Attachment N

2017 NSDUH_PDF 5 (ATT N).pdf

2017 National Survey on Drug Use and Health (NSDUH)

Attachment N

OMB: 0930-0110

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0930-0110 can be found here:

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2017 NSDUH, Supporting Statement
Attachment N – Showcard Booklet

2017 National Survey on
Drug Use and Health
SHOWCARD BOOKLET

RTI INTERNATIONAL

RTI Telephone Numbers
Tech Support .......... (877) 419-1768
Headway ................ (800) 208-7043
To reach other RTI staff, call 1-800-848-4079 then ask the
operator for the employee with whom you wish to speak.
Website Addresses
NSDUH ................... http://nsduhweb.rti.org
RTI ......................... http://www.rti.org
SAMHSA ................. http://www.samhsa.gov

Interview Troubleshooting Guide

To suppress a Hard Error involving two questions:
• Read the message box carefully.
–
–

–

If the first question listed is the one to be changed, press [ENTER].
If the second question listed is the one to be changed, press the down arrow to
highlight the second question, then press [ENTER].
In the rare event that neither question needs to be changed and the data entered
are correct, press [Tab] until the Suppress box is highlighted and press [ENTER],
then provide an explanation for why the error was suppressed.

To edit a lengthy response:

•

With the cursor in the answer field, press the Insert key [Ins]. Use the arrow keys to
move to the precise place within the answer field to edit or add to existing text. If
necessary, record additional text in a comment box, by pressing [F8].

To correct range errors:
•
•
•

For numerical questions, read the box carefully, making note of the expected range, if
provided in the message. Press [ENTER] to clear the error, then type a new answer
within range.
For pre-coded questions, read the message box carefully, then press [ENTER] to clear
the error. Type a new answer that corresponds with a pre-coded answer choice on the
screen.
For multiple choice questions (Code All That Apply), read the message box carefully,
then press [ENTER] to clear the error. Type a new answer that corresponds with a precoded answer choice on the screen, pressing the [Space bar] between each response as
needed.

To correct date errors:
•

Review the instructions on the screen to determine the date format for the question.
For “MM-DD-YYYY” format, the date must be entered with a 2-digit month and day and
4-digit year. For “MM-YYYY” format, the date must be entered with a 2-digit month and
4-digit year. Do not enter dashes or spaces—just the number including any leading
zeroes for month or day.

If an R needs assistance with an ACASI question, provide the corresponding steps above
for the problem they are having. Take care not to view the screen while assisting the R, to
ensure the confidentiality of their answers. For additional details on entering CAI responses
and troubleshooting error messages, refer to Chapter 5 in your FI Computer Manual.

INTRODUCTION AND INFORMED CONSENT FOR
INTERVIEW RESPONDENTS AGE 18+

INTRODUCE YOURSELF AND STUDY AS NECESSARY: Hello, I’m ________,
and I’m working on a nationwide study sponsored by the U.S. Department of
Health and Human Services. You should have received a letter about this study.
(SHOW LEAD LETTER, IF NECESSARY.)
READ THE BOXED INFORMATION BELOW
BEFORE STARTING EVERY INTERVIEW

This year, we are interviewing about 70,000 people across the nation. You have
been randomly chosen to take part. You will represent over 4,500 other people who
are similar to you. You may choose not to take part in this study, but no one else
can take your place. We will give you $30 when you finish the interview.
GIVE STUDY DESCRIPTION TO R IF YOU HAVE NOT ALREADY DONE SO.
This study asks about tobacco, alcohol, and drug use or non-use, knowledge and
attitudes about drugs, mental health, and other health issues. It takes about an
hour. You will answer most of the questions on the computer, so I will not see your
answers. We are only interested in the combined responses from all 70,000 people,
not just one person’s answers. This is why we do not ask for your name and we
keep your answers separate from your address. RTI may contact you by phone or
mail to ask a few questions about the quality of my work. This is why we ask for
your phone number and current address at the end of the interview.
While the interview has some personal questions, federal law keeps your answers
private. We hope that protecting your privacy will help you to give accurate
answers. You can quit the interview at any time and you can refuse to answer any
questions.
If it is all right with you, let’s get started.
(Can we find a private place to complete the interview?)

INTRODUCCIÓN Y CONSENTIMIENTO INFORMADO
PARA LOS PARTICIPANTES ENTREVISTADOS
DE 18 AÑOS DE EDAD O MÁS
PRESÉNTESE USTED MISMO Y EXPLIQUE EL ESTUDIO TAL COMO SEA
NECESARIO: Hola, me llamo ________, y trabajo para un estudio nacional
patrocinado por el Departamento de Salud y Servicios Humanos de los Estados
Unidos. Usted debe haber recibido una carta acerca de este estudio. (MUESTRE
LA CARTA, SI ES NECESARIO.)
FAVOR DE LEER LA SIGUIENTE INFORMACIÓN
ANTES DE COMENZAR CADA ENTREVISTA

Este año, estamos entrevistando a cerca de 70,000 personas en toda la nación.
Usted ha sido seleccionado(a) al azar para participar en este estudio. Usted
representará a más de 4,500 otras personas similares a usted. Usted puede decidir
no tomar parte en este estudio, pero nadie podrá tomar su lugar. Nosotros le
daremos $30 dólares en efectivo al terminar la entrevista.
ENTREGUE LA DESCRIPCIÓN DEL ESTUDIO AL PARTICIPANTE SI TODAVĺA
NO LO HA HECHO.
Este estudio hace preguntas sobre el uso o no uso de tabaco, alcohol y drogas;
conocimiento y actitudes hacia las drogas; la salud mental y otros asuntos sobre la
salud. La entrevista dura aproximadamente una hora y media. Usted usará la
computadora para responder a la mayoría de las preguntas y por lo tanto, yo no
podré ver sus respuestas. Nosotros estamos interesados únicamente en las
respuestas de todas las 70,000 personas en conjunto, y no solamente en las
respuestas de una persona. Esta es la razón por la cual nosotros no le
preguntamos por su nombre y mantenemos sus respuestas separadas de su
dirección. Es posible que el personal de RTI se comunique con usted por teléfono o
por correo para hacerle algunas preguntas acerca de la calidad de mi trabajo. Es
por eso que le preguntamos su número de teléfono y su dirección actual al final de
la entrevista.
Aunque algunas preguntas de la entrevista son personales, la ley federal mantiene
sus respuestas en forma confidencial. Esperamos que el hecho de proteger su
privacidad le ayude a darnos respuestas exactas. Usted puede dejar de participar
en cualquier momento y puede rehusarse a contestar cualquier pregunta.
Si usted está de acuerdo, podemos empezar.
(¿Podríamos ir a un lugar privado para llevar a cabo la entrevista?)

INTRODUCTION AND INFORMED CONSENT FOR
INTERVIEW RESPONDENTS AGE 12-17
READ THE SCRIPT BELOW AND OBTAIN PERMISSION FROM THE PARENT/GUARDIAN

Your (AGE) year-old child has been selected to be in this study. Your child’s participation is
voluntary. This interview asks about tobacco, alcohol, and drug use or non-use, knowledge
and attitudes about drugs, mental health, and other health related issues. All of your child’s
answers will be confidential and used only for statistical purposes. Since your child will answer
most of the questions on the computer, I will never see the answers, and you are not allowed
to see them either. If it is all right with you, we’ll get started.
(Can we find a private place to complete the interview?)

