Att I J K L M P Q T

I - Att I J K L M P Q T.pdf

2014 National Survey on Drug Use and Health (NSDUH)

Att I J K L M P Q T

OMB: 0930-0110

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Interview [Adult]—Too Busy/No Time (I1)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident:
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you expressed some reluctance
about spending the time necessary to do the interview.
A limited number of people were randomly selected to represent the population of the U.S. You cannot
be replaced. If you choose not to participate, your experiences and views—as well as the thousands of
people you represent—will not be heard.
As you know, this nation is made up of all kinds of people, and so we are interviewing all kinds of
people—including busy people like you. If we only interviewed people who have a lot of free time, then
active people like yourself would not be fairly represented. Your participation is critical to the success of
this study, and we are happy to make a special effort to work around your schedule so that you can be
included.
We appreciate that your time is a precious commodity. As a token of our appreciation, you will receive
$30 in cash at the end of the interview.
We combine your answers with the answers of thousands of other people and report them only as overall
numbers. The survey is set up so that you record most of your own answers—the interviewer never sees
or hears them. Also, the option to refuse to answer any question is always available.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you will make a direct impact on
important health-related decisions.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely beneficial
study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].
________________________
*The National Survey on Drug Use and Health is conducted by Research Triangle Institute for the Substance Abuse and Mental
Health Services Administration, an agency of the U.S. Public Health Service in the Department of Health and Human Services.
[http://nsduhweb.rti.org] [http://www.samhsa.gov] [http://www.rti.org]
I1

Interview [Adult]—Surveys/Government Too Invasive (I2)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you expressed some concerns
about participating in the study.
We understand that your privacy is important—Research Triangle Institute protects your privacy by not
providing any individual answers to anyone. Your answers are combined with the answers of thousands
of other people and reported only as overall numbers. Also, we never ask for your name.
To further protect your privacy, the survey is set up so that you record most of your own answers—the
interviewer never sees or hears them. Also, the option to refuse to answer any question is always
available.
A limited number of people were randomly selected to represent the population of the U.S. You cannot
be replaced. If you choose not to participate, your experiences and views—as well as the thousands of
people you represent—will not be heard.
We also appreciate that your time is a precious commodity. As a token of our appreciation, you will
receive $30 in cash at the end of the interview.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you will make a direct impact on
important health-related decisions.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions, telephone me toll-free at [TOLL FREE NUMBER].
________________________
*The National Survey on Drug Use and Health is conducted by Research Triangle Institute for the Substance Abuse and Mental
Health Services Administration, an agency of the U.S. Public Health Service in the Department of Health and Human Services.
[http://nsduhweb.rti.org] [http://www.samhsa.gov] [http://www.rti.org]
I2

Interview [Adult]—Needs Clarification (I3)
[DATE]
Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you expressed some concerns
about the study.
A limited number of people were randomly selected to represent the population of the U.S. You cannot
be replaced. If you choose not to participate, your experiences and views—as well as the thousands of
people you represent—will not be heard.
Your answers to the survey questions are combined with the answers of thousands of other people and
reported only as overall numbers. To further protect your privacy, the survey is set up so that you record
most of your own answers—the interviewer never sees or hears them. Also, the option to refuse to
answer any question is always available.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you will make a direct impact on
important health-related decisions.
Your participation is critical to the success of this study, and we are happy to make a special effort to
work around your schedule so that you can be included.
We appreciate that your time is a precious commodity. As a token of our appreciation, you will receive
$30 in cash at the end of the interview.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.

Sincerely,

Interview [Adult]—"Nothing in it for me"/Uncooperative (I4)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you were not interested in
participating. We are writing this letter to ask you to reconsider.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you will make a direct impact on
important health-related decisions.
Without adequate levels of participation, these health-related decisions might not be as informed, and
money for programs that might be needed in your state or community could be directed elsewhere.
A limited number of people were randomly selected to represent the population of the U.S.—and you
were one of them! You cannot be replaced. If you choose not to participate, your experiences and
views—as well as the thousands of people you represent—will not be heard.
We appreciate that your time is a precious commodity. As a token of our appreciation, you will receive
$30 in cash at the end of the interview.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

Interview [Adult]—Spouse/HH Member will not allow Participation (I5)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you expressed some concerns
about participating in the study.
We understand that your privacy is important—Research Triangle Institute protects your privacy by not
providing any individual answers to anyone. Your answers are combined with the answers of thousands
of other people and reported only as overall numbers. Also, we never ask for your name.
To further protect your privacy, the survey is set up so that you record most of your own answers—the
interviewer never sees or hears them. Also, the option to refuse to answer any question is always
available.
A limited number of people were randomly selected to represent the population of the U.S. You cannot
be replaced. If you choose not to participate, your experiences and views—as well as the thousands of
people you represent—will not be heard.
Your participation is critical to the success of this study, and we are happy to make a special effort to
work around your schedule so that you can be included. Please feel free to call me to set up an
appointment at a time that would be convenient for you.
We also appreciate that your time is a precious commodity. As a token of our appreciation, you will
receive $30 in cash at the end of the interview.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

Interview [Teen]—Too Busy/No Time (M1)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you expressed some reluctance
about spending the time necessary to do the interview.
A limited number of teenagers were randomly selected to represent the teenage population of the U.S.
You cannot be replaced. If you choose not to participate, your experiences and views—as well as a
thousand other teenagers you represent—will not be heard.
We understand that you have many demands on your time. However, if we only interviewed teenagers
who had lots of free time, then active teenagers like yourself would not be fairly represented. Your
participation is critical to the success of this study, and we are happy to make a special effort to work
around your schedule so that you can be included.
We appreciate that your time is precious to you. As a token of our appreciation, you will receive $30
in cash at the end of the interview.
Please know that your privacy will be protected. Your answers cannot be looked at by anyone—
including your parents. We combine your answers with the answers of thousands of other teenagers and
report them only as overall numbers. Also, the survey is set up so that you record most of your own
answers—the interviewer never sees or hears them. The option to refuse to answer any question is always
available.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial survey.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].

________________________
*The National Survey on Drug Use and Health is conducted by Research Triangle Institute for the Substance Abuse and Mental
Health Services Administration, an agency of the U.S. Public Health Service in the Department of Health and Human Services.
[http://nsduhweb.rti.org] [http://www.samhsa.gov] [http://www.rti.org]
M1

Interview [Parent]—Teen Exposure (M2)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: Parent/Guardian of [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute asked permission for a young person in
your home to participate in the National Survey on Drug Use and Health. At the time, you expressed
some reluctance about exposing your teen to questions related to substance use.
We understand your concern. Please know that if you allow your teen to participate, the option is always
available for him or her to answer “I don’t know” to any question.
The survey also includes other questions related to school and community topics, such as participation in
different types of school-based activities.
A limited number of teens were randomly selected to represent the teenage population of the U.S. Your
teenager cannot be replaced. We need responses from everyone selected to get an accurate picture of
teenage health issues. For example, in order to know how many teens are using various substances, we
need to hear from the thousands of teens who are not using any substances.
We also appreciate that your teen’s time is a precious commodity. As a token of our appreciation, your
teen will receive $30 in cash at the end of the interview. Also, the interviewer can give your teen a
Certificate of Participation—some participants have been able to go to their schools with this certificate
and get class or community service credit for participating in the survey.
Thank you for your time. I hope you’ll reconsider and choose to let your teenager participate in this
extremely important and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].

Interview [Teen]—Needs Clarification (M3)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you expressed some concerns
about the study.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you will make a direct impact on
important health-related decisions.
A limited number of teenagers were randomly selected to represent the teenage population of the U.S.
You cannot be replaced. If you choose not to participate, your experiences and views—as well as a
thousand other teenagers you represent—will not be heard.
Please know that your privacy will be protected. Your answers cannot be looked at by anyone—
including your parents. We combine your answers with the answers of thousands of other teenagers and
report them only as overall numbers. Also, the survey is set up so that you record most of your own
answers—the interviewer never sees or hears them. The option to refuse to answer any question is always
available.
Your participation is critical to the success of this study, and we are happy to make a special effort to
work around your schedule so that you can be included.
We appreciate that your time is a precious commodity. As a token of our appreciation, you will receive
$30 in cash at the end of the interview.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].

Interview [Teen]—"Nothing in it for me"/Uncooperative (M4)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute came to your home and asked you to
participate in the National Survey on Drug Use and Health. At the time, you were not interested in
participating. We are writing this letter to ask you to reconsider.
A limited number of teenagers were randomly selected to represent the teenage population of the U.S.—
and you were one of them! You cannot be replaced. If you choose not to participate, your experiences
and views—as well as a thousand other teenagers you represent—will not be heard.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you will make a direct impact on
important health-related decisions.
We appreciate that your time is a precious commodity. As a token of our appreciation, you will receive
$30 in cash at the end of the interview. Also, your interviewer can give you a Certificate of
Participation—some participants have been able to go to their schools with this certificate and get class or
community service credit for participating in the survey.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions, telephone me toll-free at [TOLL FREE NUMBER].

Interview [Parent]—Parent /HH Member will not allow Participation (M5)

[DATE]
Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]

Attention: Parent/Guardian of [age] year old [gender] resident

Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute asked permission for a young person in
your home to participate in the National Survey on Drug Use and Health. At the time, you expressed
some reluctance about allowing your teen to participate in the study. We are writing this letter to ask you
to reconsider.
A limited number of teens were randomly selected to represent the teenage population of the U.S. Your
teenager cannot be replaced. It is not necessary that he or she know anything about drugs, alcohol, or
tobacco to participate in the study. In fact, in order to know how many teens are using various
substances, we need to hear from the thousands of teens who are not.
If you allow your teen to participate, the option is always available for him or her to answer “I don’t
know” or to refuse any question.
We understand that the privacy of your family is important—Research Triangle Institute protects
participants’ privacy by not providing any individual answers to anyone. Your teen’s answers would be
combined with the answers of thousands of other teens and reported only as overall totals.
We also appreciate that your teen’s time is a precious commodity. As a token of our appreciation, your
teen will receive $30 in cash at the end of the interview. Also, the interviewer can give your teen a
Certificate of Participation—some participants have been able to go to their schools with this certificate
and get class or community service credit for participating in the survey.
Thank you for your time. I hope you’ll reconsider and choose to let your teenager participate in this
extremely important and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].

Screening—Too Busy/No Time (S1)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]
Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute contacted someone in your household
about participating in the National Survey on Drug Use and Health. We are sorry we called on your
household at an inconvenient time.
The initial questions for the study only take about five minutes and ask for very general information.
After these initial questions, someone in your household may or may not be randomly selected to
participate in the full interview.
If anyone is selected for the full interview, that person will receive $30 in cash at the end of the
interview as a token of appreciation for participating.
A limited number of households were randomly selected to represent the population of the U.S. Your
household cannot be replaced. If you choose not to participate, your experiences and views—as well as
the thousands of people you represent—will not have a chance to be heard.
As you know, this nation is made up of all kinds of people, and so we are talking to all kinds of people—
including busy people like you. If we only interviewed people who have a lot of free time, then active
people like yourself would not be fairly represented. Your participation is critical to the success of this
study, and we are happy to make a special effort to work around your schedule so that you can be
included.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].

Screening—Surveys /Government Too Invasive (S2)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]
Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute contacted someone in your household
about participating in the National Survey on Drug Use and Health. We understand that at the time, some
concerns were expressed about participating in the study.
Your privacy is important—Research Triangle Institute protects your privacy by not providing any
individual answers to anyone. Your answers are combined with the answers of thousands of other people
and reported only as overall numbers. Also, we never ask for your full name. To further protect your
privacy, the interview is set up so that you record most of your own answers—the interviewer never sees
or hears them.
A limited number of households were randomly selected to represent the population of the U.S. Your
household cannot be replaced. If you choose not to participate, your experiences and views—as well as
the thousands of people you represent—will not have a chance to be heard.
If you agree to participate, the option to refuse to answer any question is always available. The initial
questions for the study only take about five minutes and ask for very general information. After these
initial questions, someone in your household may or may not be randomly selected to participate in the
full interview.
If anyone is selected for the full interview, that person will receive $30 in cash at the end of the
interview as a token of appreciation for participating.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions, telephone me toll-free at [TOLL FREE NUMBER].

Screening—Needs Clarification (S3)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]
Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute contacted someone in your household
about participating in the National Survey on Drug Use and Health. We understand that at the time, some
concerns were expressed about participating in the study.
A limited number of households were randomly selected to represent the population of the U.S. Your
household cannot be replaced. If you choose not to participate, your experiences and views—as well as
the thousands of people you represent—will not have a chance to be heard.
If you agree to participate, the option to refuse to answer any question is always available. The initial
questions for the study only take about five minutes and ask for very general information. After these
initial questions, someone in your household may or may not be randomly selected to participate in the
full interview.
Your answers are combined with the answers of thousands of other people and reported only as overall
numbers. Also, we never ask for your full name. To further protect privacy, the interview is set up so
that the participant records most answers—the interviewer never sees or hears them.
If anyone is selected for the full interview, that person will receive$30 in cash at the end of the
interview as a token of appreciation for participating.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions or would like to set up an appointment, telephone me toll-free at
[TOLL FREE NUMBER].

Screening—"Nothing in it for me"/Uncooperative (S4)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]
Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute contacted someone in your household
about participating in the National Survey on Drug Use and Health. We understand that at the time, there
was no interest in participating. We are writing to ask you to reconsider.
The initial questions for the study only take about five minutes and ask for very general information.
After these initial questions, someone in your household may or may not be randomly selected to
participate in the full interview.
If anyone is selected for the full interview, that person will receive $30 in cash at the end of the
interview as a token of appreciation for participating.
A limited number of households were randomly selected to represent the population of the U.S. Your
household cannot be replaced. If you choose not to participate, your experiences and views—as well as
the thousands of people you represent—will not have a chance to be heard.
The results of this study help state and national policymakers learn about health issues—including
information on alcohol, tobacco, and drug use, non-use, and opinions—so that informed decisions about
policies and programs can be made. By participating in this study, you can make a direct impact on
important health-related decisions.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,

[FS NAME], Field Supervisor
P.S. Please, if you have any questions, telephone me toll-free at [TOLL FREE NUMBER].

Screening—Spouse/HH Member will not allow Participation (S5)
[DATE]

Resident
[STREET ADDRESS]
[CITY], [STATE] [ZIPCODE]
Dear Resident,
Recently, a Field Interviewer from Research Triangle Institute contacted someone in your household
about participating in the National Survey on Drug Use and Health. We understand that at the time, some
concerns were expressed about participating in the study.
Your privacy is important—Research Triangle Institute protects your privacy by not providing any
individual answers to anyone. Your answers are combined with the answers of thousands of other people
and reported only as overall numbers. Also, we never ask for anyone’s full name. To further protect
privacy, the interview is set up so that the participant records most answers—the interviewer never sees or
hears them.
If you agree to participate, the option to refuse to answer any question is always available. The initial
questions for the study only take about five minutes and ask for very general information. After these
initial questions, someone in your household may or may not be randomly selected to participate in the
full interview.
If anyone is selected for the full interview, that person will receive $30 in cash at the end of the
interview as a token of appreciation for participating.
A limited number of households were randomly selected to represent the population of the U.S. Your
household cannot be replaced. If you choose not to participate, your experiences and views—as well as
the thousands of people you represent—will not have a chance to be heard.
Your participation is critical to the success of this study, and we are happy to make a special effort to
work around your schedule so that you can be included. Please feel free to call me to set up an
appointment at a time that would be convenient for you.
Thank you for your time. I hope you’ll reconsider and choose to participate in this extremely important
and beneficial study.
Sincerely,
[FS NAME], Field Supervisor
P.S. Please, if you have any questions, telephone me toll-free at [TOLL FREE NUMBER].

Interview Incentive Receipt
United States Public Health Service
and
Research Triangle Institute

thank you for participating in the 2014 National Survey on Drug Use and Health.
In appreciation of your participation in this important study, you are eligible to receive $30 in cash.
Since maintaining the confidentiality of your information is important to us, your name will not be

___________________________________
Interviewer

□

_________
Date

__ __ __ __ __ __ __ __ __ __ - __
Case ID

□

Accepted Cash Incentive

Declined Cash

If you ever feel that you need to talk to someone about mental health issues, you can call the
National Lifeline Network. Counselors are available to talk at any time of the day or night and they
can give you information about services in your area.
1-800-273-TALK or 1-800-273-8255
1-888-628-9454 (Spanish)
http://suicidepreventionlifeline.org/
If you ever feel that you need to talk to someone about drug use issues, you can call the Substance
Abuse and Mental Health Services Administration’s Treatment Referral Helpline. This is a 24-hour
service that will help you locate treatment options near you.
1-800-662-HELP or 1-800-662-4357
1-800-487-4889 (TDD)
http://findtreatment.samhsa.gov
Disposition: Top copy to Respondent, yellow to Field Supervisor, pink to Field Interviewer.

Interview Incentive Receipt
United States Public Health Service
and
Research Triangle Institute

___________________________________
Interviewer

□

Accepted Cash Incentive

_________
Date

__ __ __ __ __ __ __ __ __ __ - __
Case ID

□

Declined Cash

If you ever feel that you need to talk to someone about mental health issues, you can call the
National Lifeline Network. Counselors are available to talk at any time of the day or night and they
can give you information about services in your area.
1-800-273-TALK or 1-800-273-8255
1-888-628-9454 (Spanish)
http://suicidepreventionlifeline.org/
If you ever feel that you need to talk to someone about drug use issues, you can call the Substance
Abuse and Mental Health Services Administration’s Treatment Referral Helpline. This is a 24-hour
service that will help you locate treatment options near you.
1-800-662-HELP or 1-800-662-4357
1-800-4874889 (TDD)
http://findtreatment.samhsa.gov
Disposition: Top copy to Respondent, yellow to Field Supervisor, pink to Field Interviewer.

3/18/13

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IRBs for this Organization: 3

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IRB #1

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Park

NORTH
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Triangle Inst
IRB #2

Research
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Park

NORTH
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Active

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2014 National Survey on
Drug Use and Health
SHOWCARD BOOKLET

RESEARCH TRIANGLE INSTITUTE

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Tech Support ....... (877) 419-1768
Headway.............. (800) 208-7043
To reach other RTI staff, call toll-free 1-800-848-4079
then ask the operator for the employee with whom you
wish to speak.

Website Addresses
NSDUH ................. http://nsduhweb.rti.org
RTI ...................... http://www.rti.org
SAMHSA ............... http://www.samhsa.gov

DEPARTM ENT OF HEAL TH & HUM AN SERVI CES

U.S. Public Health Service
Center for Behavioral Health Statistics and Quality
Rockville, MD 20857

______________, 2014

Dear Resident:
To better serve all people across the nation, the United States Public Health Service (USPHS)
is conducting a national study on health-related issues. Your address was randomly chosen
along with more than 200,000 others. Research Triangle Institute (RTI) is under contract to
carry out this study for the USPHS. Soon, an RTI interviewer will be in your neighborhood to
give you more information.
When the interviewer arrives, please ask to see his or her personal identification card. An
example of the ID card is shown below. The interviewer will ask you a few questions, and
then may ask one or two members of your household to complete an interview. It is possible
that no one from your household will be chosen to be interviewed. You may choose not to
take part in this study, but no one else can take your place. Every person who is chosen and
completes the interview will receive $30 in cash.
All the information collected is confidential and will be used only for statistical purposes.
This is assured by federal law. This letter is addressed to “Resident” because your address was
selected, and we do not know your name. Feel free to ask the interviewer any questions you
have about the study.
Your help is very important to this study’s success. Thank you for your cooperation.

pl
m
Ex
a

Joel Kennet, Ph.D.
National Study Director,
Center for Behavioral Health Statistics
and Quality

Sincerely,

Ilona S. Johnson
National Field Director, RTI
(800) 848-4079
______________________________
Assigned Field Interviewer

Confidentiality protected by the Confidential Information Protection and Statistical Efficiency Act of 2002 (PL 107-347)
Authorized by Section 505 of the Public Health Service Act (42 USC 290aa4)
Approved by Office of Management and Budget (OMB Approval No. 0930-0110)

Study
Description
U.S. Public Health Service
Center for Behavioral Health
Statistics and Quality
Your address is one of several in this area randomly chosen for the 2014 National
Survey on Drug Use and Health. This study, sponsored by the United States Public
Health Service, collects information for research and program planning by asking about:
• tobacco, alcohol, and drug use or non-use,
• knowledge and attitudes about drugs,
• mental health, and
• other health issues.
You cannot be identified through any information you give us. Your name and address
will never be connected to your answers. Also, federal law requires us to keep all of
your answers confidential. Any data that you provide will only be used by authorized
personnel for statistical purposes according to the Confidential Information Protection
and Statistical Efficiency Act of 2002.
The screening questions take just a few minutes. If anyone is chosen, the interview will
take about an hour. You can refuse to answer any questions, and you can quit at any
time. Each person who is chosen and completes the interview will receive $30
in cash.
If you have questions about the study, call the Project Representative at 1-800-8484079. If you have questions about your rights as a study participant, call RTI’s Office of
Research Protection at 1-866-214-2043 (a toll-free number). You can also visit our
project website: http://nsduhweb.rti.org/ for more information.
Thank you for your cooperation and time.

Peter Tice, Ph.D.
Project Officer
Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration (SAMHSA)
U.S. Public Health Service
Department of Health and Human Services
Your confidentiality is protected by the Confidential Information Protection and Statistical Efficiency Act of 2002
(CIPSEA, PL 107-347). Any project staff or authorized data user who violates CIPSEA may be subject to a jail
term of up to 5 years, a fine of up to $250,000, or both.
NOTICE: Public reporting burden for this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, Paperwork Reduction Project (09300110); Room 2-1057; 1 Choke Cherry Road, Rockville, MD 20857. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. The OMB control number for this project is 0930-0110, expiration date xx/xx/xx.

