NHANES 2013 nonsubstantive dietary pilot Att A_7-31-2013

Attachment A.

National Health and Nutrition Examination Survey (NHANES)

Feasibility Study to Collect Dietary Intakes using Remote Audio and Video Interviewing

OMB no. 0920-0950

Expires: 11/30/2015

Assurance of confidentiality – All information which would permit identification of an

individual, a practice, or an establishment will be held confidential, will be used for

statistical purposes 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).

Public reporting burden of this collection of information is estimated to average 3 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 D-74, Atlanta, GA 30333. ATTN: PRA (0920-0950).

Feasibility Study to Collect Dietary Intakes Using Remote Audio and Video Interviewing (12+ years)

Eligibility: Selected NHANES participants 12 years of age and older at multiple locations who agree to participate in the NHANES exam and who will be coming to mobile examination center (MEC) to complete other previously OMB-approved survey components. The maximum number of respondents would be 400.

Informed Consent: Written informed consent will be obtained as part of the regular National Health

and Nutrition Examination Survey (NHANES) consent process in the MEC exam.

Exclusion Criteria: The following participants will be excluded from this study:

• Under 12 years

• Require a proxy to respond

• Deaf or near deaf

• Vision impaired

• Wheelchair bound

Data Collection: A remote interview will be conducted in lieu of the in-person dietary interview that occurs during the MEC examination session. The remote interview will be administered in the private interview room currently used for the in-person dietary interview. All conditions will be the same as the in-person dietary interviews except for the mode of administration, with the interviewer residing in a remote location. Respondents will be provided the same instructions and measurement guides to aid in the estimation of volume and dimensions of food items consumed. After the dietary interview, a few questions to evaluate their experience using the remote interview mode will be asked.

Remote Interview Evaluation Questionnaire

Questions for participant

1. How comfortable were you with talking to the interviewer using the computer?

1. Very comfortable

2. Somewhat comfortable

3. Neither comfortable nor uncomfortable

4. Somewhat uncomfortable

5. Very uncomfortable

6. Don’t know

7. Refused

2. Did you have trouble using the computer for this interview?

   1. Yes

   2. No (go to #4)

3. What type of trouble did you have? (check all that apply)

   1. Seeing the interviewer on the computer

   2. Hearing the interviewer

   3. Showing or explaining the amounts I ate or drank

   4. Other, specify ________

4. Were you able to follow along with the interviewer?

   1. Yes

   2. No, specify __________

   3. Don’t know

   4. Refused

We will conduct the feasibility study after OMB clearance is obtained through September 12, 2014.

A communications server that is isolated and private to NHANES will be used. NHANES currently operates a private, encrypted network approved by CDC Office of the Chief Information Security Officer under the current NHANES System Security Plan and resulting Authority to Operate.  To ensure remote interviews remain secure and do not rely on the storage or forwarding of sensitive audio or video information, NHANES plans to operate a private Microsoft Lync 2013 communications server which is only accessible to internal, authenticated NHANES users.  All audio and video communications will occur over private, encrypted NHANES network connections between the MEC and the interviewers who will be housed in the offices of the NHANES contractor. In the event there are problems which preclude the use of Microsoft Lync 2013 another type of server will be explored.

We will conduct the feasibility study in several rounds to allow us to assess, pause, and make necessary changes to enhance the remote interview. We will ask the participant some questions to evaluate their experience with the remote interview. At the end of each round, the questions may be revised or no more than a few new questions may be added to help us better evaluate sound and video quality, communication, and ease in completing the interview. The interviewers will also answer some questions on their perception of the participant’s ability to complete the interview. Interviewer observation questions will not add participant burden.

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. We will monitor the following:

• sound and video quality

• time to complete the interview

• participant willingness to complete interview using remote interviewing

• effective communication between interviewer and respondent

Report of Findings: No data will be reported to participants.

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