The Effect of Supplemental Nutrition Assistance Program-Education on the Dietary Intake of Low-income Indiana Participants
Phase: NA
Conditions: Nutrient Intake Inadequacy
Sponsor: Purdue University

ClinicalTrials.gov Title Page 
 
Document: Study Protocol 
Official Study Title: The Effect of Supplemental Nutrition Assistance Program-Education on 
the Dietary Intake of Low-income Indiana Participants 
NCT #: NCT03436784 
Document Date: September 28, 2015 

Revised 10/10 
Ref. #  ______________ 
 
 
APPLICATION TO USE HUMAN RESEARCH SUBJECTS 
Purdue University 
 
Institutional Review Board 
 
1.  Project Title:  The effect of Supplemental Nutrition Assistance Program-Education on the dietary intake of 
low-income Indiana participants 
 
 
 
 
 
 
2. 
Full Review  
       Expedited Review   
 
 
 
 
3. 
Anticipated Funding Source:  AgSEED - Agricultural Research and Extension leading to Economic 
Development in Indiana Agriculture and Rural Communities 
 
 
4. 
Principal Investigator [ See Policy on Eligibility to serve as a Principal Investigator for Research Involving 
Human Subjects]:   
 
Name and Title 
Department, Building, Phone, FAX, E-mail address 
 
Dr. Heather A. Eicher-Miller, Assistant Professor, Department of Nutrition Science, Purdue University, 
Stone Hall Room G-2, (765) 494-6815, Fax: (765) 496-9606, heicherm@purdue.edu 
 
 
5. 
Co-investigators and key personnel [See Education Policy for Conducting Human Subjects Research]: 
 
Name and Title 
Department, Building, Phone, FAX, E-mail address 
 
Angela R. Abbott, MA, RD, CD, Program Leader and Assistant Director, Health and Human Sciences 
Extension, Purdue University, Matthews Hall Room 110, (765) 494-8252, Fax: (765) 494-0674, 
abbottar@purdue.edu 
 
 
Melissa K. Maulding, MS, RD, Nutrition Education Programs Director, Health and Human Sciences 
Extension, Purdue University, Matthews Hall Room 108, (765) 496-6849, Fax: (765) 494-0674, 
mmaulding@purdue.edu 
 
 
 
Rebecca L. Rivera, MPH Graduate Student, Department of Nutrition Science, Purdue University, Stone 
Hall, (765) 496-2757, Fax: (765) 496-9606, rcusack@purdue.edu 
 
 
 
Ashley G. Jacobs, MS, RD, Graduate Student, Department of Nutrition Science, Purdue University, Stone 
Hall, (765) 496-2747, Fax: (765) 496-9606, jacobs38@purdue.edu 
 
 
Breanne Wright, MS, Graduate Student, Department of Nutrition Science, Purdue University, Stone Hall, 
(765) 496-2747, Fax: (765) 496-9606, wrigh197@purdue.edu 
 
 
 
Key personnel: 
 
 
Indiana Nutrition Education Program Educators, Health and Human Sciences Extension, Purdue 
University, Matthews Hall Room 108, (765) 496-6849, Fax: (765) 494-0674, mmaulding@purdue.edu 
 
Note: NEP Educators have completed CITI Training as a requirement for working for Extension                       
                                                           
6. 
Consultants [See Education Policy for Conducting Human Subjects Research]: 
 
Name and Title 
Department, Building, Phone, FAX, E-mail address 
  

 
                                                                                                
7. 
The principal investigator agrees to carry out the proposed project as stated in the application and to promptly 
report to the Institutional Review Board any proposed changes and/or unanticipated problems involving risks to 
subjects or others participating in the approved project in accordance with the HRPP Guideline 207 Researcher 
Responsibilities, Purdue Research Foundation-Purdue University Statement of Principles and the 
Confidentiality Statement.  The principal investigator has received a copy of the Federal-Wide Assurance 
(FWA) and has access to copies of 45 CFR 46 and the Belmont Report.  The principal investigator agrees to 
inform the Institutional Review Board and complete all necessary reports should the principal investigator 
terminate University association. 
 
 
___________________________________ 
_________________________________________ 
 
   Principal Investigator Signature 
        Date 
 
8. 
The Department Head (or authorized agent) has read and approved the application.  S/he affirms that the use of 
human subjects in this project is relevant to answer the research question being asked and has scientific or 
scholarly merit.  Additionally s/he agrees to maintain research records in accordance with the IRB’s research 
records retention requirement should the principal investigator terminate association with the University. 
 