INTRODUCTION AND INFORMED CONSENT FOR
INTERVIEW RESPONDENTS AGE 18+

IF INTERVIEW RESPONDENT IS NOT SCREENING RESPONDENT,
INTRODUCE YOURSELF AND STUDY AS NECESSARY: Hello, I’m ________,
and I’m working on a nationwide study sponsored by the U.S. Public Health
Service. You should have received a letter about this study. (SHOW LEAD
LETTER, IF NECESSARY.)
READ THE BOXED INFORMATION BELOW
BEFORE STARTING EVERY INTERVIEW

This year, we are interviewing about 70,000 people across the nation. You have
been randomly chosen to take part. You will represent over 4,500 other people who
are similar to you. You may choose not to take part in this study, but no one else
can take your place. We will give you $30 when you finish the interview.
GIVE STUDY DESCRIPTION TO R IF YOU HAVE NOT ALREADY DONE SO.
This study asks about tobacco, alcohol, and drug use or non-use, knowledge and
attitudes about drugs, mental health, and other health issues. It takes about an
hour. You will answer most of the questions on the computer, so I will not see your
answers. We are only interested in the combined responses from all 70,000 people,
not just one person’s answers. This is why we do not ask for your name and we
keep your answers separate from your address. RTI may contact you by phone or
mail to ask a few questions about the quality of my work. This is why we ask for
your phone number and current address at the end of the interview.
While the interview has some personal questions, federal law keeps your answers
private. We hope that protecting your privacy will help you to give accurate
answers. You can quit the interview at any time and you can refuse to answer any
questions.
If it is all right with you, let’s get started.
(Can we find a private place to complete the interview?)

INTRODUCTION AND INFORMED CONSENT FOR
INTERVIEW RESPONDENTS AGE 12-17
FIRST, READ THE PARENTAL PERMISSION SCRIPT BELOW AND
OBTAIN PERMISSION FROM THE PARENT

Your (AGE) year-old child has been selected to be in this study. Your child’s participation is
voluntary. This interview asks about tobacco, alcohol, and drug use or non-use, knowledge
and attitudes about drugs, mental health, and other health related issues. All of your child’s
answers will be confidential and used only for statistical purposes. Since your child will answer
most of the questions on the computer, I will never see the answers, and you are not allowed
to see them either. If it is all right with you, we’ll get started.
(Can we find a private place to complete the interview?)

THEN, READ THE BOXED INFORMATION BELOW BEFORE STARTING EVERY
INTERVIEW WITH A 12-17 YEAR OLD

This year, we are interviewing about 70,000 people across the nation. You have been
randomly chosen to take part. You will represent over 1,000 young people in this country who
are similar to you. You may choose not to take part in this study, but no one else can take
your place. We will give you $30 when you finish the interview.
GIVE STUDY DESCRIPTION TO R IF YOU HAVE NOT ALREADY DONE SO.
This study asks about tobacco, alcohol, and drug use or non-use, knowledge and attitudes
about drugs, mental health, and other health issues. It takes about an hour. You will answer
most of the questions on the computer, so I will not see your answers. Your answers will
never be seen by either your parents or your school. We are only interested in the combined
responses from all 70,000 people, not just one person’s answers. This is why we do not ask
for your name and we keep your answers separate from your address. RTI may contact you
by phone or mail to ask a few questions about the quality of my work. This is why we ask for
your phone number and current address at the end of the interview.
While the interview has some personal questions, federal law keeps your answers private. We
hope that protecting your privacy will help you to give accurate answers. You can quit the
interview at any time and you can refuse to answer any questions.
If it is all right with you, let’s get started.

SHOWCARD 1

MEXICAN, MEXICAN AMERICAN, MEXICANO
OR CHICANO

PUERTO RICAN

CENTRAL OR SOUTH AMERICAN

CUBAN OR CUBAN AMERICAN

DOMINICAN (FROM DOMINICAN REPUBLIC)

SPANISH (FROM SPAIN)

SHOWCARD 2

WHITE

BLACK OR AFRICAN AMERICAN

AMERICAN INDIAN OR ALASKA NATIVE
(AMERICAN INDIAN INCLUDES NORTH
AMERICAN, CENTRAL AMERICAN, AND SOUTH
AMERICAN INDIANS)

NATIVE HAWAIIAN

GUAMANIAN OR CHAMORRO

SAMOAN

OTHER PACIFIC ISLANDER

ASIAN (INCLUDING: ASIAN INDIAN, CHINESE,
FILIPINO, JAPANESE, KOREAN, AND
VIETNAMESE)

SHOWCARD 3

ASIAN INDIAN

CHINESE

FILIPINO

JAPANESE

KOREAN

VIETNAMESE

SHOWCARD 4

SEPTEMBER 2001 OR LATER

AUGUST 1990 TO AUGUST 2001 (INCLUDING
PERSIAN GULF WAR)

MAY 1975 TO JULY 1990

VIETNAM ERA (MARCH 1961 TO APRIL 1975)

FEBRUARY 1955 TO FEBRUARY 1961

KOREAN WAR (JULY 1950 TO JANUARY 1955)

JANUARY 1947 TO JUNE 1950

WORLD WAR II (DECEMBER 1941 TO DECEMBER
1946)

NOVEMBER 1941 OR EARLIER

SHOWCARD 5

NEVER ATTENDED SCHOOL

PRIMARY AND SECONDARY GRADES:
1

1ST GRADE COMPLETED

2ND GRADE COMPLETED

3RD GRADE COMPLETED

4TH GRADE COMPLETED

5TH GRADE COMPLETED

6TH GRADE COMPLETED

7TH GRADE COMPLETED

8TH GRADE COMPLETED

9TH GRADE COMPLETED

10TH GRADE COMPLETED

11TH GRADE COMPLETED

12TH GRADE COMPLETED

COLLEGE OR UNIVERSITY:
13

1ST YEAR COMPLETED

2ND YEAR COMPLETED

3RD YEAR COMPLETED

4TH YEAR COMPLETED

5TH OR HIGHER YEAR COMPLETED

SHOWCARD 6

PRIMARY AND SECONDARY GRADES:
1

1ST GRADE

2ND GRADE

3RD GRADE

4TH GRADE

5TH GRADE

6TH GRADE

7TH GRADE

8TH GRADE

9TH GRADE

10TH GRADE

11TH GRADE

12TH GRADE

COLLEGE OR UNIVERSITY:
13

1ST YEAR

2ND YEAR

3RD YEAR

4TH YEAR

5TH YEAR OR HIGHER

SHOWCARD 7
1

SCHOOL WAS BORING OR I DIDN’T WANT TO BE
THERE

I GOT PREGNANT / I GOT SOMEONE PREGNANT

I GOT IN TROUBLE OR EXPELLED FOR SELLING
DRUGS

I GOT IN TROUBLE OR EXPELLED FOR USING
DRUGS

I GOT IN TROUBLE OR EXPELLED FOR SOME
OTHER REASON

I OFTEN GOT INTO TROUBLE

I HAD TO GET A JOB (OR WORK MORE HOURS)

I WAS GETTING BAD GRADES

I WASN’T LEARNING ANYTHING

I GOT MARRIED OR MOVED IN WITH MY
BOY/GIRLFRIEND

I MOVED HERE FROM ANOTHER COUNTRY AND
DIDN’T ENROLL IN SCHOOL (OR DROPPED OUT
OF SCHOOL) BECAUSE OF LANGUAGE OR OTHER
PROBLEMS

I WAS TREATED BADLY AT SCHOOL

I BECAME ILL OR INJURED

I WENT TO JAIL / PRISON

I HAD RESPONSIBILITIES AT HOME OR
PERSONAL PROBLEMS

SHOWCARD 8

MANUFACTURING

WHOLESALE TRADE

RETAIL TRADE

AGRICULTURE

CONSTRUCTION

SERVICE

GOVERNMENT

SHOWCARD 9

PRIVATE FOR-PROFIT COMPANY OR BUSINESS

PRIVATE NOT-FOR-PROFIT COMPANY OR
BUSINESS

LOCAL GOVERNMENT (CITY, COUNTY, ETC.)

STATE GOVERNMENT

FEDERAL GOVERNMENT

INTERNATIONAL OR FOREIGN GOVERNMENT

SELF-EMPLOYED IN AN INCORPORATED
BUSINESS

SELF-EMPLOYED IN AN UNINCORPORATED
BUSINESS

WORKING WITHOUT PAY IN A FAMILY BUSINESS
OR FARM

SHOWCARD 10

ON VACATION, SICK, FURLOUGH, STRIKE, OR
OTHER TEMPORARY ABSENCE

ON LAYOFF AND NOT LOOKING FOR WORK

ON LAYOFF AND LOOKING FOR WORK

WAITING TO REPORT TO A NEW JOB

SELF-EMPLOYED AND DID NOT HAVE ANY
BUSINESS LAST WEEK

GOING TO SCHOOL OR TRAINING

SHOWCARD 11

LOOKING FOR WORK

ON LAYOFF AND NOT LOOKING FOR WORK

KEEPING HOUSE OR CARING FOR CHILDREN
FULL-TIME

GOING TO SCHOOL OR TRAINING

RETIRED

DISABLED FOR WORK

DIDN’T WANT A JOB

SHOWCARD 12

LESS THAN 10 PEOPLE

10-24 PEOPLE

25-99 PEOPLE

100-499 PEOPLE

500 PEOPLE OR MORE

SHOWCARD 13

HANDLED ON AN INDIVIDUAL BASIS/POLICY
DOES NOT SPECIFY WHAT HAPPENS

EMPLOYEE IS FIRED

EMPLOYEE IS REFERRED FOR TREATMENT
OR COUNSELING

NOTHING HAPPENS

SOMETHING ELSE HAPPENS

SHOWCARD 14

SELF

FATHER (INCLUDES STEP, FOSTER,
ADOPTIVE)

SON (INCLUDES STEP, FOSTER, ADOPTIVE)

BROTHER (INCLUDES HALF, STEP, FOSTER,
ADOPTIVE)

HUSBAND

UNMARRIED PARTNER

HOUSEMATE OR ROOMMATE

SON-IN-LAW

GRANDSON

FATHER-IN-LAW

GRANDFATHER

BOARDER OR ROOMER

OTHER RELATIVE

OTHER NON-RELATIVE

SHOWCARD 15

SELF

MOTHER (INCLUDES STEP, FOSTER,
ADOPTIVE)

DAUGHTER (INCLUDES STEP, FOSTER,
ADOPTIVE)

SISTER (INCLUDES HALF, STEP, FOSTER,
ADOPTIVE)

WIFE

UNMARRIED PARTNER

HOUSEMATE OR ROOMMATE

DAUGHTER-IN-LAW

GRANDDAUGHTER

MOTHER-IN-LAW

GRANDMOTHER

BOARDER OR ROOMER

OTHER RELATIVE

OTHER NON-RELATIVE

SHOWCARD 16

PERSON IN FAMILY WITH HEALTH INSURANCE LOST
JOB OR CHANGED EMPLOYERS

LOST MEDICAID OR MEDICAL ASSISTANCE
COVERAGE BECAUSE OF NEW JOB OR INCREASE IN
INCOME

LOST MEDICAID OR MEDICAL ASSISTANCE
COVERAGE FOR SOME OTHER REASON

COST IS TOO HIGH / CAN’T AFFORD PREMIUMS

BECAME INELIGIBLE BECAUSE OF AGE OR
LEAVING SCHOOL

EMPLOYER DOES NOT OFFER COVERAGE, OR
NOT ELIGIBLE FOR COVERAGE

GOT DIVORCED OR SEPARATED FROM PERSON
WITH INSURANCE

DEATH OF SPOUSE OR PARENT

INSURANCE COMPANY REFUSED COVERAGE

DON’T NEED IT

RECEIVED MEDICAID OR MEDICAL INSURANCE
ONLY WHILE PREGNANT

SHOWCARD 17

COST IS TOO HIGH / CAN’T AFFORD PREMIUMS

EMPLOYER DOES NOT OFFER COVERAGE, OR
NOT ELIGIBLE FOR COVERAGE

INSURANCE COMPANY REFUSED COVERAGE

DON’T NEED IT

SHOWCARD 17a

VETERAN’S ADMINISTRATION PAYMENTS

OTHER DISABILITY, RETIREMENT OR SURVIVOR
PENSION

UNEMPLOYMENT OR WORKER’S COMPENSATION

INTEREST INCOME

DIVIDENDS FROM STOCKS OR MUTUAL FUNDS

INCOME FROM RENTAL PROPERTIES, ROYALTIES,
ESTATES OR TRUSTS

ALIMONY

CHILD SUPPORT

SHOWCARD 18

LESS THAN $1,000 (INCLUDING LOSS)

$1,000 - $1,999

$2,000 - $2,999

$3,000 - $3,999

$4,000 - $4,999

$5,000 - $5,999

$6,000 - $6,999

$7,000 - $7,999

$8,000 - $8,999

$9,000 - $9,999

$10,000 - $10,999

$11,000 - $11,999

$12,000 - $12,999

$13,000 - $13,999

$14,000 - $14,999

$15,000 - $15,999

$16,000 - $16,999

$17,000 - $17,999

$18,000 - $18,999

$19,000 - $19,999

SHOWCARD 19

$20,000 - $24,999

$25,000 - $29,999

$30,000 - $34,999

$35,000 - $39,999

$40,000 - $44,999

$45,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,000 OR MORE

2014 National Survey on Drug Use and Health
Summary of the Questionnaire
You have asked to know more about the National Survey on Drug Use and Health and the types of
questions the interviewer will ask. Below is a summary of each section of the questionnaire for you to
examine. Keep in mind that not everyone will see every question—the questions depend on the
participant’s own experiences. Furthermore, participants can always refuse to answer any questions
during the interview.
Demographics
This section, administered by the interviewer, consists of questions about the participant such as his/her
date of birth, race, educational background, and health status.
Sample Questions:

What is the highest grade or year of school you have completed?

Would you say your health in general is excellent, very good, good, fair, or poor?
Computer Practice Session
In this section, the interviewer shows the participant how to use the laptop computer and lets him/her
practice using a short practice session.
Cigarettes, Alcohol and Illicit Drugs
For most of the rest of the interview, the participant answers questions by listening to the questions over
the headphones and/or reading the questions on the computer screen, and then entering responses using
the computer’s keyboard. The participant answers these questions in private, although the interviewer is
available to help with any problems using the computer. During this part of the interview, only the
participant can hear and see the questions and see his/her responses.
Tobacco Products and Alcohol
These sections include questions about whether and how often participants have used cigarettes, chewing
tobacco, snuff, cigars, pipe tobacco, and alcoholic beverages such as beer, wine, or liquor.
Sample Questions:

Have you ever smoked part or all of a cigarette?

How old were you the first time you used chewing tobacco?

What is your best estimate of the number of days you drank alcohol during the past 30 days?
Illicit Drugs
The next sections ask about the participant’s use or non-use of marijuana, heroin, cocaine, hallucinogens,
and inhalants; and prescription pain killers, tranquilizers, stimulants, and sedatives when taken only for
their effect. Questions about drug dependence and drug treatment are also included in these sections.
Sample Questions:

Have you ever, even once, used marijuana or hashish?

How much do people risk harming themselves physically and in other ways when they use
cocaine once a month?

Adult Social Environment and Mental Health
Participants aged 18 and older receive questions about their social experiences such as: how many times
they have moved, their opinions about drug use, and in some cases, their experiences as a parent. Mental
health questions cover such topics as depression and treatment for mental health problems.
Sample Questions:

How do you feel about adults trying marijuana or hashish once or twice?

During the past 12 months, was there any time when you needed mental health treatment or
counseling for yourself but didn’t get it?

Have you ever in your life had a period of time lasting several days or longer when most of the
day you felt sad, empty, or depressed?
Youth Experiences and Mental Health
Youth aged 12-17 participating in the survey are also asked questions about their social experiences such
as: perceptions about the risks of using certain drugs; whether getting drugs is difficult or easy; feelings
about school and peers; and involvement in clubs, sports, and other extracurricular activities. The mental
health questions cover such topics as depression and treatment for mental health problems.
Sample Questions:

During the past 12 months, in how many different kinds of school-based activities, such as team
sports, cheerleading, choir, band, student government, or clubs, have you participated?

Have you ever in your life had a period of time lasting several days or longer when most of the
day you felt sad, empty, or depressed?

During the past 12 months, did you receive treatment or counseling from a private therapist,
psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems
that were not caused by alcohol or drugs?
Health Care and Demographic Information
In this section, the laptop is handed back to the interviewer, who asks questions about education, health
insurance, and family income information to help in analyzing the data. If necessary, a knowledgeable
adult in the household may be asked to help participants answer some of these questions.
The answers to these questions increase the government’s knowledge about health care, especially as it
may relate to drug use or treatment. This information helps in planning health care services and finding
ways to lower the costs of care.
Sample Questions:

How many hours did you work last week at all jobs or businesses?

Before taxes and other deductions, was the total combined family income during 2013 more or
less than 20,000 dollars?

Are you currently covered by private health insurance?

Please feel free to ask the interviewer if you have any other questions about the questionnaire.

Thank you for your cooperation and help!

Enumeration Rules
PERSONS WHO ARE NOT TO BE INCLUDED ON ROSTER:



Persons under the age of 12 at the time of screening (do count them in the total SDU
Members number)



Persons who are institutionalized at the time of screening



Persons who will not live at the SDU for most of the time during the quarter

PERSONS WHO ARE TO BE INCLUDED ON ROSTER:



Persons who will live at the SDU for most of the time during the quarter (provided
they are 12 or older and not institutionalized at the time of screening)

PERSONS ON ACTIVE DUTY IN THE UNITED STATES’ MILITARY/ARMED FORCES:



Active duty personnel who live at the SDU for half or more of the quarter will be
rostered, but then will be made ineligible by the iPAQ prior to selection

KNOWN CITIZENS OF FOREIGN COUNTRIES:



DO NOT INCLUDE:

—

citizens of foreign countries living on the premises of an
embassy, ministry, legation, chancellery, or consulate

—

citizens of foreign countries who consider themselves to
be just visiting or traveling in the United States
(regardless of the length of time they will be staying at the
SDU)

DO INCLUDE citizens of foreign countries who are not living on the premises of an
embassy, ministry, etc., but who are living/studying/working in the United States and
who will be living at the SDU for most of the time during the quarter.

Steps to Maximize Data Quality
This summary is not a replacement for information contained in your FI Manual, but is a listing of
some of the most crucial protocols that must be followed.
Note the FI Manual pages referenced with each key point. Keep in mind these protocols are not
the only steps necessary to follow. Use your FI Manual, Field Supervisor, and project e-mails for
information on additional steps to maximize data quality.

BE SURE YOU FOLLOW EACH OF THESE PROTOCOLS AT ALL TIMES.

SCREENING
•

Use your segment maps, and not just the address, to locate your selected
DUs. [FI Manual p. 3-21]

•

Display your ID badge when knocking on every door in your segment.
[FI Manual pgs. 4-15 and 5-1]

•

Complete screenings in-person with a resident who is 18 or older. The
only exception is in the case of emancipated minors. [FI Manual p. 4-16]

•

Give a Study Description to each SR. [FI Manual p. 4-17]

•

Obtain complete and accurate screening information, reading the screening
questions verbatim to the SR and immediately entering responses into the
iPAQ. The only missing screening data should be a result of the respondent’s
refusal or inability to provide the information. [FI Manual p. 6-15]

INTERVIEW
•

Read the CAI Introduction and Informed Consent from the Showcard
Booklet to the R (choosing the appropriate version based on the respondent’s
age) before beginning the interview. Before speaking with a selected minor,
you must obtain verbal parental permission. If the R was not the SR, give
him/her a Study Description. [FI Manual pgs. 7-22 and 7-23]

•

Make it apparent you are completing the interview in a completely
confidential and unbiased manner. [FI Manual pgs. 2-6, 2-7 and 8-1]

•

To the extent possible, choose an interview location that gives the
respondent privacy. [FI Manual pgs. 7-26 and 7-27]
2

INTERVIEW, CONT.
•

Do not rush the respondent. Do not tell the respondent how to make the
interview go faster. [FI Manual pgs. 8-2 and 8-3]

•

Use the Reference Date Calendar and read the explanation provided
on the CAI screens verbatim to the R. As appropriate, remind the
respondent to use the calendar as a visual aid throughout the interview.
[FI Manual p. 8-14]

•

Familiarize the R with the laptop and function keys by reading the provided
script in the CAI Interview and allow the R to successfully complete the
Computer Practice on his or her own. You must always explain, offer,
AND plug in the headphones with each R. [FI Manual pgs. 8-17 through 8-20]

•

Read the interview questions exactly as they appear on the screen.
It is never acceptable to use your own words or ‘wing it’. Do not assume you
know answers from a previous conversation, question, or interview.
[FI Manual pgs. 8-2 and 8-3]

•

Hand the appropriate Showcard to the respondent when instructed on
the CAI screen. [FI Manual p. 8-13]

•

Allow your respondents to complete the ACASI portion of the interview on
their own. Never read the questions in the ACASI portion out loud to
the respondent. In cases of extreme physical impairment, it may be
necessary to enter the answers into the computer for the ACASI questions, but
always allow the ACASI recording to ‘read’ the questions and answer
categories via the headphones. [FI Manual p. 8-24]

•

Have the respondent fill out the top portion of the Quality Control
Form and allow him or her to insert the form into the envelope and seal it.
Mail the form within 24 hours of the interview. [FI Manual pgs. 8-26 through 8-27]

•

Always protect the confidentiality of your respondents. Never reveal a
respondent’s answers to anyone, including the respondent’s family
members. Resist the temptation to reveal even positive information gleaned
from an interview to parents or other household members.
[FI Manual pgs. 2-6 through 2-8]
3

Sampling Process Explanation
Sam ple: A representative part of a population that is studied to gain information about the whole population.
NSDUH target population: Civilian, non-institutional population aged 12 years or older residing within the 50 United
States and the District of Columbia.

THE PROCESS:

RTI statisticians draw a smaller sample of the target population designed to represent the population as a whole using
probability sampling.
Step 1:
Break each state up into geographic areas, called State Sampling Regions (SSRs) using estimates of population and
housing unit counts from the Census Bureau.
o
o

Number of SSRs is dependent on the population of the state, as shown in the table below:
Each SSR within a state is expected to yield the same number of interviews. This means the more densely
populated the area, the smaller the region.
State

California
Texas, New York, and Florida
Illinois, Pennsylvania, Ohio, and Michigan
Georgia, North Carolina, New Jersey, and Virginia
Remaining 38 States and the District of Columbia
Step 2:
Break each
o
o
o

SSRs

Approx. Int.
per Segment

Total
Segments

36
30
24
15
12

16
14
13
13
10

288
240
192
120
96

SSR up into segments.
Scientifically selected to ensure the sample accurately represents the United States’ population.
Each area is assigned a “probability,” or “chance,” of being selected based on the Census population count.
8 segments selected within each SSR, 2 per quarter of data collection.

