TEAN Recruitment and Data Collection Manual of
Contents
1. 9 Although we have a primary contact name in the database either parent is eligible Callers should try to recruit whoever answers the phone Steps in phone call recruitment 1 Review calling history and choose relevant call script procedure 2 Initiate call Let the phone ring for at least one minute 3 When call is complete fill in outcome call code in Access form and fill in date and time of next scheduled call if need to call at a specific time please note in the next call time or comment field If a message was left 1 3 or 6 call set the next call date for 2 days later If the participant was not home and no message was left set the next call date for the next day at a different time Call times It is very important to space the calls out throughout the day over time particularly during the first few days Make sure that during the course of calling a given household subsequent calls are made about half hour before or after previous calls e g 4 15PM 4 45PM 5 15PM 5 45PM 6 15PM and 6 45PM If possible make at least one call in the morning Each participant should be called at least once around 4pm and at least once around 8pm This variety of calling times will increase the likelihood of finding someone at home This may not TEAN CODES CALL OUTCOME CODES After each call made fill in the following information into the participant s ACCESS form The date The approximate time A calling outcome code Next2. Call if teen doesn t have email or text b Prompt the consent form if it isn t already in c Set PC1 call for 4 days later 5 Consent Return a When the consent forms are received write the date received and stamp with the signature stamp and file it in a locked cabinet Enter this information into the recruitment database under date consent and date assent received b Request a food recall through the database entering in times and comments from the call availability sheet Set the 3 week window date for three weeks from TEAN MAILINGS INTRODUCTORY RECRUITMENT MAILING Steps in preparing introduction recruitment mailings A 3 Kelli will periodically print sheets of address labels for each recruiter Place the TEAN flyer into the 10 TEAN envelope label stamp and mail When flyers are ready to be mailed fill in Date letter sent and the expected calling date Next Call Date for a given household in their ACCESS record next call date should be 4 6 days after letter is sent Timing of mailings Recruitment mailings should be sent 4 6 days prior to the expected initial call date for that household This ensures that the participant will have recently received these materials when contacted by phone 60 70 letters are to be mailed per week Re send Mailing 1 2 If the prospect has lost the flyer and wants another hand write name and address on envelope and mail another flyer
3. Record this in database Date 2 letter sent Include a handwritten note in reference to previous conversation Il CONSENT FORM MAILING 1 ER If the teen did not provide verbal assent during recruitment call if either parent or teen requests more information before participation or if there is a delay in sending the meter packets consent and assent forms and call availability sheet will be sent before the package is sent Otherwise these three forms will be mailed with meter packet If mailing forms before meter packet prepare a mailing with consent form assent form call availability sheet and business reply envelope Write your Initials on business reply envelope Write a personal note to the participant and send all materials in a TEAN envelope RETURNED MAIL Procedure Scenarios When Receiving Returned Mail 1 A participant mailing comes back and you are actively calling the household a The envelope says addressee unknown forwarding order expired or vacant i Log this as RMM with date in the next available call fields and the date in date mail returned field ii Continue calling the household as it may have been a postal error and the person still lives there or they have moved and still have this phone number TEAN PHONE SCRIPTS RECRUITMENT CALLING GENERAL INFO Purpose of recruitment calling The primary purpose of recruitment calling is to facilitate eligible individuals interest i
4. IDC ATAJATAPI controllers Keyboards gt Mice and other pointing devices Monitors 88 Network adapters Por s COM amp LPT 2F Communications Purl COMA nter Po oific USB to Seria Comm Port COM3 Sound video and game controllers System devces Universal Serial Bus Lunitrullers 3 Opening PC Utility Software a Choose DG100r if prompted to select device type b Select COM Port that corresponds to number in Control Panel and verify that BAUD Rate is 115200 TEAN PARTICIPANT COMPLETION l PAYMENT 1 When study tasks have been completed and no rewear is needed request payment a Enter date in Date Payment Requested field Enter amount requested in Amount field this amount will usually be 50 For payments other than 50 ex extra payment due to meter malfunction or reduced payment due to partial completion get supervisor permission first b Close entry form and open PaymentRequest query Change date to today s date and close query c Open CheckRequest query Verify that information is correct including teen s first and last name Print out and initial back of request d Put in Lindsay s box to be sent for processing i Note If you request an amount other than 50 50 will still print out in the check amount part of the check request You must white out amount on check and write in amount requested In the comments box write in a justif
