On 2015 Jun 05, BSH Cancer Screening, Help-Seeking and Prevention Journal Club commented:

This article was selected for the HBRC journal club held on June 2nd, 2015. The topic of ‘don’t know responses’ in perceived risk items is of particular relevance to our group and raised several useful discussion points. We thank the authors for taking this work forward, and encourage further study in the area.

The general consensus of the journal club was that the use of two samples was a strength of the research. However, we noted differences in the availability of perceived risk items, the use of different predictors between the datasets, and perhaps most importantly, the availability of explicit ‘don’t know’ response options in one survey but not the other. This made comparisons between the samples and interpretation of the findings difficult. The authors should be credited with making use of available data, but it seems clear that their interesting findings warrant further investigation using study designs that explicitly set out to investigate this phenomenon. Following this, the journal club discussed the research team’s recent research endeavours in this area, presented at the Society of Behavioral Medicine Conference.1

Conversation turned to the meaning of a ‘don’t know’ response. We felt this was important because observational studies do not allow us to disentangle true ‘don’t know’ responses from those who lack the motivation to complete all survey items. Hay and colleagues addressed this limitation by excluding participants with multiple ‘don’t know’ responses elsewhere in the questionnaire; a decision we agreed with. Suggestions for future research investigating the meaning of a ‘don’t know’ response included using semi-structured interviews purposively sampling participants who selected a ‘don’t know’ response, or verbal protocol (think-aloud) studies encouraging subjects to vocalize their thoughts when completing perceived risk items. While these methods have limitations of their own, the consensus was that they would be worthwhile approaches. We also recommend that future research should include a range of perceived risk items, including ‘feelings of vulnerability’ also known as ‘risk as feelings’; an item not available to Hay and colleagues.

In sum, the HBRC journal club enjoyed reading this article, and encourages others to take note of their findings. These data have clear implications for scientists who use survey methodology, as well as those making policy level decisions based on their findings.

References

1. Kiviniemi M. T., Ellis E. M., Orom H, Waters E. A., Hay J. (2015) Providing a “don’t know” response option changes population perceived risk estimates. Annals of Behavioral Medicine. 49 (Suppl1): S1-S258, C120

On 2015 Jun 05, BSH Cancer Screening, Help-Seeking and Prevention Journal Club commented:

This article was selected for the HBRC journal club held on June 2nd, 2015. The topic of ‘don’t know responses’ in perceived risk items is of particular relevance to our group and raised several useful discussion points. We thank the authors for taking this work forward, and encourage further study in the area.

The general consensus of the journal club was that the use of two samples was a strength of the research. However, we noted differences in the availability of perceived risk items, the use of different predictors between the datasets, and perhaps most importantly, the availability of explicit ‘don’t know’ response options in one survey but not the other. This made comparisons between the samples and interpretation of the findings difficult. The authors should be credited with making use of available data, but it seems clear that their interesting findings warrant further investigation using study designs that explicitly set out to investigate this phenomenon. Following this, the journal club discussed the research team’s recent research endeavours in this area, presented at the Society of Behavioral Medicine Conference.1

Conversation turned to the meaning of a ‘don’t know’ response. We felt this was important because observational studies do not allow us to disentangle true ‘don’t know’ responses from those who lack the motivation to complete all survey items. Hay and colleagues addressed this limitation by excluding participants with multiple ‘don’t know’ responses elsewhere in the questionnaire; a decision we agreed with. Suggestions for future research investigating the meaning of a ‘don’t know’ response included using semi-structured interviews purposively sampling participants who selected a ‘don’t know’ response, or verbal protocol (think-aloud) studies encouraging subjects to vocalize their thoughts when completing perceived risk items. While these methods have limitations of their own, the consensus was that they would be worthwhile approaches. We also recommend that future research should include a range of perceived risk items, including ‘feelings of vulnerability’ also known as ‘risk as feelings’; an item not available to Hay and colleagues.

In sum, the HBRC journal club enjoyed reading this article, and encourages others to take note of their findings. These data have clear implications for scientists who use survey methodology, as well as those making policy level decisions based on their findings.

References

1. Kiviniemi M. T., Ellis E. M., Orom H, Waters E. A., Hay J. (2015) Providing a “don’t know” response option changes population perceived risk estimates. Annals of Behavioral Medicine. 49 (Suppl1): S1-S258, C120