OMB #: 0925-0593
OMB Expiration Date: 8/31/2014
Child Anthropometry Instrument, Phase 2g
OMB Specification
Child Anthropometry Instrument
Event Category: |
Time-Based |
Event: |
6M, 12M, 24M, 36M, 48M, 60M |
Administration: |
N/A |
Instrument Target: |
Child |
Instrument Respondent: |
Primary Caregiver |
Domain: |
Physical Measures |
Document Category: |
Physical Measures |
Method: |
Data Collector Administered |
Mode (for this instrument*): |
In-Person, CAI |
OMB Approved Modes: |
In-Person, CAI |
Estimated Administration Time: |
17 minutes |
Multiple Child/Sibling Consideration: |
Per Child |
Special Considerations: |
N/A |
Version: |
3.0 |
MDES Release: |
4.0 |
*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.
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Child Anthropometry Instrument
TABLE OF CONTENTS
APPENDIX A: BP SPECS- PROGRAMMER’S INSTRUCTION FOR ROF AND REFERRALS
APPENDIX B: ANTHROPOMETRY EDIT RANGES
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Child Anthropometry Instrument
WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:
DATA ELEMENT FIELDS |
MAXIMUM CHARACTERS PERMITTED |
DATA TYPE |
PROGRAMMER INSTRUCTIONS |
ADDRESS AND EMAIL FIELDS |
100 |
CHARACTER |
|
UNIT AND PHONE FIELDS |
10 |
CHARACTER |
|
_OTH AND COMMENT FIELDS |
255 |
CHARACTER |
|
FIRST NAME AND LAST NAME |
30 |
CHARACTER |
|
ALL ID FIELDS |
36 |
CHARACTER |
|
ZIP CODE |
5 |
NUMERIC |
|
ZIP CODE LAST FOUR |
4 |
NUMERIC |
|
CITY |
50 |
CHARACTER |
|
DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.) |
10 |
NUMERIC
CHARACTER
|
MM MUST EQUAL 01 TO 12 DD MUST EQUAL 01 TO 31 YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR. |
TIME VARIABLES |
TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION |
NUMERIC |
HOURS MUST BE BETWEEN 00 AND 12; MINUTES MUST BE BETWEEN 00 AND 59 |
Instrument Guidelines for Participant and Respondent IDs:
PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).
POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.
A REMINDER:
ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.
(TIME_STAMP_PMC_ST).
PROGRAMMER INSTRUCTIONS |
|
PMC01000/(ANTHRO_INTRO).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
CONTINUE |
1 |
AN_WT_MEAS1 |
REFUSED |
-1 |
|
PMC02000/(AN_REF_REASON). I am sorry that you have chosen not to participate in this activity. Can you please tell me why?
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
CONCERN ABOUT DISCOMFORT |
1 |
|
CHILD SICK |
2 |
|
CHILD TIRED/UNHAPPY |
3 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
SOURCE |
National Children’s Study, Vanguard Phase (Child Anthropometry) |
PROGRAMMER INSTRUCTIONS |
|
PMC03000/(AN_REF_REASON_OTH). SPECIFY: _______________________________
SOURCE |
National Children’s Study, Vanguard Phase (Child Anthropometry) |
PMC06000/(AN_END_REF). That’s fine. Thank you for your time.
PROGRAMMER INSTRUCTIONS |
|
PMC07000/(AN_WT_MEAS1). WEIGHT MEASUREMENT 1.
MEASURED WEIGHT |___|___|___| . |___| kg
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_WT_MEAS_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_WT_MEAS_CNO_REASON |
SOURCE |
|
PROGRAMMER INSTRUCTIONS |
|
PMC08000/(AN_WT_MEAS2). WEIGHT MEASUREMENT 2.
MEASURED WEIGHT |___|___|___| . |___| kg
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC09000/(AN_WT_MEAS3). WEIGHT MEASUREMENT 3
MEASURED WEIGHT |___|___|___| . |___| kg
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC10000/(AN_WT_MEAS_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC11000/(AN_WT_MEAS_CNO_REASON_OTH). SPECIFY: ________________________________________
PMC12000/(AN_ WT_MEAS_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
DIAPER NOT CLEAN |
2 |
|
CHILD WEARING CLOTHES |
3 |
|
CHILD WEARING SHOES |
4 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC13000/(AN_MEAS_WT_COM_OTH). SPECIFY: __________________________
PROGRAMMER INSTRUCTIONS |
|
PMC14000/(CHILD_STANDING). IS THE CHILD ABLE TO STAND?
