TY - JOUR
T1 - Methodologic artifacts in adult sun-protection trends
AU - Katz, Marc A.
AU - Delnevo, Cristine D.
AU - Gundersen, Daniel A.
AU - Rich, David Q.
PY - 2011/1
Y1 - 2011/1
N2 - 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.
AB - 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.
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U2 - https://doi.org/10.1016/j.amepre.2010.09.020
DO - https://doi.org/10.1016/j.amepre.2010.09.020
M3 - Article
C2 - 21146771
VL - 40
SP - 72
EP - 75
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 1
ER -