Cognitive Testing of American Time Use Survey’s Well-Being Module

Cognitive and Psychological Research

OMB package - ATUS well being - post OMB version

Cognitive Testing of American Time Use Survey’s Well-Being Module

OMB: 1220-0141

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March 26, 2008


NOTE TO THE REVIEWER OF:

OMB No. 1220-0141

Cognitive and Psychological Research


FROM:

Kathy Downey

Research Psychologist

Office of Survey Methods Research


SUBJECT:

Submission of Materials for Cognitive Testing of American Time Use Survey’s Well-Being Module


Please accept the enclosed materials for approval under the OMB clearance package #1220-0141, “Cognitive and Psychological Research.” In accordance with our agreement with OMB, we are submitting a brief description of the research and the materials to be used in the research at least two weeks prior to the beginning of the study.


The American Time Use Survey (ATUS) will be adding a module to gain a better understanding of how Americans experience their time and how their activities relate to their health and subjective well-being. Parts of this module (“well being module”) have been cognitively tested before. However, prior to implementation, the whole module is being cognitively tested.


We plan to interview respondents 38 (19 each in two rounds of testing). The maximum number of burden hours is estimated to be 38 hours.


If there are any questions regarding this project, please contact Kathy Downey at (202) 691-7382.


Attachments

American Time Use Survey (ATUS)

Well-Being Module


I. Introduction and Purpose


The American Time Use Survey (ATUS) is a continuous, nationally representative telephone survey of the non-institutionalized civilian population age 15 and over. Respondents are asked to sequentially describe what they did “yesterday,” from 4 a.m. of the previous day to 4 a.m. of the interview day. The sample is chosen from those households that completed the eighth (final) CPS interview, and in each of these households, one person is randomly selected to be interviewed for the ATUS. Each person is also assigned to be interviewed on a particular day (e.g., Tuesday), with interviewers attempting to reach the designated person for up to eight weeks. About half of the respondents are interviewed on a weekday and about half on a weekend day.


BLS is going to add a short module (less than 5 minutes) to the ATUS to gain a better understanding of how Americans experience their time and how their activities relate to their health and subjective well-being. The ATUS collects time use data from approximately 13,000 Americans a year. The supplemental module (or “well being module”) will collect data on measures of affective experience during randomly selected episodes of the day. The affect measures will relate to the extent to which respondents felt tired, in pain, happy, stressed, sad and interested during the sampled episodes. Individuals will also be asked if they were interacting with someone during sampled episodes. For sampled work time periods respondents will be asked whether they were mostly alone, with their boss, with coworkers, with clients/customers, or with others. (In the first round of cognitive interviewing, this will be asked during the portion of the interview on the 24-hour recall of activities. In the second round of interviewing, this will be a new separate question to be tested.) Lastly, some information will also be collected on health status. Information from the ATUS can also be linked to the Current Population Survey, which is expected to include questions on disability status and functional limitations.


The broad, long-term goal of this module is to meet the mission of the National Institutes on Aging (NIA) by measuring the well-being of the U.S. population, including the aging (elderly). The set of emotional categories to be included in the module are influenced by Kahneman’s work (Kahneman et al., 2004 ) as well as Russell’s (1980) circumplex model of core affect. By marrying time-use data with reports on affective experience, researchers will be able to: (1) identify activities that are associated with similar emotional responses (e.g., pain); (2) track activities in a meaningful way over historical time, across groups (e.g., across age groups) and across countries; (3) better understand the experience of daily life; and (4) develop an index allowing comparison of well-being across different population subgroups.


An immediate goal is to design a satisfactory set of questions that will fit with the ATUS. In order to do this, cognitive testing will be performed on the proposed new affect and health questions. An initial round of testing was already performed for most of the affect questions by the Gallup Organization. However, there have been changes to the survey items since the last round of testing and not all of the items were tested.


Prior to the proposed two rounds of cognitive testing, three participants were interviewed in order to fine tune the interview protocol. These interviews were conducted by BLS. Concurrent with the first round of cognitive testing by BLS, we will also conduct an expert review of the items.


