Att 3d_Hand Cards 2015-16

Attachment 3d

2015-16 NHANES

HAND CARDS

December 2014

SP

PFQ1

No difficulty

Some difficulty

Much difficulty

Unable to do

Do not do this activity

PFQ2

Arthritis/rheumatism

Back or neck problem

Birth defect

Cancer

Depression/anxiety/emotional problem

Other developmental problem (such as cerebral palsy)

Diabetes

Fractures, bone/joint injury

Hearing problem

Heart problem

Hypertension/high blood pressure

Lung/breathing problem

Mental retardation

Other injury

Senility

Stroke problem

Vision/problem seeing

Weight problem

Other impairment/problem

HEQ1

Prescribed Medicines for Hepatitis B

Adefovir

Alinia

Baraclude

Entecavir

Epivir

Epivir HBV

Hepsera

Interferon / Peginterferon

Intron A

Lamivudine

Nitazoxanide

Pegasys

Roferon-A

Telbivudine

Tenofovir

Tyzeka

Viread

HEQ2

Prescribed Medicines for Hepatitis C

Alinia

Boceprevir

Copegus

Incivek

Infergen

Interferon / Peginterferon

Intron A

Nitazoxanide

Olysio (simeprevir)

Pegasys

Pegintron

Rebetol

Rebetron

Ribapak

Ribasphere

Ribatab

Ribavirin

Roferon-A

Sovaldi (sofosbuvir)

Sylatron

Telaprevir

Victrelis

Virazole

DIQ1

Prediabetes

Impaired fasting glucose

Impaired glucose tolerance

Borderline diabetes

DIQ2

Risk Factors:

10. Family history

11. Overweight

12. Age

13. Poor diet

14. Race

15. Had a baby that weighed over 9 lbs. at birth

16. Lack of physical activity or sedentary lifestyle

Medical Conditions:

10. High blood pressure

11. High blood sugar

12. High cholesterol

13. Hypoglycemic

Experienced Symptoms:

10. Extreme hunger

11. Tingling/numbness in hands or feet

12. Blurred vision

13. Increased fatigue

Other Factors:

10. Anyone could be at risk

11. Doctor warning

12. Other, specify

13. Gestational diabetes

14. Frequent urination

15. Thirst

DIQ3

Less than 6

Less than 7

Less than 8

Less than 9

Less than 10

Provider did not specify a goal

CDQ1

OSQ1

OSQ2

Prescribed Medicines for Osteoporosis

Fosamax

Boniva

Actonel

Reclast

Miacalcin

Fortical

Evista

Forteo

OSQ3

Hip replacement

Knee replacement

Plates or pins to fix a broken bone

Dental implants (posts)

Metal sutures or clips

Stents

Pacemakers

AUQ1

Always

Usually

About half the time

Seldom

Never

AUQ2

Always

Usually

About half the time

Seldom

Never

No noise exposure past 12 months

DEQ1

Get a severe sunburn with blisters

A severe sunburn for a few days with peeling

Mildly burned with some tanning

Turning darker without a sunburn

Nothing would happen in half an hour

Other

DEQ2

Always

Most of the time

Sometimes

Rarely

Never

OHQ1

Could not afford the cost

Did not want to spend the money

Insurance did not cover recommended procedures

Dental office is too far away

Dental office is not open at convenient times

Another dentist recommended not doing it

Afraid or do not like dentists

Unable to take time off from work

Too busy

I did not think anything serious was wrong/expected dental problems to go away

OHQ2

Very often

Fairly often

Occasionally

Hardly ever

Never

OHQ3

1. Full load
2. Half load
3. Pea size
4. Smear

PAQ1

Baseball/softball

Basketball

Bocce ball

Cheerleading

Dance

Football

Frisbee/ultimate frisbee

Golf

Gymnastics

Hockey

Lacrosse

Running

Soccer

Swimming/diving

Tennis

Track and field

Trampoline

Volleyball

Wrestling

Other

PAQ2

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

SLQ1

Never

Rarely – 1 time a month

Sometimes – 2 to 3 times a month

Often – 5 to 15 times a month

Almost always – 15 to 30 times a month

DBQ1

Never

Rarely – less than once a week

Sometimes – once a week or more, but less than once a day

Often – once a day or more

DBQ2

A regular milk drinker for most or all of lifetime, including childhood

Never has been a regular milk drinker

Milk drinking has varied over lifetime – sometimes has been a regular milk drinker and sometimes has not been a regular milk drinker

