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Tests, Supporting Statement
Appendix B – 2015 National Survey on Drug
Use and Health: Text To Speech Investigation
and Report
2015 NATIONAL SURVEY ON
DRUG USE AND HEALTH
TEXT TO SPEECH INVESTIGATION
AND PRETEST REPORT
Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
Rockville, Maryland
February 2015
2015 NATIONAL SURVEY ON
DRUG USE AND HEALTH:
TEXT TO SPEECH
INVESTIGATION AND
PRETEST REPORT
Contract No. HHSS283201000003C
RTI Project No. 0212800.001.208.006.002
RTI Authors:
RTI Project Director:
Emily Geisen
Patty LeBaron
Marty Meyer
Gil Rodriguez
David Roe
Christina Touarti
Hilary Zelko
David Hunter
SAMHSA Project Officer:
Peter Tice
For questions about this report, please email Peter.Tice@samhsa.hhs.gov.
Prepared for Substance Abuse and Mental Health Services Administration,
Rockville, Maryland
Prepared by RTI International, Research Triangle Park, North Carolina
February 2015
Acknowledgments
This report was prepared for the Substance Abuse and Mental Health Services Administration,
Center for Behavioral Health Statistics and Quality (CBHSQ), by RTI International (a registered
trademark and a trade name of Research Triangle Institute). Contributors to this report from
CBHSQ include Joel Kennet, Grace O'Neill, and Dicy Painter. Contributors to this report at RTI
include Debbie Bond, Doug Currivan, Patti Dukes, Tim Flanigan, Valerie Garner, Becky
Granger, David Hunter, Georgina McAvinchey, Gretchen McHenry, Allison McKamey, Susan
Myers, Rosanna Quiroz, Bonnie Shook-Sa, Margaret Smith, Richard Straw, and Kevin Wang.
ii
Table of Contents
Chapter
Page
1.
Introduction ........................................................................................................................ 1
2.
Literature Review................................................................................................................ 3
3.
Investigations of Text to Speech Software ......................................................................... 7
4.
5.
3.1
2009 Investigation ...................................................................................................... 7
3.2
2013 Investigation .................................................................................................... 14
3.3
Costs and Impact on Work Processes ...................................................................... 22
3.4
Overall Conclusions and Recommendations ........................................................... 23
2014 Pretest of Text to Speech in NSDUH ...................................................................... 25
4.1
Cognitive Interview Phase ....................................................................................... 25
4.2
Pilot Test Phase ........................................................................................................ 38
4.3
Pretest Conclusions .................................................................................................. 46
References ......................................................................................................................... 47
Appendix
A
ACASI Questions Selected for TTS Prototypes ............................................................. A-1
B
Recruitment Advertisements (English and Spanish) .......................................................B-1
C
Cognitive Testing Protocol (English and Spanish) ..........................................................C-1
D
Informed Consent Forms (English and Spanish) ............................................................ D-1
E
Text to Speech Pilot Test Detailed Timing Tables .......................................................... E-1
F
Text to Speech FI Debriefing Moderator's Guide ............................................................ F-1
iii
List of Tables
Table
Page
3.1
Product Scoring for Acapela ................................................................................................9
3.2
Product Scoring for NeoSpeech .........................................................................................10
3.3
Product Scoring for AT&T Natural Voices .......................................................................10
3.4
Length of Time Required to Initially Customize Audio for a Particular Variable .............11
3.5
Ratings of Customized Text to Speech Voices ..................................................................13
3.6
Text to Speech Prototypes .................................................................................................17
3.7
Product Averages for Evaluated Text to Speech Prototypes .............................................18
3.8
Gender of Voice Preference ...............................................................................................18
3.9
Average Ratings on Quality Dimensions for NeoSpeech English Prototypes ..................18
3.10
Average Ratings on Quality Dimensions for NeoSpeech Spanish Prototypes ..................19
3.11
Average Ratings on Quality Dimensions for Microsoft Speech Platform English
Prototypes ..........................................................................................................................19
3.12
Average Ratings on Quality Dimensions for Microsoft Speech Platform Spanish
Prototypes ..........................................................................................................................19
3.13
Average Ratings on Quality Dimensions for TextSpeech Pro English Prototypes ...........20
3.14
Estimated Software Costs of Text to Speech Products ......................................................22
4.1
English-Speaking Participant Demographics ....................................................................27
4.2
Spanish-Speaking Participant Demographics ....................................................................27
4.3
Comprehension Rating of English Survey Questions, by Version ....................................30
4.4
English-Speaking Participant Preference Ratings, by Voice .............................................32
4.5
Comprehension Rating of Spanish Survey Questions, by Version....................................33
4.6
Spanish-Speaking Participant Preference Ratings, by Voice ............................................35
4.7
Question Length and Percentage Faster, by English Voice ...............................................36
4.8
Question Length and Percentage Faster, by Spanish Voice ..............................................37
4.9
Text to Speech Interview Respondents, by Age Group .....................................................41
4.10
Text to Speech Audit Trail Timing Data: Mean and Median in Minutes,
Comparison across Instruments, English-Speaking Respondents, by Age Group ............42
4.11
Text to Speech Audit Trail Timing Data: Mean and Median in Minutes,
Comparison across Instruments, Spanish-Speaking Respondents, by Age Group ............43
iv
List of Tables (continued)
Table
Page
E.1
Text to Speech Audit Trail Timing Data: Interview Overall, All Respondents .............. E-2
E.2
Text to Speech Audit Trail Timing Data: ACASI, All Respondents ............................... E-3
E.3
Text to Speech Audit Trail Timing Data: ACASI Tutorial, All Respondents ................. E-4
E.4
Text to Speech Audit Trail Timing Data: ACASI Risk Availability, All
Respondents ..................................................................................................................... E-5
E.5
Text to Speech Audit Trail Timing Date: Interview Overall, English-Speaking
Respondents ..................................................................................................................... E-6
E.6
Text to Speech Audit Trail Timing Data: ACASI, English-Speaking Respondents ....... E-7
E.7
Text to Speech Audit Trail Timing Data: ACASI Tutorial, English-Speaking
Respondents ..................................................................................................................... E-8
E.8
Text to Speech Audit Trail Timing Data: ACASI Risk Availability, EnglishSpeaking Respondents ..................................................................................................... E-9
E.9
Text to Speech Audit Trail Timing Date: Interview Overall, Spanish-Speaking
Respondents ................................................................................................................... E-10
E.10
Text to Speech Audit Trail Timing Data: ACASI, Spanish-Speaking Respondents ..... E-11
E.11
Text to Speech Audit Trail Timing Data: ACASI Tutorial, Spanish-Speaking
Respondents ................................................................................................................... E-12
E.12
Text to Speech Audit Trail Timing Data: ACASI Risk Availability, SpanishSpeaking Respondents ................................................................................................... E-13
v
1. Introduction
Audio computer-assisted self-interviewing (ACASI) is a survey technology in which question
text is simultaneously displayed on screen and read aloud to respondents through a headset. It has
been adopted widely by survey researchers and has been used in a number of national Federal surveys
because of its effectiveness in eliciting more accurate responses to highly sensitive or personal
questions (Tourangeau & Smith, 1996) and for enabling participation among respondent populations
with low literacy levels or sight impairments (Phillips, Edwards, & Dolbow, 2013). Typically,
ACASI uses human voices recorded in the form of WAV or MP3 files that read the survey questions
and response options on each screen. This requires a costly and labor-intensive effort both to record
and edit high-quality audio and to programmatically integrate audio files with survey software
(Phillips et al., 2013). This process can be especially difficult for questionnaires that dynamically
generate question text using previous response fills or other changing components, such as dates,
which need separate audio files that must be "stitched" together and can cause breaks or pauses in the
flow of the audio.
Another challenge for voice-recorded ACASI questionnaires is the reliance on a particular
human voice that may change over time or become unavailable, thereby requiring the rerecording of
all audio files with a replacement voice in order to ensure consistency within and across interviews. A
potential solution to these challenges is the integration of text to speech (TTS) software, which uses a
computer-generated voice to read text displayed on screen. This text can be recorded in WAV file
format (static) or run dynamically in conjunction with the survey instrument (dynamic), thereby
eliminating the use of audio files altogether (Phillips et al., 2013). Compared with recording WAV
files with a human voice, either approach has the potential to simplify the production of audio content
associated with modifications to questionnaire text or the incorporation of new survey items.
To assess whether the use of TTS would be viable on the National Survey on Drug Use and
Health (NSDUH), RTI International and the Substance Abuse and Mental Health Services
Administration (SAMHSA) completed a thorough investigation into the features and quality of
various TTS software packages. This investigation began in 2009 with a literature review of TTS
software used for survey data collection, followed by the evaluation of available TTS software to
assess which of the commercially available products were potentially viable for use on the NSDUH.
At that time, the TTS products available were not deemed suitable for the NSDUH. However over the
next few years, significant advances in TTS technology were made. In 2013, RTI and SAMHSA
continued their investigation of TTS software for use on the NSDUH. The 2013 evaluation resulted in
the selection one TTS product, which was then tested in 2014, and finally implemented on the 2015
NSDUH.
The results of the literature review and investigations are provided in the remainder of this
report. Chapter 2 provides the results of the TTS literature review that was initially conducted in 2009
and updated in 2013. It summarizes the projects and studies that used TTS in data collection and the
potential effects it had on data quality. Chapter 3 summarizes the results of the investigations of
commercially available TTS products. In 2009, the investigation focused on researching different
TTS systems and identifying products suitable for further evaluation. In 2013, given the advances in
TTS technology, the investigation re-assessed the different TTS systems and conducted an evaluation
of selected products.
1
After the 2013 investigation, a recommendation regarding which of the evaluated products
was most promising for the NSDUH's ACASI modules was provided and a product was selected by
SAMHSA for the 2015 NSDUH. However, the comprehensibility of TTS in the NSDUH had not
been evaluated by the individuals who may rely more heavily on the audio component when
completing the ACASI portion of the NSDUH interview. These individuals are likely to be the
youngest and oldest respondents (i.e., those aged 12-17 and 65 or older), respondents with low levels
of literacy, and non-native English speakers. Therefore, a pretest was conducted in 2014 to evaluate
whether the use of TTS had any effect on comprehension of specific survey items, to determine the
best TTS presentation speed for administering the survey questions, and to identify any major issues
in administration time or unanticipated issues with the use of TTS. The TTS pretest also included two
phases: a cognitive interview phase and a pilot test phase. The findings from the 2014 TTS pretest are
reported in Chapter 4. Based on the findings in the cognitive interview phase, the decision was made
to implement TTS for the 2015 NSDUH.
2
2. Literature Review
For years, the survey research industry has studied and documented the benefits of audio
computer-assisted self-interviewing (ACASI) when compared with other data collection modes, from
paper and pencil to computer-assisted personal interviewing (CAPI) (Tourangeau & Smith, 1996,
Turner et al. 1998, Dykema, Basson, & Schaeffer, 2007). As time went on, ACASI became even
more popular, with Couper, Tourangeau, & Marvin (2009) furthering the conversation by noting that
modest gains found through the use of ACASI called for continued research and experimentation.
As ACASI grew, the methods of audio delivery to respondents also began to evolve.
Researchers began experimenting and examining the use of text to speech (TTS) technology, which
converts entered or keyed (programmed) text into speech (Kraft & Taylor, 2006; Couper, Kirgis,
Buageila, & Berglund, 2012; Phillips et al., 2013). In survey data collection, TTS is most commonly
used in interactive voice response (IVR) or telephone audio computer-assisted self-interviewing (TACASI) modes. Surveys deployed in these modes are conducted by telephone, and the survey
instructions and questions are delivered via prerecorded scripts (Couper, Singer, & Tourangeau,
2004). Using TTS systems to provide audio for ACASI in-person interviews is not yet as common as
in telephone data collection modes. As Couper (2005, p. 488) noted, continued improvement to the
quality of TTS technology "… opens the way to increased use of TTS systems for replacing the
recording of interviewers [i.e., human voices]," including ACASI. Kraft and Taylor (2006) provided
an early example of investigating TTS for use with an ACASI protocol, in which they suggested that
the use of TTS provided greater flexibility in making edits and changes and reduced development
time and costs while providing respondents with an impersonal solicitor for sensitive questions. In
recent years, advances in TTS synthesis technology have been enabling the generation of more
realistic, accurate, and human-sounding "voices" in multiple languages that may be customized with
respect to pacing, volume, pitch, and pronunciation. Concurrent with these advances, the use of
computer-generated voices has gone from a few, highly technical applications to the point at which
many people encounter synthesized speech regularly in their daily lives and are likely becoming more
accustomed to it.
In response to this improved technology, survey researchers have begun experimenting with
implementing TTS. In September 2011, the developers of the National Survey of Family Growth
(NSFG) replaced human voice recordings with static TTS recordings for the ACASI portion of the
Cycle 8 interview, and they compared Cycle 8 data with Cycle 7 data that used human voice
recordings (Couper et al., 2012). In addition to supporting past literature on the overall cost and time
efficiencies provided by TTS in preparation for data collection, the NSFG researchers found that
more respondents used ACASI but took less time (in terms of overall interview time) to do so,
suggesting that smaller audio files, less downtime or "space" between files and fills, and the pace of
TTS led to better overall interview efficiency (and, one could assume, reduced burden) while in the
field. In 2012, the Population Assessment of Tobacco and Health (PATH) Study also turned to TTS
for a field test. Using a dynamic implementation mode, in which the TTS engine reads question text
in real time without prerecorded audio WAV files, Phillips and colleagues (2013) supported the
aforementioned research on the efficiency of using TTS, especially when it comes to eliminating the
sheer size and volume of files that must be "stitched" together to provide smooth audio delivery.
3
They noted that in this mode, TTS consumes far fewer resources (server space, storage, etc.) than live
voice recordings.1
Because many TTS products offer both female and male voices, a review of the survey
research methods literature examining how the gender of an ACASI voice might affect survey
response was also conducted. The literature remains inconclusive regarding the impact of the gender
of the voice on survey response. Outside of the survey research industry, scholars and technology
experts have suggested that computer voices are mostly female because of biology (people finding
female voices more pleasing than male voices) or history (e.g., telephone operators) (Griggs, 2011).
That said, gender experts have suggested that gender stereotypes, if present in an individual, can in
fact extend to machines, suggesting that voice selection (in terms of gender) could be highly
consequential (Nass, Moon, & Greene, 1997).
In the survey research literature, information is somewhat scarce, although Dykema, Diloreto,
Price, White, and Schaeffer (2012) presented an excellent review of the literature at the beginning of
their investigation into ACASI gender-of-voice effects on the reporting of sensitive behaviors among
young adults. They explained that, depending on a question's topic, respondents may refer to genderbased stereotypes, conversational norms, or identities when responding (Tannen, 1996; see also
Schaeffer, 2000). According to self-disclosure theory, individuals are expected to be more honest and
disclose more to someone they trust and with whom they feel comfortable (Jourard, 1971). Insofar as
respondents hold stereotypes that women are more sympathetic (Pollner, 1998) or nonjudgmental
(Nass, Robles, Heenan, Bienstock, & Treinen, 2003), respondents may disclose or report higher
levels of sensitive behaviors to female interviewers (Dindia & Allen, 1992). In contrast to selfdisclosure theory, other researchers have offered "explanations of exaggeration," which hold that
higher levels of reporting may be less valid. For example, the "macho hypothesis" of Catania and
colleagues (1996, p. 371) explains the higher levels of some sexual behaviors that males report to
male interviewers as an effort to seem more virile and manly. In a related vein but predicting a
different outcome, Weisel (2002, p. 102) argued in her study of contemporary gangs that "a female
interviewer may [have] inadvertently encourage[d] male interviewees to put on a macho bravado and
exaggerate some points." However, Dykema and colleagues (2012) found higher levels of
engagement in sensitive behaviors and more consistent reporting among males when responding to a
female voice. They did not find any evidence that female respondents were influenced by the voice's
gender.
Couper and colleagues (2004) also found no significant difference between male and female
voices on reporting sensitive behaviors or gender attitudes in a telephone survey. They compared
question administration by live telephone interviewers, an IVR system that used human voice
recordings, and an IVR system that used synthesized speech generated from TTS software. Equal
numbers of male and female respondents were enrolled in the study. Although the authors expected to
find gender-of-voice effects for gender attitudes and some sensitive questions (i.e., sexual behavior,
weight) in both the live interview and IVR conditions, surprisingly, they found no significant
differences due to the gender of the voices used. However, they did find effects for differences in
responses to the live interviewers as compared with the automated IVR system, which consistently
revealed greater disclosure of sensitive behaviors in the IVR conditions. This finding is consistent
with the research methods literature that suggests that ACASI facilitates more accurate and candid
reporting of sensitive behaviors, although it does not indicate that the gender of the voice used in
1
The PATH Study did not report any results associated with the impact on survey response because a full
implementation of TTS had not been completed at that time.
4
ACASI always has a significant impact on survey responses. One other study, conducted exclusively
with male respondents, directly tested the effect of the ACASI voice's gender on survey reports;
Fahrney, Uhrig, and Kuo (2010) explored the impact of a male versus a female voice on reports of
sexual activity among men who have sex with men. Their results were consistent with more accurate
reporting among the males who heard questions read by a female voice. Although Dykema and
colleagues (2012) concluded that a female voice should be the convention for ACASI studies, they
also noted that more experimentation and investigation are required to ensure the elimination of
underreporting across specialized topics and populations.
Based on the review of the TTS literature, RTI and the Substance Abuse and Mental Health
Services Administration proceeded with an investigation of TTS software products as detailed in
Chapter 3. Given the inconclusive literature on voice gender, both male and female voices were
examined in the TTS investigation for preference.
5
6
3. Investigations of Text to Speech Software
3.1
2009 Investigation
In July 2009, survey research staff at RTI completed an investigation into the features
and quality of various text to speech (TTS) software packages to determine which, if any,
software is best suited for use with the National Survey on Drug Use and Health (NSDUH). The
objective was to determine whether the NSDUH could transition from using a human voice for
the English and Spanish audio computer-assisted self-interviewing (ACASI) portions of the
survey to using an automated voice created through TTS software. RTI reviewed relevant
literature and presentations evaluating TTS systems for surveys or similar purposes, as described
in Chapter 2. This research and review of articles, such as Couper (2005) and Couper et al.
(2004), provided guidance in the decision to further investigate and test a carefully chosen subset
of currently available packages.
3.1.1 Static versus Dynamic Text to Speech Implementation
The use of TTS software in the NSDUH interview could take one of two forms. In the
dynamic alternative, each field laptop would be equipped with TTS software. The computerassisted interviewing (CAI) instrument would use a Blaise alien router to call the TTS run-time
software passing the question text as input. The TTS software would then generate the audio in
real time during the survey. The TTS software would theoretically have the pronunciations for
hard-to-pronounce words defined ahead of time, and identical versions of the TTS software,
along with the pronunciation definitions, would be loaded on all laptops.
The static alternative would largely mirror the approach that is currently used for creating
audio files and loading them on the field laptops. A centralized TTS application would be used to
create audio files for the ACASI section of the interview. This central bank of audio files would
then be loaded onto the field laptops for use during the interview.
In discussing the merits of these two alternatives, a decision was reached to proceed with
the latter. The Substance Abuse and Mental Health Services Administration (SAMHSA)
expressed concerns about standardization across field laptops with respect to pronunciations of
the same words from question to question if the TTS software were to be installed in each field
laptop individually. The level of effort for creating the customized pronunciations across the two
alternatives would be quite similar. RTI noted that the dynamic alternative would allow the
programming staff to reduce hours needed to maintain and store the WAV files needed for the
interview from year to year. However, it was decided that the risk of violating standardization
would outweigh any additional time required to maintain the bank of audio files. Therefore, this
investigation identified packages that would be suitable for creating customized audio files for
storage and dissemination to the field.
3.1.2 Methods
RTI initially evaluated six TTS software packages in order to identify those with the
capability to provide English and Spanish audio for NSDUH instrumentation. The packages
7
evaluated were Acapela, AT&T Natural Voices, Cepstral, Loquendo, NeoSpeech, and Real
Speech. This evaluation yielded three TTS products that RTI recommended for further testing.
Creating a standardized audio environment across field interviewer (FI) laptops was a
critical requirement of the TTS package. Neither Acapela nor NeoSpeech offered a male Spanish
TTS voice. Therefore, RTI recommended focusing investigations on female voices offered by
the companies.
RTI provided SAMHSA with the sample audio files that were created as part of the initial
investigation, using freely available demo versions of the six TTS software packages. The audio
files were created using the text from the NSDUH's lifetime alcohol use question (AL01). The
wording of this question was simple, and RTI expected the TTS audio of this question to be high
quality. However, that was not the reality.
RTI survey research staff's initial reactions to the quality of the "off-the-shelf" products
included observations that none of the packages provided voices that were free from problems.
Many of the voices possessed robotic qualities. Others stuttered when pronouncing certain words
(e.g., "alcohol"). Rankings of the Spanish versions of these TTS products were considerably
lower than their English counterparts. Evaluations of the Spanish voices elicited comments
regarding the presence of mispronunciations, heavy Spanish accents, an inappropriate tone that
may sound rude to respondents, and trembling voices.
The first round of review indicated that real difficulties might be found when the products
were subject to further testing. First, RTI staff suspected that it could be entirely possible that the
speech quality offered by even the best and most expensive TTS software would not be good
enough for NSDUH interviewing. Second, staff believed that the manual "tweaking" of text,
which would be required to produce understandable pronunciations of drug names and other
nonstandard words, might require extensive effort. This could perhaps result in expending
several times as much effort as would be required to simply re-record all of the WAV files using
a human voice. RTI recommended testing this customization process with the goal of estimating
the amount of effort that it would entail.
3.1.3 Results of the 2009 Investigation
3.1.2.1
Off-the-Shelf Testing
The next steps in the investigation included focusing on the three packages: Acapela,
NeoSpeech, and AT&T Natural Voices. Tables 3.1–3.3 show average subjective rankings of
each product on a number of dimensions. These evaluations ranked the off-the-shelf audio
produced by the individual products. These files were not customized. The English voices were
ranked by six RTI evaluators: Chuchun Chien, Doug Currivan, Patty LeBaron, Hyunjoo Park,
Gil Rodriguez, and Mai Wickelgren. Each evaluator was asked to rank the TTS voice on each
dimension using a scale from 1 to 5. The points on the scale were labeled as follows:
Numeric Value
1
2
3
4
5
Label
Poor
Fair
Good
Very Good
Excellent
8
Spanish rankings used the same scale and were scored by three RTI evaluators: Georgina
McAvinchey, Rosanna Quiroz, and Gil Rodriguez.
Initial investigations of each of the three products listed as follows indicated that they
were compatible with existing systems, were priced competitively, and had potential to be
customized to correctly pronounce and emphasize words contained within the NSDUH
interview. Further testing of these products can provide more comprehensive insight into the
process of customization and deployment.
3.1.2.2
Product 1: Acapela
As shown in Table 3.1, the product average for Acapela's English female voice tied with
NeoSpeech's for the highest ranking. Acapela's Spanish female voice also was ranked the highest
among Spanish female voices. However, this ranking was almost a full point lower than
comparable English rankings. Acapela's Spanish female voice was described as "trembling."
Acapela software possessed the capability to edit pronunciations for abbreviations and
exceptions. It was batch processing–supported and had an adjustable speaking rate and an
adjustable voice tone. Acapela included speech enhancements and control tags.
Table 3.1
Product Scoring for Acapela
English Female
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Average Score
2.83
2.67
3.00
2.83
3.83
3.03
Spanish Female
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Average Score
2.00
2.00
2.00
2.00
2.33
2.07
http://www.acapela-group.com/text-to-speech-interactive-demo.html
In 2009, Acapela's product was priced according to the number of hours of audio that
were produced. A 5-hour pack cost $2,250, a 10-hour pack cost $3,750, and a 20-hour pack cost
$5,250. If one bought a 5-hour pack, for instance, up to 5 hours of back-to-back sound files could
be created. Sound files were license free and could be duplicated and distributed without having
to pay an additional license fee. For NSDUH’s purposes, a 20-hour pack would have been
needed to record the entire ACASI portion of the English and Spanish interviews, along with all
fills, and would therefore have cost $5,250.
3.1.2.3
Product 2: NeoSpeech
As shown in Table 3.2, NeoSpeech's female Spanish voice was ranked relatively low,
with a score of 1.4. This was the third highest ranking of a female Spanish voice, with Acapela
and AT&T Natural Voices receiving higher scores. One evaluator commented that the voice
sounded "too loud or too exclamative" and "may sound rude to respondents." A comment about
NeoSpeech's English female voice described it as "assertive."
9
Table 3.2
Product Scoring for NeoSpeech
English Female
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Average Score
2.67
3.33
3.17
3.00
3.00
3.03
Spanish Female
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Average Score
1.67
1.33
1.33
1.33
1.33
1.40
http://www.neospeech.com/
NeoSpeech software supported customization of a dictionary so that developers could
adjust pronunciations of symbols, abbreviations, and new terms. In 2009, this product cost
$3,996 per year and included two developer licenses and an additional Spanish voice. There was
no additional cost for audio file distribution.
3.1.2.4
Product 3: AT&T Natural Voices
As shown in Table 3.3., the clarity score for the AT&T Natural Voices English female
voice was below the average of all of the product's clarity scores (1.83 vs. 2.28). AT&T's
Spanish voice was described as having a heavy Spanish accent and included mispronunciations.
Table 3.3
Product Scoring for AT&T Natural Voices
English Female
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Average Score
1.83
2.33
2.17
2.50
3.83
2.53
Spanish Female
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Average Score
1.67
1.67
1.67
1.33
1.33
1.53
http://www.naturalvoices.att.com/
AT&T Natural Voices included custom dictionaries that could be used to define
pronunciations phonetically. It could run the application to read text from a file and output a
WAV file. Control tags could be added to mark up text to affect pronunciation, such as
controlling the emphasis on a word.
In 2009, a single AT&T software development kit cost $295, and an extra Spanish voice
font cost $50. This purchase provided a perpetual license with no need to renew. Deployment
licenses for the software cost $5 each. The overall cost included deployment licenses for 800
laptops ($4,000). Fewer licenses would have been needed for testing the product, resulting in
significant cost savings. The estimated cost for NSDUH’s purposes was $4,345.
AT&T also offered a prescription drug module containing English pronunciation
definitions of certain drug names to RTI for $1,000. Of the 99 drugs used in the four
psychotherapeutic modules and in the special drugs modules of the 2009 NSDUH, 49 were an
exact match. Many were partial matches. For example, AT&T's Wizzard Module contained
10
Darvocet, Tylenol, and codeine, whereas the NSDUH used Darvocet-N and Tylenol with
codeine.
Each software Web site listed earlier provided the opportunity to listen to the TTS voices
speak customized phrases, often in a variety of voices. After providing audio files to SAMHSA
for further evaluation, RTI conducted further testing of available software packages listed earlier
to gain more insight into their ability to provide quality, standardized audio for the NSDUH
interview.
3.1.2.5
Customized Testing
To assess the quality of customized audio and the level of effort involved in creating such
customizations, RTI requested evaluation versions of the three software packages and tested
them off the shelf. Acapela and NeoSpeech provided RTI with trial evaluation versions of their
software at no charge. These software packages allowed for the customization of pace,
pronunciation, and tone for English voices only. Representatives from both companies indicated
that there were no differences in capabilities between the trial version and the full version of the
software. A trial evaluation version of the AT&T Natural Voices product was not available.
