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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="1.3" xml:lang="en" article-type="research-article"><?properties manuscript?><processing-meta base-tagset="archiving" mathml-version="3.0" table-model="xhtml" tagset-family="jats"><restricted-by>pmc</restricted-by></processing-meta><front><journal-meta><journal-id journal-id-type="nlm-journal-id">101630229</journal-id><journal-id journal-id-type="pubmed-jr-id">43201</journal-id><journal-id journal-id-type="nlm-ta">Surv Pract</journal-id><journal-id journal-id-type="iso-abbrev">Surv Pract</journal-id><journal-title-group><journal-title>Survey practice</journal-title></journal-title-group><issn pub-type="epub">2168-0094</issn></journal-meta><article-meta><article-id pub-id-type="pmid">40224398</article-id><article-id pub-id-type="pmc">11987661</article-id><article-id pub-id-type="doi">10.29115/SP-2024-0035</article-id><article-id pub-id-type="manuscript">HHSPA2066872</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Survey Practice in Non-Survey-Literate Populations: Lessons
Learned from a Cognitive Interview Study in Brazil</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Massey</surname><given-names>Meredith</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Collaborating Center for Questionnaire Design and
Evaluation Research, National Center for Health Statistics</aff><author-notes><corresp id="CR1"><bold><italic toggle="yes">Lead author contact information</italic></bold>:
Meredith Massey <email>mmassey2@cdc.gov</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>31</day><month>3</month><year>2025</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2025</year></pub-date><pub-date pub-type="epub"><day>02</day><month>3</month><year>2025</year></pub-date><pub-date pub-type="pmc-release"><day>11</day><month>4</month><year>2025</year></pub-date><volume>19</volume><issue>SI</issue><elocation-id>10.29115/SP-2024-0035</elocation-id><abstract id="ABS1"><p id="P1">Survey research relies on cooperation and coordination between
researchers and respondents. Survey-literate respondents possess a level of
understanding of the survey process that facilitates their participation.
Non-survey-literate respondents, on the other hand, are less equipped to provide
accurate responses, which can lead to increased survey error. In this article,
we present findings from a cognitive interview project conducted in Brazil to
illustrate potential barriers to respondent participation and demonstrate how
these barriers contribute to response error. To test questions on inclusive
education, researchers from the Collaborating Center for Questionnaire Design
and Evaluation Research at the National Center for Health Statistics facilitated
the collection of data through 80 cognitive interviews conducted in various
neighborhoods in Rio de Janeiro, Brazil. Recruitment targeted caregivers of
children with and without disabilities, and respondents were predominantly
female with low literacy levels. The results indicated that respondents with
limited familiarity with the survey process (non-survey-literate) struggled to
orient themselves to the survey task. They faced challenges in choosing response
options, understanding scale relationships, and interpreting vocabulary.
Additionally, many respondents expressed a need to share salient details of
their lives, which the survey was not designed to capture. Understanding these
barriers to participation and identifying ways to mitigate them can help reduce
survey error, particularly in vulnerable populations.</p></abstract><kwd-group><kwd>cross-cultural survey</kwd><kwd>survey methods</kwd><kwd>cognitive interviewing</kwd></kwd-group></article-meta></front><body><sec id="S1"><title>Introduction</title><p id="P2">Surveys are a fundamental tool in social science research, enabling the
collection of data on a range of topics, from health to political opinions. The
quality of survey data hinges on respondents&#x02019; clear understanding of the
questions and their ability to engage meaningfully in the survey process (<xref rid="R15" ref-type="bibr">Lenzner 2012</xref>). As structured social
interactions, interviewer-administered surveys are governed by norms and
expectations that shape how both respondents and interviewers contribute toward the
survey&#x02019;s objectives (<xref rid="R4" ref-type="bibr">Bradburn 2016</xref>;