DBQ3

Never

Rarely – less than once a week

Sometimes – once a week or more, but less than once a day

Often – once a day or more

DBQ4

examples of frozen meals & frozen pizzas

DBQ5

Often

Sometimes

Rarely

Never

WHQ1

Ate less food (amount)

Switched to foods with lower calories

Ate less fat

Ate fewer carbohydrates

Exercised

Skipped meals

Ate “diet” foods or products

Used a liquid diet formula such as Slimfast or Optifast

Joined a weight loss program such as Weight Watchers, Jenny Craig, Tops, or Overeaters Anonymous

Followed a special diet such as Dr. Atkins, South Beach, other high protein or low carbohydrate diet, cabbage soup diet, Ornish, Nutrisystem, Body-for-Life

Took diet pills prescribed by a doctor

Took other pills, medicines, herbs or supplements not needing a prescription

Started to smoke or began to smoke again

Took laxatives or vomited

Had weight loss surgery

Drank a lot of water

Ate more fruits, vegetables, salads

Ate less sugar, candy, sweets

Changed eating habits (didn’t eat late at night, ate several small meals a day)

Ate less junk food or fast food

Other (Specify)

WHQ2

Gastric bypass (Roux-en-Y gastric bypass)

Gastric banding (adjustable gastric banding or gastric stapling)

Bariatric sleeve (sleeve gastrectomy)

Duodenal switch (biliopancreatic diversion OR biliopancreatic diversion with a duodenal switch)

SMQ1

SMQ2

Cigars, cigarillos and little filtered cigars

SMQ3

E-cigarettes and other vaping devices

SMQ4

Smokeless tobacco products

OCQ1

An employee of a private company, business, or individual for wages, salary, or commission

A federal government employee

A state government employee

A local government employee

Self-employed in own business, professional practice or farm

Working without pay in family business or farm

OCQ2

Always

Usually

About half the time

Seldom

Never

No noise exposure past 12 months

ACQ1

Only Spanish

More Spanish than English

Both equally

More English than Spanish

Only English

ACQ2

English

Chinese

Farsi/Persian

Hindi

Japanese

Khmer/Cambodian

Korean

Tagalog/Filipino

Urdu

Vietnamese

Other

DMQ1

Never attended/kindergarten only

1st grade

2nd grade

3rd grade

4th grade

5th grade

6th grade

7th grade

8th grade

9th grade

10th grade

11th grade

12th grade, no diploma

High school graduate

GED or equivalent

Some college, no degree

Associate degree: Occupational, technical, or vocational program

Associate degree: Academic program

Bachelor’s degree (example: BA, AB, BS, BBA)

Master’s degree (example: MA, MS, MEng, MEd, MBA)

Professional school degree (example: MD, DDS, DVM, JD)

Doctoral degree (example: PhD, EdD)

DMQ2

September 2001 or later

August 1990 to August 2001 (including Persian Gulf War)

September 1980 to July 1990

May 1975 to August 1980

August 1964 to April 1975 (Vietnam Era)

March 1961 to July 1964

February 1955 to February 1961

July 1950 to January 1955 (Korean War)

January 1947 to June 1950

December 1941 to December 1946 (World War II)

November 1941 or earlier

DMQ3

10. Mexican

11. Puerto Rican

12. Cuban

13. Dominican (Republic)

Central American:

14. Costa Rican

15. Guatemalan

16. Honduran

17. Nicaraguan

18. Panamanian

19. Salvadoran

20. Other Central American

South American:

21. Argentinean

22. Bolivian

23. Chilean

24. Colombian

25. Ecuadorian

26. Paraguayan

27. Peruvian

28. Uruguayan

29. Venezuelan

30. Other South American

Other Hispanic or Latino:

