MEC Interview: Measuring Sensitive Behaviors Debra Brody, MPH, Geraldine McQuillan, PhD, Benny Kottiri, PhD, Elizabeth Hintz, MS Centers for Disease Control and Prevention National Center for Health Statistics

Understanding relationships between behavior and disease outcomes Modeling estimates of risk Evaluating prevention programs Impact of complete reporting of sensitive behaviors OB142S002

Two bilingual interviewers per team Two computer-based interview modes: Interview time: 10 – 30 minutes Overview Personal interview (CAPI) Self-administered interview (A-CASI) OB142S003

MEC Interview : Three sections Current health status, health behaviors, and reproductive health history Mental health assessments Risk behaviors and other sensitive topics OB142S004

Current health status and behavior Recent illness, quality of life (12+) Incontinence (20-59) Tobacco use past 5 days (20+) Alcohol use (20+) Reproductive health (females 12+) Physical Activity (12-15) OB142S005

20-39 years (1/2 sample) Panic disorder Generalized anxiety disorder Major depression Mental health assessments: Composite International Diagnostic Interview (CIDI) OB142S006

Mental health assessments: Diagnostic Interview Schedule for Children (DISC IV) Based on DSM IV/ ICD-10 Ages 8 – 19 years Youth informant (in-person) Parent informant (telephone) OB142S007

Diagnostic Interview Schedule for Children (DISC) Modules Youth modulesParent modules Depression Eating Conduct Panic GAD Depression Eating Conduct Elimination ADHD OB142S008

Audio Computer Assisted Self-Interview (A-CASI) Questions simultaneously seen and heard Greater privacy than face-to-face interview Multilingual administration possible Literacy issues minimized OB142S009

NHANES A-CASI topics Youth conduct disorder (12-19 years) Alcohol use (12-19 years) Tobacco use (12-19 years) Drug abuse (12-59 years) Sexual behavior (14-59 years) Men’s health (18+ years) OB142S010

A-CASI screen

A-CASI non-response screen You did not answer the previous question. Was it because: You really meant to answer? You prefer not to answer? You don’t know the answer? OB142S011

Non-response: Male-to-male sex CAPI vs. A-CASI NHANES NHANES Refused 5% Don’t know 3% Refused <1% Don’t know <1% OB142S012

Summary Expansion of sensitive risk behavior questions in NHANES Improved accuracy of reporting with A-CASI approach Minimizes item non-response Reduces underreporting OB142S013