Pilot study discussion and conclusion

The questionnaire was developed for use in high-school students in Riyadh, Saudi Arabia. This survey assessed several health risk behaviours, knowledge and attitudes. The response rate was very high, 99% on the first phase of the pilot study, and 96% in the second phase. It was observed that the students required no more than forty five minutes to complete the questionnaires. In general, the findings of this study suggest that the questionnaire items were appropriate to use among high school students in Riyadh. Similarly, it has been documented that self-reported health behaviour survey is widely used among adolescents and has adequate reliability

Sexual behaviour First Phase N (%)

Second Phase

N (%) P-Value Have had sexual experiences 34 (47) 34 (48)

0.87 No sexual experiences 38 (53) 36 (52)

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(Nancy et al., 1995). It was clear after the first and second study that explaining confidentiality, data entry process, using an anonymous questionnaire, encourage students to participate (by demonstrating the aims and objectives of the study) were useful approach to enhance students’ reliability and their motivation to participate.

The pilot study has achieved its objectives through establishing that the questionnaire can be effectively used in the field survey and for the main study. The format and content of the questionnaire were clearly acceptable to the population sampled. The high degree of compliance recorded. The pilot study in both two phases showed high level of response rate; however, it may have been biased by small sample size. It also demonstrated the feasibility of achieving the predefined sample size for the main study (N=1496, See Main Study Methodology in Chapter 4), and provided preliminary indications of knowledge, attitude, beliefs and practices concerning health behaviours. It also proved that the study can be conducted within the defined time. The results of this study indicate that, at least among adolescent high school students in Riyadh, the questions had acceptable test-retest reliability among year high school students. From the pre-pilot study, I found that the interviewed students were not aware of their heights and weights. So, self-reported height and weight may give invalid data among Saudi students. Therefore, students’ heights and weights were decided be measured in order to calculate their body mass index (BMI).

This instrument contributes to the current national and international literature. This study could prove useful in program development and evaluation because it is based on a holistic approach to youth programming. Specifically, the tool examines individual factors such as knowledge, and environmental factors such as peer norms, family, and schools’ role regarding health risk behaviours. All of these factors reciprocally affect the health of youth and thus serve as important intervention points.

The strengths of the study included the very high participation rate the detailed history of dietary behaviours, smoking behaviours, physical behaviours and sexual behaviours. This is, to my knowledge, the first study of test-retest study verifying health risk behaviours self-administered questionnaire among Saudi adolescents. Language and cultural factors that could affect the validity of the data could be addressed. Special care was given to translating and back-translating the questionnaire to ensure that the meaning of the questions was accurately portrayed in the local

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vernacular. The relatively high student response rates confirm the applicability of the health risk behaviours models in the Saudi context. For regional consistency, the students completed the questionnaire in their classrooms under the supervision of the survey investigator. To ensure students’ privacy and to allow for anonymous participation, teachers or any authoritative figures were not present during the survey. Ministry and school permissions for the pilot study were gained prior to the survey.

Some limitations of this study are in need of discussion. First, the reliance upon self-completion of the questionnaire has the potential for bias as adolescents may not recall their behaviour accurately. All information collected in this study is self- reported and although multiple procedures were used to ensure confidentiality, it is possible that the bias of providing socially desirable answers is present. These instruments need to be tested in other age groups and among females to ensure that the findings are not specific to Saudi male high school students. It could be tested and modified appropriately to fit the needs of other populations as well.

I concluded that the questionnaire could be safely used for the main study. Since the validity and reliability of this study has been accomplished (Table 3.5), because of using several techniques. These techniques were:

- The questions in the questionnaire, was based on international standardized questionnaire, which has been used in different countries around the world. - The questionnaire was translated first from English to Arabic, and then

translated back to English. - Interviewing twelve students

- The Questionnaire was revised and improved based on the opinions of twelve high school students and three experienced researchers.

- The questionnaire was as clear and simple as it could be.

- Discussion took a place with students regarding the questionnaire items, and the students were asked to give their comments

- Test re-test pilot study participants responses rate was high.

- Test re-retest chi-square test showed no significant differences in participant responses.

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Table 3-5. Pilot study check list

Task Comments

Acceptability of the questions 12 students have been interviewed and they all agreed that the questionnaire items are clear, appropriate to be addressed and easy to be answered. The students give some comments regarding the language and layout then the questionnaire was modified before the pilot.

Clarity of the language used Clarity of the layout

Questionnaire and question format

Visibility of sample size needed From the pilot study the response rate was very high. Questionnaire items It was stated by many students that the questionnaire is

quite long, but easy to read, understand and to complete. Validity: whether the questionnaire

answer the research questions

The questionnaire items were based on valid and reliable international questionnaires. Experienced researchers advices were obtained and considered. The Qs. was translated from English to Arabic and back to English. The Qs was pre-tested by interviewing 12 students then by pilot study.

Reliability (consistency) Test-retest study was applied and no significant differences were found in participants responses.

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