ONCE PARENTAL PERMISSION HAS BEEN GIVEN, CONFIRM THE PARENT/GUARDIAN OR
ANOTHER ADULT WILL BE PRESENT FOR THE DURATION OF THE INTERVIEW
THEN, READ THE BOXED INFORMATION BELOW BEFORE STARTING EVERY INTERVIEW
WITH A 12-17 YEAR OLD

This year, we are interviewing about 70,000 people across the nation. You have been
randomly chosen to take part. You will represent over 1,000 young people in this country who
are similar to you. You may choose not to take part in this study, but no one else can take
your place. We will give you $30 when you finish the interview.
GIVE STUDY DESCRIPTION TO R IF YOU HAVE NOT ALREADY DONE SO.
This study asks about tobacco, alcohol, and drug use or non-use, knowledge and attitudes
about drugs, mental health, and other health issues. It takes about an hour. You will answer
most of the questions on the computer, so I will not see your answers. Your answers will
never be seen by either your parents or your school. We are only interested in the combined
responses from all 70,000 people, not just one person’s answers. This is why we do not ask
for your name and we keep your answers separate from your address. RTI may contact you
by phone or mail to ask a few questions about the quality of my work. This is why we ask for
your phone number and current address at the end of the interview.
While the interview has some personal questions, federal law keeps your answers private. We
hope that protecting your privacy will help you to give accurate answers. You can quit the
interview at any time and you can refuse to answer any questions.
If it is all right with you, let’s get started.

INTRODUCCIÓN Y CONSENTIMIENTO INFORMADO PARA LOS
PARTICIPANTES ENTREVISTADOS DE 12 A 17 AÑOS DE EDAD
LEA EL TEXTO A CONTINUACIÓN Y OBTENGA PERMISO DEL PADRE DE FAMILIA/TUTOR/GUARDIÁN

Su hijo(a) de (EDAD) años ha sido seleccionado(a) para participar en el estudio. La
participación de su hijo(a) es voluntaria. Esta entrevista le hace preguntas sobre el uso o no
uso de tabaco, alcohol y drogas; conocimiento y actitudes hacia las drogas; la salud mental y
otros asuntos sobre la salud. Todas las respuestas de su hijo(a) se mantendrán en forma
confidencial y se utilizarán con propósitos estadísticos únicamente. Ya que su hijo(a) usará la
computadora para responder la mayoría de las preguntas, yo no podré ver sus respuestas, y a
usted tampoco se le permitirá ver las respuestas. Si usted está de acuerdo, podemos
empezar.
(¿Podríamos ir a un lugar privado para llevar a cabo la entrevista?)
UNA VEZ QUE SE HAYA OBTENIDO EL PERMISO DEL PADRE DE FAMILIA/TUTOR/GUARDIÁN,
CONFIRME QUE UNO DE ELLOS U OTRO ADULTO ESTARÁ PRESENTE DURANTE EL TIEMPO
QUE TOME LA ENTREVISTA
LUEGO, LEA LA SIGUIENTE INFORMACIÓN ANTES DE EMPEZAR CADA ENTREVISTA CON UN JOVEN
DE 12 A 17 AÑOS DE EDAD

Este año, estamos entrevistando a cerca de 70,000 personas en toda la nación. Tú has sido
seleccionado(a) al azar para participar en este estudio. Tú representarás a más de 1,000
jóvenes en este país que son similares a ti. Tú puedes decidir no tomar parte en este estudio,
pero nadie podrá tomar tu lugar. Nosotros te daremos $30 dólares al terminar la entrevista.
ENTREGUE LA DESCRIPCIÓN DEL ESTUDIO DE COLOR GRIS AL PARTICIPANTE SI
TODAVĺA NO LO HA HECHO.
Este estudio hace preguntas sobre el uso o no uso de tabaco, alcohol y drogas; conocimiento
y actitudes hacia las drogas; la salud mental y otros asuntos sobre la salud. La entrevista dura
aproximadamente una hora y media. Tú usarás la computadora para responder a la mayoría
de las preguntas y por lo tanto, yo no veré tus respuestas. Ni tus padres ni el personal de la
escuela podrán ver tus respuestas. Nosotros estamos interesados únicamente en las
respuestas de todas las 70,000 personas en conjunto, y no solamente en las respuestas de
una persona. Esta es la razón por la cual nosotros no preguntamos por tu nombre y
mantenemos tus respuestas separadas de tu dirección. Es posible que el personal de RTI se
comunique contigo por teléfono o por correo para hacerte algunas preguntas acerca de la
calidad de mi trabajo. Es por eso que te preguntamos por tu número de teléfono y tu dirección
actual al final de la entrevista.
Aunque algunas preguntas de la entrevista son personales, la ley federal mantiene tus
respuestas en forma confidencial. Esperamos que el hecho de proteger tu privacidad te ayude
a darnos respuestas exactas. Tú puedes dejar de participar en cualquier momento y puedes
rehusarte a contestar cualquier pregunta.
Si tú estás de acuerdo, podemos empezar.

SHOWCARD 1

MEXICAN, MEXICAN AMERICAN, MEXICANO
OR CHICANO

PUERTO RICAN

CENTRAL OR SOUTH AMERICAN

CUBAN OR CUBAN AMERICAN

DOMINICAN (FROM DOMINICAN REPUBLIC)

SPANISH (FROM SPAIN)

SHOWCARD 2

WHITE

BLACK OR AFRICAN AMERICAN

AMERICAN INDIAN OR ALASKA NATIVE
(AMERICAN INDIAN INCLUDES NORTH
AMERICAN, CENTRAL AMERICAN, AND SOUTH
AMERICAN INDIANS)

NATIVE HAWAIIAN

GUAMANIAN OR CHAMORRO

SAMOAN

OTHER PACIFIC ISLANDER

ASIAN (INCLUDING: ASIAN INDIAN, CHINESE,
FILIPINO, JAPANESE, KOREAN, AND
VIETNAMESE)

SHOWCARD 3

ASIAN INDIAN

CHINESE

FILIPINO

JAPANESE

KOREAN

VIETNAMESE

SHOWCARD 4

SEPTEMBER 2001 OR LATER

AUGUST 1990 TO AUGUST 2001 (INCLUDING
PERSIAN GULF WAR)

MAY 1975 TO JULY 1990

VIETNAM ERA (MARCH 1961 TO APRIL 1975)

FEBRUARY 1955 TO FEBRUARY 1961

KOREAN WAR (JULY 1950 TO JANUARY 1955)

JANUARY 1947 TO JUNE 1950

WORLD WAR II (DECEMBER 1941 TO DECEMBER
1946)

NOVEMBER 1941 OR EARLIER

SHOWCARD 5
0

NO SCHOOLING COMPLETED

1ST GRADE COMPLETED

2ND GRADE COMPLETED

3RD GRADE COMPLETED

4TH GRADE COMPLETED

5TH GRADE COMPLETED

6TH GRADE COMPLETED

7TH GRADE COMPLETED

8TH GRADE COMPLETED

9TH GRADE COMPLETED

10TH GRADE COMPLETED

11TH GRADE COMPLETED

REGULAR HIGH SCHOOL DIPLOMA

12TH GRADE, NO DIPLOMA

GED CERTIFICATE OF HIGH SCHOOL
COMPLETION

SOME COLLEGE CREDIT, BUT NO DEGREE

ASSOCIATE’S DEGREE (FOR EXAMPLE, AA, AS)

BACHELOR’S DEGREE (FOR EXAMPLE, BA, BS)

MASTER’S DEGREE (FOR EXAMPLE, MA, MS,
MENG, M. ED, MSW, MBA)

DOCTORATE DEGREE (FOR EXAMPLE, PHD, EDD)

PROFESSIONAL DEGREE BEYOND A BACHELOR’S
DEGREE (FOR EXAMPLE, MD, DDS, DVM, LLB, JD)

SHOWCARD 6
1

SELF

HUSBAND

SON (INCLUDES STEP, FOSTER, ADOPTIVE)

SON-IN-LAW

BROTHER (INCLUDES HALF, STEP, FOSTER,
ADOPTIVE)

