Zhang Shuyi, Wu Qiong, van Velthoven Michelle Hmmt, Chen Li, Car Josip, Rudan Igor, Zhang Yanfeng, Li Ye, Scherpbier Robert W
Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China.
J Med Internet Res. 2012 Sep 18;14(5):e119. doi: 10.2196/jmir.2183.
Maternal, Newborn, and Child Health (MNCH) household survey data are collected mainly with pen-and-paper. Smartphone data collection may have advantages over pen-and-paper, but little evidence exists on how they compare.
To compare smartphone data collection versus the use of pen-and-paper for infant feeding practices of the MNCH household survey. We compared the two data collection methods for differences in data quality (data recording, data entry, open-ended answers, and interrater reliability), time consumption, costs, interviewers' perceptions, and problems encountered.
We recruited mothers of infants aged 0 to 23 months in four village clinics in Zhaozhou Township, Zhao County, Hebei Province, China. We randomly assigned mothers to a smartphone or a pen-and-paper questionnaire group. A pair of interviewers simultaneously questioned mothers on infant feeding practices, each using the same method (either smartphone or pen-and-paper).
We enrolled 120 mothers, and all completed the study. Data recording errors were prevented in the smartphone questionnaire. In the 120 pen-and-paper questionnaires (60 mothers), we found 192 data recording errors in 55 questionnaires. There was no significant difference in recording variation between the groups for the questionnaire pairs (P = .32) or variables (P = .45). The smartphone questionnaires were automatically uploaded and no data entry errors occurred. We found that even after double data entry of the pen-and-paper questionnaires, 65.0% (78/120) of the questionnaires did not match and needed to be checked. The mean duration of an interview was 10.22 (SD 2.17) minutes for the smartphone method and 10.83 (SD 2.94) minutes for the pen-and-paper method, which was not significantly different between the methods (P = .19). The mean costs per questionnaire were higher for the smartphone questionnaire (¥143, equal to US $23 at the exchange rate on April 24, 2012) than for the pen-and-paper questionnaire (¥83, equal to US $13). The smartphone method was acceptable to interviewers, and after a pilot test we encountered only minor problems (eg, the system halted for a few seconds or it shut off), which did not result in data loss.
This is the first study showing that smartphones can be successfully used for household data collection on infant feeding in rural China. Using smartphones for data collection, compared with pen-and-paper, eliminated data recording and entry errors, had similar interrater reliability, and took an equal amount of time per interview. While the costs for the smartphone method were higher than the pen-and-paper method in our small-scale survey, the costs for both methods would be similar for a large-scale survey. Smartphone data collection should be further evaluated for other surveys and on a larger scale to deliver maximum benefits in China and elsewhere.
孕产妇、新生儿和儿童健康（MNCH）家庭调查数据主要通过纸笔收集。智能手机数据收集可能比纸笔收集更具优势，但关于两者比较的证据很少。
比较智能手机数据收集与使用纸笔进行MNCH家庭调查中婴儿喂养习惯调查的情况。我们比较了两种数据收集方法在数据质量（数据记录、数据录入、开放式答案和评分者间信度）、时间消耗、成本、访谈者的看法以及遇到的问题方面的差异。
我们在中国河北省赵县赵州镇的四个乡村诊所招募了0至23个月婴儿的母亲。我们将母亲随机分配到智能手机或纸笔问卷组。一对访谈者同时就婴儿喂养习惯对母亲进行询问，每人使用相同的方法（智能手机或纸笔）。
我们招募了120名母亲，她们均完成了研究。智能手机问卷中防止了数据记录错误。在120份纸笔问卷（60位母亲）中，我们在55份问卷中发现了192处数据记录错误。对于问卷对（P = 0.32）或变量（P = 0.45），两组之间的记录差异无显著差异。智能手机问卷会自动上传，未发生数据录入错误。我们发现，即使对纸笔问卷进行了两次数据录入，仍有65.0%（78/120）的问卷不匹配，需要进行检查。智能手机方法的访谈平均时长为10.22（标准差2.17）分钟，纸笔方法为10.83（标准差2.94）分钟，两种方法之间无显著差异（P = 0.19）。智能手机问卷每份的平均成本（143元，按2012年4月24日汇率等于23美元）高于纸笔问卷（83元，等于13美元）。智能手机方法为访谈者所接受，经过试点测试，我们只遇到了一些小问题（例如，系统暂停几秒钟或关闭），但未导致数据丢失。
这是第一项表明智能手机可成功用于中国农村地区婴儿喂养家庭数据收集的研究。与纸笔相比，使用智能手机进行数据收集消除了数据记录和录入错误，具有相似的评分者间信度，且每次访谈耗时相同。虽然在我们的小规模调查中，智能手机方法的成本高于纸笔方法，但在大规模调查中，两种方法的成本将相近。应在中国和其他地区进一步评估智能手机数据收集在其他调查中的应用，并进行更大规模的评估，以实现最大效益。