5. Shared Change Save As Type to Microsoft Excel 97 2003 Add the date no dashes or spaces to the end of the spreadsheet title and save Open this file and verify that all participants are included and that the participating parent is in the file ll Food Recaller Protocol Introduction 24 hour food recalls will be conducted via telephone from the Pediatric Clinical Research Center PCRC at Children s Hospital and Regional Medical Center CHRMC using the Nutrition Data System NDS R 2007 NDS decision rules will be the default during recalls Callers will conduct 3 separate calls for each participant over a 2 3 week period Ideally the calls will be 1 2 per week The goal is to get 1 weekend recall conducted Monday and 2 weekday recalls conducted Tuesday Friday 1 NDS R 2007 will be used throughout the initial data collection and again at the 2 year follow up A revised version will not be used due to the sample size of the current study and the projected burden of re analyzing reports to match the revised version This decision was made based on consultation with Karen Glanz and Sarah Couch on September 24 2007 TEAN ACCELEROMETER AND GPS PREPPING AND DOWNLOADING PROCEDURES METER GPS Prepping 1 GPS Meter Prep Procedures For GPS Person a Before prepping a packet make sure it can be sent that day We always want the recruiter calling the participant 3 days after the packet is mailed If they are
6. participant can have insufficient meter data does not have at least 5 10 hour days 8 hours for weekend days 1 The participant did not wear the Actigraph for 5 days including 1 weekend day resulting in less than 5 10 hour days In this case the recruiter needs to call the participant and see if they will wear the Actigraph again for the number of days that they re missing to complete 7 total days 2 The participant wore the Actigraph for seven days but there were not enough valid hours in each day In this case the recruiter needs to call and have the participant wear the Actigraph again for how many days they re missing Emphasize that the Actigraph needs to be worn the entire day and not just for a few hours 3 Computer Equipment failure The recruiter needs to call and ask the participant to re wear the meter for seven days or however many they are missing 10 can be offered as compensation for the inconvenience No matter what the GPS results a participant should never be asked to re wear the GPS unit A participant should never be asked to wear the meter more than 2 times for any reason per phase of the study Il REWEAR CALLING INSTRUCTIONS SCRIPT General Information 1 If rewear is needed GPS Person will indicate number and type of days needed on the meter GPS log If rewear is due to technical failure situation 3 GPS Person will indicate that 10 extra compensation may be offered 2 When requesting a rewe
7. Filter for NC in the Next Call Code box Then sort the 1 Call Date box in descending order This will bring any records that have been called to the beginning of the list The codes for these records will need to be changed Sort Next Call Dates in descending order and exclude the dummy dates for letters not yet sent 5 5 2155 Now sort the letter sent field in ascending order to bring up any blanks Enter dates in these fields If unknown enter a date 1 week prior to the first call Sort the Next Call Date box in ascending order The earliest call should be today or in the future Then sort the Next Call Date box in descending order Exclude 5 5 2155 and other dummy dates for letters not yet sent The date at the beginning of the list should be 5 5 2015 or 6 6 2016 Filter the Next Call Code box for CB and check that all of the dates are realistic no typos Another way to check would be to filter excluding the following Next Call Dates 12 12 2012 3 3 2013 4 4 2014 5 5 2015 6 6 2016 and 5 5 2155 amp other dummy dates Then sort the remaining dates ascending and descending to catch any errors Filter for DONE in the Next Call Field and sort the Date Consent Received fields in ascending order This will bring any blanks to the beginning of the list Filter excluding blanks in the Date Packet Sent field Then sort Date Meter Received in ascending order This will bring blanks to the beginning of the list Now Filter By Sel
8. TEAN Recruitment and Data Collection Manual of Operations TEEN ENVIRONMENT AND NEIGHBORHOOD Developed by Kelli Cain Carrie Geremia Jill Dumbauld Lisa Husak 6 1 2009 TEAN SAMPLE MANUAL TABLE OF CONTENTS TEAN RECRUITMENT TIMELINE a e las ate thane 2 TEAN MAILING Supinen piel rd ceda 3 DEAN PHONE SGRIPT S23 rai id 4 TEAN CODES ustiipe rindas adapte 5 TEAN DATA SCREENING AND ENTRY 2 a den itnnt tale tetaa eit iuaienes 6 JEAN DATABASE CHECKLIST cursis alin 7 TEAN FOOD RECALL PROCEDURES a ae o e e 9 TEAN ACCELEROMETER AND GPS PREPPING AND DOWNLOADING PROCEDURES 10 TEAN METERPLUS PROCEDURES a 11 TEAN ACCELEROMETER TROUBLESHOOTING AND CALIBRATION osos 12 TEAN GPS TESTING AND TROUBLESHOOTING 00 conil 13 TEAN PARTICIPANT COMPLETION icncssnenanissntonesmonenisiornaniniaiiaiis 14 TEAN REWEAR PROCEDURES de Raion 15 TEAN RECRUIT MENT TIMELINE 1 Recruitment Mailings a See Mailings b Set the next call date for 5 6 days later with a next call code as NC c After the first call to the parent set the next call code as CB and continue recruitment calling see Scripts 2 Consent Form a After the parent and teen have agreed mail consent and assent forms along with the meter and GPS Set a next call date for 3 days after package mailed MC Skip to 3 Meter GPS Checkup Call b After the parent has agreed if you have not yet spoken with the teen mail consent and assent form and the call availabi
