Smartphone Versus Pen-and-Paper Data Collection of Infant Feeding Practices in Rural China

BACKGROUND: Maternal, Newborn, and Child Health (MNCH) household survey data are collected mainly with pen-and-paper. Smartphone data collection may have advantages over pen-and-paper, but little evidence exists on how they compare. OBJECTIVE: To compare smartphone data collection versus the use of pen-and-paper for infant feeding practices of the MNCH household survey. We compared the two data collection methods for differences in data quality (data recording, data entry, open-ended answers, and interrater reliability), time consumption, costs, interviewers’ perceptions, and problems encountered. METHODS: We recruited mothers of infants aged 0 to 23 months in four village clinics in Zhaozhou Township, Zhao County, Hebei Province, China. We randomly assigned mothers to a smartphone or a pen-and-paper questionnaire group. A pair of interviewers simultaneously questioned mothers on infant feeding practices, each using the same method (either smartphone or pen-and-paper). RESULTS: We enrolled 120 mothers, and all completed the study. Data recording errors were prevented in the smartphone questionnaire. In the 120 pen-and-paper questionnaires (60 mothers), we found 192 data recording errors in 55 questionnaires. There was no significant difference in recording variation between the groups for the questionnaire pairs (P = .32) or variables (P = .45). The smartphone questionnaires were automatically uploaded and no data entry errors occurred. We found that even after double data entry of the pen-and-paper questionnaires, 65.0% (78/120) of the questionnaires did not match and needed to be checked. The mean duration of an interview was 10.22 (SD 2.17) minutes for the smartphone method and 10.83 (SD 2.94) minutes for the pen-and-paper method, which was not significantly different between the methods (P = .19). The mean costs per questionnaire were higher for the smartphone questionnaire (¥143, equal to US $23 at the exchange rate on April 24, 2012) than for the pen-and-paper questionnaire (¥83, equal to US $13). The smartphone method was acceptable to interviewers, and after a pilot test we encountered only minor problems (eg, the system halted for a few seconds or it shut off), which did not result in data loss. CONCLUSIONS: This is the first study showing that smartphones can be successfully used for household data collection on infant feeding in rural China. Using smartphones for data collection, compared with pen-and-paper, eliminated data recording and entry errors, had similar interrater reliability, and took an equal amount of time per interview. While the costs for the smartphone method were higher than the pen-and-paper method in our small-scale survey, the costs for both methods would be similar for a large-scale survey. Smartphone data collection should be further evaluated for other surveys and on a larger scale to deliver maximum benefits in China and elsewhere.