Uncontrolled Web-Based Administration of Surveys on Factual Health-Related Knowledge: A Randomized Study of Untimed Versus Timed Quizzing

Background

Health knowledge and literacy are among the main determinants of health. Assessment of these issues via Web-based surveys is growing continuously. Research has suggested that approximately one-fifth of respondents submit cribbed answers, or cheat, on factual knowledge items, which may lead to measurement error. However, little is known about methods of discouraging cheating in Web-based surveys on health knowledge.

Objective

This study aimed at exploring the usefulness of imposing a survey time limit to prevent help-seeking and cheating.

Methods

On the basis of sample size estimation, 94 undergraduate students were randomly assigned in a 1:1 ratio to complete a Web-based survey on nutrition knowledge, with or without a time limit of 15 minutes (30 seconds per item); the topic of nutrition was chosen because of its particular relevance to public health. The questionnaire consisted of two parts. The first was the validated consumer-oriented nutrition knowledge scale (CoNKS) consisting of 20 true/false items; the second was an ad hoc questionnaire (AHQ) containing 10 questions that would be very difficult for people without health care qualifications to answer correctly. It therefore aimed at measuring cribbing and not nutrition knowledge. AHQ items were somewhat encyclopedic and amenable to Web searching, while CoNKS items had more complex wording, so that simple copying/pasting of a question in a search string would not produce an immediate correct answer.

Results

A total of 72 of the 94 subjects started the survey. Dropout rates were similar in both groups (11%, 4/35 and 14%, 5/37 in the untimed and timed groups, respectively). Most participants completed the survey from portable devices, such as mobile phones and tablets. To complete the survey, participants in the untimed group took a median 2.3 minutes longer than those in the timed group; the effect size was small (Cohen’s r=.29). Subjects in the untimed group scored significantly higher on CoNKS (mean difference of 1.2 points, P=.008) and the effect size was medium (Cohen’s d=0.67). By contrast, no significant between-group difference in AHQ scores was documented. Unexpectedly high AHQ scores were recorded in 23% (7/31) and 19% (6/32) untimed and timed respondents, respectively, very probably owing to “e-cheating”.

Conclusions

Cribbing answers to health knowledge items in researcher-uncontrolled conditions is likely to lead to overestimation of people’s knowledge; this should be considered during the design and implementation of Web-based surveys. Setting a time limit alone may not completely prevent cheating, as some cheats may be very fast in Web searching. More complex and contextualized wording of items and checking for the “findability” properties of items before implementing a Web-based health knowledge survey may discourage help-seeking, thus reducing measurement error. Studies with larger sample sizes and diverse populations are needed to confirm our results.     

Health-risk behaviour in Croatia

OBJECTIVE: To identify the health-risk behaviour of various homogeneous clusters of individuals. STUDY DESIGN: The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. METHODS: The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. RESULTS: Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P<0.001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who self-reported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. CONCLUSION: Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations.     

心肺复苏成功后患者心理变化分析与对策

目的对心肺复苏（CPR）成功后患者的心理状况进行测查,以实施恰当的医疗护理。方法采用症状自评量表（SCL-90）,对66例心肺复苏成功患者进行心理测量,并与常模进行比较。结果心肺复苏患者的心理问题主要表现为焦虑、抑郁、依赖和恐惧症状,测评对象中心理问题检出率高达81．8％。结论心肺复苏成功后患者心理病态普遍较高,需要采取相应的心理治疗对策,以提高患者的康复与生存质量。     

外伤性截瘫患者的心理健康状况及护理

目的 对外伤性截瘫患者的心理状况进行测查,以实施恰当的医疗护理。方法 采用症状自评量表（SCL-90）,对89例外伤性截瘫患者进行心理测量,并与常模进行比较。结果 外伤性截瘫患者的心理问题主要表现为焦虑、抑郁和躯体化症状;测评对象中心理问题检出率高达88％。结论 外伤性截瘫患者心理病态普遍,需要采取相应的护理措施,以提高患者康复质量．     

中美在线问答社区中的自闭症信息分析

采用内容分析法对中美两个最大的在线社区百度知道和Yahoo!Answers上采集的自闭症问答数据进行分析发现,中美社会化在线问答社区用户在自闭症的认知上存在差距,美国用户对于疾病的基础知识掌握比中国用户好,提问内容更加详细、多样,对疾病的探索性提问更积极。在答案的选择上,清晰性、完整性、准确性和可操作性是最重要的因素,美国社会已经对自闭症产生了良好、广泛的社会接纳度和应对措施。     

Factors Affecting the Length of Responses in Field Investigative Interviews of Children (FIIC) in Child Sexual Abuse Cases

In this study some of the most prominent variables considered to facilitate interviewee responses in the literature of field investigative interviews of children (FIIC) are reviewed and included in the analysis of 100 FIICs. Analysis of variance (ANOVA) showed that of all the variables, the interviewer's utterances had the most impact on the children's responses, with the open questions eliciting the longest answers. The variable to follow was the children's age, with the oldest children yielding longer responses than the younger children to the open questions. Contrary to the hypothesis, the interviewer's competence, children's gender, and time of interview had little impact on the length of the children's responses. Possible explanations for the results are discussed.     

安康市人群艾滋病知识知晓率调查分析

目的了解安康市人群艾滋病知识知晓率,为今后评价艾滋病干预措施效果,提供基础性数据和背景资料。方法采用等容量分层整群单纯和机械抽样相结合的方法 ,在知情同意的情况下,由接受过培训的调查人员采用入户面对面询问式调查方法进行调查。结果安康市人群艾滋病知识平均知晓率仅为39.26%,人群中61.1%允许艾滋病感染者和病人继续工作和学习,63.4%愿意同艾滋病感染者和病人继续交往。结论安康市人群艾滋病知识知晓率仍较低,而人群对艾滋病感染者和患者的偏见存在偏见,提示我们在工作中,加强宣传、普及艾滋病知识,消除社会公众对艾滋病的恐惧,消除他们对艾滋病感染者和患者的偏见。