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      A Comparison of Web and Telephone Responses From a National HIV and AIDS Survey

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          Abstract

          Background

          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.

          Objectives

          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.

          Methods

          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.

          Results

          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).

          Conclusion

          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.

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          Most cited references41

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          Using the Internet for Health-Related Activities: Findings From a National Probability Sample

          Background eHealth tools on the Internet have the potential to help people manage their health and health care. However, little is known about the distribution and use of different kinds of eHealth tools across the population or within population subgroups. Objective The purpose of this study was to examine the prevalence and predictors of participation in specific online health-related activities. Methods A secondary data analysis of the National Cancer Institute’s Health Information National Trends Survey (HINTS) 2005 was conducted to study three online behaviors among Internet users (n = 3244): searching for health information for oneself, participating in a support group for those with similar health or medical conditions, and purchasing medicine or vitamins. Results A total of 58% of Internet users reported searching for health information for themselves, 3.8% used online support groups, and 12.8% bought medicine or vitamins online in the past year. Multivariate analysis found that those seeking health information were more likely to be women (OR = 2.23, 95% CI = 1.60, 3.09), have cable or satellite Internet connections (OR = 1.73, 95% CI = 1.22, 2.45) or DSL connections (OR = 1.94, 95% CI = 1.36, 2.76), have Internet access from work (OR = 2.43, 95% CI = 1.27, 4.67) or from home and work (OR = 1.73, 95% CI = 1.31, 2.30), and report more hours of weekday Internet use (OR = 4.12, 95% CI = 2.41, 7.07). Those with a high school education or less (OR = 0.44, 95% CI = 0.31, 0.63) and those with some college (OR = 0.66, 95% CI = 0.49, 0.89) were less likely to search for health information. Online support groups were more likely to be used by those with “fair” health (OR = 3.28, 95% CI = 1.21, 8.92) and “poor” health (OR = 5.98, 95% CI = 1.49, 24.07) and those with lower incomes (OR = 2.64, 95% CI = 1.09, 6.41) and less likely to be used by those with Internet access both at home and work (OR = 0.56, 95% CI = 0.35, 0.90). Those who were age 35-49 (OR = 2.16, 95% CI = 1.43, 3.26), age 50-64 (OR = 2.44, 95% CI = 1.53, 3.89), and age 65-74 (OR = 2.18, 95% CI = 1.30, 3.67) and those who were married (OR = 1.93, 95% CI = 1.13, 3.30) were more likely to purchase medicine or vitamins online. Conclusions The Internet was most widely used as a health information resource, with less participation in the purchase of medicine and vitamins and in online support groups. Results suggest that modifying survey questions to better capture forms of online support and medications purchased could provide greater understanding of the nature of participation in these activities.
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            Advantages and Disadvantages of Internet Research Surveys: Evidence from the Literature

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              A quick guide to survey research

              Questionnaires are a very useful survey tool that allow large populations to be assessed with relative ease. Despite a widespread perception that surveys are easy to conduct, in order to yield meaningful results, a survey needs extensive planning, time and effort. In this article, we aim to cover the main aspects of designing, implementing and analysing a survey as well as focusing on techniques that would improve response rates.
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                Author and article information

                Contributors
                Journal
                JMIR Public Health Surveill
                JMIR Public Health Surveill
                JPH
                JMIR Public Health and Surveillance
                JMIR Publications (Toronto, Canada )
                2369-2960
                Jul-Dec 2016
                29 July 2016
                : 2
                : 2
                : e37
                Affiliations
                [1] 1Faculty of Medicine University of Toronto Toronto, ONCanada
                [2] 2The CIHR Social Research Centre in HIV Prevention Toronto, ONCanada
                [3] 3Dalla Lana School of Public Health University of Toronto Toronto, ONCanada
                [4] 4School of Public Health and Social Policy University of Victoria Victoria, BCCanada
                [5] 5BC Centre for Disease Control Vancouver, BCCanada
                [6] 6Faculty of Medicine University of British Columbia Vancouver, BCCanada
                Author notes
                Corresponding Author: Marcella K Jones marcella.jones@ 123456mail.utoronto.ca
                Author information
                http://orcid.org/0000-0003-0609-1188
                http://orcid.org/0000-0003-2935-1851
                http://orcid.org/0000-0001-5198-751X
                http://orcid.org/0000-0003-3075-8229
                http://orcid.org/0000-0003-4450-5679
                http://orcid.org/0000-0002-0035-1201
                Article
                v2i2e37
                10.2196/publichealth.5184
                4994958
                27473597
                1344f97d-cb6a-465c-90a5-7def00953305
                ©Marcella K Jones, Liviana Calzavara, Dan Allman, Catherine A Worthington, Mark Tyndall, James Iveniuk. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 29.07.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.

                History
                : 30 September 2015
                : 22 November 2015
                : 3 January 2016
                : 6 July 2016
                Categories
                Original Paper
                Original Paper

                survey methods,cross-sectional survey,community survey,hiv,aids,social desirability,data collection methods,data quality,health attitude,health knowledge,attitudes,practice

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