2023 NHIS Sample Child Questionnaire

National Health Interview Survey

Att 9c - 2023 NHIS Sample Child Questionnaire

Child Questionnaire

OMB: 0920-0214

Document [pdf]
Download: pdf | pdf
Notice – CDC estimates the average public reporting burden for this collection of information as
60 minutes per response, including the time for reviewing instructions, searching existing
data/information sources, gathering and maintaining the data/information 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
CDC/ATSDR Information Collection Review Office, 1600 Clifton Road, MS D-74, Atlanta, GA
30333; ATTN: PRA (0920-0214).
Assurance of Confidentiality: We take your privacy very seriously. All information that relates
to or describes identifiable characteristics of individuals, a practice, or an establishment will be
used only for statistical purposes. NCHS staff, contractors, and agents will not disclose or release
responses in identifiable form without the consent of the individual or establishment in
accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)), and the
Confidential Information Protection and Statistical Efficiency Act of 2018 (CIPSEA Pub. L. No.
115-435, 132 Stat. 5529 § 302). In accordance with CIPSEA, every NCHS employee,
contractor, and agent has taken an oath and is subject to a jail term of up to five years, a fine of
up to $250,000, or both if he or she willfully discloses ANY identifiable information about
you. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity
Enhancement Act of 2015 (6 U.S.C. § 151 and 151 note) which protects Federal information
systems from cybersecurity risks by screening their networks.

Question ID: VFY.0040.00.1

Variable name: CURRES_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HHSTAT_C=1
Universe Description: Sample Children 0-17
Question Text:

Response:

The next questions are about ^SCNAME. Enter the line number of the person to
whom you are speaking. If Sample Child respondent refuses to participate enter
CTRL-R.

01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.

^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
^ALIASNAME[23]

Page 1 of 334

24.
25.
RF:
Fills:

^ALIASNAME[24]
^ALIASNAME[25]
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
If CURRES_C not in Roster.FAM.KNOWSC [goto KNOAVAIL_C]
Else
if
CURRES_C
ne
LNO_HHRESP
AND
CURRES_C
Roster.FAM.KNOWSC [goto AVAIL_C]
Else
if
CURRES_C
=
LNO_HHRESP
AND
CURRES_C
Roster.FAM.KNOWSC
AND
CURRES_C
not
Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
Else
if
CURRES_C
=
LNO_HHRESP
AND
CURRES_C
Roster.FAM.KNOWSC
AND
CURRES_C
Roster.bREL.bPerson[PX_C].PARENTS[goto VFYALL_C]

Question ID: VFY.0060.00.1

Variable name: KNOAVAIL_C

in
in
in
in
in

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (NOT(CURRES_C IN Roster.FAM.KNOWSC) OR
(CURRES_C IN Roster.FAM.KNOWSC AND
CURRES_C IN NOTKNOW_C AND KnowSC_Count > 1)
OR (NewResp_Flg = 1))
Universe Description: Sample Children 0-17 and at least one knowledgeable person is still eligible
for selection and speaking to the initial respondent and they are not
knowledgeable OR speaking to a new respondent
Question Text:

^KNOAVAIL_C_fill Enter the line number of available respondent from list or
press F9 to set up a callback if no one is available or refused. ^KNOAVAIL_C_fill_2

Response:

Page 2 of 334

01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
RF:
Fills:

^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
^ALIASNAME[23]
^ALIASNAME[24]
^ALIASNAME[25]
Refused

^KNOAVAIL_C_fill

If (KnowSC_Count = ActiveNotKnow_Count)
fill : "* If there are no other knowledgeable people to
select then press the end key."
ELSE
fill : "I have recorded that ^KNOWSC ^areis_c
knowledgeable
about
and
responsible
for
^SCNAME's health care. ^WHOIS currently available
and willing to answer these questions?"

^KNOAVAIL_C_fill_2

If (ActiveNotKnow_Count > 0)
fill : "* People listed in gray have said that they are
not knowledgeable about the SC. If you incorrectly
set someone as not knowledgeable then you may
select that person and continue the interview."

Page 3 of 334

Skip Instructions: <01-25> [goto INTMODE_C]
 if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
 [goto bCallback.ARRANGE_CALLBACK]

Question ID: VFY.0080.00.1

Variable name: INTMODE_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HHSTAT_C=1 and KNOAVAIL_C in (1-25)
Universe Description: Sample Children 0-17 and interviewer is speaking to a new respondent
Question Text:

Response:

Fills:

How are you contacting ^KNOAVAIL_C?

1.
2.

Personal visit
Telephone

^KNOAVAIL_C

Display name of person whose line number was
selected at KNOAVAIL_C

Skip Instructions: <1> if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else
if
HHRESPSC_FLG=1
and
LNO_SCRESP
Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
else [goto VFYALL_C]
<2> [goto TINTRO_C]

Page 4 of 334

not

in

Question ID: VFY.0090.00.1

Variable name: TINTRO_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HHSTAT_C=1 and INTMODE_C=2
Universe Description: Sample Children 0-17 and interviewer is conducting a telephone interview with
new respondent
Question Text:

Response:

Fills:

Hello, my name is ( say your name). I'm calling from the U.S. Census Bureau.
We are conducting the National Health Interview Survey on behalf of the
National Center for Health Statistics, part of the Centers for Disease Control
and Prevention (CDC). This is a nationwide survey about the health of both
adults and children. I have some information from ^HHRESP. ^HHSEX told me
that you would be a good person to talk to about the health of ^SCNAME.
Read if necessary: I believe I am calling you on a cell phone. Before we continue, I
have to ask: Are you currently driving a vehicle?
Even if the respondent is
using a hands-free device while driving, you must enter '1'.

DK:
RF:

Don't Know
Refused

^HHRESP

Display the name of the person selected at
Roster.HHC.HHRESPAVAIL

^SCNAME

Fill ALIAS of HHSTAT_C=1

^HHSEX

If GEN.SEX_FINAL[LNO_HHRESP]=1, fill: He
elseif GEN.SEX_FINAL[LNO_HHRESP]=2, fill: She
elseif GEN.SEX_FINAL[LNO_HHRESP] in (DK,RF),
fill: They

Skip Instructions: <1,RF,DK> [goto ATTN_C]
<2> [goto LETTER_C]

Page 5 of 334

Question ID: VFY.0100.00.1

Variable name: ATTN_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: TINTRO_C=1
Universe Description: Sample Children 0-17 and interviewer is conducting a telephone interview with
new respondent who is driving
Question Text:

For your safety, we will call you back at another time.

Enter 1 to continue.

Response:
Skip Instructions: <1> [goto bCallback.CB_POSSIBLE]

Question ID: VFY.0110.00.1

Variable name: LETTER_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: TINTRO_C=2
Universe Description: Sample Children 0-17 and interviewer is conducting a telephone interview with
new respondent who is not driving
Question Text:

Response:

If sample child respondent is a new respondent read question below, otherwise enter
1 Read if necessary: A letter describing the National Health Interview Survey was
sent to your home recently. Do you remember seeing the letter?

DK:
RF:

Don't Know
Refused

Skip Instructions: <1,2,RF,DK> [goto S_INTRO_C]

Page 6 of 334

Question ID: VFY.0120.00.1

Variable name: S_INTRO_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: TINTRO_C=2
Universe Description: Sample Children 0-17 and interviewer is conducting a telephone interview with
new respondent who is not driving
Question Text:

?[F1] If sample child respondent is a new respondent read question below,
otherwise enter 1 Read if necessary: There are a few things I need to cover before
we continue. I'd like you to know that taking part in this survey is voluntary. You may
choose not to answer any questions you don't wish to answer, or end the interview at
any time without penalty. We are required by Federal law to develop and follow strict
procedures to protect the confidentiality of your information and use your answers
only for statistical research. I can describe these laws if you wish. Except for the
National Center for Health Statistics and Census Bureau employees and specially
designated agents, no one can see your answers until all information that could
identify you and/or your family has been removed. Only after that will your data be
made available to researchers. For most children, the survey will take less than
^SCTIME minutes. I'd like to continue now unless you have any questions. If
respondent asks for more information about the privacy laws, press F1.

Response:
Fills:

^SCTIME

If ASTAT=1 and SAMEFAM_FLG=1, fill: 20
Else, fill: 30

Skip Instructions: <1> if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else
if
HHRESPSC_FLG=1
and
LNO_SCRESP
Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
else [goto VFYALL_C]

Page 7 of 334

not

in

Question ID: VFY.0130.00.1

Variable name: AVAIL_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ((CURRES_C ne LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC
AND KNOAVAIL_C = EMPTY) OR
(KNOAVAIL_C in (1-25) AND KNOAVAIL_C ne LNO_HHRESP AND
TINTRO_C not in (1,DK,RF)))
Universe Description: Sample Children 0-17 and at least one knowledgeable person is still eligible
for section AND initial respondent wasn’t the HH Resp and is
knowledgeable OR picked a new respondent and respondent is not driving
Question Text:

Response:

Fills:

I have recorded that you are knowledgeable about and responsible for
^SCNAME's health care. Is that correct?

1.
2.
RF:

Yes
No
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1>If (LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS)
{respondent is not a parent} [goto RELTIV_C]
Else If Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK)
{Sample Child is on campus} [goto VFYONCAMP_C]
Else [goto VFYALL_C]
<2> if KNOAVAIL_Count gt 0 [goto KNOAVAIL_C]
Else [goto NOMORE_C]
 if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

Page 8 of 334

Question ID: VFY.0150.00.1

Variable name: RELTIV_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: CURRES_C ne RF
AND
KNOAVAIL_Count gt 0 AND KNOAVAIL_C ne RF
AND
TINTRO_C not in (1,DK,RF)
AND
AVAIL_C ne RF AND AVAIL_C ne 2
AND
LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS
Universe Description: Sample Children 0-17 where the current respondent has not refused AND at
least one person is knowledgeable about and responsible for the sample child
AND the respondent is not driving while on the telephone AND the respondent
has not refused or said he/she is not available AND the respondent was not
identified as a parent in the roster section
Question Text:

Response:

Fills:

What is your relationship to ^SCNAME?

1.
2.
3.
4.
5.
6.
7.
8.
9.
DK:
RF:

Parent (Biological, adoptive, or step)
Grandparent
Aunt/Uncle
Brother/Sister
Other relative
Legal guardian
Foster parent
Other non-relative
Spouse or partner
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 9 of 334

Skip Instructions: <9> [goto ERR_RELTIV_C]
<4,5,8,RF,DK> [goto VFYRESP_C]
<1,2,3,6,7> if Roster.tblNAME.bPerson.[PX.C].ONOFFCAMPUS IN (1,RF,DK)
and HHRESPSC_FLG ne 1 [goto VFYONCAMP_C]
Else [goto VFYALL_C]

Check Name: ERR_RELTIV_C

Text:

{signal ERR_RELTIV_C} The spouse or partner of the Sample Child cannot answer
questions about him/her.

Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: RELTIV_C=9
Skip Instructions: If KNOAVAIL_Count gt 0 [goto KNOAVAIL_C]
else [goto NOMORE_C]

Question ID: VFY.0180.00.1

Variable name: VFYRESP_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: RELTIV_C IN (4,5,8,RF,DK)
Universe Description: Sample Children 0-17 where person identified as Child respondent is
Brother/Sister, Other Relative, Other Non-relative, refused or don't know
Question Text:

To confirm, are you RESPONSIBLE FOR ^SCNAME's health care?

Response:

Page 10 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <2,RF,DK>if KNOAVAIL_Count > 0 [goto KNOAVAIL_C]
else [goto NOMORE_C]
<1> if Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) [goto
VFYONCAMP_C]
Else [goto VFYALL_C]

Question ID: VFY.0190.00.1

Variable name: VFYONCAMP_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: AVAIL_C=1
and
Roster.HHC.tblNAME.bPerson.ONOFFCAMPUS
(1,RF,DK) and HHRESPSC_FLG ne 1 and (RELTIV_C ne 9)

in

Universe Description: A person who is knowledgeable or responsible for the sample child's health is
available and the Sample Child is living in on-campus housing and the Sample
Child respondent is not the household respondent and the Sample Child's
spouse or partner is not the respondent
Question Text:

Response:

I want to confirm some information. Does ^SCNAME live in on-campus
housing or off-campus housing? Read if necessary: On-campus housing
includes residence halls and dorms where students live together. It also includes
buildings that are owned, leased, or managed by the school. Fraternities and
sororities are on-campus housing.

1.
2.
DK:
RF:

On campus
Off campus
Don't Know
Refused

Page 11 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,RF,DK> [goto VFYALL_C]
<2> [goto NOMORE_C]

Question ID: VFY.0200.00.1

Variable name: VFYALL_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: KNOAVAIL_Count gt 0 AND KNOAVAIL_C ne RF AND TINTRO_C not in
(1,DK,RF) AND AVAIL_C ne RF AND VFYONCAMP_C ne 2 AND (RELTIV_C
ne 9)
Universe Description: Sample Children 0-17 where a person who is knowledgeable or responsible
for the sample child's health has been identified and that knowledgeable
person has not refused and the Sample Child lives on campus or refused or
don't know and the Sample Child's spouse or partner is not the respondent
Question Text:

Response:

Fills:

Please verify the following information about the sample child before proceeding: I
have recorded ^childvsex, ^AGE_C, ^NATORG_C, and ^RACE_C. Would you
like to make any changes to this ^additionalinfo_C? ^RACEVRBATvalue_C If
respondent "refuses" or says "don't know", enter "2" for "no." Read if necessary: By
sex we mean sex at birth.

1.
2.

Yes
No

^NATORG_C

If NATO_FINAL=1 fill: "^SCNAME is of Hispanic or
Latino Origin"
If NATO_FINAL=2 fill: "^SCNAME is not of Hispanic
or Latino Origin"
If NATO_FINAL=DK fill: "whether ^SCNAME is of
Hispanic or Latino Origin is not known"
If NATO_FINAL=RF fill: "information about whether
^SCNAME is of Hispanic or Latino Origin was not
provided"

^RACE_C

If GEN.RACE_FINAL[PX_C].RACE_FINAL NE 'RF'
OR 'DK', fill: "^SCNAME is^RACEFILLAND_C."
IfGEN.RACE_FINAL[PX_C].RACE_FINAL='DK', fill:
^SCNAME's race is not known"
IfGEN.RACE_FINAL[PX_C].RACE_FINAL='RF', fill:
^SCNAME's race was not provided"

Page 12 of 334

^childvsex

If SEX_FINAL=1, fill: "^SCNAME is male"
If SEX_FINAL=2, fill: "^SCNAME is female"
If SEX_FINAL=DK, fill: "^SCNAME's sex is not
known"
If SEX_FINAL=RF,fill: "^SCNAME's sex was not
provided"

^AGE_C

If AGE_FINAL NE ('RF', 'DK'), fill: "^SCNAME is
^AGENO_C ^AGETP_C old"
If AGE_FINAL IN ('RF', 'DK'), fill: "^SCNAME is
under 18"

^additionalinfo_C

See attachment for fill instructions

^RACEVRBATvalue_C

IF
GEN.HHRESPSC_FLG
ne
1
and
GEN.RACE_FINAL[PX_C].RACE_VRBAT_FINAL ne
(empty,RF,DK), fill "* If respondent wants information
on which other race ^SCNAME is listed as, say
^RACE_VRBAT."

Skip Instructions: <1> [goto VFYDEM_C]
<2> if GEN.SEX_FINAL[PX_C] IN (RF,DK) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0210.00.1

Variable name: VFYDEM_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: VFYALL_C=1
Universe Description: Sample children 0-17 would like to change demographic information
Question Text:

Read if necessary: What should I change?
Enter all that apply, separate with
commas. Read if necessary: By sex we mean sex at birth.

Response:

Page 13 of 334

1.
2.
3.
4.
DK:
RF:

Sex
Age
Hispanic or Latino Origin
Race
Don't Know
Refused

Skip Instructions: If 1 NOT IN VFYDEM_C and GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto
SEXGUESS_C]
elseif 1 IN VFYDEM_C [goto NEWSEX_C]
elseif 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
 If GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0220.00.1

Variable name: NEWSEX_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 1 IN VFYDEM_C
Universe Description: Respondent said sample child's sex is not correct
Question Text:

Response:

Is ^SCNAME male or female?

1.
2.
DK:
RF:

Read if necessary: By sex we mean sex at birth.

Male
Female
Don't Know
Refused

Page 14 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: if
GEN.SEX_FINAL[PX_C]=RF,DK
and
NEWSEX_C=RF,DK
SEXGUESS_C]
elseif 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0230.00.1

Variable name: SEXGUESS_C

[goto

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.SEX_FINAL[PX_C] IN (DK,RF) and (VFYDEM_C NOT IN 1 or
(VFYDEM_C=1 and NEWSEX_C IN (RF,DK))) and (RELTIV_C ne 9)
Universe Description: Sample children for whom there is no sex provided by the household
respondent and did not give a sex when asked to verify information and the
Sample Child's spouse or partner is not the respondent
Question Text:

Response:

Fills:

Enter your best guess of ^SCNAME's sex

1.
2.

Male
Female

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2>
if 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 15 of 334

Question ID: VFY.0240.01.1

Variable name: NEWAGENO_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 2 IN VFYDEM_C
Universe Description: Sample Children 0-17 whose age is not correct
Question Text:

Response:

Fills:

1 of 2 How old is ^SCNAME?

DK:
RF:

Enter number for age.

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: goto [NEWAGETP_C]

Question ID: VFY.0240.02.1

Variable name: NEWAGETP_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: NEWAGENO_C=001-120
Universe Description: Valid number entered at NEWAGENO_C
Question Text:

Response:

2 of 2

1.
2.
3.
4.

Enter number for age time period.

Day(s)
Week(s)
Month(s)
Year(s)

Page 16 of 334

Skip Instructions: <1,2,3,4> if 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0260.00.1

Variable name: NEWNATORG_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 3 IN VFYDEM_C
Universe Description: Sample Children 0-17 whose Hispanic Origin is not correct
Question Text:

Response:

Fills:

Is ^SCNAME Hispanic or Latino?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> if 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 17 of 334

Question ID: VFY.0270.00.1

Variable name: NEWRACE_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 4 IN VFYDEM_C
Universe Description: Sample Children 0-17 whose race is not correct
Question Text:

Response:

Fills:

What race or races is ^SCNAME? Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native
Hawaiian, Pacific Islander, Asian, or some other race? Enter all that apply,
separate with commas.

1.
2.
3.
4.
5.
6.
7.
8.
DK:
RF:

White
Black/African American
American Indian
Alaska Native
Native Hawaiian
Pacific Islander
Asian
Some other race
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: if NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 18 of 334

Question ID: VFY.0280.00.1

Variable name: HISPTYPE_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.NATO_FINAL[PX_C]=1 and (KNOAVAIL_Count gt 0 AND KNOAVAIL_C
ne RF AND TINTRO_C not in (1,DK,RF) AND AVAIL_C ne RF AND
VFYONCAMP_C ne 2 AND (RELTIV_C ne 9))
Universe Description: Sample Children 0-17 are of Hispanic Origin and a person who is
knowledgeable or responsible for the sample child's health has been identified
and that knowledgeable person has not refused and the Sample Child lives on
campus or refused or don't know and the Sample Child's spouse or partner is
not the respondent
Question Text:

Response:

Fills:

What is ^SCNAME's Hispanic or Latino ancestry or origin, such as Mexican,
Mexican American, ^CHICANOA, Central or South American, Puerto Rican,
Cuban, Dominican (Republic), or Other Hispanic, ^LATINOA, or Spanish -- and
if ^SCNAME has more than one, tell me all of them. Enter all that apply,
separate with commas.

1.
2.
3.
4.
5.
6.
7.
DK:
RF:

Mexican, Mexican American, or Chicano(a)
Central American
South American
Puerto Rican (Boricua)
Cuban
Dominican (Republic)
Other Hispanic, Latino(a), or Spanish (specify)
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^CHICANOA

If SEX_FINAL = 1 fill: "Chicano"
if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"

^LATINOA

If SEX_FINAL= 1 fill: "Latino"
if SEX_FINAL = 2,DK,RF fill "Latino or Latina"

Page 19 of 334

Skip Instructions: <7> [goto HISPOTHER_C]
<1-6,RF,DK>
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
or
(HHRESPSC_FLG ne 1 and RACE_SP[PX_C] in (ZZ,RF,DK))) [goto
RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0290.00.1

Variable name: HISPOTHER_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HISPTYPE_C=7
Universe Description: Sample Child is of Other Hispanic Origin
Question Text:

Response:

Fills:

?[F1] What is ^SCNAME's Hispanic or Latino ancestry or origin? If ^SCNAME
has more than one, tell me all of them. Start typing and then select from list. If
Hispanic or Latino ancestry is not on the list, type "ZZ" and enter verbatim. If any of
the following are mentioned, backup to previous screen and correct the entry.
Mexican Mexican American Chicano/Chicana Central American (REFER TO HELP
SCREEN) South American (REFER TO HELP SCREEN) Puerto Rican (Boricua)
Cuban/Cuban American Dominican (Republic) If respondent provides more than
one other Hispanic or Latino ancestry or origin, select 'ZZ' from the lookup table. At
the next question, enter ALL the other Hispanic or Latino ancestries or origins in the
verbatim field.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 20 of 334

Skip Instructions:  [goto HISPVRBAT_C]

if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
(GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP[PX_C]
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0300.00.1

Variable name: HISPVRBAT_C

or
in

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HISPOTHER_C=ZZ
Universe Description: Sample Child 0-17 where some other Hispanic Ancestry is reported and this is
not chosen from the picklist
Question Text:

Response:

Fills:

Read if necessary: What is ^SCNAME's Hispanic or Latino ancestry or origin? If
^SCNAME has more than one, tell me all of them.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
(GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP[PX_C]
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 21 of 334

or
in

Question ID: VFY.0310.00.1

Variable name: PITYPE_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.RACE_FINAL[PX_C]=6 and (KNOAVAIL_Count gt 0 AND KNOAVAIL_C
ne RF AND TINTRO_C not in (1,DK,RF) AND AVAIL_C ne RF AND
VFYONCAMP_C ne 2 AND (RELTIV_C ne 9))
Universe Description: Sample children 0-17 identified as Pacific Islanders and a person who is
knowledgeable or responsible for the sample child's health has been identified
and that knowledgeable person has not refused and the Sample Child lives on
campus or refused or don't know and the Sample Child's spouse or partner is
not the respondent
Question Text:

Response:

Fills:

I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group
or groups is ^SCNAME-- such as Guamanian or Chamorro, Samoan, or other
Pacific Islander? If ^SCNAME is more than one, tell me all of them. Enter all
that apply, separate with comma

1.
2.
3.
DK:
RF:

Guamanian or Chamorro
Samoan
Other Pacific Islander
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <3> [goto PIOTHER_C]
<1,2,RF,DK> if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
(GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP[PX_C]
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 22 of 334

or
in

Question ID: VFY.0320.00.1

Variable name: PIOTHER_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: PITYPE_C=3
Universe Description: Sample Child who is "Other Pacific Islander"
Question Text:

Response:

Fills:

Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific
ethnic group or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of
them. Start typing and then select from list. If Pacific Islander ethnic group is not on
the list, type "ZZ" and enter verbatim. If respondent provides more than one ethnic
group, select 'ZZ' from the lookup table. At the next question, enter ALL the ethnic
groups in the verbatim field.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto PIVRBAT_C]

if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
(GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP[PX_C]
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 23 of 334

or
in

Question ID: VFY.0330.00.1

Variable name: PIVRBAT_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: PIOTHER_C=ZZ
Universe Description: Sample Child are some other group of Pacific Islander and this is not chosen
from the picklist
Question Text:

Response:

Fills:

Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific
ethnic group or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of
them.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: 
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
(GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP[PX_C]
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0340.00.1

Variable name: ASIANTYPE_C

or
in

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.RACE_FINAL[PX_C]=7 and (KNOAVAIL_Count gt 0 AND KNOAVAIL_C
ne RF AND TINTRO_C not in (1,DK,RF) AND AVAIL_C ne RF AND
VFYONCAMP_C ne 2 AND (RELTIV_C ne 9))
Universe Description: Sample Children 0-17 identified as Asian and a person who is knowledgeable
or responsible for the sample child's health has been identified and that
knowledgeable person has not refused and the Sample Child lives on campus
or refused or don't know and the Sample Child's spouse or partner is not the
respondent
Question Text:

I have recorded that ^SCNAME is Asian. What specific ethnic group or groups
is ^SCNAME-- such as Asian Indian, Chinese, Filipino, Japanese, Korean,
Vietnamese, or Other Asian? If ^SCNAME is more than one, tell me all of them.
Enter all that apply, separate with commas.
Page 24 of 334

Response:

Fills:

1.
2.
3.
4.
5.
6.
7.
DK:
RF:

Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <7> [goto ASIANOTHER_C]
<1-6,RF,DK>
elseif
GEN.RACE_FINAL[PX_C]=8
(GEN.HHRESPSC_FLG ne 1 and
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0350.00.1

and
(NEWRACE_C=8
Roster.HHC.RACE_SP[PX_C]

Variable name: ASIANOTHER_C

or
in

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ASIANTYPE_C=7
Universe Description: Sample Child who is "other Asian"
Question Text:

Response:

What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has
more than one, tell me all of them. Start typing and then select from list. If Asian
ethnic group is not on the list, type "ZZ" and enter verbatim. If any of the following
are mentioned, backup to previous screen and correct the entry. (Asian) Indian
Chinese Filipino Japanese Korean Vietnamese If respondent provides more than
one ethnic group, select 'ZZ' from the lookup table. At the next question, enter ALL
the ethnic groups in the verbatim field.

DK:
RF:

Don't Know
Refused

Page 25 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto ASIANVRBAT_C]

if
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
or
(NEWRACE_C=EMPTY
and
GEN.HHRESPSC_FLG
ne
1
and
ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0360.00.1

Variable name: ASIANVRBAT_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ASIANOTHER_C=ZZ
Universe Description: Sample Child is some other ethnic group of Asian and this is not chosen from
the picklist
Question Text:

Response:

Fills:

Read if necessary: What is ^SCNAME's specific Asian ethnic group or groups? If
^SCNAME has more than one, tell me all of them.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: 
if
GEN.RACE_FINAL[PX_C]=8
and
(NEWRACE_C=8
or
(NEWRACE_C=EMPTY
and
GEN.HHRESPSC_FLG
ne
1
and
ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Page 26 of 334

Question ID: VFY.0370.00.1

Variable name: RACEOTHER_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (KNOAVAIL_Count gt 0 AND KNOAVAIL_C ne RF AND TINTRO_C not in
(1,DK,RF) AND AVAIL_C ne RF AND VFYONCAMP_C ne 2 AND (RELTIV_C
ne 9))
and(NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG
ne 1 and ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK)))
Universe Description: Sample Child's race was changed to "some other race" in verification section
or where the Sample Child respondent is not the Household respondent and
were identified by the household respondent as being "some other race" not
on the roster other race picklist and a person who is knowledgeable or
responsible for the sample child’s health has been identified and that
knowledgeable person has not refused and the Sample Child lives on campus
or refused or don't know and the Sample Child's spouse or partner is not the
respondent
Question Text:

Response:

Fills:

What other race or races is ^SCNAME? Start typing and then select from list. If
race is not on the list, type "ZZ" and enter verbatim.
If respondent provides more
than one other race, select 'ZZ' from the lookup table. At the next question, enter ALL
the other races in the verbatim field.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto RACEVRBAT_C]
 [goto BMONTH_C]

Page 27 of 334

Question ID: VFY.0380.00.1

Variable name: RACEVRBAT_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: RACEOTHER_C=ZZ
Universe Description: Sample Child's race was change to include "some other race" in verification
section or where the Sample Child respondent is not the Household
respondent and were identified by the household respondent as being "some
other race" not on the roster other race picklist and the Sample Child
Respondent did not select it from the Sample Adult other race picklist.
Question Text:

Response:

Fills:

Read if necessary: What other race or races is ^SCNAME?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto BMONTH_C]

Question ID: VFY.0410.01.1

Variable name: BMONTH_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (RELTIV_C IN (1,2,3,6,7) OR VFYRESP_C = 1 OR (PCNT18UP_C gt 1 and
(KNOAVAIL_C
IN
Roster.bREL.bPerson[PX_C].PARENTS))
and
DOB_COUNT_C LT 2 and (RELTIV_C ne 9)
Universe Description: A person who is knowledgeable or responsible for the sample child's health is
available or there is only one parent over 18 and no other adults in the child's
family or there are more than two adults and one of them is a parent who was
identified as available at AVAIL_C AND date of birth was verified as incorrect
fewer than 2 times and the Sample Child's spouse or partner is not the
respondent
Question Text:

1 of 3 What is ^SCNAME's date of birth? Please give month, day, and year for
the date of birth.
Enter month of birth.

Response:

Page 28 of 334

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
DK:
RF:
Fills:

January
February
March
April
May
June
July
August
September
October
November
December
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-12,RF,DK> [goto BDAY_C]

Question ID: VFY.0410.02.1

Variable name: BDAY_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (RELTIV_C = 1, 2, 3, 6, 7 OR VFYRESP_C = 1 OR (PCNT18UP_C gt 1 and
(AVAIL_C IN Roster.bREL.bPerson[PX_C].PARENTS)) and DOB_COUNT_C
LT 2 and (RELTIV_C ne 9)
Universe Description: A person who is knowledgeable or responsible for the sample child's health is
available or there is only one parent over 18 and no other adults in the child's
family or there are more than two adults and one of them is a parent who was
identified as available at AVAIL_C AND date of birth was verified as incorrect
fewer than 2 times and the Sample Child's spouse or partner is not the
respondent
Question Text:

Response:

2 of 3

DK:
RF:

Enter day of birth.

Don't Know
Refused

Page 29 of 334

Skip Instructions: <1-31,RF,DK> Only allow valid days for month entered. if days not valid [goto
ERR_BDAY_C]
else [goto BYEAR_C]

Check Name: ERR_BDAY_C

Text:

{check ERR_BDAY_C}

^BDAY_C is not a valid day for ^BMONTH_C.

Hard / Soft Edit: Hard
Fills:

^BDAY_C

Fill value from Child.VFY.BDAY_C 

^BMONTH_C

Fill value from Child.VFY.BMONTH_C

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: Invalid dates for the month entered

Question ID: VFY.0410.03.1

Variable name: BYEAR_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (RELTIV_C = 1, 2, 3, 6, 7 OR VFYRESP_C = 1 OR (PCNT18UP_C gt 1 and
(AVAIL_C IN Roster.bREL.bPerson[PX_C].PARENTS)) and DOB_COUNT_C
LT 2 and (RELTIV_C ne 9)
Universe Description: A person who is knowledgeable or responsible for the sample child's health is
available or there is only one parent over 18 and no other adults in the child's
family or there are more than two adults and one of them is a parent who was
identified as available at AVAIL_C AND date of birth was verified as incorrect
fewer than 2 times and the Sample Child's spouse or partner is not the
respondent
Question Text:

Response:

3 of 3

DK:
RF:

Enter year of birth.

