2003 NSDUH Data Collection Final Report

4. Preparation of Survey Materials

RTI and Substance Abuse and Mental Health Services Administration (SAMHSA) staff preparing survey materials for the 2003 National Survey on Drug Use and Health (NSDUH) re-examined and updated both the computer-assisted interviewing (CAI) interview program and the Newton electronic screening program as well as all other manuals and interview materials. With veteran interviewer and new interviewer training sessions, the preparation for training required meticulous planning.

4.1 Electronic Screening

The Newton screening program for the 2002 NSDUH served as the basis for the 2003 program. Several items from the 2002 version were modified slightly for the 2003 version. Exhibit 4.1 contains a complete list of changes from 2002 for the 2003 electronic screening.

4.2 Questionnaire Development

4.2.1 CAI Instrument

Using the 2002 computer program, a number of changes were made to prepare the 2003 CAI instrument. Exhibit 4.2 contains a detailed list of all changes between the 2002 and 2003 instrument versions.

Corresponding audio WAV files were recorded for all new items within the ACASI portion of the interview. Materials used during the actual interview, including the Reference Date Calendar, the Pill Cards, and the Showcard Booklet, were also updated.

4.2.2 Spanish Translations

Using the 2002 Spanish CAI instrument, the above changes were translated and incorporated. Additional Spanish audio WAV files were recorded as well to allow respondents to listen to the ACASI sections in Spanish if necessary.

4.3 Manuals/Miscellaneous Materials Development

4.3.1 Manuals

Based upon the 2002 manuals, updated versions of the manuals listed below were prepared. These new versions provided all staff, both experienced and new, with accurate, detailed manuals for both training and reference.

Field Interviewer Manual: All field staff (from interviewers to the national field director) received a Field Interviewer Manual detailing all aspects of an interviewer's work requirements on the 2003 NSDUH. This manual was sent to all veteran and new FIs for reading prior to the start of classroom training, was utilized throughout the training sessions, and served as a ready reference when questions arose during field work throughout the year.
Field Interviewer Computer Manual: This companion FI manual provided details about hardware use and care issues for both the Newton and the Gateway laptop computer, instructions for using the programs on each computer, transmission steps, and a troubleshooting guide to assist staff encountering technical difficulties. This computer manual was included with—but bound separately from—the FI Manual, so FIs could easily include it in their computer carrying case as a quick reference while working.
Field Supervisor Manual: This detailed manual for FSs included instructions and tips for recruiting field staff and managing the Counting and Listing (C/L) effort and Screening and Interviewing work. Strategies for managing staff using information on the Web-based case management system (CMS) were also presented, as were administrative issues for both the FSs and their staff. Copies of the FS Manual were also provided to RS and RD staff.
Field Supervisor Computer Manual: Explanations of the equipment provided for FSs (computer, printer, fax, and speakerphone) were included in this separate volume, as were instructions on using the various software tools (Windows/MS Word/MS Excel, e-mail, Fed-Ex tracking). Detailed instructions on how to use the Web-based CMS were provided for instruction and reference.
Regional Supervisor Manual: This manual provided specific guidelines for RSs on supervising the FSs in their region and on reporting requirements to the RDs. Separate chapters provided instructions for managing the various stages of NSDUH, including FI Recruitment, C/L, and Screening and Interviewing. RDs also received a copy of this manual.
Counting and Listing Manual: The NSDUH Counting and Listing Manual included explanations and examples of the detailed C/L procedures. All listers and management staff working on that phase of the NSDUH received copies of the manual.
Data Quality Coordinator and Consistency Check Manuals: These manuals documented the processes to be followed by the Data Quality Team in the verification process and in resolving consistency check problems.

These manuals, developed in earlier years, remained available to all staff and were given to any new staff:

Guide to Controlled Access Situations: This manual, given to all management staff, documented the various ways to try to gain admittance in challenging access situations.
NSDUH Guide Book: This guidebook for project management and headquarters staff provided details about issues such as chain-of-command, use of the project network drive, and whom to include on various e-mails.

4.3.2 Miscellaneous Materials

Based on the 2002 versions, the following respondent materials were updated:

Lead Letter to all screener dwelling units (SDUs)
Question and Answer Brochure
Refusal Conversion and Unable to Contact letters
Reference Date Calendar
NSDUH Highlights
Newspaper Articles
Who Uses the Data?
Incentive Receipt Form.