 
___________________________________ 
_________________________________________ 
 
   Department Head (printed) 
        Department Name 
 
 
___________________________________ 
_________________________________________ 
 
   Department Head Signature 
        Date 
 
 

 
APPLICATION TO USE HUMAN RESEARCH SUBJECTS 
 
9. This project will be conducted at the following location(s): (please indicate city & state) 
 
 
Purdue West Lafayette Campus 
 
 
Purdue Regional Campus (Specify):        
 
 
Other (Specify): Indiana Nutrition Education Program class locations throughout Indiana, these 
may include: Emergency food distribution centers; Supplemental Nutrition Assistance Program (SNAP) offices; 
Women, Infant, and Children Program (WIC) offices; participant homes 
 
10. 
If this project will involve potentially vulnerable subject populations, please check all that apply. 
 
 
Minors under age 18 
 
 
 
Pregnant Women  
 
 
 
Fetus/fetal tissue 
 
 
 
Prisoners Or Incarcerated Individuals 
 
 
 
University Students (PSYC Dept. subject pool ___)  
 
 
Elderly Persons 
 
 
 
Economically/Educationally Disadvantaged Persons 
 
 
Mentally/Emotionally/Developmentally Disabled Persons 
 
 
 
Minority Groups and/or Non-English Speakers 
 
 
Intervention(s) that include medical or psychological treatment 
 
11. 
Indicate the anticipated maximum number of subjects to be enrolled in this protocol as justified by the 
hypothesis and study procedures:  800 (400 for control group and 400 for experimental group) __ 
 
12. 
This project involves the use of an Investigational New Drug (IND) or an Approved Drug For An 
Unapproved Use. 
 
  YES         
 NO 
 
Drug name, IND number and company:         
13. 
This project involves the use of an Investigational Medical Device or an Approved Medical Device For An 
Unapproved Use. 
 
  YES         
 NO 
 
Device name, IDE number and company:         
14. 
The project involves the use of Radiation or Radioisotopes: 
 
  YES         
 NO 
 
15. 
Does this project call for: (check-mark all that apply to this study) 
 
 
Use of Voice, Video, Digital, or Image Recordings? 
 
 
Subject Compensation?  Please indicate the maximum payment amount to subjects. $100    
 Purdue’s Human Subjects Payment Policy  
Participant Payment Disclosure Form 
 
 
 
VO2 Max Exercise? 
 
 
 
 
 
 
More Than Minimal Risk? 
 
 
 
 
Waiver of Informed Consent? 
 
 
       Extra Costs To Subjects? 
 
 
       The Use of Blood? 
Total Amount of Blood 
      
 
 
 
 
Over Time Period (days)       
 
       The Use of rDNA or Biohazardous materials? 
 
       The Use of Human Tissue or Cell Lines? 
 
 
The Use of Other Fluids that Could Mask the Presence of Blood (Including Urine and Feces)? 
 
 
The Use of Protected Health Information (Obtained from Healthcare Practitioners or Institutions)? 
 
 
The Use of academic records? 
16. 
Does investigator or key personnel have a potential financial or other conflict of interest in this study?  

 
  YES         
 NO 
 
APPLICATION NARRATIVE 
 
 
A. 
PROPOSED RESEARCH RATIONALE 
The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is an educational program offered 
to SNAP participants. The Nutrition Education Program (NEP) through Purdue University Health and Human 
Sciences Extension administers SNAP-Ed in Indiana. The NEP curriculum comprises 10 lessons that are 
focused on nutrition and food resource management.  
The goal of this study is to determine the efficacy of SNAP-Ed to improve the immediate and long-term 
dietary quality (using the Healthy Eating Index (HEI)), BMI (measured height and weight), and food security 
(using the 18-item US HFSSM) and how the provision of SNAP-Ed with the presence of other characteristics 
can mediate improvement in these outcomes. Previous studies by Dr. Eicher-Miller have shown significant 
improvements in household food security over short-term periods and a 1-year longitudinal period among 
Indiana NEP participants; however, the impact of SNAP-Ed on participants’ dietary quality and BMI remains to 
be investigated. The hypothesis of this study is that dietary quality and food security will improve and BMI will 
remain steady over the short-term, and these improvements will be maintained over a 1-year, or “long-term”, 
time frame in participants receiving SNAP-Ed compared to those not receiving SNAP-Ed. Results may be used 
as a basis for changes to the program or policies relevant to SNAP-Ed and other nutrition education programs 
throughout the US. 
 