Don't Know
Refused

Page 30 of 334

Skip Instructions: <1900-current year,RF,DK>
if (BYEAR_C gt current year) or (BYEAR_C=current year and BMONTH_C gt
current month) or (BYEAR_C=current year and BMONTH_C=current month
and BDAY_C gt current day) [goto ERR_BYEAR_C]
elseif BDAY_C=29 and BMONTH_C=2 and (BYEAR=2000 or BYEAR_C/4
remainder ne 0) [goto ERR_BDAYLEAP_C]
elseif AGETEMP_C
NOMORE_C]

in

(RF,DK)

AND

BYEAR_C

in

(RF,DK)

[goto

elseif ((BYEAR_C not IN (RF,DK) and AGETEMP_C not IN (RF,DK) and
AGETEMP_C ne AGE_CALC_C) AND (AGETEMP_C not IN (RF,DK) and
AGETEMP_C ne AGE_CALCMINUS1_C)) and DOB_COUNT_C ne 1 [goto
VFYDOB_C]
elseif (AGETEMP_C eq AGE_CALC_C or AGE_CALCMINUS1_C) or
DOB_COUNT_C=1
if AGE_FINAL ge 18 [goto NOMORE_C]
else [goto next section]

Check Name: ERR_BDAYLEAP_C

Text:

{check ERR_BDAYLEAP_C}

^BDAY_C is not a valid day for ^BMONTH_C.

Hard / Soft Edit: Hard
Fills:

^BDAY_C

Fill value from Child.VFY.BDAY_C 

^BMONTH_C

Fill value from Child.VFY.BMONTH_C

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: Invalid dates for the leap year

Page 31 of 334

Check Name: ERR_BYEAR_C

Text:

{check ERR_BYEAR_C}

Future date invalid.

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (BYEAR_C>current
year)
or
(BYEAR_C=current
BMONTH_C>current
month)
or
(BYEAR_C=current
BMONTH_C=current month and BDAY_C>current day)

year
year

and
and

Universe Description: Birthday is in the future

Question ID: VFY.0430.00.1

Variable name: VFYDOB_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ((BYEAR_C not IN (DK,RF) and AGETEMP_C not IN (DK,RF) and
AGETEMP_C ne AGE_CALC_C) AND (AGETEMP_C not IN (DK,RF) and
AGETEMP_C
ne
AGE_CALCMINUS1_C
and
(AGETEMP_C
ne
AGE_CALCSCSTART_C
AND
SCSTARTAGE_FLG
ne
1)))
and
DOB_COUNT_C ne 1 and (RELTIV_C ne 9)
Universe Description: Sample Children whose age provided in either HHC or NEWAGE_C does not
match either age calculated from date of birth information and the Sample
Child's spouse or partner is not the respondent
Question Text:

There is a difference between the age the computer calculated from
^SCNAME's date of birth of ^AGEDOB_C_fill and the age I had previously
recorded of ^TEMPAGE_C. I recorded ^SCNAME's ^dateofbirth_C

Response:

Page 32 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^TEMPAGE_C

fill value of AGETEMP_C as "(age) year(s) old"
If AGETEMP_C is equal to 0, then display as "less
than 1"

^SCNAME

Fill ALIAS of HHSTAT_C=1

^AGEDOB_C_fill

Fill one age calculated from AGE_CALC_C as "(age)
year(s) old"
Fill two ages calculated from AGE_CALC_C and
AGE_CALCMINUS1_C as "(age) or (age) year(s)
old"
If AGE_CALC_C or AGE_CALCMINUS1_C is equal
to 0, then display as "less than 1"

^dateofbirth_C

If BDAY_C, BMONTH_C and BYEAR_C are all valid,
fill: "date of birth as ^BMONTH_C ^BDAY_C,
^BYEAR_C, is that correct?"
If only BMONTH_C and BYEAR_C are valid, fill:
"date of birth as ^BMONTH_C ^BYEAR_C, is that
correct?"
If only BDAY_C and BYEAR_C are valid, fill: "year of
birth as ^BYEAR_C, is that correct?"
If only BYEAR_C is valid, fill: "year of birth as
^BYEAR_C, is that correct?"

Skip Instructions: <1,RF,DK> if GEN.AGE_FINAL[PX_C] ge 18 [goto NOMORE_C]
else [goto next section]
<2> if DOB_COUNT_C le 1 [goto BMONTH_C]
elseif GEN.AGE_FINAL[PX_C] ge 18 [goto NOMORE_C]
else [goto next section]

Page 33 of 334

Question ID: VFY.0440.00.1

Variable name: NOMORE_C

Interview module: VFY(Child.VFY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] GT 17 or GEN.AGE_FINAL[PX_C] in (RF,DK) or
VFYONCAMP_C=2 OR (KNOAVAIL_Count = 0)
Universe Description: Sample child whose age is now over 17 or whose age is refused or don't know
or who lives off-campus or there is no knowledgeable sample child respondent
Question Text:

Response:
Fills:

^SCNAME no longer meets the requirements to be sample child for this family. End
this interview and begin the Sample Adult Interview. If there is no Sample Adult or the
Sample Adult interview has been completed, EXIT ^auxNoMore Not everyone in
our survey is asked all questions. I have all the information that I need from
you about ^SCNAME.
Enter '1' to continue.

1.

Enter 1 to Continue

^SCNAME

Fill ALIAS of HHSTAT_C=1

^auxNoMore

IF KNOAVAIL_Count = 0,fill "* If there is still a
knowledgeable respondent available, back up and
select that person."

Skip Instructions: If there is a callback set for Sample Adult [goto BCK.THANKS_CB]
else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

Page 34 of 334

Question ID: HIS.0010.00.1

Variable name: PHSTAT_C

Interview module: HIS(Child.HIS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

Would you say ^SCNAME's health in general is excellent, very good, good, fair,
or poor?

1.
2.
3.
4.
5.
DK:
RF:

Excellent
Very Good
Good
Fair
Poor
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-5,RF,DK> [goto next section]

Question ID: AST.0010.00.1

Variable name: ASTINTRO_C

Interview module: AST(Child.AST)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Now I am going to ask you about certain medical conditions.
continue.

1.

Enter 1 to Continue

Page 35 of 334

Enter '1' to

Skip Instructions: <1> [goto ASEV_C]

Question ID: AST.0020.00.1

Variable name: ASEV_C

Interview module: AST(Child.AST)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

Has a doctor or other health professional EVER told you that ^SCNAME had
asthma?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto ASTILL_C]
<2,RF,DK> [goto next section]

Question ID: AST.0030.00.1

Variable name: ASTILL_C

Interview module: AST(Child.AST)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ASEV_C=1
Universe Description: Sample Children 0-17 who were ever told they have asthma
Question Text:

Does ^SCNAME still have asthma?

Response:

Page 36 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto ASAT12M_C]

Question ID: AST.0040.00.1

Variable name: ASAT12M_C

Interview module: AST(Child.AST)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ASEV_C=1
Universe Description: Sample Children 0-17 who were ever told they had asthma
Question Text:

Response:

Fills:

During the past 12 months, has ^SCNAME had an episode of asthma or an
asthma attack?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto ASER12M_C]

Page 37 of 334

Question ID: AST.0050.00.1

Variable name: ASER12M_C

Interview module: AST(Child.AST)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ASEV_C=1
Universe Description: Sample Children 0-17 who were ever told they had asthma
Question Text:

Response:

Fills:

During the past 12 months, did ^SCNAME have to visit an emergency room or
urgent care center because of ^hisher_C asthma?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1,2,RF,DK> [goto next section]

Question ID: DIB.0010.00.1

Variable name: PREDIB_C

Interview module: DIB(Child.DIB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample children 0-17
Question Text:

Has a doctor or other health professional EVER told you that ^SCNAME had
prediabetes or borderline diabetes?

Response:

Page 38 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto DIBEV_C]

Question ID: DIB.0020.00.1

Variable name: DIBEV_C

Interview module: DIB(Child.DIB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

^NOTPRED a doctor or other health professional EVER told you that ^SCNAME
had diabetes?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^NOTPRED

If PREDIB_C=1: "Not including prediabetes, has"
If PREDIB_C IN ('2','DK','RF'): "Has"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto next section]

Page 39 of 334

Question ID: DLD.0010.00.1

Variable name: ADHDEV_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17
Universe Description: Sample Children 2-17
Question Text:

Response:

Fills:

Has a doctor or other health professional ever told you that ^SCNAME had
Attention-Deficit/Hyperactivity Disorder or ADHD or Attention-Deficit Disorder
or ADD? Read if necessary: Health professionals can include school psychologists
and school nurses.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto ADHDNW_C]
<2,RF,DK> [goto IDEV1_C]

Question ID: DLD.0020.00.1

Variable name: ADHDNW_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17 and ADHDEV_C=1
Universe Description: Sample Children 2-17 who had an ADHD diagnosis
Question Text:

Does ^SCNAME currently have Attention-Deficit/Hyperactivity Disorder or
ADHD or Attention-Deficit Disorder or ADD?

Response:

Page 40 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto IDEV1_C]

Question ID: DLD.0030.00.1

Variable name: IDEV1_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

Has a doctor or other health professional ever told you that ^SCNAME had an
intellectual disability, previously known as mental retardation? Read if
necessary: Health professionals can include school psychologists and school nurses.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto IDNW1_C]
<2,RF,DK> [goto ASDEV_C] if GEN.AGE_FINAL[PX_C]
GEN.AGE_FINAL[PX_C] le 17, else [goto DDEV_C]

Page 41 of 334

ge

2

and

Question ID: DLD.0040.00.1

Variable name: IDNW1_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: IDEV1_C=1
Universe Description: Sample Children 0-17 who had an intellectual disability diagnosis
Question Text:

Response:

Fills:

Does ^SCNAME currently have an intellectual disability, previously known as
mental retardation?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le
17 [goto ASDEV_C]
else [goto DDEV_C]

Question ID: DLD.0050.00.1

Variable name: ASDEV_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17
Universe Description: Sample Children 2-17
Question Text:

Has a doctor or other health professional ever told you that ^SCNAME had
Autism, Asperger's disorder, pervasive developmental disorder, or autism
spectrum disorder? Read if necessary: Health professionals can include school
psychologists and school nurses.

Response:

Page 42 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto ASDNW_C]
<2,RF,DK> [goto DDEV_C]

Question ID: DLD.0060.00.1

Variable name: ASDNW_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17 and ASDEV_C=1
Universe Description: Sample Children 2-17 who had an autism spectrum disorder diagnosis
Question Text:

Response:

Fills:

Does ^SCNAME currently have Autism, Asperger's disorder, pervasive
developmental disorder, or autism spectrum disorder?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto DDEV_C]

Page 43 of 334

Question ID: DLD.0070.00.1

Variable name: DDEV_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

^NOTEVER a doctor or other health professional ever told you that ^SCNAME
had any other developmental delay? Read if necessary: Health professionals
can include school psychologists and school nurses. Read if necessary:
Developmental delays are significant delays in a child's development. Examples
include cognitive, motor, speech, social, emotional and behavioral delays.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^NOTEVER

If ADHDEV_C ne 1 AND IDEV1_C ne 1 and
ASDEV_C ne 1 fill: "Has"
If ADHDEV_C=1 AND IDEV1_C ne 1 and ASDEV_C
ne 1 fill: "Not including ADHD, has"
If ADHDEV_C ne 1 AND IDEV1_C=1 and ASDEV_C
ne 1 fill: "Not including an intellectual disability, has"
If ADHDEV_C ne 1 AND IDEV1_C ne 1 and
ASDEV_C=1 fill: "Not including autism spectrum
disorder, has"
If ADHDEV_C=1 AND IDEV1_C=1 and ASDEV_C
ne fill: "Not including ADHD or an intellectual
disability, has"
If ADHDEV_C=1 AND IDEV1_C ne 1 and
ASDEV_C=1 fill: "Not including ADHD or autism
spectrum disorder, has"
If ADHDEV_C ne 1 AND IDEV1_C=1 and
ASDEV_C=1 fill: "Not including an intellectual
disability or autism spectrum disorder, has"
If ADHDEV_C=1 AND IDEV1_C=1 and ASDEV_C=1
fill: "Not including ADHD, an intellectual disability or
autism spectrum disorder, has"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 44 of 334

Skip Instructions: <1> [goto DDNW_C]
<2,RF,DK> if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le
17 [goto LDEV_C]
else [goto next section]

Question ID: DLD.0080.00.1

Variable name: DDNW_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: DDEV_C=1
Universe Description: Sample Children 0-17 who had any other developmental delay diagnosis
Question Text:

Response:

Fills:

Does ^SCNAME still have this other developmental delay?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le
17 [goto LDEV_C]
else [goto next section]

Question ID: DLD.0090.00.1

Variable name: LDEV_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17
Universe Description: Sample Children 2-17
Question Text:

Has a representative from a school or a health professional ever told you that
^SCNAME had a learning disability?

Response:

Page 45 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto LDNW_C]
<2,RF,DK> [goto next section]

Question ID: DLD.0100.00.1

Variable name: LDNW_C

Interview module: DLD(Child.DLD)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17 and LDEV_C=1
Universe Description: Sample Children 2-17 who had a learning disability diagnosis
Question Text:

Response:

Fills:

Does ^SCNAME currently have a learning disability?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto next section]

Page 46 of 334

Question ID: VIS.0010.00.1

Variable name: VISINTRO_C

Interview module: VIS(Child.VIS)

Inherited Universe: (GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17))
Universe Description: Sample Children 2-17
Question Text:

Response:
Fills:

I would like to ask you some questions about difficulties ^SCNAME may have.
Enter '1' to continue.

1.

Enter 1 to Continue

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto WEARGLSS_C]

Question ID: VIS.0020.00.1

Variable name: WEARGLSS_C

Interview module: VIS(Child.VIS)

Inherited Universe: (GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17))
Universe Description: Sample Children 2-17
Question Text:

Response:

Does ^SCNAME wear glasses ^CONTACTS? Read if necessary: Persons who
wear glasses to read or to do other occasional tasks should answer yes to this
question.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 47 of 334

Fills:

^CONTACTS

If AGE=5-17 fill "or contact lenses"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto VISIONDF_C]

Question ID: VIS.0030.00.1

Variable name: VISIONDF_C

Interview module: VIS(Child.VIS)

Inherited Universe: (GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17))
Universe Description: Sample Children 2-17
Question Text:

Response:

Fills:

^GLASSCONTACT ^SCNAME have difficulty seeing? Would you say ^SCNAME
has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this
at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^GLASSCONTACT

If WEARGLSS_C=1 fill "When wearing glasses
^CONTACTS does"
else if WEARGLSS_C ne 1 "Does"

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 48 of 334

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: HEA.0010.00.1

Variable name: HEARAID_C

Interview module: HEA(Child.HEA)

Inherited Universe: (GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17))
Universe Description: Sample Children 2-17
Question Text:

Response:

Fills:

Does ^SCNAME use a hearing aid?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto HEARINGDF_C]

Question ID: HEA.0020.00.1

Variable name: HEARINGDF_C

Interview module: HEA(Child.HEA)

Inherited Universe: (GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL ge 2 and GEN.AGE_FINAL le 17))
Universe Description: Sample Children 2-17
Question Text:

^USEHRAID_C ^SCNAME have difficulty hearing sounds like people's voices or
music? Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Response:

Page 49 of 334

1.
2.
3.
4.
DK:
RF:
Fills:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^USEHRAID_C

If HEARAID_C=1 fill "When using ^hisher_C hearing
aid(s) does " else fill "Does "

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: MOB.0010.00.1

Variable name: EQUIP_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17
Universe Description: Sample Children 2-17
Question Text:

Response:

Fills:

Does ^SCNAME use any equipment or receive assistance for walking?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 50 of 334

Skip Instructions: <1> if GEN.AGE_FINAL[PX_C]=2-4 [goto NOEQWLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto NOEQWLK100_C]
<2,RF,DK> if GEN.AGE_FINAL[PX_C]=2-4 [goto WLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto WLK100_C]

Question ID: MOB.0020.00.1

Variable name: NOEQWLKDF_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4) and EQUIP_C=1
Universe Description: Sample Children 2-4 who use equipment or assistance for walking
Question Text:

Response:

Fills:

Without using ^hisher_C equipment or assistance, does ^SCNAME have
difficulty walking? Would you say ^SCNAME has: no difficulty, some difficulty,
a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 51 of 334

Skip Instructions: <1-4,RF,DK> [goto EQWLKDF_C]

Question ID: MOB.0030.00.1

Variable name: EQWLKDF_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4) and EQUIP_C=1
Universe Description: Sample Children 2-4 who use equipment or assistance for walking
Question Text:

Response:

Fills:

When using ^hisher_C equipment or assistance, does ^SCNAME have difficulty
walking? Read if necessary: Would you say ^SCNAME has: no difficulty, some
difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Page 52 of 334

Question ID: MOB.0040.00.1

Variable name: WLKDF_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4) and EQUIP_C IN (2,RF,DK)
Universe Description: Sample Children 2-4 who do not use equipment or assistance for walking or
Refused or Don't Know
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
walking? Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Page 53 of 334

Question ID: MOB.0050.00.1

Variable name: NOEQWLK100_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17 and EQUIP_C=1
Universe Description: Sample Children 5-17 who use equipment or assistance for walking
Question Text:

Response:

Fills:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have
difficulty walking 100 yards on level ground? That would be about the length of
1 football field or 1 city block. Would you say ^SCNAME has: no difficulty,
some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-3,RF,DK> [goto NOEQWLK13M_C]
<4> [goto EQWLK100_C]

Page 54 of 334

Question ID: MOB.0060.00.1

Variable name: NOEQWLK13M_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17 and NOEQWLK100_C IN (1,2,3,RF,DK)
Universe Description: Sample Children 5-17 who use equipment or assistance for walking and have
no, some or a lot difficulty walking 100 yards when not using their
equipment/assistance or Refused or Don't Know
Question Text:

Response:

Fills:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have
difficulty walking a third of a mile on level ground? That would be about the
length of 5 football fields or 5 city blocks. Read if necessary: Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do
this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 55 of 334

Skip Instructions: <1-4,RF,DK> [goto EQWLK100_C]

Question ID: MOB.0070.00.1

Variable name: EQWLK100_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17 and EQUIP_C=1
Universe Description: Sample Children 5-17 who use equipment or assistance for walking.
Question Text:

Response:

Fills:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have
difficulty walking 100 yards on level ground? That would be about the length of
1 football field or 1 city block. Read if necessary: Would you say ^SCNAME has:
no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 56 of 334

Skip Instructions: <1-3,RF,DK> [goto EQWLK13M_C]
<4> [goto next section]

Question ID: MOB.0080.00.1

Variable name: EQWLK13M_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17 and EQWLK100_C IN (1,2,3,RF,DK)
Universe Description: Sample Children 5-17 who use equipment or assistance for walking and have
no, some or a lot of difficulty walking 100 yards when using their
equipment/assistance or Refused or Don't Know
Question Text:

Response:

Fills:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have
difficulty walking a third of a mile on level ground? That would be about the
length of 5 football fields or 5 city blocks. Read if necessary: Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do
this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 57 of 334

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: MOB.0090.00.1

Variable name: WLK100_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17 EQUIP_C=2,RF,DK
Universe Description: Sample Children 5-17 who do not use equipment or assistance for walking or
Refused or Don't Know
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
walking 100 yards on level ground? That would be about the length of 1 football
field or 1 city block. Would you say ^SCNAME has: no difficulty, some
difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-3,RF,DK> [goto WLK13M_C]
<4> [goto next section]

Page 58 of 334

Question ID: MOB.0100.00.1

Variable name: WLK13M_C

Interview module: MOB(Child.MOB)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17 and WLK100_C IN (1,2,3,RF,DK)
Universe Description: Sample Children 5-17 who do not use equipment or assistance for walking and
have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or
Refused or Don't Know
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
walking a third of a mile on level ground? That would be about the length of 5
football fields or 5 city blocks. Read if necessary: Would you say ^SCNAME has:
no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Page 59 of 334

Question ID: UPP.0010.00.1

Variable name: PICKUPDF_C

Interview module: UPP(Child.UPP)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4)
Universe Description: Sample Children 2-4
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
picking up small objects with ^hisher_C hands? Read if necessary: Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot
do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Page 60 of 334

Question ID: UPP.0020.00.1

Variable name: SELFCAREDF_C

Interview module: UPP(Child.UPP)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

Fills:

Does ^SCNAME have difficulty with self care, such as eating or dressing?
Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot
of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: COM.0010.00.1

Variable name: UNDRSTYOU_C

Interview module: COM(Child.COM)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4)
Universe Description: Sample Children 2-4
Question Text:

Does ^SCNAME have difficulty understanding you? Read if necessary: Would
you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C
cannot do this at all?

Response:

Page 61 of 334

1.
2.
3.
4.
DK:
RF:
Fills:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto UNDRSTCHD_C]

Question ID: COM.0020.00.1

Variable name: UNDRSTCHD_C

Interview module: COM(Child.COM)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4)
Universe Description: Sample Children 2-4
Question Text:

Response:

When ^SCNAME speaks, do you have difficulty understanding
^himherthem_C? Read if necessary: Would you say ^SCNAME has: no difficulty,
some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

Page 62 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^himherthem_C

if GEN.SEX_FINAL[PX_C]=1 fill "him";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"them"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: COM.0030.00.1

Variable name: UNDRSTIHH_C

Interview module: COM(Child.COM)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being
understood by people inside of this household?
Read if necessary: Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot
do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

Page 63 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^doesheshedothey_C

If SEX=1 fill: "does he"
If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto UNDRSTOHH_C]

Question ID: COM.0040.00.1

Variable name: UNDRSTOHH_C

Interview module: COM(Child.COM)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

Fills:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being
understood by people outside of this household? Read if necessary: Would
you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C
cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^doesheshedothey_C

If SEX=1 fill: "does he"
If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 64 of 334

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: COG.0010.00.1

Variable name: LEARNDF_C

Interview module: COG(Child.COG)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=2-17
Universe Description: Sample Children 2-17
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
learning things? Read if necessary: Would you say ^SCNAME has: no difficulty,
some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto REMEMBERDF_C]

Page 65 of 334

Question ID: COG.0020.00.1

Variable name: REMEMBERDF_C

Interview module: COG(Child.COG)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
remembering things? Read if necessary: Would you say ^SCNAME has: no
difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: ANX.0010.00.1

Variable name: ANXFREQ_C

Interview module: ANX(Child.ANX)

Inherited Universe: (GEN.AGE_FINAL[PX_C]=5-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=5-17))
Universe Description: Sample Children 5-17
Question Text:

How often does ^SCNAME seem very anxious, nervous, or worried? Would you
say: daily, weekly, monthly, a few times a year, or never?

Response:

Page 66 of 334

1.
2.
3.
4.
5.
DK:
RF:
Fills:

Daily
Weekly
Monthly
A few times a year
Never
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-5,RF,DK> [goto next section]

Question ID: DEP.0010.00.1

Variable name: DEPFREQ_C

Interview module: DEP(Child.DEP)

Inherited Universe: (GEN.AGE_FINAL[PX_C]=5-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=5-17))
Universe Description: Sample Children 5-17
Question Text:

Response:

Fills:

How often does ^SCNAME seem very sad or depressed? Would you say: daily,
weekly, monthly, a few times a year, or never?

1.
2.
3.
4.
5.
DK:
RF:

Daily
Weekly
Monthly
A few times a year
Never
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 67 of 334

Skip Instructions: <1-5,RF,DK> [goto next section]

Question ID: BEH.0010.00.1

Variable name: BEHDFPLYG_C

Interview module: BEH(Child.BEH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4)
Universe Description: Sample Children 2-4
Question Text:

Response:

Fills:

Compared with children of the same age, does ^SCNAME have difficulty
playing? Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto BEHKBHYG_C]

Page 68 of 334

Question ID: BEH.0020.00.1

Variable name: BEHKBHYG_C

Interview module: BEH(Child.BEH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C] IN (2,3,4)
Universe Description: Sample Children 2-4
Question Text:

Response:

Fills:

Compared with children of the same age, how much does ^SCNAME kick, bite,
or hit other children or adults? Would you say: not at all, the same or less,
more, or a lot more?

1.
2.
3.
4.
DK:
RF:

Not at all
The same or less
More
A lot more
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: BEH.0030.00.1

Variable name: BEHDFCNTR_C

Interview module: BEH(Child.BEH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Compared with children of the same age, does ^SCNAME have difficulty
controlling ^hisher_C behavior? Read if necessary: Would you say ^SCNAME
has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Response:

Page 69 of 334

1.
2.
3.
4.
DK:
RF:
Fills:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto BEHDFFCS_C]

Question ID: BEH.0040.00.1

Variable name: BEHDFFCS_C

Interview module: BEH(Child.BEH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

Does ^SCNAME have difficulty concentrating on an activity that ^heshe_C
enjoy^s doing? Read if necessary: Would you say ^SCNAME has: no difficulty,
some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

1.

No difficulty

Page 70 of 334

2.
3.
4.
DK:
RF:
Fills:

Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

^s

if SEX_FINAL[PX_C]=1,2 fill "s"
else fill blank

Skip Instructions: <1-4,RF,DK> [goto BEHDFCHG_C]

Question ID: BEH.0050.00.1

Variable name: BEHDFCHG_C

Interview module: BEH(Child.BEH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

Does ^SCNAME have difficulty accepting changes in ^hisher_C routine?
Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot
of difficulty, or ^heshe_C cannot do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

Page 71 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1-4,RF,DK> [goto BEHDFMKFR_C]

Question ID: BEH.0060.00.1

Variable name: BEHDFMKFR_C

Interview module: BEH(Child.BEH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

Fills:

Does ^SCNAME have difficulty making friends? Read if necessary: Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot
do this at all?

1.
2.
3.
4.
DK:
RF:

No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Page 72 of 334

Skip Instructions: <1-4,RF,DK> [goto next section]

Question ID: BSC.0010.00.1

Variable name: BSCINTRO_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children under 2 years
Question Text:

Response:

The following statements are not to be read to the respondent. They are displayed
and included here for legal reasons. The Baby Pediatric Symptom Checklist is part
of the larger Survey of Well-being of Young Children, copyrighted by Tufts Medical
Center. For more information go to
https://www.floatinghospital.org/The-Survey-of-Wellbeing-of-Young-Children/Overvie
w.aspx Enter '1' to continue.

1.

Enter 1 to Continue

Skip Instructions: <1> [goto BSCNWPPL_C]

Question ID: BSC.0020.00.1

Variable name: BSCNWPPL_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

These next questions are about ^SCNAME's behavior. Think about what you
would expect of other children the same age, and tell me how much each
statement applies to ^SCNAME. Does ^SCNAME have a hard time being with
new people? Would you say not at all, somewhat, or very much?

Response:

Page 73 of 334

1.
2.
3.
DK:
RF:
Fills:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCNWPLCS_C]

Question ID: BSC.0030.00.1

Variable name: BSCNWPLCS_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Does ^SCNAME have a hard time in new places? Would you say not at all,
somewhat, or very much?

1.
2.
3.
DK:
RF:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCCHG_C]

Page 74 of 334

Question ID: BSC.0040.00.1

Variable name: BSCCHG_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Does ^SCNAME have a hard time with change?
say not at all, somewhat, or very much?

1.
2.
3.
DK:
RF:

Read if necessary: Would you

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCHLOPPL_C]

Question ID: BSC.0050.00.1

Variable name: BSCHLOPPL_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Does ^SCNAME mind being held by other people?
you say not at all, somewhat, or very much?

Response:

Page 75 of 334

Read if necessary: Would

1.
2.
3.
DK:
RF:
Fills:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCCRYALT_C]

Question ID: BSC.0060.00.1

Variable name: BSCCRYALT_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Does ^SCNAME cry a lot?
somewhat, or very much?

1.
2.
3.
DK:
RF:

Read if necessary: Would you say not at all,

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCCLMDWN_C]

Page 76 of 334

Question ID: BSC.0070.00.1

Variable name: BSCCLMDWN_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Does ^SCNAME have a hard time calming down?
you say not at all, somewhat, or very much?

1.
2.
3.
DK:
RF:

Read if necessary: Would

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCFUSSY_C]

Question ID: BSC.0080.00.1

Variable name: BSCFUSSY_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Is ^SCNAME fussy or irritable?
somewhat, or very much?

Response:

Page 77 of 334

Read if necessary: Would you say not at all,

1.
2.
3.
DK:
RF:
Fills:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCSTHE_C]

Question ID: BSC.0090.00.1

Variable name: BSCSTHE_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Is it hard to comfort ^SCNAME?
somewhat, or very much?

1.
2.
3.
DK:
RF:

Read if necessary: Would you say not at all,

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCSCHD_C]

Page 78 of 334

Question ID: BSC.0100.00.1

Variable name: BSCSCHD_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Is it hard to keep ^SCNAME on a schedule or routine?
Would you say not at all, somewhat, or very much?

1.
2.
3.
DK:
RF:

Read if necessary:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCPTSLP_C]

Question ID: BSC.0110.00.1

Variable name: BSCPTSLP_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Is it hard to put ^SCNAME to sleep?
somewhat, or very much?

Response:

Page 79 of 334

Read if necessary: Would you say not at all,

1.
2.
3.
DK:
RF:
Fills:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCSTYSLP_C]

Question ID: BSC.0120.00.1

Variable name: BSCSTYSLP_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Does ^SCNAME have trouble staying asleep?
say not at all, somewhat, or very much?

1.
2.
3.
DK:
RF:

Read if necessary: Would you

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3,RF,DK> [goto BSCPRLKSL_C]

Page 80 of 334

Question ID: BSC.0130.00.1

Variable name: BSCPRLKSL_C

Interview module: BSC(Child.BSC)

Inherited Universe: (GEN.AGE_FINAL[PX_C] lt 2) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C] lt 2))
Universe Description: Sample Children with Age under 2 years
Question Text:

Response:

Fills:

Is it hard for ^youmembersoffamily to get enough sleep because of ^SCNAME?
Read if necessary: Would you say not at all, somewhat, or very much?

1.
2.
3.
DK:
RF:

Not at all
Somewhat
Very much
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^youmembersoffamily

If PCNT='2' fill "you"
elsefill "members of your family"

Skip Instructions: <1-3,RF,DK> [goto next section]

Question ID: SCH.0010.00.1

Variable name: SCHDYSMSS_C

Interview module: SCH(Child.SCH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: GEN.AGE_FINAL[PX_C]=5-17
Universe Description: Sample Children 5-17
Question Text:

Response:

During the past 12 months, about how many days of school did ^SCNAME miss
because ^HeShe_C had an illness, injury, or disability? Enter '996' if child did
not go to school in the past 12 months.

DK:
RF:

Don't Know
Refused

Page 81 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^HeShe_C

If SEX_FINAL_C=1 fill "He"
else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C=blank: fill "They"

Skip Instructions: <0-99,996,RF,DK> [goto SCHSPEDEV_C]
<100-365> [goto ERR1_SCHDYSMSS_C]
<366-995> [goto ERR2_SCHDYSMSS_C]

Check Name: ERR1_SCHDYSMSS_C

Text:

{signal ERR1_SCHDYSMSS_C} ^SCHDYSMSS_C is an unusually large number,
did ^SCNAME miss ^SCHDYSMSS_C days of school because of illness, injury,
or disability? Please verify.

Hard / Soft Edit: Soft
Fills:

^SCHDYSMSS_C

Fill value from SCHDYSMSS_C

^SCNAME

Fill ALIAS of HHSTAT_C=1

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: SCHDYSMSS_C=100-365
Universe Description: Sample child missed 100 to 365 days of school

Page 82 of 334

Check Name: ERR2_SCHDYSMSS_C

Text:

{check ERR2_SCHDYSMSS_C} "366-995" days not allowed in this field.