Label |
Code |
Go To |
YES |
1 |
AN_STAND_HEIGHT1 |
NO |
2 |
AN_STAND_HEIGHT1 |
PMC15000/(AN_RECUMB_LENGTH1). FIRST RECUMBENT LENGTH.
MEASURED RECUMBENT LENGTH |___|___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
EXCEEDS CAPACITY |
-9 |
AN_RECUMB_LENGTH_CNO_REASON |
REFUSED |
-1 |
AN_RECUMB_LENGTH_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_RECUMB_LENGTH_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC16000/(AN_RECUMB_LENGTH2). SECOND RECUMBENT LENGTH.
MEASURED RECUMBENT LENGTH |___|___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC17000/(AN_RECUMB_LENGTH3). THIRD RECUMBENT LENGTH.
MEASURED RECUMBENT LENGTH |___|___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC18000/(AN_ABOVE_WAIST_ADJ_RECUMB). ABOVE WAIST ADJUSTMENT (RECUMBENT).
ABOVE WAIST ADJUSTMENT |___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
PROGRAMMER INSTRUCTIONS |
|
PMC19000/(AN_BELOW_WAIST_ADJ_RECUMB). BELOW WAIST ADJUSTMENT (RECUMBENT).
BELOW WAIST ADJUSTMENT |___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
PROGRAMMER INSTRUCTIONS |
|
PMC21000/(AN_RECUMB_LENGTH_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC22000/(AN_RECUMB_LENGTH_CNO_REASON_OTH). SPECIFY: _____________________________
PMC23000/(AN_MEAS_LENGTH_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
POSITION NOT STRAIGHT FOR LENGTH |
2 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
3 |
|
AMPUTATION – LEG |
4 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC24000/(AN_MEAS_LENGTH_COM_OTH). SPECIFY: __________________________
PROGRAMMER INSTRUCTIONS |
|
PMC25000/(AN_STAND_HEIGHT1). FIRST STANDING HEIGHT.
MEASURED STANDING HEIGHT |___|___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
CHILD UNABLE TO STAND |
-7 |
AN_STAND_HEIGHT_CNO_REASON |
EXCEEDS CAPACITY |
-9 |
AN_STAND_HEIGHT_CNO_REASON |
REFUSED |
-1 |
AN_STAND_HEIGHT_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_STAND_HEIGHT_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC26000/(AN_STAND_HEIGHT2). SECOND STANDING HEIGHT.
MEASURED STANDING HEIGHT |___|___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC27000/(AN_STAND_HEIGHT3). THIRD STANDING HEIGHT.
MEASURED STANDING HEIGHT |___|___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC28000/(AN_ABOVE_WAIST_ADJ_STAND). ABOVE WAIST ADJUSTMENT (STANDING HEIGHT).
ABOVE WAIST ADJUSTMENT |___|___| . |___| cm
DATA COLLECTOR INSTRUCTIONS |
|
PROGRAMMER INSTRUCTIONS |
|
PMC29000/(AN_BELOW_WAIST_ADJ_STAND). BELOW WAIST ADJUSTMENT (STANDING HEIGHT).
BELOW WAIST ADJUSTMENT |___|___| . |___| cm
PROGRAMMER INSTRUCTIONS |
|
PMC31000/(AN_STAND_HEIGHT_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC32000/(AN_STAND_HEIGHT_CNO_REASON_OTH). SPECIFY: _____________________________
PMC33000/(AN_MEAS_STAND_HEIGHT_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
POSITION NOT STRAIGHT FOR HEIGHT |
2 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
3 |
|
AMPUTATION – LEG |
4 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC34000/(AN_MEAS_STAND_HEIGHT_COM_OTH). SPECIFY: __________________________
PROGRAMMER INSTRUCTIONS |
|
PMC35000/(AN_THIGH_LENGTH). THIGH (FEMUR) LENGTH
MEASURED THIGH (FEMUR) LENGTH |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_MID_THIGH_MEAS_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_MID_THIGH_MEAS_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC36000/(AN_MID_THIGH_CIRC1). MID THIGH CIRCUMFERENCE 1 MEASURED AT {AN_MID_THIGH_LENGTH}.
