Background: Novel survey instrument development requires reliability testing, but limited information informs the preferred approach in Qatar. The testing of survey characteristics of the Multi-Cultural Assessment Inventory-Qatar (MAI-Q), a novel multicultural assessment tool in Arabic, English, Hindi and Urdu, provided the opportunity to investigate survey distribution procedures. Objective: To determine willingness to participate, and response rates during survey reliability testing by mail and in person. Methodology: To examine participation preferences and rates, patients were recruited through HMC and six primary health centers. When recruited, subjects could choose to take the MAI-Q a second time for the reliability testing in person or by mail. Subjects were either scheduled for follow-up in-person, or were sent the survey in a prepaid, preaddressed envelope. Results: Among 387 subjects who initially took the survey, 177 (46%) declined taking the survey a second time for reliability testing. Of 210 subjects who agreed to take the survey a second time for reliability testing, 145/210 (69%) chose mail, and 65/210 (31%) were offered and chose in person follow-up. Actual follow-up to complete reliability testing was only 29/145 (21%) by post but 40/65 (63%) in person. Conclusion: These findings reveal challenges researchers face when developing and distributing surveys in Qatar. Nearly half of subjects initially recruited were not willing to participate in follow-up testing. Among those agreeing to follow-up testing, the majority chose mail, but only a fifth of them returned instruments. The majority of subjects who chose in person follow up completed testing. These data inform researchers about the tough choices for developing and conducting surveys in Qatar.


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