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Published online first on April 1, 2008
[Cancer Epidemiology Biomarkers & Prevention, 10.1158/1055-9965.EPI-07-2622]
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CEBP Focus: Validating Colorectal Cancer Screening Behaviors

The Effects of Survey Mode and Asking About Future Intentions on Self-Reports of Colorectal Cancer Screening

Timothy J. Beebe 1*, Sarah M. Jenkins , Kari J. Anderson , Michael E. Davern , Todd H. Rockwood

1 1Department of Health Sciences Research, Survey Research Center, Mayo Clinic College of Medicine, Rochester, Minnesota and 2Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota

* To whom correspondence should be addressed. E-mail: beebe.timothy{at}mayo.edu.


   Abstract

Colorectal cancer (CRC) screening rates are often ascertained via self-reports but can be subject to overreporting bias. Asking about intention to get screened before asking about past screening may minimize overreporting of cancer screening. In a statewide survey conducted from July through October of 2005, we embedded an experiment that tested the effect of question ordering (asking about future intention to get screened before or after asking about past screening; "future first" and "future second," respectively), crossed with survey mode (mail versus telephone), on CRC screening rates. Weighted analysis focused on 752 respondents who were ages 50 years or older. We found (a) that asking about future intentions to get screened before asking about past screening (future first) statistically significantly lowers reports of past CRC screening [70.9% future second versus 58.0% future first; odds ratio (OR), 1.83; 95% confidence interval (95% CI), 1.08-3.13]; (b) that there was no main effect of survey mode; and (c) that the effect of the ordering of the future intentions item varies by survey mode. In the mailed survey, the odds of reporting past CRC screening were almost thrice greater in the future second condition compared with the future first condition (72.4% versus 49.0%, respectively; OR, 2.74; 95% CI, 1.22-6.17). In the telephone condition, the odds of reporting were only 28% higher in the future second (69.5%) condition than in the future first condition (63.9%; OR, 1.28; 95% CI, 0.64-2.57). The results suggest that asking about future intentions to get screened before the actual behavior elicits lower, and arguably more truthful reports of CRC screening but mainly in mailed surveys. (Cancer Epidemiol Biomarkers Prev 2008;17(4):785–90)

Key Words: cancer screening, self-reports, mode effects, mail surveys, telephone surveys




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Validation of Colorectal Cancer Screening Behaviors
Cancer Epidemiol. Biomarkers Prev., April 1, 2008; 17(4): 745 - 747.
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Copyright © 2008 by the American Association for Cancer Research.