31. Filipino

32. Spaniard

33. Spanish

34. Spanish American

35. Hispano/Hispana

36. Hispanic/Latino

41. Chicana/Chicano

DMQ4

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

DMQ5

1. Native Hawaiian

2. Guamanian or Chamorro

3. Samoan

4. Other Pacific Islander

DMQ6

10. Asian Indian

11. Bangladeshi

12. Bengalese

13. Bharat

14. Bhutanese

15. Burmese

16. Cambodian

17. Cantonese

18. Chinese

19. Dravidian

20. East Indian

21. Filipino

22. Goanese

23. Hmong

24. Indochinese

25. Indonesian

26. Iwo Jiman

27. Japanese

28. Korean

29. Laohmong

30. Laotian

31. Madagascar/Malagasy

32. Malaysian

33. Maldivian

34. Mong

35. Nepalese

36. Nipponese

37. Okinawan

38. Pakistani

39. Siamese

40. Singaporean

41. Sri Lankan

42. Taiwanese

43. Thai

44. Vietnamese

DMQ7

Yes, born in United States

Yes, born in Puerto Rico, Guam, American Virgin Islands, or other U.S. territory

Yes, born abroad to American parents

Yes, U.S. citizen by naturalization

No, not a citizen of the United States

HIQ1

Private health insurance

Medicare

Medi-gap

Medicaid

SCHIP (CHIP/Children’s Health Insurance Program)

Military Health Care (Tricare/VA/
Champ-VA)

Indian Health Service

State-sponsored health plan

Other government program

Single service plan (e.g., dental, vision, prescriptions)

HIQ2

DSQ1a

VITAMINS MINERALS	Calcium Iron Zinc	Vitamin C Vitamin E	Calcium and Magnesium Calcium plus Vitamin D
MULTI-VITAMIN-- MULTI-MINERALS	Flintstones Tri-Vi-Flor	One a Day B-Complex	Prenatals Centrum
HERBALS AND BOTANICALS	Echinacea Ginkgo	Garlic Ginseng	Saw Palmetto
FIBER	Metamucil	Fibercon	Benefiber
AMINO ACIDS	Lysine	Methionine	Tryptophan
OTHERS	Fish Oil	Chondroitin	Glucosamine

DSQ1b

EXAMPLES OF ANTACIDS

Tums

Rolaids

Maalox

Mylanta

DSQ2

Decided to take it for reasons of my own

A doctor or other health provider told me to

DSQ3

To:

Build muscle

Gain weight

Get more energy

Improve digestion

Improve my overall health

Maintain health (to stay healthy)

Maintain healthy blood sugar level, diabetes

Prevent colds, boost immune system

Prevent health problems

Supplement my diet (because I don’t get enough from food)

For:

Anemia, such as low iron

Bone health, build strong bones, osteoporosis

Eye health

Good bowel/colon health

Healthy Joints, arthritis

Healthy skin, hair, and nails

Heart health, cholesterol

Kidney and bladder health, urinary tract health

Liver health, detoxification, cleanse system

Menopause, hot flashes

Mental health

Muscle related issues, muscle cramps

Pregnancy/breastfeeding

Prostate health

Relaxation, decrease stress, improve sleep

Teeth, prevent cavities

Weight loss

FAMILY

DMQ1

Never attended/kindergarten only

1st grade

2nd grade

3rd grade

4th grade

5th grade

6th grade

7th grade

8th grade

9th grade

10th grade

11th grade

12th grade, no diploma

High school graduate

GED or equivalent

Some college, no degree

Associate degree: Occupational, technical, or vocational program

Associate degree: Academic program

Bachelor’s degree (example: BA, AB, BS, BBA)

Master’s degree (example: MA, MS, MEng, MEd, MBA)

Professional school degree (example: MD, DDS, DVM, JD)

Doctoral degree (example: PhD, EdD)

CBQ1

EXAMPLES OF PLACES OTHER
THAN GROCERY STORES

Convenience Stores (7-11, Mini Mart)

Wholesale Stores (Costco, Sam’s Club, BJ’s)

