NATIONAL CENTER Series 2 

For HEALTH STATISTICS “Number 26 “ 

PROPERTYOF THE : 

PUBLICATIONSBRANCH 

EDITORIAL LIBRARY 

VITAL axacl HEALTH STATISTICS 

DATA EVALUATION AND METHODS RESEARCH 

the influence of 

Interviewer and Respondent 

Psychologicaland 

Behavioral Variables 

on the Reporting in Household Interviews 

A methodological study of the relationship of the behoviors, attitudes, 

perceptions, and information levels of the respondent and the interviewer to the levels of reporting health information in household interviews. 

Washington, D.C. March 1968 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WELFARE Public Heolth Service 

John W. Gardner Wil Iiam H. Stewart 

Secretary Surgeon General 
Public Health Service lui)li.’ation \o. IOC)O-Series 2.s0. Z6 

For sale by the Superintendent of Documents, U.S. rlovemment Printing Office, Washington, D. C., ‘20402- Price 45cents 
NATIONAL CENTER FOR HEALTH STAT STICS 

THEODORE D. VV’OOLSE~, hkCtoT 

PHILIP S. LAWRENCE, SC.~.,: ‘:~.ssociateDirector 

OSWALD K. SAGEN, PH.D.,, Assistant Director /or Health Statistics Development 

WALT R. SIMMONS,M.A., Assistant Director for Research and Scientific Development 

ALICE M. WATERHOUSE, M.D., Medical Consultant 

JAMES E. KELLY, D. D. S., Dental Advisor 

LOUIS R. STOLCIS, M.A., Executive O//icer 

DONALD GREEN, 17Z/O~cZtifM o//iCf?r 

D1V1S1ON OF HEALTH INTERVIEW STATISTICS 

ELIJAH L. WHITE, Director 

ROBERT R. FUCHSBERG, ChiefSwvey Methods Branrb 

GERALDINE A. GLEESQN, Chief.Analysts and Reports Branch 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health 

Survey, the Public Health Service is authorized to use, insofar 

as possible, the services or facilities of other Federal, State, 

or private agencies. 

In accordance with specifications established by the 

National Health Survey, the Bureau of the Census, under a 

contractual arrangement, participates in most aspects of survey planning, selects the sample, collects the data, and carries 

ou t certain parts of the statistical processing. 

Public Health Service Publication No. 1000-Series 2 Ne. 26 

Library of Congress Catalog Card Number 67-61847 
FOREWORD


In attempting to develop procedures and devices which will increase 

the accuracy and completeness of data collection in the Health Interview 

Survey, the National Center for Health Statistics has had a continuing 

program of methodological studies conducted by contractual arrangement with the Survey Research Center, Institute for Social Research, 

The University of Michigan. * 

The present study, carried out with the cooperation of the U.S. Bureau of the Census, was undertaken for the purpose of identifying some 

of the major variables that may affect the degree of success with which 

health information can be collected by the interview method. Research 

in this area in the past has focused principally on the training and supervision of interviewers and on the development of a standard interviewing instrument which can be applied in a standard manner, namely, 

the questionnaire. There is little doubt that these two approaches have 

improved th& level and consistency of reporting, but no real breakthrough in methodology has been accomplished. 

More recently researchers have begun to consider the respondent 

as a major source of reporting bias and have turned their efforts to 

gaining some understanding of the respondents attitudes and perceptions 

in relation to his demographic characteristics. 

In the present study consideration has been given to many aspects 

of the interview, with particular emphasis on the individual attitudes, 

behaviors, and backgrounds of the respondent and the interviewer and 

the interaction of these characteristics during the course of the interview. 

This study, which introduces a new dimension in NCHS survey research programs, suggests 

more effectively increased 

rather than by attempting 

levels of information. 

The cooperative efforts 

have resulted in a better 

have made it possible to 

testing. 

that interview reporting accuracy can be 

by changing the behavior in the interview 

to change basic attitudes or to increase 

of the three agencies involved in the study 

understanding of the interview process and 

develop a series of hypotheses for further 

Elijah L. White


Director


Division of Health Interview Statistics


. .. 111

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CONTENTS 

Foreword 

Introduction 

Background 

Interview Variation 

Respondent Variation 

Sources of Data for theStudy 

The Study Model ------------------------------------------------------

Methods of Investigation 

Observation Procedure 

HIS hterviewer Ratings 

Respondent’s Reactions to the HIS kterview 

Interviewerts Reactions to the HIS Interview 

Principal Ftidings 

Summary of Principal Ftidings 

Respondent Characteristics 

Interviewer Characteristics 

Behavior During the Interview 

The Study Design and Sample 

Description of the Health Interview Survey 

General Orientation to the Health Interview Survey 

Objective 

Interviewers 

Interviewer Tratitig 

Type of hterview


The Interview Process


Respondents


Summary


Respondentts View of the Health Interview Survey 

Respondent’s Level of Information 

RespondentAttitudes and Perceptions 

Attitude Differences for Subparts of the Sample 

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CONTENTS—Con. 

Page 

Attitudes and Feelings of the Interviewers


Description of the Interview From Observation Records


Observation Techniques


Characteristics of the SRC Observation Procedure


Observation Item Pretesting and Selection


Description of the Observation Form Content


Observer Traifing


Descriptive Data From Observation Records


Initial Contact


Question-Answer Behavior


Unrelated Conversation


Reactions to Unrelated Conversation


Interview Behaviors and Respondent Demographic Characteristics


Hypothesis Testing


The Dependent Variable, Reporting Accuracy


Demographic Characteristics and Reporting


Behavior ~ring the Interview


Demographic Characteristics and Behaviors


Interview Behavior and Reporting


Relationship Among Behaviors


Behavior Similari~at Emremes


Factor Analysis of Interview Observation Variables


Psychological Orientation of the Respondent


Back~o~d


Respondent Orientations


Motives for Cmperating


Perceptions of the Task


Psychological Orientation of theInterviewer


Style of Interviewing


Interviewer Feeling About Job and Questiomaire


In~erviewer E~ectations


Interviewer Orientations on the Interview


Interpretationof the Findings


conclusions and Possible Implications


Further Interpretations of the Findings


Implications for Future Research


Implications for Interviewing Practice


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References


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CONTENTS-Con. 

Page 

Bibliography


Appendix I. Factortiadings


Appendix II. ~dex Construction


The Dependent Variable


Relation to Accuracy


Discriminability ------------------------------------------------:-


Underreporting


Initial Attempts To Construct a Dependent Variable


Final hdexof Reporting Accuracy


Characteristics of the Final Index of Accuracy


Behavior hdexes


Construction of hitialhdexes


Construction of Major Behavioral Orientations Indexes


Indexes of Respondent Orientation


Indexes of Respondent Feeling Ahut Interview


Respondent Motivation and Concern


Indexes of Interviewer Orientation


Validity of hdexes


Appendix III. Description of the Coefficient Gamma


Introduction


Significance Test of Gamma


Appendix IV. ~ehterview Observation Form


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IN THIS REPORT a methodological study is descvibed which was designed to identify some of the major variables velating to the level of 

the reporting of health information in a household interview. Procedures developed to evalwate the in.uence of despondent and interviewer 

vwigbles during an o bsevved interview sitwation include (1) a description in the form of a series of “snupshots” of the ongoing behavior of 

the participants during the interview, (2) the rating by the interviewer 

of her perceptions of and attitudes toward the despondent and the interview, (3) a reinterview to obtain respondent reactions to the interview, 

and (4) a discussion with the interview concerning her attitudes toward 

hev job, her reaction to specific aspects of hew work, and her feelings 

about the interview situation. 

The model constructed for the study assumed that demographic characteristics, expem”ences, feelings, and attitwdes of the participants in the 

interview were the principal causal factors of reporting and tkzzt these 

factors were mediated by the behaviors exhibited. However, the findings 

of this study indicate that behaviors are the most important variables in 

determining the course of the interview, with psychological and demographic characteristics having minimal predictive value. 

. .. Vlll 
THE INFLUENCE OF 

INTERVIEWER AND RESPONDENT 

PSYCHOLOGICAL AND BEHAVIORAL VARIABLES 

ON THE REPORTING IN HOUSEHOLD INTERVIEWS 

Charles F. Cannell, Ph. D., FIoyd J. Fowler, Jr., Ph. D., and Kent H. Marquis, Ph.D. 

Survey Reseavch Center, Institute fov Social Research, University of Michigan 

INTRODUCTION 

Background 

For years survey practitioners and users of 

survey data have been concerned about problems 

of inaccuracies in interviews. For example, Myers f1study of age data obtained by interviewers 

in the 1940 Decennial Census found a marked 

“heaping” of ages ending in zero, such as 10, 20, 

and 30, Hanson~ and his colleagues at the U.S. 

Bureau of the Census conducted reinterviews of 

families regarding their status in the labor force. 

Significantly different responses were obtained 

fo$ about 40 percent of the items of the interview. 

Hyman8 reported a study conducted during World 

War II which showed that nearly half the respondents known to have cashed war bonds during the 

week previous to the interview failed to report 

this to the interviewer. 

In attempts to isolate and provide tech~ques 

for overcoming these problems, early attention 

was centered upon the interviewer. In 1929 Stuart 

Rice published a pioneering article entitled “Contagious Bias in the Interview. f14Rice was working 

with some interviewers who were collecting information to determine reasons fcir destitution of 

men living. in cheap hotels and floph@U3e&In reading the interviews he discovered that various re. 

sponses received by one interviewer were similar to one another but different from those 

received by another interviewer. He also discovered that respondents of one interviewer consistently reported overindulgence in liquor as the 

cause of their destitution whiIe respondents of 

another interviewer tended to blame social and 

economic conditions. An investigation showed that 

the former interviewer was a prohibitionist and 

the latter a socialist. 

Katz5 showed that interviewers from workingclass backgrounds consistently obtained more 

radical social and political opinions from respondents than did interviewers from the middle class. 

Since early studies have demonstrated significant differences between interviewers, it is not 

surprising that much attention has been devoted 

to measuring the effect of interviewers on research results and to seeking a means of overcoming potential bias. Two main lines of activity have resulted. First, greater emphasis has 

been placed on the adequate training and supervision of interviewers, and, second, research 

workers have given more attention to the wording 

of questions in order to provide the interviewer 

with a standard instrument which can be applied 

in a standard manner. The objective is to obtain 

greater control over interviewer participation. 

However, interview studies still report sizable 

interviewer variance, the antecedents of which are 

largely unknown. 

1 
Interview Variation 

Several factors may be responsible for interview variation. The interviewer’s attitudes, her 

expectations of the respondent, her motives, her 

social and occupational class, and even her physi. 

cal appearance have all at times been shown to be 

related to the results she obtains in interviews. 

Such findings were considered at one time to be 

relevant only when the subject matter of the survey was psychological (perceptions, attitudes, and 

motives) as contrasted with cognitive inquiries 

(level of information, descriptive data, and ,SO 

forth). It becomes clear as more research is done 

that the “attitude” versus “fact” dichotomy is not 

valid. The reason appears to be that even though 

the subject matter of the inquiry may be nonattitudinal, the interviewer and the respondent have 

perceptions, attitudes, and motives about the information, interview, and each other which may 

affect the accuracy of the responses which are obtained during the interview. A respondent’s income is an objective, nonattitudinal variable, but 

feelings about one’s income and about reporting 

it are very strong among some people. Almost 

any descriptive data may be influenced on occasion 

by strong emotional feelings. 

There is no question but that better training 

of interviewers results in more accurate data, 

but even now not too much is actually known about 

factors underlying and leading to inaccurate reporting, although speculation abounds. If the problem could be solved simply, the solution probably 

would have been discovered long ago. Although 

small advances have been made toward improvement, no real breakthrough in methodology has 

occurred. 

Respondent Variation 

Recently, researchers have begun to turn 

their attention from the interviewer as the sole 

source of bias to the other participant in the interview—the respondent. Research is being focused more specifically on the respondent’s information, perceptions, attitudes, and motives, 

Even more important, however, is the growing 

realization that the product of an interview is not 

solely the result of either person, but rather it is 

the outcome of the interaction between the two-. 

each with his individual attitudes, perceptions, and 

motives and each with his own personal characteristics. 

Studies such as those cited above provide a 

basis for speculating alxmt where some of the 

sources of inaccurate data may be and for considering various theoretical bases for understanding the problems. 

It was against this background that the Survey 

Research Center (SRC) and the Health Interview 

Survey (HIS) planned the present study. The hypotheses which were stated were at a broad, general level, and for the most part it was felt that 

systematic and controlled exploration of the interview would be a profitable first step. From this 

study it was hoped that the researchers could 

select, sharpen, or generate hypotheses or identify variables which showed sufficient promise to 

be worth further testing. This study, then, is an 

exploration to provide a better understanding of 

the Health Interview Survey interview and to develop a series of hypotheses for further testing. 

Sources of Data for the Study 

Five sources of data were used in the study— 

the reported health information and demographic 

characteristics obtained in the HIS interview; 

questionnaires measuring the personal and social 

characteristics of the interviewer; questionnaires 

tapping respondents feelings, motives, attitudes, 

and information about the interview; an interviewer rating form describing the respondent, the 

interview, and the interviewer’s impressions and 

feelings; and a procedure which recorded the ongoing behavior in the interview. Basic to the 

study was the intention that the results should be 

indicative of specific changes which would improve reporting in the HIS. 

2 
—. I 

THE STUDY MODELa 

I 

As a basis for considering some of the relevant variables in this exploratory research, the 

following model of the interview is presented: 

RFSPONDh?lZ INTERVIEWER


Demographic Demographic
 c 

Personall.ty Personality 

XnfonnatSon Training 

rl Interviewing


experience


[ Attitudes 

* um


The model assumes that the outcome of the 

interview is a joint product of background characteristics, psychological attributes, perceptions, 

and behaviors of both persons taking part in the 

interview. The emphasis is on the psychological 

characteristics of persons, the effects these persons have on each other, and the resultant effects 

on reporting accuracy. According to this conception, knowing only about one set of variables or 

knowing only about one of the persons in the situation will not provide enough information to predict 

completely the course and outcome of the interview. 

The first set of variables consists of the 

basic characteristics of the individuals such as 

their demographic characteristics, abilities, personalities, beliefs, levels of knowledge, normative 

standards, and effects of experience and other 

learning situations. It is assumed that these 

characteristics form the basis for the more flexible attitudes and expectations which are important 

in the interview. 

At the next level, it is assumed that attitudes, 

expectations, and emotions based on these psychoaThis model is taken from R. L. Kahn and C. F. Cannell, 

The Dynamios of Interviewing, New York, John Wiley and 

Sons, Ino., 1957. 

logical characteristics play a major part in determining how the interviewer and respondent perceive the interview situation. In this study a major 

attempt was made to measure a wide range of 

attitudes, expectations, and motives which were 

relevant to the interview. For example, this research measures attitudes toward health, respondent attitudes toward the whole interview experience, and interviewer attitudes toward her job. 

Possible respondent motives for cooperating, such 

as a citizen orientation or hopes of deriving personal benefit from participation, are measured. 

Interviewers were asked questions concerning 

how they expect their respondents to react to different aspects of the interview. 

For purposes of presenting this model in a 

simplified form, it is arbitrarily assumed that the 

behavior of each person is based on what are 

called here her “perceptions” (how she interprets 

the situation). Her interpretations are based on 

what she already believes and knows and on what 

she learns from the behavior of the respondent. 

The determinants of perceptions are undoubtedly 

much more complex than this since they are probably also arrived at on the basis of nonbehavioral 

cues about the respondent’s social class or ability 

that are obtained from her physical appearance, 

her type of neighborhood, her manner of speech, 

and from other sources. In this study, attention 

was primarily focused on how well the respondent 

understood what she was supposed to do as a respondent (e.g., did she know that she was supposed 

to report all health ailments and the use of health 

facilities for all relevant members of the household). Interviewers were asked to describe, using 

a check list, how they perceived each of their respondents on several dimensions. 

The perceptions of persons are assumed to 

be the final determining link with behavior, and behavior in the interview determines how accurately 

health information is reported. This study measured a wide range of behaviors in as great detail 

as possible. 

Reporting accuracy is hypothesized to be dependent not on the behavior of only one of the interview participants during interview but on both. 

The choice of dependent variables will be discussed in detail later. They consist of reports of 

health from the HIS interview. 

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METHODS OF INVESTIGATION 

Since the present study was designed primarily as a basis for identifying some of the 

major variables relating to the accuracy of reporting health informsJion in the Health Interview 

Survey, it might be described as a search for 

hypotheses upon which to base further studies 

within the framework of the model specified above. 

Meeting this objective required the development 

of procedures which would focus attention on the 

behaviors, attitudes, perceptions, and information 

level of both the respondent and the interviewer 

and obtain some insights into the interaction between the two participants in the HIS interview. 

To do this, questionnaires were constructed for 

both the respondent and the interviewer, and special observational techniques were developed to 

permit a standardized and reliable method of 

measuring the behavior of both the interviewer and 

the respondent during the course of the HIS interview. A description of these instruments and the 

procedures follows. The Interview Observation 

Form is reproduced in Appendix IV, and other 

forms used are available on request from the 

Survey Research Center. 

Observation Procedure 

A special observation technique was designed 

to provide a permanent record, in the form of a 

series of “snapshots, ” of the behavior of the interviewer and the respondent at intervals during 

the interview. 

Of the several techniques used previously to 

record ongoing behaviors, two were found to be 

relevant to the present study. 6!7Although the procedures developed for this study used some of the 

techniques of both these systems, they are unique 

in most respects, Items were selected which it was 

felt would best describe the significant behaviors 

of both participants in the interview and which 

could be observed and recorded reliably. The procedures and forms are described in more detail 

in a later section of this report. 

HIS Interviewer Ratings 

Following the HIS interview, the interviewer 

made several ratings of her perceptions Qf and 

attitudes toward both the respondent and the interview. These ratings were similar to ratings 

made by the observers at the end of each interview. 

Respondent’s Reactions to the HIS Interview 

To obtain respondent reactions to being interviewed, a second group of interviewers from 

the Survey Research Center were sent out to reinterview the respondents on the day following the 

HIS interview. The questionnaire used for this 

interview contained a large number of open questions that covered such topics as the respondent’s 

information and perceptions of the HIS, her 

motives for cooperating, and her reactions to 

various aspects of the interview. Probing for 

negative feelings was emphasized, and some 

semiprojective techniques were used to make it 

easier for the respondent to make critical 

remarks. 

Interviewer’s Reactions to the HIS Interview 

Each of the 35 HIS interviewers was interviewed by Survey Research Center interviewers 

after all of her observed interviews were completed. Questions were asked about her attitudes 

toWard her job, about how she felt about interviewing different types of respondents, about her 

reactions to specific aspects of her work, and 

about her reactions to the questions on the HIS 

questionnaire. 

Information from the HIS was used as a 

source of data for respondent demographic characteristics as well as for her reports of health 

information, 

PRINCIPAL FINDINGS 

According to the model, respondent and interviewer characteristics such as experiences, feelings, motives, and attitudes are the principal 

causal factors of reporting in the interview. They 

are. mediated by behaviors and perceptions of the 

other person’s behaviors. The results of this 

study cast doubt on the causal links postulated in 

the model and suggest a different ordering of the 

variables with respect to importance. Specifically, 

it appears that the psychological characteristics 

and demographic characteristics measured are of 

4 
minimal predictive importance. The behaviors 

and possibly the mutual perceptions of these 

behaviors have appeared as the variables of 

greatest importance in determining the course 

of the interview, 

Summary of Principal Findings 

The data from this study may be cast into four 

main findings which have direct relevance to understanding the dynamics of the information-gathering household interview. 

1,	 Respondent feelings, level of information 

about the survey, motives, attitudes, and 

perceptions when measured the day after 

the interview are not directly related to 

health reporting behavior. 

2.	 Interviewer attitudes, preferences, styles 

of interviewing, or expectations as measured here are not related to the reporting 

of conditions she obtained from her respondents. 

3. Respondent demographic characteristics 

showed no important systematic associations with the reporting index. 

4’.	 The amount of behavior in the interview 

shows a strong association with reporting. 

Both the task and interpersonal behavior 

indexes of the interviewer and the respondent were positively related to the reporting index. The higher the level of behavioral activity in the interview the better 

the overall reporting on the part&f therespondent. 

Respondent Characteristics 

Several things were learned from the reinterview of the respondent which took place the 

day after she participated in the health interview. 

The general level of knowledge about the purpose 

and sponsorship of the interview was low; and 

even though the respondent was sent a letter explaining the purpose of the household interview 

survey and telling her that an interviewer would 

call on her, there was almost no improvement in 

this knowledge. The major predictor of respondent’s information level was her general level of 

education—higher educated respondents had more 

relevant information than did those with lesser education. 

Two major attempts were made to assess the 

respondent’s overall reaction to the interview. 

When questioned directly, about one-third of the 

respondents reacted positively to the interview, 

more than half were “neutral, and the remainder 

were classified as reacting negatively. Using a 

semiproj ective technique in which the respondent 

was asked to “describe the feelings of the person in the picture, ” almost half of the respondents 

were classified as reacting at least somewhat 

negatively to the interview. 

