Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States.
Center for Biostatistics in AIDS Research, Harvard TH Chan School of Public Health, Boston, MA, United States.
J Med Internet Res. 2020 Nov 11;22(11):e18588. doi: 10.2196/18588.
Longitudinal follow-up of older persons living with HIV is essential for the ascertainment of aging-related clinical and behavioral outcomes, and self-administered questionnaires are necessary for collecting behavioral information in research involving persons living with HIV. Web-based self-reported data collection results in higher data quality than paper-and-pencil questionnaires in a wide range of populations. The option of remote web-based surveys may also increase retention in long-term research studies. However, the acceptability and feasibility of web-based data collection in clinical research involving older persons living with HIV have never been studied.
This study aims to assess the acceptability and feasibility of a web-based survey to collect information on sexual, substance use, and physical activity behaviors; compare the data quality of the web-based survey with that of a paper-and-pencil questionnaire; and summarize web-based survey metrics.
This pilot study took place within the AIDS Clinical Trials Group A5322 study, a longitudinal cohort of men and women living with HIV (aged ≥40 years), followed at 32 clinical sites in the United States and Puerto Rico. A total of 4 sites participated in this study. A web-based survey was created using self-administered questionnaires typically completed in A5322 via paper and pencil. Pilot study participants completed these questionnaires via web-based survey at one research visit in lieu of paper-and-pencil administration. Two questions were added to assess feasibility, defined as participants' perception of the ease of web-based survey completion (very hard, hard, easy, very easy), and their preferred format (computer or tablet, paper and pencil, no preference) for completing the questions in the future (acceptability). Feasibility and acceptability were summarized overall and by demographic and clinical characteristics; the proportion of evaluable data by web-based survey versus previously administered paper-and-pencil questionnaires (data quality) was compared for each question.
Acceptability and feasibility were high overall: 50.0% (79/158) preferred computer or tablet, 38.0% (60/158) reported no preference, and 12.0% (19/158) preferred paper and pencil; 93.0% (147/158) reported survey completion easy or very easy. Older age was associated with lower odds of preferring computer or tablet to paper and pencil (odds ratio per 1-year increase in age: 0.91, 95% CI 0.85-0.98). Individuals who found the survey hard or very hard had a lower median neurocognitive test score than those who found it easy or very easy. Data quality with web-based survey administration was similar to or higher than that with paper-and-pencil administration for most questions.
Web-based survey administration was acceptable and feasible in this cohort of older adults living with HIV, and data quality was high. Web-based surveys can be a useful tool for valid data collection and can potentially improve retention in long-term follow-up studies.
对感染艾滋病毒的老年人进行纵向随访对于确定与衰老相关的临床和行为结果至关重要,而自我管理问卷对于收集涉及艾滋病毒感染者的研究中的行为信息是必要的。在广泛的人群中,基于网络的自我报告数据收集比纸质问卷在数据质量方面更具优势。基于网络的远程调查选项也可能增加长期研究的保留率。然而,基于网络的数据收集在涉及老年艾滋病毒感染者的临床研究中的可接受性和可行性从未得到过研究。
本研究旨在评估基于网络的调查收集性、物质使用和身体活动行为信息的可接受性和可行性;比较基于网络的调查与纸质问卷的数据质量;并总结基于网络的调查指标。
该试点研究在艾滋病临床试验小组 A5322 研究中进行,这是一个由美国和波多黎各 32 个临床站点随访的感染艾滋病毒的男性和女性(年龄≥40 岁)的纵向队列。共有 4 个站点参与了这项研究。使用自我管理问卷通过纸质问卷创建了一个基于网络的调查。试点研究参与者在一次研究访问中通过基于网络的调查完成了这些问卷,而不是通过纸质问卷进行管理。添加了两个问题来评估可行性,将参与者对完成基于网络的调查的难易程度的看法定义为(非常难、难、容易、非常容易),以及他们对未来完成问卷的首选格式(计算机或平板电脑、纸笔、无偏好)(可接受性)。总体上和按人口统计学和临床特征总结了可行性和可接受性;比较了每个问题基于网络的调查与之前管理的纸质问卷的可评估数据的比例(数据质量)。
总体而言,可接受性和可行性都很高:50.0%(79/158)更喜欢计算机或平板电脑,38.0%(60/158)表示没有偏好,12.0%(19/158)更喜欢纸笔;93.0%(147/158)表示调查完成容易或非常容易。年龄较大与更喜欢计算机或平板电脑而不是纸笔的可能性较低有关(每增加 1 岁的优势比:0.91,95%置信区间 0.85-0.98)。认为调查困难或非常困难的人比认为调查容易或非常容易的人神经认知测试得分中位数较低。基于网络的调查管理的数据质量与纸质问卷管理的数据质量相似或更高,对于大多数问题都是如此。
在本感染艾滋病毒的老年人群体中,基于网络的调查管理是可以接受和可行的,数据质量很高。基于网络的调查可以作为有效数据收集的有用工具,并有可能提高长期随访研究的保留率。