Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, Injury Center, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Violence Prevention, Injury Center, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2024 Dec;67(6):941-950. doi: 10.1016/j.amepre.2024.08.001. Epub 2024 Aug 8.
Data on adverse childhood experiences are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect adverse childhood experiences data may be affected by item nonresponse. This study examines differences in nonresponse to the optional Behavioral Risk Factor Surveillance System adverse childhood experiences module overall, by sociodemographic characteristics, by year, and by question.
This study used Behavioral Risk Factor Surveillance System adverse childhood experiences module data from 21 states in 2019 and 16 states in 2021. Weighted proportions and 95% CIs of responders and nonresponders to the adverse childhood experiences module by year and sociodemographic characteristics and percentages of nonresponders for each question were calculated. Chi-square tests were used to assess statistically significant (p<0.05) differences. Analyses were conducted in 2023.
In 2019 and 2021, 1.2% (95% CI=1.1, 1.4) and 2.4% (95% CI=2.2, 2.5) of Behavioral Risk Factor Surveillance System participants were nonresponders to the adverse childhood experiences module, respectively (p<0.01). Nonresponders were more likely to be non-Hispanic Black (p=0.01) or non-Hispanic Asian (p=0.01), to be unemployed (p<0.01), to have income <$15,000 (p<0.01), or to report poor health (p<0.01) than responders. Nonresponse by question increased as the module progressed, and nonresponse was highest for sexual abuse questions.
Overall, findings demonstrate that individuals are willing to respond to the adverse childhood experiences module questions. Although low, nonresponse to the module increased from 2019 to 2021. Higher nonresponse for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher nonresponse among racial/ethnic minorities and economically disadvantages groups highlights opportunities to improve existing surveillance systems.
有关不良童年经历的数据对于了解其负担以及为预防计划和策略提供信息至关重要。收集不良童年经历数据的基于人群的调查可能会受到项目无应答的影响。本研究通过社会人口统计学特征、年份和问题，检查了整个行为风险因素监测系统不良童年经历模块的无应答差异。
本研究使用了 2019 年来自 21 个州和 2021 年来自 16 个州的行为风险因素监测系统不良童年经历模块数据。按年份和社会人口统计学特征计算了对不良童年经历模块的应答者和无应答者的加权比例和 95%置信区间，以及每个问题的无应答者的百分比。卡方检验用于评估具有统计学意义（p<0.05）的差异。分析于 2023 年进行。
在 2019 年和 2021 年，行为风险因素监测系统参与者对不良童年经历模块的无应答率分别为 1.2%（95%CI=1.1, 1.4）和 2.4%（95%CI=2.2, 2.5）（p<0.01）。无应答者更有可能是非西班牙裔黑人（p=0.01）或非西班牙裔亚裔（p=0.01），失业（p<0.01），收入<$15,000（p<0.01）或报告健康状况不佳（p<0.01），而不是应答者。随着模块的进行，无应答问题的比例增加，性虐待问题的无应答率最高。
总体而言，研究结果表明，人们愿意回答不良童年经历模块的问题。尽管比例较低，但从 2019 年到 2021 年，模块的无应答率有所增加。性虐待问题的高无应答率可能是由于其敏感性或由于模块末尾的位置导致潜在的调查疲劳。在种族/族裔少数群体和经济弱势群体中较高的无应答率突出了改进现有监测系统的机会。