The reason given most frequently for cooperating in the survey was that it is a citizen’s 

duty to do so. The next most frequently given reason was that the respondent merely enjoyed being 

interviewed or enjoyed having a chance to talk to 

someone. 

The most frequently given reason for not cooperating was that the respondent did not know the 

purpose of the surveyor that she felt that surveys 

in general were not worthwhile. 

There were practically no criticisms of the 

interviewer. Respondents see the interviewer as 

highly educated, highly trained, and as a professional rather than a clerical or neighborly 

person. Although respondents were divided in 

their preferences for a businesslike or friendly 

interviewer, almost all of them said that their interviewer was just right. 

Some criticism of the questions was given; 

there was slightly more among the higher income 

respondents. The major complaints were that the 

questions were too personal or too detailed. 

Interviewer Characteristics 

The 35 HIS interviewers employed on this 

study were interviewed after they had completed 

all of their assignments. Most of them expressed 

very favorable attitudes toward their jobs. The 

main appeal was the chance to come in contact 

with other people; however, they did not like the 

idea of going into dirty homes or bad neighborhoods. 

They stated preferences for interviewing respondents who were demographically similar to 

themselves or who, on the basis of other attri5 
butes, were easy to interview. Most interviewers 

felt respondents enjoyed the interview. Very few 

said respondents reacted negatively. 

Behavior During the Interview 

A description of the HIS interview was obtained by counting and recording the behaviors 

which took place. It appears that the interviewer 

gave a short introduction to the HIS and that respondents took most of the initiative in inviting 

the interviewer in and setting the stage for the interview. Respondents usually appeared polite and 

receptive at the door. 

The question and answer process generally 

followed the programed procedures specified in 

the Inte?wieweYfS ManmL8 As a rule, interviewer 

activity was confined to asking questions and probing for answers. Respondents usually answered the 

questions adequately, but they often volunteered 

extra information not needed by the interviewer 

to fill out the questionnaire. Radical departures 

such as the respondent asking the interviewer to 

clarify a question or a respondent consulting 

records were seldom noted. 

Irrelevant conversation was more frequent 

than might have been expected and was initiated 

primarily by the respondent rather than the interviewer. Respondents usually talked abut themselves or about those for whom they were reporting, or they laughed and joked. The very few 

instances of nonquestion-related conversation initiated by interviewers were primarily concerned 

with the respondent or were instances of laughter 

or joking. Respondents reacted more favorably 

to irrelevant initiations than did the interviewers. 

In general, older respondents showed a higher 

level of behavior than did the younger ones. Interviewers did a little more initiating of irrelevant 

conversation for the higher educated and higher 

income respondents but showed more specific 

initiative of a directive sort for the lower educated, 

the lower income, and older respondents. 

originally, based on previous research and 

theory, it was felt that the behaviors in the interview could be classified on at least two dimensions, interpersonal and task oriented behaviors. 

It was possible to make this distinction in devising 

the recording form, but the data indicated that 

behaviors classified by this system were, in fact, 

highly related to each other or nonorthogonal, In 

an attempt to understand how the interview behaviors should be classified with respect to eacl 

other, the behavior data were subjected to factor 

analysis (see Appendix I). In spite of the emergence 

of two orthogonal or independent factors, one ir 

which task behaviors loaded highly and the other 

in which interpersonal behaviors showed exclusively high loadings, a plot of the actual behaviors in the factor space suggested that if the 

two dimensions existed psychologically, they were 

better described as oblique (not independent). In 

addition, one of the most surprising findings was 

that the interviewer and respondent usually behaved on the same level of task and interpersonal 

behavior, especially when the level of behavior in 

the interview was either very high or very low. 

Hence, according to these data, the best way to 

classify behavior in the HIS interview is on a 

single dimension of activity rather than by trying 

to make distinctions between the quality of the 

behaviors or distinctions between the behavior 

levels of the interviewer and respondent, 

THE STUDY DESIGN AND SAMPLE 

Health Interview Survey interviews are supervised by the 12 regional offices of the Bureau 

of the Census. Between 7 and 10 interviewers work 

out of each regional office, receiving assignments 

each week or every other week. Each assignment 

calls for interviews at about 18 households in the 

same primary sampling unit (PSU). The interviewers are expected to complete their assignments as early in the week as possible, and they 

usually interview 10 or 12 respondents by Tuesday 

of the week in which an assignment is received, 

In order to save travel costs, the sample for 

this study was drawn from areas serviced by six 

of the regional offices and included all of the 

United States east of the Mississippi River with 

the exception of a small section of the Northeast. 

It was felt that six regions were needed to insure 

an adequate sample spread of lmth urban and rural 

and northern and southern areas. 

Within each region, a sample of six interviewers was chosen, one for each week Qf the 

study. Observers attended all of the interviews 

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taken on Monday and Tuesday of each week. The 

reinterviewers for the followup interviews were 

told to reinterview only those respondents who 

could be contacted in the 2 days following the 

original interview. Even with this restriction, 90 

percent of the respondents were reinterviewed. 

Only 13 respondents (3 percent) refused to be reinterviewed. 

In all, 412 respondents were observed and 

reinterviewed. Table 1 shows the composition 

of the sample. 

Eligible respondents in the health interview—that is, people who could report for themselves as well as for other members of their 

families—were adults 19 years of age andover or 

married residents of the household. However, 

single people 17 or 18 years of age could respond 

for themselves but not for other people. Adults 

not related to the head of the household were required to answer for themselves. As shown in 

table 1, a high proportion of respondents were 

women. 

DESCRIPTION OF THE HEALTH 

INTERVIEW SURVEY 

Genera! Orientation to the 

Health Interview Survey 

Before discussing the descriptions of the HIS 

from the point of view of respondents, interviewers, and behavioral records, a brief outline 

of the general characteristics of the Health Interview Survey will be given. In addition to providing a brief overview of HIS procedures, this description points out that the HIS represents one of 

several possible types of household interviews. 

Therefore the findings of this study cannot be 

applied to all household interviews automatically, 

A complete description of the aims and methods of the HIS may be found in three earlier publications. ‘-1 1 The information in these publications is applicable to current operation and goals. 

Obiective 

The main objective istoprovide data on illnesses, impairments, accidents, and injuries of 

persons; on use of medical, dental, and hospital 

facilities; and on allied health-related topics. 

Table 1. percent distribution of demographic characteristics of 412 respondents in the sample 

Percent 

Demographic characteristics distribution 

Age 

Total 100 

Under 35 years 27 

35-54 years 39 

55-74 years 28 

75 years and over 6 

Race I 

Total 100 

l===== 

White 85 

Nonwhite 15 

Sex I 

Total 

G 

Male 20 

Female 80 

Family income I 

Total 100 

$0-$1,999----------------------- 14 

$2,000-$3,999------------------- 21 

$4,000- 6,999------------------- 2.5 

$7,000- $ 9,999------------------- 20 

$10,000 ormore--.-----.-------- 14 

Income unknown 6 r 

Education I 

Total 

x 

Interviewers 

The interviewers are female, part-time employees of the Bureau of the Census. Most have 

graduated from high school and a few have had 

7 
some college education. Compared with other interviewer jobs in the United States, the HIS interviewer’s job is fairly demanding. She must carry 

out 15 or 16 extremely complicated interviews as 

early in the week as possible, often calling at a 

household several times before information is obtained. Her workload varies, depending upon the 

population density of the area to which she is 

assigned. Her task is largely repetitive, but it 

changes enough from time to time that she must 

be adaptive. She is aware that extensive quality 

control records are being kept on her performance; and she is required to fill out “homework” 

tests throughout her term of employment. 

Interviewer Training 

An explicit assumption of Health Interview 

Survey planners was that interviewers can represent a large potential source of bias in data collection. Anyone familiar with the early research 

on interviewing techniques will recognize the 

validity of such an assumption: The Bureau of 

the Census has concentrated on creating a detailed 

job procedure description and, in addition, has 

provided for extensive training and continuous 

supervision of interviewer performance. 

Type of Interview 

The HIS is a survey sponsored by the U.S. 

Government and therefore carries a high degree 

of legitimacy for the majority of respondents. 

The questionnaire contains a large number of 

detailed questions about demographic and health 

characteristics. The questions call for the reporting of largely factual information. The health questions emphasize recall of past conditions, the impact of these conditions, the utilization of health 

services and facilities. The task is undoubtedly 

difficult and taxing for many respondents. Attempts are made to minimize the effects of the 

respondent’s personal perception of his own state 

of health in collecting objective health information. 

The Interview Process 

A letter explaining the sponsorship, general 

purpose of the survey, and the confidential nature 

of reported information is sent to each household 

prior to the interviewer’s arrival. When the interviewer arrives, she is instructed to introduce herself, mention why she is there, and then to begin 

the interview without volunteering further explanation. The interviewer proceeds through the 

questionnaire, adhering to the printed format exactly. Irrelevant conversation is expected to be 

minimal, and a respondent who deviates from the 

subject is quickly brought back to the questions. 

Instructions in the Intewiewer’$ Mm.d define 

how the interviewer should answer certain respondent questions and how to handle other specific 

problems with respondents. In general, the iriteraction is task oriented, with only a minimum of 

attention paid to respondent behavior, 

Respondents 

The HIS is based on a national sample, but 

most respondents are housewives and must report 

information both for themselves and related members of the household if the latter are not present, 

Respondents are informed only generally about the 

purposes and content of the interview. Some re. 

spondents receive almost no information and many 

others do not remember anything about the information they did receive, 

Summary 

This brief description of HIS is intended to 

call attention to features in which this type of h’tterview differs from other household interview 

projects, Differences occur in such areas as objectives of the planners, type of interviewer, demands made on the interviewer, type of interview content, legitimacy of sponsor, construction 

of the interview, and eligibility of respondents. 

It is necessary to take such factors into account 

when considering how these data might be applied 

to other types of interviews. 

RESPONDENT’S VIEW 

OF THE HEALTH INTERVIEW SURVEY 

This section of the report summarizes the 

highlights of the reinterviews with regard to the 

respondents’ perceptions of and feelings akdut 

the HIS interview. 

Respondent’s Level of Information 

There is a common assumption that it is necessary for the responderit to have some information about the interview in order to report health 

8 
--

� 

events accurately—the more information avail- however, it is impossible to identify the sources 

able, the better the reporting can be, To gather of a respondent’s information, since the reinterdata to test this assumption, one of the objectives view was conducted after the respondent could 

of the reinterview was to ascertain the amount have been exposed to all three sources. 

and accuracy of information which respondents Adequate addresses are often not available 

had about the HIS interview, to researchers. Therefore theletterandbrochure 

Respondent information about the survey may not have reached al.lof the households to be 

comes mainly from three potential sources. The interviewed. Even. if the information did reach 

first is his general level of sophistication about the correct address, itmaynot have reached the 

the U.S. Public Health Service and about research correct family in a multifamily dwelling or the 

and surveys in general. Having such information person who eventually served asa respondent in 

may be useful if it provides a positive reason for a single-familyd welling. It was estimated that no


reporting, It may also be indicative of how read- more than 73percent of theletters weredelivered


ily the respondent understands and assimilates to the intended family. Even where the address


new information. The second source of information appeared adequate, 42 percent of the respondents


is the printed materials from HIS-a letter and reported reading neither the letter nor the bro­


brochure mailed to the respondents home prior chure (table 2). Not surprisingly, when the ad-


to the interview from the Bureau of the Census. dress was unclear, reported readership wasvery


The third source is the interviewer, in mention- low.


ing why she is there and in answering questions A comparison of level of readership by char-


which arise during the interview. acteristics of respondents showed surprising


Ideally one would analyze data separately for similarities. Respondents of all age, educational, 

the three sources of information. In this study,	 and income groups reported similar readership. 

There was a slight tendency for women to have 

read more than men. 

The main interest in this analysis is to dis- Table 2. Number and percent 

by

dis txibut ion 

cover the level of respondent information about of persons in the sample, readership


of advance materials according to ade- the task he is being asked to perform, i.e., to be


quacy of address a respondent in the Health Interview Survey. Sev-


I 

‘eta’””-l===@41 

eral questions were asked in the reinterview to 

Total ascertain the leveI of information about the PubMaterials read Pe:ps 

sample 

a;$%:s $Kaddress 

lic Health Service, surveys in general, and the 

HIS in particular, 

In general the results indicated a low level of 

Number of 

persons 412 301 78 

information in all areas questioned. Those who 

reported reading the letter and brochure were 

slightly better informed than the nonreaders. More 

Percent distribution important than readership was educational level 

of the respondent. The high educational group was 

better informed than the lower educated. Even ‘OO1 

Both letter 

100within the higher educational group, however, the 

and brochure. 28 3.5 

Letter only-.. 21 23 1: 

Nef.ther letter 

nor brochure- ij~l 42 85 

r , 

NOTE: 33 cases where the adequacy of 

the address was unclear are excluded. 

information level was low. Data on the information 

level for different educational groups are shown 

in tables 3, 4, and 5, 

Advance materials were not effective in communicating information even though they were 

especially prepared for that purpose. The main 

factor in the amount of information was the re-
--------------------------

--------------------------------- -----

----------------------

------------------------

--------------------------------

-------------------------------

------------

--------------------------

--------------------------------------

-----------------------

--------------------

-----------------------

------------

Table 3. Number and percent distribution of persons in the samPle, by resPonse ‘o ‘he


question ‘Who did the interviewers work for?” according to education of respondent


Education of respondent


Total


Response persons Not High
 in high school
 sample school graduate


graduate and above


Number of persons 412 1222 190


Percent distribution


Total 100 100 100


Interviewer works for:


U.S. Bureau of the Census 11 5’ 161


A Federal health agency 20 11 29


A health agency 17 17 1/


“The Government’’


Did not know or was not ascertained 4; 6! 2:


lIncludes 4 responses for which education was not ascertained.


Table 4. Number and percent distribution of persons in the sample, by response-to the


question “Why is the information being collected?” according to educat~on of


;espondent


Response


Number of persons


Total


Information being collected:


For statistical purposes


To help the Nation’s health


To find answers to specific health problems----


For legislative purposes


Gave vague response or did not know


Total


persons


in


sample


412


Education of respondent


Not High


high school


school graduate


graduate and above


1222 I 

Percent distribution


+! 100	 I 100 

I 

34 26 42


5 6


2 1 :


5; 6; 5:


lIncludes 4 responses for which education was not ascertained.


10 

190 
--------------------------

--------------------------------------

---------------------- ------------------- ----- ------- --------------------------------

Table 5. Number and percent distribution of persons in the sample, by response to the 

question “What does the U.S. Public Health Service do?” according to education of, 

respondent 

Education of respondent 

Total 

Response persons Not High in high school sample school graduate graduate and above 

I 

Number of persons 412 1222 190 

I Percent distribution 

Total 

l===== 

Knowledge of Public Health Service: 

Specific or general, indicating some knowledge Y 

of Public Health Service 35 

Vague or obviously incorrect 

Heard of it, but did not know its function 3! 

Never heard of the Public Health Service 20 

Not ascertained 2 

I 

lIncludes 4 responses for which education was not ascertained. 

spondent’s educational level. Respondents generally did not have much information about the 

survey purpose orsponsorship. Manyrespondents 

participated in the interview with little knowledge 

of the organization conducting the survey or of 

why it was being conducted. Withthisbackground, 

it is interesting to see how respondents react to 

being interviewed in the HIS. 

Respondent Attitudes and Perceptions 

In the reinterview, respondents were asked 

questions to obtain their general reactions tothe 

HIS interview. Their reactions might have been 

influenced by such factors as how busy therespondent was, how she felt about her health, how 

she liked the interviewer, or how much health 

information she hadto report. 

Previous studies have shown that somereapondents tend to respond more positively than 

they actually feel when asked direct questions 

about any interview; this is probablybecausethey 

do not want to say anything which might reflect 

unfavorably on the interviewer, For this reason, 

indirect questions were also asked. Respondents 

were shown three pictures,one 

ning of an interview with the 

door, a second showingtwopeople 

showing the interviewer leaving 

ing the interview. Respondents 

showingthebegininterviewer at the 

sitting,thethird 

the housefollowwere asked how 

the person in the picture was feeling. In addition, 

direct questions were asked later about therespondent’s general reactions to the interview. 

Responsesto both the direct and indirect questions, categorized as positive and negativeaffect, 

are.shown in table 6. 

The proportion of respondents with positive 

reactions was about the same for both typesof 

questions, but, as wasexpected, theindirectquestions brought outa significantlyhigherproportion 

of negative reactions. It must be pointed out that 

ttnegativet!
 was broadly interpreted and did not 

necessarily imply major unhappiness or criticism. For example, among the 50 percent who 

gave anegative reaction to the picture of the end 

of the interview are many who simply said that 

the respondent was glad the interview was over. 

When asked for reasons for a positive response, respondents mostoftensaid thattheywere 

glad to be of service in a worthwhile activity. The 

11

-------- -------- --------

-------- -------- ---------- ---------

------------------------

--------- --------

---------------------

Table 6. Percent distribution of the 412 

from indirect and direct question about 

interview 

Respondent affect 

Total . ..-.*. 

Positive . .


Qualified posi.ti.ve


Neutral or equally posit%ve and negati.ve--


Quali.fied negative-.--.--..-.--.- . ...---”-


Negative . . . . . . . ----------- -.


Depends, did not know


Not ascertained --.----- . . . . . . . . . . ...”-----


next most frequent responsewasthat therespondent enjoyed the interview itself—either enjoyed 

responding to the questions or enjoyed talking to 

the interviewer, 

The most common reasons givenfor negative 

reactions were that the respondent did not know 

enough about why she was being interviewed,i,e., 

she did not know the purpose of the survey, and 

she had a feeling that the survey was not worthwhile. Some mentioned specific problemswiththe 

questionnaireor the@estions, There werevirtually no negative reactions tothe interviewer,Only 

3 percent had any specific criticism to makeof 

her, while 68 percent of respondents had positive 

statements to make about the interviewer, 

Several questions were asked about therespondent’s perception of the interviewer since it 

was felt that these perceptions might influence 

how conscientiously the respondent role wouldbe 

performed. ofparticular interest was the levelof 

expertise and professional status attached to the 

interviewer. In general, respondents saw interviewers as being somewhat better educated than 

they actually were: 53 percent thought the interviewers hadat least some college. Further, over 

half thought that the interviewers must have had 

persons in che sample, by respondent affect 

the i.ntervi-ew according ~0 phase of the 

I II


Indirect questions about how Overall the person feels-- reaction 

tm direct At In After qlM&on beginning middle interview of l-- of 

I 

is over interview interview interview 

Percent distribution 

100 

LL#LH 

20 11 25 

19 } 30 { 10 

1! 34 6 31 

2: :: } 50 { ; 

23	 1; 

2 6 1: 

at least 6 months of special training for her job, 

When presented with a list of possible profe ssional 

and nonprofessional roles—ranging from doctor, 

teacher, to clerk, salesman, neighbor, etc.— 

nearly half thought that the interviewers role most 

closely resembled that of a social worker, aprofessional role. Overall, 60 percent selected a 

professional role asmostresembling that of the 

interviewer while 19 percent thought she most 

resembled someone in clerical or sales occupations. The remainder considered her role more 

personal, resembling that of a neighlmr or friend, 

Respondents did not agree as to whether the 

interview should be strictly businesslike and efficient or whether it should allow for’ ‘visiting” and 

friendly interaction, About 40 percent voted for a 

strict businesslike interview while another equal 

percentage wanted visiting, This question was 

followed by one asking whether the respondent 

would have preferred the interviewer to have 

been more businesslike or more friendly. Nearly 

90 percent said that they preferred the interviewer 

to behave just as she did, only 8 percent wished 

she had been more friendly, and 2 percent wished 

she had been more businesslike. 

12

---------------------

----------

--------

---------------

-----

---------------

---------------------

-------- ---------

-----------

------------------

-----------------

--------------

--------------

-----------

!f’able 7. Frequency distribution of most 

and least preferred aspects of interviewer job 

INumber


of
 Reasons given inter-


viewers


Total 35 

l==== 

Most preferred aspects:


Enjoy meeting people


Flexible working hours


Other (traveling, money, etc.)
 No~ ascertained


Least preferred aspects: 

Dirty homes, bad neighborhoods 10 

Physical hardship (bad roads, 

long hours, etc.)------------

Tiine production pressures 

Other (imposing on 

respondents, too much or too 

li.?xle work, etc.)----------- 12 

Not ascertained 1 

Attitude Differences for Subparts of the 

Sample 

When the da~awere analyzed in reference m 

specific demographic groups, a few differences 

appeared. Older respondents had somewhat more 

favorable attitudes toward the imerviewt handid 

the younger, This positive attitude was not connected withan accurateperception oftherespondent role—older respondents were more likelyto 

report that the interviewer wanted only general 

rather than exact answers, 

Better educated respondents tended tomention more specificnegativefactors—reluctanceto 

give up time, inconvenience of the time of the 

call-and they were more likely to prefer. the 

interviewer tobe businesslikeinher approach.Although somewhat more negative generally, they 

had a clearer perception of their role asarespondent, and they were more likely to think that 

the interviewer wanted exact answers. They also 

more often reported the desire to be of public 

service as apositive reason for participationin 

the interview. 