The BLS requests permission to interview 38 participants, separated into two rounds of cognitive testing of 19 participants each.



II. Participants


The participants will be solicited from a database of general population research participants. This database is compiled and maintained by the BLS Office of Survey Methods Research (OSMR).


During recruitment, we will collect the following to make sure we are interviewing a cross-section of the general population: age, race, income, and education. We will also make sure that three-fourths of our participants are employed (in order to have “work” as an activity during the interview).



III. Research Design


Three research psychologists from the OSMR will interview the participants.


The cognitive testing protocol will follow a structured format (see Appendix A). The first part of the interview gathers a respondent’s 24-hour recall of activities, the second part asks the well-being module, and the third part is debriefing questions. The interviews should last about 60 minutes each.


We will have a quota on the day of the interview so that one-quarter will be interviewed about their weekend (Sunday) activities. This is consistent with the day-of-week interview quota in the ATUS.


There will be two rounds of testing. Both rounds will have 19 participants. The protocol and items will be slightly modified between testing rounds. If there are major changes to the protocol or items, we will alert OMB. The protocol in Appendix A is for, right now, both rounds.


IV. Burden Hours


BLS estimates the total burden hours will be 38 hours. OMB Clearance is requested through July 2008.

V. Data Confidentiality


Participants will be informed as to the voluntary nature of the study. Participants will also be informed that the study will be used for internal purposes to improve general survey methodology knowledge and how to test questions. Information related to this study will not be released to the public in any way that would allow identification of individuals except as prescribed under the conditions of the Privacy Act Notice. A copy of the consent form is included (see Appendix B).


VI. Attachments


Appendix A: Interview protocol

APPENDIX B: CONSENT FORM









Appendix A: Interview protocol



ATUS Well-being Module

Cognitive Interview Protocol



Instructions to CATI interviewers or programmer notes are in ALL CAPS (for future reference when the items are deployed).


Cognitive interviewer questions and notes in italics:

Please note that the cognitive interviewing questions are suggested probes and may not be asked exactly as shown and extemporaneous follow-up probes will be used for unclear answers from respondents.


Since the ATUS is a telephone interview, the diary portion of the ATUS and the well-being questions and health questions will be administered via telephone. For the debriefings, the respondent and the interviewer will be in different rooms of the BLS-OSMR suite for HALF of the interviews. The other HALF of the time, they will be in the same room. We are trying to figure out the effect of being in the same room versus on the telephone for debriefings.



All module questions will be asked after the basic ATUS. (ATUS questionnaire is available at /www.bls.gov/tus/tuquestionnaire.pdf)



Participant Recruitment


  • General population

  • During recruitment call, collect the following information (to see if sample is diverse):

      • Age

      • Race

      • Income

      • Education

  • Quotas:

      • ¼ interviews to take place on Monday (to get Sunday recall)

      • ¾ interviews to take place rest of week

Beginning of Cognitive Interview


Introduction to respondent:


  1. Explanation of tasks

    1. topic: go through a diary of what you did yesterday and then ask questions about health and well-being

    2. evaluate questions, not you

    3. need to know how people like you answer the questions, what you think when you hear certain terms and phrases, and how easy or difficult the question is

    4. no wrong answer

    5. ask a question, then ask follow-up questions after to determine how you arrived at an answer

    6. for the follow-up questions, think back to your thoughts as you originally answered the question

    7. one thing – you will be in this room and I’ll be in another – I will call you and we will do this over the phone. In real life the diary is asked over the phone, so want this to be similar.


  1. General issues

    1. confidentiality

    2. voluntary

    3. permission to tape

    4. consent form

  1. I’ll leave now and call you on the phone. I’ll have you on the speaker phone and there might be another person with me taking notes.

  2. REMEMBER – FOR HALF OF THE INTERVIEWS – you will be in the same room as the respondent. FOR THE OTHER HALF – you will be in different rooms. We are trying to figure the effects of being in the same room versus being on the telephone for the debriefings.


