Abstract
Background and Aims
Increasing numbers of school‐based drug surveys are transitioning data collection to electronic tablets from paper‐and‐pencil, which may produce a survey mode effect and consequent discontinuity in time trends for population estimates of drug prevalence. This study tested whether (a) overall, self‐reported drug use prevalence is higher on electronic tablets v. paper‐and‐pencil surveys, (b) sociodemographics moderate survey mode effects, and (c) levels of missing data are lower for electronic tablet v. paper‐and‐pencil modes.
Design
A randomized‐controlled experiment.
Setting
Results are nationally‐representative of students in the contiguous United States.
Participants
41,866 8th, 10th, and 12th grade students who participated in the 2019 Monitoring the Future school‐based survey administration.
Intervention and comparator
Surveys were administered to students in a randomly‐selected half of schools with electronic tablets (intervention) and with paper‐and‐pencil format (comparator) for the other half.
Measurements
Primary outcome was the total number of positive drug use responses. Secondary outcomes were percent of respondents completing all drug questions, percent of drug questions unanswered, and mean number of missing drug items.
Findings
The relative risk for total number of positive drug use responses for electronic tablets v. paper‐and‐pencil surveys were small and 95% confidence intervals included for reporting intervals of lifetime (RR=1.03; 95% CI, 0.93‐1.14), past 12‐months (RR=1.01; 95% CI, 0.91‐1.11), past 30‐days (RR=1.05; 95% CI, 0.93‐1.20), and for heavy use (RR=1.10; 95% CI, 0.93‐1.29). Multiplicative interaction tests indicated no moderation of these relative risks by race (white v. nonwhite), population density, census region, public/private school, year of school participation, survey version, or non‐complete drug responses. Levels of missing data were significantly lower for electronic tablets v. paper‐and‐pencil surveys.
Conclusions
Adolescent drug prevalence estimates in the US differed little across electronic tablet v. paper‐and‐pencil survey modes and showed little to no effect modification by sociodemographics. Levels of missing data were lower for electronic tablets.