As a next step, RTI customized the tone of the audio files, the pronunciations of the
words contained within a select number of variables, and the pace of the voice. A number of
questions within the NSDUH's tranquilizer module were selected for this customization. These
questions contained both standard text and more complicated drug names. Throughout the
customization process, programming staff tracked the level of effort that was required to achieve
the highest possible quality in the end product.
To customize the audio files, pronunciations of the words were defined either
phonetically or using pronunciation symbols within the lexicon/pronunciation editor of the
particular application. RTI found that the same phonetic pronunciation definition of a word did
not always yield the same pronunciation in the two software packages that were tested.
Pronunciations of drug names were particularly laborious to customize, as the default
pronunciation of these words differed dramatically from the correct pronunciation. Because
some questions contained more than one drug name, the time required to customize each
question varied. It is estimated that each drug name required between 10 and 20 minutes to
define.
Additional time was required to customize other words and pronunciations in the
question. Table 3.4 illustrates the length of time it took to initially program each WAV file. It
was estimated that after the iterative rounds of review and revision needed to achieve an
acceptable level of quality, these lengths of time could increase threefold.
Table 3.4
Length of Time Required to Initially Customize Audio for a Particular Variable
Variable
INTROTR2
TR01
TR02
TR03
TR04a question
TR04a responses
Time
15 minutes
45 minutes
1 hour, 15 minutes
45 minutes
3 hours, 30 minutes
15 minutes
11
After defining pronunciations and customizing the results, RTI reviewed and rated the
resulting Acapela and NeoSpeech audio files through a process similar to the off-shelf evaluation
process (see Table 3.5 for the results). The review and rating process elicited some negative
comments about the quality of the audio files. The pronunciation of most drug names by both
products presented a problem. Comments about the customized Acapela voice noted difficulty
with pronouncing most prescription drug names, problems with inflection at the end of a
question, and a strange accent when pronouncing the word "caused." Other comments noted that
the voice seemed "laborious" while speaking. Comments about the NeoSpeech product were
more favorable. However, the pronunciations of the drug names were not accurate, and in one
particular WAV file, the voice sounded as though she talked with a lisp (TR04a question).
3.1.4 Conclusions from the 2009 Investigation
In response to a lack of acceptable quality and to the extensive level of effort that would
be needed to create the WAV files for the English and Spanish NSDUH interviews, RTI
compiled observations about the packages. After performing a fairly thorough initial
investigation using free demo versions of two of the popular representative commercial TTS
packages, RTI observed the following:
It was fairly easy to quickly produce audio files from question text. However, these
files sounded robotic, and pronunciations of many words were clumsy or incorrect.
Customization of pronunciation was possible, so RTI investigated that in some detail.
Some observations on the customized products were noted as follows.
Experimentation with some simple examples of questions from the NSDUH CAI
instrument clearly showed that it might be difficult, if not impossible, to produce
high-quality and natural-sounding audio files using any of the TTS packages RTI
examined. This was true even after fairly extensive tweaking and customization of
pronunciations using phonetic spellings and pronunciation enhancements.
Customization of simple question text proved quite time consuming. On the basis of
what was seen, RTI estimated that it could take between 1 and 2 hours per question to
optimize the pronunciations and cadence of the questions. This was an optimistic
estimate because it neglected to factor in the effect of "fills," in which the question
audio was dynamically produced based on the answers to prior questions. It also did
not factor in much time for the iterative review process, in which RTI sent audio to
SAMHSA to review and comment on, RTI modified the audio, and so on. This would
undoubtedly be a time-consuming process.
If RTI estimated that it would take 1.5 hours to optimize each audio file, for
approximately 3,500 audio files in the questionnaire, then twice that to account for
Spanish as well, RTI concluded that it could take 10,500 person hours (5 people
working full time for more than 1 year) to finish the work. Even if a 1.5-hour per
question estimate was a significant overestimate, the amount of effort involved still
could be prohibitive and would undoubtedly be many times the effort involved in
completely re-recording all the audio files from scratch using a human voice.
12
Table 3.5
Ratings of Customized Text to Speech Voices
Voice
Intro TR02
Acapela
NeoSpeech
Clarity
Inflection
Tone
Humanness
Pace
Product Average
1.8
2.0
3.0
1.8
2.6
2.2
3.8
3.6
4.0
3.6
3.2
3.6
Clarity
Inflection
Tone
Humanness
Pace
Product Average
1.4
2.0
2.8
1.8
2.8
2.2
2.8
3.0
3.4
3.2
3.0
3.1
Clarity
Inflection
Tone
Humanness
Pace
Product Average
1.8
2.0
3.0
1.6
3.2
2.3
3.0
2.8
3.4
3.2
3.0
3.1
Clarity
Inflection
Tone
Humanness
Pace
Product Average
TR04a Question
Clarity
Inflection
Tone
Humanness
Pace
Product Average
TR04a Responses
Clarity
Inflection
Tone
Humanness
Pace
Product Average
2.2
2.4
3.2
1.8
3.0
2.5
3.0
3.0
3.6
3.2
3.4
3.2
3.0
2.4
3.2
2.2
2.8
2.7
3.8
3.4
3.8
3.4
3.4
3.56
1.8
2.2
2.6
1.8
3.0
2.3
2.4
3.4
3.2
3.4
3.8
3.2
TR01
TR02
TR03
NOTE: Scale: 5=Excellent, 4=Very good, 3=Good, 2=Fair, 1=Poor. A trial evaluation version of the AT&T Natural
Voices product was not available.
13
•
The whole issue of an audio Spanish version seemed extremely challenging. The
effort involved, the ability of the TTS software packages to produce accurate Spanish
pronunciations, and the limited availability of Spanish speakers who could tweak
those have caused RTI to further question the viability of the proposed approach.
•
The option to purchase AT&T Wizzard's prescription drug module might be a time
saver. However, this module would help with the pronunciation of drug names in
English only. In cases where the Spanish pronunciation differed from the English,
RTI would have been charged with the task of creating custom pronunciations for
each drug name in Spanish.
3.1.5 Recommendations from the 2009 Investigation
At the conclusion of the 2009 investigation, it was determined that TTS technology was
not appropriate for the NSDUH. At that time, very high levels of effort would have been needed
to customize audio files so that they would be of a quality appropriate for use with the NSDUH.
As a result of the level of effort that would be involved in this process, RTI did not recommend
the use of NSDUH resources to continue further down this path at that time. However, RTI and
SAMHSA understood the importance of reevaluating TTS options as technology improved with
time. A reevaluation was conducted in 2013 as part of the TTS investigation and is described in
the following section.
3.2
2013 Investigation
In 2013, SAMHSA asked RTI to assess changes in the TTS software landscape and
reexamine the possibility of implementing TTS on the NSDUH. RTI conducted a broad review
of the TTS landscape at the time to identify software products that could be considered for
further hands-on assessment. A wide variety of TTS software products was available in 2013,
ranging from small Web plug-ins or mobile applications, to stand-alone desktop software, to
server-based solutions for streaming speech output. The sound and quality of the speech output
depended largely on the speech synthesizer software that generated the "voice" and on the
methods that were available to vary the pacing, volume, emphasis, or pronunciation of terms.
Products varied with respect to the synthesizer technology used and the functionality provided
for customization. For example, some products provided a "studio" editing interface that allowed
for easier manual editing and manipulation of the pronunciation, volume, and pacing of the
speech output, whereas others required customization using programming code, such as Speech
Synthesis Markup Language (SSML). In 2013, Microsoft, Apple, and Android all had a TTS
synthesizer built into their operating systems. In addition, Microsoft's Speech Platform Software
Development Kit (SDK) allowed developers to build applications that interacted with the
synthesizer programmatically. Other commercial providers, such as AT&T Natural Voices,
Acapela, and NeoSpeech, had developed their own TTS synthesizers that could run on the
Windows platform and be integrated with a variety of applications. Some commercial providers
also included editing or "studio" software that could be used for customizing the speech output.
Other products typically provided a user interface for inputting text or selecting documents/web
pages to be read and used either the operating system's built-in synthesizer or one of the
commercial third-party synthesizers, such as AT&T or NeoSpeech.
To identify feasible options for the evaluation, RTI staff conducted online research and
contacted a variety of vendors to learn about different TTS products. The most important factors
14
in selecting products were the sound and quality of the voice, the ability to customize speech
output (pronunciation/pacing), and the ability to run on a laptop in an offline environment. Also,
the search was limited to vendors that had a track record in the industry and were likely to
remain key players with well-supported products. As requested by SAMHSA, the research began
with the three products evaluated as part of the 2009 TTS investigation (i.e., Acapela, AT&T
Natural Voices, and NeoSpeech) to determine whether they remained feasible options for the
2013 evaluations. These products evolved since 2009 and were considered among the top
commercially available TTS products in 2013. RTI staff examined software features, listened to
online demos of the voices, and spoke with company representatives to discuss the software's
capability to provide both a dynamic speech solution and a static, prerecorded audio file–based
solution. The conclusion was that all three products should remain viable options for further
investigation. Next, RTI staff extended the search to include other products that other survey
groups had used or had come on the market or gained prominence since 2009. TextSpeech Pro
emerged as an additional product for consideration because it was used on both the National
Survey of Family Growth (NSFG) and Population Assessment of Tobacco and Health (PATH)
Study (see the discussion in Chapter 2).
In addition to the four products mentioned earlier, RTI staff researched a wide variety of
new TTS products. Several turned out to be less suitable with limited capabilities and were
marketed mainly for personal use, so the team focused on seven mainstream and commercially
available TTS packages, each of which supported integration with other applications, as follows:
•
TextSpeech Pro
•
AT&T Natural Voices
•
NeoSpeech
•
Microsoft Speech Platform
•
Acapela
•
IVONA
•
Loquendo
The 2013 evaluation plan required an assessment of the two core modes for
implementing TTS software in the NSDUH ACASI module: static and dynamic
implementations. As mentioned earlier, "static" implementation used TTS software to record all
of the audio files needed by the ACASI instrument. These recordings were saved as WAV files,
stored on the laptop, and played by the ACASI program as the respondent moved through the
interview. This was similar to the NSDUH's existing ACASI approach, with the primary
difference being that the TTS "voice" was recorded rather than a human voice. "Dynamic"
implementation installed the TTS engine on each laptop, and the ACASI program interfaced with
the TTS engine to construct the audio in real time as each question appeared on screen.
The features of the TTS packages were examined with respect to both implementation
modes. The dynamic implementation required a Windows-based desktop SDK or an application
programming interface (API) to interact with the NSDUH's Blaise survey software. The static
audio file–based approach required that TTS speech be output as WAV audio files. In summary,
the TTS software features required to support the NSDUH's needs were as follows:
15
•
For dynamic implementation, Windows-compatible SDK or API to allow integration
with the NSDUH interview software and the ability to run offline
•
For static implementation, the ability to output speech to WAV file format
•
Customizable pronunciation and extensible dictionaries to accommodate specialized
terminology
•
A graphical user interface (GUI) that enabled customization of volume, pausing, and
speaking rate
•
Availability of male and female voices
•
Availability of English and Spanish voices
Three of the seven products listed earlier satisfied the requirements: TextSpeech Pro,
NeoSpeech, and AT&T Natural Voices. The Microsoft Speech Platform met most of the
requirements but did not include any male voices. The requirements excluded three of the seven
TTS products listed earlier: Acapela, IVONA, and Loquendo.
Sections 3.2.1 and 3.2.2 describe the 2013 evaluation methods and results. Additionally,
RTI's technical team evaluated the advantages and disadvantages of the static and dynamic
implementation modes, which are described in Section 3.2.3.
3.2.1 Methods
After discussions with the NSDUH team at SAMHSA, three products were selected for
purchase: TextSpeech Pro, NeoSpeech, and AT&T Natural Voices.2 Shortly before the purchase
was made, AT&T unexpectedly pulled its Natural Voices product off the market without
providing any information on possible future availability. As a result, SAMHSA and RTI staff
decided to eliminate the AT&T product from further consideration, and the Microsoft Speech
Platform (which met most of the requirements to support the NSDUH) was used to replace the
AT&T product in the 2013 evaluation.
An initial set of prototypes using a subset of 12 ACASI questions was developed using
the static and dynamic modes, English and Spanish languages, and male and female voices. The
CAI questions were selected to include a mix of specialized terms, such as the names of
alcoholic beverages or prescription drug names, long sections of text, and question fills. These
questions are listed in Appendix A. Because many of the default pronunciations, particularly for
specialized terms and prescription drug names, were incorrect, the technical team worked to finetune and enhance these pronunciations and customize the pausing, speed, and pitch of voices to
maximize the probability that respondents could understand the voice. The team spent
approximately 10 minutes per screen to enhance the quality, which provided a realistic test of the
quality that could be achieved in a full-scale implementation.
A total of 12 prototypes—8 in English and 4 in Spanish—were developed and are listed
in Table 3.6. These included male, female, and Spanish versions that were available from each
product. Although both female and male voices were originally required for testing, no male
2
The Microsoft Speech Platform product was not included initially because it did not need to be purchased,
and an initial review indicated that it did not meet all of the requirements. Before RTI conducted the evaluation, a
newer and higher quality voice option offered by Microsoft was identified and included in the 2013 evaluation.
16
Spanish voices were available for any of the products, so only female Spanish voices were
tested. Also, no male English voice was available for the Microsoft Speech Platform.
Table 3.6
Text to Speech Prototypes
English Prototypes
1. NeoSpeech male static
2. NeoSpeech female static
3. Microsoft Speech Platform female static
4. TextSpeechPro female static
5. TextSpeechPro male static
6. Microsoft Speech Platform female dynamic
7. NeoSpeech female dynamic
8. NeoSpeech male dynamic
Spanish Prototypes
1. NeoSpeech female static
2. Microsoft Speech Platform female static
3. NeoSpeech female dynamic
4. Microsoft Speech Platform female dynamic
A team of seven evaluators (five English speakers and two Spanish speakers), including
one male and six females who had experience in survey research were recruited to assess the
prototypes. Both Spanish-speaking evaluators had experience in designing Spanish-language
surveys.
Each evaluator was assigned to assess four prototypes in a specific order. Assignments
were made so that evaluators were presented with a mix of static, dynamic, male, and female
prototypes in different orders to minimize any potential bias due to the order in which evaluators
heard the prototypes. Each prototype was assessed by at least two evaluators. The evaluators
were instructed to navigate through the CAI prototype and rate each screen along the following
dimensions using a rating scale from 1 to 5: clarity, inflection, tone, humanness, and pace. The
points on the scale were labeled as follows:
Numeric Value
1
2
3
4
5
Label
Poor
Fair
Good
Very Good
Excellent
Ratings were then averaged across all screens, and the evaluators generated an average
product score for each prototype. After completing the ratings, evaluators were asked to report a
gender preference and which, if any, of the prototypes they preferred.
3.2.2 Results of the 2013 Investigation
This section presents the results of the evaluation. Ratings on all screens for each
dimension were averaged across all evaluators to provide an overall product average for each
prototype (see Table 3.7). Table 3.8 presents the gender of voice preferences. The following
sections include the detailed results for each product.
17
Table 3.7
Product Averages for Evaluated Text to Speech Prototypes
Product
NeoSpeech
Microsoft
Speech
Platform
TextSpeech Pro
English
Static
Female
2.6
English
Dynamic
Female
2.9
English
Static
Male
2.8
English
Dynamic
Male
3.0
Spanish
Static
Female
2.1
Spanish
Dynamic
Female
2.5
2.6
2.9
--
--
2.1
2.8
2.1
--
2.0
--
--
--
-- Not available.
When asked if they had a preference for a male or female voice, most evaluators were
indifferent or preferred female, as shown in Table 3.8.
Table 3.8
Gender of Voice Preference
Gender of Voice Preference
Number of Evaluators
3.2.2.1
Male
1
Female
2
Indifferent
2
Product 1: NeoSpeech
Table 3.9 shows the audio quality ratings for the NeoSpeech English prototypes, and
Table 3.10 shows the ratings for the Spanish prototypes. The product average scores for
NeoSpeech's female English voice tied with Microsoft Speech Platform's female English voice in
both the static and dynamic versions (see Section 3.2.2.2 for the Microsoft product results).
NeoSpeech's static prototypes were ranked higher than both TextSpeech Pro's female and male
prototypes (see Section 3.2.2.3 for the TextSpeech Pro product results). The dynamic
implementations were higher than the static versions and were the highest of all female
prototypes. NeoSpeech's male English voice was ranked slightly higher than the female voice.
Despite these higher rankings, only one English evaluator preferred a male voice over a female
one.
The product average for NeoSpeech's female Spanish voice was higher for the dynamic
version than the static version, but it was lower than the product average for Microsoft Speech
Platform's female Spanish voice. No male Spanish voices were available from NeoSpeech or
Microsoft Speech Platform.
Table 3.9
Average Ratings on Quality Dimensions for NeoSpeech English Prototypes
Dimension
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Static Female
2.8
2.5
2.9
2.0
2.8
2.6
Dynamic Female
3.3
2.7
2.9
2.5
3.2
2.9
18
Static Male
2.9
2.6
3.4
2.2
3.0
2.8
Dynamic Male
3.6
2.8
2.9
2.6
3.1
3.0
Table 3.10
Average Ratings on Quality Dimensions for NeoSpeech Spanish Prototypes
Dimension
Clarity
Inflection
Tone
Humanness
Pace
Product Average
3.2.2.2
Static Female
2.4
1.9
1.9
2.1
2.3
2.1
Dynamic Female
2.5
2.3
2.4
2.3
3.1
2.5
Product 2: Microsoft Speech Platform
Table 3.11 shows the audio quality ratings for the Microsoft Speech Platform English
prototypes, and Table 3.12 shows the ratings for the Spanish prototypes. Microsoft Speech
Platform's female English voice tied with NeoSpeech's female English voice for the highest
ranking of the female voices and outranked the TextSpeech Pro female prototype by one-half
rating point. As with NeoSpeech, the product average for the dynamic version was higher than
that of the static version. No male English voices were available with Microsoft Speech Platform
at the time of evaluation.
Table 3.11
Average Ratings on Quality Dimensions for Microsoft Speech Platform English
Prototypes
Dimension
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Table 3.12
Static Female
3.5
2.2
2.7
1.7
2.8
2.6
Dynamic Female
3.9
2.8
2.9
2.5
2.7
2.9
Average Ratings on Quality Dimensions for Microsoft Speech Platform Spanish
Prototypes
Dimension
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Static Female
2.1
2.0
2.0
2.4
2.1
2.1
Dynamic Female
2.8
2.7
2.8
2.8
3.0
2.8
Microsoft Speech Platform's dynamic female Spanish voice was ranked the highest of all
Spanish voices. The static version had a product average equivalent to NeoSpeech's female
Spanish static version.
3.2.2.3
Product 3: TextSpeech Pro
The product averages for the TextSpeech Pro female and male English prototypes were
the lowest of all English prototypes (see Table 3.13). On almost every dimension, they scored
19
lower than both NeoSpeech's female and male static prototypes as well as Microsoft Speech
Platform's female static prototype. A dynamic version of TextSpeech Pro was unavailable, and
no Spanish voices were available with the TextSpeech Pro software.
Table 3.13
Average Ratings on Quality Dimensions for TextSpeech Pro English Prototypes
Dimension
Clarity
Inflection
Tone
Humanness
Pace
Product Average
Static Female
2.7
1.8
1.9
1.5
2.8
2.1
Static Male
2.4
1.8
2.0
1.4
2.5
2.0
3.2.3 Static versus Dynamic Implementation
As part of the activity associated with developing the prototypes, the NSDUH's technical
team at RTI also assessed requirements and tradeoffs associated with the static versus dynamic
TTS implementations. This section summarizes the key advantages and disadvantages of each
approach. Overall, the team concluded that the advantages of the dynamic approach, which
allowed greater flexibility, efficiency, and audio quality, outweighed those of a static approach.
In addition, the dynamic prototypes were consistently rated higher than the static prototypes.
Using the static TTS approach to prerecord audio files would have many advantages
associated with eliminating the process for human voice recording and minimizing the impact on
the development process:
•
Audio files could be generated in a batch from text descriptions of the questions. This
would require significantly less time than human voice recording and would not
require the use of a recording studio.
•
Also, in a static TTS implementation, the Blaise program on the laptop would remain
largely the same as the current version, with only minimal changes required.
•
Installing TTS software on the laptops would be unnecessary, and the configuration
of the NSDUH's field laptops would remain largely the same, with audio files
installed locally on each laptop.
•
Testing would be similar to the current approach and somewhat easier than a dynamic
implementation because no TTS software would be required to listen to audio files,
which could be played on any computer or even a mobile device.
One of the main drawbacks of the static approach was that audio files still had to be
"stitched" together, which would not eliminate some of the breaks or pauses that could occur
when multiple files must be played for a single question. Also, the static implementation would
require the production of approximately 10,000 audio files (5,000 for ACASI in English and
5,000 for ACASI in Spanish) to replace the human voice recordings currently used on the
NSDUH. This work would require purchasing or developing software to generate and edit the
audio files on RTI development computers, and it would also require developing a database for
storing and maintaining all of the audio files and text scripts for each audio segment.
20
A dynamic implementation would offer many advantages largely associated with
eliminating the use of audio files:
•
Audio files would not be prerecorded, thereby eliminating the audio file production
process and the effort associated with editing, prerecording, storing, and maintaining
a database of audio files.
•
The dynamic approach also offered a smoother audio delivery on questions with fills
because breaks or pauses that could occur when audio files have to be "stitched"
together would no longer be present.
•
Eliminating audio files would simplify the process of distributing patches to in-field
laptops because there would be no audio files to distribute as part of a patch. This
would make patches smaller and easier to deploy, providing increased flexibility to
make needed changes to the questionnaire during ongoing data collection.
•
There would be no need to maintain audio files and scripts used for recording.
Among the disadvantages of a dynamic implementation was that more sophisticated
programming would be necessary, requiring familiarity with specific tools and features of the
TTS product and the Microsoft Speech API. Although many changes would be required in the
Blaise programming code to implement a dynamic approach, the experience acquired during the
development of the prototypes allowed the team to establish methods that could be implemented
in the entire set of ACASI modules fairly easily. Additionally, the dynamic approach would tend
to make the interview software testing process somewhat more cumbersome because each testing
laptop would require installation and configuration of TTS software, whereas in a static
implementation, a finite set of audio files could be easily shared and played on any laptop. Also
of interest is that the dynamic implementation required that TTS software be installed and
configured on every field laptop, which could potentially introduce complications associated
with software licensing agreements. In particular, the NeoSpeech TTS product required each
laptop to be configured with a unique license activation key, permanently tied to the media
access control (MAC) address (the hardware ID number) of that laptop. As such, a dynamic
implementation based on NeoSpeech would severely complicate the duplication and
maintenance of NSDUH field laptops and would require that a NeoSpeech license be purchased
for every laptop. It is certainly worth noting here that the Microsoft TTS product, which was
free, did not impose any such licensing requirements or restrictions. Therefore, a dynamic
implementation based on the Microsoft TTS product would not have the same drawbacks
associated with a dynamic implementation based on NeoSpeech.
Finally, it should be noted that regardless of mode, TTS implementation in the first year
would require a significant effort with respect to customizing pronunciations and testing the
audio components. Many of the default pronunciations for specialized terms and drug names
would need to be corrected using alternate, phonetically based spellings. Furthermore, even with
customization, the pronunciations for some terms or phrases would likely be suboptimal, which
was true for both the static and dynamic implementations. The technical team estimated that the
level of effort to customize and test the audio components would be similar in either the static or
dynamic approaches.
21
3.3
Costs and Impact on Work Processes
Cost is a key factor in adopting any new technology. The implementation of TTS
software offered the potential for work process efficiencies and long-term cost savings associated
with developing and updating the NSDUH ACASI program. Startup and ongoing costs were
associated with purchasing and using the TTS software and the level of effort required to
implement the new technology. This section discusses both the software costs and the impact on
the level of effort in key work processes involved in TTS implementation.
Each product evaluated in 2013 is summarized in Table 3.14. Estimated costs associated
with the purchase and ongoing use of the product are provided in both static and dynamic
implementations based on vendors' estimates in 2013. Licensing requirements were different for
each product. NeoSpeech required an annual license agreement with the purchase of their
products, whereas Microsoft did not. TextSpeech Pro licenses were bundled in the purchase
prices of the software on a one-time, per-laptop basis, and no renewal was required.
Table 3.14
Estimated Software Costs of Text to Speech Products
Text to Speech Product
NeoSpeech
Microsoft Speech Platform
TextSpeech Pro
License
Required
Yes, annual
renewal
No
Yes, one time
Cost: Static
Implementation1
$5,300/year
(700 laptops)
$0
$1,500
(10 development
computers)
Cost: Dynamic
Implementation1
$9,800/year
(700 laptops)
$0
N/A2
N/A = Not applicable.
1
Costs presented in the table are based on estimates gathered from vendors in 2013.
2
Although RTI staff were initially told that a software development kit (SDK) was available for implementing a
dynamic version, only a demo version could be obtained, which appeared to be last updated in 2009. RTI staff
were later told that the voice provider (i.e., NeoSpeech, AT&T) would need to be contacted to obtain the SDK
needed to implement a dynamic version.
RTI staff also reviewed key work processes involved in the NSDUH's current ACASI
development effort that would be affected by TTS implementation to assess whether an increase,
decrease, or similar level of effort would be required. These work processes were in four areas:
1. Production of audio files for ACASI
2. Customization/editing and testing of audio components
3. ACASI programming
4. Field laptop configuration and mass duplication
The production of audio files in the current approach involves activities associated with
human voice recording using a recording studio and sound engineer and maintaining a database
for storing and maintaining audio files. A reduced level of effort and greater efficiency over time
would be expected in a static implementation because audio files could be generated from text
scripts in batch using purchased or developed software, thereby eliminating costs associated with
human voice recording and rerecording. Clearly, in the first year of implementation, a learning
curve would be associated with using the new software, implementing new processes, and
22
generating scripts for approximately 10,000 new audio files. In a dynamic implementation, this
process would be eliminated altogether.
The second area (i.e., customization/editing and testing of audio components) would
require the greatest increase in effort, regardless of implementation mode, especially in the first
year of implementation. The RTI staff's experience in developing the TTS prototypes revealed
that default pronunciations for specialized terms (e.g., alcohol types, prescription drugs, health
conditions) had to be customized using alternate phonetic spellings. The speaking rate, pitch, and
volume also were modified to improve the quality. As a result, it was expected that a greater
number of audio components would require editing and quality control checks than in the current
approach, where pronunciations, pacing, and pitch are more easily adjusted by the human voice
in the studio at the time of initial recording. Therefore, TTS implementation was expected to
require an increased level of effort associated with editing pronunciations compared with the
current approach. However, the same level of effort for customization/editing and testing was
expected, regardless of whether a static or dynamic implementation is adopted.
In the third area, the ACASI programming effort, a static implementation would require
essentially the same effort as in the current approach, and minimal changes would be required in
the Blaise code to accommodate the TTS audio files. A dynamic implementation would require
more complex programming to integrate the TTS engine with the Blaise software. However,
because RTI staff developed the programming approach and an initial set of code to achieve this
while building the prototypes, a small increase was anticipated in programming effort to
implement this for the full set of ACASI modules.
Similarly, the process for field laptop configuration and mass duplication (the fourth
area) would be similar to the current effort in a static implementation and somewhat more
complicated for a dynamic implementation, which would require TTS software to be installed
and configured on each field laptop. As noted earlier, this process would be significantly more
complex if the NeoSpeech product were deployed because of its hardware-based annual
licensing structure, which would complicate not only the initial deployment, but also annual
updates and ongoing replacements of field laptops. Because Microsoft Speech Platform did not
require a license, the configuration process would be significantly simplified.
