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

  • Braekman, Elise1, 2
  • Drieskens, Sabine1
  • Charafeddine, Rana1
  • Demarest, Stefaan1
  • Berete, Finaba1
  • Gisle, Lydia1
  • Tafforeau, Jean1
  • Van der Heyden, Johan1
  • Van Hal, Guido2
  • 1 Scientific Direction Epidemiology and public health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium , Brussels (Belgium)
  • 2 University of Antwerp, Antwerp, Belgium , Antwerp (Belgium)
Published Article
BMC Medical Research Methodology
Springer (Biomed Central Ltd.)
Publication Date
Nov 21, 2019
DOI: 10.1186/s12874-019-0860-3
Springer Nature


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.

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