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: SCHDYSMSS_C=366-995
Universe Description: Sample children who missed 366 to 995 days of school

Question ID: SCH.0020.00.1

Variable name: SCHSPEDEV_C

Interview module: SCH(Child.SCH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

Has ^SCNAME ever had a special education or early intervention plan, such as
an Individualized Education Plan, an IEP, or an Individualized Family Service
Plan, an IFSP?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto SCHSPED_C]
<2,RF,DK> [goto next section]

Page 83 of 334

Question ID: SCH.0030.00.1

Variable name: SCHSPED_C

Interview module: SCH(Child.SCH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: SCHSPEDEV_C=1
Universe Description: Sample Children 0-17 who ever received special education services
Question Text:

Response:

Fills:

Does ^SCNAME currently have a special education or early intervention plan?
Read if necessary: Consider special education or early intervention plans received
during the past school year.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto SCHSPEDEM_C]
<2,RF,DK> [goto next section]

Question ID: SCH.0040.00.1

Variable name: SCHSPEDEM_C

Interview module: SCH(Child.SCH)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: SCHSPED_C=1
Universe Description: Sample Children 0-17 who have received services in the past 12 months
Question Text:

Does ^SCNAME receive these services to help with ^hisher_C emotions,
concentration, behavior, or mental health?

Response:

Page 84 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1,2,RF,DK> [goto next section]

Question ID: INS.0010.00.1

Variable name: HICOV_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

?[F1] The next questions are about health insurance. Include health insurance
obtained through employment or purchased directly as well as government
programs like Medicare, Medicaid, and the Children's Health Insurance
Program that provide medical care or help pay medical bills. Is ^SCNAME
covered by any kind of health insurance or some other kind of health care
plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 85 of 334

Skip Instructions: <1,R,D> [goto HIKIND_C]
<2> [goto MCAIDPRB_C]

Question ID: INS.0020.00.1

Variable name: HIKIND_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HICOV_C IN (1,RF,DK)
Universe Description: Sample Children 0-17 covered by any kind of health insurance or health care
coverage or refused/don't know if they have insurance or health care
coverage.
Question Text:

Response:

?[F1] What kinds of health insurance or health care coverage does ^SCNAME
have? Is it...Private health insurance, Medicare, Medicare supplement,
Medicaid, Children's Health Insurance Program or CHIP, military related health
care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, state-sponsored health plan, or an other government program?
Enter all that apply, separate with commas.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
DK:
RF:

Private health insurance
Medicare (including Medicare Advantage)
Medicare supplement (Medigap)
Medicaid
Children's Health Insurance Program (CHIP)
Military related health care: TRICARE (CHAMPUS) / VA health care /
CHAMP-VA
Indian Health Service
State-sponsored health plan
Other government program
No coverage of any type
Don't Know
Refused

Page 86 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: if > 1 answer selected and (<10> in HIKIND_C) [goto ERR1_HIKIND_C]
else if HIKIND_C=RF,DK or (<10> in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]

Check Name: ERR1_HIKIND_C

Text:

{check ERR1_HIKIND_C} Cannot mark "no coverage of any kind" and another type.
Please correct.

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: if more than 1 answer selected at HIKIND_C and (<10> in HIKIND_C)

Question ID: INS.0030.00.1

Variable name: MCAIDPRB_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HIKIND_C IN (10,RF,DK)
Universe Description: Sample Children 0-17 who have indicated they are uninsured, refused, or don't
know if they are insured
Question Text:

Response:

?[F1] There is a program called Medicaid that pays for health care for persons
in need. ^STATEMA Is ^SCNAME covered by Medicaid?

1.

Yes

Page 87 of 334

2.
DK:
RF:
Fills:

No
Don't Know
Refused

^STATEMA

if STMEDICAID ne empty, fill: "In ^STATENAME it is
alsocalled ^STMEDICAID."
else fill: blank

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto SINCOVDE_C]

Question ID: INS.0040.00.1

Variable name: SINCOVDE_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

?[F1] ^INADDITIONIS ^SCNAME covered by a SEPARATE plan that only pays
for dental services?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^INADDITIONIS

If (HIKIND_C=1-9 or MCAIDPRB_C=1), fill "In
addition to ^HITYPECNOSS, is"
else fill "Is"

Skip Instructions: <1,2,RF,DK> [goto SINCOVVS_C]

Page 88 of 334

Question ID: INS.0050.00.1

Variable name: SINCOVVS_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

?[F1] Is ^SCNAME covered by a SEPARATE plan that only pays for vision
services?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto SINCOVRX_C]

Question ID: INS.0060.00.1

Variable name: SINCOVRX_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

?[F1] Is ^SCNAME covered by a SEPARATE plan that only pays for
prescriptions?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 89 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto HICHANGE_C]

Question ID: INS.0070.00.1

Variable name: HICHANGE_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

?[F1] I have recorded ^SCNAME is ^COVEREDC. Is this correct?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^COVEREDC

if HIKIND_C=10,R,D and MCAIDPRB_C=2,R,D and
SINCOVDE_C=2,R,Dand SINCOVVS_C=2,R,Dand
SINCOVRX_C=2,R,Dfill: "not covered by health
insurance"
else fill: "covered by ^HITYPEC"

Skip Instructions: <1,RF,DK>
if 2 in HIKIND_C [goto MCPART_C]
else if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C]
else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else if 7 in HIKIND_C [goto HINOTYR_C]
else if 10 in HIKIND_C and MCAIDPRB_C IN (2,RF,DK) [goto HILAST_C]
else [goto FINISH_C]
<2> [goto ERR1_HICHANGE_C]

Page 90 of 334

Check Name: ERR1_HICHANGE_C

Text:

{check ERR1_HICHANGE_C}
coverage.

Press enter to go back to HIKIND_C and update

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HICHANGE_C=2

Question ID: INS.0080.00.1

Variable name: MCPART_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 2 IN HIKIND_C
Universe Description: Sample Children 0-17 with Medicare
Question Text:

Response:

Fills:

?[F1] What type of Medicare coverage does ^SCNAME have? Is it Part A hospital insurance, Part B - medical insurance, or both?

1.
2.
3.
DK:
RF:

Part A- hospital only
Part B- medical only
Both Part A and Part B
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <2,3,RF,DK> [goto MCCHOICE_C] <1> [goto MCPARTD_C]

Page 91 of 334

Question ID: INS.0090.00.1

Variable name: MCCHOICE_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 02 IN HIKIND_C AND MCPART_C IN (2,3,RF,DK)
Universe Description: Sample Children 0-17 with Medicare part B only or both parts A and B
Question Text:

Response:

Fills:

?[F1] Is ^SCNAME enrolled in a Medicare Advantage plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto MCHMO_C]

Question ID: INS.0100.00.1

Variable name: MCHMO_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 02 IN HIKIND_C AND MCPART_C IN (2,3,RF,DK)
Universe Description: Sample Children 0-17 with Medicare part B only or both parts A and B
Question Text:

Response:

?[F1] Is ^SCNAME under a Medicare managed care arrangement, such as an
HMO, that is, a Health Maintenance Organization?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 92 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto MCANAME_C]
<2,RF,DK> if MCCHOICE_C=1 [goto MCANAME_C]
else if MCCHOICE_C=2,RF,DK, [goto MCPARTD_C]

Question ID: INS.0110.00.1

Variable name: MCANAME_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: MCCHOICE_C=1 or MCHMO_C=1
Universe Description: Sample Children 0-17 with a Medicare Advantage plan or a Medicare
managed care arrangement
Question Text:

Response:

Fills:

?[F1] What is the name of ^SCNAME's Medicare Advantage or Medicare HMO
plan?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto MCDNCOV_C]

Question ID: INS.0111.00.1

Variable name: MCDNCOV_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: MCCHOICE_C=1 or MCHMO_C=1
Universe Description: Sample Children 0-17 with a Medicare Advantage plan or a Medicare
managed care arrangement
Question Text:

?[F1] Does ^MEDADVNAME_C pay for any of the costs for dental care?

Response:

Page 93 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^MEDADVNAME_C

If MCANAME_C has value, fill value of
MCANAME_C
If MCANAME_C is DK/RF, fill: "this Medicare
Advantage or Medicare HMO plan"

Skip Instructions: <1,2,RF,DK> [goto MCVSCOV_C]

Question ID: INS.0112.00.1

Variable name: MCVSCOV_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: MCCHOICE_A=1 or MCHMO_A=1
Universe Description: Sample Children 0-17 with a Medicare Advantage plan or a Medicare
managed care arrangement
Question Text:

Response:

Fills:

?[F1] Does ^MEDADVNAME_C pay for any of the costs for routine vision care,
such as glasses and contact lenses?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^MEDADVNAME_C

If MCANAME_C has value, fill value of
MCANAME_C
If MCANAME_C is DK/RF, fill: "this Medicare
Advantage or Medicare HMO plan"

Page 94 of 334

Skip Instructions: <1,2,RF,DK> [goto MCPARTD_C]

Question ID: INS.0120.00.1

Variable name: MCPARTD_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 2 IN HIKIND_C
Universe Description: Sample Children 0-17 with Medicare
Question Text:

Response:

Fills:

?[F1] Is ^SCNAME enrolled in Medicare Part D, also known as the Medicare
Prescription Drug Plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK>
if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C]
else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Page 95 of 334

Question ID: INS.0130.00.1

Variable name: MACHMN_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 4 IN HIKIND_C or MCAIDPRB_C=1
Universe Description: Sample Children 0-17 with Medicaid coverage
Question Text:

Response:

Fills:

?[F1] The next questions are about Medicaid coverage. What is the name of
^SCNAME's Medicaid health plan?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto MAXCHNG_C]

Question ID: INS.0140.00.1

Variable name: MAXCHNG_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 4 IN HIKIND_C or MCAIDPRB_C=1
Universe Description: Sample Children 0-17 with Medicaid coverage
Question Text:

Response:

?[F1] Was ^SCNAME's Medicaid obtained through Healthcare.gov or the
^MARKETPLACE?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 96 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"

Page 97 of 334

Skip Instructions: <1,2,RF,DK> [goto MAPREM_C]

Question ID: INS.0150.00.1

Variable name: MAPREM_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 4 IN HIKIND_C or MCAIDPRB_C=1
Universe Description: Sample Children 0-17 with Medicaid coverage
Question Text:

Response:

Fills:

?[F1] A health insurance premium is the amount ^SCNAME or a family member
pays each month for health care coverage. Does ^SCNAME or a family member
pay a premium for this Medicaid plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto MADEDUC_C]

Question ID: INS.0160.00.1

Variable name: MADEDUC_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 4 IN HIKIND_C or MCAIDPRB_C=1
Universe Description: Sample Children 0-17 with Medicaid coverage
Question Text:

?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does ^SCNAME's Medicaid plan have an annual deductible? Read if
necessary: A deductible is different from a copay (copayment).

Response:

Page 98 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto MAHDHP_C]
<2,RF,DK>
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0170.00.1

Variable name: MAHDHP_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: MADEDUC_C=1
Universe Description: Sample Children 0-17 with Medicaid coverage who have a deductible
Question Text:

Response:

?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.

1.
2.
DK:
RF:

Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused

Page 99 of 334

Fills:

^HDHPDED

Fill: $1,400

Skip Instructions: <1,2,RF,DK>
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0260.00.1

Variable name: PLANNAME1_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: INSPRI1_FLG1_C=1 and INSPRI1_FLG2_C=1 and INSPRI1_FLG3_C=1 and
GEN.INSPRI_FLG=1
and
GEN.SAMEFAM_FLG=1
and
Adult.INS.PLANNAME1_A=empty
Universe Description: Sample Children 0-17 with private health insurance coverage, where the
Sample Adult interview has already been conducted, the Sample Adult is in
the same family, and the Sample Adult also had private health insurance, and
the first private plan is not self only coverage, a plan name was not don't know
or refused, and the source and who pays for the coverage is not don't know or
refused.
Question Text:

Response:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by ^HIPNAM1_A. Is
^SCNAME covered by this same plan as ^YOUSANAME?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 100 of 334

Fills:

^YOUSANAME

If GEN.SARESPSC_FLG=1, fill "you"
else fill "^SANAME"

^HIPNAM1_A

Fill value from Adult.INS.HIPNAM1_A

^SCNAME

Fill ALIAS of HHSTAT_C=1

^WEREWAS

If SARESPSC_FLG=1, fill "were",
else "was"

Skip Instructions: <1> if Adult.INS.bPlan[1].POLHLD_A ne 1 [goto POLHLDA1_C],
if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1
and INSPRI2_FLG5_C=1 [goto PLANNAME2_C] else [goto MORPLAN_C]
<2,RF,DK> if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and
INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1 [goto PLANNAME2_C] else
[goto HIPNAM1_C]

Question ID: INS.0270.00.1

Variable name: POLHLDA1_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: PLANNAME1_C=1 and Adult.INS.bPlan[1].POLHLD_A=2,RF,DK
Universe Description: Sample Children 0-17 with a shared private health plan with the Sample Adult,
where the Sample Adult is not the policyholder for their first private plan or
refused or don't know.
Question Text:

Response:

?[F1] Health insurance plans are usually obtained in one person's name even if
other family members are covered by that plan. That person is called the
policyholder. Is ^SCNAME the policyholder for ^HIPNAM1_A?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 101 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^HIPNAM1_A

Fill value from Adult.INS.HIPNAM1_A

Skip Instructions: <1,2,RF,DK> if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1
INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1 [goto PLANNAME2_C]
else [goto MORPLAN_C]

Question ID: INS.0280.00.1

Variable name: PLANNAME2_C

and

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and
INSPRI2_FLG5_C=1 and GEN.INSPRI_FLG=1 and GEN.SAMEFAM_FLG=1
and Adult.INS.PLANNAME2_A=empty
Universe Description: Sample Children 0-17 with private health insurance coverage, where the
Sample Adult interview has already been conducted, the Sample Adult is in
the same family, and the Sample Adult also had private health insurance, and
listed two plans. The second private plan is not self only coverage, a plan
name was not don't know or refused, and the source and who pays for the
coverage is not don't know or refused.
Question Text:

Response:

Fills:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by a second plan
^HIPNAM2_A. Is ^SCNAME covered by this same plan as ^YOUSANAME?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^YOUSANAME

If GEN.SARESPSC_FLG=1, fill "you"
else fill "^SANAME"

^HIPNAM2_A

Fill value from Adult.INS.HIPNAM2_A

^SCNAME

Fill ALIAS of HHSTAT_C=1

^WEREWAS

If SARESPSC_FLG=1, fill "were",
else "was"

Page 102 of 334

Skip Instructions: <1> if Adult.INS.bPlan[2].POLHLD_A ne 1 [goto POLHLDA2_C],
else if PLANNAME1_C IN(2,RF,DK) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
<2,RF,DK> if PLANNAME1_C IN (2,RF,DK,empty) [goto HIPNAM1_C]
else [goto MORPLAN_C]

Question ID: INS.0290.00.1

Variable name: POLHLDA2_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: PLANNAME2_C=1 and Adult.INS.bPlan[2].POLHLD_A=2,RF,DK
Universe Description: Sample Children 0-17 with a shared private health plan with the Sample Adult,
where the adult is not the policyholder for their second private plan or refused
or don't know
Question Text:

Response:

Fills:

?[F1] Read if necessary: Health insurance plans are usually obtained in one
person's name even if other family members are covered by that plan. That person is
called the policyholder. Is ^SCNAME the policyholder for ^HIPNAM2_A?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^HIPNAM2_A

Fill value from Adult.INS.HIPNAM2_A

Page 103 of 334

Skip Instructions: <1,2,RF,DK> if PLANNAME1_C IN(2,RF,DK,empty) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0300.00.1

Variable name: HIPNAM1_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (3 in HIKIND_C) or (1 in HIKIND_C and ((PLANNAME1_C
IN(2,RF,DK,empty)) and (PLANNAME2_C IN (2,RF,DK,empty)))
Universe Description: Sample Children 0-17 enrolled in a Medigap plan or private health insurance
and the sample child did not share or refused or did not know if they shared or
did not have a value for both of the two listed private plans for the sample adult
Question Text:

Response:

Fills:

?[F1] It is important that we record the complete and accurate name of each
private health insurance plan. What is the COMPLETE name of ^SCNAME's
plan? Do NOT include plans that only provide extra cash while in the hospital
or plans that pay for only one type of service such as long term care, accidents,
or dental care. Read if necessary: Do you have a health plan card or something
with the plan name on it?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto MORPLAN_C]

Page 104 of 334

Question ID: INS.0310.00.1

Variable name: MORPLAN_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HIPNAM1_C
ne
empty
or
((PLANNAME1_C=1
and
PLANNAME2_C=2,RF,DK,empty) or (PLANNAME1_C=2,RF,DK,empty and
PLANNAME2_C=1))
Universe Description: Sample Children 0-17 enrolled in a private health plan where the name of the
plan was given or don't know or refused or the sample child only shared one
private plan with the Sample Adult
Question Text:

Response:

Fills:

?[F1] Is ^SCNAME covered by any other private health insurance plans?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto HIPNAM2_C]
<2,RF,DK>
if (PLANNAME1_C = 1 or PLANNAME2_C = 1) then
if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
else [goto bPlan[1].POLHLD_C]

Page 105 of 334

Question ID: INS.0320.00.1

Variable name: HIPNAM2_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: MORPLAN_C=1
Universe Description: Sample Children 0-17 with a second private health insurance plan
Question Text:

Response:

?[F1] What is the name of that private health insurance plan?
Read if
necessary: Do you have a health plan card or something with the plan name on it?

DK:
RF:

Don't Know
Refused

Skip Instructions:  [goto bPlan[1].POLHLD_C]

Question ID: INS.0340.00.1

Variable name: POLHLD_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know.
Question Text:

Response:

?[F1] I am going to ask you some questions about ^FIRSTPLANC. Health
insurance plans are usually obtained in one person's name even if other family
members are covered by that plan. That person is called the policyholder. Is
^SCNAME the policyholder for ^THISPLANC?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 106 of 334

Fills:

^FIRSTPLANC

If PlanNum = 1 then
if
HIPNAM1_C
IN
(RF,DK)
AND
HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

^SCNAME

Fill ALIAS of HHSTAT_C=1

^THISPLANC

if PlanNum=1 then
if HIPNAM1_C IN('RF','DK') fill: "this plan"
Else fill: "^HIPNAM1_C"
if PlanNum=2 then
if HIPNAM2_C IN('RF','DK') fill: "this plan"
Else fill: "^HIPNAM2_C"

Skip Instructions: <1,RF,DK> [goto PRPLCOV_C]
<2> [goto PLNWRK_C]

Question ID: INS.0350.00.1

Variable name: PRPLCOV_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: POLHLD_C=1,RF,DK
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know and where the Sample Child is the
policyholder or refused or don't know.
Question Text:

Does this plan cover someone other than ^SCNAME?

Response:

Page 107 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto PLNWRK_C]

Question ID: INS.0360.00.1

Variable name: PLNWRK_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children with private health insurance coverage where a plan name
was given or refused or don't know.
Question Text:

Response:

?[F1] Which one of these categories best describes how this plan was
obtained? Was it obtained through an employer or union, purchased directly,
obtained through Healthcare.gov or the Affordable Care Act, also known as
Obamacare, obtained through a state or local government or community
program or obtained in some other way?

1.
2.
3.
4.
5.
DK:
RF:

Through an employer, union, or professional association
Purchased directly
Through Healthcare.gov or the Affordable Care Act, also known as
Obamacare
Through a state or local government or community program
Other
Don't Know
Refused

Skip Instructions: <1,3> [goto PLNPAY_C]
<2,4,RF,DK> [goto PLNEXCHG_C]
<5> [goto PLNWKSP_C]

Page 108 of 334

Question ID: INS.0370.00.1

Variable name: PLNWKSP_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: PLNWRK_C=5
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know and private health insurance
coverage was obtained from an other source
Question Text:

Response:

Read if necessary: How was this plan obtained?

DK:
RF:

Don't Know
Refused

Skip Instructions:  [goto PLNEXCHG_C]

Question ID: INS.0380.00.1

Variable name: PLNEXCHG_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: PLNWRK_C IN (2,4,5,RF,DK)
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know and who have private coverage that
is directly purchased, or obtained through a state, local, government or
community program, or obtained another way, or refused/don't know how
obtained
Question Text:

?[F1] Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?

Response:

Page 109 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^MARKETPLACE

If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"

Page 110 of 334

Skip Instructions: <1,2,RF,DK> [goto PLNPAY_C]

Question ID: INS.0390.00.1

Variable name: PLNPAY_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know and were enrolled in a private health
plan where a plan name was given or refused or don't know.
Question Text:

Response:

Who pays for this health insurance plan?
commas.

1.
2.
3.
4.
5.
6.
DK:
RF:

Enter all that apply, separate with

^SCNAME or family (living in the household)
Employer or union
Someone outside the household
Medicare
Medicaid
Other government program
Don't Know
Refused

Skip Instructions: <1-6,RF,DK> if 1 IN PLNPAY_C [goto HICOSTN_C]
else [goto PRDEDUC_C]

Question ID: INS.0400.01.1

Variable name: HICOSTN_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: 1 IN PLNPAY_C
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know who paid for by self or family
Question Text:

Response:

?[F1] How much does ^SCNAME's family currently spend for health insurance
premiums for ^FIRSTPLANC? Please include payroll deductions for premiums.

DK:
RF:

Don't Know
Refused
Page 111 of 334

Fills:

^FIRSTPLANC

If PlanNum = 1 then
if
HIPNAM1_C
IN
(RF,DK)
AND
HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <20000-99995> [goto ERR1_HICOSTN_C]
<1-19999> [goto HICOSTT_C]
 [goto PRDEDUC_C]

Check Name: ERR1_HICOSTN_C

Text:

{signal ERR1_HICOSTN_C} [^HICOSTN_C] is unusually high. Please verify. Make
corrections if necessary.

Hard / Soft Edit: Soft
Fills:

^HICOSTN_C

Fill value from Child.INS.HICOSTN_C

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: if HICOSTN_C GE 20000

Page 112 of 334

Question ID: INS.0400.02.1

Variable name: HICOSTT_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: HICOSTN_C IN (1-99995)
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know who gave a premium amount.
Question Text:

?[F1]

Response:

1.
2.
3.
4.
5.
6.
7.
8.
DK:
RF:

Enter time period for premium payments.

Once a week
Once every 2 weeks
Once a month
Twice a month
Every two months
Quarterly (every 3 months)
Once a year
Twice a year
Don't Know
Refused

Skip Instructions: <1-8,RF,DK> [goto PRDEDUC_C]

Question ID: INS.0410.00.1

Variable name: PRDEDUC_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance plans where a plan name
was given or refused or don't know.
Question Text:

?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does this health plan have an annual deductible? Read if necessary: A
deductible is different from a copay (copayment).

Response:

Page 113 of 334

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Skip Instructions: <1> [goto PRHDHP_C]
<2,RF,DK> [goto INTROCOV_C]

Question ID: INS.0420.00.1

Variable name: PRHDHP_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: PRDEDUC_C=1
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know with a deductible.
Question Text:

Response:

Fills:

?[F1] Is the ^FAM_C annual deductible for medical care for this plan less than
^HDHPAMT_C, or ^HDHPAMT_C or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.

1.
2.
DK:
RF:

Less than ^HDHPAMT_C
^HDHPAMT_C or more
Don't Know
Refused

^HDHPAMT_C

if
POLHLD_C=2
"^HDHPDED_family"
Else fill"^HDHPDED"

^FAM_C

if POLHLD_C=2 or PRPLCOV_C=1, fill 'family'.
Else no fill.

Page 114 of 334

or

PRPLCOV_C=1,

fill

Skip Instructions: <1> [goto INTROCOV_C]
<2,RF,DK> [goto HSAHRA_C]

Question ID: INS.0430.00.1

Variable name: HSAHRA_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe: PRHDHP_C=2,RF,DK
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know with a high deductible
Question Text:

Response:

There are special accounts or funds that can be used to pay for medical
expenses, sometimes referred to as Health Savings Accounts or HSAs, Health
Reimbursement Accounts or HRAs, Personal Care accounts, Personal Medical
funds, or Choice funds. These are DIFFERENT from Flexible Spending
Accounts or FSAs. Is there one of these accounts or funds with this plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Skip Instructions: <1,2,RF,DK> [goto INTROCOV_C]

Question ID: INS.0435.00.1

Variable name: INTROCOV_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know
Question Text:

The next three questions are about services ^FIRSTPLANC may cover. Enter
'1' to continue.

Response:

Page 115 of 334

1.
Fills:

Enter 1 to Continue

^FIRSTPLANC

If PlanNum = 1 then
if
HIPNAM1_C
IN
(RF,DK)
AND
HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

Skip Instructions: <1> [goto PRRXCOV_C]

Question ID: INS.0440.00.1

Variable name: PRRXCOV_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance coverage where the name
of the plan was given or refused or don't know.
Question Text:

Response:

Fills:

Does ^FIRSTPLANC pay for any of the costs for medications prescribed by a
doctor? Read if necessary: Even if ^SCNAME has not used this benefit, please
answer if this plan would cover at least some of the costs if ^SCNAME were
prescribed medications.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^FIRSTPLANC

If PlanNum = 1 then
if
HIPNAM1_C
IN
(RF,DK)
AND
HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 116 of 334

Skip Instructions: <1,2,RF,DK> [goto PRDNCOV_C]

Question ID: INS.0450.00.1

Variable name: PRDNCOV_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance coverage where the plan
name was given or refused or don't know.
Question Text:

Response:

Fills:

Does ^FIRSTPLANC pay for any of the costs for dental care? Read if
necessary: Even if ^SCNAME has not used this benefit, please answer if this plan
would cover at least some of the costs if ^SCNAME did have dental care.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^FIRSTPLANC

If PlanNum = 1 then
if
HIPNAM1_C
IN
(RF,DK)
AND
HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto PRVSCOV_C]

Page 117 of 334

Question ID: INS.0460.00.1

Variable name: PRVSCOV_C

Interview module: INS(Child.INS.bPlan)

Inherited Universe: (HIPNAM1_C NE empty or HIPNAM2_C NE empty) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(HIPNAM1_C NE empty or HIPNAM2_C NE empty))
Universe Description: Sample Children 0-17 with private health insurance coverage where a plan
name was given or refused or don't know.
Question Text:

Response:

Fills:

Does ^FIRSTPLANC pay for any of the costs for routine vision care, such as
glasses and contact lenses? Read if necessary: Even if ^SCNAME has not used
this benefit, please answer if this plan would cover at least some of the costs if
^SCNAME did have vision care.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^FIRSTPLANC

If PlanNum = 1 then
if
HIPNAM1_C
IN
(RF,DK)
AND
HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> If there is another plan [goto bPlan for next plan]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Page 118 of 334

Question ID: INS.0470.00.1

Variable name: CHNAME_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 05 IN HIKIND_C
Universe Description: Sample Children 0-17 with a CHIP plan
Question Text:

Response:

Fills:

?[F1] Earlier I recorded that ^SCNAME is covered by the Children's Health
Insurance Program or CHIP. What is the name of the plan?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto CHXCHNG_C]

Question ID: INS.0480.00.1

Variable name: CHXCHNG_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 05 IN HIKIND_C
Universe Description: Sample Children 0-17 with a CHIP plan
Question Text:

Response:

?[F1] Was ^SCNAME's CHIP plan obtained through Healthcare.gov or the
^MARKETPLACE?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 119 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"

Page 120 of 334

Skip Instructions: <1,2,RF,DK> [goto CHPREM_C]

Question ID: INS.0490.00.1

Variable name: CHPREM_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 05 IN HIKIND_C
Universe Description: Sample Children 0-17 with a CHIP plan
Question Text:

Response:

Fills:

?[F1] A health insurance premium is the amount ^SCNAME or a family member
pays each month for health care coverage. Does ^SCNAME or a family member
pay a premium for this CHIP plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto CHDEDUC_C]

Question ID: INS.0500.00.1

Variable name: CHDEDUC_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 5 IN HIKIND_C
Universe Description: Sample Children 0-17 with a CHIP plan
Question Text:

?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does ^SCNAME's CHIP plan have an annual deductible? Read if necessary: A
deductible is different from a copay (copayment).

Response:

Page 121 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto CHHDHP_C]
<2,RF,DK> if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0510.00.1

Variable name: CHHDHP_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 5 IN HIKIND_C and CHDEDUC_C=1
Universe Description: Sample Children with a CHIP plan who have a deductible
Question Text:

Response:

Fills:

?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.

1.
2.
DK:
RF:

Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused

^HDHPDED

Fill: $1,400

Page 122 of 334

Skip Instructions: <1,2,RF,DK> if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0520.00.1

Variable name: OPNAME_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 8 IN HIKIND_C
Universe Description: Sample Children 0-17 with a state-sponsored plan
Question Text:

Response:

Fills:

?[F1] Earlier I recorded that ^SCNAME is covered by a state-sponsored plan.
What is the name of the plan?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto OPXCHNG_C]

Question ID: INS.0530.00.1

Variable name: OPXCHNG_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 8 IN HIKIND_C
Universe Description: Sample Children 0-17 with a state-sponsored plan
Question Text:

?[F1] Was ^SCNAME's state-sponsored plan obtained through Healthcare.gov
or the ^MARKETPLACE?

Response:

Page 123 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"

Page 124 of 334

Skip Instructions: <1,2,RF,DK> [goto OPPREM_C]

Question ID: INS.0540.00.1

Variable name: OPPREM_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 8 IN HIKIND_C
Universe Description: Sample Children 0-17 with a state-sponsored plan
Question Text:

Response:

Fills:

?[F1] A health insurance premium is the amount ^SCNAME or a family member
pays each month for health care coverage. Does ^SCNAME or a family member
pay a premium for this state-sponsored plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto OPDEDUC_C]

Question ID: INS.0550.00.1

Variable name: OPDEDUC_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 8 IN HIKIND_C
Universe Description: Sample Children 0-17 with a state-sponsored plan
Question Text:

?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does ^SCNAME's state-sponsored plan have an annual deductible? Read if
necessary: A deductible is different from a copay (copayment).

Response:

Page 125 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1>[goto OPHDHP_C]
<2,RF,DK> if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0560.00.1

Variable name: OPHDHP_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 8 IN HIKIND_C and OPDEDUC_C=1
Universe Description: Sample Children 0-17 with a state-sponsored plan with a deductible
Question Text:

Response:

Fills:

?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.

1.
2.
DK:
RF:

Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused

^HDHPDED

Fill: $1,400

Skip Instructions: <1,2,RF,DK> if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Page 126 of 334

Question ID: INS.0570.00.1

Variable name: OGNAME_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 9 IN HIKIND_C
Universe Description: Sample Children 0-17 who have an other government plan
Question Text:

Response:

Fills:

?[F1] Earlier I recorded that ^SCNAME is covered by an other government
program. What is the name of the plan?

