Cross-Cultural Survey Guidelines (CCSG) workshop Dublin, Feb. 2012

1. Cross-Cultural Survey Guidelines (CCSG) workshopDublin, Feb. 2012 Prof. Edwin van Teijlingen

2. Comparative research Comparative studies • Cross-national research helps one to look at problems from a different angle, questioning current practice, warn against side effects, etc. I.e. there exist ways of doing things which have not been considered in the UK (or Germany or Finland or …..) . • Cognitive psychology recognises that cognition is a situated process and that knowledge is a collaborative, culture-bounded effort.

3. Cross-Cultural Survey Guidelines Guidelines are part of Comparative Survey Design & Implementation (CSDI) Guidelines Initiative. Initiative promotes internationally recognized guidelines that highlight best practice for the conduct of comparative survey research across cultures and countries. Designed for researchers planning or engaged in cross-cultural or cross-national research. http://ccsg.isr.umich.edu/index.cfm

4. Starter question What makes a good quantitative survey? What are the characteristics of well designed and implemented survey? • How do student midwives in Ireland see the job market in their field developing over the coming five years?

5. A good survey consists of: • .…. • ….. • ….. • …..

6. Overview 15 chapters CCSG • Study, Organizational, and Operational Structure • Survey Quality • Ethical Considerations in Surveys • Tenders, Bids, and Contracts • Sample Design • Questionnaire Design • Adaptation of Survey Instruments • Translation • Instrument Technical Design • Interviewer Recruitment, Selection, and Training • Pretesting • Data Collection • Data Harmonization • Data Processing and Statistical Adjustment • Data Dissemination

7. CCSG Glossary (as specifically relevant today Adaptation • Changing existing materials (e.g., management plans, contracts, training manuals, questionnaires, etc.) by deliberately altering some content or design component to make the resulting materials more suitable for another socio-cultural context or a particular population. Coordinating centre • A research centre that facilitates and organises cross-cultural or multi-site research activities.

8. Overview 15 chapters CCSG • Study, Organizational, and Operational Structure • Survey Quality • Ethical Considerations in Surveys • Tenders, Bids, and Contracts • Sample Design • Questionnaire Design • Adaptation of Survey Instruments • Translation • Instrument Technical Design • Interviewer Recruitment, Selection, and Training • Pretesting • Data Collection • Data Harmonization • Data Processing and Statistical Adjustment • Data Dissemination

9. CCSG: Survey Lifecycle

10. First 9 chapters CCSG • Study, Organizational, and Operational Structure • Survey Quality • Ethical Considerations in Surveys • Tenders, Bids, and Contracts • Sample Design • Questionnaire Design • Adaptation of Survey Instruments • Translation • Instrument Technical Design

11. Shaping a Network of Local Researchers COST brings together midwifery/maternity care researchers from a range of different academic disciplines working across Europe. To conduct a cross-national survey there has to be a balance between (a) standardisation of implementation and (b) adaptation of the cultural context. This needs ‘leadership’/coordinating centre.

12. Guidelines: leadership To establish study's overall structure & locus of control at all levels and across all aspects of study's design & implementation, and to communicate this structure to each participating country's survey organization.

13. II. Survey Quality http://ccsg.isr.umich.edu/quality.cfm

14. II. Survey Quality

15. Sampling frames • As maternity services, health systems and the was populations are registered varies across countries we may have to deal with different sampling frames across COST countries.

16. 8 Translation Translation is : • Language; • Culture; • Context & system (related). Starting point cross-national survey? Translate from Dutch into German / French / English.

17. 8 Translation / language • Language Words have ‘meaning’ which needs to be translated. Translations from English into other European languages take more space. Miles & lbs & pints………

18. 8 Translation / Culture • Culture Will we have a questionnaire in German? Or A German questionnaire, a Swiss questionnaire and an Austrian questionnaire?

19. 8 Translation / Culture • Culture Will we have a questionnaire in minority languages such as Hindi, Urdu, Turkish, etc. and use same questionnaire in Hindi different European countries?

20. 8 Translation / Culture • Culture Some colours and numbers have special significance in some cultures so should perhaps be avoided answers to multiple choice questions.

21. 8 Translation / context C. Context • ‘Private health services’ means something different in a state health service system such as in the UK than in a health-insurance system such as the Netherlands or Germany.

22. Problematising Terminology Comparing like with like? • Trained nurse-midwife • Direct-entry midwife (NB: UK vs US meaning) • Midwifery assistant / maternity care assistant • Maternity benefits • Economic migrant • etc.

23. 11. Pretesting • Test instrument • Test research protocol • Training researcher/ Education • Collect preliminary data • Impress (potential) funders • Help calculate sample size

24. Reasons for pilot studies Test instrument: • test questions; • test possible answers for multiple choice questions; • test order of questions; • test colour of paper; • etc. • etc.

25. Reasons for pilot studies Test research protocol: • test way of questionnaire distribution • test process of returning them to you • test intervening factors (gate keepers, etc.) • try out different incentives to increase response rates

26. Reasons for pilot studies Training researcher/ Education: • Project as part of training/ degree • Train new researcher on a study • Train researcher in new technique

27. Ethics committees Glasziou & Chalmers (2004) found that piloting of leaflet aimed at elderly to improve GP consultations needed ethical review, in Belgium, Slovenia and UK, but not in Austria, France, Germany and Switzerland, whilst UK has one of most complicated ethical processes (Hearnshaw 2004).

28. Ethics committees • What if ethics committee in the UK does not think question 17 in the questionnaire is appropriate, but ethics committee in Belgium and in xxxx has accepted the questionnaire as it stands? • What do we do?

29. Balance Uniformity Context & cultural sensitivity Balance between the need to keep survey as uniform as possible to be able to make cross-national comparisons AND the need to be as sensitive as possible to the local context, culture & health system!

30. References Glasziou P, Chalmers I (2004) Ethics review roulette: What can we learn? Brit Med J, 328: 121-122. Hearnshaw H (2004) Comparisons of requirements of research ethics committees in 11 European countries for a non-invasive interventional study. Brit Med J, 328: 140-141. Survey Research Center. (2010). Guidelines for Best Practice in Cross-Cultural Surveys. Ann Arbor, MI: Survey Research Center, Institute for Social Research, University of Michigan. Retrieved Feb. 2012 from http://www.ccsg.isr.umich.edu/ van Teijlingen ER, Sandall J, Wrede S, Benoit C, DeVries R, Bourgeault I. (2003) Comparative studies in maternity care RCM MidwivesJ 6: 338-40. Peat J et al. (2002), Health Science Research: A Handbook of Quantitative Methods, London: Sage. Teijlingen van, E., Hundley, V. (2001) The importance of pilot studies, Social Research Update Issue 35, http://www.soc.surrey.ac.uk/sru/SRU35.html

32. Thank you! Edwin van Teijlingen