Supplemental slides and activity: developing a baseline questionnaire

To accompany MEASURE Evaluation PHE M&E Training Guide

Learning objectives of this module

By the end of this module, participants will be able to: 1.

  Identify what can be measured through a questionnaire Adapting/using existing tools Determining gaps individual-level or household-level information?

2.

Use the M&E plan to match information needs to questionnaire components 3.

4.

Write effective, appropriate, valid, and reliable questions Adapt an existing questionnaire tool to fit specific programmatic needs

Elements of Questionnaire Design

1.

Identify the questionnaire content 2.

Write or select questions to measure variables of interest 3.

Construct the questionnaire

A Questionnaire Is More than the Questions!

 Opening/cover page  Instructions (skip patterns, probes, optional wording)  Introductions to questions  Definitions and explanations  Privacy concerns

Before Designing a Questionnaire

    Decide the study’s purpose (aims, research questions, hypotheses) Identify what you need to measure  Use your M&E plan to determine what information you will need to measure  What individual-level or household-level information can you *not* get somewhere else? (think: internal versus external data) Develop a preliminary analysis plan Decide the data collection mode (e.g., interview, paper/pencil, computer-assisted)

Designing Questionnaires

  Don’t recreate the wheel! – Use existing tools where possible Type of questionnaire/questions depends on study design      Self-administered survey Self-reported test results Clinical measurements Pre-/post-test tests for training When the survey takes place (before, after, during, unrelated to a clinical visit)  Motivations: Inform policy vs. inform programs

Objectives When Writing Questions

 To get reliable and valid reports of respondents’ experiences  Good survey questions provide consistent (reliable) and accurate (valid) measures  When 2 respondents are in the same situation they should answer the question the same way.

Reasons Why Respondents Report Events with Less than Perfect Accuracy

 They do not know the information  They cannot recall it, although they do know it  They do not understand the question  They do not want to report the answer in the context in which they are being asked it.

Considerations When Writing Questions

 Type of question  Response formats  Question wording

Types of Questions

 Open-ended questions  Close-ended questions  Ordered response categories  Unordered response categories  Partially close-ended questions

Open-ended Questions

      Responses are not provided to the respondent Advantages: Researcher does not need to know universe of possible answers  Respondent not influenced by specific alternatives suggested Respondent can reveal what is most salient Useful in exploratory work Can be used to build rapport in interview

Open-ended Questions

Disadvantages:  Effort required of respondent  Respondents may vary in ability/willingness to articulate  Respondents may be reluctant to reveal detailed information or socially unacceptable opinions or behaviors  Large amount of information may be revealed, information may be vague or irrelevant  Difficulties in recording and in reducing and coding material

Close-ended Questions

    A list of acceptable responses is provided to the respondent    Advantages: Easier for respondent Communicates same frame of reference to respondents Standardization Less variability in interviewer performance Less time to administer and record response

Close-ended Questions

  Disadvantages:  Need to know appropriate response categories in advance Lack of spontaneity permitted respondent Respondent may be forced into an unnatural frame of reference  May suggest response categories respondent has not thought of  Respondent may not feel as involved or motivated by questionnaire

Close-Ended Questions

Q11 9

ZS BS

Q12 0

ZS BS

Q12 1

ZS BS

Have you ever taken an alcoholic drink of any kind, for example, beer, wine, whiskey, sura (local brew) or tontont (local brew)? Have you ever gotten ‘drunk’ (bebado grosso) from drinking one of these drinks? Including sura or tontont? YES ............................................................. 1 NO ............................................................... 2 YES ............................................................. 1 NO ............................................................... 2 In the last 4 weeks, on how many occasions did you get drunk? (ENTER 0 IF NONE OR NEVER) NEVER ........................................................ 0 1 TIME......................................................... 1 2-5 TIMES ................................................... 2 6 OR MORE TIMES..................................... 3 DON’T KNOW ............................................. 9

16

Q307

Food for Hungry

Q308

WORLD RELIEF

How confident are you in your ability to abstain from sex if you choose to? Very confident, somewhat confident, not that confident, not that confident at all? What are your reasons for not having had sex?

DO NOT READ ANSWERS. CIRCLE ALL THAT APPLY.

VERY CONFIDENT ...................... 1 SOMEWHAT CONFIDENT ............ 2 NOT THAT CONFIDENT ............... 3 NOT CONFIDENT AT ALL ............ 4 DON’T KNOW ............................... 8 To please God........... ................... A To avoid HIV/AIDS ........................ B Wait for marriage........................... C No opportunity............................... D Not old enough .............................. E Not fallen in love ........................... F Avoiding pregnancy ..................... G Committed to abstinence .............. H Peer pressure not to ..................... I Regret previous sex ...................... J OTHER _______________________ ....... Z (SPECIFY)

Open Ended Questions

Q641 Q641a Do you have any plans, dreams or goals for your future? YES..................................... 1 NO....................................... 2 DON’T KNOW ...................... 8 What are your plans, dreams, or goals for the future? ____________________________ ______________ ____________________________ ______________ Q70 1

Response Formats

 Multiple categories that exhaust all meaningful answers and are mutually exclusive       During a typical work week (40 hours), how many hours do you spend on health promotion in the community?: _____less than 10 hours _____10 to 19 hours _____20 to 29 hours _____30 to 39 hours _____40 hours or more

Ordered Response Formats

    Response categories are ordered along a gradient. Examples: Strongly agree to strongly disagree (3 to 7 point scale; include or not include a neutral response category) Excellent, Good, Fair, Poor Numerical rating scales Complete Confidence No Confidence at All ______________________________ 1 2 3 4 5 6 7 8 9 10

Unordered Response Format

2.

