成年人防晒趋势中的方法学偏倚。

Methodologic artifacts in adult sun-protection trends.

机构信息

Hunterdon County Department of Health, Flemington, New Jersey, USA.

出版信息

Am J Prev Med. 2011 Jan;40(1):72-5. doi: 10.1016/j.amepre.2010.09.020.

DOI:10.1016/j.amepre.2010.09.020

PMID:21146771

Abstract

BACKGROUND

Skin cancer is the most common of all cancers and a public health concern of increasing magnitude in the U.S.

PURPOSE

A mid-year review of Healthy People 2010 found that the percentage of adults engaging in sun-safe practices increased from 59% in 2000 to 71% in 2005. This paper examines whether this increase in sun-safe practices in adults is an artifact caused by the change from 2000 to 2005 in the operational definition of "sun-safe practices" in the National Health Interview Survey (NHIS).

METHODS

This study analyzed the 2000 and 2005 NHIS data sets in 2009 to examine changes in sun-safe practice prevalence estimates and to estimate the relative odds of practicing sun-safe behaviors associated with gender, age, race/ethnicity, education, and geographic region.

RESULTS

Contrary to the Healthy People 2010 mid-year review, it was found that engaging in sun-safe practices by adults decreased from 59% (2000) to 55% (2005). A question order effect and use of images for use of sun-safe hats likely caused an artificial change in "cover-up" behavior estimates from 31% (2000) to 18% (2005) and wide-brim hat usage from 27% (2000) to 12% (2005). When eliminating data from these two questions added in 2005, the relative odds of practicing sun-safe behaviors was significantly lower for men in both 2000 and 2005 but were not different for other demographic characteristics.

CONCLUSIONS

The current analyses suggest that the increase in sun-safe behaviors in adults and a notable decrease in "hat use" may be due to methodologic artifacts. When operational definitions change, caution should be used in interpreting estimates over time.

摘要

背景

皮肤癌是所有癌症中最常见的一种，也是美国日益严重的公共卫生问题。

目的

《2010 年健康人》年中审查发现，参与防晒措施的成年人比例从 2000 年的 59%上升到 2005 年的 71%。本文研究了成年人防晒措施的增加是否是由于《国家健康访谈调查》（NHIS）中防晒措施的操作定义从 2000 年到 2005 年的改变而导致的一种假象。

方法

本研究于 2009 年分析了 2000 年和 2005 年 NHIS 数据集，以检查防晒措施流行率估计值的变化，并估计与性别、年龄、种族/族裔、教育和地理区域相关的防晒行为的相对几率。

结果

与《2010 年健康人》年中审查相反，发现成年人参与防晒措施的比例从 59%（2000 年）下降到 55%（2005 年）。问题顺序效应和使用图像来表示戴防晒帽的行为可能导致“遮盖”行为的估计值从 2000 年的 31%（2000 年）变为 2005 年的 18%（2005 年），宽边帽的使用率从 2000 年的 27%（2000 年）变为 2005 年的 12%（2005 年）。当从 2005 年新增的两个问题中删除数据时，男性在 2000 年和 2005 年的防晒行为的相对几率显著降低，但其他人口统计学特征则没有差异。