Published Papers - Abstract 1012

Fitzgerald D, Hockey R, Jones M, Mishra G, Waller M and Dobson A. Use of Online or Paper Surveys by Australian Women:Longitudinal Study of Users, Devices, and Cohort Retention. Journal of Medical Internet Research, 2019; 21(3): e10672

Background: There is increasing use of on-line surveys to improve data quality and timeliness, and to reduce costs. While there have been numerous cross-sectional studies comparing responses to on-line or paper surveys, there is little research from a longitudinal perspective.Objective: In the context of the well-established Australian Longitudinal Study on Women’s Health, we examined the patterns of responses to on-line or paper surveys across the first two waves of the study in which both modes were offered. We compared: 1. Differences between women born in 1946-51 and in 1973-78; 2. Types of device used for on-line completion; 3. The socio-demographic, behavioral and health characteristics of women who responded on-line or using mailed paper surveys; 4. Associations between mode of completion of the first survey, and participation and mode of completion in the second survey.Methods: Participants in this study, who had responded to regular mailed surveys since 1996, were offered a choice of completing surveys using paper questionnaires or web-based electronic questionnaires, starting in 2012. Two groups of women were involved: an older cohort born in 1946-51 and aged in their 60s, and a younger cohort born in 1973-78 aged in their 30s when the on-line surveys were first introduced. We compared women who responded on-line on both occasions, women who responded on-line at the first survey and used the paper version of the second survey, women who changed from paper to on-line, and those who used paper for both surveys.Results: Of the 9663 women in their 60s who responded to one or both of the surveys, more than 50% preferred to continue with paper surveys (5290 at the first survey and 5373 at the second survey). If they chose the on-line version most used computers. In contrast, of the 8628 women in their 30s, more than 50% (4835) chose the on-line version at the first survey. While most favored computers to phones or tablets, many did try these alternatives at the subsequent survey. Many women who completed the survey on-line the first time preferred the paper version at the subsequent survey. In fact, for women in their 60s, the number who went from on-line to paper (n=1151) exceeded the number who went from paper to on-line (n=734). The on-line option was more likely to be taken up by better educated and healthier women. In both cohorts, women who completed paper surveys were more likely than on-line completers to become non-respondents at the next survey. Due to the large sample size almost all the differences were statistically significant with P < .001.Conclusions: Despite the cost-saving advantages of on-line compared to paper surveys, paper surveys are likely to appeal to a different population of potential respondents, with different socio-demographic, behavioral and health characteristics and potentially greater attrition from the study. Not offering a paper version is therefore likely to induce bias in the distribution of responses unless weighting for respondent characteristics (relative to the target population) is employed. Therefore, if mixed mode (paper or on-line) options are feasible, they are highly likely to produce more representative results than if only the less costly on-line option is offered.

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