MEC In-Person Dietary Interviewers Procedures Manual January 2016 Table of Contents Chapter Page 1 Introduction to the Dietary Interview ............................................................. 1-1 1.1 Dietary Interview Component in the National Health and Nutrition Examination Survey ............................................................ 1-1 1.2 The Role of the Dietary Interviewer .................................................. 1-3 1.3 Other Duties of the Dietary Interviewer ........................................... 1-4 1.4 Observers and MEC Visitors .............................................................. 1-5 2 Equipment, Supplies, and Materials ................................................................. 2-1 2.1 Description of the MEC Interview Room and Equipment ............ 2-1 2.2 MEC Interview Supplies and Other Equipment .............................. 2-1 2.2.1 Measuring Guides ................................................................. 2-1 2.3 MEC Dietary Interviewer Materials ................................................... 2-3 2.3.1 Hand Cards ............................................................................ 2-3 2.3.2 Reminder Cards .................................................................... 2-4 2.3.3 Measuring Guide Package ................................................... 2-4 2.4 Equipment Setup and Teardown Procedures ................................... 2-4 2.4.1 MEC Dietary Interview Room Setup Procedures ........... 2-4 2.4.2 MEC Dietary Interview Room Teardown Procedures ............................................................................. 2-5 3 General Interviewing Techniques .................................................................... 3-1 3.1 Before Beginning the Interview .......................................................... 3-1 3.2 Activities and Resources Helpful to Your Interview ....................... 3-1 3.2.1 Getting Oriented to a New Community ........................... 3-1 3.2.2 Helpful Contacts ................................................................... 3-2 3.2.3 Beginning the Interview ....................................................... 3-3 3.3 Administering the Interview ................................................................ 3-4 3.3.1 Asking the Questions ........................................................... 3-5 3.3.2 Maintaining Rapport ............................................................ 3-7 3.3.3 Difficult Situations ................................................................ 3-8 iii MEC In-Person Dietary Interviewers 2016 Contents (continued) Chapter Page 3.3.4 Incomplete Information ...................................................... 3-8 3.4 Probing ................................................................................................... 3-8 3.4.1 What is Probing and Why is it Necessary?........................ 3-9 3.4.2 Probing Inappropriate Responses ...................................... 3-10 3.4.3 Probing Methods Should be Neutral ................................. 3-11 3.4.4 Kinds of Probes .................................................................... 3-11 3.4.5 The Don’t Know (DK) Response...................................... 3-13 3.4.6 Additional Guidelines for Probing ..................................... 3-13 3.4.7 When to Stop Probing ......................................................... 3-14 3.5 General Rules for Recording Answers............................................... 3-14 3.6 Ending the Interview ............................................................................ 3-15 4 Dietary Interview Application Features .......................................................... 4-1 4.1 General Overview of Computer ......................................................... 4-1 4.1.1 Keyboard ................................................................................ 4-1 4.1.2 Dietary Interview Application Features ............................ 4-3 4.1.3 Turning Computer On and Accessing the Program .................................................................................. 4-14 5 Conducting the 24-Hour Dietary Recall Interview ........................................ 5-1 5.1 Introduction of the MEC 24-Hour Dietary Recall Using the USDA Automated Multiple Pass Method (AMPM) Instrument .............................................................................................. 5-1 5.2 Key Features of the 24-Hour Dietary Recall .................................... 5-2 5.3 Step 1: The Quick List Pass (QL) ....................................................... 5-3 5.3.1 The Main Food List (MFL) ................................................. 5-9 5.3.2 Leaving the Quick List (QL) Pass ...................................... 5-17 5.4 Step 2: The Forgotten Foods List (FFL) ........................................... 5-18 5.5 Step 3: The Time and Occasion Pass (T/O) .................................... 5-24 5.6 Step 4: The Detail and Review Cycle (DRC) .................................... 5-31 5.6.1 Measuring Guide Instructions Screen ............................... 5-33 5.6.2 Midnight to First Occasion Probe ..................................... 5-33 iv MEC In-Person Dietary Interviewers 2016 Contents (continued) Chapter Page 5.6.3 Collecting Details and Amounts ......................................... 5-35 5.6.4 Food Source Question ......................................................... 5-73 5.6.5 Review of Occasion .............................................................. 5-80 5.6.6 Occasion Location Question .............................................. 5-81 5.6.7 Between Interval Probe ....................................................... 5-83 5.6.8 Last Occasion to Midnight Probe ...................................... 5-84 5.6.9 Collection of Remainder Foods ......................................... 5-85 5.7 Step 5: The Final Review Probe (FR) ................................................ 5-86 5.8 Intake Health-Related Questions ........................................................ 5-87 5.8.1 Usual Intake ........................................................................... 5-87 5.8.2 Source of Plain Drinking Water ......................................... 5-88 5.8.3 Salt Use Questions ................................................................ 5-89 5.8.4 Following a Special Diet ...................................................... 5-93 5.9 Dietary Recall Section Status ............................................................... 5-99 6 Supplement and Antacid Collection ................................................................ 6-1 6.1 Basic Scenarios ...................................................................................... 6-1 6.2 Recording Other Supplements ............................................................ 6-5 6.3 Antacid Data Collection ....................................................................... 6-9 6.4 No Supplements Reported in the Past 30 Days ............................... 6-11 6.5 No Antacids Reported in the Past 30 Days ...................................... 6-12 6.6 Hand Cards ............................................................................................ 6-14 6.7 Edits ........................................................................................................ 6-15 7 Conducting the Post-Recall Questions ............................................................ 7-1 7.1 General Overview of the Post-Recall Section .................................. 7-1 7.2 Fish and Shellfish Questions ............................................................... 7-2 7.3 Child Recent Health Questions .......................................................... 7-3 7.4 Child Pesticide Use Questions ............................................................ 7-4 7.5 Scheduling a Phone Follow-Up Interview ........................................ 7-6 7.6 Observations Questions ....................................................................... 7-19 7.7 Post-Recall Section Status .................................................................... 7-20 8 Additional Intake Procedures ........................................................................... 8-1 8.1 Proxy and Assisted Interviews ............................................................ 8-1 v MEC In-Person Dietary Interviewers 2016 Contents (continued) Chapter Page 8.1.1 Proxy Interviews with Child SPs Under 9 Years of Age ..................................................................................... 8-2 8.1.2 Assisted Interviews with Child SPs 9 to 11 Years Old .......................................................................................... 8-3 8.1.3 Proxy or Assisted Interviews with Adults Unable to Report for Themselves ...................................... 8-3 8.2 Interviewing Children ........................................................................... 8-3 8.3 Data Retrieval Procedures ................................................................... 8-4 8.3.1 Data Retrieval Criteria .......................................................... 8-5 8.3.2 Flagging Eating Occasions for Data Retrieval ................. 8-5 8.3.3 Documenting Data Retrieval Source Information ........................................................................... 8-10 8.3.4 Data Retrieval Collection Procedures ................................ 8-16 8.4 Documenting Missing Meals (if Data Retrieval is Not Required) ...............................................................................................