<xref rid="R9" ref-type="bibr">Groves 1990</xref>; <xref rid="R12" ref-type="bibr">Hines 1993</xref>). Successful survey outcomes therefore rely on
respondents&#x02019; ability to participate and their awareness of their role within
this social exchange (<xref rid="R3" ref-type="bibr">Biemer and Lyberg 2003</xref>;
<xref rid="R4" ref-type="bibr">Bradburn 2016</xref>; <xref rid="R24" ref-type="bibr">Tourangeau, Rips, and Rasinski 2000</xref>).</p><sec id="S2"><title>Survey literacy</title><p id="P3">Researchers such as Gerber and Harkness have noted that
respondents&#x02019; familiarity with the expectations of the survey process is
crucial for successful data collection (Gerber and Wellens 1995; <xref rid="R10" ref-type="bibr">J. Harkness 1999</xref>; <xref rid="R13" ref-type="bibr">Houtkoop-Steenstra 2000</xref>; <xref rid="R14" ref-type="bibr">Hudler and
Richter 2001</xref>). The term <italic toggle="yes">survey literacy</italic> is sometimes
used to describe respondents&#x02019; understanding of these expectations and
their familiarity with the dynamics of survey participation (<xref rid="R10" ref-type="bibr">J. Harkness 1999</xref>; <xref rid="R14" ref-type="bibr">Hudler and Richter 2001</xref>; <xref rid="R28" ref-type="bibr">Willis and
Miller 2011</xref>). Survey-literate respondents typically approach the
survey with an understanding of what is expected from the interaction. They
recognize that their primary task is to respond to questions by selecting
response options that most closely align with their experience (<xref rid="R9" ref-type="bibr">Groves 1990</xref>). While they understand that capturing
their experience is important, they are also aware that their responses will be
aggregated, contributing to a broader research objective. Additionally, they
possess enough background knowledge and familiarity with basic concepts to
effectively map their experiences onto the broader concepts explored in the
survey (<xref rid="R10" ref-type="bibr">J. Harkness 1999</xref>; <xref rid="R13" ref-type="bibr">Houtkoop-Steenstra 2000</xref>).</p><p id="P4">Although &#x0201c;survey literacy&#x0201d; is not always explicitly named
in academic literature, studies have documented its impact on survey error,
manifesting as inaccurate, incomplete or missing data (<xref rid="R3" ref-type="bibr">Biemer and Lyberg 2003</xref>; <xref rid="R18" ref-type="bibr">Miller 2003</xref>; <xref rid="R22" ref-type="bibr">Pan,
Craig, and Scollon 2005</xref>; <xref rid="R21" ref-type="bibr">Pan
2008</xref>; Pan and <xref rid="R5" ref-type="bibr">Chan, 2011</xref>). For
example, <xref rid="R18" ref-type="bibr">Miller (2003)</xref> describes
challenges faced by respondents from rural Mississippi who, with limited
exposure to surveys, struggled with the survey interaction. While Miller does
not label this phenomenon as &#x0201c;survey illiteracy,&#x0201d; her findings
illustrate how unfamiliarity with survey practices can compromise the
respondent&#x02019;s ability to effectively engage in the survey task. Other
researchers, such as <xref rid="R5" ref-type="bibr">Chan and Pan (2011)</xref>,
directly refer to this concept, emphasizing the importance of survey literacy in
fostering respondent engagement and improving measurement accuracy. These
studies illustrate how a lack of survey literacy often manifests in low-income,
low-education settings, with difficulties further amplified in cross-cultural
contexts. Nevertheless, research into the practical effects of survey illiteracy
remains sparce.</p></sec><sec id="S3"><title>Overview of Cognitive interviewing and cross-cultural contexts</title><p id="P5">Cognitive interviewing is a qualitative method used to examine how
respondents interpret and respond to survey questions, providing insights into
the question-response process that help refine items and offer context for data
users (<xref rid="R27" ref-type="bibr">Willis 2015</xref>). This approach is
particularly valuable in cross-cultural research, where language, norms, and
experiences may lead to varied interpretations of questions (<xref rid="R20" ref-type="bibr">Miller et al. 2011</xref>; <xref rid="R23" ref-type="bibr">Tourangeau 1984</xref>; <xref rid="R27" ref-type="bibr">Willis
2015</xref>). For example, cognitive interviews reveal how cultural norms shape
understanding of survey concepts. (<xref rid="R11" ref-type="bibr">J. A.
Harkness et al. 2010</xref>; <xref rid="R16" ref-type="bibr">Massey
2018</xref>; <xref rid="R20" ref-type="bibr">Miller et al. 2011</xref>).
