Comparison of web-based versus paper-and-pencil self-administered questionnaire: effects on health indicators in Dutch adolescents.

Because of the many advantages, computerized questionnaires are used more often in youth surveys, replacing the more traditional paper-and-pencil (pp Bowling 2005), it is important to determine whether responses to computerized questionnaires are comparable to those obtained by paper-and-pencil method. So far, findings from previous studies among school-aged children and adolescents are inconclusive. Several studies did not find major differences between computerized and paper-and-pencil questionnaires (Truman et al. 2003; Hays and McCallum 2005; Mangunkusumo et al. 2005, 2006; McCabe et al. 2005), whereas other studies showed that adolescents disclose more sensitive information in computerized questionnaires than in paper-and-pencil conditions (Paperny et al. 1990; Turner et al. 1998; Wright, Aquilino, and Supple 1998; Wang et al. 2005) or found (gender-related) differences for some topics (Beebe et al. 1998; Webb et al. 1999; Hallfors et al. 2000; Vereecken and Maes 2006). Of these studies, a few were web-based (Mangunkusumo et al. 2005, 2006; McCabe et al. 2005; Wang et al. 2005). Several factors may be responsible for the differences found in these studies. It is known that the validity of self-reports may be affected by cognitive as well as situational factors. Factors considered especially influential include the presence of others while responding to questions and the respondents’ perceptions of privacy or confidentiality (Brener, Billy, and Grady 2003; Bowling 2005). A perceived lack of privacy or confidentiality could cause response bias because of a fear of reprisal. In particular, behavior that is illegal, stigmatized, or laden with moral implications may be underreported because of this concern (Brener et al. 2003). As the setting of computerized administration of questionnaires at schools is likely to be different from the administration of paper-and-pencil questionnaires, it is important to investigate respondents’ perceived level of privacy and confidentiality as a possible source of response bias. However, little is known about adolescents’ perceived level of privacy and confidentiality in surveys. Because of this and the inconsistent pattern that appears from the literature, the following issues were examined in the present study: (a) (gender-related) differences in perceived level of privacy and confidentiality between web-based and paper-and-pencil questionnaires and (b) (gender-related) differences in the report of indicators of (mental) health and behavior between web-based and paper-and-pencil questionnaires when taking into account pupils’ perceived level of privacy and confidentiality.