ATTITUDES AND FEELINGS OF THE 

INTERVIEWERS 

On completion of her assignments for this 

study, the HIS interviewer was interviewed bya 

staff member of the Survey Research Centerto 

measure her attitudes, feelings, and perceptions. 

In tables 7-9several questionsfrom thisinterview 

have been selected togive apicture ofhowthe35 

HIS interviewers reacted to the job of beingan 

interviewer, how they felt about thequestionnaire 

with which they were currently working, and how 

they felt about their respondents. 

It appears that the main attraction ofthe job 

was that it offered the interviewer a chance to 

Table 8. Frequency distribution of interviewer feelings about the cmestionnaire 

and interview­

— 

Question and response


Total


5.	 Are there any things that 

the respondents find too personal or embarrassing to report? 

Response:


Yes-----------------------

No------------------------

22. . . are there some sections


of the questionnaire with which


respondents have particular


trouble?


Response:


Yes --.,----


Depends on the respondent-


No------------------------


Not ascertained


15. Do you feel that the in­


terviews are too long or not?


Response:


Too long


Qualified


Not too long


Did not know


Not ascertained


Number


of


inter-


viewers


35 

29 

6 

31 

2 

: 

16 

7 

; 

1 

13

--------

--------

-----------

--------

------------------

-------- -------- -----

-----------

-----------------

----------

----------

--------------

-----------

-------------------

meet different
 people.Thisreasonwas givenfirst


by most oftheinterviewers inpreference
toother


possibleresponsessuch as gettinga chanceto


travel, havingextramoney,ordoingapublic
serv­


ice.As major reasonsfordisliking
 thejob,inter­


viewersmentionedhavingtogo intodirtyhomes


or undesirable neighborhoods,
havingto endure


Table 9. Frequency distributions of in­


terviewer orientations to respondents
— 

Number


of


Question and response	 inter-


viewers


Total---------------------


1.	 In general, how do respondents feel about being interviewed? Do they like it, not


like, or what?


Response:


Generally positive


Generally neutral---------
 Some like it, some do not-


Generally negati.ve


Not ascertained


2. What things do respondents


usually enjoy most about being


interviewed?


Response:


Chatting, visiting


Being good ci,tizen, 

helping

;~:~;ered at being chosenNothing enjoyed


9. Here Ls a list of kinds of


respondents;which would you


prefer to interview? (Inter-


viewer was allowed to select
 more than one kind of re­
 spondent.)


Most chosen type:


Concerned about health----


Quiet---------------------
 Friendly------------------
 Middle income ($3,500-
 $10,000) 

Middle aged (30-60 years)-


College educated


Women---------------------
 Least chosen type:


Low income (under $3,500)­


Grade school education----


Over 60 years of age------


Men---.---.----.---.------


35


12


11


4


6


2


23


4


:


3


26


24


22


19


19


17


16


1


1


:


Table 10. Gamma coefficients showing the


direction and degree of association be­


tween how hard the interviewer had to


work in the interview and her ratings


of the respondent


Direction


and


degree of


associa-


Rating of respondent	 tion with


how hard


the in­


terviewer


worked


Respondent tenseness +.62


Respondent ability to under­


stand questions -.72


Respondent cooperativeness---- -.58


Respondent willingness to


give time-------------------- -.48


Respondent accuracy -.57


How much interviewer liked


respondent -,48


Other comments (negative sign


indicates more critical than


positive comments)----------- -,61


1A description of the statistic gamma,
 a nonparametric coefficient of associa­


tion, is given in Appendix III.


conditions ofphysical
hardshipsuchas drivingin


bad weatherand puttingin longhours,or being


away from home overnight (table
7).


Interviewers indicated asensitivity
 toprob­


lems which theirrespondents
had withtheques­


tionnaire (table 8}.Most interviewers
 feltthatthe


questionnaire contained
itemswhichweretooper­


sonalorembarrassingfortherespondent
 toreport


easilyand thattherewere some sections
ofthe


questionnaire whichweredifficultfor
 respondents


tocopewithforvariousotherreasons.Abouthalf


of the interviewers thoughtthe interviews
were


toolong.


HIS interviewers
portrayedrespondentsin


generalas eitherenjoying
orbeingneutraltoward


theinterview experience, although
asmallminor­


ityof the interviewers
feltthatrespondentsin


generaltendedtoreactnegatively
 tobeinginter­


viewed.Most interviewers
feltthatrespondents


enjoyeda chancetotalkwithsomeone
 newand that


thiswas probablythemost enjoyableaspectof


the interviewfor the respondent.
Interviewers


14

themselves tended to prefer certain types of respondents. In table 9 it can be seen that interviewers preferred to interview respondents who 

were interested in the topic of the interview, who 

behaved in such a way as to make conducting the 

interview easier (a preference for quiet rather 

than talkative respondents), and who were friendly 

rather than businesslike. They also preferred interviewees who were demographically similar to 

themselves (moderate income, middle aged, 

higher education, and female). They tended not to 

prefer respondents who had low income, low educat ion level, who were over 60 years of age, or who 

were male. 

From the ratings which each interviewer 

made of each of her respondents after the HIS interview, it would seem that the harder the interviewer had to work, the less she liked the respondent and the greater the likelihood that she would 

rate the respondent as tense, inaccurate, uncooperative, and unwilling to give of her time. Furthermore, the interviewer was more likely to make 

a negative rather than positive comment about such 

a respondent at the end of her rating form. Table 

10 shows the degree of association between the 

interviewer’s rating of each respondent and her 

rating of how hard she had to work in each interview. 

From these data it appears that interviewers 

like the opportunity to get out and meet other 

people, and they feel that respondents like to meet 

them and are willing at least to put up with the 

business part of the interview. Interviewers do not 

like to interview respondents who are demographically different from themselves. Interviewers 

react negatively to difficult respondents in the 

ratings and yet are sensitive to respondent problems in the interview. Since these interviewer 

rating and preference data will not be discussed 

further in this report, it should be pointed out 

here that there is no evidence from this study to 

indicate any relationship between interviewer 

preferences or interviewer feelings and the measure of respondent reporting accuracy employed. 

Preferences and feelings may exist but they do not 

produce a discernible effect on the data. 

DESCRIPTION OF THE INTERVIEW 

FROM OBSERVATION RECORDS 

Observation Techniques 

One of the principal instruments used to collect data in this study was the Behavior Observation Form, a technique for recording what went 

on during the interview. Since this technique was 

developed especially for this study, a detailed 

description is provided here. 

For the purposes of this study, the observation 

procedure had to meet three general criteria: 

1.	 It should describe as much of the significant behavior which takes place during the 

interview as possible 

2.	 It should obtain reliable and valid measures of the concepts of interest 

3.	 It should be simple enough that people not 

acquainted with observation techniques 

could be taught the procedure in a relatively short period of time and could use 

it in the field without difficulty 

A search of the literature revealed several 

procedures for observing and recording interaction between two persons or more. However, it 

was found that none combined the criteria of comprehensiveness, reliability, validity, and economy 

required for this particular study; therefore it was 

necessary to design a new procedure specifically 

for this study. 

Characteristics of the SRC Observation 

Procedure 

The observation procedure was designed to 

obtain measures of a wide range of behaviors of 

both interviewer and respondent while keeping the 

observer’s job simple so that it could be done adequately with relatively little training. The various 

activities of interviewer and respondent were broken down into small segments of easily identifiable behaviors. The observer’s job was to make 

tallies or checkmarks when the specific behaviors 

were observed. 

15

To record a wide variety of behaviors, the 

interview was divided into segments, each containing a specific set of questions from the HIS 

questionnaire. For each segment, several types 

of behaviors were observed. By sampling segments of the interview in this way, observation 

could be focused on different kinds of interviewer 

and respondent activity, with measures obtained 

on a variety of behaviors while keeping the task 

within the observer’s capability. 

Problems of validity were resolved partially 

by recording only directly observable behavior, 

i.e., words spoken or gestures used rather than 

inferred behavior. Inferences about the psychological meaning of the data were made after the objective data were recorded. These inferences were 

made both by the observers in the form of a set of 

ratings made at the end of the interview and by the 

experimenters in the data analysis presented in 

this report. 

Observation Item Pretesting and Selection 

A set of initial items was developed and subjected to intensive laboratory and field testing. 

Laboratory testing involved actual and simulated 

interviews observed simultaneously by three 

members of the research staff. Fieldtesting consisted of observation of actual HIS interviews by 

members of the research staff. 

If any one of the staff judged an item or procedure difficult or impossible, it was eliminated 

or simplified. An item was also discarded if agreement between observers was consistently low in 

the staged interviews, 

On the basis of these pretests, many items 

were eliminated and others simplified. Items 

which were eliminated were those for which reliability was low and could not be improved easily as 

well as those which required too much time to 

record. A number of the items involving complex 

judgments were deleted or shifted to the last section of the observation form so that the observer 

could have time to think about them after the interview, For example, observers tried to rate 

whether the respondent “shows lack of understanding” after each respondent answer. Because 

this judgment took too much time and was unreliable, it was moved to the end of the observation 

form and the observer was asked to make a rating 

on: “How well did the respondent grasp the mean. 

ing of the questions?” Most judgments which re. 

quired the observer to use visual cues (e.g., pos. 

ture and facial expressions) proved unreliable an{i 

were discarded. 

Also eliminated were codings of long sequences of interaction, indicating what was said, 

who said it, what was the reaction of the other 

person, and so forth. Finally, most of the t imt: 

recordings were eliminated— both measures 01 

duration (e.g., amount of time spent answering t. 

particular question or explaining the survey) ancl 

actual times (e.g., when the interviewer enterec[ 

the house, when the first question was asked), Several efforts were made to get an objective indication of the pace of the interview (e.g., how fast the 

questions were being asked or answers being 

given), but all proved impossible and subjective 

ratings had to be used. Use of a stop watch was 

found to be of no great value. 

Description of the Observation Form 

Content 

The observation form is divided into four 

major sections. The first section includes behaviors occurring during the first minutes of contact 

between the interviewer and respondent, both at 

the door and inside the house, as the preparation 

for the interview takes place; the next section focuses on the interview itself, including the question and answer exchanges between interviewer 

and respondent; the third section concentrates on 

events taking place after the last interview question has been answered; and in the final section, 

the observer records general impressions of the 

interview. 

Different behaviors were recorded within 

each of the major sections of the interview, 

Observer Training 

For this study the U.S. Bureau of the Census, 

the agency which collects the data for the Health 

Interview Survey, selected six HIS interviewers to 

be trained as observers. 

During the week before the field work began, 

the six observers were trained at the Survey Research Center. Training sessions were primarily 

concerned with the goals of the study, a detailed 

explanation of the Interview Observation Manual, 

16

----------------

-------------------------------

-----------------

Table J.L. Percent of interviews in which


selected explanations were used by in­


terviewers to introduce the survey


Percent


of inter-


views in
 Topic used in introduction which it
 was men­
 tioned


U.S. Bureau of the Census----- 96


U,S, Public Health Service----


interview process2------------ i:


H13 (specifically)------------


Advance letter f?;


0ther3------------------------ 41


lNumber of interviews= 412. 

‘Anything which describes the inter-


view for example, “I want to ask same
 questions about your health,” or “It


should take about 20 minutes,”


~Usually indicates interviewer showed


her credentials to respondent, but neg­


lected to mention either of the sponsor­


ing agencies,


and practice in observing and recording staged 

interviews. The staged interviews followed carefully prepared scripm covering all aspects of the 

form and stressing difficult items. Furthermore, 

each simulated interview was taperecorded while 

it was inprogress. Differences among observers 

concerning any verbal behavior were resolved by 

listening to the tape recordings. 

To supplementthe role-played
interviews,


two training
 filmswere madeof stagedHISinter.


views.For thesefilms,an experiencedHISinter­


viewer questionedtwo respondentswho had no


connectionwithtbeHISorwith SRC. The movies


provedvaluable inconveyingthesubtleties
 ofusing


the observationform, and theycouldbe rerun


when questions
arose,


One halfdayoftraining
was devotedtoactual


fieldexperience, sothatthe-trainers
 wouldbave


anopportunity toanswer questions
 andtodealwith


problemsthatdidnotappearinthe
controlledset­


ting.


Trainingperformancerecordswere keptfor


eachobserveron sixstagedinterviews,
 including


the two movies,and servedas acheckupon the


amount ofinterobserver reliabilitytobe
 efiected.


In ordertoeliminate onepotential
 sourceof


bias,itwas continually emphasizedtothe
observ­


ersthatthestudywas notdesignedto“checkup”


on theircolleagues
whorntheywouldbeobserving.


Itwas stressedthatrespondent
performancewas


ofprimary interest,


Descriptive Data From Observation Records 

Thissection ofthereportisa description
 of


theHIS interview
asitwasobservedusingtheob­


servation proceduredescribedabove.
 Thedataare


presentedtoprovidea generaldescription
 ofwhat


HIS interview
lookslikeas observedbythistech-


nique.The dataarebasedontbeobservationof
 412


HIS interviews.


Table 12. Average frequency of interviewer and respondent behaviors at the begin­


ning of each interview and percentage of interviews in which the bebavior occurred


Behavior


Number of different topics mentioned by interviewer in


introduction-.--.----“---.---------­
-------------.-------------


Number of respondents’ questions


Number of polite acts initiated by respondents


Number of times interviewer takes initiative (getting in door,


selecting a chair, and so forth)------------------------------


Percent of
 Average interviews
 frequency in which


per


interview behavior


occurred


2,45 100 

20.51 40 

1.22 73 

0.55 41 

lRecorded from the time interviewer knocked on door until first question from ciuestionnai,rewas asked, 

‘Approximate;if respondent asked more than two questions, this was treated as if 

she had asked only two. 

17 
-----------

---------------

--------------- ------

-------------

------------

-----------

-----------------

-------

Initial Contact 

Table 11 shows the distribution of explanations used by the interviewers at the beginning of 

the interview. From this table it can be seen that 

most frequently the interviewer mentioned that she 

was from the Bureau of the Census and that she 

was taking a survey for the Public Health Service. 

If she said anything beyond this minimum identificat icm, it was usually something about the interview process, such as how long it would take or 

that the questions pertained to health issues. 

On the average, the interviewer mentioned 

about 2?4 introductory topics at the beginning of 

the interview (table 12). 

In about 40 percent of the interviews the respondent asked some questions before he permitted the interviewer to enter the house. A count was 

kept of the number of behaviors indicating politeTable 13. Average number and percent distribution of task related behavior in 

sampled segments of the interview 

Average Percent 

number of total 

Behavior per recorded 

inter- task 

view behavior 

Interviewer 

To’cal 6.2 100 

Repeats question as 

worded 0.7 11 

Other nondirective 

probes 

Directive probes

Clarifies meaning of 

2.4 

2.2 :; 

question 0.8 13 

Suggests other sources 

of information be 

consulted 0.1 2 

Respondent 

Total 53.4 100 

Acceptable answers---- 39.0 7: 

Inadequate answers----

Elaborated answers---- 1::: 21 

Requests clarification 1.0 2 

Consults other information sources 0.2 (1) Questions adequacy of 

answer-----------k--- 0.2 (1, 

lLess than .5 percent. 

18 

ness by the respondent, such asinvitingtheinter. 

viewer inside or offering her a chair. Another 

count was kept of the number of times the inter. 

viewer had to take theintiative inaskingtobe let 

into the home, finding a chair for herself, and s{) 

forth. The average respondent made 1.2 polite 

gestures at the beginning ofthe interview ,and7:l 

percent ofthe respondents madeatleastone Palit(: 

gesture. The interviewer took some initiative in 

41 percent of the interviews. 

Question-Answer Behavi,or 

Table 13 containsa description of behavior$: 

in the interview relevant either togainingorgiving 

information necessary to fill out the health questionnaire. These are the main behaviors relating 

directly to the task. The behaviorswererecordecl 

for three sections of the interview andcombinec 

into single scores. The results are presented in 

terms of the average frequency of each behavior 

in the three sampled sections of the interview 

and its frequency relative totheothertask related 

behaviors. The latter is expressed as a percent of 

the total task related behavior recorded in the 

three selected sections. 

Table 13 shows the kinds of behavior used by 

the interviewer in obtaining health information 

after the initial question had beenasked. Probes— 

directive, nondirective, and repeating the question-made up 85 percent of the interviewer’s 

task behavior. The average interview contained 

five probes in the three sampled sections. Nondirective probes were slightly more frequent 

than directive probes. While nondirective probes 

are generally more acceptable techniques, the 

reader should not conclude that the directive 

probes necessarily produce biased information. 

Frequently they merely check on what the respondent is thought to have said, for example,’ ‘You said 

that was within the last six months, didn’t you 

Mrs. Smith?”) lt is clear from the table that the 

interviewer took little initiative in suggesting that 

medical records, hospital bills, and other sources 

of information be consulted. 

Table 13 also shows the behavior of the respondent in answering questions for the same three 

sections of the interview. The major activity was 

the giving of acceptable answers, those for which 

the interviewer did not need to probe further, One 

surprising finding is the high frequency with which 

respondents elaborated or voluntarily furnished 
------------

--------------

----------

------------------ ----------

------------

----------------

----------

------------------ ----------

more information than required by the question. 

Such elaborations characterize 21 percent of the 

answers in the average interview. 

An average of 2 answers were given by the 

respondent which were inadequate to meet the objective of the question. For an answer to qualify 

as inadequate, it had to be probed by the interviewer, and the observer had to concur that probing 

was required to obtain the needed information. In 

the table it appears that interviewers probed an 

average Iof about 5 times in the sampled parts of 

the interview. The discrepancy may reflect both 

conflicting definitions of probing and also “superfluous” probing by interviewers. 

The other respondent behavior categories 

show a low frequency of initiative on the part of 

the respondent in requesting clarification of a 

question, consulting other sources of information, 

and questioning the adequacy of an answer. 

The overall picture from this table is of a 

reasonably cooperative respondent who seldom 

gave inadequate information and who often volunteered additional information and of an interviewer 

who did not probe excessively and who incorporated a variety of techniques when she did use 

probes. Neither takes special initiative in searching for other sources of information beyond the 

question and answer process. 

Unrelated Conversation 

Table 13 deals with those behaviors which are 

an intrinsic part of the questionnaire and thus anticipated by the designers of the interview. Regardless of how well designed and well engineered 

an interview schedule and procedure may be, behaviors which are not relevant to the questions and 

answers do occur. Because these behaviors may 

play an important part in determining the accuracy of information gathered from an interview, 

they received special attention in this study. 

Rather than record them from particular parts of 

the interview, observers attempted to record 

every instance of behavior which was not directly 

related to the task outlined by the questionnaire. 

Each such behavior was categorized by whether 

it was initiated by the interviewer or by the respondent as well as by content. Finally, the observers recorded the reaction of the other person 

to this behavior. Table 14 shows the content and 

frequency of behavior initiations which are not 

directly related to health information, For ease 

of reference this is called “unrelated conversation” or “interpersonal behavior.” 

Throughout the average interview, the interviewer initiated 1.7 instances of unrelated conversation (table 14). About half of these are classified 

as humor—the classification includes anything 

from a short chuckle to the telling of a funny story. 

Nearly all of the remaining initiations-40 percent 

of the total— were directly concerned with the respondent and took the form of flattery, praise, nonhealth questions, and suggestions. The respondent 

initiated nearly 16 instances of unrelated conversation during the average interview. These are 

divided about equally between “humor” and “talking about self, family, friends. ” Only rarely was 

the respondent observed to have initiated conversation directly “almut the interviewer or about the 

interview. The high frequency of “talking about 

self, family, or friends” was an unexpected finding. 

This category did not appear in other descriptions 

of task oriented interaction, and it proved valuable 

in further analysis of the data from this study. 

Table 14. Average number and perca-t 

distribution of unrelated convezsa~i,orh 

initiations by interviewer and respondent during entire interview 

Interviewer I 

Total 

l=== 

Talks about the respondent 0.68 

Talks about self, family, friends 0.19 

Talks about the interview 0.00 

Laughs, jokes 0.81 

Respondent I 

Total 

U= 

Talks about the interviewer 0.34 

Talks about self, family, friends 7.58 

Talks about the interview 0.69 

Laughs, jokes 7.26 

Percent 

of 

total 

initiations 

100 

40 

11 

4: 

100 

2 

48 

4 

46 

19 
--------------

------------------------

--------------

---------------------- ----------------------------------

-------------

-------------------------

--------------

---------------------- ----------------------------------

Table 15. Number and percent distribution of unrelated conversation initiations, by 

interviewer and respondent reaction according — to content of initiation 

Content of initiation 

Total respondent initiation 

Talks about interviewer


Talks about self, family, friends


Talks about the intervia


Laughs, jokes


Content of initiation 

Total interviewer initiation 

Talks about respond~t


Talks about self, familyi friends


Talks about the titerviw


Laughs, jokes


These findings suggest that the interviewer 

and responded haddifferent orientationsto theinterviewsituation ingeneraI. 

