Not Assigned Child Identification

Page 1 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.001_00.000 Instrument Variable Name: CURRES QuestionnaireFileName: Sample Child

QuestionText: * Enter the line number of the person to whom you are speaking.

01-25 Person number of the respondent for Sample Child

UniverseText: Sample child section not started or not completed

SkipInstructions: if CSTAT <> empty and CSTAT <> 2 THEN

if ASTAT = empty or ASTAT = 2 THEN

goto adult.aid.SADULT

elseif recontact.RCIFLAG <> 1 THEN

goto recontact.RCI_BEGIN procedure

else

goto back.OUTCOMEB1 procedure

endif

goto back.OUTCOMEB1 procedure

endif

<01-25> if this is NOT an allowable line number

goto ERR_CURRES

elseif CURRES = a line number entered in KNOWSC2

store CURRES in CSPAVAIL and CSRESP

goto CSRELTIV

elseif KNOWSC2 = 'Don't know' or 'Refused' or empty (no line numbers in KNOWSC2)

goto KNOAVAIL

else

goto CSPAVAIL

endif

Page 2 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.010_00.000 Instrument Variable Name: CSPAVAIL QuestionnaireFileName: Sample Child

QuestionText: The next questions are about [fill1: S.C. name].

Is [fill2:KNOWSC2 names] available to answer some questions about [fill3: HISHER] health?

* Enter line number of available respondent from list or enter '96' if no one is available.

* If refused enter CTRL_R.

01-25 Person # of person available to answer questions about Sample Child

96 No person available

UniverseText: Someone identified as knowledgeable about child's health and knowledgeable person(s) not entered in CURRES

SkipInstructions: <01-25> if line number not equal one of the line numbers in KNOWSC2

goto child.cid.ERR_CSPAVAIL

else

store child.cid.CSPAVAIL in child.cid.CSRESP

goto child.cid.CSRELTIV

endif

<96> store child.cid.CSPAVAIL in child.cid.CSRESP

goto cbk.CCALLBK1

<R> store <4> in CSTAT(FAMINT)

if ASTAT = empty or ASTAT = 2 THEN

goto adult.aid.SADULT

elseif recontact.RCIFLAG <> 1 THEN

goto recontact.RCI_BEGIN procedure

else

goto back.OUTCOMEB1 procedure

endif

Question ID: CID.030_00.000 Instrument Variable Name: CSRELTIV QuestionnaireFileName: Sample Child

QuestionText: (book) C1

[fill1: The next questions are about [fill2: S.C. name]

What is your relationship to [fill2: S.C. name]?

01 Parent (Biological, adoptive, or step)

02 Grandparent

03 Aunt/Uncle

UniverseText: Someone identified as knowledgeable about child's health

SkipInstructions: <1-8,R,D> If CSRESP = demographics.hhc.RELRESP_A

goto child.chs.BWGT_LB

elseif CSRESP = demographics.hhc.HHRESP

goto child.chs.BWGT_LB

else]

goto CSPVERF_S

endif]

Page 3 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.040_00.000 Instrument Variable Name: CSPVERF_S QuestionnaireFileName: Sample Child

QuestionText: * Please verify the following information about the sample child before proceeding:

I have recorded [fill1: S.C. name]'s sex as [fill2: Sex of Sample Child]. Is this correct?

* If respondent "refuses" or says "don't know", enter "1" for "yes".

1 Yes

2 No

UniverseText: Respondent is not the person entered in HHRESP or RELRESP_A.

SkipInstructions: <1> goto CSPVERF_A

<2> goto NEWSEX

Question ID: CID.041_00.000 Instrument Variable Name: NEWSEX QuestionnaireFileName: Sample Child

QuestionText: * Ask if appropriate; otherwise, enter your best guess of the person's sex.

Is [fill: S.C. name] Male or Female?

1 Male

2 Female

UniverseText: Respondent said child's sex is not correct.

SkipInstructions: <1,2> store NEWSEX in SEX

goto ERR_NEWSEX

reset CSPVERF_S

goto CSPVERF_S

Question ID: CID.042_00.000 Instrument Variable Name: CSPVERF_A QuestionnaireFileName: Sample Child

QuestionText: * Please verify the following information about the sample child before proceeding:

I have recorded [fill1: S.C name]'s age as [fill2: Age of Sample Child] old. Is this correct?

* If respondent "refuses" or says "don't know", enter "1" for "yes".

1 Yes

2 No

UniverseText: Respondent verified child's sex

SkipInstructions: <1> goto CSPVERF_D

<2> goto NEWAGE

Page 4 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.043_00.000 Instrument Variable Name: NEWAGE QuestionnaireFileName: Sample Child

QuestionText: How old is [fill1: S.C. name]?

* If age given in months, weeks, or days, convert age to appropriate year. If less than one year old, enter "0".

000-120 Age in years

UniverseText: Respondent said child's age is not correct

SkipInstructions: <0-120, Refused, Don't know>

if NEWAGE = Refused or NEWAGE = Don't know or NEWAGE = AGE

reset CSPVERF_A

goto ERR_NEWAGE

else

store NEWAGE in AGE

goto NEWDOB_M

Question ID: CID.044_00.000 Instrument Variable Name: CSPVERF_D QuestionnaireFileName: Sample Child

QuestionText: * Please verify the following information about the sample child before proceeding:

I have recorded [fill1: S.C. name]'s birthday as [fill2: Birthday of Sample Child]. Is this correct?