Target/ Wal-Mart/ Kmart

Dollar Store

Bakeries

Meat Markets

Vegetable stands

Farmer’s Markets

INQ1

U. $20,000 - $20,999

V. $21,000 - $21,999

W. $22,000 - $22,999

X. $23,000 - $23,999

Y. $24,000 - $24,999

Z. $25,000 - $25,999

AA. $26,000 - $26,999

BB. $27,000 - $27,999

CC. $28,000 - $28,999

DD. $29,000 - $29,999

EE. $30,000 - $30,999

FF. $31,000 - $31,999

GG. $32,000 - $32,999

HH. $33,000 - $33,999

II. $34,000 - $34,999

JJ. $35,000 - $39,999

KK. $40,000 - $44,999

LL. $45,000 - $49,999

MM. $50,000 - $54,999

NN. $55,000 - $59,999

OO. $60,000 - $64,999

PP. $65,000 - $69,999

QQ. $70,000 - $74,999

RR. $75,000 - $79,999

SS. $80,000 - $84,999

TT. $85,000 - $89,999

UU. $90,000 - $94,999

VV. $95,000 - $99,999

WW. $100,000 and over

INQ2

A. Less than $1,000

B. $1,000 - $1,999

C. $2,000 - $2,999

D. $3,000 - $3,999

E. $4,000 - $4,999

F. $5,000 - $5,999

G. $6,000 - $6,999

H. $7,000 - $7,999

I. $8,000 - $8,999

J. $9,000 - $9,999

K. $10,000 - $10,999

L. $11,000 - $11,999

M. $12,000 - $12,999

N. $13,000 - $13,999

O. $14,000 - $14,999

P. $15,000 - $15,999

Q. $16,000 - $16,999

R. $17,000 - $17,999

S. $18,000 - $18,999

T. $19,000 - $19,999

INQ3

Cash

Checking account

Saving accounts

CDs (Certificates of deposit)

Retirement accounts (such as IRAs, 401K, etc.)

Stocks

Bonds

Mutual funds

INQ4

A: $0 - $3,000

B: $3,001 - $5,000

C: $5,001 - $10,000

D: $10,001 - $15,000

E: $15,001 - $20,000

________________________________________

Cash

Checking account

Saving accounts

CDs (Certificates of deposit)

Retirement accounts (such as IRAs, 401K, etc.)

Stocks

Bonds

Mutual funds

INQ5

In my car

In a car that belongs to someone I live with

In a car that belongs to someone who lives elsewhere

Walk

Ride bicycle

Bus, subway or other public transit

Taxi or other paid driver

Someone else delivers groceries

Other

MEC

STEPS IN MAKING THE MEC APPOINTMENT

1. Inform the R that s/he has been randomly selected to participate in a health examination.

2. Inform the R that their household has been randomly selected for morning or afternoon/evening session.

3. Have the R read/sign the appropriate SP Consent/Assent Brochure.

4. Have the R read/complete the appropriate consent for specimen storage and continuing studies.

5. Arrange a general appointment date and time for the examination.

6. Complete the SP CAPI Appointment Module.

7. If necessary, have the R sign the Authorization for Transportation Arrangements for Person Under 18 Years of Age Form.

8. If necessary, tell the R that the field office will provide him/her with a school excuse letter.

9. Complete the appropriate appointment slip and review the instructions with the R.

10. Record all appointment information on the front cover of the Household Folder.

11. Make a closing statement to the R/Hand Certificate of Appreciation.

SUMMARY OF FORMS USED TO COMPLETE THE CONSENT PROCESS

	Household Interview Consent	Transport	MEC Consent/ Assent	MEC Child Assent	Future Research Consent/Assent	Birth Certificate
SP 0-11 Months	Signed by Parent	YES	Signed by Parent	N/A	N/A	Signed by Parent
SP 1-6 Years	Signed by Parent	YES	Signed by Parent	N/A	Signed by Parent	Signed by Parent
SP 7-11 Years	Signed by Parent	YES	Signed by Parent	Signed by Child	Signed by Parent & Child	Signed by Parent
SP 12-17 Years	Signed by Parent & Child (16-17)	YES	Signed by Parent & Child	N/A	Signed by Parent & Child	Signed by Parent (12-15)
SP 18+ Years	YES	N/A	YES	N/A	YES	N/A