Phone in room 5: 15037


Administer Diary


S1: Introduction

We will go ahead and start the interview now.


1. We are conducting a survey for the Bureau of Labor Statistics on how people in America spend their time. This information will help policy makers understand how people divide their time between work, family and other demands in our fast-paced society.


S2: Household Roster


  1. What are the names (just the first) of all the persons living in your household? Please start with your name. I have you as [FILL NAME].

  2. What is the name of the next person?

  3. What is [FNAME]’s sex?

  4. How is [FNAME]’s related to you?

20. Spouse (husband/wife)

21. Unmarried partner

22. Child/stepchild

23. Grandchild

24. Parent (mother or father)

25. Brother/sister

26. Other related person (aunt, cousin, nephew, mother-in-law, etc.)

27. Foster child

28. Housemate/roommate

29. Roomer/boarder

30. Other nonrelative

  1. Was [FNAME] older than 18 years old on [your / his or her] last birthday?


  1. Is anyone else living here now?



person ID

First name

Sex

Relationship

Under 18?

1

 

 

 

 

2

 

 

 

 

3

 

 

 

 

4

 

 

 

 

5

 

 

 

 

6

 

 

 

 

7

 

 

 

 


S4: Time-use Diary


  1. Now I'd like to find out how you spent your time yesterday, [yesterday's day & date], from 4 am yesterday morning to 4 am this morning. I'll need to know where you were and who else was with you. If an activity is too personal, there's no need to mention it.


  1. So let's begin. Yesterday, [previous weekday] at 4:00 AM, what were you doing? What did you do next?

IF PERSON MENTIONS THAT HE/SHE WAS DOING TWO OR MORE THINGS AT ONCE, ASK WHAT WAS THE MAIN ACTIVITY.


  1. How long did you spend [ACTIVITY]?

  1. ASK FOR ALL ACTIVITIES, EXCEPT:

    • SLEEPING (1),

    • GROOMING (2),

    • PERSONAL” ACTIVITIES, AND

    • DK/REFUSAL.

IN ROUND 2 OF COG TESTING, ALSO SKIP THIS FOR WORK ACTIVITIES (4, 5)


Who was with you? / Who accompanied you?


  1. Where were you while you were [ACTIVITY]?

  1. asked only if the respondent did not report any eating or drinking as a main activity


You did not report any eating or drinking yesterday. Did you do any eating or drinking yesterday as your main activity?


INTERVIEWER NOTES ON PROBING

  1. Activities lasting longer than 2 hours (excludes sleeping, working, or attending high school). PROBE: Did you stop [ACTIVITY] to do anything else during that time? If yes, record the activity.


b. Breaks at Work or High School


Work activities with a duration time greater than 4 hours are probed about, to determine if the DP took any breaks of 15 minutes or longer. PROBE: "Did you take any breaks of 15 minutes or longer?" for work activities that exceed the duration time of 4 hours.


(1) If yes, ask the probe "What did you do?" and record the activity.

  1. If no, proceed on with the interview.


c. Probe for simultaneous activity: What would you say is your MAIN Activity?


  1. If DP can estimate the time for each activity: Record each activity on its own line in the diary

  2. If DP cannot estimate the time for each activity but reports a MAIN

activity: Record the main activity first followed by a / and then the second activity

  1. If DP cannot identify a MAIN activity: Record the first activity mentioned followed by a / and then the second activity mentioned

NOTE: GRID SHOULD ONLY TAKE ABOUT 5 MINUTES

ACTIVITY GRID

Duration






Times

or duration



Select for affect

#

activity

start time

stop time

Hrs*

mins

who was with**

where


1

 

 

 

 

 

 

 

 


2

 

 

 

 

 

 

 

 


3

 

 

 

 

 

 

 

 


4

 

 

 

 

 

 

 

 


5

 

 

 

 

 

 

 

 


6

 

 

 

 

 

 

 

 


7

 

 

 

 

 

 

