# Presentation: 406417

## Patient Recruitment, Interviewing Techniques and Data Strategies

**Jane French**
**Felicia Cerbone**
**Katherine Locke**

## Patient Recruitment 

- Jane French
- Research Coordinator, ResNet

## Slide 3

## Conducting the Interviews

- Felicia Gray Cerbone
- Senior Survey Director, NORC

**Notes:**
Today I’ll be talking about survey interviewing and data quality. 
By survey interviewing I’m referring to research that utilizes interviewer administered questionnaires designed to produce quantitative data, not cognitive interviewing, exploratory research or case studies. I’ll first review the survey interviewing process and specific practices and procedures that you want to keep in mind if you are conducting interviews or training others to interview. Throughout the presentation I will discuss ways in which interviewers affect data quality and present strategies for reducing  interviewer related error.  

## The Research Cycle

_**Data Collection**_** **
**Data Entry **
**Data Analysis**
**Review and Dissemination of Findings**

**Notes:**
Lets first review the research cycle.

The data collection task is what interviewers do, but that’s only the beginning

 The instruments are data entered

Data are analyzed and statistics produced

Distributing the findings

Because interviewers play a central role in gathering data they influence greatly the quality of the data and therefore the survey results. The interviewer is critical to the success of the entire research program—they collect the all important data which represent the backbone of most research programs.

## Roles and Responsibilities

**Enlist Cooperation**
**Informed Consent and Confidentiality**
**Standardized Interviewing Techniques**
**Interpersonally Effective and Professionally Objective**
**Appropriate interviewing environment**
**Control the interview**

**Notes:**
Interviewers have a demanding role to fill and have a number of important responsibilities.
Often interviewers are the first and only person respondents come into contact with, they play a vital role in that they are tasked with enlisting the cooperation of the respondent.

Consent and Confidentiality: As interviewer must always observe your professional obligation to preserve r’s confidentiality and privacy. Should not begin any component of interview without receiving prior respondent consent. Ethics statement. 

The quality of the entire program is dependent on the reliability and validity of the data. The key defining part of a measurement process is standardization. In all sciences meaningful measurement occurs by applying the same procedure across a set of situations so that differences in readings that result can be compared and interpreted as indicating real differences in what is being measured. The same is true for surveys.  Standardization allows for: Future comparisons across each interview interviewers and practices, consistent quex administration. Minimize bias by using “standardized interviewing techniques” and ensures data are of high quality
	-differences may result from different interviewing techniques rather than real differences./ Validity of the data is compromised if every interview does it  	differently or different for different respondents
  Data should be collected in a standardized manner including:
The way you sample
The way you ask the questions
The way you record the information
Ordinary conversational exchange, interrogation, i.e., “a conversation with a purpose” actually highly specialized dialogues structured to elicit specific information from the r. Questions are determined by the quex, any clarifying ?s must comply w/ guidelines to ensure accuracy & completeness w/out biasing data.
Engage respondent in survey, convince of legitimacy and value of study and influence them to stretch memories and give fully and carefully considered answers Instill trust. Still employ interpersonal skills
Professional/ task-oriented/ objective/ focused approach beginning w/ first words 
Train respondent: reinforcement (thank you), modeling, standardized instructions (read introductory paragraph to brief respondent—introduces that this is a specialized interaction with a special set of rules. 

## Cooperation

- Gaining:
- Establish Eye Contact
- Introduction
- Consent Script
- Answer Questions
- Assure Confidentiality

- Maintaining:
- Maintain Eye Contact
- Rapport
- Answer Questions
- Instill Trust

**Notes:**
 How should you come across?
Keep it short - May say something that will trigger a refusal

Practice and be familiar, comfortable with introduction and consent. Read verbatim. 
 Page 

## Would you say Yes to...

**Notes:**
What do you think of these folks?

How you come across will play into the rapport you build with the arrestee
Don’t want to be : 
Angry or unfriendly
Unapproachable, scientist,nerdy
Scared
Overly friendly
snobby
SHOULD BE
 Professional, Courteous, Direct, and Honest

## Converting Refusals

- Listen to Concerns
- Identify Objections
- Respond Accordingly

**Notes:**
There are ways to convert refusals, but ultimately the respondent has the right to refuse any or all project. We tell r this in the consent statement.

 [INTERVIEWER NAME] What do you say if someone doesn’t say yes right away?

 Some Refusals & Ways to Overcome Them:
Don’t want to do urine – Urine won’t be tested. OK. Do all other sections.
Will this affect my relationship w/ my dr..will he know my answers? - No. We are researchers. Assure confidentiality
 Too much.  - Incentive, helping inform larger study, give opinions

## Terminating an Interview

- The respondent seems noticeably:
- fatigued
- irritated or upset
- ill
- Breaks
- Move to next section
- Terminate interview

**Notes:**
Interviewer has right to end interview.
Need to be aware of respondent fatigue, etc throughout interview.
 Has anyone here ever terminated an interview?  Why?

 Reasons Why Might Terminate
 tired, keep asking you to repeat, inconsistencies
Irritated or upset
Ill/not feeling well

What to do????
Offer break, get some water, stretch
Move on to next section
Terminate

## Interview Environment

**Privacy**
**Comfort**
**Light**
**Quiet**

**Notes:**
Ideal interviewing conditions would call for a well lit room, an interviewer seated directly across a large uncluttered table from a  willing and alert respondent and no one else present or in close proximity. This is ideal and is extremely rare. We must strive for the ideal but settle for acceptable interviewing condition:

The need for privacy, strongest argument for this is commitment to confidentiality. 
The need for comfort. But must be flexible.
You will need light.
The need for quiet, this shortens the time of the interview, and thus reduces the burden on the respondent, there should be minimal distractions.