BROTHER-IN-LAW

FATHER (INCLUDES STEP, FOSTER,
ADOPTIVE)

FATHER-IN-LAW

UNCLE

NEPHEW

GRANDFATHER

GRANDSON

COUSIN

EX-HUSBAND

UNMARRIED PARTNER

HOUSEMATE OR ROOMMATE

TENANT, BOARDER, OR EXCHANGE STUDENT

OTHER RELATIVE

OTHER NON-RELATIVE

SHOWCARD 7
1

SELF

WIFE

DAUGHTER (INCLUDES STEP, FOSTER,
ADOPTIVE)

DAUGHTER-IN-LAW

SISTER (INCLUDES HALF, STEP, FOSTER,
ADOPTIVE)

SISTER-IN-LAW

MOTHER (INCLUDES STEP, FOSTER,
ADOPTIVE)

MOTHER-IN-LAW

AUNT

NIECE

GRANDMOTHER

GRANDDAUGHTER

COUSIN

EX-WIFE

UNMARRIED PARTNER

HOUSEMATE OR ROOMMATE

TENANT, BOARDER, OR EXCHANGE STUDENT

OTHER RELATIVE

OTHER NON-RELATIVE

SHOWCARD 8

PERSON IN FAMILY WITH HEALTH INSURANCE LOST
JOB OR CHANGED EMPLOYERS

LOST MEDICAID OR MEDICAL ASSISTANCE
COVERAGE BECAUSE OF NEW JOB OR INCREASE IN
INCOME

LOST MEDICAID OR MEDICAL ASSISTANCE
COVERAGE FOR SOME OTHER REASON

COST IS TOO HIGH / CAN’T AFFORD PREMIUMS

BECAME INELIGIBLE BECAUSE OF AGE OR
LEAVING SCHOOL

EMPLOYER DOES NOT OFFER COVERAGE, OR
NOT ELIGIBLE FOR COVERAGE

GOT DIVORCED OR SEPARATED FROM PERSON
WITH INSURANCE

DEATH OF SPOUSE OR PARENT

INSURANCE COMPANY REFUSED COVERAGE

DON’T NEED IT

RECEIVED MEDICAID OR MEDICAL INSURANCE
ONLY WHILE PREGNANT

SHOWCARD 9

COST IS TOO HIGH / CAN’T AFFORD PREMIUMS

EMPLOYER DOES NOT OFFER COVERAGE, OR
NOT ELIGIBLE FOR COVERAGE

INSURANCE COMPANY REFUSED COVERAGE

DON’T NEED IT

SHOWCARD 10

INCOME EARNED AT A JOB OR BUSINESS
RETIREMENT, DISABILITY, OR SURVIVOR PENSION
UNEMPLOYMENT OR WORKER’S COMPENSATION
VETERAN’S ADMINISTRATION PAYMENTS
CHILD SUPPORT
ALIMONY
INTEREST INCOME
DIVIDENDS FROM STOCKS OR MUTUAL FUNDS
INCOME FROM RENTAL PROPERTIES, ROYALTIES,
ESTATES OR TRUSTS

SHOWCARD 11

LESS THAN $1,000

$1,000 - $1,999

$2,000 - $2,999

$3,000 - $3,999

$4,000 - $4,999

$5,000 - $5,999

$6,000 - $6,999

$7,000 - $7,999

$8,000 - $8,999

$9,000 - $9,999

$10,000 - $10,999

$11,000 - $11,999

$12,000 - $12,999

$13,000 - $13,999

$14,000 - $14,999

$15,000 - $15,999

$16,000 - $16,999

$17,000 - $17,999

$18,000 - $18,999

$19,000 - $19,999

SHOWCARD 12

$20,000 - $24,999

$25,000 - $29,999

$30,000 - $34,999

$35,000 - $39,999

$40,000 - $44,999

$45,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,000 - $149,999

$150,000 OR MORE

TARJETA 1

MEXICANO, MEXICANOAMERICANO O
CHICANO

PUERTORRIQUEÑO

CENTROAMERICANO O SUDAMERICANO

CUBANO O CUBANOAMERICANO

DOMINICANO (DE LA REPÚBLICA DOMINICANA)

ESPAÑOL (DE ESPAÑA)

TARJETA 2

BLANCO

NEGRO O AFROAMERICANO

INDÍGENO AMERICANO O NATIVO DE ALASKA
(INDÍGENO AMERICANO INCLUYE INDÍGENOS DE
NORTEAMÉRICA, CENTROAMÉRICA Y
SUDAMÉRICA)

NATIVO DE HAWAII

GUAMEÑO O CHAMORRO

SAMOANO

OTRO ISLEÑO DEL PACÍFICO

ASIÁTICO (INCLUYENDO: INDIO ASIÁTICO,
CHINO, FILIPINO, JAPONÉS, COREANO Y
VIETNAMITA)

TARJETA 3

INDIO ASIÁTICO

CHINO

FILIPINO

JAPONÉS

COREANO

VIETNAMITA

TARJETA 4

SEPTIEMBRE DEL 2001 O DESPUÉS

AGOSTO DE 1990 A AGOSTO DEL 2001
(INCLUYENDO LA GUERRA DEL GOLFO PÉRSICO)

MAYO DE 1975 A JULIO DE 1990

ÉPOCA DE VIETNAM (MARZO DE 1961 A ABRIL
DE 1975)

FEBRERO DE 1955 A FEBRERO DE 1961

LA GUERRA DE COREA (JULIO DE 1950 A ENERO
DE 1955)

ENERO DE 1947 A JUNIO DE 1950

SEGUNDA GUERRA MUNDIAL (DICIEMBRE DE
1941 A DICIEMBRE DE 1946)

NOVIEMBRE DE 1941 O ANTES

TARJETA 5
0

NO COMPLETÓ NINGÚN GRADO EN LA ESCUELA

COMPLETÓ EL 1er. GRADO

COMPLETÓ EL 2o. GRADO

COMPLETÓ EL 3er. GRADO

COMPLETÓ EL 4o. GRADO

COMPLETÓ EL 5o. GRADO

COMPLETÓ EL 6o. GRADO

COMPLETÓ EL 7o. GRADO

COMPLETÓ EL 8o. GRADO

COMPLETÓ EL 9o. GRADO

COMPLETÓ EL 10o. GRADO

COMPLETÓ EL 11o. GRADO

DIPLOMA DE ESCUELA PREPARATORIA O ‘HIGH SCHOOL’

GRADO 12, SIN DIPLOMA

CERTIFICADO “GED” POR COMPLETAR ‘HIGH SCHOOL’

ALGUNOS CRÉDITOS UNIVERSITARIOS, PERO SIN TÍTULO

TÍTULO DE ASOCIADO UNIVERSITARIO (POR
EJEMPLO, AA, AS)

TÍTULO DE LICENCIATURA UNIVERSITARIA (POR
EJEMPLO, BA, BS)

TÍTULO DE MAESTRÍA (POR EJEMPLO, MA, MS, MENG,
M. ED, MSW, MBA)

TÍTULO DE DOCTORADO (POR EJEMPLO, PHD, EDD)

TÍTULO PROFESIONAL POSTERIOR A UN TÍTULO DE
LICENCIATURA UNIVERSITARIA (POR EJEMPLO, MD,
DDS, DVM, LLB, JD)

TARJETA 6
1

SÍ MISMO

ESPOSO

HIJO (INCLUYE HIJASTRO, HIJO “FOSTER”
O DE CRIANZA, HIJO ADOPTIVO)

YERNO

HERMANO (INCLUYE MEDIO HERMANO,
HERMANASTRO, HERMANO “FOSTER” O DE
CRIANZA, HERMANO ADOPTIVO)

