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Public U s e
D a t a T a D e
Documentation
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Part II - Field Representative's Manual, HIS-
National Health Interview Survey, 1992
From the CENTERS FOR DISEASE CONTROL AND PREVENTION/National Center for Health Statistics
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Centers for Disease Control and Prevention CDC
National Center for Health Statistics CENTERS AnDPREVENnoNFOR^ MSEISE CoFrmOL'
D a t a T a D e
Documentation
Part II - Field Representative'sManual, HIS-
National Health Interview Survey, 1992
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention National Center for Health Statistics
Hyattsviile, Maryland September 1993
CHAPTER 1. DESCRIPTION OF THE SURVEY
A. Purpose of the National Health Interview Survey
- I General The basic purpose of the National Health Interview Survey is to obtain information about the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kind of health services people receive.
The National Health Interview Survey is part of the National Health Survey, which began in May 1957. Prior to that time, the last nationwide survey of health had been conducted in 1935-36. Many developments affecting the national health had taken place in the intervening years:
The Nation went from depression to prosperity and through two wars.
"Wonder drugs" such as penicillin were discovered and put into use.
Public and private health programs were enlarged.
Hospitalization and other health insurance plans broadened their coverage to protect many more people.
.Increased research programs were providing information leading to the cure, control, or prevention of such major diseases as heart disease, cancer, tuberculosis, muscular dystrophy, and polio through the development of products like the Salk Polio Vaccine.
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2. Examples of
uses of the
data
a. Helps give
direction
to health
expenditures,
b. Occurrence
and severity
of illness
and
disability
Despite extensive research on individual
diseases in the years 1937-1957, one important
element had been missing. We had only piece-
meal information from the people themselves on
their illness and disability or the medical
care they obtained. Many persons, although
sick or injured, never became a "health
statistic," since requirements for reporting
illnesses were limited to hospitalized
illnesses and certain contagious diseases.
In recognition of the fact that current infor-
mation on the Nation's health was inadequate,
and that national and regional health
statistics are essential, the Congress
authorized a continuing National Health Survey
(Public Law 652 of the 84th Congress). Since
Hay 1957, the .United States Public Health
Service has regularly collected health
statistics under Congressional authority.
How is the information obtained from the
National Health Survey used? Here are some
examples taken-from a discussion of the
program before the Congress.
Total health expenditures, both public and
private, & into many billions of dollars a
year. Better statistical information helps to
give more effective direction to the expendi-
ture of these large sums.
Data on health statistics are valuable tools
for the public health officer. The nationwide
system of reporting communicable diseases has
been an important factor in the reduction, and
in some instances virtual eradication, of some
diseases which were chief causes of illness,
disability, and even death several generations
ago. Knowledge of the number and location of
many diseases made it possible to develop
. effective programs of immunization, environ-
mental sanitation, and health education which
are essential factors in their control..
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f. Health
facilities--
The growth of prepayment coverage under
voluntary health insurance has increased the
hospital
care,
rehabilitation,
demand for the kind of illness statistics
which can provide reliable estimates of the
number of people who will be ill for a given
insurance, e tc. number of weeks or months. Illness statistics
provide an improved measurement of the need
for hospitals and other health facilities and
assist in planning for their more effective
distribution. Public school authorities are
aided in their planning for the special
educational problems of mentally retarded or
physically handicapped children. Vocational
rehabilitation programs, public officials and
industries concerned with manpower problems
and industrial safety health measures, the
insurance industry, the pharmaceutical and
appliance manufacturers are also greatly
assisted by reliable statistics on illness and
disability.
g. Factors
related to
Furthermore, statistical information of this
kind is an additional tool for medical
various
diseases
research. A study of data showing this
relationship between certain economic,
geographic, or^ other factors and^ the various
diseases indicates new avenues of exploration
and suggest hypotheses for more precise
testing.
3. Who uses the The principal users of the data are the U.S.
data Public Health Service, state and local health
departments, public and private welfare
agencies, medical schools, medical research
organizations, and corporations engaged in the
manufacture of drugs and medical supplies.