MEASURED MID THIGH CIRCUMFERENCE |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_MID_THIGH_MEAS_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_MID_THIGH_MEAS_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC37000/(AN_MID_THIGH_CIRC2). MID THIGH CIRCUMFERENCE 2 MEASURED AT {AN_MID_THIGH_LENGTH}.
MEASURED MID THIGH CIRCUMFERENCE |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC38000/(AN_MID_THIGH_CIRC3). MID THIGH CIRCUMFERENCE 3 MEASURED AT {AN_MID_THIGH_LENGTH}.
MEASURED MID THIGH CIRCUMFERENCE |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC39000/(AN_MID_THIGH_MEAS_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC40000/(AN_MID_THIGH_MEAS_CNO_REASON_OTH). SPECIFY: _____________________________
PMC41000/(AN_MEAS_MID_THIGH_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
MEASUREMENT TAKEN OVER THICK CLOTHING |
2 |
|
MEASUREMENT TAKEN ON LEFT THIGH |
3 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
4 |
|
AMPUTATION – LEG |
5 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC42000/(AN_MEAS_MID_THIGH_COM_OTH). SPECIFY: __________________________
PMC43000/(AN_WAIST_CIRC1). WAIST CIRCUMFERENCE 1
MEASURED WAIST CIRCUMFERENCE |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_WAIST_CIRC_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_WAIST_CIRC_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC44000/(AN_WAIST_CIRC2). WAIST CIRCUMFERENCE 2
MEASURED WAIST CIRCUMFERENCE |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC45000/(AN_WAIST_CIRC3). WAIST CIRCUMFERENCE 3
MEASURED WAIST CIRCUMFERENCE |___|___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC46000/(AN_WAIST_CIRC_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC47000/(AN_WAIST_CIRC_CNO_REASON_OTH). SPECIFY: _____________________________
PMC48000/(AN_MEAS_WAIST_CIRC_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
MEASUREMENT TAKEN OVER THICK CLOTHING |
2 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
3 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC49000/(AN_MEAS_WAIST_CIRC_COM_OTH).
DATA COLLECTOR MEASUREMENT COMMENTS
SPECIFY: __________________________
PROGRAMMER INSTRUCTIONS |
|
PMC50000/(AN_HEAD_CIRC1). HEAD CIRCUMFERENCE 1
MEASURED HEAD CIRCUMFERENCE |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_HEAD_CIRC_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_HEAD_CIRC_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC51000/(AN_HEAD_CIRC2). HEAD CIRCUMFERENCE 2
MEASURED HEAD CIRCUMFERENCE |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC52000/(AN_HEAD_CIRC3). HEAD CIRCUMFERENCE 3
MEASURED HEAD CIRCUMFERENCE |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC53000/(AN_HEAD_CIRC_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC54000/(AN_HEAD_CIRC_CNO_REASON_OTH). SPECIFY: _____________________________
PMC55000/(AN_MEAS_HEAD_CIRC_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
MEASUREMENT TAKEN OVER THICK HAIRSTYLE |
2 |
|
MEASUREMENT TAKEN OVER HAIR/HEADPIECE |
3 |
|
CHILD NOT STILL DURING MEASURE |
4 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC56000/(AN_MEAS_HEAD_CIRC_COM_OTH). DATA COLLECTOR MEASUREMENT COMMENTS
SPECIFY: __________________________
PMC57000/(AN_UPPER_ARM_LENGTH). UPPER ARM (HUMERUS) LENGTH
MEASURED HUMERUS LENGTH |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_MID_UPARM_MEAS_CNO_REAS |
COULD NOT OBTAIN |
-8 |
AN_MID_UPARM_MEAS_CNO_REAS |
PROGRAMMER INSTRUCTIONS |
|
PMC58000/(AN_MID_UPPER_ARM_CIRC1). MID UPPER ARM CIRCUMFERENCE 1 MEASURED AT {AN_MID_UPPER_ARM_LENGTH}.
