MEC In-Person Dietary Interviewers Procedures Manual January 2012 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 2.2.2 Tape Recorder ..................................................................... 2-3 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 2.3.4 Audiotape Consent Forms ................................................... 2-5 2.4 Equipment Setup and Teardown Procedures ...................................... 2-5 2.4.1 MEC Dietary Interview Room Setup Procedures ............... 2-5 2.4.2 MEC Dietary Interview Room Teardown Procedures ........ 2-6 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 3.3.4 Incomplete Information ....................................................... 3-8 iii TABLE OF CONTENTS (continued) Chapter Page 3.4 Probing ................................................................................................ 3-9 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 .............................. 4-4 4.1.3 Turning Computer On and Accessing the Program ............ 4-15 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 (AMPM) Instrument .................................. 5-1 5.2 Key Features of the 24-Hour Dietary Recall ...................................... 5-2 5.3 Introduction to Respondent ................................................................. 5-4 5.4 Step 1: The Quick List Pass (QL) ....................................................... 5-5 5.4.1 The Main Food List (MFL) ................................................. 5-10 5.4.2 Leaving the Quick List (QL) Pass ....................................... 5-20 5.5 Step 2: The Forgotten Foods List (FFL) ............................................. 5-21 5.6 Step 3: The Time and Occasion Pass (T/O) ........................................ 5-27 5.7 Step 4: The Detail and Review Cycle (DRC) ..................................... 5-35 5.7.1 Measuring Guide Instructions Screen ................................. 5-37 5.7.2 Midnight to First Occasion Probe ....................................... 5-38 5.7.3 Collecting Details and Amounts ......................................... 5-39 5.7.4 Food Source Question ......................................................... 5-82 5.7.5 Review of Occasion ............................................................ 5-90 5.7.6 Occasion Location Question ............................................... 5-92 5.7.7 Between Interval Probe ....................................................... 5-94 iv TABLE OF CONTENTS (continued) Chapter Page 5.7.8 Last Occasion to Midnight Probe ........................................ 5-95 5.7.9 Collection of Remainder Foods........................................... 5-96 5.8 Step 5: The Final Review Probe (FR) ................................................. 5-97 5.9 Intake Health-Related Questions ........................................................ 5-98 5.9.1 Usual Intake ........................................................................ 5-98 5.9.2 Source of Plain Drinking Water .......................................... 5-99 5.9.3 Salt Use Questions .............................................................. 5-100 5.9.4 Following a Special Diet ..................................................... 5-104 5.10 Dietary Recall Section Status ............................................................. 5-111 6 SUPPLEMENT AND ANTACID COLLECTION ......................................... 6-1 6.1 Basic Scenarios ................................................................................... 6-1 6.2 Recording Other Supplements ............................................................ 6-6 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 ......................................................................................... 6-15 6.7 Edits .................................................................................................... 6-16 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 ........................................................... 7-4 7.4 Child Pesticide Use Questions ............................................................ 7-5 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 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 v TABLE OF CONTENTS (continued) Chapter Page 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 ................................. 8-18 8.4 Documenting Missing Meals (if Data Retrieval is Not Required) ...... 8-19 8.5 Documenting Skipped Meals .............................................................. 8-19 8.6 Documenting Fasts on the Recall Day ................................................ 8-20 8.7 Documenting Breastfed Infants .......................................................... 8-20 8.8 “Same As” (Foods Previously Reported by the SP or Household Member) ............................................................................................