Section 7. Behavioral Surveys

Learn how behavioral surveys do not try to determine what people think; rather, they focus on what people do - or what people say they do.

 

This section is based on an article in the Work Group Evaluation Handbook: Evaluating and Supporting Community Initiatives for Health and Development by Stephen B. Fawcett, Adrienne Paine-Andrews, Vincent T. Francisco, Jerry Schultz, Kimber P. Richter, R.K. Lewis, E.L. Williams, K.J. Harris, Jannette Berkley, Jacqueline L. Fisher, and Christine M. Lopez of the Work Group on Health Promotion and Community Development, University of Kansas, Lawrence, Kansas.

• What are behavioral surveys?

• Why would you need to use behavioral surveys?

• When should you use behavioral surveys?

• How do you conduct a behavioral survey?

What are behavioral surveys?

As you have probably already guessed after reading some of the other sections in this chapter, asking people questions can be immensely valuable for gaining insight and information into various questions, puzzles, and problems that may exist in your community.

Another type of survey, the behavioral survey, asks people to respond to questions about certain actions or behaviors that affect their physical, emotional, or mental well-being. These behaviors might include cigarette use, unprotected sexual activity, or habits that might increase the chance for cardiovascular diseases.

Unlike the constituent surveys of goals, process, and outcomes, behavioral surveys do not try to determine what people think; rather, they focus on what people do. But, one important distinction to make with behavioral surveys is this: these surveys will tell you what people say they do. Consequently, the surveys must be taken as self-reports. That is, your group should recognize that the results will be subjective accounts of individual actions. This doesn't diminish the value of behavioral surveys; rather, it simply must be taken into consideration when you analyze the data.

Why would you need to use behavioral surveys?

Behavioral surveys provide information that is crucial to the success of the initiative. Without knowing exactly what the extent of the problem is in your community, improving it would be quite a challenge! Behavioral surveys help clear up these questions by providing you with data that can help you move in the right direction towards improving your community.

Also, the data you receive from these surveys can be used to push the issue to the forefront of public awareness. Maybe individuals in your community don't know that a large percentage of the seventh-graders at the local junior high school smoke at least one cigarette each day. Seeing this kind of information on paper and supported by numbers may give it the validity that will convince more people of the need for change. The behavioral survey is an excellent way to obtain this kind of evidence.

Finally, behavioral surveys offer yet another way to evaluate the success of the initiative. Of course, it is important to keep in mind that behavioral surveys focus on self-reported behavior. That's to say, these surveys must be recognized as being potentially-biased reports of what is going on in people's lives. Because some people might exaggerate or minimize their behaviors, these surveys must be examined in this context. However, that in no way makes behavioral surveys less valuable. It just means the results should be interpreted carefully.

When conducted at regular intervals, behavioral surveys can reinforce the fact, for example, that your group's work has helped decrease the number of self-reported teenage smokers in your community. Seeing the proof in numbers can give you a feeling of satisfaction, and renew your determination to keep working with continued spirit and zest!

When should you use behavioral surveys?

We recommend that surveys be conducted at regular intervals. That might mean every three months, every six months, or once a year. That will depend upon the resources your group has. Regardless, the surveys should be distributed regularly so you can keep you finger on the pulse of the community. Read on for specific details on how to conduct the survey.

How do you conduct a behavioral survey?

Are you ready to go? Let's get to it! The behavioral survey requires four steps.

Obtaining behavioral data

The first step in this process involves defining your objectives. You already did this on a grander scale when you determined objectives for your initiative in general. Now you will want to repeat this process as you try to determine, "What do we want to discover by conducting a behavioral survey?" After you have determined what your goals are for the behavioral survey, then you can begin to write the questions.

Here are some questions that might help you determine these objectives.

• What do we hope to learn from this survey?
• Who do we want to survey?
• How will the information we will obtain help us achieve our goals and objectives for the group?

Next, put these questions to good use. To conduct a behavioral survey, you must first decide whether your group wants to write, design, and distribute the survey yourself. First, you will have to come up with questions related to your group's objectives. There are many ways to conduct behavioral surveys. One way is to use a measurement tool called the Likert scale. This scale uses questions that ask individuals to rate their activities. Below are some questions that might appear on a behavioral survey using the Likert scale.

Following are some examples of topics to consider and possible questions for several different areas of focus.

If you are focusing on substance use, you might ask questions about the use of cigarettes, smokeless tobacco, alcohol, marijuana, and cocaine.

