ wishes but had no beneficial effects on patient outcome. No negative effects were found when individual PRO results were disclosed, and the return of individual PRO results can therefore be safely implemented in daily clinical practice.Trial RegistrationNetherlands Trial Register NTR5953; https://www.trialregister.nl/trial/5790International Registered Report Identifier (IRRID)RR2-10.1186/s13063-017-1943-2

Establishing the Reliability and Validity of Web-based Singing Research

In this study, the robustness of an online tool for objectively assessing singing ability was examined by: (1) determining the internal consistency and test-retest reliability of the tool; (2) comparing the task performance of web-based participants (n = 285) with a group (n = 52) completing the tool in a controlled laboratory setting, and then determining the convergent validity between settings, and (3) comparing participants’ task performance with previous research using similar singing tasks and populations. Results indicated that the online singing tool exhibited high internal consistency (Cronbach’s alpha = .92), and moderate-to-high test-retest reliabilities (.65–.80) across an average 4.5-year-span. Task performance for web- and laboratory-based participants (n = 82) matched on age, sex, and music training were not significantly different. Moderate-to-large correlations (|r| =.31–.59) were found between self-rated singing ability and the various singing tasks, supporting convergent validity. Finally, task performance of the web-based sample was not significantly different to previously reported findings. Overall the findings support the robustness of the online tool for objectively measuring singing pitch accuracy beyond a controlled laboratory environment and its potential application in large-scale investigations of singing and music ability.

A Web-Based and Print-Based Computer-Tailored Physical Activity Intervention for Prostate and Colorectal Cancer Survivors: A Comparison of User Characteristics and Intervention Use.

BackgroundPhysical activity (PA) is beneficial in improving negative physical and psychological effects of cancer. The rapidly increasing number of cancer survivors, resulting from aging and improved cancer care, emphasizes the importance to develop and provide low cost, easy accessible PA programs. Such programs could be provided through the Internet, but that could result in the exclusion of cancer survivors not familiar with the Internet. Therefore, we developed a computer-tailored PA intervention for prostate and colorectal cancer survivors in which both Web-based and print materials are provided, and participants can choose their own preferred delivery mode.ObjectiveThe aim of this study was to assess participants’ characteristics related to delivery mode and use of intervention materials.MethodsWe studied characteristics of participants using Web-based and printed intervention materials in a randomized controlled trial (RCT). Prostate and colorectal cancer survivors recruited from hospitals were randomized to OncoActive (computer-tailored PA intervention) or a usual-care control group. OncoActive participants received both Web-based and printed materials. Participants were classified into initial print- or Web-based participants based on their preferred mode of completion of the first questionnaire, which was needed for the computer-tailored PA advice. Intervention material use during the remainder of the intervention was compared for initial print- or Web-based participants. Additionally, participants were classified into those using only print materials and those using Web-based materials. Differences in participant characteristics and intervention material use were studied through analysis of variance (ANOVAs), chi-square tests, and logistic regressions.ResultsThe majority of the participants in the intervention group were classified as initial Web-based participants (170/249, 68.3%), and 84.9% (191/249) used Web-based intervention materials. Dropout was low (15/249, 6.0%) and differed between initial Web-based (4/170, 2.4%) and print-based (11/79, 14%) participants. Participants were less likely to start Web-based with higher age (odds ratio [OR]=0.93), longer time since last treatment (OR=0.87), and higher fatigue (OR=0.96), and more likely with higher education (OR=4.08) and having completed treatments (OR=5.58). Those who were older (OR=0.93) and post treatment for a longer time (OR=0.86) were less likely to use Web-based intervention materials. Initial print-based participants predominantly used print-based materials, whereas initial Web-based participants used both print- and Web-based materials.ConclusionsTo our knowledge, this is one of the first studies that assessed participant characteristics related to delivery mode in an intervention in which participants had a free choice of delivery modes. Use of print-based materials among the initial Web-based participants was substantial, indicating the importance of print-based materials. According to our findings, it may be important to offer Web- and print-based materials alongside each other. Providing Web-based materials only may exclude older, less educated, more fatigued, or currently treated participants; these groups are especially more vulnerable and could benefit most from PA interventions.