9. ar from a participant be sure to request the specific number of days and types of days requested on the meter log 3 If you have received surveys back from parent and teen the rewear call may be a good time to ask for missing survey information It is not recommended to call for missing information before calling for a rewear 4 If you have not received the surveys back or are waiting for other study materials use the rewear call as a survey or other prompt 5 If possible ask the teen directly to rewear instead of going through his her parent 6 If participant has questions about meter wearing use the meter GPS log to verify information Rewear Selling Points if participant refuses 1 Participant agreed to complete steps in study including wear meter for 7 full days
10. call date and code EAS Ex If you called at 7 15pm on August 6 2007 and got a busy signal enter 8 6 07 7 15p BUSY and enter CB as next call code CALLS NOT YET INITIATED Next Call Code NC New Call participant has not been contacted yet Once an attempt has been made to call this household regardless of the outcome replace the NC from the Next Call Code field with appropriate In Progress or Outcome Reached code IN PROGRESS Actual call outcomes only Next Call Code is usually CB BUSY Phone busy MSG Left message MSGO Left message with other person NH Not home HU Person hung up After 2 HU s change to R Next Call Codes for in progress calls CB Call back no final outcome has been reached for all pending recruitment calls CBC Call back to recruit teen TEAN DATA SCREENING AND ENTRY I RECEIVED Preparing materials for screening As you receive study materials keep them filed together by participant ID de 3 4 When you receive a meter GPS log from GPS Person check the number of valid days for meter and GPS on the form and enter them in the recruitment database If fewer than 5 meter days or missing a weekend day the participant will be asked to wear the meter again and complete another meter log If sufficient days are completed make sure that payment has been requested When you receive a survey online or paper parent or adolescent mark date received in recruitment database under P Survey o
11. ected days and a location isn t specified a box will pop up telling you to first select a location Run Meter Plus on a dat file from which you wish to select days to score It needs to be a participant file that starts with Firstmeter or Secondmeter in order for the selecting of days to work TEAN ACCELEROMETER TROUBLESHOOTING AND CALIBRATION TROUBLESHOOTING THE ACTIGRAPH Various problems can arise during all stages of Actigraph use Below are some of the more common occurrences 1 Downloading the Actigraph results in the error that the ini file for this meter is missing If you think that there should be an ini file for this meter choose CANCEL to try to locate the original file If it is not available you will need to create a new ini file using the start date and time from the meter Access database Press OK to create a new ini file you will receive a notice that the file may not be exactly as the one initially created for this monitor The program will lead you through the process of creating a new file Be sure to use the start date and time from the meter Access database 2 Checking the battery initializing downloading performing any of these functions results in the error activity monitor did not respond First check to make sure that the meter is firmly placed in the carriage and then try it again The Actigraphs are sensitive so sometimes the carriage cannot read the information on the first t
12. ection to select only blanks Scroll through the records to be sure appropriate action is scheduled to take place or the situation has been handled Examples of appropriate action are MC MR PC DROP and DROPPED Repeat for GPS and survey fields Make sure to log any lost meters or GPS units and let Jill know also If the survey is delinquent you can resend the online link or mail another survey REMINDER NA vs NK For households without a child NK For households with a grown child over 20 or children out of age range but don t know how far out of range NK For households with a younger or older child who lives at home NA and enter exact age or 6 for younger and 20 for older If have 2 ages enter youngest REMINDER SURVEY TYPE If an online person completes a written survey change the 1 in the Survey type field to a 2 REMINDER DEMOGRAPHICS OF REFUSERS Ask demographic questions of refusers If you can t get any information you should at least be able to verify the gender of the person who refused Change this in the database if necessary A refusal code in the Demographic fields should be filled in 998 if the questions were asked of the person and they refused to answer any or all of the questions REMINDER DROPPED vs R vs NOCON Ifa participant has been mailed a packet and then chooses not to participate they would be coded as a DROPPED Leave the 1 in the agree fields Ifa participan