Uany other organizations and individuals also
use the data.
B. Sponsorship of
the Survey
The National Health Survey is sponsored by the
National Center for Health Statistics which is
part of the U.S. Public Health Service.
Because of the Bureau's broad experience in
conducting surveys, we conduct much of the
interviewing for the Public Health Service.
The findings of the survey are analyzed and
published regularly by the Public Health
Service.
The National Health Survey is not a single
survey but a continuing program of surveys
which includes the following:
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- The National Health Interview Survey (HIS)
- The National Health and Nutrition Examination Survey (HANES)
- The National Hospital Discharge Survey (HDS)
- The National Medical Expenditures Survey (NMES 1
C. Design of the HIS Sample
- Selection of sample PSUs
The National Health Interview Survey, which is covered in this Manual, is the one which you will be working on most of the time. It is referred to simply as "HIS" to distinguish it from the other surveys which are described below.
The National Health and Nutrition Examination Survey, as the name suggests, collects health information primarily by means of an actual clinical examination. Census interviewing played an important role in past cycles of
this survey in that it identified the repre-
sentative sample of persons who were asked to participate in the examinations. The latter were conducted by doctors and dentists from the Public Health Service.
The National Hospital Discharge Survey collects information on hospital stays for persons discharged from short-stay hospitals, such as length of stay, age, race, sex, marital status, diagnoses, and operations.
The National Medical Expenditures Survey contains information on health, access to and use of medical services, associated charges and sources of payment, and health insurance coverage.
The National Health Interview Survey is based on a sample of the entire civilian noninstitu- tionalized population of the United States. Overthe course of a year, a total of approximately 50,000 households are interviewed. These households are located in the 50 states and the District of Columbia.
The HIS sample is designed as follows:
a. All the counties in the United States, as reported in the 1980 Decennial Census, are examined.
b. Counties which have similar character- istics, are grouped together. These include geographic region, size and rate of growth of population, principal industry, type of agri- culture, etc.
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- The quarterly sample
For purposes of quarterly tabulations of data, separate samples are designated for each quarter of the year. Each quarterly sample is then distributed into 13 weekly samples, of approximately equal size, so that any seasonal factors will not distort the survey results.
The sample designation identifies the calendar year and quarter in which sample units are interviewed. For example, 951 designates the sample beginning in January 1995, 952 designates the sample beginning in April 1995, etc.
D. Scope of the survey (^) Each year, health information is gathered for every civilian person in about 50,000 sample households. Adult residents, found at home at the time of your call, provide the information required.
The HIS-1 questionnaire for the survey provides for certain information to be collected on a continuing basis. (^) In addition to this basic infomation, supplemental inquiries are added from time to time in order to provide information on special topics. Any one special topic inquiry may be repeated at regular intervals, or may be used only once.
E. Information accorded
confidential treatment
All information which would permit identifi- cation of the individual is held strictly confidential, seen only by persons engaged in the National Health Interview Survey (including related studies carried out by the Public Health Service) and not disclosed or released to others for any other purpose without the written consent of the
individual. (See Appendix A to part E of
this manual for a thorough discussion of confidentiality.)
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CHAPTER 2. YOUR JOB PERFORMANCE ON THE HIS
A. General As^ a Field^ Representative for^ the National Health Interview Survey you will be assigned to work in one or more of the sample areas (PSUs). Your duties will be much the same on each assignment, although you may also perform various functions in different parts of the sample area.
B. Basic field duties It will be your responsibility to perform field duties of the following types:
- Listing or updating units at time of inter- view in Permit Segments.
- Prelisting or updating Area and Block Segments.
- Interviewing at units designated for the current sample in various types of segments.
You will interview households by personal inter- view in most cases. Callbacks by telephone are permitted in certain situations.
Chapter E, paragraph L for more detailed
information concerning telephone contacts.) Courtesy and discretion at all times are especially important in gaining the confidence and cooperation of the respondents.
