Managing Questionnaire Development for a National HIV Surveillance Survey, Medical Monitoring Project (303387)

Amy Baugher, CDC 
*Jennifer L Fagan, CDC 
Mark Freedman, CDC 
Mabel Padilla, Oakridge Institute for Science and Education 
Alejandro Pérez, CDC 
Roy Luke Shouse, CDC 

Keywords: computer-assisted personal interview, questionnaire design, HIV, Centers for Disease Control and Prevention, database

The Medical Monitoring Project (MMP), a population-based HIV surveillance system, includes a 45-minute computer-assisted personal interview, face-to-face or over the telephone, among HIV-infected adults in the United States and Puerto Rico. Conducted since 2007, MMP’s interview is updated every three years. The current questionnaire has 23 modules, 876 variables, and complex data validation and skip logic. We needed a comprehensive, efficient system to manage questionnaire development. We designed an MS Access database to capture details about research questions, question source, pretesting, modifications, survey questions, response options, and associated instructions. Associated instructions included the variable names, labels, introductory statements, response ranges, edit checks, skip logic, calculated variables, and programming commands. Using these elements, we generated reports to create customized versions of the questionnaire, tailored for different audiences, while maintaining a single questionnaire source through the database. This process streamlined our questionnaire and enabled us to rapidly develop versions based on changes in audiences or their needs. For example, a questionnaire for field use included questions, response options, and skip logic; whereas, a report for analytic use included research questions, question source, calculated variables, as well as other question elements. Furthermore, we specified all survey elements in the database prior to electronic application programming, thereby reducing the potential for programming errors and improving efficiency. For the latest questionnaire revision, we used the database to manage 814 suggested modifications from over 200 stakeholders and track revision details and final changes. Using the database, we streamlined and effectively managed questionnaire development for MMP. Surveillance and other large survey-based studies may consider using a database to improve survey development.