National Center for Health Statistics

Expanding the Use of NCHS’ Research and Development Survey to 

Quantify Health Characteristics During the Coronavirus Pandemic

Paul Scanlon, PhD 

Katherine Irimata, PhD

September 21, 2020
Research and Development Survey (RANDS)

• Ongoing, periodic set of surveys conducted by the NCHS 

Division of Research and Methodology 

• Designed to expand NCHS’ methodological research: 

– To supplement NCHS’ survey and questionnaire evaluation 

efforts 

– To explore ways to integrate data from commercial survey 

panels with high-quality data collections

2
RANDS Program So Far...

RANDS 1 RANDS 2 RANDS 3

RANDS 

during 

COVID-19 

(2 Rounds)

RANDS 4 RANDS 5 

(Planned)

Year 2015 2016 2018 2020 2020 2021

Survey 

Focus

Health 

Conditions 

and 

Behaviors

Health 

Conditions 

and 

Behaviors

Disability 

and 

Opioids

COVID-19-

related 

concepts

Disability 

and 

Opioids

National 

Survey of 

Family 

Growth

3
RANDS Sample Sources

Recruited commercial survey panels 

– Managed by commercial or non-governmental firms and organizations 

– Panel is recruited based on statistical sampling methodology 

– Typically well-maintained with good levels of panel retention 

– Very few in the United States—to our knowledge, there are only six 

– There is a theoretical ability to assign probabilities of selection 

– Major coverage and response issues as compared to NCHS’ household 

surveys

4
RANDS Sample Sources

• Gallup Panel (RANDS 1 and RANDS 2) 

– Panel recruitment via Gallup’s Dual Frame Random Digit Dial (RDD) Daily 

Tracking Poll 

– No non-response follow up (NRFU) during recruitment 

– Non-internet panelists surveyed via phone or mail 

• NORC’s AmeriSpeak Panel (RANDS 3 through present) 

– Panel recruitment via a dedicated mail out/mail back survey 

– Extensive NRFU (~60% of panel comes from this effort) 

– Non-internet panelists surveyed via phone

5
Adapting RANDS for Estimation: 

RANDS during COVID-19

• Traditional NCHS surveys require advanced planning and cannot always 

adapt quickly to collect data on major events in real-time 

• RANDS, as a largely web-based survey, could provide some information on 

COVID-19 in a rapid and timely way 

• NCHS worked with the Office of Management and Budget to adapt the 

purpose of RANDS from a strictly methodological survey to one that could 

produce a limited set of experimental estimates 

• The new survey was named RANDS during COVID-19 to distinguish it from 

previous versions of RANDS

6
What is RANDS during COVID-19?

• Two-round survey, with a longitudinal design 

• Web and phone mode, with a minimum sample size of 6,000 in the 

first round and 5,000 in the second round 

• The questionnaire includes several health topics: 

– Health Status, Chronic Conditions, Depression and Anxiety 

– Loss of Work due to Illness with COVID-19 

– Health Insurance and Health Care Access 

– Telemedicine Access and Use 

– COVID-19 Related Health Care and Behaviors 

– Reduced Access to Health Care

7
Data Overview

8,663

• Randomly selected adult 

panelists invited to participate

6,800

• Completed surveys

• 94% by web; 6% by telephone

23%

• Weighted cumulative 

response rate

Survey responses 

collected: June 9, 

2020 – July 6, 2020

8
Question Evaluation on RANDS during COVID-19

Three general areas: 

– Planned/New NHIS questions 

• Unmet Care

• Autoimmune Chronic Conditions

• COVID-19 testing and results

• Intensity of COVID-19 symptoms

– RANDS “estimation” questions 

– General coronavirus/COVID-related topics 

• Understanding of terms such as “quarantine”

• Exploration of reference period terminology

9
Producing Experimental Estimates

• Experimental estimates were produced using calibrated 

weights to account for possible differences in the survey 

design 

• Sample weights were raked to the 2018 National Health 

Interview Survey sample adult weights (n=25,417) to adjust for 

differences in demographic and health factors 

• After raking, the weighted distributions of the calibration 

variables in RANDS matched the NHIS

10
RANDS during COVID-19 Round 1 Release

• National and subgroup estimates are reported online for the following groups: 