Minor modifications from the 2002 versions were made to the following forms,

Study Description (minor wording change)
Verification Form renamed as Quality Control Form
Certificate of Participation (more formal layout).

The following materials remained virtually unchanged from 2002 for use in 2003:

RTI Fact Sheet
"Sorry I Missed You" cards
Spanish cards
Appointment cards.

4.4 Preparation for New-to-Project Interviewer Training

This section reviews the main steps necessary to prepare for new-to-project interviewer trainings.

4.4.1 Home Study Package

Prior to training, each new FI hired for screening/interviewing work was sent a home study package containing:

A 2003 Field Interviewer Manual
A 2003 Field Interviewer Computer Manual
A cover memorandum from the national field director
Home study exercises.

Trainees were instructed to:

read both manuals; and
complete the home study exercises.

Completed exercises were to be brought to training. Exercises were collected at registration, graded, and returned to the appropriate training team. Any trainee scoring less than 84 percent was asked to redo the incorrect portions. Appendix A contains the new-to-project home study memorandum, while Appendix B contains the home study exercises.

4.4.2 New-to-Project Training Supplies

Using a master list of needed supplies, all supplies were prepared, ordered (if necessary), and stored in preparation for training activities throughout the survey year.

4.4.2.1 Printed Materials Related to Training

While using computers for data collection greatly reduced the production of printed materials, many paper forms were still necessary, particularly for training. A detailed, near-verbatim guide was prepared for each member of the team of trainers. Along with the training guide, numerous printed materials were developed:

Data Collection Agreements for all trainees to signify they agreed to follow procedures and maintain confidentiality.
A Training Workbook that contained necessary exercises, printed examples, screening scripts, and additional instructions.
A Training Segment packet with example listing and locating materials for the practice segment used in training.
Mock Scripts separately bound for two different paired mocks and including the screening mocks for the case.
Quality Control Forms specifically for the various training cases, printed in padded form.
Reference Date Calendars and Incentive Receipt Forms for use during the practice interviews.
Showcard Booklets and Pillcards for training and use during subsequent field work.
Supplies to be used during the course of training, including the Lead Letter, the Study Description, and various tools used during obtaining participation, such as the RTI Fact Sheet, Newspaper Articles handout, Certificate of Participation, Question and Answer brochure, Who Uses the Data handout, "Sorry I Missed You" cards, NSDUH Highlights, and "Preliminary Estimates."
Certification Materials used during the certification process at the conclusion of training.

4.4.2.2 Training Videotapes

Using videotapes during training provides controlled, standardized, visual presentations of the various tasks assigned to interviewers. This videotape contained multiple segments for use throughout the course of new FI training. Portions of the videotape originally developed for new-to-project FI training in 1999 were used again in 2003, including transmission details and administrative tasks. The important screening and interviewing portions were accurate as they had been refilmed for 2002 to reflect the name change and incentive procedures. During training, trainees also viewed the video "Your Important Role," which is used for controlled access situations.

4.4.3 New-to-Project Bilingual Training

Interviewers who were RTI-Certified as bilingual interviewers attended an additional day of classroom training. A detailed, near-verbatim guide with group exercises was prepared for the bilingual trainers.

4.5 Preparation for Veteran Interviewer Training

Special training sessions for all veteran interviewers were held the first week of January 2003. Having worked in 2002, these experienced interviewers gathered to review important data collection topics, learn about changes for 2003 and practice with the newly loaded 2003 computer programs. This section reviews the main steps necessary to prepare for this special veteran training.

4.5.1 Veteran Home Study Package

Prior to training, all veteran interviewers continuing for 2003 received a home study package containing:

A 2003 Field Interviewer Manual
A 2003 Field Interviewer Computer Manual
A cover memorandum from the national field director.

In order to prepare for training, veteran FIs were instructed to:

review both manuals;
transmit to receive the electronic home study on their laptop;
complete the electronic home study exercise; and
transmit to RTI from their laptop to submit their completed work.