13. hat agree and eligible fields match up with the Next Call Codes NC should be changed once you have attempted contact with the person The only recruitment in progress codes that should be used are CB and O All new calls should have a date in the date letter mailed field All Next Call Dates should be reasonable dates in the future Check that all people who are coded as DONE have a date consent received filled in for both parent and child Check that all meters GPS units and surveys are accounted for Filter for each Next Call Date 12 12 2012 3 3 2013 4 4 2014 5 5 2015 6 6 2016 7 7 2017 and go through the records to be sure the correct code is present in the Next Call Code box Filter for each outcome NA NEVER R DONE NM etc and sort Next Call Date in both orders to bring up dates that don t match the rest Filter for all refusals 3 3 2013 and make sure there is a 0 in either the parent or child agree fields not both Then filter for all ineligibles 12 12 2012 and make sure there is a blank in the agree field and a 0 in the eligible field Filter excluding blanks in the Date packet sent field and make sure there is a 1 in the agree and eligible fields of these records Next filter for NOCON_C and check that those whose parent agreed but child didn t follow through have a 1 in the agree field of the parent Filter for NMs and make sure the eligible field is blank
14. ication for the changed amount example 60 for extra tasks completed or 30 for partial participation e Lindsay will give you a copy of the signed request This means that the request has been sent to be processed Keep the copy in participant folder to verify that check was requested 2 When the payment check arrives from SDSU Foundation send the check to the participant with the Thank You letter see Appendices Check should be sent in a 10 TEAN letterhead envelope Add a sticky note with a personalized message Shred copy of request in folder ll PACKET When packet is returned from Data Collection Entry it should be completely collected and entered Go through the packet and verify the following 1 Consent forms not in packet filed separately give to Kelli 2 Food recall printout all missing information filled in recruiter and enterer ID written 3 Both parent and child surveys included and complete 4 Paper Surveys if applicable Both survey entry dates filled in entered twice Last page of surveys torn away if there are comments GPS Meter Log included Copy of check request removed and shredded 7 Name on label deleted only participant ID visible OV lil RECRUITMENT DATABASE 1 Verify that all fields entered in database and enter necessary items 2 In Data Retrieval Section TEAN REWEAR PROCEDURES PARTICIPANTS WITH INSUFFICIENT METER DATA Situations There are three ways a
15. lity sheet and set a next call date for 1 week later with a next call code as CFU Use this call to get the teen s verbal assent c If you re unable to speak to teen during this call set next call date for 2 days later and make CBC call see Scripts Continue calling to reach teen up to 8 tries Upon getting verbal consent go over assent form CFU to answer questions If verbal assent is received before or during this call prep meter and GPS packet and mail d After making the CFU call see Scripts set a next call date for 3 days after package mailed unless already spoke with participant MC 3 Meter GPS Checkup a When the MC call comes up on the call list check in the database to make sure that a mailing was sent at least 3 days previous to call date Then make a check up call to the teen see Scripts b Use this call for a CFU if consent mailed with package and prompt consent return See Scripts c If the teen cannot be reached leave a detailed message See Scripts and call the parent for CFU if the consent was sent with the package d Set a next call date for 3 days later with a next call code as MR meter reminder e Continue to prompt consent return during each call until it s received Make sure to attempt to reach the parent at least once for a CFU 4 Meter GPS Reminder a When the MR call comes up on list send email or text message reminding teen to wear and charge the meter and GPS see Scripts
