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The respondent’s perspective in health-related surveys
Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.ORCID iD: 0000-0002-6281-7783
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Declining response rates are threatening the usefulness of and confidence in survey data. Survey practitioners have therefore studied why nonrespondents refuse to respond and have tried to counter the declining response rates by intensified follow-up methods. Such efforts sometimes yield negative reactions among respondents. This thesis focuses on the respondent’s perspective in self-administered health-related surveys. The aim was to investigate positive and negative aspects that respondents experience when participating in surveys, to study factors that could increase motivation and to study possibilities to increase response rates in a way that promotes data quality as well as positive experiences among respondents. Self-Determination Theory is a motivation theory that was used as a theoretical framework.

Paper I is a study regarding two self-administered health questionnaires among patients in 20 intervention groups in 18 Swedish hospitals. Paper II is a qualitative analysis of data from telephone interviews with respondents to a self-administered health-related survey of the population in the county of Östergötland. Paper III is a randomized experiment in a self-administered survey of a random sample of parents in the municipality of Stockholm. Paper IV is an experimental study concerning a self-administered health questionnaire in a random sample of the general adult population in the county of Östergötland.

The results from paper I show that questionnaire length and ease of response were not crucial arguments in choosing between two health questionnaires for use in routine health care. Instead, the most common motives for the choice concerned aspects of the questions’ comprehensiveness and ability to describe the health condition. Respondent satisfaction as described by respondents in paper II includes being able to give correct and truthful information as well as reflection and new insights from the questions. Respondent burden includes experiences of being manipulated or controlled by the researcher as well as worry, anxiety or sadness caused by the questions. Experiences of satisfaction and burden differed depending on the respondents’ primary motive for participating in surveys. The findings of paper III illustrate that the use of lottery tickets as incentives to parents may be less valuable or even harmful as a means of increasing response rates. In paper IV a survey design inspired by Self-Determination Theory yielded higher satisfaction among respondents and improved response rates with similar or better data quality compared with a standard design.

Focusing on the respondents’ perspective provided important new knowledge. The results show a broad spectrum of positive as well as negative aspects of survey participation. The results support Self-Determination Theory as a useful theoretical framework for studying motivation in survey research and an interesting additional source to provide ideas on how to design surveys with the potential to motivate respondents. The results suggest that it is possible to improve response rates in a way that promotes data quality as well as positive experiences among the respondents.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2010. , 95 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1193
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-60183ISBN: 978-91-7393-346-9 (print)OAI: oai:DiVA.org:liu-60183DiVA: diva2:355603
Public defence
2010-10-22, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2013-10-09Bibliographically approved
List of papers
1. Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care
Open this publication in new window or tab >>Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care
2007 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 16, no 10, 1647-1654 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate respondent satisfaction regarding SF-36 and EQ-5D and patients' perspectives concerning health outcome assessment within routine health care. Methods: Eighteen Swedish hospitals participated in the study which included 30 patient intervention groups (e.g. education groups for patients with ischemic heart disease or chronic obstructive pulmonary disease). Patients responded to SF-36 and EQ-5D before and after ordinary interventions (n = 463), and then completed an evaluation form. Results: Regarding respondent satisfaction, most patients found both questionnaires easy to understand (70% vs. 75% for SF-36 and EQ-5D respectively), easy to respond to (54% vs. 60%), and that they gave the ability of describing their health in a comprehensive way (68% for both). Health outcome assessment in routine health care was perceived as valuable by 57% of the patients, while 4% disapproved. Most patients (68%) considered both questionnaires equally suitable, 25% preferred SF-36 and 8% EQ-5D. Among those who were more satisfied with a short questionnaire (EQ-5D), several still preferred a longer and more comprehensive questionnaire (SF-36). Conclusion: Health outcome assessment within routine health care seems to be acceptable, and even appreciated, by patients. Questionnaire length and ease of response were not found to be crucial arguments in choosing between SF-36 and EQ-5D. © 2007 Springer Science+Business Media B.V.