While conventional cognitive interview methods focus primarily on identifying
and quantifying problems and error typologies with questions, an interpretive
approach to cognitive interviewing, grounded in social theory, provides critical
insights into how respondents&#x02019; response processes are linked to their
social location and lived experiences (<xref rid="R7" ref-type="bibr">Gerber and
Wellens 1997</xref>; <xref rid="R18" ref-type="bibr">Miller 2003</xref>).
This interpretive approach not only ensures that questions are understood across
sub-groups but also aligns them with the lived realities of respondents, thereby
enhancing the reliability and validity of the data collected (<xref rid="R19" ref-type="bibr">Miller et al. 2014</xref>).</p><p id="P6">Drawing on findings from an interpretive cognitive interview study, this
article focuses on how survey illiteracy contributes to response error and item
nonresponse, underscoring the need to account for this issue in survey design
and implementation. Findings from this study, conducted with caregivers in
low-income favelas in Rio de Janeiro, Brazil, highlight the particular
challenges encountered by this survey-illiterate population and demonstrate how
these challenges lead to response error&#x02014;inaccurate, incomplete, and
missing data.</p></sec></sec><sec id="S4"><title>Method</title><sec id="S5"><title>Project background</title><p id="P7">Data for this study were drawn from 80 cognitive interviews conducted in
three low-income favelas in Rio de Janeiro, Brazil, in August 2023. These
interviews represented the final phase of a larger question evaluation study
conducted by the National Center for Health Statistics&#x02019; Collaborating
Center for Questionnaire Design and Evaluation Research (CCQDER)<sup><xref rid="FN1" ref-type="fn">1</xref></sup> to support the development of a
survey on Inclusive Education<sup><xref rid="FN2" ref-type="fn">2</xref></sup>
for UNICEF. This survey, intended as a companion to a previously developed
module on child functioning (<xref rid="R25" ref-type="bibr">UNICEF,
n.d.-a</xref>), was designed to measure factors related to school
participation among children with and without disabilities (<xref rid="R26" ref-type="bibr">UNICEF, n.d.-b</xref>). As tested, the module consisted of
four sections covering school type, school environment, out-of-school children,
attendance determinants, and attitudes to inclusive education. The instrument
had previously undergone extensive testing and revision in various countries
including the United States, India, Jamaica, and Cambodia. This final round of
testing focused principally on questions related to out-of-school children, and
Brazil was selected as the testing location due to its relatively high
population of children not attending school. While individual question
performance is beyond this article&#x02019;s scope, a forthcoming report will
detail findings and revisions (<xref rid="R17" ref-type="bibr">Massey,
forthcoming</xref>).</p></sec><sec id="S6"><title>Sample</title><p id="P8">A purposive sample of 80 caregivers of children, both with and without
disabilities, was recruited by partner organizations within each community
through outreach and word of mouth. The majority of respondents were mothers,
though some were grandmothers, aunts, or other caretakers. Most respondents had
very low education levels and resided in extremely low-income communities
characterized by high levels of police and gang-related violence. <xref rid="T1" ref-type="table">Table 1</xref> details the demographic characteristics of
the sample. Additionally, due to pervasive violence and poverty, government
officials and researchers have extremely limited access to favela communities,
and as a result, the respondents in this study were largely unfamiliar with the
norms of survey research.</p></sec><sec id="S7"><title>Data collection and analysis</title><p id="P9">The study employed interpretive cognitive interview methods entailing
hour long semi-structured interviews with respondents. The interviews were
conducted in Portuguese by a team of social scientists from the Brazilian
Institute of Geography and Statistics, who were trained by researchers from
CCQDER. The interviews were observed by CCQDER researchers employing a real-time
translation from Portuguese to English. During the interviews, respondents were
first asked all of the survey items, followed by semi-structured probing where
they were invited to explain their answers and how they interpreted the
questions within their lived context. The semi-structured format allowed the
interviewer to explore how the questions related to the respondents&#x02019;
lives while also focusing on identifying potential sources of measurement error
within the instrument. Respondents were remunerated R$100 (Brazilian Reais) for
their time.</p><p id="P10">The analysis of interviews involved a systematic process of data
reduction and theory building, using a grounded theory approach (<xref rid="R8" ref-type="bibr">Glaser and Strauss 1967</xref>; <xref rid="R19" ref-type="bibr">Miller et al. 2014</xref>). Initially, detailed interview
notes, based on audio recordings of the interviews, were generated by
summarizing each interview. These summary notes detailed how each respondent
answered every survey question, documenting their interpretations of questions
and key terms, the activities and experiences they considered, as well as any
response difficulties or errors encountered. These notes were translated into
English for further analysis by CCQDER researchers. In the next phase,
comparisons across all interviews identified interpretive patterns, including
common types of response errors. Findings from this second level of analysis