To receive the home study exercise, FIs transmitted after a specified date and the exercise was automatically loaded on their laptop. FIs then had about one week to complete the exercise and transmit the finished work back to RTI where it was scored electronically and the results posted on the CMS. Any FI not achieving a score of 80 percent on this open book test was contacted by RTI staff for a telephone re-test. Failure to pass the telephone re-test meant placement on probation. Of the 652 FIs completing the home study, 98.8 percent passed the first attempt. Eight FIs were required to complete a phone retest, with all eight passing the retest. Appendix C contains the Veteran home study memorandum, while Appendix D contains the home study exercises.

4.5.2 Veteran Interviewer Training Supplies

Using a master list of needed supplies, all supplies were prepared, ordered (if necessary), and stored in preparation for training activities.

4.5.2.1 Printed Materials Related to Training

A detailed, near-verbatim Veteran Training Guide was prepared for each member of the training team. Based in part on the guide developed for 2002, most sections of the guide were newly developed to present different topics and emphasize the changes for 2003. Along with the training guide, numerous printed materials were developed:

Data Collection Agreements for all veterans to signify they agreed to continue to follow procedures and maintain confidentiality.
A Veteran Training Workbook that contained necessary exercises, printed examples, scripts, and additional instructions.
Quality Control Forms specifically for the training cases, printed in padded form.
Reference Date Calendars and Incentive Payment Receipts for use during the practice interview.
Showcard Booklets and Pillcards for training and use during subsequent field work.
Supplies to be used during training such as Incentive Advance Agreements and opinion questionnaires to gather FI input on NSDUH procedures.
NSDUH FI Ideas Booklets which presented numerous suggestions from FIs to other FIs to be used during training and then taken home for future reference.

4.5.2.2 Training Videotape

A new videotape was developed for Veteran FI training to show portions of the 2001 study results presentation given by Dr. Donald Goldstone of SAMHSA. Filmed while presenting at the November 2002 Train-the-Trainers session, these excerpts were chosen to further increase the interviewers' awareness of how the data are used.

4.6 Preparation for Field Data Collection

To prepare for data collection, a master list of needed supplies was developed. Using this list, all supplies were developed, ordered (if necessary), and stored for use in data collection activities throughout the survey year.

4.6.1 Assignment Materials

Veteran interviewers were given assignment materials as each new quarter approached. These materials included a packet of Segment Materials (including the various maps and listing sheets for a segment) and a packet of lead letters. Letters were prepared and sent by the FIs prior to the time they would be working a particular area. Before beginning a new quarter's work, interviewers also transmitted from their Newton to receive their new assignments.

Trainees performing well at New-to-Project training were given assignment materials for the cases assigned to them. The assignment materials consisted only of the Segment Materials packet. Usually, the FS mailed the lead letters so that the trainee could begin work immediately upon the successful completion of training. Interviewers also had to transmit at the end of training to pick up their assigned cases on their Newtons. Trainees struggling during training were placed on probation and received no assignments until they adequately completed further training with their FS. Any unassigned or partial segment packets were sent to the FSs for later assignment.

4.6.2 Bulk Supplies

Bulk supplies were packed at RTI and shipped via FedEx directly to the homes of veteran staff and those staff completing training successfully. During the year, additional needed supplies were requested by FSs using a resupply ordering process on the management website. Requested items were sent from the Field Distribution Center directly to the FIs needing supplies.

4.7 Website Development

Using the power of the Internet to enhance communication, RTI staff continued to refine and enhance the two NSDUH websites.

4.7.1 Project Case Management System (CMS)

The up-to-date Web-based CMS enhanced the ability of all levels of management to make informed decisions based on current field conditions. Each night, data were transmitted to RTI from the interviewers' Newtons and Gateway laptops for inclusion in the CMS. The next morning, each supervisor and manager had access to the results of the previous day's work and its effect on the totals for that quarter.

Besides case work reports, the website also contained many helpful tools, such as electronic versions of the FI and FS Manuals, logs to enter new recruits and training information, links to other pertinent sites, project calendars, and other administrative tools.

Access to this secure website was tightly controlled with system-wide security provided through secure links to the network from each user's computer. Additionally, several levels of passwords were required to enter the system. Supervisors had access limited to the information needed to manage their areas (e.g., an FS could only see data about his/her staff, while an RS viewed details about all cases and staff in his/her region).