Step 3:
Dwelling Units within the segments are counted and listed, and recorded on the List of Dwelling Units or Group
Quarters Listing Form.
Step 4:
From the listed dwelling units, specific HUs and GQUs are randomly selected.
o Selected units are called sample dwelling units, or SDUs which you contact for screening and possible
interviewing.
o Approximately 165,000 SDUs randomly selected each year
Step 5:
Either 0, 1, or 2 persons (respondents) are selected for interview using the roster information entered into the iPAQ
during screening. Approximately 70,000 respondents are selected and complete the interview each year.
o Eligibility for interview is based only on the AGE of the SDU members
o All screening data is used by the RTI statisticians
Analysis:
“Sample Weighting” is used to determine how many people in the population each respondent represents.
o 1 adult - represents over 4,500 other adults
o 1 youth - represents over 1,000 other youths
FIELD INTERVIEWER’S ROLE
Maintain the integrity of the sample by:
o Using segment materials properly
o Following project procedures, including editing address and adding missed DU protocols
o Investigating discrepancies between the materials and what you actually see in the field
o Paying close attention to details

Sampling Process Explanation (continued)
United States

(50 States + DC)

State Sampling Regions
(SSRs)

Number of SSRs varies by State

Segments
8 per SSR

Listed Dwelling Units

Selected Dwelling Units
~ 165,000 randomly
selected per year

Respondents
1 adult=over

4,500 other adults
1 youth=over
1,000 other youths

Overview of the Screening and Interview Process
Review segment materials to locate area and plot the best
and most direct travel route to and from the area.
Prepare and mail lead letters.
Locate (using the segment materials) and contact selected DU.
Enter Physical Features Data based on first visit to DU.
Determine that the SDU is a true HU or GQU,
and check for missed dwelling units.

Complete Record of Calls (ROC) in
iPAQ. Try DU later. If unit is vacant,
not a DU, or only a temporary
residence, verify with neighbor or
other knowledgeable person.
Complete verification information
and ROC.

Try to determine a good time to
return. Complete ROC.

Is anyone home?
Yes

Is an eligible SR
(resident of DU, 18+)
available?

Yes
Complete the household roster and selection process with the SR.

Any
respondents
selected?

Obtain verification information and
thank SR. Complete ROC.

Establish an appointment. Complete
ROC, including an entry about the
interview appointment.

Yes
Can the
selected R complete
interview now?
Yes
Introduce self, study, and obtain informed consent from respondent.
(Obtain parent/guardian consent before approaching a selected youth.)

Conduct interview.
Complete end of the interview tasks, including Quality Control (QC) Form.

Give respondent payment and completed receipt. Give adult respondents & parent/
guardian of youth respondents a Q&A Brochure if not done already.

Thank respondent, complete ROC.
Transmit data to RTI.
Mail Quality Control Form to RTI within 24 hours.

Screening and Interview Tasks
When you work in the field, you will encounter a variety of situations:

Can’t screen (i.e. no one home, vacant units, SR not available, etc.)
•
•
•
•

choose case from Select Case, tap Actions, Screen DU
approach unit and discover you can’t screen
obtain verification information for codes 10, 13 and 18
complete ROC to document situation

Screen only (codes 22, 26, 30)
•
•
•
•
•

choose case from Select Case, tap Actions, Screen DU
approach unit and obtain participation of eligible SR
complete screening
obtain verification information
complete ROC

Screen, then interview (31, 32 and then 70)
•
•
•
•
•
•
•
•
•
•

choose case from Select Case, tap Actions, Screen DU
approach unit and obtain participation of eligible SR
complete screening
complete ROC for screening
obtain participation/informed consent of selected respondent(s)
prepare laptop and enter QuestID from iPAQ
conduct interview(s) with available selected respondent(s)
enter QC ID from Quality Control Form in CAI program in laptop
complete ROC(s) in iPAQ for completed interview(s)
mail completed Quality Control Form(s) to RTI within 24 hours

Screen, make appointment for interview (codes 31, 32 and then 50)
•
•
•
•
•
•

choose case from Select Case, tap Actions, Screen DU
approach unit and obtain participation of eligible SR
complete screening
complete ROC for screening
complete ROC to document appointment for each selected respondent
prepare appointment card and give to each respondent

Interview only at appointment time or other follow-up contact
•
•
•
•
•
•
•

choose case from Select Case, review selections and roster
obtain participation/informed consent of selected respondent(s)
prepare laptop and enter QuestID from iPAQ
conduct interview(s) with selected respondent(s)
enter QC ID from Quality Control Form in CAI program in laptop
complete ROC(s) in iPAQ
mail completed Quality Control Form to RTI within 24 hours

Always enter Physical Features Data based on your first visit to a DU.
7

Physical Features Data Reference Sheet
There are two key elements for entering accurate Physical Features Data into the iPAQ:
1. The SDU characteristic and controlled access type should be based on what you encounter
during your first visit to the SDU. Details on what transpires during subsequent contact
attempts are documented in the Record of Calls (ROC). If the situation changes during future
visits, that information will be reported in the ROCs.
2. Reference the definitions for SDU characteristic and controlled access type. The
categories are abbreviated in the iPAQ program, so reference, as necessary, the additional
information provided in parentheses below or the additional text provided in the iPAQ
information screen.
Physical Features Data provides a “picture” associated with the SDU. These data are used in
conjunction with ROCs to provide more complete information about issues impacting field
interviewers and household surveys.
SDU Characteristic:
Select the description of the characteristics of the SDU from the list on the SDU Characteristic
screen.
IMPORTANT NOTE: Some SDUs may fall into several characteristic categories—if so, check
all characteristics that apply to the SDU. For example, if the SDU is a high-rise apartment
complex (more than 50 units) on a military base, use codes 4 and 5.
1. House/Single Unit (single family home, trailer, or cottage)
2. Multi-unit, 2-9 units (multi-unit structure with 2-9 units)
3. Multi-unit, 10-49 units (multi-unit structure with 10-49 units)
4. Multi-unit, 50+ units (multi-unit structure with 50 or more units)
5. Military Base
6. Student Housing (includes dormitory, fraternity/sorority housing, or college-owned apartment)
7. Native American Tribal Land (Reservation)
8. Senior Housing/Assisted Living (includes houses, apartments, or condos)
9. Other GQU (group quarters units OTHER than those listed in the above options, such as shelters)
10. Empty Lot (empty home site or mobile home site)

Controlled Access Type:
"Controlled access" is defined as any situation where an FI approaches an SDU and
encounters some barrier that prevents the FI from gaining access to the door of the SDU.
Select the type of physical barrier(s), if any, that prevents you from gaining access to the door of the
SDU during your initial visit from the list on the Controlled Access Type screen. If you encounter a
controlled access barrier during your initial visit to a multi-unit building or complex that prevents you
from gaining access to any SDUs, you should enter the barrier type for all SDUs in that building or
complex.
IMPORTANT NOTE: Some SDUs may include multiple types—if so, check all types that apply
to the SDU. For example, if you encounter a guard station and locked gate with no intercom when
trying to approach an SDU in a community and the guard does not grant you access to the
community, you would enter 2 and 3.
1. None (The vast majority of SDUs possess none of the types of access barriers listed below, so
“None” will be a common entry. Remember, if you encounter any of the access barriers below,
but gain access to the door of the SDU during your initial visit, the barrier would be coded as
“None” per the Controlled Access definition.)
2. Guard/Door Person/Staff/Manager (door person at front door who has to call the unit, door
person that must give access to building, guard at gate of community, on-site or off-site manager
who controls access)
3. Locked main entrance/gate, no intercom/buzzer (locked doors, locked gate, controlled gate, or
other locked entry)
4. Locked main entrance/gate with intercom/buzzer, no unit address labels (may contain other
labels such as names, but does not provide address label)
5. Locked main entrance/gate with intercom/buzzer, with unit address labels
Example Scenarios
One story brick home in a gated neighborhood. The gate was open upon your arrival & you
entered and accessed the SDU successfully.
The manager of a college dorm will not grant you access to the locked building (with no
intercom/buzzer). There are 8 SDUs within the 16 unit dorm.
The SDU is in a high rise apartment building with over 100 units. There is a locked elevator
and intercoms with only names listed in the lobby. You are unable to gain access to any
SDUs on your first attempt.
The rural SDU on a reservation is located down a long driveway that is dangerous to traverse
due to severe ice from a recent storm.
The SDU is located in a senior housing apartment building with 18 units. After being granted
access to the building from a guard in the lobby, you buzz residents from an intercom with
room numbers. The residents can unlock the main door from their apartment. You are
granted access by the resident of the first SDU contacted.
After screening 5 SDUs in the senior housing example above, you return a week later to
initially visit the remaining 7 SDUs, but the manager has told the guard not to grant you
access to the building. How do you code the physical features data for the remaining cases?
You try to contact 4 SDUs in an 8 unit apartment complex on a military base, but the guard at
the controlled entrance gate will not grant you access to the base on your first attempt. How
do you code the physical features data for these 4 SDUs?

CHAR

TYPE

3 and 6

2 and 3

1 and 7

3 and 8

2 and 5

2 and 3

If you have questions about entering Physical Features Data, contact your FS.

Editing Address Protocol
When to Edit an Address
Editing SDU addresses should not be a common task. An address should only be edited if the
physical address is missing or incorrect, such as when only a description of the SDU is provided.
Before editing an address, first confirm you are at the correct selected dwelling unit. To do this, use a
combination of project resources, including the handwritten List of DUs, block listing maps, and the
address or description in your iPAQ. If you are confident you are at the correct DU but the address is
incorrect, you should consult the Editing Address Protocol chart. It will guide you on the steps to
follow.
When you edit an address, there are two additional steps you must take to complete the process.
First, you must enter a note in the Record of Calls explaining the reason for the edit. Second, you
should notify your FS of the edit. Your FS must update their copy of the segment materials with the
edit, and in many cases notify RTI’s Sampling Department to update the project sampling frame.
Never make edits to an address which creates a duplicate of an address already listed on the
original List of DUs. Enter a note in the Record of Calls describing the situation and address
discrepancy, and then obtain permission from your FS and Sampling before making the edit.
Carefully checking the original List of DUs before making an edit will ensure no duplication occurs.
After reviewing the Editing Address Protocol chart, if you are unsure whether an address should be
edited or the appropriate procedures to follow, enter detailed notes about the situation in the ROCs
and contact your FS promptly for assistance.
When NOT to Edit an Address
In order to maintain the integrity of the sample, there are specific situations when you should not edit
an address. These situations are listed as “Improper” in the third column of the Editing Address
Protocol chart.
For example, addresses must never be edited due to screening on the incorrect line or at the wrong
dwelling unit. Always double-check the address at the top of the iPAQ screen and consult your
segment materials to prevent this type of error.
Also, do not change an address or description to a Post Office Box, but instead enter any PO Box
information in the Record of Calls.
Lastly, do not edit addresses to change abbreviations to full spellings, such as “Dr.” to “Drive,” or from
full spellings to abbreviations, such as “Boulevard” to “Blvd.”
Reminder:
Always refer to the chart:


when deciding whether or not to edit an address, and



to be certain all appropriate procedures have been completed when editing an address.

EDITING ADDRESS PROTOCOL
REMINDER: Always review your segment maps, original list of dwelling units, and iPAQ information before editing SDU
Scenario

Description of Situation

addresses.
Proper or
Improper to
Appropriate FI Action
Edit

Appropriate FS Action

Description edited to a street address

Proper

Check handwritten list of DUs, if
address is not on list, delete
description; enter street address in
iPAQ; proceed with screening; enter
notes in ROCs; notify FS

Street name spelling corrected or
drive/avenue/street/etc. corrected

Proper

Edit address in iPAQ; proceed with
screening; enter notes in ROCs;
notify FS

Make correction in segment materials

Correction of one SDU address due to
911/U.S. Postal Service/ local
government address revisions

Proper

Edit address in iPAQ; proceed with
screening; enter notes in ROCs;
notify FS

Make correction in segment materials

Correction of listing error for one SDU
(includes edits to street/apt. number)

Proper

Check handwritten list of DUs, if
address is not on list, edit address in
iPAQ; proceed with screening; enter
notes in ROCs; notify FS

Make correction in segment materials

Adding apt. numbers to differentiate
between added units in a SDU or on
SDU property

Proper

Check handwritten list of DUs, if
address is not on list, edit address in
iPAQ; proceed with screening; enter
notes in ROCs; notify FS

Make correction in segment materials

City, state, or zip code corrected

Proper

Edit address in iPAQ; proceed with
screening; enter notes in ROCs;
notify FS

Make correction in segment materials

Within controlled access
buildings/complexes, edits to
addresses for multiple units originally
gained through "blind" listing or listing
by buzzer/mailbox

Proper (with
prior approval
from FS)

Notify FS; if approved by FS, edit
address in iPAQ; proceed with
screening; enter notes in ROCs

Make correction in segment materials;
instruct FI to make edit and proceed
with screening; notify Sampling

Complete street name change

Proper (with
prior approval
from FS and
Sampling)

Notify FS; if approved by FS and
Sampling, edit address in iPAQ;
proceed with screening; enter notes
in ROCs

Seek Sampling approval; if approved,
make correction in segment materials
and instruct FI to make edit in iPAQ
and proceed with screening

Removing the apt. number from SDU
address

Proper (with
prior approval
from FS and
Sampling)

Notify FS; if approved by FS and
Sampling, edit address in iPAQ;
proceed with screening; enter notes
in ROCs

Seek Sampling approval; if approved,
make correction in segment materials
and instruct FI to make edit in iPAQ
and proceed with screening

Correction of address for multiple
units due to 911/U.S. Postal
Service/local government address
revisions

Proper (with
prior approval
from FS and
Sampling)

Notify FS; if approved by FS and
Sampling, edit address in iPAQ;
proceed with screening; enter notes
in ROCs

Seek Sampling approval; if approved,
make correction in segment materials
and instruct FI to make edit in iPAQ
and proceed with screening

Correction of listing error for multiple
units (includes edits to street and/or
apt. number) *See Scenario G for
additional information

Proper (with
prior approval
from FS and
Sampling)

Notify FS; if approved by FS and
Sampling, edit address in iPAQ;
proceed with screening; enter notes
in ROCs

Seek Sampling approval; if approved,
make correction in segment materials
and instruct FI to make edit in iPAQ
and proceed with screening

Adding apt. numbers to single
dwelling units *See Scenario E for
additional information

Proper (with
prior approval
from FS and
Sampling)

Notify FS; if approved by FS and
Sampling, edit address in iPAQ;
proceed with screening; enter notes
in ROCs

Seek Sampling approval; if approved,
make correction in segment materials
and instruct FI to make edit in iPAQ
and proceed with screening

Description or street address edited to
a Post Office Box address

Improper

Place Post Office Box address in
ROCs

Retrain FI

Edit due to screening on the wrong
line or at the wrong dwelling unit

Improper

Request status code change or
reopen code from FS; complete
screening on correct line

Give status code change code or
reopen code or instruct FI to final
code, as appropriate; retrain FI

Edit due to merged or condemned
unit, or unit does not exist

Improper

Notify FS; code case as instructed by
FS and Sampling

Seek Sampling input; instruct FI to
code case as instructed by Sampling

Make correction in segment materials

Missed DUs
You are not required to check the entire segment for missed dwelling units. Instead, you
will ask the screening respondent about possible missed DUs as part of the screening
process at every selected DU. (However do not ignore significant changes, such as a new
development or new apartment building—call your FS.)
At a selected housing unit:
•

For regular housing units (houses, townhouses, trailers, cottages, duplexes), during each
screening you ask the SR if there are any other units within the structure or on the property,
such as a separate apartment with a separate entrance. If so, simply enter the address of the
other unit(s) and proceed with screening.

•

For housing units in apartment and condo buildings, do not ask the Missed DU question.
However, if the SR reports a missed DU such as the rare but possible ‘unit within a unit,’
confirm with the SR and add the unit from the Select Case Screen by tapping “Actions/Add
Missed DU.”

For group quarters structures listed by persons or beds:
•

Compare the original list with the current situation. If there are more units now, call your FS
who will contact RTI’s Sampling Department about which missed GQUs to add.

Limits on missed DUs:
•
•
•

Up to 5 units at one SDU
Up to 10 units per segment
iPAQ stores space for 5 added DUs per segment. If more are required, contact your FS to
have 5 more lines transferred to your iPAQ.

For more information on missed DUs, refer to pages 3-31 through 3-38 and 3-44 through
3-46 in your FI Manual.

Reconciling Missed DUs
Recording the addresses of missed DUs in the iPAQ does not automatically add them to
your assignment. When ready to reconcile these missed DUs to see if they should be
added, be sure that you have the handwritten List of Dwelling Units and the block listing
maps.
You can Reconcile at three different spots in the iPAQ:
•

At the end of screening if you have entered a missed DU address(es). If you don’t have
time or your segment materials, simply tap “No” and reconcile later.

•

If you entered a missed DU address using “Actions/Add Missed DUs,” you will be asked
if you want to reconcile.

•

From the option “Admin/Reconcile Missed DUs.”

To Reconcile Missed DUs:
•

Follow the instructions on the iPAQ screen carefully, making certain you refer to your
segment materials as you reconcile the unit.

•

Determine if the missed unit is already on the handwritten List of DUs.

•

If the missed unit is not on the list, it will be added to your assignment.

•

Complete the List of Added Dwelling Units to document the unit.

•

Remember to mark the location of the missed DU on the correct Block Listing Map.

If you have any questions, exit the program and contact your FS.
In the following situations, check with your FS who will check with RTI’s Sampling
Department:
•
•
•
•
•
•

more than five missed DUs are found at a specific SDU
more than 10 missed DUs are found in a segment
a missed HU (other than a ‘unit within a unit’) is discovered in an apartment or condo
building
a missed GQU is discovered within a group quarters structure
a missed group quarters structure is discovered
a significant listing problem is discovered.

For more information on reconciling missed DUs, refer to pages 3-40 through 3-46 in
your FI Manual.

Guidelines for Speaking with Neighbors
When speaking with neighbors, it’s important only to ask for and obtain certain information. Always
be very general and concise, and do not offer more information than is necessary.
If the neighbor is suspicious and won’t provide any information unless you tell them why you are
interested in a particular address, simply state the household has been selected to participate in a
national study. Do not name or describe the survey.
You CAN speak to a neighbor to:
1. Verify whether someone actually lives at the selected DU(s)
2. Find out a good time to find the residents at home
3. Obtain verification data if the SDU is vacant
When speaking with neighbors, you CANNOT:
1. Explain that the household has been selected to participate in the NSDUH
2. Obtain screening information for the selected DU(s)
Suggested wording to use when speaking with neighbors:
“Hello, my name is [INSERT NAME] with Research Triangle Institute. I am working on a nationwide
study sponsored by the U. S. Public Health Service and need to speak with your neighbor. Do you
know when would be a good time to find them at home?”
OR
“Hello, my name is [INSERT NAME] with Research Triangle Institute. Your neighbor has been
selected to participate in a national study and I’m having trouble catching them at home. Do you
know when a good time would be for me to find them at home?”
Suggested wording for vacancy verification:
“Hello, my name is [INSERT NAME] with Research Triangle Institute. Your neighbor has been
selected to participate in a national study, but it looks like the house may be vacant. Can you tell me
if someone lives there?”

ROC Comments
ROC comments should be appropriate, non-judgmental, and:
•

•
•

Informative – Record appointment times, best times to return, who you talked to, or if no
adult was home, record which cars were in the driveway.
Helpful – Note relevant information for you to use in preparing to return or when discussing
the case with your supervisor. If a case gets transferred to another FI, the notes are very
important to the new FI to understand what has happened.
Concise – Explain your comments directly, leaving out unnecessary words or information.
Your comments must be easily understood by you, your FS, other FIs, and project managers.

Examples of good ROCs:
•
•
•

•

CB after 7:00 pm
2:30 Sat appt
W M 15ish said parents home after 8:00
HISP F 60s send SPAN letter

PROJECT ABBREVIATIONS
R
SR
FI
Q&A
DU

respondent (for the interview)
screening respondent
field interviewer
Q&A Brochure
dwelling unit

STANDARD ABBREVIATIONS
days of the week
F
M
B
W
HISP
SPAN
INFO
REF

(with 3 letters)
female
male
black
white
Hispanic
Spanish
information
refused

SUGGESTED HELPFUL ABBREVIATIONS
CB
APPT
AM
AFTRN
PM
NGHBR
GTKPR
WKND

call back (or come back)
appointment
morning
afternoon
evening
neighbor
gatekeeper
weekend

Counting and Listing Abbreviations
COLORS
BG
BK
BL
BR
DK
GR
GN
LT
MED
OR
PK
RD
TN
WH
YL

ADDRESSES
Beige
Black
Blue
Brown
Dark
Grey
Green
Light
Medium
Orange
Pink
Red
Tan
White
Yellow

ADD
ALY
APT
AVE
BLK
BLVD
BLDG
CIR
CT
DRWR
DR
HWY
JCT
LN
PKWY
PL
PT
PO

OTHER/GENERAL
Address
Alley
Apartment
Avenue
Block
Boulevard
Building
Circle
Court
Drawer
Drive
Highway
Junction
Lane
Parkway
Place
Point
Post Office
(Box)
Road
Route
Street
Terrace

RD
RTE
ST
TER

DIRECTION/ORIENTATION

STRUCTURE/MATERIALS

ABV
ACR
ADJ
BCK
BEH
BTWN
BTM
E
FRT
L
N
NE
NW
RE
R
S
SE
SW
W

ALUM
BRK
BRNSTN
CDR
CBLK
CEM
LOG
RCK
SDG
STN
STU
VNY

Above
Across
Adjacent
Back
Behind
Between
Bottom
East
Front
Left
North
Northeast
Northwest
Rear
Right
South
Southeast
Southwest
West

ARCHITECTURE/BUILDING
STYLE
APT
CPCD
CLNL
CONDO
CNTP
DBLWID
DPX
RCH
RF
SPL
TRAD
TRLR
TRANS

Apartment
Cape Cod
Colonial
Condominium
Contemporary
Doublewide
Duplex
Ranch
Roof
Split Level
Traditional
Trailer
Transitional

Aluminum
Brick
Brownstone
Cedar
Cement Block
Cement
Log
Rock
Siding
Stone
Stucco
Vinyl

TYPES OF ROOFS
FLT

Flat

GBL

Gable

GMBR Gambrel
HIP

Hip

MNSD Mansard
SHGL Shingle
SPNTL Spanish Tile
TIN
Tin

ATT
BSMT
BUS
CPT
CG
CHNLNK
CHMY
CHUR
COL
COR
CO
DB
DRMR
DBL
DRWY
ELCMTR
ENT
EXT
EXTR
FEN
FLR
FDN
FRM
FR
GAR
GRD
GRV
GRND
HSE
LG
MBX
MID
MI
PKT
PCH
PVT
RR
RSTR
RM
SCRN
SHK
SHUT
SD
STR
STY
TR
UC
VAC
VER
VEST
WIN
WD

Attached
Basement
Business
Carport
Cattleguard
Chainlink
Chimney
Church
Column
Corner
County
Doorbell
Dormer
Double
Driveway
Electric Motor
Entrance
Exit
Exterior
Fence
Floor
Foundation
Frame
From
Garage
Guard
Gravel
Ground
House
Large
Mailbox
Middle
Mile
Picket
Porch
Private
Railroad
Restaurant
Room
Screen/Screened
Shake
Shutters
Side Door
Store
Story
Trim
Under
Construction
Vacant
Veranda
Vestibule
Window
Wood

Refusal Reasons
Use these descriptions to help you classify refusals in the iPAQ.
1.

