Attachment 8 -Distress guide

Attachment 8 -Distress guide.docx

[NCHS] Collaborating Center for Questionnaire Design and Evaluation Research

Attachment 8 -Distress guide

OMB: 0920-0222

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Attachment 8: Distress guidance

Level 1 Mild Distress:

Respondent actions:

  • Change in voice tone or volume

  • Change in focus

  • Hesitancy to answer questions or probes

  • Fidgeting

  • Use of inappropriate language

  • Non-relevant answers

  • Says, does not want to continue with interview

Interviewer actions:

  • Pause give respondent time to recover/compose themselves

  • Check respondent happy to continue if they have not already indicated that they would like to stop – terminate interview if necessary

  • Change topic/move to next question/topic

  • Inform PI

  • Offer appropriate helpline numbers at the end of the interview


Level 2: Moderate distress

Respondent actions:

Level one signs plus…

  • Long pauses and sighing

  • Tearful / crying

  • Extreme forms of agitation

  • Non-responsiveness

  • Nonsensical responses to questions or probes

  • Asks for your advice/help

Interviewer actions:

  • Stop interview and offer helpline numbers

  • Inform PI and Operations team lead

  • Complete respondent distress report form


Level 3: Severe distress

Respondent actions:

  • Mentions suicidal thoughts

  • Talks about wishing another person was dead or talks about committing harm to another person

  • Respondent asks for immediate help from a health care professional

Interviewer actions:

  • Stop interview and offer helpline numbers

  • Inform PI and Operations team lead

  • Complete respondent distress report form

  • Operations team lead to submit incident report to ERB





Helpline telephone numbers and web resources



For help with emotional distress:

National Suicide Prevention lifeline 1-800-273-TALK (8255) English, 1-888-628-9454 Spanish

National Child Abuse hotline:1-800-4AChild (1-800-422-4453) or text 1-800-422-4453

Additional resources can be found on the CDC Website: https://www.cdc.gov/violenceprevention/



For further information on safety and health in the work place or to report an incident at work

National OSHA information line 1-800-321-OSHA (1-800-321-6742)

Additional resources about youth employment can be found on the OSHA website: https://www.osha.gov/youngworkers/resources.html






The CCQDER operations study team lead Kristen Gregory-Lee/Amanda Titus and the study PI will be informed of distress displayed during the interview.

The operations team lead will be responsible for reporting any signs of severe distress to the ERB.





NIOSH Teen Respondent Distress Report form



CASE ID number___________



Interviewer name_______________________________________________________________



Name of PI____________________________________________________________________



Level of distress (moderate/severe)_________________________________________________



Distress Description

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



Interviewer Actions

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



Date reported to PI and Operations team lead_________________________________________


Severe distress


Date reported to ERB____________________________________________________________



Name of operations team lead making report____

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWilmot, Amanda (CDC/DDPHSS/NCHS/DRM)
File Modified0000-00-00
File Created2025-05-19

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