4.7.2 NSDUH Respondent Website

For computer savvy respondents, an informative public NSDUH website was maintained. Visitors to the site could access a variety of topics such as project description, confidentiality, and frequently asked questions. Brief information was included about both SAMHSA and RTI, with links to the websites of both organizations. Also included was a listing of various users of NSDUH data, which included links to those users' websites.

4.8 Maintaining NSDUH Equipment

Staff used an extensive inventory system to monitor the disbursement and location of all NSDUH equipment, including interviewer Newtons and Gateway laptops; management laptops, printers, and faxes; training projectors and VCRs; and the many miscellaneous parts and cords. Technical assistance to the users of the equipment was an important and necessary task.

All issued equipment received annual routine maintenance during the January veteran training sessions (for interviewing staff) or during management meetings (for management staff).

If staff left the project, equipment was returned to Technical Support for check-in and maintenance. Detailed procedures were in place to recover any equipment not readily returned by former staff.

4.9 Problems Encountered

Development of all NSDUH materials and the computer programs for the electronic instruments requires a tight schedule in order to complete all preparations on time. For 2003, the work for the Electronic Field Test for Quarter 1 combined with all other changes made for a busy preparation season.

Switching the Industry and Occupation Coding process caused a number of problems as the details about the needs of the Census Bureau were not clear until early November after the CAI program had been completed and the interviewer manual finalized.

One problem that affected training was the reduction of the open-ended question/answer field sizes to either 15 or 50 characters in length. RTI had always emphasized entering as much information as possible, with interviewers free to type all responses to the field limit of 100 characters and even continue typing in the Interviewer Comment field, if necessary. With the field limits imposed by the Census system as well as the inability of Census coders to review interviewer comments, the field lengths meant interviewers usually had to listen to the entire response, then recall and enter only the most important information. This was particularly troublesome when recording the respondent's most important duties on the job as respondents frequently gave lengthy answers to this question.

Another problem related to the inclusion of data from two automatic probes. If the respondent indicated the company was engaged in either manufacturing or wholesale or retail trade, a scripted probe asked respondents about what the company makes or sells. Those probes had been added to the questionnaire based on coder feedback to be sure interviewers recorded that important information. In order to comply with the limits of the Census system, the response to the first question was truncated (effectively limiting the field size to just 35 characters from the limit of 100 characters from the prior year) and any response to the make or sell probe was added to the end of the first data field. Because of the limited field size, the full responses were not always included when the data were sent to Census for coding.

With very little time for implementation and thorough testing of the computer program, our dedicated and experienced staff made the necessary revisions to the instrument, manual, and training materials.

Exhibit 4.1 2003 Newton Updates

2003 NSDUH
Newton Screening Program Updates

Select Case Screen:

Identify SR Screen:

"First, just let me verify: do you live here?"

Missed DUs screen:

Are there any other living quarters within this structure or on this property, such as a separate apartment with a separate entrance?

Missed DU - Segment Kit Check screen:

IS THE ADDITIONAL UNIT REPORTED EARLIER [xxxx] ALREADY ON THE HANDWRITTEN LIST OF DWELLING UNITS?

Members 12 or Older screen:

Housing Units:

Of these [fill # from Total SDU Members] people, how many are now age 12 or older?

Also, for a response of 1, the programming logic was altered to follow the same skips and screens used if Total SDU Member screen is 1. For a 1 response:

Skip the Roster Intro screen, and display HU_ENUM message box: "CONFIRM RESPONSE: IS THERE ONLY 1 PERSON AGE 12 OR OLDER IN THIS HOUSEHOLD?" YES/NO.

If No: Go back to Members 12 or Older screen so FI can correct entry.
If Yes: Ask ROSTER message box question, "IS THIS SCREENING RESPONDENT THE ONE ELIGIBLE RESIDENT OF THE DU? YES/NO.
If Yes: Display Roster screen using text, "Please tell me your age on your last birthday."
If No: Display Roster screen using text, "Please tell me the age of this person on his or her last birthday."

Group Quarters Units:
The same updates and associated skip changes were made for the GQU program if the answer at the Transient screen = No.

Change text to: [ONLY IF NOT TRANSIENT SHELTER]:
Of these [ # ] people, how many are now age 12 or older?