B. 
SPECIFIC PROCEDURES TO BE FOLLOWED 
 
NEP educators are considered key personnel because they will have direct contact with study participants; 
however, they will not have any part in data entry, analysis, or dissemination of study results. NEP educators, 
employees of Purdue University Extension, across Indiana will help facilitate the study. NEP educators have 
completed CITI training as a requirement for employment through Purdue University Extension. Before 
recruiting study participants, participating NEP educators will attend training sessions facilitated by the co-
investigators of the study. The training sessions will include instructions on how to interact with participants; 
answer questions related to the study; and protocol for administering surveys, measuring height and weight, 
keeping participant information private, and the use of identification numbers.  The study goals and hypothesis 
will not be shared with the NEP educators in order to keep their work with the participants as unbiased as 
possible. 
 
NEP educators will recruit study participants who are interested in participating in NEP. The details of 
recruitment are described in Section D. A screening survey determining eligibility will be administered in 
addition to an explanation of consent. After completion of the screening survey and consent process, NEP 
educators will randomize participants into one of two groups: control or experimental. The NEP educators will 
be assigned a random number using Excel and then listed in order from least to greatest according to their 
random number. The first half of the NEP educators will assign their first recruited participants to the 
experimental group. After the first assignment, they will alternate assigning participants to either study group in 
an “every other” participant fashion. The second half of the NEP educators will assign their first recruited 
participants to the control group. After the first assignment, they will also alternate assigning participants to 
either study group in an “every other” participant fashion. The control group will wait 1 year from taking the 
second survey before starting NEP lessons. The experimental group will start NEP lessons immediately. 
Participants in the experimental group must take at least the first 4 NEP lessons within a time period of 4 to 10 
weeks. The NEP SNAP-Ed curriculum includes 10 lessons, and participants may take the additional 6 lessons if 
desired.    
 
 
All participants will complete three 30 minute surveys throughout the study. Surveys will be administered 
by NEP educators using the Qualtrics Offline Application on their program-provided iPads or paper surveys. 
The first survey will be administered upon enrollment in the study. Participants in the experimental group will 
take the second survey after they have completed the first 4 lessons between 4 and 10 weeks after enrollment in 
the study. Control participants will take the second survey after 4 to 10 weeks with no lessons. Since 
participants will be recruited on a rolling basis, they will take surveys at different times within a designated time 

period. The third survey will be administered to both groups 1 year after the second survey. Surveys are 
comprised of the US Household Food Security Survey Module from the United States Department of 
Agriculture Economic Research Service, questions querying household and individual level characteristics, and 
the Indiana Food and Nutrition Program Evaluation Tool.  
 
Participants will also complete two 24-hour dietary recalls using the Automated Self-Assisted 24-hour 
recall (ASA-24) and one food frequency questionnaire (FFQ) using the Diet History Questionnaire II (DHQ II) 
at each data collection time point. Both instruments are online and complementary dietary assessment tools 
created by the National Cancer Institute and have a respondent and researcher website. Results will be analyzed 
by the researchers using the researcher website. One dietary recall and the FFQ may be administered by the NEP 
Educators immediately following the in person survey, or a link to complete the dietary recall and FFQ online 
will be emailed to the participant within 2 days, or the participant can request to complete the dietary recalls and 
FFQ over the phone with the co-investigators at Purdue within 7 days after completing the survey. A script will 
be provided for the Purdue researchers to administer the dietary recalls and FFQ. The completion of the dietary 
recalls and the FFQ is necessary to perform complex modeling techniques for estimating usual dietary intake. 
The program that administers the dietary recalls assists participants through the recall process using an animated 
guide with audio and visual cues. Previous research has shown that the majority of Indiana SNAP-Ed 
participants have a computer with high-speed Internet connection in their home or residence. Participants 
without email, without access to a computer with internet, or with limited computer skills will be instructed to 
complete the assessments via telephone with assistance from researchers. If assistance from researchers is 
needed via telephone, participant identifying information will not be collected at that time. Participants will be 
identified only by their participant identification number, which they will receive upon enrollment in the study. 
Participants will provide days and time frames over the following week when they will be available to complete 
the dietary assessments over the phone with Purdue researchers. In addition, participants may call the co-
investigator’s Purdue office phone number any time after the survey for assistance with completing the dietary 
assessments. If the first dietary recall and FFQ have not been completed within 4 days after the survey, 
researchers will call the participant no more than once per day to complete the first dietary recall and FFQ over 
the phone at that time or to set up appointments to complete the dietary recalls and FFQ over the phone with 
researchers within the 7 days after completing the in person survey. The second dietary recall should be 
completed 24 hours after the first dietary recall at the earliest but before 9 days after completing the in person 
survey. Participants will have the same options as described above to complete the second dietary recall. 
 
