2003 NSDUH Field Interviewer Manual

7. PREPARING TO INTERVIEW

7.1 Introduction

With every scientific survey, there are many necessary components that contribute to the overall success of the research. This is especially true for an enormous survey such as the NSDUH. As a professional field interviewer for this study, you are responsible for one of the most important aspects of the study: making sure the interview is administered properly according to acceptable survey procedures. This chapter discusses the steps required to prepare for an interview and offers suggestions for dealing with some respondent situations you may encounter. Instructions about the NSDUH interview are provided in Chapter 8, while instructions for administering the CAI questionnaire and using the CAI Manager are outlined in Chapter 5 of the FI Computer Manual.

7.2 Your Role as a Professional Field Interviewer

Always keep in mind that you are a professional doing a very important job. As a professional, you are expected to possess a great deal of knowledge about the survey you are conducting—its purpose, the type of sample, the interview process, etc. You must be knowledgeable about what you are doing and why it is being done, and you must be prepared to answer any questions a respondent might have.

As a professional FI, you must always maintain the highest of ethical standards, collecting data with complete objectivity and treating with the utmost confidentiality and respect all information gathered or observed during an interview. You must convey to every respondent that you are a professional Field Interviewer, that you are completing the interview in a completely confidential manner, and that you are not affected by any personal biases, opinions or prejudices.

Following the questionnaire administration procedures and ethical standards is absolutely critical. Any FI found to have violated these procedures may be terminated immediately. We are asking you to maintain high response rates AND to follow all procedures exactly. We know that sometimes those two goals might not be easy to achieve together—you may even lose a case if a respondent refuses to complete the interview "by the rules." The important point is to make every effort to obtain all interviews according to specified procedures.

7.3 Case Assignment

All respondents to be interviewed are identified in the screening process using the Newton handheld computer. When you screen a household, the Newton instructs you to conduct one, two or no interviews at that household. You may also have other cases transferred to you for completion that were screened by a different field interviewer. Your FS will keep you informed of such situations.

At the Respondent Selection screen, the Newton lists the respondent selected, the roster number, the Mode (NSDUH Interview), and demographic information from the roster. The Newton also automatically assigns a QuestID that is displayed on the screen below the mode.

Whenever possible, proceed with the interview immediately after you finish the screening. The best way to achieve high response rates and be efficient is to always try to complete the interview when you are already at the SDU and have identified the respondent(s) to be interviewed. If one or both respondents are present and willing to participate, begin the interview(s). Remember that if two respondents in the same household are selected to complete interviews, never complete both interviews simultaneously. Try to schedule these back–to–back instead.

If you cannot conduct an interview at the time of screening, try to schedule an appointment—within 2 or 3 days—while you are at the DU. Record the appointment information for the appropriate respondent, either under Interview A or Interview B, in the Record of Calls on the Newton on the Interview Call Record screen.

If the respondent offers you his/her phone number to set an appointment, accept the number, recording it in the Newton ROC for the case. However, do NOT specifically ask for a phone number as this may raise concerns about confidentiality. A respondent freely offering a telephone number is acceptable, but an FI requesting a number is not.

Offering your telephone number to a respondent may be convenient, but is something for you to carefully consider. If you wish, you may give out a personal cell phone number—understanding that RTI, Headway, and SAMHSA do not accept any liability which might result from you doing so, and any charges for air time or phone use are not reimbursable. You are strongly advised to not give out your home telephone number or e–mail address for personal safety reasons.

For selected respondents that are not available, consider this example: you complete a screening and one person is selected but is not at home. Once you finish the screening and enter the ROC information for the 31, add an event for the interview's Record of Calls—52 (R unavailable) in this example—for the A case. The Newton automatically enters the date and time of the event. Complete this step at the SDU after screening.

The first interview contact you enter in the Record of Calls is the interview result for that respondent from the screening visit.

You are responsible for assigning interview result codes, recording them in the Newton Record of Calls, and discussing them with your FS throughout the data collection period. Like screening codes, interview result codes are either "pending" or "final." Assigning the proper code is critical because result codes are used in progress reports to evaluate the status of fieldwork. RTI managers then use these reports to make important decisions about how best to manage the project. It is very important that you understand when and why to use each kind of code.

If you have a final screening code of 31 (one selected for interview) or 32 (two selected for interview), assigning interview result codes follows the same process as assigning screening result codes (see Chapter 6). Always remember to enter the appropriate pending or final interview code for every screening that results in a code 31 or 32. The following summarizes how to enter interview result codes:

One Selected for Interview (Screening Code 31)

• The Newton prompts you to remember to enter a call record for interview A and takes you to the Record of Calls screen.
• Tap Add to go to the Interview Call Record screen, tap Result Code, then choose the appropriate result code from the list, entering comments as needed.

Two Selected for Interview (Screening Code 32)

• The Newton prompts you to enter call records for interviews A and B and takes you to the Record of Calls screen.
• Go to the Interview Call Record screen, choose interview A or B, and choose the appropriate result code.
• If you forget who was selected for interview A or B or need to enter data at a later date or time:

  –	From the Record of Calls screen, tap the Sels button on your Newton. This will take you to the Respondent Selection screen where roster information for interviews A and B is displayed. This should give you enough information to identify and add a call record for the correct respondent.
  OR
  –	From the Select Case screen, tap the case you need to view, then tap Actions, View Selections/Roster. This will take you to the Respondent Selection screen, as just described.

In the event that there are two household members with exactly the same demographic information and one is chosen for an interview, you need to know which one to contact. Since we ask that the roster be completed from oldest to youngest, use the members' birthdays to determine which one is oldest. Then, assume that the oldest of the two was listed first. As an example, consider an apartment with 4 residents, the last two (roster numbers 3 and 4) are both 21 and have the exact same demographics. If roster number 3 is chosen for an interview, ask for the older of the two. If roster number 4 is selected, ask to speak with the younger. If the screening respondent cannot identify which is older, you may choose one of the two at random. This unusual situation is the ONLY case where you can choose a respondent at random. Be sure to explain the circumstances in the ROC Notes.

