2. 2
2003 M.D. (First-Class Honors) (Ramathibodi)
2009 M.S. in Health Informatics (U of MN)
2011 Ph.D. in Health Informatics (U of MN)
2012 Certified HL7 CDA Specialist
• Deputy Executive Director for Informatics (CIO/CMIO)
Chakri Naruebodindra Medical Institute
• Lecturer, Department of Community Medicine
Faculty of Medicine Ramathibodi Hospital
Mahidol University
nawanan.the@mahidol.ac.th
www.SlideShare.net/Nawanan
Introduction
3. 3
Lecture
• Overview of Surveys
• Survey Methodology
• A Sample Survey
Group Exercise
• Sample Surveys & Critique
Outline
5. 5
• An activity in which many people are
asked a question or a series of
questions in order to gather
information about what most people
do or think about something
Survey (การสารวจ)
Merriam Webster Dictionary
6. 6
• A written set of questions that are
given to people in order to collect
facts or opinions about something
Questionnaire (แบบสอบถาม)
Merriam Webster Dictionary
7. 7
• To know something
– Personal information
– Knowledge, Opinions & Attitudes
– Behaviors & Practice
– etc.
• About someone
– Individuals
– Organizations
• In order to understand, create knowledge,
or make decisions
Why Do a Survey?
16. 16
• “The development of survey
procedures that create respondent
trust and perceptions of increased
rewards and reduced costs for being
a respondent, which take into account
features of the survey situation and
have as their goal the overall
reduction of survey error”
The Tailored Design
Dillman et al. (2007)
17. 17
• Rewards
• Costs
• Trust
Social Exchange Theory
Dillman et al. (2007)
Image Source: http://horsebusinessschool.com/using-stick-and-carrot-to-motivate-employees/
18. 18
• “The likelihood of responding to the
request to complete a self-
administered questionnaire, and
doing so accurately, is greater when
the respondent trusts that the
expected fix rewards of responding
will outweigh the anticipated costs”
Social Exchange
Dillman et al. (2007)
19. 19
Providing Rewards
• มีท่าทีเชิงบวก (Show positive
regard)
• กล่าวขอบคุณ (Say thank you)
• ขอคาแนะนา (Ask for advice)
• สนับสนุนค่านิยม/คุณค่าของ
กลุ่มเป้าหมาย (Support group
values)
• ให้รางวัลที่จับต้องได้ (Give
tangible rewards)
• ทาให้แบบสอบถามน่าสนใจ น่า
ตอบ (Make questionnaire
interesting)
• ส่งสัญญาณว่าสังคมสนับสนุนให้
ตอบ (Give social validation)
• แจ้งว่าโอกาสตอบมีน้อย (Inform
respondents that
opportunities to respond are
scarce)
Survey &
Social Exchange Theory
Dillman et al. (2007)
20. 20
Reducing Social Costs
• หลีกเลี่ยงคาที่ทาให้รู้สึกถูกสั่งการ
(Avoid subordinating
language)
• หลีกเลี่ยงการสร้างความอับอาย
(Avoid embarrassment)
• หลีกเลี่ยงความรู้สึกไม่สะดวก
(Avoid inconvenience)
• ทาให้แบบสอบถามดูสั้นและตอบ
ง่าย (Make questionnaires
appear short & easy)
• ลดการสอบถามข้อมูลส่วนตัว
(Minimize requests to obtain
personal information)
• ทาให้การตอบ คล้ายกับการสารวจ
ที่เขาเคยตอบแล้ว (Keep
requests similar to other
requests to which a person
has already responded)
Survey &
Social Exchange Theory
Dillman et al. (2007)
21. 21
Establishing Trust
• ให้รางวัลล่วงหน้า (เช่น พร้อม
กับแบบสอบถาม) (Provide a
token of appreciation in
advance)
• ได้รับการสนับสนุนจาก
หน่วยงานที่เกี่ยวข้อง
(Sponsorship by legitimate
authority)
• ทาให้เรื่องนั้นดูสาคัญ (Make
the task appear
important)
• เชื่อมโยงกับความสัมพันธ์อื่นที่
มีการแลกเปลี่ยน (Invoke
other exchange
relationship)
Survey &
Social Exchange Theory
Dillman et al. (2007)
22. 22
• Study Design
– Cross-sectional vs. Longitudinal
– Descriptive vs. Analytical
Survey Design
24. 24
• เลือกใช้คาง่ายๆ มากกว่าคาหรูๆ
• ใช้คาให้น้อยที่สุดเท่าที่ทาได้ในการตั้งคาถาม
• ถามด้วยประโยคเต็มประโยค
• หลีกเลี่ยงคาเชิงปริมาณที่กว้างๆ เมื่อใช้คาที่ “เป๊ะ” กว่าได้
• หลีกเลี่ยงความจาเพาะ (specificity) ที่เกินความสามารถของ
ผู้ตอบในการตอบได้ตรงความจริงอย่างรวดเร็ว (Avoid
specificity that exceeds respondent’s potential for
having an accurate, ready-made answer
• มีตัวเลือกด้านบวกและด้านลบจานวนเท่ากัน
Instrument Design
Dillman et al. (2007)
25. 25
Problem
• Number of years lived in Idaho
Years
• Your city or town
City or Town
• Your county
County
Use complete sentences
Dillman et al. (2007)
26. 26
Revision
• How many years have you lived in Idaho?