In addition to the survey, dietary recalls, and FFQ, NEP educators will take height and weight 
measurements on each participant at each assessment time point. Weights will be measured using the SECA 869 
mobile medical flat scale with remote display. Heights will be measured using the SECA 213 mobile 
stadiometer. This weight scale and stadiometer are research grade measurement tools. Height and weight 
measurements will be taken following the Centers for Disease Control and Prevention (CDC) National Health 
and Nutrition Examination Survey (NHANES) anthropometry manual guidelines. Height and weight 
measurements will be completed in a private setting or privacy screens will be used. Only the NEP educators 
will be able to see the measurements. Three measurements will be taken at each assessment time point in order 
to calculate an average. Participants will be allowed to know their measurements upon request at the time of 
measurement. Researchers will use these measurements to calculate BMI. 
 
An in person survey, two dietary recalls, one FFQ, and height and weight measurements will be completed 
for each participant at each of the three assessment time points. The first and third assessments will cover a 
reference period the past 12 months, while the second assessment will cover the past 30 days. Participants 
randomized to the control group will be provided the opportunity to complete the SNAP-Ed program at the 
completion of the study. 
 
C. 
SUBJECTS TO BE INCLUDED 
 
Describe: The inclusion criteria for the study population includes: an interest in taking NEP lessons, 
willingness to wait 1 year to start NEP lessons, eligibility for SNAP, age of at least 18 years, not pregnant, living 
in a household located in Indiana, ability speak and read English, willingness to complete three 30 minute 
surveys at the designated time intervals, willingness to provide height and weight measurements, willingness to 
complete one 30 minute dietary recall and 60 minute FFQ at each assessment time point, willingness to stay in 
touch with NEP educators, and no previous participation in NEP lessons within the last year.  

 
The exclusion criteria only include not meeting the inclusion criteria.  
 
Women who are pregnant will not be able to enroll in the study; however, once recruited, participants 
who become pregnant during the study period will be able to continue participating in the study. 
 
The study population may be considered vulnerable because they are a low income and low resource 
population that may have a lower than average level of education. Precautions will be taken to minimize 
potential risks to the study population.  
  
The maximum number of participants targeted for the study is n=800, n=400 in the control group and 
n=400 in the experimental group. Previous studies were used to calculate these estimates.  Based on these “short 
term” studies, a 7% rate of attrition (n=17 out of 236) is expected to increase to approximately 40% (n≈320 of 
800) in the proposed study due to the duration of 1 year between the post-assessment and the follow-up 
assessment. Based on these attrition considerations and our previous work, a sample size of n=800 will be the 
recruitment goal (control group n=400 and intervention group n=400) with an approximate final sample size of 
n=480 expected. 
 
NEP educators will make no more than four coordinated efforts to remind participants of their 
participation in the study during the one year period between the second assessment and the final assessment. 
These attempts will also serve to update contact information, which NEP educators normally collect as part of 
their normal programming. Purdue researchers do not have access to participant names or home addresses. 
Purdue researchers only have participant names on consent forms and these documents are separated and stored 
separately from surveys. There is no way for researchers to identify participants or match their surveys with 
names. All participants in the study are also clients of the NEP Educators because they currently participate in 
the Nutrition Education Program as a participant in the intervention study group, or will participate at the 
conclusion of the study because they have indicated that they have the desire to participate as part of eligibility 
for the research study. The methods for contacting the participants include phone calls from the NEP educators, 
emails, physical flyers mailed to participants’ home addresses, and a raffle. The email and physically mailed 
flyer will use the same content (attached). NEP educators will either email or physically mail the flyer, not both, 
depending on which method is preferred by the participant. All contact methods will be the same for control and 
intervention study group participants and are described below. Researchers will not directly contact participants 
unless the participant has requested telephone assistance to complete the dietary recalls and FFQ. Participants 
who have not completed the dietary recalls and FFQ in the amount of time provided will be called and asked if 
they would like to complete the dietary recalls and FFQ at that time over the phone, if they would like for 
researchers to resend the email link, or if they would like to make an appointment for researchers to call at a 
later time to complete the dietary recalls and FFQ over the phone. Participants will also be provided a Purdue 
telephone number for contacting researchers to complete the dietary recalls and FFQ.  
 
