Supplemental slides and activity: developing a baseline questionnaire

To accompany MEASURE Evaluation PHE M&E Training Guide

Learning objectives of this moduleBy 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. Write effective, appropriate, valid, and reliable questions

4. 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

Q119 ZSBS

Have you ever taken an alcoholic drink of any kind, for example, beer, wine, whiskey, sura (local brew) or tontont (local brew)?

YES ............................................................. 1 NO............................................................... 2

Q122

Q120 ZSBS

Have you ever gotten ‘drunk’ (bebado grosso) from drinking one of these drinks? Including sura or tontont?

YES ............................................................. 1 NO............................................................... 2

Q122

Q121 ZSBS

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

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?

VERY CONFIDENT ...................... 1 SOMEWHAT CONFIDENT............2 NOT THAT CONFIDENT ...............3 NOT CONFIDENT AT ALL ............4 DON’T KNOW ............................... 8

Q308 WORLD RELIEF

What are your reasons for not having had sex? DO NOT READ ANSWERS.

CIRCLE ALL THAT APPLY.

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 Do you have any plans, dreams or goals for your future?

YES..................................... 1

NO....................................... 2 DON’T KNOW...................... 8

Q701

Q641a What are your plans, dreams, or goals for the future?

__________________________________________

__________________________________________

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

No

Complete Confidence

Confidence at All

______________________________

1 2 3 4 5 6 7 8 9 10

Unordered Response Format

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

2. Poor staff training.

3. Many patients.

4. 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 Standardsfor 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?