Refusal to answer specific questions in a survey: a case study

It is well known that non ignorable item non response may occur when the cause of the non response is the value of the latent variable of interest. In these cases, a refusal by a respondent to answer specific questions in a survey should be treated sometimes as a non ignorable item non response. The Rasch-Rasch model (RRM) is a new two-dimensional item response theory model for addressing non ignorable non response. This article demonstrates the use of the RRM on data from an Italian survey focused on assessment of healthcare workers’ knowledge about sudden infant death syndrome (that is, a context in which non response is presumed to be more likely among individuals with a low level of competence). We compare the performance of the RRM with other models within the Rasch model family that assume the unidimensionality of the latent trait. We conclude that this assumption should be considered unreliable for the data at hand, whereas the RRM provides a better fit of the data.