Not back-translating questionnaire questions.
Explanation: Survey managers, especially expatriates or outside consultants, often do not speak the language understood by the survey respondents. They will pre- pare survey questions and data collection forms in their native language. This text then must be translated into the language of the survey workers and respondents. No single translation is perfect. Because the managers may not speak this langua- ge, they cannot judge the accuracy of the translation. To make such a judgement, the translated questionnaire then must be translated back to the language of the survey managers to determine the accuracy of the original translation. A different translator, who has never seen the original questions, should make this second translation. The two translators and the survey managers then should discuss any differences between the original version and the back-translation to decide how best to pose each question in the language of the survey respondents.
Solution: Always translate, then back-translate, the data collection form, especially those questions to be posed to survey respondents.
STOP
10. SELECT AND TRAIN SURVEY WORKERS
Make a list of all the tasks to be performed by survey teams when they go to the field to collect the survey data. This list may include:
1) interviewing household members; 2) measuring the weight and height
of children;
3) measuring the weight and height of women;
4) examining children and women for signs of micronutrient deficiency; and 5) performing a fingerstick and measuring
hemoglobin.
Next, decide what type of worker you will need to perform each of these tasks. When possible, hire someone with experience in taking anthropometric measurements to weigh and measure children. Survey wor- kers with clinical training may be needed to examine children and women. You may wish to hire a laboratory technician to per- form the fingersticks and operate the HemoCue and other serologic tests. One survey worker may be able to do more than one task. However, in some cultures, it may be unacceptable for men to weigh, measure and examine adult women; these workers may need to be female. Other cul- tural factors may also play a role in selec- ting survey workers.
Team members do not have to be health workers. In fact, health professionals such as physicians are sometimes more difficult to train because they have learned a diffe- rent method of measuring or examining during their medical education. Persons from many backgrounds can serve as sur- vey workers as long as they can endure the rigors of field work and are literate and able to count.
You will need at least three people per team, sometimes more. Each survey team
needs a supervisor who is responsible for the quality and completeness of data col- lection. The supervisor should check each completed data collection form at each household to be sure that all data have been collected and recorded correctly because it may be impossible to revisit households to correct errors after the team has left the cluster. The team also needs two individuals to perform anthropometric measurements and record the data on the data collection form. If testing for micro- nutrient deficiencies, the team may need an additional person who is trained in physical examination and the gathering of laboratory specimens. It may also be use- ful to have a respected community mem- ber on the team. This person can introdu- ce the survey team to the population and help guide the team around the site. The number of teams should be sufficient to complete data collection in the time allotted in the survey schedule. Having more teams than absolutely needed can be a disadvantage because more teams pro- duce larger inter-observer variation. In addition, it is often difficult to supervise and organize a larger number of teams. Survey team members should receive comprehensive training in the tasks they will perform as part of survey activities. All members performing a specific task should undergo the same training in that task, regardless of their former experience; this will ensure standardization of methods. The training for a survey usually takes 2 to 5 days and should include: 1) A clear explanation of the objectives
of the survey.
2) An explanation of the sampling method. This should stress the importance of proper household and child selection to ensure a representa- tive sample.
3) A demonstration and practice of
weight and height measurements. Each measurer should practice height and weight measurements and asses- sments of oedema twice on each of 10 children. Standardization of mea- surements among survey team mem- bers during training will help detect and correct errors in measurement technique before the actual data col- lection. Figure 3.5 shows one exam- ple of a spreadsheet with which to compare the measurements of the trainees.
4) An explanation and discussion of the questionnaire questions. This will ensure that the questions are phrased
correctly and that each interviewer understands what data the survey managers wish to collect with each question. Role play exercises are use- ful in practicing interviews.
5) A pilot test in the field. A pilot test is an essential component of the trai- ning and should test all the compo- nents of survey data collection under realistic conditions. Be sure that you visit a location that was not selected for the real survey but is similar to those sites actually selected. Data col- lected during the pilot test should not be used in the analysis of the survey results.
Figure 3.5 A spreadsheet for comparing height measurements among survey worker trainees
DESIGNING A SURVEY CHAPTER