CUÑADO

PADRE (INCLUYE PADRASTRO, PADRE
“FOSTER” O DE CRIANZA, PADRE ADOPTIVO)

SUEGRO

TÍO

SOBRINO

ABUELO

NIETO

PRIMO

EX-ESPOSO

PAREJA (SIN ESTAR CASADOS)

COMPAÑERO DE CASA O DE CUARTO

INQUILINO, HUÉSPED O ESTUDIANTE DE
INTERCAMBIO

OTRO PARIENTE

OTRO QUE NO SEA PARIENTE

TARJETA 7
1

SÍ MISMA

ESPOSA

HIJA (INCLUYE HIJASTRA, HIJA “FOSTER” O
DE CRIANZA, HIJA ADOPTIVA)

NUERA

HERMANA (INCLUYE MEDIA HERMANA,
HERMANASTRA, HERMANA “FOSTER” O DE
CRIANZA, HERMANA ADOPTIVA)

CUÑADA

MADRE (INCLUYE MADRASTRA, MADRE
“FOSTER” O DE CRIANZA, MADRE ADOPTIVA)

SUEGRA

TÍA

SOBRINA

ABUELA

NIETA

PRIMA

EX-ESPOSA

PAREJA (SIN ESTAR CASADOS)

COMPAÑERA DE CASA O DE CUARTO

INQUILINA, HUÉSPED O ESTUDIANTE DE
INTERCAMBIO

OTRA PARIENTE

OTRA QUE NO SEA PARIENTE

TARJETA 8
1

LA PERSONA EN LA FAMILIA CON SEGURO DE SALUD
PERDIÓ EL EMPLEO O CAMBIÓ DE EMPLEADOR O
PATRÓN

PERDIÓ LA COBERTURA DE MEDICAID O DE
BENEFICIOS MÉDICOS POR CAMBIAR DE EMPLEO O
POR UN AUMENTO EN LOS INGRESOS

PERDIÓ LA COBERTURA DE MEDICAID O ASISTENCIA
MÉDICA POR ALGUNA OTRA RAZÓN

EL COSTO ES DEMASIADO ALTO O NO PUEDE PAGAR
LAS CUOTAS O PRIMAS

PERDIÓ LOS BENEFICIOS DEBIDO A LA EDAD O POR
DEJAR LA ESCUELA

EL EMPLEADOR NO OFRECE COBERTURA O LA
PERSONA NO LLENA LOS REQUISITOS PARA RECIBIR
COBERTURA

SE DIVORCIÓ O SE SEPARÓ DE LA PERSONA CON
SEGURO

MUERTE DEL ESPOSO(A) O DEL PADRE O LA MADRE

LA COMPAÑÍA DE SEGUROS LE NEGÓ LA COBERTURA

NO LO NECESITA

RECIBIÓ MEDICAID O SEGURO MÉDICO SOLAMENTE
DURANTE EL EMBARAZO

TARJETA 9

EL COSTO ES DEMASIADO ALTO O NO PUEDE
PAGAR LAS CUOTAS O PRIMAS

EL EMPLEADOR NO OFRECE COBERTURA O LA
PERSONA NO LLENA LOS REQUISITOS PARA
RECIBIR COBERTURA

LA COMPAÑÍA DE SEGUROS LE NEGÓ LA
COBERTURA

NO LO NECESITA

TARJETA 10

INGRESOS OBTENIDOS DE UN EMPLEO O NEGOCIO
JUBILACIÓN, DISCAPACIDAD O PENSIÓN PARA
SOBREVIVIENTES
COMPENSACIÓN POR DESEMPLEO O DE
TRABAJADORES
PAGOS DE LA ADMINISTRACIÓN DE VETERANOS
MANUTENCIÓN INFANTIL
PENSIÓN DE SU EX-PAREJA
INGRESO PROVENIENTE DE INTERESES
DIVIDENDOS PROVENIENTES DE ACCIONES O
FONDOS MUTUOS
INGRESOS POR ALQUILER DE PROPIEDADES,
REGALÍAS, HERENCIAS O FIDEICOMISOS

TARJETA 11

MENOS DE $1,000 DÓLARES

DE $1,000 A $1,999 DÓLARES

DE $2,000 A $2,999 DÓLARES

DE $3,000 A $3,999 DÓLARES

DE $4,000 A $4,999 DÓLARES

DE $5,000 A $5,999 DÓLARES

DE $6,000 A $6,999 DÓLARES

DE $7,000 A $7,999 DÓLARES

DE $8,000 A $8,999 DÓLARES

DE $9,000 A $9,999 DÓLARES

DE $10,000 A $10,999 DÓLARES

DE $11,000 A $11,999 DÓLARES

DE $12,000 A $12,999 DÓLARES

DE $13,000 A $13,999 DÓLARES

DE $14,000 A $14,999 DÓLARES

DE $15,000 A $15,999 DÓLARES

DE $16,000 A $16,999 DÓLARES

DE $17,000 A $17,999 DÓLARES

DE $18,000 A $18,999 DÓLARES

DE $19,000 A $19,999 DÓLARES

TARJETA 12

DE $20,000 A $24,999 DÓLARES

DE $25,000 A $29,999 DÓLARES

DE $30,000 A $34,999 DÓLARES

DE $35,000 A $39,999 DÓLARES

DE $40,000 A $44,999 DÓLARES

DE $45,000 A $49,999 DÓLARES

DE $50,000 A $74,999 DÓLARES

DE $75,000 A $99,999 DÓLARES

DE $100,000 A $149,999 DÓLARES

$150,000 O MÁS

Enumeration Rules
PERSONS WHO ARE NOT TO BE INCLUDED ON ROSTER:



Persons under the age of 12 at the time of screening (do count them in the total SDU
Members number)



Persons who are institutionalized at the time of screening



Persons who will not live at the SDU for most of the time during the quarter

PERSONS WHO ARE TO BE INCLUDED ON ROSTER:



Persons who will live at the SDU for most of the time during the quarter (provided
they are 12 or older and not institutionalized at the time of screening)

PERSONS ON ACTIVE DUTY IN THE UNITED STATES’ MILITARY/ARMED FORCES:



Active duty personnel who live at the SDU for half or more of the quarter will be
rostered, but then will be made ineligible by the tablet prior to selection

KNOWN CITIZENS OF FOREIGN COUNTRIES:



DO NOT INCLUDE:

—

citizens of foreign countries living on the premises of an
embassy, ministry, legation, chancellery, or consulate

—

citizens of foreign countries who consider themselves to
be just visiting or traveling in the United States
(regardless of the length of time they will be staying at the
SDU)

DO INCLUDE citizens of foreign countries who are not living on the premises of an
embassy, ministry, etc., but who are living/studying/working in the United States and
who will be living at the SDU for most of the time during the quarter.

NSDUH Screening/Interviewing Tasks
Carefully review the below list to be sure you understand how to properly complete each task, referring to the
FI Manual section(s) as needed for details.
Global Tasks

Manual

Read Verbatim Using the Exact Words Provided
Do not skip or change words. Do not add additional words or explanations. Take
your time to ensure you read each word.
Know the Study
Accurately and concisely answer respondent questions about the study and
participation.
Use Materials Correctly
Be organized and have materials accessible. Hand required materials as prompted
on the screen. Remember to pack the Showcard Booklet, completed QC Form
(sealed in the envelope) and Interview Incentive Receipt copies at the end of the
interview. Do not ask for any other materials to be returned.
Protect Respondent Rights
Follow ALL informed consent protocols exactly. Treat all information observed/
provided confidentially. Treat each person you encounter respectfully, professionally
and ethically. Never reveal a respondent’s answers to anyone, including the
respondent’s family members. Resist the temptation to reveal even positive
information gleaned from an interview to parents or other household members.
Perform all Tasks in an Unbiased Manner
Work calmly and professionally. Any comments must be neutral and unbiased.