* If respondent "refuses" or says "don't know", enter "1" for "yes".

1 Yes

2 No

UniverseText: Respondent verified child's sex

SkipInstructions: <1> if AGE of Sample Child ge <18>

goto CNO_MORE

else

goto child.chs.BWGT_LB

endif

<2> goto NEWDOB_M

Page 5 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.046_01.000 Instrument Variable Name: NEWDOB_M QuestionnaireFileName: Sample Child

QuestionText: 1 of 3

What is [fill: S.C. name]'s birthday?

*Enter month of birth.

1 January

10 October

11 November

12 December

2 February

3 March

4 April

5 May

6 June

7 July

8 August

9 September

UniverseText: Respondent said child's date of birth is not correct or child's age is not correct

SkipInstructions: <01-12, Refused, Don't know> goto NEWDOB_D

Question ID: CID.046_02.000 Instrument Variable Name: NEWDOB_D QuestionnaireFileName: Sample Child

QuestionText: 2 of 3

* Enter day of birth.

01-31 Day of the month

UniverseText: Respondent said child's date of birth is not correct or child's age is not correct

SkipInstructions: <01-31,Refused,Don't know> goto NEWDOB_Y

If days not valid, goto ERR_NEWDOB_D

Page 6 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.046_03.000 Instrument Variable Name: NEWDOB_Y QuestionnaireFileName: Sample Child

QuestionText: 3 of 3

* Enter year of birth.

1880-2020 Year of birth

UniverseText: Respondent said child's date of birth is not correct or child's age is not correct

SkipInstructions: <1880-2020, Refused, Don't know> if CSPVERF_A = No then reset CSPVERF_A to empty

goto CSPVERF_A

elseif CSPVERF_D = No then reset CSPVERF_D to empty

goto CSPVERF_D

endif

(if year GT current year) or (if year = current year and month GT current month) or (if year = current year and month

= current month and day GT current day)

goto ERR1_NEWDOB_Y

endif

(if birth month = <02> and birth day = <29> and this is not a leap year)

goto ERR2_NEWDOB_Y

endif

(if NEWDOB_M = Ref or DK) or (if NEWDOB_D = Ref or DK) or (if NEWDOB_Y = Ref or DK)

goto ERR3_NEWDOB_Y

else

store NEWDOB_M in DOBM

store NEWDOB_D in DOBD

store NEWDOB_Y in DOBY

if CSPVERF_A = No then reset CSPVERF_A to empty

goto CSPVERF_A

elseif CSPVERF_D = No then reset CSPVERF_D to empty

goto CSPVERF_D

endif

endif

Calculate age from NEWDOB_M, NEWDOB_D, and NEWDOB_Y.

if age from NEWDOB items is ne AGE and age from NEWDOB items is valid

reset CSPVERF_A or CSPVERF_D

goto ERR4_NEWDOB_Y

endif

Page 7 of 7

2007 NHIS Questionnaire - Sample Child

Child Identification

Document Version Date: 12-Jul-06

Question ID: CID.051_00.000 Instrument Variable Name: SCSSN QuestionnaireFileName: Sample Child

QuestionText: * Read to respondent:

We also need [fill 1: ALIAS] Social Security number. The National Center for Health Statistics

will use [fill ALIAS] 's Social Security number to conduct health-related research by linking [FILL

HIS/HER] survey data with vital statistics and other records. We may also use it if we need to

recontact you or your family. Except for these purposes, the National Center for Health

Statistics will not release [fill ALIAS]'s Social Security number to anyone, including any

government agency. Providing this information is voluntary and is collected under the authority

of the Public Health Service Act. There will be no effect on [fill ALIAS]'s benefits if you do not

provide it.

* Read if necessary.

The Public Health Service Act is Title 42, United States Code, Section 242K.

What is [fill1: ALIAS’s] Social Security number?

* Enter 'N' if no Social Security number.

001010000-799999999 Number

R Refused

D Don’t know

UniverseText: All sample Children

SkipInstructions: <001010000-799999999> goto SCSSNREP

<000000000-999999999> goto ERR_SCSSN_2

<R, D> goto ERR_SCSSN_1, if suppressed goto beginning of Sample Adult, Recontact, or

Back section

<N> goto beginning of Sample Adult, Recontact or Back section

Question ID: CID.052_00.000 Instrument Variable Name: SCSSNREP QuestionnaireFileName: Sample Child

QuestionText: * Enter how Social Security number was reported.

1 From memory

2 From records

UniverseText: SSN was given at SCSSN

SkipInstructions: <1,2> goto SCSSNTEL

Question ID: CID.053_00.000 Instrument Variable Name: SCSSNTEL QuestionnaireFileName: Sample Child

QuestionText: * Select one category below to indicate reporting of Social Security number.

1 In person

2 Telephone

UniverseText: Recorded how SSN was reported

SkipInstructions: <1,2> goto beginning of Sample Adult, Recontact, or Back section