Description of the Questionnaire

5.2.1 Development of the questionnaire instrument

The design of the questionnaire instrument is a most important aspect of the research, as it is necessary for achieving the aims of the study. Three important aspects have been

Chapter 5

considered in order to develop an appropriate questionnaire instrument for data collection, which are:

i. The type of information that needs to be collected from the respondents;

ii. The appropriate respondents from whom to extract that required information;

iii. The useful and appropriate questions and approaches to extract that information (Goodman, 1997; Patten, 2016).

Therefore, the questionnaire was developed from a pool of survey instruments that were generated based on the findings of the Second Phase (i.e., the Developed Version of the JoinSTNassistant Framework). Its questions were aimed at identifying the perspective of the respondents, regarding the important, influential strategic-level barriers, determined in the Second Phase, with respect to their decision to join the STN.

Furthermore, the questionnaire was designed to be distributed to and responded by the decision makers of HCFs across the KSA who have knowledge and experience about telemedicine and its implementation.

Therefore, the questionnaire, as shown in Appendix C, contained six main parts, as follows:

i. The first part provided a brief about the aims and objectives of this research, making clear the intention to measure the respondents’

perspective of the questions presented, and ensuring complete confidentiality. Furthermore, the Questionnaire’s code number (201504-0003), which is generated by the MOH, as well as the names of the researchers, their affiliations, and their contact information were also provided in this part.

ii. The second part included abbreviations’ meanings and a glossary for all unfamiliar terms within the questionnaire.

iii. The third part asked the respondents about their role (i.e., position /job title) within the HCFs. This data was required to allow us to determine whether the respondents belong to the strategic level (i.e., working at the top echelons of HCFs) and can influence or participate in the decision-making process of his/her HCF regarding the decision of

Chapter 5

joining the STN). Therefore, returned questionnaires from any respondents who did not belong to the strategic level were excluded in this study. Furthermore, the respondents were asked if they had ever heard of telemedicine before, or if they had ever participated in any telemedicine project. When their answers were No, their returned questionnaires were also excluded.

iv. The fourth part was designed to collect data about each respondent’s HCF (its sector, type, and location). This data was required to allow us to categorise and sort the returned questionnaires, based on the 22-diverse categories of HCFs within the KSA, in order to identify the perspective of each of them and understand differences and similarities between the 22-diverse categories of HCFs regarding their perspectives.

v. The fifth part was designed to measure and assess the opinions and perspectives of the respondents about the important, influential strategic-level barriers with respect to their decision to join the STN, as determined in the Second Phase (i.e., the Developed Version of the JoinSTNassistant Framework). In this part, the participants were asked to answer the questions by indicating their opinions regarding the influence of each statement on a seven point Likert scale. This was done by ticking the appropriate box, where -3 = strongly no influence;

-2= no influence; -1= somewhat no influence; 0= uncertain; 1= some influence; 2= influence; 3= strong influence. Each question in this part is linked to one of the important, influential strategic-level barriers with respect to their decision to join the STN (i.e., the findings of the Second Phase).

vi. Finally, in the sixth part, the respondents were given the opportunity to make any comments or suggestions.

5.2.2 The pre-test of the questionnaire instrument

The questionnaire was drafted using the focus group technique, utilising the authors’

personal and professional experiences. Then, the questionnaire was reviewed by a number of academics and by the Researches and Studies General Department of the MOH. Consequently, modifications were made to form the final approved

Chapter 5

questionnaire, which was further reviewed by the Researches and Studies General Department of the MOH. Afterward, a pilot study was conducted, where the initial draft of the questionnaire was distributed to and responded by 68 chosen at random decision makers of HCFs across the KSA. The pilot study was aimed at ensuring the understanding and applicability of each question. Notes from pilot respondents were taken and questions were accordingly amended. The pilot study has been tested in order to improve the content, accuracy, validity, and reliability of the adopted questions. The pilot test was conducted by identifying the values of factor loadings, Cronbach alpha, and Average Variance Extracted (AVE). The results of the pilot tests were fairly satisfactory, as manifested by good Cronbach's alpha values (all above 0.80 (George & Mallery, 2010)), acceptable factor loadings values (all above 0.66 (Nunnally, 1978)), and acceptable AVE values (all above 0.5 (Fornell & Larcker, 1981)) (More details about the results of the pilot tests of the questionnare are shown in Appendix D) . The overall analysis suggested that the questionnaire instrument was of adequate reliability and construct validity.

5.2.3 The ethical statement

This questionnaire was reviewed and approved by the Faculty Research Ethics Committee at Staffordshire University and by the Regional Research Ethics Committee at MOH (as shown in Appendices A and B), and it follows their code of practice. For instance, all respondents were informed about the purpose of the study and they gave their consent for participation. Respondents were:

i. Asked not to participate in this questionnaire if they are vulnerable to coercion or undue influence;

ii. Assured that all answers will be treated in confidence and that their names are not required;

iii. Assured that they could withdraw from the survey at any time without any consequences;

iv. Informed that their participation in this project is voluntary and that there are no direct personal benefits for participating in this research;

v. Assured that there are no risks associated with participation.

Chapter 5

5.2.4 Settings and administration of the questionnaire

During the period from April 2015 to September 2015, the questionnaire was available in two different types of media: paper-based and web-based, as well as in Arabic and English languages. The invitations to participate in the questionnaire were sent by the authors, by the STN agency, and by the National eHealth Strategy and Change Management Office in the MOH, through emails, to all the decision makers of HCFs across the KSA. Social media (e.g., Tweeter, Facebook, etc.) and Instant Messages (IM) applications (e.g., WhatsApp) were also used to distribute the questionnaire. The questionnaire has the logo of Staffordshire University and the MOH, who share responsibility for the study, to make clear that this study is certified and credible by the MOH.