Supporting Statement

National Survey on Drug Use and Health:

Focus Groups for Redesigned Contact Materials

SUPPORTING STATEMENT

1. Purpose and Use of Information

The National Survey on Drug Use and Health (NSDUH), sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), is a national survey of the U.S. civilian non-institutionalized population aged 12 and older. The conduct of the NSDUH is paramount in meeting a critical objective of SAMHSA’s mission to maintain current data on the prevalence of substance use in the United States.

This package is submitted under the NSDUH Methodological Field Tests generic OMB clearance (OMB No. 0930-0290).

The goals of this study are to evaluate alternative versions of materials used to contact potential respondents to the survey. These materials include the lead letter, lead letter envelope, and the question and answer (Q&A) brochure. SAMHSA is interested in updating these materials and collecting qualitative information regarding individuals’ overall reactions as well as reactions to individual characteristics of the materials. The revised materials will likely be used starting with the upcoming redesign of the NSDUH, currently slated to be fielded in 2013.

To this end, SAMHSA requested that two specific tasks be completed:

Task 1. Develop alternative versions of the lead letters, lead letter envelopes, and Q&A brochure.

Task 2. Conduct focus groups with participants from different parts of the United States to evaluate how potential NSDUH respondents would react to the new and revised contact materials and whether they would find the materials comprehensive, clear, and compelling.

Alternative versions of the draft redesigned materials have been developed and are included in Attachments E through K. A total of 17 focus groups will be conducted with up to 170 participants (10 per group) in five metropolitan areas to evaluate the redesigned contact materials.

2. Use of Information Technology

Information will be gathered in a focus group setting. Each focus group session will have a note taker, who will take notes in an unobtrusive manner. As facilities allow, the note taker will observe the group from behind a one-way glass. The sessions will be audio and video recorded so the research team can reference the recordings when compiling notes for the study report. During the session a focus group moderator will present the participants with the three types of revised materials and ask for their feedback on each type. The moderator will ask both scripted questions as well as impromptu probes about participants’ reactions.

3. Efforts to Identify Duplication

The Office of Applied Studies, SAMHSA, is in contact with all major Federal health survey managers and is aware of no other efforts to assess how potential respondents may react to changes made to the NSDUH contact materials. To date, no duplication of effort has been identified.

4. Consequences if Information Collected Less Frequently

The data collection will start in early September and continue through October of 2009 with the final contact materials and report being completed by February, 2010. This will allow the contact materials to be used in other experiments that will inform the 2013 survey design. This project will not be repeated.

5. Consultation Outside the Agency

A number of consultants conducted a review of the materials and procedures. Andy Peytchev, Survey Methodologist, RTI International, (919) 485-5604 coordinated an initial review in 2008. This review also included Don Dillman, Regents Professor and the Thomas S. Foley Distinguished Professor of Government and Public Policy, Departments of Sociology and Community and Rural Sociology, Washington State University, (509) 335-4150. Doug Currivan, also a Survey Methodologist with RTI International, (919) 316-3334 conducted a further review among RTI staff. Following the focus groups, Dr. Dillman and eight NSDUH field interviewers employed by RTI subcontractor Headway Corporate Resources will participate in a further review of the revised contact materials.

There are no unresolved issues resulting from these consultations.

6. Payment to Respondents

Participants will receive a $75 cash incentive for a session that will last approximately 90 minutes, but not longer than two hours. This amount should be enough to compensate for the respondent’s time and any travel expenses incurred (Willis, 2005). This amount was informed by advice from individuals representing the focus group facilities about the current amount provided for focus groups of this length at these locations and is the same as the $75 provided to NSDUH focus group participants in 2005.

The incentive for the focus group is mentioned in the following materials: Focus Group Recruitment and Screening Protocol [Attachment A], Focus Group Informed Consent Form [Attachment B], Focus Group Moderator’s Guide [Attachment C], and Focus Group Incentive Receipt Form [Attachment D].