Flyer: 
 Flyers will include these components: thanking the participants for their participation, reminding them to 
update contact information with their NEP educator, information on an appropriate and free local event 
not related to nutrition or budgeting information in which the participants could take part, raffle 
information.  
 NEP educators will either email the attached flyers to participants or physically mail the attached flyer to 
the participants’ addresses they have on file. 
Phone Call:  
 NEP educators will call participants and update contact information, and either set an appointment to 
take the final survey or remind them of their appointment if already set 
Raffle:  
 Participants who complete the final survey before January 1st, 2017 will be entered into a $500 raffle. 
The odds of winning are approximately 1 in 480 and one $500 check will be awarded. The odds of 
winning may be updated on the study reminder flyer to reflect actual number of participants. The winner 

will be randomly chosen by April 1st, 2017. If researchers are unable to contact the winning participant 
through their NEP Assistant after 3 attempts within one week (phone call, mailing, email), another 
participant will be randomly chosen. The winning participant may decline the $500. The winning 
participant’s name, address, and social security number or taxpayer identification number will need to be 
shared with researchers at Purdue only if they win the raffle and only for dispersing the $500 check. The 
participant will also need to complete the Institutional Review Board Human Subject Receipt Log, 
which will be provided by the researchers. Non-resident alien recipients will have to complete 
information within the Glacier Tax Compliance software system (www.online-tax.net) to assess tax 
reporting and withholding requirements. This is explained in the consent form. Other than previously 
stated, no payment or additional action is required to enter the raffle. Participation in additional research 
or other consideration is not necessary. Void where prohibited or restricted by law. Subject to all federal, 
state, and local laws.     
 The raffle will be advertised on the scheduled email and physically mailed flyers and through phone calls 
to participants. 
 
Proposed Retention Tasks Timeline: 
 
 
 
 
 
 
 
D.  RECRUITMENT OF SUBJECTS AND OBTAINING INFORMED CONSENT 
 
NEP educators will recruit potential clients for the study. NEP educators will administer a screening 
survey to determine eligibility for the study. If potential participants do not wish to participate in the study or 
complete the screening survey, they may proceed with taking NEP lessons as usual without any effect on their 
relationship with the NEP, NEP educator, Extension, state or federal programs, or Purdue University. Study 
participants and non-participants may receive NEP lessons together without any effect on the study.  
 
If a NEP client is eligible and willing to participate in the study, an informed consent form requiring their 
name and signature will be provided unless the IRB approves a waiver of signed consent, in which case NEP 
educators will explain the informed consent form to participants and allow them to read the consent form. If the 
consent form is provided electronically online, participants will be asked to select the “I agree” radio button to 
provide informed consent before proceeding to complete the survey. Participants will be provided their choice 
of an email or physical copy of the informed consent form.  
 
NEP educators will facilitate data collection and use identification numbers to keep participant data 
together. NEP educators also collect private identifying information such as names, home addresses, email 
addresses, and telephone numbers for the NEP, but not as part of the study. The study investigators and co-
investigators will receive the data with the participant identification numbers only and without any private 
identifying information. Researchers will be provided with only participant phone numbers and email addresses 
which will be linked only to participant identification numbers and never linked with participant names. 
 
E.  
PROCEDURES FOR PAYMENT OF SUBJECTS 
 
Study participants will be paid either in cash or through gift certificate to compensate them for the time 
they have spent in the study. NEP educators will provide participants $5 in cash for completing the first survey 
in person and a $10 gift certificate for completing the in person portions of surveys 2 and 3. Participants will 
receive a gift certificate of $15 for completing both the first dietary recall and FFQ and a $10 gift certificate for 
completing the second dietary recall at all 3 assessment time points. Participants may receive up to $30 for the 
first assessment and up to $35 for the second and third assessments.The gift certificate will be chosen by the 
participant from participating stores through an online gift certificate company and emailed to participants or 
mailed to participants’ homes by the NEP educator, depending on the participant’s preference. Participants 
could receive up to a monetary value of $100 for completing all three surveys. 
 