depict the phenomena captured by each question and enables the assessment of
construct validity.</p></sec></sec><sec id="S8"><title>Results</title><sec id="S9"><title>The Survey Task</title><p id="P11">Despite being briefed on the research goals and process during
recruitment and again upon arrival for participation, many remained uncertain
about what was expected of them. One respondent expressed her unfamiliarity with
the survey process by explaining, &#x0201c;I never participated in something like
that. [The interviewer] asked questions that we would never imagine. I would
never imagine someone asking me a question like that.&#x0201d;</p><p id="P12">Some respondents misunderstood the purpose of the interaction, believing
that the researchers were there to offer assistance, which distracted them from
fully engaging with the survey. For example, notes from one interview describe a
respondent who was not focused on the survey, saying, &#x0201c;[This respondent]
was just released from prison. She asked us all the time for a job and could not
think about the questions. The conversation was relatively
shallow/superficial.&#x0201d; Similarly, due to the nature of the questions,
other respondents hoped the research team could help them secure better school
placements for their children.</p><p id="P13">Even those respondents who remained focused on the survey questions
often exhibited hesitation and insecurity in providing their answers. Though
most questions on the survey focused on basic information from their own lives,
many respondents were concerned about providing the &#x0201c;right&#x0201d;
answer. Notes from one interview state, &#x0201c;The interviewee states that she
felt very nervous when answering, even though it was explained that there was no
right or wrong answer&#x02026; She still remained nervous and gave her last
answers without thinking about the question.&#x0201d;</p><p id="P14">This hesitation became even more evident when respondents encountered
the final set of opinion-based questions which asked about attitudes toward
inclusive education. In one interview, a respondent hesitated to answer any of
the opinion questions. This respondent expressed embarrassment over her lack of
knowledge, admitting, &#x0201c;I&#x02019;m too bad for these things.&#x0201d; The
notes from this interview continue, &#x0201c;She was nervous, worried if she was
answering right because she had never participated in an interview.&#x0201d; Such
apprehension indicates that respondents&#x02019; anxiety extended beyond concerns
about factual accuracy, affecting their perceived ability to contribute
meaningfully to the survey interaction even on subjective, opinion-based
topics.</p></sec><sec id="S10"><title>Terms and Concepts</title><p id="P15">Respondents often lacked knowledge of basic terminology and concepts
relevant to the survey domain. For example, respondents had difficulty with
terms such as <italic toggle="yes">social skills, academic skills, teaching methods,</italic>
or <italic toggle="yes">special school</italic>. When asked about her understanding of the
term &#x0201c;academic skills,&#x0201d; one respondent seemed very unsure and
said, &#x0201c;Having more resources? Is that it?&#x0201d; Further discussion with
the respondent indicated that she was unfamiliar with the overall idea of
academic skills not just the term.</p><p id="P16">Indeed, extensive probing by the interviewers revealed that
respondents&#x02019; difficulties with these terms stemmed more from a lack of
understanding of the underlying concepts than from the vocabulary itself. Since
all respondents had children&#x02014;some with disabilities, some
without&#x02014;who had participated in some way in the local education system,
it was expected that they would have the basic background knowledge necessary to
engage with the survey. However, many were unable to translate their experiences
of their child&#x02019;s education into related concepts that they could think
about or articulate. Because these concepts were fundamental to understanding
the questions, respondents often struggled to answer accurately or, in some
cases, to answer at all.</p><p id="P17">This difficulty engaging with the survey&#x02019;s system of knowledge
was further exemplified when one respondent was presented with a question asking
her to indicate how strongly she agreed with the statement, &#x0201c;Having
children with disabilities in regular school requires extensive adaptation of
the school.&#x0201d; Notes from this interview state, &#x0201c;She didn&#x02019;t
understand; she asked to have the question repeated. Even after the repetition,
she didn&#x02019;t understand. I tried to rephrase the question with simpler
terms and examples, but she still didn&#x02019;t understand. She responded by
saying, &#x02018;I think a special school is better&#x02026; a room with 40
children, two handicapped, how will you have patience?&#x02019; I asked again,
trying to rephrase again, but she still didn&#x02019;t understand the
question.&#x0201d; In this case, the interviewer repeatedly tried using different
words to help the respondent understand the question, but the
respondent&#x02019;s lack of conceptual understanding of the foundational
constructs of the question prevented her from offering a meaningful response,
even with the interviewer&#x02019;s assistance.</p></sec><sec id="S11"><title>Response Options</title><p id="P18">Respondents often had difficulty choosing from the available response
options, especially when those options did not perfectly align with their
expectations or experiences. In one notable example, a respondent was asked to
answer the question, &#x0201c;What type of classroom does [name] currently
attend?&#x0201d; by selecting from the options: &#x0201c;a. regular classroom, b.
