eprintid: 26185 rev_number: 14 eprint_status: archive userid: 1589 dir: disk0/00/02/61/85 datestamp: 2019-05-22 14:03:29 lastmod: 2024-04-07 13:44:57 status_changed: 2019-05-22 14:03:29 type: article metadata_visibility: show creators_name: Harling, Guy creators_name: Chanda, Michael M. creators_name: Ortblad, Katrina F. creators_name: Mwale, Magdalene creators_name: Chongo, Steven creators_name: Kanchele, Catherine creators_name: Kamungoma, Nyambe creators_name: Barresi, Leah G. creators_name: Bärnighausen, Till creators_name: Oldenburg, Catherine E. title: The influence of interviewers on survey responses among female sex workers in Zambia subjects: ddc-610 divisions: i-912800 keywords: Gender, Interviewer, Validity, Zambia, Female sex workers, Gender-based violence abstract: Background: Interviewers can substantially affect self-reported data. This may be due to random variation in interviewers’ ability to put respondents at ease or in how they frame questions. It may also be due to systematic differences such as social distance between interviewer and respondent (e.g., by age, gender, ethnicity) or different perceptions of what interviewers consider socially desirable responses. Exploration of such variation is limited, especially in stigmatized populations. Methods: We analyzed data from a randomized controlled trial of HIV self-testing amongst 965 female sex workers (FSWs) in Zambian towns. In the trial, 16 interviewers were randomly assigned to respondents. We used hierarchical regression models to examine how interviewers may both affect responses on more and less sensitive topics, and confound associations between key risk factors and HIV self-test use. Results: Model variance (ICC) at the interviewer level was over 15% for most topics. ICC was lower for socio-demographic and cognitively simple questions, and highest for sexual behaviour, substance use, violence and psychosocial wellbeing questions. Respondents reported significantly lower socioeconomic status and more sex-work related violence to female interviewers. Not accounting for interviewer identity in regressions predicting HIV self-test behaviour led to coefficients moving from non-significant to significant. Conclusions We found substantial interviewer-level effects for prevalence and associational outcomes among Zambian FSWs, particularly for sensitive questions. Our findings highlight the importance of careful training and response monitoring to minimize inter-interviewer variation, of considering social distance when selecting interviewers and of evaluating whether interviewers are driving key findings in self-reported data. Trial registration: clinicaltrials.gov; NCT02827240. Registered 11 July 2016. date: 2019 publisher: BioMed Central ; Springer id_scheme: DOI ppn_swb: 1666355445 own_urn: urn:nbn:de:bsz:16-heidok-261850 language: eng bibsort: HARLINGGUYTHEINFLUEN2019 full_text_status: public publication: BMC Medical Research Methodology volume: 19 number: 60 place_of_pub: London ; Berlin, Heidelberg pagerange: 1-12 issn: 1471-2288 citation: Harling, Guy ; Chanda, Michael M. ; Ortblad, Katrina F. ; Mwale, Magdalene ; Chongo, Steven ; Kanchele, Catherine ; Kamungoma, Nyambe ; Barresi, Leah G. ; Bärnighausen, Till ; Oldenburg, Catherine E. (2019) The influence of interviewers on survey responses among female sex workers in Zambia. BMC Medical Research Methodology, 19 (60). pp. 1-12. ISSN 1471-2288 document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26185/1/12874_2019_Article_703.pdf