 

 


8

 

 

 

 

 

 

 

 


9

 

 

 

 

 

 

 

 


10

 

 

 

 

 

 

 

 


11

 

 

 

 

 

 

 

 


11

 

 

 

 

 

 

 

 


12

 

 

 

 

 

 

 

 


13

 

 

 

 

 

 

 

 


14

 

 

 

 

 

 

 

 


15









16









17









18









19









20








*Ask Did you stop [ACTIVITY] to do anything else during that time” for activities lasting 2+ hours or ask about “breaks” for work lasting 4+ hours

** ASK FOR ALL ACTIVITIES, EXCEPT SLEEPING (1), GROOMING (2), “PERSONAL” ACTIVITIES, AND DK /REFUSAL. IN ROUND 2 OF COG TESTING, ALSO SKIP THIS FOR WORK ACTIVITIES (4, 5)


S5. Secondary Childcare


No Children under aged 13:



1. Now I'd like to talk with you about childcare. People often spend time with friends', neighbors' or relatives' children. During [FILL TIME THAT USED WILL USE FOR DIARY RECALL] yesterday was a child who is 12 years old or younger in your care? Please do not include any paid childcare.


IF YES - Ask: When was that?






OR


Has children under 13 years of age:


1. Now I'd like to talk with you in a little more detail about childcare. During which activities during that time was/were [FNAME] in your care and he or she was awake?


(fills name(s) of all the DP’s own children under 13 in the household)

* Probe: Any other times or activities?


1. Activities where child was in your care. [Go to next row]

96. All day.

97. None/no more childcare activities.

Don’t Know, Refused

2. Other than [FNAME] during [FILL TIME THAT USED WILL USE FOR DIARY RECALL] yesterday was a child who is 12 years old or younger in your care? Please do not include any paid childcare.

(fills household and own nonhousehold children’s names)







Preface to module


Now we want to go back and ask you some additional questions about how you felt yesterday. We are asking these questions to understand people’s health and well-being during their daily lives. As before, whatever you tell us will be kept confidential.



Items 1 – 10: Affective Dimensions



[STATE IF ACTIVITY LIST > 5, OTHERWISE SKIP THIS STATEMENT.]

The computer has selected 4 activities.



[FOR COGNITIVE INTERVIEWING, PICK ONE TV WATCHING AND ONE WORKING EPISODE. tHEN, PICK A VARIETY OF activities FOR THE REST, UP TO 5. Pick one mundane and one stressful activity.


NOTE: DO NOT ASK ABOUT SLEEPING OR ABOUT ACTIVITIES THE RESPONDENT DECLINED TO DESCRIBE.]



Between [Starttime of Episode] and [Stoptime of Episode] yesterday, you said you were doing [activity]. The next set of questions asks how you felt during this particular time.


Please use a scale from 0 to 6, where a 0 means you did not experience this feeling at all and a 6 means the feeling was very strong. You may choose any number 0,1,2,3,4,5 or 6 to reflect how strongly you experienced this feeling during this time. [REPEAT THE FIRST SENTENCE OF THIS PARAGRAPH FOR ALL THE FEELINGS FOR THE FIRST ACTIVITY.]


  1. Happy First, from 0 – 6, how happy did you feel during this time?

  2. Tired From 0 – 6, How tired did you feel during this time?

  3. Stressed From 0 – 6, How stressed did you feel during this time?

  4. Sad From 0 – 6, How sad did you feel during this time?

  5. Interested From 0 – 6, How interested did you feel during this time?

  6. Pain From 0 – 6, How much pain did you feel during this time, if any?


7. During this time, from 0 to 6, how meaningful did you consider what you were doing? 0 means it was not meaningful at all to you and a 6 means it was very meaningful to you.


8. During this time, from 0 to 6, did you consider what you were doing a waste of time? 0 means it was not a waste of time and a 6 means it was a waste of time.

[RANDOMIZE THE TWO QUESTIONS BELOW. IN ODD # INTERVIEWS, USE 9 FIRST. IN EVEN # INTERVIEWS, USE 10 FIRST.]