Comparison of a Web-Based vs In-Person Nutrition Education Program for Low-Income Adults

As access to computers and the Internet by the low-income population is increasing and the “digital divide” is slowly diminishing, other methods of delivering nutrition information to this audience are evolving. This randomized, block equivalence trial sought to determine whether web-based nutrition education could result in equivalent nutrition-related behavior outcomes when compared with traditional in-person nutrition education in low-income adults. A convenience sample of low-income adults (n=123) was randomized to receive in-person education (n=66) or web-based education (n=57) in a community setting within 14 counties of Indiana from April through December 2010. The web-based group received three nutrition education lessons (eg, fruits and vegetables, Nutrition Facts label reading, and whole grains) designed to replicate lessons received by the in-person group. Lessons were developed using Kolb's Learning Styles and Experiential Learning Model. Self-reported nutrition-related behaviors were assessed using a previously validated survey for low-income adults. Most nutrition-related behavior outcomes (eg, fruit, vegetable, whole-grain intake, Nutrition Facts label use, breakfast, and meal-planning frequency) improved significantly (P<0.05) from pre to post within both groups, meaning that each intervention was effective. When these nutrition-related behavior improvements were compared between groups, the changes were statistically equivalent (P>0.05), except for one question about use of the Nutrition Facts label. Therefore, web-based nutrition education can lead to favorable and equivalent nutrition-related changes when compared with in-person delivery. Most (83%) web-based participants also reported willingness to use the website again. Future application of web-based interventions for low-income populations could broaden delivery reach, increase frequency and length of contacts, and possibly decrease costs.

Effectiveness of a web-based protocol for the screening and phenotyping of individuals with Tourette syndrome for genetic studies.

Genome-wide association studies (GWAS) and other emerging technologies offer great promise for the identification of genetic risk factors for complex psychiatric disorders, yet such studies are constrained by the need for large sample sizes. Web-based collection offers a relatively untapped resource for increasing participant recruitment. Therefore, we developed and implemented a novel web-based screening and phenotyping protocol for genetic studies of Tourette syndrome (TS), a childhood-onset neuropsychiatric disorder characterized by motor and vocal tics. Participants were recruited over a 13-month period through the membership of the Tourette Syndrome Association (TSA; n = 28,878). Of the TSA members contacted, 4.3% (1,242) initiated the questionnaire, and 79.5% (987) of these were enrollment eligible. 63.9% (631) of enrolled participants completed the study by submitting phenotypic data and blood specimens. Age was the only variable that predicted study completion; children and young adults were significantly less likely to be study completers than adults 26 and older. Compared to a clinic-based study conducted over the same time period, the web-based method yielded a 60% larger sample. Web-based participants were older and more often female; otherwise, the sample characteristics did not differ significantly. TS diagnoses based on the web-screen demonstrated 100% accuracy compared to those derived from in-depth clinical interviews. Our results suggest that a web-based approach is effective for increasing the sample size for genetic studies of a relatively rare disorder and that our web-based screen is valid for diagnosing TS. Findings from this study should aid in the development of web-based protocols for other disorders.

Decision Support and the Effectiveness of Web-based Delivery and Information Tailoring for Bowel Cancer Screening: An Exploratory Study

BackgroundColorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females throughout the developed world. Population screening using fecal occult blood tests (FOBTs) facilitates early detection and greater chance of survival, but participation rates are low. We developed a Web-based decision tool to provide information tailored to an individual’s decision stage for CRC screening and attitude toward screening utilizing the Preventive Health Model (PHM) and Precaution Adoption Process Model (PAPM) as theoretical frameworks for screening behavior. We describe the practical steps employed in the tool’s design and the subsequent conduct of an exploratory study.ObjectiveTo design a decision tool for CRC screening and conduct an exploratory study among average-risk men and women to (1) test the impact of message type (tailored vs non-tailored) and message delivery modality (Web-based vs paper-based) on attitudes toward screening and screening uptake, and (2) investigate the acceptability of the decision tool and relevance of materials.MethodsParticipants (n = 100), recruited from a population sample of men and women aged 50-76 residing in urban Adelaide, Australia, were randomly assigned to a control group or one of 4 interventions: (1) Web-based and tailored information, (2) paper-based and tailored information, (3) Web-based and non-tailored (generic) information, or (4) paper-based and non-tailored information. Participation was augmented by snowball recruitment (n = 19). Questionnaires based on PHM variables were administered pre- and post-intervention. Participants were given the opportunity to request an FOBT. Following the intervention, participants discussed the acceptability of the tool.ResultsFull data were available for 87.4% (104/119) of participants. Post-intervention, perceived susceptibility scores for individuals receiving tailored information increased from mean 10.6 (SD 2.1) to mean 11.8 (SD 2.2). Scores on self-efficacy increased in the tailored group from mean 11.7 (SD 2.0) to mean 12.6 (SD 1.8). There were significant time x modality x message effects for social influence and salience and coherence, reflecting an increase in these scores for tailored Web-based participants only; social influence scores increased from mean 11.7 (SD 2.6) to mean 14.9 (SD 2.3), and salience and coherence scores increased from mean 16.0 (SD 2.2) to mean 17.7 (SD 2.1). There was no greater influence of modality or message type on movement toward a decision to screen or screening uptake, indicating that neither tailored messages nor a Web modality had superior effect. Overall, participants regarded tailored messages positively, but thought that the Web tool lacked “media richness.”ConclusionsThis exploratory study confirms that tailoring on PHM predictors of CRC screening has the potential to positively address attitudes toward screening. However, tailoring on these variables did not result in significantly increased screening uptake. Future research should consider other possible psychosocial influences. Mode of delivery did not affect outcomes, but as a delivery medium, the Web has economic and logistical advantages over paper.