Once you identify your respondent, you cannot switch to another household member. If you have any questions about determining which respondent to interview, talk with your FS.

Both pending and final interview result codes are described in this section.

PENDING INTERVIEW CODES

Pending codes are assigned when the case is not yet complete. Explanations of when to use a particular code, and what action to take to resolve the situation so that the case can be completed, are as follows:

Result Code	Result Code Description	Use This Code When...	Follow Up Actions to Take
50	APPOINTMENT FOR INTERVIEW	You have spoken with the interview respondent and have set a time to conduct the interview	Note the appointment in the Newton ROC and in your personal calendar. Complete an appointment card to leave at the household.
51	NO ONE AT DU	No one is at the DU.	Plan another call, making sure to visit at a different time of day or another day of the week. Try contacting the unit on the same day of the week or same time of day when the screening was completed. Ask a neighbor when would be a good time to catch someone at home. Record any information in the ROC.
52	RESPONDENT UNAVAILABLE, CALL BACK	Someone is at the SDU but not the selected interview respondent.	Try to determine a good time to find the respondent at home. Ask the household member, and record any information in the Comments in the ROC about possible times to contact the respondent. Plan another visit at a different time of day or another day of the week.
53	BREAKOFF (PARTIAL INTERVIEW)	You have started the interview and the respondent you are interviewing either refuses to allow you to complete the interviewing process or cannot complete the interview at that time.	If the breakoff is friendly, schedule a time convenient for the respondent to complete the interview. Record the information about the appointment in the ROC. If the breakoff is not friendly, tactfully try to persuade the respondent to continue. For helpful ideas see Chapter 5 about overcoming refusals and obtaining participation. Section 7.5 discusses how to respond to questions about the interview. DO NOT antagonize the respondent. Leave the door open for you or someone else to attempt to convert the refusal and complete the case. This decision is made by your FS. Make notes in the ROC comments while the incident is still fresh in your mind. Recording what happened helps you and your FS decide how to handle the case and also helps any other FI who may be assigned to complete the case.
54	PHYSICALLY/ MENTALLY INCOMPETENT	The respondent is unable to meaningfully answer the questions. Examples are respondents with pronounced mental retardation, autism, or who are intoxicated. Also, physical problems due to serious illness, deafness, or severe speech disorders may qualify.	Try to determine if the incompetence is temporary (as in illness or intoxication). If so, return at a more convenient time. If the incompetence is not temporary, discuss the situation with your FS. Always attempt the interview unless it is absolutely clear that the respondent cannot be interviewed. Describe the situation fully in the ROC.
55	LANGUAGE BARRIER – SPANISH	The respondent speaks Spanish and does not speak English well enough to complete the interview.	Talk with your FS about transferring the case to a bilingual FI. Unlike screening, there can be NO translators for an interview.
56	LANGUAGE BARRIER – OTHER	The screening respondent speaks a language other than English or Spanish, and does not speak English well enough to complete the interview.	Talk with your FS. Unlike screening, there can be NO translators used for the interview.
57	REFUSAL	The respondent refuses to let you start the interviewing process. This code is for adult respondents and for youth respondents who refuse to complete the interview. If a parent refuses to give permission for a youth to be interviewed, use code 58 Parental Refusal, whether or not the youth is willing to be interviewed. If a parent or other household member refuses to allow you to interview another selected adult (such as a spouse or an adult child living at home) use this code and mark "Gatekeeper" as the reason on the Newton Refusal Report. Be sure to specify who the gatekeeper is in the Refusal Report comments.	Tactfully try to persuade the respondent to participate. See Chapter 5 for information about overcoming refusals and obtaining participation. Section 7.5 also discusses answering questions about the interviewing part of the survey. DO NOT antagonize the respondent. Leave the door open for you or someone else to attempt to convert the refusal and complete the case. Your FS makes this decision. Make notes in the Newton Refusal Report while the incident is still fresh in your mind. Recording what happened helps you and your FS decide how to handle the case and also helps any other FI assigned to complete the case.
58	PARENTAL REFUSAL FOR 12–17 YEAR OLD	The parent refuses to allow you to interview the selected youth.	Tactfully try to persuade the parent to let you talk with the youth. Section 7.5.1 discusses dealing with parental concerns. DO NOT antagonize the parent. Make any necessary notes in the Newton Refusal Report and discuss this with your FS. A special refusal letter may be sent to the parent.
59	OTHER	The situation you encounter does not fit into any of the above categories.	Describe the situation in the ROC Comments section, and discuss with your FS how to handle the case.

Final interview result codes indicate the case is finished—either because the interview was successfully completed OR because you were unable to obtain an interview. For noninterviews, be sure you have completed all suggested, relevant steps described in the pending codes section before asking your FS for approval to assign a final code. Consult with your FS for any additional strategies. If all of these attempts fail, your FS must agree that the case is complete and must approve your use of a final noninterview code.

The following list describes the final codes:

