Measurement of Health and Social Behaviors in Schoolchildren: Randomized Study Comparing Paper Versus Electronic Mode

Zdr Varst. 2019 Jan 21;58(1):1-10. doi: 10.2478/sjph-2019-0001. eCollection 2019 Mar.

Abstract

Introduction: Electronic survey mode has become a more common tool of research than it used to be previously. This is strongly associated with the overall digitization of modern society. However, the evidence on the possible mode effect on study results has been scarce. Therefore, the aim of this study is to investigate the comparability of findings on health and behaviours using a paper-versus-electronic mode of survey with randomization design among schoolchildren.

Methods: A randomized study was conducted using a mandatory questionnaire on international Health Behaviour in School-aged Children (HBSC) study in Lithuania, enrolling 531 schoolchildren aged 11-15 years. The questionnaire included health and social topics about physical activity, risk behaviours, self-reported health and symptoms, life satisfaction, bullying, fighting, family and school environment, peer relationships, electronic media communication, sociodemographic indicators, etc. The schoolchildren within classes were randomly selected for electronic or paper mode.

Results: It was found that by study mode differences are inconsistent and in the majority of cases do not exceed 5%-point difference between the modes. The only significant difference was that in the paper survey the participants reported more exercise than in the electronic survey (OR=8.08, P<.001). Other trends were nonsignificant and did not show a consistent pattern - in certain behaviours the paper mode was related to healthier choices, while in others - the electronic.

Conclusions: The use of electronic questionnaires in surveys of schoolchildren may provide findings that are comparable with concurrent or previously conducted paper surveys.

Uvod: Uporaba elektronskih vprašalnikov postaja vse bolj pogosto raziskovalno orodje, ki ga omogoča vsesplošna digitalizacija sodobne družbe. Dokazi o morebitnih učinkih elektronskih vprašalnikov na rezultate študije pa so pomanjkljivi. Cilj te študije je raziskati primerljivost dognanj o zdravstvenih vedenjih med šoloobveznimi otroki z uporabo tiskanih vs. elektronskih vprašalnikov.

Metode: Randomizirano študijo smo izvajali v Litvi in je vključevala 531 šoloobveznih otrok med 11. in 15. letom starosti. Uporabili smo vprašalnik mednarodne raziskave Z zdravjem povezano vedenje šoloobveznih otrok (Health Behaviour in School-aged Children (HBSC)). Vprašalnik je zajemal vprašanja s področja zdravja in družbe; povpraševal je o fizični aktivnosti otrok, tveganih vedenjih, samoporočanem zdravju in simptomih, življenjskem zadovoljstvu, ustrahovanju, pretepanju, družinskem in šolskem okolju, odnosih z vrstniki, sociodemografskih dejavnikih, komunikaciji po elektronskih medijih itd. Šoloobvezni otroci znotraj razredov so bili naključno izbrani za odgovarjanje na vprašalnike v tiskani in elektronski obliki.

Rezultati: Ugotovitve kažejo, da so razlike med obema oblikama vprašalnikov nekonsistentne in v večini primerov ne presegajo 5 % razlike med oblikama. Edina pomembna razlika je, da so v skupini, ki je odgovarjala na tiskani vprašalnik, poročali o več gibanja kot v skupini, ki je uporabljala elektronski vprašalnik (OR = 8,08, P < ,001). Drugi trendi niso znatni in ne prikazujejo konsistentnega vzorca; pri določenih vedenjih so se rezultati tiskanega vprašalnika nagibali k bolj zdravim izbiram, medtem ko so se v nekaterih drugih vedenjih nagibali k bolj zdravim izbiram rezultati elektronskega vprašalnika.

Zaključek: Uporaba elektronskega vprašalnika v raziskavah pri šoloobveznih otrocih lahko prinaša rezultate, ki so primerljivi s sočasnimi ali predhodno izvedenimi raziskavami, ki so uporabljale tiskane vprašalnike.

Keywords: Lithuania; health behavior; prevalence; questionnaire design; reliability; school-aged children; social support; validity.