Years
• In what city or town do you live?
City or Town
• In what Idaho county do you live?
Idaho County
Use complete sentences
Dillman et al. (2007)
27. 27
Problem
• How often did you attend religious services
during the past year?
Never
Rarely
Occasionally
Regularly
Avoid vague quantifiers
Dillman et al. (2007)
28. 28
Revision
• How often did you attend religious services
during the past year?
Not at all
A few times
About once a month
Two to three times a month
About once a week
More than once a week
Avoid vague quantifiers
Dillman et al. (2007)
29. 29
Problem
• About how many books have you read for
leisure during the past year?
Number of books
Avoid too much
specificity
Dillman et al. (2007)
30. 30
Problem
• About how many books have you read for
leisure during the past year?
less that 10
11-25
26-50
51-75
76 or more
Avoid too much
specificity
Dillman et al. (2007)
31. 31
• แยก “ไม่แน่ใจ” (undecided) กับ “เฉยๆ” (neutral) ออกจากกัน
โดยเอา undecided อยู่ท้ายสุดของ scale
• หลีกเลี่ยงอคติจากการเปรียบเทียบที่ไม่เท่ากัน (Avoid bias from
unequal comparisons)
• ใช้คาที่กล่าวถึงทัศนคติทั้งด้านบวกและลบในคาถาม (State both
sides of attitude scales in the question stems)
• หลีกเลี่ยงคาถาม “check-all-that-apply” เพื่อลดปัญหาจาก
primacy effects (เลือกตอบเฉพาะ choice ต้นๆ แล้วหยุดตอบ)
• ออกแบบคาตอบที่ไม่ทับซ้อนกัน (mutually exclusive)
Instrument Design (2)
Dillman et al. (2007)
32. 32
Problem
• Which one of the following do you feel is most
responsible for recent outbreaks of violence in
American’s schools?
Irresponsible parents
School policies
Television programs
Avoid bias from
unequal comparisons
Dillman et al. (2007)
33. 33
Revision
• Which one of the following do you feel is most
responsible for recent outbreaks of violence in
American’s schools?
The way children are raised by parents
School policies
Television programs
Avoid bias from
unequal comparisons
Dillman et al. (2007)
34. 34
Problem
• From which one of these sources did you first
learn about the tornado in Derby?
Radio
Television
Someone at work
While at home
While traveling to work
Mutually Exclusive
Dillman et al. (2007)
35. 35
• ใช้เทคนิคที่ช่วยการฟื้นความจา (Use cognitive design techniques to
improve recall)
• เลือกใช้จุดอ้างอิงเวลาที่เหมาะสม (Provide appropriate time referents)
• ตรวจสอบความถูกต้องทางทฤษฎีของคาถาม (Be sure each question is
technically accurate)
• เลือก wording ของคาถามที่ช่วยให้เปรียบเทียบกับข้อมูลจากการสารวจครั้ง
ก่อนๆ ได้
• หลีกเลี่ยงการถามให้ตอบ “ใช่” เพื่อให้หมายถึง “ไม่ใช่”
• หลีกเลี่ยงคาถาม double-barreled questions
Instrument Design (3)
Dillman et al. (2007)
36. 36
Problem
• Should the city build a new swimming pool that
includes lanes for swimming laps that is not
enclosed for winter use?
Yes
No
Double Barreled
Dillman et al. (2007)
46. 46
Unknown State of
IT Adoption in
Thai Hospitals
Need to improve
theoretical
knowledge
This
Study
Dual Opportunities
47. 47
• To describe current state of IT adoption in Thai
hospitals nationwide
• To test proposed conceptual framework & explore
relationships between organizational
characteristics, IT management, and IT adoption
Study Objectives
49. 49
• Study Design: Nationwide cross-sectional mail survey
• Sample: All hospitals in Thailand except pilot (N =
1,302)
• Pilot: 5 hospitals (10 respondents each)
• Sampling Frame: List of hospitals from Ministry of
Public Health’s Web site
• Subjects: Hospital’s staff responsible for managing
information systems (CIO/IT manager or equivalent;
hospital director if N/A)
• Data Collection Period: 16 weeks
Design & Population
50. 50
• Modified from original instrument
• Face & content validity established
(Theera-Ampornpunt, 2009)
• Further modified based on pilot
findings
• Translated to Thai
Section 1 Hospital Profile
Section 2 IT Adoption & Use Profile
Section 3 Respondent’s Information
English version
Survey Instrument
51. 51
• Managerial: To what extent do you agree or disagree
with each statement? e.g.,
• Those who will use the information systems are fully
involved in hospital IT development
• Functional: How much is each activity supported by
computerized information systems in your hospital?