Result Code	Result Code Description	Use This Code in This Situation
70	INTERVIEW COMPLETED	The respondent has completed the interview. This is the BEST result code and is the desired result for all selected interviews.
71	NO ONE AT HOME AFTER REPEATED VISITS	Given the importance of each and every interview, we expect diligence in pursuing selected household members. However, if your repeated attempts at different times of the day and days of the week fail and your FS agrees, then use this code.
72	RESPONDENT UNAVAILABLE	We hope that with persistence this code will be used rarely. However, there may be situations in which the respondent is out of the country or institutionalized (hospital, etc.,) and will not be returning before the end of the data collection quarter. For respondents who move and cannot be contacted at the new address, use code 79, not 72.
73	BREAKOFF – PARTIAL INTERVIEW	You have started the interview and the respondent you are interviewing either refuses to allow you to complete the interviewing process or cannot complete the interview at that time.
74	PHYSICALLY / MENTALLY INCOMPETENT	If the respondent is physically or mentally unable to respond meaningfully to the interview questions, your FS will approve the use of this code.
75	LANGUAGE BARRIER – SPANISH	Use this code if the case cannot be completed because of a Spanish language barrier and no bilingual interviewer was available to complete the case. Your FS must give approval.
76	LANGUAGE BARRIER – OTHER	Use this code for any interviews that cannot be completed due to a language barrier other than Spanish. We do not certify interviewers to conduct the interview in other languages. Be sure to specify the language in the ROC comments. Your FS must give approval.
77	FINAL REFUSAL	If all attempts to convert an adult, youth, or gatekeeper refusal are unsuccessful, your FS will approve the use of this code. Be sure you indicate the reason for the refusal in the Newton Refusal Report. For gatekeeper situations with a parental refusal for a youth, use code 78.
78	PARENTAL REFUSAL FOR 12–17 YEAR–OLD	If all attempts to persuade the parent or guardian to allow you to interview the youth are unsuccessful, your FS will approve the use of this code. Be sure to complete the Newton Refusal Report.
79	OTHER	Use this code only for cases that do not fit any of the other categories such as if the selected respondent is found to be under age 12 or in the military. Also use this code for respondents who move and cannot be contacted at the new address. Be sure to fully describe the situation in the Comments section of the ROC and talk with your FS for approval to assign this code. Carefully consider if another result code applies, since each case with a code 79 must be reviewed by RTI staff.

7.4 Contacting the Selected Respondent(s)

Chapter 4 discussed the process for contacting a sample dwelling unit for screening. The techniques for contacting interview respondents are similar, except that selected interview respondents usually are familiar with the reason for your visit and you are asking them for a longer time commitment. Other strategies and tools for contacting selected respondents are outlined here. Review the list of CAI interviewing materials in Chapter 12 before leaving your home and make sure you have all necessary paperwork and equipment. Before you leave, check that the Newton date and time are correct—transmit to RTI if needed, to correct the settings. (Transmission is covered in Chapter 6 of the FI Computer Manual.)

As mentioned before, you should always attempt to complete the interview at the time of screening. If necessary, ask the screening respondent to locate the selected respondent for you.

If you must revisit the SDU to contact the selected interview respondent, go to the Newton Record of Calls screen to view all the previous visit information. To see who the selected person is for the SDU you are contacting, tap Sels (for selections) to review the roster information for your selected household member. This screen also gives you the Questionnaire ID (QuestID) to enter into your Gateway computer before the actual interview begins (see Chapter 5 of the FI Computer Manual).

If you also want to see the completed roster for the household, simply tap View HH Roster. Use this information to identify the screening respondent and other household members. You can also view the respondent selection(s) and household roster information from the Select Case screen. Tap the line for the case you need to review. Tap Actions, then tap View Selections/Roster.

Approach the selected respondent using an introduction similar to the one used for screening. Keep it simple and straightforward. It may help to mention which member of the household was the screening respondent, since this person may have discussed the situation with the selected person. If you need to review who the screening respondent was, the household roster displays which of the roster members was the SR.

One disadvantage of not completing an interview right away is that the selected individual may move from the SDU. If the respondent no longer lives there, try to obtain the new address/location.

• If the move is local, try to contact the respondent at the new address.
• Following a respondent would be inappropriate, of course, if the respondent is now in the hospital or in jail. Determine the expected length of stay to see if an interview may be possible before the end of the quarter, and talk with your FS.
• If the respondent has moved to a group home, find out the type of situation and talk with your FS about whether or not additional contact is appropriate.
• If the move is not local, determine the distance and discuss the case with your FS. Depending on how far, you may be asked to attempt the interview, or the case may be transferred to another interviewer located closer to the new address.

No matter what the situation, keep in mind that respondent eligibility is based on the information received at the time of screening. If you later return to complete an interview and discover a respondent has, for example, been jailed, he/she is not disqualified even though he/she is institutionalized when you revisit. Ineligible respondents that move do not need to be followed as their status has already been determined.

7.5 Obtaining Interview Participation

Convincing persons who are selected for the interview to participate in the study is an important part of your job as an FI. The selected respondent may not have been the screening respondent and may be unfamiliar with the study. Persons who were the SR are aware of the importance of the study, but keep in mind that respondents who willingly completed a 5–minute screening may need additional convincing to complete a more lengthy interview.

Be sure you are thoroughly familiar with the background information on the study (see Chapter 1) and are comfortable answering questions about it (see Chapter 5). Specific questions relating to the interview and suggested responses are given in Exhibit 7.1. Be comfortable with these topics as well. Remember that the specially designed refusal conversion letters in Appendix C are available to help convert reluctant respondents. See Section 5.6 for more information about refusal letters.

I don't use drugs. How can I help you?	We are interested in the practices, beliefs, and activities of all people who live in this country, including those who do not use illicit drugs. Also, the questions ask about the use of tobacco products such as cigarettes, prescription medications, and alcohol. Even if you do not currently use any of these items, it is important for us to learn that information too.
Are the questions personal?	Some questions may seem a little personal to some people. All answers are confidential; no one else—not even those in your own household—will know what you said. You don't have to answer any question that you don't want to answer.
What type of questions will you ask?	The questions are about health issues, including past and current use of various substances and medications. Some questions ask about types of behaviors so we can learn whether certain behaviors indicate patterns of abuse. You may decide not to answer a certain question.
Will my family get to see my answers?	No. You will be interviewed privately. When we are finished, the case will be locked and no one can go back into it—not even me. Then it will be transmitted straight to RTI that night. Remember, we pledge to keep your responses completely confidential.

Often, someone is apprehensive about participating in a "survey." In some instances, their cooperation in the past has resulted in subjection to disguised sales promotions. Using the words "study," "research," or "interview" can be helpful. Assure the respondent that you are not selling anything. Show the respondent the NSDUH Highlights and Preliminary Results to explain how the data are used.

