Cognitive testing of the WG questions in Egypt ( Question on Hearing )

1. Cognitive testing of the WG questions in Egypt(Question on Hearing) By Fatma M. El-Ashry CAPMS-Egypt

2. Data collection • A sample of disabled persons in three governorates with different kinds of disabilities and in different socio economic status (age, sex, education, residence, income) was selected. 27 disabled persons were selected from the Social Rehabilitation Centers and 21 disabled persons were selected from normal families. Other persons without disability were selected randomly from the same areas of disabled persons.

3. Data collection •  The respondent (disabled or not) was asked cognitive testing questions about themselves and then, for the proxy sections, another member of the household answered the same questions about the first respondent.

4. The questionnaires • The questionnaire translated to Arabic. A manual of interviewer's instructions based on the Specifications for the Cognitive Test Protocol was prepared in Arabic and typed.  • The translated questionnaire was reviewed by a demographer person. The questions on health condition were checked by a person working in the field of health. • The completed questionnaires were edited for ensuring the completeness and following the instructions of skips. • The open questions were translated from Arabic to English and then entered to the Excel sheet.

5. Distribution of the selected sample by sex and place of residence

6. Kinds of disability

7. Disability prevalence

8. %Disability Prevalence For Core Hearing Question

9. %Disability Prevalence For Core & Extended Hearing Question Self person

10. %Disability Prevalence For Core & Extended Hearing Question -Proxy person

11. The results of the survey indicated that asking about having any difficulty of hearing in a crowed room lead to an increase in the disability prevalence by some cases, the most of these cases having only some difficulty in the core question. In contract, asking about having any difficulty of hearing in a quiet room lead to a decrease in the disability prevalence by some cases, the most of these cases having only some difficulty in the core question.

12. Response Pattern

13. Interviewer Coding: The difficulties to response are much higher for disable persons and for the less educated persons

14. Core question : The open-ended probe question (Why did you answer that way?) Persons answered by (No difficulty) mentioned reasons such as: • No problem in hearing • Good hearing • No complain of hearing • Hear very well / normal • Hear every thing Persons answered by (any difficulty) mentioned reasons such as: • because of suffering from some diseases. • because of a disease in the ears. • As a result of accident or betting on ears

15. Interpretation of response patterns of Hearing question and extended questions

16. Explanation for the problematic response patterns • Only two cases presented disagreement between the Core question and the extended questions. • The reason : although the person does not have hearing difficulty in core question , he fells some difficulty of hearing only in crowed rooms.

17. According to these results, the Core question of hearing can used as a general question to test hearing disabilities in population censuses and surveys.

18. Interviewer's Comments on hearing section

19. In general, when the core question of each section (vision, hearing,…) the respondent answered that just there is a difficulty and don't define the degree of that difficult. This required asking another question on the degree of difficulty. • The word "activities" has been understood either by interviewer himself or the proxy one as cultural or sports activities not as ordinary day activities. So, it is recommended to be exchanged by (the ordinary or normal day activities

20. The question of (How often do you have difficulty …..), the word how often in all difficult cases is not understandable especially in case of continuous& permanent difficulties that is not frequent. • All the questions about (some difficulty, a lot of difficulties, some effort, and a lot of effort) required to be explained to declare the degree of difficulty and effort .

21. All the questions include (no answer, don't know), it recommended to add a category of other (specify) to be able to code this questions in case of different answer. For example the question of “How often do you miss words in conversation or on the radio or television because you have difficulty hearing?”. Someone said “I raise the voice of TV”.

22. -Question (10) (How often do you miss words in conversation…) : It is recommended to add other categories like : sometimes/ according to the circumstances. • If the respondent is deaf and can't hear absolutely, there is no need for asking some questions such as : 2, 3, 4, 9 and (10) or add not applicable code in such questions

23. Thank You