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Assessing the Perceived Importance of Skin Cancer: How Question-Order Effects Are Influenced by Issue Involvement

Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland

Kevin Real, PhD

Department of Communication, University of Kentucky, Lexington

Question-order effects refer to systematic differences in responses that can be attributed to the manner in which questions assessing attitudes and cognitions are asked. This article hypothesized that question-order effects in assessing the perceived importance of skin cancer would be moderated by the extent to which people are involved with the issue of skin cancer. A telephone survey (N = 325) was conducted by administering two versions of the same questionnaire, one in which importance of skin cancer was assessed without other contextual variables and another in which contextual variables were asked before assessing the importance of skin cancer. As hypothesized, when people were highly involved with the issue, question-order effects did not occur. When involvement was low, importance of skin cancer was greater in the absence of contextual questions than in their presence. Findings have implications for how health-related issues are communicated to the public and how formative research is conducted.

Key Words: framing • involvement • question-order effects • skin cancer

Health Education & Behavior, Vol. 32, No. 3, 398-412 (2005)
DOI: 10.1177/1090198104272341


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