MEC EXAMINATION COMPENSATION

SPs 16+ who agree to be examined at the
preselected time slot $125

SPs 16+ who refuse to be examined at the
preselected time slot $90

SPs 12-15 who agree to be examined at the
preselected time slot $75

SPs 12-15 who refuse to be examined at the
preselected time slot $60

SPs under age 12 $40

NonSP parent (per trip) $20

Child/Adult care $5.25/hour

Transportation allowance by area

INFORMATION ABOUT CHILD ABUSE

Physical child abuse is a serious and widespread problem. Every year more than a million children in the United States are abused, and between 2,000 and 5,000 die as a result of their injuries. Physicians are in a unique position to detect child abuse and are mandated by law to report such cases.

Physical abuse of a child is defined as the nonaccidental injury of a child. Some physical signs are unusual bruises, welts, burns or multiple broken bones. Usually, the injuries are more severe than those that could be attributed to the claimed cause.

CHILD ABUSE Q & A's

What do you mean by "clear evident of physical child abuse?"

This card contains information about and definition of "child abuse" obtained from two publications produced by the American Medical Association entitled "Diagnostic and Treatment Guidelines on Child Sexual Abuse" and "Child Physical Abuse and Neglect."

Why are the people working on the survey
concerned about child abuse?

We are concerned about the health, safety, and proper treatment of all children and our physicians are mandated by state law to report such cases.

Who gave you the right to determine
whether my child is being abused?

My purpose here today is to administer the Health and Nutrition Examination Survey questionnaire. However, the physicians in the Mobile Examination Center are mandated by federal law to report such cases.

What actions are taken in suspected cases of child abuse?

Investigations of suspected cases of child abuse are dependent upon the specific laws in your state.

Will the physician at the Mobile Examination Center tell me
if s/he is reporting my child as being abused?

Yes, they will inform you of their intention to do so.

Where do you get your guidelines on child abuse?

Guidelines vary from state to state, but the guidelines our physician uses for reporting come from two publications produced by the American Medical Association entitled "Diagnostic and Treatment Guidelines on Child Sexual Abuse" and "Child Physical Abuse and Neglect."

Are your physicians mandated by law to report
instances of physical abuse of adults?

The law mentioned in the consent form only applies to physical abuse of children.

How can I get more information about child abuse
and how it is treated in the National Health and
Nutrition Examination Survey project?

My supervisor can give you more information and can be reached at (Give current phone number of Field Operations Coordinator).

If I have more questions which you or your
supervisor cannot answer, who else can I call?

You may call the agency in your state that deals with child abuse cases (Give agency number) or the person to contact on a national level is Dr. Kathryn S. Porter at the National Center for Health Statistics. Her toll free number is 1 800 452-6115.

AIDS INFORMATION SHEET

NHANES is a survey that looks at the health of the United States population, studying many diseases such as heart disease, diabetes, and osteoporosis. One of the major health issues in the United States is AIDS. Because it is such an important public health problem and scientists need to know how widespread the infection is in the general population, we plan to test the blood of everyone ages 18-59 years for AIDS infection.

You cannot get AIDS from any procedure in the mobile examination center. All needles used in obtaining your blood are sterile and are used only on you. All other equipment used during the examination is either disposable or sterilized after each use.

NHANES Text Messages

Fasting Text Reminder for Morning Appointments - SPs 12+

(Sent at 1:00 pm and 7:00 pm the day before the MEC exam appointment)

Your health exam is at 8:30am tomorrow morning. Please do not eat or drink anything except water after 11:30pm tonight.

Su examen de salud es mañana a las 8:30 de la mañana. Por favor no coma ni beba nada excepto agua después de las 11:30 de esta noche.

Call In Test Result Reminder Text - SPs 14-59

(Sent 3:00 pm 38 days after MEC exam if SP has not called in for test results)

Reminder: please call 888-301-2360 to get your password protected test results from the health survey.

Recordatorio: por favor llame al 888-301-2360 con su clave para obtener los resultados de su prueba de la encuesta de salud.

