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- Interviewer-Administered Questionnaire
- Self-Administered Questionnaire: Paper
- Self-Administered Questionnaire: Web
Interviewer-Administered Questionnaire
The Dietary Screener Questionnaire (DSQ) was administered by interviewers in the National Health and Nutrition Examination Survey (NHANES) 2009-2010 series. English and Spanish versions are available:
Self-Administered Questionnaire: Paper
The DSQ in English [PDF - 126 KB] is formatted in Teleform. The form is publicly available for you to print. Please note that this instrument is not machine scannable. It can be used only if data are to be input by hand.
Scanning Information for the DSQ
Depending on the information technology (IT) resources at your organization, you may be able to print and scan the DSQ. If you have to outsource the printing and/or scanning, the costs involved will vary depending on whether you use the DSQ without changes or you make changes specific to your study.
To order printed, machine-scannable forms, you may use a variety of vendors at your own expense.
Self-Administered Questionnaire: Web
The Web-based version of the Dietary Screener Questionnaire (DSQ) is available for public use. DSQ*Web takes advantage of the features of automated and electronic questionnaires -- respondents follow automated skip patterns, are queried to complete all questions before proceeding to the next, navigate within the instrument to correct or modify responses, and can log in at any time to complete the questionnaire, starting where they left off. DSQ*Web provides efficiency with respect to data quality because the possibility of missing or inconsistent responses is eliminated.
DSQ*Web was modeled after DHQ*Web, a system that has been operating since 2005.
You may view a demonstration of DSQ*Web or submit a request to use the system for your study.