Rachel Davis, MPH Center for Health Communications Research November 10, 2006

1. Exploring the Influence of Interviewer Racial Identity on Telephone-Administered Surveys with African Americans Rachel Davis, MPH Center for Health Communications Research November 10, 2006

2. The Importance of Survey Data to Public Health • Prevalence estimates • Incidence rates • Information about health behaviors, beliefs, and attitudes • Population characteristics • Program creation • Program evaluation • Policy

3. Threats to Data Validity Survey Data The Truth

4. The Truth Threats to Data Validity Stable Respondent Factors TemporalRespondent Factors Factors Related to the Survey The Interviewer-Respondent Interaction Survey Data Temporal Interviewer Factors Stable Interviewer Factors

5. Interviewer Characteristics • Gender • Age • Race

6. (1) Statistical Estimates • Race-matching produced lower estimates of disapproval of binge drinking and marijuana use among African Americans (Livert, Kadushin, Schulman, & Weiss, 1998) • Race of interviewer effects may have affected answers provided about feelings close to African Americans by 10% on the 1984 National Election Study (Anderson, Silver, Abramson, 1988) • Groves (1989) showed that an average workload of 41 interviews results in a 17% increase in the standard error of a sample mean • Higher interviewer load  higher impact of error

7. (2) Variable Relationships • Race of interviewer effects can impact relationships between variables • Over 60% of racial attitude questions affected by interviewer race on the 1984 National Black Election Study (Davis, 1997) • Interviewer race as a latent variable • Interviewer race significantly affected the relationship between Black consciousness and support for Jesse Jackson (Davis)

8. (3) Historical Effects • Race of interviewer effects are representative of prevailing race relations (Anderson, Silver, & Abramson, 1988) • Interviewer staff changes may impact data obtained in repeated administrations of survey instruments • Changes in social relations or interviewer staffing may impact repeat survey administrations

9. (4) Impact on Health Behavior • No research on race of interviewer effects on health behavior • Sub-populations of African American participants who were interviewed face-to-face by Black interviewers in five National Election Studies were 12% more likely to vote than respondents interviewed by White interviewers (Anderson, Silver, & Abramson, 2005) • Does interviewer race affect health behavior?

10. (5) Respondents May Care • No studies of interviewer race preferences among African American respondents • However, a study of counselor race preference among students at a predominantly Black college revealed that 30% of respondents preferred an ethnically dissimilar counselor (Atkinson, Furlong, & Poston, 1986) • Some African American respondents may prefer to interact with ethnically dissimilar interviewers

11. What Do We Know? • Many surveys match interviewers and respondents by race • Race of interviewer effects more common for racial attitude items • Perceived race is a stronger predictor than actual race (Davis, 1997) • Listeners’ perceptions of race are often inaccurate (Wolford et al., 1995) • Dialect influences perceived race (Thomas & Reaser, 2004)

12. What Don’t We Know? • Only 7 peer-reviewed studies of race of interviewer effects on telephone surveys with African Americans • Only 1 study on a health topic • Only 1 study of validity • No studies of influence on sociodemographic data • No studies of respondent preferences, trust in, or comfort with interviewers • No studies of influence of racial identity • No studies of speech patterns

13. The Eat for Life Study • Purpose: • To test the effectiveness of Black identity as a message tailoring variable • Intervention: • 3 tailored print newsletters • 16 Black identity types • Two Recruitment Sites: • Henry Ford Health System (Detroit) • Kaiser Permanente of Georgia (Atlanta) • Surveys: Group Health Cooperative (Seattle)

14. Eat for Life Study Design • Baseline telephone interview • Three tailored newsletters, spaced about one month apart • Follow-up telephone interview at approximately 90 days post-baseline

15. An Interesting Problem … • Telephone-administered survey • African American interviewers from Seattle with ethnically neutral, Pacific Coast accents • How to convey race to (in theory) put respondents at ease when answering racially sensitive survey questions?

16. … Presents Opportunity • Perceived interviewer race biases racially sensitive survey data. • Respondent identity type predicts interviewer race preferences for racially sensitive surveys. • Interviewers and respondents affect one another’s expressions of race through speech. • Matching of interviewer and respondent Black identity types results in larger changes in health behavior, higher program satisfaction, higher health plan satisfaction, and more agreement with the concept that “these newsletters were designed for me” at the 3-month follow-up.

17. Study Design • Baseline telephone interview (2 questions) • Validation survey within 4 days post-baseline • Interviewer study • Three tailored newsletters, spaced about one month apart • Follow-up telephone interview at approximately 90 days post-baseline

18. Baseline Survey Questions • Q1: How important is it to you to be interviewed by an interviewer of your same race and ethnicity for a survey like this? (1-10 pts) • Q2: How comfortable would you have felt if this interview had been done by a White interviewer? (1-10 pts)

19. Validation Survey • Questions measure: • Trust in the interviewer • Comfortable with the interviewer • Treated with respect by the interviewer • Importance of interviewer being of “your same race and ethnicity” • Comfort if interviewer had been White • Conducted within 4 days post-baseline • Different interviewer

20. Validation Survey, Cont’d • 265 of 267 (99%) who have completed the Eat for Life baseline have consented • 209 of 265 (79%) of those who have consented have completed the survey

21. Interviewer Study • Seattle interviewers (estimated n = 15) • Written survey assessing racial identity and sociodemographics • Three digitally recorded Eat for Life baseline surveys with mock respondents representing three identity types: • Assimilated • Black American • Black American with Cultural Mistrust

22. Linguistic Coding • Proxy measure for perceived race • 10 phonological features: • “star” like “stah” • “the” like “de” • “DEE-troit” • Are these features displayed more by certain interviewers, during interviews with certain respondent types, or during certain parts of the survey script? • Do interviewer and respondent speech patterns affect one another?

23. Study Timeline • Validation surveys now being done • Eat for Life data collection for to be completed May 2007 • Interviewer study ready to begin

24. Challenges • Timing  Whether to hire fake respondents based on speech patterns? • Funding  About $10K still needed

25. Thank You!