Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
JMIR Public Health Surveill. 2016 Jul 29;2(2):e37. doi: 10.2196/publichealth.5184.
Response differences to survey questions are known to exist for different modes of questionnaire completion. Previous research has shown that response differences by mode are larger for sensitive and complicated questions. However, it is unknown what effect completion mode may have on HIV and AIDS survey research, which addresses particularly sensitive and stigmatized health issues.
We seek to compare responses between self-selected Web and telephone respondents in terms of social desirability and item nonresponse in a national HIV and AIDS survey.
A survey of 2085 people in Canada aged 18 years and older was conducted to explore public knowledge, attitudes, and behaviors around HIV and AIDS in May 2011. Participants were recruited using random-digit dialing and could select to be interviewed on the telephone or self-complete through the Internet. For this paper, 15 questions considered to be either sensitive, stigma-related, or less-sensitive in nature were assessed to estimate associations between responses and mode of completion. Multivariate regression analyses were conducted for questions with significant (P≤.05) bivariate differences in responses to adjust for sociodemographic factors. As survey mode was not randomly assigned, we created a propensity score variable and included it in our multivariate models to control for mode selection bias.
A total of 81% of participants completed the questionnaire through the Internet, and 19% completed by telephone. Telephone respondents were older, reported less education, had lower incomes, and were more likely from the province of Quebec. Overall, 2 of 13 questions assessed for social desirability and 3 of 15 questions assessed for item nonresponse were significantly associated with choice of mode in the multivariate analysis. For social desirability, Web respondents were more likely than telephone respondents to report more than 1 sexual partner in the past year (fully adjusted odds ratio (OR)=3.65, 95% CI 1.80-7.42) and more likely to have donated to charity in the past year (OR=1.63, 95% CI 1.15-2.29). For item nonresponse, Web respondents were more likely than telephone respondents to have a missing or "don't know" response when asked about: the disease they were most concerned about (OR=3.02, 95% CI 1.67-5.47); if they had ever been tested for HIV (OR=8.04, 95% CI 2.46-26.31); and when rating their level of comfort with shopping at grocery store if the owner was known to have HIV or AIDS (OR=3.11, 95% CI 1.47-6.63).
Sociodemographic differences existed between Web and telephone respondents, but for 23 of 28 questions considered in our analysis, there were no significant differences in responses by mode. For surveys with very sensitive health content, such as HIV and AIDS, Web administration may be subject to less social desirability bias but may also have greater item nonresponse for certain questions.
人们已知在完成问卷的不同模式下，对调查问题的反应存在差异。先前的研究表明，对于敏感和复杂的问题，模式差异引起的反应差异更大。然而，尚不清楚完成模式可能会对专门针对艾滋病毒和艾滋病的调查研究产生什么影响，因为此类研究涉及到特别敏感和污名化的健康问题。
我们旨在比较自我选择的网络和电话受访者在全国艾滋病毒和艾滋病调查中，在社会期望和项目无反应方面的差异。
2011 年 5 月，我们对加拿大 18 岁及以上的 2085 人进行了一项关于艾滋病毒和艾滋病的公众知识、态度和行为的调查。参与者通过随机数字拨号法招募，可以选择通过电话接受采访或通过互联网自行完成。在本文中，评估了 15 个被认为是敏感、与耻辱相关或性质不敏感的问题，以估计回答与完成模式之间的关联。对于具有显著（P≤.05）双变量差异的问题，进行了多变量回归分析，以调整社会人口统计学因素。由于调查模式不是随机分配的，我们创建了一个倾向评分变量，并将其纳入我们的多变量模型中，以控制模式选择偏差。
共有 81%的参与者通过互联网完成了问卷，19%通过电话完成。电话受访者年龄较大，受教育程度较低，收入较低，而且更有可能来自魁北克省。总体而言，在多变量分析中，有 2 个评估社会期望的 13 个问题和 3 个评估项目无反应的 15 个问题与模式选择显著相关。在社会期望方面，网络受访者报告过去一年有超过 1 个性伴侣的可能性大于电话受访者（完全调整后的优势比（OR）=3.65，95%置信区间（CI）1.80-7.42），并且更有可能在过去一年中向慈善机构捐款（OR=1.63，95%CI 1.15-2.29）。在项目无反应方面，网络受访者在回答以下问题时，更有可能出现缺失或“不知道”的回答：他们最关心的疾病（OR=3.02，95%CI 1.67-5.47）；他们是否曾经接受过艾滋病毒检测（OR=8.04，95%CI 2.46-26.31）；以及当他们对在已知店主患有艾滋病毒或艾滋病的杂货店购物的舒适度进行评分时（OR=3.11，95%CI 1.47-6.63）。
网络和电话受访者之间存在社会人口统计学差异，但在我们分析的 28 个问题中的 23 个问题中，模式之间的反应没有显著差异。对于涉及非常敏感健康内容的调查，例如艾滋病毒和艾滋病，网络管理可能受到的社会期望偏差较小，但对于某些问题，项目无反应可能更大。
