National School of Public Health, Carlos III Health Institute, Madrid, Spain.
The Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Front Public Health. 2023 Apr 14;11:971239. doi: 10.3389/fpubh.2023.971239. eCollection 2023.
Question-order changes in repeated surveys can distort comparisons. We want to describe the evolution of drug risk perceptions among Spanish adolescents and assessing whether the 2006 peaks in perceived risk of occasional drug use can be explained by question-order changes.
The subjects were secondary students from a biennial national survey during 2000-2012. A one-off intervention was applied in 2006, replacing the two-adjacent items on perceived risk of occasional and regular use of each drug by non-adjacent items. Annual prevalence of high-risk perception were obtained for occasional and regular use of cannabis, heroin, cocaine and ecstasy. Subsequently, the 2006 percent level change (PC) in such were estimated prevalence using segmented Poisson regression, adjusting for various student and parent covariates.
The 2006 PC in prevalence of high-risk perception of occasional drug use ranged from +63% (heroin) to +83% (ecstasy). These PCs were very high in all considered subgroups. However, the 2006 PC in prevalence of high-risk perception of regular drug use ranged from 1% (heroin) to 12% (cannabis). The evolution of preventive interventions does not suggest alternative causal hypotheses for 2006 peaks other than question-order changes.
Within the cognitive heuristics framework, the 2006 spikes in perceived risk of occasional drug use were most likely due to a release of the anchor exerted by perceived risk of regular drug use over that of occasional use triggered by 2006 question-order changes. In repeated surveys it is inexcusable to pre-test the effect of any change in questionnaire format.
在重复调查中改变问题的顺序会扭曲比较。我们想描述西班牙青少年对药物风险认知的演变，并评估 2006 年偶尔使用药物的风险感知峰值是否可以用问题顺序的变化来解释。
研究对象为 2000-2012 年期间两年一次的全国性调查中的中学生。2006 年进行了一次性干预，用不相邻的项目替换了偶尔和经常使用每种药物的感知风险的两个相邻项目。获得了大麻、海洛因、可卡因和摇头丸偶尔和经常使用的高风险感知的年度流行率。随后，使用分段泊松回归估计了这些高风险感知的 2006 年百分比变化（PC），并调整了各种学生和家长协变量。
偶尔使用药物的高风险感知的 2006 年 PC 从 63%（海洛因）到 83%（摇头丸）不等。在所有考虑的亚组中，这些 PC 都非常高。然而，经常使用药物的高风险感知的 2006 年 PC 从 1%（海洛因）到 12%（大麻）不等。预防干预措施的演变并不能为 2006 年的峰值提供除问题顺序变化之外的替代因果假设。
在认知启发式框架内，偶尔使用药物的风险感知 2006 年的峰值很可能是由于 2006 年问题顺序变化引发的经常使用药物的风险感知对偶尔使用药物的风险感知的锚定作用的释放所致。在重复调查中，预先测试问卷格式任何变化的效果都是不可原谅的。