SP Age	Fluid Ounces	Equivalency in Tablespoons	Equivalency in Teaspoons	# of Tubes
1-2	.3	½	1 ½	3
3-5	.5	¾	2 ¼	4
6-11	1	2	6	5
12+	4	7-8	21-24	12

Interviewer Procedures for Identifying, Working with, and Paying Interpreters

for Non-English and Non-Spanish Speaking Households and SPs

Identifying Language Needs

• Present Language Identification Card to identify respondent’s language.

• If language identified is one in which an Introduction Card (Apple Card) is available, present Introduction Card to find good time to return with interpreter.

• Discuss situation with supervisor, including information on spoken language and a good time to return.

Minimum Qualifications for Identifying Interpreters

• Screener/Relationship Questionnaires: try to find a household member, friend or neighbor to assist in the conduct of interview.

• SP/Family Questionnaires: call SM before beginning interview to obtain approval.

• Interpreter must be age 18 or older.

• Interpreter must speak and understand English as well as the respondent’s language.

• If you cannot identify an interpreter, the Field Office staff will attempt to recruit one.

Procedures for Working with Interpreters

• If the interpreter is not a family or household member or arranged by FO, explain and have interpreter sign a Non-Disclosure Form.

• Record interpreter’s name and contact information in CAPI instrument and inside Household Folder.

• Record household language at top of the Record of Contacts page.

• While interpreter available, obtain signature on appropriate study consent forms in one of the five translated languages (Spanish, Chinese Simplified, Chinese Traditional, Korean, Vietnamese).

• Household Interview Consent.

• Consent/Assent and Parental Permission for Examination at the Mobile Examination Center.

• Child Assent for the Examination at the Mobile Exam Center.

• Consent/Assent and Parental Permission for Specimen Storage and Continuing Studies with or without DNA.

• Authorization for Transportation Arrangements for Persons Under 16 Years of Age.

• If SP does not speak any of the translated consent form languages, use English Consent forms and have interpreter translate your explanation of each form.

• When English consent forms are used for a non-English speaking SP, the interpreter will sign on the witness line.

• Once all appropriate consents have been obtained, arrange for a MEC appointment following protocols.

• Make sure identified interpreter can accompany the SP to the MEC.

• When contacting Field Office for MEC appointment, have interpreter name and contact information available.

Training Interpreters

• Interpreter is recruited by the interviewer: Prior to conducting the SP/Family Questionnaires, use the NHANES Interpreter Protocol Handout to train the interpreter.

• Interpreter is arranged by the Field Office: Field Office training depends on amount and type of interpretation person is expected to conduct. Field Office interpreter training can include:

• Overview of the study,

• Review of the interpreter protocol, (Required)

• Attendance at the MEC Dry-Run or tour of the MEC,

• Review of the Confidentiality Brochure and Health Measurements List with a field staff member, and

• Review of the Advance Letter and Outreach folder with study brochures to read at home. (Required)

Paying Interpreters

Do not discuss any payments with potential interpreters until receiving approval from the Study Manager. Below are some of the payments that may be approved.

• Household members: Cannot be paid for their time.

• Non-household family, friends and neighbors: Do not offer payment for their time unless it is requested. Regional rates vary for payment but can be from about $10.50 to $15 an hour. Study Managers can only approve regional rates. Any higher rates require home office or NCHS approval, which will take time. Interpreters who are paid for their time must go in-person to the Field Office to receive payments. Interpreter payments are tracked in the Field Office/ISIS management system. Appointments for payment must be made with the Office Manager and a signed receipt from the interpreter must be obtained. Non-household family, friends and neighbors who drive themselves to the household or MEC to interpret for an SP can be paid mileage.

• Interpreters arranged by the Field Office: Have already agreed to a pay rate and will be paid in-person in the field office.

• In general, interpreters should not be paid their hourly rate portal to portal but instead be paid only for their time working in the field or in the MEC.

NHANES
INTERPRETER PROTOCOL

This document summarizes the interpreter protocol for NHANES participants who speak languages other than English and Spanish. The role of the interpreter is to provide the link between the data collector and the participant. The interpreter offers a channel through which statements are conveyed from one language into another.