3.4
Overall Conclusions and Recommendations
Implementing TTS technology in the ACASI module of the NSDUH interview offered an
opportunity for work process efficiencies and cost savings in the NSDUH's ACASI software
development. Although TTS software did not match the audio quality of human voice recording,
the evaluation presented in this report, along with the experience of both the NSFG and the
PATH Study, indicate that it was of sufficient quality to replace human voice recordings in
ACASI. The goal of implementation was to create audio recordings that both English- and
Spanish-speaking respondents of all ages could easily understand. None of the evaluators had
difficulty understanding any words or phrases produced by the TTS voices. A significant
advantage of TTS, regardless of implementation mode, was the elimination of the effort and
costs associated with the use of a recording studio and human voices for generating ACASI
audio. TTS also eliminated relying on a particular human voice, which could change or become
unavailable over time.
23
The evaluation results indicated that a dynamic implementation offered a higher quality
audio experience than the static implementation largely because of the elimination of audio files.
The dynamic approach also eliminated processes for producing, maintaining, and storing audio
files and would simplify the process for updating or modifying the NSDUH's ACASI modules.
The dynamic approach outperformed the static approach in the evaluation, and all of the
evaluators indicated that they preferred the dynamic prototypes. Therefore, a dynamic
implementation mode was recommended over a static mode. With respect to the TTS products
evaluated in both English and Spanish, the evaluation teams ranked Microsoft Speech Platform
the highest and therefore recommended use of this product. Also, the Microsoft product offered a
significant advantage over NeoSpeech because it was freely available and required no licensing
agreement or user fees.
As a result of the 2013 evaluation, SAMHSA asked RTI to develop two versions of the
2015 NSDUH CAI. One version used the traditional human voice recordings, and the other
version included TTS using the Microsoft Speech Platform female voice. Developing the two
instruments simultaneously allowed RTI to customize and test the TTS pronunciations in the
NSDUH but provided an alternative in case the TTS version was deemed unacceptable. The TTS
instrument was then evaluated in a pretest, which was used by SAMHSA in its final decision to
use TTS in the 2015 NSDUH.
As mentioned above, after the 2013 evaluation, SAMHSA asked RTI to develop a full
version of the 2015 NSDUH CAI instrument using the Microsoft Speech Platform’s female
English and Spanish voices for further testing and potential full-scale implementation in 2015. A
team of survey methodologists was recruited to review and edit the TTS pronunciations for all 36
ACASI modules in both the English and Spanish versions of the CAI instrument. The NSDUH
programming team developed a TTS database application that would allow the editors to listen to
and adjust the pronunciations of any problematic terms or phrases. All editors participated in a 1day training to learn how to use the application. Edited terms or phrases were saved in the
database along with the module and screen names. The database was then used by the
programming team to generate pronunciation files that were incorporated into the survey
instrument to ensure that the TTS audio was accurate. Once the customized pronunciations were
incorporated into the CAI, the instrument underwent additional reviews by the editing team and
the NSDUH survey methodologists. This process was conducted over 4 months and involved
multiple iterations of review and customization. All modules were reviewed on a flow basis by
SAMHSA staff. The TTS version of the instrument was then configured for use in the pretest
described in Chapter 4.
24
4. 2014 Pretest of Text to Speech in NSDUH
The text to speech (TTS) investigation determined that the National Survey on Drug Use
and Health (NSDUH) could transition from using a human voice for the English and Spanish
audio computer-assisted self-interviewing (ACASI) portions of the survey to using an automated
voice created through TTS software. This investigation concluded that advances in TTS
technology have enabled realistic, accurate, and clear-sounding voices with a reduced level of
effort to program and customize. However, the comprehensibility of TTS in the NSDUH had not
been evaluated by the individuals who may rely more heavily on the audio component when
completing the ACASI portion of the NSDUH interview. These individuals are likely to be the
youngest and oldest respondents (i.e., those aged 12-17 and 65 or older), respondents with low
levels of literacy, and non-native English speakers.
The purpose of the TTS pretest was to explore the use of TTS on the NSDUH with these
populations to (1) evaluate whether the use of TTS had any effect on comprehension of specific
survey items or administration of those items compared with the human voice, (2) determine the
best TTS presentation speed for administering the survey questions, (3) evaluate participants'
preferences and opinions regarding the voices (human and computerized) used for ACASI, and
(4) identify any major issues in administration time or any unanticipated issues with the use of
TTS.
The TTS pretest included two phases: a cognitive interview phase and a pilot test phase.
The findings from the cognitive interviews assisted the Substance and Mental Health Services
Administration (SAMHSA) in determining that TTS should be used on the 2015 NSDUH and in
determining the preferred speaking rate. The cognitive interview findings were also used to
refine the TTS audio to improve comprehensibility (e.g., altering the speed or modifying
pronunciations). These refinements were then tested in the pilot test phase to identify any major
issues with administration time or any unanticipated issues with the use of TTS.
4.1
Cognitive Interview Phase
4.1.1 Methods
RTI conducted 36 cognitive interviews in August 2014 to evaluate the use of TTS
software. Details on this process are outlined in the following sections.
4.1.1.1
Participant Selection and Recruitment
RTI conducted cognitive testing with the type of participants who are believed to be the
most likely to rely on the audio component of the ACASI portion of the interview. RTI recruited
a convenience sample of 24 English-speaking participants with at least 6 interviews in each of
the following groups:
•
Group 1. Participants aged 12-17
•
Group 2. Participants aged 65 or older
•
Group 3. Participants with low levels of literacy
25
•
Group 4. Non-native English speakers who would complete the interview in English
Across all groups, RTI tried to recruit a diverse population with respect to gender,
ethnicity, and race. Participants were recruited from the Research Triangle Park, North Carolina,
area; the Washington, DC, metro area; and Chicago, Illinois.
To recruit English-speaking participants with low education or low literacy levels, RTI
worked with the Literacy Volunteers and Advocates organization in Washington, DC. RTI
recruited the remaining English-speaking participants using online advertisements posted on
Craigslist (www.craigslist.org) and word of mouth. Online advertisements included information
about the nature of the study, the incentive amount, and next steps if the individual was eligible
for the study. All individuals were screened for eligibility over the telephone using a phone
number provided on the flyer. Advertisements are provided in Appendix B.
RTI was contacted by 62 individuals, completed 45 screenings, and conducted 24
interviews. Screenings were conducted with all individuals who could be contacted to ensure that
there was a sufficient pool of eligible participants in each recruitment group. Demographic
characteristics for the English-speaking participants are provided in Table 4.1.
RTI also recruited 12 Spanish speakers with limited or no English-speaking ability to
complete the cognitive interview in Spanish. The 12 Spanish-speaking participants were
recruited by word of mouth and administered a screening. All participants were eligible and
completed the interview, so no additional individuals were screened. Five of the participants
were considered low education (i.e., they did not complete high school). Three of these
participants had very low literacy, had not attended high school, and were not familiar with
computers. All participants were screened for basic demographic information. Table 4.2 provides
the demographics of the Spanish-speaking participants.
26
Table 4.1
English-Speaking Participant Demographics
Participant ID
1-006-100
1-009-100
1-010-100
1-015-100
1-017-100
1-019-100
1-025-100
1-027-100
2-001-100
2-005-100
2-011-100
2-013-100
2-016-100
2-020-100
2-023-100
2-026-100
3-002-100
3-004-100
3-008-100
3-014-100
3-018-100
3-021-100
3-024-100
3-028-100
Table 4.2
Age
14
65
25
13
22
42
34
53
15
81
67
16
65
63
77
32
68
13
23
16
56
81
13
46
Low
Education
No
No
No
No
No
Yes
No
Yes
No
No
No
No
No
Yes
Yes
No
No
No
No
No
Yes
Yes
No
No
Sex
M
F
F
F
M
F
F
M
M
F
M
F
M
F
F
F
F
M
F
F
F
F
M
F
Race/Ethnicity
Black
White
Asian
Black
Asian
Black
Hispanic/Am. Indian
Black
White
White
White
Black
White
Black
Black
Hispanic
White
Black
Asian
Hispanic
Black
Black
White
White
Non-Native
Speaker
No
No
Yes
No
Yes
No
Yes
No
No
No
No
No
No
No
No
Yes
No
No
Yes
No
No
No
No
Yes
Spanish-Speaking Participant Demographics
Participant ID
1-101-500
1-102-500
1-106-500
1-109-500
2-201-500
2-202-500
2-107-500
2-110-500
3-301-500
3-302-500
3-108-500
3-111-500
4.1.1.2
Age
50
51
30
26
35
26
49
46
54
50+
33
36
Sex
M
F
F
M
F
F
M
F
M
M
F
M
Low Education
Yes
Yes
Yes
No
Yes
No
Yes
No
No
No
No
No
Country of Origin
Honduras
Mexico
Mexico
Dominican Republic
Honduras
Mexico
Mexico
Colombia
Mexico
Peru
Mexico
Mexico
Description of Procedures
RTI staff conducted cognitive interviews with English-speaking participants in private
locations in RTI office buildings. RTI staff conducted cognitive interviews with Spanish27
speaking participants in private locations in RTI office buildings or in participants' homes if they
were unable or unwilling to travel to RTI offices.3 All participants were played audio recordings
of survey questions using three voices: human voice, TTS moderate speed, and TTS slow speed.
Participants only heard the questions and were not able to see the questions.4 Although this
differs from the main study protocol, the purpose was to test the clarity of the audio without
helping the participants by showing them the question text. Participants were not asked to answer
the recorded survey questions; rather, they were asked follow-up probes about the questions to
assess how well they understood the words or concepts presented in the questions. For example,
participants were asked to repeat some of the survey questions or explain what the questions
meant in their own words. As needed, spontaneous probes were asked to further evaluate
participants' understanding of the questions.
After each set of audio recordings, interviewers asked participants a set of debriefing
questions to assess participants' thoughts on speed, inflection or cadence, pronunciation,
comprehensibility, sound quality, and overall affective response (how well participants liked the
voice). A copy of the protocol is available in Appendix C.
All participants received the same questions and the same probes in the same order, but
the order of the voices presented varied. Participants from each of the recruitment categories
were randomly assigned to one of three versions for order of the voice tested:
•
Version 1. Human voice, TTS slow, TTS moderate
•
Version 2. TTS moderate, human voice, TTS slow
•
Version 3. TTS slow, TTS moderate, human voice
For example, a participant assigned to Version 1 heard the first third of the interview with
a human voice, then answered the debriefing questions. Next, the participant listened to the
middle third of the interview using the TTS slow voice, followed by a second debriefing. Finally,
the participant heard the final third of the interview in the TTS moderate voice and answered the
last set of questions and debriefing. Because there were 24 English-speaking participants and 3
voices, each question was tested in each voice with 8 participants. Each Spanish question was
tested in each voice with four participants.
Before starting the interviews, the cognitive interviewers administered the informed
consent form (Appendix D). Participants were compensated $40 for completing the interview,
which lasted approximately 45-60 minutes.
4.1.1.3
Analysis and Reporting
RTI survey methodologists analyzed the results of the pretest by comparing how well
participants understood the questions read using the TTS voice compared with the questions read
A total of seven interviews were conducted in participants’ homes. Interviews were conducted in
participants’ homes when participants did not have reliable transportation and were unable to travel to RTI offices
easily or when participants did not feel comfortable coming to RTI facilities, which required going through security
and presenting a form of ID.
4
For six of the Spanish-speaking participants (1-106-500, 1-109-500, 2-107-500, 2-110-500, 3-108-500, 3111-500), the cognitive interviewer placed the screen so participants could also read the questions if they wanted to.
3
28
using the human voice. In addition, RTI analyzed whether there were differences in
comprehension for TTS slow compared with TTS moderate.
For each survey question, the cognitive interviewer reviewed the participants' responses
to the probes and assigned a code based on how well the participant appeared to understand the
question as intended. The code assigned was verified by another methodologist during analysis.
For any codes on which the methodologists disagreed, they met to discuss the codes and came to
a consensus. Codes were assigned as follows:
1. Poor understanding. Participant did not understand the question or instructions as
intended.
2. Moderate understanding. Participant mostly understood the question or instructions
as intended.
3. Good understanding. Participants clearly understood the question or instructions as
intended.
In the sections 4.1.2 and 4.1.3, RTI provides a general assessment of whether differences
in comprehension appeared to be due to the voice or other factors (question wording, cognitive
ability, etc.).
In addition, RTI documented how many times participants asked for a question to be
repeated in each voice. It may be that participants need to listen to one of the voices several
times before they fully understand it. This has implications for general comprehension and for
the timing of administration.
RTI also analyzed participant preference based on the responses to the debriefing
questions. These results were used to assess participants' overall thoughts and preferences
regarding TTS and the human voice.
It is important to note that because of the limited number of participants and qualitative
nature of the study, the results of this study are not generalizable. The intent of this study is only
to provide SAMHSA with a general assessment of the comprehensibility of the TTS for
subpopulations that may rely most on the audio component of ACASI. SAMHSA can use these
findings in evaluating whether to use TTS in the 2015 NSDUH, but the findings cannot be used
to determine the potential impact of TTS on survey estimates.
4.1.2 English-Speaking Participant Results
4.1.2.1
Participant Comprehension
4.1.2.1.1
Overall Findings
As discussed in Section 4.1, participants' comprehension of the survey questions was
assigned a value of 1, 2, or 3, based on whether their understanding was poor, moderate, or good,
respectively. The average score across all questions and all 24 participants was 2.5, indicating
that participants understood most of the questions well. As shown in Table 4.3, this score varied
somewhat by question set. All participants received the same three sets of questions in the same
order, but the voice played for each set of questions differed depending on which version of the
29
pretest the participant was assigned. The second set of questions appeared to be the hardest for
participants to understand. However, the comprehension rating did not vary by voice.
Table 4.3
Comprehension Rating of English Survey Questions, by Version
Voice
Human
TTS moderate
TTS slow
All voices
Set 1
2.3
2.7
2.6
2.5
Comprehension (Higher=Better)
Set 2
Set 3
2.5
2.7
2.5
2.4
2.3
2.6
2.4
2.6
Overall
2.5
2.5
2.5
2.5
TTS = Text to Speech.
NOTE: This study consisted of a convenience sample, and results are not generalizable.
Examination of the qualitative comments from participants confirmed that participant
understanding did not appear to differ by voice. Participants did not tend to repeat the questions
word for word but tended to understand the general meaning or the intent of the question. When
participants misunderstood the question, this appeared to be consistent across voices. For
example, three participants (one from each group) thought that the very first question they
listened to mentioned marijuana. However, it mentioned only tobacco products: "These questions
are about your use of tobacco products. This includes cigarettes, chewing tobacco, snuff, cigars,
and pipe tobacco. The first questions are about cigarettes only."
Although there did not appear to be much difference in comprehension overall among the
voices, a few survey questions appeared more problematic in one voice compared with the other
voices. These are described as follows:
•
Human. The human voice performed the worst in the two questions about alcohol
(ALCINTR2 and AL01). Understanding of these questions was low across all
voices—most likely because they were the first long, detailed introductions played for
participants. When summarizing the introductions, participants tended to miss the part
about not including a sip or two or thought it was asking only about a sip or two.
However, participants hearing the human voice tended to misunderstand the question
more severely. For example, one participant said that AL01 was asking, "If I had a sip
of alcohol, did it get me drunk?" Another participant said, "She's asking: when you
have a glass of wine if you drink the whole glass or just have a sip of it."
•
TTS slow. Question CG06 asks participants when they last smoked "part or all of a
cigarette." Two participants who heard the question in TTS slow had a hard time
understanding the word "part." They initially thought it said "heart" or "hard."
•
TTS moderate. SP03a asks participants if they were arrested for "motor vehicle
theft" in the past 12 months. Three participants who heard the question in TTS
moderate had difficulty. One participant understood the phrase but said it sounded
like the words were running together. Another participant thought it asked about
"identity theft" instead of "motor vehicle theft." A non-native English speaker could
not understand the word "booked" and thought it was asking if he voted. However,
one participant who heard the human voice also had some difficulty with the
question. He thought it asked about "motorcycle theft" instead of "motor vehicle
theft." Across all voices, at least one participant misunderstood the specific nature of
30
the crime and thought it was asking about breaking into a motor vehicle or some sort
of driving offense.
It also appears that some words are hard to hear in all voices. For example,
METHINTRO provides an introduction for methamphetamine. In all three voices, at least one
participant misheard "crank" for "crack."
4.1.2.1.2
Repeating of Bolded Words
One of the main differences between the human voice and the TTS voices is that the TTS
voices cannot be used to emphasize certain words, such as words that are bolded on the computer
screen. To evaluate whether this was problematic for comprehension, RTI examined how often
participants used the bolded words from the survey question when repeating or summarizing the
question in their own words.
Despite the fact that the bolded words and phrases were emphasized when read in the
human voice, RTI found no difference in the number of bolded words repeated by participants
between questions read with the human voice and TTS slow. In questions read with the TTS
moderate voice, participants did repeat slightly fewer of the bolded words. However, it did not
appear that repeating the bolded words was necessarily associated with a better understanding of
the survey question. Participants could have repeated the bolded phrase and still misinterpreted
the question. For example, RK01a asks, "How much do people risk harming themselves
physically and in other ways when they smoke one or more packs of cigarettes per day?" One
participant said this question was asking, "How do people try to make themselves feel better if
they smoke more than one pack of cigarettes per day?" Conversely, most other participants did
not mention smoking one or more packs of cigarettes but correctly understood that the question
was asking about the risks associated with smoking.
4.1.2.1.3
Number of Times the Question Was Repeated
Another metric that RTI examined was the number of times participants asked for a
question to be repeated with each voice. On average, participants asked for a question to be
repeated about 12 percent of the time. This varied slightly by voice. Participants asked for
questions to be repeated about 10 percent of the time with the human voice, 11 percent of the
time with TTS moderate, and 14 percent of the time with TTS slow.
4.1.2.1.4
Differences by Recruitment Characteristics
RTI also examined differences across recruitment characteristics and found that
participants with low education or low literacy had the most difficulty understanding the survey
questions, and non-native speakers had the least difficulty (average comprehension score of 2.2
compared with 2.7, respectively). However, the non-native speakers in our sample were highly
educated. For each recruitment group, comprehension did not appear to differ based on the voice
heard.
4.1.2.2
Participant Preference
After questions were played for each voice, participants were asked a series of debriefing
questions (see cognitive interview protocol in Appendix C) rating the voice on a number of
31
characteristics. The specific ratings and the number of participants who preferred each voice are
shown in Table 4.4. It should be noted that although participants were asked about which voice
they preferred, the ultimate goal of this exercise was to determine whether any characteristics of
the TTS voices would render them unusable in the survey.
Table 4.4
English-Speaking Participant Preference Ratings, by Voice
Preference Rating (Lower=Better)
Human
TTS Slow
TTS Moderate
2.9
3.1
3.5
2.0
2.4
2.5
1.7
2.0
2.0
1.3
1.7
1.8
Voice Characteristic
Speed (1=Much too slow, 5=Much too fast)
Cadence (1=Excellent, 5=Very poor)
Pronunciation (1=Excellent, 5=Very poor)
Comprehension (1=Not at all difficult,
5=Extremely difficult)
Pleasantness1 (1=Extremely pleasant, 5=Not at
all pleasant)
Overall quality (1=Excellent, 2=Good, 3=Fair,
4=Poor, 5=Very poor)
Comfort1 (1=Extremely comfortable, 5=Not at all
comfortable)
Average (1=Best, 5=Worst)
Number of participants preferring voice2
2.3
3.4
2.9
1.5
2.2
2.2
2.1
3.0
2.7
1.8
12
2.4
7
2.4
4
TTS = Text to Speech.
1
Reverse coded so that lower scores are better.
2
One participant selected "no preference."
NOTE: It is important to note that this study consisted of a convenience sample, and results are not generalizable.
Participants rated the human voice slightly better than the two TTS voices, which were
rated the same. However, participants rated all voices as more positive than negative. The
cognitive interviews asked participants to elaborate on what they liked or disliked about each
voice.
Participants tended to like the human voice because it was natural sounding, easy to
understand, and had a good pace. Eight participants described it as nice, pleasant, or soothing.
One non-native English speaker commented that the human voice sounded "authoritative" and
that it was easier to give a real answer to the human voice compared with the TTS voices.
However, some participants commented that the human voice was monotonous, sounded sad or
depressed, and was a little too slow. Only one participant was particularly negative about the
human voice. He said, "The voice is distracting. It sounds like she's going to cough or is on the
edge of being sick."
Participants' opinions varied on which of the TTS voices sounded better. One participant
would say that the TTS slow voice was less robotic than the TTS moderate voice, and another
participant would say the opposite. In fact, although many participants commented that the TTS
moderate voice was faster than the TTS slow voice, three participants thought that the TTS
moderate voice was slower than the TTS slow voice. Interestingly, all three of these participants
were in Group 1, which means that TTS slow was played before TTS moderate. It may be that
they became more accustomed to the TTS voice by the third set of questions, and it was easier
for them to understand.
32
When commenting on the comprehension of the TTS voices, participants tended to be
less effusive in their praise of the human voice compared with the TTS voices. For example, in
reference to one or both of the TTS voices, eight participants commented, "I could understand
it." In contrast, no participants made that comment about the human voice. Instead, seven
participants noted that the human voice was "easy" or "clear" to understand.
When remarking on which of the two TTS voices was easier to understand, participants
were divided. Some participants thought the TTS slow voice was harder to understand because it
was choppier and the cadence was not as good. One participant commented that the TTS slow
voice was difficult to understand because it was hard to tell which words "fell together" when
being listed. He provided the example of drugs that included the word generic after them. He
said that it sounded like "generic" was the name of a drug and not being used to modify another
drug. For example, it sounded like "zolpidem, generic, extended-release zolpidem, generic"
instead of "zolpidem generic, extended-release zolpidem generic." He said that this was less
problematic in the TTS moderate voice. This appears to be related to the fact that "generic" is
always listed in parentheses, which causes TTS to add a slight pause. This slight pause is less
noticeable in TTS moderate.
Three participants noted that the faster voice was harder for them to understand, and they
would have to concentrate more or listen to the question multiple times in order to understand.
4.1.3 Spanish-Speaking Participant Results
4.1.3.1
Participant Comprehension
Of the 12 Spanish-speaking participants, half read the question text and listened to the
audio. The other half of the participants listened to the audio only.
As discussed in Section 4.1, participants' comprehension of the survey questions was
assigned a value of 1, 2, or 3, based on whether their understanding was poor, moderate, or good,
respectively. The average score across all questions and all participants was 2.7, indicating that
overall, participants understood the questions quite well. As shown in Table 4.5, this varied little
by voice.
Table 4.5
Comprehension Rating of Spanish Survey Questions, by Version
Voice
Human
TTS moderate
TTS slow
All voices
Set 1
2.7
2.7
2.6
2.7
Comprehension (Higher=Better)
Set 2
Set 3
2.4
2.9
2.6
2.9
2.5
2.9
2.5
2.9
Overall
2.7
2.7
2.7
2.7
TTS = Text to Speech.
NOTE: It is important to note that this study consisted of a convenience sample, and results are not generalizable.
For Spanish-speaking participants, most differences in comprehension appeared to be
based on the question rather than on the voice. For example, on the introduction question
ALCINTR2, many participants did not repeat or recall that "a sip or two" was not considered a
33
drink. Following is a summary of survey questions in which comprehension may have differed
by voice:
•
Cognitive interviewers asked participants to repeat the following question as best as
they could: "How often do you get a real kick out of doing things that are a little
dangerous?" Two TTS slow participants could not repeat or recall this question
correctly. One person interpreted it vaguely as, "What things give you pleasure when
you do them?" Another said, "How satisfied do you feel when doing dangerous
things?" The other participants appeared to understand that the question was asking
about the frequency of doing dangerous things for the pleasure of doing so.
•
Participants received the introduction question INHINTRO. This is a rather long
introduction listing a variety of inhalants. Interviewers asked participants if the
introduction was asking about times when substances were inhaled accidentally, on
purpose, or both. Only two participants (one TTS moderate and one TTS slow)
correctly answered that it was asking about using them on purpose.
•
Several questions included the instructions to press 95 if the respondent had not used
any of the drugs listed. In two separate instances on two different questions,
participants misheard or misunderstood these instructions. In both cases, the
participants heard the question in the human voice. In one case, the participant
thought the question was asking if he had used a drug 95 percent of the time. The
other participant thought it was asking if he had used the drugs in 1995. However,
neither participant had ever used computers before, which was likely responsible for
their confusion.
4.1.3.2
Participant Preference
After questions were played for each voice, participants were asked a series of debriefing
questions rating the voice on a number of characteristics. The specific ratings and the number of
participants who preferred each voice are shown in Table 4.6.
Although the human voice was rated slightly better than the two TTS voices, the ratings
were fairly similar across all categories. Slightly more than half of the participants indicated that
they preferred the human voice, and the remaining participants said they preferred the TTS slow
voice. None of the participants preferred the TTS moderate voice.
When participants commented on the human voice, they tended to say that it was pleasant
and easy to understand, but a little too slow. One participant commented, "It was perfect, very
clear," whereas another participant commented, "She sounds like she is about to go to sleep; it
makes me sleepy."
Three participants commented that the TTS voice has a slight Spanish accent (i.e., from
Spain), which they did not care much for. The accent for the human voice is a neutral Latin
American accent. However, only one participant said it was harder to understand the TTS voice
and that he had to pay more attention. Although most participants thought the TTS voices were
okay, one participant particularly did not like them. With respect to the slow voice, he said, "The
voice is shrilling, piercing, uncomfortable, not understood." For the moderate voice, he said,
"You can't understand it at all. It's extremely fast; it doesn't get the message across. It talks like a
machine without conveying the message. It doesn't care." Despite these comments, this
34
participant had the same comprehension score for TTS moderate and the human voice. The
comprehension score was slightly lower for the TTS slow voice, but that was also the voice that
was heard first.
Table 4.6
Spanish-Speaking Participant Preference Ratings, by Voice
Preference Rating (Lower=Better)
Human
TTS Slow
TTS Moderate
2.3
3.3
3.6
2.2
2.3
2.3
1.9
2.3
2.1
1.6
1.8
1.8
Voice Characteristic
Speed (1=Much too slow, 5=Much too fast)
Cadence (1=Excellent, 5=Very poor)
Pronunciation (1=Excellent, 5=Very poor)
Comprehension (1=Not at all difficult,
5=Extremely difficult)
Pleasantness1 (1=Extremely pleasant, 5=Not at
all pleasant)
Overall quality (1=Excellent, 2=Good, 3=Fair,
4=Poor, 5=Very poor)
Comfort1 (1=Extremely comfortable, 5=Not at all
comfortable)
Average (1=Best, 5=Worst)
Number of participants preferring voice
2.8
2.9
3.2
2.0
2.4
2.3
2.7
3.3
2.9
2.2
7
2.5
5
2.4
0
TTS = Text to Speech.
1
Reverse coded so that lower scores are better.
NOTE: It is important to note that this study consisted of a convenience sample, and results are not generalizable.
Two participants commented that the moderate voice was too fast, but one other
participant thought the slow voice was faster than the moderate voice. However, this person was
in Group 2 and heard the TTS slow voice immediately after hearing the human voice.
4.1.4 Timing
RTI conducted a brief timing test to compare the length of time required to listen to a
question being read with the human voice compared with TTS slow or TTS moderate. For the
comparison, RTI selected the 14 items in the ACASI tutorial section. These items include a
variety of question types that may affect speed, including introductions with no response options,
yes/no response options, and relatively long lists of response options.