6.2, 8.2

Screening Tasks

5.1 – 5.6
7.5
4.6
12.2

2.4 – 2.6
4.10
7.6

7.2
8.2

Manual

Use Segment Materials to locate the correct SDU
Introduce Yourself and the Study to the Screening Respondent (SR)
SR must be an adult (18+) resident of the SDU. Have your ID badge visible. Include
the 4 points: your name, you represent RTI International, the sponsor is the US
Department of Health and Human Services, and mention/offer the Lead Letter.
Obtain Informed Consent for screening
Give the SR a copy of the Study Description to keep, and read the Informed
Consent screen verbatim.
Complete the Household Roster
Ask the questions verbatim and carefully enter responses. The SR must hear each
question read in its entirety one time to hear all options. Subsequently you may
accept responses early, only if the SR interrupts. Never assume or code by
observation other than gender (with one RARE exception if ethnicity/race refused for
Householder – see FI Manual).
Transition to the Interview Smoothly
For selected respondent(s), share selection information with SR and interview
respondent(s) if available. Ask and be prepared to complete the interview(s) at that
time.
Collect Verification Information (for SDUs with no one selected)
Read the text verbatim and enter details accurately.

3.4
4.8
4.9

4.10

6.4

7.3
7.4
6.5

NSDUH Screening/Interviewing Tasks (continued)
Interview Tasks
Obtain Parental Permission to Speak with Selected Youth
PRIOR to talking with youth about the study, read the script available on the tablet
Respondent Selection screen to the parent/guardian.
Introduce Yourself and the Study to the interview respondent (R)
Accurately answer any questions the R may have.
Obtain Parental Permission to Interview Selected Youth
Read the top box of the youth script from the Showcard Booklet to the
parent/guardian. If two youth are selected, read the script twice to obtain separate
permission for each youth. Confirm an adult will be at home during the interview.
Complete Informed Consent Protocols
Read the age appropriate script from the Showcard Booklet verbatim and when
prompted give the R a copy of the Study Description to keep (unless the R was the
SR and still has a copy available; in all other situations, provide a copy to the R).
Choose an interview location that gives the respondent privacy
Set up the Laptop Properly and Efficiently
Plug in laptop and headphones, and place fresh covers on the ear pieces in front of
R. Turn on laptop and enter password. Enter the QuestID to begin the interview.
Ask Questions as Worded; Ask All Questions
Allow R time to respond. Do not rush the R or allow R to rush you. Ask all questions
even if you think you know the answer. Never assume/code by observation. Probe
to ensure accurate/complete responses, particularly for initial answer of don’t know.
Use Showcards Properly
Turn the Showcard Booklet to the proper card, and give it to the R when instructed
on the screen (or lay it on the table for the R). Do not prop up or hold the booklet
yourself. Take the booklet back when finished with the question.
Introduce the Laptop to the R
Read the introduction screens verbatim. As instructed, first point (with your finger)
then read the description. Be sure the R can see the keyboard. Offer the
headphones and demonstrate the volume adjustment.
Be Available During the ACASI
Assist if the R has questions, but be sure you cannot see the screen. To protect
confidentiality and privacy, NEVER read the ACASI questions out loud or allow them
to play through the laptop speakers (even if the R thinks it is OK). Prepare the end
of interview forms (Interview Incentive Receipt: Case ID ONLY; QC Form: all boxes
in the FI portion). Leave the headphones plugged in until the very end of the
interview.
Complete the QC Form Process
Read the screen text exactly, provide the prepared form and envelope as instructed.
R should place the completed QC Form in the envelope and seal before returning it
to you. For youth respondents, ask the parent/guardian to complete the form.
Complete the Incentive Process
Follow the steps on the screen in order (hand cash, mark box, sign and date receipt,
give R top copy). Read the text on the screen verbatim. Provide a Q&A Brochure to
the R, or the parent/guardian of a youth, reading the screen text. (This is not
required if you provided a brochure earlier, such as when explaining the study.)
Understand your professionalism and dedication make a difference!

Manual
7.4.2

7.4, 7.5
7.6.2

7.6

7.7
7.7.3

8.2

8.6

8.7

8.11.1

8.11.2

7.2

Sampling Process Explanation
Sam ple: A representative part of a population that is studied to gain information about the whole population.
N SDUH target population: Civilian, non-institutional population aged 12 years or older residing within the 50
United States and the District of Columbia.
THE PROCESS:
RTI statisticians draw a smaller sample of the target population designed to represent the population as a
whole using probability sampling.
Step 1:
Break each state into geographic areas, called State Sampling Regions (SSRs) using population estimates
and housing unit counts from the Census Bureau.
o Number of SSRs is dependent on the population of the state, as shown in the table below.
o Each SSR within a state is expected to yield the same number of interviews. This means the more
densely populated the area, the smaller the region.
Approx.
Total
State
SSRs
Int. per
Segments
Segment
California
36
16
288
Texas, New York, and Florida
30
14
240
Illinois, Pennsylvania, Ohio, and Michigan
24
13
192
Georgia, North Carolina, New Jersey, and Virginia
15
13
120
Remaining 38 States and the District of Columbia
12
10
96
Step 2:
Break each SSR up into segments.
o Scientifically selected to ensure the sample accurately represents the United States’ population.
o Each area is assigned a “probability,” or “chance,” of being selected based on the Census
population count. 8 segments selected within each SSR (2 per quarter of data collection).
Step 3:
Dwelling units (DUs) within the segments are counted and listed, and recorded on the List of DUs or Group
Quarters Listing Form.
Step 4:
From the listed DUs, specific housing units (HUs) and group quarters units (GQUs) are randomly selected.
o Selected units are called sample dwelling units (SDUs) which you contact for screening and
possible interviewing. Approximately 186,000 SDUs are randomly selected each year
Step 5:
Either 0, 1, or 2 persons (respondents) are selected for the interview using the roster information entered
into the tablet during screening. Approximately 70,000 respondents are selected and complete the interview
each year.
o All screening data are used by RTI statisticians
Analysis:
“Sample Weighting” is used to determine how many people in the population each respondent represents.
o 1 adult - represents over 4,500 other adults
o 1 youth - represents over 1,000 other youths
FIELD INTERVIEWER’S ROLE
Maintain the integrity of the sample by:
o Using segment materials properly
o Following project procedures, including editing address and missed DU protocols
o Investigating discrepancies between the materials and what you actually see in the field
o Paying close attention to details
4

Sampling Process Explanation (continued)
United States

(50 States + DC)

State Sampling Regions
(SSRs)

Number of SSRs varies by State
12 in remaining states

Segments
8 per SSR

Listed Dwelling Units

Selected Dwelling Units
~ 186,000 randomly
selected per year

Respondents
1 adult=over

4,500 other adults
1 youth=over
1,000 other youths

Overview of the Screening and Interview Process
Review segment materials to locate area and plot the best
and most direct travel route to and from the area.
Prepare and mail lead letters.

Locate (using the segment materials) and contact selected DU.

Determine that the SDU is a true HU or GQU.

Complete Record of Calls (ROC) in
tablet. Try DU later. If unit is vacant,
not a DU, or only a temporary
residence, verify with neighbor or
other knowledgeable person.
Complete verification information
and ROC.

Try to determine a good time to
return. Complete ROC.

Is anyone home?
Yes

Is an eligible SR
(resident of DU, 18+)
available?

Yes
Complete the household roster and selection process with the SR.

Any
respondents
selected?

Obtain verification information and
thank SR. Complete ROC.

Establish an appointment. Complete
ROC, including an entry about the
interview appointment.

Yes
Can the
selected R complete
interview now?
Yes
Introduce self, study, and obtain informed consent from respondent.
(Obtain parent/guardian permission before speaking to a selected youth.)