Keyword
outcome assessment, SF-36, EQ-5D, patient perspective, respondent satisfaction
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-39617 (URN)10.1007/s11136-007-9263-8 (DOI)50285 (Local ID)50285 (Archive number)50285 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
2. Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey
Open this publication in new window or tab >>Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey
2010 (English)In: Field Methods, ISSN 1525-822X, E-ISSN 1552-3969, Vol. 22, no 4, 378-390 p.Article in journal (Refereed) Published
Abstract [en]

Response rates in surveys have declined in many countries over the last decade. Reasons for refusal by nonrespondents have been discussed in many studies, but less attention has been paid to motivation among respondents who do take part. One theoretical framework for studying motivation is self-determination theory, which distinguishes between extrinsic and intrinsic motivation. This article describes respondents' experiences of participating in a self-administered health-related survey. Qualitative content analysis was used to analyze data from semistructured telephone interviews with 30 Swedish respondents aged 45–64 years. The results show a broad spectrum of positive as well as negative aspects of survey participation.

Place, publisher, year, edition, pages
Sage, 2010
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-60180 (URN)10.1177/1525822X10376704 (DOI)000283656600005 ()
Note
The final, definitive version of this paper has been published in: Field Methods, (22), 4, 378-390, 2010. Marika Wenemark, Gunilla Hollman Frisman, Tommy Svensson and Margareta Kristenson, Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey http://dx.doi.org/10.1177/1525822X10376704 by SAGE Publications Ltd, All rights reserved. http://www.uk.sagepub.com/ Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2017-12-12
3. Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?
Open this publication in new window or tab >>Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?
2010 (English)In: EUROPEAN JOURNAL OF EPIDEMIOLOGY, ISSN 0393-2990, Vol. 25, no 4, 231-235 p.Article in journal (Refereed) Published
Abstract [en]

Response rates to surveys are decreasing. The purpose of this study was to evaluate the use of lottery tickets as incentives in an epidemiologic control group. A self-administered questionnaire was sent to parents in the municipality of Stockholm, Sweden, who were to be used as a control group in a study addressing stress in parents of children with cancer. A stratified random sample of 450 parents were randomized into three incentive groups: (a) no incentive; (b) a promised incentive of one lottery ticket to be received upon reply; (c) a promised incentive of one lottery ticket to be received upon reply and an additional lottery ticket upon reply within 1 week. The overall response rate across the three groups was 65.3%. The response rate was highest in the no incentive group (69.3%) and lowest in the one plus one lottery ticket group (62.0%). In a survival analysis, the difference between the two response curves was significant by the log-rank test (P = 0.04), with the no incentive group having a shorter time to response than the incentive group. Our findings suggest that the use of lottery tickets as incentives to increase participation in a mail questionnaire among parents may be less valuable or even harmful. Incentives may undermine motivation in studies in which the intrinsic motivation of the respondents is already high.

Place, publisher, year, edition, pages
Springer Science Business Media, 2010
Keyword
Data collection, Incentives, Participation, Response rate, Self-administered questionnaire, Survey
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-55054 (URN)10.1007/s10654-010-9434-8 (DOI)000276478800003 ()
Note
The original publication is available at www.springerlink.com: Marika Wenemark, Åsa Vernby and Annika Lindahl Norberg, Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?, 2010, EUROPEAN JOURNAL OF EPIDEMIOLOGY, (25), 4, 231-235. http://dx.doi.org/10.1007/s10654-010-9434-8 Copyright: Springer Science Business Media http://www.springerlink.com/ Available from: 2010-04-28 Created: 2010-04-28 Last updated: 2013-10-09
4. Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey
Open this publication in new window or tab >>Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey
Show others...
2011 (English)In: Journal of Official Statistics, ISSN 0282-423X, E-ISSN 2001-7367, Vol. 27, no 2, 393-414 p.Article in journal (Refereed) Published
Abstract [en]

Response rates to surveys are declining in most countries. Attempts to persuade or pressure respondents to increase response might be counterproductive in the long-term because they can negatively affect attitudes towards future surveys. Targeting respondents’ own motivation to participate in surveys is an alternative approach to achieve higher response rates. Self-determination theory provides a theoretical framework for how intrinsic motivation can be stimulated. We used self-determination theory as inspiration to re-design a self-administered health-related survey. Two versions of the questionnaire and two data collection methods were used in an experimental design. Effects were measured in terms of respondent satisfaction, response rate, and data quality. The results suggest that it is possible to improve response rates in a way that also promotes data quality and positive experiences for the respondents.

Place, publisher, year, edition, pages
Almqvist & Wiksell International / Statistics Sweden, 2011
Keyword
Survey design; respondent motivation; self-determination theory; intrinsic motivation; questionnaire
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-60182 (URN)000292708100013 ()
Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2017-12-12

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