special classroom for children with disabilities, or c. both regular and special
classroom.&#x0201d; The following exchange illustrates her struggle:</p><speech><speaker>Respondent</speaker><p id="P19">He goes to the resource room alone.</p></speech><speech><speaker>Interviewer</speaker><p id="P20">Can you choose regular classroom or special classroom?</p></speech><speech><speaker>Respondent</speaker><p id="P21">It&#x02019;s called the resource room.</p></speech><speech><speaker>Interviewer</speaker><p id="P22">Is it a regular classroom or a special classroom?</p></speech><speech><speaker>Respondent</speaker><p id="P23">Special. It only has special children.</p></speech><p id="P24">Although the respondent stated that she understood that her
child&#x02019;s classroom was a special classroom and not a regular classroom,
she was reluctant to choose that response option because it did not exactly
match the name of her child&#x02019;s classroom. With the interviewer&#x02019;s
help, the respondent was eventually able to choose from the given options, but
without this guidance, she struggled to relate her experience to the provided
categories, even though a suitable choice was available and even though she
recognized that her child&#x02019;s classroom fit within those categories.</p><p id="P25">Response scales are a particular type of response option that
survey-literate respondents understand as being ordered and mutually exclusive.
The attitudes section of the instrument asked respondents to state their level
of agreement with opinion statements using the options &#x0201c;a. strongly
agree, b. agree, c. disagree, d. strongly disagree.&#x0201d; This scale was
chosen because previous testing with &#x0201c;yes/no&#x0201d; response options
indicated a preference for a non-binary choice that allowed for more subtle
degrees of agreement. However, the respondents in the current study struggled to
respond using the scale.</p><p id="P26">One respondent struggled to grasp the relationships among the response
options. Notes from her interview read, &#x0201c;She didn&#x02019;t seem to quite
understand the scale, always asking to repeat. She showed a lot of confusion.
First, she chose the option [strongly agree]. Then she wanted to add [disagree].
I told her it could not be both. At the end, she declared, &#x02018;I
don&#x02019;t know.&#x02019;&#x0201c; Ultimately, the respondent could not provide
a response because she found the format of the question and the response scale
confusing.</p><p id="P27">Other respondents had difficulty distinguishing between
&#x0201c;agree/disagree&#x0201d; and &#x0201c;strongly agree/strongly
disagree.&#x0201d; One respondent saw the options as binary, saying, &#x0201c;If I
say agree, it can&#x02019;t be more agree. Either I agree or disagree.&#x0201d;
The notes from another interview state, &#x0201c;The respondent sees no
difference between &#x02018;agree&#x02019; and &#x02018;strongly agree&#x02019;. To
her, it has the same meaning.&#x0201d; These examples indicate that the response
scale posed significant challenges for some respondents.</p></sec><sec id="S12"><title>Expressing Salience</title><p id="P28">Respondents also expressed a strong desire to share the details of their
lives. Given the unusual opportunity to reflect on and answer questions about
their life experiences, they were eager to share their full stories rather than
just the specific information requested by the survey. This eagerness often made
it challenging to efficiently proceed through the survey. The following notes
from one interview summarize this difficulty:</p><disp-quote id="Q1"><p id="P29">The interview was quite time-consuming because the mother did not
directly answer the questions and ended up narrating her life story. Most of
the questions I had to filter through the whole story and direct her to the