(See
C. Additional duties You will also be expected to:
- Be available for day and evening work.
2. Read instructional material and complete home study exercises.
3. (^) Complete your assignment within a prescribed period of time.
4. Hake weekly transmittals of completed work to your office.
- Keep an accurate daily record of the work you do, the time you spend, and the miles you travel.
6. Meet the standards of accuracy and efficiency described below.
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b. Reduction
of
' callbacks
c. Efficient
conduct of
interviews
2. Quality of
interviewing
Costs and timing are also affected by the number
of callbacks (revisits to an address) required.
You may find that your rate of production is
relatively high during the first few days of
interviewing because somebody is at home at most
of the addresses you visit. However, production
may fall off if you have scattered callbacks.
You can minimize this by planning your initial
visits at the most productive time, and by tying
in callbacks with remaining initial visits to
the same part of the sample area.
Where a household is not at home during your
first visit, make a careful inquiry of
neighbors, janitors, etc., to.find out when
would be the best time to call.
Another time saver is the efficient conduct of
interviews. If you are thoroughly familiar with
the sequence of items on the HIS-1 question-
naires, and how to fill each one, you can
conduct a rapid and efficient interview without
sacrificing accuracy. Be prepared to explain,
briefly and clearly, the purpose of the survey,
how the information is used, and related
subjects. You will be given copies of
publications which you can show the respondent
to help you in your explanation. You should
also save any articles from local newspapers or
magazines that report results of Census survey
work in association with the National Center
for Health Statistics.
No matter how efficiently the survey is
conducted, the results may be seriously affected
by incomplete, or inaccurately filled, listing
and interview forms. In rating Field
Representatives, the quality of their work is
given as much weight as their productivity.
This manual, and other materials which will be
provided, contain all of the instructions
needed to list and interview. Learn how to use
the manual to look up unfamiliar things. Also,
learn how to use the INTERviewer COHHunication
to advise your office of special situations or
problems.
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a. Your accuracy rate
b. Field evaluation of your work
- Performance rating
Each week, your supervisor will give you a report of errors detected in the course of reviewing your work. The report will specify steps you should take to avoid similar errors in the future. Serious and frequent errors can be eliminated if you are thoroughly familiar
with the instructions, and if you ask the
questions on the questionnaire in a uniform and consistent fashion.
Aside from the office review, there will be field observations of each FR's listing and interviewing work. From time to time, you will be observed by your supervisor as you actually perform these duties. Your office will also reinterview some of your households to be sure that you obtain accurate and complete information.
Each quarter, your supervisor will tell you how your performance in the preceding quarter compared with the production and mileage allow- ances, and how you may improve your performance. The administrative handbook for Field Representatives gives standards of performance, and tells how to accurately complete payroll and other administrative forms.
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I
HIS-
TABLE OF CONTENTS
PART D
HOW TO CONDUCT THE HIS INTERVIEW
CHAPTER 1. INTERVIEW FORMS ...........................................
A. Description of the HIS-1 Questionnaire ........................ B. Description of the HIS-1 Supplement Booklets................... C. Format of the HIS-1 Questionnaires ............................ D. Field Representative's Flashcard Booklet Form HIS- ......... E. Use of the Spanish Translation Guides ......................... F. Calendar Card ...................................................
CHAPTER 2. GENERAL INSTRUCTIONS FOR USING THE HIS QUESTIONNAIRES .....
A. Types of Questions ............................................
1. Family-Style ..............................................
- Individual-Style .......................................... B. Symbols and Print Type ........................................ C. Skip Instructions .............................................. D. How to Make Entries ........................................... E. Questions Which Are Reasked ................................... F. Corrections ................................................... G. More Than One HIS-1 Questionnaire ............................ H. Events Starting During the Interview Week .....................
I. Footnotes and Comments ........................................
J. Computing Answers .............................................
K. Flashcards ....................................................
L. Conducting the Interview ......................................
M. Sample Selection Labels .................................:......
N. Hispanic Oversample for 1992 ..................................
0. Youth Behavior Survey .........................................
CHAPTER 3. RESPONDENT RULES ..........................................
