National Health and Nutrition Examination Survey
OMB No. 0920-0950
(Expires November 30, 2015)
Nonsubstantive Change to conduct a Feasibility Study to Collect Dietary Intakes Using Remote Audio and Video Interviewing
Contact Information
Vicki L. Burt, ScM RN
Chief, Planning Branch
National Health and Nutrition Examination Survey
National Center for Health Statistics/CDC
3311 Toledo Road, Room 4211
Hyattsville, MD 20782
Telephone: 301-458-4127
FAX: 301-458-4028
E-mail: [email protected]
July 30, 2013
This is a request for a nonsubstantive change to the National Health and Nutrition Examination Survey (NHANES) (OMB No. 0920-0950, exp. November 30, 2015), conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), to conduct a methodological study. Burden for this project has already been approved; thus, no change to the burden is requested.
The study planned is the following:
Feasibility Study to Collect Dietary Intakes Using Remote Audio and Video Interviewing
A 24-hour dietary recall is currently collected by a trained interviewer during the mobile exam center (MEC) visit. There is interest in assessing whether these interviews may be conducted by an interviewer stationed at a remote location. This study of approximately 400 participants, will determine if it is feasible to collect dietary intake information via remote interviewing of the same or similar quality as those obtained via in-person interviewing. Participants younger than 12 years, those who are deaf or near deaf, vision impaired, wheelchair bound, or require a proxy respondent will not be eligible for the feasibility study.
To evaluate if remote interviewing is an acceptable proxy for the in-person interview, we plan to interview up to 400 subjects over an extended period divided into rounds of evaluation and refinement. After each stage, approximately 15 interviews will be reviewed and discussed to determine if interviewers need further instruction for themselves or participants for the remote conduct of the interview. Evaluation of the remote interview will be based on observation which is the current method of evaluating the quality of the dietary interview. See Attachment A for more details the evaluation process.
A. Justification
Circumstances Making the Collection of Information Necessary.
The National Health and Nutrition Examination Survey (NHANES) contributes to the mission of CDC by collecting objective data that are used to promote health and to prevent and control disease and disability. CDC works with partners throughout the nation and the world to monitor public health, formulate and implement prevention strategies, develop health policies, promote healthy behaviors, and foster safe and healthful environments. In addition to the groups within the CDC, NCHS collaborates with over two dozen federal agencies to plan and fund the NHANES. The survey partners include numerous institutes of the National Institutes of Health, several programs within the U.S. Department of Agriculture, the Food and Drug Administration, and the U.S. Environmental Protection Agency. NHANES data are used to assess environmental exposures; evaluate nutrition program and policy impacts; and estimate prevalences of health risk factors, chronic conditions, and infectious diseases.
NHANES is a continuous survey, meaning survey data are collected every year. It includes a household interview, done in participants’ homes and physical measures and additional interviews done at the NHANES MEC. There may also be follow-up interviews or components (such as a 2nd dietary interview or the physical activity monitor (PAM) that take place after the MEC exam. A major advantage of continuous NHANES data collection is the ability to address emerging public health issues and provide objective data on more health conditions and issues. Because of the NHANES sample design, data are released in two year cycles. Some of the survey information gathered may change at the beginning of each two year cycle. In some cases, this means new content will be added. In other cases, this means that existing content may be modified.
New methodology must be tested before being implemented. There are many reasons for this. This allows us to find out how long the procedure being tested will take or how well received the procedure will be among our participants. The results of such testing also allow the NHANES program to make changes or adjustments to improve the methodology. It also provides hands on training opportunities for NHANES survey staff responsible for collecting the data. Testing is a vital step in making sure NHANES is effective and efficient in its use of resources. Such measures promote improved data quality once the data are collected in an actual survey. Since data collection is continuous, methodology studies must be conducted during ongoing NHANES data collection.
Purpose and Use of the Information Collection
The purpose and uses of the study are detailed below. Tests will include NHANES participants. Participation is voluntary. Tests will be conducted as soon as clearance is received.
Feasibility study to collect dietary intakes using remote audio and video interviewing
A 24-hour dietary recall is currently collected in person by a trained interviewer during the MEC visit. Technology allows for new modes of interviewing, including remote interviewing. We propose to add remote interviewing to reduce overall cost associated with collecting dietary intake data. A large portion of the overall cost is incurred by interviewer travel. Currently, there are two MEC teams with two dietary interviewers in each team. By replacing one dietary interviewer per MEC team with remote interviewers, we reduce the travel cost, thus reducing overall costs significantly. One dietary interviewer will remain in the MEC to collect information from participants excluded from remote interviewing. Hiring dietary interviewers poses a challenge due to the travel requirement; having remote interviewers in a fixed location alleviates hiring issues as well. In addition, dietary interviews in the MEC require an interpreter on occasion. Interviews conducted with an interpreter take more time than those without an interpreter. Providing remote interviewing may allow us to hire interviewers who speak foreign languages, eliminating the need for interpreter-assisted dietary interview.
This study will determine if it is feasible to collect dietary intakes using remote audio and video interviewing in NHANES. The information collected will be used for the same purposes as that provided by the in-person dietary interviews. These uses include:
provide detailed benchmark data on food and nutrient intakes of the population
monitor the nutritional quality of diets and determine the size and nature of populations at risk of having diets low in certain nutrients
provide dietary results to inform public policy and food program decisions such as determining appropriate levels of enrichment and fortification, and estimating exposure to pesticide residues, food additives, contaminants and naturally occurring toxic substances
After the dietary interview, we will ask participants a few questions to evaluate their experience with the remote interview mode. The questions and more details about the feasibility study on remote interviewing are provided in Attachment A.
9. Explanation of any payment or gift to respondents.
No additional remuneration will be offered for the remote dietary interviews.
12. Estimates of Annualized Burden Hours and Cost.
The remote interview has been budgeted for 25 minutes, which is identical to that required for the in-person dietary interview. As it is done in place of the in- person interview which has already been budgeted and approved, no additional burden is sought. The evaluation questions about the remote interview process (see Attachment A) have been budgeted for 3 minutes. We will test at multiple NHANES locations until a sample of up to 400 participants has been reached. The maximum number of respondents would be 400 and the maximum burden 20 hours (400 respondents * .05 hours = 20 hours).
The total burden is 20 hours. This time was already budgeted and approved in line 2 (Special Studies) of the original submission. No additional burden is sought.
15. Explanation for Program Changes and Adjustments. There are no changes in this package from the previous-approved clearance. The burden hours were approved by OMB in the full clearance.
List of attachments:
A. Feasibility Study to Collect Dietary Intakes Using Remote Audio and Video Interviewing
| File Type | application/msword |
| File Title | National Health and Nutrition Examination Survey |
| Author | vlb2 |
| Last Modified By | CDC User |
| File Modified | 2013-07-31 |
| File Created | 2013-07-31 |