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. 2023 Apr 19:7:100161.
doi: 10.1016/j.dadr.2023.100161. eCollection 2023 Jun.

Evaluating cannabis exposure in survey items: Insights, strategies, and remaining challenges identified from cognitive interviewing

Claire A Walsh  1 , Cara A Struble  2 , Efrat Aharonovich  1   3 , Dvora Shmulewitz  1   3 , Jacob Borodovsky  2 , Mohammad I Habib  2 , Alan Budney  2 , Ofir Livne  1   3 , Deborah S Hasin  1   3   4
Affiliations

Evaluating cannabis exposure in survey items: Insights, strategies, and remaining challenges identified from cognitive interviewing

Claire A Walsh et al. Drug Alcohol Depend Rep. .

Abstract

Background: The diversity in characteristics of cannabis products and behavior patterns make evaluation of cannabis exposure in population-based, self-report surveys challenging. Accurate identification of cannabis exposure and related outcomes necessitates a thorough understanding of participants' interpretations of survey questions assessing cannabis consumption behaviors.

Objectives: The current study utilized cognitive interviewing to gain insight on participants' interpretation of items in a self-reported survey instrument used to estimate the quantity of THC consumed in population samples.

Methods: Cognitive interviewing was used to evaluate survey items assessing cannabis use frequency, routes of administration, quantity, potency, and perceived "typical patterns" of use. Ten participants ≥18 years (n = 4 cisgender-men; n = 3 cisgender-women; n = 3 non-binary/transgender) who had used cannabis plant material or concentrates in the past week were recruited to take a self-administered questionnaire and subsequently answer a series of scripted probes regarding survey items.

Results: While most items presented no issues with comprehension, participants identified several areas of ambiguity in question or response item wording or in visual cues included in the survey. Generally, participants with irregular use patterns (i.e., non-daily use) reported more difficulty recalling the time or quantity of cannabis use. Findings resulted in several changes to the updated survey, including updated reference images and new quantity/frequency of use items specific to the route of administration.

Conclusion: Incorporating cognitive interviewing into cannabis measurement development among a sample of knowledgeable cannabis consumers led to improvements in assessing cannabis exposure in population surveys, which may otherwise have been missed.

Keywords: Cannabis; Cognitive interviewing; Marijuana; Measurement assessment; Qualitative; Survey development; THC.

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Conflict of interest statement

Alan Budney has served as a scientific consultant for Canopy Growth, Inc. and Jazz Pharmaceuticals.

Figures

Fig 1
Fig. 1
Survey branching logic for personalization of quantity reporting.
Fig 2
Fig. 2
Number of participants screened, eligible, contacted, and interviewed.
See this image and copyright information in PMC

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