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Subgroup-specific effects of questionnaire wording on population-based estimates of mammography prevalence
P Z Siegel1, J R Qualters, P D Mowery
1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga., USA. pzsl@cdc.gov
Objectives:
This study investigated whether an apparent downturn in prevalence rates of mammography use reported in the 1992 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire resulted from a change in questionnaire wording.
Methods:
In a pretest-posttest design (1990-1991 vs 1992), piecewise linear regression analyses were based on monthly prevalence estimates of mammography use among female BRFSS respondents 40 years or older.
Results:
Self-reported mammography use was lower by 3.5 percentage points (95% confidence interval [CI] = 1.5, 5.5) overall--and lower by 13.6 percentage points (95% CI = 2.6, 24.6) among Black women with less than a high school education--when predicted from 1992 data than when predicted from 1990-1991 data.
Conclusions:
A change in questionnaire wording in the BRFSS caused demographic-specific effects in population-based estimates of mammography use.