QDRL 10-day letter justification

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

September 21, 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 a round of Spanish language testing to 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). English language testing of these questions was described in a letter to you dated July 20, 2007, and approved on August 30, 2007. The questions proposed for the Spanish language testing are exactly the same as the English language testing submitted to you on July 20. However, probing and analysis will focus on particular problems Hispanic mothers have in answering the survey questions as reported in the past two cycles of the questionnaire. We propose to advertise for volunteer participants and start testing as soon as possible.

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 in Spanish

This project will conform to the usual QDRL procedures for cognitive testing of a questionnaire module and follow the exact procedures as used in the English language testing described in our letter to you on July 20.

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 Spanish-speaking new mothers (aged 18 and over) who have an infant between the ages of 2-12 months through a combination of flyers and word-of-mouth. As with the English language testing, 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 English-version flyer we submitted to you on July 20 and attached as Attachment 1 will be translated into Spanish and used to recruit Spanish-speaking mothers.

Interviews will be conducted 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 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 English-version of the testing instrument we submitted to you on July 20 and shown in Attachment 2, will be translated into Spanish. At the end of the interviews, participants will be paid and provided with copies of all papers they signed.

We propose paying Spanish-speaking Mothers $50. This is the same amount we paid the English-speaking Mothers. Our approved base incentive is $40. However we hope that the increased incentive will be sufficient to entice Spanish-speaking new mothers of babies and multiple young children to participate as evidenced with English-speaking mothers participating in earlier rounds of testing. 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

Note: This is the English-version flyer we submitted to OMB on July 20. The flyer will be translated into Spanish and used to recruit Spanish-speaking mothers.

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 [Fill Name] at: [Fill Number]

Centers for Disease Control and Prevention

National Center for Health Statistics

3