1. The 2003 RRFSS Workshop New Module Development Issues and Solutions David Northrup and Renee Elsbett-Koeppen Inst itute for Social Research, York University June 19, 2003

2. Outline of Talk  why new modules?  number of new modules  examples of the questions we started with and what we ended up with (and why)  new modules, questions of reliability & validity, SARS and West Nile Virus modules

3. Number of New Modules  in terms of numbers of items, new modules account for almost half of the questions in the RRFSS survey instrument  new modules tend to be the modules with the most questions EatSmart, West Nile Virus, Pesticides

4. Modules Added To Survey Jan 2001Jan 2002Jan 2003

5. Fetal Alcohol Syndrome: # 1  initial question When is it most dangerous for a pregnant woman to consume alcohol? During the first trimester, during the second trimester, during the third trimester, or is alcohol equally dangerous in all three trimesters?  revised question If a woman drank alcohol during pregnancy, when do you think it would be most harmful to the unborn baby: at the beginning of the pregnancy, in the middle of the pregnancy, at the end of the pregnancy or do you think it is harmful thoughout the pregnancy?

6. Fetal Alcohol Syndrome: # 2 n = 320

7. FAS, Gender and Education n = 320

8. Two Versions of the Dental Question  >dental 5< (after questions about dental visits) In general would you say the health of your teeth including your teeth and gums is excellent, very good, good, fair or poor?  >dent_1< (first question in module) Compared to other people of your age, would you say the health of your mouth including your teeth and gums is excellent, very good, good, fair or poor?

9. Results Dental Questions

10. Larviciding: Initial Question First, larvicides are chemical or biological pest- icides used to kill mosquitoes before they have matured into adults. Killing mosquito larvae can reduce or eliminate the need to apply pest- icides to kill adult mosquitoes. Larvicides are applied directly to water where mosquitoes are breeding in places such as ditches, ponds, wood- land pools, pastures, marshes and catch basins.

11. Larviciding: Initial Question Con’t They are usually applied in a granular or pellet form but in some cases may be sprayed. When applied by a certified pesticide control company, would you strongly support, somewhat support, somewhat oppose or strongly oppose the use of larvicides to kill mosquitoes?

12. Larviciding: Revised Questions: # 1 Now some questions about methods used to control mosquitoes and the spread of the West Nile Virus to people. Have you ever heard anything about larvicides?

13. Larviciding: Revised Questions: # 2 Larvicides are pesticides that come in a pellet or granular form. They are applied directly to water where insects like mosquitoes breed to kill them before they mature into adults. They are used to control the spread of diseases like the West Nile Virus. Is this something like what you have heard or read about larvicides?

14. Larviciding: Revised Questions: #3 When applied by a certified pesticide control company, would you strongly support, somewhat support, somewhat oppose or strongly oppose the use of larvicides to control the spread of the West Nile Virus?

15. Larviciding & Adulticiding: Pretest Results: 1 Question Pretest Results Heard of larvicides7/25 Have the definition correct1/7 Heard of adulticides1/25

16. Larviciding & Adulticiding: Pretest Results: # 2  comments from pretest respondents definitional new words for me hard to follow when you are given new words and asked about them right away context will it poison the water? no to private property but okay to government land will it get into vegetables and farmers’ crops?

17. WNV and Pesticides: Current RRFSS Question  Now I want to ask about the use of pesticides to control the spread of West Nile Virus to people. Would you strongly support, somewhat support, somewhat oppose or strongly oppose the use of pesticides in areas where mosquitoes rest and breed?

18. Response to WNV & Pesticides Question

19. Food Consumption and Reliability: # 1  data from the Nutrition Survey completed at ISR for Cancer Care Ontario  study directors, Loraine Marrett (PI) Victoria Nadalin & Melody Roberts  analysis was completed by Victoria Nadalin  used almost the same question as in RRFSS

20. Food Consumption and Reliability: # 2  Not counting juices, over the past month how many times per day, per week or per month did you eat fresh, frozen or canned fruit?  If one portion of fruit is one medium piece of fruit, or about half a cup cut up, how many portions of fruit do you usually have when you eat fruit?  Correlations: question 1 =.79, question 1 =.12

21. Reliability: WNV Knowledge Question n = 2,400

22. Education and WNV Knowledge Question n = 2,300

23. Education, Replicate,WNV Knowledge Question and Univariate Analysis of Variance VariableSignificance Replicate.581 Education.018 Replicate by Education.862

24. SARS: Clarification & Instruction  Original: Some people have been hospitalized with SARS or have been quarantined because of SARS. In the past month, were you or anyone in your household, hospitalized, quarantined or isolated because of the SARS outbreak?  Revised: Some people have been hospitalized with SARS or have been told by health officials to quarantine or isolate themselves at home because of SARS. In the past...  Interviewer instruction: Do not count people who have decided to isolate themselves WITHOUT being told to do so by a health official. When quarantined by a health official, a person is in daily contact with health authorities to report their temperature.

25. An Accidental Test of Reliability SARS Module  Original >sars_a1<: In the past month have you made an effort to watch television, listen to the radio, read the newspaper, or look at the internet specifically to find out about the SARS outbreak?  Revised >sars_k6< Where did you get current information about the SARS outbreak? Interviewer indicates each source mentioned by respondent.

26. Agreement Between SARS_A1 and SARS_K6 n = 92

27. SARS: Behaviours & Geography All differences significant, n = 1,455

28. Hand Washing Version 1  I am going to read you a list of things you may have done because of the SARS outbreak. Please tell me if you have done any of the following in the past month.  Fifth item of the list of six was hand washing.  Washed your hands more thoroughly or frequently?

29. Hand Washing Version 2 Health care workers have been urging people to wash their hands more frequently and thoroughly as a way to reduce the spread of colds, flu bugs, and virus and so on for some time. We find that some people have been washing their hands more frequently and thoroughly for some time while others have started to do this more recently because of the SARS outbreak. What about you, in the last month have you washed your hands more frequently and thoroughly SPECIFICALLY BECAUSE OF THE SARS OUTBREAK?

30. Hand Washing Version 3 People have been encouraged to wash their hands more frequently and thoroughly as a way to reduce the spread of colds, flu bugs, and viruses for some time. But thinking just about SARS, in the last month have you washed your hands more frequently and thoroughly SPECIFICALLY because of the SARS outbreak?

31. Hand Washing: Results

32. Current Practice and Future Plans: #1  give it to the program people  new data sets every month, new modules all the time, then there are the program people and what they need  we do look at the data for the first month or two  we compare to external sources PADS Falls

33. Current Practice and Future Plans: #2  systematically think about reliability and validity task to be assigned & information shared with larger collective look for opportunities to embed experiments in the questionnaire to help assess reliability and validity add a column to our module development chart to indicate what work, if any has been completed on reliability and validity for the module

34. For further information contact: David Northrup northrup@yorku.ca Renee Elsbett Koeppen (koeppen@yorku.ca)