TUTORIAL 10: CAUSATION

1. What are the strength and weaknesses of a longitudinal study? Describe how you would design such as survey if you were aiming to study changes in peoples use of health services over a 20-year period. Give the target group, survey design, and frequency of contact. You should give examples of a few of the questions you might ask. (Study guide Sample Questions)

Answer: Longitudinal studies track the same respondents continuously over a period of time. The following are the strength of a longitudinal study: Allow trends to be monitored. In this case, a longitudinal study allows the researcher to monitor if people visit health services more regularly over the period of study. It might also determine the extent people use health services for their preventive services over time. Allows behaviour to be tracked at an individual level rather than an aggregate level. When analyses are made at an individual level rather than at an aggregate level, rich information can be obtained. These include questions such as `of the people who do not visit doctors for preventive medicine 10 years ago, how many of them do now? There is no need for recall from the respondents.

The weaknesses of the longitudinal study are: Respondents over a period of time may decline to participant in the panel for various reasons e.g. death. When this happens, it would not be possible for analysis to be undertaken at an individual level. Respondents behaviour changes if they know they are being monitored. This effect may result in behaviour that do not represent the population they are supposed to represent.

Objective: The objective of the survey is to determine the changes in peoples use of health services over a 20 year period.

Dr Raymond Teo, 2011

Causation

Page 1 of 2

Survey design: The objective of the survey requires that a longitudinal study be undertaken. Using a panel survey method, the sample group of people who are recruited for the study will be re-interviewed every 5 years.

1st survey

2nd survey

3rd survey

4th survey

2005

2010

2015

2020

Contact Method: The personal interview method will be the method used for the study. This allows the respondents to clarify questions and also allow the researchers to probe using open-ended questions. Sampling Method: Given that some respondents will leave the panel, and also the level of precision required, it is proposed that a sample size of 1000 be used for the study. Given that this is a government sponsored study, it would be possible to do a random sample of the 1000 from a list obtainable from the department of census. Here are some questions that might be used: 1. 2. 3. How often do you and your family members visit the doctor each year? Do you perceive the standard of health care provided by government health services are as good as those of the private health services? Overall, are you satisfied with the level of services provided by the health services in your country?

Dr Raymond Teo, 2011

Causation

Page 2 of 2