Low response rate schools in surveys of adolescent risk taking behaviours: possible biases, possible solutions.

STUDY OBJECTIVE To examine the potential biases introduced when students in low response rate schools are dropped from classroom based surveys of adolescent risk taking behaviour. DESIGN Self administered confidential surveys were conducted in classrooms, with follow up visits to each school to survey students absent during the initial survey administration. Data on students in schools that achieved a 70% response rate are compared with data on students in schools that did not achieve this level of response. SETTING New York City, United States. PARTICIPANTS 1854 10th graders in 13 public (state supported) high schools. MAIN RESULTS Students in schools with low response rates resulting from high rates of absenteeism have different demographic characteristics and engage in more risk behaviours than students in schools with low absenteeism and high response rates. Excluding schools with low rates of response can have an effect on estimates of risk behaviour, even after data are weighted for individual absences. The potential for bias is greatest when, in sampling schools, the proportion of schools with low response rates is large, and when such schools represent a large share of the students in the area under study. CONCLUSIONS Excluding schools with poor response rates from survey samples using a classroom based approach does not improve, and may, under some circumstances, underestimate risky behaviour among adolescent populations.