answer. She talked a lot about herself and not about the boy. She rambled on
about the answers. It was very difficult to get to the point.</p></disp-quote><p id="P30">This tendency to share more than was asked reflects a deeper need for
respondents to have their broader experiences acknowledged, which can complicate
data collection. At times, this desire led respondents to choose more expansive
response options rather than more specific ones. For example, when answering the
question, &#x0201c;Why does [name] need help to get to school?&#x0201d; one
respondent did not choose the response option &#x0201c;d. it&#x02019;s not safe
for [him/her] to go alone.&#x0201d; Instead, she chose &#x0201c;e. for some other
reason&#x0201d; so that she could explain the details of why it was not safe for
her child to travel to school. She said, &#x0201c;The path is not safe. Sometimes
there are police operations against drug trafficking and it&#x02019;s not
possible to leave the house. Shootings.&#x0201d; For respondents living in an
atmosphere of pervasive danger and violence, sharing these details was not just
about answering the survey; it was an opportunity to voice the gravity of their
daily realities, taking every opportunity to talk about the dangers they
faced.</p></sec><sec id="S13"><title>Impact on Response Error</title><p id="P31">These manifestations of a lack of survey literacy, had substantial
impacts on response error, leading to satisficing, nonresponse, inaccurate
responses, and drop-off due to respondent fatigue. For example, the notes from
one interview describe a respondent&#x02019;s satisficing, &#x0201c;The
interviewee had difficulty thinking about the survey questions. (For example,
sometimes when asked if she had doubts about a question, she simply repeated the
answer she had given in the question, instead of saying whether she had
understood it or not.) Often, during the survey questions, the interviewee was
embarrassed that she might not understand, so she gave a simple
answer.&#x0201d;</p><p id="P32">Another respondent repeatedly refused to answer questions. The notes
from this interview read, &#x0201c;She could not respond. When I asked her why,
the respondent repeated again &#x02018;I don&#x02019;t know&#x02019; and could not
explain. It was clear she did not understand and didn&#x02019;t want to say
this.&#x0201d; Response error was frequently observed when respondents
misunderstood the questions. One interviewer explained, &#x0201c;She answered,
but I realized that she believed she understood the statements even when she
answered the opposite of what she thought.&#x0201d;</p><p id="P33">The stress of engaging in a new and unfamiliar activity also caused
respondents to quickly become tired. This respondent fatigue led to drop-off
when respondents stopped answering questions, forcing the survey to be ended
prematurely. The notes from one interview describe what happened when the
respondent gave up, &#x0201c;At that moment, the interviewee was already quite
mentally tired and was only answering &#x02018;agree,&#x02019; not being possible
to work the survey. She only shook her head until we stopped.&#x0201d;</p><p id="P34">These effects were less noticeable in fact-based questions centered on
respondents&#x02019; personal lives and more evident in abstract, opinion-based
questions. Nonetheless, response errors were observed throughout the survey and
across the entire sample.</p></sec></sec><sec id="S14"><title>Conclusion</title><p id="P35">An interpretive approach to cognitive interviewing, with an emphasis on the
sociocultural factors that influence question response, provides valuable insights
into the challenges of Brazilian respondents from underserved and marginalized
communities, particularly in how they understand and engage with the survey process.