Conduct interview.
Complete end of the interview tasks, including Quality Control (QC) Form.

Give respondent cash and completed receipt. Give adult respondents & parent/
guardian of youth respondents a Q&A Brochure if not done already.

Thank respondent, complete ROC.
Transmit data to RTI.
Mail Quality Control Form to RTI within 24 hours.

Overview of the Screening and Interview Process (continued)
When you work in the field, you will encounter a variety of situations:

Can’t screen (i.e. no one home, vacant units, SR not available, etc.)
•
•
•
•

touch Case ID on the Select Case Screen, touch Screen DU
approach unit and discover you can’t screen
obtain verification information for codes 10, 13 and 18
complete ROC to document situation

Screen only (codes 22, 25, 26, 30)
•
•
•
•
•

touch Case ID on the Select Case Screen, touch Screen DU
approach unit and obtain participation of eligible SR
complete screening
obtain verification information
complete ROC

Screen, then interview (31, 32 and then 70)
•
•
•
•
•
•
•

•
•

touch Case ID on the Select Case Screen, touch Screen DU
approach unit and obtain participation of eligible SR
complete screening
obtain participation/informed consent of selected respondent(s) (and permission of
parent/guardian if minor)
prepare laptop and enter QuestID from tablet
conduct interview(s) with available selected respondent(s)
perform end of interview steps by carefully following the instructions on the screen for the
Quality Control Form and incentive procedures, providing a Q&A Brochure to each adult
respondent and the parent/guardian of each youth respondent, if not done earlier
complete ROC(s) in tablet for screening and completed interview(s)
mail completed Quality Control Form(s) to RTI within 24 hours

Screen, make appointment for interview (codes 31, 32 and then 50)
•
•
•
•
•
•

touch Case ID on the Select Case Screen, touch Screen DU
approach unit and obtain participation of eligible SR
complete screening
complete ROC for screening
complete ROC to document appointment for each selected respondent
prepare appointment card and give to each respondent

Interview only at appointment time or other follow-up contact
•
•
•
•
•

•
•

touch Case ID on the Select Case Screen, review selections and roster
obtain participation/informed consent of selected respondent(s) (and permission of
parent/guardian if minor)
prepare laptop and enter QuestID from tablet
conduct interview(s) with selected respondent(s)
perform end of interview steps by carefully following the instructions on the screen for the
Quality Control Form and incentive procedures, providing a Q&A Brochure to each adult
respondent and the parent/guardian of each youth respondent, if not done earlier
complete ROC(s) in tablet
mail completed Quality Control Form(s) to RTI within 24 hours
7

Guidelines for Speaking with Neighbors
When speaking with neighbors, it’s important only to ask for and obtain certain information. Always
be very general and concise, and do not offer more information than is necessary.
If the neighbor is suspicious and won’t provide any information unless you tell them why you are
interested in a particular address, simply state the household has been selected to participate in a
national study. Do not name or describe the survey.
You CAN speak to a neighbor to:
1. Verify whether someone actually lives at the selected DU(s)
2. Find out a good time to find the residents at home
3. Obtain verification data if the SDU is vacant
When speaking with neighbors, you CANNOT:
1. Explain that the household has been selected to participate in the NSDUH
2. Obtain screening information for the selected DU(s)
Suggested wording to use when speaking with neighbors:
“Hello, my name is [INSERT NAME] with RTI International. I am working on a nationwide study
sponsored by the U.S. Department of Health and Human Services and need to speak with your
neighbor. Do you know when would be a good time to find them at home?”
OR
“Hello, my name is [INSERT NAME] with RTI International. Your neighbor has been selected to
participate in a national study and I’m having trouble catching them at home. Do you know when a
good time would be for me to find them at home?”
Suggested wording for vacancy verification:
“Hello, my name is [INSERT NAME] with RTI International. Your neighbor has been selected to
participate in a national study, but it looks like the house may be vacant. Can you tell me if someone
lives there?”

Informed Consent Reference Guide
This reference guide is not a replacement for information contained in your FI Manual, but is a
listing of crucial protocols that must be followed when obtaining informed consent. Refer to
pages 7-19 through 7-23 in your FI Manual for more information on informed consent procedures.

YOUTH INFORMED CONSENT PROCEDURES:
Parental Permission:
•

Before talking with the selected youth, ask the parent/guardian for permission to speak with
the youth using the Parental Introductory script on the tablet.

•

After the parent agrees, speak with the selected youth. Introduce yourself and the study,
providing materials as necessary, and inform the youth they have been selected for the
interview.

•

Once the youth agrees to do the interview, read the top box of the Intro to CAI 12-17 to
parent/ guardian and obtain their permission to interview the youth. Permission MUST be
given IN PERSON

•

After parental permission has been given, confirm the parent/guardian or another adult will be
present for the duration of the interview (not in interview room)

•

If you obtain permission from one parent/guardian who is not home when you return to do
the interview, you may only proceed if the other parent/guardian is available, grants
permission for the interview, and confirms he/she or another adult will be present for the
duration of the interview

•

If the parent/guardian cannot communicate well enough in English to understand the Intro to
CAI:
o If parent speaks Spanish, have the parent read the Spanish translation of the Intro to CAI
themselves (if you are not a RTI-Certified bilingual FI who could read it to them)


If parent cannot read, the youth or another translator may read script to the parent,
along with reading the Spanish Study Description

o If language is other than Spanish, the youth or another translator may use the script and
Study Description and translate the information for the parent
o Use the youth or translator to confirm the parent/guardian or another adult will be present
for the duration of the interview and answer any questions the parent may have
•

Exception: If the youth is 17 years old and living independently without a parent or guardian
residing in the home (such as a college student), proceed with youth Informed Consent
procedures without parental permission, using the Intro to CAI 12-17 script

After Obtaining Parental Permission:
•

Read the main box of the Intro to CAI 12-17 to the youth. When instructed, give the youth a
Study Description to read and keep.

ADULT INFORMED CONSENT PROCEDURES:
•

Read the Intro to CAI 18+ to R. When instructed, give the R a Study Description to read and
keep (unless the R was the SR and still has a copy available; in all other situations, provide a
copy to the R).
o If R cannot read the Study Description themselves, you must read it to them
9

The Interview Process
Informed Consent Procedures
•

READ THE INFORMED CONSENT FOUND AT THE FRONT OF THIS BOOKLET TO RESPONDENT

•

If the respondent is 12 - 17 years old, obtain parental permission first

Choose the Best Interview Location
•

Consider the following issues:
– Privacy and ethics
– Comfort and safety
– Battery power and/or the availability of an electrical outlet

•

Be flexible in choosing a location, but never compromise NSDUH protocols

Setting up the Computer
•

Unpack the computer and plug it in using the extension cord if needed

•

Place clean headphone covers on the ear pieces of the headphones and plug the headphones
into the computer

•

Press the Power button and WAIT for the computer to boot up

•

While waiting, make sure you have the QuestID displayed on the tablet, your Showcard
Booklet, a Quality Control Form and envelope, a Q&A Brochure (if not given earlier), $30 and
an Interview Incentive Receipt

•

Enter the password, then enter the QuestID from the tablet to begin the interview

Conducting the Interview
•

Obtain informed consent (if not done earlier)

•

If respondent is under the age of 12 or is active in the military, the computer will automatically
complete this case (If this occurs, remember to enter a Code 79 in the tablet and explain the
situation)

•

Use the Showcards as instructed

•

During the ACASI, be available to assist the respondent without being intrusive




Prepare the Quality Control Form:
–

Record the date and approximate interview completion time

–

Print your name and FI ID # legibly

–

Record the Case ID, including the A or B

–

Indicate which parent (or guardian) gave permission if respondent is a minor

Prepare the Interview Incentive Receipt:
–

Record the Case ID, including the A or B

–

Do not sign, date or check the box for cash acceptance until prompted by the computer