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions:  [goto OGXCHNG_C]

Question ID: INS.0580.00.1

Variable name: OGXCHNG_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 9 IN HIKIND_C
Universe Description: Sample Children 0-17 who have an other government plan
Question Text:

Response:

?[F1] Was ^SCNAME's other government plan obtained through Healthcare.gov
or the ^MARKETPLACE?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 127 of 334

Fills:

^MARKETPLACE

If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 128 of 334

Skip Instructions: <1,2,RF,DK> [goto OGPREM_C]

Question ID: INS.0590.00.1

Variable name: OGPREM_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 9 IN HIKIND_C
Universe Description: Sample Children 0-17 who have an other government plan
Question Text:

Response:

Fills:

?[F1] A health insurance premium is the amount ^SCNAME or a family member
pays each month for health care coverage. Does ^SCNAME or a family member
pay a premium for this other government plan?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto OGDEDUC_C]

Question ID: INS.0600.00.1

Variable name: OGDEDUC_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 9 IN HIKIND_C
Universe Description: Sample Children 0-17 with an other government plan
Question Text:

?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does ^SCNAME's other government plan have an annual deductible? Read if
necessary: A deductible is different from a copay (copayment).

Response:

Page 129 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto OGHDHP_C]
<2,RF,DK> if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0610.00.1

Variable name: OGHDHP_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 9 IN HIKIND_C and OGDEDUC_C=1
Universe Description: Sample Children 0-17 with an other government plan with a deductible
Question Text:

Response:

Fills:

?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.

1.
2.
DK:
RF:

Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused

^HDHPDED

Fill: $1,400

Skip Instructions: <1,2,RF,DK> if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Page 130 of 334

Question ID: INS.0620.00.1

Variable name: MILSPC_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 6 IN HIKIND_C
Universe Description: Sample Children 0-17 with military related health care
Question Text:

Response:

Fills:

?[F1] Earlier I recorded that ^SCNAME is covered by military related health
care. What types of military related health care ^areisSEX_C ^heshe_C covered
by?
Enter all that apply, separate with commas.

2.
3.
DK:
RF:

TRICARE (CHAMPUS)
CHAMP-VA (do not include CHAMPUS)
Don't Know
Refused

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

^SCNAME

Fill ALIAS of HHSTAT_C=1

^areisSEX_C

if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is"
elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"

Skip Instructions: <2-3,RF,DK> [goto HINOTYR_C]

Page 131 of 334

Question ID: INS.0630.00.1

Variable name: HILAST_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and MCAIDPRB_C IN (2,RF,DK)
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe.
Question Text:

Response:

Fills:

How long has it been since ^SCNAME last had health care coverage that paid
for doctor's visits or hospital stays?

0.
1.
2.
3.
4.
5.
6.
DK:
RF:

Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto HILASTMY_C]
<2,3> [goto HISTOPJOB_C]
<4,5,6,0,RF,DK> [goto RSNHICOST_C]

Page 132 of 334

Check Name: ERR1_HILAST_C

Text:

{check ERR1_HILAST_C} Years since last health coverage exceedchild's age.
Please correct.

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (AGE_FINAL = 0 and HILAST_C in (2,3,4,5,6)) or
(AGE_FINAL = 1 and HILAST_C in (3,4,5,6)) or
(AGE_FINAL = 2 and HILAST_C in (4,5,6)) or
(AGE_FINAL in (3,4) and HILAST_C in (5,6)) or
(AGE_FINAL in (5,6,7,8,9) and HILAST_C in (6))

Question ID: INS.0640.00.1

Variable name: HILASTMY_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HILAST_C=1
Universe Description: Sample Children 0-17 without known health insurance who last had insurance
at some time within the last 12 months
Question Text:

Response:

Fills:

In the past 12 months, how many months was ^SCNAME without coverage?
If less than 1 month, enter '1'.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 133 of 334

Skip Instructions: <1-12,RF,DK> [goto HISTOPJOB_C]

Question ID: INS.0650.00.1

Variable name: HISTOPJOB_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HILAST_C IN (1,2,3)
Universe Description: Sample Children 0-17 who have been uninsured for less than 3 years
Question Text:

Response:

Fills:

?[F1] Think about the last time that ^SCNAME did have health care coverage. I
am going to read a list of reasons why someone might no longer be enrolled in
coverage. Please tell me, yes or no, if this is a reason why ^SCNAME is no
longer enrolled in ^hisher_C last health care plan. The policyholder retired,
lost a job, or changed employer?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1,2,RF,DK> [goto HISTOPMISS_C]

Page 134 of 334

Question ID: INS.0660.00.1

Variable name: HISTOPMISS_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HILAST_C IN (1,2,3)
Universe Description: Sample Children 0-17 who have been uninsured for less than 3 years
Question Text:

Response:

Fills:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan
because... A deadline was missed for signing up or paying for ^hisher_C
coverage?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1,2,RF,DK> [goto HISTOPAGE_C]

Question ID: INS.0670.00.1

Variable name: HISTOPAGE_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HILAST_C IN (1,2,3)
Universe Description: Sample Children 0-17 who have been uninsured for less than 3 years
Question Text:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan
because... ^HeShe_C became ineligible because of ^hisher_C age or because
^heshe_C left school?

Response:

Page 135 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^HeShe_C

If SEX_FINAL_C=1 fill "He"
else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C=blank: fill "They"

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1,2,RF,DK> [goto HISTOPCOST_C]

Question ID: INS.0680.00.1

Variable name: HISTOPCOST_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HILAST_C IN (1,2,3)
Universe Description: Sample Children 0-17 who have been uninsured for less than 3 years
Question Text:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan
because... The cost for the coverage increased?

Response:

Page 136 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1,2,RF,DK> [goto HISTOPELIG_C]

Question ID: INS.0690.00.1

Variable name: HISTOPELIG_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HILAST_C IN (1,2,3)
Universe Description: Sample Children 0-17 who have been uninsured for less than 3 years
Question Text:

Response:

Fills:

?[F1] Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health
care plan because... ^HeShe_C had Medicaid, CHIP, or other public coverage,
but ^werewas_C no longer eligible?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^HeShe_C

If SEX_FINAL_C=1 fill "He"
else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C=blank: fill "They"

^werewas_C

If SEX_FINAL_C=1,2 fill "was"
else if SEX_FINAL_C=DK, RF fill "were"
Page 137 of 334

Skip Instructions: <1,2,RF,DK> [goto RSNHICOST_C]

Question ID: INS.0700.00.1

Variable name: RSNHICOST_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK))
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe.
Question Text:

Response:

Fills:

^INSREASONS_C Is ^SCNAME currently uninsured because coverage is not
affordable?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^INSREASONS_C

If HILAST_C=0,4,5,6,RF,DK, fill: "There are many
reasons why people do not have health insurance
coverage."
If HILAST_C=1,2,3, fill: "We just discussed reasons
you lost coverage, now I am going to ask you some
questions about why ^SCNAME hasn't obtained
coverage."

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto RSNHIWANT_C]

Page 138 of 334

Question ID: INS.0710.00.1

Variable name: RSNHIWANT_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK))
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe.
Question Text:

Response:

Fills:

There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because... ...your family does not
need or want coverage for ^SCNAME?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^PLUSCOSTC

if REASNHICOST_C = 1 then fill "In addition to cost,
is"
Else fill "Is"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto RSNHIELIG_C]

Question ID: INS.0720.00.1

Variable name: RSNHIELIG_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK))
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe
Question Text:

Read if necessary: There are other reasons that people do not have health insurance
coverage. ^PLUSCOSTC ^SCNAME currently uninsured because... ...^heshe_C
^areisSEX_C not eligible for coverage?

Response:

Page 139 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^PLUSCOSTC

if REASNHICOST_C = 1 then fill "In addition to cost,
is"
Else fill "Is"

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

^areisSEX_C

if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is"
elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"

Skip Instructions: <1,2,RF,DK> [goto RSNHICONF_C]

Question ID: INS.0730.00.1

Variable name: RSNHICONF_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK) )
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe
Question Text:

Read if necessary: There are other reasons that people do not have health insurance
coverage. ^PLUSCOSTC ^SCNAME currently uninsured because... ...the process
of signing up for coverage for ^SCNAME is too difficult or confusing?

Response:

Page 140 of 334

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^PLUSCOSTC

if REASNHICOST_C = 1 then fill "In addition to cost,
is"
Else fill "Is"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto RSNHIMEET_C]

Question ID: INS.0740.00.1

Variable name: RSNHIMEET_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK))
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe
Question Text:

Response:

Fills:

Read if necessary: There are other reasons that people do not have health insurance
coverage. ^PLUSCOSTC ^SCNAME currently uninsured because... ...your family
cannot find a plan that meets ^SCNAME's needs?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^PLUSCOSTC

if REASNHICOST_C = 1 then fill "In addition to cost,
is"
Else fill "Is"

Page 141 of 334

Skip Instructions: <1,2,RF,DK> [goto RSNHIWAIT_C]

Question ID: INS.0750.00.1

Variable name: RSNHIWAIT_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK))
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe
Question Text:

Response:

Fills:

Read if necessary: There are other reasons that people do not have health insurance
coverage. ^PLUSCOSTC ^SCNAME currently uninsured because... ...you applied
for coverage for ^SCNAME but it has not started yet?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^PLUSCOSTC

if REASNHICOST_C = 1 then fill "In addition to cost,
is"
Else fill "Is"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto RSNHIOTH_C]

Page 142 of 334

Question ID: INS.0760.00.1

Variable name: RSNHIOTH_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: 10 IN HIKIND_C and (MCAIDPRB_C IN (2,RF,DK))
Universe Description: Sample Children 0-17 without known health insurance and answered no,
refused or don't know to the Medicaid probe
Question Text:

Response:

Fills:

Is there another reason that ^SCNAME currently does not have health
insurance coverage?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto RSNHIOTHSP_C]
<2,RF,DK> [goto FINISH_C]

Question ID: INS.0770.00.1

Variable name: RSNHIOTHSP_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: RSNHIOTH_C=1
Universe Description: Sample Children 0-17 who have another reason for not having coverage
Question Text:

Response:

What is the other reason for not having coverage?

DK:
RF:

Don't Know
Refused

Page 143 of 334

Skip Instructions:  [goto FINISH_C]

Question ID: INS.0780.00.1

Variable name: HINOTYR_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HIKIND_C IN (1-9) or MCAIDPRB_C=1
Universe Description: Sample Children 0-17 with known health insurance coverage or responded
yes to the medicaid probe
Question Text:

Response:

Fills:

In the past 12 months, was there any time when ^SCNAME did NOT have ANY
health insurance or coverage?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto HINOTMYR_C]
<2,RF,DK> [goto FINISH_C]

Question ID: INS.0790.00.1

Variable name: HINOTMYR_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: HIKIND_C IN (1-9) or (MCAIDPRB_C=1) and HINOTYR_C=1
Universe Description: Sample Children 0-17 with known health insurance coverage and did not have
health insurance for some period of time in the past 12 months
Question Text:

Response:

In the past 12 months, about how many months was ^SCNAME without
coverage?
If less than 1 month, enter '1'.

DK:
RF:

Don't Know
Refused

Page 144 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-12,RF,DK> [goto FINISH_C]

Question ID: INS.0800.00.1

Variable name: FINISH_C

Interview module: INS(Child.INS)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

The Sample Child health insurance section is now complete.

1.

Enter '1' to continue.

Enter 1 to Continue

Skip Instructions: <1> [goto next section]

Question ID: PAY.0010.00.1

Variable name: PAYINTRO_C

Interview module: PAY(Child.PAY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (SAMEFAM_FLG=1 and PAY_FLG_A=blank) or (SAMEFAM_FLG=1 and
PAY_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)
Universe Description: Sample Children 0-17 living in same family as the Sample Adult when the PAY
section of the Sample Adult has not been completed
or Sample Children living in same family as Sample Adult when the Sample
Child respondent is not the Sample Adult and the Sample Adult answered
don't or refused to PAYBLL12M_A and PAYNOBLLNW_A
or Sample children living in different families than the Sample Adult.
Question Text:

?[F1] Now I am going to ask you about your family's medical bills. Include bills
for doctors, dentists, hospitals, therapists, medication, equipment, and nursing
home or home care. Enter '1' to continue.

Response:

Page 145 of 334

1.

Enter 1 to Continue

Skip Instructions: <1> [goto PAYBILL12M_C]

Question ID: PAY.0020.00.1

Variable name: PAYBLL12M_C

Interview module: PAY(Child.PAY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (SAMEFAM_FLG=1 and PAY_FLG_A=blank) or (SAMEFAM_FLG=1 and
PAY_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)
Universe Description: Sample Children 0-17 living in same family as the Sample Adult when the PAY
section of the Sample Adult has not been completed
or Sample Children living in same family as Sample Adult when the Sample
Child respondent is not the Sample Adult and the Sample Adult answered
don't or refused to PAYBILL12M_A and PAYNOBLLNW_A
or Sample children living in different families than the Sample Adult.
Question Text:

Response:

?[F1] In the past 12 months, did anyone in your family have problems paying or
were unable to pay any medical bills? Read if necessary: Include bills for
doctors, dentists, hospitals, therapists, medication, equipment, nursing home or home
care.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Skip Instructions: <1,RF,DK> [goto PAYNOBLLNW_C]
<2> [goto PAYWORRY_C]

Page 146 of 334

Question ID: PAY.0030.00.1

Variable name: PAYNOBLLNW_C

Interview module: PAY(Child.PAY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: ((SAMEFAM_FLG=1 and PAY_FLG_A=blank) or (SAMEFAM_FLG=1 and
PAY_FLG_A=2 and SARESPSC_FLG ne 1)) or ((SAMEFAM_FLG ne 1) and
PAYBLL12M_C IN (1,RF,DK))
Universe Description: Sample Children 0-17 who said someone in their family had trouble paying
bills and Sample Adult and Sample Child are in the same family and Sample
Adult PAY section has not been completed OR the Sample Child and Sample
Adult are not in the same family AND said anyone in their family had problems
paying medical bills in the past 12 months or refused or didn't know if they had
problems paying medical bills.
Question Text:

Response:

Does anyone in your family currently have any medical bills that you are unable
to pay at all?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Skip Instructions: <1,2,RF,DK> [goto PAYWORRY_C]

Question ID: PAY.0040.00.1

Variable name: PAYWORRY_C

Interview module: PAY(Child.PAY)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

If ^SCNAME gets sick or has an accident, how worried are you that your family
will be able to pay ^hisher_C medical bills? Are you very worried, somewhat
worried, or not at all worried?

Response:

Page 147 of 334

1.
2.
3.
DK:
RF:
Fills:

Very worried
Somewhat worried
Not at all worried
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1-3,RF,DK> [goto next section]

Page 148 of 334

Question ID: CVL.0010.00.3

Variable name: CVDINTRO_C

Interview module: CVL(2023 Future Content.Child.CVL)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

The next set of questions are about coronavirus or COVID-19.
continue.

1.

Enter '1' to

Enter 1 to Continue

Skip Instructions: <1> [goto CVDDIAG_C]

Question ID: CVL.0020.00.3

Variable name: EVERCOVD_C

Interview module: CVL(2023 Future Content.Child.CVL)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

Has ^SCNAME ever had COVID-19? Read if necessary: Include being told by a
doctor that you had or likely had COVID-19. Also include antibodies or blood tests as
well as other forms of testing for COVID-19, such as a nasal swabbing or throat
swabbing. Also include if you had close contact with someone who had COVID-19
and you had symptoms.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Page 1 of 4

Skip Instructions: <1> [goto LONGCOVD1_C]
<2,RF,DK> [goto next section]

Question ID: CVL.0030.00.3

Variable name: LONGCOVD1_C

Interview module: CVL(2023 Future Content.Child.CVL)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: EVERCOVD_C=1
Universe Description: Sample Children 0-17 who have ever had COVID-19
Question Text:

Response:

Fills:

Did ^SCNAME have any symptoms lasting 3 months or longer that ^heshe_C
did not have prior to having coronavirus or COVID-19? Read if necessary:
Long term symptoms may include tiredness or fatigue, difficulty thinking,
concentrating, forgetfulness or memory problems, sometimes referred to as "brain
fog," difficulty breathing or shortness of breath, joint or muscle pain, fast-beating or
pounding heart (also known as heart palpitations), chest pain, dizziness on standing,
menstrual changes, changes to taste/smell, and inability to exercise.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

Skip Instructions: <1,2,RF,DK> [goto SYMPNOW1_C]

Page 2 of 4

Question ID: CVL.0040.00.3

Variable name: SYMPNOW1_C

Interview module: CVL(2023 Future Content.Child.CVL)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: LONGCOVD1_C=1
Universe Description: Sample Children 0-17 who have ever had COVID-19 and had symptoms
lasting 3 months or longer
Question Text:

Response:

Fills:

Does ^SCNAME have symptoms NOW?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> if LONGCOVD1_C=1 [goto LCVDACT_C]
else [goto next section]

Question ID: CVL.0050.00.3

Variable name: LCVDACT_C

Interview module: CVL(2023 Future Content.Child.CVL)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: LONGCOVD1_C=1 and SYMPNOW1_C=1
Universe Description: Sample Children 0-17 with COVID-19 symptoms lasting 3 months or longer
that they did not have prior to having coronavirus or COVID-19 and they have
symptoms now
Question Text:

How much do these long-term symptoms reduce ^SCNAME's ability to carry
out day-to-day activities compared with the time before ^SCNAME had
COVID-19? Would you say... Read categories below.

Response:

Page 3 of 4

1.
2.
3.
4.
DK:
RF:
Fills:

Not at all
A little
A lot
Somewhere in between a little or a lot
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-4,RF,DK> [goto next section]

Page 4 of 4

Question ID: DNC.0010.00.2

Variable name: DNCINTRO_C

Interview module: DNC(Child.DNC)

Inherited Universe: (GEN.AGE_FINAL[PX_C]=1-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=1-17))
Universe Description: Sample children 1-17
Question Text:

These next questions ask about ^SCNAME's dental care.

Response:

Page 152 of 334

Enter '1' to continue.

1.
Fills:

Enter 1 to Continue

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto DENPREV_C]

Question ID: DNC.0020.00.2

Variable name: DENPREV_C

Interview module: DNC(Child.DNC)

Inherited Universe: (GEN.AGE_FINAL[PX_C]=1-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=1-17))
Universe Description: Sample Children 1-17
Question Text:

Response:

Fills:

About how long has it been since ^SCNAME last had a dental examination or
cleaning? Read if necessary: Include cleanings from all types of dental care
providers such as dentists, orthodontists, oral surgeons, dental hygienists, and all
other dental specialists.

0.
1.
2.
3.
4.
5.
6.
DK:
RF:

Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <0-6,RF,DK> [goto DENDL12M_C]

Page 153 of 334

Check Name: ERR1_DENPREV_C

Text:

{check ERR1_DENPREV_C} Years since last dental cleaning exceedchild's age.
Please correct.

Hard / Soft Edit: Hard
Inherited Universe: (GEN.AGE_FINAL[PX_C]=1-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=1-17))
Universe: (AGE_FINAL = 0 and DENPREV_C in (2,3,4,5,6)) or
(AGE_FINAL = 1 and DENPREV_C in (3,4,5,6)) or
(AGE_FINAL = 2 and DENPREV_C in (4,5,6)) or
(AGE_FINAL in (3,4) and DENPREV_C in (5,6)) or
(AGE_FINAL in (5,6,7,8,9) and DENPREV_C in (6))

Question ID: DNC.0030.00.2

Variable name: DENDL12M_C

Interview module: DNC(Child.DNC)

Inherited Universe: (GEN.AGE_FINAL[PX_C]=1-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=1-17))
Universe Description: Sample Children 1-17
Question Text:

Response:

During the past 12 months, has ^SCNAME been DELAYED in getting dental
care because of the cost?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

Page 154 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto DENNG12M_C]

Question ID: DNC.0040.00.2

Variable name: DENNG12M_C

Interview module: DNC(Child.DNC)

Inherited Universe: (GEN.AGE_FINAL[PX_C]=1-17) AND
((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND
(GEN.AGE_FINAL[PX_C]=1-17))
Universe Description: Sample Children 1-17
Question Text:

Response:

Fills:

During the past 12 months, was there any time when ^SCNAME needed dental
care, but DID NOT GET IT because of the cost?

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto next section]

Question ID: UTZ.0010.00.1

Variable name: UTZINTRO_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

^UTZINTRO2_C

Enter '1' to continue.

Response:

Page 155 of 334

1.
Fills:

Enter 1 to Continue

^UTZINTRO2_C

If AGE LT 1 fill "I would like to ask you about
^SCNAME's health care." else fill "Now, I would like
to ask you about ^SCNAME's health care, not
including dental care."

Skip Instructions: <1> [goto LASTDR_C]

Question ID: UTZ.0020.00.1

Variable name: LASTDR_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

About how long has it been since ^SCNAME last saw a doctor or other health
professional about ^hisher_C health? Read if necessary: Include doctors seen
while a patient in a hospital. Read if necessary: Do not include dental care.

0.
1.
2.
3.
4.
5.
6.
DK:
RF:

Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Page 156 of 334

Skip Instructions: <1-6> if GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 11
[goto WELLNESS_C]
<1-6> if GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 17
[goto TIMEALONE_C]
<0,RF,DK> [goto USUALPL_C]

Check Name: ERR1_LASTDR_C

Text:

{check ERR1_LASTDR_C} Years since last saw a doctor exceedchild's age. Please
correct.

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (AGE_FINAL = 0 and LASTDR_C in (2,3,4,5,6)) or
(AGE_FINAL = 1 and LASTDR_C in (3,4,5,6)) or
(AGE_FINAL = 2 and LASTDR_C in (4,5,6)) or
(AGE_FINAL in (3,4) and LASTDR_C in (5,6)) or
(AGE_FINAL in (5,6,7,8,9) and LASTDR_C in (6))

Page 157 of 334

Question ID: UTZ.0040.00.1

Variable name: WELLNESS_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: LASTDR_C in (1,2,3,4,5,6)
Universe Description: Sample Children 0-17 who have seen a doctor
Question Text:

Response:

Fills:

Was this a well ^babychild visit, physical, or general purpose check-up?
Read if necessary: This kind of visit typically includes: height and weight
measurements, vaccinations, and vision or hearing checks. The doctor or other
health professional may also discuss topics related to ^SCNAME's health such as
^hisher_C growth and development, diet and exercise, safety, and sleep patterns.
These visits are usually scheduled in advance and occur when ^hesheistheyare_C
not sick. Read if necessary: If a wellness exam was combined with a sick care visit,
include this visit. Read if necessary: An obstetrician/gynecologist (OB/GYN) may
perform this visit.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^babychild

If AGE LE 2 fill "baby";
else if AGE GE 3 or AGE IN ('DK','RF') fill "child"

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^hesheistheyare_C

If SEX_FINAL_C=1 fill: "he is"
If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C=blank fill: "they are"
Page 158 of 334

Skip Instructions: <1> [goto USUALPL_C]
<2,RF,DK> [goto WELLVIS_C]

Question ID: UTZ.0050.00.1

Variable name: WELLVIS_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: WELLNESS_C IN (2,RF,DK)
Universe Description: Sample Children 0-17 were reported to have seen a doctor, but the last visit
was not a wellness visit or they didn't know or refused whether it was a
wellness visit
Question Text:

Response:

About how long has it been since ^SCNAME last saw a doctor or other health
professional for a well ^babychild visit, physical, or general purpose check-up?
Read if necessary: This kind of visit typically includes: height and weight
measurements, vaccinations, and vision or hearing checks. The doctor or other
health professional may also discuss topics related to ^SCNAME's health such as
^hisher_C growth and development, diet and exercise, safety, and sleep patterns.
These visits are usually scheduled in advance and occur when ^hesheistheyare_C
not sick. Read if necessary: If a wellness exam was combined with a sick care visit,
include this visit. Read if necessary: An obstetrician/gynecologist (OB/GYN) may
perform this visit.

0.
1.
2.
3.
4.
5.
6.
DK:
RF:

Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused

Page 159 of 334

Fills:

^SCNAME

Fill ALIAS of HHSTAT_C=1

^babychild

If AGE LE 2 fill "baby";
else if AGE GE 3 or AGE IN ('DK','RF') fill "child"

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^hesheistheyare_C

If SEX_FINAL_C=1 fill: "he is"
If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C=blank fill: "they are"

Skip Instructions: <0,RF,DK> [goto USUALPL_C]
<1-6> if 0<=GEN.AGE_FINAL<=11 [goto USUALPL_C]
<1-6> if 12<=GEN.AGE_FINAL<=17 [goto PTIMEALONE_C]

Check Name: ERR1_WELLVIS_C

Text:

{check ERR1_WELLVIS_C} Years since wellness visit exceedchild's age. Please
correct.

Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: (AGE_FINAL = 0 and WELLVIS_C in (2,3,4,5,6)) or
(AGE_FINAL = 1 and WELLVIS_C in (3,4,5,6)) or
(AGE_FINAL = 2 and WELLVIS_C in (4,5,6)) or
(AGE_FINAL in (3,4) and WELLVIS_C in (5,6)) or
(AGE_FINAL in (5,6,7,8,9) and WELLVIS_C in (6))

Page 160 of 334

Question ID: UTZ.0080.00.1

Variable name: USUALPL_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Is there a place that ^SCNAME USUALLY goes to if ^hesheistheyare_C sick
and needs health care?

1.

Yes

Page 161 of 334

2.
3.
DK:
RF:
Fills:

There is NO place
There is MORE THAN ONE place
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hesheistheyare_C

If SEX_FINAL_C=1 fill: "he is"
If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C=blank fill: "they are"

Skip Instructions: <1,3,RF,DK> [goto USPLKIND_C]
<2> If GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 17
[goto PERSDOC_C]
Else if GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 11 [goto
URGENT12M_C]

Question ID: UTZ.0090.00.1

Variable name: USPLKIND_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: USUALPL_C IN (1,3,RF,DK)
Universe Description: Sample Children 0-17 with 1+ usual place of care or who don't know or
refused to answer if they have a usual place of care
Question Text:

What kind of place ^isitgomostoften - a doctor's office or health center; an
urgent care center, a clinic in a drug store or grocery store; a hospital
emergency room; or some other place? Read if necessary: A doctor's office or
health center is a place where ^heshe_C see^s the same doctor or the same group of
doctors every visit, where you usually need to make an appointment ahead of time,
and where ^hisher_C medical records are on file. Read if necessary: Urgent care
centers, and clinics in a drug store or grocery store are places where you do not need
to make an appointment ahead of time, and do not usually see the same health care
provider at each visit.

Response:

Page 162 of 334

1.
2.
3.
4.
5.
DK:
RF:
Fills:

A doctor's office or health center
Urgent care center or clinic in a drug store or grocery store
Hospital emergency room
Some other place
Does not go to one place most often
Don't Know
Refused

^isitgomostoften

If USUALPL_C=1, fill: "is it"
else fill: "^doesheshedothey go to most often"

^SCNAME

Fill ALIAS of HHSTAT_C=1

^heshe_C

If GEN.SEX_FINAL[PX_C]=1 fill "he"
else if GEN.SEX_FINAL[PX_C]=2 fill "she"
else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they"

^s

if SEX_FINAL[PX_C]=1,2 fill "s"
else fill blank

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Skip Instructions: <1-5,RF,DK> if 0<=GEN.AGE_FINAL<=11 [goto URGENT12M_C]
<1-5,RF,DK> if 12<=GEN.AGE_FINAL<=17 [goto PERSDOC_C]

Page 163 of 334

Question ID: UTZ.0110.00.1

Variable name: URGENT12M_C

Interview module: UTZ(Child.UTZ)

Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe Description: Sample Children 0-17
Question Text:

Response:

Fills:

During the past 12 months, how many times has ^SCNAME gone to an urgent
care center or clinic in a drug store or grocery store about ^hisher_C health?
Enter '96' if number is 96 or greater. Read if necessary: Urgent care centers and
clinics in drug stores or grocery stores are places where you do not need to make an
appointment ahead of time, and do not usually see the same health care provider at
each visit. Read if necessary: This is different from a hospital emergency room.

DK:
RF:

Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Page 164 of 334

Skip Instructions: <0-39,RF,DK> [goto EMERGE12M_C]
<40-96> [goto ERR1_URGENT12M_C]

Check Name: ERR1_URGENT12M_C

Text:

{signal ERR1_URGENT12M_C} ^URGENT12M_C is an unusually large number.
Did ^SCNAME visit an urgent care center or clinic in a drug store or grocery
store about ^hishertheir health ^URGENT12M_C times in the past 12 months?
Please verify.

