Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/87682
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Type: Journal article
Title: Methodological issues associated with collecting sensitive information over the telephone - experience from an Australian non-suicidal self-injury (NSSI) prevalence study
Author: Taylor, A.
Martin, G.
DalGrande, E.
Swannell, S.
Fullerton, S.
Hazell, P.
Harrison, J.
Citation: BMC Medical Research Methodology, 2011; 11(Feb):20-1-20-7
Publisher: BioMed Central
Issue Date: 2011
ISSN: 1471-2288
1471-2288
Statement of
Responsibility: 
Anne W Taylor, Graham Martin, Eleonora Dal Grande, Sarah Swannell, Simon Fullerton, Philip Hazell and James E Harrison
Abstract: BACKGROUND Collecting population data on sensitive issues such as non-suicidal self-injury (NSSI) is problematic. Case note audits or hospital/clinic based presentations only record severe cases and do not distinguish between suicidal and non-suicidal intent. Community surveys have largely been limited to school and university students, resulting in little much needed population-based data on NSSI. Collecting these data via a large scale population survey presents challenges to survey methodologists. This paper addresses the methodological issues associated with collecting this type of data via CATI. METHODS An Australia-wide population survey was funded by the Australian Government to determine prevalence estimates of NSSI and associations, predictors, relationships to suicide attempts and suicide ideation, and outcomes. Computer assisted telephone interviewing (CATI) on a random sample of the Australian population aged 10+ years of age from randomly selected households, was undertaken. RESULTS Overall, from 31,216 eligible households, 12,006 interviews were undertaken (response rate 38.5%). The 4-week prevalence of NSSI was 1.1% (95% ci 0.9-1.3%) and lifetime prevalence was 8.1% (95% ci 7.6-8.6). Methodological concerns and challenges in regard to collection of these data included extensive interviewer training and post interview counselling. Ethical considerations, especially with children as young as 10 years of age being asked sensitive questions, were addressed prior to data collection. The solution required a large amount of information to be sent to each selected household prior to the telephone interview which contributed to a lower than expected response rate. Non-coverage error caused by the population of interest being highly mobile, homeless or institutionalised was also a suspected issue in this low prevalence condition. In many circumstances the numbers missing from the sampling frame are small enough to not cause worry, especially when compared with the population as a whole, but within the population of interest to us, we believe that the most likely direction of bias is towards an underestimation of our prevalence estimates. CONCLUSION Collecting valid and reliable data is a paramount concern of health researchers and survey research methodologists. The challenge is to design cost-effective studies especially those associated with low-prevalence issues, and to balance time and convenience against validity, reliability, sampling, coverage, non-response and measurement error issues.
Keywords: Humans
Population Surveillance
Cross-Sectional Studies
Self-Injurious Behavior
Truth Disclosure
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Child
Australia
Female
Male
Interviews as Topic
Young Adult
Rights: © 2011 Taylor et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.1186/1471-2288-11-20
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