Too busy/no time/did too many surveys already
The number one reason for refusals is lack of time.

Surveys/Govt. invasive/teen exposure
These people feel that the government invades their privacy too much with surveys. There
may be philosophical, political, or religious reasons for not participating in surveys. Parents
may be concerned about exposing their teen to the sensitive subject matter in the survey.

Clarify confidentiality, legitimacy, or selection
Be sure to listen carefully to what respondents are telling you—questions about the legitimacy
of the survey or how the survey guarantees confidentiality can often be explained by you on
the doorstep, if you understand their concern.

“Nothing in it for me”/uncooperative
Although rare, sometimes people will either not give a reason for their refusal or they’ll tell you
that there’s no reason for them to participate.

Gatekeeper/Parent/HH member disallow
Sometimes you encounter a refusal situation controlled by another person besides the person
selected for the interview. A spouse, parent, guardian, or another influential person in the
household may refuse for the selected individual, or deny you the ability to talk directly to the
selected person. Even if you are able to talk with the selected person, he or she may refuse
because of the other person’s opinions.

Welfare or INS concern
Persons involved with various government programs may fear that you are a welfare worker or
an immigration officer checking on their status.

Too ill/house messy/not dressed
These refusals are situational and will not generate a refusal letter. They refused because you
caught them at an awkward time.

Need to discuss with FS
In some cases, a respondent’s refusal won’t fit any of the above categories, but you are able
to gather a sense of what is preventing them from participating. With this option write a very
specific note in the refusal comment section to alert your FS. Then you can talk with him/her
about how best to handle the refusal.

The Interview Process
Informed Consent Procedures
•
•

READ THE INFORMED CONSENT FOUND AT THE FRONT OF THIS BOOKLET TO RESPONDENT
If the respondent is 12 - 17 years old, obtain parental consent first

Choose the Best Interview Location
•

•

Consider the following issues:
– Privacy and ethics
– Comfort and safety
– Battery power and/or the availability of an electrical outlet
Be flexible in choosing a location, but never compromise NSDUH protocols

Setting up the Computer
•
•
•

•
•

Unpack the computer and plug it in using the extension cord if needed
Press the ON button and WAIT for the computer to boot up
While waiting, make sure you have the QuestID displayed on the iPAQ, a Reference Date
Calendar, your Showcard Booklet, a Quality Control Form and envelope, a Q&A Brochure (if not
given earlier), $30 and an Interview Incentive Receipt
Place clean headphone covers on the ear pieces of the headphones and plug the headphones
into the computer
Enter the passwords, then enter the QuestID from the iPAQ to begin the interview

Conducting the Interview
•
•

•

Obtain informed consent (if not done earlier)
If respondent is under the age of 12 or is active in the military, the computer will automatically
complete this case (If this occurs, remember to enter a Code 79 in the iPAQ and explain the
situation)
Complete the Reference Date Calendar, following the script on the computer screen
Write the 12-month and 30-day dates given to you on the computer screen in the
appropriate boxes
– Circle the 12-month reference date
– Circle the 30-day reference date, then underline the 30 days between the circled day and
the current date
– Record the Case ID at the top of the calendar
Use the Showcards as instructed
During the ACASI, be available to assist the respondent without being intrusive
 Prepare the Quality Control Form:
– Record the date and approximate interview completion time
– Print your name and FI ID # legibly
– Record the Case ID, including the A or B
– Indicate which parent (or guardian) gave permission if respondent is a minor
 Prepare the Interview Incentive Receipt:
– Record the date and Case ID, including the A or B
– Do not sign or check the box for cash acceptance until prompted by the computer
–

•
•

The Interview Process (continued)
Other possible tasks include: review your iPAQ ROCs and plan work for the day, re-read
portions of the FI Computer Manual or FI Manual (remove a chapter or two at a time from
the binder) complete your Data Quality Knowledge Notebook entries, re-read the Job Aids
section in the Showcard Booklet, and review materials for information to use when
obtaining cooperation
Enter the QC ID and the Case ID when prompted and follow Quality Control Form procedures
– For a youth, the Quality Control Form should be completed by a parent or guardian (If no
parent is available, it is acceptable for the youth to complete the form)
– The R/parent should place the Quality Control Form into the envelope and seal it (If
R/parent refuses to complete the Quality Control Form, ask him/her to write “REFUSED”
across the top)
Give R the $30 cash, sign your name and mark the appropriate box on the Interview Incentive
Receipt and give the respondent the top copy
Give adult interview respondents and parent/guardian of youth respondents a Q&A Brochure
(if not done earlier)
Answer the observation questions


•

•
•
•

When Finished with the Interview
•

•
•
•
•

Pack up your equipment:
– Unplug the power cord from the computer first, unplug from the wall, then wrap them up and
place in carrying case
– Close the screen display until you hear a click, place the laptop in the case and zip closed
– Remember your iPAQ, Showcard Booklet, Reference Date Calendar, and other papers
THANK YOUR RESPONDENT!
Enter a Code 70 in your iPAQ.
Mail Quality Control Form to RTI within 24 hours of completion of the interview
Mail Reference Date Calendar and Interview Incentive Receipt (FS copy) to your FS each week

Possible Respondent Difficulties
•

•
•

•

Is the respondent physically or emotionally capable of participating?
– Slow the pace of the questions to see if comprehension improves
– Allow adequate time to answer
– If respondent does not seem to understand, politely discontinue the interview and speak with
your FS
Is the respondent intoxicated or under the influence of other drugs?
– Attempt to schedule another time to return
Is the respondent blind or paralyzed?
– Take the time to figure out if respondent can complete interview–each interview is precious!
– Only in these situations are you allowed to enter the responses during the ACASI portion for
the respondent (Make note of this in the FI Observation questions)
Does the respondent exhibit behaviors that suggest he or she may have difficulty reading?
– Remember that the respondent can listen to all the questions through the headphones and
answer most questions with a number
19

Helpful Hints for Gathering Good I&O Data
What you record in the Industry and Occupation questions is used to classify the respondent’s work
by assigning two separate codes. To assign these codes, the coding staff needs descriptive, yet
concise information. For all of the industry and occupation questions, it is important to probe
for further details. Use adjectives in your probesfor example, find out what type of doctor or
salesperson, what kind of engineer or programmer, supervisor of what?
Also, keep in mind the following:
•

List the most important information first, as each answer field has a character limit.

•

Consider abbreviating when possible. Use typical abbreviations that coding staff will
understand, such as dr for doctor and mgr for manager. Don't use abbreviations that are
not standard—deciphering abbreviations takes a lot of time and the end result may not be
what you originally intended.

The chart below lists the open-ended I&O questions, plus hints and character limits for each.
Name

Question

INOC01

In what kind of business or
industry do you work? That is,
what product is made or what
kind of service is offered?

Character
Limit

Hints

• Don't enter just the name of a company as the
Industry—include a description of the type of
company. There could be multiple industries with
the same name (e.g., Lowe's Foods or Lowe's
Home Improvement Store).

100

• Probe for the specific product the respondent’s
INOC02M

What do they make?

employer makes (for example, car timing belts,
small aircraft propellers).

• One word answers are usually too general and not
descriptive enough.

• Probe for the specific product the respondent’s
employer sells.

INOC02T

What do they sell?

INOC03

PLEASE SPECIFY THE
TYPE OF INDUSTRY

• If the respondent has difficulty specifying what is

sold, it could be the response to the previous
question should not have been “wholesale or retail
trade.” Probe for accuracy.

• Probe for the specific business or industry in which

the respondent works. Company name and/or job
title are not sufficient descriptions.

• Try to use detailed terms that describe the
INOC04

What kind of work do you do?
That is, what is your
occupation?

Occupation (for example, "Electrical Engineer"
rather than "Engineer").

• Don't list a generic job title as the Occupation (for

example, manager). Try to get a specific title for
the occupation.

• Be sure to list only one occupation.
INOC05

What are your most important
activities or duties in that job?

• Describe the work the R spends most of his/her

100

time doing for that business or occupation.

The following are examples of probes and the types of details required for certain jobs in order to
correctly assign the industry and occupation codes.
Industry/Occupation
Service
[Businesses and
occupations that work with
the public]

Questions to Ask
What type of service? (housekeeping, customer service, waiter)
What type of location? (restaurant, hotel, private home)
For whom is the service done? (airline industry, the government, bank
customers)
What type of medical field or office? (doctor, dentist, pediatrician, orthopedic
surgeon)

Medical Field

What is their full title? (Write out the word–orthodontist, orthopedist, podiatrist–do
not use abbreviations such as "ortho")
What type of location? (hospital, private doctor's office, Planned Parenthood)
What grade level do they teach? (K-5, 6-9, 10-12, college)
What subject do they teach? (English, Biology, French)

Education

What type of position? (Dean, Professor, Principal, Teacher, Teacher's aide,
School Board member, Janitor, Cafeteria Worker)
What type of location? (the YMCA, a recreation center, a school)
Is the school public or private?

Childcare
[Babysitter, Nanny,
Daycare Center, etc.]
Supervisors/
Managers

Where is the service given? (private home, someone else’s home such as a
neighbor, daycare center)
What is their employment status? (self-employed, employee in a business)
What type of position? (teacher, care provider, cleaner)
Who or what type of activity do you supervise or manage? (sales clerks,
laborers, accountants)
What type of manager are you? (hotel, office, property, bakery)

Government
Contractors

Call Centers

Is the company run by the government or is it a private company? (for
example, RTI is a contractor for the federal government—RTI is not a government
agency)
What type of call center is it? (retail, credit card, delinquent debt, market
research, non-market research—do not only give the company name)
What is the primary purpose of the call center? (repair service center, catalog
ordering center, merchandising)

Manufacturing

What specific product do they make? (for example, does the company develop
the software for a program or manufacture the products holding the software (e.g.,
discs, CD-ROMs))?
What type of machine do they operate? (Riveter, lathe operator, punch press
operator)

Additional examples and information on Industry and Occupation Questions can be found in your FI Manual, pages
8-21 through 8-23.

Result Codes

01
02
03
04
05
06
07
08
09

Pending Screening Codes
No One at DU
Screening Respondent Unavailable
Neighbor Indicates Occupancy
Incapable
Language Barrier (Spanish)
Language Barrier (Other)
Refusal to Screening Questions
Unable to Locate SDU
Other

Final Screening Codes

Requires
FS Approval

Verification
Info Required

iPAQ
Auto Codes

Requires
FS Approval

Verification
Info Required

iPAQ
Auto Codes

Ineligible SDUs
10
13
18
19
20
22
25
26
29

Vacant
Not a Primary Residence
Not a Dwelling Unit
GQU Listed as HU
HU Listed as GQU
DU Contains Only Military Personnel
No Eligible SDU Members
In DU less than ½ of the Quarter
Listing Error













Screening Not Obtained
11
12
14
15
16
17
21
23

No One at DU after Repeated Visits
SR Unavailable after Repeated Visits
Incapable
Language Barrier (Spanish)
Language Barrier (Other)
Refusal
Denied Access to Building/Complex
Other










Screening Completed
30
31
32

No One Selected for Interview
One Selected for Interview
Two Selected for Interview

Result Codes (continued)

50
51
52
53
54
55
56
57
58
59

Pending Interview Codes
Appointment for Interview
No One at DU
Respondent Unavailable
Breakoff (Partial Interview)
Incapable
Language Barrier (Spanish)
Language Barrier (Other)
Refusal (By Respondent)
Parental Refusal for 12-17 Year Old
Other

70
71
72
73
74
75
76
77
78
79

Final Interview Codes
Interview Complete
No One at Home after Repeated Visits
Respondent Unavailable
Breakoff (Partial Interview)
Incapable
Language Barrier (Spanish)
Language Barrier (Other)
Final Refusal by Respondent
Parental Refusal for 12-17 Year Old
Other

Requires
FS Approval

Verification
Info Required

iPAQ
Auto Codes

Requires
FS Approval

Verification
Info Required

iPAQ
Auto Codes












Instructions for Using the Certificate of Participation
At the end of the interview, you can give a Certificate of Participation that authenticates the
respondent’s participation in NSDUH. Youth and other interested respondents may use the
completed certificate to verify with teachers or group leaders that they participated in NSDUH, and
may then receive credit for participating in the study. Possibilities include:
•
•
•

extra credit for school
incorporating the NSDUH experience into a school project
credit towards community service hours.

It is the respondents’ responsibility to arrange to receive any possible credit. Respondents and
parents must understand that:
•
•
•

they are responsible for making arrangements for any credit
their school or group may or may not give credit; credit is not guaranteed
no advance arrangements have been made with any schools or community groups.

The certificate is worded to allow for use with respondents other than middle or high school students,
such as a young adult required to perform community service or for classes beyond high school.
However, the certificate should be used primarily with youth respondents. Adult respondents should
not receive a certificate unless they ask for acknowledgement that he/she completed the survey or
seem very interested in receiving one.
Upon completion of the interview, prepare the certificate by:
•
•

filling in the date the interview was completed
and your FI name and ID number.

To preserve confidentiality, the respondent adds his or her name at a later time.
Also provide a Question and Answer Brochure along with the certificate, as it contains additional
details and includes contact information and Website addresses where interested persons can obtain
additional information.

Procedures After an Automobile Accident
Immediately After an Accident...
•
•
•

•
•

Check for injuries. Life and health are more important than damage to vehicles.
Make note of specific damages to all vehicles involved.
Write down the names, addresses and license numbers of persons involved in the accident. Also, write
a description of the other vehicles.
Call the police, even if the accident is minor.
Jot down names and addresses of anyone who may have witnessed the accident. This can prevent
disagreement concerning how the accident actually happened.

DOs and DON’Ts
•
•
•

DO jot down details about the accident and circumstances such as weather conditions and visibility.
DO notify your FS, Headway, and your insurance agent about the accident immediately. If you are
working as a traveling interviewer in a rental car, notify the car rental agency as well.
DO NOT sign any document unless it is for the police or your insurance agent.

Headway Accident/Injury Reporting Procedures
•

In the event of an accident, the employee must contact his/her FS immediately. The employee must
also contact a Headway Representative directly to report the accident within 24 hours of the injury. If
you’re calling after hours, leave a message.

•

Employees are expected to seek treatment at an Emergency Room, Urgent Care Facility, or General
Practitioner. If the employee seeks treatment elsewhere, the employee may be responsible for
payment depending on the applicable state workers’ compensation laws.

•

Whenever possible, the employee will notify a Headway representative before seeking medical
treatment.

•

The employee will provide a signed written statement to Headway detailing the nature and extent of all
injuries sustained at work.

•

The employee is required to submit the results of all evaluations to a Headway representative, as well
as any doctor’s notes that prevent the employee from working, within 24 hours of any doctor’s visit
related to injury.

•

Headway will investigate all on-the-job injuries thoroughly to determine causes and
contributing factors. The employee will cooperate with the investigation of any accident
he/she is involved in or witness to. Workers’ Compensation fraud is a felony offense and
Headway will prosecute anyone proven to be committing fraud.

•

If physical therapy or surgery (in the event of a non-threatening injury) is recommended, preauthorization must be obtained from the worker’s compensation insurance carrier in order to guarantee
payment of services. The physician should contact the Human Resources Department of Headway at
(800) 948-9379 for approval.

Failure to comply with these policies and procedures may jeopardize your workers’ compensation benefits.
Please also be reminded that workers’ compensation laws vary from state to state. There may be additional
requirements that you must meet in compliance with your state’s laws.

EQUIPMENT MAINTENANCE CHECKLIST
Before Leaving Home to Screen/Interview:
Ensure iPAQ is in the canvas case and fully charged
Ensure you have all accessories needed [car charger and mini-USB cable]
Check iPAQ date & time, and transmit to correct if necessary

While Screening/Interviewing:
Reset from Today Screen or Admin menu every 30 minutes *
Turn off iPAQ between screenings
Be careful not to drop iPAQ
Be extremely careful to select the correct case when screening
Keep an eye on the battery level and charge as needed
Before leaving the field, exit screener program to the Today Screen **

Upon Returning Home from Screening/Interviewing:
Exit to the Today Screen if not done earlier **
Transmit
Plug in iPAQ to charge when not in use, noticing an orange light to ensure you have a
good connection

When Transmitting/Charging:
Reset iPAQ from Today Screen or Admin Menu
Follow steps in computer manual for transmission
If problems occur, refer to computer manual

Never remove the battery from the iPAQ unless instructed to do so while on the phone with
Tech Support. Data loss can occur!

* Resetting enhances the function of your iPAQ by cleaning up memory leaks
** Exiting screening program saves all data to the storage card—if the iPAQ battery runs down before you have
exited the screening program, you will lose data

English
Spanish

Lead Letter

English
Spanish

Study Description

English
Spanish

Introduction and Informed Consent for
Interview Respondents age 18+
Intro to CAI/
Informed Consent [18+]

English
Spanish

Introduction and Informed Consent for
Interview Respondents ages 12-17

Intro to CAI/
Informed Consent [12-17]

Showcards 1-4

Pillcards A-D

Showcards 5-19

English
Spanish

Summary of the NSDUH Questionnaire
Questionnaire
Summaries

Page

Quick Reference Guide .................................................. Inside
Back Cover

Equipment Maintenance Checklist ....................................... 26

Procedures After an Automobile Accident............................. 25

Instructions for Using the Certificate of Participation............. 24

Result Codes ............................................................... 22, 23

Helpful Hints for Gathering Good I&O Data .................... 20, 21

The Interview Process .................................................. 18, 19

Refusal Reasons ................................................................ 17

Counting and Listing Abbreviations...................................... 16

ROC Comments ................................................................. 15

Guidelines for Speaking With Neighbors .............................. 14

Reconciling Missed DUs ...................................................... 13

Missed DUs ..................................................................... 12

Editing Address Protocol ............................................... 10, 11

Physical Features Data Reference Sheet ............................ 8, 9

Screening and Interviewing Tasks ......................................... 7

Overview of the Screening and Interview Process.................. 6

Sampling Process Explanation ........................................... 4, 5

Steps to Maximize Data Quality ......................................... 2, 3

Enumeration Rules ............................................................... 1

Informed Consent FAQ .............................Back of Job Aids Tab

Interviewer Job Aids

Interviewer
Job Aids

o If R cannot read the Study Description themselves, you must read it to them

• When instructed, give the R a Study Description to read and keep (if not done earlier)

• Read the Intro to CAI 18+ to R

ADULT INFORMED CONSENT PROCEDURES:

• When instructed, give the youth a Study Description to read and keep

• Read the main box of the Intro to CAI 12-17 to the youth

After Obtaining Parental Permission:

o If parent speaks Spanish, have the parent read the Spanish translation of the Intro to CAI
themselves (if you are not a RTI-Certified bilingual FI who could read it to them)
 If parent cannot read, the youth or another translator may read script to the parent,
along with reading the Spanish Study Description
o If language is other than Spanish, the youth or another translator may use the script and
Study Description and translate the information for the parent
o Use the youth or translator to answer any questions the parent may have

• If the parent/guardian cannot communicate well enough in English to understand the Intro to
CAI script:

• If you obtain permission from one parent/guardian who is not home when you return to do
the interview, you may only proceed if the other parent/guardian is available and grants
permission for the interview

o Exceptions: Explicit permission was given to conduct interview without parent/guardian
present
 In this case, you must read the top box of the Intro to CAI 12-17 to parent/guardian in
person to obtain permission and give parent/guardian a copy of the Q&A Brochure
o OR the youth is 17 years old and living independently without a parent or guardian
residing in the home (such as a college student)
 In this case, proceed with youth Informed Consent procedures without parental
permission, using the Intro to CAI 12-17 script

• Parent/guardian should be present during interview (not in interview room)

o Introduce yourself to parent/guardian
o Read the top box of the Intro to CAI 12-17 to parent/guardian and obtain their permission
o Consent MUST be given IN PERSON

• Must obtain parental permission to interview youth BEFORE speaking with youth

Parental Permission:

YOUTH INFORMED CONSENT PROCEDURES:

This reference guide is not a replacement for information contained in your FI Manual, but is a listing of crucial
protocols that must be followed when obtaining informed consent. Refer to pages 7-22 and 7-23 in your FI
Manual for more information on informed consent procedures.

Informed Consent Reference Guide

Quick Reference Guide
In the CAI Manager, if you want to:

CLICK ON

Start an interview .............................................................................. Start CAI
Cancel the start of an interview .............................................................Cancel
Resume (re-start) an interview ......................................................... Start CAI
Transmit data to RTI ....................................................... Transmit to RTI, Yes
View e-mail messages .................................................... View Email Messages
Start the ePTE Program .....................................................................PTE Entry
List the cases by Descending Order (based on date) .................... Descending
List the cases in Ascending Order (based on date) ..........................Ascending
Hide previous quarters’ interviews ........................................................... Hide
Exit CAI Manager ........................................................................................ Exit

To begin a CAI Interview:

Enter QuestID from iPAQ for selected sample member. Double check!

In the Interview, if you need to:

Break off an interview ................................................................... [Alt] [f], [x]
Enter Don’t Know ....................................................................................... [F3]
Enter Refused ............................................................................................ [F4]
Return to the first screen .......................................................................... [F5]
Return to the first unanswered question .................................................. [F6]
Toggle audio on/off ................................................................................... [F7]
Enter a comment ....................................................................................... [F8]
Save a comment .................................................................................. [Alt] [s]
Back up one screen .................................................................................... [F9]
Replay audio ............................................................................................ [F10]
Edit a lengthy text field ............................................................................ [Ins]
Return the focus to the CAI window so the top bar is blue ............ [Alt] [Tab]

To adjust the main laptop volume*:

Increase volume ...................................................................... [Fn], [Page Up]
Decrease volume ................................................................ [Fn], [Page Down]
Mute volume ................................................................................ [Fn], [Home]
*Keep the main laptop volume turned all the way UP at all times. Respondents will only
adjust the volume on the headphone cord.