  1. *Were you interacting with anyone during this time, including over the phone?


  1. *Was it an unpleasant or pleasant experience?




How you felt” questions


Activity

Happy

Tired

Stressed

Sad

Interested

Pain

Meaningful

Waste

Interacting

Pleasant

























































*Note: in round 2, these will have to be moved between items 8 – 10 because that is how it’ll be implemented

General follow-up questions

Now I’d like to ask some follow-up questions. So, for these questions, I’ll ask you about how you gave your ratings for your feelings during yesterday’s activities. Try to think about how you came up with your answers about how you were feeling.

  1. We asked you how you felt using this list of feelings [USE SHOW CARD IF IN SAME ROOM; OTHERWISE SAY LIST: happy, tired, stressed, sad, interested, and pain]. Was one of these questions more difficult to answer than the others.

  • (if yes) Which ones?





  • Do you think your answers reflect how you really felt at the time or did you just come up with a number to answer the question?





  • Which feelings were you most confident about reporting?





  • How did you react to hearing these questions about how you felt during an activity?





  • Was the explanation that we gave about why they were asked a satisfactory explanation? Or, did you wonder why we were asking them and how the information might be used?





  1. Now I’d like to ask you how you defined certain terms when you heard them. When you heard the word “Pain,” what did you think of?



  • PROBE: Did you include both mental and physical pain?





  • Does the pain you felt depend on what you were doing?

  1. Now I’d like to ask you more about using the 0 to 6 scale.

  • Can you describe an activity where your rating of feeling pain would be zero? How about an activity where your rating of feeling pain would be 6? And what about the middle point, 3?

0” –

6” –

3” –



  • Can you describe an activity where your rating of feeling happy would be zero? Can you give me an example of an activity where your rating of feeling happy would be 6? How about an example of an activity where your rating of feeling happy would be 3?

0” –

6” –

3” –



  • Can you give me an example of an activity where your rating of feeling stress would be zero? Can you give me an example of an activity where your rating of feeling stress would be 6? How about an example of an activity where your rating of feeling stress would be 3?

0” –

6” –

3” –



  • Do you have a preference for either a 0 to 6 scale or a 0 to 10 scale? Can you tell me why?





  1. Can you tell me what you thought “meaningful” meant when giving your ratings?







  1. We used the word “interacting” in one of the questions. We asked “Were you interacting with anyone during this time, including over the phone?” Can you give me some examples of what you thought about when you heard this?





    • What is another word for “interacting” in this question?





  1. I’m going to read a list of activities and I’d like to know whether you consider something “interacting” or not interacting. {based on this, will fill in the interviewer note attached to the question for round 2 testing}

      1. Talking to someone one-on-one

      2. Listening to someone one-on-one

      3. Emailing

      4. Texting or IMing

      5. Being on the phone with someone

      6. Listening to a conference ca1l

      7. Playing a game like tennis or chess

      8. Running with others

      9. Sitting in the same room as another person, but just reading a book

      10. Listening to a lecture – meaning you are a member of the audience

      11. Sitting in the same room as someone else, watching TV, but not talking to each other

Questions by Activity

Next, I’d like to find out more about how you reacted when you heard the questions about your feelings during a specific activity. I’m going to go back to the first activity you discussed. Let’s talk about [FILL] activity.



Again, I want to find out how you reacted to the questions about feeling pain, tiredness, stress, sadness, and so on.[USE SHOW CARD IF FACE-TO-FACE]



  1. Do you think other people might have a problem answering questions like these for an activity like [FILL ACTIVITY]. Do you think other people might think the questions are too personal – or do you think they wouldn’t have a problem?

      • If yes: How so?

      • If yes: What about you – do you think you would or wouldn’t have a problem with these questions if they were asked about [FILL ACTIVITY]?



Activity

Notes















Stress

  1. Next, I’d like to ask you about your answer regarding stress. How easy or difficult would you say it was to give the rating or answer? Was it very easy, easy, difficult, or very difficult? How so?

