Annals of epidemiology
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Annals of epidemiology · Jul 1997
Improving question wording in surveys of culturally diverse populations.
The purpose of this paper is to briefly describe a theoretical model articulating cognitive theory and sources of potential response bias resulting from racial or ethnic cultural experience to survey questions that deal with health behavior. The theory components are then evaluated using questions obtained from national health surveys conducted by the National Center for Health Statistics and Centers for Disease Control and Prevention. The analysis explores the effects of four cognitive tasks involved in responding to questions as specified by the model: question interpretation, information retrieval from memory, judgment formation, and response editing. Implications for epidemiological research are considered. ⋯ Overall, the results of this research suggest several ways in which the validity of questions about risk behavior can be improved. In designing such questions, the investigator should envision the interview as a structured conversation in which ordinary conversational norms apply. Thus, questions that might request redundant information or that are threatening to the respondent need to be asked in ways that minimize these effects. Using interviewers of the same racial or ethnic group is important. Attending to the order of questions to ensure that redundant information is not requested is important. Writing questions to ensure that where response cues occur they lead the respondent to answer in unbiased ways is also important. Testing questions for potential racial or ethnic bias before using them is also important, even if the questions have been used successfully with population groups other than that or those included in a study.