MEASURED MID UPPER ARM CIRCUMFERENCE |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_MID_UPARM_MEAS_CNO_REAS |
COULD NOT OBTAIN |
-8 |
AN_MID_UPARM_MEAS_CNO_REAS |
PROGRAMMER INSTRUCTIONS |
|
PMC59000/(AN_MID_UPPER_ARM_CIRC2). MID UPPER ARM CIRCUMFERENCE 2 MEASURED AT {AN_MID_UPPER_ARM_LENGTH}.
MEASURED MID UPPER ARM CIRCUMFERENCE |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC60000/(AN_MID_UPPER_ARM_CIRC3). MID UPPER ARM CIRCUMFERENCE 3 MEASURED AT {AN_MID_UPPER_ARM_LENGTH}.
MEASURED MID UPPER ARM CIRCUMFERENCE |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC61000/(AN_MID_UPARM_MEAS_CNO_REAS).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC62000/(AN_MID_UPARM_MEAS_CNO_REAS_OTH). SPECIFY: _____________________________
PMC63000/(AN_MEAS_MID_UPPER_ARM_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
MEASUREMENT TAKEN OVER THICK CLOTHING |
2 |
|
MEASUREMENT TAKEN ON LEFT ARM |
3 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
4 |
|
AMPUTATION – ARM |
5 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC64000/(AN_MEAS_MID_UPPER_ARM_COM_OTH). SPECIFY: __________________________
PROGRAMMER INSTRUCTIONS |
|
PMC65000/(AN_LOWER_ARM_LENGTH1). LOWER ARM (ULNAR) LENGTH 1
MEASURED LOWER ARM (ULNAR) LENGTH |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
AN_LOWER_ARM_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_LOWER_ARM_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC66000/(AN_LOWER_ARM_LENGTH2). LOWER ARM (ULNAR) LENGTH 2
MEASURED LOWER ARM (ULNAR) LENGTH |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC67000/(AN_LOWER_ARM_LENGTH3). LOWER ARM (ULNAR) LENGTH 3
MEASURED LOWER ARM (ULNAR) LENGTH |___|___| . |___| cm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC68000/(AN_LOWER_ARM_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC69000/(AN_LOWER_ARM_CNO_REASON_OTH). SPECIFY: _____________________________
PMC70000/(AN_LOWER_ARM_LENGTH_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
MEASUREMENT TAKEN OVER THICK CLOTHING |
2 |
|
MEASUREMENT TAKEN ON LEFT ARM |
3 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
4 |
|
AMPUTATION – ARM |
5 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC71000/(AN_LOWER_ARM_LENGTH_COM_OTH). SPECIFY: __________________________
PROGRAMMER INSTRUCTIONS |
|
PMC72000/(AN_TRICEPS_SKINFOLD1). TRICEPS SKINFOLD MEASUREMENT 1
MEASURED TRICEPS SKINFOLD |___|___| mm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
EXCEEDS CAPACITY |
-9 |
AN_TRI_SKINFOLD_CNO_REASON |
REFUSED |
-1 |
AN_TRI_SKINFOLD_CNO_REASON |
COULD NOT OBTAIN |
-8 |
AN_TRI_SKINFOLD_CNO_REASON |
PROGRAMMER INSTRUCTIONS |
|
PMC73000/(AN_TRICEPS_SKINFOLD2). TRICEPS SKINFOLD MEASUREMENT 2
MEASURED TRICEPS SKINFOLD |___|___| mm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC74000/(AN_TRICEPS_SKINFOLD3). TRICEPS SKINFOLD MEASUREMENT 3
MEASURED TRICEPS SKINFOLD |___|___| mm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC75000/(AN_TRI_SKINFOLD_CNO_REASON).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC76000/(AN_TRI_SKINFOLD_CNO_REASON_OTH). SPECIFY: _____________________________
PMC77000/(AN_MEAS_TRI_SKINFOLD_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
|
MEASUREMENT TAKEN ON LEFT ARM |
2 |
|
MEDICAL APPLIANCE/CAST NOT REMOVED |
3 |
|
AMPUTATION – ARM |
4 |
|
OTHER |
-5 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC78000/(AN_MEAS_TRI_SKINFOLD_COM_OTH). SPECIFY: __________________________
PMC79000/(AN_SUBSCAP_SKINFOLD1). SUBSCAPULAR SKINFOLD MEASUREMENT 1
MEASURED SUBSCAPULAR SKINFOLD |___|___| mm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
EXCEEDS CAPACITY |
-9 |
AN_SUBSCAP_SNFLD_CNO_REAS |
REFUSED |
-1 |
AN_SUBSCAP_SNFLD_CNO_REAS |
COULD NOT OBTAIN |
-8 |
AN_SUBSCAP_SNFLD_CNO_REAS |
PROGRAMMER INSTRUCTIONS |
|
PMC80000/(AN_SUBSCAP_SKINFOLD2). SUBSCAPULAR SKINFOLD MEASUREMENT 2
MEASURED SUBSCAPULAR SKINFOLD |___|___| mm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC81000/(AN_SUBSCAP_SKINFOLD3). SUBSCAPULAR SKINFOLD MEASUREMENT 3
MEASURED SUBSCAPULAR SKINFOLD |___|___| mm.