Other possible tasks include: review your ROCs and plan work for the day, re-read portions
of the FI Computer Manual or FI Manual (access from the FI Assistant feature or remove a
chapter or two at a time from the binder), re-read the Job Aids section in the Showcard
Booklet, and review materials for information to use when obtaining cooperation

The Interview Process (continued)
•

Enter the QC ID and the Case ID when prompted and follow Quality Control Form procedures
– For a youth, the Quality Control Form should be completed by a parent or guardian (If no
parent is available, it is acceptable for the youth to complete the form)
– The R/parent should place the Quality Control Form into the envelope and seal it (If
R/parent refuses to complete the Quality Control Form, ask him/her to write “REFUSED”
across the top)

•

Give R the $30 cash, sign, date and mark the appropriate cash acceptance box on the
Interview Incentive Receipt and give the respondent the top copy

•

Give adult interview respondents and parent/guardian of youth respondents a Q&A Brochure
(if not done earlier)

When Finished with the Interview
•

Turn off your laptop

•

Pack up your equipment:
– Unplug the power cord from the computer first, unplug from the wall, then wrap them up and
place in carrying case
– Close the screen, place the laptop in the case and zip closed
– Remember your tablet, Showcard Booklet, and other papers

•

THANK YOUR RESPONDENT!

•
•

Enter a Code 70 in your tablet.
Answer the FI debriefing questions

•

Mail Quality Control Form to RTI within 24 hours of completion of the interview

•

Mail Interview Incentive Receipt (FS copy) to your FS each week

Possible Respondent Difficulties
•

Is the respondent physically, mentally, and emotionally capable of participating?
– Slow the pace of the questions to see if comprehension improves
– Allow adequate time to answer
– If respondent does not seem to understand, politely discontinue the interview and speak with

your FS

•

Is the respondent intoxicated or under the influence of other drugs?
– Attempt to schedule another time to return

•

Is the respondent blind or paralyzed?
– Take the time to figure out if respondent can complete interview–each interview is precious!
– Only in these situations are you allowed to enter the responses during the ACASI portion for

the respondent (Make note of this in the FI debriefing questions)

•

Does the respondent exhibit behaviors that suggest he or she may have difficulty reading?

– Remember that the respondent can listen to all the questions through the headphones and
answer most questions with a number

Instructions for Using the Certificate of Participation
At the end of the interview, you can give a Certificate of Participation that authenticates the
respondent’s participation in NSDUH. Youth and other interested respondents may use the
completed certificate to verify with teachers or group leaders that they participated in NSDUH, and
may then receive credit for participating in the study. Possibilities include:
•
•
•

extra credit for school
incorporating the NSDUH experience into a school project
credit towards community service hours.

It is the respondents’ responsibility to arrange to receive any possible credit. Respondents and
parents must understand that:
•
•
•

they are responsible for making arrangements for any credit
their school or group may or may not give credit; credit is not guaranteed
no advance arrangements have been made with any schools or community groups.

The certificate is worded to allow for use with respondents other than middle or high school students,
such as a young adult required to perform community service or for classes beyond high school.
However, the certificate should be used primarily with youth respondents. Adult respondents should
not receive a certificate unless they ask for acknowledgement that he/she completed the survey or
seem very interested in receiving one.
Upon completion of the interview, prepare the certificate by:
•
•

filling in the date the interview was completed
and your FI name and ID number.

To preserve confidentiality, the respondent adds his or her name at a later time.
Also provide a Question and Answer Brochure along with the certificate, as it contains additional
details and includes contact information and Website addresses where interested persons can obtain
additional information.

ROC Comments
ROC comments should be appropriate, non-judgmental, and:
•
•
•

Informative – Record appointment times, best times to return, who you talked to, or if no
adult was home, record which cars were in the driveway.
Helpful – Note relevant information for you to use in preparing to return or when discussing
the case with your supervisor. If a case gets transferred to another FI, the notes are very
important to the new FI to understand what has happened.
Concise – Explain your comments directly, leaving out unnecessary words or information.
Your comments must be easily understood by you, your FS, other FIs, and project managers.

Examples of good ROCs:
•
•
•

•

CB after 7:00 pm
2:30 Sat appt
W M 15ish said parents home after 8:00
HISP F 60s send SPAN letter

PROJECT ABBREVIATIONS
R
SR
FI
Q&A
DU

respondent (for the interview)
screening respondent
field interviewer
Q&A Brochure
dwelling unit

STANDARD ABBREVIATIONS
days of the week
F
M
B
W
HISP
SPAN
INFO
REF

(with 3 letters)
female
male
black
white
Hispanic
Spanish
information
refused

SUGGESTED HELPFUL ABBREVIATIONS
CB
APPT
AM
AFTRN
PM
NGHBR
GTKPR
WKND

call back (or come back)
appointment
morning
afternoon
evening
neighbor
gatekeeper
weekend

Refusal Reasons
Use these descriptions to help you classify refusals.
1.

Too busy/no time/did too many already
The number one reason for refusals is lack of time.

Surveys/ Government invasive / teen exposure
These people feel that the government invades their privacy too much with surveys. There
may be philosophical, political, or religious reasons for not participating in surveys. Parents
may be concerned about exposing their teen to the sensitive subject matter in the survey.

Clarify confidentiality, legitimacy, selection
Be sure to listen carefully to what respondents are telling you—questions about the legitimacy
of the survey or how the survey guarantees confidentiality can often be explained by you on
the doorstep, if you understand their concern.

“Nothing in it for me”/ Uncooperative
Sometimes people will either not give a reason for their refusal or they’ll tell you that there’s
no reason for them to participate.

Gatekeeper / Parent / HH member disallow
Sometimes you encounter a refusal situation controlled by another person besides the person
selected for the interview. A spouse, parent, guardian, or another influential person in the
household may refuse for the selected individual, or deny you the ability to talk directly to the
selected person. Even if you are able to talk with the selected person, he or she may refuse
because of the other person’s opinions.

Welfare / INS / ICE / USCIS concern
Persons involved with various government programs may fear that you are a welfare worker or
an immigration officer checking on their status.

Too ill / house messy / not dressed
These refusals are situational and will not generate a refusal letter. They refused because you
caught them at an awkward time.

Need to discuss with FS
In some cases, a respondent’s refusal won’t fit any of the above categories, but you are able
to gather a sense of what is preventing them from participating. With this option write a very
specific note in the refusal comment section to alert your FS. Then you can talk with him/her
about how best to handle the refusal.
14

Result Codes

01
02
03
04
05
06
07
08
09

Pending Screening Codes
No One at DU
Screening Respondent (SR)
Unavailable
Neighbor Indicates Occupancy
Pending Incapable
Pending Language Barrier (Spanish)
Pending Language Barrier (Other)
Pending Refusal
Unable to Locate SDU
Pending Other - Specify

Final Screening Codes

Requires
FS Approval

Verification
Info Required

Tablet
Auto Codes

Requires
FS Approval

Verification
Info Required

Tablet
Auto Codes

Ineligible SDUs
10
13
18
19
20
22
25
26
29





Vacant
Not Primary Residence
Not a Dwelling Unit
GQU Listed as HU
HU Listed as GQU
All Military
No Eligible SDU Members
Respondent (R) in DU Less than ½
Quarter
Listing Error













Screening Not Obtained
11
12
14
15
16
17
21
23




No One at DU - Repeated
Screening Respondent (SR)
Unavailable - Repeated
Final Incapable
Final Language Barrier (Spanish)
Final Language Barrier (Other)
Final Refusal
Denied Access
Final Other - Specify








