Timothy P. Johnson

Methodologies for Improving Response Rates in Surveys of Physicians: A Systematic Review

Although physician surveys are an important tool in health services and policy research, they are often characterized by low response rates. The authors conducted a systematic review of 66 published reports of efforts to improve response rates to physician surveys. Two general strategies were explored in this literature: incentive and design-based approaches. Even small financial incentives were found to be effective in improving physician response. Token nonmonetary incentives were much less effective. In terms of design strategies, postal and telephone strategies have generally been more successful than have fax or Web-based approaches, with evidence also supporting use of mixed-mode surveys in this population. In addition, use of first-class stamps on return envelopes and questionnaires designed to be brief, personalized, and endorsed by legitimizing professional associations were also more likely to be successful. Researchers should continue to implement design strategies that have been documented to improve the survey response of physicians.

The Relation Between Culture and Response Styles Evidence From 19 Countries

The authors investigated at the country level the effects of four cultural orientations identified and studied by Hofstede on two commonly recognized response biases: extreme response style and acquiescent responding. Data are presented from approximately 18,000 survey questionnaires completed by employees in 19 nations on five continents (Australia, Belgium, Brazil, Czech Republic, Germany, Hungary, India, Japan, Malaysia, Portugal, Turkey, the United Kingdom, Mexico, the Philippines, Poland, Singapore, Hong Kong, France, and Italy). Hierarchical linear modeling was employed to examine the associations between person-level response styles and country-level cultural orientations. Consistent with theoretical expectations, power distance and masculinity were found to be positively and independently associated with extreme response style. Individualism, uncertainty avoidance, power distance, and masculinity were each found to be negatively associated with acquiescent response behavior. Further research is needed to identify how question characteristics might interact with cultural orientations to influence response behavior.

Accuracy of Self-Reported Cancer-Screening Histories: A Meta-analysis

Background: Survey data used to study trends in cancer screening may overestimate screening utilization while potentially underestimating existing disparities in use. Methods: We did a literature review and meta-analysis of validation studies examining the accuracy of self-reported cancer-screening histories. We calculated summary random-effects estimates for sensitivity and specificity, separately for mammography, clinical breast exam (CBE), Pap smear, prostate-specific antigen testing (PSA), digital rectal exam, fecal occult blood testing, and colorectal endoscopy. Results: Sensitivity was highest for mammogram, CBE, and Pap smear (0.95, 0.94, and 0.93, respectively) and lowest for PSA and digital rectal exam histories (0.71 and 0.75). Specificity was highest for endoscopy, fecal occult blood testing, and PSA (0.90, 0.78, and 0.73, respectively) and lowest for CBE, Pap smear, and mammogram histories (0.26, 0.48, and 0.61, respectively). Sensitivity and specificity summary estimates tended to be lower in predominantly Black and Hispanic samples compared with predominantly White samples. When estimates of self-report accuracy from this meta-analysis were applied to cancer-screening prevalence estimates from the National Health Interview Survey, results suggested that prevalence estimates are artificially increased and disparities in prevalence are artificially decreased by inaccurate self-reports. Conclusions: National survey data are overestimating cancer-screening utilization for several common procedures and may be masking disparities in screening due to racial/ethnic differences in reporting accuracy. (Cancer Epidemiol Biomarkers Prev 2008;17(4):748–57)

Pet Ownership and Attachment as Supportive Factors in the Health of the Elderly

AbstractIn order to examine pet ownership and pet attachment as factors supporting the health of the elderly, a national probability sample of Americans 65 years of age and older was drawn. Participants answered telephone survey questions regarding pet ownership, life stress, social support, depression, and recent illness. In multiple regression analyses, pet ownership failed to predict depression and illness behavior, while pet attachment significantly predicted depression but not illness experience. In a group with particularly great distress (the bereaved), pet ownership and strong attachment were significantly associated with less depression only when the number of available confidants was minimal.