7. Methods to Maintain Confidentiality

Concern for the confidentiality and protection of respondents’ rights has always played a central part in the implementation of the NSDUH. This is also the case for the planned focus groups for the NSDUH contact materials. The focus groups will incorporate several procedures to ensure that participants’ rights will be protected and to reduce the risk of distress due to disclosure of responses. The recruitment protocol [Attachment A] and the informed consent form [Attachment B] both indicate that the respondents’ answers will be kept private and confidential; information given by the participants will not be shared with any persons aside from the project staff and the other focus group participants in the room; their name will never be connected with the answers they provide; and that their answers will be kept confidential. In these same study materials, participants are informed that their responses are voluntary and are assured that there will be no penalties if they decide not to respond, either to the information collection as a whole or to any particular question. The only people who will have access to any of the responses given by the participants are researchers at RTI, SAMHSA, Dr. Jim Leiman and Mr. Arturo Obscura at Morpace who will moderate the focus groups, and staff at the focus group facilities not owned by RTI. All of these people have completed the Confidential Information Protection and Statistical Efficiency Act of 2002 (CIPSEA) training and signed the NSDUH confidentiality pledge [Attachment L], or will do so prior to performing any work on this study.

Of the 17 focus groups planned, 12 will be conducted at facilities that are not owned or operated by RTI. In these cases, RTI will be contracting with organizations to procure the use of both their facility and their assistance with recruiting subjects. If participants contact these facilities directly, staff at these facilities could learn information about participants that was collected as part of the recruitment and screening protocol. These staff members will not be present for the focus group itself. Staff at these facilities may also be needed to transfer the video recording of the sessions onto a DVD, thereby giving them access to the recording. All staff members who have access to confidential data, including the video recording, will complete CIPSEA training and sign the NSDUH confidentiality pledge.

During the recruitment process, potential participants will be told that we would like to audio and video record the interactions between them and the moderator during the focus group so we can make sure we have all of the information from them on their reaction to the new materials. Participants will be told that the recordings will be heard and viewed only by members of the research team. Additional information on the recordings is provided in the Informed Consent Form [Attachment B]. This document informs participants that the recordings will be destroyed once they have been used in completing the study report.

All internal communication regarding a participant will only include the first name of the participant and time of interview. An example of internal communication would be when the recruiter notifies the moderator of a scheduled session with participants. Any other materials (including the recruitment screeners, “will call” list, and informed consent forms) connecting the first name of the participant with his/her last name, telephone number, etc. will be locked in a cabinet (if in hardcopy form) or password protected (if in electronic form). This password will be set to expire within four weeks after the last focus group is completed and both the electronic files and hard copies will be destroyed at that time.

Although some personal information will be collected during the recruitment process and the focus groups, data will not be retrieved by personal identifiers, and thus the Privacy Act does not apply to these activities. More specifically, during the recruitment process, we will collect the age, phone number, and city or town of residence of potential participants. The telephone numbers collected will be used to either remind the participants about their upcoming appointments or to recruit additional participants who were placed on a “will call” list in the event that spaces opened up for them to participate. During the focus group, we will record the age and gender of all participants in order to further inform the results. No links to individuals of any kind will be preserved in the focus group report.

8. Questions of a Sensitive Nature

No sensitive data will be collected in the focus groups. All questions and probes presented in the focus groups will refer only to the NSDUH contact materials and participants’ opinions about the materials. The focus group moderator’s guide [Attachment C] does not include questions or probes that encourage participants to divulge any personal information about themselves.

9. Estimates of Annualized Hour Burden

Up to 170 participants will take part in the focus groups discussions for this study. It is expected that approximately 210 screenings with potential participants will be completed to obtain the 170 study participants.

Administration of the screening questionnaire during the recruitment process will take an average of five minutes per participant. It is estimated that the average amount of time required to conduct each focus group will be approximately 90 to 120 minutes.

Both the recruitment and focus group phases of this study will span for approximately three weeks in September and October 2009. The recruitment phase will begin shortly after OMB clearance is received, and the focus groups will begin directly after that.

The respondent burden for this study is shown in the table at the top of page 6. The hourly wage of $14.61 was calculated based on weighted data from the 2007 NSDUH respondents’ personal annual income.

Estimated Burden for 2009 Focus Groups for Redesigned Contact Materials

Activity	Number of Respondents	Responses per Respondent	Total Responses	Average Burden per Response	Total Burden (Hrs.)	Hourly Wage Rate	Total Hour Cost
Screening	210	1	210	0.083 hr.	17.43	$14.61	$254.65
Focus Group	170	1	170	2 hrs.	340	$14.61	$4,967.40
TOTAL	210	–	210	–	357.43	–	$5,222.05

10. Estimates of Annualized Cost to the Government

Total costs associated with the 2009 Focus Groups for Contact Materials are estimated to be $225,042 over a 17 month performance period. This cost includes respondent incentives of $75 for 170 participants. Of the total costs, $191,042 is for study design, preparation of materials for laboratory testing, recruiting, conducting the focus groups, analysis and report/publication writing, and approximately $34,000 represents SAMHSA costs to manage/administrate the process.