All interpreters are expected to assume the following basic responsibilities and employ the following procedures when working with NHANES participants and data collectors, which include household interviewers and examiners at the Mobile Examination Center (MEC).

1. Basic Responsibilities

• Professionalism and Confidentiality – The interpreter must exhibit professionalism at all times and maintain the confidentiality of the data collector-participant dialogue. As well as adherence to the interpreter protocol, important aspects of professionalism include: being courteous but not overfriendly, being honest but tactful, and showing respect to the data collector and the participant.

• Accuracy and Completeness – The interpreter should accurately and completely convey statements made by the participant and the data collector. This does not mean that a literal interpretation is necessarily appropriate. Interpreters must accurately relay the full meaning and spirit of what is said, rather than a literal interpretation per se, which conveys all of the words but not always all of the meaning.

The interpreter must communicate everything that is spoken by the participant and data collector. The same applies to hard-copy scripts and computer screens that the data collector asks the interpreter to read to the participant. The interpreter’s role is not to decide what statements are relevant—no matter how familiar the interpreter becomes with the NHANES materials or questions.

• Cultural Bridge and Knowing Limits – Interpreters need the ability to serve as a cultural bridge between the participant and data collector, while keeping within the limits of the interpretation process. Besides repeating what the participant says to the data collector, certain instances may call for the interpreter to explain the cultural context of a specific statement. However, great care should be taken to provide only the essential, cultural background information. Guessing or making up terms is not acceptable. If the interpreter does not understand something that was said, he or she should ask for clarification in order to provide a complete and accurate interpretation.

2. Specific Procedures

• Interpreter Introduction – State your name and role to the participant. Introduce yourself and tell the participant that you are the interpreter. Introduce the data collector as well. The data collector may also initiate the introductions.

• Interpret in the First Person “I” – Do not use, “He said, she said…” when interpreting what the participant or data collector has said. For example, instead of saying, “He says he listened to loud music…” the interpreter should state, “I listened to loud music….” The interpreter is the voice, or mouthpiece, of both the participant and the data collector.

• Positioning and Eye Contact – Use positioning and eye contact to foster the relationship between the data collector and the participant. The interpretation process should promote eye-to-eye contact between the data collector and the participant. The interpreter may use eye contact, but it is also acceptable to look down and avoid eye contact while interpreting. The interpreter’s position in the setting—between the participant and the data collector or beside either one—can also facilitate the data collector-participant dialogue.

• No Side Conversations – Avoid unnecessary conversations with the data collector or the participant during the interview setting. Irrelevant discussions or “side conversations” between the interpreter and the data collector are impolite and unprofessional whether or not the participant fully understands what is spoken. However, the participant will often initiate conversation with the interpreter. To politely dissuade the participant, you can simply offer to talk more after the interview is finished. In such cases, always be sure to inform the data collector so that he or she understands what is going on.

Water Collection Instructions

INTRO: The NHANES survey is studying fluoride. Fluoride is in many dental products such as toothpaste, but is also found in most tap water. For this fluoride study, I will need to collect a tap water sample using a collection kit. This kit contains a plastic water vial in a plastic zip lock bag. I will collect the water sample according to the instructions I have been given. I will take the water sample with me when I leave.

Instructions for collecting tap water sample:

1. Identify the faucet used mostly for drinking and cooking. If only bottled water is used for cooking and drinking, still take a tap water sample from a faucet in the home. (Do not take water sample from bottled water or some other place. All samples should be tap water.)

2. Once you have identified the faucet from which you will take the sample, ask the respondent if there is a filter attached. This could be a full house filter or a filter attached to this specific faucet. (Filters may reduce or remove fluoride.)

3. Turn on the water.

4. Let the water run for 10-15 seconds. (The first water out of the tap may have higher amounts of fluoride due to evaporation. So, be sure to let the water run for 10-15 seconds).

5. Take the cap off the 10mL plastic tube. Carefully fill the tube halfway (to about the 5 mL line) with water.

6. Screw the cap tightly on the tube.

7. Turn the tube upside down to make sure it does not leak. (If the tube does leak, then remove the cap and try tightening the cap again.)

8. Put the water vial back into the plastic bag.

Stand 338+