An Online Questionnaire: improving timeliness of outbreak investigations

Amy E. Parry1,2, K.Byron-Gray1, D.Johnson1, J.Raupach1, M. McPherson2

1. Communicable Disease Control Branch, SA Health, Australia2. National Centre for Epidemiology and Population Health, Australian National University, Australia

December 2010

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Outbreak Background

Date 23rd – 26th April 2010 (3 day camp)

CDCB first informed 28th April 2010 (2 days later)

Camp attendees 89

Reported ill 46

Symptoms Diarrhoea

Abdominal pain

Nausea

Participants under 30 75%

Data Collection Method Options

Option 1: Paper-based

Traditionally used

Manually print, pack, label, post

Relies on postage (both ways)

Manual entry of data

Data Collection Method Options

Option 2: Online

Never previously been

used in South Australia

for an outbreak investigation

Why an online survey?

Young cohort

Available email addresses

66% of South Australians had access to internet at home*

*2009 Australian Bureau of Statistics

Non-Responder Follow-up

After 1 week: • reminder email (n= 36)

At 2 weeks: • reminder phone call (n=14)

Online vs Paper-Based

A recent paper based cohort study selected (n=328)• Cohort study• Multi-day camp situation

Timeliness and response rate of online compared with paper-based

Timeliness: 24 Hours

Online Questionnaire

35%(9% in first hour)

(n= 31 of 89)

Paper Based Method

0%(n= 0 of 328)

Timeliness: Day 5

Online Questionnaire

65%(n=58 of 89)

Paper Based Method

16%(n= 52 of 328)

Timeliness: Day 10

Online Questionnaire

78%(n= 69 of 89)

Paper Based Method

50%(n= 164 of 328)

Overall Response Rate

Online Questionnaire

83%(n=74 of 89)

Paper Based Method

75%(n=246 of 328)

Timeliness: Participant Survey CompletionOnline Questionnaire

14

days

(analysis at day 3)

Paper Based Method

2

months

Online Questionnaire Response Times(n=74)

0

5

10

15

20

25

30

35

Time (days)

Num

ber

of r

espo

nses

Email Reminder

PhoneReminder

Day1: 42%

(n=31)

Day 7: 92%

(n=68)

Day 3: initial

analysis

Data Entry

Online Questionnaire

Minimal data entry

necessary

2 of 74manually entered

Data Cleaning

Paper Based Method

Manuallyentered

Importance of Timeliness?

Higher quality information collected

Rapid public health action

Limitations

Shared email accounts

Survey completeness for children

24 hour clock issues

Third party data storage

Comparison outbreak much larger

Conclusion

Easy tool to use

Cost efficient

Time efficient

Resource efficient

However, offsite data storage needs to be addressed

Acknowledgements

The outbreak investigation team

Field Supervisor: Dr Jane Raupach

ANU Supervisor: Michelle McPherson

SA Health

Australian Department of Health and

Ageing for funding the MAE program

2009 and 2010 Australian MAE cohorts

Confidentiality: Zoomerang

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