      • How accurately do you think you are able to report your stress for this activity that happened yesterday?



Activity

Notes













Pain

  1. How easy or difficult would you say it was to give your answer? Was it very easy, easy, difficult, or very difficult?

  • How so?



Activity

Notes













  1. [IF PAIN RATING > 0] You gave the pain rating for this activity a [fill]. Was that physical pain?

    • [If yes] Where did you feel the pain?

    • [If yes] Have you had this pain repeatedly in the last month?



  1. Do you think people would think asking where the pain was is too personal a question – or do you think people don’t care?







Meaningful

  1. Can you tell me how you came up with your rating for whether the activity was meaningful to you?

Activity

Notes













      • How important was the activity to you on a scale from 0 to 6, with 0 being not important at all and 6 being very important? How did you come up with this rating?

Activity

Notes













Waste of time

  1. Can you tell me how you came up with your rating for whether the activity was a waste of time to you?

Activity

Notes

















Scale

  1. Among happy, tired, stressed, sad, interested and pain, you gave [FILL FEELING] the highest rating. Was that the most intense feeling you had during this [FILL ACTIVITY]?

Activity

Notes













Interacting

  1. Now I’d like to ask you about whether you said you were interacting with someone while doing the activity.

  • Can you tell me why you gave this answer?

  • Was it easy or difficult to answer using the yes/no format?



Activity

Notes













REPEAT 7 – 15 FOR EACH ACTIVITY.





  1. [COMPARE ACROSS ACTIVITIES TO FIND HIGHEST STRESSED, PAIN, AND HAPPY]

Of the 5 activities, you gave [FILL] activity your highest rating on [STRESS /PAIN /HAPPY]. Was this the most [STRESS/PAIN/HAPPY] you felt during the 5 activities?



Notes

Stress


Pain


Happy






  1. During the activities we asked about, [FILL LIST OF 5], were there any emotions we haven’t asked about that were a strong part of the experience?


Item Pain 1


1) Please think about the pain you experienced throughout all of your activities yesterday. Was the pain you experienced yesterday similar to, or more or less than the typical pain you experienced over the last 7 days?


  • Lower than last 7 days

  • Similar

  • Higher than last 7 days



    1. Can you tell me how you came up with this answer?



    1. When you thought of yesterday, were you thinking about 4 am yesterday to 4 pm today or some other time period?



    1. How far back did you think when you were thinking about the “last 7 days” – calendar week, a couple of days, etc?



    1. Were you thinking about some activities more than others?



    1. What if you experienced no pain yesterday and no pain in the last 7 days? What would you answer?



    1. What kind of pain were you thinking about?




Item Pain 2

2) Did pain limit your participation in any activities yesterday?

  • Yes

  • No


    1. What do you think is meant by the word “limit” in the question?



    1. What kind of pain were you thinking about?



    1. Were you thinking about some activities more than others?



Item Pain 3

3) Did you take any pain medication yesterday, such as Aspirin, Tylenol, Ibuprofen or prescription medication?

  • Yes

  • No



    1. What kind of pain medication did you think about when I read the question?




    1. Does it matter to you whether you hear the drug name, such as Ibuprofen, or the brand name, such as Advil?



Item 10



Lastly, I have a couple of questions about your health.


Would you say your health is excellent, very good, good, fair, or poor?


  1. Excellent

  2. very good

  3. good

  4. fair

  5. poor

9. dk/refused







Item 11



In the last five years, were you ever told by a doctor or other health professional that you have hypertension, also called high blood pressure, or borderline hypertension?


    1. Yes

    2. No






  1. Whom did you include under “doctor or other health professional?”





If yes to question

  1. If yes: What specifically did the doctor or other health professional say to you when he/she said you had high blood pressure or borderline hypertension?