To suppress a Hard Error in the interview, involving two questions:
•

Read the message box carefully.
– If the first question listed is the one to be changed, press [Enter].
– If the second question listed is the one to be changed, press the down arrow key to
highlight the second question, then press [Enter].
– In the rare but possible event that neither question needs to be changed and the data
entered are correct, press [Tab] until the Suppress box is highlighted and then press
[Enter].

To edit a lengthy response:
•

With the cursor blinking in the answer field, press the Insert key [Ins]. You can then use the
arrow keys to move to the precise place within the answer field and add additional text or edit
existing text.

CIPSEA Confidentiality Agreement, SAMHSA/CBHSQ
Administered by RTI International
This agreement is intended for review and signature by employees of RTI International and all its subcontractors who have
access to information designated as confidential on a research study sponsored by SAMHSA/CBHSQ covered under CIPSEA.
This agreement must be renewed each year as part of mandated CIPSEA training to maintain access to confidential project
information.
Assurances of Confidentiality under CIPSEA
For any research study sponsored by the Substance Abuse and Mental Health Services Administration’s (SAMHSA)
Center for Behavioral Health Statistics and Quality (CBHSQ) that is covered under the Confidential Information
Protection and Statistical Efficiency Act (CIPSEA) of 2002* and Section 501(n) of the Public Health Service Act, all
data and associated materials collected and/or utilized on that study are subject to protection by CIPSEA. CIPSEA
ensures the confidentiality of all information provided is protected by Federal Law and stipulates that all
information collected shall be used exclusively for statistical purposes. All research subjects contacted on
SAMHSA/CBHSQ’s behalf by RTI International are notified of these protections prior to study participation.
You have been identified as a person who has access to confidential information on a SAMHSA/CBHSQ-sponsored
study covered under CIPSEA (NSDUH and/or DAWN**) and therefore have been designated as an Agent under
CIPSEA. This confidential information includes (but is not limited to) all electronic and hard copy documents
containing respondent information and data, as well as non-data related records containing information that could
identify a location or respondent associated with a particular study.
Protection Agreement under CIPSEA
Per CIPSEA regulations, you agree that any materials that would permit the identification of research subjects are
to be treated as confidential, and that you will never share or use that confidential information with anyone else or
in a manner other than those authorized by CBHSQ. This includes never disclosing confidential information with
law enforcement officials, officers of the court or your supervisor (if not also authorized as an Agent).
To ensure the protection of all confidential information in both physical and electronic form, as an Agent, you also
agree to:
1) keep all confidential information in a space where access is limited only to authorized personnel,
whether on a computer or in hard copy form;
2) keep all confidential information within computer memory controlled by password protection;
3) maintain a secure location (such as file cabinet or locked drawer) for printed materials, diskettes, and
data on hard disks of personal computers when not in use;
4) never remove confidential information from your approved worksite without prior approval from
CBHSQ and/or RTI International;
5) never permit any unauthorized removal of any confidential project information from the limited access
space protected under the provisions of this agreement without first notifying and obtaining written
approval from RTI;
6) notify RTI when you no longer have access to electronic or hard copy files or printed materials
containing confidential project information;
* Public Law 107-347, Title V; for more info: http://www.whitehouse.gov/omb/fedreg/2007/061507_cipsea_guidance.pdf
**National Survey on Drug Use and Health (NSDUH); Drug Abuse Warning Network (DAWN)

v. 12.12

CIPSEA Confidentiality Agreement, SAMHSA/CBHSQ
Administered by RTI International

7) when appropriate, return all confidential project information to RTI;
8) complete annual training on restrictions associated with the use of confidential information;
9) agree that representatives of CBHSQ have the right to make unannounced and unscheduled
inspections of the facilities where you work to evaluate compliance with this agreement;
10) notify RTI International immediately upon receipt of any legal, investigatory, or other demand for
disclosure of confidential project information;
11) notify RTI International immediately upon discovering any breach or suspected breach of security or
any disclosure of confidential project information to unauthorized parties or agencies.
12) and agree that obligations under this agreement will survive the termination of any assignment with
SAMHSA/CBHSQ and/or RTI International.
Penalties under CIPSEA
Any violation of the terms and conditions of this agreement may subject you, the Agent, to immediate termination
of access to confidential information by RTI International or CBHSQ, and will require the immediate return of all
electronic and hard copy files and materials in your possession.
Any violation of this agreement may also be a violation of Federal criminal law under Title V, subtitle A of the EGovernment Act of 2002 (P.L. 107-347); and/or Section 501(n) of the Public Health Services Act. Alleged violations
under the Title V, subtitle A of the E-Government Act of 2002 are subject to prosecution by the United States
Attorney. The penalty for violation of subtitle A of the E-Government Act of 2002 is a fine of not more than
$250,000 and imprisonment for a period of not more than 5 years. In addition to the above, all relevant statutory
and regulatory penalties apply.
Your signature (whether in electronic or written form) below affirms your understanding and acknowledgement of
all the regulations, requirements and penalties associated with CIPSEA as part of your work on this
SAMHSA/CBHSQ project for RTI International.

Name

ID Number (if applicable, RTI employees only)

Signature

Company Name

Date

Job Title

v. 12.12

Project Name:

National Survey on Drug

Project No.:

Use and Health
0213757

.
.

DATA COLLECTION AGREEMENT

I, __________________________________________, an employee of Headway, agree to provide field data collection
services for the benefit of RTI in connection with the RTI Project shown above (“the Project”). Further, I
1)

am aware that the research being conducted by RTI is being performed under contractual arrangement with the
Substance Abuse and Mental Health Services Administration (SAMHSA);

hereby accept all duties and responsibilities of performing specified data collection tasks and will do so
personally, in accordance with the training and guidelines provided to me. At no time will I engage the services
of another person to perform any data collection tasks for me without the prior written approval of both my
employer (Headway) and RTI;

agree to treat as confidential all information secured during interviews or obtained in any Project-related way
during the period I am working on the Project, as required by the Confidential Information Protection and
Statistical Efficiency Act of 2002 (CIPSEA), and understand, under Section 513 of this Act, I am subject to
criminal felony penalties of imprisonment for not more than five years, or fines of not more than $250,000, or
both, for voluntary disclosure of confidential information. Any breach of confidentiality must be reported
immediately to the National Field Director. This information will be shared with the SAMHSA Project Officer
and Headway. I have also completed and fully understand the CIPSEA training provided to me;

4) agree to treat as confidential and proprietary to RTI/SAMHSA any and all information provided by the
public, whether collected or accessed in electronic or printed form during the course of my service on this
Project, including but not limited to all data collection computer software and respondent data, and will protect
such items from unauthorized use or disclosure;
5) am aware that the survey instruments completed form the basis from which all analyses will be drawn, and
therefore, agree that all work for which I submit invoices will be legitimate, of high quality and performed in
compliance with all Project specifications to ensure the scientific integrity of the data;
6) understand that I am fully and legally responsible for taking all reasonable and appropriate steps to ensure that
any computer equipment issued to me for use on this Project is safeguarded against damage, loss, or theft. I also
understand that I have a legal obligation to immediately return all equipment at the conclusion of my
assignment or at the request of my supervisor;
7) fully agree to conduct myself at all times in a manner that will obtain the respect and confidence of all
individuals that I encounter as a representative of the Project and I will not betray this confidence by divulging
information obtained to anyone other than authorized Project representatives of RTI;
8) understand that evidence of falsification, fabrication or distortion of any data collected for this Project will
be reported to RTI's Scientific Integrity Committee, and such acts are grounds for immediately removing me
from the Project and can result in my suspension from any government-funded research. Also, if falsification of
data is substantiated, I understand a formal fraud complaint will be submitted to the U.S. Department of
Health and Human Services’ Office of Inspector General (OIG) and I could be subject to criminal and/or
civil prosecution and thereby face imprisonment, financial penalties or both;
9) understand my obligations under this agreement supersede any prior or existing agreements on the same subject
matter and will survive the termination of any assignment with RTI and/or my employment by Headway.
_________________________________________________________
Employee Signature

Disposition: Original to Headway, Yellow retained by employee.

__________________________
Date

2/12

SELECTED HIGHLIGHTS from the

2011 National Survey on Drug Use and Health
Past Month Cigarette Use among Persons Aged 12 or Older,
by Age: 2011
Tobacco Use
•

An estimated 68.2 million Americans
reported current use (during the past
month) of a tobacco product in 2011,
which is 26.5 percent of the population
aged 12 and older. About 56.8 million
(22.1 percent) smoked cigarettes.

•

The graph to the right illustrates past
month cigarette use among persons
age 12 or older.

Alcohol Use
Current Alcohol Use among Persons Aged12-20,
by Age: 2002-2011
•

Slightly more than half of all
Americans age 12 or older, 51.8
percent or an estimated 133.4 million
persons, were current drinkers in the
2011 survey, which is similar to the
131.3 million persons (51.8 percent)
reported in 2010.

•

Although consumption of alcoholic
beverages is illegal for those under
21 years of age, 25.1 percent of this
age group (9.7 million) were current
drinkers in 2011. The graph on the
left displays the current use of
alcohol for 12-20 year olds from
2002 through 2011.

Illicit Drug Use
•

An estimated 22.5 million Americans were current users of illicit drugs in 2011, meaning
they used an illicit drug at least once during the 30 days prior to the interview. This
estimate represents 8.7 percent of the population 12 years old or older.

•

Marijuana is the most commonly used illicit drug, with an estimated 18.1 million current
users, or 7.0 percent of the population 12 years old or older, similar to the 2010 rate of 6.9
percent. Similar to 2010, an estimated 1.4 million persons were current users of cocaine. In
2011, an estimated 6.1 million (2.4 percent) used prescription-type psychotherapeutic drugs
nonmedically in the past month which is lower than the 2010 estimate of 2.7 percent.

Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings,
DHHS/SAMHSA/CBHSQ, September 2012

Mental Health
•

In 2011, an estimated 15.2 million adults, or 6.6 percent of the population aged 18 or older,
had at least one major depressive episode (MDE) in the past 12 months. Among adults, the
percentage having MDE in the past year varied by age and gender, as shown in the graph below.
Major Depressive Episode in the Past Year among Adults Aged 18 or Older,
by Age and Gender: 2011

Substance Dependence or Abuse among Adults Aged 18 or Older,
by Major Depressive Episode in the Past Year: 2011
•

Persons with past year MDE
were more likely than those
without MDE to have used
an illicit drug in the past
year (28.5 vs. 13.4 percent).

•

Similarly, substance
dependence or abuse was
more prevalent among
persons with MDE than
among those without MDE
(20.0 vs. 7.3 percent), as
shown in the graph to the
right.

Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings,
DHHS/SAMHSA/CBHSQ, 2012

United States
Public Health Service

Certificate of Participation
The United States Public Health Service and Research Triangle Institute would like to thank

[Participant’s Signature]

for participating in the National Survey on Drug Use and Health
on
_____________________________
[Date of Interview]

Field Interviewer
FI ID #

Ilona S. Johnson,

National Field Director
Research Triangle Institute
3040 Cornwallis Road
Research Triangle Park, NC 27709

This document certifies that the above named individual participated in NSDUH, a voluntary survey for the United States Public Health Service.
Across the country, some participants approach their school teachers or other group leaders to ask about possible special community service credit
as they completed this important national survey. The time commitment for participation in this survey is between 1 and 2 hours. A copy of the
NSDUH brochure, which explains the study in more detail, should accompany this certificate. If you need further information, contact the
National Field Director, Ilona Johnson, at (800) 848-4079.

NATIONAL SURVEY ON
DRUG USE AND HEALTH
Nonresponse among Respondents Aged 50
and Older
Potential Respondents Focus Group Report
Contract No. 283-03-9028
RTI Project No. 08726

Authors:
Joe Murphy
Michael Schwerin
Donna Hewitt
Adam Safir

Project Director:
Tom Virag

Prepared for:
Substance Abuse and Mental Health Services Administration
Rockville, Maryland 20857

Prepared by:
RTI
Research Triangle Park, North Carolina 27709

May 19, 2005

NATIONAL SURVEY ON
DRUG USE AND HEALTH
Nonresponse among Respondents
Aged 50 and Older
Potential Respondents Focus Group Report
Contract No. 283-03-9028
RTI Project No. 08726

Authors:

Project Director:

Joe Murphy
Michael Schwerin
Donna Hewitt
Adam Safir

Tom Virag

Prepared for:
Substance Abuse and Mental Health Services Administration
Rockville, Maryland 20857

Prepared by:
RTI
Research Triangle Park, North Carolina 27709

May 19, 2005

Table of Contents
TABLE OF CONTENTS ............................................................................................................................................ I
LIST OF TABLES ......................................................................................................................................................II
LIST OF EXHIBITS ..................................................................................................................................................II
1.

EXECUTIVE SUMMARY ...........................................................................................................................1
TOPIC UNDERSTANDING AND INTEREST ...........................................................................................................1
COURTESY AND FLEXIBILITY ...........................................................................................................................1
THE SELECTION PROCESS ................................................................................................................................2
DESCRIPTIVE MATERIALS ................................................................................................................................2
SAFETY, TRUST, AND CONFIDENTIALITY .........................................................................................................2
FI ISSUES AND TRAINING .................................................................................................................................3
INCENTIVES ......................................................................................................................................................3

BACKGROUND............................................................................................................................................4

2.1.
2.2

IMPETUS FOR STUDY ........................................................................................................................................4
RESEARCH QUESTIONS.....................................................................................................................................5

FOCUS GROUP DESIGN ............................................................................................................................7

3.1
3.2
3.3

FOCUS GROUP COMPOSITION ...........................................................................................................................7
SELECTION OF PARTICIPANTS ..........................................................................................................................9
DATA COLLECTION ........................................................................................................................................ 10

FOCUS GROUP RESULTS ....................................................................................................................... 11

4.1
4.2
4.3
4.4

4.5

4.6
4.7

TOPIC UNDERSTANDING AND SALIENCY ........................................................................................................ 11
COURTESY AND FLEXIBILITY ......................................................................................................................... 12
THE SELECTION PROCESS .............................................................................................................................. 14
MATERIALS .................................................................................................................................................... 16
LEAD LETTER................................................................................................................................................. 16
Q & A BROCHURE.......................................................................................................................................... 18
NEWSPAPER ARTICLES ................................................................................................................................... 18
REFUSAL LETTER ........................................................................................................................................... 18
OTHER 19
SAFETY, TRUST, AND CONFIDENTIALITY ....................................................................................................... 20
4.5.1
Safety ................................................................................................................................................... 20
4.5.2
Trust ..................................................................................................................................................... 21
4.5.3
Confidentiality ..................................................................................................................................... 23
FI ISSUES AND TRAINING ............................................................................................................................... 24
INCENTIVES .................................................................................................................................................... 26

LIMITATIONS ........................................................................................................................................... 28

SPECIFIC RECOMMENDATIONS......................................................................................................... 30
FACILITATING TRUST. .................................................................................................................................... 30
COSTS AND BENEFITS. .................................................................................................................................... 32

REFERENCES ............................................................................................................................................ 33

List of Tables
TABLE 1.

CHARACTERISTICS OF FOCUS GROUP PARTICIPANTS ......................................................................... 10

List of Exhibits
FIGURE 1.

WEIGHTED NONRESPONSE RATES: 2002 .............................................................................................7

FIGURE 2.

REFUSAL REASON BY AGE FOR THE 2002 50+ SAMPLE .......................................................................8

1. Executive Summary
Response rates in the National Survey on Drug Use and Health (NSDUH) are lower for those 50
and older (50+) than for any other age category. This difference is significant for both weighted and
unweighted response rates. As part of the NSDUH Methodological Improvement Protocol (MIP) for
increasing response rates among 50+ sample members, input was sought from potential respondents in
this age group to provide a basis for viable methods to test and implement. Twelve focus groups were
conducted to explore the issue of nonresponse among those 50 and older and ways of addressing it. This
report summarizes the ideas and themes resulting from these focus groups. Highlights are presented
below and more detailed results can be found in the body of this report.

Topic Understanding and Interest
After hearing only the brief FI (Field Interviewer) introduction and name of the survey, most
participants did not have a clear understanding of the survey topics. After reading the lead letter, most
participants still did not understand the topic of the survey and believed the study objective described in
the letter was vague. Many focus group participants described their initial impression of the NSDUH
survey as a study of prescription drug benefits, prescription drugs, and health insurance. There were no
discernable differences by geographic location, household size, or participant age in perceptions or
misperceptions of the survey topic. Once the topic of the survey was fully explained to the focus group
participants, almost all expressed the opinion that drug use and health is an important topic to research.
All participants believed that interest in the topic would make them more likely to participate, but it was
obvious that this would not be the sole deciding factor. Nearly all groups recommended that the Q&A
brochure, or similar summary of the survey, be included in an advance mailing with the lead letter so
potential survey respondents would have advance knowledge of what the study is all about and what will
be expected of them.

Courtesy and Flexibility
Across age groups, household size groups, and focus group sites, a number of participants felt
that the interviewing process showed a lack of courtesy to the respondent. Many also felt that the survey
recruitment process might benefit from a more flexible and accommodating approach. Focus group
participants said almost uniformly that it was inappropriate for a stranger to make a personal visit to
solicit time from a respondent without scheduling the visit in advance, whether by calling on the
telephone, or through some other form of prior notification. A number of participants stated that they
would be more likely to participate if an appointment was scheduled before the first in-person visit.
Participants felt that it was impolite for an FI to appear at a respondent’s doorstep unannounced, and
inconsiderate to expect the respondent to make time for the interview. In addition, many participants
considered the repetitiveness of the screening interview questions to be a misuse of the respondent’s time,
particularly since the possibility existed that the respondent may not even be selected to participate in the
survey. To address this, we could experiment with lead letter verbiage to provide respondents with a
1

more precise range of time that an FI will be in their area. FI trainings could address the specific
concerns of participants regarding the presumption of availability and the repetitiveness of the screener
questions.

The Selection Process
Participants from each focus group expressed confusion over the language used to describe the
selection process or “qualification process,” as some called it. There were many questions about the
meaning of “random” selection of households. Respondents and participants wanted more information
about this process to feel more comfortable with the study objectives and protocol. Most participants
believed RTI or the federal government also had access to their names and phone numbers. All
participants in both age groups wanted the screening script and questions to get directly to the point. The
repetition of the questions was a major issue, specifically for those in households of 2 or 3 where roster
questions are asked for all household members. For some group members, the possibility of having
another person in their household selected for the interview would make a difference. For others, it
would not have made a difference to their participation. One recommendation would be to include a
better explanation of the selection process in advance materials and the FI introduction and possibly add
some text that explains that eligibility is based on who lives at that residence during a specific time
period. Also, it should be made clear, as needed, that RTI and SAMHSA/US Public Health Service/the
federal government do not have participants’ names or phone numbers on file.

Descriptive Materials
Remarks about the project materials provided to the focus group participants mirrored the overall
focus group feedback of desiring additional detailed information about the purpose and benefits of the
research and information that would facilitate trust and legitimacy to the research organization and FI.
The lead letter was seen as a good tool and the information in the Q&A brochure addressed the issues
being raised by the group. The newspaper articles received a mixed review. The refusal letter appeared
to address many participants’ concerns, but some said it would not have changed their minds. Several
experiments may prove beneficial from the focus group feedback on materials. Researching a better way
to address the recipient of the lead letter to be used in place of ‘Resident,’ and mailing the letters using a
first class postage stamp in a higher-quality envelope with a pre-printed Research Triangle Institute return
address with a logo may help get more people to open and read the letter.

Safety, Trust, and Confidentiality
Concerns were raised about the survey approach and physical safety, security of the household,
and fear of “scams” or other uses of information for reasons other than what was specified by the FI or in
the survey materials. Concerns about physical safety were most prevalent in the groups of participants
living alone, especially among those aged 65 and older, and in the Oakbrook location. Suspicion was
raised concerning some of the screening questions. Some participants were confused as to why the FI
asked about separate residences on the property, convinced she was asking about separate entrances to the
2

residence. More than physical or household safety, concern was raised over safety from scams and
mistrust of the FI’s intentions.
The importance of trusting the FI, the research organization, and the study purpose were
expressed throughout all of the focus groups. The importance of the FI establishing rapport and creating a
level of trust with the respondent was communicated by many participants. Trust in the research
organization and legitimacy of the survey were special concerns of the 65+ age group.
Overall, confidentiality was not a major concern voiced by the participants. However,
participants expressed major concerns about the questions being intrusive, invasive, and too personal.
Experiments in streamlining the screening questions and adding purpose statements with specific
questions, such as the Missed DU question, would alleviate some respondent concerns. Experiments with
advance materials focused on maximizing the extent to which household members read and retain the
information may shed light on improving methods for gaining trust, eliminating fear, and gaining the
participation of respondents in this age group. Similarly, additional FI training focused on increasing
respondent trust and familiarity with the purpose of the survey and questions, especially among
respondents in this age group, could prove beneficial. Finally, research into or experimentation with
alternative FI identification (ID cards rather than just badges or larger badges) could lead to increased
trust and participation among this age group.

FI Issues and Training
On the whole, focus group participants said they would be more likely to respond to an FI who
was prepared and polished, without being “slick.” They expect FIs to perform their task in a professional
manner, which includes being polite and positive, while displaying knowledge of the survey questions.
Participants also expressed they would not respond well to an FI who was timid or who presented a weak
approach. An approach issue that should be included in training is FIs need to be aware that they are
“guests” to the respondent’s property and understand how the respondent feels about someone unknown
coming to their door. Training interviews to be sensitive to these matters may improve their ability to
build rapport with the respondent.