Hard / Soft Edit: Soft
Fills:

^URGENT12M_C

fill value from URGENT12M_C

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hishertheir

If
GEN.SEX_FINAL=1
fill
"his";
else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their" Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: URGENT12M_C=40-96 Universe Description: Sample child reported going to urgent care 40-96 times Page 165 of 334 Question ID: UTZ.0120.00.1 Variable name: EMERGE12M_C Interview module: UTZ(Child.UTZ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, how many times has ^SCNAME gone to a hospital emergency room about ^hisher_C health? Read if necessary: This includes emergency room visits that resulted in a hospital admission. Enter '96' if number is 96 or more. DK: RF: Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <0-39,RF,DK> if GEN.AGE_FINAL GE 001 [goto HOSPONGT_C] else [goto MEDDL12M_C] <40-96> [goto ERR1_EMERGE12M_C] Check Name: ERR1_EMERGE12M_C Text: {signal ERR1_EMERGE12M_C} ^EMERGE12M_C is an unusually large number. Did ^SCNAME visit a hospital emergency room about ^hishertheir health ^EMERGE12M_C times in the past 12 months? Please verify. Hard / Soft Edit: Soft Fills: ^EMERGE12M_C Fill value from Child.UTZ.EMERGE12M_C ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hishertheir If GEN.SEX_FINAL=1 fill "his";
else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their" Page 166 of 334 Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: EMERGE12M_C=40-96 Universe Description: Sample child reported going to ER 40-96 times Question ID: UTZ.0130.00.1 Variable name: HOSPONGT_C Interview module: UTZ(Child.UTZ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=1-17 Universe Description: Sample Children 1-17 Question Text: Response: Fills: During the past 12 months, has ^SCNAME been hospitalized overnight? ^PAST12MER_C 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^PAST12MER_C If ((EMERGE12M_C GE '01' and EMERGE12M_C LE '96') or EMERGE12M_C='RF','DK'): Fill: "Do not include an overnight stay in the emergency room." Skip Instructions: <1,2,RF,DK> [goto MEDDL12M_C] Page 167 of 334 Question ID: UTZ.0140.00.1 Variable name: MEDDL12M_C Interview module: UTZ(Child.UTZ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, has medical care BEEN DELAYED for ^SCNAME because of the cost? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto MEDNG12M_C] Question ID: UTZ.0150.00.1 Variable name: MEDNG12M_C Interview module: UTZ(Child.UTZ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: During the past 12 months, was there any time when ^SCNAME needed medical care, but DID NOT GET IT because of the cost? 1. 2. DK: RF: Yes No Don't Know Refused Page 168 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: TLH.0010.00.1 Variable name: VIRAPP12M_C Interview module: TLH(Child.TLH) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, has ^SCNAME had an appointment with a doctor, nurse, or other health professional by video or by phone? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: PMD.0010.00.1 Variable name: RX12M_C Interview module: PMD(Child.PMD) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: At any time in the past 12 months, did ^SCNAME take prescription medication? Response: Page 169 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto RXDL12M_C] <2,RF,DK> [goto RXDG12M_C] Question ID: PMD.0020.00.1 Variable name: RXDL12M_C Interview module: PMD(Child.PMD) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: RX12M_C=1 Universe Description: Sample Children 0-17 who have taken prescription medication in the past 12 months Question Text: Response: Fills: During the past 12 months, did you DELAY filling a prescription for ^SCNAME to save money? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto RXDG12M_C] Page 170 of 334 Question ID: PMD.0030.00.1 Variable name: RXDG12M_C Interview module: PMD(Child.PMD) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, was there any time when ^SCNAME needed prescription medication, but DID NOT GET IT because of the cost? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: IMM.0001.00.1 Variable name: FLUINTRO_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: There are currently vaccines available for seasonal influenza and coronavirus or COVID-19. I will first ask you questions about seasonal flu vaccination and then about coronavirus or COVID-19 vaccination. Enter '1' to continue. 1. Enter 1 to Continue Skip Instructions: <1> [goto SHTFLU12M_C] Page 171 of 334 Question ID: IMM.0010.00.1 Variable name: SHTFLU12M_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: There are two types of flu vaccinations. One is a shot and the other is a spray, mist, or drop in the nose. During the past 12 months, has ^SCNAME had a flu vaccination? Read if necessary: A flu vaccination is usually given in the fall and protects against influenza for the flu season. 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto SHTFLUNUM_C] <2,RF,DK> [goto next section] Question ID: IMM.0020.00.1 Variable name: SHTFLUNUM_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SHTFLU12M_C=1 Universe Description: Sample Children 0-17 who have had a flu shot in the past 12 months Question Text: During the past 12 months, how many flu vaccinations has ^SCNAME received? Response: Page 172 of 334 1. 2. DK: RF: Fills: 1 vaccination 2 or more vaccinations Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2> [goto FLUVAC1M_C] [goto next section] Question ID: IMM.0030.01.1 Variable name: FLUVAC1M_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SHTFLUNUM_C IN (1,2) Universe Description: Sample Children 0-17 who have had one or more shots in the past 12 months Question Text: Response: 1 of 2 During what month and year did ^SCNAME receive ^hisher_C most recent flu vaccine? Enter month of most recent flu vaccine. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. DK: RF: January February March April May June July August September October November December Don't Know Refused Page 173 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1-12,DK> [goto FLUVAC1Y_C] if SHTFLUNUM_C=2 [goto FLUVAC2M_C] else if SHTFLUNUM_C=1 [goto next section] Question ID: IMM.0030.02.1 Variable name: FLUVAC1Y_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC1M_C=1-12 or FLUVAC1M_C=DK) Universe Description: Sample Children 0-17 who have had one or more shots in the past 12 months and gave month/don't know month of flu shot Question Text: Response: 2 of 2 DK: RF: Enter year of most recent flu vaccine. Don't Know Refused Skip Instructions: and SHTFLUNUM_C = 2 FLUVAC2M_C] else [goto next section] if FLUVAC1M_C and FLUVAC1Y_C = a future date ERR1_FLUVAC1Y_C]; if FLUVAC1M_C and FLUVAC1Y_C = a date prior to birth ERR2_FLUVAC1Y_C]; if FLUVAC1M_C and FLUVAC1Y_C = a date prior to 12 months ago ERR3_FLUVAC1Y_C] Page 174 of 334 [goto [goto [goto [goto Check Name: ERR1_FLUVAC1Y_C Text: {check ERR1_FLUVAC1Y_C} Future date invalid Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC1Y_C gt current year) or (FLUVAC1Y_C=current year and FLUVAC1M_C gt current month) Universe Description: Date of first flu vaccine is in the future Check Name: ERR2_FLUVAC1Y_C Text: {check ERR2_FLUVAC1Y_C} Date prior to birth Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: FLUVAC1M_C and FLUVAC1Y_C = date prior to birth date Universe Description: Date of first flu vaccine is before sample child's birth date Check Name: ERR3_FLUVAC1Y_C Text: {check ERR3_FLUVAC1Y_C} Date before 12 months ago Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC1Y_C lt current year-1) or (FLUVAC1Y_C=current year-1 and FLUVAC1M_C lt current month) Universe Description: Date of first flu vaccine is prior to 12 months ago Page 175 of 334 Question ID: IMM.0040.01.1 Variable name: FLUVAC2M_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SHTFLUNUM_C=2 Universe Description: Sample Children 0-17 who have had two or more flu shots in the past 12 months Question Text: Response: Fills: 1 of 2 During what month and year did ^SCNAME receive the flu vaccine before that one? Enter month of the flu vaccine. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. DK: RF: January February March April May June July August September October November December Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-12,DK> [goto FLUVAC2Y_C] [goto next section] Page 176 of 334 Question ID: IMM.0040.02.1 Variable name: FLUVAC2Y_C Interview module: IMM(Child.IMM) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC2M_C=1-12 or FLUVAC2M_C=DK) Universe Description: Sample Children 0-17 who have had two or more flu shots and gave month/don't know month of 2nd vaccine dose Question Text: Response: 2 of 2 DK: RF: Enter year of next most recent flu vaccine. Don't Know Refused Skip Instructions: [goto next section] If FLUVAC2M_C and FLUVAC2Y_C = a date in the future [goto ERR1_FLUVAC2Y_C] If FLUVAC2M_C and FLUVAC2Y_C = a date prior to birth [goto ERR2_FLUVAC2Y_C] If FLUVAC2M_C and FLUVAC2Y_C = a date prior to 12 months ago [goto ERR3_FLUVAC2Y_C] If FLUVAC2M_C and FLUVAC2Y_C = a date more recent than answer given in (FLUVAC1M_C and FLUVA1Y_C) [goto ERR4_FLUVAC2Y_C] Check Name: ERR1_FLUVAC2Y_C Text: {check ERR1_FLUVAC2Y_C} Future date invalid Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC2Y_C gt current year) or (FLUVAC2Y_C=current year and FLUVAC2M_C gt current month) Universe Description: Date of second flu vaccine is in the future Page 177 of 334 Check Name: ERR2_FLUVAC2Y_C Text: {check ERR2_FLUVAC2Y_C} Date prior to birth Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: FLUVAC2M_C and FLUVAC2Y_C = a date prior to birth Universe Description: Date of second flu vaccine is prior to sample child's birth date Check Name: ERR3_FLUVAC2Y_C Text: {check ERR3_FLUVAC2Y_C} Date before 12 months ago Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC2Y_C lt current year-1) or (FLUVAC2Y_C=current year-1 and FLUVAC2M_C lt current month) Universe Description: Date of second flu vaccine is prior to 12 months ago Check Name: ERR4_FLUVAC2Y_C Text: {check ERR4_FLUVAC2Y_C} The date entered for the second most recent flu vaccine is after the date of the most recent flu vaccine. Please verify. Hard / Soft Edit: Soft Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (FLUVAC2Y_C gt FLUVAC1Y_C) or (FLUVAC2Y_C=FLUVAC1Y_C and FLUVAC2M_C gt FLUVAC1M_C) Universe Description: Date of second flu vaccine is more recent than date of first flu vaccine Page 178 of 334 Question ID: CVV.0010.00.3 Variable name: SHTCVD191_C Interview module: CVV(Child.CVV) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: The next questions are about coronavirus or COVID-19 vaccination. Has ^SCNAME had at least one dose of a COVID-19 vaccination? ^COVIDAGES Read if necessary: There are three vaccines for COVID-19 approved for use in the United States. The first is made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two initial shots. The second is made by Moderna, is called Spikevax®, and also requires two initial shots. The third is made by Johnson and Johnson and requires one initial shot. 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^COVIDAGES If GEN.AGE_FINAL[PX_C] lt 5, fill: "Read if necessary:The COVID-19 vaccination has been available for children under the age of 5 since June 2022." If GEN.AGE_FINAL[PX_C] ge 5 and GEN.AGE_FINAL[PX_C] le 11, fill: "Read if necessary:The COVID-19 vaccination has been available for children betweenthe ages of 5 and 11 since November 2021." If GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 15, fill: "Read if necessary:The COVID-19 vaccination has been available for children betweenthe ages of 12 and 15 since May 2021." If GEN.AGE_FINAL[PX_C] ge 16 and GEN.AGE_FINAL[PX_C] le 17, fill: "Read if necessary:The COVID-19 vaccination has been available for children between the ages of 16 and 17 since 2020." Page 179 of 334 Skip Instructions: <1> [goto SHTCVD19NM_C] <2,RF,DK> [goto next section] Question ID: CVV.0020.00.3 Variable name: SHTCVD19NM_C Interview module: CVV(Child.CVV) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SHTCVD191_C=1 Universe Description: Sample Children who have received at least one COVID-19 vaccination Question Text: Response: Fills: How many COVID-19 vaccinations has ^SCNAME received? 1. 2. 3. 4. DK: RF: 1 vaccination 2 vaccinations 3 vaccinations 4 or more vaccinations Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-4> [goto SHOTTYPE_C] [goto next section] Page 180 of 334 Question ID: CVV.0030.02.3 Variable name: CVDVAC1Y_C Interview module: CVV(Child.CVV.CVDVAC1Y_C) Inherited Universe: (GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (CVDVAC1M_C=1-12,DK) Universe: CVDVAC1M_C=1-12,DK Universe Description: Sample Children who gave month of most recent COVID-19 vaccination or don't know Question Text: Response: 2 of 2 DK: RF: Enter year of most recent COVID-19 vaccination. Don't Know Refused Skip Instructions: if SHTCVD19NM_C=2,3,4 [goto CVDVAC2M_C] else [goto SHOTTYPE_C] if CVDVAC1M_C and CVDVAC1Y_C = a future date [goto ERR1_CVDVAC1Y_C]; if CVDVAC1M_C and CVDVAC1Y_C = a date prior to birth [goto ERR2_CVDVAC1Y_C]; if CVDVAC1M_C and CVDVAC1Y_C = a date prior to 2020 [goto ERR3_CVDVAC1Y_C]; if GEN.AGE_FINAL[PX_C] ge 16 and GEN.AGE_FINAL[PX_C] le 17 and CVDVAC1M_C=1-11 and CVDVAC1Y_C=2020 [goto ERR4_CVDVAC1Y_C] if GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 15 and CVDVAC1M_C and CVDVAC1Y_C = date before May 2021 [goto ERR5_CVDVAC1Y_C] if GEN.AGE_FINAL[PX_C] ge 5 and GEN.AGE_FINAL[PX_C] le 11 and CVDVAC1M_C and CVDVAC1Y_C = date before Nov 2021 [goto ERR6_CVDVAC1Y_C] if GEN.AGE_FINAL[PX_C] lt 5 and CVDVAC1M_C and CVDVAC1Y_C = date before June 2022 [goto ERR7_CVDVAC1Y_C] Page 1 of 1 Question ID: CVV.0030.02.3 Variable name: CVDVAC1Y_C Interview module: CVV(Child.CVV.CVDVAC1Y_C) Inherited Universe: (GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (CVDVAC1M_C=1-12,DK) Universe: CVDVAC1M_C=1-12,DK Universe Description: Sample Children who gave month of most recent COVID-19 vaccination or don't know Question Text: Response: 2 of 2 DK: RF: Enter year of most recent COVID-19 vaccination. Don't Know Refused Skip Instructions: if SHTCVD19NM_C=2,3,4 [goto CVDVAC2M_C] else [goto SHOTTYPE_C] if CVDVAC1M_C and CVDVAC1Y_C = a future date [goto ERR1_CVDVAC1Y_C]; if CVDVAC1M_C and CVDVAC1Y_C = a date prior to birth [goto ERR2_CVDVAC1Y_C]; if CVDVAC1M_C and CVDVAC1Y_C = a date prior to 2020 [goto ERR3_CVDVAC1Y_C]; if GEN.AGE_FINAL[PX_C] ge 16 and GEN.AGE_FINAL[PX_C] le 17 and CVDVAC1M_C=1-11 and CVDVAC1Y_C=2020 [goto ERR4_CVDVAC1Y_C] if GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 15 and CVDVAC1M_C and CVDVAC1Y_C = date before May 2021 [goto ERR5_CVDVAC1Y_C] if GEN.AGE_FINAL[PX_C] ge 5 and GEN.AGE_FINAL[PX_C] le 11 and CVDVAC1M_C and CVDVAC1Y_C = date before Nov 2021 [goto ERR6_CVDVAC1Y_C] if GEN.AGE_FINAL[PX_C] lt 5 and CVDVAC1M_C and CVDVAC1Y_C = date before June 2022 [goto ERR7_CVDVAC1Y_C] Page 1 of 1 Question ID: CVV.0050.00.3 Variable name: SHOTTYPE_C Interview module: CVV(Child.CVV) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SHTCVD19NM_C=1-4 Universe Description: Sample Children who had at least one COVID-19 vaccination Question Text: ^FIRST_C brand of COVID-19 vaccine did ^SCNAME receive? Read if necessary: There are three vaccines for COVID-19 approved for use in the United States. The first is made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two initial shots. The second is made by Moderna, is called Spikevax®, and also requires two initial shots. The third is made by Johnson and Johnson and requires one initial shot. Response: 1. 2. 3. 4. 5. DK: RF: Fills: Pfizer-BioNTech Comirnaty® shot Moderna Spikevax® shot Johnson and Johnson (Janssen) shot One of the brands that requires two initial shots, but not sure which brand None of these brands Don't Know Refused ^FIRST_C If SHTCVD19NM_C=2-4, fill "For ^hisher_C first shot, which" else fill "Which" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> [goto next section] Question ID: PTC.0010.00.2 Variable name: EYEEX12M_C Interview module: PTC(Child.PTC) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, has ^SCNAME had an eye exam from an eye specialist such as an optometrist, ophthalmologist, or eye doctor? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto THERA12M_C] Page 181 of 334 Question ID: PTC.0020.00.2 Variable name: THERA12M_C Interview module: PTC(Child.PTC) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, did ^SCNAME receive physical therapy, speech therapy, rehabilitative therapy, or occupational therapy? Read if necessary: Do not include mental health therapy. 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto HOMEHC12M_C] Question ID: PTC.0030.00.2 Variable name: HOMEHC12M_C Interview module: PTC(Child.PTC) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: During the past 12 months, did ^SCNAME receive care at home from a nurse or other health professional? 1. 2. DK: RF: Yes No Don't Know Refused Page 182 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: MHC.0010.00.2 Variable name: MHRX_C Interview module: MHC(Child.MHC) Inherited Universe: (AGE_FINAL GE '002' and AGE_FINAL LE '017') AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (AGE_FINAL GE '002' and AGE_FINAL LE '017')) Universe Description: Sample Children 2-17 Question Text: Response: Fills: During the past 12 months, did ^SCNAME take any prescription medication to help with ^hisher_C emotions, concentration, behavior or mental health? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1,2,RF,DK> [goto MHTHRPY_C] Page 183 of 334 Question ID: MHC.0020.00.2 Variable name: MHTHRPY_C Interview module: MHC(Child.MHC) Inherited Universe: (AGE_FINAL GE '002' and AGE_FINAL LE '017') AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (AGE_FINAL GE '002' and AGE_FINAL LE '017')) Universe Description: Sample Children 2-17 Question Text: Response: Fills: During the past 12 months, did ^SCNAME receive counseling or therapy from a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto MHTHDLY_C] Question ID: MHC.0030.00.2 Variable name: MHTHDLY_C Interview module: MHC(Child.MHC) Inherited Universe: (AGE_FINAL GE '002' and AGE_FINAL LE '017') AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (AGE_FINAL GE '002' and AGE_FINAL LE '017')) Universe Description: Sample Children 2-17 Question Text: During the past 12 months, has ^SCNAME been DELAYED in getting counseling or therapy from a mental health professional because of the cost? Response: Page 184 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto MHTHND_C] Question ID: MHC.0040.00.2 Variable name: MHTHND_C Interview module: MHC(Child.MHC) Inherited Universe: (AGE_FINAL GE '002' and AGE_FINAL LE '017') AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (AGE_FINAL GE '002' and AGE_FINAL LE '017')) Universe Description: Sample Children 2-17 Question Text: Response: Fills: During the past 12 months, was there any time when ^SCNAME needed counseling or therapy from a mental health professional, but DID NOT GET IT because of the cost? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Page 185 of 334 Question ID: SOS.0020.00.4 Variable name: COMSUPPORT_C Interview module: SOS(Child.SOS) Inherited Universe: (GEN.AGE_FINAL=12-17) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.AGE_FINAL=12-17)) Universe Description: Sample Children 12-17 Question Text: Response: Fills: Other than parents or adults living in ^SCNAME's home, is there at least one adult in ^SCNAME's school, neighborhood, or community who makes a positive and meaningful difference in ^hisher_C life? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: SLE.0010.00.2 Variable name: SLEINTRO_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: The next set of questions are about events that may have happened during ^SCNAME's life. These things can happen in any family, but some people may feel uncomfortable with these questions. You may skip any questions you do not want to answer. Enter '1' to continue. Response: Page 186 of 334 1. Fills: Enter 1 to Continue ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto VIOLENEV_C] Question ID: SLE.0020.00.2 Variable name: VIOLENEV_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Has ^SCNAME ever been the victim of violence or witnessed violence in ^hisher_C neighborhood? 1. 2. DK: RF: Yes No Don't Know Refused ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto JAILEV1_C] Page 187 of 334 Question ID: SLE.0030.00.2 Variable name: JAILEV1_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Has ^SCNAME ever been separated from a parent or guardian because the parent or guardian went to jail, prison, or a detention center? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto MENTDEPEV_C] Question ID: SLE.0040.00.2 Variable name: MENTDEPEV_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Did ^SCNAME ever live with anyone who was mentally ill or severely depressed? 1. 2. DK: RF: Yes No Don't Know Refused Page 188 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto ALCDRUGEV_C] Question ID: SLE.0050.00.2 Variable name: ALCDRUGEV_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Did ^SCNAME ever live with anyone who had a problem with alcohol or drugs? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto PUTDOWN_C] Question ID: SLE.0060.00.3 Variable name: PUTDOWN_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Has ^SCNAME ever lived with a parent or adult who frequently swore at ^himher_C, insulted ^himher_C, or put ^himher_C down? Response: Page 189 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" Skip Instructions: <1,2,RF,DK> [goto BNEEDS_C] Question ID: SLE.0070.00.3 Variable name: BNEEDS_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Has there ever been a time when ^SCNAME's basic needs were NOT met, such as having enough to eat, being able to go to a doctor when ^heshe_C was sick, or having a safe place to stay? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" Page 190 of 334 Skip Instructions: <1,2,RF,DK> [goto UNFAIRRE_C] Question ID: SLE.0080.00.4 Variable name: UNFAIRRE_C Interview module: SLE(Child.SLE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Has anyone ever treated or judged ^SCNAME unfairly because of ^hisher_C race or ethnic group? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 17 [goto UNFAIRSO_C] else [goto next section] Page 191 of 334 Question ID: INJ.0010.00.2 Variable name: INJINTRO_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample children 0-17 Question Text: The next set of questions asks about all types of injuries. People can be injured accidentally or on purpose. They may hurt themselves or others may cause them to be hurt. Enter '1' to continue. Response: Skip Instructions: <1> [goto ANYINJURY_C] Question ID: INJ.0020.00.2 Variable name: ANYINJURY_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample children 0-17 Question Text: Response: Fills: During the past 3 months, did ^SCNAME have an accident or an injury where any part of ^hisher_C body was hurt? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Page 192 of 334 Skip Instructions: <1> [goto INJLIMIT_C] <2,RF,DK> [goto next section] Question ID: INJ.0030.00.2 Variable name: INJLIMIT_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: ANYINJURY_C=1 Universe Description: Sample children 0-17 who had an injury in past 3 months Question Text: Response: Fills: Did any of these injuries limit ^SCNAME's usual activities for at least 24 hours after the injury occurred? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto NUMINJ_C] <2,RF,DK> [goto next section] Question ID: INJ.0040.00.2 Variable name: NUMINJ_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 Universe Description: Sample Children 0-17 reported injuries in past 3 months which limited activities for at least 24 hours Question Text: Response: For the next questions, please think only about the significant injuries that occurred during the past 3 months. By significant, I mean those injuries that limited ^SCNAME's usual activities for at least 24 hours after the injury occurred. During the past 3 months, how many times did ^SCNAME have a significant injury? Enter '96' if number is 96 or greater. DK: RF: Don't Know Refused Page 193 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-9,RF,DK> [goto INJHOME_C] <10-96> [goto ERR1_NUMINJ_C] Check Name: ERR1_NUMINJ_C Text: {signal ERR1_NUMINJ_C} verify. ^NUMINJ_C is an unusually large number. Please Hard / Soft Edit: Soft Fills: ^NUMINJ_C Number of injuries Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: NUMINJ_C=10-96 Universe Description: Number of injuries reported in NUMINJ_C is 10-96 Question ID: INJ.0050.00.2 Variable name: INJHOME_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 Universe Description: Sample Children 0-17 reported injuries in past 3 months which limited activities for at least 24 hours Question Text: During the past 3 months, did ^siginj_C occur while ^SCNAME was at ^hisher_C home? Read if necessary: Include the yards, garage, basement, and other places on the home property. Response: Page 194 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1> if NUMINJ_C=1 and GEN.AGE_FINAL le 2 [goto INJFALL_C] elseif NUMINJ_C=1 and GEN.AGE_FINAL ge 3 [goto INJSPORTS_C] elseif (NUMINJ_C gt 1 OR NUMINJ_C IN (RF,DK)) [goto INJSCHOOL_C] <2,RF,DK> [goto INJSCHOOL_C] Question ID: INJ.0060.00.2 Variable name: INJSCHOOL_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: ((NUMINJ_C gt 1 or NUMINJ_C IN (DK,RF)) or (NUMINJ_C=1 and INJHOME_C IN (2,RF,DK)) Universe Description: Sample children 0-17 who had more than one injury or didn't know or refused or who had one injury that did not occur at home Question Text: During the past 3 months, did ^siginj_C occur while ^SCNAME was at ^DAYCARESCHOOL? Read if necessary: Include classrooms, playgrounds, sports fields, swimming pools, parking lots and other places on school or daycare property. Response: Page 195 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^DAYCARESCHOOL If GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 2, fill: "daycare" If GEN.AGE_FINAL[PX_C] ge 3 and GEN.AGE_FINAL[PX_C] le 5, fill: "school or daycare" ifGEN.AGE_FINAL[PX_C] ge 6 and GEN.AGE_FINAL[PX_C] le 17, fill: "school" ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL lt 3 [goto INJFALL_C] elseif GEN.AGE_FINAL ge 3 [goto INJSPORTS_C] Question ID: INJ.0070.00.2 Variable name: INJSPORTS_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 and GEN.AGE_FINAL ge 3 and GEN.AGE_FINAL le 17 Universe Description: Sample children 3-17 with injury in past 3 months which limited activities for at least 24 hours Question Text: During the past 3 months, did ^siginj_C occur while ^SCNAME was playing sports or exercising, including walking, biking, or running, playing baseball, basketball, football or doing any other physical activity? Read if necessary: Include recreational sports such as skating, skiing, tennis, golf, bowling, or fishing. Response: Page 196 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto INJFALL_C] Question ID: INJ.0080.00.2 Variable name: INJFALL_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 Universe Description: Sample children 0-17 with injury in past 3 months which limited activities for at least 24 hours Question Text: Response: Fills: During the past 3 months, did ^siginj_C occur as a result of a fall or falling? 1. 2. DK: RF: ^siginj_C Yes No Don't Know Refused If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Page 197 of 334 Skip Instructions: <1> if NUMINJ_C=1 [goto INJMOTOR_C] elseif NUMINJ_C gt 1 or NUMINJ_C IN (RF,DK) and INJHOME_C=1 [goto INJFALLHOM_C] elseif NUMINJ_C gt 1 or NUMINJ_C IN (RF,DK) and INJSCHOOL_C=1 [goto INJFALLSCH_C] else [goto INJMOTOR_C] <2,RF,DK> [goto INJMOTOR_C] Question ID: INJ.0090.00.2 Variable name: INJFALLHOM_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (NUMINJ_C gt 1 OR NUMINJ_C IN (RF,DK)) and INJFALL_C=1 and INJHOME_C=1 Universe Description: Sample children 0-17 who had more than 1 significant injury or refused or don't know, and were injured as a result of a fall or falling, and who were also injured at home Question Text: Response: Fills: Did any fall occur while ^SCNAME was at ^hisher_C home? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Page 198 of 334 Skip Instructions: <1,2,RF,DK> if INJSCHOOL_C=1 [goto INJFALLSCH_C] else [goto INJMOTOR_C] Question ID: INJ.0100.00.2 Variable name: INJFALLSCH_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (NUMINJ_C gt 1 OR NUMINJ_C IN (RF,DK)) and INJFALL_C=1 and INJSCHOOL_C=1 Universe Description: Sample children 0-17 who had more than 1 significant injury or refused or don't know, and were injured as a result of a fall or falling, and who were also injured at school Question Text: Response: Fills: Did any fall occur while ^SCNAME was at ^DAYCARESCHOOL? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^DAYCARESCHOOL If GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 2, fill: "daycare" If GEN.AGE_FINAL[PX_C] ge 3 and GEN.AGE_FINAL[PX_C] le 5, fill: "school or daycare" ifGEN.AGE_FINAL[PX_C] ge 6 and GEN.AGE_FINAL[PX_C] le 17, fill: "school" Skip Instructions: <1,2,RF,DK> [goto INJMOTOR_C] Page 199 of 334 Question ID: INJ.0110.00.2 Variable name: INJMOTOR_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 Universe Description: Sample children 0-17 with injury in past 3 months which limited activities for at least 24 hours Question Text: Response: Fills: During the past 3 months, did ^siginj_C occur as a result of being in a motor vehicle crash or being hit by a motor vehicle while walking or biking? Read if necessary: Motor vehicles include cars, trucks, vans, buses, motorcycles, motorized scooters, motorized wheelchairs, motorized carts, tractors, ATVs, snowmobiles, dune buggies, and other motorized vehicles. 1. 2. DK: RF: ^siginj_C Yes No Don't Know Refused If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Skip Instructions: <1> [goto INJMVTYPE_C] <2,RF,DK> [goto INJSAWDOC_C] Page 200 of 334 Question ID: INJ.0120.00.2 Variable name: INJMVTYPE_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJMOTOR_C=1 Universe Description: Sample children 0-17 with a motor vehicle injury Question Text: Response: Fills: Was ^SCNAME a ^DRIVER passenger, bicyclist, pedestrian, or doing something else when this occurred? Enter all that apply, separate with commas. 1. 2. 3. 4. 5. DK: RF: ^INJDRIVER Passenger Bicyclist Pedestrian Something else Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^DRIVER If GEN.AGE_FINAL[PX] ge 6, fill: "driver," else, no fill. Skip Instructions: If GEN.AGE_FINAL[PX_C] lt ERR1_INJMVTYPE_C] <1-5,RF,DK> [goto INJSAWDOC_C] Page 201 of 334 6 and INJMVTYPE_C=1 [goto Check Name: ERR1_INJMVTYPE_C Text: {check ERR1_INJMVTYPE_C} Verify. "Driver" is unavailable for children under 6 years old. Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C] lt 6 and INJMVTYPE_C=1 Universe Description: Sample child is less than 6 years old and Driver was selected at INJMVTYPE_C Question ID: INJ.0130.00.2 Variable name: INJSAWDOC_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 Universe Description: Sample children 0-17 with injury in past 3 months which limited activities for at least 24 hours Question Text: Response: Fills: During the past 3 months, did ^SCNAME see a doctor or other health professional about ^siginj_C? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Page 202 of 334 Skip Instructions: <1> if UTZ.EMERGE12M_C IN (1-96,RF,DK) [goto INJER_C] elseif UTZ.EMERGE12M_C=0 and UTZ.HOSPONGT_C IN (1,RF,DK) [goto INJHOSP_C] else [goto INJBONES_C] <2,RF,DK> [goto INJSCHDAYS_C] Question ID: INJ.0140.00.2 Variable name: INJER_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJSAWDOC_C=1 and UTZ.EMERGE12M_C IN (1-96,RF,DK) Universe Description: Sample children 0-17 who saw doctor about their injuries and either went to the ER in the past year or didn't know or refused if they went to the ER Question Text: Response: Fills: During the past 3 months, did ^SCNAME go to an emergency room because of ^siginj_C? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Skip Instructions: <1,2,RF,DK> if UTZ.HOSPONGT_C IN (1,RF,DK) [goto INJHOSP_C] else [goto INJBONES_C] Page 203 of 334 Question ID: INJ.0150.00.2 Variable name: INJHOSP_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJSAWDOC_C=1 and UTZ.HOSPONGT_C IN (1,RF,DK) Universe Description: Sample children 0-17 who saw a doctor for their injuries and were hospitalized overnight in the past year or didn't know or refused Question Text: Response: Fills: During the past 3 months, was ^SCNAME hospitalized overnight for ^siginj_C? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Skip Instructions: <1,2,RF,DK> [goto INJBONES_C] Question ID: INJ.0160.00.2 Variable name: INJBONES_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJSAWDOC_C=1 Universe Description: Sample children 0-17 who saw a doctor about an injury Question Text: During the past 3 months, did ^SCNAME have any broken bones as a result of ^siginj_C? Response: Page 204 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Skip Instructions: <1,2,RF,DK> [goto INJSTITCH_C] Question ID: INJ.0170.00.2 Variable name: INJSTITCH_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJSAWDOC_C=1 Universe Description: Sample children 0-17 who saw a doctor about an injury Question Text: Response: Fills: During the past 3 months, did ^SCNAME get any stitches or staples because of ^siginj_C? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Page 205 of 334 Skip Instructions: <1,2,RF,DK> [goto INJSCHDAYS_C] Question ID: INJ.0180.00.2 Variable name: INJSCHDAYS_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJLIMIT_C=1 Universe Description: Sample children 0-17 who had an injury that limited their activities for at least 24 hours Question Text: Response: Fills: During the past 3 months, how many days of ^DAYCARESCHOOL did ^SCNAME miss because of ^siginj_C? Enter '90' if ^SCNAME missed every day of daycare or school in the past 3 months DK: RF: Don't Know Refused ^DAYCARESCHOOL If GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 2, fill: "daycare" If GEN.AGE_FINAL[PX_C] ge 3 and GEN.AGE_FINAL[PX_C] le 5, fill: "school or daycare" ifGEN.AGE_FINAL[PX_C] ge 6 and GEN.AGE_FINAL[PX_C] le 17, fill: "school" ^SCNAME Fill ALIAS of HHSTAT_C=1 ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Page 206 of 334 Skip Instructions: <0,RF> [goto next section] <1-90, DK> [goto INJFUTSCH_C] Question ID: INJ.0190.00.2 Variable name: INJFUTSCH_C Interview module: INJ(Child.INJ) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: INJSCHDAYS_C IN (1-90, DK) Universe Description: Sample children 0-17 who have missed at least one day of daycare or school due to injury in past 3 months or don't know Question Text: Response: Fills: Do you expect ^SCNAME to miss any more days of ^DAYCARESCHOOL because of ^siginj_C that occurred during the past 3 months? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^DAYCARESCHOOL If GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 2, fill: "daycare" If GEN.AGE_FINAL[PX_C] ge 3 and GEN.AGE_FINAL[PX_C] le 5, fill: "school or daycare" ifGEN.AGE_FINAL[PX_C] ge 6 and GEN.AGE_FINAL[PX_C] le 17, fill: "school" ^siginj_C If NUMINJ_C=1, fill: "the significant injury" elseif NUMINJ_C gt 1, fill: "any significant injuries" elseif NUMINJ_C in (DK,RF), fill: "any significant injuries" Page 207 of 334 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: TBI.0010.05.3 Variable name: TBIINTRO1_C Interview module: TBI(Child.TBI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: The next questions are about head injuries that may have occurred in the past 12 months. Please think about all head injuries, for example, from playing sports, car accidents, falls, or being hit by something or someone that may have occurred in the past 12 months. Enter '1' to continue. 1. Enter 1 to Continue Skip Instructions: <1> [goto TBILCDCMG_C] Question ID: TBI.0020.00.3 Variable name: TBILCDCMG_C Interview module: TBI(Child.TBI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: During the past 12 months, as a result of a blow or jolt to the head, has ^SCNAME been knocked out or lost consciousness, been dazed or confused, or had a gap in ^hisher_C memory? Read if necessary: Please think about all head injuries, for example, from playing sports, car accidents, falls, or being hit by something or someone that may have occurred in the past 12 months. 1. 2. DK: RF: Yes No Don't Know Refused Page 208 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1,2,RF,DK> [goto TBIHLSBMC_C] Question ID: TBI.0030.00.3 Variable name: TBIHLSBMC_C Interview module: TBI(Child.TBI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: During the past 12 months, as a result of a blow or jolt to the head, has ^SCNAME had headaches, sensitivity to light or noise, balance problems, or changes in mood or behavior? Read if necessary: Please think about all head injuries, for example, from playing sports, car accidents, falls, or being hit by something or someone that may have occurred in the past 12 months. 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto TBISPORT_C] <2,RF,DK> if TBILCDCMG_C=1 [goto TBISPORT_C] <2,RF,DK> if TBILCDCMG_C=2,RF,DK [goto next section] Page 209 of 334 Question ID: TBI.0040.00.3 Variable name: TBISPORT_C Interview module: TBI(Child.TBI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: TBILCDCMG_C=1 or TBIHLSBMC_C=1 Universe Description: Sample Children 0-17 who experienced TBI symptoms from a blow or jolt to the head over the past 12 months Question Text: Response: Fills: ^CDCMG_C Was ^SCNAME playing a sport or participating in a physical or recreational activity, such as playing on the playground, biking, or pick-up games, when ^heshe_C experienced any of these blows or jolts to the head? Read if necessary: Include team or league sports competitions or practices. Read if necessary: Include organized and non-organized sports. Read if necessary: A pick-up game is when a group of players get together and spontaenously start a game, like basketball or soccer. 1. 2. DK: RF: Yes No Don't Know Refused ^CDCMG_C If TBILCDCMG_C=1, fill: "Think about the blows or jolts to the head that caused ^SCNAME to lose consciousness, become dazed or confused, or have a gap in ^hisher_C memory." ^SCNAME Fill ALIAS of HHSTAT_C=1 ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" Skip Instructions: <1> [goto TBILEAGUE_C] <2,RF,DK> [goto TBIEVAL_C] Page 210 of 334 Question ID: TBI.0050.00.3 Variable name: TBILEAGUE_C Interview module: TBI(Child.TBI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: TBISPORT_C=1 Universe Description: Sample Children 0-17 who had a sports or recreational related injury Question Text: Response: Fills: Was ^SCNAME participating in an organized team or league sports competition or practice when they experienced any of these blows or jolts to the head? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto TBIEVAL_C] Question ID: TBI.0060.00.4 Variable name: TBIEVAL_C Interview module: TBI(Child.TBI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: TBILCDCMG_C=1 or TBIHLSBMC_C=1 Universe Description: Sample Children 0-17 who experienced TBI symptoms from a blow or jolt to the head over the past 12 months Question Text: During the past 12 months, as a result of a blow or jolt to the head, was ^SCNAME evalauted for a concussion or brain injury by a doctor, nurse, paramedic, athletic trainer, or other health professional? Response: Page 211 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: SVI.0010.00.3 Variable name: CVISTST_C Interview module: SVI(Child.SVI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Has ^SCNAME EVER had ^hisher_C vision tested by a doctor or other health professional? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1> [goto CVISLT_C] <2,RF,DK> [goto CVISDIST_C] Page 212 of 334 Question ID: SVI.0020.00.3 Variable name: CVISLT_C Interview module: SVI(Child.SVI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: CVISTST_C=1 Universe Description: Sample Children 0-17 who have ever had their vision tested by a doctor or other health professional Question Text: Response: Fills: When was ^hisher_C vision last tested? 1. 2. 3. DK: RF: Within the past year (anytime less than 12 months ago) Within the past 2 years (1 year but less than 2 years ago) 2 years ago or more Don't Know Refused ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1-3,RF,DK> [goto CVISDIST_C] Question ID: SVI.0030.00.3 Variable name: CVISDIST_C Interview module: SVI(Child.SVI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Does ^SCNAME wear eyeglasses or contact lenses to read road and street signs, see the board in school, watch TV, or see things in the distance? Response: Page 213 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto CVISREAD_C] Question ID: SVI.0040.00.3 Variable name: CVISREAD_C Interview module: SVI(Child.SVI) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Does ^SCNAME wear eyeglasses or contact lenses to read books, write, use smartphones, iPads or other electronic devices, or do other things that require ^himher_C to see well up close? 1. 2. DK: RF: Yes No Don't Know Refused ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Page 214 of 334 Question ID: SHE.0010.00.3 Variable name: AHEARST1_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: ?[F1] These next questions are about ^SCNAME's hearing WITHOUT the use of hearing aids or other listening devices. Without a hearing aid or other listening devices, is ^SCNAME's hearing excellent, good, ^heshe_C has a little trouble hearing, moderate trouble, a lot of trouble, or is ^heshe_C deaf? 1. 2. 3. 4. 5. 6. DK: RF: Excellent Good A little trouble hearing Moderate trouble A lot of trouble Deaf Don't Know Refused ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> if GEN.AGE_FINAL[PX_C]=3-17 [goto HRWHISP_C] else [goto EARINFECT_C] <6> [goto EARINFECT_C] Page 215 of 334 Question ID: SHE.0020.00.3 Variable name: HRWHISP_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=3-17 and AHEARST1_C IN (1-5,RF,DK) Universe Description: Sample Children 3-17 who are not deaf or refused or don't know Question Text: Response: Fills: Without a hearing aid or other listening devices, can ^SCNAME usually HEAR and UNDERSTAND what a person says without seeing his or her face if that person WHISPERS to ^SCNAME from across a quiet room? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto EARINFECT_C] Question ID: SHE.0030.00.3 Variable name: EARINFECT_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: DURING THE PAST 12 MONTHS, has ^SCNAME had an ear infection accompanied by earache, or fluid in the ear, and/or temporary hearing loss? Read if necessary: Temporary hearing loss includes "muffled" hearing. 1. Yes Page 216 of 334 2. DK: RF: Fills: No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto EARINFECT3_C] <2,RF,DK> if TBI.TBILCDCMG_C=1 CBALHDNO_C] else [goto CBALHDINJ_C] Question ID: SHE.0040.00.3 or Variable name: EARINFECT3_C TBI.TBIHLSBMC_C=1 [goto Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: EARINFECT_C=1 Universe Description: Sample Children 0-17 who have had an ear infection in the past 12 months Question Text: Response: Fills: DURING THE PAST 12 MONTHS, has ^SCNAME had three or more ear infections accompanied by earache, or fluid in the ear, and/or temporary hearing loss? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> if TBI.TBILCDCMG_C=1 CBALHDNO_C] else [goto CBALHDINJ_C] Page 217 of 334 or TBI.TBIHLSBMC_C=1 [goto Question ID: SHE.0050.00.3 Variable name: CBALHDINJ_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: TBI.TBILCDCMG_C=2,RF,DK and TBI.TBIHLSBMC_C=2,RF,DK Universe Description: Sample Children 0-17 who have not lost consciousness and have not had symptoms of a head injury in the past 12 months Question Text: Response: Fills: In ^SCNAME's LIFETIME, has ^heshe_C EVER had a significant head injury or concussion? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" Skip Instructions: <1> [goto CBALHDNO_C] <2,RF,DK> if GEN.AGE_FINAL[PX_C]=1-17 [goto HRTEST_C] elseif GEN.AGE_FINAL[PX_C] lt 1 and HEA.HEARAID_C=1 HRAIDAQR_C] else [goto HRVLOUD12M_C] Page 218 of 334 [goto Question ID: SHE.0060.00.3 Variable name: CBALHDNO_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: TBI.TBILCDCMG_C=1 or TBI.TBIHLSBMC_C=1 or CBALHDINJ_C=1 Universe Description: Sample Children 0-17 who have had a head injury in the past 12 months or lifetime Question Text: Response: Fills: ^HEADINJ many significant head injuries or concussions has ^SCNAME had in ^hisher_C LIFETIME? 0. 1. 2. 3. 4. 5. DK: RF: 0 1 2 3 4 5 or more Don't Know Refused ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^HEADINJ If TBI.TBILCDCMG_C=1 or TBI.TBIHLSBMC_C=1, fill: "Counting any injuries you told me about earlier, how" else, fill: "How" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <0-5,RF,DK> if GEN.AGE_FINAL[PX_C]=1-17 [goto HRTEST_C] elseif GEN.AGE_FINAL[PX_C] lt 1 and HEA.HEARAID_C=1 HRAIDAQR_C] else [goto HRVLOUD12M_C] Page 219 of 334 [goto Question ID: SHE.0070.00.3 Variable name: HRTEST_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=1-17 Universe Description: Sample Children 1-17 Question Text: Response: Fills: A hearing test by a specialist is one that is done in a sound-proof booth or room, or with headphones. Not including tests that may have been done when ^heshe_C was born, has ^SCNAME ever had ^hisher_C hearing tested by a hearing specialist? Read if necessary: Hearing specialists include audiologists, ear nose and throat (ENT) doctors, and trained technicians or occupational nurses. 1. 2. DK: RF: Yes No Don't Know Refused ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1> [goto HRTESTLAST_C] <2,RF,DK> if HEA.HEARAID_C=1 [goto HRAIDAQR_C] elseif GEN.AGE_FINAL[PX_C]=3-17 [goto BALDIZZ_C] else [goto HRVLOUD12M_C] Page 220 of 334 Question ID: SHE.0080.00.3 Variable name: HRTESTLAST_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=1-17 and HRTEST_C=1 Universe Description: Sample Children 1-17 who have had ever had a hearing test Question Text: Response: Fills: When was the last time ^SCNAME had ^hisher_C hearing tested by a hearing specialist? Read if necessary: Do not count tests done before 6 months of age. 1. 2. 3. 4. 5. DK: RF: Less than a year ago 1 to 2 years ago 3 to 4 years ago 5 to 9 years ago 10 or more years ago Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1-5,RF,DK> if HEA.HEARAID_C=1 [goto HRAIDAQR_C] elseif GEN.AGE_FINAL[PX_C]=3-17 [goto BALDIZZ_C] else [goto HRVLOUD12M_C] Page 221 of 334 Question ID: SHE.0090.00.3 Variable name: HRAIDAQR_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: HEA.HEARAID_C=1 Universe Description: Sample Children 0-17 who wear a hearing aid Question Text: Response: Earlier, you told me that ^SCNAME uses a hearing aid. Was that hearing aid fit by a health care professional, or was it purchased online or over the counter without assistance from a health care professional? 1. 2. DK: RF: Fills: Hearing aid fit by a health care professional Hearing aid purchased online or over the counter without assistance from a health care professional Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_C]=3-17 [goto BALDIZZ_C] else [goto HRVLOUD12M_C] Question ID: SHE.0100.00.3 Variable name: BALDIZZ_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=3-17 Universe Description: Sample Children 3-17 Question Text: These next questions are about dizziness or balance problems. DURING THE PAST 12 MONTHS, has ^SCNAME had a problem with dizziness, vertigo, lightheadedness, blurred vision when moving head, feeling like ^heshe_C is going to pass out or faint, or with unsteadiness or feeling off-balance? Read if necessary: Vertigo is a sensation of feeling off-balance from rotation, rocking, or other motion, such as riding a carousel. Response: Page 222 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" Skip Instructions: <1> [goto BALDPROB_C] <2,RF,DK> [goto BFALL12M_C] Question ID: SHE.0110.00.3 Variable name: BALDPROB_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=3-17 and BALDIZZ_C=1 Universe Description: Sample Children 3-17 who have had a problem with balance or dizziness in the past 12 months Question Text: Response: DURING THE PAST 12 MONTHS, how much of a problem did ^SCNAME have with dizziness or balance? Would you say it was... Read answer categories below. 1. 2. 3. 4. 5. DK: RF: No problem A small problem A moderate problem A big problem A very big problem Don't Know Refused Page 223 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> [goto BALDHP_C] Question ID: SHE.0120.00.3 Variable name: BALDHP_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=3-17 and BALDIZZ_C=1 Universe Description: Sample Children 3-17 who have had a problem with balance or dizziness in the past 12 months Question Text: Response: Fills: Has ^SCNAME EVER seen a doctor or other health professional for evaluation or treatment of ^hisher_C difficulties with dizziness or balance? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1,2,RF,DK> [goto BFALL12M_C] Page 224 of 334 Question ID: SHE.0130.00.3 Variable name: BFALL12M_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=3-17 Universe Description: Sample Children 3-17 Question Text: Response: Fills: The next two questions are about falling. By falls or falling, we mean unexpectedly dropping to the floor or ground from a standing, walking, or bending position. DURING THE PAST 12 MONTHS, has ^SCNAME fallen at least one time? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto BFALLTIMES_C] <2,RF,DK> if GEN.AGE_FINAL[PX_C]=6-17 [goto HRTINNITUS_C] else [goto HRVLOUD12M_C] Question ID: SHE.0140.00.3 Variable name: BFALLTIMES_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=3-17 and BFALL12M_C=1 Universe Description: Sample Children 3-17 who have fallen at least once in the past 12 months Question Text: DURING THE PAST 12 MONTHS, how many times has ^SCNAME fallen? Response: Page 225 of 334 1. 2. 3. 4. 5. DK: RF: Fills: 1 time 2 times 3 to 4 times 5 to 7 times 8 or more times Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> if GEN.AGE_FINAL[PX_C]=6-17 [goto HRTINNITUS_C] else [goto HRVLOUD12M_C] Question ID: SHE.0150.00.3 Variable name: HRTINNITUS_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 Universe Description: Sample Children 6-17 Question Text: Response: Fills: DURING THE PAST 12 MONTHS, has ^SCNAME been bothered by ringing, roaring, or buzzing in ^hisher_C ears or head that lasts for 5 minutes or more? Read if necessary: Tinnitus (TIN-uh-tus) is the medical term for ringing, roaring or buzzing in the ears or head. 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Page 226 of 334 Skip Instructions: <1> [goto HRTINLNG_C] <2,RF,DK> if GEN.AGE_FINAL[PX_C]=12-17 [goto HRLOUDJOB_C] else [goto HRFIREEV_C] Question ID: SHE.0160.00.3 Variable name: HRTINLNG_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 and HRTINNITUS_C=1 Universe Description: Sample Children 6-17 who have been bothered by ringing, roaring, or buzzing in ears or head in the past 12 months Question Text: Response: Fills: How long has ^SCNAME been bothered by this ringing, roaring, or buzzing in ^hisher_C ears or head? 1. 2. 3. 4. 5. DK: RF: Less than 1 year 1 to 2 years 3 to 4 years 5 to 9 years 10 years or more Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1-5,RF,DK> [goto HRTINPROB_C] Page 227 of 334 Question ID: SHE.0170.00.3 Variable name: HRTINPROB_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 and HRTINNITUS_C=1 Universe Description: Sample Children 6-17 who have been bothered by ringing, roaring, or buzzing in ears or head in the past 12 months Question Text: Response: Fills: DURING THE PAST 12 MONTHS, how much of a problem is this ringing, roaring, or buzzing in ^SCNAME's ears or head? Would you say it is... Read answer categories below. 1. 2. 3. 4. 5. DK: RF: No problem A small problem A moderate problem A big problem A very big problem Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> [goto HRTINMEDSP_C] Question ID: SHE.0180.00.3 Variable name: HRTINMEDSP_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 and HRTINNITUS_C=1 Universe Description: Sample Children 6-17 who have been bothered by ringing, roaring, or buzzing in ears or head in the past 12 months Question Text: IN THE PAST 5 YEARS, has ^SCNAME been evaluated or treated for the ringing, roaring, or buzzing in ^hisher_C ears or head by a medical specialist in hearing, such as an Ear, Nose and Throat doctor, audiologist, neurologist, or psychiatrist? Read if necessary: Include otolaryngologists (oh-toe-lair-in-GAH-luh-gists), otologists, and neuro-otologists. Response: Page 228 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_C]=12-17 [goto HRLOUDJOB_C] else [goto HRFIREEV_C] Question ID: SHE.0190.00.3 Variable name: HRLOUDJOB_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=12-17 Universe Description: Sample Children 12-17 Question Text: Response: The next few questions are about ^SCNAME's current or previous exposure to loud and very loud sounds or noises. First, we will ask about exposure to loud noises or sounds ^SCNAME may have had while working. Loud means so loud that ^heshe_C must speak in a raised voice to be heard. Has ^SCNAME EVER had a job, or combination of jobs, where ^heshe_C was exposed to loud sounds or noise for 4 or more hours a day, several days a week? 1. 2. DK: RF: Yes No Don't Know Refused Page 229 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" Skip Instructions: <1> [goto HRLOUDJBYR_C] <2,RF,DK> [goto HRFIREEV_C] Question ID: SHE.0200.00.3 Variable name: HRLOUDJBYR_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=12-17 and HRLOUDJOB_C=1 Universe Description: Sample Children 12-17 who have been exposed to loud noise during work Question Text: Response: Fills: In ^hisher_C LIFETIME, how many years has ^SCNAME had a job, or combination of jobs, where ^heshe_C was exposed to LOUD sounds or noise for 4 or more hours a day, several days a week? Read if necessary: Loud means so loud that you must speak in a raised voice to be heard. 1. 2. 3. 4. 5. DK: RF: Less than 1 year 1 to 2 years 3 to 4 years 5 to 9 years 10 years or more Don't Know Refused ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^SCNAME Fill ALIAS of HHSTAT_C=1 ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" Page 230 of 334 Skip Instructions: <1-5,RF,DK> [goto HRLOUDJB12M_C] Question ID: SHE.0210.00.3 Variable name: HRLOUDJB12M_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=12-17 and HRLOUDJOB_C=1 Universe Description: Sample Children 12-17 who have been exposed to loud noise during work Question Text: Response: Fills: DURING THE PAST 12 MONTHS, has ^SCNAME had a job, or combination of jobs, where ^heshe_C was exposed to LOUD sounds or noise for 4 or more hours a day, several days a week? Read if necessary: Loud means so loud that you must speak in a raised voice to be heard. 1. 2. DK: RF: Yes No Don't Know Refused ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto HRJOBPROT_C] <2,RF,DK> [goto HRFIREEV_C] Page 231 of 334 Question ID: SHE.0220.00.3 Variable name: HRJOBPROT_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=12-17 and HRLOUDJB12M_C=1 Universe Description: Sample Children 12-17 who have been exposed to loud noise at work in the past 12 months Question Text: Response: Fills: DURING THE PAST 12 MONTHS, how often did ^SCNAME wear hearing protection such as ear plugs or ear muffs when exposed to LOUD sounds or noise at work? Would you say... Read answer categories below. 1. 2. 3. 4. 5. DK: RF: Always Usually About half the time Seldom Never Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> [goto HRFIREEV_C] Question ID: SHE.0230.00.3 Variable name: HRFIREEV_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 Universe Description: Sample Children 6-17 Question Text: ^NOISEEXP Has ^SCNAME EVER used guns or firearms for any reason? Read if necessary: Include target shooting, hunting, military service, and job-related firearm use. Read if necessary: Firearms include pistols, shotguns, rifles, and other types of guns. Do not include BB or pellet guns. Response: Page 232 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^NOISEEXP If GEN.AGE_FINAL[PX_C]=6-11, fill: "The next few questions are about ^SCNAME's current or previous exposure to very loud sounds or noises." ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto HRFIRETOTR_C] <2,RF,DK> [goto HRVLOUD12M_C] Question ID: SHE.0240.00.3 Variable name: HRFIRETOTR_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 and HRFIREEV_C=1 Universe Description: Sample Children 6-17 who have ever used a firearm or gun Question Text: Response: Fills: How many total rounds has ^SCNAME EVER fired? Read categories if necessary. Read if necessary: One round is equal to one shot. 1. 2. 3. 4. DK: RF: Less than 100 rounds 100 to less than 1,000 rounds 1,000 to less than 10,000 rounds 10,000 rounds or more Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Page 233 of 334 Skip Instructions: <1-4,RF,DK> [goto HRFIRE12M_C] Question ID: SHE.0250.00.3 Variable name: HRFIRE12M_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 and HRFIREEV_C=1 Universe Description: Sample Children 6-17 who have ever used a firearm or gun Question Text: Response: Fills: DURING THE PAST 12 MONTHS, did ^SCNAME use guns or firearms for any reason? Read if necessary: Include target shooting, hunting, military service, and job-related firearm use. Read if necessary: Firearms include pistols, shotguns, rifles, and other types of guns. Do not include BB or pellet guns. 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto HRFIREPROT_C] <2,RF,DK> [goto HRVLOUD12M_C] Question ID: SHE.0260.00.3 Variable name: HRFIREPROT_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=6-17 and HRFIRE12M_C=1 Universe Description: Sample Children 6-17 who have used a firearm or gun in the past 12 months Question Text: DURING THE PAST 12 MONTHS, when shooting firearms how often did ^SCNAME wear hearing protection, such as ear plugs or ear muffs? Would you say... Read answer categories below. Response: Page 234 of 334 1. 2. 3. 4. 5. DK: RF: Fills: Always Usually About half the time Seldom Never Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-5,RF,DK> [goto HRVLOUD12M_C] Question ID: SHE.0270.00.3 Variable name: HRVLOUD12M_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: The next question asks about ^HR_OTHER VERY LOUD sounds. VERY LOUD means so loud you must shout in order to be understood by someone standing 3 feet or arm's length away from you. This includes noise from power tools, machinery, recreational vehicles, racing or speedways, some sporting events, and other things. ^HR_EXCLUDE DURING THE PAST 12 MONTHS, ^HR_WORK has ^SCNAME been exposed to VERY LOUD sounds or noise 10 or more times? 1. 2. DK: RF: Yes No Don't Know Refused ^HR_WORK IfGEN.AGE_FINAL[PX_C]=12-17, work," ^SCNAME Fill ALIAS of HHSTAT_C=1 ^HR_OTHER IfGEN.AGE_FINAL[PX_C]=6-17, fill "other" ^HR_EXCLUDE IfGEN.AGE_FINAL[PX_C]=12-17 fill "Do not include exposure to very loud noises or sounds ^heshe_C may have had while working." Page 235 of 334 fill "outside of Skip Instructions: <1> [goto HRVLDPROT_C] <2,RF,DK> [goto next section] Question ID: SHE.0280.00.3 Variable name: HRVLDPROT_C Interview module: SHE(Child.SHE) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: HRVLOUD12M_C=1 Universe Description: Sample Children 0-17 who have been exposed to very loud noise 10 or more times in the past 12 months Question Text: Response: Fills: DURING THE PAST 12 MONTHS, how often has ^SCNAME worn earplugs or ear muffs when exposed to VERY LOUD sounds or noise ^HR_WORKMOD? Would you say... Read answer categories below. Read if necessary: VERY LOUD means so loud you must shout in order to be understood by someone standing 3 feet (arm's length) away from you. 1. 2. 3. 4. 5. DK: RF: Always Usually About half the time Seldom Never Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^HR_WORKMOD IfGEN.AGE_FINAL[PX_C]=12-17, work" Skip Instructions: <1-5,RF,DK> [goto next section] Page 236 of 334 fill "outside of Question ID: PAR.0010.00.1 Variable name: PARINTRO_C Interview module: PAR(Child.PAR) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.PARENTS_FINAL[PX_C].NONFOST_CNT_FINAL GE 1 Universe Description: Sample Children 0-17 with at least one resident parent who is a biological, adoptive, or step parent. Question Text: Response: Fills: Now I'm going to ask questions about ^SCNAME's parents living here. '1' to continue. 1. Enter Enter 1 to Continue ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto tblPARREL] Question ID: PAR.0030.00.1 Variable name: RELCHPAR_C Interview module: PAR(Child.PAR.tblPARREL.bParent) Inherited Universe: (GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.PARENTS_FINAL[PX_C].NONFOST_CNT_FINAL GE 1) Universe Description: Sample Children 0-17 with at least one resident parent who is a biological, adoptive, or step parent. Question Text: Response: ^AreyouIspar ^SCNAME's biological, adoptive, or step ^fathermother? 1. 2. 3. 4. DK: RF: Biological Adoptive Step Other Don't Know Refused Page 237 of 334 Fills: ^AreyouIspar If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]" ^fathermother If GEN.SEX_FINAL[PX]='1', fill: "father" If GEN.SEX_FINAL[PX]='2', fill: "mother" If GEN.SEX_FINAL[PX]='('DK','RF')', fill: "parent" ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-4,RF,DK> if last parent in GEN.PARENTS_FINAL[PX_C].NONFOST_FINAL [goto MARINTRO_C if any parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has MAR_FLG_A ne 1] else [goto tblPARBORN.bParent.PARBORN_C GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL Adult.NAT.NATUSBORN_A=empty] for first parent in where else [goto next section] else [goto RELCHPAR_C for next GEN.PARENTS_FINAL[PX_C].NONFOST_FINAL] parent listed at **Note: update skip instructions to tblPARBORN** Question ID: PAR.0040.00.1 Variable name: MARINTRO_C Interview module: PAR(Child.PAR) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1) Universe Description: At least one parent has marital flag of 3 or blank, or at least one parent has marital flag of 2 and the parent is the sample adult and not the sample child respondent Question Text: The next set of questions are about marriage and cohabitation. continue. Response: Page 238 of 334 Enter '1' to 1. Enter 1 to Continue Skip Instructions: For the first parent in GEN.PARENTS_FINAL[PX_C].PARENTS _FINAL with GEN.MAR_FLG_A ne 1, If GEN.MAR_FLG_A=blank or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1) [goto tblMAR.bParent.MARITAL_C] Elseif GEN.MAR_FLG_A=3 [goto tblMAR.bPARENT.EVRMARRIED_C] Question ID: PAR.0090.00.1 Variable name: MARITAL_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: (GEN.MAR_FLG_A[PX]=EMPTY or (GEN.MAR_FLG_A[PX]=2 PX=GEN.PX_A and GEN.SARESPSC_FLG ne 1)) auxMARSTATSetByPreviousPerson[PX] ne 2 and and Universe Description: Sample Children 0-17 where parent's marital status is not determined in the Sample Adult section OR the parent's marital status is don't know or refused in the Sample adult section and the parent is the sample adult but not the sample child respondent OR the parent's marital status has not been obtained in this block Question Text: Response: ^AreyouIspar married, living with a partner together as an unmarried couple, or neither? 1. Married Page 239 of 334 2. 3. DK: RF: Fills: Living with a partner together as an unmarried couple Neither Don't Know Refused ^AreyouIspar If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]" Skip Instructions: <1> [goto SPOUSLIV_C] <2> if GEN.PCNT16PLUSNOSC=1 [got ERR1_MARITAL_C] else [goto PARTNERWHO_C] <3,RF,DK> [goto EVRMARRIED_C] Check Name: ERR1_MARITAL_C Text: {signal ERR1_MARITAL_C} Respondent is the only person 16 or older on the household roster. There is no one else eligible to select. Hard / Soft Edit: Soft Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: MARITAL_C=2 and GEN.PCNT16PLUSNOSC=1 Universe Description: Parent reports he/she is living with a partner but parent is the only person eligible to be living with a partner on the household roster Skip Instructions: Correct: [goto MARITAL_C] Suppress: [goto EVRMARRIED_C] Page 240 of 334 Question ID: PAR.0100.00.1 Variable name: SPOUSLIV_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: MARITAL_C=1 Universe Description: Sample Children 0-17 where one parent is married Question Text: Response: Fills: Does ^yourPARspouse currently live in the household? 1. 2. DK: RF: Yes No Don't Know Refused ^yourPARspouse if PX=LNO_SCRESP, fill: "your spouse" else fill: "ALIAS[PX]'s spouse" Skip Instructions: <1> if GEN.PCNT16PLUSNOSC=1 [goto ERR1_SPOUSLIV_C] else [goto SPOUSWHO_C] <2> [goto SPOUSEP_C] loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]] Page 241 of 334 Check Name: ERR1_SPOUSLIV_C Text: {signal ERR1_SPOUSLIV_C} Respondent is the only person 16 or older on the household roster. There is no one else eligible to select. Hard / Soft Edit: Soft Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: MARITAL_C=1 and SPOULIV_C=1 and GEN.PCNT16PLUSNOSC=1 Universe Description: Parent is married and says spouse lives in household but parent is the only person eligible to be married on the household roster Skip Instructions: Correct: [goto SPOUSLIV_C] Suppress: loop through table for remaining parent else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]] Question ID: PAR.0110.00.1 Variable name: SPOUSEP_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: SPOUSLIV_C=2 Universe Description: Sample children 0-17 where parent is married and their spouse doesn't live in the household Page 242 of 334 Question Text: Response: Fills: Does ^yourPAR spouse not live here because ^youPAR and ^yourPAR spouse are legally separated? 1. 2. DK: RF: Yes No Don't Know Refused ^yourPAR If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's " ^youPAR If PX=LNO_SCRESP, fill: "you" else fill "ALIAS[PX]" Skip Instructions: <1,2,RF,DK> loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] Question ID: PAR.0120.00.1 Variable name: SPOUSWHO_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: SPOUSLIV_C=1 Universe Description: Sample Children 0-17 where parent is married and spouse lives in the household Question Text: Which person is ^yourPAR spouse? Enter line number of spouse. Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person. Response: Page 243 of 334 00. 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. DK: RF: Fills: Not on roster ^ALIASNAME[1] ^ALIASNAME[2] ^ALIASNAME[3] ^ALIASNAME[4] ^ALIASNAME[5] ^ALIASNAME[6] ^ALIASNAME[7] ^ALIASNAME[8] ^ALIASNAME[9] ^ALIASNAME[10] ^ALIASNAME[11] ^ALIASNAME[12] ^ALIASNAME[13] ^ALIASNAME[14] ^ALIASNAME[15] ^ALIASNAME[16] ^ALIASNAME[17] ^ALIASNAME[18] ^ALIASNAME[19] ^ALIASNAME[20] ^ALIASNAME[21] ^ALIASNAME[22] ^ALIASNAME[23] ^ALIASNAME[24] ^ALIASNAME[25] Don't Know Refused ^yourPAR If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's " Skip Instructions: <1-25> if MARITAL_C=3 "Neither" for person selected at SPOUSWHO_C [goto ERR1_SPOUSWHO_C] {person selected at SPOUSWHO_C has conflicting answer of "Neither" married or living with a partner at MARITAL_C} elseif SPOUSLIV_C=2 "Outside household" for person selected at SPOUSWHO_C [goto ERR2_SPOUSWHO_C] {person selected at SPOUSWHO_C has conflicting answer of married with a spouse living outside the household at SPOUSLIV_C} elseif person selected at SPOUSWHO_C ((was already selected previously at SPOUSWHO_C or PARTNERWHO_C) or (already chose a spouse/partner)) [goto ERR3_SPOUSWHO_C] {person selected at SPOUSWHO_C is already indicated as married to someone else/a partner of someone else} Page 244 of 334 else if GEN.SEX_FINAL[SPOUSWHO_C] IN('1','2') and GEN.SEX_FINAL[PX] IN ('1','2') [goto SPOUSSEX_C] else loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] <0,RF,DK> loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL Adult.NAT.NATUSBORN_A=empty] else [goto next section] for first parent in where Check Name: ERR1_SPOUSWHO_C Text: {signal ERR1_SPOUSWHO_C} Person selected also has answer of "Neither" married or living together as an unmarried couple. Please correct. Hard / Soft Edit: Soft Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: if MARITAL_C=3 "Neither" for person selected at SPOUSWHO_C Universe Description: Person selected at SPOUSWHO_C has conflicting answer of "Neither" married or living with a partner at MARITAL_C Skip Instructions: [goto MARITAL_C] [goto SPOUSWHO_C] Page 245 of 334 Check Name: ERR2_SPOUSWHO_C Text: {signal ERR2_SPOUSWHO_C} Person selected was indicated to have a spouse living outside the household. Please correct. Hard / Soft Edit: Soft Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: SPOUSLIV_C=2 "Outside household" for person selected at SPOUSWHO_C Universe Description: Person selected at SPOUSWHO_C has conflicting answer of married with a spouse living outside the household at SPOUSLIV_C Skip Instructions: [goto SPOUSLIV_C] [goto SPOUSWHO_C] Check Name: ERR3_SPOUSWHO_C Text: {signal ERR3_SPOUSWHO_C} Person selected is already indicated as ^marriedpartner someone else. Please correct. Hard / Soft Edit: Soft Fills: ^marriedpartner if person selected was previously selected at SPOUSWHO or person selected has MARITAL_C=1 fill "married to"