If the response is 1:

Display GQU message box: "CONFIRM RESPONSE. IS THERE ONLY 1 PERSON AGE 12 OR OLDER IN THIS HOUSEHOLD?" YES/NO.
If No: Go back to Total GQU Members screen to enter correct response.
If Yes: Display roster screen using text, "Please tell me your age on your last birthday."

Roster Intro screen:

Next I would like to ask a few questions about the people who live here. Let's start with the person or one of the persons living here who owns or rents this home. We'll refer to this person as the householder.

Roster screen:

Please tell me the age of this person on his or her last birthday.

Use the fill "your" for "this person" and "his or her" with a one person household and if the Roster message box "IS THIS SCREENING RESPONDENT THE ONE ELIGIBLE RESIDENT OF THE DU?" is yes.

Verify Data screen, Ineligible for Quarter message box, and Another Eligible HH Member message box:

Housing Units:

Verify Data screen: Revised text from "I have listed …(READ AGES AND RELATIONSHIPS ABOVE)" to:

I need to make sure this list is accurate. I have listed [READ AGES, AND RELATIONSHIPS ROSTERED.]

Ineligible for Quarter message box: Revised text from, "Is there anyone that I have listed who will NOT live here for most of the time during the months of [REFERENCE MONTHS]? (Please let me know if I have included anyone who will live at school or somewhere else for most of the time during the months of [REFERENCE MONTHS].)" to:

Have/Will all of these people (ONE PERSON HH = "Has/Will this person") lived/live here for most of the time during the months of [REFERENCE MONTHS]?
(Please let me know if I have included anyone who will live/lived at school or somewhere else for most of the time during [REFERENCE MONTHS].)

Other Eligible HH Member message box: Revised text from, "Is there anyone 12 or older that I have NOT listed who will live in this household for most of the time during the months of [REFERENCE MONTHS]? (Do not include anyone who will live at school or somewhere else for most of the time during the months of [REFERENCE MONTHS].)" to:

Is there anyone we missed who is 12 or older and who will live/was living here for most of the time during the months of [REFERENCE MONTHS]?)
(Do not include anyone who will live/lived at school or somewhere else for most of the time during [REFERENCE MONTHS].

Group Quarters Units:

The same updates were made to the non-transient shelter GQU script, altering text to the following:

Verify Data Screen:

I need to make sure this list is accurate. I have listed [READ LIST OF GQU OCCUPANTS' AGES AND NAMES].
Ineligible for Quarter message box:

Have/Will all of these people(ONE PERSON HH = "Has/Will this person") lived/live in this room for most of the time during the months of [REFERENCE MONTHS]?
Another Eligible HH Member message box:

Is there anyone we missed who is 12 or older and who will live/was living in this room for most of the time during the months of [REFERENCE MONTHS]?

Verification Screen

So that my supervisor may check the quality of my work, may I please have your first name and telephone number?

Post Transmission Messages:

For successful transmissions:

Your transmission was successful. [X] new cases were received and [Y] existing cases were removed. The light bulb at the top of the screen indicates the Newton is processing data. DO NOT turn off the Newton while the light bulb is visible. Wait until the light bulb is gone.

For unsuccessful transmissions:

[X] new cases were received and [Y] existing cases were removed. HOWEVER, ALL YOUR DATA WERE NOT TRANSMITTED SUCCESSFULLY. The light bulb at the top of the screen indicates the Newton is processing data. DO NOT turn off the Newton while the light bulb is visible. Wait until the light bulb is gone, then please repeat the transmission procedures.

Exhibit 4.2 2003 CAI Changes

2003 NATIONAL SURVEY ON DRUG USE AND HEALTH
CAI INSTRUMENT REVISIONS

General/Misc.

All questions within the interview that request verbatim entries to specify responses of "other" are now scripted for the Field Interviewer (FI).

All Core Drugs

Inconsistency resolution questions for recent new users were added to all core drug modules in 2002. These questions are triggered if there is a discrepancy between the respondent's age at first use and month/year of first use. The respondent is routed through inconsistency resolution questions that ask which piece of information is correct, then ask the respondent to fix the incorrect pieces(s) of information.
For 2003, the logic in this series of inconsistency resolution questions was modified to skip the last question in the series if the re-reported month and year matches the respondent's age at first use, or is the same as month and year originally given.

