Questionnaire DesignDr. J Kishore,

MBBS, MD, PCHFWM, PGDEE, MSc, MNAMS, FIPHA

Professor Community Medicine, Maulana Azad Medical College,

New Delhi

Aim of Questionnaire

• It is to extract useful and accurate information.

• Any defect in the questionnaire could have impact in data collection.

Use of Questionnaire

• Scientific Research

• Screening

• Diagnostic Tool

• Audit

• Administration

• Demography

• Public relations

J Kishore. Ind J O & EM 2000

Basic Requirements for a questionnaire design

• Clear Objectives

• Sampling methods

• Sample Size

• Respondent: Literacy, physical and mental capabilities

J Kishore. Ind J O & EM 2000

Qualities of Questionnaire• Without ambiguity

• Unbiased

• Appropriateness: studying heat exposure in Cold unit workers

• Intellegibility: it should be understood

• Validity, Reliability

• Logical order

• Capable to cope with all possible responses

• Coded

• Pretested, open to close/structured

• No double barreled questions

• Ethical

• Language

J Kishore. Ind J O & EM 2000

Approaches

• Structured: you set a line of questionnaire in your survey and all respondents are led through it. This approach guarantee that all respondents consider the same issues or topics so their results can be compared with each other and easily summerized.

• Unstructured: Allow the person being interview to take the lead and talk about whatever aspects of the survey topic he or she chooses. It is best suited for qualitative data in which once opinion or attitude needs to be assessed.

Mode of Inquiry

• Based on qualitative or quantitative or both type of data collection

• a) Face to Face Interview

• b) Telephone Interview

• c) Self-reported/completed questionnaire

Comparison of three modes of data collection

Parameter Interview Telephone Mail/Self

Cost Mostexpensive

Mediumexpensive

Cheapest

Standardization Depend oninterviewer

Depend oninterviewer

Good &reduces bias

Coverage Depend onpersonalcontact

Reach widely& scatteredarea

Reach widely& scatteredarea

Observation Listen &watch, controlquestion,assess attitude

Listen &watch, controlquestion,assess attitude

Noobservation

Probing Allow, reducemisunderstanding & missinganswers

Allow, reducemisunderstanding & missinganswers

Not permitted

Comparison of three modes of data collection

Parameter Interview Telephone Mail/Self

Literacy Not require Not require Require

Respondentskills

Language &skills needed

Language &skills needed

Not needed

ResponseRate

Highest Medium Lowest

Privacy Difficult Someanonymity forgiving replies

Good; noembarrassment

Consent Easy toconvince &get consent

Convincing ispossible

Convincing isdifficult soconsent

Designing of questionnaire: Stages -1

• A. Basic components (Parts) I. Guidelines on the introduction to, and the ending of

interview/questionnaire II. A section on identification of the study unit and its

location III. Consent IV. The main body of the questionnaire: subdivision is

allowed V. Interviewer guidelines dispersed throughout the

questionnaire VI. Filters (Jump) instructions

Questionnaire Design-2

For example

• Ques. 1. Do you smoke cigarette? 1. Yes, 2. No.

If No, please go to the Ques. No. 4.

• Ques. 2. What brand of Cigarette? _____________.

• Ques. 3. How many per day?

A. 1-5, B.6-10, C. 11-15, D. 16-20, E. More than 20

• Ques. 4. Do you take alcohol? 1. Yes, 2. No.

If No. Please go to the Ques. No. 8.

Designing of questionnaire: Stages-3

• B. Practical Steps 1. Write out, as breifly as you can. 2. Make a list of the information 3. Decide the main section (Components) a) A section on identification/address b) Separate section for each aspect of study 4. Within each section and for each item of

information required, write out the questions 5. Check each of the questions against the aims 6. Check whether the list of questions will obtain

and record all the information necessary.