A. Overall Objective .............................................
B. General Definitions ...........................................
C. General Instructions ..........................................
- Who Jky Respond to Questions on the Household Page and to Questions 1 and 2 (Name and relationship of
all persons living in the unit) ...........................
- Who May Respond to the Remaining HIS-1 Questions
("Eligible"Respondent) ...................................
3. Return Visit May Be Necessary .............................
Pase
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D1- D1- D1- D1- D1- D1-
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D2. 12
D2. 13
D2. 13
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D2. 15
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D2. 16
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D3- D3- D3-
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D3-
D3-
i
Items 12 and 13, Interview Observed. Interviewer's
Check Item B3 and Question 8. Major Activity
- ins-
- CHAPTER 1 DESCRIPTION OF THE SURVEY A l - Paae - A Purpose of the National Health Interview Survey a1- - 1 General a1- - 2 Examples of uses of the data a1- - a Helps give direction to health expenditures A1- - b Occurrence and severity of illness and disability a1- - c Control of accidents a1- - d Health of the aged A1- - e Health education and research A1- - insurance. etc A1- f Health facilities.. hospital care. rehabilitation. - g Factors related to various diseases A1- - 3 Who uses the data A1- - B Sponsorship of the survey a1- - 1 The National Health Interview Survey (HIS) A1- - (HANES) A1- 2 The National Health and Nutrition Examination Survey - 3 The National Hospital Discharge Survey (HDS) A1- - Survey (NMCUES) a1- 4 The National Medical Care Utilization and Expenditure - C Design of the HIS sample A1- - 1 Selection of sample PSUs A1- - 2 Sample ED8 and segments A1- - 3 Sample units A1- - 4 Sample of newly constructed units A1- - 5 Sample of special places A1- - 6 The quarterly sample A1- - D Scope of the survey A1- - E Information accorded confidential treatment A1-
- CHAPTER 2 YOUR JOB PERFORMANCE ON THE HIS A 2 - - A General A 2 - - B Basic field duties A 2 - - C Additional duties A 2 - - D Standards of performance for Field Representatives A2- - 1 Production standards A2- - a Planning your travel route A2- - b Reduction of callbacks A2- - c Efficient conduct of interviews A2- - 2 Quality of interviewing A2- - a Interviewer's accuracy rate A2- - b Field evaluation of interviewer's work A2- - 3 Performance rating A2-
- CHAPTER 4 HOUSEHOLD PAGE D4-
- Overall Objective D4- - Item 1. Book of Books D4- - Instructions D4- - Items 2 through 5. Identification D4- - A Objective D4- - B Instructions D4-
- Question 6. Address D4- - A Objective D4- - B Instructions D4-
- Question 7. Year Built D4- - A Objective D4- - B Definition D4- - C Instructions D4-
- Question 8. Coverage D4- - A Objective D4- - B Instructions D4-
- Item 9. Land Use D4- - A Objective D4- - B Definitions D4- - C Instructions D4-
- Item 10. Classification of Living Quarters D4- - A Objective D4- - B Definitions D4- - C Instructions D4-
- Question 11. Telephone Number D4- - A Objective D4- - B Instructions D4- - lame and Code and Language of Interview D4- - Instructions D4-
- Item 14. Noninterview Reason D4- - A Objective D4- - B Definition D4- - C Instructions D4-
- Item 15. Record of Calls D4- - A 'Definitions D4- - B Instructions D4-
- Items 16 and 17. Record of Callbacks D4- - A Objective D4- - B Instructions D4-
- CHAPTER 5 HOUSEHOLD COMPOSITION PACE D5- Pase
- Overall Objective D5-