As shown in Table 4.7, the timing for the English TTS slow voice was about 10 percent
faster than the English human voice across all 14 items, and the English TTS moderate voice was
about 21 percent faster. However, for some items, timing differences among the three voices
varied somewhat compared with the overall pattern.
Two variables (INTRO1 and RANGEERR) had very little difference between the TTS
slow voice and the human voice. RTI retested the timing to verify the lengths and found that the
human voice recordings on those questions had practically no pause between paragraphs,
enabling them to be read more quickly than other items of the same length. RTI also found that
the TTS moderate voice is about 12 percent faster than the TTS slow voice.
35
Table 4.7
Question Length and Percentage Faster, by English Voice
Item
HEADPHONE
INTRO1
INTRO2
GOTDOG
EYECOLOR
ALLAPPLY
NUMBER
BACKUP
PLAYINFO
RANGEERR
CALENDAR
CALENDR2
CALENDR3
ANYQUES
Total
Human
20
29
15
26
35
58
19
26
28
45
41
25
27
8
402
Length (seconds)
Percentage Faster
TTS
Slow
18
27
14
22
29
52
17
22
23
44
38
23
25
7
363
TTS
Moderate
vs. Human
20.0
10.3
20.0
26.9
25.7
20.7
21.1
26.9
28.6
13.3
19.5
20.0
22.2
25.0
20.9
TTS
Moderate
16
26
12
19
26
46
15
19
20
39
33
20
21
6
318
TSS Slow
vs. Human
10.0
6.9
6.7
15.4
17.1
10.3
10.5
15.4
17.9
2.2
7.3
8.0
7.4
12.5
9.7
TTS
Moderate
vs. TTS
Slow
11.1
3.7
14.3
13.6
10.3
11.5
11.8
13.6
13.0
11.4
13.2
13.0
16.0
14.3
12.4
TTS = Text to Speech.
All three Spanish voices are slower than the respective English voices, but the differences
between the TTS voices and the human voice show a similar pattern in Spanish and English. As
shown in Table 4.8, the timing for the Spanish TTS slow voice was about 13.5 percent faster
than the Spanish human voice across all 14 items, and the Spanish TTS moderate voice was
about 21 percent faster. However, for some items, timing differences among the three voices
varied somewhat compared with the overall pattern.
Although the TTS voices are faster than the human voice, it does not necessarily mean
that administration times will be shorter. For example, if use of TTS makes respondents more
likely to listen to the survey questions being read, that could increase administration time. On the
other hand, if use of TTS makes respondents less likely to listen to the survey questions, it could
decrease time of administration even more than what is shown in the table. The timing was
evaluated further in the TTS pilot test phase of this project (see Section 4.2).
36
Table 4.8
Question Length and Percentage Faster, by Spanish Voice
Item
HEADPHONE
INTRO1
INTRO2
GOTDOG
EYECOLOR
ALLAPPLY
NUMBER
BACKUP
PLAYINFO
RANGEERR
CALENDAR
CALENDR2
CALENDR3
ANYQUES
Total
Human
22
38
19
32
46
82
24
28
36
50
53
32
38
11
511
Length (seconds)
Percentage Faster
TTS
Slow
22
36
17
26
37
67
19
26
26
54
45
27
30
10
442
TTS
Moderate
vs. Human
13.6
15.8
15.8
21.9
26.1
25.6
29.2
14.3
30.6
2.0
22.6
21.9
28.9
18.2
20.9
TTS
Moderate
19
32
16
25
34
61
17
24
25
49
41
25
27
9
404
TSS Slow
vs. Human
0.0
5.3
10.5
18.8
19.6
18.3
20.8
7.1
27.8
-8.0
15.1
15.6
21.1
9.1
13.5
TTS
Moderate
vs. TTS
Slow
13.6
11.1
5.9
3.8
8.1
9.0
10.5
7.7
3.8
9.3
8.9
7.4
10.0
10.0
8.6
TTS = Text to Speech.
4.1.5 Summary
NSDUH interviewers encourage all survey respondents to wear the headphones when
completing the survey, even if they choose to turn off the volume. As a result, it is unclear
exactly what percentage of NSDUH respondents rely on the audio when completing the survey
questions, and thus, how much change in the voice used to read the questions could have on their
comprehension of the questions. As a result, the cognitive interview phase was designed to
evaluate differences in comprehension between the human voice and TTS for the most difficult
situations—relying on audio only—and for participants who might have the hardest time
understanding the questions; that is, the youngest and oldest participants (12-17 and 65 or older),
non-native English speakers, and participants with low education or low literacy levels. Any
issues that were identified were likely exacerbated by not allowing respondents to read the screen
along with the voice.
Although both English and Spanish-speaking participants seemed to prefer the human
voice slightly, most participants thought the TTS voice was pleasant and understandable. It is
important to recognize that this cognitive interview included only static questions and did not
include any dynamic questions that apply fills. It is believed that TTS sounds better compared
with human voice recordings that must be stitched together on these types of questions.
Furthermore, there were no differences in comprehension ratings among the three voices for
either English- or Spanish-speaking participants. As a result, RTI recommended proceeding with
the use of TTS for the 2015 NSDUH.
37
Although it appeared that there were very few differences between TTS slow and TTS
moderate, RTI recommended using TTS slow for the NSDUH. Several participants noted that
the TTS moderate voice required them to concentrate harder to understand it. Therefore, the
slower voice might be less cognitively demanding when used for the entire ACASI portion of the
survey.
4.2
Pilot Test Phase
Upon deciding that TTS software will be implemented on the 2015 NSDUH, the
cognitive interview findings were used to refine the TTS audio to improve comprehensibility
(e.g., altering the speed or modifying pronunciations), and then these refinements were tested in
the pilot test phase to identify any major issues with administration time or any unanticipated
issues with the use of TTS. In October and November 2014, RTI conducted 43 field interviews
to evaluate the use of TTS. These field interviews mirrored the 2015 main study protocol in
order to identify any major issues in administration time or any unanticipated issues with the use
of TTS. Details on the pilot test and the results are outlined in the following sections.
4.2.1 Methods
4.2.1.1
Sampling
The respondent universe for the pilot test was the civilian, noninstitutionalized population
aged 12 or older residing in the selected areas. Eligibility for the pilot test was determined based
on where the occupants of the sampled dwelling units (DUs) reside for most of October,
November, and December 2014. Data collection took place in the fourth quarter of 2014.
The pilot test goal was to include at least 20 interviews completed in English and at least
10 interviews completed in Spanish. The sample was selected in Los Angeles, California, and
Miami, Florida, to meet staffing needs and ensure a sufficient number of Spanish interviews.
Retired quarter 1 2014 segments were used for selection. Based on past experience with
these segments, three segments were selected to yield the desired number of interviews. After
accounting for eligibility, nonresponse, and the person-level sample selection procedures, RTI
estimated that approximately 107 selected DUs would yield at least 30 completed interviews. As
discussed in the data collection section, RTI did not return to convert refusals for the pilot test.
Refusal rates were taken into account when selecting the sample, and an additional reserve
sample of 37 DUs was also sampled in case the 107 selected DUs did not yield a sufficient
number of interviews.
To sufficiently evaluate the impacts of TTS among youths and the older population, the
target respondent sample by age group was as follows:
Age Group
12-17
18-25
26-34
35-49
50+
38
Allocation
10
5
4
4
7
4.2.1.2
Staffing and Training
The pilot test involved purposefully selecting 3 segments to yield at least 30 interviews in
total, including a minimum of 10 Spanish interviews. Nine field interviewers (FIs) were needed,
including seven bilingual FIs. FIs were selected based on their performance in the 2013 Dress
Rehearsal, location, data quality, dependability, availability to travel, and availability to attend
training and complete data collection.
The FI training for the pilot test included at-home and in-person components. The
training was a brief refresher training because all of the FIs already participated in the Dress
Rehearsal, which used similar equipment, questionnaires, and procedures. For the at-home
training, the pilot test FIs were sent an FI handbook, comprising relevant sections from the draft
2015 FI Manual and FI Computer Manual on the tablet and laptop computers and screening and
interview procedures and materials, as well as a memorandum outlining the pilot test schedule,
training, and related details. The FIs carefully read the FI handbook before attending the inperson refresher training session.
The in-person FI refresher training was a 1-day session held at RTI's Research Triangle
Park, North Carolina, office. The morning of training was spent covering the equipment,
instruments, and procedures, and the afternoon included practice exercises and mock interviews
under trainer observation. Bilingual FIs completed one mock interview in Spanish under the
observation of a bilingual trainer.
During training, trainers carefully observed FIs as they completed the practice exercises
and mock interviews, and they provided specific feedback and retraining on any items completed
incorrectly. Similar to the Dress Rehearsal, this process was used to reinforce the proper
procedures before FIs began their fieldwork.
4.2.1.3
Description of Procedures
The pilot test FIs administered the screener instrument using 7-inch touchscreen Samsung
Galaxy tablets that will be used for the 2015 NSDUH. The tablet contained the 2015 screening
program, as well as tablet tools such as the parental introductory script and tablet video. FIs were
provided with instruction on how to use these new tools at training.
The FIs administered the computer-assisted interview (CAI) instrument using lightweight
Samsung Ultrabook laptops that will be used for the 2015 NSDUH. The laptops contained both
the 2015 NSDUH CAI instrument and the TTS program. Customized TTS pronunciations were
used in both languages. Based on the results from the TTS cognitive interview phase, TTS slow
was used for both the English and Spanish instruments.
Data collection occurred immediately after training and lasted approximately 2 weeks.
FIs reported to a survey specialist for case management and field issues during data collection.
The programmers modified the case management system to accommodate case assignment and
transfer requirements for the pilot test.
All data collection software and procedures were very similar to those planned for use in
the 2015 NSDUH data collection. All materials mirrored those for 2015, with some minor
wording changes to references regarding sample size, as well as data collection and project dates
39
and Office of Management and Budget approval numbers. Respondents received a $30 incentive
for their participation, which is the same incentive amount used in the NSDUH main data
collection. Finally, case management procedures mirrored those for main study data collection
with a few exceptions:
•
Lead letters were sent to selected DUs with valid mailing addresses, but no follow-up
contact occurred through mail. Refusal and unable-to-contact letters were not sent for
the pilot test.
•
Efforts were made to successfully complete each case within the data collection
period. However, given that data collection lasted approximately 2 weeks, all
screening or interview refusals were finalized at the initial refusal without any refusal
conversion attempts.
4.2.1.4
Analysis and Reporting
RTI staff analyzed the results of the pilot test by comparing the timing data from the pilot
test against the timing data from the Dress Rehearsal and those from the 2013 main study.
Results were evaluated to assess whether the implementation of TTS affected overall instrument
timing. However, it should be noted that the comparison to the Dress Rehearsal and the 2013
main study are limited because of the different questionnaires used. This is particularly true
when comparing the results with the 2013 main study results.
Because of the short turnaround required for this pilot test, a full range of timing
estimates was not produced. Timing data were provided by age (12-17, 18-64, and 65 or older)
and by language (English vs. Spanish) for the following:
•
Interview overall
•
ACASI portion of the interview
•
ACASI tutorial
•
ACASI risk availability
The ACASI tutorial and risk availability sections were chosen because they are offered to all
respondents, and all respondents are asked identical questions (i.e., there are no differences due
to routing or skip logic), which made the timing estimates more comparable to those of the Dress
Rehearsal and the 2013 main study.
Of the 107 selected DUs, 74 screenings were completed and 63 interviews were yielded.
Of these 63 interviews, 43 interviews were completed. Of the interviews, 22 (51 percent) were
completed in English, and 21 (49 percent) were completed in Spanish. Of the 43 interview
respondents, 19 (44 percent) were aged 12-17, 23 (54 percent) were aged 18-64, and 1 (2
percent) was aged 65 or older. The respondent sample by the target age groups is provided in
Table 4.9.
It is important to note that these distributions differ from those of the Dress Rehearsal and
the 2013 main study, particularly regarding the proportion of interviews that were completed in
Spanish, which was much higher in the pilot test (at 49 percent) compared with the Dress
Rehearsal (at 9 percent) and the 2013 main study (at 3 percent).
40
Table 4.9
Age Group
12-17
18-25
26-34
35-49
50+
Text to Speech Interview Respondents, by Age Group
Completed Interviews
19
5
8
6
5
Percentage
44
12
17
14
12
Cumulative Percentage
44
56
73
87
99
Comparing the TTS pilot test mean in minutes for all respondents with that of the Dress
Rehearsal and the 2013 main study showed that the timings were longest for the pilot test across
the entire interview, the entire ACASI, and certain portions of the ACASI. As noted previously,
this is primarily due to the high proportion of Spanish respondents, who tend to have longer
interview times. Therefore, Sections 4.1.2 and 4.1.3 detail timing results and analysis by English
and Spanish respondents. Detailed timing tables for all respondents who completed the pilot test
can be found in Appendix E.
4.2.2 English-Speaking Participant Results
Of the pilot test interviews, 22 were completed in English. Of these 22 interviews, 12 (55
percent) were completed with respondents aged 12-17, 9 (41 percent) with respondents aged 1864, and 1 (5 percent) with a respondent aged 65 or older.
Table 4.10 compares the TTS pilot test mean and median in minutes with that of the
Dress Rehearsal and the 2013 main study for English respondents across the entire interview, the
entire ACASI, and certain portions of the ACASI. The average overall pilot test interview time
was slightly longer compared with the Dress Rehearsal, but the median overall pilot test
interview time was slightly shorter. This suggests the presence of outliers, which can have a
large effect when sample sizes are small. The average and median ACASI times for the pilot
were slightly shorter compared with the Dress Rehearsal. This is consistent with the fact that the
number of questions administered via ACASI in the Dress Rehearsal and the 2015 instrument
were very similar.
The overall pilot test interview time was about the same (or shorter) as the 2013 main
study, but the ACASI time was longer. This difference is likely explained by the addition of
some questions to ACASI in the pilot test, such as questions on disability, language, sexual
orientation, and military family members. Some questions from the 2013 computer-assisted
personal interview were also moved to the ACASI for the pilot test, including questions on
education, employment, moving, and country in which the respondent was born.
The two modules that had roughly the same content among the pilot test, the Dress
Rehearsal, and the 2013 main study were the ACASI tutorial and ACASI risk availability. The
ACASI tutorial time was shorter in the pilot test than the Dress Rehearsal or the 2013 main
study, but the pilot test ACASI risk availability time was slightly longer compared with both the
Dress Rehearsal and the 2013 main study. The cause of this difference is unclear.
Table 4.10 also details the pilot test data by age group. Pilot test timings were the same as
or faster than those of the Dress Rehearsal and the 2013 main study for participants aged 18 or
older. However, timings for the 12-17 age group were longer on the pilot compared with the
41
Dress Rehearsal and the 2013 main study, with the exception of the ACASI tutorial. The 12-17
age group represented a much larger portion of the English interview respondents in the pilot test
than in the Dress Rehearsal and the 2013 main study (55 percent compared with 25 percent and
33 percent, respectively). Consequently, the difference in the overall timings is almost entirely
explained by the differences in the 12-17 age group. It is unclear why the younger age group had
slower timings on the pilot test compared with the Dress Rehearsal or the 2013 main study.
Increased timings may be due to differences in respondents among the three studies. Another
possible explanation is that respondents in this age group are more likely to listen to the TTS
slow voice reading the question compared with the human voice.
Detailed timing tables for respondents who completed the pilot test in English can be
found in Appendix E.
Table 4.10
Text to Speech Audit Trail Timing Data: Mean and Median in Minutes, Comparison
across Instruments, English-Speaking Respondents, by Age Group
Text to
Speech
Interview Overall
Overall
61.40
12-17
69.63
18-64
50.38
65+
61.80
ACASI1
Overall
43.27
12-17
49.17
18-64
35.21
65+
45.02
2
ACASI Tutorial
Overall
2.92
12-17
3.37
18-64
2.53
65+
1.02
ACASI Risk Availability
Overall
3.14
12-17
3.38
18-64
2.80
65+
3.40
Mean
Dress
Rehearsal
2013 Main
Study
Text to
Speech
Median
Dress
Rehearsal
2013 Main
Study
59.56
59.55
57.16
84.98
61.95
61.37
61.38
74.38
54.86
68.62
51.22
61.80
55.88
57.13
53.53
79.75
58.87
58.97
58.15
70.40
44.72
42.09
43.56
67.11
41.01
41.31
39.94
53.87
40.65
51.01
35.15
45.02
41.20
40.37
40.30
61.48
38.30
39.37
37.03
50.37
3.43
3.56
3.19
5.42
3.44
3.69
3.20
4.88
2.67
3.17
2.62
1.02
3.23
3.47
2.95
4.85
3.25
3.58
3.00
4.72
2.89
2.76
2.77
4.59
2.94
3.00
2.80
4.48
2.83
2.99
2.75
3.40
2.62
2.63
2.50
4.15
2.65
2.78
2.53
3.93
ACASI = audio computer-assisted self-interview.
1
Timing for the ACASI section began with the INTROACASI1 variable and ended with the ENDAUDIO variable.
The ACASI section for the 2013 main study did not include several questions that were included in the Text to
Speech and Dress Rehearsal instruments.
2
Timing for the ACASI tutorial began with the INTRO1 variable for all instruments. The end variable for the Text
to Speech and Dress Rehearsal was RANGEERR, and the end variable was ANYQUES for the 2013 main study.
4.2.3 Spanish-Speaking Participant Results
Of the pilot test interviews, 21 were completed in Spanish. Of these 21 interviews, 7 (33
percent) were completed with respondents aged 12-17, and 14 (67 percent) were completed with
42
respondents aged 18-64. No interviews were completed in Spanish with respondents aged 65 or
older.
Table 4.11 compares the TTS pilot test mean and median in minutes for all Spanish
respondents with that of respondents who completed the Dress Rehearsal and the 2013 main
study in Spanish across the entire interview, the entire ACASI, and portions of the ACASI. All
timings were longest for the pilot test, including the tutorials and risk availability portions for the
ACASI. The reason for the longer times in the pilot test is unclear because the TTS Spanish
voice is faster than the Spanish human voice. The mean and median times for the pilot are
similar; therefore, the difference does not appear to be due to outliers. Again, increased timings
may be due to differences in respondents among the three studies or because Spanish-speaking
respondents are more likely to listen to the TTS voice reading the question compared with the
human voice.
Table 4.11
Text to Speech Audit Trail Timing Data: Mean and Median in Minutes, Comparison
across Instruments, Spanish-Speaking Respondents, by Age Group
Text to
Speech
Interview Overall
Overall
89.45
12-17
82.05
18-64
93.15
65+
N/A
ACASI1
Overall
69.90
12-17
60.88
18-64
74.41
65+
N/A
ACASI Tutorial2
Overall
5.36
12-17
4.94
18-64
5.57
65+
N/A
ACASI Risk Availability
Overall
4.88
12-17
3.71
18-64
5.47
65+
N/A
Mean
Dress
Rehearsal
Text to
Speech
Median
Dress
Rehearsal
2013 Main
Study
2013 Main
Study
83.94
65.57
86.70
109.71
83.43
71.24
86.54
92.85
89.67
74.95
92.73
N/A
79.32
63.40
83.44
100.19
79.83
67.87
84.07
93.38
63.61
40.48
67.87
87.45
57.70
48.09
60.03
67.37
66.98
56.68
73.77
N/A
59.47
40.27
62.89
78.98
55.25
46.42
58.35
66.82
4.94
3.63
5.16
6.48
5.07
4.44
5.26
5.16
5.53
4.25
6.00
N/A
4.92
3.20
5.18
6.50
5.10
4.33
5.32
5.57
4.38
2.92
4.59
6.56
4.85
3.79
5.10
6.02
4.60
3.47
4.77
N/A
4.20
2.82
4.47
7.58
4.40
3.53
4.63
5.97
N/A = Not applicable; ACASI = audio computer-assisted self-interview.
1
Timing for the ACASI section began with the IntroAcasi1 variable and ended with the ENDAUDIO variable. The
ACASI section for the 2013 main study did not include several questions that were included in the TTS and Dress
Rehearsal instruments.
2
Timing for the ACASI tutorial began with the INTRO1 variable for all instruments. The end variable for the TTS
and Dress Rehearsal was RANGEERR, and the end variable was ANYQUES for the 2013 main study.
Table 4.11 also details the pilot test data by age group. Pilot test timings for the 12-17 age
group were longer compared with the Dress Rehearsal and the 2013 main study, except when
looking at the ACASI risk availability timing in which the pilot test timing was shorter than the
43
2013 main study timing but longer than the Dress Rehearsal timing. Pilot test timings for the 1864 age group were longer compared with the Dress Rehearsal and the 2013 main study across all
interview sections. Detailed timing tables for respondents who completed the pilot test in
Spanish can be found in Appendix E.
4.2.4 FI Debriefing Call Results
The purpose of the pilot test FI debriefing call was to obtain direct feedback from FIs on
their experiences collecting data using the 2015 NSDUH questionnaire with the TTS voice. The
debriefing also provided the opportunity to gather additional feedback on other 2015 changes,
such as completing interviews on the new Samsung Ultrabook laptop and completing screenings
on the Samsung Galaxy tablet in both English and Spanish. The goal of the debriefing call was to
gather feedback from FIs (including bilingual FIs) on topics including
•
significant questions or concerns raised by interview respondents about the
computerized ACASI voice;
•
significant questions or concerns raised by members of sample households about the
tablet video, which is a new tool for 2015;
•
challenges encountered using the tablet to conduct household screenings; and
•
challenges encountered using the laptop to conduct interviews.
The results of the pilot test FI debriefing call will be used to inform preparations for the 2015
NSDUH or the 2016 NSDUH.
One FI debriefing call, which lasted approximately 45 minutes, was held with 8 pilot test
FIs attending. The call included a moderator and a note taker, along with several observers
including SAMHSA staff, and was recorded. The remaining pilot test FI who was unable to join
the call provided feedback on the debriefing questions on an individual call.
The moderator began the call with a brief introduction, and the remainder of the call
focused on specific section topics:
•
Screening and Using the Tablet
•
TTS Questionnaire and ACASI Voice
•
Administering the TTS Interview and Using the Laptop
The TTS Debriefing Moderator's Guide can be found in Appendix F and includes the specific
questions covered in each section.
Feedback on the tablet video was positive. Two FIs used the video with respondents, and
in these situations, the respondents did not make any comments about the video. However, these
respondents also did not have any further questions after viewing the video, and the FIs thought
this was due to the content of the video. Neither FI experienced issues with bringing up the video
for the respondents. All FIs liked the content of the video and did not have any suggested
changes. It should be noted that refusal conversion was not attempted for the pilot test, and some
FIs thought the video would be best used with difficult respondents.
44
Regarding the tablet and the screening program, the FIs mentioned only a few issues,
outlined here:
•
Some FIs mentioned that they were concerned about losing the stylus because it did
not fit tightly into the holder. Some FIs chose not to use the stylus to avoid losing it,
and one FI did lose the stylus while in the field. However, this did not interrupt the
screening process because FIs could use their fingers to navigate through the
program. The stylus has a clip that can be used to secure it in the holder.
•
Two FIs mentioned that they had some difficulty connecting to the Internet in public
locations, mainly because they needed to open the Internet browser to accept the
business's user agreement before connecting. All FIs will practice connecting to WiFi
at the 2015 Veteran FI Training.
•
Within the screening program, some FIs noted that they could not enter certain
symbols such as apostrophes in the Record of Call comments. Although most
standard symbols may be entered into comment fields in the screening program, the
use of single and double apostrophes was disabled in the 2015 screener program to
prevent problems that these symbols could cause in the data transmission process.
•
A couple of FIs mentioned that unlike the iPAQ, the tablet screening program did not
allow persistent highlighting of cases on the Select Case screen. This functionality is
not available because of constraints imposed by the tablet's operating system.
•
A few FIs thought that the tablet goes into sleep mode too quickly, resulting in having
to enter the password frequently. One FI expressed concern about entering the
password in the presence of respondents. The tablet has been configured to allow for
the maximum time of inactivity (10 minutes) before entering sleep mode.
•
One FI thought the tablet battery drained too quickly, which may have been due to
having the WiFi setting enabled. Training and practice have been incorporated into
the 2015 Veteran FI Training program to ensure that FIs know how to turn WiFi on
and off. Also, previous testing on the tablet battery has indicated an expected battery
life of approximately 6 hours, and all FIs will be provided with a car charger and a
standard charger to use with the tablet.
The debriefing call uncovered no issues with the TTS ACASI voice or the questionnaire.
No respondents commented on the voice or showed nonverbal signs of confusion, frustration, or
changing the volume during the ACASI section of the interview. One FI commented that two
youth respondents made comments about the questionnaire being repetitive. Two FIs had
respondents (one English-speaking and one Spanish-speaking) who commented that the
interview was long. However, the FIs also mentioned that these comments are not different from
what they hear with the main study data collection.
Regarding the laptop and the interview program, the FIs mentioned only a few issues,
outlined as follows:
•
No FI reported respondent confusion over the function key labels, and all FIs were
fine with using the same labels for 2015. One FI did comment that the function keys
themselves are very small, and a couple of respondents had to look closely to find
45
them. This FI thought it may be harder for some respondents (particularly older
respondents) to use and select the keys accurately.
•
Two FIs had respondents say that the laptop screen was too bright. However, both of
these respondents were completing the interview in rooms with dim lighting.
•
One FI commented that the Windows lock screen appeared between interviews when
completing two interviews in the same household. The FI needed to call technical
support for the password the first time this happened and was able to use the laptop
without technical support on future occasions.
Aside from the minor issues detailed previously, the FIs liked the new equipment and the
changes to the screening and interview programs and look forward to using the equipment in
2015.
4.3
Pretest Conclusions
Based on the TTS cognitive interviews, SAMHSA decided to use the TTS slow voice for
the 2015 NSDUH. After the cognitive interviews, RTI continued to test and modify the TTS
pronunciations to improve the quality and cadence before the pilot test. For example, drugs that
include "generic" in parentheses were modified so that the TTS did not add the slight pause
associated with parentheses for drug lists. The updated 2015 CAI instrument with TTS software
was used to complete 43 interviews in the pilot test.
The overall results of the pilot test did not reveal any issues with administering the 2015
CAI instrument with the TTS software. Respondents did not make any comments about the
voice. The pilot test timing data show only slight variations among all English respondents
compared with the Dress Rehearsal and the 2013 main study, although timings were longer for
adolescents and shorter for other age groups. It is inconclusive at this point whether the 2015
administration times will be longer or shorter for English respondents. For Spanish respondents,
the pilot test timing data show that TTS was longer when compared with the Dress Rehearsal and
the 2013 main study. However, it is important to note that with a small sample size, it is difficult
to know if these longer times can be attributed to the instrument, the respondents, or both. The
early data review conducted in January 2015 will provide another opportunity to review overall
timing data across all respondents compared with the Dress Rehearsal and the 2013 main study.
The FI feedback provided on the pilot test data collection will be taken into consideration
to refine the screening and interviewing programs as feasible. Only small suggestions were
made, and overall, the data collection did not uncover any major issues with the 2015 instrument,
equipment, or protocols.
46
5. References
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Effects of interviewer gender, interviewer choice, and item wording on responses to questions
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Couper, M. P. (2005). Technology trends in survey data collection. Social Science Computer
Review, 23, 486-501. doi:10.1177/0894439305278972
Couper, M. P., Kirgis, N., Buageila, S., & Berglund, P. (2012). Using text-to-speech (TTS) for
audio-CASI. Presented at the American Association for Public Opinion Research 67th Annual
Conference, Orlando, FL.
