QDRL 10 day letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

July 20, 2007

Ms. Margo Schwab

Office of Management and Budget

725 17th Street, N.W.

Washington, DC 20503

Dear Ms. Schwab:

The staff of the NCHS Questionnaire Design Research Laboratory (QDRL) plans to conduct research to test and evaluate questions for the Pregnancy Risk Assessment Monitoring System (PRAMS) for the National Center for Chronic Disease Prevention and Health Promotion/Division of Reproductive Health (CDC/NCCCDPHP/DRH) under (OMB No. 0920-0222, exp. 02/28/10). We propose to advertise for volunteer participants starting August 28, and to start testing as soon as possible after that.

Background Information about Cognitive Testing of Questionnaires

The methodological design of this proposed study is consistent with the design of typical cognitive testing research. The purpose of cognitive testing is not to obtain survey data, but rather to obtain information about the processes people use to answer survey questions as well as to identify any potential problems in the questions.

Data collection procedures for cognitive interviewing are quite different from survey interviewing. While survey interviewers strictly adhere to scripted questionnaires, cognitive interviewers use survey questions as starting points to begin a more detailed discussion of questions themselves: how participants interpret key concepts, their ability to recall the requested information, and the appropriateness of response categories. Because the interviews generate narrative responses rather than statistics, results are analyzed using qualitative methodologies. This type of in-depth analysis reveals problems in particular survey questions and, as a result, can help to improve the overall quality of surveys.

Proposed project: Testing and evaluation of PRAMS Questions

PRAMS collects state-specific, population-based data on maternal attitudes and experiences prior to, during and immediately following pregnancy.

The PRAMS questionnaire, first implemented in 1988, has been revised several times over the life of the project and the QDRL has cognitively tested questions for earlier revisions (1999, 2001, and 2003). Revisions to the questionnaire have occurred primarily to capture data on recent guidelines or emerging issues concerning maternal and child health and to improve respondents’ comprehension of questions.

This project will conform to the usual QDRL procedures for cognitive testing of a questionnaire module.

The proposed PRAMS questions (designed for Phase 6) of the survey will be asked of new mothers (aged 18 and over) who have an infant 2-9 months of age. The questions to be cognitively tested primarily focus on a mother’s health behavior and experiences before and during her pregnancy and early infancy of her child including prenatal care, fertility, C-section, breastfeeding stress, family history and other things that affect her health and the health of her baby.

We propose to recruit 20 new mothers (aged 18 and over) who have an infant between the ages of 2-12 months through a combination of a newspaper advertisement, flyers, word-of-mouth and our database of previously interviewed participants. We are purposely extending the cut-off age of the infant to 12 months in order to make sure we get adequate coverage of the questions. The newspaper advertisement/flyer will be used to recruit mothers relevant to the questionnaire. The newspaper advertisement/flyer is shown in Attachment 1. Within these constraints, we hope to recruit participants with some demographic variety (particularly in terms of gender, education, race/ethnicity, and income).

Interviews will be conducted in the QDRL, or in a private room of a community facility.

With the consent of the participants, the interviews will be recorded on audio or videotape. Participants will be informed of taping procedures (including observation if applicable) in the process of reviewing the consent forms, and the equipment will be turned on once it is clear that the procedures are understood and agreed upon. Then the interviewer will conduct individual cognitive interviews with as many as 20 participants for 60 minutes each. The testing instrument is shown in Attachment 2. At the end of the interviews, participants will be paid and provided with copies of all papers they signed.

We propose paying participants $50. Our approved base incentive is $40. However we hope that the increased incentive will be sufficient to entice new mothers of babies and multiple young children to come to the QDRL. In previous PRAMS testing we have found that these women have difficulties keeping appointments due to problems with baby sitters, childhood illnesses, and transportation. In total, for this project, the maximum respondent burden will be 20 hours of interviewing in addition to travel time.

Attachments (2)

cc:

M. Moien

M. Daneshvar

S. Perryman

Attachment 1 – Advertisement

Mothers Wanted for Research Study

The National Center for Health Statistics

is looking for mothers (aged 18 and over) with babies 2-12 months old to test questions that may be used on a national survey. All mothers are welcome, but we are especially interested in mothers who had a C-section, mothers who used medical treatment to get pregnant, mothers with additional children, and smokers. The interview will be no longer than 60 minutes and participants will receive $50.

FOR MORE INFORMATION,

Please call Karen at: 301-458-4676

Centers for Disease Control and Prevention

National Center for Health Statistics

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