Quality, rigour and usefulness of free-text comments collected by a large population based longitudinal study - ALSWH.

While it is common practice for health surveys to include an open-ended question asking for additional comments, the responses to these questions are often not analysed or used by researchers as data. The current project employed an automated semantic program to assess the useability and thematic content of the responses to an open-ended free response item included in the Australian Longitudinal Study on Women's Health (ALSWH) surveys. The study examined the comments of three cohorts of women, born between 1973-78, 1946-51, and 1921-26, from Survey 1 (in 1996) and Survey 5 (in 2007-2009). Findings revealed important differences in the health status of responders compared to non-responders. Across all three cohorts, and at both time points, women who commented tended to have poorer physical health (except for women aged 82-87) and social functioning, experienced more life events, were less likely to be partnered, and (except for women aged 18-23 years) more likely to have higher levels of education, than women who did not comment. Results for mental health were mixed. The analysis revealed differences between cohorts as well as changes over time. The most common themes to emerge for the 1973-78 cohort were health, time, pregnant and work, for the 1946-51 cohort, the most common themes were health, life, time and work, while for the 1921-26 cohort, the most common themes were husband, health and family. The concepts and frequency of concepts changed from the first to the fifth survey. For women in the 1973-78 cohort, pregnant emerged as a prevalent theme, while eating disappeared. Among women in the 1946-51 cohort, cancer, operation and medication emerged as prevalent themes, while for women in the 1921-26 cohort, the concept children disappeared, while family emerged. This analysis suggests that free-text comments are a valuable data source, suitable for content, thematic and narrative analysis, particularly when collected over time.