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Investigating the proxy effect and the saliency principle in household based postal questionnaires
A Tennant1, E M Badley, M Sullivan
1ARC Epidemiology Research Unit, University of Manchester, United Kingdom.
Journal of Epidemiology and Community Health
|December 1, 1991
Summary
Household surveys using postal questionnaires can be biased by the "proxy effect," where one person inaccurately reports on others, especially for minor disabilities and joint issues. This bias is less apparent for severe, obvious conditions.
Area of Science:
- Epidemiology
- Survey Methodology
- Public Health
Background:
- Postal questionnaires are common for population screening.
- Household surveys may rely on proxy respondents.
- Potential biases include the proxy effect and saliency principle.
Purpose of the Study:
- Investigate the
- proxy effect
- and
- saliency principle
- in household postal surveys.
- Assess bias in reporting disability and joint troubles.
- Inform the design of population screening tools.
Main Methods:
- Two-stage survey in Calderdale, England.
- Phase 1: Postal questionnaire to 25,168 households.
- Phase 2: In-depth interviews with a sample of disabled respondents.
Main Results:
- Individuals living alone reported disability more often (29%) than those with others (10%).
- Proxy reporting bias affected overall disability and joint troubles, but not severe disability.
- An interaction was found: higher disability decreased reporting of joint troubles.
Conclusions:
- The
- proxy effect
- is significant in postal surveys of symptoms and minor disability.
- The
- saliency principle
- may apply to severe, long-standing conditions.
- Multitopic questionnaires require careful design due to reporting interactions.