For example, if you are focusing on substance use, you might ask questions about the use of:

• Cigarettes
• Smokeless tobacco
• Alcohol
• Marijuana
• Cocaine

A possible question would be:

How often have you used marijuana in the last 30 days?

• Never
• One to three times
• Once a week
• More than three times a week
• At least once a day

If you are focusing on adolescent pregnancy, you might ask about:

• Sexual activity
• Use of contraceptives

A possible question would be:

How often have you had sexual intercourse without using some method of birth control in the last 30 days?

• I used birth control every time I had sexual intercourse
• I sometimes used birth control
• I usually didn't use birth control
• I never used birth control
• I am not sexually active

If you are focusing on tobacco control, you might ask about:

• Use of cigarettes
• Quit attempts

A possible question would be:

How many cigarettes have you smoked during the past 30 days?

• None
• Less than one cigarette per day
• One to five cigarettes per day
• About one-half pack per day
• About one pack per day
• About one and one-half packs per day
• Two packs or more per day

If you are focusing on cardiovascular risk reduction, you might ask about consumption of:

• Higher fat foods
• Fruits and vegetables
• Breads and grains

A possible question would be:

Yesterday I ate:

___Three to five servings of fruits and vegetables
___One to three servings of fruits and vegetables
___No fruits and vegetables

With these examples in mind, now you can write a survey that will address the specific needs of your group and your community. But then what?

If your target population is the adolescents in your community, you would want to distribute the surveys to local elementary, junior high, and high schools. If you're going to be researching a potentially sensitive subject (for example, sexual activity or drug use), think about presenting a finished copy of the questions to the school before you begin working with the students. You may need to receive permission from the principal, teachers, and parents before you begin work. This way, you will have the help and support of community members as you conduct your survey.

If you simply want to gain an understanding of the behaviors of the general population, you might conduct a random phone survey to reach a sampling of the population.

Another great resource might be local school districts, health departments, or other community organizations. Maybe they have already conducted a behavioral survey of their own. If so, asking if you can use their data might help you feed two birds with one seed.

In order to obtain a more national perspective, you may want to contact the Centers for Disease Control and Prevention (CDC) in Atlanta to obtain information about adult health issues and a variety of youth issues such as substance use, adolescent pregnancy, and youth violence. For more information about the CDC, see Resources at the end of this section.

Tabulating the data

Now that you have an assortment of numbers in your hands, it's time to calculate the data. Evaluators or others in your group will want to determine the percentage of people who engage in risk behaviors in your community, perhaps compared to others. Then, this information can be used to benefit your group by helping you better understand the extent of an issue in your community.

Plotting the data and providing feedback

By plotting the data in a chart form, you will have a visual representation of the problem. Also, by plotting the data, you'll be able to see the trends of the problem over time. These trends might include changes in data across different age groups, and changes in data across time. For example, you might graph the regular use of substances (such as cigarettes, smokeless tobacco, alcohol, marijuana, and cocaine) by high school seniors in the community across different years. Finally, you'll want to provide feedback to your group and to the community.

Using the data

Now, what should you do with this data? You have several possibilities! First, you will probably want to distribute the data to members of the group and to leaders of the community. Then, these data can help serve other important purposes.

Some of the important options include:

• Using the data to assess risk. That is, the information you gather can help you determine where the greatest risk lies, and how you can continue to address that need in your community. If, after several years of working towards ending teen pregnancy, your behavioral surveys reveal an increase in unprotected sexual activity, you'd know to continue focusing your objectives on addressing this issue. More importantly, however, you could change your approach so that you can begin doing work that lowers the incidence of unprotected sexual activity.
• Raising public awareness about the issue. The results from these behavioral surveys can be yet another way to push important issues to the forefront of your community's agenda. Again, sometimes attaching a number to a problem helps people put it into a perspective that is easier to understand. If your research shows that the number of teenage smokers continues to rise in your community's junior high and high schools, this would be a terrific time to spread the word. Who knows? With everyone in the community working together towards ending a problem, greater progress might be made.
• Evaluating the effects of the initiative. In addition to all of the other benefits of behavioral analysis, you can also use the information you've obtained to evaluate the initiative. Like the other evaluation methods, behavioral surveys can help you recognize the weaker points in your action plan so you can try to strengthen and improve them.

As always, these evaluation methods should be seen as springboards for continued improvement. And, they will help you stay inspired to keep up the great work you've done and that you will continue to do!