In many cases, you will find that the computerized nature of the study will be a positive factor in convincing many respondents to participate. If your interview respondent was also the screening respondent, he/she already observed you conducting the selection process with the Newton handheld computer. This alone may create interest in completing the interview on the Gateway. Young people in particular are often interested in and familiar with the technology. The privacy afforded by completing more sensitive questions using the computer has been shown to be particularly important in getting honest answers from youth respondents.

For individuals who seem intimidated by the technology, such as some elderly respondents, try to begin the interview by suggesting that they try the initial questions to see how easy it will be to complete the interview. Field staff report that some respondents who were initially hesitant became more confident as the interview progressed and were practically sold on computers by the end! Assure a potential respondent of how simple it will be to complete the interview and that you will be present to help with any problems that might arise.

Sometimes you may encounter a reluctant respondent whom you suspect is making an appointment for the interview at a later date with no intention of keeping the appointment (an "unstated refusal"). If you believe this may be the case, suggest that the respondent just try a few questions now to see how it goes. Once into the interview, most respondents will complete it.

Your flexibility and willingness to suit the respondent's needs will go a long way in convincing reluctant persons to participate. However, for your personal safety, never offer to drive a respondent somewhere in your car. Also, you cannot offer to exchange a service for respondents if they will participate. Offering to finish washing the car during the ACASI portion, or cutting hair or mowing the lawn or anything similar are all unacceptable bribes to obtain participation and are completely against project protocol. There is only one exception: if a respondent has small children, you may offer to entertain the children while the respondent completes the interview.

You will pay a cash incentive to respondents who complete the entire interview. The possibility of $30 in cash for completing an interview for about an hour may increase your chances of swaying those reluctant persons to participate.

As an interviewer, you encounter many types of persons. Included in this section are descriptions of some of these respondent types and helpful suggestions from experienced and successful field staff.

Busy Respondents/No Time — This is the most common reason given for not wanting to participate. Many people do lead busy lifestyles and have little free time. Even people that aren't busy claim to be because it is almost fashionable!

• Acknowledge their limited and valuable spare time, but let them know how valuable they are to an extremely important study. "We need to speak with busy, active people just like you. Our study will lack balance if we only interview people who have lots of free time."
• Assure them that you will work around THEIR schedule. "I can return in an hour or tomorrow. Which is better for you?" Giving the respondent a choice allows you to maintain control of the outcome.
• Offer to get started and see how it goes. "I know your time is very limited. We can start now and finish on another day, if necessary."
• Engage them in a conversation to educate them about the NSDUH and their significant role in it. Appeal to their pride. They are important to the study and cannot be replaced. "We need you and your help."
• As a last resort, offer to meet them somewhere convenient that will provide privacy. "May I meet you someplace after work?" Do not offer to drive them in your car. While you may suggest a neutral location such as a public library, do not suggest meeting at their place of employment. A respondent may offer to meet you at a work location. A respondent offering is acceptable, but an interviewer suggesting this may be viewed as intrusive or an invasion of privacy.

Suspicious or Frightened Respondents — These persons suspect that you are at their home to sell them something, preach to them, or to take advantage of them. Particularly with elderly persons, they may be afraid of your presence and may avoid you by speaking through a closed door or not opening the door at all. Counter their concerns by establishing your legitimacy.

• Allow plenty of "personal space." Take two steps back when the door is opened. Speak with a smile and a reassuring tone of voice. Empathize with them. "I understand your concerns completely. I always tell my mother to be very careful with strangers, too! However......"
• Be sure to show your photo ID badge. Introduce yourself and try to get the respondent to allow you to explain why you are there and what you are doing.
• Show the Lead Letter, Letter of Authorization with your name in it, and the Study Description.
• Provide a copy of the Q&A Brochure and any other conversion materials that seem appropriate. People usually like to have something in their hands when speaking with a stranger.
• Offer to let the respondent telephone your FS or the 800# printed on the inside cover of your Showcard Booklet to verify your employment while you wait outside.
• Be persistent, if no one answers the door, trying back at different times and on different days. Ask your FS about sending an Unable to Contact letter.

Apathetic Respondents — If you hear "I'm not interested" or "I don't care about this," chances are you have an apathetic respondent who may announce their disinterest before you even speak. Your challenge is to convince them that the NSDUH is something they should care about.

• Recognize and appreciate their form of reluctance. "I can understand why you might be hesitant until you know more about our study, let me explain...." Use your NSDUH information materials including the brochure and newspaper articles. You want to spark or capture their interest. Begin a conversation in which you educate and draw the individual out. Building rapport helps!
• Their input matters. "Your answers are very important to the quality of the study results. The results are used to make policy decisions on education and drug abuse prevention programs."
• Apologize. Maybe they didn't receive a lead letter or the SR didn't mention it to the selected respondent. "I'm sorry! You must not have seen the letter telling you I would be stopping by. Let me give you a copy and tell you about it."
• Find out specifically why they don't care or don't want to participate. "It would be helpful for me if you would share your reasons for not wanting to participate in this important research." OR "It's important to me and my supervisor that your questions and concerns are addressed. Can you describe them to me?"
• Try to move through the objection. Begin with the easy questions which just require "yes," such as checking the address and, "Are you a resident of this household?" Launch into the introduction. Sometimes "I'm not interested," is offered to see if you will take the bait and go away. Try to stand your ground.

"Doesn't Apply to Me" Respondents — Selected respondents may feel the study does not apply to them if they don't use drugs, or they may feel they have nothing to contribute.

• Explain that we need all types of respondents to get an accurate picture of the entire population. "You are extremely important to this study, as you represent over 3,000 people just like you."
• Assure them that their answers are very important. "Without answers from people like you, this study wouldn't be accurate. If we only spoke with drug–users, it would look like the entire population used drugs, and that is not true."
• Appeal to their curiosity. "Many participants find the study questions to be very interesting."

Government/Confidentiality Issues — Many people desire privacy and want to protect their personal information from telemarketers and scam artists. Some think the government already knows too much and that government surveys are a waste of taxpayer dollars.

