Attachments L,M,N

Attachment L
QFT Sample Design_Updated

SAMPLE DESIGN
Selection of State Sampling Regions and Segments
The National Survey on Drug Use and Health (NSDUH) sample design is a multi-stage area
probability sample. At the second stage of selection, area segments are formed so that they
contain sufficient numbers of dwelling units to support one field test and two annual survey
samples. This allows for any special supplemental sample or field test that SAMHSA may wish
to conduct within the segments used for the main study.
An estimated 213 segments will be needed to yield approximately 2,000 completed interviews
for the Questionnaire Field Test (QFT). First, a sample of state sampling regions will be selected.
To achieve national representation of the English-speaking population, a probability proportional
to size (PPS) sample of 213 (out of 8761) state sampling regions will be selected. This design
will maximize the efficiency (i.e., increase precision) of the QFT estimates by reducing variation
in the weights. In addition, this design has the benefit of placing the sample in heavily populated
areas where a sufficient mix of field interviewers (FIs) with various experience levels would be
available to meet the QFT staffing needs.
Within each selected state sampling region, a sample of dwelling units will be drawn from the
segment to be retired from use in Quarter 1 of the 2012 NSDUH. If an insufficient number of
eligible dwelling units remains in any segment, this segment will be replaced with the Quarter 4,
2011 retired segment in the same state sampling region.
Selection of Dwelling Units
Dwelling units that were not selected for the 2010, 2011 and 2012 main studies will be eligible
for selection in the field test. A sufficient number of dwelling units will be drawn to account for
the lower sample yield resulting from conducting interviews in English only. After accounting
for eligibility, nonresponse, and the person-level sample selection procedures, it is estimated that
approximately 4,552 dwelling units will need to be selected in order to yield 2,000 completed
interviews for the field test as shown in Table 1. The 2010 NSDUH experience, adjusted for the
planned QFT age distribution, was used to estimate the number of dwelling units needed.
Similar to the main study, a small reserve sample of dwelling units from each segment will be
selected and the total sample will be partitioned into equal probability subsamples. While the
majority of the sample will be released at the beginning of the QFT data collection period,
having the additional sample and sample partitions will allow for greater flexibility in controlling
the sample size. Using this procedure will ensure data collection goals are attained within the
field period.

1

The annual NSDUH sample is selected from 900 state sampling regions. However, Alaska and Hawaii
will be excluded from the QFT. Thus, the QFT sampling frame consists of 876 state sampling regions in the
contiguous U.S.

P-1

Table 1. Summary of the Questionnaire Field Test Sample Design
Statistic
SS Regions
Segments
Selected Dwelling Units
Expected Eligible Dwelling Units
Expected Completed Screening Interviews
Expected Selected Persons
Expected Eligible Persons (English-Speaking)
Expected Completed Interviews

Total
213
213
4,552
3,751
3,338
2,637
2,532
2,000

Expected
Rate

0.82
0.89
0.96
0.79

Selection of Persons
The respondent sample will be allocated to the three major age groups in the following
proportions: 25 percent aged 12 to 17, 25 percent aged 18 to 25, and 50 percent aged 26 or older.
This sample allocation will match the planned allocation for the 2015 NSDUH partial redesign.
One implication of the respondent sample allocation by age groups is a potential impact on QFT
response rates. Retaining more of the 26 or older adults identified in households to complete
interviews could have a negative effect on interview response rates. Specifically, respondents age
50 and older have shown lower propensities to participate than other age groups in the NSDUH
sample. On the other hand, while a smaller proportion of 12 to 17 year olds will be selected, this
age group will continue to drive the number of dwelling units needed (that is, the age group will
continue to be sampled at the highest rate). Thus, fewer dwelling units will be needed to yield the
desired sample than would be needed under the current sample design.
After dwelling units are selected within each QFT segment, an interviewer will visit each
selected dwelling unit to obtain a roster of all persons residing in the dwelling unit. This roster
information will be used to select 0, 1, or 2 persons for the survey. Sampling rates will be pre-set
by segment and age group. Roster information will be entered directly into the electronic
screening instrument which will automatically implement this stage of selection based on the
segment and age group sampling parameters.
As illustrated in Table 1, roughly 2,637 people will be selected from within 3,338 screened and
eligible dwelling units. Assuming a 96% eligibility rate (English-Speaking), a 79% interview
completion rate and an 89% screening completion rate, these sample sizes are sufficient to obtain
the desired 2,000 person respondents.

P-2

Attachment M
QFT Interview Incentive Receipt

Interview Incentive Receipt
U.S. Department of Health and Human Services
and
RTI International
thank you for participating in the 2012 National Survey on Drug Use and Health.
In appreciation of your participation in this important study, you are eligible to receive $30 in cash.
Since maintaining the confidentiality of your information is important to us, your name will not be entered on this
form. However, the interviewer must sign and date this form to certify you received (or declined) the cash incentive.

___________________________________
Interviewer

□

_________
Date

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

□

Accepted Cash Incentive

Declined Cash Incentive

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

v. QFT 9.12

Interview Incentive Receipt
U.S. Department of Health and Human Services
and
RTI International
thank you for participating in the 2012 National Survey on Drug Use and Health.
In appreciation of your participation in this important study, you are eligible to receive $30 in cash.
Since maintaining the confidentiality of your information is important to us, your name will not be entered on this
form. However, the interviewer must sign and date this form to certify you received (or declined) the cash incentive.

___________________________________
Interviewer

□

Accepted Cash Incentive

_________
Date

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

□

Declined Cash Incentive

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

v. QFT 9.12

Attachment N
QFT Certificate of Participation

U..S. Deepartm
ment of Heealth
and H
Human
n Serv
vices

Certificate of Participation
The U.S. Department of Health and Human Services and RTI International would like to thank

[Participant’s Signature]

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

Field Interviewer
Field Interviewer

Ilona S Johnson
Ilona S. Johnson, 

FI ID #

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

This document certifies that the above named individual participated in NSDUH, a voluntary survey for the U.S. Department of Health and 
Human Services.  Across the country, some participants approach their school teachers or other group leaders to ask about possible special 
community service credit as they completed this important national survey.  The time commitment for participation in this survey is between 1 
and 2 hours.  A copy of the NSDUH brochure, which explains the study in more detail, should accompany this certificate.  If you need further 
information, contact the National Field Director, Ilona Johnson, at (800) 848‐4079.
v. QFT 9.12