• Topic areas: 

– Loss of work due to illness 

– Telemedicine 

– Reduced access to care

https://www.cdc.gov/nchs/covid19/rands.htm

– Age group

– Race/Hispanic origin

– Sex

– Education

– Urbanization

– Chronic conditions 

11
Loss of Work due to Illness

The inability to work at any 

point in the past week due to 

being sick or having a family 

member sick with COVID-19

0.9% of U.S. adults were 

unable to work due to 

personal or family 

member illness

12
Loss of Work due to Illness Highlights

• Non-Hispanic Black adults had 

the highest percent of work 

loss (2.5%) followed by 

Hispanic adults (1.3%) 

• Adults with some college 

education reported the 

highest percent of work loss 

(1.6%)

• Loss of work was similar 

among males and females

• Loss of work for adults with 

chronic conditions ranged 

from 0.7% (diagnosed 

diabetes) to 1.0% (current 

asthma)

13
Telemedicine

Access and use of telemedicine, including video and telephone 

appointments both before and during the pandemic

24.2% of adults in 

the U.S. had one or 

more telemedicine 

appointments in the 

last two months

36.6% of adults in 

the U.S. have a 

provider that offered 

telemedicine in the 

last two months

14.1% of adults in 

the U.S. have a 

provider that offered 

telemedicine prior to 

the pandemic

14
Telemedicine Highlights

Access 

• In the last two months, access 

varied by age group, sex, and 

education 

• In the last two months, access 

was similar between metro 

and non-metro areas

Use

• Telemedicine usage was higher 

among adults 65 years and 

older and females compared to 

adults 18-64 years and males

• Telemedicine usage was above 

the national average for adults 

with diagnosed chronic 

conditions

15
Reduced Access to Care

Inability to receive medical care for any reason and due to the pandemic

✓ Dental care 

✓ Diagnostic or medical screening 

test 

✓ Hearing care 

✓ Prescription drugs or medications 

✓ Regular checkup 

✓ Surgical procedure 

✓ Treatment for ongoing condition 

✓ Urgent care 

✓ Vision care 

48.4% of U.S. adults missed one 

or more types of care in the last 

two months for any reason

38.7% of U.S. adults missed one 

or more types of care in the last 

two months due to the pandemic

16
Reduced Access to Care Highlights

Reduced access to care reflects 

amount of missed care and is 

affected by the varying need for 

care in the first place 

• Care missed most often: 

dental care, regular check 

ups, vision care 

• Care missed least often: 

surgical procedures, urgent 

care, hearing care

Certain types of care were impacted 

more than others

• Relatively high % missed care due 

to the pandemic: dental care, 

vision care, surgical procedures

• Relatively low % missed care due 

to the pandemic: urgent care, 

prescription drugs or 

medications

17
Summary

• RANDS is a platform designed for methodological purposes including 

conducting survey question evaluation and statistical research 

• NCHS adapted RANDS to produce timely data on COVID-19 

• Experimental estimates from the first round are currently available at: 

https://www.cdc.gov/nchs/covid19/rands.htm

• Round 2: 

– Data collection was conducted in August 

– Experimental estimates will be released in September

18
Future RANDS during COVID-19 Research

• Questionnaire evaluation: 

– Report combining RANDS findings with the findings from a series of 

cognitive interviews focused on coronavirus-related survey questions 

• Estimation: 

– Statistical testing comparing round 1 and 2 

– Evaluation of COVID-19 data from opt-in sample (n=10,000) from each 

round

19
For more information, contact CDC

1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348 www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the 

official position of the Centers for Disease Control and Prevention.

https://www.cdc.gov/nchs/rands

https://www.cdc.gov/nchs/covid19

Paul Scanlon, pscanlon@cdc.gov 

Katherine Irimata, kirimata@cdc.gov

20