• Avoid discussions of government spending and politics!
• Use your support materials as you explain the purpose of the study and how the data are used. Find some common ground to interest the respondent.
• Reassure them that all answers are strictly confidential. "By law, the information you provide will remain completely private and confidential."
• Persons concerned about what happens to the information may need to understand the process. "I won't even see your answers because you will enter them in the computer yourself. After the interview is complete, the file is closed and I cannot reopen it."
• Explain how all the answers are combined into statistical reports and it is not possible to tell who provided the information or where they lived. Show them the Highlights from a previous survey. "NO ONE will know how you answered the questions. The data are reported only in statistical form." The Summary of Findings book with preliminary results is also useful to show what the data reports actually look like.
• If they are curious, try "You can read all the questions, but refuse to answer any that you are uncomfortable with." OR "Wouldn't you like to know what questions are asked? We can start now and you can skip any that you would rather not answer."
• Even people who prefer privacy or dislike the government have strongly held views. "This is your chance to have input and contribute to the formation of public policy." Do not state that this is their chance to "tell the government what they think." Very few of the questions ask for opinions.
• Regarding the waste of taxpayer dollars spent on surveys, you can offer the following response: "The funds have been allocated and Congress has mandated that this research takes place. If you participate you have the opportunity to represent thousands like yourself . These people will not be represented if you do not help."

Language and Cultural Issues — Communicating with selected respondents who are not citizens or are from different backgrounds may be a problem. There may be language barriers, cultural differences (perhaps females are uncomfortable speaking with strangers), or non–citizens may fear you are from the immigration department.

• If their language is Spanish and you are not bilingual, tell your FS a bilingual FI is needed.
• Honor any requests to return to speak to someone else, such as a husband or a father. Do not pressure a reluctant spouse.
• Show appropriate credentials, including your ID badge, letters, and the Q&A Brochure.
• Stress the confidential nature of the study.

In addition to surveying adults, the NSDUH surveys young people ages 12–17. Completing an interview with a minor requires the consent of both the youth and his/her parent or guardian. The only exception to this rule is in the case of emancipated minors living on their own, including college students not living at home. In these cases only, you may conduct an interview without an adult's permission.

Sometimes when screening, you may encounter respondents who are reluctant to provide information about young people in the household. Be sure to emphasize that the screening questions are important and ask to list the residents age 12 and older living in the household. Point out that a youth residing in the unit may or may not be selected to participate in the interview portion of the study.

If a young person is selected for an interview, the parents/guardians may be hesitant to give consent for a "stranger" to ask the young person questions. Allow the parent to review the informational materials, including the Authorization Letter. Since this is a computer interview we do not have a paper questionnaire, but you can offer to show the parent the summary of the NSDUH questionnaire (see Exhibit 7.2) included with the Job Aids in the Showcard Booklet. If desired, you have copies of this summary to give to respondents to keep as well. Also, suggest looking at the NSDUH Website (http://nsduhweb.rti.org) for more information. If necessary, the parent may call your FS or RS for additional confirmation of your status as a professional Field Interviewer for RTI.

Examples of some responses you may provide to parents include:

• "This provides an opportunity for you to discuss this subject with your child."
• "There are other topics included besides drugs. Knowing the opinions and experiences of your child is important as well."
• "'No' answers are just as important as 'yes' answers to get an accurate picture of today's youth."
• "Participating in a study like this provides an opportunity to learn about the research process."
• "This gives your child an opportunity to do something for their community."
• "It is apparent that you have taught your child to make wise choices. Through your child's involvement, the efforts of parents like you who have taken the time and effort to provide your child with guidelines for living will not go unnoticed."

Although it may seem like a difficult process to obtain consent from both the parent and the youth and to find a time to complete the interview, the vast majority of adolescents complete the NSDUH survey. Being able to offer a cash incentive payment for participation will help persuade reluctant youth. You may also offer a Certificate of Participation. Guidelines for the use of the certificate are covered in the next section.

2003 National Survey on Drug Use and Health

Summary of Questionnaire

You have asked to know more about the National Survey on Drug Use and Health and the types of questions the interviewer will ask. Below is a summary of each section of the questionnaire for you to examine. Keep in mind that not everyone will see every question–the questions depend on the participant's own experiences. Furthermore, participants can always refuse to answer any questions during the interview.

Demographics

This section, administered by the interviewer, consists of questions about the participant such as his/her date of birth, race, educational background, and health status.

Sample Questions:

	What is the highest grade or year of school you have completed?
	Would you say your health in general is excellent, very good, good, fair, or poor?

Computer Practice Session

In this section, the interviewer shows the participant how to use the laptop computer and lets him/her practice using a short practice session.

Cigarettes, Alcohol and Illicit Drugs

For most of the rest of the interview, the participant answers questions by listening to the questions over the headphones and/or reading the questions on the computer screen, and then entering responses using the computer's keyboard. The participant answers these questions in private, although the interviewer is available to help with the questions or the computer. During this part of the interview, only the participant can hear and see the questions and see his/her responses.

Tobacco Products and Alcohol

These sections include questions about whether and how often participants have used cigarettes, chewing tobacco, snuff, cigars, pipe tobacco, and alcoholic beverages such as beer, wine, or liquor.

Sample Questions:

	Have you ever smoked part or all of a cigarette?
	How old were you the first time you used chewing tobacco?
	What is your best estimate of the number of days you drank alcohol during the past 30 days?

Illicit Drugs

The next sections ask about the participant's use or non–use of marijuana, heroin, cocaine, hallucinogens, and inhalants; and prescription pain killers, tranquilizers, stimulants, and sedatives when taken only for their effect. Questions about drug dependence and drug treatment are also included in these sections.

Sample Questions:

	Have you ever, even once, used marijuana or hashish?
	How much do people risk harming themselves physically and in other ways when they use cocaine once a month?

Adult Social Environment and Mental Health

Participants 18 and older receive questions about their social experiences such as: availability of illicit drugs; perceptions of their neighborhood; their relationship with their spouse or partner; and in some cases, their experiences as a parent. Mental health questions cover such topics as depression, social anxieties, and treatment for mental health problems.