Response Rates and Nonresponse Errors in Surveys

A S PERHAPS THE MOST WELL KNOWN OF ALL social science methodologies, survey research findings are commonly reported in the professional literature. Indeed, many biomedical journals routinely publish articles that report results from high-quality survey studies. Discerning unbiased survey findings can be challenging, however, to both editors and readers, necessitating some reflection as to the multiple sources of error in surveys and how to assess them. In this Viewpoint, we provide an overview of one of these sources of survey error—nonresponse bias—and briefly consider approaches for estimating, evaluating, and reporting it.

Psychometric Evaluation of the Lexington Attachment to Pets Scale (Laps)

AbstractThis paper reports on the development and psychometric evaluation of a scale for assessing emotional attachment of individuals to their pets. Previous attachment scales have suffered variously from low internal consistency and reliance on small or nonrepresentative samples for their development. Telephone interviews of a random, representative sample of 412 pet owners in Fayette County, Kentucky, were completed in September 1990; a 69.5 percent response rate was achieved. From a preliminary set of 42 questions, a final 23-question instrument, the Lexington Attachment to Pets Scale (LAPS), was developed, having excellent psychometric properties. The scale is suitable for use with dog and cat owners. Data on internal consistency, factor structure, and item response theory (IRT) modeling are presented, along with correlations between the LAPS and several domains of variables known to relate to pet attachment.

Sexual harassment and generalized workplace abuse among university employees : Prevalence and mental health correlates

OBJECTIVES This study hypothesized that interpersonal workplace stressors involving sexual harassment and generalized workplace abuse are highly prevalent and significantly linked with mental health outcomes including symptomatic distress, the use and abuse of alcohol, and other drug use. METHODS Employees in 4 university occupational groups (faculty, student, clerical, and service workers; n = 2492) were surveyed by means of a mailed self-report instrument. Cross-tabular and ordinary least squares and logistic regression analyses examined the prevalence of harassment and abuse and their association with mental health status. RESULTS The data show high rates of harassment and abuse. Among faculty, females were subjected to higher rates; among clerical and service workers, males were subjected to higher rates. Male and female clerical and service workers experienced higher levels of particularly severe mistreatment. Generalized abuse was more prevalent than harassment for all groups. Both harassment and abuse were significantly linked to most mental health outcomes for men and women. CONCLUSIONS Interpersonally abusive workplace dynamics constitute a significant public health problem that merits increased intervention and prevention strategies.

Sex Differences in Environmental Concern and Knowledge: The Case of Acid Rain.

Several theories have been presented that predict differences between women and men in attitudes toward the environment due to differences in sex roles. Research on which these theories can be tested has tended to examine general environmental concern, and the results have generally been weak and inconclusive. Using an approach suggested in the literature, this study examines sex differences in concern and knowledge, using multi-item scales for each, about one environmental issue — acid rain. The results contradict the theories being tested, however: if there is a sex difference, men are found to be more concerned and knowledgeable about the environmental problem.

Survey Methods in Multinational, Multiregional, and Multicultural Contexts: Harkness/Survey

This book provides up-to-date insight into key aspects of methodological research for comparative surveys. It discusses methodological considerations for surveys that are deliberately designed for ...

Enhancing Surveys of Health Care Professionals A Meta-Analysis of Techniques to Improve Response

Surveys involving health care providers are characterized by low and declining response rates (RRs), and researchers have utilized various strategies to increase survey RRs among health professionals. Based on 48 studies with 156 subgroups of within-study conditions, a multilevel meta-regression analysis was conducted to summarize the effects of different strategies employed in surveys of health professionals. An estimated overall survey RR among health professionals was 0.53 with a significant downward trend during the last half century. Of the variables that were examined, mode of data collection, incentives, and number of follow-up attempts were all found to be significantly related to RR. The mail survey mode was more effective in improving RR, compared to the online or web survey mode. Relative to the non-incentive subgroups, subgroups receiving monetary incentives were more likely to respond, while nonmonetary incentive groups were not significantly different from non-incentive groups. When number of follow-ups was considered, the one or two attempts of follow-up were found to be effective in increasing survey RR among health professionals. Having noted challenges associated with surveying health professionals, researchers must make every effort to improve access to their target population by implementing appropriate incentive- and design-based strategies demonstrated to improve participation rates.