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
REFUSED |
-1 |
|
COULD NOT OBTAIN |
-8 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC82000/(AN_SUBSCAP_SNFLD_CNO_REAS).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
PARENT/CAREGIVER REFUSAL |
1 |
|
CHILD REFUSAL |
2 |
|
COMMUNICATION ISSUES |
3 |
|
PARENT/CAREGIVER ILL/EMERGENCY |
4 |
|
CHILD ILL/EMERGENCY |
5 |
|
NO TIME |
6 |
|
EQUIPMENT FAILURE |
7 |
|
SAFETY EXCLUSION |
8 |
|
PHYSICAL LIMITATION |
9 |
|
DATA COLLECTOR ERROR |
10 |
|
OTHER |
-5 |
|
NONE GIVEN |
-7 |
|
PROGRAMMER INSTRUCTIONS |
|
PMC83000/(AN_SUBSCAP_SNFLD_CNO_REAS_OTH). SPECIFY: _____________________________
PMC84000/(AN_MEAS_SUBSCAP_SKINFOLD_COM).
DATA COLLECTOR INSTRUCTIONS |
|
Label |
Code |
Go To |
NONE |
1 |
PMC86000 |
OTHER |
-5 |
|
PMC85000/(AN_MEAS_SUBSCAP_SKINFOLD_COM_OTH). SPECIFY: __________________________
PMC86000. WEIGHT IN POUNDS AND OUNCES: {AN_CONV_WEIGHT_LBS}, {AN_CONV_WEIGHT_OZ}
RECUMBENT LENGTH IN INCHES: {AN_CONV_RECUMB_LENGTH}
STANDING HEIGHT IN INCHES: {AN_CONV_STAND_HEIGHT}
PROGRAMMER INSTRUCTIONS |
|
PROGRAMMER INSTRUCTIONS |
|
DATA COLLECTOR INSTRUCTIONS |
|
PMC88000. {Thank you for taking the time to answer these questions./Thank you for having {C_FNAME/the child} complete these measures.}
PROGRAMMER INSTRUCTIONS |
|
(TIME_STAMP_PMC_ET).
PROGRAMMER INSTRUCTIONS |
|
IF CHILD_SEX = 1:
IF VALID RESPONSE PROVIDED FOR AN_STAND_HEIGHT_MEAN IN ANTHROPOMETRY MODULE, CALCULATE CHILD’S AGE USING CURRENT DATE AND CHILD_DOB AND THEN CHECK CHILD’S AGE AND AN_STAND_HEIGHT_MEAN AGAINST APPENDIX B, APPENDIX C-1, AND TABLE A-1 (REFERRAL TABLE).
IF VALID RESPONSE PROVIDED FOR AN_RECUMB_LENGTH_MEAN IN ANTHROPOMETRY MODULE, CALCULATE CHILD’S AGE USING CURRENT DATE AND CHILD_DOB AND THEN CHECK CHILD’S AGE AND AN_RECUMB_LENGTH_MEAN AGAINST APPENDIX B, APPENDIX C-2, AND TABLE A-1 (REFERRAL TABLE).
