Form 4 Screening Verification Questionnaire

NSFG 2009-2012 Attachment J OMB No. 0920-0314

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NSFG Verification Summary

On NSFG, a sample of household addresses is selected for the study.  Interviewers complete a short screener interview at the selected addresses in order to determine if someone is eligible for the study (individuals ages 15-44 are eligible).  When a screener interview is complete, the household is either deemed eligible (someone in the household is 15-44 and is selected to participate in the main interview) or not eligible (everyone living in the household is 45 years of age or older).  One selected person goes on to complete the main interview.

For quality control purposes, we call back a percentage of the completed interviews (both screener “not-eligible” interviews and main interviews) to confirm that the interviewer was there and completed the work.  As a general rule, a random 10% of the interviewer's completed screener and main interviews are flagged for verification.  If an interview fails verification (for example, the respondent says he or she was not interviewed), the interviewer is told to stop working while the situation is investigated, and all of the interviewer’s work is verified.  

The verification questionnaires are administered through our sample management system called WebTrak. Screen shots of the questionnaires begin on the next page.

In addition to verification efforts, field supervisors monitor other aspects of each interviewer’s work, looking for outliers that may indicate quality problems.  Some of these measures include monitoring the interviewer’s calling patterns, average interview length (very short interviews could indicate that the interviewer was not completing all of the interview with a respondent or may be falsifying the interview entirely), how often she is able to secure a phone number for households and respondents so her work can be verified, the hours she is charging the project in relation to the work she is producing and when the work was completed (for example, if she charges the project six hours one day, but there is no documentation that she completed any work  that day).

OMB No. 0920-0314

Assurance of Confidentiality – All information which would permit identification of an individual, a practice, or an establishment will be held confidential, will be used only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other persons without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and Statistical Efficiency Act (PL-107-347).

NOTICE-Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road, MS E-11, Atlanta, GA 30333. ATTN: PRA (0920-0314).

Screening Verification Questionnaire

Verification
	Sampleline ID
	Interviewer
	Respondent
	Address
	Phone
	Purchased Phone
	Verifier
	Verification Date
	Result Code

 

Verification Questions

Interview Response

Verification Response

Verify (Yes/No)

1

Hello, my name is XXX with the Institute for Social Research at the University of Michigan. Our records show that one of our interviewers recently contacted you/your household regarding the National Survey of Family Growth. I'm calling to verify that one or our interviewers, XXX, who reported speaking with someone at your household on 04/09/2007 for the National Survey of Family Growth. Do you remember Ms.XXX contacting you?

Yes

Yes

Yes

2

According to our interviewer, your household includes no one between the ages of 15 and 44. Is this correct?

Yes

Yes

Yes

3

In your opinion, did the interviewer conduct herself in a professional manner?

Yes

Yes

Yes

4

Are there any additional comments that you want to share about the interview or the interviewer?

Conclusion: Those are all the questions I have. Thank you very much for your help with this study.

 

	Verification Outcome
	Verification status
	Details:		Additional Details:

Main Interview Verification Questionnaire

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Verification
	Sampleline ID
	Instrument Type
	Interviewer
	Respondent
	Address
	Phone
	Purchased Phone
	Verifier
	Verification Date

 

Verification Questions

Interview Response

Verification Response

Verify (Yes/No)

1

Our records show that one of our interviewers recently interviewed you for the National Survey of Family Growth. The University of Michigan contacts people who were interviewed to check the work of our interviewers. May I take about two minutes of your time to ask you about the interview and the interviewer? Do you remember XXX contacting you?

Yes

Yes

Yes

2

XXX would have asked you about child bearing, contraceptive use, sexual activity, marriage and divorce, and your attitudes about marriage, children and family life. Do you remember a visit where someone asked you questions about such things?

Yes

Yes

Yes

3

How long did the interview take?

37.84 minutes

40 minutes

Yes

4

Was the interview conducted over the phone or in person?

In Person

In Person

Yes

5

To verify our records, what is your date of birth?

MM/DD/YYYY

MM/DD/YYYY

Yes

6

Did you sign a form agreeing to participate in the survey, or give verbal agreement to participate in the survey?

Yes

Yes

Yes

7

Did you receive a token of appreciation for completing the interview?

Yes

Yes

Yes

8

Did you enter some of your responses into the computer yourself?

Yes

Yes

Yes

9

In your opinion, did the interviewer conduct herself in a professional manner?

Yes

Yes

Yes

10

Are there any additional comments that you want to share about the interview or the interviewer?

No she was professional and very good.

Conclusion: Those are all the questions I have. Thank you very much for your help with this study.

 

INTERVIEWER INSTRUCTION (not asked):

	Verification Outcome
	Verification status
	Details:		Additional Details:

 

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