Designing of questionnaire: Stages-4 7. Examine each and every questions following: I) Is it Necessary? II) It is Clear and Unambiguous? III) Is it Simple and Short? IV) Is it A reasonable question to ask? V) Is it Non-offensive? VI) Should it be an “open” or “close” question?• Closed Question offers a list of possible options (Answers)

from which the respondent must select one or two answer• Open Question offers the respondent to answer in her/his

own words.

For ExampleQues. What are the controlling methods of air pollution? Rank according to your priority.A. Advancement of technologyB. Ban on polluting industriesC. PlantationD. Widening of roadsE. Any other, please specify (Dumping Category)

List of answer could be exhaustive, for exampleQues. What was the cause of death of your child?A. An accident or serious injury.B. Pneumonia.C. Diarrhea.D. Some other reason, please specify (Dumping category)

Designing of questionnaire: Stages-5

Designing of questionnaire: Stages-6 8. Check that the interview does not take too

long

9. Think of Layout and presentation

10. Write a draft

11. Pilot and evalution

* Validity

* Test-Retest Reliability

* Acceptability

12. Enhancing the reliability of interviewers by conducting training

13. Conducting survey

Validity indices of DSM-IIIR CIDI Against DSM III R Clinical Diagnosis

Clinical Diagnosis+ -

Total

CIDI DSM III + 28 1 29a b a+b

- 20 21 41c d c+d

Total 48 22 70a+c b+d a+b+c+d

Sensitivity=a/a+c 59.1%Specificity=d/b+d 95.4%Positive Predictive Value=a/a+b 96.6%Negative Predictive Value=d/c+d 51.2% Kishore J 1999

• Check Respondent’s Consistency• For example

Ques. How many children would you like to have?

Ques. What do you consider the ideal (best) number of children for you?

Codes• Numeric and alphabetic codes transfor answers

into variables that can be tabulated and analyzed statically.

• For nominal variable, the code can be labels without meaning, For example: “1” for Hindu, “2” for Muslim, “3” Christian, etc.

• For ordinal variable the numeric value has inherent meaning that reflects the rank order, for example, “0” for non-smoker, “1” smoking less than 1 pack per day, “2” 1-2 packs per day, etc.

Scores

• Answer to the questions are given in a score as a way of measuring an abstract characteristics: Measuring attitude,

• e.g., “1” Not important, “4” very important

Importance

A. Annual health check 1 2 3 4B. Health & Safety training 1 2 3 4C. Nutrition 1 2 3 4

How important of these items for maintaining the health of workers?

Scales• Summative Scales: Likert scales is used to quantify

attitude and behavior• e.g., Please read the statement below and answer

these questions using one of the five options (Tick)

Strongly Agree Neutral Disagree StronglyAgree Disagree

1. Smoking should be banned - - - - -2. Compulsory testing for HIV - - - - -3. Compulsory Sex education in - - - - - Secondary schools

Scales• Cummulative (Guttman) Scales: A series of

statements that express increasing intensity of a characteristics.

Ques. Circle the letter of every statement that you agree with: A. Asbestos can cause lung cancer

B. Asbestos is an important cause of cancer

C. Asbestos is a very important cause of lung cancer and death.

D. Asbestos is the most important cause of lung cancer and death in India

Ques. What is the highest level of education you have completed? A. Primary School certificate

B. High School Certificate

C. Undergraduate Degree

D. Postgraduate Degree

E. Doctoral or higher Degree

Scales• Multiple Choice Questions: where respondent

must choose just one answer from many choices; use in competitive exam or screening the disease

e.g., Ques. Which one of the following is the most common methods of transmission of HIV?

A. Sharing meals

B. Sharing needles

C. Sharing towel

e.g., For TB Screening

Ques Which symptoms do you experienced for last one month?

A. Cough

B. Fever

C. Weight loss

D. Loss of appetite

Scales

• Visual /leaner Analogue Scale: The characteristics such as preference, attitude, pain, hunger can be measured

0 50 100

No stress Intolerable Stress

Scale

• Sentence Completion Test• This is very useful scale to measure internal

conflict, stress, personality, etc.

• Commonly used in psychiatric assessment