COMPARE REFERRAL CATEGORY DETERMINED USING AN_STAND_HEIGHT_MEAN WITH REFERRAL CATEGORY DETERMINED USING AN_RECUMB_LENGTH_MEAN IF VALID RESPONSES FOR BOTH IN ANTHROPOMETRY MODULE. IF THE RESULTING REFERRAL CATEGORIES DIFFER, USE THE LOWER CATEGORY LEVEL FOR THE REPORT OF FINDINGS.
OTHERWISE, IF VALID RESPONSE NOT PROVIDED FOR AN_RECUMB_LENGTH_MEAN IN ANTHROPOMETRY MODULE, CALCULATE CHILD’S AGE USING CURRENT DATE AND CHILD_DOB AND THEN CHECK CHILD’S AGE AGAINST APPENDIX D AND TABLE A-1 (REFERRAL TABLE).
IF CHILD_SEX = 2:
IF VALID RESPONSE PROVIDED FOR AN_STAND_HEIGHT_MEAN IN ANTHROPOMETRY MODULE, CALCULATE CHILD’S AGE USING CURRENT DATE AND CHILD_DOB AND THEN CHECK CHILD’S AGE AND AN_STAND_HEIGHT_MEAN AGAINST APPENDIX B, APPENDIX F-1, AND TABLE A-1 (REFERRAL TABLE).
IF VALID RESPONSE PROVIDED FOR AN_RECUMB_LENGTH_MEAN IN ANTHROPOMETRY MODULE, CALCULATE CHILD’S AGE USING CURRENT DATE AND CHILD_DOB AND THEN CHECK CHILD’S AGE AND AN_RECUMB_LENGTH_MEAN AGAINST APPENDIX E, APPENDIX F-2 AND TABLE A-1 (REFERRAL TABLE).
COMPARE REFERRAL CATEGORY DETERMINED USING AN_STAND_HEIGHT_MEAN WITH REFERRAL CATEGORY DETERMINED USING AN_RECUMB_LENGTH_MEAN IF VALID RESPONSES FOR BOTH IN ANTHROPOMETRY MODULE. IF THE RESULTING REFERRAL CATEGORIES DIFFER, USE THE LOWER CATEGORY LEVEL FOR THE REPORT OF FINDINGS.
OTHERWISE, IF VALID RESPONSE NOT PROVIDED FOR IN ANTHROPOMETRY MODULE AN_RECUMB_LENGTH_MEAN, CALCULATE CHILD’S AGE USING CURRENT DATE AND CHILD_DOB AND THEN CHECK CHILD’S AGE AGAINST APPENDIX G AND TABLE A-1 (REFERRAL TABLE).
Measure |
Age (years) |
Gender |
Soft edit |
|
Low |
High |
|||
Weight |
< 1 |
M |
7.5 |
11.7 |
|
|
F |
6.9 |
11.2 |
|
1 - <2 |
M |
7.7 |
15.3 |
|
|
F |
7.1 |
14.8 |
|
2 - <3 |
M |
10.4 |
18.1 |
|
|
F |
10.05 |
15.1 |
|
<4 |
M |
11.5 |
20.7 |
|
|
F |
11.5 |
21.3 |
|
<5 |
M |
13.3 |
24.2 |
|
|
F |
12.9 |
24.9 |
|
<6 |
M |
14.8 |
28.3 |
|
|
F |
14.5 |
28.9 |
|
<7 |
M |
16.6 |
32.5 |
|
|
F |
16.0 |
33.4 |
|
<8 |
M |
18.4 |
37.4 |
|
|
F |
17.9 |
38.5 |
|
<9 |
M |
20.3 |
43.1 |
|
|
F |
19.7 |
44.6 |
Recumbent Length (cm) |
< 1 |
M |
61.7 |
79.7 |
|
|
F |
59.6 |
79.2 |
|
1 - <2 |
M |
70.9 |
93.9 |
|
|
F |
68.9 |
91.7 |
