Premium
Survey Conditioning in Self‐Reported Mental Health Service Use: Randomized Comparison of Alternative Instrument Formats
Author(s) -
Duan Naihua,
Alegria Margarita,
Canino Glorisa,
McGuire Thomas G.,
Takeuchi David
Publication year - 2007
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2006.00618.x
Subject(s) - respondent , mental health , vietnamese , medicine , ethnic group , test (biology) , service (business) , national health interview survey , psychology , survey data collection , logistic regression , family medicine , gerontology , applied psychology , medical education , environmental health , psychiatry , statistics , marketing , population , paleontology , linguistics , philosophy , mathematics , sociology , political science , anthropology , law , business , biology
Objective. To test the effect of survey conditioning (whether observed survey responses are affected by previous experience in the same survey or similar surveys) in a survey instrument used to assess mental health service use. Data Sources. Primary data collected in the National Latino and Asian American Study, a cross‐sectional household survey of Latinos and Asian Americans residing in the United States. Study Design. Study participants are randomly assigned to a Traditional Instrument with an interleafed format placing service use questions after detailed questions on disorders, or a Modified Instrument with an ensemble format screening for service use near the beginning of the survey. We hypothesize the ensemble format to be less susceptible to survey conditioning than the interleafed format. We compare self‐reported mental health services use measures (overall, aggregate categories, and specific categories) between recipients of the two instruments, using 2 × 2 χ 2 tests and logistic regressions that control for key covariates. Data Collection. In‐person computer‐assisted interviews, conducted in respondent's preferred language (English, Spanish, Mandarin Chinese, Tagalog, or Vietnamese). Principal Findings. Higher service use rates are reported with the Modified Instrument than with the Traditional Instrument for all service use measures; odds ratios range from 1.41 to 3.10, all p ‐values <.001. Results are similar across ethnic groups and insensitive to model specification. Conclusions. Survey conditioning biases downward reported mental health service use when the instrument follows an interleafed format. An ensemble format should be used when it is feasible for measures that are susceptible to survey conditioning.