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Title: The impact of self-interviews on response patterns for sensitive topics : a randomized trial of electronic delivery methods for a sexual behaviour questionnaire in rural South Africa
Authors: Harling, Guy 
Gumede, Dumile 
Mutevedzi, Tinofa 
McGrath, Nuala 
Seeley, Janet 
Pillay, Deenan 
Bärnighausen, Till W. 
Herbst, Abraham J. 
Keywords: Interview methods;Mixed-methods;Randomized trial;Sexual behaviour;Single-paper meta-analysis;1117 Public Health and Health Services;General & Internal Medicine
Issue Date: 17-Aug-2017
Publisher: Springer Science and Business Media LLC
Source: Harling, G. et al. 2017. The impact of self-interviews on response patterns for sensitive topics: a randomized trial of electronic delivery methods for a sexual behaviour questionnaire in rural South Africa. BMC medical research methodology. 17(1): 125-. doi:10.1186/s12874-017-0403-8
Journal: BMC medical research methodology; Vol. 17, Issue 1 
BackgroundSelf-interviews, where the respondent rather than the interviewer enters answers to questions, have been proposed as a way to reduce social desirability bias associated with interviewer-led interviews. Computer-assisted self-interviews (CASI) are commonly proposed since the computer programme can guide respondents; however they require both language and computer literacy. We evaluated the feasibility and acceptability of using electronic methods to administer quantitative sexual behaviour questionnaires in the Somkhele demographic surveillance area (DSA) in rural KwaZulu-Natal, South Africa.


We conducted a four-arm randomized trial of paper-and-pen-interview, computer-assisted personal-interview (CAPI), CASI and audio-CASI with an age-sex-urbanicity stratified sample of 504 adults resident in the DSA in 2015. We compared respondents' answers to their responses to the same questions in previous surveillance rounds. We also conducted 48 cognitive interviews, dual-coding responses using the Framework approach.


Three hundred forty (67%) individuals were interviewed and covariates and participation rates were balanced across arms. CASI and audio-CASI were significantly slower than interviewer-led interviews. Item non-response rates were higher in self-interview arms. In single-paper meta-analysis, self-interviewed individuals reported more socially undesirable sexual behaviours. Cognitive interviews found high acceptance of both self-interviews and the use of electronic methods, with some concerns that self-interview methods required more participant effort and literacy.


Electronic data collection methods, including self-interview methods, proved feasible and acceptable for completing quantitative sexual behaviour questionnaires in a poor, rural South African setting. However, each method had both benefits and costs, and the choice of method should be based on context-specific criteria.
ISSN: 1471-2288 (Online)
DOI: 10.1186/s12874-017-0403-8
Appears in Collections:Research Publications (Health Sciences)

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