Generalizing from the conversation data,it 

may be suggested that respondents were more 

active than interviewers in initiating tmrelated 

comments ‘and were more preoccupied with their 

Own interests. The use of humor is particularly 

interesting since some research finds thathumor 

is frequentlya reactiontotension.12 Thusthedata 

presentedheremay indicate thatthe respondents, 

especially, were under sotne tension. 

Interviewers appeared to be somewhat less 

active, more task oriented, more preoccupied 

with the respondent than with themselves, and 

under less tension. The special emphasiswhich 

interviewers placed on comments about therespondent may reinterpreted ashehaviordesigned 

to gain or maintain rapport with the respondent. 

Interviewer reaction 

Number 

~ 

Percent distribution 

6,516 100 21 78 1 

146 100 34 4 

3,121 100 % 1 

284 100 E 

2,965 100 ;2 85 : 

Respondent reaction 

Nimber 

Percent distribution 

705 100 55 44 1 

100 70 

100 60 :: ‘ ; 

100 

100 :: % : 

1 

Reactions te Unrelated Conversation 

The observers recorded the nature of the 

verkdresponse following initiations ofunrelated 

conversation. Each response was rated as to 

whether it encouraged furtherunrelated behavior, 

wasneutral,or whetheritdiscouraged suchbehavior. 

Interviewer reactions to the various kinds of 

unrelated conversation initiated bythe respondent 

are shown intable 15. 

In total, about 78 percent of the intefview& 

reactions were classified as “neutral,” and nearly 

all of theremaining reactions wereinthe’’encourages” category. The interviewer tended to react 

encouragingly when the respondent talked about the 

interview. Shewasahnost as Iikelytobeencouraging when the respondent initiated conversation 

about the interviewer. The neutral reactions were 

20 
most prevalent when the respondent talked about 

himself or Ms family and when he laughed or joked. 

These two categories, “talking about self or 

family” and “jokes,” represented the large proportion of respondent initiation of irrelevant conversation, 

Also shown in table 15 are data on how respondents reacted to interviewer initiations of 

unrelated conversation. The respondents divided 

their reactions to interviewer initiations about 

equally between “encourages” and “neutral” (55 

and 44 percent, respectively). “Encouraging” 

reactions were most frequent when the interviewer 

talked about the respondent, or the purpose of the 

survey, use of results, and other topics related to 

the interview. “Neutral” reactions were most 

frequent when the interviewer laughed or joked and 

when she talked about herself. “Discouraging” 

reactions were seldom recorded, they were most 

frequent when the interviewer initiated conversation about the respondent, 

The major difference between interviewer 

reactions and respondent reactions to unreIated 

conversation was that interviewer reactions were 

likely to be neutral while respondent reactions 

were about evenly divided between neutral and 

encouraging, with the latter slightly more frequent. Respondent and interviewer responded in 

about the same ways to the different content areas. 

Both were more likely to respond encouragingly 

to initiations about the other person or to “humor.” 

Neither interviewer nor respondent gave many 

reactions classified as “discouraging,” 

It appears therefore that the atmosphere of 

the interview was neither overly friendly nor 

overly businesslike. 

Interview Behaviors and Respondent 

Demographic Characteristics 

The several hundred variables arising from 

the observation form have been related to respondent demographic characteristics (age, education, family income, race, and sex) and have been 

inspected for patterns of relations. In general, 

the magnitude of the relations between objectively 

counted behaviors and demographic characteristics was very small, while the magnitude of th’e 

relations to s~bjectively rated items was a little 

larger. Both types of measures suggest that three 

demographic characteristics (age, income, and 

education) showed some association with counts 

or ratings of respondent behavior. Furthermore, 

a consistent pattern of relations was found. 

Generally, of the three demographic variables age, income, and education, the one most 

closely associated with respondent behavior was 

age. Older persons tended to engage in many 

different types of behaviors and in large quantities; 

younger respondents exhibited- less variability in 

behavior. Like younger respondents, persons 

with high income or high education exhibited 

less behavior. Further qualitative distinctions 

can be made. Older respondents showed much 

less discrimination in the types of behavior— 

they elaborated more and engaged in more irrelevant conversation; they were rated as wanting 

to talk a lot, trying hard to communicate, and as 

being not fully accurate. Because of these types 

of behaviors, the interviewer had to use mpre 

probes for them, read the specialist card more 

often, and frequently help them ascertain family 

income. The pace of the interaction was rated as 

slow and not smooth. 

Respondents with high education or high income elaborated less, and they initiated an average 

amount of unrelated conversatiorq they were rated 

as understanding the questions well and reporting 

relatively accurately. They gave fewer answers 

that required probing, they considered the questions more carefully, and they needed less help 

in figuring family income. Although their IXhaviors occurred less often, they appeared to be 

consistent with the giving of accurate information. 

One hypothesis about the relation between ‘ 

respondent demographic characteristics and behavior is that a different pattern of interaction 

takes place when interviewer and respondent are 

of the same social class than when they are from 

different social classes. Specifically, when a 

higher status person communicates with a lower 

status person, he tends to take more initiative, 

to be more active in directing the interaction, 

and to stick to the job, while the lower status 

person exhibits a deference pattern of compliance 

and often initiates conversation of an irrelevant 

nature. 

In the interview situation, this dominancedeference pattern may also hold. If it can be assumed that the less educated, lower income, and 

21

older respondents represent persons who are of 

a relatively lower social class than the average 

interviewer, then it can be assumed that for these 

respondents, interviewer behavior will show more 

initiative, directiveness, and task orientation while 

respondent behavior will show deference and 

nontask orientation. 

To test this hypothesis, the observed interviewer behaviors were divided into three groups: 

programed-task behavior (probes on the routine 

health questions), initiation of unrelated conversation, and opportunities for specific task initiative (reading the specialist card, giving help on 

the income question, and adjusting the pace of 

reading the chronic and acute conditions lists). 

The data indicate that interviewers did not 

engage in more of the programed-task activity 

(probes to health questions) for any group of respondents. This finding suggests that little variance in the main interviewer-task activity is determined by status differences between interviewer and respondent, and it probably reflects 

a successful training procedure. 

On the other hand, interviewer initiations of 

irrelevant conversation support the dominancedeference hypothesis to some degree. Interviewer 

initiation of almost all types of irrelevant conversation (praise, suggestions, talking about herself, 

and jokes) shows a low but positive relationship 

to both respondent education and income. 

Finally, interviewers showed much more initiative in guiding the response for older, less 

educated, and lower income persons. The interviewer was more likely to read the specialist 

card to these respondents rather than letting 

them fill it out themselves; she was more likely 

to read the chronic and acute conditions list 

slowly enough to make sure the respondent understood and considered each of the items; and she 

was more likely to help the respondent arrive at 

the correct family income figure. These findings 

are supplemented by the two observer ratings of 

interviewer initiative. According to these initiative ratings, the interviewer clarified more and 

tried harder to communicate for older, less educated, and lower income respondents. 

In summary, interviewers initiated somewhat 

more unrelated conversation to the higher educated and higher income respondents, thereby indicating an interviewer-deference pattern. Second, 

there were no differences in frequency of initiatillg 

the main task activity of probing answers to the 

principal, repetitive health questions for respondents of different demographic characteristics. In ­

terviewer-probing behavior on these question:; 

was given careful and extensive attention durinf: 

interviewer training, and it is possible that this 

training reflected itself in the lack of variation 

of effort for the respondent groups of concern 

here. The third pattern shows the expected differences to a slight degree in interviewer initiative 

with respect to respondent demographic groups. 

These items consisted of observer ratings of the 

amount of interviewer initiative and some nonroutine behavior items where interviewer initiative can make a dramatic difference in reporting 

quality. 

HYPOTHESIS TESTING 

This section examines the relationship between the main variables of the study. A detailed 

discussion of how the variables were constructed 

is given in Appendix II. 

The Dependent Variable, 

Reporting Accuracy 

Because of the lack of good, independent validation criteria, the most difficult variable to construct in this study was an index representing the 

accuracy of reported health information. For reasons discussed in Appendix II, the main dependent variable used is an index based on the number 

of chronic and acute conditions which the respondent reported for himself, corrected for the age 

of the respondent and hereafter referred to as 

the “reporting index. ” It is assumed on the basis 

of the’ evidence presented in this appendix that 

within a certain range the number of chronic and 

acute conditions reported for oneself reflects the 

general degree to which all information in the interview is reported accurately. 

Demographic Characteristics and Reporting 

It may be hypothesized that certain demographically defined groups of respondents will 

report more accurately than others. Specifically, 

on the basis of previous SRC research, the follow22 
--------------------- ----------------- --------------------------

--------

----------

--------

ing demographic groups were thought to represent 

the highest potential for good reporting: the highly 

educated, high income, female, and white groups. 

Conversely, groups thought to have the lowest 

potential for good reporting were the less educated, low income. male, and nonwhite groups. 

Table 16 shows the amount and direction of 

the association between these demographic variables and the reporting index. There are no 

significant relations between the demographic 

characteristics and the measure of reporting accuracy. 

Behav~or During the Interview 

h was hypothesized that behavior in the interview could be classified on three independent 

dimensions: (1) behavior directly related to the 

task, (2) behavior related to the maintenance of 

the relationship between the interviewer and respondent, and (3) behavior oriented essentially 

toward the rapid completion of or escape from 

the interview. These are referred to as “task,” 

“interpersonal, 1I and t!Completionttbehaviors, respectively. Indexes of these behaviors were constructed for both the interviewer and respondent 

for every interview, according to the procedures 

described in Appendix 11, and were related to the 

reporting accuracy index. As it turned out, completion behavior could be identified only as the 

absence of task and interpersonal behavior. Because of this, no further consideration is given 

to a completion-behavior index. 

To test the validity of the classification of 

interview behaviors, a factor an?lysis was perTable 16. Gamma coefficients showing the 

direction and degree of association between respondent demographic characteristics and the reporting index 

Respondent demographic Report ing, 

characteristic index 

1 

Education -.12 

Family income -.03 

Race .11 

Sex--------------------------- -.03 

Table ~7. Gamma coefficients showing the 

direction and degree of association between respondent demographic characteristics and observation indexes of respondent and interviewer behavior 

Respondent demographic 

Observation characteristics 

indexes 

Age Educa- Income tion 

Respondent interpersonal behavior------------- 1.22 -.03 -.02 

Respondent

behavior 1.21 -.06 � 04 

Interviewer interpersonal behavior .07 .09 .15 

Intervisver task 

behavior .09 -.18 -.09 

task 

lSignificant, p = .05 or less. 

formed using the items from the interviewobservation records which discriminated well between 

respondents. The appearance of one factor made 

up largely of laskrelated,behaviors and another 

made up of interpersonal behaviors tends toprovide some confidence in the validity of the a 

priori classification. A further examination of the 

behavioral dimensions of interview behavior is 

made in the sections to follow. 

Demographic Characteristics and Behaviors 

Initially it was felt that certain behaviors 

would be more frequent among respondents with 

certain demographic characteristics. It washypothesized that more highlyeducated respondents 

would show more task oriented behavior than 

lower educated respondents and that older respondents would show more interpersonal behavior than younger respondents. 

The data indicate that older respondents are 

more likely to score higher both onthe task and 

interpersonal indexes (table 17). 

Task behavior was not found to bemorefrequent for higher educated or higher income respondents; there is a nonsignificant trend for 

interviewer task behavior to be comparatively 

lower correspondents with thesecharacteristics. 

23 
-----------------

------------------------

-------

-----------------------

-----------------------

--------

Table 18. Gamma coefficients s,howing the directicm and degree of association between 

interview behavior indexes and four measures of health reporting 

Measures of health reporting 

Interview behavior indexes Respondent T:::;=:U Total RU Total RU 

comlicions doctor hospi,tml­ index tions 1 visitsl izationsl 

Respondent task behavior ;,56 ;:;; ‘.23 

Interviewer task behavior .46 5.40 

Respondent interpersonal behavior 9.22 ;.30 ,04 

Interviewer interpersonal behavior .18 “.20 ,02 

lRu is an abbreviation for the total household re~ortin~ unit (all Persons in the 

household for whom the principal respondent reported filly in pa~t), “ 

2Significant, p = .05 or less, 

Interview Behavior and Reporting 

One of the major hypothe~es of this study 

was that interviewers andrespondents whoengage 

in a high level of task behavior during the interview would produce imerviewsh avingahighdegree of accuracy and completeness. It was also 

thought that even though interpersonal behavior 

was essentiallyindependentofreportingaccuracy, 

it would correlate with length of the interview, 

These hypotheses and relevant data ar,ediscussed 

below. 

Table 18 shows the gamma coefficients between theinterview behaviorsand reporting,lnadditionto the reporting index, severalothermeasures of reporting frequency have been includedto 

demonstrate the generality of the findings. 

The table indicates a positive relationship 

between each behavior index and the various 

measures of reporting frequency—the more task 

behavior engaged in by the interviewer or respondent, the better the reportin~ the more 

interpersonal behavior engaged in by the interviewer or respondent, the better the quality of 

reporting, The task behavior indexes appear to 

be more strongly related to reporting than the 

indexes of interpersonal behavior, 

interpersonal behavior is not independentof 

reporting accuracy as originally hypothesized, 

With respect to the hypothesis concerning intero; 

personal behavior and length of the interview, 

table 19 shows that both interpersonal and task 

behavior arepositively relatedtothelength oftime 

thr? interview lasted. Again, the relation holds for 

both interviewer and respondent behavior, 

Re[ationsh!p Among Behav~ors 

Initially, it was hypothesized that interview 

behaviors would formtwoclusters (taskbehaviors 

and interpersonal behaviors) and that them 

clusters would be statistically independent of 

each other, Essentially, behaviors in the interTable 19. Ganma coefficients showing the 

direction and degree of association beWeen behavior indexes and length of 

the interview 

Behavior index 

I 

Respondent interpersonal

behavior 1,26 

Interviewer interpersonal

behavior 1,20 

Respondent task behavior 1,51

InCerv@wer task behavior -...-.. 1.51 I 

significant, p = ,05 or less, 

24 
Table 20. Number and percent d$stxibution of the incervtews, by reqxmden~ cask, ttem 

havior accmrding tm ~esponclent incerpersmal behavior 

Reqvandent task behav?or 

. . .. . . . . .......” .--~., Respondent MEarpersanal behav%~r Nlxuber 

Sslle; S:cl: 

TQtx%l liQw M@ 

Lx? high 

. 

l%lxexlt dislW*lW19@n 

Lw-.-...n.....-m........-......mm= 102 loo 40 39 M 

Somewhat high 

Somewha&low. . . . . . . . . . . . . . . . . . . . . . . 129 MN) 3(3 J . . . . . . . . ..s *...-”..-.=. M) ?$ :! M 

High m...””.”.-” . ..-..”..-. .-...===” :; MM 28 :: -.. . . 

view do form two chwtera$ but there. Ls some 

evidence that these clusters are not independent. 

Tables 20 and 21 shawindatail therelati~ns between the task behavior indexes and the inter. 

personal behavior indexes separately for therespcmdent and for the interviewer, Afairly strong 

positive relationshipoccursb~tweentheresp~ndent behaviors? indicating that a reaptmdent who 

is ptxrfortning at a high level of task !mbavior 

is also likely to be engaging in a gcmddealof 

interpersonal bhavi9r. The relation between in. 

terviewcx ta~k behavior and intervi~wer interLow--u.-------...-..m . . . . . . . . ..m.mm !.00 34 

SomawhaE LOW- . . . . . . . . . . . . . . . . . . ...= Ji 1(-)0 24 

Somewhat high . . . . . . . . . . . . . . . . . . . . . . I,QQ 15 

High ..-- . ...””. . . . . . . . . . . . “....*-”= 11? MM 17 —.. 

NOTE: Gamma = ,26 (Mgniflmmt, p = ,05 o% less), 
--------- -----

---------------------- --------- -------- -------- ------

-------- -------- -----

---------------------- -------- ----------------

Table 22. Number and percent distribution of the interviews, by interviewer task behavior according to respondent task behavior 

I I Interviewer task behavior 

Respondent task behavior Number 

Some- Some- Total Low what what High low high 

Percent distribution 

Low--------- ------.-- 102 100 46 25 

Somewhat low----------------------- 115 100 29 % Ii


Somewhat high 10J 100 7 22 ::
 High 100 2 8 37 :;


NOTE: Gamma = .64 (significant, p = .05 or less). 

to be high in task behavior if the respondentis 

high in task behavior .Thesame istrue for interpersonal behavior. 

Taking into account the above empirical relations between the behaviors which occur inthe 

interview, ahighdegree ofinterdependenceisobserved both between qualities of behavior andbetweenthe persons doing the behavior. It appears, 

then, that using these apriori indexes of behavior each interview canbe ranked ona single behavioral dimension ’and on a general behavioral 

activity level and that this behavior level isposiBehavior Similarity at Extremes 

The data do not permit discovery ofwhois 

primarily responsible for setting this common 

general activity level—the interviewer, the respondent, or some interaction of the two. Suchan 

analysis must await further experimentation in 

which variables are experimentally manipulated 

rather than merely observed, (Such a study is 

being carried out by SRC in conjunction withHIS.) 

However, one interesting dynamic of behavioral 

balance maybe studiedwithexisting data. 

tively relatedto reporting accuracy. 

Table 23. Number and percent distribution 

sonal behavior according to 

Respondent interpersonal behavior 

Low-------- --., 

Somewhat low-----------------------

Somewhat high High “------

of the interviews, by interviewer interperrespondent interpersonal behavior 

I Interviewer interpersonal behavior 

I Percent distribution 

102 100 46 10 

129 100 14 H 2; 

95 100 4 20 :: 36 

86 100 2 10 27 61 

NOTE: Gamna = .65 (significant, p = .05 or less). 

26 
-----------

----------

---------

I 

1’ 

I 

I 

~“ 

I 

I 

I 

I 

Table 24. Relationship of interviewer interpersonal behavior to respondent interpersonal behavior 

Interviewer interpersonal


Respondent I behavior


Ratio of obtained to ex­
 pected cell frequencies


Ilow 

Somewhat low--


Somewhat high-


High w


lBased on data shown in table 23. 

oil Ratio = q-’ 

n,. x n.j where ‘%]= N 

n,. = row frequency


n. I = column frequency 

Eij = expected frequency in cell ij 

0,,= obtained frequency in celljj


N = total number of cases 

The number of persons who score low, or 

high, or at any other point on an index isofno 

intrinsic interest since the distributions were 

arbitrarily constructed. (See Appendix II.) It is 

possible, however, to compute thenumber oftiterviews in which behavioral balanceis expected 

“on the basis of chance” by the chi-square procedure of multiplying marginal totals anddividing by total N. Expected cell frequencies canthen 

be compared with obtained cell freque~cies, independent of spurious effects in the,&bitrarily 

constructed distributions on single indexes. This 

procedure was used to construct tables 24and25, 

which show the ratio of observedto expec~ed cell 

frequencies for task behavior and interpersonal 

behavior. Both of these tablesindicatet&tbehavioral balanceis most likely at the behavioral exmemes. In other words, the interviewer andrespondent are most likely to behave similarlyhigh 

or similarly low, and the probability of balance 

at some intermediate level of effort is not as 

great. These tables as well as some others indicate that behavioral balance at any level is more 

likely than behavioral imbalance. 

The reasons for this phenomenon are not 

clear. It may be that behavioral balance is 

achieved only when one or both of the interacting 

persons furnish. obvious cues shut their “preferred” levels of behavior. Themostobviouscues 

are probably those associated with the extreme 

rather than intermediate levels of behavior. 

Factor Analysis of 

Interview Observation Variables 

In an attempt to test the validity of the a priori 

index construction procedure, a factor analysis 

was performed using most of the variables from 

the interview observation recording form. 

Table 25. Relationship of interviewer 

task behavior to respondent task behavior 

1 

Ratio of obtained to ex­ pected cell frequencies 

Low-= 1.2 0.8 0.0 

Somewhat low-- 2; 1.5 0.8 0.5 

Somewhat high- 0.9 1.4 1.2 

High---------- ::? 0.3 1.2 2.4 

lBased on data shown in table 22.


Oij , Ratio = — Eij 

where Eij = ni.	 xn. i 

N 

ni. = row frequency 

‘“J = column frequency 

Eij=expected frequency in Cellij 

Oij =obtained frequency in cell ij 

N = total number of cases 

27

kerns which represented actu@ coums or 

ratings of behavior, which provided a reason. 

able Wcriminat?on between respondents (fewer 

than 90 percent of the individuals were coded in 

the most frequent category), were intercurrelateti 

arid factor analyzed afid the factors subjected to 

orthogonal rotation. (Principal Axis Factor Awilysis and Hotelling Varimax Rotation with mmmalized solution, Missing dam, which existed fof a 

small number of the ratings only, were treated 

by assigning the individual a rating score at the 

mode of the overall chstrikttion on the rating,) 

Five significant factors were found, four of 

which could be interpreted rneaningfuily, The 

four faemrs were labeled interperstm?l behavior, 

task behavio~$ task ratings, and respondent receptiveness, A more detailed presentation of the 

content of each factor is in Appendix 1. ‘ 

The facto? wmiysis confirmed the Mtial CHS. 