16. meter past midnight time will have to be adjusted before scoring If for example an EST participant wore a meter initialized in PST the time would stay the same thus giving each participant s night 3 more hours This program has certain default settings for classifying categories of movement The default settings in Meter Plus are as follows 999 not wearing 0 100 sedentary 101 1952 light 1953 5724 moderate 5725 9498 hard and 9499 10000 very hard To set the not wearing category set both the minimum and maximum to 999 To change these criteria or to add new categories open Meter Plus select Tools and select Options To edit select the Categories tab and highlight the category you want to change Select Edit and change the name and minimum and maximum count to your desired range Click on OK to accept the changes To add select Add choose the name and set the minimum and maximum counts You can also delete a category by selecting it and clicking delete Il SELECTING DAYS TO BE SCORED USING METER PLUS 1 First you need to set up a folder for Meter Plus to send the chosen data Open Meter Plus and go to Tools Options and then File Under File it will say Location to send new data filesto Click on the button to the right of the text and select the folder you want the files to go to This location will then be saved as the default place to store the files that are ready to be scored If you try to save sel
17. n participating in TEAN Study Direct phone contact with eligible individuals also allows recruiters to answer questions about the study to facilitate the consent process and to obtain some information about the characteristics of study participants and refusers Guidelines for contacting participants 1 There should be no fewer than 8 attempts to contact a given possible participant 2 Messages should be left on answering machines on the first third and sixth calls 3 Each potential participant should not receive more than 3 contact attempts in any given week 4 Each potential participant should receive a maximum of one call per day unless the recruiter is asked to call back at a different time that same day or if the telephone line is busy No more than 2 contact attempts should be made in any single day Calls should be spaced throughout a few weeks giving the potential participants a chance to respond to the answering machine messages 5 No more than one answering machine message should be left with a potential participant on any one day 6 If a potential participant refuses or is ineligible the recruiter should ask for another adult in the household 7 If the potential participant has moved the recruiter should try to recruit the person who answered the phone and verify address eligibility if different from what is in the record 8 If a potential participant refuses the recruiter should ask them the demographic questions
18. not calling on that day wait to send the packet on a day that works out If it is a rewear and they only need weekend days wait to send the packet on a Monday or Tuesday so there s a better chance that they rewear on the correct days Double check supply of all materials to be sure we have what is needed remember that long term meters are needed for rewears b Use the whiteboard to write down important dates vi vil Day that packet is going out usually the same day Short term last day 1 Since the meter gets initialized for 2 days after send date and it lasts 11 full days date is 12 days from send date 2 An easy way to tell that you did this correctly day of the week should be 2 days before send day of the week 3 For example if you send it Thursday J une 25 the Short term last day will be Tuesday J uly 7 Long term last day 1 45 days from start date GPS last day 1 The GPS last day really depends on when it was turned on and whether it was left on You can t be sure what this will be but 1 month before the long term last day is a good guess This gives it 3 4 days past the short term last day Start day 1 This is the day that everyone should start wearing the meter even with long term meters 2 Choose 1 week before the short term last day It will be the same day of the week as the short term last day So using the example above the start date would be Tuesday J une 30 MC 1 This isthe meter call da
19. ppear This indicates a problem with the meter and regardless of the outcome you will need to send the meter for repairs In order to attempt to retrieve the data go to Admin then Recovery Mode You will then have to select the number of epochs to download Calculate the number of epochs by multiplying the number of days it has TEAN GPS TESTING AND TROUBLESHOOTING I Software Setup Track point data from the units is compatible with free Google Earth software which can be downloaded at http earth google com ll Testing to be completed periodically in batches See DG 100 User Manual for more information regarding GPS unit and software use 1 Turn unit on and plug into USB Port 2 Verify through Control Panel that USB port is recognized Through Performance and Maintenance gt System click on Hardware tab and then the Device Manager button Expand the Ports COM amp LPT item and look for port that says Prolific USB to Serial Comm Port Click on this port and close Control Panel a Note This usually has to be done after shutting down computer If re opening software after setting USB port through Control Panel this step usually isn t necessary E Device Manager jek Fie Acton View Help m CHM R By RICHARDWANG 08 Computer 1 Se Disk drives 8 Display adapters DYD CC ROM drives 4 Floppy disk zontrollers 48 Floppy disk drives 93 Hunan Intefaca Devices 2