Sample Questions:

	How many times during the past 12 months have you and your spouse or partner spent an hour or more together doing an activity that you both enjoyed?
	During the past 12 months, was there any time when you needed mental health treatment or counseling for yourself but didn't get it?
	People differ a lot in how much they worry. In general, would you say you worry more than, about the same as, or less than most other people worry about everyday problems?

Youth Experiences and Mental Health

Youth aged 12–17 participating in the survey are also asked questions about their social experiences such as: perceptions about the risks of using certain drugs; whether getting drugs is difficult or easy; feelings about school and peers; and involvement in clubs, sports, and other extracurricular activities. The mental health questions assess youth participants' use of services aimed at treating mental health problems.

Sample Questions:

	During the past 12 months, in how many different kinds of school–based activities, such as team sports, cheerleading, choir, band, student government, or clubs, have you participated?
	During the past 12 months, have you stayed overnight or longer in any type of hospital to receive treatment or counseling for emotional or behavioral problems not caused by alcohol or drugs?

Health Care and Demographic Information

In this section, the laptop is handed back to the interviewer, who asks questions about education, health insurance, and family income information to help in analyzing the data. If necessary, a knowledgeable adult in the household may be asked to help participants answer some of these questions.

The answers to these questions increase the government's knowledge about health care, especially as it may relate to drug use or treatment. This information helps in planning health care services and finding ways to lower the costs of care.

Sample Questions:

	How many hours did you work last week at all jobs or businesses?
	In 2002, did you have money in any kind of savings or other bank account that earned interest?
	Are you currently covered by private health insurance?

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

Thank you for your cooperation and help!

Dealing with 12–17 year–olds can present some special challenges. When attempting to gain the cooperation of a youth, keep in mind the following tips:

• Try not to nag.
• Respect the youth by listening carefully and responding to any concerns.
• Emphasize how important each teen is—that he or she represents about 1,000 other youth and cannot be replaced.
• Offer choices with Either/Or responses, instead of yes/no responses. For example, "We can either do this now or I can meet you tomorrow after school."
• Stress the confidentiality of all responses, mentioning that no teacher or parent will see the answers.
• Be flexible and schedule the interview around the teen's busy schedule.
• Don't get in the middle of a power struggle between the youth and the parent. Likewise, don't involve another party such as a guidance counselor or teacher.
• Mention the computer used for the study.

Additional suggestions for converting youth refusals are included in Exhibit 7.3.

At the completion of an interview, you can give a Certificate of Participation (see Exhibit 7.4) to any respondent. Students can use the certificate to confirm participation in the NSDUH. Explain that some students have been able to receive credit for participation, but that the student must initiate the request, and the teacher/school administration may or may not allow the student to receive credit of any sort. No advance arrangements have been made with any school in the nation.

It is very important that the respondents and, if a youth, their parents understand that it is the student's responsibility to arrange to receive any possible school or community service credit. Be very careful not to mislead the respondents into thinking that they will definitely receive some direct benefit from their participation.

The certificate is worded to allow for use with respondents other than middle or high school students. In certain circumstances, such as a young adult required to perform community service or for classes beyond the high school level, you may also distribute a Certificate of Participation.

When the interview is finished, complete the certificate following these steps:

• To ensure confidentiality, fill in only the date the interview was completed, your name, and your FI ID #. Do not write the respondent's name on the form.
• Give the form to the student and tell him/her to sign it before showing it to a teacher. Be sure to also give a copy of the NSDUH Q&A Brochure. Also, tell the student that if he/she has access to the Internet, there is a Website with more information about the survey. The address, http://nsduhweb.rti.org, is on the back of the brochure.

Reason for Refusal	Response
Too busy/No time	Be flexible in setting up an interview. With school and extracurricular activities, teens can be very busy so you must be flexible and adjust to their schedules. Remember that a parent should be present in the house (though not the same room) unless explicit permission is granted to conduct the interview without the parent being present. Drop by before the youth goes out. On the weekends and during the summer, teens generally sleep late and then go out for the day. It helps to visit the house just after they get up but before they are ready to "hit the road."
Lack of interest / Nothing in it for me	Mention the cash incentive. Teens in particular enjoy having extra cash in their pockets. Explaining that they will receive cash at the conclusion of the interview will often persuade them to find time for the interview. Make them feel important. One of the most important methods for obtaining teen participation is to give them a sense of their own importance. Many have never been singled out and this will give them an opportunity to feel special. Let them know they are irreplaceable. Suggest that it could count toward school or community service credit. Some teens can get school credit or community service credit for participating in the study by bringing the lead letter and brochure to their teachers and explaining what it was like to participate. Teens have even written papers about their experience of participating in our study! Encourage the teen to explore this. Give a Certificate of Participation (see Section 7.5.3). Send mail. This age group generally likes to receive mail, so make use of the refusal letters. We have developed special letters addressed to many of the concerns teens express. Ask your FS. Mention school prevention programs. Almost all youth today have been through a school program and remember the class projects involved. Remind the teen of what was learned and ask him/her to be part of the solution or provide input.
Concerns about confidentiality	Provide a private setting. Some teens are concerned about privacy. They don't want their parents to know about things they have done. You need to be sensitive to this and conduct the interview in a private setting, reassuring the youth that his/her parents will never see the answers.
Teen–parent power struggles	Sometimes parents worry about their children growing up and try to control that process. Permission to participate in the survey is something parents may feel they can control. You must first convince the parents (before dealing with the teen) that it is to their child's benefit to participate. If the parent is won over, he/she may then insist the teen participate. Other times the power struggle is in reverse—the parent wants the teen to participate so the teen refuses, knowing it will irritate the adult. In this situation, it helps to get the teen alone and discuss the interview away from the parent. This will help the teen consider participating in a context other than the conflict with the parent(s).