11. Time Schedule, Publication and Analysis Plans

The 2009 Focus Groups for Contact Materials results will be used to gauge the impact of edits to existing contact materials for future waves of the NSDUH survey. The sample size and design do not allow for statistical inference to be conducted. As a result, the analyses will be based on observations that contribute to key themes. Moderators will provide their notes from conducting the focus groups and their assessments of respondents’ reactions to the materials.

When the study has been completed, the SAMHSA and RTI liaisons will discuss opportunities for presenting results of the study to the external research community at a professional conference and/or via external publication.

The time schedule for the 2009 Focus Groups for Contact Materials is indicated in the table at the top of page 7.

2009 Focus Groups for Contact Materials Schedule

Subtask	Due Date
Complete Focus Group Recruitment Plan	7/10/09
Complete Redesigned Contact Materials	7/15/09
Complete Focus Group Moderator’s Guide	7/16/09
OMB Blanket Clearance Package (Develop, Review, Approval)	8/28/09
RTI IRB package (Develop, Review, Approval)	8/28/09
Complete Recruitment for Focus Groups	9/25/09
Complete Focus Groups	10/16/09
Draft Focus Group Report	10/30/09
Receive SAMHSA feedback on Draft Focus Group Report	11/13/09
Complete Focus Group Report	12/4/09
Obtain Feedback from D. Dillman and NSDUH Interviewers	1/25/10
Finalize Contact Materials	2/1/10

12. Respondent Universe and Sampling Methods

The sample of 170 focus group participants to be recruited will be non-probability based. Participants will consist of adult volunteers who are screened and determined to meet recruitment criteria. Volunteers will primarily be recruited via advertisements posted in local publications in each metropolitan area and online listings on www.craigslist.com.

The objectives require the study to include people who represent a variety of key characteristics of the target population for the NSDUH. To meet this objective, the composition of potential participants for the focus groups will adhere to the following guidelines:

• Only adults who are at least 18 years old will be recruited for the focus groups. While the NSDUH interviews individuals 12 and older, the contact materials are targeted at adults only and screening interviews are not conducted with minors.

• Participants will be evenly distributed across three age groups at each of the interviewing sites – 18 to 29, 30 to 49, and 50 and over. Each focus group will be comprised of only respondents within one of these three age groups. This will ensure that we are able to discern any differences in reactions that persist amongst one specific age group. These divisions will also ensure that age differences among participants are limited, so that all participants feel comfortable contributing comments and ideas.

• As NSDUH interviews are conducted in both English and Spanish, we will conduct both English and Spanish focus groups. The Spanish groups will attempt to include participants who speak primarily or only Spanish and would not be included in the pool of potential participants for the English focus groups at each site.

• A total of 17 focus groups will be conducted across five metropolitan areas: Chicago, IL; Dallas-Fort Worth, TX; Los Angeles, CA; Raleigh-Durham, NC; and Washington, D.C. Recruiting participants from each of these five metropolitan areas is intended to provide diversity in the views expressed by people who live in different parts of the country. The five sites also represent a range of population sizes, from the largest metropolitan areas to considerably smaller areas. For this reason, we anticipate that the focus group participants across the five metropolitan areas will contribute input based on a significant range of socio-cultural considerations. In addition, two different sites will facilitate recruiting participants who speak primarily or only Spanish who have some diversity of regional, national, and cultural backgrounds. We expect the distribution of background characteristics of Spanish-speaking participants recruited for the Chicago groups to be significantly different from those recruited for the Washington groups. This diversity will facilitate collecting a broader range of input than would likely be possible from a single site.

The table on page 9 details the estimated number of participants to be recruited according to the characteristics detailed above for the focus groups. If after approximately 210 screenings (see Section 9), some of the cells specified in the table are unfilled, potential participants who give permission to be put on a “will call” list (because the requisite number of participants for their criteria had already been recruited) will be re-contacted to fill the vacant interview slots to maximize the attempt to obtain 170 study participants.

13. Information Collection Procedures

Potential participants who call into the study line will be screened for eligibility [Attachment A]. Eligible respondents will be scheduled for a focus group session based on language and age group.