Findings from this study are congruent with previous studies that find that
nonsurvey literate respondents have difficulty understanding the survey task,
comprehending fundamental concepts within the survey&#x02019;s sphere of knowledge,
choosing among available response options, intuiting scale relationships and
limiting personal commentary (<xref rid="R1" ref-type="bibr">Agans, Deeb-Sossa, and
Kalsbeek 2006</xref>; <xref rid="R2" ref-type="bibr">Bernal, Wooley, and
Schensul 1997</xref>; <xref rid="R6" ref-type="bibr">Flaskerud 1988</xref>;
<xref rid="R18" ref-type="bibr">Miller 2003</xref>; <xref rid="R22" ref-type="bibr">Pan, Craig, and Scollon 2005</xref>; <xref rid="R5" ref-type="bibr">Chan and Pan 2011</xref>). Further, this study explicitly ties
these difficulties to specific types of response error.</p><p id="P36">While survey-literate groups may also encounter any of the difficulties
described to a greater or lesser degree, these challenges are compounded among
survey-illiterate populations, creating substantial barriers to meaningful survey
participation. The current findings suggest practical measures to make participating
in surveys accessible to a broader range of respondents by addressing the specific
obstacles and limitations they face. First, testing questions in the target context
is essential to ensure that respondents can engage fully and provide accurate
responses. Other recommended measures include: 1) maximizing opportunities to orient
respondents to the survey task prior to administration, ideally using community
members, 2) interviewer training on this population&#x02019;s special needs, 3)
avoiding abstract or unfamiliar terminology, 4) ensuring response options are
relevant and remain as consistent as possible throughout the instrument, and 5)
focusing questions on respondents&#x02019; direct experiences.</p><p id="P37">In summary, this research provides further evidence that fully understanding
the relationship between sociocultural factors and the response process is crucial
for conducting effective survey research. Respondents&#x02019; social and cultural
backgrounds profoundly shape how they interpret and respond to survey questions and
the survey task, directly influencing data quality and the overall effectiveness of
the research. The complexities of survey interaction revealed in this study
underscore the importance of inclusive survey design for marginalized
populations.</p></sec></body><back><fn-group><fn id="FN1"><label>1</label><p id="P38">In collaboration with UNICEF and the Washington Group on Disability
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<bold>Age of
respondent</bold>
</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">18&#x02013;28</td><td align="left" valign="middle" rowspan="1" colspan="1">7</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">29&#x02013;39</td><td align="left" valign="middle" rowspan="1" colspan="1">36</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">40&#x02013;50</td><td align="left" valign="middle" rowspan="1" colspan="1">23</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">51&#x02013;61</td><td align="left" valign="middle" rowspan="1" colspan="1">12</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">62&#x02013;72</td><td align="left" valign="middle" rowspan="1" colspan="1">2</td></tr><tr><td colspan="3" align="left" valign="middle" rowspan="1">
<bold>Relationship to
child</bold>
</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Mother</td><td align="left" valign="middle" rowspan="1" colspan="1">67</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Grandmother</td><td align="left" valign="middle" rowspan="1" colspan="1">9</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Aunt</td><td align="left" valign="middle" rowspan="1" colspan="1">2</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Sister</td><td align="left" valign="middle" rowspan="1" colspan="1">1</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Brother</td><td align="left" valign="middle" rowspan="1" colspan="1">1</td></tr><tr><td colspan="3" align="left" valign="middle" rowspan="1">
<bold>Residential
Status</bold>
<xref rid="TFN1" ref-type="table-fn">*</xref>
</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Low-income community</td><td align="left" valign="middle" rowspan="1" colspan="1">70</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Non-low-income community</td><td align="left" valign="middle" rowspan="1" colspan="1">10</td></tr><tr><td colspan="3" align="left" valign="middle" rowspan="1">
<bold>Age of child</bold>
</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">&#x0003c;5</td><td align="left" valign="middle" rowspan="1" colspan="1">10</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">5&#x02013;10</td><td align="left" valign="middle" rowspan="1" colspan="1">24</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">11&#x02013;14</td><td align="left" valign="middle" rowspan="1" colspan="1">28</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">15&#x02013;18</td><td align="left" valign="middle" rowspan="1" colspan="1">17</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">&#x0003e;18</td><td align="left" valign="middle" rowspan="1" colspan="1">1</td></tr><tr><td colspan="3" align="left" valign="middle" rowspan="1">
<bold>Gender of
child</bold>
</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Female</td><td align="left" valign="middle" rowspan="1" colspan="1">26</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Male</td><td align="left" valign="middle" rowspan="1" colspan="1">54</td></tr><tr><td colspan="3" align="left" valign="middle" rowspan="1">
<bold>Disability status of
child</bold>
</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Disabled</td><td align="left" valign="middle" rowspan="1" colspan="1">54</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"/><td align="left" valign="middle" rowspan="1" colspan="1">Notdisabled</td><td align="left" valign="middle" rowspan="1" colspan="1">26</td></tr></tbody></table><table-wrap-foot><fn id="TFN1"><label>*</label><p id="P41">Address-based residential status determined through recruitment by
partner organizations</p></fn></table-wrap-foot></table-wrap></floats-group></article>