Improving Survey/Cognitive Completions and Home Examination Successes in Wave VI of Add Health

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Project Summary Achieving high consent and response rates in nationally-representative longitudinal studies is a pressing scientific issue. Wave VI of the National Longitudinal Study of Adolescent to Adult Health (Add Health) – consisting of a web-based survey and cognitive functioning assessment (Sample 1), an in-person based survey and cognitive, physical, and sensory functioning assessments (Sample 2), and a blood-based home examination for both Sample 1 and Sample 2 – is now in the field. Over the last six months, we have fielded our web-based survey and cognitive assessment in one state as part of Sample 1. In addition, we launched our home exam in June 2022, where we are collecting blood to test for several risk markers for AD/ADRD, including neurodegeneration and inflammation. This pilot has gone quite well in two very important ways. First, our fieldwork processes are working well. Second, the data that we are receiving, both from the web-based survey with cognitive assessment and the biological samples that will be used to test for AD/ADRD biomarkers, are of high quality. At the same time, it is also already clear from our pilot fieldwork that achieving our survey response rate goals and our home exam response rate goal is going to be very challenging. This may be in part due to ongoing fieldwork hurdles related to the Covid-19 pandemic; the polarized social and political context of the country is likely an issue as well, although both of these factors are difficult to ascertain. But there are also key study-specific challenges, some of which were unanticipated when we proposed the study, that make attainment of our survey response rate goals and our home exam response rate goal especially difficult. These include the age range and extremely busy lives of our respondents (ages 40-49), the longer- than-anticipated length of our survey and cognitive assessment instruments (especially for our in-person Sample 2 survey), and the specific challenges of reaching our less-educated and racial/ethnic minority sample members. Given the immense scientific potential of Add Health, particularly given the racial/ethnic and socioeconomic diversity, age range, and overall poor health of participants, enhanced investment in methods to increase consent and participation is needed. In response to the above challenges and opportunities, the Specific Aims of this supplement are: 1) To achieve the highest web-based and cognitive functioning survey response rate possible in Sample 1 of Wave VI, particularly among less-educated and minority respondents, through three fresh strategies we will employ. 2) To achieve the highest in-person-based survey response rate possible in Sample 2 of Wave VI, particularly among less-educated and minority group respondents, through two key adaptations we will be making. 3) To achieve the highest possible home exam completion rate in Add Health Wave VI, particularly among less-educated and minority group respondents. This will involve targeted efforts toward achieving both a higher consent rate for the home exam and a high completion rate for the home exam once respondents are consented.