Month 
Retention Task 
January 
 Email Flyer/ Mail physical flyer to home address 
March 
 Phone Call 
May 
 Email Flyer/ Mail physical flyer to home address 
July 
 Phone Call 

F.   CONFIDENTIALITY 
 
NEP educators will keep a code key with participant names and participant ID numbers so that the surveys 
can be matched by participant ID number across assessment time points. They will keep this code key securely 
locked in a filing cabinet in their County Extension Office. NEP educators will be instructed to destroy the code 
key upon completion of the study. Only NEP educators will have access to their code key. The code key is 
attached. 
 
Researchers will keep signed consent forms in a locked filing cabinet in the graduate student office of the 
Eicher-Miller lab in B-28 of Stone Hall. The consent forms will be kept for three years after the conclusion of 
study protocol. Researchers performing data entry, data analysis, and discussion of results will not have access 
to private identifying information. NEP educators may collect names but will be instructed to keep study data 
forms free from any identifiable information. 
 
G.   POTENTIAL RISKS TO SUBJECTS 
 
Risks included in the study are no more than those encountered in everyday life.  
 
 
To ensure that participants do not link their name with their identification number, NEP educators will be 
trained to remind participants not to write their names on any surveys. The NEP also does not collect names on 
the NEP Evaluation Tool used as part of usual NEP protocol, which will help maintain adherence to this study 
protocol. 
 
H.   BENEFITS TO BE GAINED BY THE INDIVIDUAL AND/OR SOCIETY 
 
There are no direct benefits to the study participants. The benefits to society include a better informed 
understanding of the effects of SNAP-Ed on dietary quality, BMI, and food insecurity. This information could 
have policy implications such as providing more funding for the program, informing changes to the program or 
improvements to the program, and extending the reach of the program.  
 
I.   
INVESTIGATOR’S EVALUATION OF THE RISK-BENEFIT RATIO 
 
Since the risk to study participants is no more than that found in everyday life, and the benefits to society 
of the implications the study may have on policy and funding, the investigators conclude that the benefits far 
outweigh the risks. 
 
J.   WRITTEN INFORMED CONSENT FORM  (to be attached to the Application Narrative) 
 
Written informed consent form is attached if signed consent is required by the IRB. Researchers request a 
waiver of signed consent. 
 
K.   WAIVER OF INFORMED CONSENT OR SIGNED CONSENT 
 
Researchers are requesting a waiver of signed consent for individuals who prefer to complete all tasks 
including consent electronically; however, the individual will be present to complete the verbal consent 
process whether he/she signs the form or provides consent electronically. Participants will be provided the 
attached informed consent form after the being screened for study eligibility and before proceeding to 
complete the in-person survey. If participants complete the screening survey electronically through the 
Qualtrics application on the NEP educator’s iPad, they will be required to provide informed consent by 
selecting the “I agree” radio button at the bottom of the informed consent form before proceeding to 
complete the survey. If participants complete the screening survey in paper form, then they will be 
provided an informed consent form that will not require a signature. All participants will be provided a 
copy of the informed consent form through their choice of email or a paper copy.   
L. 
INTERNATIONAL RESEARCH 
 
N/A 
 
M. 
SUPPORTING DOCUMENTS (to be attached to the Application Narrative) 
 Consent Forms: 1. Signed Consent and 2. Informed Consent without signature 
 Recruitment advertisement flyer 
 Recruitment script 

 Study reminder flyer to be emailed or physically mailed 
 Instructions for height and weight measurements 
 Participant Information Sheet 
 Participant Code Key 
 Email script and Phone call script for administering dietary recall and FFQ 
 Survey instruments (Screening Survey, 18-item US Household Food Security Survey Module including 
characteristics questions for 3 time points, NEP medium term survey, Diet History Questionnaire II 
questions for past year and past month reference time periods)   
 Supplemental Question (pregnancy status questions for use with paper surveys at time points 2 and 3) 
 A link to the ASA24 (24-hour dietary recall) demonstration website can be viewed at  
https://asa24.nci.nih.gov/demo.aspx (Microsoft Silverlight must be installed if not already: 
http://www.microsoft.com/silverlight/).  
 The official participant site link to the ASA24 can be viewed at  
https://asa24.nci.nih.gov. 
 A link to the Diet History Questionnaire II (DHQ II) demonstration website can be viewed at 
https://appliedresearch.cancer.gov/cgi-bin/dhq2.pl?module=2&method=1