Incentives
In general, the offer of a $30 incentive was not seen as persuasive by the focus group participants.
Very few mentioned they would be convinced to do the interview for that amount. In some cases,
participants felt that being offered money by the government to complete the survey was inappropriate.
Still others were suspicious of the $30 offer, thinking it was a trick, part of a sales pitch, or that something
other than completing the survey would be expected in return. Most participants agreed that money,
while potentially a persuasive tool, would not be a sufficient enough incentive on its own to gain their
participation. Although no solid suggestions for non-cash incentives were offered, these participants felt
that the most important factors in deciding whether to participate was trust in the motives of the FI and
survey, and an understanding and appreciation for the topic and value of the data.
3

2. Background
2.1.

Impetus for Study

Low response rates may lead to bias in survey estimates. If sample members who do not respond
are systematically different on the intended measures of the survey than those who do respond, estimates
will be biased. In the NSDUH, low response rates could result in biased drug use prevalence estimates if
those who respond are more or less likely to use drugs than those who do not respond. Potential bias
increases with a decrease in response rate. Often, response rates are lower among certain sample
subgroups than among others. Respondent characteristics such as gender, ethnicity, and education may
be associated with propensity to respond. A respondent characteristic associated with response in the
NSDUH is age.
Response rates in the NSDUH are lower for the 50+ age group than for any other sampled age
group. Lower response rates for this age group represent a potential threat to the reliability of both agespecific and overall prevalence rates. Statistical analyses have shown that lower response rates for the
50+ age group are due to higher refusal rates across the group. One reason for the lower response rates
and higher refusal rates might be the effect of response burden compounded by increasingly higher rates
of physical or mental incapability beginning at age 60 (Murphy & Eyerman, 2003). Analyses presented
in Murphy and Eyerman (2003) also show that respondents aged 50 and older in households with 1 or 2
members are significantly more likely to refuse than those in households with 5+ members.
In an effort to identify some of the possible underlying dynamics for nonresponse in the 50+ age
group, focus group interviews were conducted with NSDUH Field FIs (FIs). Interview refusal data
collected by FIs show that among all age groups refusal codes representing the reasons “nothing in it for
me,” “no time,” and “government/surveys too invasive” are the most common reasons for refusal. The FIs
focus groups suggest that in most cases these categories capture the true reasons for refusal. However,
there may be additional information that is not captured in these general categories or additional reasons
for nonparticipation that 50+ respondents do not overtly state (Murphy & Schwerin, 2003). FIs in these
focus group interviews reported that many 50+ respondents refuse due to fears of being victimized and a
perceived lack of trust in the NSDUH survey process. FIs stated that in order to gain the cooperation of
50+ sample members, a great deal of patience and friendly professionalism is needed. While FIs reported
that the $30 incentive is helpful in gaining the cooperation of most respondents, certain subsets of the 50+
population may not be as receptive.
In order to develop strategies that reduce refusal rates among the 50+ age group without affecting
trend data, focus groups were completed with members of the general population aged 50 and older
concerning reasons for nonresponse and strategies for reducing nonresponse. The results of these focus
groups can be used to inform changes in field protocols that could be tested and potentially implemented
for the full survey.

2.2

Research Questions

The ultimate goal of this research is to recommend methodological enhancements to improve
response among the 50+. To help achieve this, we developed a focus group moderator’s guide (included
in Appendix A) to address several research questions:
•

•

What are the reasons sample members ages 50 and older may not wish to participate in
the NSDUH?
-

Do the refusal reasons captured by the FIs reflect the true reasons?

Is the population ages 50 and older likely to refuse to participate in a household
survey like the NSDUH because of fears associated with crime, scams, and use
of a laptop computer?

Is this segment of the population likely to misunderstand the purpose of the
survey and the intentions of the FI?

Is disdain for the government’s motives a common reason for refusal among
respondents?

Are sensitivity to the survey topic and fear of divulging private information to
unknown individuals driving factors?

Do these sample members perceive that they have nothing to offer the study?

What would lend legitimacy?

What is the role of household composition in the decision to participate?
-

Does the number of people in the household affect the decision process?

Is the presence of younger people a factor?



Do they make older sample members feel safer?
Do they make the topic more salient?

•

Within the 50+ group, how does the decision process differ by age?

•

Gaining the trust of the respondent is an important first step that needs to be taken before
attempting to complete a screener or interview. How can we gain the trust of respondents
ages 50 and older?
-

How would they prefer to be approached by FIs?

Is public awareness an important factor?





•

Ad campaigns?
Press?
Publicized support of federal, state, and local agencies?
What media do they respond to?

Is the current incentive appropriate?
-

Would a higher incentive result in higher response rates?

Would non-monetary incentives be effective? Would anything work better than
cash? If so, what?

Does the offer of cash raise suspicions of fraud or scams?
5

•

Does the topic of the survey matter to sample members aged 50 and older?
-

How can the lead letter best express the importance of the study?

What concepts are salient to the older population?





Civic duty?
The problems of drug-related crime?
Helping the younger generation (i.e., grandchildren)?
How is the survey name perceived among older respondents?

3. Focus Group Design
3.1

Focus Group Composition

The composition of the focus groups was based on the quantitative findings in the NSDUH data.
Statistical analysis uncovered some important characteristics of 50+ sample members.
As shown in Figure 1, refusal rates in 2002 were above 15% for all age groups 50 and older and
under 15% for all age groups under 60. Rates of physical or mental incapability in 2002 reached 5% for
the 65 to 69 age group and reached their highest age-specific rate of 25% for the 80+ group.
Figure 1. Weighted Nonresponse Rates: 2002
45%
40%

Nonresponse Rate

35%
30%
25%
20%
15%
10%
5%
0%
1214

1519

2024

2529

3034

3539

4044

4549

5054

5559

6064

6569

7074

7579

80+

Age
Noncontacts

Refusals

Other Incompletes

All Nonresponse

While refusal propensity did not differ significantly by age within the 50+ group when
controlling for other factors, reasons for nonresponse among the 50+ differed by age. As shown in
Figure 2, refusal for other reasons 1 is much more common among the oldest respondents than among the
younger portion of the 50+, and the reasons “nothing in it for me” and “no time” are less common.
Because of this difference and that of nonresponse components shown in Figure 1, focus groups were
split between those aged 50 to 64 and 65+. Each of these groups represents approximately half of the
weighted 50+ main study sample.

predominantly: house too messy/too ill, confidentiality or survey legitimacy concerns, and gatekeeper/household
member won’t allow participation
7

Figure 2. Refusal Reason by Age for the 2002 50+ Sample
12%

Weighted Refusal Rate

10%

0%
50-54

55-59

60-64

65-69

70-74

75-79

80+

Age
Nothing in it for me

No time

Government/Surveys too invasive

Other

Propensity to refuse among the 50+ is significantly higher inside MSAs with a population of 1
million or more than outside those areas. The weighted rate of refusals for the 50+ in 2002 was 22.8%
inside MSAs with a population of 1 million or more and 18.5% outside. The magnitude of this difference
warranted limiting the focus groups to MSAs with populations of 1 million or more. About 75% of the
weighted 50+ main study sample live in MSAs with populations of 1 million or more.
Refusal propensity is significantly higher among the 50+ in 1 and 2 person households, and
higher and marginally significant among those in 3+ households (compared to 5+ households). The
weighted refusal rates for 50+ sample members in 1, 2, and 3 person households in 2002 were 19.8%,
22.1% and 19.3%, respectively. By comparison, 50+ sample members in households of 4 and 5+
members had refusal rates of 16.7% and 13.2%, respectively. For this reason, the focus groups can were
limited to respondents in households of 3 persons or fewer. Because the situations of those in 1 person
households likely differ from those in 2 and 3 person households, we conducted separate groups for these
respondents (half of the groups with those in 1 person households and the other half with those in 2-3
person households). The rationale for splitting the focus groups into people from 1 person and 2-3 person
households was based on our hypotheses after reviewing the qualitative and quantitative analyses:
•

We think that living alone is a unique arrangement that might trigger a different response
process than is common in 2 and 3 person households. Older persons living alone may
feel particularly vulnerable and may be less likely to trust an unknown person coming to
the door. Warnings about scams targeting seniors who live alone may exacerbate their
fears.

•

Households with 2 or 3 members are eligible for pair selection (two respondents selected
in the household). The data analysis shows that 50+ sample members are more likely to
refuse when two respondents are selected instead of one. This issue does not apply to the
1 person households, since they are not eligible for pair selection. Because of these
differences, we drafted different subsets of questions for 1 and 2-3 person household
focus groups to investigate these topics more fully with the appropriate types of
respondents.

So that the groups represented perspectives from more than one locale, they were conducted in
three sites: Raleigh, NC, Washington, DC, and Oakbrook, IL (suburban Chicago). Four groups were
conducted in each site. Following recommendations for focus group size and duration (Krueger, 1994),
each group lasted 2 hours and aimed to include 7 to 9 participants. A $75 incentive was given to each
focus group participant.

3.2

Selection of Participants

Past experience in recruiting older participants for focus groups and cognitive interviews
suggested that recruitment among the 50 and older age group would be difficult. Therefore, to keep costs
at a minimum and expedite recruitment, we used the services of three reliable and experienced focus
group vendors. The vendors recruited the participants, provided meeting space and audio and video
recording services, and handled the logistics of reminder phone calls and payment of a $75 incentive to
participants. The vendors were E&L Research in Raleigh, NC, Olchak Market Research in Washington,
DC, and Delve, Inc. in Oakbrook, IL.
Vendors used the screener in Appendix B to recruit participants, contacting members of their
respective databases and inviting eligible participants to the appropriate session for their age and
household size group. The vendors were asked to strive for the greatest possible variation in age, gender,
and other demographic characteristics, to ensure a heterogeneous set of viewpoints in each group.
Vendors were also asked to avoid, as much as possible, recruiting “professional focus group participants.”
The goal was to recruit ten to twelve participants for each group to ensure that seven to nine would attend
the focus group session When more than nine participants showed, it was left to the moderator and note
taker’s discretion as to whether a tenth participant would be included. All participants who were asked to
leave because the session quota had been filled were given their $75 incentive before departing.
Recruitment began on March 18, 2005 and concluded before the first focus group was conducted
on April 11, 2005. The vendors provided RTI with regular updates on the recruitment status and the
characteristics of each group, using the recruitment grid form in Appendix C. Table 1 presents the final
composition of the twelve focus groups.

Table 1.

Characteristics of Focus Group Participants

Location and Group

Date

Sample
Size

Time

Total

Gender
Male Female

Range

Age
Median

111

50-90

Raleigh, NC
HH Size 1, 50-64
HH Size 1, 65+
HH Size 2-3, 50-64
HH Size 2-3, 65+

April 11, 2005
April 11, 2005
April 13, 2005
April 13, 2005

6:00 PM
3:00 PM
6:00 PM
3:00 PM

10
8
10
10

4
2
4
5

6
6
6
5

50-61
65-70
50-64
65-76

53
67
56
68

Washington, DC
HH Size 1, 50-64
HH Size 1, 65+
HH Size 2-3, 50-64
HH Size 2-3, 65+

April 18, 2005
April 15, 2005
April 18, 2005
April 15, 2005

4:00 PM
10:30 AM
6:30 PM
1:00 PM

9
9
10
9

4
4
5
4

5
5
5
5

52-64
67-78
52-64
65-90

56
70
58
69

Oakbrook, IL
HH Size 1, 50-64
HH Size 1, 65+
HH Size 2-3, 50-64
HH Size 2-3, 65+

April 11, 2005
April 11, 2005
April 12, 2005
April 12, 2005

6:00 PM
3:00 PM
6:00 PM
3:00 PM

9
9
9
9

4
3
5
4

5
6
4
5

50-64
65-81
51-64
66-79

60
73
60
71

3.3

Data Collection

Twelve two-hour focus group sessions were conducted in the three locations, with four groups in
each location. Each participant attended only one session. All participants signed an informed consent
form (Appendix D) prior to participation, as well as a payment receipt form (Appendix E) upon receipt of
the $75 incentive.
The moderator began each session by welcoming the participants and asking them to introduce
themselves to the group using first names only. The moderator explained the purpose of the focus groups,
and the ground rules. The moderator then asked questions of and presented video and hard copy materials
(Appendix F) to the participants as specified in the Moderators Guide (Appendix A).
Each session was audio- and video-taped so the note taker could review the content of the
sessions when finalizing the session notes. A note taking shell was created for each session to make the
task of taking notes uniform across sessions. All notes were taken on a laptop computer as each question
was read from the script. The shell followed the script closely, leaving blanks to insert responses after
each question. As the participants provided their comments and opinions on each question, the note taker
recorded them as close to verbatim as possible. The name of the participant making the comment was
also recorded when possible. An average of seven pages of notes was recorded for each group. The
edited focus group notes are presented in Appendix G: Focus Group Session Notes. After the sessions,
the moderator and note taker debriefed and reviewed major themes discussed during the interview.

4. Focus Group Results
Qualitative results from the focus groups are presented in this section, sorted by major theme.
Each subsection contains several quotations from the participants. Rather than fully stating the age,
location, and household size associated with participant quotations, abbreviated superscripts are
appended. For instance, the superscript 66R1 indicates the participant was 66 years old, in the Raleigh
location, from a household size of one. The superscript 54O2 indicates the participant was 54 years old, in
the Oakbrook location, from a household size of two or three. The full set of focus group quotations and
notes are included in Appendix G.

4.1

Topic Understanding and Saliency

Focus group participants were asked to describe the topic of the survey in their own words and
provide their thoughts on the survey topic. They were asked to provide these thoughts after only seeing
the FI’s introduction at the door, after hearing the screening questions, and again after reading the lead
letter and other survey materials. One recurring theme was the misperception of the objective of the
NSDUH. After hearing only the brief FI introduction and name of the survey, most participants did not
have a clear understanding of the survey topics. The screening added little information; the lead letter and
study description helped clarify the topic, but perhaps not enough and not soon enough to make a positive
impression on the participants. Many focus group participants described their initial impression of the
NSDUH as a survey about prescription drug benefits, prescription drugs, and health insurance. A few
participants mentioned illegal drugs, tobacco, and alcohol as potential topics. There were no discernable
differences by geographic location, household size, or participant age in their perceptions or
misperceptions of the survey topic.
Once the topic of the survey was fully explained to the focus group participants, almost all
expressed the opinion that drug use and health is an important topic to research. They believed the topic
was important for all age groups, especially children. One woman said the topic was important for
“everyone 8 to 80.79O2” A male participant mentioned, “It's important to educate children on these issues.
Drugs seem to be a bigger subject today than it was years ago.65R1” Participants thought issues of
prescription drug availability and cost and health insurance were equally important. One participant
expressed her opinion that these topics were more important: “I'm not as interested in the illegal drug
issue. It should be handled by conversations between children and their parents. It would be a waste of the
government's time because the legitimate prescription drug issue is so much more important. 50O1” All
participants believed that interest in the topic would make them more likely to participate, but it was
obvious that this would not be the sole deciding factor.
When focus group participants were asked about the study materials and had an opportunity to
review the lead letter and Q&A brochure, many reported that they would not have discarded the letter
without even opening the envelope. Others noted that the Health and Human Services envelope captured
their attention but a letter addressed to “Resident” would quickly lose value. One woman said, “Andy
Rooney [from the television news program ‘60 Minutes’] says you shouldn't read anything that says
11

Resident.75O1” After reading the lead letter, most participants still did not understand the topic of the
survey and believed the study objective described in the letter was vague. One man said, “When the letter
says, ‘health-related issues’… this means nothing to me and I would throw it away. If they went further
and explained what these issues were and how they would affect me, then I might be interested.51R2”
Participants were asked to read through the NSDUH Q&A brochure to determine whether the
level of detail reflected captured their interest and addressed their questions about the topic and purpose
of the survey. All participants found this brochure very enlightening. One woman said, “This makes a
big difference.64O1” A man added, “The Q&A brochure should be mailed out with the lead letter.56O1”
The importance of getting this information before the FI comes to the door, regardless of whether the lead
letter was read, was brought up in all the groups. One woman said, “You're not going to be able to read
these materials while the FI is at your front door.52D1” Another woman added, “We need to get the
additional material before the interview and before the FI comes to the door.64D1” Nearly all groups
recommended that the Q&A brochure, or similar summary of the survey, be included in an advance
mailing with the lead letter so potential survey respondents would have advance knowledge of what the
study is about and what will be expected of them.
Focus group participants, regardless of age, household size, and location, did not understand the
topic of the survey from the lead letter. Much of the research in survey methodology cites the importance
of topic salience in facilitating survey participation (Groves et al., 2004). Intertwined in the decision
about how much information to include in the advance mailing is the impact that the amount of advance
information has on substance use disclosure and data quality. This is an empirical question that could be a
topic of a methodological experiment in future administrations of the NSDUH survey for this as well as
other age groups.

4.2

Courtesy and Flexibility

The importance of courtesy and flexibility were recurring themes throughout all focus group
sessions. Across age groups, household size groups, and focus group sites, a vocal number of participants
felt that the interviewing process showed a lack of courtesy to the respondent. Many also felt that the
survey recruitment process might benefit from a more flexible and accommodating approach. In their
responses, the participants addressed the subjects of courtesy and flexibility at both the survey- and FIlevel.
Focus group participants said almost uniformly that it was inappropriate for a stranger to make a
personal visit to solicit time from a respondent without scheduling the visit in advance, whether by calling
on the telephone, or through some other form of prior notification. One participant said that “I dislike
people coming to my door,58R1” while another stipulated that “I would have preferred she set an
appointment.63D1” However, the nature of a survey that samples by household unit rather than telephone
number makes advance notification by telephone a difficult proposition. Even more problematic, many
participants did not consider the lead letter to be sufficient notice, for two reasons: 1) a letter addressed to
“Resident” would likely go unopened, and 2) the letter does not adequately specify an approximate time
frame for the pending visit. One participant questioned “How was the letter addressed? It matters if it
12

says ‘Occupant’ or ‘Resident’,68D1”; another said that he would “throw ‘Occupant’ letters in the trash.76D1”
A number of participants stated that they would be more likely to participate if an appointment was
scheduled before the first in-person visit.
Participants expressed surprise that the interview presumed the respondent had time available,
asking the respondent in the video to complete an hour-long survey without prior notification or some
other demonstration of concern for the respondent’s time. One participant said “It is bad form for
someone to come to your door and ask you questions without warning.64O1” Participants felt that it was
impolite for an FI to appear at a respondent’s doorstep unannounced, and inconsiderate to expect the
respondent to make time for the interview. One participant said, in response to a question about the
reason they wouldn’t talk to the FI, “I would say that I’m busy; if you just show up at my house, I think
that’s rude.66D1” Some respondents noted that just because they are retired, it doesn’t mean that they are
not busy. For example, one participant remarked “A phone call would [be] better… Today, people are
busy all the time, even the retired, 75O2” and another said “[I] feel like [the FI] was wasting my time. My
time is valuable.63O1”
In addition, many participants considered the repetitiveness of the screening interview questions
to be a misuse of the respondent’s time, particularly since the possibility existed that the respondent may
not even be selected to participate in the survey. To address this, participants suggested that the
administration of the survey exhibit greater flexibility, and allow respondents to provide screening
interview information over the telephone or through a mail questionnaire. Participants also said that they
would be more likely to complete the survey if the screening and interview process was more flexible
(i.e., allowed FIs to initiate contact over the telephone first, conducted the screening interview via the
telephone, and only then schedule the main interview). However, empirical evidence, such as response
rate comparisons between in-person and telephone interviewing, suggests otherwise (Aquilino, 1992;
Brogan, et al, 2001).
Concerns about courtesy and flexibility on the part of the FI also existed. After watching the
video, participants stressed the importance of FI courtesy when interacting with respondents. One
participant said “She really didn’t introduce herself,69R1” while a second said “She was not professional…
she interrupted the woman [respondent],65R1” and a third said “I was concerned with her greeting: “Hi
There” – there’s something wrong with that.78D1” Many participants noted that the FI’s aggressive
attempts to gain cooperation might be interpreted as rude, and that steps should be taken by all FIs to
avoid the appearance of a lack of consideration for the respondent. One participant said, “[The FI] was
too pushy. She pushed until she got [the respondent] to agree to start, in spite of [the respondent] having
company.52D1” Other participants were divided on the FI’s approach. While some participants felt that the
FI needed to soften up their introduction, and emphasize a more conversational tack, other participants
thought that the FI’s speech was too circumspect, and that they should come to the point of the interview
more quickly. For example, one participant said “I think you need to soften it up a little…, and keep it
conversational,60D2” and another agreed, “I think the language could be softer and more persuasive,75D2”
while others took a different, although not necessarily conflicting, perspective: “The FI should come to
the point right away.62O2”
13

While many of the issues addressed by the participants are artifacts of the survey design (e.g.,
sampling from a frame of household units rather than telephone numbers makes the advance acquisition
of respondent telephone numbers difficult) and would be arduous to change without a major procedural
overhaul, there are areas where the process can be improved. We might experiment with lead letter
verbiage to provide respondents with a more precise range of time that an FI will be in their area. Other
tests can be conducted, such as investigating the feasibility of using addressee references other than
“Resident” or reducing the repetitiveness of the screener questions. Finally, FI trainings may address the
specific concerns of participants regarding the presumption of availability. Again, although some
components of the screening process are part-and-parcel of established procedures, trainings can
specifically address likely respondent concerns, such as why FIs need to verify certain responses.
For example, FIs may emphasize at the outset of the interview that although not all screened
respondents are selected, it is still important to do the screening. FIs may also take special care to
acknowledge the time the respondent is making available to complete the screening. However, it should
be noted that the example in the video does not display the typical flexibility allowed for completing the
interview, and the majority of FIs do go to great lengths to address all respondent concerns. This includes
scheduling interviews at the convenience of the respondent, especially if a respondent indicates that “now
is not a good time, but maybe later.”

