"Don't Know" Responses to Risk Perception Measures: Implications for Underserved Populations
"Don't Know" Responses to Risk Perception Measures: Implications for Underserved Populations
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DOI：
10.1177/0272989x12464435
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发表时间：
2013-02-01
影响因子：
3.6
通讯作者：
Drake, Bettina F.
中科院分区：
文献类型：
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作者：
Waters, Erika A.;Hay, Jennifer L.;Drake, Bettina F.
背景：风险认知是行为干预的合法目标，因为它们可以激励医疗决策和健康行为。然而，一些调查受访者可能不知道(或可能不表明)他们的风险认知。“不知道”(DK)响应的范围未知。目的：研究DK反应对结直肠癌感知风险评估项目的患病率及其相关性。方法：两项具有全国代表性的、以人口为基础的横断面调查(2005年全国健康访谈调查[NHIS]；2005年健康信息全国趋势调查[HINTS])，以及一项由低收入社区个人组成的初级保健诊所调查。分析包括31,202名(NHIS)，1,937名(提示)和769名(临床)个体。测量：五个项目评估了结直肠癌的感知风险。其中四个项目在格式和/或反应量表上不同：相对风险(NHIS，提示)；绝对风险(提示，临床)；以及“可能性”和“机会”反应(临床)。只有基于临床的调查包括明确的DK反应选项。结果：“不知道”的回答分别为6.9%(NHIS)、7.5%(提示-比较)和8.7%(提示-绝对)。对于“机会”和“可能”的回答选项(诊所)，“不知道”的回答分别为49.1%和69.3%。DK回答的相关因素是通常与差异相关的特征(例如，低教育程度)，但结果的模式因样本、问题形式和回答量表而异。局限性：这些调查是独立开发的，采用了不同的方法和项目。因此，这些结果不能直接进行比较。对于DK反应的大小和特征的差异，可能有多种解释。结论：“不知道”的反应在受健康差距影响的人群中更为普遍。不评估或不分析DK反应可能会进一步剥夺这些人口的权利，并对寻求消除健康差距的研究的有效性和干预措施的效力产生负面影响。
Background: Risk perceptions are legitimate targets for behavioral interventions because they can motivate medical decisions and health behaviors. However, some survey respondents may not know (or may not indicate) their risk perceptions. The scope of "don't know" (DK) responding is unknown. Objective: Examine the prevalence and correlates of responding DK to items assessing perceived risk of colorectal cancer. Methods: Two nationally representative, population-based, cross-sectional surveys (2005 National Health Interview Survey [NHIS]; 2005 Health Information National Trends Survey [HINTS]), and one primary care clinic-based survey comprised of individuals from low-income communities. Analyses included 31,202 (NHIS), 1,937 (HINTS), and 769 (clinic) individuals. Measures: Five items assessed perceived risk of colorectal cancer. Four of the items differed in format and/or response scale: comparative risk (NHIS, HINTS); absolute risk (HINTS, clinic), and "likelihood" and "chance" response scales (clinic). Only the clinic-based survey included an explicit DK response option. Results: "Don't know" responding was 6.9% (NHIS), 7.5% (HINTS-comparative), and 8.7% (HINTS-absolute). "Don't know" responding was 49.1% and 69.3% for the "chance" and "likely" response options (clinic). Correlates of DK responding were characteristics generally associated with disparities (e. g., low education), but the pattern of results varied among samples, question formats, and response scales. Limitations: The surveys were developed independently and employed different methodologies and items. Consequently, the results were not directly comparable. There may be multiple explanations for differences in the magnitude and characteristics of DK responding. Conclusions: "Don't know" responding is more prevalent in populations affected by health disparities. Either not assessing or not analyzing DK responses could further disenfranchise these populations and negatively affect the validity of research and the efficacy of interventions seeking to eliminate health disparities.