  1. If yes: How long ago was it?





  1. If yes: Were you ever on medication for it? If so, are you still? {to see how significant the problem was}



If no to question

  1. If no: Have you ever had your blood pressure tested by a doctor or health professional? How long ago?



  1. If no: Has the doctor or health professional made any comment about your blood pressure, even if it was a side effect of some medication?


Item 12



When you woke up yesterday, did you feel well-rested?


  1. YES

  2. NO



    1. Can you tell me why you gave this answer?







    1. For this question, how easy or difficult was it to remember whether you were well-rested yesterday? Would you say very easy, easy, difficult, or very difficult?







That is the end of the interview. Thank you so much!


ask only if round 2 of cognitive testing

place after affective items



Item 7


Universe: ask only if ACTIVITY IS WORK (of the 5 Randomly Selected Episodes):


During [FILL] time yesterday, were you alone for at least half of the time?


  1. yES, alone – skip to item 9

  2. nO, not alone – ask item 8

  3. Don’t know/refused – skip to item 9



  1. For this question, how easy or difficult was it to answer whether you were alone for at least half of the time? Would you say very easy, easy, difficult, or very difficult?

  2. How would you answer if you worked in an open office with lots of cubicles close together?

  3. How would you answer if for more than half of this time, you were on the telephone in your office with no else present?



Item 8


Universe: only if previous item = 1


During this time yesterday, were you with your boss or manager, co-workers, customers, people whom you supervise, or others? [multiple answers may be selected]


    1. Boss OR MANAGER

    2. Co-workers

    3. customers

    4. people whom you supervise

    5. Others



      1. If you were with your boss and your co-workers in a meeting, how would you answer? {checking to see if clear that multiple responses allowed}










Appendix B: consent form


Consent Form


The Bureau of Labor Statistics (BLS) is conducting research to increase the quality of BLS surveys. This study is intended to suggest ways to improve the procedures the BLS uses to collect survey data.


The BLS, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. The Privacy Act notice on the back of this form describes the conditions under which information related to this study will be used by BLS employees and agents.


During this research you may be audio and/or videotaped, or you may be observed. If you do not wish to be taped, you still may participate in this research.


We estimate it will take you an average of 45 minutes to participate in this research (ranging from 30 minutes to 60 minutes).


Your participation in this research project is voluntary, and you have the right to stop at any time. If you agree to participate, please sign below.


Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. OMB control number is 1220-0141, and expires February 28, 2009.


------------------------------------------------------------------------------------------------------------


I have read and understand the statements above. I consent to participate in this study.




___________________________________ ___________________________

Participant's signature Date



___________________________________ ______________________________

Participant's printed name Researcher's signature




OMB Control Number: 1220-0141

Expiration Date: 2/28/09



PRIVACY ACT STATEMENT

In accordance with the Privacy Act of 1974, as amended (5 U.S.C. 552a), you are hereby notified that this study is sponsored by the U.S. Department of Labor, Bureau of Labor Statistics (BLS), under authority of 29 U.S.C. 2. Your voluntary participation is important to the success of this study and will enable the BLS to better understand the behavioral and psychological processes of individuals, as they reflect on the accuracy of BLS information collections. The BLS, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. The BLS may release individually identifiable information to individuals designated as agents of the BLS in accordance with Public Law 107-347 to perform exclusively statistical activities. Individuals designated as agents of the BLS may be imprisoned for not more than 5 years or fined not more that $250,000 or both for any knowing and willful disclosure of respondent information to unauthorized persons. Such designated agents may include individuals from other sponsoring agencies; to contractors, grantees, and their employees or volunteers who are working on this study for the BLS and who need access to the information; or to the National Archives and Records Administration or the General Services Administration for records management purposes. Under written agreements to protect the confidentiality and security of individually identifiable information, the BLS may provide individually identifiable information to other researchers designated as agents of the BLS to conduct statistical research projects that further the mission and functions of the BLS.







File Typeapplication/msword
File TitlePLAN FOR FIELD TEST ANALYSIS
AuthorSylvia Kay Fisher
Last Modified ByLAN User Support
File Modified2008-04-08
File Created2008-04-08

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