4.3

The Selection Process

Participants from each focus group expressed confusion over the language used to describe the
selection process or “qualification process,” as some called it. There were many questions about the
meaning of “random” selection of households and respondents and participants wanted more information
about this process to feel more comfortable with the study objectives and protocol. One woman wanted
to know why “only certain addresses were picked.62O2” Another woman asked, “It says random on the
letter. Then why is it so important they talk to me?65O1” There was general confusion about how the
sample is designed and why the screening data are needed. Most participants believed RTI or the federal
government also had access to their names and phone numbers.
There was also confusion concerning the selection criteria. One man felt it didn’t make sense
that, “The lead letter is addressed to resident but it says that no one can take my place if I decline
participation.66R2” Questioning the selection criteria, a woman asked, “It says some people may be chosen,
or no one, or other people can be chosen, but I can’t be replaced?76D1” Another woman questioned “what
it would take to qualify me for the interview. It seemed like everyone could be eligible.50R2” Expressing
her confusion about who is eligible, a woman said, “I don’t think they need to ask all of the questions on
the selection process. I don’t understand why it has to be a specific person [who does the survey].65O1”
One man expressed concern about the time required for the screening when no one is selected, “If no one
was selected it would be a waste of 10 minutes. 51O2”
All participants in both age groups wanted the screening script and questions to get directly to the
point. The repetition of the questions was a major issue, specifically for those in households of 2 or 3
where roster questions are asked for all household members. One woman said, “She’s got more patience
14

than I do! The repetition is aggravating! Let me fill out the information in a form.64D1” Many asked about
the possibility of completing screening on a form, by telephone or via the web. One man suggested,
“Another option would be to do the survey online. I think it would be best to do it on the web because it
would be faster and I could complete it at a time that I choose.58R2” The repetitiveness of the questions
also makes them think it will take a long time, so it was suggested that the FI tell the respondent upfront
how long the screening will take. One man wondered, “If that is just the pre-qualifying, you have in the
back of your mind that the full interview must be longer than an hour.53D1”
Participants also felt a short explanation for some of the screening questions would be helpful.
One man said, “I need a more verbal explanation. I’d need to know where we are going with this.56O1” A
woman felt, “I would want her to explain the reasons for these questions.65R1” Several groups wondered
about the months of October, November, and December as part of the screening questions. One man
voiced his curiosity, “I would have answered her questions, but I would have also wanted to know what
was so special about those months.67D1”
For some group members, the possibility of having another person in their household selected for
the interview would make a difference. For others, it would not have made a difference to their
participation. One woman for whom it would make a difference said, “I know my husband wouldn’t do
it.70O2” One man said, “It would matter to me. What about different answers from a husband and wife
about a child smoking?66D2”
Several limitations should be mentioned concerning the screening process feedback from the
focus groups. First of all, the FI in the video was an example of a mediocre FI. Her performance on the
video, while not unrealistic, may have been influenced by the presence of the video camera and need to
read from a script. Many focus group participant responses were directed explicitly towards her
performance, as opposed to the process. Additionally, participants did not see the lead letter, study
description or brochure in the normal sequence of the screening process. Although some respondents do
not see the lead letter until the FI contacts them, the letters were distributed later in the focus groups;
therefore some of their questions or remarks may be atypical of a screening respondent as a result of not
yet viewing the letter. Finally, in the video for participants living alone, the FI emphasized “YOU are
selected” when the respondent was selected as opposed to ‘You ARE SELECTED!” This caused some
focus group participants to question the scientific nature of the selection process, commenting that “It
sounded like she was selecting the person right there, which doesn’t make any sense to me.63O1”
One recommendation would be to include a better explanation of the selection process in advance
materials and the FI introduction and possibly add some text that explains that eligibility is based on who
lives at that residence during a specific time period. Also, it should be made clear, as needed, that RTI
and SAMHSA/US Public Health Service/the federal government do not have participants’ names or
phone numbers on file.

4.4

Materials

Feedback on project materials shown during the focus group interview was consistent across all
age groups and household size groups. Focus group interview participants expressed a desire for
additional detailed information about the purpose and benefits of the research, and information that would
impart trust of or legitimacy to the research organization and FI. Interestingly, focus group feedback on
the use of the materials (detailed below) was very close to the objective of the materials and the manner in
which the materials are used on the project.
First, the lead letter was seen as a good tool. Operationally, the lead letter is provided by mailing
one to each valid mailing address; next the letter is referenced during the initial household contact, with a
copy available for each screening respondent. Second, the information in the brochure tapped exactly
into the issues being raised by the group, and brochures are handed out generously on the project. Third,
the newspaper articles received a mixed review. These are distributed intermittently on the project, as
needed, to address specific and unique respondent concerns. Finally, the general refusal letter appeared to
address many participants’ concerns, but some said it would not have changed their minds. The project
utilizes multiple refusal letters to address specific concerns and this sample letter was successful in
addressing a percentage of the group’s concerns.

Lead Letter
The overall perception of the lead letter was positive, as stated by one man, “I think it’s a good
letter, and if I do open it, and I think I would, it would sensitize me to the fact that someone is
coming.66D2” Many agreed the purpose of the letter was basically to let you know someone is coming.
One woman said, “I was glad they sent a letter ahead of time. Otherwise I probably would not be very
receptive.70R2” Another woman said, “I would have thought it was a scam. If I didn’t receive a letter, I
would have automatically thought it would be a scam.53O2” The government letterhead was helpful in
getting the person to read the letter as well as provides legitimacy to the project. One man said,
“Anything with a government letterhead on it, I would probably read.56D1” A woman also spoke to this
issue, “The letterhead of DHHS shows credibility. I might do it for nothing if I saw this.54R1” Some
participants expressed interest in making inquiries about the legitimacy of the survey. One woman said,
“I like that we can see who the project officer is and we can look him up.77D1” Some participants
expressed that the photo ID was helpful. “I like the identification card shown on the letter.65R2”
Many expressed concern that the lead letter was a bit too vague. “The letter should be more
specific in terms of what ‘health-related issues’ are included in the survey.R65+2” One consistent theme
with participants from both age groups and household size compositions was a request for more details
about the study. The participants wanted the materials and FI to concisely provide details about the
survey’s purpose and outcomes and project the social/civic benefit for their participation—providing them
with the basis for a reason to participate. One man offered, “If someone were to call upon my civic duty,
I’ll do it, but this FI didn’t present the survey that way.57D2” One man said, “When the letter says,
‘Health-related issues’ …this means nothing to me and I would throw it away. If they went further and
16

explained what these issues were and how they would affect me, then I might be interested.71R2” Another
man said, “I can’t argue that there is value to the survey, but the subject (or breadth of the subject) is too
remote; it needs to be more direct and specific.73D2” Others felt the letter provided sufficient introductory
information. One woman said, “I think the letter would be enough to get me interested in the study, 76R2”
where one man said, “That’s why the letter needs to say how this study is going to help me, my
neighborhood, my world, to rouse my interest.60D2”
One major problem with the letter is getting the respondent to open it and read it. “In this time of
junk mail, I may have not read the letter.68D2” Having it addressed to ‘Resident’ was seen as a major
drawback. “Anything addressed to “Resident” would not get opened. I have a PO Box, so I don’t open
anything that comes to my house. But the letter is good.64D1” One woman pointed out that, “Andy
Rooney says you shouldn’t read anything that says ‘Resident.’75O1” A DC focus group participant
mentioned that the U.S. Postal Service changed from using ‘Resident’ to a more descriptive term and the
group brainstormed ways to anonymously address the envelope. One suggestion was ‘Health Care
Recipient,’ stating that we are all, in some way or another, health care recipients. The letter, if the
respondent reads it, attempts to explain the use of ‘resident’ but the explanation was not clear for
everyone. Text from letter: “This letter is addressed to ‘Resident’ because you were selected by your
address, and we do not know your name. Feel free to ask the FI any questions you have about the study.”
Yet, another participant, having no problem with this text, suggested putting this paragraph first in the
letter for more visibility.
Participants believed that the envelope should appear important and that the project should use 1st
class postage stamps so that the letters can be distinguished from junk mail. One woman said, “Use a
colored envelope when sending out the lead letter.55R2” They felt the letter should also include a time
frame for an appointment. One woman said the letter should say, “We’ll be in your neighborhood on this
day.58O1” The majority of participants would prefer the lead letter be followed up with a phone call to set
up an appointment. The main reason they want an appointment was because they strongly dislike
someone coming unannounced to their door. But, a woman expressed another important reason for this,
“I still think an appointment time would be helpful. It’s hard to get into large apartment buildings, it’s a
waste of time to go to an apartment building and not be able to get in.68D1” Many would like to have the
letter followed up by a phone call. When reminded we do not have names or phone numbers, the
participants felt that in today’s high tech world, we had access to their phone number and even knew their
names. One woman added, “I don’t believe they don’t know our names.70O2”
Some enhancements to the letter text were suggested. Putting ‘health-related issues’ in bold was
mentioned as well as including how long the interview will take. Some felt the incentive text should be
more explicit. One man said, “The letter doesn’t make it clear that the $30 is not provided for answering
the screening questions. I would think if the FI came to the door and asked me those questions than they
should provide the incentive.71R2” Anecdotally, this sentiment is supported by several hundred requests
per year from individuals that complete the screening questions and claim that they are due $30 for their
time and energy (D. Cunningham, personal communication, May 18, 2005)

Q & A Brochure
The vast majority of participants from all groups wanted the Q&A Brochure included with the
lead letter. “I think the letter and brochure are sufficient, but they should be sent together, at the same
time. That enhances the understanding of the study.68D1” Although issues with including the brochure in
the lead letter were also expressed. One woman offered, “If I was a drug user, I would probably not
participate if I received the brochure in the mail beforehand.75D2”
Overall, the participants thought the brochure was well-designed and that the information
provided met their needs. One man said, “The brochure is the most important tool…the $30 should be
highlighted.52R1” The major criticism was the color of the brochure. One man said, “[The brochure]
should be on more appealing paper, the gray is forbidding.73D2” The inclusion of contact information, such
as the internet addresses on the back of the brochure, and the phone number, was well-received and key
for many participants who expressed an interest in checking the legitimacy of the organization, project,
and FI, and for those who wanted additional information.

Newspaper Articles
Although the newspaper articles provided some details, specifically results, which the participants
were interested in seeing, use of the articles was not seen as overly beneficial. One woman expressed,
“Use the brochure as the newspaper articles are too much information. Most accurate news stories are not
necessarily from newspapers. It doesn’t matter about newspaper, just that it is received by mass media.
It’s not like they would read the information [at the door].65R1”

Refusal Letter
Some participants said the refusal letter would cause them to reconsider participating while others
said it would not. Participants voluntarily compared the lead letter and refusal letter and many wanted to
combine some of the points of the refusal letter into the lead letter. One man suggested, “It’s plaintive,
but the only new data is in the third paragraph. Why not just include that in the first letter.64D1” [Text
referenced from letter: Without adequate levels of participation, these health-related decisions might not
be as informed, and money for programs that might be needed in your state or community could be
directed elsewhere.] The Raleigh 50 to 64 year old age group suggested adding the second paragraph of
the refusal letter to the lead letter. [Text referenced from letter: The results of this study help state and
national policymakers learn about health issues—including information on alcohol, tobacco, and drug
use, non-use, and opinions—so that informed decisions about policies and programs can be made. By
participating in this study, you will make a direct impact on important health-related decisions.] One
woman said, “It’s important to know up front that I cannot be replaced by another person, if I refused to
participate in the study.57R2”
The refusal letter was effective for some to reconsider participation, but not for others. Once
again, this is consistent with the purpose of the refusal letter protocol, because the project utilizes multiple
refusal letter versions that address different concerns.
18

Participants also expressed the importance of the letter’s sincerity. Although meant to be
persuasive, the language and tone should be genuine. One woman said, “The letter doesn’t really ring
true, or with sincerity, like the research can’t go on with out me.52D1” One man said, “And I don’t like the
big deal made out about how I was randomly selected, like I won some award or contest. It doesn’t ring
true.64D1” Additionally, concerning their selection, one woman added, “You should personalize it a little
more, if it’s only a few people selected in DC, you should say something about DC in the letter.54D1”
Addressing the tone of the letter, one man said, “At least the letter says thank you.67D1”

Other
Some issues became themes that the screening scripts or materials could better address. There
were many questions about the screening process and selection/eligibility. Designing text to address
these concerns could prove beneficial. Additionally, the 50+ age group would like a more direct
explanation of the study. One woman said, “I’d like to know what the information is going to be used
for.82D2” One man said, “I need to know what it means to me to do this study. Aside from the $30, are
there real benefits to me or to others?68D2” Another expressed wanting to know more about local
community benefits, “If it focused in more on how it would help your community, make it more personal
instead of how it would help the whole country.55D2”
Clarification about exactly what is expected of the respondent and the amount of time it will take
was expressed by many participants. “I’d be worried about false advertising, that there would be more
needed after doing the survey, and so I’d be concerned about that, and wouldn’t do the survey.63D1”
Several participants felt that the organization name, ‘Research Triangle Institute’ should be used
instead of RTI. They felt additional information about RTI would also be helpful in gaining the
respondent’s trust and interest. One man said, “They should explain who RTI is a little more.65O1”
Another man said, “There should be more on RTI and its track record on these kind of things.90D2”
The vast majority of participants saw no benefit to providing an iPAQ video clip of a
spokesperson providing information about the survey. This quote from one woman sums up the general
consensus on identifying and utilizing a spokesperson, “A spokesperson wouldn’t make me believe
anything because they’d be getting paid and be getting exposure [for doing it].70O2”
The participants, as a whole, were suspicious of someone coming to the door and many expressed
concerns about the FI coming into their home to complete the interview. Perhaps it would be beneficial
if the refusal letter explained the option of completing the interview at another location, such as an office
or library.
Several experiments may prove beneficial from the focus group feedback on materials.
Researching a better way to address the lead letter, to be used in place of ‘Resident,’ and mailing the
letters using a 1st class postage stamp in a higher-quality envelope with a pre-printed Research Triangle
Institute return address with logo may help get more people to open and read the letter. Because
including the brochure in the lead letter may have far reaching consequences, consider developing a
special letter to be used after FIs are unable to complete screenings or interviews at households that they
19

identify as possibly being in the 50+ age group. The special letter mailing would include the brochure
and the letter would contain more details about the purpose of the study while appealing to the person’s
civic duty to participate. Also consider a state or regional letter where the language could more
specifically address the respondent area. Finally, enhance the explanation of “random selection” in all
materials to include what it means based on scientific research objectives.
One might see the distribution of materials after viewing the video as a limitation, but this can
also be viewed as a strength. It caused the participants to think about the type of information they needed
in order to make a decision about participating and then they were able to compare those needs with the
materials we provided them.

4.5

Safety, Trust, and Confidentiality
4.5.1

Safety

Concerns about safety fell into two categories. The first included concerns with physical
safety and the security of the household. The second included fear of “scams” or other uses of
information for reasons other than what was specified by the FI or in the survey materials.
Concerns about physical safety were most prevalent in the groups of participants living alone,
especially among those aged 65 and older, and in the Oakbrook location. There was some suspicion
about whether the woman at the door in the video was truly an FI or an impostor looking to commit a
crime. Many participants living alone mentioned they would not even answer the door if an unknown
person knocked on their door. One woman noted that the FI would have to call first to get in to the
building. She said, “I wouldn't let her in if I hadn't seen the letter.77D1” Another woman said, “I don't open
the door if I don't know who's coming.68D1” A male participant added, “I wouldn't have even opened my
door, and in my apartment building you have to buzz in anyway.66D2” Even among those who would open
the door, many suggested they might not be willing to interact with the FI. One woman said, “If I don't
recognize the person, I'll ask what they want, and I will tell them I'm not interested.75D2”
One man “thought [the FI] was gathering information for a thief with questions like ‘Is there a
back entrance?’ and ‘Do you live here by yourself?’64O1” Others shared this suspicion with comments
such as “She asked a lot of personal questions like ‘Do you live alone?’ ‘How old are you?’ ‘How long
have you lived here?’ What about safety?64O1” Another man added, “I wasn't sure if she was going to
break in or anything. I might have thought differently if I had seen the letter in advance.61O1” Yet another
added, “A stranger could have a gun or break in, you don't know.74O1” Several participants said that the
gender of the FI would make a difference to them, specifically a woman may be more apprehensive to
open the door to a male FI.
Suspicion was raised concerning some of the screening questions. Some participants were
confused as to why the FI asked about separate residences on the property, convinced she was asking
about separate entrances to the residence. Some thought the questions about who lives in the household
during the months of October, November, and December could have been tricks to get the householder to
20

tell the FI when the residence would be vacant. The FI, according to these participants, could use that
information to plan a robbery.
More than physical or household safety, concern was raised over safety from scams and mistrust
of the FI’s intentions. This was especially true for the 50 to 64 year old participants. One male
participant first thought the FI in the video was “selling something.61O1” A woman in another group said,
“I would have thought it was a scam. If I didn't receive a letter, I would have automatically thought it
would be a scam.53O2” One man related the study to the Census: “Compared to the Census where there is a
lot of PR, notice in advance, and very valid looking credentials that they present beforehand to go out of
their way to make you believe who they are… this didn't have any of that.61O1”
Suspicion was raised when the FI asked several questions that sounded similar, especially in the
groups with 2 to 3 persons in the household. One woman said, “She asked same question over and over.
Then when she said, ‘Well it selected you!’ It was like… entrapment.58O1” One woman was suspicious
because she didn’t understand how the screening questions related to the survey topic: “What in the world
do these questions have to do with the topic of health care? They're totally unrelated as far as I'm
concerned. I'd be very suspicious if those questions were asked up front before any questions on the topic
were asked.50O1” For some, the selection process was suspicious. One woman noted, “It sounded like she
was selecting the person right there, which doesn't make any sense to me.63O1” Another woman added, “I
would have questioned what it would take to qualify me for the interview. It seemed like everyone could
be eligible.50R2” Another man was wary of giving out personal information to a stranger and noted, “She
just slid right into getting this information. I would have put the brakes on right away. That woman [the
respondent] just volunteered, which she shouldn't have, especially living alone.60O1”
The overarching theme concerning safety was that familiarity with the intentions of the study and
FI are very important to gaining trust and eliminating safety fears. By eliminating these fears, the
likelihood that respondents in this age group will at least entertain the idea of participating would
increase.

4.5.2

Trust

The importance of trusting the FI, the research organization, and the study purpose was
expressed throughout all of the focus groups. If a participant felt a level of trust with the FI, he or she
would be inclined to participate, or at a minimum, continue listening to the FI. One woman said, “She
looked fairly amiable to me. I think I would’ve responded.68D1” The importance of the FI establishing
rapport and creating a level of trust with the respondent was communicated by many participants. One
woman expressed concerns about the FI in the video, “I just felt that the FI was unprofessional and did
not establish very good rapport with the homeowner.76R2” Many participants were reassured by the FI
wearing an identification badge. In fact, one woman felt the FI should have emphasized the badge more,
“She had an ID around her neck. She should have showed it more.62O2” The possibility of the badge not
being legitimate was also expressed. One man said, “She had a badge but who knows if that was
legitimate61O1” and one woman expressed, “But anyone could make a phony ID.63O1” Several participants
would have verified the legitimacy of the FI, “I would have called the police or the company to check
21

them out.76D1” The participants were pleased there was an 800 number to call RTI to verify that the FI
worked on the study for RTI.
Trust in the research organization and legitimacy of the survey were special concerns of the 65+
age group. One woman felt that it helped to have previously heard of the organization: “I would want to
know how the data are being used and that the organization is credible. I felt uncomfortable when OMR
[focus group facility] called and asked my name, but I’d heard of OMR so there was some trust.67D1”
Another woman expressed her concerns as, “I would want to make sure it was a reliable organization. I
think a survey is [legitimate] when you know the company and you are familiar with it.79O1 Several
people expressed a preference for using “Research Triangle Institute” as opposed to “RTI.” One man
said, “Research Triangle Institute means more than RTI,90D2” and a woman commented, “She gave initials,
but I wouldn't know what RTI is.64D2 “
Participants felt the FI’s presentation and the project materials needed to establish trust in the
purpose of the study. One woman stated, “She would have to tell me a little more; I really didn’t know
the purpose of why she was there.78D1” One woman stated full distrust, “Nothing she said would have
convinced me that she or the company was legitimate.52D1” while another woman felt, “Yes, I thought it
was legitimate, because she had a letter that come first, and a computer, and [an] ID [card].55D2”
Establishing trust also defrays fears of a possible scam. One man commented, “There are so many scams
you have to be really cautious.74O1” More information on the study and its purpose was expected from the
groups aged 50 to 64. One woman said, and the rest of the group agreed, “There should be more of a
preface on the background of the study. All of a sudden there were all these questions about entrances to
the house and how many people live there. How the study would help people [and] the money wasn’t
even [explained].63D1”
Another way to enhance trust among this age group would be with targeted media outreach or
through a well-known spokesperson. Participants in these groups reported that they received their news
from the television, radio, and newspapers. For the most part, they believed they would react favorably to
an endorsement of the survey by a well-known politician or celebrity. Specific names mentioned by
focus group participants were recommended as spokespersons for the NSDUH because they are perceived
as honest and straightforward. Public figures identified by name include political figures (i.e., Rudolph
Giuliani, Hilary Clinton, Barack Obama, Bob Dole, Richard Durbin), news media figures (i.e., Katie
Couric, Barbara Walters, Ed Bradley, Hugh Downs), those in the entertainment industry (i.e., Danny
Glover, Oprah Winfrey, James Garner, Bill Cosby), and other trusted public figures (i.e., Betty Ford,
Billy Graham). This view was not unanimous, however, as several participants would react negatively to
such an endorsement. As one woman said, “I get tired of celebrities… their endorsements turn me
off.50R1”
An article or advertisement in the AARP Magazine endorsing the study was mentioned in the
majority of groups as a particularly positive method of increasing trust and raising awareness of the
NSDUH. This was mentioned in the groups before any mention of the AARP by the moderator.

