MEC Interviewers Procedures Manual May 2009 TABLE OF CONTENTS Chapter Page 1 OVERVIEW OF THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY ............................................................................ 1-1 1.1 History ................................................................................................ 1-1 1.2 Goals of the Survey............................................................................. 1-4 1.3 NHANES Data Accomplishments...................................................... 1-4 1.4 National Center for Health Statistics .................................................. 1-6 1.5 Sample Selection................................................................................. 1-6 1.6 Field Organization for NHANES ....................................................... 1-7 1.7 Exams and Interviews in the Mobile Examination Center (MEC) ..... 1-10 1.7.1 Exam Sessions..................................................................... 1-11 1.7.2 Exam Team Responsibilities............................................... 1-12 1.7.3 Examination Components ................................................... 1-13 1.7.4 Sample Person Remuneration ............................................. 1-20 1.7.5 Report of Exam Findings .................................................... 1-20 1.7.6 Dry Run Day ....................................................................... 1-21 1.8 Integrated Survey Information System (ISIS) .................................... 1-21 1.9 Confidentiality and Professional Ethics.............................................. 1-22 2 OVERVIEW OF THE MEC INTERVIEW COMPONENT........................... 2-1 2.1 Purpose of the MEC Questionnaires................................................... 2-1 2.2 Role and Responsibilities of the MEC Interviewer ............................ 2-2 2.3 Procedures for Administering the MEC Interview ............................. 2-2 2.4 Description of the MEC Questionnaires............................................. 2-3 2.5 Data Collection Materials ................................................................... 2-4 3 EQUIPMENT, SUPPLIES, AND MATERIALS............................................ 3-1 3.1 Description of the MEC Interview Room and Computer Equipment. 3-1 3.2 MEC Interview Supplies and Other Equipment ................................. 3-2 3.2.1 Description and Use of Interview Supplies......................... 3-2 3.3 MEC Interviewer Materials ................................................................ 3-3 3.4 Inventory, Equipment Setup, and Teardown Procedures.................... 3-4 3.4.1 MEC Interview Room Teardown Procedures ..................... 3-5 3.4.2 MEC Interview Room Setup Procedures ............................ 3-6 -iii- TABLE OF CONTENTS (Continued) Chapter Page 4 CONDUCTING THE MEC INTERVIEW ..................................................... 4-1 4.1 Component Tasks ............................................................................... 4-1 4.2 Obtaining Minor Assent to Participate ............................................... 4-1 4.3 Obtaining Minor Assent for Specimen Storage and Future Research.............................................................................................. 4-29 4.4 Pesticide Use Questions...................................................................... 4-32 4.5 Logging in the SP ............................................................................... 4-32 4.6 Conducting the Interview.................................................................... 4-33 4.6.1 Introducing the MEC Interview to the Respondent............. 4-34 4.6.2 Administering the Actual Questionnaire............................. 4-35 4.6.3 Recording a Status for Each Section................................... 4-35 4.7 Critical Data Items.............................................................................. 4-36 4.7.1 Critical Data Item Collection for SPs Younger than 12 Years of Age .................................................................. 4-37 4.8 Ending the Interview........................................................................... 4-42 5 MEC INTERVIEW PROTOCOL.................................................................... 5-1 5.1 Question-by-Question Specifications Overview................................. 5-1 5.1.1 General Rounding Rules ..................................................... 5-1 5.1.2 Introduction to the MEC Interview Program ...................... 5-2 5.1.3 Beginning the MEC Interview ............................................ 5-4 5.2 The Blaise-CAPI Section of the MEC Interview................................ 5-7 5.2.1 Navigating the CAPI Interview........................................... 5-7 5.2.2 Respondent Selection Section (RIQ)................................... 5-13 5.2.3 The Volatile Toxicant Section (VTQ) of the MEC Interview ............................................................................. 5-21 5.2.4 Pesticide Use (PUQ) ........................................................... 5-37 5.2.5 Dietary Screener Module (DTQ)......................................... 5-39 5.2.6 Current Health Status (HSQ) .............................................. 5-81 5.2.7 Depression Screen (DPQ) ................................................... 5-91 5.2.8 Tobacco (SMQ)................................................................... 5-101 5.2.9 Alcohol Use (ALQ)............................................................. 5-113 5.2.10 Reproductive Health (RHQ) ............................................... 5-119 -iv- TABLE OF CONTENTS (Continued) Chapter Page 5.2.11 Kidney Conditions (KIQ).................................................... 5-165 5.2.12 Bowel Health (BHQ)........................................................... 5-173 5.2.13 Physical Activity and Physical Fitness (PAQ).................... 5-187 5.2.14 Weight History (WHQ)....................................................... 5-201 5.2.15 Ending the CAPI Interview................................................. 5-213 5.3 Audio-CASI Sections of the MEC Interview ..................................... 5-217 5.3.1 Beginning and Navigating the Audio-CASI Interview ....... 5-219 5.3.2 Food Security (FSQ) ........................................................... 5-227 5.3.3 Tobacco (SMQ)................................................................... 5-231 5.3.4 Alcohol Use (ALQ)............................................................. 5-251 5.3.5 Drug Use (DUQ)................................................................. 5-255 5.3.6 Sexual Behavior (SXQ)....................................................... 5-281 5.3.6.1 Female Sexual Behavior (SXQ) .......................... 5-281 5.3.6.2 Male Sexual Behavior (SXQ).............................. 5-305 5.3.7 Ending the Audio-CASI Interview...................................... 5-329 5.4 Critical Data Items (CDI) ................................................................... 5-339 6 MENTAL HEALTH REFERRALS ................................................................ 6-1 6.1 Referral Procedures............................................................................. 6-1 6.2 Situations Requiring a Mental Health Referral................................... 6-1 6.3 Generating a Mental Health Observation ........................................... 6-1 7 QUALITY CONTROL.................................................................................... 7-1 7.1 Data Edits............................................................................................ 7-1 7.2 Observation and Review of Interviews............................................... 7-1 7.2.1 Procedures for Audiotaping the Interview .......................... 7-3 7.3 Data Monitoring and Review.............................................................. 7-9 -v- TABLE OF CONTENTS (CONTINUED) List of Appendixes Appendix Page A.1 Launching the Spanish MEC Interview........................................................... A1-1 A.2 The Spanish CAPI Interview ........................................................................... A2-1 A.3 The Spanish Audio-CASI................................................................................ A3-1 A.4 The Spanish Critical Data Items. ..................................................................... A4-1 List of Exhibits Exhibit 1-1 Floor plan of the MEC..................................................................................... 1-11 1-2 MEC exams and rooms.................................................................................... 1-12 1-3 Examination components................................................................................. 1-14 4-1 Examination Brochure and SP Consent/Assent/Parental Permission Form .... 4-5 4-2 Child SP Assent Brochure and Form............................................................... 4-17 4-3 Consent/Assent and Parental Permission for Specimen Storage and Continuing Studies........................................................................................... 4-30 4-4 Section Status screen ....................................................................................... 4-36 4-5 Critical Data Items Report ............................................................................... 4-38 4-6 CDI Utility: Social Security Number screen.................................................... 4-39 4-7 CDI Utility: Home telephone number screen .................................................