Couper, M. P., Singer, E., & Tourangeau, R. (2004). Does voice matter? An interactive voice
response (IVR) experiment. Journal of Official Statistics, 20, 551-570.
Couper, M., Tourangeau, R., & Marvin, T. (2009). Taking the audio out of audio CASI. Public
Opinion Quarterly, 73, 281-303.
Dindia, K., & Allen, M. (1992). Sex differences in self-disclosure: A meta-analysis.
Psychological Bulletin, 112, 106-124. doi:10.1037/0033-2909.112.1.106
Dykema, J., Basson, D., & Schaeffer, N. C. (2007). Face-to-face surveys. In W. Donsbach & M.
W. Traugott (Eds.), The SAGE handbook of public opinion research (pp. 240-248). London:
Sage Publications.
Dykema, J., Diloreto, K., Price, J. L., White, E., & Schaeffer, N. C. (2012). ACASI gender-ofinterviewer voice effects on reports to questions about sensitive behaviors among young adults.
Public Opinion Quarterly, 76, 311-325. doi:10.1093/poq/nfs021
Fahrney, K. M., Uhrig, J., & Kuo, T. M. (2010, April). Gender-of-voice effects in an ACASI
study of same-sex behavior (RTI Press Methods Report MR-0017-100). Retrieved from
http://www.rti.org/publications/rtipress.cfm?pubid=14766
Griggs, B. (2011, October 21). Why computer voices are mostly female. Retrieved from
http://www.cnn.com/2011/10/21/tech/innovation/female-computer-voices/
Jourard, S. M. (1971). Self-disclosure: An experimental analysis of the transparent self. New
York, NY: Wiley-Interscience.
Kraft, J., & Taylor, W. (2006, May). Text-to-speech application in audio CASI: Evaluation of
implementation and deployment. Presented at the International Field Directors & Technologies
Conference, Montreal, Quebec, CA.
Nass, C., Moon, Y., & Greene, N. (1997). Are machines gender neutral? Gender-stereotypic
responses to computers with voices. Journal of Applied Social Psychology, 27, 864-876.
doi:10.1111/j.1559-1816.1997.tb00275.x
47
Nass, C., Robles, E., Heenan, C., Bienstock, H., & Treinen, M. (2003). Speech-based disclosure
systems: Effects of modality, gender of prompt, and gender of user. International Journal of
Speech Technology, 6, 113-121. doi:10.1023/A:1022378312670
Phillips, J., Edwards, B., & Dolbow, E. (2013). Using text-to-speech software for ACASI.
Presented at the Federal CASIC Workshops, Washington, DC.
Pollner, M. (1998). The effects of interviewer gender in mental health interviews. Journal of
Nervous and Mental Disease, 186, 369-373.
Schaeffer, N. C. (2000). Asking questions about threatening topics: A selective overview. In
A.A. Stone, J.S. Turkkan, C.A. Bachrach, J.B. Jobe, H.S. Kurtzman, & V.S. Cain (Eds.), The
science of self-report: Implications for research and practice (pp. 105-121). Mahwah, NJ:
Lawrence Erlbaum Associates.
Tannen, D. (1996). Gender and discourse. New York, NY: Oxford University Press.
Tourangeau, R., & Smith, T.W. (1996). Asking sensitive questions: The impact of data collection
mode, question format, and question context. Public Opinion Quarterly, 60, 275-304.
Turner, C.F., Forsyth, B. H., O'Reilly, J., Cooley, P. C., Smith, T. K., Rogers, S. M., & Miller, H.
G. (1998). Automated self-interviewing and the survey measurement of sensitive behaviors. In
M. P. Couper, et al. (Eds.), Computer-assisted survey information collection. New York: Wiley.
Weisel, D. L. (2002). Contemporary gangs: An organizational analysis. New York: LFB
Scholarly.
48
Appendix A: ACASI Questions Selected for
TTS Prototypes
A-1
A.1. Summary of Proposed CAI Items for Prototypes
The full question text and response options from the 2013 Dress Rehearsal computer-assisted
interviewing (CAI) specifications are provided in Section A.2.
Variable Name
1. Card 3a
2. AL 01
3. HALINTRO
4. INHINTRO
5. TR03
6. TR05
7. ST04
8. SV03
9. PRINTROYR2
10. HLTH25
11. AD19
12. INTROINC
Description
Long list of types of alcoholic beverages
Asks whether R has ever drank alcohol
Introduction to hallucinogen module – lists various hallucinogens
Introduction to inhalant module – lists various inhalants
Asks about past use of specific tranquilizers
Asks about past use of other tranquilizers
Asks about past use of specific stimulants
Asks about past use of specific sedatives
Pre-fills a previous response
Asks whether R has had a specific set of health conditions
Includes pre-fills from previous response about mood problems
Asks about family income, includes fills and wording changes
depending on family relationships and whether proxy is answering
R = respondent.
A.2. Selected Items from CAI Specifications—Full Question Text and
Response Options (2013 Dress Rehearsal CAI Specifications)
A. English Versions
1. CARD3a Types of Alcoholic Beverages
Beer
Regular beer
Lite or light beer
Low-alcohol (LA) beer
Malt liquor
Ale
Stout
Lager
Wine
Red, white, blush wine
Wine coolers
Champagne
Sherry
Homemade wines, such as muscadine, scuppernong, or fruit wines
Fortified wines, such as Cisco
Liquor
Bourbon
Gin
A-2
Rum
Scotch
Tequila
Vodka
Homemade liquor, such as moonshine
Liqueurs, Cordials, and Brandy
Brandy
Cassis
Cognac
Creme de menthe
Drambuie
Grand Marnier
Kahlua
Port
Schnapps
Tia Maria
Triple sec
Vermouth
Mixed Drinks and Cocktails
Bloody Mary
Bourbon and water
Daiquiri
Gin and tonic
Manhattan
Margarita
Martini
Piña colada
Rob Roy
Rum and cola
Scotch and soda
Whiskey sour
Press [ENTER] to continue.
2. AL01
Have you ever, even once, had a drink of any type of alcoholic beverage? Please do not include
times when you only had a sip or two from a drink.
1
Yes
2
No
DK/REF
3. HALINTRO
The next questions are about substances called hallucinogens. These drugs often cause people to
see or experience things that are not real.
A-3
A list of some common hallucinogens is shown below. These and many other substances that
people use as hallucinogens are often known by street names, and we can't list them all. Please
take a moment to look at the substances listed below so you know what kind of drugs the next
questions are about.
LSD, also called "acid"
PCP, also called "angel dust" or phencyclidine
Peyote
Mescaline
Psilocybin
"Ecstasy," also called MDMA
Ketamine, also called "Special K" or "Super K"
DMT, also called dimethyltryptamine
AMT, also called alpha-methyltryptamine
Foxy, also called 5-MeO-DIPT
Salvia divinorum
Press [ENTER] to continue
4. INHINTRO
These next questions are about liquids, sprays, and gases that people sniff or inhale to get high or
to make them feel good.
We are not interested in times when you inhaled a substance accidentally—such as when
painting, cleaning an oven, or filling a car with gasoline. The questions use the word "inhalant"
to include all the things listed below, as well as any other substances that people sniff or inhale
for kicks or to get high.
Take a moment to look at the substances listed below so you know what kinds of liquids, sprays,
and gases these questions are about.
Amyl nitrite, "poppers," locker room odorizers, or "rush"
Correction fluid, degreaser, or cleaning fluid
Gasoline or lighter fluid
Glue, shoe polish, or toluene
Halothane, ether, or other anesthetics
Lacquer thinner, or other paint solvents
Lighter gases, such as butane or propane
Nitrous oxide or "whippits"
Felt-tip pens, felt-tip markers, or magic markers
Spray paints
Computer keyboard cleaner, also known as air duster
Other aerosol sprays
Press [ENTER] to continue.
5. TR03
Please look at the names and pictures of the tranquilizers shown below.
A-4
PROGRAMMER: DISPLAY PILLS HERE FOR VALIUM, DIAZPEPAM, TRANXENE, AND
OXAZEPAM.
In the past 12 months, which, if any, of these tranquilizers have you used?
To select more than one drug from the list, press the space bar between each number you have
typed. When you have finished, press [ENTER].
1
Valium
2
Librium
3
Tranxene
4
Diazepam (generic)
5
Oxazepam (generic), also known as Serax
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
6. TR05
Please look at the names and pictures of the tranquilizers shown below.
PROGRAMMER: DISPLAY PILLS FOR BUSPIRONE, HYDROXYZINE, AND
MEPROBAMATE.
In the past 12 months, which, if any, of these tranquilizers have you used?
To select more than one drug from the list, press the space bar between each number you have
typed.
When you have finished, press [ENTER].
1
Buspirone (generic), also known as BuSpar
2
Hydroxyzine (generic), also known as Atarax or Vistaril
3
Meprobamate (generic), also known as Equanil or Miltown
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
7. ST04
Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY PILLS FOR BENZPHETAMINE, DIDREX,
DIETHYLPROPION, PHENDIMETRAZINE, AND PHENTERMINE.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between each number you have
typed. When you have finished, press [ENTER].
1
2
3
4
5
95
Benzphetamine
Didrex
Diethylpropion
Phendimetrazine
Phentermine
I have not used any of these stimulants in the past 12 months
A-5
DK/REF
8. SV03
Please look at the names and pictures of the sedatives shown below.
PROGRAMMER: DISPLAY PILLS FOR DALMANE, HALCION, FLURAZEPAM AND
TRIAZOLAM.
In the past 12 months, which, if any, of these sedatives have you used?
To select more than one drug from the list, press the space bar between each number you have
typed. When you have finished, press [ENTER].
1
Dalmane
2
Halcion
3
Flurazepam (generic)
4
Triazolam (generic)
95
I have not used any of these sedatives in the past 12 months
DK/REF
9. PRINTROYR2
NOTE: For this question, we will assume a fill of 4 drug names.
[IF PR12MON=1 AND (PR11 NE 1 OR (PR11=1 AND PRYRCOUNT > 1))]
Earlier, the computer recorded that, in the past 12 months, you used [PRFILL].
Press Enter to continue.
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH REFERENCE DATE FOR THE
INTRO SCREEN
10. HLTH25
Below is a list of health conditions that you may have had during your lifetime.
Please read the list and type in the numbers of all of the conditions that a doctor or other health
care professional has ever told you that you had.
To select more than one condition, press the space bar between each number you type. When you
have finished, press [ENTER].
1
2
3
4
5
6
7
8
Any kind of heart condition or heart disease
Diabetes or sugar diabetes
Chronic bronchitis, emphysema, chronic obstructive pulmonary disease, also
called COPD
Cirrhosis of the liver
Hepatitis B or C
Kidney disease, not including bladder infection or incontinence
Asthma
HIV or AIDS
A-6
9
Cancer or a malignancy of any kind
10
Hypertension, also called high blood pressure
95
None of the above - I have never had any of these conditions
DK/REF
11. AD19
[IF AD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two weeks or longer
when [NUMPROBS] with your mood [WASWERE] most severe and frequent.
How often, during those times, was your emotional distress so severe that you could not carry
out your daily activities?
1
Often
2
Sometimes
3
Rarely
4
Never
DK/REF
12. INTROINC
NOTE: For this question, we will assume a 4 person family with father, mother, son, daughter
[IF NO FAMILY MEMBERS IN ROSTER]
These next questions are about the kinds and amounts of income that you receive.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1]
These next questions are about the kinds and amounts of income received by you and your
[FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1]
These next questions are about the kinds and amounts of income received by [SAMPLE
MEMBER] and you.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1]
These next questions are about the kinds and amounts of income received by your family living
here, including you, your [FAMILY RELATIONSHIP FILLS].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN=1]
These next questions are about the kinds and amounts of income received by [SAMPLE
MEMBER] and [IF QD01=5 FILL his, QD01 = 9 FILL her] family living here, including you,
[IF QD01=5 FILL his, QD01 = 9 FILL her] [FAMILY RELATIONSHIP FILLS].
[PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN [FAMILY
RELATIONSHIP FILLS]. ALSO, USE ‘other' AS A MODIFIER TO THE FAMILY
RELATIONSHIP FILL WHEN THE RELATIONSHIP TYPE IS EQUAL TO PROXY
A-7
RELATIONSHIP TYPE AND ONE OF THESE RELATIONSHIP TYPES IS STILL IN THE
LIST. PLEASE PRECEDE EACH RELATIONSHIP WITH ‘HIS/HER'.]
[IF HASJOIN NE 1] These questions refer to the calendar year [CURRENT YEAR - 1] rather
than to the past 12 months that were referred to in some earlier questions. The calendar year
[CURRENT YEAR - 1] would be from January 1st, [CURRENT YEAR - 1], through December
31st, [CURRENT YEAR - 1].
Press [ENTER] to continue.
A.3. Spanish Versions
1. CARD3a
Tipos de Bebidas Alcohólicas
Cerveza
Cerveza
Cerveza ligera o "lite"
Cerveza con poco alcohol (LA)
Malta con alcohol
"Ale"
Cerveza negra
Lager o Cerveza dorada
Vino
Vino tinto, blanco, rosado
"Wine coolers"
Champaña
Jerez
Vinos caseros, tales como uva moscatel, scuppernong o vinos frutales
Vinos fortificados tales como Cisco
Licor
Whisky americano
Ginebra o "Gin"
Ron
Whisky escocés
Tequila
Vodka
Alcohol casero destilado ("Moonshine")
Licores de esencias, Cordiales y Brandy
Brandy
Cassis
Coñac
Crema de menta
Drambuie
Grand Marnier
Kahlua
Oporto
A-8
Schnapps
Tía María
Triple seco
Vermut
Bebidas mezcladas y Cocteles
Bloody Mary
Whisky con agua
Daiquiri
"Gin y tónic"
Manhattan
Margarita
Martini
Piña colada
Rob Roy
Ron con Coca Cola
Whisky escocés con soda
Whisky sour
Presione [ENTER] para continuar.
2. AL01
¿Alguna vez ha tomado una bebida alcohólica, aunque haya sido solo una vez? Por favor no
incluya las ocasiones en que usted haya tomado solo uno o dos sorbos de una bebida.
1
Sí
2
No
DK/REF
3. HALINTRO
Las siguientes preguntas se tratan de las sustancias que se llaman alucinógenos. Estas drogas
muchas veces hacen que las personas vean o experimenten cosas que no son reales.
A continuación hay una lista de algunos alucinógenos populares. Estas y muchas otras sustancias
que la gente usa como alucinógenos se conocen frecuentemente por su nombre popular o de la
calle. No podemos enumerarlos todos. Por favor preste atención al leer la lista de sustancias que
sigue para saber a qué drogas se refieren las próximas preguntas.
LSD, también llamado ‘ácido'
PCP, también llamado ‘polvo de ángel' o fenciclidina
Peyote
Mescalina
Psilocibina
‘Éxtasis,' también llamado MDMA
Ketamina, conocida en inglés como "Special K" o "Super K" y en español se le llama
"Ketalar," "Hoyo K" o "vitamina K"
DMT, también llamado dimetiltriptamina
AMT, también llamado alfa-metiltriptamina
A-9
Foxy, también llamado "metoxi foxy" y cuyo nombre químico es 5-metoxi-N o 5-MeODIPT
Salvia divinorum, también llamada "Salvia de los adivinadores," "San Pedro," "planta
sagrada" o "hierba pastora"
Presione [ENTER] para continuar.
4. INHINTRO
Las siguientes preguntas son acerca de líquidos, aerosoles o esprays y gases que las personas
aspiran o inhalan para drogarse o para sentirse alegres.
No estamos interesados en ocasiones en que usted inhaló alguna sustancia accidentalmente como
en el caso de pintar, limpiar un horno o echarle gasolina al automóvil. Las preguntas usan el
término ‘inhalante' para incluir todas las cosas mencionadas a continuación, así como cualquier
otra sustancia que las personas aspiran o inhalan para divertirse o para drogarse. Por favor mire
con atención la lista de sustancias a continuación, para saber a qué clases de líquidos, aerosoles o
esprays y gases se refieren las próximas preguntas.
Nitrato de amilo, ‘bombitas,' desodorante ambiental, o ‘rush'
Líquido de corrección o ‘liquid paper', desengrasador o líquido de limpieza
Gasolina o líquido para encendedores
Pegamento, crema o betún para limpiar zapatos, o tolueno
Halotano, éter u otros anestésicos
‘Tiner' u otros solventes para pintura
Gases para encendedores, tales como butano o propano
Óxido nitroso o ‘whippits'
Marcadores de punta fina, plumones o plumones mágicos
Pintura en aerosol
Limpiador para teclado de computadora, también llamado aire comprimido removedor de
polvo
Otros aerosoles o esprays
Presione [ENTER] para continuar.
5. TR03
Por favor mire los nombres y las fotos de los tranquilizantes que se muestran a continuación.
PROGRAMMER: DISPLAY PILLS HERE FOR VALIUM, DIAZPEPAM, TRANXENE, AND
OXAZEPAM.
En los últimos 12 meses, ¿cuál de estos tranquilizantes ha usado, si es que ha usado alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora entre cada
número que haya registrado. Cuando haya terminado, presione la tecla [ENTER].
1
2
3
Valium
Librium
Tranxene
A-10
4
Diazepam (genérico)
5
Oxazepam (genérico), también conocido como Serax
95
No he usado ninguno de estos tranquilizantes en los últimos 12 meses
DK/REF
6. TR05
Por favor mire los nombres y las fotos de los tranquilizantes que se muestran a continuación.
PROGRAMMER: DISPLAY PILLS HERE FOR BUSPIRONE, HYDROXYZINE, AND
MEPROBAMATE.
En los últimos 12 meses, ¿cuál de estos tranquilizantes ha usado, si es que ha usado alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora entre cada
número que haya registrado. Cuando haya terminado, presione la tecla [ENTER].
1
Buspirona (genérico), también conocido como BuSpar
2
Hidroxizina (genérico), también conocido como Atarax o Vistaril
3
Meprobamato, (genérico) también conocido como Equanil o Miltown
95
No he usado ninguno de estos tranquilizantes en los últimos 12 meses
DK/REF
7. ST04
Por favor mire los nombres y las fotos de los estimulantes que se muestran a continuación.
PROGRAMMER: DISPLAY PILLS FOR BENZPHETAMINE, DIDREX,
DIETHYLPROPION, PHENDIMETRAZINE, AND PHENTERMINE.
En los últimos 12 meses, ¿cuál de estos estimulantes ha usado, si es que ha usado alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora entre cada
número que haya registrado. Cuando haya terminado, presione la tecla [ENTER].
1
Benzfetamina
2
Didrex
3
Dietilpropión
4
Fendimetracina
5
Fentermina
95
No he usado ninguno de estos estimulantes en los últimos 12 meses
DK/REF
8. SV03
Por favor mire los nombres y las fotos de los sedantes que se muestran a continuación.
PROGRAMMER: DISPLAY PILLS FOR DALMANE, HALCION, FLURAZEPAM AND
TRIAZOLAM.
En los últimos 12 meses, ¿cuál de estos sedantes ha usado, si es que ha usado alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora entre cada
número que haya registrado. Cuando haya terminado, presione la tecla [ENTER].
A-11
1
Dalmane
2
Halcion
3
Flurazepam (genérico)
4
Triazolam (genérico)
95
No he usado ninguno de estos sedantes en los últimos 12 meses
DK/REF
9. PRINTROYR2
NOTE: For this question, we will assume a fill of 4 drug names
[IF PR12MON=1 AND (PR11 NE 1 OR (PR11=1 AND PRYRCOUNT > 1))]
Anteriormente, la computadora registró que usted usó [PRFILL] en los últimos 12 meses.
Presione [Enter] para continuar.
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH REFERENCE DATE FOR THE
INTRO SCREEN
10. HLTH25
A continuación se muestra una lista de trastornos de la salud que usted pudiera haber tenido en el
transcurso de su vida.
Por favor, lea la lista y escriba los números correspondientes a las enfermedades que alguna vez
un doctor u otro profesional médico le dijo que tuvo.
Para seleccionar más de una enfermedad, presione la barra espaciadora entre cada número que
haya registrado. Cuando haya terminado, presione la tecla [ENTER].
1
2
3
Algún tipo de enfermedad o trastorno del corazón
Diabetes o diabetes del azúcar
Bronquitis crónica, enfisema, enfermedad pulmonar obstructiva crónica,
también llamada COPD en inglés
4
Cirrosis del hígado
5
Hepatitis B o C
6
Enfermedad de los riñones, sin includir infección a la vejiga o incontinencia
urinaria
7
Asma
8
VIH o SIDA
9
Cáncer o algún tipo de tumor maligno
10
Hipertensión, también llamada presión sanguínea alta
95
Ninguna enfermedad arriba mencionada - Nunca he tenido ninguna de estas
enfermedades
DK/REF
11. AD19
[IF AD16 = 2, 3, 4, OR DK/REF] Una vez más, por favor piense en las veces que
[NUMPROBS] con su estado de ánimo [WASWERE] por dos semanas o más.
A-12
Durante esas ocasiones, ¿con qué frecuencia era su malestar emocional tan grave que no podía
realizar sus actividades diarias?
1 Muchas veces
2 Algunas veces
3 Casi nunca
4 Nunca
DK/REF
12. INTROINC
NOTE: For this question, we will assume a 4 person family with father, mother, son, daughter
[IF NO FAMILY MEMBERS IN ROSTER]
Las siguientes preguntas se tratan de los tipos de ingreso y las cantidades que usted recibe.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1]
Las siguientes preguntas se tratan de los tipos de ingreso y las cantidades que reciben usted y su
[FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1]
Las siguientes preguntas se tratan de los tipos de ingreso y las cantidades que reciben [SAMPLE
MEMBER] y usted.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1]
Las siguientes preguntas se tratan de los tipos de ingreso y las cantidades que reciben los
miembros de su familia que viven aquí, incluyéndose usted, su [FAMILY RELATIONSHIP
FILL].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN=1]
Las siguientes preguntas se tratan de los tipos de ingreso y las cantidades que reciben [SAMPLE
MEMBER] y los miembros de su familia que viven aquí, incluyéndose usted, [FAMILY
RELATIONSHIP FILL] de su [SAMPLE MEMBER].
[PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN [FAMILY
RELATIONSHIP FILLS]. ALSO, USE ‘otro' AS A MODIFIER TO THE FAMILY
RELATIONSHIP FILL WHEN THE RELATIONSHIP TYPE IS EQUAL TO PROXY
RELATIONSHIP TYPE AND ONE OF THESE RELATIONSHIP TYPES IS STILL IN THE
LIST. PLEASE PRECEDE EACH RELATIONSHIP WITH ‘SU'.]
[IF HASJOIN NE 1]Estas preguntas se refieren al año calendario [CURRENT YEAR-1] en vez
de los últimos 12 meses a los que se refirieron algunas preguntas anteriores. El año calendario
[CURRENT YEAR-1] es del 1 de enero de [CURRENT YEAR-1] hasta el 31 de diciembre del
año [CURRENT YEAR-1].
A-13
Presione [ENTER] para continuar.
A-14
Appendix B: Recruitment Advertisements
(English and Spanish)
B-1
Adolescents
*Ages 12 to 17 Needed for Study*
RTI International, a not-for-profit research organization, is looking for adolescents aged 12 to 17
to provide input on questions for a national study on alcohol use, drug use, and other healthrelated issues. All responses will be kept confidential under federal law. No medical tests or
examinations are involved. Requires about 60 minutes. A parent or guardian must accompany
the adolescent to the interview. Parents will not observe the interview or find out answers to any
questions. The private interview will be conducted at our offices in [LOCATION]. Eligible
participants who complete the interview will receive $40.
For eligibility, call:
XXXX
or
1-800-334-8571 ext. XXXX
Adults Aged 65 or Older
*Ages 65 and Older Needed for Study*
RTI International, a not-for-profit research organization, is looking for persons aged 65 and older
to provide input on questions for a national study on alcohol use, drug use, and other healthrelated issues. All responses will be kept confidential under federal law. No medical tests or
examinations are involved. Requires about 60 minutes. The private interview will be conducted
at our offices in [LOCATION]. Eligible participants who complete the interview will receive
$40.
For eligibility, call:
XXXX
or
1-800-334-8571 ext. XXXX
B-2
Non-Native English Speakers
*Research Opportunity for Non-native English Speakers*
RTI International, a not-for-profit research organization, is looking for adults who speak English
as a second language to provide input on questions for a national study on alcohol use, drug use,
and other health-related issues. All responses will be kept confidential under federal law. No
medical tests or examinations are involved. Requires about 60 minutes. The private interview
will be conducted at our offices in [LOCATION]. Eligible participants who complete the
interview will receive $40.
For eligibility, call:
XXXX
or
1-800-334-8571 ext. XXXX
Low Education/Low Literacy
*Research Opportunity for Qualified Participants*
RTI International, a not-for-profit research organization, is looking for respondents to provide
input on questions for a national study on alcohol use, drug use, and other health-related issues.
We are interested in interviewing adults who are illiterate or have limited reading skills. All
responses will be kept confidential under federal law. No medical tests or examinations are
involved. Requires about 60 minutes. The private interview will be conducted at our offices near
Metro Center. Eligible participants who complete the interview will receive $40.
For eligibility, call:
919-485-7743
or
1-800-334-8571 ext. 27743
B-3
Master Advertisement (Print or Online)
*Research Opportunity for Qualified Participants*
RTI International, a not-for-profit research organization, is looking for respondents to provide
input on questions for a national study on alcohol use, drug use, and other health-related issues.
We are interested in interviewing adults who are over 65 years old or speak English as a second
language. We are also interested in interviewing adolescents aged 12 to 17. All responses will be
kept confidential under federal law. No medical tests or examinations are involved. Requires
about 60 minutes. The private interview will be conducted at our offices in [LOCATION].
Eligible participants who complete the interview will receive $40.
For eligibility, call:
XXXX
or
1-800-334-8571 ext. XXXX
Spanish Speakers
*Oportunidad de participar en un estudio para personas que hablan español*
RTI International, una organizacion sin fines de lucro que realiza estudios sobre la salud, está
buscando a personas de 18 años de edad o más que hablan español como su idioma principal
para dar sus opiniones sobre las preguntas de un estudio nacional sobre el uso de alcohol, el uso
de drogas y otros temas relacionados a la salud. Todas las respuestas se mantendrán en forma
confidencial de acuerdo a la ley federal. No se hará ninguna prueba ni examen médico. No
haremos preguntas sobre la situación legal o de inmigración. La entrevista se realizará en privado
en una de nuestras oficinas locales y tomará aproximadamente 60 minutos. Los participantes que
sean elegibles y que completen la entrevista recibirán $40 dólares.
Para determinar si es elegible, llame al:
XXXX
o al
1-800-334-8571 ext. XXXX
B-4
Appendix C: Cognitive Testing Protocol
(English and Spanish)
C-1
NSDUH Text-to-Speech Cognitive Testing Protocol
CASEID
DATE:
__ - __ __ __ - __ __ __
__ __ / __ __ / __ __ __ __
SELECT VERSION
Group 1
Group 2
Group 3
HUMAN, SLOW, MODERATE
MODERATE, HUMAN, SLOW
SLOW, MODERATE, HUMAN
SET UP CASE ON LAPTOP
DEMOGRAPHICS (INTERVIEWER READ)
Thank you for participating in our study. My job is to take a lot of notes and to figure out what
we can do to make the questions easier to understand and to determine which voice works
best for everyone who takes the survey. If a survey question doesn't make sense or you don't
understand a certain word used, tell me that. If you need me to replay any question, just let me
know. When we're done, I'll ask you a few overall questions, and then you'll receive $40 in cash
as a token of our appreciation.