Screening Completed
30
31
32

No One Selected for Interview
One Selected for Interview
Two Selected for Interview
15

Result Codes (continued)

50
51
52
53
54
55
56
57
58
59

70
71
72
73
74
75
76
77
78
79

Pending Interview Codes
Appointment for Interview
No One at DU
Respondent (R) Unavailable
Pending Break-off (Partial Interview)
Pending Incapable
Pending Language Barrier (Spanish)
Pending Language Barrier (Other)
Pending Refusal
Pending Parental Refusal for age 1217
Pending Other - Specify

Final Interview Codes
Interview Complete
No One at DU - Repeated
Respondent (R) Unavailable Repeated
Final Break-off (Partial Interview)
Final Incapable
Final Language Barrier (Spanish)
Final Language Barrier (Other)
Final Refusal
Final Parental Refusal for age 12-17
Final Other - Specify

Requires
FS Approval

Verification
Info Required

Tablet
Auto Codes

Requires
FS Approval

Verification
Info Required

Tablet
Auto Codes

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Counting and Listing Abbreviations
COLORS
BG
BK
BL
BR
DK
GR
GN
LT
MED
OR
PK
RD
TN
WH
YL

ADDRESSES
Beige
Black
Blue
Brown
Dark
Grey
Green
Light
Medium
Orange
Pink
Red
Tan
White
Yellow

ADD
ALY
APT
AVE
BLK
BLVD
BLDG
CIR
CT
DRWR
DR
HWY
JCT
LN
PKWY
PL
PT
PO

OTHER/GENERAL
Address
Alley
Apartment
Avenue
Block
Boulevard
Building
Circle
Court
Drawer
Drive
Highway
Junction
Lane
Parkway
Place
Point
Post Office
(Box)
Road
Route
Street
Terrace

RD
RTE
ST
TER

DIRECTION/ORIENTATION

STRUCTURE/MATERIALS

ABV
ACR
ADJ
BCK
BEH
BTWN
BTM
E
FRT
L
N
NE
NW
RE
R
S
SE
SW
W

ALUM
BRK
BRNSTN
CDR
CBLK
CEM
LOG
RCK
SDG
STN
STU
VNY

Above
Across
Adjacent
Back
Behind
Between
Bottom
East
Front
Left
North
Northeast
Northwest
Rear
Right
South
Southeast
Southwest
West

ARCHITECTURE/BUILDING
STYLE
APT
CPCD
CLNL
CONDO
CNTP
DBLWID
DPX
RCH
RF
SPL
TRAD
TRLR
TRANS

Apartment
Cape Cod
Colonial
Condominium
Contemporary
Doublewide
Duplex
Ranch
Roof
Split Level
Traditional
Trailer
Transitional

Aluminum
Brick
Brownstone
Cedar
Cement Block
Cement
Log
Rock
Siding
Stone
Stucco
Vinyl

TYPES OF ROOFS
FLT

Flat

GBL

Gable

GMBR Gambrel
HIP

Hip

MNSD Mansard
SHGL Shingle
SPNTL Spanish Tile
TIN
Tin

ATT
BSMT
BUS
CPT
CG
CHNLNK
CHMY
CHUR
COL
COR
CO
DB
DRMR
DBL
DRWY
ELCMTR
ENT
EXT
EXTR
FEN
FLR
FDN
FRM
FR
GAR
GRD
GRV
GRND
HSE
LG
MBX
MID
MI
PKT
PCH
PVT
RR
RSTR
RM
SCRN
SHK
SHUT
SD
STR
STY
TR
UC
VAC
VER
VEST
WIN
WD

Attached
Basement
Business
Carport
Cattleguard
Chainlink
Chimney
Church
Column
Corner
County
Doorbell
Dormer
Double
Driveway
Electric Motor
Entrance
Exit
Exterior
Fence
Floor
Foundation
Frame
From
Garage
Guard
Gravel
Ground
House
Large
Mailbox
Middle
Mile
Picket
Porch
Private
Railroad
Restaurant
Room
Screen/Screened
Shake
Shutters
Side Door
Store
Story
Trim
Under
Construction
Vacant
Veranda
Vestibule
Window
Wood

Editing Address Protocol
When to Edit an Address
Editing SDU addresses should not be a common task. An address should only be edited if
the physical address is missing or incorrect, such as when only a description of the SDU is provided.
Before editing an address, first confirm you are at the correct selected dwelling unit. To do this, use a
combination of project resources, including the handwritten List of DUs, block listing maps, and the
address or description in your tablet. If you are confident you are at the correct DU but the address is
incorrect, you should consult the Editing Address Protocol chart. It will guide you on the steps to
follow.
When you edit an address, there are two additional steps you must take to complete the process.
First, you must enter a note in the Record of Calls explaining the reason for the edit. Second, you
should notify your FS of the edit. Your FS must update their copy of the segment materials with the
edit, and in many cases notify RTI’s Sampling Department to update the project sampling frame.
Never make edits to an address which creates a duplicate of an address already listed on the
original List of DUs. Enter a note in the Record of Calls describing the situation and address
discrepancy, and then obtain permission from your FS and Sampling before making the edit.
Carefully checking the original List of DUs before making an edit will ensure no duplication occurs.
After reviewing the Editing Address Protocol chart, if you are unsure whether an address should be
edited or the appropriate procedures to follow, enter detailed notes about the situation in the ROCs
and contact your FS promptly for assistance.
When NOT to Edit an Address
In order to maintain the integrity of the sample, there are specific situations when you should not edit
an address. These situations are listed as “Improper” in the third column of the Editing Address
Protocol chart.
For example, addresses must never be edited due to screening on the incorrect line or at the wrong
dwelling unit. Always double-check the address at the top of the tablet screen and consult your
segment materials to prevent this type of error.
Also, do not change an address or description to a Post Office Box, but instead enter any PO Box
information in the Record of Calls.
Lastly, do not edit addresses to change abbreviations to full spellings, such as “Dr.” to “Drive,” or from
full spellings to abbreviations, such as “Boulevard” to “Blvd.”
Reminder:
Always refer to the chart:


when deciding whether or not to edit an address, and



to be certain all appropriate procedures have been completed when editing an address.

EDITING ADDRESS PROTOCOL
REMINDER: Always review your segment maps, original list of dwelling units, and tablet information before editing
SDU addresses.
Scenario

Description of Situation

Proper or
Improper to Edit

Appropriate FI Action

Description edited to a street
address

Proper

Check handwritten list of DUs, if address is not on list,
delete description; enter street address in tablet;
proceed with screening; enter notes in ROCs; notify FS

Street name spelling corrected or
drive/avenue/street/etc. corrected

Proper

Edit address in tablet; proceed with screening; enter
notes in ROCs; notify FS

Proper

Edit address in tablet; proceed with screening; enter
notes in ROCs; notify FS

Proper

Check handwritten list of DUs, if address is not on list,
edit address in tablet; proceed with screening; enter
notes in ROCs; notify FS

Correction of one SDU address
due to 911/U.S. Postal Service/
local government address
revisions
Correction of listing error for one
SDU (includes edits to street/apt.
number)

Adding apt. numbers to
differentiate between added units
in a SDU or on SDU property

Proper

Check handwritten list of DUs, if address is not on list,
edit address in tablet; proceed with screening; enter
notes in ROCs; notify FS

City, state, or zip code corrected

Proper

Edit address in tablet; proceed with screening; enter
notes in ROCs; notify FS

Within controlled access
buildings/complexes, edits to
addresses for multiple units
originally gained through "blind"
listing or listing by buzzer/mailbox

Proper (with prior
approval from FS)

Notify FS; if approved by FS, edit address in tablet;
proceed with screening; enter notes in ROCs

Complete street name change

Proper (with prior
approval from FS and
Sampling)