7.6 Informed Consent Procedures

Even after a respondent has initially agreed to the interview, you must follow the informed consent procedures. The respondents' Right to Informed Consent is a critical part of any legitimate survey. This means each person must receive all the information necessary to make a completely informed and knowledgeable decision about participating. Even if someone immediately agrees to be interviewed, you are still required to follow the informed consent procedures and read the Intro to CAI script before you begin the interview.

A potential respondent must be informed of:

• the purposes of the study
• the procedures that will be followed
• the approximate length of the interview
• the fact that consent may be withdrawn and participation discontinued at any time (i.e., that participation is voluntary)
• sources from which additional information about the study can be obtained. Examples include the Q&A Brochure, Study Description, and the NSDUH Respondent Website.

This information must be made available to each respondent. As explained in the next sections, the complexity and amount of information presented for informed consent varies depending on whether your respondent is an adult or youth.

The information you present to a selected adult respondent (age 18 and older) during the informed consent process is found in the front of the CAI Showcard Booklet (see Exhibit 7.5). For adult respondents, you must read the Introduction and Informed Consent for Interview Respondents Age 18+, which explains what is required during the interview. Some respondents may ask if they can just read the document, instead of you reading it to them. There are two problems with allowing respondents to read: first, most respondents would just skim the document to save time, and second, poor readers would not be able to and may not admit it. Because this information is so important, our procedures require that you read the text to each respondent. Also, give the respondent a copy of the Study Description to keep. Be sure the respondent appears to understand the contents before you continue.

Because we will be interviewing minors aged 12–17, we must first obtain parental permission to interview the youth. Before approaching the youth, first introduce yourself and the study to the youth's parent or guardian, then read the information in the box at the top of the Introduction and Informed Consent for Interview Respondents Age 12–17 in the Showcard Booklet (see Exhibit 7.6).

You may encounter parents who cannot communicate well enough in English to understand as you read the script.

• If the parent speaks Spanish, use the Spanish translation of the Introduction and Informed Consent script in the Showcard Booklet. The parent may read the document (if you are not an RTI–Certified bilingual FI who could read it to them). If the parent does not read well, the youth or another translator may read the document to the parent.
• If the language is other than Spanish, the youth or another translator may use the script and translate the information for the parent to understand.

Use the youth or translator to answer any questions the parent may have. In these situations, do your best to be sure the parent understands what you are requesting.

The only exception to obtaining parental permission is in the case of emancipated minors who are on their own, such as college students. In these cases, proceed with the youth Informed Consent procedures without parental permission, using the youth script as explained in the next section.

Once the parent agrees, we ask for the youth's agreement to participate. Read the information from the Introduction and Informed Consent for Interview Respondents Age 12–17, which is in the Showcard Booklet (see Exhibit 7.6). Give the respondent a copy of the Study Description to keep. Observe the youth's reaction carefully. Getting the youth to participate is not typically a problem. However, keep in mind that a youth's failure to object does not mean he or she understands the consent process, and should not be taken that way. Use your judgment. Do NOT begin an interview with a youth until you are satisfied that he/she understands what you are asking and is willing to proceed.

If the youth seems to have trouble understanding, determine if the problem is temporary. If he/she is drunk or high, end the visit and return at another time. If necessary, involve the parent in the decision about whether or not to proceed.

7.7 Getting Started

Being comfortable with the logistics of setting up the computer and starting the interview makes it much easier for you to focus on establishing rapport with respondents, gaining their cooperation, and answering any questions they may have. Practicing this beforehand improves your chances of doing this correctly during an actual interview.

Once you have obtained consent for the interview, ask the respondent where would be the best place to conduct the interview. Consider the following issues when choosing the best location:

• Privacy

  Make sure you are providing a reasonably private location for the respondent. You should also find a location where you and the respondent can sit apart so the screen is not visible to you or another household member during the ACASI portion of the interview (see Section 7.7.2 for more details).

• Ethics

  Do not interview a youth if an adult is not present in the home unless the parent has provided express permission. Never conduct an interview in a separate bedroom.

• Temperature

  High temperatures can mean the laptop feels hot on a respondent's lap and sweaty hands are more likely to slip on the keyboard. This is not insurmountable but should be a consideration if there is an option for a cooler location. Also, use of sturdy tables is recommended.

• Battery power

  Conduct the interview by plugging the power cord to an outlet whenever possible, using the extension cord if necessary. However, also make sure you have a fully charged battery in case you cannot connect to an outlet. For example, you might interview in a location, such as a front porch, where you cannot plug into an electrical outlet so you must rely on the battery. It is a good idea to recharge your battery by plugging it into a wall outlet each night before going out into the field. Remember the battery will last about two to three hours before needing to be recharged. See Chapter 4 of the Computer Manual for more information.

• Safety

  Choose a location where both you and the respondent feel reasonably safe. For example, avoid conducting the interview outside in a neighborhood where you feel theft or gang violence is likely.

Given these constraints, try to be as flexible as possible without compromising the standards and rules for administering the interview. For example, if someone cannot meet you in their home because of their schedule or concerns about privacy, offer to meet at a mutually convenient place such as a public library. Do not offer to drive a respondent in your car. Due to lack of privacy, interviews should not be conducted at fast food restaurants. Because the computer can run on battery power, it is also possible to conduct the interview outdoors if necessary, such as on a porch, the front steps, or sitting on the curb. The respondent can then rest the computer in his/her lap. Whatever location you agree upon, make sure there is the necessary privacy and convenience for the respondent to complete the survey honestly.

Obviously, the NSDUH is a personal visit survey. While you may in unusual circumstances ask your FS/RS/RD for prior approval to conduct a household screening using the telephone, the CAI interview must always be completed in person.

For several important reasons, the NSDUH interview should be conducted in private:

• Many of the questions are personal and sensitive. An adult or youth may feel very uncomfortable responding when other family members are present. Maintaining the confidentiality of the data is crucial if the respondent is to provide honest responses, thus ensuring valid data.
• Privacy helps minimize the number of distractions, allowing the respondent to focus on the task at hand.
• Respondents may tell you what they think you want to hear, instead of providing the real answer.