First I'll ask a few demographic questions to help us analyze the results of the study.
age
How are old are you?
YEARS: ________________
DK/REF
QD03 Are you of Hispanic, Latino, or Spanish origin or descent?
1
YES
2
NO
DK/REF
C-2
QD05 Which of these groups describes you? You may select all that apply.
1
White
2
Black or African American
3
American Indian or Alaska Native
4
Native Hawaiian
5
Guamanian or Chamorro
6
Samoan
7
Other Pacific Islander
8
Asian
9
OTHER (SPECIFY)
DK/REF
QD11 What is the highest grade or year of school you have completed?
INCLUDE JUNIOR OR COMMUNITY COLLEGE ATTENDANCE; DO NOT
INCLUDE TECHNICAL SCHOOLS (BEAUTICIAN, MECHANIC, ETC.).
0
1
2
3
4
5
6
7
8
9
10
11
NO SCHOOLING COMPLETED
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
12
13
REGULAR HIGH SCHOOL DIPLOMA
12TH GRADE, NO DIPLOMA
14
15
16
17
GED CERTIFICATE OF HIGH SCHOOL COMPLETION
SOME COLLEGE CREDIT, BUT NO DEGREE
ASSOCIATE'S DEGREE (FOR EXAMPLE, AA, AS)
BACHELOR'S DEGREE (FOR EXAMPLE, BA, BS)
18
MASTER'S DEGREE (FOR EXAMPLE, MA, MS, MENG, M. ED,
MSW, MBA)
19
DOCTORATE DEGREE (FOR EXAMPLE, PHD, EDD)
20
PROFESSIONAL DEGREE BEYOND A BACHELOR'S DEGREE
(FOR EXAMPLE, MD, DDS, DVM, LLB, JD)
DK/REF
C-3
QD14 Were you born in the United States?
1
Yes
2
No
DK/REF
QD15 [IF QD14 = NO] In what country or U.S. territory were you born?
COUNTRY OR US TERRITORY: _________________
DK/REF
QD55 How well would you say you speak English?
1
Very well
2
Well
3
Not well
4
Not at all
DK/REF
QD56 Are you deaf or do you have any difficulty hearing?
1
Yes
2
No
DK/REF
QD57 Are you blind or do you have serious difficulty seeing, even when wearing
glasses?
1
Yes
2
No
DK/REF
QD58 Do you have any difficulty concentrating, remembering, or making decisions?
1
Yes
2
No
DK/REF
INTRODUCTION:
As I described earlier, I will play survey questions that have been recorded using different
voices. You do not have to answer the recorded questions. For several of the questions, your
task will be to simply repeat the question. After some of the questions, I will instead ask you
some follow up items about the question you just heard. For example, I might ask you to try to
put the question into your own words. That will help me understand how you have interpreted
it. Let me give you an example.
[INTROVOICE1: INTERVIEWER: TYPE ‘1' AND PRESS ENTER WHEN YOU ARE
READY TO PROCEED WITH THE SCREENS FOR VOICE 1.]
C-4
HLTH19
During the past 12 months, how many times have you visited a doctor, nurse,
physician assistant or nurse practitioner about your own health at a doctor's office,
a clinic, or some other place?
[INTERVIEWER: ADJUST ACASI VOLUME AS NEEDED.] Putting this in my own words, I
might say, "They want to know if I saw a doctor, nurse, or other health care person in the past 12
months for my own health in a doctor's office, clinic, or some place."
Do you have any questions before we begin?
ACASI VOICE 1:
LEADCIG
____________________
These questions are about your use of tobacco products. This includes cigarettes,
chewing tobacco, snuff, cigars, and pipe tobacco. The first questions are about
cigarettes only.
P1.
Can you tell me what this introduction is telling you?
P2.
What are some of the tobacco products that were listed in this question?
RK01a
How much do people risk harming themselves physically and in other ways when
they smoke one or more packs of cigarettes per day?
1
2
3
4
P3.
In your own words, what is this question asking?
ALCINTR2
P4.
No risk
Slight risk
Moderate risk
Great risk
These questions are about drinks of alcoholic beverages. Throughout these
questions, by a "drink," we mean a can or bottle of beer, a glass of wine or a
wine cooler, a shot of liquor, or a mixed drink with liquor in it. We are not asking
about times when you only had a sip or two from a drink.
What would be considered a "drink" of alcohol according to this question? What would
not be considered a "drink" of alcohol?
C-5
AL01
Have you ever, even once, had a drink of any type of alcoholic beverage? Please do
not include times when you only had a sip or two from a drink.
1
2
P5.
Yes
No
Please repeat this question as best you can.
MRJINTRO
The next questions are about marijuana and hashish. Marijuana is also called pot
or grass. Marijuana is usually smoked, either in cigarettes, called joints, or in a
pipe. It is sometimes cooked in food. Hashish is a form of marijuana that is also
called "hash." It is usually smoked in a pipe. Another form of hashish is hash oil.
P6.
Can you tell me in your own words what this introduction is telling you?
P7.
Can you recall any of the examples of marijuana or hashish that were mentioned?
[PROBE FOR AS MANY EXAMPLES AS THEY RECALL.]
MJ01
Have you ever, even once, used marijuana or hashish?
1
2
P8.
RK04a
Please repeat this question as best you can.
How often do you get a real kick out of doing things that are a little dangerous?
1
2
3
4
P9.
PR01
Yes
No
Never
Seldom
Sometimes
Always
Please repeat this question as best you can.
Please look at the names and pictures of the pain relievers shown below. Please
note that some forms of these pain relievers may look different from the pictures,
but you should include any form that you have used.
In the past 12 months, which, if any, of these pain relievers have you used?
To select more than one drug from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].
1
Vicodin
C-6
2
Lortab
3
Hydrocodone (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
P10.
Based on this question, how would you select more than one drug at a time?
DEBRIEFING1:
The next few questions ask for your opinions about the voice that read the questions you
just heard. Please think carefully about this voice as you answer these questions.
1. How would you rate the speed or pace of the voice that read the interview questions? Would you
say the pace of the voice was much too slow, a little too slow, just right, a little too fast, or much
too fast?
1
2
3
4
5
MUCH TOO SLOW
A LITTLE TOO SLOW
JUST RIGHT (NEITHER TOO FAST NOR TOO SLOW)
A LITTLE TOO FAST
MUCH TOO FAST
2. Cadence is the way a voice changes by gently rising and falling when speaking. How would you
rate the cadence of the voice? Would you say the cadence of the voice was excellent, good, fair,
poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
3. How would you rate the pronunciation of the questions read by the voice? Would you say the
pronunciation of the voice was excellent, good, fair, poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
C-7
4. How difficult was it to understand the voice? Would you say not at all difficult, slightly difficult,
moderately difficult, very difficult or extremely difficult?
1
2
3
4
5
NOT AT ALL DIFFICULT
SLIGHTLY DIFFICULT
MODERATELY DIFFICULT
VERY DIFFICULT
EXTREMELY DIFFICULT
5. How pleasant was the voice? Would you say not at all pleasant, somewhat pleasant, moderately
pleasant, very pleasant or extremely pleasant?
1
2
3
4
5
NOT AT ALL PLEASANT
SOMEWHAT PLEASANT
MODERATELY PLEASANT
VERY PLEASANT
EXTREMELY PLEASANT
6. How do you rate the overall quality of the voice? Would you say the quality of the voice was
excellent, good, fair, poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
7. This voice might be used in an interview for about 30 minutes. How comfortable would you be
listening to that voice for 30 minutes? Would you say not at all comfortable, slightly comfortable,
moderately comfortable, very comfortable or completely comfortable?
1
2
3
4
5
NOT AT ALL COMFORTABLE
SLIGHTLY COMFORTABLE
MODERATELY COMFORTABLE
VERY COMFORTABLE
COMPLETELY COMFORTABLE
8. You said [ANSWER FROM Q7].Tell me more about how you chose your answer.
9. Was there anything else about the voice that you liked or disliked?
ACASI VOICE 2:
____________________
C-8
AD12
Think about the times when you were sad, discouraged, or lost interest in most
things. Did you ever have a period of time like this that lasted most of the day,
nearly every day, for two weeks or longer?
1
Yes
2
No
DK/REF
P11.
Please repeat this question as best you can. [ASK AFTER EACH SENTENCE IN THE
QUESTION.]
INHINTRO These next questions are about liquids, sprays, and gases that people sniff or
inhale to get high or to make them feel good.
We are not interested in times when you inhaled a substance accidentally — such
as when painting, cleaning an oven, or filling a car with gasoline. The questions
use the word ‘inhalant' to include all the things listed below, as well as any other
substances that people sniff or inhale for kicks or to get high. Take a moment to
look at the substances listed below so you know what kinds of liquids, sprays, and
gases these questions are about.
Amyl nitrite, ‘poppers,' locker room odorizers, or ‘rush'
Correction fluid, degreaser, or cleaning fluid
Gasoline or lighter fluid
Glue, shoe polish, or toluene
Halothane, ether, or other anesthetics
Lacquer thinner, or other paint solvents
Lighter gases, such as butane or propane
Nitrous oxide or ‘whippits'
Felt-tip pens, felt-tip markers, or magic markers
Spray paints
Computer keyboard cleaner, also known as air duster
Other aerosol sprays
P12.
IN01c
According to this introduction, do they want to know about times when substances
were inhaled accidentally, on purpose, or both?
Have you ever, even once, inhaled gasoline or lighter fluid for kicks or to get
high?
1
Yes
2
No
DK/REF
P13.
Please repeat this question as best you can. [IF NEEDED: Can you remember what time
period the question was asking about?]
C-9
METHINTRO
P14.
Methamphetamine, also known as crank, ice, crystal meth, speed, glass, and
many other names, is a stimulant that usually comes in crystal or powder
forms. It can be smoked, "snorted," swallowed or injected.
What is this introduction telling you?
INTROST
These next questions are about any use of prescription stimulants. People
sometimes take these drugs for attention deficit disorders, to lose weight, or to
stay awake. Please do not include "over-the-counter" stimulants such as
Dexatrim, No-Doz, Hydroxycut, or 5-Hour Energy.
P15.
Can you tell me in your own words what this introduction is saying?
P16.
This introduction said not to include certain types of stimulants. What stimulants should
not be included?
INTROSV
These next questions ask about any use of prescription sedatives or
barbiturates. These drugs are also called "downers" or "sleeping pills." People
take these drugs to help them relax or help them sleep. Please do not include
"over-the-counter" sedatives such as Sominex, Unisom, Nytol, or Benadryl.
P17.
Can you tell me in your own words what this introduction is saying?
P18.
According to this introduction, what are some of the reasons that people take these
drugs?
PRINTROYR1 Earlier you reported having used certain prescription pain relievers during
the past year. Now please think about whether you used any of these pain
relievers in any way a doctor did not direct you to use them.
When you answer these questions, please think only about your use of the
drug in any way a doctor did not direct you to use it, including:
0. Using it without a prescription of your own
1. Using it in greater amounts, more often, or longer than you were told to
take it
2. Using it in any other way a doctor did not direct you to use it
P19.
This introduction provided examples of using prescription drugs in a way a doctor did
not direct you to use. Do you recall what those were? [PROBE FOR ALL THREE
RESPONSES]
C-10
SV01
Please look at the names and pictures of the sedatives shown below. Please note
that some forms of these sedatives may look different from the pictures, but you
should include any form that you have used.
In the past 12 months, which, if any, of these sedatives have you used?
To select more than one drug from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].
1
2
3
4
Ambien
Ambien CR
Zolpidem (generic)
Extended-release zolpidem (generic)
95
I have not used any of these sedatives in the past 12 months
DK/REF
P20.
Can you recall what time period the question was asking about?
DEBRIEFING2:
The next few questions ask for your opinions about the voice that read the questions you
just heard. Please think carefully about this voice as you answer these questions.
1. How would you rate the speed or pace of the voice that read the interview questions? Would you
say the pace of the voice was much too slow, a little too slow, just right, a little too fast, or much
too fast?
1
2
3
4
5
MUCH TOO SLOW
A LITTLE TOO SLOW
JUST RIGHT (NEITHER TOO FAST NOR TOO SLOW)
A LITTLE TOO FAST
MUCH TOO FAST
C-11
2. Cadence is the way a voice changes by gently rising and falling when speaking. How would you
rate the cadence of the voice? Would you say the cadence of the voice was excellent, good, fair,
poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
3. How would you rate the pronunciation of the questions read by the voice? Would you say the
pronunciation of the voice was excellent, good, fair, poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
4. How difficult was it to understand the voice? Would you say not at all difficult, slightly difficult,
moderately difficult, very difficult or extremely difficult?
1
2
3
4
5
NOT AT ALL DIFFICULT
SLIGHTLY DIFFICULT
MODERATELY DIFFICULT
VERY DIFFICULT
EXTREMELY DIFFICULT
5. How pleasant was the voice? Would you say not at all pleasant, somewhat pleasant, moderately
pleasant, very pleasant or extremely pleasant?
1
2
3
4
5
NOT AT ALL PLEASANT
SOMEWHAT PLEASANT
MODERATELY PLEASANT
VERY PLEASANT
EXTREMELY PLEASANT
C-12
6. How do you rate the overall quality of the voice? Would you say the quality of the voice was
excellent, good, fair, poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
7. This voice might be used in an interview for about 30 minutes. How comfortable would you be
listening to that voice for 30 minutes? Would you say not at all comfortable, slightly comfortable,
moderately comfortable, very comfortable or completely comfortable?
1
2
3
4
5
NOT AT ALL COMFORTABLE
SLIGHTLY COMFORTABLE
MODERATELY COMFORTABLE
VERY COMFORTABLE
COMPLETELY COMFORTABLE
8. You said [ANSWER FROM Q7].Tell me more about how you chose your answer.
9. Was there anything else about the voice that you liked or disliked?
ACASI Voice 3:
SD01
____________________
The last questions were about prescription drugs. The next question is about nonprescription cough or cold medicines, also known as "over-the-counter"
medicines. Have you ever, even once, taken a non-prescription cough or cold
medicine just to get high?
1
Yes
2
No
DK/REF
P21.
CG06
In your own words, what is this question asking?
How long has it been since you last smoked part or all of a cigarette?
1
2
3
P22.
More than 30 days ago but within the past 12 months
More than 12 months ago but within the past 3 years
More than 3 years ago
Can you tell me in your own words what that question was asking? [And what were the
response categories provided?]
C-13
INTROBK
The next questions are about offenses that are against the law. As you read each
question, please answer whether you were arrested and booked for that offense
during the past 12 months.
SP03a
In the past 12 months, were you arrested and booked for motor vehicle theft?
P23.
1
Yes
2
No
In your own words, what is this question asking?
senrelat
During the past 12 months, how many times did you attend religious services?
Please do not include special occasions such as weddings, funerals, or other
special events in your answer.
1
2
3
4
5
6
0 times
1 to 2 times
3 to 5 times
6 to 24 times
25 to 52 times
More than 52 times
P24.
Can you tell me in your own words what that question was asking?
P25.
Can you recall what sort of occasions should be excluded when answering this question?
YE09
Have you attended any type of school at any time during the past 12 months?
1
2
P26.
Yes
No
Please repeat this question as best you can.
YDS23
Have you ever had a period of time lasting several days or longer when you lost
interest and became bored with most things you usually enjoy, like work,
hobbies, and personal relationships?
1
Yes
2
No
DK/REF
P27.
In your own words, what is this question asking?
C-14
P28.
Can you remember what time period the question was asking about?
QD17
The next questions are about school. Are you now attending or are you currently
enrolled in school? By "school," we mean an elementary school, a junior high or
middle school, a high school, or a college or university. Please include home
schooling as well.
1
Yes
2
No
DK/REF
P29.
In your own words, what is this question asking?
TR01
Please look at the names and pictures of the tranquilizers shown below. Please
note that some forms of these tranquilizers may look different from the pictures,
but you should include any form that you have used.
In the past 12 months, which, if any, of these tranquilizers have you used?
To select more than one drug from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].
1
2
3
Xanax
Xanax XR
Alprazolam (generic)
4
Extended-release alprazolam (generic)
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
P30.
Can you tell me in your own words what that question was asking?
DEBRIEFING1:
The next few questions ask for your opinions about the voice that read the questions you
just heard. Please think carefully about this voice as you answer these questions.
1. How would you rate the speed or pace of the voice that read the interview questions? Would you
say the pace of the voice was much too slow, a little too slow, just right, a little too fast, or much
too fast?
1
2
3
4
5
MUCH TOO SLOW
A LITTLE TOO SLOW
JUST RIGHT (NEITHER TOO FAST NOR TOO SLOW)
A LITTLE TOO FAST
MUCH TOO FAST
C-15
2. Cadence is the way a voice changes by gently rising and falling when speaking. How would you
rate the cadence of the voice? Would you say the cadence of the voice was excellent, good, fair,
poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
3. How would you rate the pronunciation of the questions read by the voice? Would you say the
pronunciation of the voice was excellent, good, fair, poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
4. How difficult was it to understand the voice? Would you say not at all difficult, slightly difficult,
moderately difficult, very difficult or extremely difficult?
1
2
3
4
5
NOT AT ALL DIFFICULT
SLIGHTLY DIFFICULT
MODERATELY DIFFICULT
VERY DIFFICULT
EXTREMELY DIFFICULT
5. How pleasant was the voice? Would you say not at all pleasant, somewhat pleasant, moderately
pleasant, very pleasant or extremely pleasant?
1
2
3
4
5
NOT AT ALL PLEASANT
SOMEWHAT PLEASANT
MODERATELY PLEASANT
VERY PLEASANT
EXTREMELY PLEASANT
6. How do you rate the overall quality of the voice? Would you say the quality of the voice was
excellent, good, fair, poor, or very poor?
1
2
3
4
5
EXCELLENT
GOOD
FAIR
POOR
VERY POOR
C-16
7. This voice might be used in an interview for about 30 minutes. How comfortable would you be
listening to that voice for 30 minutes? Would you say not at all comfortable, slightly comfortable,
moderately comfortable, very comfortable or completely comfortable?
1
2
3
4
5
NOT AT ALL COMFORTABLE
SLIGHTLY COMFORTABLE
MODERATELY COMFORTABLE
VERY COMFORTABLE
COMPLETELY COMFORTABLE
8. You said [ANSWER FROM Q7].Tell me more about how you chose your answer.
9. Was there anything else about the voice that you liked or disliked?
FINAL DEBRIEFING (TO BE READ AFTER ALL THREE VOICES)
1. Of the three voices you heard, which voice did you prefer most?
1
2
3
4
HUMAN VOICE (VOICE ___)
SLOWER COMPUTERIZED VOICE (VOICE ___)
FASTER COMPUTERIZED VOICE (VOICE ___)
NO PREFERENCE
2. Tell me more about why you prefer that voice.
C-17
NSDUH Text-to-Speech Cognitive Testing Protocol
SPANISH VERSION
CASEID
DATE:
__ - __ __ __ - __ __ __
__ __ / __ __ / __ __ __ __
SELECT VERSION
Group 1
Group 2
Group 3
HUMAN, SLOW, MODERATE
MODERATE, HUMAN, SLOW
SLOW, MODERATE, HUMAN
SET UP CASE ON LAPTOP
DEMOGRAPHICS (INTERVIEWER READ) [NO RECORDING]
Gracias por participar en nuestro estudio. Mi trabajo es tomar muchas notas y averiguar lo que
podamos hacer para que las preguntas del cuestionario sean fáciles de entender y para
determinar qué tipo de voz se comprende mejor para todas las personas que contestan la
encuesta. Si una pregunta de la encuesta no tiene sentido o usted no entiende cierta palabra
que se usó, entonces dígamelo por favor. Si necesita volver a escuchar cualquier pregunta,
simplemente hágamelo saber. Cuando acabemos, le haré unas preguntas en general y entonces
usted recibirá $40 dólares en efectivo como muestra de nuestro agradecimiento.
Primero, le haré algunas preguntas demográficas para ayudarnos a analizar los resultados del
estudio.
age
¿Qué edad tiene usted?
YEARS: ________________
DK/REF
QD03 ¿Es usted de origen o descendencia hispana, latina o española?
1
YES
2
NO
DK/REF
C-18
QD05 ¿Cuál de estos grupos lo describe mejor a usted? Puede seleccionar todos los que
correspondan.
1
Blanco
2
Negro o afroamericano
3
Indígeno americano o nativo de Alaska
4
Nativo de Hawaii
5
Guameño o Chamorro
6
Samoano
7
De otra isla del Pacífico
8
Asiático
9
OTRO (ESPECIFIQUE)
DK/REF
QD11 . ¿Cuál es el último grado o año de escuela o universidad que usted ha completado?
INCLUYA LA ASISTENCIA A UN ‘JUNIOR' O ‘COMMUNITY COLLEGE'; NO
INCLUYA LAS ESCUELAS TECNICAS (COSMETOLOGÍA, MECÁNICA, ETC.)
12
13
14
15
16
17
18
19
20
21
22
23
12
13
14
15
16
17
18
21
22
NO COMPLETÓ NINGÚN GRADO EN LA ESCUELA
COMPLETÓ EL 1er. GRADO
COMPLETÓ EL 2o. GRADO
COMPLETÓ EL 3er. GRADO
COMPLETÓ EL 4o. GRADO
COMPLETÓ EL 5o. GRADO
COMPLETÓ EL 6o. GRADO
COMPLETÓ EL 7o. GRADO
COMPLETÓ EL 8o. GRADO
COMPLETÓ EL 9o. GRADO
COMPLETÓ EL 10o. GRADO
COMPLETÓ EL 11o. GRADO
DIPLOMA DE ESCUELA PREPARATORIA O ‘HIGH SCHOOL'
GRADO 12, SIN DIPLOMA
CERTIFICADO ‘GED' POR COMPLETAR ‘HIGH SCHOOL'
ALGUNOS CRÉDITOS UNIVERSITARIOS, PERO SIN TÍTULO
TÍTULO ASOCIADO UNIVERSITARIO (POR EJEMPLO, AA, AS)
TÍTULO DE LICENCIATURA UNIVERSITARIA (POR EJEMPLO,
BA, BS)
TÍTULO DE MAESTRÍA (POR EJEMPLO, MA, MS, MENG, M. ED,
MSW, MBA)
TÍTULO DE DOCTORADO (POR EJEMPLO, PHD, EDD)
TÍTULO PROFESIONAL MÁS ALLÁ DE UN TÍTULO DE
LICENCIATURA UNIVERSITARIA (POR EJEMPLO, MD, DDS,
DVM, LLB, JD)
DK/REF
C-19
QD14 ¿Nació usted en los Estados Unidos?
1
Sí
2
No
DK/REF
QD15 [IF QD14 = NO] ¿En qué país o en qué territorio de los Estados Unidos nació usted?
COUNTRY OR US TERRITORY: _________________
DK/REF
QD55 ¿Qué tan bien habla inglés?
1
Muy bien
2
Bien
3
No lo hablo bien
4
No lo hablo en lo absoluto
QD56 ¿Es usted sordo o tiene mucha dificultad para oír?
1
Sí
2
No
DK/REF
QD57 ¿Es usted ciego o tiene mucha dificultad para ver, aún cuando usa lentes o
anteojos?
1
Sí
2
No
DK/REF
QD58 Debido a una condición física, mental o emocional, ¿tiene usted mucha dificultad
para concentrarse, recordar o tomar decisiones?
1
Sí
2
No
DK/REF
Gracias.
C-20
[SET UP AUDIO RECORDER IF RESPONDENT HAS AGREED TO HAVE THE
INTERVIEW RECORDED]
INTRODUCTION:
Como le expliqué anteriormente, yo haré que usted escuche el audio de las preguntas de la
encuesta que han sido grabadas usando diferentes voces. Usted no tiene que contestar las
preguntas grabadas. Para varias preguntas, su tarea será simplemente repetir la pregunta.
Después de algunas de las preguntas, yo le haré algunas preguntas de seguimiento acerca de la
pregunta que acaba de escuchar. Por ejemplo, pueda ser que le pida que trate de hacer la
pregunta en sus propias palabras. Eso me ayudará a comprender cómo interpretó la pregunta.
Permítame darle un ejemplo.
[INTROVOICE1: INTERVIEWER: TYPE ‘1' AND PRESS ENTER WHEN YOU ARE
READY TO PROCEED WITH THE SCREENS FOR VOICE 1.]
HLTH19
Durante los últimos 12 meses, ¿cuántas veces ha ido a ver a un doctor, una
enfermera, un asistente médico o una enfermera especializada acerca de su propia
salud en el consultorio de un doctor, una clínica o algún otro lugar?
[INTERVIEWER: ADJUST ACASI VOLUME AS NEEDED.] Usando mis propias palabras, yo
pudiera decir, "Ellos quieren saber si yo ví a un doctor, una enfermera u otra persona que da
atención médica en los últimos 12 meses para mi propia salud en el consultorio de un doctor, una
clínica o algún otro lugar".
ACASI VOICE 1:
LEADCIG Estas preguntas se tratan del uso de productos de tabaco. Esto incluye cigarrillos,
tabaco de mascar, tabaco en polvo (rapé o "‘snuff"‘), cigarros (puros) y tabaco en
pipa. Las primeras preguntas se tratan solamente de cigarrillos.
P31.
¿Me puede decir que le están diciendo en esta introducción?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P32.
¿Cuáles son algunos de los productos de tabaco que se mencionaron en esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-21
RK01a
¿Cuánto riesgo corren las personas de hacerse daño físico y de otro tipo cuando
fuman una o más cajetillas de cigarrillos al día?
1
Ningún riesgo
2
Poco riesgo
3
Riesgo moderado
4
Mucho riesgo
P33. En sus propias palabras, ¿qué le está diciendo esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
ALCINTR2
Estas preguntas se tratan del consumo de las bebidas alcohólicas. Para las
siguientes preguntas, una ‘bebida' quiere decir una lata o botella de cerveza,
una copa de vino o ‘wine cooler,' un trago de alcohol o un coctel que contiene
alcohol. No queremos saber de las ocasiones en que usted haya tomado solo
uno o dos sorbos de una bebida.
P34.
¿Qué es lo que consideraría usted como una "bebida" alcohólica de acuerdo a esta
pregunta? ¿Qué es lo que no consideraría una "bebida" alcohólica?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
AL01 ¿Alguna vez ha tomado una bebida alcohólica, aunque haya sido solo una vez? Por favor
no incluya las ocasiones en que usted haya tomado solo uno o dos sorbos de una
bebida.
1
2
P35.
Sí
No
Por favor, repita esta pregunta de la mejor manera que pueda.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-22
MRJINTRO
Las siguientes preguntas se tratan de marihuana y hachís. Marihuana también se
llama mota, pasto y hierba. Usualmente, la marihuana se fuma en forma de
cigarrillos llamados pitillos o ‘joints' o también en una pipa. Algunas veces se
cocina en alimentos. El hachís es una forma de marihuana que también se llama
‘hash.' Usualmente, se fuma en una pipa. Aceite de hachís (‘hash oil') es otra
forma de hachís.
P36.
¿Me puede decir en sus propias palabras qué es lo que le está diciendo esta
introducción?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P37.
¿Puede recordar alguno de los ejemplos de marihuana o hachís que se mencionaron?
[PROBE FOR AS MANY EXAMPLES AS THEY RECALL.]
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
MJ01 ¿Alguna vez ha usado marihuana o hachís, aunque haya sido solo una vez?
1
2
Yes
No
P38. Por favor, repita esta pregunta de la mejor manera que pueda.
_____________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-23
RK04a
¿Con qué frecuencia le da placer hacer cosas que son un poco peligrosas?
1
2
3
4
P39.