- Question 1. Houeehold Compoeition D5- - A Objective D5- - B Definitione D5- - C Inetructione ...........................................D5-
- Question 2, Relationehip D5- - A Objective D5- - B Inatructions D5-
- Queetion 3, Date of Birth, Age. and Sex D5- - A Objective D5- - B Inetructione D5-
- Item C1. Reference Boxee D5- - A Objective D5- - B Inetructione D5-
- Item C2, Record of Conditione D5- - A Objective D5- - B Inetructione D5-
- Item Al, Reference Periods D5- - A Objective D5- - B Definitione D5- - C Inetructione D5-
- Item AZ. Condition L i e t D5- - A Objective D5- - B lnetructione ..........................................d5-
- Check Item A3 D5- - Inetructione D5-
- Queetione 4a-d, In Armed Forcee D5- - A Objective D5- - B Definition D5- - C Inetructione D5-
- Queetione 4e-f. National Origin on Ancestry D5- - A Definitione D5- - B Inetructione D5-
- Item 4a D5- - A Objective D5- - B Inetructione D5-
- Queetione 4g. 4h. A5. Hiopanic Reeidente D5- - A Definitione D5- - B Inetructions D5-
- Item 5. Additional Reepondent Probe D5- - A Objective D5- - B Inetructione D5-
- Introductory Statement D5- - Inetruction D5-
- Question 6. Hospital Probe D5- - A Objective D5- - B Definitione D5- - C Inetructione D5-
- Question 7, Hoepitalizatione for'Birthe 05- - A Objective D5- - B Inetructione D5-
- CHAPTER 6 LIMITATION OF ACTIVITY PAGES D6- Pane
- A Overall Objective D6-
- B General Definitions D6-
- C General Instructions D6- - Check Item B1 D6- - Instructions D6- - Question 1. Major Activity in Past 12 Months D6- - A Objective D6- - B Definitions D6- - C Instructions D6- - Question 2. Limitation in Job or Business D6- - Instructions D6- - Question 3. Limitation in Housework D6- - A Definition D6- - B Instructions D6- - Question 4. Condition Causing Limitation in Housework D6- - A Definitions D6- - B Instructions D6- - Question 5. Would the Person be Limited in Work D6- - Objective D6-
- Check Item B2 and Question 6. Other Limitations D6- - A Objective -^1 D6- - B Definition D6- - C Instructions D6- - School. or Other Activities D6- Question 7. Condition Causing.Limitation in Work. - Instructions D6- - in Past 12 Months D6- - A Definitions D6- - B Instructions D6- - Question 9. Limitation in Daily Functions D6- - A'. Objective D6- - B Definitions D6- - C Instructions D6- - Question 10. Limitation in Play Activities D6- - Instructions D6- - Question 11. Limited in School D6- - A Definitions D6- - B Instructions D6- - Question 12. Limited in Any Way D6- - A Definition D6- - B Instructions D6- - Question 13. Condition Causing Limitation D6- - Instructions D6- - Check Item B4 D6- - Instructions D6- - Check Item B5 D6- - Instructions D6-
- Question 14. Limitation in Daily Functions D6- - A Objective D6- - B Definitions D6- - C Instructions D6-
- Question 15. Condition Causing Limitation D6- - Instructions D6-
- CHAPTER 7 RESTRICTED ACTIVITY PAGE D7-
- A Overall Objective D7-
- B General Instructions D7- - Introductory Statement D7- - A Objective D7- - B. Instructions D7- - Check Item D1 D7- - Instructions D7- - Question 1. 2-Week Work Status D7- - A Objective D7- - B Definitions D7- - C Instructions D7- - Question 2. Work-Loss Days D7- - A Objective D7- - B Definitions D7- - C Instructions D7- - Question 3. School-Loss Days D7- - A Objective D7- - B Definitions D7- - C Instructions D7- - Question 4. Bed Days D7- - Definitions D7- - Check Item D2 and Question 5. WorkISchool-Loss Bed Days D7- - A Objective D7- - B Instructions D7- - Question 6. Cut-Down Days in 2-Week Period D7- - A Objectives D7- - B Definitions D7- - C Instructions D7- - Restricted Activity D7- Check Item D3 and Question 7. Conditions Causing - A Objective D7- - B Definition D7- - C Instructions D7-