Due to cultural differences, the perception of privacy varies among ethnic and racial groups. For some, privacy may not be viewed as achievable or even desirable given the number of people living in the residence. Experiences often are openly shared with family members. The presence of an infant or very small child usually is not a problem. Encourage those with very young children to schedule the interview for a time when someone can assist with the children if possible. If a respondent cannot do the interview because he or she has to watch the children, you can offer to help keep an eye on the children while the respondent completes the interview.

In some instances a household member, such as a parent, may insist on being present during the interview. A parent should be present in the house during a teen interview unless they have given explicit permission to conduct the interview when they are not at home. However, a parent should not be in the same room and able to view or hear any of the questions or answers. If the parent wishes to be present in the room during the administration of the survey, explain that the youth must be able to listen and answer all questions in privacy. Explain to the parent that respondents are generally more honest—thus providing higher quality data—when allowed to answer the questions privately. It is important that the youth be comfortable enough with the situation to answer questions honestly. The presence of a parent may seriously compromise the data we receive. Well–meaning persons may try to clarify or explain a situation the youth has described or coach the youth on answers. Inform the parent that the study is very interested in the answers of the youth and would like him/her to answer without any outside influence.

If the parent still insists on being present, go on with the interview but make sure the parent cannot hear or view the questions or answers. If this is not possible and there is no privacy, politely stop the interview and reschedule for another time. Document either situation in the Newton ROC and FI Observation questions at the end of the interview.

In general, if privacy is disrupted briefly by someone walking past the room during the CAPI portion, stop reading questions until the person is gone and a private setting is reestablished. If household members are present or interrupt often during the CAPI portion, one way to achieve greater privacy is to position the respondent next to you so he/she can read the questions and response categories on the computer screen and then say the number or letter or simply point to the answer on the screen. That way, other household members passing do not hear the questions or answers. Looking at the screen allows the respondent to answer with a number or letter so other household members do not know the responses. This would not be effective when interviewing a poor or nonreader, however, who needs to hear the questions and responses read aloud.

Finally, if you believe the setting is not private enough for the respondent to answer truthfully, offer to return to the household when you can complete the interview in private.

When you choose a spot to set up the computer for the interview plan to sit opposite or catty–corner to the respondent. Here are some ergonomic considerations to maximize your own comfort and that of the respondent when setting up the equipment. Whenever possible:

• Sit with the computer straight in front of you at a comfortable height. Place your feet flat on the floor and keep your back straight. The monitor should be about 20" in front of your face.
• Keep your arms at a 90–degree angle to the keyboard with your wrists straight.
• Arrange for adequate lighting. Soft, indirect lighting is preferable. Position the screen so that sunlight or bright indoor lighting does not reflect off of it.

Just a few adjustments like these will greatly increase your comfort and the respondent's comfort in the short and long–term.

Once you are in a private location, assemble your equipment and materials.

• Unpack the computer.
• Connect the two parts of the power cord and then plug it into the computer.
• Plug the cord into a wall outlet using the extension cord if needed.
• Connect the headphones, cover the earpieces with a new set of disposable covers and offer them to the respondent. Even if the respondent chooses not to use the headphones during ACASI, you must plug the headphones into the jack in order to disable the computer speakers and thus ensure privacy. Respondents listening to the audio voice during ACASI must use the headphones, not the speakers.
• Open the laptop by pressing the display latch
.
• Press the ON button in the top right corner above the keyboard. Allow time for the computer to start and the password prompt to appear on the screen.
• While you are waiting, get the appropriate QuestID from your Newton double checking that you have the QuestID for the correct household and for the correct respondent, either A or B. Also take out the reference date calendar, Showcard Booklet, the Quality Control Form and envelope, and the Interview Payment Receipt.

When the password prompt appears, you are ready to begin the interview. See Chapter 8 of this manual as well as Chapter 5 of the Computer Manual to read about the procedures for conducting a CAI interview.

Preparing to Interview

To assist your learning process, read the following summary of key points in this chapter. Following the summary are several questions to ask yourself. These questions will help you identify those areas you understand, and pinpoint the areas where you would benefit from re–reading a particular section.

• As a professional field interviewer on this study, you are responsible for making sure that every interview is administered correctly following our detailed project protocols. In addition, you must always maintain high ethical standards, treating your respondents and their information with the utmost confidentiality and respect. It is important that you remain completely unbiased and objective.
• It is always best to try and complete the interview immediately after a respondent has been selected through the screening process. This will improve your response rates and efficiency. If this is not possible, identify a good time to return and set a firm appointment.
• As with screenings, any interview result or visit must be documented in your ROC and assigned a result code.
• Even after the screening has been completed, the Newton allows you to view the household roster and selection screen. This enables you to re–educate yourself on the make–up of the household on your return visits.
• The skills that make you successfully complete screenings likewise help you as you try to obtain interview participation. You need to be professional, friendly, knowledgeable, and PERSISTENT.
• To complete an interview with a minor, you must obtain the verbal permission of the parent/guardian and the consent of the minor.
• To actually administer the interview, it is imperative that you find a private location where you and your respondent can comfortably use the laptop.

1. What screen on the Newton allows you to add a call record?
2. Assign a code for the following situations.

   You make a return visit to the DU, but your interview respondent is not there.

   A mother does not want you to interview her 16 year old son.

   The respondent speaks only Spanish and you are not an RTI–Certified bilingual interviewer.

   You set a firm appointment with the selected respondent for tonight at 6 PM.

3. Imagine that you have completed a screening on Monday evening and you are making a return visit on Tuesday evening to try and catch the selected interview respondent at home. You are interested in knowing who the screening respondent was, and since you have done 20 cases since yesterday, you cannot remember. How can you get this information from your Newton?
4. When is a good time to catch teens at home?
5. If a teen refuses because of a lack of interest, what would you say?
6. Why is it so important that the NSDUH interview be conducted in private?

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