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      Methodological Issues in Internet-Mediated Research: A Randomized Comparison of Internet Versus Mailed Questionnaires

      research-article
      Author(s): , BSC(Hons), MA, PhD 1 ,
      Editor(s):
      Other contributor(s): (Reviewer), (Reviewer)
      Publication date (Electronic):
      Journal: Journal of Medical Internet Research
      Publisher: Gunther Eysenbach
      Keywords: Paper-and-pencil questionnaire, equivalence, questionnaire

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          Abstract

          Background

          The majority of Internet-mediated studies use measures developed as paper-and-pencil measures or face-to-face-delivered material. Previous research suggests that the equivalence between online and offline measures must be demonstrated rather than assumed.

          Objective

          The objective of this study was to explore the equivalence 4 measures completed in an online or offline setting.

          Methods

          A sample of students (n = 1969) was randomly assigned to complete 4 popular scales (the SF-12v2, the Hospital Anxiety and Depression Scale (HADS), the Fatigue Symptom Inventory, and a single-item fatigue measure) either online or by mail survey (pencil and paper). The response rate was 52.51% (n = 1034) and comparable between the online and offline groups.

          Results

          Significant differences were noted in fatigue levels between the online and offline group ( P = .01) as measured by the Fatigue Symptom Inventory, with the online sample demonstrating higher levels of fatigue. Equivalency was noted for the SF-12v2, the Hospital Anxiety and Depression Scale, and the single-item fatigue measure. Internal consistency was high except for the SF-12v2. The SF-12v2 may not be an ideal measure to use for remote administration.

          Conclusions

          Equivalency of the Hospital Anxiety and Depression Scale (HADS) and the Physical Component Score and Mental Component Score of the SF-12v2 for online and offline data were demonstrated. Equivalency was not demonstrated for the Fatigue Symptom Inventory. Explanations for the difference in fatigue score between the online and offline samples are unclear. Research that seeks to match samples and control for extraneous online and offline variables is called for, along with exploration of factors that may mediate the completion of questionnaires or alter the respondents’ relationship with the same, to enhance progress in this area.

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          Most cited references24

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          Internet Versus Mailed Questionnaires: A Randomized Comparison

          Philip Lloyd Ritter, Kate Lorig, Diana D. Laurent … (2004)
          Background The use of Internet-based questionnaires for collection of data to evaluate patient education and other interventions has increased in recent years. Many self-report instruments have been validated using paper-and-pencil versions, but we cannot assume that the psychometric properties of an Internet-based version will be identical. Objectives To look at similarities and differences between the Internet versions and the paper-and-pencil versions of 16 existing self-report instruments useful in evaluation of patient interventions. Methods Participants were recruited via the Internet and volunteered to participate (N=397), after which they were randomly assigned to fill out questionnaires online or via mailed paper-and-pencil versions. The self-report instruments measured were overall health, health distress, practice mental stress management, Health Assessment Questionnaire (HAQ) disability, illness intrusiveness, activity limitations, visual numeric for pain, visual numeric for shortness of breath, visual numeric for fatigue, self-efficacy for managing disease, aerobic exercise, stretching and strengthening exercise, visits to MD, hospitalizations, hospital days, and emergency room visits. Means, ranges, and confidence intervals are given for each instrument within each type of questionnaire. The results from the two questionnaires were compared using both parametric and non-parametric tests. Reliability tests were given for multi-item instruments. A separate sample (N=30) filled out identical questionnaires over the Internet within a few days and correlations were used to assess test-retest reliability. Results Out of 16 instruments, none showed significant differences when the appropriate tests were used. Construct reliability was similar within each type of questionnaire, and Internet test-retest reliability was high. Internet questionnaires required less follow-up to achieve a slightly (non-significant) higher completion rate compared to mailed questionnaires. Conclusions Among a convenience sample recruited via the Internet, results from those randomly assigned to Internet participation were at least as good as, if not better than, among those assigned mailed questionnaires, with less recruitment effort required. The instruments administered via the Internet appear to be reliable, and to be answered similarly to the way they are answered when they are administered via traditional mailed paper questionnaires.
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            Methodological and ethical issues in Internet-mediated research in the field of health: an integrated review of the literature.

            Lisa Claire Whitehead (2007)
            The advantages and disadvantages of using the Internet in both qualitative and quantitative researches in the field of health are readily available in the literature, but little examination has been made of the factors to be considered in developing and running Internet-mediated research. A bibliographic search of English language publications indexed in eight computerized databases (EBSCO, EMBASE, MedLine, PsycInfo, CINAHL, PubMed, Cochrane, and TRIP) was undertaken with no limit set for the data of publication. The keywords Internet, research, quality, credibility, reliability, and validity were used in all possible combinations, and mappings to headings made wherever possible. The search revealed three key areas in setting up and undertaking Internet-mediated research: addressing sampling biases, ensuring ethical practice, and exploring the validity of data collected using an online interface. This paper contributes to the ongoing development of quality standards in the conduct and write-up of Internet-mediated research in the field of health.
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              Social desirability, anonymity, and Internet-based questionnaires.

              A Joinson (1999)
              It has been argued that behavior on the Internet differs from similar behavior in the "real world" (Joinson, 1998a). In the present study, participants completed measures of self-consciousness, social anxiety, self-esteem, and social desirability, using either the World-Wide Web (WWW) or pen and paper, and were assigned to either an anonymous or a nonanonymous condition. It was found that people reported lower social anxiety and social desirability and higher self-esteem when they were anonymous than when they were nonanonymous. Furthermore, participants also reported lower social anxiety and social desirability when they were using the Internet than when they were using paper-based methods. Contrast analyses supported the prediction that participants using the WWW anonymously would show the lowest levels of social desirability, whereas participants answering with pen and paper nonanonymously would score highest on the same measure. Implications for the use of the Internet for the collection of psychological data are discussed.
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                Author and article information

                Contributors
                :
                Centre for Postgraduate Nursing StudiesUniversity of Otago72 Oxford TerraceChristchurch, 4345New Zealand64 0064 364 385864 0064 (0)3 364 0lisa.whitehead@otago.ac.nz
                Journal
                Journal ID (nlm-ta): J Med Internet Res
                Journal ID (publisher-id): JMIR
                Title: Journal of Medical Internet Research
                Publisher: Gunther Eysenbach (JMIR Publications Inc., Toronto, Canada )
                ISSN (Electronic): 1438-8871
                Publication date Collection: Oct-Dec 2011
                Publication date (Electronic): 12 December 2011
                Volume: 13
                Issue: 4
                Electronic Location Identifier: e109
                Affiliations
                [1] 1simpleCentre for Postgraduate Nursing Studies simpleUniversity of Otago ChristchurchNew Zealand
                Article
                Publisher ID: v13i4e109
                DOI: 10.2196/jmir.1593
                PMC ID: 3278095
                PubMed ID: 22155721
                SO-VID: b840cb54-4b38-4c07-8d7e-12e7272bc7db
                Copyright © ©Lisa Whitehead. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.12.2011.
                License:

                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 the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                Date received : 25 June 2010
                Date revision requested : 06 November 2010
                Date revision received : 22 August 2011
                Date accepted : 25 August 2011
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Medicine
                Keywords: paper-and-pencil questionnaire,equivalence,questionnaire
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: paper-and-pencil questionnaire, equivalence, questionnaire

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