3.

4.

 No single dimension underlies response categories. Respondent must evaluate each. Example:  Which one of the following do you think is most responsible for the long waiting period in the clinic? (Choose only ONE answer.) 1.

Low staff morale Poor staff training.

Many patients.

No other healthcare options near by.

Partially Close-ended Questions

       Answer choices are provided and respondents have the opportunity to create their own responses. Example: What is your position at this school?

Classroom teacher Principal Guidance counselor Nurse Other position (Please specify:____________)

Visual Analog Scale

  Subjective format for collecting data Instead of defining all the categories, you define only the extremes    Leads to a more personal (but variable) perspective of response Often used to assess pain levels Sometimes uses symbols that are recognizable, especially for children or illiterate  . .

.  .

.

. 

Formatting

   Create a form to obtain consent  Explain reasons for study  Explain how to respond to questions  Put questions in blocks that are related Begin with emotionally neutral questions – demographics Remember questionnaire fatigue and don’t put anything important at the end

Consider skip patterns

 These are questions that are not appropriate for everyone  Use of these may cause confusion  Use may depend on whether the questionnaire is self-administered or administered by a computer or interviewer

Wording

   Use language that is simple, free of ambiguity and encourages accurate and honest answers   Avoid embarrassing or offending respondent Make sure that there is clarity in how to express questions (if interviewer led) Use vocabulary appropriate for your audience Write questions like people talk not like people write  Translate and back-translate

Question Wording - DO

 Use techniques for enhancing recall  Shorten the reference period  Use landmarks to aid dating  Provide a helpful context  Provide cues to stimulate recall  Ask about typical behavior

Question Wording – DON’T

 Don’t use double-barreled questions Where do you go to get information about agricultural technologies and obtain seeds?

When I get ill, I know it is because I have not been eating right or washing my hands.

Question Wording – DON’T

Do not use leading questions  Do you agree that all children should be vaccinated?

 With economic conditions the way they are these days, is it fair to have more than one or two children?

 Can you tell me when you last visited the clinic?

Question Wording – DON’T

 Provide incomplete or overlapping response categories Where have you received health care in the past 12 months?

____Health clinic ____Hospitals ____Private clinic *** Use check-all-that-apply format

Question Wording – DON’T

Do not ask respondents to make unnecessary calculations.

 Out of 100 women your age, how many to you think take pills?

Do not use loaded questions or loaded words  Have you ever stolen anything?

Practical Standards for Evaluating Questions

 Is this a question that will mean the same thing to everyone?

 Is this a question that people can answer?

 Is this a question that people will be willing to answer, given the data collection procedures (i.e., sexual health or income questions)?

 

Constructing the Questionnaire:



Putting the Questions In Order

Beginning – inviting, interesting, non-threatening questions  Demographic information Middle – most important, put difficult and sensitive toward end   Sexual health income Closing – easy questions again, often routine, background  Participation in community activities

Question Design

 Include instructions, as needed, with questions - not at the beginning of the questionnaire    Clearly differentiate response categories from questions  Be consistent in placement of answer boxes Ask one question at a time: don’t stack side-by-side Number questions consecutively and simply from beginning to end

Other Elements

 Consent forms  Title/cover page  General instructions  Identifiers (e.g., respondent ID)  Transitions

Creating New Questionnaires

 Generate potential items for the instrument  Use qualitative data collection to inform – focus group or in-depth interviews  Test it  Correct it  Pilot it again  Train interviewers and data entry people well

Steps in Assembling Instruments

 List of variables potentially useful (conceptual framework)  Collect existing measures (justification)  Draft survey (long version to be revised and shortened later)  Pre-test  Validate –– are items measuring what you think they are…

Administering Instrument

 Questionnaires vs. Interviews   Questionnaires –  Self-administered (may cause bias in responses)  Less expensive Interviews –  Administered verbally (advantage when person is illiterate)  Helps for complicated surveys  More costly and time-consuming  Choice depends on costs and complexity of study

Interviewing

 Standardize approach  Train, train, train,  Document, document, document  Standardize wording, stick to it  Avoid interviewer bias  Neutral probing

Data coding, entry, and analysis

 Beyond the scope of this workshop  Many available resources  Some are in your CD in your packet, including the UNICEF, ORC Macro, CARE, and UNAID survey guides

Summary

       Decide what information (variables) is needed Draft or obtain questions to elicit that information Put questions in meaningful order Add other elements of questionnaire Pretest questionnaire Repeat Remember: you can use these guidelines for pre and post-test too!

 Allow more time than you think!

Group activity preparation discussion

 Now, you will adapt components of the example PHE baseline questionnaire to monitor and evaluate your community-based PHE program.

 If you already have a program/project, think about a mid way or final program survey (or you could consider questions to use in focus groups, interview, etc.)  Determine general study design (what communities, where, how many people, who (men, women, youth, etc.)   How will you collect the data? Will the survey be self administered, interviewer administered, etc.

Can you use skip patterns? If so, which types of questions would you skip and for whom?

Small group activity

    Go back to your M&E plan (logic model and framework) - 6 indicators   What indicators require a household survey? Focus group? Interviews? Records?

Which indicators are standard indicators [what number from the Guide]?

Look through the PHE baseline example questionnaire Using the PHE baseline example questionnaire, determine:  Can you get your 6 indicator information from the existing tool?

 What questions/sections would you keep?  Which questions/sections would you delete?

 What sections or components would you add?

Each indicator may require more than one question to get the information    Think through the numerator information Consider the denominator information Think about your data and indicator needs. Do costs, timing, other constraints make you rethink your chosen indicators? Can you collect them?