elseif person selected was previously selected at PARTERWHO or person selected has MARITAL_C=2 fill "a partner of" Page 246 of 334 Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: person selected at SPOUSWHO_C ((was already selected previously at SPOUSWHO_C or PARTNERWHO_C) or (already chose a spouse/partner)) Universe Description: Person selected at SPOUSWHO_C is already indicated as married to someone else/a partner of someone else Question ID: PAR.0130.00.1 Variable name: SPOUSSEX_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: SPOUSEWHO_C=1-25 and GEN.SEX_FINAL[SPOUSWHO_C] IN (1,2) and GEN.SEX_FINAL[PX] IN (1,2) Universe Description: Sample Children 0-17 where parent is married and spouse lives in the household and the sex of the residential parent of interest is not refused/don't know and the sex of the spouse of this parent is not refused/don't know Question Text: I have previously recorded that ^ParentX ^sex_ParentX and that ^fillSPOUSWHO_C ^sex_SPOUSWHO_C. Is that correct? Response: Page 247 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^fillSPOUSWHO_C If SPOUSWHO_C=LNO_SCRESP, fill: "you are" else fill "ALIAS[SPOUSWHO_C] is" ^sex_SPOUSWHO_C If SEX[SPOUSWHO_C]=1 fill: "male" If SEX[SPOUSWHO_C]=2 fill: "female" ^ParentX If PX=LNO_SCRESP, fill: "you are" else fill: "ALIAS[PX] is" ^sex_ParentX If SEX[PX]=1, fill: "male" If SEX[PX]=2, fill: "female" Skip Instructions: <1,RF,DK> loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] <2> [goto FIXSPOUSSEX_C] Question ID: PAR.0140.00.1 Variable name: FIXSPOUSSEX_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: SPOUSSEX_C=2 Universe Description: Sample Children 0-17 where parent is married and spouse lives in the household and the sex of the residential parent of interest is not refused/don't know and the sex of the spouse of this parent is not refused/don't know, and the sex of one or both individuals was incorrect Question Text: Which was not correct? Enter all that apply, separate with commas. Page 248 of 334 Response: 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. ^ALIASNAME[1] ^ALIASNAME[2] ^ALIASNAME[3] ^ALIASNAME[4] ^ALIASNAME[5] ^ALIASNAME[6] ^ALIASNAME[7] ^ALIASNAME[8] ^ALIASNAME[9] ^ALIASNAME[10] ^ALIASNAME[11] ^ALIASNAME[12] ^ALIASNAME[13] ^ALIASNAME[14] ^ALIASNAME[15] ^ALIASNAME[16] ^ALIASNAME[17] ^ALIASNAME[18] ^ALIASNAME[19] ^ALIASNAME[20] ^ALIASNAME[21] ^ALIASNAME[22] ^ALIASNAME[23] ^ALIASNAME[24] ^ALIASNAME[25] Skip Instructions: <1-25> loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] Page 249 of 334 Question ID: PAR.0150.00.1 Variable name: PARTNERWHO_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: MARITAL_C=2 and GEN.PCNT16PLUSNOSC ge 2 Universe Description: Sample Children 0-17 where parent is cohabitating with a partner and there are at least two people eligible to be cohabitating in the household Question Text: Response: Which person is ^yourPAR partner? Enter line number of partner. Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person. 00. 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. Not on roster ^ALIASNAME[1] ^ALIASNAME[2] ^ALIASNAME[3] ^ALIASNAME[4] ^ALIASNAME[5] ^ALIASNAME[6] ^ALIASNAME[7] ^ALIASNAME[8] ^ALIASNAME[9] ^ALIASNAME[10] ^ALIASNAME[11] ^ALIASNAME[12] ^ALIASNAME[13] Page 250 of 334 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. DK: RF: Fills: ^ALIASNAME[14] ^ALIASNAME[15] ^ALIASNAME[16] ^ALIASNAME[17] ^ALIASNAME[18] ^ALIASNAME[19] ^ALIASNAME[20] ^ALIASNAME[21] ^ALIASNAME[22] ^ALIASNAME[23] ^ALIASNAME[24] ^ALIASNAME[25] Don't Know Refused ^pareja_C Spanish fill ^yourPAR If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's " Skip Instructions: <1-25> if MARITAL_C=3 "Neither" for person selected at PARTNERWHO_C [goto ERR1_PARTNERWHO_C] {person selected at PARTNERWHO_C has conflicting answer of "Neither" married or living with a partner at MARITAL_C} elseif SPOUSLIV_C=2 "Outside household" for person selected at PARTNERWHO_C [goto ERR2_PARTNERWHO_C] {person selected at PARTNERWHO_C has conflicting answer of married with a spouse living outside the household at SPOUSLIV_C} elseif person selected at PARTNERWHO_C ((was already selected previously at SPOUSWHO_C or PARTNERWHO_C) or (already chose a spouse/partner)) [goto ERR3_PARTNERWHO_C] {person selected at PARTNERWHO_C is already indicated as married to someone else/a partner of someone else} elseif GEN.SEX_FINAL[PX] IN ('1','2') GEN.SEX_FINAL[PARTNERWHO_C] IN ('1','2')[goto PARTNERSEX_C] else [goto EVRMARRIED_C] <0,RF,DK> [goto EVRMARRIED_C] Page 251 of 334 and Check Name: ERR1_PARTNERWHO_C Text: {signal ERR1_PARTNERWHO_C} Person selected also has answer of "Neither" married or living together as an unmarried couple. Please correct. Hard / Soft Edit: Soft Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: if MARITAL_C=3 "Neither" for person selected at PARTNERWHO_C Universe Description: Person selected at PARTNERWHO_C has conflicting answer of "Neither" married or living with a partner at MARITAL_C Skip Instructions: [goto MARITAL_C] [goto PARTNERWHO_C] Check Name: ERR2_PARTNERWHO_C Text: {signal ERR2_PARTNERWHO_C} Person selected was indicated to have a spouse living outside the household. Please correct. Hard / Soft Edit: Soft Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Page 252 of 334 Universe: SPOUSLIV_C=2 "Outside PARTNERWHO_C household" for person selected at Universe Description: Person selected at PARTNERWHO_C has conflicting answer of married with a spouse living outside the household at SPOUSLIV_C Skip Instructions: [goto SPOUSLIV_C] [goto PARTNERWHO_C] Check Name: ERR3_PARTNERWHO_C Text: {signal ERR3_PARTNERWHO_C} Person selected is already indicated as ^marriedpartner someone else. Please correct. Hard / Soft Edit: Soft Fills: ^marriedpartner if person selected was previously selected at SPOUSWHO or person selected has MARITAL_C=1 fill "married to"
elseif person selected was previously selected at PARTERWHO or person selected has MARITAL_C=2 fill "a partner of" Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: person selected at PARTNERWHO_C ((was already selected previously at SPOUSWHO_C or PARTNERWHO_C) or (already chose a spouse/partner)) Universe Description: Person selected at PARTNERWHO_C is already indicated as married to someone else/a partner of someone else Page 253 of 334 Question ID: PAR.0160.00.1 Variable name: PARTNERSEX_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: PARTNERWHO_C=1-25 and GEN.SEX_FINAL[PX] GEN.SEX_FINAL[PARTNERWHO_C] IN (1,2) IN (1,2) and Universe Description: Sample Children 0-17 where parent is cohabitating with a partner and the partner lives in the household and the sex for the residential parent is not refused or don't know and the sex for the partner is not refused or don't know Question Text: Response: Fills: I have previously recorded that ^ParentX ^sex_ParentX and that ^fillPARTNERWHO_C ^sex_PARTNERWHO_C. Is that correct? 1. 2. DK: RF: Yes No Don't Know Refused ^ParentX If PX=LNO_SCRESP, fill: "you are" else fill: "ALIAS[PX] is" ^sex_ParentX If SEX[PX]=1, fill: "male" If SEX[PX]=2, fill: "female" ^fillPARTNERWHO_C If PARTNERWHO_C=LNO_SCRESP, fill: "you are" else fill "ALIAS[PARTNERWHO_C] is" ^sex_PARTNERWHO_C If GEN.SEX_FINAL[PARTNERWHO_C]=1 fill: "male" If GEN.SEX_FINAL[PARTNERWHO_C]=2 fill: "female" Page 254 of 334 Skip Instructions: <1,RF,DK> [goto EVRMARRIED_C] <2> [goto FIXPARTSEX_C] Question ID: PAR.0170.00.1 Variable name: FIXPARTSEX_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: PARTNERSEX_C=2 Universe Description: Sample Children 0-17 where parent is cohabitating with a partner and the partner lives in the household and the sex for the residential parent is not refused/don't and the sex for the partner is not refused/don't know, and the sex of one or both of the individuals is incorrect. Question Text: Response: Which was not correct? Enter all that apply, separate with commas. 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. ^ALIASNAME[1] ^ALIASNAME[2] ^ALIASNAME[3] ^ALIASNAME[4] ^ALIASNAME[5] ^ALIASNAME[6] ^ALIASNAME[7] ^ALIASNAME[8] ^ALIASNAME[9] ^ALIASNAME[10] Page 255 of 334 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. ^ALIASNAME[11] ^ALIASNAME[12] ^ALIASNAME[13] ^ALIASNAME[14] ^ALIASNAME[15] ^ALIASNAME[16] ^ALIASNAME[17] ^ALIASNAME[18] ^ALIASNAME[19] ^ALIASNAME[20] ^ALIASNAME[21] ^ALIASNAME[22] ^ALIASNAME[23] ^ALIASNAME[24] ^ALIASNAME[25] Skip Instructions: <1-25> [goto EVRMARRIED_C] Question ID: PAR.0180.00.1 Variable name: EVRMARRIED_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: MARITAL_C IN (2,3,RF,DK) or GEN.MAR_FLG_A[PX] auxMARSTATSetByPreviousPerson[PX] = 2 = 3 or Universe Description: Sample Children 0-17 where parent is either cohabitating or not in relationship with anyone else in the household, or the marriage/cohabitation status is refused/don't know in the Adult section or the parent is reported as cohabitating with another parent Question Text: ^HaveyouHasPAR ever been married? Response: Page 256 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^HaveyouHasPAR If PX=LNO_SCRESP, fill: "Have you" else, fill: "Has ALIAS[PX]" Skip Instructions: <1> if (MARITAL_C=2 or GEN.PAR_FLG_C[PX]=3 or GEN.MAR_FLG_A[PX]=3) [goto LEGALSTAT_A] elseif MARITAL_C=3 [goto WIDIVSEP_A] else loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] <2,RF,DK> loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] Question ID: PAR.0190.00.1 Variable name: LEGALSTAT_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: EVRMARRIED_C=1 and (MARITAL_C=2 or GEN.PAR_FLG_C[PX]=3 or GEN.MAR_FLG_A[PX]=3) Universe Description: Sample Children 0-17 where parent has been married and is living with a partner or person selected as a cohabitating partner in PAR or person selected as a cohabitating partner in MAR Question Text: What is ^yourPAR current legal marital status? Response: Page 257 of 334 1. 2. 3. 4. DK: RF: Fills: Married Widowed Divorced Separated Don't Know Refused ^estadocivil_C Spanish Fill ^yourPAR If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's " Skip Instructions: <1-4,RF,DK> loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section] Question ID: PAR.0200.00.1 Variable name: WIDIVSEP_C Interview module: PAR(Child.PAR.tblMAR.bParent) Inherited Universe: (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((At least one parent listed in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has GEN.MAR_FLG_A IN (3,empty) or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1)) AND (auxIsParent[PX]=1 and auxMARSTATNotSetByMAR[PX]=1 and auxMARSTATSetByPreviousPerson[PX] ne 1))) Universe: EVRMARRIED_C=1 and MARITAL_C=3 Universe Description: Sample Children 0-17 where parent is neither living with a partner nor married, but has been married Question Text: ^AreyouIspar widowed, divorced, or separated? Response: Page 258 of 334 1. 2. 3. DK: RF: Fills: Widowed Divorced Separated Don't Know Refused ^AreyouIspar If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]" Skip Instructions: <1-3,RF,DK> loop through table for remaining parents else [goto FINISH_MAR_C] Question ID: PAR.0210.00.1 Variable name: FINISH_MAR_C Interview module: PAR(Child.PAR) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Question Text: Response: The Sample Child MAR section is now complete. 1. Enter 1 to Continue Skip Instructions: <1> [goto tblPARBORN.bParent.PARBORN_C GEN.PARENTS_FINAL[PX_C].PARENTS Adult.NAT.NATUSBORN_A=empty] else [goto next section] Question ID: PAR.0230.00.1 Enter '1' to continue. Variable name: PARBORN_C for first parent in where Interview module: PAR(Child.PAR.tblPARBORN.bPerso Inherited Universe: (PX ne PX_A or (PX=PX_A and Adult.NAT.NATUSBORN_A=empty)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (PX ne PX_A or (PX=PX_A and Adult.NAT.NATUSBORN_A=empty))) Universe Description: Sample Children 0-17 where whether the parent was born in the US or US territory is unknown Question Text: ^WereyouWaspar born in the United States or a U.S. territory? Response: Page 259 of 334 1. 2. DK: RF: Fills: Yes No Don't Know Refused ^WereyouWaspar If PX=LNO_SCRESP, fill: "Were you" else fill: "Was ALIAS[PX]" Skip Instructions: <1,2,RF,DK> loop through table for remaining parents else [goto next section] Question ID: PAR.0240.00.1 Variable name: LOCK_PARENTS_VFY_FINAL Interview module: PAR(Child.PAR) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Question Text: Response: 1. Enter 1 to Continue Skip Instructions: <1> [goto next section] Question ID: NAT.0010.00.1 Variable name: NATUSBORN_C Interview module: NAT(Child.NAT) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Was ^SCNAME born in the United States or a U.S. territory? 1. 2. DK: RF: Yes No Don't Know Refused Page 260 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto NATSTBORN_C] <2> [goto NATUSYR_C] [goto next section] Question ID: NAT.0020.00.1 Variable name: NATSTBORN_C Interview module: NAT(Child.NAT) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: NATUSBORN_C=1 Universe Description: Sample Children 0-17 born in the United States or U.S. territory Question Text: Response: Fills: In what state or U.S. territory was ^SCNAME born? DK: RF: Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: [goto CITIZEN_C] else [goto next section] Question ID: NAT.0040.00.1 Variable name: NATUSYR_C Interview module: NAT(Child.NAT) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: NATUSBORN_C=2 Universe Description: Sample Children 0-17 not born in the United States or U.S. territory Question Text: Response: In what year did ^SCNAME come to the United States to stay? DK: RF: Don't Know Refused Page 261 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <2000-Current Year,RF,DK> if NATUSYR_C gt current year [goto ERR1_NATUSYR_C] if NATUSYR_C lt VFY.BYEAR_C [goto ERR2_NATUSYR_C] else [goto CITIZEN_C] Check Name: ERR1_NATUSYR_C Text: {check ERR1_NATUSYR_C} Future year invalid. Please correct. Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: NATUSYR_C is a future year Check Name: ERR2_NATUSYR_C Text: {check ERR2_NATUSYR_C} Year is prior to date of birth. Please correct. Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: NATUSYR_C = a year prior to child's birth year Page 262 of 334 Question ID: NAT.0050.00.1 Variable name: CITIZEN_C Interview module: NAT(Child.NAT) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: NATUSBORN_C=2 or NATSTBORN_C=American Samoa Universe Description: Sample children 0-17 not born in the United States or U.S. territory or born in American Samoa Question Text: Response: Fills: Is ^SCNAME a citizen of the United States? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1> [goto NATCTZN_C] <2,RF,DK> [goto next section] Question ID: NAT.0060.00.1 Variable name: NATCTZN_C Interview module: NAT(Child.NAT) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: CITIZEN_C=1 Universe Description: Sample Children 0-17 are United States citizens Question Text: Was ^SCNAME born abroad to an American parent, born abroad and adopted by an American parent, or did ^SCNAME become a U.S. citizen by naturalization? Response: Page 263 of 334 1. 2. 3. DK: RF: Fills: Born abroad to American parent Born abroad and adopted by an American parent Became U.S. citizen by naturalization Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-3,RF,DK> [goto next section] Question ID: FEM.0010.00.1 Variable name: FEMINTRO_C Interview module: FEM(Child.FEM) Inherited Universe: ((SAMEFAM_FLG ne 1) OR (SAMEFAM_FLG=1 and PCNT18UP_C=1 and EMP_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=2 and SARESPSC_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG ne 1) OR (SAMEFAM_FLG=1 and PCNT18UP_C=1 and EMP_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=2 and SARESPSC_FLG ne 1))) Universe Description: Sample Child is not in the same family as the Sample Adult OR Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has don't know/refused responses for all questions and the sample adult isn't the sample child respondent. Page 264 of 334 Question Text: Response: Fills: Now I have a few questions about ^youandothfam. 1. Enter '1' to continue. Enter 1 to Continue ^youandothfam IF LNO_SCRESP <> PX_A OR ( LNO_SCRESP = PX_A AND ( (SARESPSC_FLG <> 1 AND EMP_FLG_A=2) OR (EMP_FLG_A = EMPTY) ) )THEN fill: "you" ENDIF IF PCNT18UP_C >= 2 THEN IF fill = EMPTY THEN fill: "other members of your family" ELSEIF (PCNT18UP_C = 2 AND ( (SAMEFAM_FLG <> 1) OR ( (SAMEFAM_FLG = 1) AND ( (SARESPSC_FLG <> 1 AND EMP_FLG_A=2) OR (EMP_FLG_A = EMPTY) ) ) ) ) OR (PCNT18UP_C > 2)THEN fill: "you and other members of your family" ENDIF ENDIF Skip Instructions: [goto tblFEM_C] Question ID: FEM.0030.00.1 Variable name: FEMWORK_C Interview module: FEM(Child.FEM.tblFEM_C.bPerson) Inherited Universe: ((GEN.AGE_FINAL[PX] GE 18 or Roster.HHC.tblAGE.bPerson.AGE18[PX]=2 or Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2) AND (FAMILYC_FLG[PX]=1) AND (HHSTAT_A NE 1 OR (HHSTAT_A=1 AND ((SAMEFAM_FLG=1 AND SARESPSC_FLG ne 1 AND EMP_FLG_A=2) or SAMEFAM_FLG=1 AND EMP_FLG_A='blank'))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG ne 1) OR (SAMEFAM_FLG=1 and PCNT18UP_C=1 and EMP_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=2 and SARESPSC_FLG ne 1)) AND ((GEN.AGE_FINAL[PX] GE 18 or Roster.HHC.tblAGE.bPerson.AGE18[PX]=2 or Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2) Page 265 of 334 AND (FAMILYC_FLG[PX]=1) AND (HHSTAT_A NE 1 OR (HHSTAT_A=1 AND ((SAMEFAM_FLG=1 AND SARESPSC_FLG ne 1 AND EMP_FLG_A=2) or SAMEFAM_FLG=1 AND EMP_FLG_A='blank'))))) Universe Description: (Sample Child is not in the same family as the Sample Adult OR Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has don't know/refused responses for all questions and the sample adult isn't the sample child respondent.) AND Person is in Sample Child's family and over the age of 18 Question Text: Response: Fills: ^DoesDoyouALIASNAME work for pay at a job or business? If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business, enter '1' for yes. 1. 2. DK: RF: Yes No Don't Know Refused ^DoesDoyouALIASNAMEIf PX=LNO_SCRESP, fill: "Do you" (that is if the subject of the question is the sample child respondent, fill: "Do you") else fill: "Does ^ALIASNAME" ^heshetheywork elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works" elseif GEN.SEX_FINAL IN (RF,DK) fill "they work" Page 266 of 334 Skip Instructions: <1> [goto FEMWKFT_C] <2,RF,DK> if there is another adult in the family [goto FEMWORK_C] for the next adult 18+ else [goto next section] Question ID: FEM.0040.00.1 Variable name: FEMWKFT_C Interview module: FEM(Child.FEM.tblFEM_C.bPerson) Inherited Universe: ((GEN.AGE_FINAL[PX] GE 18 or Roster.HHC.tblAGE.bPerson.AGE18[PX]=2 or Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2) AND (FAMILYC_FLG[PX]=1) AND (HHSTAT_A NE 1 OR (HHSTAT_A=1 AND ((SAMEFAM_FLG=1 AND SARESPSC_FLG ne 1 AND EMP_FLG_A=2) or SAMEFAM_FLG=1 AND EMP_FLG_A='blank'))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG ne 1) OR (SAMEFAM_FLG=1 and PCNT18UP_C=1 and EMP_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=blank) OR (SAMEFAM_FLG=1 and PCNT18UP_C GT 1 and FEM_FLG_A=2 and SARESPSC_FLG ne 1)) AND ((GEN.AGE_FINAL[PX] GE 18 or Roster.HHC.tblAGE.bPerson.AGE18[PX]=2 or Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2) AND (FAMILYC_FLG[PX]=1) AND (HHSTAT_A NE 1 OR (HHSTAT_A=1 AND ((SAMEFAM_FLG=1 AND SARESPSC_FLG ne 1 AND EMP_FLG_A=2) or SAMEFAM_FLG=1 AND EMP_FLG_A='blank'))))) Universe: FEMWORK_C=1 Universe Description: (Sample Child is not in the same family as the Sample Adult OR Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has don't know/refused responses for all questions and the sample adult isn't the sample child respondent.) Page 267 of 334 AND Person is in Sample Child's family and over the age of 18 AND The adult in question works for pay at a job or business Question Text: Response: Fills: ^DoesDoyouALIASNAME usually work 35 hours or more per week in total at ^hisheryour job or jobs? 1. 2. DK: RF: Yes No Don't Know Refused ^DoesDoyouALIASNAMEIf PX=LNO_SCRESP, fill: "Do you" (that is if the subject of the question is the sample child respondent, fill: "Do you") else fill: "Does ^ALIASNAME" ^hisheryour If PX=LNO_SCRESP, fill: "your" (that is, if the subject of the question is the sample child respondent, fill: "your") else if SEX_FINAL[PX] = 1, fill "his" else if SEX_FINAL[PX] = 2, fill "her" else if SEX_FINAL[PX] in (DK,RF), fill "their" Skip Instructions: <1,2,RF,DK> if another adult in the family [goto FEMWORK_C] for the next adult 18+ else [goto next section] Page 268 of 334 Question ID: INC.0010.00.1 Variable name: INCINTRO_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: The next questions are about your total family income in ^LASTYEAR BEFORE TAXES. Based on questions asked earlier, we have that ^SCNAME's family consists of ^INCINTRO_C_fill. Read if necessary: Income is important in analyzing the health information we collect. For example, with this information, we can learn whether persons in one income group use certain types of medical services more or less often than those in another group. Please be assured that, like all other information you have provided, these answers will remain confidential. Enter '1' to continue. 1. Enter 1 to Continue ^LASTYEAR Fill year prior to current year ^SCNAME Fill ALIAS of HHSTAT_C=1 ^INCINTRO_C_fill For all people with FAMC_REL_FLG =1 OR (SAME_REL_FLG=1 for SC and tblRelate_SA.bPerson.RELATE in (1-13,DK,RF)) OR (FAMA_REL_FLG=1 and 1st person in SC's family has tblRelate_SA.bPerson.RELATE in (1-13,DK,RF), fill with their names. Description: Person was identified as being in the SC's family at WHOPAR/WHOFOST OR (Sample Child is related to the Sample Adult and person on roster was placed in Sample Adult's family based on answer provided at RELATE), include their name as part of the list of SC's family. Include sample child on the list. Page 269 of 334 If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list. Include the word "and" before the last name on the list. Skip Instructions: <1> [goto INCWRKO_C] Question ID: INC.0020.00.1 Variable name: INCWRKO_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: In ^LASTYEAR, did ^YOUFAM18YRS_C receive income from wages, salaries, commissions, bonuses, tips, or self-employment? Read if necessary: For the purpose of this survey, ^SCNAME's family includes ^FAMVERSC_fill 1. 2. DK: RF: Yes No Don't Know Refused Page 270 of 334 Fills: ^YOUFAM18YRS_C If GEN.PCNT18UP_C=1 fill "you" else if GEN.PCNT18UP_C GT 1 fill "you or any family members 18 or older" ^SCNAME Fill ALIAS of HHSTAT_C=1 ^FAMVERSC_fill Loop through all persons on roster and add to list of names if FAMILYC_flg = 1 Do not include Sample Child on list. If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list. If only one person on the list of names and person ne Roster.HHC.HHRESPAVAIL, follow list with "is". If more than one person on the list or only one person on list and person is Household Respondent (Roster.HHC.HHRESPAVAIL), follow list with "are". ^LASTYEAR Fill year prior to current year Skip Instructions: <1,2,RF,DK> [goto INCINTER_C] Question ID: INC.0030.00.1 Variable name: INCINTER_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: In ^LASTYEAR, did ANY FAMILY MEMBERS receive income from interest-bearing accounts or investments, dividends from stocks or mutual funds, net rental income, royalty income, or income from estates and trusts? Page 271 of 334 Response: Fills: 1. 2. DK: RF: Yes No Don't Know Refused ^LASTYEAR Fill year prior to current year Skip Instructions: <1,2,RF,DK> [goto INCSSRR_C] Question ID: INC.0031.00.1 Variable name: INCSSRR_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCWRKO_C IN (1,2,DK) or INCINTER_C in (1,2,DK) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused and both the income from wages and income from accounts questions have not been refused Question Text: Response: Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive... Income from Social Security or Railroad Retirement? 1. 2. DK: RF: Yes No Don't Know Refused Page 272 of 334 Fills: ^LASTYEAR Fill year prior to current year ^YOUFAMHERE_C If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT2 fill "you or any family members" Skip Instructions: <1,2,RF,DK> [goto INCSSISSDI_C] Question ID: INC.0040.00.1 Variable name: INCSSISSDI_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCWRKO_C IN (1,2,DK) or INCINTER_C in (1,2,DK) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused and both the income from wages and income from accounts questions have not been refusedv Question Text: Response: Read if necessary: In ^LASTYEAR, did ANY FAMILY MEMBERS receive... Supplemental Security Income, SSI, or Social Security Disability Income, SSDI, which are different from Social Security? 1. 2. DK: RF: Yes No Don't Know Refused Page 273 of 334 Fills: ^LASTYEAR Fill year prior to current year Skip Instructions: <1> [goto SSISSDIBTH_C] <2,RF,DK> [goto INCWELF_C] Question ID: INC.0050.00.1 Variable name: SSISSDIBTH_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCSSISSDI_C=1 Universe Description: Sample Children 0-17 where someone in the family gets SSI or SSDI and Sample Child INC section has not been completed OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused OR the Sample Adult and Sample Child are not in the same family Question Text: Response: Was this Supplemental Security Income, SSI, Social Security Disability Income, SSDI, or both? 1. 2. 3. DK: RF: SSI SSDI Both SSI and SSDI Don't Know Refused Skip Instructions: <1-3,RF,DK> [goto SSISSDIDSB_C] Page 274 of 334 Question ID: INC.0060.00.1 Variable name: SSISSDIDSB_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCSSISSDI_C=1 Universe Description: Sample Children 0-17 living in families where someone in the family gets SSI or SSDI and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Was this received as a disability benefit? 1. 2. DK: RF: Yes No Don't Know Refused Skip Instructions: <1> [goto SSISSDIP_C] <2,RF,DK> [goto INCWELF_C] Question ID: INC.0070.00.1 Variable name: SSISSDIP_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCSSISSDI_C=1 and SSISSDIDSB_C=1 Universe Description: Sample Children 0-17 with more than one person in the family where someone in the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult Page 275 of 334 questions is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: In ^LASTYEAR, who received this disability benefit? Read if necessary: Do NOT include a benefit received on behalf of someone else. Enter all that apply, separate with commas. 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. DK: RF: ^ALIASNAME[1] ^ALIASNAME[2] ^ALIASNAME[3] ^ALIASNAME[4] ^ALIASNAME[5] ^ALIASNAME[6] ^ALIASNAME[7] ^ALIASNAME[8] ^ALIASNAME[9] ^ALIASNAME[10] ^ALIASNAME[11] ^ALIASNAME[12] ^ALIASNAME[13] ^ALIASNAME[14] ^ALIASNAME[15] ^ALIASNAME[16] ^ALIASNAME[17] ^ALIASNAME[18] ^ALIASNAME[19] ^ALIASNAME[20] ^ALIASNAME[21] ^ALIASNAME[22] ^ALIASNAME[23] ^ALIASNAME[24] ^ALIASNAME[25] Don't Know Refused ^LASTYEAR Fill year prior to current year Page 276 of 334 Skip Instructions: <1-25,RF,DK> [goto INCWELF_C] Question ID: INC.0090.00.1 Variable name: INCWELF_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCWRKO_C IN (1,2,DK) or INCINTER_C in (1,2,DK) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused and both the income from wages and income from accounts questions have not been refused Question Text: Response: Fills: In ^LASTYEAR, did ^YOUFAMHERE_C receive... Any public assistance or welfare payments from the state or local welfare office? 1. 2. DK: RF: Yes No Don't Know Refused ^LASTYEAR Fill year prior to current year ^YOUFAMHERE_C If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT2 fill "you or any family members" Page 277 of 334 Skip Instructions: <1,2,RF,DK> [goto INCRETIRE_C] Question ID: INC.0100.00.1 Variable name: INCRETIRE_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCWRKO_C IN (1,2,DK) or INCINTER_C in (1,2,DK) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused and both the income from wages and income from accounts questions have not been refused Question Text: Response: Fills: Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive... Income from retirement, survivor, or disability pensions? 