20. r C Survey a If online survey Carrie will note missing information on the survey form b If paper survey Survey will be screened see below For teen paper survey verify that last page raffle and comments has been removed c For both surveys check demographic information mark as checked When the food recall location form comes in add dates recalls completed to database if not already done If participant has worn meter for enough days send payment When steps 1 3 have been completed study materials are ready for screening and data entry Clip together parent survey teen survey food recall sheet teen availability sheet and coversheet Place packet in basket to be screened Il SCREENING Surve aper Note all missing information on screening cover sheet and flag pages in survey Make all corrections with a red pen and initial 1 Parent Survey a Check entire survey for blank double answered and or ambiguous answers for example if sometimes a few etc is written instead of a number answer b Section B i Bl If yes then B2 and B3 should be answered ii B2 3 Verify school name and address with Google Make corrections c Section G i G5 If filled in number should be circled ii G6 G8 Verify food store names and addresses in Food Sources Database see procedure below TEAN DATABASE CHECKLIST WHAT TO CHECK HOW TO CHECK Check that Next call Dates and Codes match up Check t
21. ry If the problems persist wiggle the wires connected to the carriage to ensure they haven t come loose Also you can blow gently on the carriage and try it again sometimes dust or dirt will stop the meter from being read 3 When you place a meter in the carriage to download the red light is not rapidly flashing like it should be if it s still recoding data The first step is always to attempt to download the meter anyway a If the meter still flashes the 1 2 3 sequence it means the meter never initialized in the first place Check the ini file to verify the meter was initialized correctly and for the correct date and time If the ini file is correct this could indicate a serious problem with the computer or software Contact MTI and your IT person to help troubleshoot the problem b If the meter is flashing the slow 1 1 1 sequence it means the meter was either never initialized check ini file or it means the meter is full of data and is no longer recording The short term meters record for 22 days and the long term meters for 91 days If the meter has been recording for longer than the maximum time the data will not be lost Continue downloading the meter as usual If the meter is flashing the slow 1 1 1 sequence but the meter has not been out longer than its run time 22 or 91 days and it did indeed get initialized something else may be wrong Download the meter An error saying the current memory address is zero may a
22. t agrees but later changes their mind before a packet is mailed code as an R Change or remove the 1 in the agree fields Enter a 0 in the agree field for parent OR child depending on who refused Ifa participant agreed and was only mailed the consent forms not likely and then never follows through for whatever reason code as NOCON Leave the 1 in agree fields TEAN FOOD RECALL PROCEDURES I Requesting Food Recalls 1 When the signed consent form arrives or upon verification that family sent consent in a b c d e In the Date FR requested field fill in today s date In the Next call date for recaller field fill in the date 2 days from today In the Date 3 week window ends field fill in the date 3 weeks from the Next call date for recaller field Fill out the Food Recall times and Food Recall comments with as much information as possible Using information from the availability sheet and from recruitment fill out as much information as possible in the Availability fields You have to enter something into this form for the query to work 2 At the end of the call shift run and Export the Food Recall Query gt ompong Open the qryFoodRecallRequest found in the Queries menu In design view change the FR_request field to today s date Close query and save changes Right click query and choose Export Find the Food Recall Requests folder in TEAN
23. te Set for 4 days after the send day or the next possible day if weekend days get in the way 2 So with the example above the MC would be Monday J une 29 Initialize 1 Always 2 days after send date 2 In example it would be J une 27 c Open and set up databases TEAN METERPLUS PROCEDURES CONFIGURING METER PLUS This program has certain default settings based upon our criteria for a valid hour and day see section VI 3 above and our choices for dealing with missing data and invalid hour data 1 To change the criteria for scoring data open Meter Plus select Tools and select Options Under the View Data tab you can change the criteria for a valid day and hour To change the criteria for saving data open Meter Plus select Tools and select Options Under the Score Data tab you can change the criteria for a valid day and hour To change the value used for undefined fields and replacing strings of zeros if an hour is invalid open Meter Plus select Tools and select Options Under the Score Data tab you can change these settings To adjust for time zone differences between location of initialization download and location of wearing open Meter Plus select Tools and select Options Under View Data tab you can adjust the start time to account for these differences For example if initialized in PST and worn in EST adjust by 3 hours If initialized in EST and worn in PST adjust by 3 hours If a participant wore the
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