Irintxion ‘made between interpersonal a~d task 

tMetIt&l behaviors, ifidi~ating that these factors 

can be made orthogonal ifi rn?tihematit%l spzme. 

)+iowever, data from the a priori indexes and 

ftwther Work with the factor data indicated that 

the%%!two behaviors were best de8eribed by two 

obliqueWnendcm rather than by orthogonal dimttnsiomii fcm thbs study and that one dimetwion 

z@ctmfit$for “mostof the variance iti the repMting 

index, 

The factor armlysig also tmfifirmed the above 

fintihig concerning the high degree of dependence 

between the behaviors of the respondent and 

interviewer, The two factors heavily loaded with 

behavioral variables, the task and interpersonal 

behavior factors} contained both interviewer and 

respondent Items. Interviewer and respondem 

task behaviors were not separated, nor were 

interviewer and respotident interpersonal behavitm$, 

A third factor &mtained most of the observers’ rating~ of both interviewer and respondent task oriented behaviorb w’hichsuggests 

that these ratings are made largely with respect 

to a Single tlhmmsitm and are nobhighly correIatt?d with the objectively measured task behaviors even though they were designed to be. 

In the ififtial analysis of the observation data, 

an attempt waa made to cmmtruct an itidex of re. 

Bpondtmtreceptivityy to the imerview based largely 

upofi objective behavior recorded at the beginning of the interview, This index did not meet the 

criteria necessary for its inclusion in further 

afialysi~, The fourth factor from the factor analysis contained a number of subjective ratings which 

appeared to represent the degree to which therespondent wwswilling to admit the interviewer and 

to provide time for the interview. However, there 

were no items indicative of the quality or degree 

of effort put into the performance, Although an 

index of receptivity could not be constructed by 

u~ing objective behaviors, it seems that it is possible to capture essentially the same idea by using 

the subjective ratings which the observers made 

at the beginning and end of the interview, 

A further analysis of the characteristics of 

this receptivity factor was obtained, but it was 

not possible to demonstrate any relationship between it and either respondent demographic 

characteristics respondent task and interpersonal behaviors, respondent attitudes, or quality 

of repofting, If the factor correctly identifies 

respondent receptivity, the data suggest that respondent. reporting performance cannot be predicted by superficial indications of cooperativeness and friendliness. 

PSYUKXC)GICAL ORIENTATION OF . . 

THE RESPONDENT 

Btmkground 

Earlier in this report two general hypotheses 

were implied concerning the effects ofpsychological orientations of the respondents, The first was 

that the quality of the~e orientations (her attitudes, 

expectations+ motives, and perception) would be, 

at least partially, related to the respondent’s 

characteristic~ and that favorable dispositions 

would be related to goodreporting, 

In this study a high degree of correlation was 

expected between respondent demographic charticteristice and respondent psychological orientations, OrI the other hand~ it was assumed that 

interviewers would be reasonably homogeneous 

with respect m background characteristics and 

also with respect to training and further experience with respondents. It was felt that this homogeneity precluded finding any relationships at this 

level of analysis for interviewers, 

28 
The ~econd general hypothesis was that psychological orientations are the main causal variables indetermining behavior intheinterviewmid 

reporting accuracy, Specifically, it was assumed 

that positive attitudes or feelings toward the iriterview would be related to good reporting. It 

was further assumed that attitudes, motives, expectations, and perceptions relevant tci specific 

aspects of the interview would determine specific 

behaviors during the interview. 

In the following sections specific interviewer 

and respondent psychological orientations are examined for their relations to demographic characteristics, behavior in the interview, and the reporting index, The general results indicate a lack 

of any of the expected relationships, a finding 

which implies that the model hypothesized above 

is not especially useful for understanding this 

particular type of interview. 

Respondent Orientations 

Two scales of respondent attitude or feeling toward the interview experience were cmlst rutted—one based on questions of an indirect 

,nature and the other based on questions which 

asked the respondent how she felt about the imerview, The details of the construction of these 

scales is given in Appendix 11, 

Contrary to the initial hypotheses, there is 

nu significant association between the feeling of 

the respondent about the interview and her demuTuble 26, Gamma coeffi-ctents showing the 

direction and degree of association between respondent attitude and respondent demographic characters tics 

Respondent 

attitude 

Feeling about 

Lnterview (in­

:::r; quest--------

Feeling about 

interview (di. 

rect questions) 

Respondent dernographi.e 

characteristics 

EducaI Age I tion Inc!ome 

-*O3 -.11 -,09 

,08 -*13 -.15 

Table 27. Gamma coefficients showing the 

direction and degree of association between respondent attitude and the reporting index, respondent interpersonal 

behavior. and respondent task behavior 

indexes “ 

Respondent 

behavior 

Re- indexes Respondent p;;:gg attitude lnterper- Task 

sonal 

Feeling about interview (indirect 

questions )------- ,03 ,00 .07 

Feeling about interview (direct 

questions)------- ,01 .01 .06 

f 

graphic characteristics, either for the director 

indirect measure of overall feeling (table 26). 

These data indicate that respondents ofhigh 

education and income status donothaveas positive 

a feeling toward theinterviewas wouldbehypothesized on the basis of previous data. In fact, the 

data indicate atrendfor these respondents to be 

more critical of the interview, although thistrend 

is not statistically significant. Indirectly these 

data also indicate that having information abut the 

HIS or about surveys in general does not, in itself, result in a positive evaluation of the interview experience. 

To test thehypothesis that positive attitudes 

or feelings are necessary conditions for behavior 

which will lead to inaccurate interview, the two 

respondent attitude scales are related to the indexes of respondent interpersonal and task behavior and to the index of reporting accuracy, 

The data in table 27 indicate that no systematic 

relations exist. 

In this particular study, having a positive 

(or negative) feeling about theinterview experience is not related to background characteristics 

nor does it have any direct effect on behavior or 

reporting during the interview. It appears that 

respondents, like good interviewers, do not let 

their feelings about the situation bias the interview. Data presented in Appendix II indicate, 

however, that these feelings arenotalwayshidden 

from the observer. 

29 
------

------

------

------

---------

-------

-------

-------

-------

Table 28. Gamma coefficients showing the 

direction and degree of association between respondent motive for cooperating 

and respondent demographic characteristics 

Respondent

motive for 

cooperating 

Good ci izen motivatx .2 n--------

Chance to talk 

motivation 

Personal benefit 

motivation 

Chance to rest 

motivation 

Like talking 

about health 

motivation 

~espondent demographic 

characteristics 

Age Educa- Income tion 

.04 .14 .03 

.06 .02 -.03 

.03 -.35 -.16 

I-27 .00 1-,26 

-.18 -.18 .00 

‘Significant, p = .05 or less, 

Motives for Cooperating 

Respondents say they cooperate for one or 

more of many possible reasons. The data from 

this study identify five such reasons: the willingness to perform the duties ofacitizen,the feeling 

that cooperation will result in personal benefit, a 

desire to talkto someone,adesire totake abreak 

from usual activities, and satisfactionindiscussing health. 

Initially it was felt that the distribution of 

these motivesin the sample would berandomwith 

respect to demographic characteristics with the 

possible exception of age.Itwasfelt thatolderrespondents, because of social isolationandgeneral 

lack ofactivi~ ,would show more indicationsthat 

they enjoyed the interview because itgave thema 

chance to talk to someone. In table 28, the five 

motives for cooperating are relatedtorespondent 

demographic characteristics. The coefficients of 

association are all small, and the only statistically 

significant associations are between age and 

chance to rest and between income and chanceto 

rest. ‘l%erefor etheolderrespondents andthosein 

low income groups are morelikely tomentionthat 

the interview affordsachance totakeabreak from 

usual activities than are other groups. 

It was further hypothesized (1) that the existence of these motives forcooperation would correlate positively with reporting; (2) that the qualities 

of a good citizen, personal benefit, and desire to 

talk about health would correlate with respondent 

task behavior; and (3) that the willingness to talk 

to anyone andthechance torestfromusual activities would show a positive association to interpersonal behavior of the respondent. The data 

indicate that none of these motives correlates significantly with the reporting index (table 29), None 

of theexpected correlations with behavior is found, 

although some trends may exist. 

It was felt that certain negative feelings may 

be generated in the interview situation. Two such 

forces were identified in this study: respondent 

concern about the time the interview took andrespondent concern about thenatureofthe questions. 

Only a very fewrespondents voiced any concern 

about the interviewer and the way she conducted 

herself. Therefore this concern is excluded from 

further analysis. 

The mention of time pressure and question 

concern in the followup interview is correlated 

with respondent demographic characteristics. 

Four of the six possible relations are statistically 

significant although still rather weak (table 30). 

Table 29. Gamma coefficients showing the 

direction and degree of association between respondent motives for cooper- ating and reporting index, respondent 

interpersonal behavior. and respondent 

task behavior indexes -

Respondent 

behavior 

Respondent motive indexes 

for cooperating Interper- rask 

sonal 

Good citizen mo- tivation .08 .00 .03 

Like talking 

motivation -.05 .12 .02 

Personal benefit 

motivation -.13 .14 .21 

Chance to rest 

motivation .08 � 20 -.06 

Like talking 

about health 

motivation -.07 -.20 -.14 

30 
-------------

--------

--------

---------

---------

The younger, higher educated, and higher income Tab le 31. G+ coef f i.cients showing the 

respondents are more likely to mention time direction and degree of association between respondent concern and report&g 

pressure. ‘The higher income groups are slightly index, respondent interpersonal -

more likely to mention a concern about the nature havior, and respondent task behavior inof the questions. dexes 

Contrary to expectations, the existence of 

reporting accuracy. Although the coefficients of 

association reported in table 31 are not significantly different from zero, there is a tendency for 

Respondent 

concern 

Re -

p::;gg 

behavior 

indexes 

Inter- I 

question concern to be positively related to task pers onal Task 

behavior and the reporting index. 

Perceptions of the Task Concern about 

time -.01 

+ 

.00 .00 

It can be hypothesized that accurate percepConcern about 

questions .15 

tion or understanding of the task is a necessary * 

condition for accurate and complete reporting and 

that a misunderstanding of what is wanted can lead 

negative forces or feelings does not act to suppress Respondent 

to poor performance. Respondents were asked two viewer wanted exact rather than general answers 

specific questions almut the conduct of the inter- and more likely to give at least one accurate 

view: Did the interviewer want exact or general reason why the health information was being colanswers? Did the interviewer want everything or lected (for compilation of statistics). While the 

only the important things? In addition, an under- other coefficients of association are not signifistanding of why information about health was being cant, there is a trend for the older respondents 

collected (respondent information level) also more often to say thattheinterviewer wanted genserves as an indirect indication of how accurately eral answers and to have a less clear idea of the 

the respondent understood the task. There is some 

indication from the data presented in table 32 that 

respondents in the higher educational groups have Table 32. Gamma coefficients showing the 

direction and degree of association be- a more accurate understanding of what the inter- tween respondent understanding and reviewer wanted than do other demographic groups. spondent demographic characteristics 

They are also more likely to say that the interRespondent demographic 

characteristics 

Table 

direction and degree of association be- understand ing 

tween respondent concern 

demographic characteristics 

and respondent Age Education Income 

Interviewer 

Respondent wanted exact answers -.21 1.43 .17 

30. Gamma coefficients showing the Respondent 

Interviewer Concern E=Rsl=wanted everything to be reported .06 -.10 -.09 

Respondent knew 

why information being collected -.25 .13 .11 

*Significant, p = . 05 or less, +.significant, p = . 05 or less. 

31 
----------

----------

-------

Table 33, Gamma coefficient~ showing the 

direction and degree of a~tmciation be. 

tween respondent understanding and re. 

po%tifig index, respondent interpersonal 

behaviar~ and respondent tagk behavior 

ittdexe~ 

I Respondent 

behavior 

Respondent 

ufldemtaflthg ‘Zig= 

per. 

s ona 1 Task 

Interviewer 

wanted exact 

ariswers .06 .07 

Interviaver 

wanted everything to be reported .10 -,02 -.13 

Responderit knew


why the inform­


ation was being


collected ,22 ,02 ,13


purpose for which the information was being collected. 

The da_taintable33 showthedirecteffectsof 

having knowledge abouttherequirements andgoals 

of the survey on reporting accuracy and on the 

majorreqxmdent behavior indexes .Althoughnone 

of the gamma coefficients is significantly greater 

Ithan zero, there is atrendinthe directlonindicatIing that increased understanding doeshaveapositive effect on reporting. 

One other finding which, inretrospect ,seems 

to be relevant totherespondents ‘understanding of 

the requirements of the surveyis thetmexpected 

(and not quite significant) positive relationship between the respondent conditions index and therespondents’ saying that the interviewer did fiotget 

all the information abut the family’s health during 

the interview~Ofthe27 respondents who said the 

interviewer missed something, about half scored 

high on the conditions index. The remaining 385 

respondents either avoidedansweringthe question 

(“lgaveherwhat sheaskedfor’’)or said the inter. 

viewer did not miss anything. Onlyahutaquarter 

of this group scored high on the reporting index, 

The gamma coefficient is-621, 

It would seem that inorder fora respondent 

tosay thatthe interviewerdid notgetallthe infer. 

mation about the family’s health during theinter. 

view, she must have understood what the inter. 

viewer wanted to know, Granting this assumption, 

it maybea little lesssurprisingtofind that those 

who have reported well are a little more likely 

to understand what was required andalittlemore 

likely to say that the interviewer didnot get all 

the required information. 

The data presented essentially point to a lack 

of relationship between respondent psychological 

orientation and the behavior or accuracy-corn. 

pleteness outcome m! the interview. While a few 

of the measured orientations show a slight correlation with rtwpondent demographic characteristics, the orientations themselves are of little 

value in predicting directly the level or quality 

of respondent behavior during the interview or in 

predicting reporting accuracy, Of the various 

categories of respondent orientations mentioned, 

the mom promising to be followed up are the respondent “perceptions, ” or her understanding of 

the task requirements, Fowler13~iscusges and 

analyzes these data further inhis doctoral thesis, 

PSYCHOLOGICAL ORIENTATION 

OF THE INTERVIEWER 

Interviewer data collectedin a separate interview after the Census interviewer had completed 

her work for this study are grouped into three 

major categories—the interviewers style of in. 

terviewing, her feelings about her job, and her 

general expectations about respondents, Data are 

presented, again, in terms of gamma coefficients, 

This was accomplished bytreating the35 interviewers as 412 independent interviewers, one for 

each interview taken, Because of this artificial 

procedure, nosignificant tests have been applied 

to the data, The conclusions reached from these 

data are based on what appear to be consistent 

patterns of data rather than statistically significant coefficients of association. 

style of Infw’vfewing 

The interviewers were asked to state their 

preferences for’ types ofrespo~dents from aliat 

of respondents grouped according todemographic 

32 
---------

-------

-----------

------

Table 34, Gmma coeffi,ci.ents showing the 

direction and degree of association between intervi,ewe? style and reporting index, interviewer interpersonal, and 

triterviewer task behavior indexes 

I Interviewer 

behavior 

Re- indexes 

pc):)gg 

I 

5 

Ctmcernwi.th 

ttccuracy ,09 -,16 -.08 

Ctmcern w$th 

#peed and 

eff%21ency ,01 .06 � 01 

Ccmcernwith 

afftlf.ation.----= .00 .00 -.07 

tmd personality characteristics .Aftereachchoice 

was made interviewers were asked to state the 

reasons for the choice (or’in many cases forrefusing tomakea choice).Thesereasons werecontent analyzed (see Appendix II) forthree dimensicms of interviewing style: the interviewer’s 

concern with accm’acy,herconeernwith speedand 

efficiency, and her concern with affiliation.Itwas 

initially hypothesized thatinterviewers withaconcern for accuracy would get more accurate data 

tmcl~howmcme task behavior, Itwasalsofelt that 

interviewer concerned with the pleasantnessof 

the relathwwhip would show more interpersonal 

behavior, but that the data obtained wouldnot differ 

significantly inaccuracy, Finally, itwashypothesized that interviewers whowereoriented tospeed 

and efficiency would obtain poor reporting and 

would show low levels of both task and interpersonal behavior. The data in table 34 indicate not 

only that the hypotheses were wrong but also that 

there iseemsto bea clear lack ofrelationship between these indexes ofinterviewer style andactual behavior and production in the interview, 

Intw’viowsr Feeling About Job 

tand Questionhatre 

Interviewers were asked a series of direct 

questions ontheir feelings about their jobs,about 

the importance they attached to the HIS survey 

effort, and aboutthe efficiencyofthequestionnaire 

anti other data-collection instruments. Initially it 

was hypothesized that interviewers with favorable 

attitudes toward their job and witharealizationof 

the importance of the data-gathering function of 

the interview would be better interviewers—they 

would obtain better reporting and show more task 

behavior, Recognition that there are problems 

associated with using therather coniplicated HIS 

questionnaire andother materials was thought to 

be an indication of interviewer sensitivity to the 

possible difficulties inherent in getting accurate 

data with the given instruments. Hence, the mentioning of problems with the questionnaire and 

procedures was hypothesized to be associated 

with the obtaining of accurate information. The 

data again show a lack of any relationship between the interviewer orientations and either 

reporting accuracy or interviewer behavior 

(table 35), 

Ifiterviewer Expedationt 

Each of the 35 Census interviewers responded 

to a series of direct questions about the reaction 

of respondents to the interview situation. The 

answers to these questions were made into seven 

indexes representing different types of expectations. Inspection of the data in table 36 leads to 

the conclusion that expectations as they are mess= 

ured here are not related to the performance 

variables, although it is interesting that the great 

Table 35, Gammacoeff%c~ents showing tihe 

direction and deg~ee of association betweeti j ob,.related attitude and report­ , index, interviewer interpersonal 

%~avior3 and iritetiviewer task behavior 

indexes 

Interviewer 

behavioz 

Job-related Re- indexes 

attitude por;:g ~~ 

lnterper. Task sonal 

Attittide toward 

jOb-------------- -609 

Importance of 

s~cvev .07 -.10 -*L5 

,05 II-,17 

Problehs with 

ins Wuments ,09 .16 -*O3 
---------

-------

-------

-----------

-------

Table 36. Gamna coefficients showing the 

direction and degree of association between interviewer expectation and reporting index, interviewer interpersonal behaviors. and interviewer task 

behavior indexes’ 

Interviewer 

expectation 

Expect posi.ti.ve 

attitude 

Expect citizen 

motivation 

Expect affi.li.ati.on 

motivation 

Expect personal 

benefit motivation 

Expect respondents 

to be busy 

Expect respondent 

to think survey 

is worthwhile----

Expect respondent 

to have problems 

with questions---

Interviewer 

behavior 

Re- indexes 

porr:g . Interper- Task 

s ona 1 

.01 -.18 .05 

-.04 -.20 -.02 

.02 -.01 -.05 

-.32 -.04 .01 

-.08 .08 -.06 

-.13 -.16 -.05 

-.08 .04 .03 

majority of the gamma coefficient signs are 

negative. Further analysis of these data (notpresented here) suggested that this “negative effect” 

may be “real” and has led to the hypothesis that 

interviewers who do not expect problems or who 

predict that their respondents will have some 

positive orientation to the interview are not as 

effective as the interviewers who anticipate some 

trouble. 

Interviewer Orientations on the Interview 

As with the data on the effects of respondent 

orientations, the interviewer orientations did not 

show any associations” with interviewer behavior 

or productivity. Her interviewing style orientations, her evaluation ofher job, and her general 

expectations about respondents did not give any 

direct insight into how she behaves in the interviewor how accurate and complete her interview 

data tend to be. Further analysis ofthesedata has 

not revealed anydefiniteareaswhere associations” 

occur, but these expostfactoanalyseshaveled to 

the hypothesis that interviewers whoexpectrespondent cooperation and a general lack ofproblems may not obtain asmuchdataas interviewers 

who do expect problems and lack of cooperation. 

In addition,data analysis(notpresented here)suggeststhatif thereis any variation in interviewer 

behavior which is related tointerviewer orientations, it seems to be intheinterpersonal behavior 

of the interviewer. Unfortunately adequate exploration of this area is precluded in this study because there is really little general variation between interviewers or withininterviewersintheir 

interpersonal behavior. In approximately 90percent of the interviews, theonlyinterviewer initiations of irrelevant “conversation’’ w?reinitiations 

of laughter. On the other hand, this aspect of the 

interview receives relatively little emphasis in 

training, in theinstructionmanual,in supervision, 

or in the feedback evaluations which interviewers 

get. In the absence of such trainingandcontrol, it 

is reasonable to expect variation attributable to 

individual differences in psychological orientation in the interpersonal behavior area. 

INTERPRETATION OF THE 

FINDINGS 

Conclusions and Possible Implications 

As stated at the beginning of thereport, this 

investigation was planned as a broad exploration 

of the HIS interview to provide insights andto develop hypotheses almut techniques of improving 

reporting in the household interview which could 

be investigated in future research. In the section 

below afurther discussion of the most important 

findings of this study andsorn etentativ einterpretations are presented. 

