OMB Memo

Generic Information Collection Request

Cognitive Testing of National Survey of Children’s Health Questionnaire

Request: The U.S. Census Bureau plans to conduct additional research under the generic clearance for questionnaire pretesting research (OMB number 0607-0725). We propose to conduct cognitive interviews to pretest new and revised content for the topical questionnaires for the 2025 National Survey of Children’s Health (NSCH). We are seeking approval for this project.

Background: The National Survey of Children’s Health (NSCH), is conducted by the Census Bureau and sponsored by the Health Resources and Services Administration (HRSA). The NSCH is conducted using self-administered paper and web modes. The survey first employs a screener instrument (NSCH-S1) and then one child is selected to be the focus of a main topical questionnaire. The three topical questionnaires collect detailed information about children who are aged 0-5 (NSCH-T1), 6-11 (NSCH-T2), and 12-17 (NSCH-T3). The Census Bureau’s Demographic Statistical Methods Division (DSMD) Survey Methodology (SM) team was tasked with evaluating new and revised content for the topical questionnaires in preparation for the upcoming survey cycle. The SM team made recommendations to enhance the proposed new items and prepared a Qualtrics questionnaire for cognitive testing, as requested by HRSA. The next step is to conduct cognitive interviews to evaluate how well the new content performs and to identify improvements. We will probe on up to 24 new items on the NSCH questionnaires.

Purpose: The purpose of this research is to interview adults from the general U.S. population who have a child or children within the age ranges covered by the three topical questionnaires. The research will assess their understanding of the new questions and response options. In the cognitive interviews, we will assess the clarity and potential effectiveness of the new items and identify respondent issues with comprehension or interpretation, with the goal of producing valid survey items that minimize the potential for measurement error attributable to the questions themselves. The results of the cognitive interviews will influence decisions about final content and wording of the topical questionnaires for the 2025 NSCH survey cycle.

Population of Interest: Participants will be screened during the study recruitment effort to ensure they have a child within the target age ranges of the topical questionnaires. To maximize feedback across questions, we will focus our recruitment efforts on parents of children ages 3-17 who meet one or more of our recruitment criteria. This will allow testing of the NSCH-T1 questionnaire items with participants whose reference child is aged 3-5, the NSCH-T2 questionnaire items with participants whose reference child is aged 6-11 and the NSCH-T3 questionnaire with participants whose reference child is aged 12-17. Topics to be included in this research are: access to ADHD/ADD medication, chronic health conditions, asthma, early intervention services, and childcare received from someone who is not a family member. We will also recruit participants from regions of the country where smoke from wildfires and other air quality issues may impact children’s outdoor activities. Additionally, we will recruit from regions of the country with high temperatures to test a survey item on heat stroke.

Language: The interviews will be conducted in English.

Timeline: Cognitive interviews are planned for July through October 2024.

Project scope: The cognitive testing of the proposed revisions to the NSCH topical questionnaires will be carried out according to the schedule described in Table 1.

Table 1. Estimated Project Schedule

Activity	Dates
Recruiting (Ongoing)	7/26/24 – 10/18/24
Conduct Cognitive Interviews	7/29/24 – 10/23/24
Develop Final Content Recommendations	10/24/23 – 11/29/23
Deliver Report	1/24/25

General Protocol: DSMD will conduct this research remotely, via Microsoft Teams. Teams is a Census Bureau approved platform and allows for secure video conferencing capabilities and screen-sharing to maximize both the respondent and interviewer experience. The interviews will be conducted in accordance with guidelines and policies outlined in the internal Census Bureau policy memo Use of Microsoft Teams for Conducting Title 13 Qualitative Research Remotely.

At the start of the interview, the participant will electronically sign an online consent form via Qualtrics that references the OMB approval for the study, the confidentiality of the session, the voluntary nature of the study, and acknowledges that the session will be recorded.

Once the consent form has been signed, any participant questions will be answered, and audio recording will begin. The participant will complete the relevant survey questions in Qualtrics (based on the age of the reference child). The researcher will walk the participant through the questions using a think aloud technique, verbally expressing their thoughts to allow researchers to gain insight into how they interpret and respond to questions. The cognitive interviewer will administer both concurrent and retrospective probes to gain a full understanding of respondent perceptions of specific elements of the survey.

Sample: Up to 30 participants will be interviewed over two rounds (15 per round) throughout the U.S. Participants will be screened during the study recruitment to ensure they have children within the target age ranges of the topical questionnaires and meet other recruitment criteria.

Recruitment: We will use a multi-pronged strategy to recruit participants, such as posting ads on internet and social media platforms (e.g., Facebook), parenting group pages, and using personal networks. While not intended to be nationally representative, an attempt will be made to recruit participants with varying demographic characteristics (e.g., sex, education, age, race and ethnicity).

Use of Incentive: Due to the length and complexity of the task, we will offer an incentive of $50 per participant. The target population: those with children in the age ranges of interest to the study are notably busy with childcare related responsibilities, especially during the summer months. The incentive value is intended to compensate them sufficiently to motivate them to participate and pay for any childcare arrangements needed to do so.

The materials to be used in this research, entitled “Selected 2025 NSCH Content and Probes” is included as an attachment.

Length of interview: Based on past experience with similar pretesting efforts, it will require approximately 2 minutes for potential participants to complete the online cognitive interviewing screener questionnaire. We estimate up to 120 screener completions to result in 30 participants. Therefore, total recruitment burden is 4 hours. We estimate it will take 1 hour per participant to complete the cognitive interview. For 30 participants, the estimated burden for the interviews is therefore 30 hours, bringing the total burden to no more than 34 hours with recruitment.

The contact person for questions regarding data collection and statistical aspects of the design of this research is listed below:

M. Christopher Stringer

Demographic Statistical Methods Division

U.S. Census Bureau

Washington, D.C. 20233

[email protected]

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