Nunca
Rara vez
Algunas veces
Siempre
Por favor, repita esta pregunta de la mejor manera que pueda.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
PR01
Por favor, mire los nombres y las fotos de los analgésicos que se muestran a
continuación. Por favor, tome en cuenta que la forma de algunos analgésicos
puede parecer diferente a la de las fotos, pero usted debe incluir los analgésicos
que haya usado aunque hayan tenido otra forma.
En los últimos 12 meses, ¿cuál de estos analgésicos ha usado, si es que ha usado
alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora
entre cada número que haya registrado. Cuando haya terminado, presione la tecla
[ENTER].
1
Vicodin
2
Lortab
3
Hidrocodona (genérico)
95
No he usado ninguno de estos analgésicos en los últimos 12 meses
DK/REF
P40. De acuerdo con esta pregunta, ¿cómo seleccionaría más de un medicamento a la vez?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-24
DEBRIEFING1:
Las siguientes preguntas le piden sus opiniones acerca de la voz que leyó las preguntas que acaba de
escuchar. Por favor, piense cuidadosamente acerca de esta voz a medida que responde estas
preguntas.
10. ¿Cómo calificaría la velocidad de la voz que leyó las preguntas de la entrevista? ¿Diría usted que la
velocidad de la voz era demasiada lenta, un poco lenta, tenía la velocidad adecuada, era un poco
rápida o demasiada rápida?
☒
☐
☐
☐
☐
DEMASIADA LENTA
UN POCO LENTA
VELOCIDAD ADECUADA (NI MUY RÁPIDA NI MUY LENTA)
UN POCO RÁPIDA
DEMASIADO RÁPIDA
11. Cadencia es la manera en que una voz cambia al subir y bajar de tono suavemente al hablar.
¿Cómo calificaría la cadencia de la voz? ¿Diría que la cadencia de la voz fue excelente, muy buena,
buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
12. ¿Cómo calificaría la pronunciación de las preguntas que leyó la voz? ¿Diría que la pronunciación
fue excelente, buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
13. ¿Qué tan difícil era entender lo que decía la voz? ¿Diría que nada difícil, un poco difícil,
moderadamente difícil, muy difícil o sumamente difícil de entender?
☐
☐
☐
☐
☐
NADA DIFÍCIL
UN POCO DIFÍCIL
MODERADAMENTE DIFÍCIL
MUY DIFÍCIL
SUMAMENTE DIFÍCIL
C-25
14. ¿Qué tan agradable era la voz? ¿Diría que nada agradable, un poco agradable, moderadamente
agradable, muy agradable o sumamente agradable?
☐
☐
☐
☐
☐
NADA AGRADABLE
UN POCO AGRADABLE
MODERADAMENTE AGRADABLE
MUY AGRADABLE
SUMAMENTE AGRADABLE
15. ¿Cómo calificaría la calidad de la voz en general? ¿Diría que la calidad de la voz era excelente,
buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
16. Puede que esta voz se use en una entrevista de aproximadamente 30 minutos. ¿Qué tan a gusto
se sentiría usted escuchando esa voz por 30 minutos? ¿Diría que nada a gusto, un poco a gusto,
moderadamente a gusto, muy a gusto o sumamente a gusto?
☐
☐
☐
☐
☐
NADA A GUSTO
UN POCO A GUSTO
MODERADAMENTE A GUSTO
MUY A GUSTO
SUMAMENTE A GUSTO
17. Uste dijo [ANSWER FROM Q7]. Hábleme más sobre cómo decidió esa respuesta.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
18. ¿Hubo algo más acerca de la voz que le gustó o que no le gustó?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
C-26
ACASI VOICE 2:
AD12 Piense en la veces cuando se sintió triste, desanimado o perdió interés en la mayoría de
las cosas. ¿Pasó alguna vez por un periodo de tiempo como este, el cual duró la mayor
parte del día, casi todos los días, por dos semanas o más?
P41.
1
Sí
2
No
DK/REF
Por favor, repita esta pregunta de la mejor manera que pueda. [ASK AFTER EACH
SENTENCE IN THE QUESTION.]
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
INHINTRO Las siguientes preguntas son acerca de líquidos, aerosoles o esprays y gases que
las personas aspiran o inhalan para drogarse o para sentirse alegres.
No estamos interesados en ocasiones en que usted inhaló alguna sustancia
accidentalmente como en el caso de pintar, limpiar un horno o echarle gasolina al
automóvil. Las preguntas usan el término ‘inhalante' para incluir todas las cosas
mencionadas a continuación, así como cualquier otra sustancia que las personas
aspiran o inhalan para divertirse o para drogarse. Por favor mire con atención la
lista de sustancias a continuación, para saber a qué clases de líquidos, aerosoles o
esprays y gases se refieren las próximas preguntas.
Nitrato de amilo, ‘bombitas,' desodorante ambiental, o ‘rush'
Líquido de corrección o ‘liquid paper', desengrasador o líquido de limpieza
Gasolina o líquido para encendedores
Pegamento, crema o betún para limpiar zapatos, o tolueno
Halotano, éter u otros anestésicos
‘Tiner' u otros solventes para pintura
Gases para encendedores, tales como butano o propano
Óxido nitroso o ‘whippits'
Marcadores de punta fina, plumones o plumones mágicos
Pintura en aerosol
Limpiador para teclado de computadora, también llamado aire comprimido
removedor de polvo
Otros aerosoles o esprays
C-27
P42.
De acuerdo con esta introducción, ¿quieren saber ellos acerca de las veces que las
sustancias se inhalaron en forma accidental, a propósito o ambos?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
IN01c ¿Alguna vez ha inhalado gasolina o líquido para encendedores para divertirse o para
drogarse, aunque haya sido solo una vez?
1
Sí
2
No
DK/REF
P43.
Por favor, repita esta pregunta de la mejor manera que pueda. [IF NEEDED: ¿Puede
recordar a qué periodo de tiempo se estaba refiriendo la pregunta?]
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
METHINTRO
P44.
La metanfetamina, también conocida como "arranque" o "crank", "hielo",
"cristal", "crystal meth", "velocidad" o "speed", "vidrio" y muchos otros
nombres, es un estimulante que normalmente consiste en pedazos de cristales
o se presenta en forma de polvo. La metanfetamina se puede fumar, inhalar
por la nariz, tomar por vía oral o se puede inyectar.
¿Qué le están diciendo en esta introducción?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-28
INTROST
P45.
Las siguientes preguntas se refieren a cualquier uso de estimulantes que se
normalmente se venden con una receta médica. Algunas veces las personas
toman estos medicamentos para trastornos por déficit de la atención, para bajar de
peso o permanecer despiertas. Por favor no incluya estimulantes de "venta libre"
tales como Dexatrim, No-Doz, Hydroxycut o 5-Hour Energy.
¿Me puede decir en sus propias palabras lo que está diciendo esta introducción?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P46.
Esta introducción dijo que no se incluyan ciertos tipos de estimulantes. ¿Qué
estimulantes no se deberían incluir?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
INTROSV
Las siguientes preguntas se refieren a cualquier uso de sedantes o barbitúricos
que normalmente se venden con una receta médica. Estos medicamentos
también se llaman "downers" o "pastillas para dormir". Las personas toman estos
medicamentos para poder relajarse o para poder dormir. Por favor no incluya
sedantes de "venta libre" tales como Sominex, Unisom, Nytol o Benadryl.
P47. ¿Me puede decir en sus propias palabras qué le está diciendo esta introducción?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P48.
De acuerdo a esta introducción, ¿cuáles son algunas de las razones por las que las
personas toman estos medicamentos?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-29
PRINTROYR1 Anteriormente, usted reportó haber usado ciertos analgésicos que
normalmente se venden con una receta médica durante los últimos 12
meses. Ahora, por favor piense si usted usó alguno de estos analgésicos de
alguna manera que un doctor no le haya indicado.
Cuando responda estas preguntas, por favor, piense solamente en el uso del
medicamento de alguna manera que un doctor no le haya indicado,
incluyendo:
3. Usarlo sin tener su propia receta médica
4. Usarlo en mayor cantidad, con más frecuencia o durante más tiempo del
que le dijeron
5. Usarlo de alguna otra manera que un doctor no le haya indicado
P49.
Esta introducción le dio ejemplos de cómo usar medicamentos que normalmente se
venden con una receta médica de una manera que un doctor no le haya indicado.
¿Recuerda cuáles fueron esas maneras? [PROBE FOR ALL THREE RESPONSES]
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SV01
Por favor mire los nombres y las fotos de los sedantes que se muestran a
continuación. Por favor, tome en cuenta que la forma de algunos sedantes puede
ser diferente a la de las fotos, pero usted debe incluir los sedantes que haya
tomado aunque hayan tenido otra forma.
En los últimos 12 meses, ¿cuál de estos sedantes ha usado, si es que ha usado
alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora
entre cada número que haya registrado. Cuando haya terminado, presione la tecla
[ENTER].
5
6
7
8
Ambien
Ambien CR
Zolpidem (genérico)
Zolpidem de liberación prolongada (genérico)
95
No he usado ninguno de estos sedantes en los últimos 12 meses
DK/REF
C-30
P50.
¿Puede recordar a qué periodo de tiempo se estaba refiriendo esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
DEBRIEFING2:
Las siguientes preguntas le piden sus opiniones acerca de la voz que leyó las preguntas que acaba de
escuchar. Por favor, piense cuidadosamente acerca de esta voz a medida que responde estas
preguntas.
1.
¿Cómo calificaría la velocidad de la voz que leyó las preguntas de la entrevista? ¿Diría usted
que la velocidad de la voz era demasiada lenta, un poco lenta, tenía la velocidad adecuada, era
un poco rápida o demasiada rápida?
☐
☐
☐
☐
☐
2.
Cadencia es la manera en que una voz cambia al subir y bajar de tono suavemente al hablar.
¿Cómo calificaría la cadencia de la voz? ¿Diría que la cadencia de la voz fue excelente, muy
buena, buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
3.
DEMASIADA LENTA
UN POCO LENTA
VELOCIDAD ADECUADA (NI MUY RÁPIDA NI MUY LENTA)
UN POCO RÁPIDA
DEMASIADO RÁPIDA
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
¿Cómo calificaría la pronunciación de las preguntas que leyó la voz? ¿Diría que la
pronunciación fue excelente, buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
C-31
4.
¿Qué tan difícil era entender lo que decía la voz? ¿Diría que nada difícil, un poco difícil,
moderadamente difícil, muy difícil o sumamente difícil de entender?
☐
☐
☐
☐
☐
5.
¿Qué tan agradable era la voz? ¿Diría que nada agradable, un poco agradable, moderadamente
agradable, muy agradable o sumamente agradable?
☐
☐
☐
☐
☐
6.
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
Puede que esta voz se use en una entrevista de aproximadamente 30 minutos. ¿Qué tan a
gusto se sentiría usted escuchando esa voz por 30 minutos? ¿Diría que nada a gusto, un poco a
gusto, moderadamente a gusto, muy a gusto o sumamente a gusto?
☐
☐
☐
☐
☐
8.
NADA AGRADABLE
UN POCO AGRADABLE
MODERADAMENTE AGRADABLE
MUY AGRADABLE
SUMAMENTE AGRADABLE
¿Cómo calificaría la calidad de la voz en general? ¿Diría que la calidad de la voz era excelente,
buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
7.
NADA DIFÍCIL
UN POCO DIFÍCIL
MODERADAMENTE DIFÍCIL
MUY DIFÍCIL
SUMAMENTE DIFÍCIL
NADA A GUSTO
UN POCO A GUSTO
MODERADAMENTE A GUSTO
MUY A GUSTO
SUMAMENTE A GUSTO
Uste dijo [ANSWER FROM Q7]. Hábleme más sobre cómo decidió esa respuesta.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
C-32
9.
¿Hubo algo más acerca de la voz que le gustó o que no le gustó?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
_____________________________________________________________________
ACASI Voice 3
SD01
Las últimas preguntas fueron acerca de medicamentos que normalmente se
venden con una receta médica. La siguiente pregunta es acerca de medicamentos
para la tos o el resfrío que se venden sin receta médica, también conocidos
como medicamentos "de venta libre". ¿Alguna vez tomó un medicamento para la
tos o el resfrío que se vende sin una receta médica, solo para drogarse, aunque sea
solo una vez?
3
Sí
4
No
DK/REF
P51. En sus propias palabras, ¿qué le están pidiendo en esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CG06 ¿Cuánto tiempo hace desde la última vez que fumó un cigarrillo entero o parte de uno?
1
2
3
Hace más de 30 días pero dentro de los últimos 12 meses
Hace más de 12 meses pero dentro de los últimos 3 años
Hace más de 3 años
P52.
¿Me puede decir en sus propias palabras qué le estaba diciendo esa pregunta? [¿Y
cuáles fueron las opciones de respuestas que se proporcionaron?]
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-33
INTROBK Las siguientes preguntas se tratan de delitos contra la ley. Al leer cada pregunta, por
favor conteste si lo arrestaron y ficharon por ese delito en los últimos 12 meses.
SP03a En los últimos 12 meses, ¿lo arrestaron y ficharon por robar un vehículo?
1
2
Sí
No
[INTERVIEWER: REPEAT THE PROBE QUESTION FOR EACH SCREEN]
P53. En sus propias palabras, ¿qué le están diciendo en esta pregunta?
INTROBK: ____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SP03a: _______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
senrelat
1
2
3
4
5
6
En los últimos 12 meses, ¿cuántas veces fue a servicios religiosos? Por favor no
incluya en su respuesta ocasiones especiales tales como matrimonios, entierros u
otros eventos especiales.
Ninguna vez
1 a 2 veces
3 a 5 veces
6 a 24 veces
25 a 52 veces
Más de 52 veces
P54. ¿Me puede decir en sus propias palabras qué le están diciendo en esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P55.
¿Puede recordar qué tipo de ocasiones no deberían incluirse al responder esta
pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-34
YE09 ¿Has estado inscrito o matriculado en algún tipo de escuela en algún momento durante
los últimos 12 meses?
1
2
P56.
Sí
No
Por favor, repita esta pregunta de la mejor manera que pueda.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
YDS23
¿Alguna vez pasaste por un periodo de tiempo, el cual duró varios días o más,
cuando perdiste el interés y te sentiste aburrido de la mayoría de las cosas que
generalmente disfrutas hacer, como tu trabajo, tus pasatiempos y tus relaciones
con otras personas?
1
Sí
2
No
DK/REF
P57. En sus propias palabras, ¿qué le están diciendo en esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
P58. ¿Puede recordar a qué periodo de tiempo se estaba refiriendo esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-35
QD17 Las siguientes preguntas se tratan de la escuela. ¿Actualmente asiste a la escuela o está
inscrito o matriculado en la escuela? Por ‘escuela', nos referimos a la escuela primaria,
media (‘junior high' o ‘middle school'), preparatoria o ‘high school', o un ‘college' o
universidad. Por favor incluya también el programa de educación en el hogar llamado
‘home schooling'.
1
Sí
2
No
DK/REF
P59. En sus propias palabras, ¿qué le están diciendo en esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
TR01
Por favor mire los nombres y las fotos de los tranquilizantes que se muestran a
continuación. Por favor, tome en cuenta que la forma de algunos tranquilizantes
puede parecer diferente a la de las fotos, pero usted debe incluir los
tranquilizantes que haya usado aunque hayan tenido otra forma.
En los últimos 12 meses, ¿cuál de estos tranquilizantes ha usado, si es que ha
usado alguno?
Para seleccionar más de un medicamento en la lista, presione la barra espaciadora
entre cada número que haya registrado. Cuando haya terminado, presione la tecla
[ENTER].
4
5
6
Xanax
Xanax XR
Alprazolam (genérico)
4
Alprazolam de liberación prolongada (genérico)
95
No he usado ninguno de estos tranquilizantes en los últimos 12 meses
DK/REF
P60. ¿Me puede decir en sus propias palabras qué le están diciendo en esta pregunta?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-36
DEBRIEFING3:
Las siguientes preguntas le piden sus opiniones acerca de la voz que leyó las preguntas que acaba de
escuchar. Por favor, piense cuidadosamente acerca de esta voz a medida que responde estas
preguntas.
1. ¿Cómo calificaría la velocidad de la voz que leyó las preguntas de la entrevista? ¿Diría usted
que la velocidad de la voz era demasiada lenta, un poco lenta, tenía la velocidad adecuada, era
un poco rápida o demasiada rápida?
☐
☐
☐
☐
☐
DEMASIADA LENTA
UN POCO LENTA
VELOCIDAD ADECUADA (NI MUY RÁPIDA NI MUY LENTA)
UN POCO RÁPIDA
DEMASIADO RÁPIDA
2. Cadencia es la manera en que una voz cambia al subir y bajar de tono suavemente al hablar.
¿Cómo calificaría la cadencia de la voz? ¿Diría que la cadencia de la voz fue excelente, muy
buena, buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
3. ¿Cómo calificaría la pronunciación de las preguntas que leyó la voz? ¿Diría que la
pronunciación fue excelente, buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
4. ¿Qué tan difícil era entender lo que decía la voz? ¿Diría que nada difícil, un poco difícil,
moderadamente difícil, muy difícil o sumamente difícil de entender?
☐
☐
☐
☐
☐
NADA DIFÍCIL
UN POCO DIFÍCIL
MODERADAMENTE DIFÍCIL
MUY DIFÍCIL
SUMAMENTE DIFÍCIL
C-37
5. ¿Qué tan agradable era la voz? ¿Diría que nada agradable, un poco agradable, moderadamente
agradable, muy agradable o sumamente agradable?
☐
☐
☐
☐
☐
NADA AGRADABLE
UN POCO AGRADABLE
MODERADAMENTE AGRADABLE
MUY AGRADABLE
SUMAMENTE AGRADABLE
6. ¿Cómo calificaría la calidad de la voz en general? ¿Diría que la calidad de la voz era excelente,
buena, regular, mala o muy mala?
☐
☐
☐
☐
☐
EXCELENTE
BUENA
REGULAR
MALA
MUY MALA
7. Puede que esta voz se use en una entrevista de aproximadamente 30 minutos. ¿Qué tan a gusto
se sentiría usted escuchando esa voz por 30 minutos? ¿Diría que nada a gusto, un poco a gusto,
moderadamente a gusto, muy a gusto o sumamente a gusto?
☐
☐
☐
☐
☐
NADA A GUSTO
UN POCO A GUSTO
MODERADAMENTE A GUSTO
MUY A GUSTO
SUMAMENTE A GUSTO
8. Uste dijo [ANSWER FROM Q7]. Hábleme más sobre cómo decidió esa respuesta.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
9. ¿Hubo algo más acerca de la voz que le gustó o que no le gustó?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
C-38
FINAL DEBRIEFING (TO BE READ AFTER ALL THREE VOICES)
1. De las tres voces que escuchó, ¿qué voz prefirió mejor?
☐
☐
☐
☐
VOZ HUMANA (VOZ ___)
VOZ COMPUTARIZADA MÁS LENTA (VOZ ___)
VOZ COMPUTARIZADA MÁS RÁPIDA (VOZ ___)
NO TENGO PREFERENCIA
2. Hábleme más sobre por qué prefirió esa voz.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
C-39
C-40
Appendix D: Informed Consent Forms
(English and Spanish)
D-1
Text to Speech Testing
Adult Cognitive Interview Participant Informed Consent Form
National Survey on Drug Use and Health (NSDUH)
Introduction
I am going to explain this study to you. You can stop me at any time if you have questions about
anything I tell you.
The purpose of this study is to test some questions that will be used in the National Survey on
Drug Use and Health, or NSDUH. The NSDUH is a large survey given to about 70,000 people
across the country each year. It collects information on many health-related issues. The aim is to
better serve all people throughout the United States. Right now, we're interested in evaluating the
voice that will read some questions in the study. We want to see how well people understand
these questions and how they might go about answering them. RTI is carrying out this research
study for the Substance Abuse and Mental Health Services Administration, or SAMHSA, which
is part of the US Department of Health and Human Services. You are one of 36 participants at
least 12 years old (including about 24 adults) who will review the survey questions for this study.
Description of the Interview
Your participation in this interview will involve listening to survey questions being played using
different voices. The survey includes questions about the use of tobacco, alcohol, drugs such as
marijuana, and other health issues. However, I will not be asking you to answer these questions.
Instead, I will ask you follow up questions to determine whether the voices used to read the
questions were clear and easy for you to understand. For some questions, I may ask you to put
the questions in your own words. The interview will last approximately 60 minutes. Your
participation in this study will end after you finish the interview.
We also would like to audio record what you say during the interview. Only the people who
work on this study will hear the recording. It will help us make sure we have understood your
answers. If you don't want us to audio record you, that's okay.
Confidentiality/Your Rights
Taking part in the interview is completely voluntary. You can skip any interview questions you
do not wish to answer. Your personal information will not be connected to your answers in any
way. Federal law requires us to keep your answers confidential and to use these answers only for
statistical purposes (the Confidential Information Protection and Statistical Efficiency Act of
2002). With your agreement, we will audio record your interview. You can ask us to pause or
stop the recording at any time. Only RTI and SAMHSA research team members will be able to
listen to the recordings. The recordings will be destroyed within 60 days of the end of this study.
Comments from all interviews will be combined in a report that will not identify who made the
comments.
D-2
[Read only if observer is present: A member of the RTI research team or representative(s) of
SAMHSA is here with us today and would like to observe this interview from a separate
observation room. If you do not want anyone else to observe your interview, we will simply ask
this person (these people) to leave the observation room and then do the interview.]
Possible Risks and Benefits
You can ask me to stop the interview at any time. If you want to take a break at any time during
the interview, please tell me. It is possible some of the survey questions may make you feel
uncomfortable or upset. If this happens, I can tell you how to contact a counselor.
There are no direct benefits to you from participating in this interview. However the answers you
give will help us to improve the quality of questions for the NSDUH.
Payment for Participation
You will be given $40 in cash for completing the interview.
Your Questions
If you have any other questions about the study, you can call Ms. Emily Geisen at 1-800-3348571 ext. 26566. If you have any questions about your rights as a study participant, you can call
RTI's Office of Research Protection at 1-866-214-2043 (a toll-free number).
I will sign my name here to indicate that I have explained this information to you and that you
have agreed to be interviewed.
___________________________
Signature of Interviewer
_________________________
Date
Read only if observer is present: I also will sign my name here to indicate that you have given
your consent for a member of the RTI research team or representative of SAMHSA to observe
the interview. [INTERVIEWER, PLEASE WRITE "NA" ON THE SIGNATURE LINE IF THE
INTERVIEW IS NOT BEING OBSERVED.]
___________________________
Signature of Interviewer
_________________________
Date
Finally, I will sign my name here to indicate that you have agreed for the interview to be audio
recorded.
___________________________
Signature of Interviewer
_________________________
Date
D-3
Parental Permission and Informed Consent
The National Survey on Drug Use and Health is a large survey given to about 70,000
people across the country every year. RTI International conducts the National Survey on Drug
Use and Health. It collects information on many health-related issues. We ask about a lot of
health issues, so that we can better help everyone in the United States. Right now we're
interested in testing a new computerized voice that will read some questions in the study. Before
we do this, we want to see how well people understand these questions and how they might go
about answering them. We are under contract with the Substance Abuse and Mental Health
Services Administration to carry out this survey. You or your child responded to an
advertisement that we placed for research subjects. At present, we are seeking the help of young
people like your child to see how our new questions work.
Your child is one of six adolescent respondents in Washington, DC, and Research
Triangle Park, NC, who are participating in this study. Taking part in the interview is strictly
voluntary. Your child can skip any portion of the interview he/she does not wish to be involved
with. There is no penalty if he/she chooses to skip any part of the interview. The interview will
be conducted in private to ensure nobody else overhears his/her answers. All answers will be
kept private and confidential. We will not share the information given to us with any person
outside the project staff, and your child's name will never be connected to the answers he/she
provides. Federal law requires us to keep your child's answers confidential and to use his/her
answers only for statistical purposes (the Confidential Information Protection and Statistical
Efficiency Act of 2002). The only exception to this promise of confidentiality is if your child
tells me that he/she intends to seriously harm him/herself or someone else or if he/she has been
abused or if your child identifies a person who has given him/her drugs; in this situation I may
need to notify a mental health professional or other authorities.
The interview will take about one hour. During the interview, your child will listen to
survey questions being played using different voices. The survey includes questions about the
use of tobacco, alcohol, drugs such as marijuana, and other health issues. However, we will not
be asking your child to answer these questions. Instead, we will ask follow up items about the
survey questions to determine whether the voice used to read the questions was clear and easy to
understand. For example, we may ask your child to repeat the question in his or her own words.
He/She will receive $40 in cash in appreciation for the interview.
We would like to audio record the interactions between your child and the interviewer.
The recording will be heard only by members of the research team to help us make sure we have
all the information from your child about how these questions work. To protect his/her privacy,
the recording will remain on the laptop computer, which will be protected by a password. The
recording will be destroyed soon after the study ends. However, having the interactions recorded
is voluntary and you can decline for your child.
If you have any questions about this study, you can contact Emily Geisen at RTI at 1800-334-8571 X. 26566. If you have any questions about your rights as a parent or legal
guardian or your child's rights as a study participant, you can call RTI's Office of Research
Protection at 1-866-214-2043 (a toll-free number).
D-4
Do we have your permission for [CHILD'S NAME] to participate?
As Parent/Guardian, I give my permission for my child to participate in this interview.
____Yes
____No
As Parent/Guardian, I give my permission for my child's interview to be audio recorded:
____Yes
____No
Signature of Interviewer:______________________________
Date:__________________
D-5
Participant Informed Assent (ADOLESCENT)
Introduction
I am going to explain this study to you. You can stop me at any time if you have questions about
anything I tell you.
The purpose of this study is to test some questions that will be used in the National Survey on
Drug Use and Health, or NSDUH. The NSDUH is a large survey given to about 70,000 people
across the country each year. It collects information on many health-related issues, to better help
everyone in the United States. We're interested in evaluating the voice that will read some
questions in the study. We want to see how well people understand these questions. We also
want to know how people go about answering the questions. RTI is doing this study for the
Substance Abuse and Mental Health Services Administration, or SAMHSA. You are one of six
participants between the ages of 12 to 17 who will help us test these questions.
Description of the Interview
Your participation in this interview will involve listening to survey questions being played using
different voices. The survey includes questions about the use of tobacco, alcohol, drugs such as
marijuana, and other health issues. However, I will not be asking you to answer these questions.
Instead, I will ask you follow up questions to determine whether the voices used to read the
questions were clear and easy for you to understand. For some questions, I may ask you to put
the questions in your own words. The interview will last approximately 60 minutes. Your
participation in this study will end after you finish the interview.
We also would like to audio record what you say during the interview. Only the people who
work on this study will hear the recording. It will help us make sure we have understood your
answers. If you don't want us to audio record you, that's okay.
Confidentiality/Your Rights
You don't have to answer a question if you don't want to. If you want to take a break at any time,
just tell me. Your name will be kept private. No one else will see your answers to these
questions. Your parents will not find out about your answers to questions. The only exceptions to
this promise of confidentiality are if you tell me that you intend to seriously harm yourself or
someone else or if you have been abused or if you identify an adult who has given you drugs; in
these situations I may need to notify a mental health professional or other authorities.
Possible Risks and Benefits
Some of the the questions we ask may make you feel uncomfortable or upset. If this happens, let
me know right away, and we can either take a break or I can give you information about talking
with a counselor.
We are required by law to keep your answers private. The law also requires the study to use your
answers only to learn how the questions work. The name of this law is the Confidential
Information Protection and Statistical Efficiency Act of 2002.