A model of the antecedents of good reporting 

was offered at the beginning of this report. It was 

this model which dictated the overall design of the 

study. 

Twogeneral interpretations of the pattern of 

results may be made: one is thatthehypothesized 

model of the dynamics of theinterview needs to be 

revised; the other is that the initial madel is essentially correct but thatitdidnot receive an adequate test in this study. 

The question may be raised as to whether the 

lack of expected relationships between theclemo34 
graphic or attitude-type variables and reporting 

was not due to the inadequacy and omission of 

measurement of the important variables. Because 

the question is a crucial one, this report contains 

a detailed description of the operational definition of each of the main variables used in the 

analysis (see Appendix II). The following two points 

can be made: 

1.	 This study was especially comprehensive 

in including measures of demographic and 

attitude-type variables. 

2.	 The operational definitions of these variables have at least face validity, and, in 

addition, the variables do show patterns of 

acceptable reliability and internal consistency in places where this type of analysis could be performed. 

It appears reasonable to conclude, therefore, 

thot the variables were comprehensive enough to 

test the hypothesized model and that, while the 

variables may contain some “error” variance, 

they should be considered moderately acceptable 

opetwtions for the concepts they were designed to 

represent. 

If the measures of the variables of interest 

are valid, some explanation is needed of why the 

expected relationships of the social and psychological variables to reporting were not found. Two 

complementary explanations for the findings are 

offered here and developed further in the next section. First, it seems highly likely that, even though 

respondents do possess attitudes, feelings, and 

motives which are potentially relevant to the 

household interview situation, the strength of these 

characteristics is such as to make them relatively 

unimportant in determining the outcome of the interview once the respondent has made the commitment to be interviewed. Apparently other variables 

become paramount in guiding behavior once the 

interview has started. 

Second, with respect to the interviewer, the 

lack of relationship between preferences for type 

of respondents, preferred styles of interviewing, 

demographic characteristics, expectations about 

respondents, or rated feelings toward individual 

respondents is a little less surprising. The most 

cogent explanation of these data is that the interviewers are well trained and are successful in 

keeping their personal feelings from biasing the 

data, 

One hypothesis which may have merit for future research is that a household interview maybe 

a unique experience for respondents. It maybe so 

out of the ordinary stream of daily events that respondents really have no cognitive “set” which they 

bring to the situation. The situation is so new that 

it is difficult to generalize their associated feelings, attitudes, and expectations. Therefore exist ­

ing attitudes, expectations, and feelings do not 

provide a basis for behavior, and the respondent 

must look to the interviewer or some other source 

for cues as to her expected behavior. 

On the other hand, the interviewer may be in 

somewhat the same situation. She has been trained 

in how to ask questions and fill in the spaces on the 

questionnaire, but she has learned from experience that respondents are different: some will 

enjoy the interview, others will be amoyed with it; 

some will have trouble with certain sections, 

others will not; some will be rushed or pressed for 

time, others will want to talk about many irrelevancies. Therefore the interviewer too will beattentive to subtle cues from the respondent to supplement her training and to arrive at a strategy for 

dealing with this particular respondent. 

This hypothesis implies that both interviewer 

and respondent search for cues from each other on 

appropriate behavior. It maybe this cue-searching 

process which accounts for the very strong tend­


ency of interviewer and respondent to behave at the


same level of activity in the interview. This heavy


reliance on cues from the other person to set the


behavior pattern may also account for the fact that


orientations measured in this study were not pre­


dictive of behavior. In addition the reciprocal cue-


searching process may explain why it is not pos­


sible to determine that one person sets the


behavior activity level and the other follows. An .


experiment which purposefully manipulates the


cues given by either the interviewer or the re­


spondent or lmth should yield predictable behavior


changes, provided relevant cues are discovered


and then experimentally varied.


Further Interpretations of the Findings 

Initially, it was felt that g~d reporting would 

come from respondents who were positively inclined in their attitudes, expectations, and motives. 

The empirical data have suggested these factors 

are not relevant to reporting. The data do demon35 
strate, however, that there is a strcmg associaticm 

between behavior levels in the interview and in the 

quality of information reported, Althoughthe cuesearching procem may be responsible for behav. 

ior levels, it is unclear whybehavior levels are so 

strongly related coreporting, Before any extensive 

speculation is attempted onthe basis for this rela. 

tionship, it is necessary to list the varioufi causal 

possibilities which may exist between behavior 

level and reporting level and to discover through 

research which is correct, Since relationship is 

correlational, the following four causal possibilities exist: 

1. Behavior level causm reporting level. 

2, Reporting level causes behavior level. 

3, There is reciprocal causality -e.g,, having more to report causes higher behavior 

levels which in turn cause even further 

xeporting, 

4.	 BcIthreporting level and behavior level are 

caused by some third variable andhave no 

direct effect on each other. Anexample of 

this last possibility would be the case 

where the respondent reports well because 

he likes the interviewer and also does a 

lot of behaving for the same r~ascm. If, 

somehow, this respondent could be made 

to behave at a high level without liking the 

interviewer, he would not show any accompanying increase in the accuracyfrequency of his repcming. 

As was shown earlier, activity level of an individual consists oftwo conceptually distinct types of 

behavior: task and interpersonal irrelevant behaviors, The data from this study suggest ~ome difficulty in making a psychologically meaningful yet 

statistically acceptable differentiation between 

these behavior qualities, Qne can hypothesize that 

there is no meaningful distinction between these 

behaviors or that there is a qualitative distinction 

to be made between them but that they both “naturally” occur at the same levels in this type of 

interview. For example, the rapport hypothesis 

might suggest that a high degree of personal affiliative attention (encouraging respondent to 

engage in irrelevant behavior) causes the respondent to engage in a great deal of task oriented behavior. The reverse ordering hypothesis may also 

hold, It maybe that tension increases in a respond. 

em whois engaging in much task oriented behavior; 

and in order to maintain this level of output, he 

must engage in a higher quantity of irrelevant behavior as a means of relieving the built-up tension, 

If tension release is not obtained, both behavior 

types will fall to a low level, 

Implications for Future Research 

The data from this study have led away from 

the traditional social psychological interpretation 

that actions are based on enduring psychological 

characteristics measured by the attitude-type 

variables and have suggested that research he directed more in the area of social behaviorism for 

a better understanding of certain interview situa. 

tions. The interpretations offered abomhave Euggested that research proceed at several levels, 

First, since the major findings were unexpected, a thorough replication ~f these findings is 

needed. A replication of this type of study need not 

involve the wide diversity of measurements used, 

Fewer and more refined measures of attitudes, 

motives, and behaviors should suffice. Although 

the attitude to behavior and behavior to behavior 

findings are interesting in themselves, the inter. 

view practitioner should be especially interested 

in employing a dependent variable ofhigher valid. 

ity in a replication than the one used in this etudy, 

The feasibility of obtaining and using healtb record 

data in such studies has already been demon. 

strated. (Areview of some of these studies appears 

at the beginning of this report,) 

Next, the above discussion has pointed to the 

need for future research on the direction of causality between several of the important variablea 

in this study. The nature of the relaticmhip bem 

tween the various qualities of behavior aa well as 

between behavior level and reporting should be 

discovered before meaningful theoretical interpretations or practical suggestions can be made, 

Finally, it appears that future research work 

could proceed to test certain aspects of the cuesearch model mentioned almve as well aa some of 

the underlying assumptions which led to its formulation. Such research could focus not only on identifying what are the behavioral cues present in the 

interview but also the subsequent effect of these 

cues on different types of behavior, on general be. 

havioral level, and on reporting accuracy. 

36

Implications for Interviewing Practice 

It was the implicit assumption of the writers 

prim? tQ this study that the way tQturn respondents 

into good reporters was tminduce positive attitudes 

taward the various aspects of the Interview (the 

interviewer, the questions, and the purpose). It 

naw appears that the most promising point of leverage for change is in the behavioral interaction 

procewses of the interview itself, Ifthi6 conclusion 

is correct, two courses of action appear open to 

the applied researcher; he may take advantage of 

the present experimental work and theory dealing 

with behavior change in the sacial setting or he 

may wish m perform his awn studies to identify 

the crucial variables affecting interview behavior, 

Research in experimental, clinical, and social 

psychology can be translated direc~ly into attempts 

to change behavior in the interview, For example, 

relevant work would ipclude that in the areas of 

verbal crmditicming2 ncmdirective therapeutic techniques, speech and silence durations in the inter+iew, social influence, social facilitation, suggestion, and conformity, 

In summary, the data from this study suggest 

that one potentially effective way to influence in. 

terview reporting accuracy is by changing the be.


havior in the interview, Effective ways of bringing


about behavior change involve manipulating cues


in the immediate situation rather than trying to


change basic attitudes or increase level of infor. ..


mation. Research is possible along two lines. One


possibility is basic research into the important


dimensions of interview behavior, their causal re­


lation tQ one another, Bnd their immediate ante­


cedents, me other possibility appears to be


applied research which attempts to adapt already


existing behavior-change techiques to the house-


hold interview setting.


REFERENCES


1 

Myww, FL J,’I Error and bias in t-he reporting of age in 

cmrtius finta. Trmwacthna o~the .40tMadal thiotyofiherica, 

Jf, 10ML pp. 39ii-41i3, 

%mwm, R. H,, and hlarks, E. S.’: Influence of the intervlower on the acauraoy of survey results. J.4ra ,Statist..4. 

M:ti3K.llFill, I!lriR! 

3 

Hyman, H. H., Cahb, W. J., I%ldnran, J, J,, Hart, C. W., 

find Nornher, C, H. IInterviewing in Souia? @esearch. Chicago. 

University of Chioaga Presti, 1954, 

4

Rico, S. A. I Contagious bias in the interview, -4m.J. 

S, I(+(J, XXXV’:HO.423, 1929, 

5

Mtz, t). I The funotkmi approaoh tQ the study Qf attiturlos, Pub,@, Quart, X~IV@): 163.204, 1960, 

0 

lkltw, IL F.’: Interaction Process Anatywk. Cambridge, 

M*ss.. Wesley Press, Ino., 1950, 

7’Hnyns, R. W,, and Lippitt, R.’: Systematic observational 

toohniquefi, in Cl. Lindzey, ed,, Handbook of Sooial Psy­

(hulo~y, Rending, Mass. Addisrm~Wrwley, Ino,, 1954. pp. 370-

404. 

~~l,$i, RUNWU of the CNMWS’:NHS /nteroi@wer’s Mawa?, 

1,’ormNfIS.IJiS- 100. (rcwised peri~dically) 

9Nntional Center for Health Statistics: Health survey pro­

[~wtur~,,conoepts, questionnaire development, and definitions 

~n the Health Interview Survey, Vital and i/eaWi Statistics. 

PHS Pub, No, 1000.Series l.Ncr, 2. P~blio Health Servioe. 

Wn~hington, Government Printing Office, hfay 1964. 

10NatiQnal Cen@r for Health Statistics: Origin, program, 

and aper~tipn of the U,S, National Health Survey, Vital and 

HeraLthStat\stias, PHS Pub. No, 1000-Series I.No. 1. Publio 

Health Servioe. Wasbingtm. Government Printing Offioe, Aug. 

1963. 

11 

U.S. National Health Survey: The statistical design of 

the health household .interview survey. tiealth Statistics, 

PHt3 Pub, No, Mi4.A% Public Health Service. Washington, 

D.C., July 1958, 

12Flugel, J. C.: Humor and laughter, oh. 20, Vol. H in G. 

Lindzey, cd., Hmdb~okof Sociat Psychology, Reading, bfass. 

Addison-Wesley, Inc., 1954. pp. 709-734. 

13 

Fowler, F, J,: Education, [ntoraction, and Iaterview 

performance. Ann Arbor, Miuh. University of Michigan, 1965, 

(unpublished dootoral thesis) 

l’%ational Center for Health Statistics’: Interview data on 

ohronic conditions compared with information derived from 

medical records. Vita? and t/eu2th Statistics. PHSPub. No. 

10t30,Series 2-No. %3, Puhlio Health Servioe. Wash@cur. 

Government Printing Offioe, hlay 19M. 

~b~ati~nal Center for Health Statistics; Comparison of 

hospitalization reporting in three survey procedures. Vita? and 

I/ealth Statistics, IWS Pub. No, 1000-Series 2.No, 8, Publio 

Health Service, Washington, Government Printing office, July 

1965, 

‘6National Center for Health Statistics; Health interview 

responses compared with medical records, Vitai and Hea2th 

37 
Statistics. PHS Pub. No. 1000-Series 2-No. 7. PubIic Health 

Service. Washington. Government Printing Office, July 1965. 

17National Center for Health Statistics: Reporting of hospitalization in the Health Interview Survey. Vital and Heuttlt 

Statistics. PHS Pub. No. 1000 -Seriee 2-No. 6. Public Health 

Service. Washington. Government Printing Office, July 1965. 

18Survey Research Centet: A Study of the Reporting of 

Visits to Doctors in the National Health Sureey. Ann lrbor. 

The University of Michigan, Oct. 1963. (mimeo. ) 

19National Center for Health Statistics’: Cycle I of the 

Herd th Examination Survey’: sample and response, United 

States, 1960-1962. Vital and Health Statistics. PHS Pub. No. 

lCCO-Series 11-No. 1. Public Health Service. Washington. 

LI.% Government Printing Office, Apr. 1964. 

20 Wilcox, K. Ft., Jr.’: Comparison of Three Methods for the 

Collection of Morbidity Data by Household Survey. Ann Arbor. 

University of hiichigan, School of Public Health, Department 

of Epidemiology and the Tecumseh Community Health Study, 

1963. 

91hlooney, H. W.: Methodology in Two California Health 

Surtieys. Public Health hionograph No. 70, PHS Pub. No. 94!2. 

Public Health Service. Washington. U.S. Government Printing 

Office, 1962. 

22 Goodman, L. H. and Kruskal, W. H.’: kieasures of association for cross classifications. J. Arn.Statist.A. 49:732-764. 

23 hfcCartby, P. J.’: Analysis of Data From Complex Sample 

Surveys. (unpublished paper) 

24 Goodman, L. H. and Kruskal, W. H.: Measures of association, HI. Approximate sampling theory. J. Arn.Statist.A. fi~: 

310-364, 1963. 

BIBLIOGRAPHY


Lamale, H. H.’: Study of Consumer Expenditures, Incomes, 

and Savings. Philadelphia. University of Pennsylvania, 1959. 

Lansing, J. B., and Blood, D. hi.’: The Changing Travel 

Market. Survey Research Center hlonograph No. 38, pt. 3, 2179 

ISR. Ann Arbor. The University of Michigan, 1964. 

,Neter, J., and Waksberg, J.: Response Errors in Collection of Ezjm?nditures Done by Household Interviews: An Experimental Study. Washing@n. U.S. Department of Commerce, 

1965. 

Parry, H., and Crossley, H.: Validation of responses @ 

survey questions. Pub. Op.Quart. XIV(1) :61-80, 1950. 

Survey Research Center: Observation of NHS-HIS lnterviews. Ann Arbor. The University of Michigan, May 1965. 

U.S. National Health Survey: 4 study of special purpose 

medical-history techniques. Health Statistics. PHS Pub. No. 

584-D 1. Fublic Heaith Service. Washington, D. C., Jan. 1960. 

000 

38 
APPENDIX 1 

FACTOR LOADINGS 

A list of items and their loadings on the factors discussed in the body of this report (items with loadings 

less than ,50 are not listed) 

I. Interpersonal Behavior 

Respondent Characteristics Interviewer Characteristics 

Talks about himself .73 Talks about respondent 

Laughs, jokes .63 Laughs, jokes 

“Encourages reactions to interviewer .unre- “Encourages” reactions to respondent, unrelated conversation .74 lated conversation 

“Neutral” reactions to interviewer unrelated “Neutral” reactions to respondent unrelated 

conversation .51 conversation 

Rating of the amount of respondent talking .57 

Rating of how much the respondent wanted 

to chat about unrelated matters .61 

H. Task Behavior 

Respondent Characteristics Interviewer Characteristics 

Acceptable answers .58 Directive probes 

Elaborated answers .53 Question clarifications 

Asks for clarification .71 

Length of interview .61 

HI. Task Orientation Ratings 

Respondent Characteristics Interviewer Characteristics 

Degree of effort put into communicating .59 Amount of clarification of questions given 

Ability of respondent to understand the ques- Degree of effort put into communicating 

tions -.67 

Furnishing additional information on List A 

items .54 

Srn.,othness of the interview -.68 

Pace of the interview -.50 

IV. Respondent Receptiveness 

Respondent Characteristics 

Rating of initial politeness .70 

Rating of initial friendliness .69 

Rating of cooperativeness .61 

Rating of willingness to give time for interview .54 

V. Miscellaneous Factor 

(no loadings greater than .50) 

.65 

.6o 

.79 

.70 

.55 

.71 

.72 

.72 

39 
----------- ------

APPENDIX II


INDEX CONSTRUCTION


The Dependent Variable 

The basic aim of this study was to make statements 

abut the correlates of accurate and complete reporting of health information, The purpose of this section 

is to describe the rationale for choosing, as the major 

operation for accurate and complete reporting, an index 

based on the number of chronic and acute conditions 

the respondent reported for himself. 

Sevefal ways of assessing the accuracy of a reported health condition or event are available, The fes.­

sibili~ of using medical records as a check on accuracy 

of respondent reporting has been demonstrated in several studies. 1+18 NCHS has instituted an extensive survey using actual health examinations to assess the accuracy of health conditions reported in the’ household 

interview. 19 

Since it was decided that neither of these methods 

was feasible for validation of data in this study, it was 

decided to use a less precise but standardized and readily available indicator of health reporting accuracy—the 

index based on the number of conditions the respondent 

reported for himself. 

This index has three im~rtant characteristics, It 

has been found to correlate with accuracy of reporting 

health information in record check studies, it has staTable 1. PruporKLonof underreportingof known


hospital episodes for the sample person, by


the number of chronic or acute conditionsre­
 ported for sample person$excludtnghospitali­


zations for deliveries


Number of


Number of chronic or Percent episodes


acute condi.eions of under- excluding


reported for the reported deliveries


sample person episodes in hospital


records


O conditions ;~;
 1 or 2 conditions :;
 3 conditionsor more--- 6 322


lThe “sample person” is the person for whom


the hospital record was selected.Since the in­


tistical characteristics permitting good discrimination 

between respondents on the basis of accuracy of reporting, and the reporting of chronic and acute conditions 

itself is subject to a large underreporting bias. These 

three properties are discussed below. 

Relat~ori
 fo Accuracy 

Previousstudiesdemonstratethatthenumber of


chronicand acwteconditions reportedinthehealth
in­


terviewisarough indicator ofthevalidity
 ofotherin­


formation reported and probably an indication of the 

extent to wltich the respondent is being cooperative. In 

two studies of the accuracy of reporting hospitalization 

episodes, underreporting ofhospital episodes wasfound 

to be inversely related to the number of chronic and 

acute conditions reported (tables 117and If15). 

In these studies a sample of hospital discharges was 

drawn. Tables I and II show the proportion of known 

hospitalizations which were underreported and indicate 

the tendency for underreporting of hospitalizationsto 

be associatedwith reportingasmaller numberofchronic 

and acute conditions. Rtrtheranalysesreportedinthese 

studies show that the number of conditions wisich the 

respondent reports for himself iscorrelatedw ithhow 

weIl he reports hospitalizations either for other mem. 

hers of the family or for himself. Thus the effect M not 

entirely due to the respondent’s lack of knowledge of 

Table II. Proportionof underreportingof known


hospital episodes for sample person, by the


number of chronicoracute conditionsreported


for the sample person, excludingoverreported


hospitalizations


,


Number of chronic or Percent Number of


acu&a condi~ions of undez- episodes


reported for the reported ‘inr~;;~al.


sample person episodes


r) cond~tfons....--...-. 

I or 2 condition5------

3 conditionsor more---

I 

terview report could be given by another fam%l.y


member, the respondentmay or may not be the NOTE: Table combines daea from three data


sample person, collectionprocedures.

-------------

--------------

------------- -----

the health characteristics of the sample person but 

probably reflects an overall willingness to cooperate 

with the interviewer to furnish therequiredinformation. 

A study of theaccuracy of thereportingof visits to 

physicians reveals the same relation between the reporting of chronic and acute conditions and accuracy of 

reporting other health information (table 11118). 

Table 111. Propor&i.onof underreporting of phy ­ sidan viaits by number of chronic or acute 

conditions reported 

Number of chronic or Percent Number of acute conditions re- ef under- visits in ported for the reported records sample person visits 

O conditions 50 54 

1 condf.ti.on 24 136 

2 conditions 10 106 

3 conditions or more 20 108 

The same association is found with reapect to the 

number of conditions reported by the respondent for 

himself and his accuracy inreporting physician visits 

either for other household members or for himself. 

In summary, the number ofconditions reportedby 

thereqxmdent either for himself or for another person 

is related to how accurately the respondent reports 

hospitalization or doctor visits data both for himself 

and for other family members. The relation to doctor 

visit andhospitalization reporting is not due entirelyto 

the effects of a lack of knowledge almutthe sample per­

~onon the part of the respcutdent. Ratherthe number of 

chronic and acute conditions reported seems to reflect 

a general willingness tocooperate intheinterview. 

