The inclusion of ‘then-test’ questions in post-test questionnaires alters post-test responses: a randomized study of bias in health program evaluation

Nolte, Sandra, Elsworth, Gerald R., Sinclair, Andrew J. and Osborne, Richard H. 2012, The inclusion of ‘then-test’ questions in post-test questionnaires alters post-test responses: a randomized study of bias in health program evaluation, Quality of life research, vol. 21, no. 3, pp. 487-494.

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Title The inclusion of ‘then-test’ questions in post-test questionnaires alters post-test responses: a randomized study of bias in health program evaluation
Author(s) Nolte, Sandra
Elsworth, Gerald R.
Sinclair, Andrew J.
Osborne, Richard H.
Journal name Quality of life research
Volume number 21
Issue number 3
Start page 487
End page 494
Total pages 8
Publisher Springer Netherlands
Place of publication Dordrecht, The Netherlands
Publication date 2012-04
ISSN 0962-9343
1573-2649
Keyword(s) Chronic disease
Self-management
Patient education
Program evaluation
Bias
Response shift
Then-test
Retrospective pre-test
Summary Objectives Program evaluations are frequently based on ‘then-test’ data, i.e., pre-test collected in retrospect. While the application of the then-test has practical advantages, little is known about the validity of then-test data. Because of the collection of then-test in close proximity to post-test questions, this study was aimed at exploring whether the presence of then-test questions in post-test questionnaires influenced subjects’ responses to post-test.
Patients and methods To test the influence of then-test questions, we designed a randomized three-group study in the context of chronic disease self-management programs. Interventions had comparable goals and philosophies, and all 949 study participants filled out identical Health Education Impact Questionnaires (heiQ) at pre-test. At post-test, participants were then randomized to one of the following three groups: Group A responded to post-test questions only (n = 331); Group B filled out transition questions in addition to post-test (n = 304); and Group C filled out then-test questions in addition to post-test (n = 314).
Results Significant post-test differences were found in six of eight heiQ scales, with respondents who filled out then test questions reporting significantly higher post-test scores than respondents of the other groups.
Conclusions This study provides evidence that the inclusion of then-test questions alters post-test responses,
suggesting that change scores based on then-test data be interpreted with care.
Language eng
Field of Research 111717 Primary Health Care
Socio Economic Objective 920205 Health Education and Promotion
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2011, Springer Science+Business Media B.V.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30040977

Document type: Journal Article
Collection: School of Health and Social Development
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