Potential participants who call the RTI study line after the requisite number of participants has been recruited will be placed on a “will call” list with their permission, but only for the duration of the focus groups. During this phase, individuals on the “will call” list may be called to ask if they are available, if one or more originally scheduled participants is not able to attend a scheduled focus group. As specified in Section 7, recruitment and contact information will be kept in locked cabinets and password protected electronic files and only shared with those who are assigned to recruit participants for the sessions.

When each participant arrives for their focus group, he or she will be greeted and asked to listen to instructions and information from the moderator, including completion and acknowledgement of the Informed Consent Form [Attachment B]. All focus groups will be both audio and video recorded. For logistical purposes, participants must consent to be audio and video recorded in order to be included in the study.

To begin the interview, the moderator will welcome respondents and have them sign the Informed Consent Form [Attachment B]. Throughout the session, respondents will only be identified by their first names, which will be written on a name tent and placed in front of them on the table. Participants will be asked to provide feedback about the three sets of redesigned contact materials. The moderator may probe based upon the content of the discussion and participant responses. The moderator’s guide developed for use during the focus group can be found in Attachment C. The moderator role will also require some latitude to deviate from and/or make changes to the guide during the focus group process in order to follow up on new information that is gained from respondents during the course of the discussion. After the interview, participants will be thanked and given the $75 cash incentive, for which they will be asked to sign a Focus Group Incentive Receipt Form [Attachment D].

14. Methods to Maximize Response Rates

Participants will be offered a $75 cash incentive to encourage participation. Recruiting flyers will advertise the incentive in order to encourage people to call in to learn about the focus group and volunteer to participate. To assure recruited focus group participants attend their scheduled session, each selected person will receive a reminder telephone call the day before the session. Participants will also receive directions to the facility and have an opportunity to ask any questions about the goals or procedures of the study.

Distribution of 2009 Focus Groups by Language, Site, and Age

Language Spoken			Metropolitan Area			Age Group
	Groups	participants		groups	participants		groups	participants
English	11	110	Dallas-Fort Worth	3	30	18 to 29	1	10
						30 to 49	1	10
						50 +	1	10
			Los Angeles	3	30	18 to 29	1	10
						30 to 49	1	10
						50 +	1	10
			Raleigh-Durham	3	30	18 to 29	1	10
						30 to 49	1	10
						50 +	1	10
			Washington	2	20	18 to 29	1	10
						30 to 49	0	0
						50 +	1	10
Spanish	6	60	Chicago	3	30	18 to 29	1	10
						30 to 49	1	10
						50 +	1	10
			Washington	3	30	18 to 29	1	10
						30 to 49	1	10
						50 +	1	10
Totals	17	170	Chicago	3	30	18 to 29	6	60
			Dallas-Fort Worth	3	30
			Los Angeles	3	30	30 to 49	5	50
			Raleigh-Durham	3	30
			Washington	5	50	50 +	6	60

15. Tests of Procedures

The activities to be conducted under this approval are in themselves tests of procedures.

16. Statistical Consultants

Arthur Hughes (240) 276-1261 Project Officer/Mathematical Statistician Division of Population Surveys OAS, SAMHSA	Dicy Painter (240) 276-1264 Alternate Project Officer Division of Population Surveys OAS, SAMHSA
Peggy Barker (240) 276-1258 Statistician Division of Population Surveys OAS, SAMHSA	Joel Kennet (240) 276-1265 Statistician Division of Population Surveys OAS, SAMHSA

ATTACHMENTS

Attachment A - Focus Group Recruitment and Screening Protocol

Attachment B - Focus Group Informed Consent Form

Attachment C ‑ Focus Group Moderator’s Guide

Attachment D ‑ Focus Group Incentive Receipt Form

Attachment E - Contact Materials – Lead Letter Envelope (Version 1)

Attachment F - Contact Materials – Lead Letter Envelope (Version 2)

Attachment G - Contact Materials – Lead Letter (Version 1)

Attachment H - Contact Materials – Lead Letter (Version 2)

Attachment I - Contact Materials – Lead Letter (Version 3)

Attachment J - Contact Materials – Q&A Brochure (Version 1)

Attachment K - Contact Materials – Q&A Brochure (Version 2)

Attachment L - NSDUH Confidentiality Pledge

Attachment M - Focus Group Recruitment Advertisement (sample)

REFERENCES

Willis, G. B. (2005). Cognitive Interviewing: A Tool for Improving Questionnaire Design (p. 144). Sage Publications, Inc.: Thousand Oaks, CA.

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