Module Specific

Introduction

Updated CAI instrument version, OMB Number and OMB expiration date.

Core Demographics

After QD01 (respondent gender), a question was added, QD01a, to verify that the FI has entered the correct gender of the respondent.
Question QD06 (which race best describes you) is deleted as required by OMB.

Beginning ACASI Section

The Introduction to the ACASI Tutorial has been scripted so that the presentation to all respondents is standardized. The introductory script stretches across two screens - INTROACASI1 and INTROACASI2
A screen, HEADPHONE, has been added to the beginning of the Tutorial. This screen is now the first audio file that the respondent hears. The screen plays while the respondent is adjusting the headphones, so they don't miss any of the ACASI introduction.

Hallucinogens

Logic was changed at the beginning of the Hallucinogens module, to correct the fill wording used throughout the module:

Revised the hallucinogen "fills" in question LS02 and LSLAST for respondents whose only use was LSD, PCP, or Ecstasy but who answered one or more other lifetime hallucinogen questions as DK or RE. For these respondents, the respective "fills" will be "LSD or any hallucinogen," "PCP or any hallucinogen," or "Ecstasy or any hallucinogen."
For respondents whose only use was LSD, PCP, or Ecstasy and who answered all other lifetime hallucinogen questions as "no," the respective "fills" will continue to be "LSD," "PCP," or "Ecstasy." In these situations, respondents have unambiguously used only the one hallucinogen that they reported.
No changes were made to the skip/routing logic.

In the Hallucinogens section, there are consistency checks for related recency among substances. If a respondent revised their first recency (i.e., "any hallucinogens" changes from over 12 months ago to past 30 days) in response to a consistency check, the CAI was not capturing the past 12 months and past 30 day frequency of use for that substance. To capture this information, a parallel set of questions was set up after each recency consistency check. Any respondent who revises their recency and has not received the past 12 months and/or past 30 day frequency of use questions are routed through them (LSFRAME4 – LSCC80, LSFRAME5 – LSCC89, and LSFRAME6 – LSCC98).

Inhalants

On the first screen of the Inhalants module, the list of inhalants was corrected to include "other anesthetics" with "halothane and ether", and to include "lacquer thinner or other paint solvents".

Stimulants

In the Stimulants section, there are also consistency checks for related recency among substances. If a respondent revised their first recency in response to a consistency check, the CAI was not capturing the past 12 months frequency of use for that substance. To capture this information, a parallel set of questions was set up after this recency consistency check. Any respondent who revises their recency and has not received the past 12 months frequency of use questions are routed through them (ST10a - ST13a).

Special Drugs

In SDHEUSE (How have you used heroin?), "powder" was added to the end of response option 2 to be consistent with question SD04 (recency of sniffed/snorted heroin powder).

Risk/Availability

Item count questions in the Risk/Availability section (RK05 – RK19) have been deleted.

Substance Dependence and Abuse

The Drug Dependence and Withdrawal section was renamed Substance Dependence and Abuse to be consistent with SAMHSA documentation.
In the Substance Dependence and Abuse module, the calculation for ST12MON (used a stimulant within the last 12 months) was incorrect. SD10b (recency of methamphetamine use with a needle) was omitted. Logic was changed for 2003 to include this question in the calculation of the ST12MON variable.

Added new module:
Prior Marijuana and Cigarette Use

This module was designed to capture additional information on respondents' history of marijuana and cigarette use. It consists of four main questions, with inconsistency resolution questions. The four main questions ask:

lifetime marijuana users - if they've used marijuana or hashish the year before last (LU01)
former marijuana users who last used over 30 days ago - how old they were the last time they used marijuana (LU02)
former cigarette smokers who last smoked over 30 days ago - how old they were the last time they smoked a cigarette (LU03)
former daily cigarette smokers - how old they were the last time they smoked daily

Treatment

For TX22a (reasons for not getting needed drug or alcohol treatment) and TX23a (reasons for not getting additional needed drug or alcohol treatment), frequencies were high for the "other, specify" categories. Responses for these categories with the highest frequencies were added as new categories on subsequent screens (TX22b and TX23b, respectively).
The "other, specify" variables TX22SP1–4 and TX23SP1–4 were deleted.

