National Center for Health Statistics An Exploration of How Fact-Based Survey Questions Can Prompt Respondents to Categorize Themselves QDET2 Miami, FL November 9-13, 2016 Stephanie Willson Sheba K. Dunston National Center for Health Statistics

Interpretations Vary on Seemingly Straightforward Questions

Questions Based on Dichotomous answers are Often Problematic

Data from Cognitive Interview Final Reports Data and conclusions are examined from reports in Q-Bank, an on-line library of cognitive interviewing final reports. Survey topics include smoking, alternative medicine, diabetes, cancer control, and dental health. https://wwwn.cdc.gov/QBANK/Beta/Home.aspx

Behavior Questions Smoking Alternative medicine (use of herbs)

Smoking Have you smoked at least 100 cigarettes in your ENTIRE LIFE? Yes No

Use of Alternative Medicine Have you ever used natural herbs or other non-vitamin supplements for your own health or treatment? Yes No

Fact-Based Questions Diabetes Cancer Dental health

Diabetes Have you ever been told by a doctor or other health professional that you have diabetes or sugar diabetes? Yes No Borderline (prediabetes)

Cancer Control Have you ever been told by a doctor or other health professional that you had cancer or a malignancy of any kind? Yes No

Dental Health Have you lost all of your upper and lower natural, permanent teeth? yes no During the last 6 months, have you had any of the following problems? Toothache sensitive teeth bleeding gums Crooked teeth broken teeth stained teeth Missing teeth loose teeth decayed teeth

Common Solutions? Use dichotomies judiciously; “real life” is rarely that simple!

References Willson, S., (2010). Cognitive Interview Evaluation of the 2010 National Health Interview Survey Supplement on Cancer Screenings & Survivorship: Results of interviews conducted October – December, 2008 . National Center for Health Statistics. Hyattsville, MD Willson, S., 2006, Cognitive Interviewing Evaluation of the 2007 Complementary and Alternative Medicine Module for the National Health Interview Survey, Round 2, Hyattsville, MD: National Center for Health Statistics.

References, cont. Dunston, S., Willson, S., Lessem, S., Salvaggio, M., Sibley, C., Cortes, L. (2016). Cognitive Testing of the 2016 NHIS Diabetes Primary Prevention Questions. NCHS. Hyattsville, MD. Willson, S., 2007, Cognitive Interview Evaluation of the 2008 Oral Health Supplement for the National Health Interview Survey, Hyattsville, MD: National Center for Health Statistics.