Discriminabiiity 

Reporting of chronic and acute conditions isespecially useful asadependentvariable because of tie large 

between-res~ndent variation in the number reparked. 

Conditions are more frequent in thepopulation thanare 

other health events asked about inthe HIS, such as visits 

tocioctors orhospitalizations. Ifitcan reassumed that 

amount reported reflects accuracy, then theprobability 

of statistical discrimination of reporing accuracy among 

persons on the basis of reported conditions is greater 

than for other health events. 

Underreporting 

Because evidence from several studies indicates 

that conditions areprobably underreported at a higher 

rare than either visits to doctors or hospitalizations, 

there is agreater chance that the number of conditions 

reported reflects a general level of reporting accuracy 

as well as an indication of the respondents’ real health 

status. In addition studies by Wilcox20andMooney~ Imth 

show that keeping day-by-day diaries of illnesses results in substantially more conditions being reported 

than were obtained by personal interviews. In comparing interview reports with medical records, Madow14 

demonstrates a substantial underreporting of chronic 

conditions in interviews. 

Initial Attempts to Construct a 

Dependent Variable 

On the basis of the above data, it appeared that the 

number of chronic and acute conditions reported could 

be used as a basis of constructing a variable which 

would reflect, albeit imprecisely, the accwvacy with 

which health information was reported. To construct 

such a variable, variations in actual morbidity must be 

minimized. 

Since consistent data on morbidity rates which were 

independent of underreporting effects could not be obtained from previous studies, an alternative method of 

minimizing the effects of real health was used. This 

method involved dividing the interviews from this study 

into six categories based on age and sex of each person for whom health information was obtained. It was 

assumed that the average number of conditions reported 

within each age-sex category represented a rough estimate of the actual morbidity rates for that group and 

that aggregate deviations below this mean were more 

likely to contain underreports. 

An accuracy of reporting index was constructed 

for each family by computing a reporting accuracy score 

based on data for each family member. An expected 

number of conditions was computed for each family by 

multiplying the number of persons in each age-sex 

category by the expected number of conditions for that 

category, summing overall categories, and subtracting 

this sum from the number of reported conditions, Since 

the variance in morbidity rates varies from category 

to category, the resulting difference score was divided 

by a correction term that was based on the number of 

persons in each category and the rep’ting variance 

for that category. Thus each family received a score 

representing how far its reporting deviated in standardized units from that which would have been expected. 

Even with the age-sex correction, it is assumed that 

some of the deviation variance is still a result of real 

health. 

It was expected that this procedure would minimize 

the contribution which real health would make to the 

dependent variable. Preliminary analysis revealed that 

respondent age and family size were significantly correlated with this index: older respondents and those respmdents with small families appeared as the most 

41 
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-------

--------

-------------- ------

--------------

-----------------

------------------

---------

--------------

-----------------

---------------

---------

-------

--------------

-----------------

----------

--------------

-------------

-----------

-----------

accurate reporters. Recent data from Madow 1~ lend 

support to the findings that older respondents do tend to 

report their chronic conditions more accurately than 

middle-aged or younger respondents. The negative association of family size and reporting accuracy is not 

surprising since numerous reports indicate that reporting for others is less accurate than reporting 

for self. The larger the family size, in general, the 

larger the number of proxy reports. 

Because of these findings, it seems likely that the 

index based on total family members minimized the 

systematic variations in real health, but it also placed 

too much emphasis on age and family size as determinants of the reporting index score. 

Final Index of Reporting Accuracy 

To focus more precisely on the forces other than 

those due to age or family size that affect only the respondents, a new index of reporting accuracy was constructed using as its base the total number of chronic 

and acute conditions reported by the respondent only 

for himself. To minimize the effects of real health, an 

age correction was made and is described below. Family 

size corrections were umecessary because only respondent conditions were used in the index. Since most 

respondents were female, adjustments based on respondent sex were not used. 

The sample of respondents was divided into four 

age groups; under 35 years, 35-54, 55-74, and 75 and 

over. Each group was then divided into thirds on the 

basis of the number of conditions reported (table IV). 

Table IV. Assigned classification on reporting 

index based upon age of respondent and number 

of conditions reported for respondent 

Age of respondent 

Number of 

conditions Freported for Under 35-54 55-74 75+ self 35 

years years years years 

0 conditions--- Low Low Low Low 

1 condition---- Medium Medium Low Low 

2 conditions--- High Medium Medium Medium 

3 conditions--- High High Medium Medium 

4 condi.tions---

5 conditions 

High High High Medium 

or more High High High High 

Characteristics of the Final Index of Accuracy 

The revised accuracy of reporting index, referred 

to either as the respondent conditions index or simply 

as the “reporting index,” is related to the probability 

that other health events will be reported even though the 

systematic contribution of real health has been minimized somewhat. The data in table V show how the respondent conditions index score relates to the reporting 

of hospitalizations, doctor visits, visits to specialists, 

visits to dentists, and total family conditions for the 

whole family. The tables indicate small to moderate 

degrees of positive association. 

There are no strong relations between the reporting index and respondent demographic characteristics. 

These data are discussed more fully in the section “Demographic Characteristics and Reporting” on page 22. 

Table V. Number and percent distribution of 

reporting index, by number of doctor visits, 

hospitalizations, visits to specialists, dentist visits, and total conditions reported for 

reporting unit according to reporting indexes 

Total number 138 162 I 112 

Numberof hospitalizations 

for reporting unxt Percent distribution 

Total---------------

O hospitalizations 

1 hospitalization 

2 hospitalizations or more 

Number of doctor visits 

for reporting unit 

Total 

0 visits


1 visit


2 visits or more


Number of specialist 

visxts for reporting unit 

Total 

0 visits


1-2 visits


3 visits or more


Number of dentist visits 

for reporting urmt 

Total 

0 viaita 

1 visit or more 

Total conditions reported 

tor reportxng unit 

Total 

0 conditions


1-2 conditions


3-5 conditions


6 conditions or more-----


100 100 100 

77 72 59 

17 20 22 

6 8 19 

100 100 100 

75 65 53 

15 22 29 

10 13 18’ 

100 100 100 

49 43 

R 

23 ;; 2: 

100 100 100 

96 85 85 

4 15 15 

100 100 100 

0 

:; 

17 4; 

4 48 

42 
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-----------

---------------------------

-------------------------

-----------

-----------------------------

----------

---------------------------

------------------

--------------------------

----------------------------

-----------------------

-----

------

--------------------

---

----------------------

--------

----------------

------------------------

------------

------------------

Behavior Indexes 

Construction of Initial Indexes 

When the observation procedure was developed, 

items were included which could be expected to beat 

least partial measures of one of six major behavioral 

concepts. Although items explicitly designed to reflect 

the completion orientations of the interviewer and respondent were included in the data observed, they could 

not, for various reasons, be used to form indexes of 

completion orientation. Therefore attempts to form an 

index of this orientation were abandoned. 

Construction of Maior 

Behavioral Orientations Indexes 

T& remaining items were classified as measuring 

one of the four remaining concepts: interviewer task 

behavior, respondent task behavior, interviewer interpersonal behavior, and respondent interpersonal behavior. Items hypothesized as measuring each single 

concept were then intercorrelated. Any item which 

did not exhibit the expected pattern of correlation with 

other items hypothesized as measuring the same concept was discarded from further consideration. Because 

all behaviors tend to reflect a general activity level (a 

finding which became obvious only later in the analysis) 

it should be noted that few items were discarded because they did not meet the intercorrelation requirements. 

Each item was then examined for its power to differentiate among interviewers or respondents and recoded onto collapsed scales. Those items which provided 

good discrimination (i.e., large variance) were made 

into four-point scales, those with relatively poor discrimination power were put onto two-point scales and 

those which provided an intermediate amount of discrimination were assigned to three-point scales. 

The recoded item scales for each concept were then 

added together to form a total index. In order to present 

results in tabular form, each of the total indexes was 

again recoded into four almost equal categories. Thesp 

collapsed indexes are used throughout this report, even 

where coefficients of association rather than tables are 

presented. 

Item composition and item weight are shown below 

for each of the four behavior indexes. The number following each item, labeled as scale length, refers to the 

number of categories for that item used in the total 

index construction. These numbers give a rough idea 

of the potential relative weight of each item in each index. 

1. Respondent interpersonal behavior 

Asks questions about the interviewer


Talks about self, family, friends


Laughs, jokes


Rating: how much did respondent want


to chat --------------------------------

Number of “encourages” reactions + 

total reactions 

11. Interviewer interpersonal behavior 

Flatters or praises respondent 

Asks nonhealrh questions of 

respondent 

Talks about self, family, friends 

Laughs, jokes 

Rated as wanting to continue postinterview conversation 

hlumber of “encourages’t reactions + 

total reactions 

111. Respondent task behavior 

Elaborations 

Asks clarification 

Consults other sources of information 

Questions the adequacy of an answer 

Pauses to consider itemson chronic and 

acute conditions list 

Considers the specialists card carefully 

Iv. Interviewer task behavior 

Number of inadequate answers (those interviewer probed) 

Repeats question exactly as worded 

Other nondirective probes 

Directive probes 

Clar\fies meaning of a question 

Suggests respondent consult other 

sources of information 

Probes, chronic and acute conditions list---

Indexes of Respondent Orientation 

The followup interview with the respondent 

Scale 

length 

2 

4 

3 

3 

2 

2 

2 

2 

2 

2 

3 

3 

2’ 

2 

2 

2 

2 

3 

3 

3 

3 

3 

2 

3 

containeda lar~e number of questions, usually of the openended nature, designed to elicit information in three 

general areas. 

1.	 The basic psychological characteristics ofrespondents that apply to the interview (e.g., the 

43 
2. 

3, 

amount of information he has about surveys, his 

general feelings abut government surveys, and 

his motives, such as willingness to perform citizen duties, applicable to the interview situation). 

The presence and effects of specific situational 

factors such as strong reactions to the type of 

questions asked or effects of competing demands 

for time and attention. 

The demees to which respondents understood 

what fi~y were expected ~o do in their role as 

respondents. 

An initial list of specific variables of hypothesized 

importance was formulated at the beginning of the study. 

Once the data were collected, a sample of interviews was 

selected and content analyzed to ascertain whether or 

not the answers to the questions contained relevant information for each variable. On the basis of the initial 

content analysis, certain variables were excluded from 

further consideration and a standard content analysis 

procedure was constructed and used to code all the reinterview data. 

The analysis was further divided into two parts on 

the basis of the type of question from which the information came. Two types of questions were asked: a set of 

indirect questions asking the respondent to describe the 

feelings of two persons portrayed in pictures representing the interview setting and a set of open-ended questions (with subsequent probes) asking the respondent 

how he felt about the health interview he had had the 

previous day. 

Indexes of Respondent Feeling About Interview 

For each question in which the respondent had the 

opportunity to express a feeling about the interview, a 

positive point was assigned: 

Each time he stated a positive feeling or reaction or 

Each time he avoided stating a negative feeling; 

a negative point was assigned 

Each time the respondent stated a negative feeling 

or reaction or 

Each time he avoided stating a positive feeling. 

This coding procedure was applied to two sets of 

questions, yielding an index based on indirect questions 

and an index based on direct questions. The queatfon sets 

are listed below with the question number and an abbreviated version of the exact wording. 

~Projective Index 

(to picture of interviewer at door) 

Question 2a. “How does the person in the picture feel now?’1 

Question 2b. “Why does she feel that way?” 

44 

(to picture of interview taking place) 

Question 3. “How does the person in the picture 

feel now?” 

Question 3a. “Why is that?” 

Question 4. “What does the respondent enjoy 

abut the interview?” 

(scored only for stating and avoiding positive comments) 

Question 5. “What does the respondent not enjoy about the interview?” 

(scored only for stating and avoiding negative comments) 

(to picture of interviewer leaving) 

Question 6. “How does the respondent feel now 

that the interview is over?” 

Direct Index 

Question 9. “In general, how do you feel about 

the interview you had yesterday?” 

Question llb. (if respondent talked to anyone 

about the interview) 

“What did you talk about?” 

Question 14. “What did you like about the inter. 

view?” 

(scored only for stating positive 

and avoiding negative) 

Question 16. “How did you feel about her coming 

just then?” 

Question 17. “How did you feel about giving up 

your time for the interview?” -

Respondent Motivation and Concern 

Scales reflecting respondent motives and negative 

concerns were constructed from answers to both direct 

and projective questions. Each scale, with the exceptions 

listed below, has a range of O-7 with three possible 

Wints coming from the projective questions and four 

points based on answers to the direct question as noted 

below. 

Time Concern (?’ange O-7) 

Up to three points for mentioning time concern in 

answer to the projective questions and one point for 

each mention of it in the direct ones. 

Projective QuestionsQuestion 2. (Showing Picture 1, an interviewer 

at the door)’ ‘What does the woman 

(man) of the house think when the 
person says that she is an interviewer?” 

Question 3. (Showing Picture 2, interviewer 

and respondent in the house) 

“How is the woman (man) of the 

house feellng now?” 

Question 5, (Picture 2) “IS there anything about 

being interviewed which she (he) 

doesn’t like?” 

Direct QuestionsQuestion 15-16. “How did you feel about the interviewer coming just then?” 

QuestIon 17, “How did you feel abut giving up 

your time to answer question?” 

Quet%ion 17EL “Do you usually have some free 

time during the day?” 

Quetxion 23. “During the interview did you feel 

rushed or hurried?” 

QUesliOn Concern (vange O-6) 

Up to three points for the projective questions and 

one point, for mentioning question concern in each of the 

direct questions, 

Questions 2,3,5 (see above) 

Direct Quwim&..-

Question 9, “How do you feel about the health 

interview you had yesterday’” 

Question 13, “Were there any things the in. 

terviewer asked about that you 

thought were too personal or embarrassing?” 

Qwtion 27a,b, “IS everything too much to expect 

a person to be able to answer?” 

Good Clttzen MoMation (vange O-7) 

Up to four points for the projective items and one 

point for mentioning motivation to be a good citizen 

in each of the direct questions. 

Projective queMions -

Quemicm 2,3, (me dxwe) 

Question 4, (Picture 2) “Is there anything about 

being interviewed that he (she) 

enjoys?” 

@emion 6, (Showing Picture 3, the interviewer 

leaving the house) “How does the 

woman (man) of the house feel 

now?” 

Direct QuestionsQuestion 9. “How do you feel abut the health 

interview you had yesterday?” 

Question 14, “Were there any things alxmt the 

interview you especially liked’?” 

Question 22. “Why do you think people cooperate 

on these health surveys?” 

Ckance to Talk Motivdion (vange O-8) 

Up to four points for the projective questions and 

one point for mentioning chance to talk motivation in 

each of the direct questions. 

Projective QuestionsQuestion 2. ~ (Picture 1) “What doea the woman 

(man) of the house think when the 

person says that she is an inter. 

viewer?” 

Question 3. (Picture 2) “How is the woman 

(man) of the house feeling now?” -. 

Question 4. (Picture 2) “Is there anything about 

being interviewed that she (he) 

enjoys?” 

Direct QuestionsQuestion 9. “How do you feel about the health 

interview you had yesterday?” 

Question 14, “Were there any things about the


interview you especially liked?”


Question 34. “What kind of person do you think


the interviewer was?” 

(Interviewer seen as a friend or 

neighimr rather than professional) 

Personal Benefit Motivation (vange O-4) 

Up to three points for the projective and one point 

for mentioning personal benefit as motivation in the 

direct question. 

Projective Questions— 

Questions 2,3,4 (see above) 

Direct QuestionQuestion 9. “How do you feel about the health 

interview you had yesterday?” 

Ckance to Rest Motivation {range O-6) 

Up to three points for the projective items and one 

each for mentioning chance to rest as motivation in 

each of the direct questions. 

45 
Projective Questions— 

Questions 2,3,4 (see almve) 

Direct Questions— 

Questions 15.16. “How did you feel about the interviewer coming just then?” 

Question 17. “How did you feel about giving up 

time to answer questions?” 

Question 17a. t!Do you usually have some ‘ree 

time during the day?” 

Talking About Health Motivation (vange O-3) 

One point possible for the projective question and 

one each for the direct questions for mentioning thdt 

motivation was a chance to talk alxmt the health. 

Projective Question— 

Question 4. (Picture 2) “How is the woman 

(man) of the house feeling now?” 

Direct Questions— 

Question 9. “How do you feel about the health 

interview you had yesterday?” 

Question 14. “Were there any things about the 

interview you especially liked?” 

Indexes of Interviewer Orientation 

A number of answers to questions in the interview 

with the interviewer were coded into indexes of interviewer attitudes. The first three indexes are based primarily on a content analysis of the interviewer’s reasons for preferring particular kinds of respondents. The 

ranges vary widely according to the number of possible 

index items in which the interviewer could express the 

particular orientation. 

Accuracy Imagery (vange O-8) 

One point for every indication of preferring accurate, complete performance or more accurate answers 

from respondents to the following questions: 

Question 8. “Can you describe picture of the 

‘ideal’ respondent— what would 

she (he) be like?” 

Question 9. “Here is a list of kinds of respondents, which would you rather interview?” (Interviewer indicates 

that preference is because this 

kind of respondent is more accurate, gives more complete responses.) 

Question 12,12a. “why do you think most respondents would prefer that you stick 

right to your job, or that you visit 

a little?” 

Inte?@?’sonal Imagery (range O-4) 

One point for each time the interviewer prefers a 

respondent because she (he) is more pleasant, less 

hostile, or more relaxed, plus one point for every time 

the interviewer advocates a given approach to respondents because it produces these results. Same questions 

as above. 

Efficiency-Speed Imagery (range O-4) 

One point for each time the interviewer prefers a 

given type of respondent because he (she) is more 

efficient or doesn’t take as much time. Also one point 

for every time the interviewer prefers a given procedure for the same reasons. Same questions as almve. 

Worthwhile Work (range O-3) 

One point for saying that HIS is important to the 

Nation, or fof saying that one of the things she liked 

abut her job was that it was important, worthwhile, 

or constructive. 

Question 18. “Why do you or don’t you feel that 

it is important for res~ndents to 

know that the survey is being done 

for the Public Health Service?” 

Question 26. “All jobs have some things that are 

enjoyable and some things that we 

don’t like, what things do you like 

best almut interviewing?” 

Question 27b. “How important do you think the information from the survey is to 

the nation’s health?” 

Like To Intwact (~ange O-2) 

One point for saying that one of the things she likes 

about her job is talking to people, plus one point for 

saying that she preferred to visit (rather than be businesslike) because she likes to talk to people. 

Question 13. “Do you prefer to stick right to 

your job or visit a little?” I IA1l jobs have some things that are Question 26. 

enjoyable and other things we 

don’t like, what things do you like 

best about interviewing work?” 

46 
----------

----------

-----------------

-----------------

Does Not Like To Impose (vange O-5) Validity of Indexes 

One pint for saying that one of the things she does This study was designed to test the validity of an 

not like about her job is imposing, plus one point for ~ overall model rather than that of specific components. 

saying that she liked to be businesslike because it 

doesn’t take up too much of the respondents time, plus 

one point for thinking that interviews are too long because of imposing. 

Question 12a, “Why do you think that most respondents would prefer that you 

be businesslike?” 

Question 13. “Which do you pref.er—businesslike or visiting?” 

Question 26a. “What things do you like least about 

interviewing work?” 

Question 26b. “If you were to make changes to 

make your job better, what would 

you change?” 

Question 15. “Do you feel that interviews are 

usually too long or not ?“ 

Perceived Respondent’s Attitude 

Taken directly from Question 1 

Question 1. “How do respondents feel about being interviewed—like it, not like 

it, or what?” 

problems with Questions (vange O-5) 

One point for saying that people do not like something in the questionnaire, plus one for mentioning 

something which is hard for respondents in the questionnaire; a ‘yes’ answer to question 5 gained the interviewer another point, and one point for each change 

suggested in the questionnaire. 

C@estion 3, “What things do respondents not 

like akmutbeing interviewed?” 

Question 4. “What are the hardest things in the 

questionnaire for people to answer?” 

Question 5, “Are there things the respondent 

finds too personal or embarrassing to report?” 

Question 22a,b, “How almt the questionnaire, are 

there some sections with which 

respondents have particular troubles?” 

a, “What parts?” b, “Why do 

they have trouble?” 

However, some comments may be made almut the validity 

of the indexes used, based on available data. 

There is some doubt about what the task and interpersonal indexes are measuring, that is, whether task 

and interpersonal behavior are empirically different 

phenomena in the HIS. The task behavior index shows a 

low level of correlation with an index of observer ratings of task orientation as follows: 

observer task ratings of: 

Task behavior 

indexes 

Respondent Interviewer 

Gamma coefficient 

Respondent task 

behavior 

Interviewer task 

behavior x 

The low degree of intercorrelation is also present 

in the factor analysis where the task orientation rating 

items appeared on a dimension orthogonal to one made 

up of task behavior items. 