Adult Mental Health Service Utilization

For ADMT27 (reasons for not getting needed mental health treatment), frequencies were high for the "other, specify" category. "Other" responses with the highest frequencies were added as new categories on a subsequent screen (ADMT27a).
The "other, specify" variables ADMT27SP1–4 were deleted.

Social and Neighborhood Environment

The Social Environment module was renamed Social and Neighborhood Environment.
The Item Count questions were deleted (SEN12d-SEN12k).
Questions SEN03a–d, SEN05–11c, SEN13a, and SEN 13c–14d were deleted. Questions remaining are SEN04 (how many times moved in the past 5 years), SEN12a–c (illegal behavior questions), SEN13b (how respondent feels about adults using marijuana once or twice) and the four religion questions (SENRELAT, SENREB1, SENREB2, SENREB3 and SENREB4).
A 10–item neighborhood cohesiveness scale was added to this section (SEN01a – SEN02e).

Youth Experiences

The item count questions were deleted (YE18h-YE18o).

Serious Mental Illness

The seven questions that pertain to affective psychosis were deleted (NPVOICE - NPVISION).

End of ACASI

At the end of the ACASI section, once the FI goes through ENDAUDIO, the ACASI portion of the interview will be locked. The FI can still make corrections to front-end demographics, but the CAI program will skip over the ACASI sections.

Back-End Demographics

For respondents currently in grades 1–12, new questions were added about the type of school the respondent attends (QD18a–d). This group of questions required a new showcard.
For question QD24 (reasons for leaving high school before getting a diploma), the phrase I GOT SOMEONE PREGNANT was added to the end of response option 2.
For question QD25 (how old were you when you stopped attending school), error checks were added if QD25 is less than 10 or if QD25 is greater than the respondent's current age. If either of these errors is triggered, the FI is prompted to fix them before continuing with the interview.
To accommodate the Census coding operations, character lengths for the open-ended Industry & Occupation questions were shortened.
In the household roster, some respondents were confused about the "self" category in MRELATON and FRELATON (what is this person's relationship to you?) when rostering themselves. An interviewer note was added to these two questions that allows the FI to prompt the respondent with "Is this you?" if the FI notices the respondent is having trouble.
Edit checks within the household roster were added to help get the highest quality data in the field. The FI receives an error message if:

A respondent has a spouse or partner that is 16 years old or younger
The respondent is 16 years old or younger, and has a spouse or partner
The respondent's son- or daughter- in-law is the same age as or older than the respondent
The respondent's father- or mother- in-law is the same age as or younger than the respondent
The respondent's biological parent is less than 13 years older than the respondent
The respondent's biological child is less than 13 years younger than the respondent
The respondent's biological sibling is 25 years (or more) older or younger than the respondent.

The FI is instructed to either fix the incorrect information, or explain the response.

The instruction to exit PROXYINT (introduction to the proxy questions) was changed from press ENTER to press "1".
In QP01, the FI has had to manually enter the relationship of the proxy to the respondent. This was changed for 2003. Relationship information from the household roster is now filled into this question, and the FI enters the roster number of the proxy. The proxy's relationship to the respondent is then filled into subsequent questions.
The Medicare and Medicaid questions (QHI01 and QHI02) were rearranged so that for each question, the definition is read before the question. The last syllable ("care" and "aid") in these terms is highlighted in the questions, prompting the FI to emphasize the term.
Verification questions were added for respondents less than 65 years old who indicated they received Medicare(QHI01v), and respondents 65 or older who indicated they received Medicaid (QHI02v). For both verification questions, the respondent is re-read the definition of Medicaid or Medicare, and then asked to verify their answer.
Updated state Medicaid/Medicare, TANF and CHIP program names.
QI16a - wording changed to not repeat the definition of child support the second time the question is read.
If the respondent indicates in QI20 that their personal income is more than $20,000 a year, they skip over the question that asks if the total family income is more or less than $20,000 (QI22).

FI Debriefing Questions

Questions asking the FI to estimate how many pillcards the respondent used (FIDBF04a-b) were deleted
For the question that asks for how much of the ACASI portion of the interview the respondent had their headphones on (FIDBF04c), a category was added for NONE/TOOK HEADPHONES OFF IMMEDIATELY.

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