Justification for Change

National Health and Nutrition Examination Survey

OMB No. 0920-0950

(Expires November 30, 2015)

Nonsubstantive Change – Cognitive Testing of Revisions to the Flexible Consumer Behavior Survey (FCBS) Module

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]

March 18, 2014

Supporting Statement (Change)

National Health and Nutrition Examination Survey (0920-0950)

This is a request for a nonsubstantive change to the National Health and Nutrition Examination Survey (NHANES) (OMB No. 0920-0950, exp. November 30, 2013), conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), to conduct pilot/methodological studies. Burden for this project has already been approved; thus, no change to the burden is requested. The study planned is Cognitive Testing of Revisions to Flexible Consumer Behavior Survey (FCBS) Module.

The revised FCBS questions were developed in collaboration with the Economic Research Service (ERS), USDA for inclusion in the 2015-16 NHANES. Changes to 14 existing questions and adding 14 new questions are proposed. These revisions cover five subject areas:

1. Alcoholic beverages, tips, and taxes in the food expenditure questions

2. Family assets

3. The Supplemental Nutrition Assistance Program (SNAP, previously known as the Food Stamp Program) participation

4. Special Supplemental Food Program for Women, Infants and Children (WIC) participation

5. Household’s vehicle availability – whether the household has regular access to a vehicle to buy foods

The first 4 subject areas are currently included in the NHANES questionnaires. The fifth topic area, household’s vehicle availability, is closely related to existing NHANES questions about access to grocery stores.

The study will be conducted in the cognitive lab of the NHANES data collection contractor, under contract with NCHS.

A. Justification

1. Circumstances Making the Collection of Information Necessary.

Since 2005 NHANES has contained a subset of questions referred to as the Flexible Consumer Behavior Survey (FCBS) module sponsored by the Economic Research Service of the USDA. For 2015, changes to 14 questions and 14 new questions are proposed to gather additional information about consumer behavior related to food access. This contributes to the major NHANES objectives of studying the relationship between diet, nutrition and health, as well as monitoring trends in risk behaviors and the prevalence of risk factors in population subgroups.

2. Purpose and Use of Information Collection:

The proposed cognitive testing is designed to evaluate the FCBS module through in-depth interviews. The test will be conducted with 100 volunteer participants aged 18 years and over (60 in English and 40 in Spanish). An in-depth interview will be given to each participant to collect his/her responses to the questionnaires, including the participant’s understanding of the wording of the questions and the decision process the participant went through in answering these questions. The results from the test will be used to assess and improve the instruments’ validity, and determine the feasibility of inclusion in the NHANES.

The major objectives of the cognitive testing are:

• To assess how well the meaning of the questions are understood by potential participants.

• To assess the appropriateness of the wording used in both English and Spanish questionnaires.

3. Explanation of Any Payment or Gift to Respondents.

A $40 token of appreciation will be given to the participant after the completion of interview.

4. Estimates of Annualized Burden Hours and Cost.

NHANES’ respondents will not be involved in this test. This project will be done among paid volunteers. Burden for this project has been budgeted for 90 minutes (1.5 hours). The maximum number of volunteers would be 100 (ages 18+) and the maximum burden 150 hours (100 respondents * 1.5 hours = 150 hours).

The total burden is 150 hours. This time was already budgeted and approved in line 2 (Special Studies) of the original submission. No additional burden is sought.

There is no cost to individual volunteers other than their time to come to the location and complete the interview.

5. Explanation for Program Changes and Adjustments.

There are no changes in this package from the previous-approved clearance.

6. Plans for Tabulation and Publication and Project Time Schedule:

The study will be conducted at the cognitive lab of the NHANES data collection contractor in 2014. The findings will be used to improve the quality of the data. The results from the test will be used to assess and improve the instrument’s validity and determine the feasibility of inclusion in NHANES starting in 2015.

B. Collections of Information Employing Statistical Methods.

l. Respondent Universe and Sampling Methods.

NHANES’ respondents will not be involved in this test. Statistical methods will not be used to select participants. We propose to recruit 100 individuals (60 English Speaking and 40 Spanish-speaking persons aged 18 years and older) through a combination of a newspaper advertisement, flyers, and our data collection contractor’s database of previously interviewed volunteers. The newspaper advertisement/flyer will be in both English and Spanish. The primary requirement in recruitment will be participation in SNAP or WIC within the most recent 12 months. Within these constraints, we hope to recruit participants with some demographic variety (particularly in terms of gender, education, race/ethnicity, and income).

2. Procedures for the Collection of Information.

Interviews will be conducted in person in a private setting. Before the interview begins participants will be asked to read and sign an informed consent. As part of the consent process, we will also ask for permission to audio tape the interview. If the participant agrees to have the interview audio taped, the written permission will be included in the consent form. At the end of the taping, permission to keep the audiotape will be obtained verbally from the participant. All of consent processes will be recorded in the tape. If the participant chooses not to allow the tape to be kept, the tape will be immediately destroyed in the presence of the participant. Please note that during recruitment we will indicate that we plan to tape the interview. Individuals indicating in advance that they are not willing to be recorded will not be asked to participate as volunteers. This procedure exists to allow participants to change their mind at the last minute and documents their consent for taping.

At the beginning of the interview, the interviewer will orient the participant to the cognitive interview. During the interview, interviewers will use cognitive probes where appropriate. The respondent burden is estimated to be 60 to 90 minutes per interview. A $40 token of appreciation will be given to the participant after the completion of interview. All the forms and instruments used in the test will be available in English and Spanish languages. Respondents who only speak other languages will not be asked to participate in the cognitive testing.

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