4.5.3

Confidentiality

Overall, confidentiality was not a major concern voiced by the participants. There was a
shared consciousness that in today’s high-tech world, “how confidential is anything?” One man said, “I
don’t know how much people trust confidentiality statements.68D2” There were a few concerns expressed
about “where the data would be going”; however, most of the concerns reflected trust issues and the
intrusiveness of the questions being asked.
Some confidentially issues surfaced when participants expressed concern about identity theft.
One man said, “We are worried these days about people stealing their information and what they are
going to do with it.67R2” Another man expressed his concern about the interview questions and the privacy
of his answers, “I think it’s too invasive, I’m concerned about privacy with respect to medications,
especially if it gets in to the hands of insurance companies, so if you are taking a lot of medication, it’s
something you don’t want anyone to know about but your doctor.58D2” The FI’s use of the iPAQ in the
video was questioned. One man said, “If someone came to the door with the computer, I would want to
see what she is recording…I am concerned about identity theft.71R2” How the FI engages the respondent
when using the iPAQ is important. One man had this concern: “One thing that would concern me is that
she didn’t say what was happening with the information and whether it was being sent off to someone
right there.68D2” In general, however, use of the iPAQ was not a concern. Most participants agreed using
the device was not a problem. “Technology is used so much these days that I would [have] thought it was
weird [or] tacky if she was using pencil and paper,73D2” said one man. But the way in which the FI in the
video seemed to hide the iPAQ was suspicious to some participants. They would have liked the FI to
briefly explain the device and what it would be used for. One man suggested “It would have helped to
have seen the screen she was entering information into.53D1”
Participants expressed major concerns about the questions being intrusive, invasive, and too
personal. These concerns were expressed across all age groups and household compositions. One
woman said, “The questions were intrusive and redundant.69R1” The respondents who lived alone were
especially concerned about divulging household composition information, “I never would have told her
any personal information, how many people lived there, etc.66D1” Another man said, “The questions are
very dangerous. They are asking personal things. When you’re living alone, that’s very dangerous.69O1” It
was not necessarily the case that these participants were not trusting individuals, but they were very
suspicious about having someone come to their home and ask these questions. One man said, “It’s not
that we don’t trust anyone, but I don’t want to tell that no one lives here during this time.74O1” A woman
expressed, “My mom is in her eighties and we tell her do not answer the door because people prey on
others who live alone.58O1” One man said he would answer the questions, but admitted some reservation
in doing so: “I would have answered the questions, maybe it’s a little uncautious of me.70D1”
Establishing trust is a key component to alleviate concerns with confidentiality and intrusive
issues. FIs need to confidently and accurately convey the purpose of the study and use of data so
respondents will be willing to provide answers to what they regard as “intrusive” questions. If the FI can
create an atmosphere of trust and comprehensively respond to concerns, respondents will feel there is a
reason enough to provide the needed information. FI training on ways to increase respondent trust by
23

better explaining the purpose of the study, why the data collected are important, and what RTI is would be
beneficial. The project is already tailoring a RTI informational brochure to be reviewed and approved by
SAMHSA for use during the 2006 NSDUH.
The FI should not conceal the iPAQ, but rather allow the respondent, to the extent interested, see
what is being entered. Many FIs already do this with success on the project. Training other FIs on how
to naturally include the respondent in the screening process with the iPAQ would prove beneficial.
Experiments in streamlining the screening questions and adding purpose statements with specific
questions, such as the Missed DU question, would alleviate some respondent concerns. Experiments with
advance materials focused on maximizing the extent to which household members read and retain the
information may shed light on improved methods for gaining trust, eliminating fear, and gaining the
participation of respondents in this age group. Similarly, additional FI training focused on increasing
respondent trust and familiarity with the purpose of the survey and questions, especially among
respondents in this age group, could prove beneficial. Finally, research into or experimentation with
alternative FI identification (ID cards rather than just badges or larger badges) could lead to increased
trust and participation among this age group.
Familiarity may be enhanced and trust may be gained through the tailored use of advance
materials including those already in use, advance phone notice, increased public awareness of the study,
and clarification of the study and question purposes at each stage of the FI-respondent interaction. One
female participant contrasted the NSDUH approach with that of the focus group facility, citing familiarity
as an important factor: “I felt uncomfortable when OMR [focus group facility] called and asked my name,
but I'd heard of OMR so there was some trust.67D1” As noted elsewhere in this report, the fact that all
participants agreed to do a focus group in the first place may mean that viewpoints of those who would
not participate in any type of research were not considered. This was an anticipated limitation of this
study.

4.6

FI Issues and Training

The focus group participants provided valuable feedback concerning FI style and behavior that
were important to them in their decision to participate in the survey. The feedback was consistent across
age groups and focus group locations. Participants said they would be more likely to respond to an FI
who was prepared and polished, without being ‘slick.’ One man said, “This lady wasn’t slick…If
someone was going to con you then they would be slick. A con artist would be slick.50R1” The focus
group participants expect FIs to perform their task in a professional manner, which includes being polite
and positive, while displaying knowledge of the survey questions. The Raleigh 50 to 64 group thought
the FI’s unprofessional approach distracted from the message and that she did not seem to know her job
very well. Additionally, they thought it was important for FIs to be able to succinctly explain the purpose
of the study and respond, convincingly, to questions without reading or using mechanical responses. One
woman said, “If I’m pressed for time I’ll just ask “what’s the point?” If she satisfies my requirements and
it is OK, then I’ll do it.50O1” The FI’s advance preparation is critical. One woman said, “I mainly would be
suspicious of the FI because of the lack of familiarity with the questions.61R1” One man thought, “She
24

looked unprepared so you know that the interview is going to take along time.64O1” Another woman
added, “The FI should be more prepared. She should make better eye contact.70O2”
Participants also reported that they would not respond well to an FI who was timid nor would
they respond well to someone who was overly assertive or “pushy”. One man said, “I am looking at a
weak approach…It would be easy to get rid of her.64R2” Another man said, “She seemed like she opened
herself up to the possibility of being refused.58D2” “Pushiness” is partly an issue of the FI being inflexible
during the screening/interview process. For example, the FI should be considerate of the prospective
respondent when handing the lead letter or study description to the respondent. One participant described
it as “…she shoved that disclosure sheet in the homeowner’s face.66R2” Another participant commented,
“She presumes that putting something in your hand obligates you to read it. She should have asked.82D2”
One recommendation would be to review FI interaction styles and specific behavior during FI
training to enhance FI’s performance. Role-plays could be developed using comments noted in these
focus group interviews for scenarios for prospective participants in the age group of 50 and greater.
Special attention could be directed to veteran FIs working on the NSDUH who may have developed
“pushy” tendencies and may need reminders of how the respondent perceives the study and someone
attempting to collect this information at their home.
It is also recommended that FI training reinforce two screening script protocols. First, for a one
person household, the FI should not read the FI instruction message box titled, “Only Householder
Member,” to the respondent. That box is designed for the FI to confirm, in the iPAQ program, that there
is only one person in the household to ensure there was not a data entry error of ‘1’ to the Total SDU
Members question. This instructional message is displayed in all caps, thus not something that should be
read to the respondent. If the FI, in error, reads this or confirms this information aloud, it can cause
suspicion and safety concerns for the respondent. “I thought she was gathering information for a thief
with questions like…“Do you live here by yourself?”64O1”
Secondly, proper execution on the Verify Data screen text should be reviewed at training so that
FIs do not confirm, unnecessarily, additional pieces of data that add to the respondent’s frustration with
the screening questions being repetitive. The FI is to read only relationship and age of all listed
household members, to ensure everyone is listed. They are not to confirm other data, such as race, as
confirmation of that data is completed at the end of each roster section.
Some FIs may need refresher training to increase their comfort level entering data in the iPAQ.
One woman commented about the FI in the video, “If she had looked like she was using it better than she
was, it would have made me feel better. I’m a techie.63O1” Another aspect discussed was making the
iPAQ visible when entering data so the respondent does not become skeptical of what the FI is doing.
One woman said, “She should have been more up front with what she was doing with the computer.55D2”
Inviting the prospective respondent to watch as data are entered into the iPAQ and while the selection is
occurring not only alleviates reservations regarding what is occurring with the iPAQ but it shows value
and respect for the respondent, facilitating greater trust in the FI.

Another perspective that could be reinforced through training is the notion that FIs need to be
aware that they are ‘guests’ to the respondent’s property and understand how the respondent feels about
someone unknown coming to their door. One woman said, “Your home is sacred ground.64O2” Another
woman said, “I think I would be afraid she would take something if I let her in.66R1” Participants wanted
the privacy of their home respected. One man offered this comment, “I would want them to make an
appointment. I have an office in my home and I don’t want people to disturb me unannounced.68 D2” One
woman said about her decision on participation, “It depends on how intimidating the FI appeared.55R2”
Subtle behaviors like how an FI scans the prospective respondents home can cause suspicion. One man
felt, “You need to watch their eyes to see what they see in the home because they might be setting up a
burglary.62O2” Training interviews to be sensitive to these matters may improve their ability to build
rapport with the respondent.

4.7

Incentives

In general, the offer of a $30 incentive was not seen as persuasive by the focus group participants.
Very few mentioned they would be convinced to do the interview for that amount. Also, very few said
they would change their minds about participating if the incentive amount was higher. To most
participants, money was not the factor that would keep them from participating. As one man stated,
“There has to be some benefits other than the money.68D2” Another woman suggested, “It's not all about
money.53O2”
Some thought that $30 was appropriate compensation for a one-hour interview, especially in the
Raleigh groups. These participants either replied “Yes” to the question about the incentive amount or
otherwise indicated “It's about right.” One woman said, “If they came to my house and I needed $30, yes
I'd do it, and so would other people, depending on the situation at the time.52D2” Some felt that $30 would
be convincing for some types of people but not others. One woman stated, “It depends on the person. A
young person might think, ‘$30 is half my grocery bill.’70O1” A man half-jokingly suggested, “If I was on
drugs, I'd let her in so I could get the $30.65O1”
About two or three participants in each group thought $30 was not enough. When asked how
much would be appropriate, most found it difficult to come up with a dollar value. Those who did tended
to think $50 would be an appropriate payment for an hour-long household survey. One woman
mentioned, “The $30 was a courtesy. For one hour, $50 would have been more appropriate.65R1” One man
suggested, “$50. She's already spent 15 minutes with the FI, and then another hour on top of that is too
much.56D1” Another added, “I'd say $50. $30 is not going to move me, but $50 begins to whet my
appetite.64D1” A man in another group said, “$50 might start to turn my head.73D2” And yet another said,
“If I was offered $30, I wouldn't think that it was that important of a survey. An hour of someone's time is
worth more than that.90D2” However, when asked if they would complete the interview for $50, most
remained unconvinced, returning to other issues and concerns with the interview environment. Again, it
must be stated that all focus group participants agreed to do a two-hour focus group interview for $75, but
most participants saw the focus group task as very different in nature compared to a household interview.

One woman suggested, “Call, send a letter and not someone pushing their way in my door. It's one thing
to call us up and ask us to come in here for $75, but another to have someone come into your home.56O1”
In some cases, participants felt that being offered money by the government to complete the
survey was inappropriate. One man mentioned, “If it were legitimate and credentialed, we shouldn't have
to be bribed. People don't have to be paid for the Census.61O1” One woman expressed an anti-government
sentiment by saying of the incentive, “Nothing is enough if it is government.63O1”
Still others were suspicious of the $30 offer, thinking it was a trick, part of a sales pitch, or that
something other than completing the survey would be expected in return. This was especially true with
the Oakbrook participants. One woman stated, “I would be suspicious if someone offered me $30.61R1”
Another woman shared this sentiment: “Money makes me more suspicious.71O2” One man, when asked if
the $30 made him uncomfortable said it “didn't feel right to me.61O1” Another man said, “I'd be skeptical,
like I was going to be ripped off.65O1”
Most participants agreed that money, while potentially a persuasive tool, would not be a sufficient
enough incentive on its own to gain their participation. Although no solid suggestions for non-cash
incentives were offered, these participants felt that the most important factors in deciding whether to
participate was trust in the motives of the FI and survey, and an understanding and appreciation for the
topic and value of the data.

5. Limitations
The discussion that follows addresses general limitations that are characteristic of all focus
groups, as well as limitations specific to the methods used in this study. The quality of focus group
results can be limited by factors that include group composition, group size, and moderator
selection/training (Bischoping and Dykema, 1999). These considerations are addressed in Section 3 of
this report. Additional limitations in focus group interviewing methodology include generalizability,
FI/materials bias, and selection methods.
As with other forms of qualitative research that use non-random samples, the results of this study
cannot be generalized to the general population with any statistical validity. While the participants were
divided by age and household size, they were not randomly selected and assigned to groups. The
objective of qualitative research is not a random, representative sample but insights from a homogeneous
group of people that are typical of one’s study population. Additionally, several groups are facilitated for
a group of participants to gather main themes while sorting out idiosyncratic differences between groups.
The goal of focus group interviews for this and many other studies is not representative results but rather
insights typical of one’s study population.
Additionally, the small sample size of the study (N = 111) and geographic clustering further
hinder the generalization of the results to the larger population. Geographically, the focus groups were
conducted in only three locations across the country – two focus group sites in large MSAs (the
Raleigh/Durham, NC, Chicago, IL, and Washington, DC MSAs). All focus group interviews were in the
eastern half of the United States so the extent that participants in the western half of the United States
share the views expressed by their counterparts in the East is unknown. Similarly, there was no
comparison groups including potential respondents under the age of 50. It might be important to conduct
such focus groups in order to determine which concerns are unique to those 50 and older, and which span
across all age groups.
Focus group results are further affected by both the interaction between the participants and all
study personnel involved (moderator, note takers, and vendor staff), as well as the materials presented to
them. Specific to this report, content analysis of comments and the conclusions reached are based on the
judgment and interpretation of the authors. The responses provided by the participants are also directly
affected by the materials used in the session. In this case, the field FI who was the scenario protagonist in
the video did not display the “usual” flexibility interviews use in scheduling the interview; the FI in the
video example aggressively pursued the cooperation of the respondent. The characteristics of this field FI
may have negatively affected participants’ overall impressions of the interaction and therefore affected
their responses to questions posed in the sessions. While there could be a negative impression bias from
the field FI (or “pitchfork effect” – opposite of a “halo effect”), the larger finding is likely valid – the skill
and ability of field FIs are invaluable in 1) establishing a trust relationship with the participant, 2)
seeming credible and thus reinforcing the benefits of the study, and 3) minimizing costs or reservations
that may lead the participant to doubt the integrity of the study.
28

Finally, although vendors were instructed to avoid recruiting “professional” focus group
participants, many of the participants made reference to past focus group participation. In any data
collection enterprise, evidence that responses may have been conditioned by previous survey participation
or that key survey statistics may be correlated with the respondent’s decision to participate is cause for
concern (Wang, et al, 2000; Groves, et al, 2004). The issue is more pronounced for this study because the
decision to participate is itself a characteristic under investigation. Put more simply, we are attempting to
analyze the responses of individuals who have decided to participate in a study (and who may have
participated in many studies), in order to gain insight into the participation decision of others in the same
population subgroup who display lower than average response rates.
This last limitation manifested itself most strongly in apparently inconsistent responses to
questions about survey length, incentive amount, and demographics. In response to questions posed
about the NSDUH interview, many participants stated that they consider an hour-long interview
excessive, $30 per hour insufficient as an incentive and questions about age and household size too
personal to answer. However, in order to be eligible for the focus group, all participants had agreed to a
two-hour interview, agreed to receive a $75 incentive (for a 2-hour focus group interview), and had
released information about age and household size. Therefore, it is important to recognize that while the
participants in these focus groups may have important insights into the participation decision of others of
a similar age group and household size, they themselves are not necessarily the type of respondent who
may be reluctant to participate or refuse to cooperate with the NSDUH interview request.

6. Specific Recommendations
This focus group study has elicited feedback from people typical of respondents aged 50 years
and older for the NSDUH survey. The summary of recurring themes and comments from focus group
participants identified areas of study for future methodological studies to improve participation in the
NSDUH survey. Key to all of the insights forwarded by focus group participants and the study of
methodological enhancements to facilitate greater response rates without introducing response bias is the
theoretical reasons for survey responding.
The social exchange theory (Blau, 1964; Dillman, 1978; Goyder, 1987; Dillman, 2000) describes
the nature of the relationship between the survey organization and prospective survey respondent. A
person’s willingness to open a survey-related mailing or entertain an FI is contingent on 1) the belief that
the benefits of responding outweighs the costs and 2) developing a level of trust that would assure the
respondent that the benefits will indeed outweigh the costs. Many of the general themes described in
focus groups directly or indirectly point to concerns with the social exchange. For some in the 50+ group,
the benefits do not appear to outweigh the cost and there may not be enough trust to assure them that their
time and energy is worth the long-term benefit of participating in the survey.

Facilitating trust.
Three aspects of trust in the social exchange relationship noted by Dillman (2000) are
establishing the legitimacy of the sponsoring and research organizations, making the task seem important,
and invoking other trust relationships. These concerns and other trust-related issues were especially
prominent in focus group results. Specifically, results indicate that more could be done to 1) establish a
personal relationship with the prospective survey respondent, 2) better communicate the survey topic and
the importance of participation, 3) more clearly describe the selection process and the importance of their
representation in the survey sample, 4) facilitate greater positive regard for the personal safety of
participants, and 5) train field FIs to immediately reinforce the trust established through the contact
materials by bridging the trust relationship so that it extends to the field FI as well as the organizations
sponsoring and administering the survey.
A number of focus group participants noted that they do not open mail addressed to “Resident.”
While there are concerns about maintaining the confidentiality of the respondent, most stated that merely
printing their name and address on the envelope and lead letter does not necessarily mean that
confidentiality is lost. Focus group participants noted that much of the mail they receive is personally
addressed to them but name, address, and basic demographic information is widely known and used in
direct mail solicitations. Mailings addressed to “Resident” seem to indicate a lower level of effort to
establish a relationship with the potential respondent. While there are challenges associated with
sampling households and also personalizing lead letter mailings, consideration should be given to
exploring ways of identifying a palatable alternative to addressing lead letters with the title “Resident.”

To better communicate the survey topic and importance of participation it is recommended that
there is an examination of how well the contact materials 1) establish the legitimacy of the sponsoring and
research organizations, 2) clearly convey the survey objectives and importance of participation, and 3)
describe the selection process and importance of the selected individual’s participation. Many focus
group participants did not know the objective of the study. Nearly all recommended increasing the font
used in the lead letter and including the NSDUH Q&A Brochure with the lead letter so potential
respondents could learn more about the study in advance of the field FI arriving for the household
screening and interview. 2 While there may be some reluctance to describe the study objectives in great
detail, enough information should be provided so a trust relationship can be established and so
participants can weigh the benefits against the cost of participation.
A sentiment conveyed by focus group participants that may exist to a greater degree among
survey participants aged 50 or older are concerns for their personal safety and fear of fraud (i.e., “being
the victim of a scam”). Three specific recommendations might be considered to facilitate a greater sense
of trust through concern for the respondent’s personal safety and security from RTI and SAMHSA: 1)
calling potential participants in advance to schedule visit appointments, 2) creating larger, more easy to
comprehend identification badges that can be shown to participants, and 3) clearly describe the screening
and interview process and how the information gathered in each will be used.
Most focus group participants questioned whether the household screening or appointments for
the household screening could be made in advance via telephone. Survey participants in this age group
are especially wary of being a victim of crime or fraud. Calling in advance to schedule appointments
allows prospective participants to schedule the screening with a family member present. Advance calling
has the added advantage of serving as a benefit of study participation by conveying a sense of respect and
value for the prospective participant’s time.
Another recommendation noted by focus group participants was the use of larger, easier to read,
non-affixed identification badges for field FIs. Many of the focus group participants commented that they
are not able to easily read identification badges worn around a person’s neck and they feel vulnerable
leaning forward to read the badge. Larger identification badges/certificates placed on a clipboard that can
be passed over to the participant for their review rather than a badge affixed on a lanyard worn around a
field FI’s neck will likely make it easier to review a field FI’s credentials.
Another major barrier to establishing a trust relationship in the social contract is transferring the
prospective participant’s trust in the survey sponsor/research organization to the field FI. Focus group
participants reported that the field FI was very important in their decision to participate in the screening.
If the field FI was less than polished, any credibility established through the advance materials (i.e., lead
letter, Q&A Brochure, possible telephone call appointment, etc) was lost. The hand off in trust from the
survey sponsor/research organization to the field FI could be done more effectively by training FIs to

It must be noted that the example lead letter used for the focus groups showed smaller type than the one used on
the study to accommodate the heading “Example Lead Letter.” Nevertheless, it is recommended that printed
materials for older populations use a font size of 13 points or more (Work Group on Consumer Health Information,
2005). The current NSDUH lead letter uses a 12-point font.
31

reinforce the trust established through the contact materials and building rapport by describing the
screening/interview process, making the screening process transparent (e.g., showing the participant the
iPAQ and letting respondents see how the selection process unfolds), and explaining any tedium
associated with responding to questions that seem obvious or repetitive (e.g., “In order to ensure that all
participants are asked the same questions, I have to read these questions word for word, so please bear
with me if some of these questions seem obvious or repetitive.”).

Costs and benefits.
Many of the recommendations that facilitate trust also serve to minimize the costs and enhance
the benefits of participation. For example, providing additional information regarding the study
objectives in the lead letter and the Q&A Brochure not only facilitates trust but more clearly describes the
benefits of the study both for the study participant and the long-term well-being of their family (e.g.,
children and grandchildren). As mentioned above, many focus group participants noted that having a
field FI arrive unannounced expecting the resident to make time for them indicated a lack of consideration
of the value of their time. Calling in advance and establishing an approximate timeframe for the
screening would convey a sense of value for their time and the importance of their responses to the
NSDUH survey. Not only would this reinforce the value of the study and credibility of the
sponsor/research organization, but it may alleviate fears of being a victim of crime or fraud. While this
may be impractical for the entire study population, it may be possible for participants in this age group.
Conversely, there may be other, more practical alternatives to demonstrate respect for the participant’s
time such as identifying specific days or times of week when field FIs will be visiting or leaving “Sorry I
Missed You” cards on the initial home visit and scheduling a return visit.
Some, but not all, of these recommendations are possible to implement given the current
sampling and survey methodology used in the NSDUH survey. These recommendations serve as a
framework for considering alternatives to strengthen the social contract through increased trust, greater
awareness of the benefits, and reduced concerns of the costs associated with participating in the NSDUH
survey. These recommendations for changes to the NSDUH survey methodology should be examined in
a controlled, experimental setting to ensure that there is no introduction of response bias in the NSDUH
survey data.

7. References
Aquilino, WS (1992). “Telephone versus face-to-face interviewing for household drug use
surveys.” International Journal of the Addictions. 27:1:71-91
Bischoping, K., and J. Dykema (1999). "Towards a Social Psychological Program for Improving
Focus Group Methods of Developing Questionnaires." Journal of Official Statistics.
15:495–516.
Blau, P.M. (1964). Exchange and power in social life. New York, NY: Wiley.
Brogan DJ, M. Denniston, J.Liff, E. Flagg, R. Coates, and L. Brinton (2001). “Comparison of
telephone sampling and area sampling: response rates and within household coverage.”
American Journal of Epidemiology. 153:1119–27.
Dillman, D.A. (1978). Mail and telephone surveys. The total design method. New York, NY:
Wiley-Interscience.
Dillman, D.A., (2000). Mail and internet surveys. The tailored design method (2nd Edition).
New York, NY: John Wiley & Sons, Inc.
Goyder, J.C. (1987). The silent majority: Nonrespondents on sample surveys. Boulder, CO:
Westview Press.
Groves, R. M., S. Presser, and S. Dipko (2004). “The role of topic interest in survey participation
decisions.” Public Opinion Quarterly. 68(1):2-31.
Krueger, R.A. (1994). Focus Groups: A Practical Guide for Applied Research (2nd Edition).
Sage Publishing: Thousand Oaks, CA
Murphy, J. & Eyerman, J. (2003) “Nonresponse among sample members 50 and older.” Draft
report prepared by RTI for the Substance Abuse and Mental Health Services
Administration.
Murphy, J. & Schwerin, M. (2003) “NSDUH field interviewer focus group final report –
nonresponse among sample members 50 and older.” Prepared by RTI for the Substance
Abuse and Mental Health Services Administration.
Wang, K., D. Cantor, and A. Safir (2000). “Panel Conditioning in an RDD Survey.” Proceedings
of the Section on Survey Research Methods, American Statistical Association, pp. 822827.
Work Group on Consumer Health Information (2005) “Designing Your Report: Font Size and
Type.” http://www.talkingquality.gov/docs/section3/3_5.htm

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