Conducting Think-Aloud Interviews Online: Development of a Recall Questionnaire in the PECUNIA Project

he PECUNIA project, on which this case study is based, is a pan-European consortium that aims to develop tools for improving the ways in which we measure and assess costs in economic studies of health and social care interventions (e.g. a new treatment for back pain, or a new way of delivering hospital care). This case study describes our experiences of conducting think-aloud interviews online to test the first draft of a new questionnaire that asks respondents about their use of items such as hospital care or the justice system. The questionnaire was developed to be used across Europe, and it was therefore important to test that it was understood by respondents in a variety of international contexts.

Think-aloud interviews (or cognitive interviews) are a means of gaining qualitative information about how a respondent is understanding the questionnaire. Respondents are asked to complete the questionnaire while verbalizing their thought processes, or “thinking aloud.” The interviewer takes no part in the interview, other than prompting the respondent to continue talking if they stop verbalizing their thoughts. Common themes can then be derived from the interview transcripts that allow the researcher to understand how to refine and improve the questionnaire.

Originally, we anticipated carrying out the interviews face-to-face but, as a result of the COVID-19 pandemic, we were compelled to adapt our planned approach. We carried out think-aloud studies in four different European countries, with three different languages. This case study details our experiences in moving to an online environment.