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1. Questionnaire DesignDr. Abdulaziz Ali Almezam, MD, MSC, ABCMFamily and Community Medicine DepartmentCollage of Medicine, King Saud University

2. Questionnaire Design n

3. What Is A Questionnaire? A tool for collecting information to describe, compare, or explain knowledge, attitudes, behaviors, and/or socio-demographic characteristics on a particular target group.

4. Well designed questionnaires A highly structured to allow the same types of information to be collected from a large number of people in the same way and for data to be analyzed quantitatively and systematically.

5. Well designed questionnaires Questionnaires are best used for collecting factual data and appropriate questionnaire design is essential to ensure that we obtain valid responses to our questions

6. What can questionnaires measure? - Questionnaires are quite flexible in what they can measure, however they are not equally suited to measure all types of data. - We can classify data in two ways: Subjective vs. Objective Quantitative vs. Qualitative.

7. Objectives in designing questionnaires There are two main objectives in designing a questionnaire: • To maximize the proportion of subjects answering our questionnaire - that is, the response rate. • To obtain accurate relevant information for our survey.

8. Response Rate and Respondents To maximize our response rate, we have to consider carefully how we administer the questionnaire, establish rapport, explain the purpose of the survey, and remind those who have not responded. The length of the questionnaire should be appropriate.

9. Obtaining accuracy & relevancy In order to obtain accurate and relevant information, we have to give some thought to what questions we ask, how we ask them, the order we ask them in, and the general layout of the questionnaire

10. Obtaining accuracy & relevancy The length of the questionnaire should be appropriate. In order to obtain accurate relevant information, we have to give some thought to what questions we ask, how we ask them, the order we ask them in, and the general layout of the questionnaire

11. potential types of information: There are three potential types of information: • Information we are primarily interested in that is, dependent variables. • Information which might explain the dependent variables-that is, independent variables. • Other factors related to both dependent and independent factors which may distort the results and have to be adjusted for - that is, confounding variables.

12. The steps required to designa questionnaire? The steps required to design and administer a questionnaire include: • Defining the Objectives of the survey. • Determining the Sampling Group. • Literature Review. • Writing the Questionnaire. • Administering the Questionnaire. • Data Entry and analysis. • Interpretation of the Results.

13. Several points that must by considered? : 1.Clarity: This is probably the area that causes the greatest source of mistakes in questionnaires. Questions must be clear, succinct (brief), and unambiguous. The goal is to eliminate the chance that the question will mean different things to different people. If the designers fails to do this, then essentially participants will be answering different questions.

14. Example of Clarity: such as:Very Often Often Sometimes Rarely Never It is better to quantify the choices, such as:Every Day or More 2-6 Times a Week About Once a Week About Once a Month Never

15. 2. Leading Questions: A leading question is one that forces or implies a certain type of answer. It is easy to make this mistake not in the question, but in the choice of answers. A closed format question must supply answers that not only cover the whole range of responses, but that are also equally distributed throughout the range. All answers should be equally likely.

16. Example of a Leading Questions: An obvious, nearly comical, example would be a question that supplied these answer choices: Superb Excellent Great Good Fair Not so Great

17. 3.Phrasing Most adjectives, verbs, and nouns in English have either a positive or negative connotation(meaning). Two words may have equivalent meaning, yet one may be a compliment and the other an insult. Consider the two words "child-like" and "childish", which have virtually identical meaning. Child-like is an affectionate term that can be applied to both men and women, and young and old, yet no one wishes to be thought of as childish.

18. 4. Embarrassing Questions: Embarrassing questions dealing with personal or private matters should be avoided. Your data is only as good as the trust and care that your respondents give you. If you make them feel uncomfortable, you will lose their trust. Do not ask embarrassing questions.

19. 5.Hypothetical Questions Hypothetical are based, at best, on conjecture(Thinking) and, at worst, on fantasy. Simple question such as: If you were governor, what would you do to stop crime? This forces the respondent to give thought to something he may have never considered. This does not produce clear and consistent data representing real opinion. Do not ask hypothetical questions.