• Technological: To what extent is each technology
made available in your hospital?
• Integration: To what extent is information shared or
transmitted among information systems within/outside
your hospital?
Sample Questions
52. 52
Week 0:
Prenotice Letter
Week 1:
1st
Questionnaire
Mailout
(Dec. 18, 2010)
Week 6:
2nd
Questionnaire
Mailout
(Jan. 27, 2011)
Weeks 9-13:
Planned Follow-up Phone
Calls to Nonrespondents
and 3rd
Questionnaire
Mailout If Necessary
(Never Conducted
Because of Satisfactory
Response Rate)
Week 16:
Survey Returns
Closed
(Apr. 8, 2011)• 150-baht (~US$5) incentive if completed
• Endorsed by President of the Thai Medical Informatics Association
• Funded by a leading medical school with known informatics focus
• Anonymous unless contact information provided for incentive & results
mailing
Survey Methodology
(Nationwide)
53. 53
• 64% response rate
• Some items problematic
– Differing within-hospital responses on total & IT
budgets,
No. of IT staff, quality accreditation status
– Poor interrater reliability for some dimensions
• Quality accreditation status dropped
• Item wording revised & survey shortened
• Integration sophistication items restructured
Pilot Study Findings
54. 54
• 4 of 1,302 hospitals ineligible
• Response rate 69.9%
Characteristic Overall Responding
Hospitals
Non-
Responding
Hospitals
N of eligible hospitals 1,298 908 390
Bed size** 106.9 117.5 82.9
Public status**
Private
Public
24.0%
76.0%
17.4%
82.6%
39.2%
60.8%
Geography*
Central
East
North
Northeast
South
West
33.4%
7.5%
11.1%
27.1%
15.3%
5.6%
31.1%
7.8%
13.5%
26.9%
14.9%
5.8%
39.0%
6.7%
5.4%
27.7%
16.2%
5.1%
*p < 0.01, **p < 0.001.
Nationwide Findings
55. 55
Characteristic Number of Responses Statistic†
Public status
Private
Public
908
158
750
17.4%
82.6%
Teaching status
Non-teaching
Teaching
901
716
185
79.5%
20.5%
Total employees 890 368.2 ± 573.5 (10-5269)
IT employees 901 4.3 ± 5.3 (0-60)
Total budget (million baht) 443 146.67 ± 313.60 (0.25-3,067)
IT budget (million baht) 598 2.77 ± 8.79 (0-100)
Ratio of IT budget to total budget‡
< 1%
1-4%
5-8%
> 8%
416
135
218
40
23
2.7% ± 4.6% (0-43.3%)
32.5%
52.4%
9.6%
5.5%
Extent of overall IT utilization
Very low
Low
Moderate
High
Very high
905
5
35
169
454
242
0.6%
3.9%
18.7%
50.2%
26.7%
Total PCs in use 883 126.1 ± 218.6 (0-3,000)
Nationwide Findings
56. 56
Estimate (Partial or Complete Adoption) Nationwide
Basic EHR, outpatient 86.6%
Basic EHR, inpatient 50.4%
Basic EHR, both settings 49.8%
Comprehensive EHR, outpatient 10.6%
Comprehensive EHR, inpatient 5.7%
Comprehensive EHR, both settings 5.3%
order entry of medications, outpatient 96.5%
order entry of medications, inpatient 91.4%
order entry of medications, both settings 90.2%
order entry of all orders, outpatient 88.6%
order entry of all orders, inpatient 81.7%
order entry of all orders, both settings 79.4%
Adoption Estimates
57. 57
• Overview of Surveys
• Survey Methodology
• A Sample Survey
Recap
58. 58
• Survey Design (การออกแบบการสารวจ)
– Study Design (การออกแบบการศึกษา)
– Modes of Data Collection (วิธีการเก็บข้อมูล)
• Instrument Design (การออกแบบแบบสารวจ)
• Sampling (การสุ่มตัวอย่าง)
• Survey Conduct (การดาเนินการสารวจ)
• Data Analysis (การวิเคราะห์ข้อมูล)
• Reports (การรายงานผล)
Survey Methodology