Reaching Emergency Medical Services Providers: Is One Survey Mode Better than Another?

Objectives. To determine which mode of completing a survey yields the highest response rate among emergency medical services (EMS) providers, examine rural and urban differences, and determine the completeness of questions by mode of response. Methods. A random sample of EMS providers was mailed one of the following: 1) a paper survey, with instructions to return it via the enclosed self-addressed, stamped envelope; 2) a letter, with instructions to complete the survey at the provided URL (Web address); or 3) a paper survey with a self-addressed, stamped envelope and a URL, with the option of choosing the mode of response. We compared response rates based on the three different modes. We conducted analysis of the number of skipped multiple-choice and open-ended questions by mode and content analysis of the open-ended questions. Results. The paper-only option resulted in the highest response rate (40.4%, p = 0.003) compared with the response rates from Web-only and choice of mode. Overall, rural EMS providers responded at a higher rate than urban EMS providers (40.3% vs. 31.6%, respectively [p = 0.0002]). Web respondents were more likely to complete all the open-ended questions (p = 0.003). Almost a fourth (22.8%) of the paper respondents skipped multiple-choice questions. There was a pattern of more complete responses for open-ended questions among the Web-based participants, but this was not significant (p = 0.17). Conclusion. EMS providers seem to prefer a more traditional mode (paper) when responding to a survey. Rural providers are more likely to respond. Mode of response influences the number of skipped questions but does not impact the quality of open-ended answers.

Video-Driven Multimedia, Web-Based Training in the Corporate Sector: Pedagogical Equivalence and Component Effectiveness

The purpose of this study was to assess the pedagogical equivalence, as determined by knowledge gains, and the pedagogical effectiveness of certain components in a video-driven multimedia, web-based professional development training program as compared to a traditional, face-to-face program under real-world constraints of time and limited economic resources. The study focused on the use of video-driven multimedia, web-based instruction in the corporate environment to determine if the quality of the learning experience and the knowledge gained from the instruction were the same as with traditional methods. This experimental study assigned business professionals quasi-randomly to either a control group or an experimental group, where they attended either a live-instructed professional development program or a video-driven multimedia, web-based professional development program. Overall, results indicated that the video-driven multimedia, web-based instruction was not only pedagogically equivalent in terms of knowledge gains to the live instruction but that the knowledge gains were slightly higher among the web-based participants. Further, certain components in the web-based environment contributed more than components in the live environment to pedagogical effectiveness.

Web-Based and Traditional Public Participation in Comprehensive Planning: A Comparative Study

The present paper examines whether the potential advantages of the expanding practice of web-based public participation only complement the benefits of the traditional techniques, or whether they are empowering enough to replace them. The question is examined in a real-world case of neighborhood revitalization, in which both techniques were practiced simultaneously. Comparisons are made at four major planning junctions, in order to study the contributions of each technique to the qualities of involvement, trust, and empowerment. The results show that web-based participants not only differ from the participation of traditional practices, but they also differ from each other on the basis of their type of web participation. The results indicate that web-based participation is an effective complementary means of public participation, but it cannot replace the traditional unmediated techniques.

Measuring 3-D understanding on the Web and in the laboratory

We describe the ongoing development of a psychometric test to measure understanding of three-dimensional (3-D) concepts represented in drawings. The test consists of five subtests requiring participants to complete timed choice tasks previously used in experimental investigations of 3-D understanding, and a new subtest based on the idea of true length. We examined performance in terms of accuracy and response time usingboth laboratory- and Web-based methods of delivery. Reliability coefficients were high for both methods (.90 and .96, respectively, for accuracy, and .87 and .95, respectively, for response time measures), but Web-based participants produced consistently lower overall scores. Issues regarding the deployment of, and recruitment for, complex Web-based experimental tasks, and factors affecting comparisons between Web and laboratory results, such as the presence of an experimenter, and interface and sample differences, are discussed.