|
2 - <3 |
M |
82.2 |
102.0 |
|
|
F |
82.0 |
102.0 |
|
<4 |
M |
82.0 |
102.0 |
|
<4 |
F |
82.0 |
102.0 |
Height Adjustment-Below waist |
–ALL |
M |
2.0 |
N/A |
|
ALL |
F |
N/A2.0 |
N/A |
Height Adjustment-Above waist |
ALL |
M |
2.0 |
N/A |
|
ALL |
F |
2.0 |
N/A |
Femur Length (cm) |
< 1 |
M |
14.5 |
23.0 |
|
|
F |
14.5 |
23.0 |
|
1 - <2 |
M |
14.5 |
23.0 |
|
|
F |
14.5 |
23.0 |
|
2 - 3 |
M |
14.5 |
23.0 |
|
|
F |
14.5 |
23.0 |
Thigh Circumference (cm) |
< 1 |
M |
23.1 |
34.0 |
|
|
F |
23.8 |
36.1 |
|
1 - <2 |
M |
23.1 |
34.0 |
|
|
F |
23.8 |
36.1 |
|
2 - 3 |
M |
23.1 |
34.0 |
|
|
F |
23.8 |
36.1 |
Waist Circumference (cm) |
< 1 |
M |
1 |
50.8 |
|
|
F |
1 |
52.2 |
|
1 - <2 |
M |
1 |
50.8 |
|
|
F |
1 |
52.2 |
|
2 - <3 |
M |
10 |
54.2 |
|
|
F |
10 |
55.3 |
|
<4 |
M |
10 |
57.6 |
|
|
F |
10 |
58.3 |
|
<5 |
M |
10 |
61.0 |
|
|
F |
10 |
61.4 |
Head Circumference (cm) |
< 1 |
M |
43.4 |
48.2 |
|
|
F |
42.0 |
47.1 |
|
1 - <2 |
M |
43.2 |
51.0 |
|
|
F |
42.3 |
49.8 |
|
2 - <3 |
M |
45.7 |
52.1 |
|
|
F |
44.7 |
51.2 |
|
<4 |
M |
47.5 |
53.5 |
|
|
F |
45.9 |
52.6 |
Humerus and Ulnar Length (cm) |
< 1 |
M |
10.0 |
16.8 |
|
|
F |
9.5 |
16.0 |
|
1 - <2 |
M |
13.3 |
19.0 |
|
|
F |
12.8 |
19.0 |
|
2 - <3 |
M |
15.3 |
20.5 |
|
|
F |
15.1 |
20.9 |
Upper Arm Circumference |
< 1 |
M |
7.0 |
14.0 |
|
|
F |
7.0 |
14.0 |
|
1 - <2 |
M |
7.0 |
14.0 |
|
|
F |
7.0 |
14.0 |
|
2 - <3 |
M |
10.0 |
21.0 |
|
|
F |
10.0 |
21.0 |
|
<4 |
M |
15.0 |
27.0 |
|
|
F |
15.0 |
27.0 |
|
<5 |
M |
15.0 |
27.0 |
|
|
F |
15.0 |
27.0 |
|
<6 |
M |
15.0 |
35.0 |
|
|
F |
15.0 |
35.0 |
|
<7 |
M |
15.0 |
35.0 |
|
|
F |
15.0 |
35.0 |
|
<8 |
M |
15.0 |
35.0 |
|
|
F |
15.0 |
35.0 |
|
<9 |
M |
21.0 |
35.0 |
|
|
F |
21.0 |
35.0 |
Triceps Skinfold (mm) |
< 1 |
M |
6 |
16 |
|
|
F |
6 |
16 |
|
1 - <2 |
M |
5 |
15 |
|
|
F |
6 |
16 |
|
2 - <3 |
M |
5 |
14 |
|
|
F |
6 |
16 |
Subscapular Skinfold (mm) |
< 1 |
M |
5 |
13 |
|
|
F |
5 |
13 |
|
1 - <2 |
M |
4 |
12 |
|
|
F |
4 |
13 |
|
2 - <3 |
M |
4 |
11 |
|
|
F |
4 |
15 |
|
|
|
|
|
Public reporting burden for this collection of information is estimated to average 17 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 2021-01-27 |