D-6
There are no direct benefits to you from doing this interview. Your involvement in this study will
help us improve the questions for the NSDUH.
When we finish, I will give you $40 in cash to thank you for taking time to talk to me.
If you or your parent/guardian have any other questions about the study, you can call Ms. Emily
Geisen at 1-800-334-8571 ext. 26566. If you or your parent/guardian have any questions about
your rights as a participant in this study, you can call RTI's Office of Research Protection at 1866-214-2043.
I will sign my name here to indicate that I have explained this information to you and that you
have agreed to be interviewed. You will be given a copy of this form.
___________________________
Signature of Interviewer
_________________________
Date
I will sign my name here to indicate that you have agreed for the interview to be audio recorded.
___________________________
Signature of Interviewer
_________________________
Date
D-7
Participant Assent to Be Observed (ADOLESCENT)
[Another person who works on the study/A person or people who work(s) with the sponsor of
this study] also is here with us today. This person (These people) would like to watch your
interview in a separate observation room. We have already talked with your parent or guardian
about this, and they have said it is okay to have this person (these people) watch the interview.
What you say will still be kept private. It's okay if you don't want this person (these people) to
watch your interview. We will simply ask that person(them) to leave the observation room.
Is it OK for this person (them) to watch your interview?
CHECK ONE OF THE BOXES BELOW. SIGN AND DATE FORM
____Other study team member or sponsor representative may observe the interview.
____Other study team member or sponsor representative may not observe the interview.
___________________________
Signature of Interviewer
_______________________
Date
D-8
Prueba sobre la conversión de texto a voz
Formulario de consentimiento informado del participante adulto
para la entrevista cognitiva
Encuesta Nacional Sobre la Salud y el Consumo de Drogas (NSDUH, por sus siglas
en inglés)
Introducción
Le voy a explicar el estudio. Usted me puede detener en cualquier momento si tiene preguntas
sobre cualquier cosa que le diga.
El objetivo de este estudio es realizar la prueba de algunas preguntas que se usarán en la
Encuesta Nacional Sobre la Salud y el Consumo de Drogas (NSDUH), la cual es una encuesta
grande que se realiza con aproximadamente 70,000 personas en todo el país. La encuesta
recopila información sobre muchos temas relacionados con la salud. El objetivo es servir mejor a
las personas en los Estados Unidos. En este momento, nos interesa evaluar la voz que se utilizará
para leer algunas preguntas en el estudio. Deseamos saber qué tan bien entienden las personas
estas preguntas y cómo las contestarían. RTI esta realizando un estudio para la Administración
de Salud Mental y Abuso de Sustancias (SAMHSA, por sus siglas en inglés), que forma parte del
Departamento de Salud y Servicios Humanos de los Estados Unidos. Usted es uno de 12
participantes de por lo menos 18 años de edad que van a revisar las preguntas de la encuesta para
este estudio.
Descripción de la entrevista
Su participación en esta entrevista se tratará de escuchar las preguntas de la encuesta usando
varias voces. La encuesta incluye preguntas sobre el uso de tabaco, alcohol, drogas como
marihuana y otros temas de salud. Sin embargo, no se le pedirá que responda a estas preguntas.
Por el contrario, yo le haré preguntas de seguimiento para determinar si las voces que se usaron
para leer las preguntas fueron claras y fáciles de entender para usted. Para algunas preguntas,
quizás le pida que me diga la pregunta en sus propias palabras. La entrevista tomará
aproximadamente 60 minutos. Su participación en este estudio terminará al finalizar la
entrevista. No haremos preguntas sobre su situación legal o de inmigración.
También nos gustaría grabar en audio lo que usted diga durante la entrevista. Solo las personas
que trabajan en este estudio escucharán la grabación. Esto nos ayudará asegurar que entendimos
sus respuestas. Está bien si usted no desea que se haga la grabación.
Confidencialidad y sus derechos
Tomar parte en esta entrevista es completamente voluntario. Usted puede dejar de contestar
cualquier pregunta de la entrevista que no desee contestar. Su información personal no se
asociará con sus respuestas de ninguna manera. La ley federal requiere que mantengamos sus
respuestas en forma confidencial y que las usemos solo para propósitos estadísticos (Ley de
Protección de la Información Confidencial y Eficiencia Estadística del año 2002). Con su
permiso, grabaremos su entrevista. Nos puede pedir hacer una pausa o detener la grabación en
cualquier momento. Solo los miembros del personal del estudio de RTI y SAMHSA podrán
D-9
escuchar las grabaciones. Las grabaciones se destruirán dentro de los siguientes 60 días de haber
terminado este estudio. Los comentarios de todas las entrevistas se combinarán en un reporte que
no identificará quién hizo los comentarios.
[Leer solo si un observador está presente: Un miembro del personal del estudio de RTI o un(os)
representante(s) de SAMHSA está(n) aquí con nosotros y le gustaría observar la entrevista desde
otro salón de observación. Si usted no desea que nadie más observe su entrevista, simplemente le
pediremos a esta persona o personas que salga(n) del salón de observación y luego haremos la
entrevista.
Posibles riesgos y beneficios
Usted me puede pedir que detenga la entrevista en cualquier momento. Si desea tomar un
descanso en cualquier momento, solo tiene que avisarme. Es posible que algunas de las
preguntas de la encuesta le puedan hacer sentirse incómodo(a) o le molesten. Si esto sucede, le
puedo decir cómo comunicarse con un consejero(a).
No hay beneficios directos para usted por participar en esta entrevista. Sin embargo, las
respuestas que usted nos dé nos ayudarán a mejorar la calidad de las preguntas de la encuesta
NSDUH.
Pago por participación
Usted recibirá $40 dólares en efectivo por completar la entrevista.
Sus preguntas
Si tiene cualquier otra pregunta sobre el estudio, puede llamar a la Sra. Rosanna Quiroz al 1-919541-7172. Si tiene preguntas sobre sus derechos como participante en un estudio, puede llamar a
la Oficina de RTI para la Protección de Participantes en Estudios al 1-866-214-2043 (número de
teléfono gratuito).
Voy a firmar mi nombre aquí para indicar que le expliqué esta información y que usted estuvo de
acuerdo en ser entrevistado(a).
___________________________
Firma del entrevistador
_________________________
Fecha
Leer solo si un observador está presente: También firmaré aquí para indicar que usted ha dado
su consentimiento para que un miembro del personal de RTI o un representante de SAMHSA
observe la entrevista. [ENTREVISTADOR, POR FAVOR ESCRIBA "NA" EN LA LÍNEA DE
LA FIRMA SI LA ENTREVISTA NO SERÁ OBSERVADA.]
___________________________
Firma del entrevistador
_________________________
Fecha
D-10
Por último, yo voy a firmar mi nombre aquí para indicar que usted está de acuerdo en que la
entrevista sea grabada en audio.
___________________________
Firma del entrevistador
_________________________
Fecha
D-11
D-12
Appendix E: Text to Speech Pilot Test
Detailed Timing Tables
E-1
Table E.1
Text to Speech Audit Trail Timing Data: Interview Overall, All Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
43
0
12-17
19
0
18-64
23
0
65+
1
0
75.10
652.55
25.55
74.20
400.64
20.02
76.41
907.45
30.12
61.80
.
.
130.25
90.42
66.48
52.72
41.80
.
88.45
113.87
84.75
72.70
57.93
45.18
.
68.68
130.25
111.57
63.73
51.40
41.80
.
88.45
61.80
61.80
61.80
61.80
61.80
61.80
0.00
130.25
122.43
114.08
46.43
45.18
41.80
113.87
113.87
107.92
45.70
45.18
45.18
130.25
126.38
122.43
46.43
43.93
41.80
61.80
61.80
61.80
61.80
61.80
61.80
130.25
126.38
122.43
117.03
114.08
46.43
45.70
45.18
43.93
41.80
113.87
107.92
103.38
90.42
84.75
57.93
55.67
50.65
45.70
45.18
130.25
126.38
122.43
117.03
114.08
51.22
51.07
46.43
43.93
41.80
.
.
.
.
61.80
.
.
.
.
61.80
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-2
Table E.2
Text to Speech Audit Trail Timing Data: ACASI, All Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
43
0
12-17
19
0
18-64
23
0
65+
1
0
56.28
562.68
23.72
53.48
310.77
17.63
59.07
799.26
28.27
45.02
.
.
107.75
73.35
49.45
37.07
21.87
.
85.88
83.63
65.05
53.05
39.67
26.45
.
57.18
107.75
92.85
46.95
35.15
21.87
.
85.88
45.02
45.02
45.02
45.02
45.02
45.02
0.00
107.75
102.05
92.87
31.53
29.15
21.87
83.63
83.63
81.13
29.15
26.45
26.45
107.75
106.43
102.05
31.53
30.40
21.87
45.02
45.02
45.02
45.02
45.02
45.02
107.75
106.43
102.05
98.52
92.87
31.53
30.40
29.15
26.45
21.87
83.63
81.13
80.23
73.35
65.05
39.67
33.37
32.18
29.15
26.45
107.75
106.43
102.05
98.52
92.87
33.85
32.63
31.53
30.40
21.87
.
.
.
.
45.02
.
.
.
.
45.02
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-3
Table E.3
Text to Speech Audit Trail Timing Data: ACASI Tutorial, All Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
43
0
12-17
19
0
18-64
23
0
65+
1
0
4.11
4.29
2.07
3.95
4.04
2.01
4.38
4.35
2.08
1.02
.
.
10.32
5.58
3.67
2.48
1.02
2.62
9.30
10.32
5.20
3.88
2.48
1.45
.
8.87
7.87
6.30
3.67
2.62
1.17
2.62
6.70
1.02
1.02
1.02
1.02
1.02
1.02
0.00
10.32
7.37
6.55
1.88
1.45
1.02
10.32
10.32
5.70
1.83
1.45
1.45
7.87
7.37
7.17
1.97
1.88
1.17
1.02
1.02
1.02
1.02
1.02
1.02
10.32
7.87
7.37
7.17
6.55
1.88
1.83
1.45
1.17
1.02
10.32
5.70
5.58
5.22
5.20
2.48
2.12
1.98
1.83
1.45
7.87
7.37
7.17
6.55
6.45
2.25
2.10
1.97
1.88
1.17
.
.
.
.
1.02
.
.
.
.
1.02
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-4
Table E.4
Text to Speech Audit Trail Timing Data: ACASI Risk Availability, All Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
43
0
12-17
19
0
18-64
23
0
65+
1
0
3.99
4.96
2.23
3.50
2.63
1.62
4.42
6.89
2.62
3.40
.
.
9.78
4.78
3.47
2.45
1.33
3.40
8.45
8.37
4.60
3.47
2.27
1.65
.
6.72
9.78
4.83
3.80
2.72
1.33
.
8.45
3.40
3.40
3.40
3.40
3.40
3.40
0.00
9.78
9.47
8.37
1.88
1.65
1.33
8.37
8.37
5.40
1.77
1.65
1.65
9.78
9.62
9.47
1.88
1.43
1.33
3.40
3.40
3.40
3.40
3.40
3.40
9.78
9.62
9.47
8.87
8.37
1.88
1.77
1.65
1.43
1.33
8.37
5.40
5.15
4.62
4.60
2.27
2.23
1.98
1.77
1.65
9.78
9.62
9.47
8.87
5.65
2.33
1.97
1.88
1.43
1.33
.
.
.
.
3.40
.
.
.
.
3.40
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-5
Table E.5
Text to Speech Audit Trail Timing Date: Interview Overall, English-Speaking
Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
22
0
12-17
12
0
18-64
9
0
65+
1
0
61.40
286.59
16.93
69.63
348.50
18.67
50.38
34.86
5.90
61.80
.
.
107.92
70.77
54.86
50.65
41.80
.
66.12
107.92
82.07
68.62
53.16
45.18
.
62.73
61.82
51.67
51.22
46.43
41.80
.
20.02
61.80
61.80
61.80
61.80
61.80
61.80
0.00
107.92
84.75
82.57
45.18
43.93
41.80
107.92
107.92
84.75
45.70
45.18
45.18
61.82
61.82
61.82
41.80
41.80
41.80
61.80
61.80
61.80
61.80
61.80
61.80
107.92
84.75
82.57
81.58
78.43
46.43
45.70
45.18
43.93
41.80
107.92
84.75
82.57
81.58
78.43
65.82
55.67
50.65
45.70
45.18
61.82
54.05
51.67
51.40
51.22
51.22
51.07
46.43
43.93
41.80
.
.
.
.
61.80
.
.
.
.
61.80
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-6
Table E.6
Text to Speech Audit Trail Timing Data: ACASI, English-Speaking Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
22
0
12-17
12
0
18-64
9
0
65+
1
0
43.27
218.58
14.78
49.17
287.53
16.96
35.21
52.80
7.27
45.02
.
.
83.63
52.57
40.65
32.18
21.87
.
61.77
83.63
58.90
51.01
32.77
26.45
.
57.18
46.95
40.12
35.15
31.53
21.87
.
25.08
45.02
45.02
45.02
45.02
45.02
45.02
0.00
83.63
65.05
60.82
29.15
26.45
21.87
83.63
83.63
65.05
29.15
26.45
26.45
46.95
46.95
46.95
21.87
21.87
21.87
45.02
45.02
45.02
45.02
45.02
45.02
83.63
65.05
60.82
56.98
55.53
31.53
30.40
29.15
26.45
21.87
83.63
65.05
60.82
56.98
55.53
44.83
33.37
32.18
29.15
26.45
46.95
41.18
40.12
37.07
35.15
35.15
32.63
31.53
30.40
21.87
.
.
.
.
45.02
.
.
.
.
45.02
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-7
Table E.7
Text to Speech Audit Trail Timing Data: ACASI Tutorial, English-Speaking
Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
22
0
12-17
12
0
18-64
9
0
65+
1
0
2.92
1.71
1.31
3.37
2.12
1.45
2.53
0.64
0.80
1.02
.
.
5.58
3.67
2.67
1.97
1.02
.
4.57
5.58
4.69
3.17
2.05
1.45
.
4.13
3.67
2.93
2.62
1.97
1.17
.
2.50
1.02
1.02
1.02
1.02
1.02
1.02
0.00
5.58
5.22
5.20
1.45
1.17
1.02
5.58
5.58
5.22
1.83
1.45
1.45
3.67
3.67
3.67
1.17
1.17
1.17
1.02
1.02
1.02
1.02
1.02
1.02
5.58
5.22
5.20
4.18
4.08
1.88
1.83
1.45
1.17
1.02
5.58
5.22
5.20
4.18
4.08
2.48
2.12
1.98
1.83
1.45
3.67
3.52
2.93
2.73
2.62
2.62
2.25
1.97
1.88
1.17
.
.
.
.
1.02
.
.
.
.
1.02
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-8
Table E.8
Text to Speech Audit Trail Timing Data: ACASI Risk Availability, English-Speaking
Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
22
0
12-17
12
0
18-64
9
0
65+
1
0
3.14
2.46
1.57
3.38
3.60
1.90
2.80
1.28
1.13
3.40
.
.
8.37
3.57
2.83
1.98
1.33
.
7.03
8.37
3.57
2.99
2.11
1.65
.
6.72
4.83
3.43
2.75
1.97
1.33
.
3.50
3.40
3.40
3.40
3.40
3.40
3.40
0.00
8.37
5.40
4.83
1.65
1.43
1.33
8.37
8.37
5.40
1.77
1.65
1.65
4.83
4.83
4.83
1.33
1.33
1.33
3.40
3.40
3.40
3.40
3.40
3.40
8.37
5.40
4.83
3.80
3.58
1.97
1.77
1.65
1.43
1.33
8.37
5.40
3.58
3.57
3.53
2.45
2.23
1.98
1.77
1.65
4.83
3.80
3.43
2.92
2.75
2.75
2.72
1.97
1.43
1.33
.
.
.
.
3.40
.
.
.
.
3.40
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-9
Table E.9
Text to Speech Audit Trail Timing Date: Interview Overall, Spanish-Speaking
Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
21
0
12-17
7
0
18-64
14
0
65+
0
.
89.45
646.68
25.43
82.05
449.29
21.20
93.15
743.31
27.26
.
.
.
130.25
113.87
89.67
63.85
52.72
.
77.53
113.87
103.38
74.95
61.10
57.93
.
55.93
130.25
117.03
92.73
63.85
52.72
.
77.53
.
.
.
.
.
.
.
130.25
126.38
122.43
58.77
57.93
52.72
113.87
113.87
113.87
57.93
57.93
57.93
130.25
130.25
126.38
58.77
52.72
52.72
.
.
.
.
.
.
130.25
126.38
122.43
117.03
114.08
63.73
61.10
58.77
57.93
52.72
113.87
103.38
90.42
74.95
72.70
90.42
74.95
72.70
61.10
57.93
130.25
126.38
122.43
117.03
114.08
76.63
63.85
63.73
58.77
52.72
.
.
.
.
.
.
.
.
.
.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-10
Table E.10
Text to Speech Audit Trail Timing Data: ACASI, Spanish-Speaking Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
21
0
12-17
7
0
18-64
14
0
65+
0
.
69.90
571.14
23.90
60.88
304.17
17.44
74.41
672.53
25.93
.
.
.
107.75
92.85
66.98
48.28
33.85
.
73.90
81.13
80.23
56.68
42.02
39.67
.
41.47
107.75
98.52
73.77
48.28
33.85
.
73.90
.
.
.
.
.
.
.
107.75
106.43
102.05
42.02
39.67
33.85
81.13
81.13
81.13
39.67
39.67
39.67
107.75
107.75
106.43
44.68
33.85
33.85
.
.
.
.
.
.
107.75
106.43
102.05
98.52
92.87
44.93
44.68
42.02
39.67
33.85
81.13
80.23
73.35
56.68
53.05
73.35
56.68
53.05
42.02
39.67
107.75
106.43
102.05
98.52
92.87
56.15
48.28
44.93
44.68
33.85
.
.
.
.
.
.
.
.
.
.
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-11
Table E.11
Text to Speech Audit Trail Timing Data: ACASI Tutorial, Spanish-Speaking
Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
21
0
12-17
7
0
18-64
14
0
65+
0
.
5.36
4.00
2.00
4.94
6.44
2.54
5.57
3.04
1.74
.
.
.
10.32
6.45
5.53
3.88
2.10
6.00
8.22
10.32
5.70
4.25
3.27
2.85
.
7.47
7.87
6.55
6.00
5.23
2.10
6.00
5.77
.
.
.
.
.
.
.
10.32
7.87
7.37
2.85
2.62
2.10
10.32
10.32
10.32
2.85
2.85
2.85
7.87
7.87
7.37
2.62
2.10
2.10
.
.
.
.
.
.
10.32
7.87
7.37
7.17
6.55
3.33
3.27
2.85
2.62
2.10
10.32
5.70
4.32
4.25
3.88
4.32
4.25
3.88
3.27
2.85
7.87
7.37
7.17
6.55
6.45
5.52
5.23
3.33
2.62
2.10
.
.
.
.
.
.
.
.
.
.
ACASI = audio computer-assisted self-interview.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-12
Table E.12
Text to Speech Audit Trail Timing Data: ACASI Risk Availability, Spanish-Speaking
Respondents
Age Group
Sample Used in Analysis
Extreme Records*
Summary Statistics (Minutes)1
Mean
Variance
Standard Deviation
Quartiles
Maximum
Q3
Median
Q1
Minimum
Mode
Range
Percentiles
99%
95%
90%
10%
5%
1%
Extremes
5 Highest
(Highest)
5 Lowest
(Lowest)
Overall
21
0
12-17
7
0
18-64
14
0
65+
0
.
4.88
6.19
2.49
3.71
1.21
1.10
5.47
7.86
2.80
.
.
.
9.78
5.15
4.60
3.25
1.88
.
7.90
5.15
4.62
3.47
2.62
2.27
.
2.88
9.78
8.87
4.77
3.40
1.88
.
7.90
.
.
.
.
.
.
.
9.78
9.62
9.47
2.33
2.27
1.88
5.15
5.15
5.15
2.27
2.27
2.27
9.78
9.78
9.62
2.33
1.88
1.88
.
.
.
.
.
.
9.78
9.62
9.47
8.87
5.65
2.83
2.62
2.33
2.27
1.88
5.15
4.62
4.60
3.47
3.25
4.60
3.47
3.25
2.62
2.27
9.78
9.62
9.47
8.87
5.65
3.83
3.40
2.83
2.33
1.88
.
.
.
.
.
.
.
.
.
.
ACASI = audio computer-assisted self-interviewing.
* Extreme records have an interview length, without field interviewer debriefing, of shorter than 30 minutes or
longer than 240 minutes.
E-13
E-14
Appendix F: Text to Speech FI Debriefing
Moderator's Guide
F-1
NSDUH Text-to-Speech Pilot Test Field Interviewer Debriefing Call
Moderator's Guide – FINAL
SECTION I: Introduction (5 minutes)
Hello and thank you for attending today's debriefing call to discuss your experiences during the
Text-to-Speech Pilot Test.
My name is [MODERATOR'S NAME] from RTI. Also on the call today from RTI are [NOTE
TAKER'S NAME], as well as [OTHER RTI OBSERVERS]. I will be leading today's discussion
with help from [NOTE TAKER'S NAME], who will be taking notes.
[IF SAMHSA STAFF ON CALL] In addition, on the call with us today from our client, SAMHSA,
are [STAFF NAMES].
Before we get started, I want to remind everyone to have your TTS FI Feedback Worksheet in
front of you as we talk, so you can reference your notes.
This discussion is intended to gather feedback on your experiences completing data collection
for the TTS Pilot Test. As you know, a new computer-generated ACASI voice was tested during
this effort, but we cannot gather all of the information we need just by analyzing survey data.
Therefore, we are hoping you can share your experiences, including feedback you received
from respondents, and any issues you encountered that could be improved in the future.
A summary of your feedback from today's discussion will be provided to SAMHSA to help inform
potential changes in the future.
A couple of notes about our discussion today:
We are recording this call and have a note taker so we can capture all of your comments.
Please be respectful of everyone on this call, so only one person should speak at a time.
Doing so allows the whole group to hear each person and ensures the recording will be
clear.
Also, if you have not done so already, move to a location with minimal background noise.
If I haven't heard from you, I may call on you. If I do call on you, but you'd rather not answer
a particular question or if you don't have anything to add, you can just tell me that you would
like to "pass."
Since we are on the phone, each time you speak, I would like you to begin your comments
by saying your name, such as, "This is [MODERATOR'S NAME], and I think…"
Please know there is no right or wrong answer to the questions I will be asking. Everyone's
input is important and helpful.
Also, for the bilingual FIs on this call, when providing feedback, please clarify if any issues
you encountered were experienced with only Spanish-speaking respondents, only Englishspeaking respondents, or both.
Any general questions before we get started?
F-2
SECTION I: Screenings and Using the Tablet (10 minutes)
NOTE: BILINGUAL FIs SHOULD ALSO INCLUDE RESPONSES SPECIFIC TO THEIR
ADMINISTRATION OF SPANISH SCREENINGS.
For this first section of the call, we are going to discuss the tablet video you showed to
respondents.
1.
How often did you use the tablet video with respondents and what were their general
reactions to it?
What do you think about the content of the tablet video? What changes would you make to
the video to improve it?
2.
Did you have any difficulty accessing or playing the tablet video? How was the volume level
of the video?
3.
Based on your experience using the tablet video during this pilot test, do you think the
video would be effective for use with respondents during regular main study data
collection?
4.
What other feedback do you have about the tablet video that we have not already
discussed?
For this next set of questions, I will be asking about your experience with other aspects of
the tablet and screening program both in the field and at home.
5.
What problems did you experience, if any, with the tablet case or stylus when using the
tablet at the door with respondents?
6.
Did you have any issues transmitting from the tablet at your home? If so, what were they?
7.
How often did you connect your tablet to a wireless Internet connection outside of your
home to transmit? [FOR THOSE WHO DID: Where did you connect to wireless Internet?
Were there any issues with transmitting from this location outside your home?]
8.
What features or capabilities of the tablet did you have difficulty with? If any, please
describe in detail.
9.
Please describe any issues you experienced while using the screening program.
10. Did you ever call Technical Support for assistance with the tablet at any point during data
collection? [FOR ANY WHO INDICATE CALLING TECHNICAL SUPPORT, ASK: What
happened that required you to call TSG and how was the issue resolved?]
F-3
SECTION II: TTS Questionnaire and ACASI Voice (15 minutes)
NOTE: BILINGUAL FIs SHOULD INCLUDE RESPONSES SPECIFIC TO THEIR
ADMINISTRATION OF SPANISH INTERVIEWS.
Now I am going to ask a series of questions about the Text-to-Speech software and the
interview questionnaire.
1. Did respondents comment on whether the ACASI voice was easy or difficult to understand?
If difficult, what specific questions or aspects of the survey were difficult to understand?
2. Did respondents comment on whether or not they liked the voice? If so, what did they like or
dislike?
3. Did respondents comment on the speed of the voice? If so, did they think it was too fast, too
slow, or just right?
4. Did respondents comment specifically on the fact that the voice was computerized
(negative, positive, neutral)?
5. Did any respondents exhibit nonverbal feedback during the ACASI portion, such as showing
signs of being confused or frustrated, having difficulty hearing and turning the volume up, or
removing the headphones or turning the volume off? If so, did respondents exhibit these
actions more or less frequently on the TTS Pilot Test compared to the Main Study?
6. Did respondents make any other comments about the ACASI voice? If so, what particular
comments did they make?
FOR BILINGUAL FIs ONLY:
7. We are interested in detecting any issues in the translation of the Spanish questionnaire.
Did respondents indicate they were confused or unsure about any Spanish text in the
questionnaire? [PROBE: Please provide examples of questions or wording that caused
confusion.]
8. Do you personally have any feedback on questions in the Spanish interview where the
Spanish translation may be problematic? [PROBE: What part of the translation seems to be
problematic? Can you tell me more about that?]
9. Are there any other comments that you would like to make about the Spanish
questionnaire?
F-4
SECTION III: Administering the TTS Interview and Using the Laptop (10 minutes)
NOTE: BILINGUAL FIs SHOULD INCLUDE RESPONSES SPECIFIC TO THEIR
ADMINISTRATION OF SPANISH INTERVIEWS.
In this section, we are going to discuss the new laptop, including how respondents reacted to it.
1. What are your reactions to the function key label for the laptop keyboard? Did you have any
issues with the label?
2. How did respondents react to the function key label for the laptop keyboard? Were there any
issues finding or using the function keys?
3. Did you ever call Technical Support for assistance with the laptop at any point during data
collection? [FOR ANY WHO INDICATE REQUESTING TECHNICAL SUPPORT, ASK: Can
you tell me why you called?]
4. Did respondents raise any other specific concerns when completing the ACASI portion or
the questions you administered? [PROBE: Please provide examples of any concerns that
you can recall.]
SECTION lV: Conclusion (5 minutes)
Are there any final comments on any of the topics we discussed, or other feedback you would
like to provide at this time about your experience with this pilot test?
I want to thank you all again for your participation on this call.
NOTE TAKER WILL NOW STOP THE AUDIO RECORDING.
PROVIDE INSTRUCTIONS FOR CHARGING TIME FOR THIS CALL; GIVE CODE AND
AMOUNT OF TIME TO CHARGE.
PROVIDE REMINDERS ON DESTROYING ALL TTS PT MATERIALS, PROCEDURES FOR
RETURN OF EQUIPMENT (IF NOT ALREADY DONE SO), ETC.
F-5
| File Type | application/pdf |
| Author | gmchenry |
| File Modified | 2017-01-11 |
| File Created | 2017-01-11 |