## Avoiding Bias

- Style Bias
- Voice Appeal
- Dress Appeal
- Attitude
- Non-Verbal Bias
- Verbal Bias

**Notes:**
Style Bias: Bias by first impression. Pleasant but neutral. 
Voice : Precise, clear..practice introduction, scripts
Dress: compatible to medical office
Attitude: positive self-assured but matter of fact
Non-verbal bias: subtle: body language and facial expressions.
Verbal Bias: Way questions read or probed, transitional statements, side comments. Do not indicate agreement or disagreement w/ answers. Do not comment on respondent.

## Asking the Questions

- Use _exact_ wording
- Don’t change the order of words
- Ask questions in exact sequence
- Ask every specified question** **

## Asking the Questions

- Never assume
- Avoid suggesting answers
- Read slowly and clearly
- Read the transition statements

## Probing

- To motivate the respondent to provide more information
- To focus the respondent’s answer

## Neutral Probing

- Unbiased Questions or Statements
- Not Leading
- Stress “their opinion”

## Probing Techniques

- Silent probe
- Repeat question and/or response
- Repeat word
- Neutral statements
- Stress generality/subjectivity
- “I don’t know”
- “I refuse”

## Standardized Recording 

- Legibility
- Recording numbers
- Correctly recording response codes
- Verbatim

**Notes:**
Interviewers can ask all the questions perfectly, probe skillfully to obtain complete and acceptable responses, and then cancel his/her good work by haphazard recording. The recording process when done correctly, produces a complete accurate record of answer to questions.
	Legibility is of prime importance
	Numbers: clearly and in units asked for
	Circle, marking codes correctly
	verbatims: do not paraphrase or summarize respondents answer. 	Tell r what you are doing, begin to record as soon as they begin 	to answer, repeat answer, slow r down. 
Standardized recording involves: No interviewer judgement, no interviewer summary and no interviewer effects on what is recorded.
Open-ended factual questions 
Record information relevant to questions objectives
Open-ended opinion questions
Record answer verbatim, no paraphrasing or summaries
Closed-ended factual questions
Circle answer given by respondent
If R is unsure, record all relevant information. Final decision made during coding.
Closed-ended opinion questions
Circle answer given by respondent
Probe
Do not check off category until r chooses it.

## Conclusion

- Interviewing is an *art* and a *science*

**Notes:**
Many researchers say that interviewing is an “art” but through this presentation I hope I’ve shown that its also a science. Just as in other scientific efforts, in the interviewing process there are specific procedures that need to be followed in order to maximize the validity of the measurement in surveys and strategies to minimize interviewer related effects on the data.

## Data Analysis

- Katherine Locke
- Senior Research Analyst, NORC

## Collecting Usable Data

- Quality Assurance
- Prevents problems with data collection
- Typically at the planning stage
- Quality Control
- Responds to observed problems
- Occurs at processing stage

## Quality Assurance

- Instruments
- Eliminating “leading” questions
- Ordering questions appropriately
- Using validated measures, when possible
- Mode of administration
- Study population
- Sensitive questions
- Training Interviewers

## Quality Control

- Validation
- Can be a standard practice or a corrective method
- Field Editing
- Ensuring more accurate data entry
- Missing Data Retrieval
- Better if factual in nature

## Data Types and Collection Methods

- Focus Groups
- Interviews
- Semi-structured
-  Free-form
- Written Materials
- Journal/log entries,
- Surveys
- Pre-existing data
- Medical records

## Common Terms for Quality Issues	

**Data cleaning**: method for ensuring data quality, elimination of data that is incorrect, incomplete or improbable
**Coding**: A process for converting questionnaire information into numbers or symbols to facilitate subsequent data processing operations. Sometimes, this involves interpreting responses and classifying them into predetermined results.
**Double entry**: entering data twice and using software to check accuracy
**Imputation**: Replacing either missing or invalid data with accepted data. Normally performed in accordance with predetermined decision rules.

## Population parameter: population statistic
Parameter estimate: population statistic calculated from sample data (also called sample statistic)
Standard error of estimate: average difference of survey estimate from population parameter across multiple samples (non-technical definition).  Decreases with sample size.
Sampling error: general term for differences between population parameters and their sample estimates due to sample design.  
Non-sampling error: general term for bias in survey estimates (due to non-response, misreporting , bad questionnaire design)
Statistical power: the probability to detect a difference or effect if one actually occurs.  Increases with sample size.

**Parameter estimate**: population statistic calculated from sample data (also called sample statistic)
**Standard error of estimate**: average difference of survey estimate from population parameter across multiple samples (non-technical definition).  Decreases with sample size.
**Sampling error**: general term for differences between population parameters and their sample estimates due to sample design.
**Non-sampling error**: general term for bias in survey estimates (due to non-response, misreporting , bad questionnaire design)
**Statistical power**: the probability to detect a difference or effect if one actually occurs.  Increases with sample size.

**Statistical Terms**

## Conclusion

- The person responsible for data collection has a huge impact on data analysis
- Quality Assurance/Quality Control activities are great tools for analysis and data collection
- Understanding issues with data analysis can help with collecting better quality data