A suggestion has been made that the task and interpersonal scales are actually reflections of a more 

general activity level in the interview. The characteristics of general activity level are discussed above. 

The interpersonal behavior indexes seem somewhat valid since they relate to the length of conversation between interviewer and respondent after the interlnt erpex;~;e;ehavior Post interview 

conversation length 

I Gam coefficient 

Respondent interpersonal behavior ,34 

Interviewer interpersonal behavior � 44 

47 
-----

view is over, llmy are not related very strongly to any 

of the interpersonal attitudes or orientations measured 

by other instruments. 

The projective and direct indexes of respondent 

feeling are assumed to be somewhat valid since they 

correlate with an observer rating of respondent affect 

during the interview as follows: 

Obsexver rating of respondent Respondent affect affect during 

che interview 

Gamma coefficient 

ZndWect que~tion index-.. ,1$ 

DirecC ques~ion index ,33 

—ooo— 

The gamma coefficient between thedirect and indirect 

indexes is ,37’. 

Each indirect and direct indexofre8pondent feelit’v 

discussed in this report is actually made up of four sub­

.acales-number of positive comments ,numberofnegative”comments, number of times therespondent avoidec 

Eaying something Nsitive (includes neutralandnegative 

comments), and number of timestherespondentavoided 

saying ~ornething negative (includes neutral andpasitive comments), The expected intercorrelations were 

obtained atnongthe subscales within each index, partly 

due to the definition of each subscale with respectto 

others, The intercorrelations of each projective subscales with its paired direct index subacales ranged 

from ,31 to ,46, yielding additional evidence of validit y, 

Unfortunately, few independent validating criteria 

are available for either the indexes of specific respndent concerns and motives or for the interviewer orienta. 

tions, 

48 
APPENDIX Ill 

DESCRIPTION OF THE COEFFICIENT GAMMA 

Introduction 

Throughout this report gamma, a measure of the 

degree of association between two variables, has been 

used in place of the presentation of detailed tables of 

marginal interest. 

Gamma is an index of association for two-way 

classifications which was proposed by Goodman and 

IWwkal in 1%54.29The measure is appropriate to data 

where both classifications have inherent and meaningful order. (Both variables are in categorical form, and 

the categories are ordered in some way @ interest.) 

The coefficient gamma is the difference in conditional probabilities of like and unlike order, given no 

ties; it indicates how much more likely two individuals 

are to agree than to disagree with respect to their order 

in two classifications. 

When estimated from a sample, the index is defined 

as ~-Pd 

G=— 

1 -Pt 

where P’ is the probability that two randomly chosen 

individuals will have the same ordering in the two 

classifications; 

~ is the probability that they will have a different 

ordering; and 

Pt is the probability that one or both classifications 

will be identical (a tie) so that a definite order 

cannot be stated. 

~+~+~=1 

Signlficanc@ Test of Gamma 

Several problems arise in testing the significance 

of gamma, First, the data in this study are based on a 

sample of six census regions located east of the Mis-

—000 

sissippi. A sample of the entire U.S, population would 

include data for all census regions. Therefore any .aignificant tests on data from this study are not intended 

to be exact population estimates. 

Second, the available methods of estimating the 

standard error of gamma are based on the assumption 

that the data come from a simple random sample rather 

than from clustered samples, Empirical methods have 

been developed to estimate standard errors of clustered 

samples )23 but these methods were judged too expensive 

to use on these data because of the other limitations on 

interpretation which are discussed above. 

On the other hand, in spite of the inability to make 

true population estimates or to estimate variance on 

the basis of clustered samples, some indication af the 

probability that obtained findings where not due to 

“chance” was desired, Therefore a conservative estimate of the standard error of gamma, proposed by 

Goodman and Kruskal,24 based on the asymptotic upper 

bound of the variance has been used as a means of get. 

ting a “ball park” estimate: 

where Nc=total number of cases; 

q =probability of ties (1- F“- @; and 

G = obtained gamma coefficient 

The ,95 confidence interval is then given by G k 2 

x S.E~when the statement is made that the relation between two variables is significant, the confidence interval defined above did not include zero. 

49 
APPENDIX IV 

THE INTERVIEW OBSERVATION FORM 

The interview observation booklet used in this 

study consisted of nine sections designed to obtain information on the actual processes of the interview. 

The first two sections were filled out before the interview actually began (see pp. 52 and 53). Most of the re­

. maining sections were related to specific questions on 

the basic questionnaire. Forms in these sections had 

the specific question(s) printed in a box at the top of 

the page and were completed only when the particular 

questions were being asked or answered. 

One form, “Conversation not related directly to 

the interview questions” (see page 55), was used re. 

peatedly as the right-hand page throughout the observation booklet. These pages were filled out when conversation unrelated to the content of the questionnaire 

caused major changes in the interview format. This 

page, which is shown only once in this appendix, actually appeared eight times in the observation booklet. 

The final two pages of the booklet, devoted to the 

overall rating of the respondent and the observer’s 

impressions of the interview, were filled out after the 

interview had been completed and the interviewer and 

the observer had left the dwelling unit. 

The observation form was designed to apply to 

only one respondent. The observer chose as the prin. 

cipal respnfent the person who answered for herself 

and for other family members. If two persons or more 

were responding equally often, the observer selected 

the female respondent; if two females were reporting 

equally, she chose the younger person (18 years of 

age or over). 

—ooo — 

50 
Bureau of the BudM.t 

NO. 68-6412 -

Approvalexpires 

June 30, 1965 

SURVBY RSSEARCHCENTER€

THS UNIVERSITYOF MICHIGAN€

IN COOPERATIONWITH THE 

UNITED STATES PURLICHEALTH SERVICE 

AND THE 

UNITED STATES BUREAU OF THE CENSUS 

CONFIDENTIAL- All informationwhich would permit identificationof the inditid’ual 

will be heId strictlyconfidential,will be used only by personsengaged in and 

for the purposesof the survey,and will not be disclosedor releasedto others 

for any other purposes. (42 CFR 1.101-1.108) 

Miss 

Name of Principalrespondent: Mrs. 

Mr. 

Address: 

Street 

IdentificationCode: PSU No. 

SegmentNo. 

SerialNo. 

Interviewer’sName 

Instructionsfor reachingDU, if rural: 

Age: 

City State 

Time of Calls: A.M.: I 

,m, I Date of Interview: i: I 

Name of observer: 

PHS-T274-1 

4-64 

51

BEFORE THR INTERVISW- AT THR DOOR


m 

1. The time the interviewerknocks cm the door is o ‘clock


m


2. Check number of secondswaiting for door to open.


~ o- 9 seconds 

� 10-29 seconds 

� 30-60 #econds 

� Over 60 seconds 

3. How far was door opened at first?


4.	 HtIwmany questionsdid the


RESPONDENTask?


� None 

D one 

� 2 or more 

~mmlm-~


5.	 Check those thingsINTSRVIRWER


mentionsat che door.


,


PublicHealth Service


Census Bureau


The “DearFriend!’ \


letterto respondents \


or the brochure 1


The interview


Other (specify)


52 

I 
BEI’OSETHE INTERV’IRW-
INSIDE‘ME HOUSE,


6. What occurs? Who takes the initiative?


Respondent.Interviewer 

Getting in the door 

Suggestw chair


Suggeststable


Other (specify)


Specifieations: (Describeanythingelse which occurs to affect the settingor


physicalatmosphereof the ifiterview.
 )


\


)


7. Who sits first? [RespondentI


8. Are the respondentand ifiterviewet
 sittingclose to each othar?


m m


GENERhLRATTNGS


9, Flowpolite has the respondentbeen to the interviewer?


� Particularlypolite 

~ Slightlypolite 

� Average 

� Slightlyimpolite 

Q Particularlyimpolite 

10.	 How warm and friendlyhas the respondentbeen to the interviewer? 

Q Very warm and friendly 

� 9omewhatwarm and friendly 

� Average - Impersonal 

5 somewhatunfriendly


� Very unfriendly 

53 
Q. 3. How old were you on your last birthday?€

Q. 4. Race€

Q. 5. Sex€

Q. 6. Are you now married, widowed, divorced, separated, or€

never married? 

Q. i’. (a) What were you doing most of the past 12 months ...? 

(b) Are you retired? 

GENERAL RATINGS 

11. Which of the following describes the respondent now? (Check one or more) 

� Enthusiastic � Bored 

� Attentive � Irritated 

� Neutral � Can’ t rate 

12. How loud is each speaking? 

Interviewer Can’ t hear 1 mlXzzzlmRespondent /Can; t hear m-mm 

54 
CONVERSATIONNOT RELATEDDIRECTLYTO THE INTERVIEWOUESTIONS


(Use this form only for MAJOR changes)


Who brings the topic UP? Code 

Talks (tally) Reactionof 

about: j Respondent Interviewerother person 

Flattersor praises [


Other Questionsabout the I


person other person I 

Gives suggestions ~


to other I
1


Talks about self, ;


family,friends,etc.


Talks about things


Self she would ratherbe


doing now


Talks about things \


she is avoidingnow ;


(likeironing) :


!


Asks purposeof	 I 

study or of question1! ~


Inter-
Asks aboutHealth ~
 view
 Service,Census i


Other
 ,


Humor	 Laughs,jokes,tries


to relievetension


Other Specify


Interviewercalls respondent


I


,


I


!


I


1


1


I


I


REACTION


CODE


A =	Encourages


or answers


adequately


B =	Allows,


evades


c =	Discourages, no 

answer 

~m


DISTRACTIONS& INTERRUPTIONS(check)


Childrenpresent � 131x3mm 

Adults present lx!1311zla@l 

TV, radio lxl13@l@lm


Other lzlmlz3 @l@


55 

~~m


Respondentcalls Interviewer First name


DISTRACTIONCODE


A. Inhibits,causes to withholdinformation


B. Distractsbut does not cause an


interruption


c. Causa8 an interruption 

D. Helps respondentgive answers 

E. No effect 
Q. 8. Were yo. sick at any time IASTWEEK OR THSWSEK BEFORE? 

Q. 9, Last week or the week before did you take sny medicineor treatmentfor 

any condition? 

Q.1O. Last week or the week before did you have any accidentsor injuries? 

Q.Il. Did you ever have an accidentor injurythat still bothersyou or affects 

you in any way? 

(Including (a) and (b) for each question) 

13, How does RESPONDENTrespond to 14, What does IWTERVISWERdo in -

questions?(tally) 

ANSWERS IMMEDIATELY 

Givee adequate 

answer 

Elaborateresponse 

Answers inadequately 1


DELAYS ANSWER 

Asks for clarification or repetition 

Consultsanother 

personor records 

Consultscalendar 

attemptto get adequateanswers? 

(tally) 

Repeatsquestionfrom schedule 

Asks questionnot from 

schedulewhich DOESNtTSUGGESI 

an answer (e,g,, could you 

explain that, please?) 

Asks questionnot from 

schedulewhich MAY SUGGESTa 

specificanswer,or asks 

respondentif she agrees to 

a specifican8wer 

Clarifiesthe ~aoing of the 

questionfrom the schedule 

Suggestsrecgrds,calendar, 

other peoplebe consulted 

Other (specify) 

56 
12.	 Has anyone in the family--you,your--,


etc., had any of these conditions


DURINGTHE PAST 12 MONTHS?


Asthma, tuberculosis,chronic


bronchitis,repeatedattacksof


sinus trouble... epilepsy,chronic


nervoustrouble,cancer,chronic


skin trouble,hernia or rupture,


prostatetrouble.


(Tally)


15.	 How many conditionsdoes respondentpause


to consider?


16.	 Number of conditionsrespondentasks for 

clarification;definition? 

17.	 How many conditionsdoes respondent


elaborateon?


18.	 How many conditionsdid the INTERVIEWER


have to ask additionalquestions,probe,


or suggestan answer for?


. Does anyone in the familyhave any
 K(Deafnessthroughany condition


19, Does the interviewerlook up at the respondentafter readingeach /-


condition?


Almost � always @ Often � Sometimes 

20.	 Does the respondenthave enough time to think about each condition


before the interviewerasks the next?


57

I TAELE ONE 

Did you ever at any time talk to a doctor about... (condition)?


What did the doctor say it was? Did he give it a medicalname,


etc,?


(Tallyentire table,for conditions1, 3, 5, 7, etc.)


21.	 How does RESPONDENTrespondto


questions? (tally)


_ ANSWERSIMMEDIATELY


Gives adequate


answer


Elaboratesresponse


Answers inadequate 

DELAYSANSWER


Asks for clarifica­


tion, repetition


Consultsrecords,


calendar


wANTSFEEDBACK. 

I 

Repeatsquestionfrom schedule


Asks questionnot from


schedulewhich DOESN‘T SUGGEST


an answer (e.g., could you


explainthat, please?)


Asks questionnot from


schedulewhich MAY SUGGESTa


specificansweror asks


respondentif she agrees to


a specificanswer


Clarifiesthe maaningof the


questionfrom the schedule


Suggestsrecords,calendar,or


other people be coneulted 

Other (specify)


I Qwstions the


adequacy of answer I


OTHER


r’ Other (mcify) 

58 
Q. 18. LAST WEEI( OR THE WBEK BEFORE did anyone in the family go to a dentist? 

Q. 19. If “no,” ask: About how long has it been since you went to a dentist? 

GENERAL RATINGS ,—~


(Whila “interviewer is asking questions 18 and 19 rate the respondent


on his general behavior up to now. )


23. How we 11 does this respondent grasp the meaning of the questions?


l_J Perfectly 

� Very well 

� Fairly well 

� Not too well 

� Not well at all 

24. How much talking is this respondent doing.?


� A great deal--lots of elaboration; unusually talkative


� Quite a bit


� A moderate amount


� Not too much


� Very little--gives minimum answers; unusually reticent


25. How smoothly are interviewer and respondent working together?


� Extremely smoothly--no strain


� Very smoothly


� Fairly smoothly


� Not too smoothly


� Not smoothly at all--working at cross -purposes


59 
Q, 20.	 I&l’ WEEK OR THE WEEK BEFORR did anyone in the familygo to a


doctoror to a doctor’sofficeor clinic? (Include(a) - (f))


Q. 21. About how long has it been since you have seen or talkedto a


doctor?


26.	 How does RESPONDENTrespond to


queationa? (tally)


ANSWERS IMMEDIATELY


Gives adequate


answer


Elaboratesreeponse


Answers inadequate
ly


DEIAYS ANSWER


Asks for clarification,


repetition


Consultsanother


person


Consultsrecords,


calendar


WANTS FEEDBACK


I [


Questionsthe


adequacyof answer


r


27.	 What does INTERVIEWERdo in attempt


to get adequateanswers. (tally)


Repeatequestionfrom schedule


Asks questionnot from


schedulewhich DOESN’T SUGGEST


an answer (e.g., could you


explain that, please?)


Asks questionnot from 

schedulewhich MAY SUGGESTa 

specificansweror asks 

respondentif she agrees to 

‘aspecificanswer


Clarifiesthe meaningof the


questionfrom the echedule


Suggestsrecords,calendar,or


other peoplebe consulted


Other (specify)


60 
SPECIALISTSCARD


Q. 23.	 DURINGTHE PAST 12 MONTHS has ANYONE in the family--thatis, you, 

your , etc.--receivedany servicesfrom any of the persons 

listedon this card? Please check ‘Yes”or ‘No” for each one listed. 

28. Did respondentask for definitions,clarificacion,or meaning of any of the


item-son the card?


❑ Yes n No 

la. (If yes) What did the interviewerdo?


Gave thoroughinformation(accordingto instructionmanual)


Gave partialinformation


Other (specify)


29.	 Did respondentask any other question? 

❑ Yes ❑ No 

30. How did respondentrespondto the card? 

a Consideredthe items carefully


O Rushed throughit


a Other (specify)


31.	 Did the interviewerhave to read any of the list to respondent? 

❑ All of it a Some of it ❑ None of it 

Check nothingfor the probeswhich may follow


61

Q. 25. (a) What is the highest grade you attended in school?


Q. 26.	 Did you work at any time last week or the week before?


If “no”, aslc Even though you did not work last week or the week


before, do you have a job or business? Were YOU looking for work


or on layoff?


GENERAL RATINGS


32.	 Which of the following describes the respondent now? (Check one or more) 

� Enthusiastic � Bored 

� Attentive � Irritated 

� Neutral ~ Can’t rate 

33. How loud is each speaking?


‘interviewer s m m m m


Respondent ~! ~1 -l H F!


Q. 27. Which of these income groupa represents your total combined family


income ...?


34. Did respondent ask the reason for the question?


� Yes No •1 35. Did the interviewer help the respondent arrive at an answer?


� Yes n

No

62 

I 
CLOSE OF INTERVIEW


36.	 TinE last question (’Whatis the telephonenumber here?”)answered:


o’clock.


37.	 Was there some conversationafter the last questionwas answered?


(Excludingstandardthank you Ietterstatement)


D Yes �No

If yes: 

38. Who wanted to continuethe conversation?


@Qmm


Time leavehouse: O ‘clock


63 
YOUH OVESALLRATINGSOF THE RESPONDENT


1. How cooperativewas this respondent?


Much less Somewhat Somewhat Much more 

� than � less than •1 

About � more than � than average average

average average average 

2. How well did this respondentgrasp the meaningof the queetions?


Not too Not well . � Perfectly � Very well •1 Fairly •1 well � well at all

3.	 How much talkingdid this respondentdo during the interview? 

� A great deal--lots of elaboration;unusuallytalkative 

� Quite a bit 

� A moderateauwunt 

� Not too much 

IJ Very little--givesminimum answers;unusuallyreticent 

4.	 How willingwa$ the respondentto give all the time necesearyfor this


interview?­


� Very willing � Somewhatwilling � Not too willing � ~~~lling 

5.	 How much did the respondentwant to chat with the intervieweraboutmatters


unrelatedto the schedule
?


� Very much � Somewhat � Almost not at all 

6. How much did the interviewerhave to clarifyand interpretfor this respondent?


� Much more than average


� Somewhatmore than average


•1 Average


� Somewhatless than average


c1 Much lees than average


64 
YOUH OVERALL TMFHSSSIONSOF THE INTERVIEW


1. How smoothlydid interviewerand respondentwork together?


� Extremelysmoothly--nostrain


� Very smoothly


� Fairly smothly


� Not too smoothly


� Not smsothlyat all--workingat cross-purposes


2. How hard did aach try to communicate? (Checkone box for each)


Interviewer � 

Very 

much � ‘$&t � ~j~rt � ~~fl � 

Almost 

none 

effort at all 

Respondent � Very 

much � ~f~rt � ~~rt � ~~~t � 

Almost 

none .. 

effort at all 

3. In general,what was the pace of this interview?


Much faster than average


Somewhatfaster than average


About average


Somewhatslower than average


Much slower than average


4. How much did the distractionsand interruptionsaffeet the interview?


� Very much � Much � Somewhat � Little � Very little 

5.	 To what extent do you fee1 that the information obtainedwas accurateand


complete?


65 
OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publi~ation No. 1000 

Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Se7ies 11. 

Series 12. 

Series 13. 

Series 20. 

Series 21. 

Series 22. 

Programs and collection pYocedures.— Reports which describe the general programs of the National 

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Data evaluation and methods research. —Studies of new statistical methodology including: experimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliability of collected data, contributions to statistical theory. 

Analytical studies. — Reports presenting analytical or interpretive studies based on vital and health 

statist ics, carrying the analysis further than the expository types of reports in the other series. 

Documents and committee Yeports. — Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration laws and revised birth 

and death certificates. 

Data from the Health InteYview SuYuey. —Statistics on illness, accidental injuries, disability, use of 

hospital, medical, dental, and other services, and other health-related topics, based on data coHected 

in a continuing national household interview survey. 

Data from the Health Examination Su?wey. — Data from direct examination, testing, and measurement of national samples of the population provide the basis for two types of reports: (1) estimates 

of the medically defined prevalence of specific diseases in the United States and the distributions of 

the population with respect to physical, physiological, and psychological characteristics; and (2) 

anal ys is of relationships among the various measurements without reference to an explicit finite 

universe of persons. 

Data from the Institutional Population SuYveys. —Statistics relating to the health characteristics of 

persons in institutions, and on medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples of the residents or patients. 

Data from the Hospital DischaYge Suraey. —Statistics relating to discharged patients in short-stay 

hospitals, based on a sample of patient records in a national sample of hospitals. 

Data on mortality .-Various statistics on mortality other than as included in annual or monthly 

reports— special analyses by cause of death, age, and other demographic variables, also geographic 

and time series analyses. 

Data on natality, mar~iage, artddivoyce. —Various statistics on natality, marriage, and divorce other 

than as included in annual or monthly reports— special analyses by demographic variables, also 

geographic and time series analyses, studies of fertility. 

Data from the National Natality and Mortality Surueys. —Statistics on characteristics of births and 

deaths not available from the vital records, based on sample surveys stemming fkom these records, 

including such topics as mortality by socioeconomic class, medical experience in the last year of 

life, characteristics of pregnancy, etc. 

For a list of titles of reports published in these series, write to: Office of Information 

N?tional Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201