Exploring a Method to Evaluate Survey Response Scales
Rene Bautista
NORC
Lisa Lee
NORC
We present results from a qualitative study of two alternate scales used in a survey of consumer attitudes toward health information technology. Respondents were presented with a 4-point scale for questions on privacy and security of electronic health records (very-somewhat-not very-not concerned at all). Across these questions, 25% to 50% of respondents expressed the highest level of concern (very concerned). It was unclear whether this was a ceiling effect or whether this reflected the need for an additional option between very and somewhat concerned. We conducted cognitive interviews in English and Spanish to test an alternative 5-point scale that included fairly concerned. Respondents first answered the questions using the 4-point scale and then decided whether they would have chosen a different answer on the 5-point scale. Respondents also visually represented on a line the distance between options on the 4- and 5-point scales. Distances between response options were not always perceived as equidistant and some respondents switched the ordering of two options, fairly and somewhat. The cognitive interviews also highlighted issues that were unique to the Spanish translation.