Floyd J. Fowler, Jr.

The problem of survey error was at the center of Fowler’s research work starting with his graduate work at Michigan. He continued to focus on that throughout his career. One example is his work on interviewer-related error. A major study of the role of interviewer training and supervision in error reduction led to a 1989 book, with Tom Mangione, Standardized Survey Interviewing.[11] Another major study with Charles Cannell explored the potential of coding the interaction between interviewers and respondents in pretest interviews as a way of evaluating survey questions. This technique was labeled behavior coding.[12] That work was also a major contributor to his next book on the role of question design in survey error, Improving Survey Questions in 1995.[13] The value of randomized experiments to evaluate alternative versions of questions was also the focus of several of Fowler’s studies. Among his most important contributions are two text books on survey methods. He is the author of Survey Research Methods, currently in its 5th edition since original publication in 1984[14] and a co-author, with Robert Groves, Mick Couper, James Lepkowski, Eleanor Singer and Roger Tourangeau of Survey Methodology.[15]

Fowler's research has also focused on health studies. In graduate school at Michigan, he was a co-author on several reports about the sources of error in the Health Interview Survey. However, one of his most seminal health-related projects in the early 1970s involved working with John Wennberg. Wennberg had observed wide variations in the rates at which medical services were delivered in adjacent communities in Northern New England. Wennberg thought the differences were driven by differences in physician decision making, but critics thought all the differences had to be due to differences in the people living in the communities. Fowler and Wennberg did a survey study of residents of 6 communities that differed widely in the rates at which they received health care. The study showed that the patient characteristics could not account for the differences in care: the populations were all virtually the same with respect to health status, access to care and how well their medical needs were being met. Hence, the only conclusion was that health care providers were practicing medicine very differently from one community to another.[16]

Next came a series of studies applying survey methods to the measurement of the effect of medical treatments on patients. The most influential of these was a study of patients in Maine who were surgically treated for Benign Prostatic Hyperplasia (BPH), which causes problems with urination as men age. Fowler and his colleagues applied survey methods in new ways to assess the extent to which men benefitted from surgical treatment.[17] While they found many patients had their symptoms improved, their most important finding was that men differed greatly in the extent to which the same level of symptoms bothered them and how they felt about the side effects of surgery. How they felt about their symptoms was a key factor in how much 'good' they got from surgery. This work lay the foundation for their work on the importance of informing and involving patients in treatment decisions so that they could play a meaningful role in deciding what was best for them as individuals. Among the most enduring and widely used products of the work on BPH was the development of the American Urological Association Symptom Index.[18]

Fowler also applied the measurement approaches used in the study of BPH to the treatment of other medical conditions including benign uterine conditions, AIDS and prostate cancer.[19][20] Among these studies a particularly important result was the finding from a national survey of Medicare patients who had had surgery for prostate cancer with complications, which include urinary incontinence and sexual dysfunction, were occurring at much higher rates than had previously been thought.[21]

Out of the work on patient preferences and treatment outcomes came a concern about how medical decisions are made. In his work with the Foundation for Informed Medical Decision Making, Fowler initiated three national surveys to take a look at how medical decisions were actually being made by representative samples of patients. The first such survey was conducted by researchers at the University of Michigan;[22] the second was done in collaboration with researchers at Dartmouth Medical School; and the third by researchers at the Foundation for Informed Medical Decision Making. The surveys, taken together, showed the gaps in how well patients understood issues relevant to decisions about their treatments and how little they were involved in making many of those decisions.[23][24]

In the late 1960s, the Urban Observatory Program undertook a survey project to collect comparable data about citizen’s views of their city services and functioning of the governments in ten major American cities. Fowler was the leader of the survey effort for that project and wrote a book describing the results.[25]

In the late 1970s, there was an experimental effort in the City of Hartford to see if changing the physical environment of an urban neighborhood could help reduce crime and fear. Fowler led the evaluation of that project. The results showed that physical design and community cohesion could reduce crime and fear.[26]

• Cannell, C. F., Fowler, Jr., F.J., & Marquis, K. (1968). The Influence of Interviewer and Respondent Psychological and Behavioral Variables on the Reporting in Household Interviews, Washington: U.S. Department of Health, Education and Welfare, Public Health Service
• Fowler Jr, FJ (1974) Citizen Attitudes Toward Local Government, Services and Taxes, Cambridge, MA: Ballinger Press
• Fowler, Jr., F.J., Mangione, T. W., & Pratter, F. E. (1978). Gambling Law Enforcement in Major American Cities, Washington: Department of Justice
• Fowler, Jr., F.J., McCalla, M. E., & Mangione, T. W. (1979). Reducing Crime and Fear, Washington: U.S. Department of Justice
• Fowler, Jr., F.J., and Mangione, T. W. (1982). Neighborhood Crime, Fear and Social Control: A second look at the Hartford Program, Washington: Department of Justice, 1982.
• Fowler, Jr., F.J.,(Ed.) (1989). Conference Proceedings: Health Survey Research Methods, Washington: National Center for Health Services Research.
• Fowler, Jr., F.J., and Mangione, T. W. (1990). Standardized Survey Interviewing, Newbury Park: Sage Publications.
• Fowler, Jr.,F.J., (1995). Improving Survey Questions, Thousand Oaks, CA: Sage Publications, ISBN 0-8039-4582-5.
• Groves, R.M., Fowler, Jr., F.J., Couper, M. P., Lepkowski, J. M., Singer, E., & Tourangeau, R. (2009). Survey Methodology (2nd Edition), New York: Wiley.
• Fowler, Jr.,F.J., (2014). Survey Research Methods (5th Edition). Thousand Oaks, CA:Sage Publications.