20. 6. Prestige Bias: Prestige bias is the tendency for respondents to answer in a way that make them feel better. People may not lie directly, but may try to put a better light on themselves. Are You Smoker?

21. Questionnaire General Format • Self administered (mailed or personal contact). • In person (face-to-face). • Telephone interviews.

22. Questionnaire General Format The exact method of administration also depends on who the respondents are? For example, university lecturers may be more appropriately surveyed by email; older people by telephone interviews; train passengers by face to face interviews.

23. Self administered questionnaires May be sent by Post Email Electronically online

24. Interview administered questionnaires May be by Telephone face to face

25. The Questions or Items • Are the focus on any survey or questionnaire. • It is crucial to know how to ask the questions in written and spoken form. • The way you ask the questions determines the answers.

26. Questions Context • Standardize the interviewer. • Standardize the response format. • Ask questions in a social, cultural, and economic context. • Keep confidentiality and voluntary participation. • Include a letter of introduction or presentation.

27. Questions Format • Open questions – more information but difficult to codify, enter, and analyze. • Closed questions – less information but easy to codify, enter, and analyze.

28. Advantages of open format • Allows exploration of the range of possible themes arising from an issue. • Can be used even if a comprehensive range of alternative choices cannot be compiled (explained).

29. Advantages of Closed-thatis, forced choice-format • Easy and quick to fill in. • Minimize discrimination against the less literate (in self administered questionnaire) or the less articulate(explain) (in interview questionnaire). • Easy to code, record, and analyze results quantitatively. • Easy to report results.

30. Types of closed (forced choice) format 1. Choice of categories: Fro example, “What is your marital status”? •  Single •  Married •  Divorced •  Widowed

31. Types of closed (forced choice) format 2. Likert style scale: • For example, “Statistics is an interesting subject”. •  Strongly disagree  Disagree  Cannot decide  Agree  Strongly agree

32. Types of closed (forced choice) format 3. Differential Scales • For example, “How would you rate the presentation”? • Extremely interesting>>> 1 2 3 4 5 6 7 8 9 10 >>>>Extremely dull • It may also be diagrammatic.

33. Types of closed (forced choice) format 4. Checklists For example, “Circle the clinical specialties you are particularly interested in”. General medicine OBS/GYN General Surgery Orthopedics Ophthalmology Accident and Emergency Pediatrics General practice

34. Types of closed (forced choice) format 5. Ranking For example, “Please rank your interests in the following specialties”. (1 = most interesting >>>>>8 = least interesting)  General medicine  OBS/GYN  General Surgery  Orthopaedics  Ophthalmology  Accident and Emergency  Pediatrics  General practice

35. How to obtain valid information? • Ask purposeful questions. • Ask concrete questions. • Use time periods based on importance of the question. • Use conventional language. • Use complete sentences. • Avoid abbreviations.

36. How to obtain valid information… • Review questions with experts and potential respondents. • Use shorter questions. • Avoid two-edged questions. • Avoid negative questions. • Adopt/adapt questions used successfully in other questionnaires

37. General rules for constructing good questions in a questionnaire

38. General rules for constructing good questions in a questionnaire - Use short and simple sentences - Ask for only one piece of information at a time - Avoid negatives if possible - Ask precise questions

39. General rules for constructing good questions in a questionnaire - Ensure those you ask have the necessary knowledge - Avoid unnecessary details - Avoid Sensitive issues - Minimize bias

40. Piloting and evaluation of questionnaires - Given the complexity of designing a questionnaire, it is impossible even for the experts to get it right the first time round. - Questionnaires must be pretested - that is, piloted - on a small sample of people characteristic of those in the survey. - In a small survey, there might be only pretesting of the drafted questionnaire.

41. Why we should "pilot" it (i.e. test it)? - To test how long it takes to complete - To check that the questions are not ambiguous - To check that the instructions are clear - To allow you to eliminate questions that do not yield usable data

42. Ideal Pilot Study • - It should be piloted on a group similar to the one that will form the population of your study. • - It is difficult to give an exact number for the pilot group, but as a rule of thumb, try to pilot on about • 5-10% of your final sample number. • - The results from the pilot study, however, should not be included with your final results.

43. THANK YOU