1. 2. DK: RF: Yes No Don't Know Refused ^LASTYEAR Fill year prior to current year ^YOUFAMHERE_C If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT2 fill "you or any family members" Page 278 of 334 Skip Instructions: <1,2,RF,DK> [goto INCOTHR_C] Question ID: INC.0110.00.1 Variable name: INCOTHR_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCWRKO_C IN (1,2,DK) or INCINTER_C in (1,2,DK) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused and both the income from wages and income from accounts questions have not been refused Question Text: Response: Fills: Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive... Any other sources of income such as VA payments from the Veterans Benefits Administration, unemployment compensation, child support, or alimony? 1. 2. DK: RF: Yes No Don't Know Refused ^LASTYEAR Fill year prior to current year ^YOUFAMHERE_C If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT2 fill "you or any family members" Page 279 of 334 Skip Instructions: <1,2,RF,DK> [goto INCTOTAL_C] Question ID: INC.0120.00.1 Variable name: INCTOTAL_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCWRKO_C IN (1,2,DK) or INCINTER_C in (1,2,DK) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused and both the income from wages and income from accounts questions have not been refused Question Text: Response: When answering this next question, please remember to include your income PLUS the income of all family members living in this household. What is your best estimate of the total income of all family members from all sources, before taxes, in the last calendar year? Enter '999995' if the reported income is $999,995 or greater. DK: RF: Don't Know Refused Skip Instructions: <0-999> [goto ERR1_INCTOTAL_C] <250001-999995> [goto ERR2_INCTOTAL_C] <1000-250000> [goto next section] [goto INC250PCT_C] Page 280 of 334 Check Name: ERR1_INCTOTAL_C Text: {signal ERR1_INCTOTAL_C} Do not read to the respondent. unusually low. Make corrections if necessary. ^INCTOTAL_C is Hard / Soft Edit: Soft Fills: ^INCTOTAL_C Fill value from INCTOTAL_C Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCTOTAL_C=0-999 Check Name: ERR2_INCTOTAL_C Text: {signal ERR2_INCTOTAL_C} Do not read to the respondent. unusually high. Make corrections if necessary. ^INCTOTAL_C is Hard / Soft Edit: Soft Fills: ^INCTOTAL_C Fill value from INCTOTAL_C Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCTOTAL_C=250001-999995 Page 281 of 334 Question ID: INC.0140.01.1 Variable name: INC250PCT_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INCTOTAL_C IN (DK,RF) Universe Description: Sample Children 0-17 who don't know or refuse the total family income and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: Was your total family income from all sources less than ^250POVERTY_C or ^250POVERTY_C or more? 1. 2. DK: RF: Less than ^250POVERTY_C ^250POVERTY_C or more Don't Know Refused ^250POVERTY_C Fill value stored in Child.INC.INC250PCT_C Skip Instructions: <1> [goto INC138PCT_C] <2> if GEN.PCNT_C=2 and GEN.PCNT66UP_C ge 1 [goto INC75K_C]; else if GEN.PCNT_C=4 OR GEN.PCNT_C ge 6 [goto INC400PCT_C]; else if (GEN.PCNT_C=2 and GEN.PCNT66UP_C=0) or GEN.PCNT_C IN (3,5) [goto INC100K_C] [goto next section] Page 282 of 334 Question ID: INC.0150.01.1 Variable name: INC138PCT_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INC250PCT_C=1 Universe Description: Sample Children 0-17 answered less than 250% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: Was your total family income from all sources less than ^138POVERTY_C or ^138POVERTY_C or more? 1. 2. DK: RF: Less than ^138POVERTY_C ^138POVERTY_C or more Don't Know Refused ^138POVERTY_C Fill value stored in Child.INC.INC138PCT_C Skip Instructions: <1> [goto INC100PCT_C] <2> [goto INC200PCT_C] [goto next section] Page 283 of 334 Question ID: INC.0160.01.1 Variable name: INC100PCT_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INC138PCT_C=1 Universe Description: Sample Children 0-17 who answered less than 138% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: Was your total family income from all sources less than ^100POVERTY_C or ^100POVERTY_C or more? 1. 2. DK: RF: Less than ^100POVERTY_C ^100POVERTY_C or more Don't Know Refused ^100POVERTY_C Fill value stored in Child.INC.INC100PCT_C Skip Instructions: <1,2,RF,DK> [goto next section] Page 284 of 334 Question ID: INC.0170.01.1 Variable name: INC200PCT_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INC138PCT_C=2 Universe Description: Sample Children 0-17 who answered 138% of poverty or more and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: Was your total family income from all sources less than ^200POVERTY_C or ^200POVERTY_C or more? 1. 2. DK: RF: Less than ^200POVERTY_C ^200POVERTY_C or more Don't Know Refused ^200POVERTY_C Fill value stored in Child.INC.INC200PCT_C Skip Instructions: <1> if GEN.PCNT ge 9 [goto INC100K_C] else [goto next section] <2,RF,DK> [goto next section] Page 285 of 334 Question ID: INC.0180.00.1 Variable name: INC75K_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INC250PCT_C=2 and GEN.PCNT_C=2 and GEN.PCNT66UP_C ge 1 Universe Description: Sample Children 0-17 who answered 250% of poverty threshold or more and are from a 2 person family where the adult is 66 years of age or older and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Was your total family income from all sources less than $75,000 or $75,000 or more? 1. 2. DK: RF: Less than $75,000 $75,000 or more Don't Know Refused Skip Instructions: <1> [goto INC400PCT_C] <2> [goto INC100K_C] [goto next section] Page 286 of 334 Question ID: INC.0190.00.1 Variable name: INC100K_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: INC75K_C=2 or (INC250PCT_C=2 and (GEN.PCNT_C IN (3,5) or (GEN.PCNT_C=2 and GEN.PCNT66UP_C =0))) or (INC200PCT_C=1 and GEN.PCNT_C ge 9) Universe Description: Sample Children 0-17 who answered $75,000 or more OR answered 250% of poverty threshold or more and are from a 3 or 5 person family or are from 2 person family and the adult is less than 66 years of age or who answered less than 200% of the poverty level and are from a 9 or more person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Was your total family income from all sources less than $100,000 or $100,000 or more? 1. 2. DK: RF: Less than $100,000 $100,000 or more Don't Know Refused Skip Instructions: <1> if GEN.PCNT_C IN (2,5,9+) [goto next section] else if GEN.PCNT_C=3 [goto INC400PCT_C] <2> if GEN.PCNT_C IN (1,2,3) [goto INC150K_C] else if GEN.PCNT_C=5 [goto INC400PCT_C] else if GEN.PCNT_C ge 9 [goto next section] [goto next section] Page 287 of 334 Question ID: INC.0200.01.1 Variable name: INC400PCT_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: (INC75K_C=1 or (INC100K_C=1 and (GEN.PCNT_C=3 or (GEN.PCNT_C=2 and GEN.PCNT66UP_C=0))) or (INC100K_C=2 and GEN.PCNT_C=5) or (INC250PCT_C=2 and (GEN.PCNT_C=4 or GEN.PCNT_C ge 6))) Universe Description: Sample Children 0-17 who answered less than $75,000 OR answered less than $100,000 and are from a 3 person family OR answered $100,000 or more and from a 5 person family OR answered 250% of poverty threshold or more and are from a 4 or 6+ person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Fills: Was your total family income from all sources less than ^400POVERTY_C or ^400POVERTY_C or more? 1. 2. DK: RF: Less than ^400POVERTY_C ^400POVERTY_C or more Don't Know Refused ^400POVERTY_C Fill value stored in Child.INC.INC400PCT_C Page 288 of 334 Skip Instructions: <1> if GEN.PCNT_C in (7,8) [goto INC150K_C] else [goto next section] <2> if GEN.PCNT_C IN (2,3) or GEN.PCNT_C ge 6 [goto next section] else if GEN.PCNT_C IN (4,5) [goto INC150K_C] [goto next section] Question ID: INC.0210.00.1 Variable name: INC150K_C Interview module: INC(Child.INC) Inherited Universe: ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND ((SAMEFAM_FLG=1 and INC_FLG_A=blank) or (SAMEFAM_FLG=1 and INC_FLG_A=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1))) Universe: (INC100K_C=2 and GEN.PCNT_C IN (2,3)) or (INC400PCT_C=2 and GEN.PCNT_C IN (4,5)) or (INC400PCT_C=1 and GEN.PCNT_C IN (7,8)) Universe Description: Sample Children 0-17 who answered $100,000 or more and are from 2 or 3 person family OR answered 400% of poverty threshold or more and are from 4 or 5 person family OR answered less than 400% of poverty threshold and are from a family of 7 or 8 persons and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused Question Text: Response: Was your total family income from all sources less than $150,000 or $150,000 or more? 1. 2. DK: RF: Less than $150,000 $150,000 or more Don't Know Refused Page 289 of 334 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: FOO.0010.00.1 Variable name: FSNAP12M_C Interview module: FOO(Child.FOO) Inherited Universe: (FINISH_FOO_C ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (FINISH_FOO_C ne 1)) Universe: ((GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_A=blank) (GEN.SAMEFAM_FLG ne 1) or (GEN.SAMEFAM_FLG=1 GEN.FOO_FLG_A=2 and GEN.SARESPSC_FLG NE 1)) or and Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was not the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK. Question Text: Response: Fills: At any time in the last 12 months did any family members living here receive ^FSSNAPNM? Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy food. 1. 2. DK: RF: Yes No Don't Know Refused ^FSSNAPNM If AL then fill "Food Assistance Program or food stamp benefits" If AK then fill "SNAP or food stamp benefits" If AZ then fill "Nutrition Assistance or food stamp benefits" If AR then fill "SNAP or food stamp benefits" If CA then fill "CalFresh or food stamp benefits" If CO then fill "SNAP or food stamp benefits" If CT then fill "SNAP or food stamp benefits" If DE then fill "Food Supplement Program or food stamp benefits" If DC then fill "SNAP or food stamp benefits" If FL then fill "SNAP or food stamp benefits" If GA then fill "Georgia Food Stamp Program or food stamp benefits" If HI then fill "SNAP or food stamp benefits" If ID then fill "SNAP or food stamp benefits" Page 290 of 334 If IL then fill "SNAP or food stamp benefits" If IN then fill "SNAP or food stamp benefits" If IA then fill "SNAP or food stamp benefits" If KS then fill "Food Assistance Program or food stamp benefits" If KY then fill "SNAP or food stamp benefits" If LA then fill "SNAP or food stamp benefits" If ME then fill "Food Supplement Program or food stamp benefits" If MD then fill "SNAP or food stamp benefits" If MA then fill "SNAP or food stamp benefits" If MI then fill "Food Assistance Program (FSP) or food stamp benefits" If MN then fill "SNAP or food stamp benefits" If MS then fill "SNAP or food stamp benefits" If MO then fill "SNAP or food stamp benefits" If MT then fill "SNAP or food stamp benefits" If NE then fill "SNAP or food stamp benefits" If NV then fill "SNAP or food stamp benefits" If NH then fill "SNAP or food stamp benefits" If NJ then fill "NJ SNAP or food stamp benefits" If NM then fill "SNAP or food stamp benefits" If NY then fill "SNAP or food stamp benefits" If NC then fill "Food and Nutrition Services or food stamp benefits" If ND then fill "SNAP or food stamp benefits" If OH then fill "SNAP or food stamp benefits" If OK then fill "SNAP or food stamp benefits" If OR then fill "SNAP or food stamp benefits" If PA then fill "SNAP or food stamp benefits" If RI then fill "SNAP or food stamp benefits" If SC then fill "SNAP or food stamp benefits" If SD then fill "SNAP or food stamp benefits" If TN then fill "SNAP or food stamp benefits" If TX then fill "SNAP or food stamp benefits" If UT then fill "SNAP or food stamp benefits" If VT then fill "3SquaresVT or food stamp benefits" If VA then fill "SNAP or food stamp benefits" If WA then fill "Basic Food or food stamp benefits" If WV then fill "SNAP or food stamp benefits" If WI then fill "FoodShare Wisconsin or food stamp benefits" If WY then fill "SNAP or food stamp benefits" Page 291 of 334 Skip Instructions: <1> [goto FSNAP30D_C] <2,RF,DK> if PCNTF1255_C GE 1 or PCNTC05_C GE 1, [goto FWIC12M_C] else if PCNTC517_C GE 1 [goto FLUNCH12M1_C] else [goto FINISH_FOO_C] Question ID: FOO.0020.00.3 Variable name: FSNAP30D_C Interview module: FOO(Child.FOO) Inherited Universe: (FINISH_FOO_C ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (FINISH_FOO_C ne 1)) Universe: FSNAP12M_C=1 Universe Description: Sample Child 0-17 and someone in the family received food stamps in the past 12 months Question Text: Response: Fills: Did any family members living here receive ^FSSNAPNM in the LAST 30 days? Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy food. 1. 2. DK: RF: Yes No Don't Know Refused ^FSSNAPNM If AL then fill "Food Assistance Program or food stamp benefits" If AK then fill "SNAP or food stamp benefits" If AZ then fill "Nutrition Assistance or food stamp benefits" If AR then fill "SNAP or food stamp benefits" If CA then fill "CalFresh or food stamp benefits" If CO then fill "SNAP or food stamp benefits" If CT then fill "SNAP or food stamp benefits" If DE then fill "Food Supplement Program or food stamp benefits" If DC then fill "SNAP or food stamp benefits" If FL then fill "SNAP or food stamp benefits" If GA then fill "Georgia Food Stamp Program or food stamp benefits" If HI then fill "SNAP or food stamp benefits" If ID then fill "SNAP or food stamp benefits" If IL then fill "SNAP or food stamp benefits" If IN then fill "SNAP or food stamp benefits" If IA then fill "SNAP or food stamp benefits" Page 292 of 334 If KS then fill "Food Assistance Program or food stamp benefits" If KY then fill "SNAP or food stamp benefits" If LA then fill "SNAP or food stamp benefits" If ME then fill "Food Supplement Program or food stamp benefits" If MD then fill "SNAP or food stamp benefits" If MA then fill "SNAP or food stamp benefits" If MI then fill "Food Assistance Program (FSP) or food stamp benefits" If MN then fill "SNAP or food stamp benefits" If MS then fill "SNAP or food stamp benefits" If MO then fill "SNAP or food stamp benefits" If MT then fill "SNAP or food stamp benefits" If NE then fill "SNAP or food stamp benefits" If NV then fill "SNAP or food stamp benefits" If NH then fill "SNAP or food stamp benefits" If NJ then fill "NJ SNAP or food stamp benefits" If NM then fill "SNAP or food stamp benefits" If NY then fill "SNAP or food stamp benefits" If NC then fill "Food and Nutrition Services or food stamp benefits" If ND then fill "SNAP or food stamp benefits" If OH then fill "SNAP or food stamp benefits" If OK then fill "SNAP or food stamp benefits" If OR then fill "SNAP or food stamp benefits" If PA then fill "SNAP or food stamp benefits" If RI then fill "SNAP or food stamp benefits" If SC then fill "SNAP or food stamp benefits" If SD then fill "SNAP or food stamp benefits" If TN then fill "SNAP or food stamp benefits" If TX then fill "SNAP or food stamp benefits" If UT then fill "SNAP or food stamp benefits" If VT then fill "3SquaresVT or food stamp benefits" If VA then fill "SNAP or food stamp benefits" If WA then fill "Basic Food or food stamp benefits" If WV then fill "SNAP or food stamp benefits" If WI then fill "FoodShare Wisconsin or food stamp benefits" If WY then fill "SNAP or food stamp benefits" Page 293 of 334 Skip Instructions: <1,2,RF,DK> if PCNTF1255_C GE 1 or PCNTC05_C GE 1, [goto FWIC12M_C] else if PCNTC517_C GE 1 [goto FLUNCH12M1_C] else [goto FINISH_FOO_C] Question ID: FOO.0030.00.1 Variable name: FWIC12M_C Interview module: FOO(Child.FOO) Inherited Universe: (FINISH_FOO_C ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (FINISH_FOO_C ne 1)) Universe: (PCNTF1255_C ge 1 or PCNTC05_C ge 1) AND ((GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_A=blank) or (GEN.SAMEFAM_FLG ne 1) or (GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_A=2 GEN.SARESPSC_FLG ne 1) or (GEN.SAMFAM_FLG=1 and GEN.FOO_FLG_A=1 Adult.FOO.FWIC12M_A = EMPTY)) and and Universe Description: Sample Children 0-17 living in families with females 12-55 years of age or children 0-5 years of age and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK. Question Text: Response: At any time in the last 12 months did any family members living here receive benefits from the WIC program, that is, the Women, Infants, and Children program? 1. 2. DK: RF: Yes No Don't Know Refused Page 294 of 334 Skip Instructions: <1,2,RF,DK> If PCNTC517_C GE 1 [goto FLUNCH12M1_C] else [goto FINISH_FOO_C] Question ID: FOO.0040.00.1 Variable name: FLUNCH12M1_C Interview module: FOO(Child.FOO) Inherited Universe: (FINISH_FOO_C ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (FINISH_FOO_C ne 1)) Universe: PCNTC517_C ge 1 AND ((GEN.SAMEFAM_FLG=1 GEN.FOO_FLG_A=blank) or (GEN.SAMEFAM_FLG ne 1) or (GEN.SAMEFAM_FLG=1 GEN.FOO_FLG_A=2 and GEN.SARESPSC_FLG NE 1) (GEN.SAMFAM_FLG=1 and GEN.FOO_FLG_A=1 Adult.FOO.FLUNCH12M1_A = EMPTY)) and and or and Universe Description: Sample Children living in families with children between the ages of 5-17 and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK. Question Text: Response: At any time in the last 12 months, did ^SCCHILDFAM_C receive free or reduced-price breakfasts or lunches at school? Read if necessary: The National School Lunch Program and the School Breakfast Program provide cash assistance to states to operate breakfast and lunch programs in schools and residential childcare institutions. The programs provide low-price or free breakfasts and lunches to low-income children in kindergarten through 12th grade. 1. 2. DK: RF: Yes No Don't Know Refused Page 295 of 334 Fills: ^SCCHILDFAM_C if PCNTC517_C=1, fill "^SCNAME", elseif PCNTC517_Cgt 1, fill "any child in your family", Skip Instructions: <1,2,RF,DK> [goto FINISH_FOO_C] Question ID: FOO.0050.00.1 Variable name: FINISH_FOO_C Interview module: FOO(Child.FOO) Inherited Universe: (FINISH_FOO_C ne 1) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (FINISH_FOO_C ne 1)) Universe: FOO_FINISH_C = EMPTY AND ((GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_A=blank) or (GEN.SAMEFAM_FLG ne 1) or (GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_A=2 and GEN.SARESPSC_FLG NE 1) or (GEN.SAMFAM_FLG=1 and GEN.FOO_FLG_A=1 and Adult.FOO.FWIC12M_A = EMPTY and (PCNTF1255_C ge 1 or PCNTC05_C ge 1)) or (GEN.SAMFAM_FLG=1 and GEN.FOO_FLG_A=1 and Adult.FOO.FLUNCH12M1_A = EMPTY and PCNTC517_C ge 1)) Question Text: Response: The Sample Child food related programs section is now complete. continue. 1. Enter 1 to Continue Skip Instructions: <1> [goto next section] Page 296 of 334 Enter '1' to Question ID: FDS.0010.00.3 Variable name: FDSINTRO_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent Question Text: Response: These next questions are about whether you were always able to afford the food you needed in the last 30 days. I'm going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for your family in the last 30 days. Enter '1' to continue. 1. Enter 1 to Continue Skip Instructions: <1> [goto FDSRUNOUT_C] Question ID: FDS.0020.00.3 Variable name: FDSRUNOUT_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent Question Text: The first statement is "We worried whether our food would run out before we got money to buy more." Was that often true, sometimes true, or never true for your family in the last 30 days? Page 297 of 334 Response: 1. 2. 3. DK: RF: Often true Sometimes true Never true Don't Know Refused Skip Instructions: <1-3,RF,DK> [goto FDSLAST_C] Question ID: FDS.0030.00.3 Variable name: FDSLAST_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent Question Text: Response: "The food that we bought just didn't last, and we didn't have money to get more." Was that often true, sometimes true, or never true for your family in the last 30 days? 1. 2. 3. DK: RF: Often true Sometimes true Never true Don't Know Refused Skip Instructions: <1-3,RF,DK> [goto FDSBALANCE_C] Page 298 of 334 Question ID: FDS.0040.00.3 Variable name: FDSBALANCE_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent Question Text: Response: "We couldn't afford to eat balanced meals." Was that often true, sometimes true, or never true for your family in the last 30 days? 1. 2. 3. DK: RF: Often true Sometimes true Never true Don't Know Refused Skip Instructions: <1-2> [goto FDSSKIP_C] <3,RF,DK> if FDSRUNOUT_C IN (1,2) OR FDSLAST_C IN (1,2) [goto FDSSKIP_C]; else [goto next section] Page 299 of 334 Question ID: FDS.0050.00.3 Variable name: FDSSKIP_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: FDSRUNOUT_C IN (1,2) or FDSLAST_C IN (1,2) or FDSBALANCE_C IN (1,2) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals. Question Text: Response: Fills: In the last 30 days, did ^youorother_C ever cut the size of your meals or skip meals because there wasn't enough money for food? 1. 2. DK: RF: Yes No Don't Know Refused ^youorother_C If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family" ^dejar_C Spanish Only Page 300 of 334 Skip Instructions: <1> [goto FDSSKIPDYS_C] <2,RF,DK> [goto FDSLESS_C] Question ID: FDS.0060.00.3 Variable name: FDSSKIPDYS_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: FDSSKIP_C = 1 Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent respondent answered they skipped meals due to cost Question Text: Response: In the last 30 days, how many days did this happen? DK: RF: Don't Know Refused Skip Instructions: <1-30,RF,DK> [goto FDSLESS_C] Page 301 of 334 Question ID: FDS.0070.00.3 Variable name: FDSLESS_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: (FDSRUNOUT_C IN (1,2) or FDSLAST_C IN (1,2) or FDSBALANCE_C IN (1,2)) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals. Question Text: Response: Fills: In the last 30 days, did ^youorother_C ever eat less than you felt you should because there wasn't enough money for food? 1. 2. DK: RF: Yes No Don't Know Refused ^youorother_C If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family" ^COMER_C Spanish Only ^pensar_C Spanish Only Page 302 of 334 Skip Instructions: <1,2,RF,DK> [goto FDSHUNGRY_C] Question ID: FDS.0080.00.3 Variable name: FDSHUNGRY_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: (FDSRUNOUT_C IN (1,2) or FDSLAST_C IN (1,2) or FDSBALANCE_C IN (1,2)) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals. Question Text: Response: Fills: In the last 30 days, were ^youorother_C ever hungry but didn't eat because there wasn't enough money for food? 1. 2. DK: RF: Yes No Don't Know Refused ^youorother_C If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family" ^estar_C Spanish Only ^COMER_C Spanish Only Page 303 of 334 Skip Instructions: <1,2,RF,DK> [goto FDSWEIGHT_C] Question ID: FDS.0090.00.3 Variable name: FDSWEIGHT_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: (FDSRUNOUT_C IN (1,2) or FDSLAST_C IN (1,2) or FDSBALANCE_C IN (1,2)) Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals. Question Text: Response: Fills: In the last 30 days, did ^youorother_C lose weight because there wasn't enough money for food? 1. 2. DK: RF: Yes No Don't Know Refused ^perder_C Spanish Only ^youorother_C If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family" Page 304 of 334 Skip Instructions: <1> [goto FDSNOTEAT_C] <2,RF,DK> if FDSSKIP_C=1 or FDSLESS_C=1 or FDSHUNGRY_C=1 [goto FDSNOTEAT_C]; else [goto next section] Question ID: FDS.0100.00.3 Variable name: FDSNOTEAT_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: FDSSKIP_C=1 OR FDSWEIGHT_C=1 FDSLESS_C=1 OR FDSHUNGRY_C=1 OR Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered they cut the size of the meals, skipped meals, were hungry but didn't eat, or lost weight in the last 30 days because there wasn't enough money for food. Question Text: Response: Fills: In the last 30 days, did ^youorother_C ever not eat for a whole day because there wasn't enough money for food? 1. 2. DK: RF: Yes No Don't Know Refused ^pasar_C Spanish Only ^youorother_C If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family" Page 305 of 334 Skip Instructions: <1> [goto FDSNEDAYS_C] <2,RF,DK> [goto next section] Question ID: FDS.0110.00.3 Variable name: FDSNEDAYS_C Interview module: FDS(Child.FDS) Inherited Universe: (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1))) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (((SAMEFAM_FLG=1 and FDS_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and FDS_FLG_A=2 and SARESPSC_FLG ne 1)))) Universe: FDSNOTEAT_C=1 Universe Description: Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and adults in the family have ever not eaten for a whole day because there wasn't enough money for food in the last 30 days Question Text: Response: In the last 30 days, how many days did this happen? DK: RF: Don't Know Refused Skip Instructions: <1-30,RF,DK> [goto next section] Page 306 of 334 Question ID: HOU.0010.00.1 Variable name: HOUYRSLIV_C Interview module: HOU(Child.HOU) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: GEN.AGE_FINAL[PX_C]=1-17 Universe Description: Sample Children 1-17 Question Text: Response: Fills: About how long has ^SCNAME lived in this house/apartment? 1. 2. 3. 4. DK: RF: Less than 1 year 1 to 3 years 4 to 10 years 11 years or more Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1-4,RF,DK> if ((SAMEFAM_FLG=1 and HOU_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and HOU_FLG_A=2 and SARESPSC_FLG ne 1)) [goto HOUTENURE_C] else [goto next section] If GEN.AGE_FINAL[PX_C] ERR1_HOUYRSLIV_C] lt 11 and HOUYRSLIV_C=4 [goto Check Name: ERR1_HOUYRSLIV_C Text: {check ERR1_HOUYRSLIV_C} Years in house/apartment exceedchild's age. Please correct. Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (AGE_FINAL GE 1 AND AGE_FINAL LE 3, and HOUYRSLIV_C in (3,4)) or (AGE_FINAL LE 10, and HOUYRSLIV_C=4) Page 307 of 334 Question ID: HOU.0020.00.1 Variable name: HOUTENURE_C Interview module: HOU(Child.HOU) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (((SAMEFAM_FLG=1 and HOU_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and HOU_FLG_A=2 and SARESPSC_FLG ne 1)) ) Universe Description: Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult HOU section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the HOU section with RF or DK. Question Text: Response: Fills: Is this house/apartment owned or rented by you ^SOMEFAM_C? a mortgage, record as owned. 1. 2. 3. DK: RF: If house has Owned or being bought Rented Other arrangement Don't Know Refused ^SOMEFAM_C If PCNT_C=2 fill: blank If PCNT_C gt2 fill: "or someone in your family" Skip Instructions: <1,3,RF,DK> [goto next section] <2> [got HOUGVASST_C] Page 308 of 334 Question ID: HOU.0030.00.1 Variable name: HOUGVASST_C Interview module: HOU(Child.HOU) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: HOUTENURE_C=2 and (((SAMEFAM_FLG=1 and HOU_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and HOU_FLG_A=2 and SARESPSC_FLG ne 1))) Universe Description: Sample Children 0-17 living in a house/apartment that is being rented and Sample Adult and Sample Child are in the same family and the Sample Adult HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult HOU section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the HOU section with RF or DK. Question Text: Response: Is anyone in your family paying lower rent because the Federal, State, or local government is paying part of the cost? Read if necessary: Federal, State, or Local government housing programs for persons with low income may take many forms. Government housing assistance could come from monetary assistance to help pay rent, a program called "Section 8," direct payments to landlords, vouchers, or other types of assistance from a local housing authority. Living in public housing is considered housing assistance from the government. 1. 2. DK: RF: Yes No Don't Know Refused Skip Instructions: <1,2,RF,DK> [goto next section] Page 309 of 334 Question ID: REC.0010.00.1 Variable name: LNKFNAME_C Interview module: REC(Child.REC) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: Ask or verify: What is ^SCNAME's full name? DK: RF: Enter first name. Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: [goto LNKMNAME_C] Question ID: REC.0020.00.1 Variable name: LNKMNAME_C Interview module: REC(Child.REC) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Enter middle name. DK: RF: Press "Enter" to skip to last name if child has no middle name. Don't Know Refused Skip Instructions: [goto LNKLNAME_C] Page 310 of 334 Question ID: REC.0030.00.1 Variable name: LNKLNAME_C Interview module: REC(Child.REC) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Enter last name. DK: RF: Don't Know Refused Skip Instructions: [goto next section] Question ID: TEL.0010.00.1 Variable name: TELCURWRK_C Interview module: TEL(Child.TEL) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: (SAMEFAM_FLG=1 and TELCURWRK_A=empty) or (SAMEFAM_FLG=1 and TELCURWRK_A IN (DK,RF) and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1) Universe Description: Sample Children 0-17 who live in the same family as a sample adult, where TELCURWRK_A has not be asked OR who live in the same family as a sample adult, where TELCURWRK_A was answered don't know or refused and the sample child respondent is not the sample adult OR who do not live in the same family as the sample adult Question Text: Response: Is there at least one telephone INSIDE ^SCNAME's home that is currently working and is not a cell phone? 1. 2. DK: RF: Yes No Don't Know Refused Page 311 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto PHONELIVE_C] Question ID: TEL.0020.00.1 Variable name: PHONELIVE_C Interview module: TEL(Child.TEL) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: TELCEL_A ne 1 and ((SAMEFAM_FLG=1 and PHONELIVE_A=blank) or (SAMEFAM_FLG=1 and PHONELIVE_A IN (DK,RF) and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) Universe Description: Sample Children 0-17 in a family with at least one other person without working cell phones where Sample Adult does not live in same family as Sample Child or Sample Adult and Sample Child are in the same family but PHONELIVE_A has not been asked OR Sample Adult and Sample Child are in the same family, PHONELIVE_A was answered dk/rf and the Sample Adult is not the Sample Child Respondent. Question Text: Response: Fills: Does ^SCNAME live with anyone who has a working cell phone? 1. 2. DK: RF: Yes No Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Page 312 of 334 Question ID: LNK.0010.00.1 Variable name: LNKINTRO_C Interview module: LNK(Child.LNK) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: ?[F1] We would like the last four digits of ^SCNAME's Social Security Number. This information will help us link ^hisher_C survey data with other health-related records of other government agencies, and allow us to conduct additional research without taking up your time with more questions. The National Center for Health Statistics (NCHS) uses this information for research purposes only. Providing this information is voluntary. There will be no effect on ^SCNAME's benefits if you do not provide this information. Federal laws authorize us to ask for this information. Like all other answers you have provided, this information will remain confidential. Read if necessary: The specific federal laws protecting ^SCNAME's privacy and the confidentiality of ^hisher_C data are the Public Health Service Act (Title 42, U.S.C., Section 242m(d)), the Confidential Information Protection and Statistical Efficiency Act of 2018 (Title lll, Public Law No. 115-435), and the Privacy Act of 1974 (5 U.S.C. § 552a). In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks Read if necessary: NCHS collects health-related data from other government agencies, including records from Medicare and Medicaid Services, Social Security, housing, and death certificates. If you agree, NCHS will attempt to link records such as these with ^SCNAME's survey data to give a fuller picture of the kinds of things that affect health. NCHS does this linkage. ^SCNAME's name and ^hisher_C information are not given to these agencies. Read if necessary: If asked: ^SCNAME's data will not be linked to records from the IRS (Internal Revenue Service) or ICE (Immigration and Customs Enforcement). Enter '1' to continue. 1. Enter 1 to Continue ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Page 313 of 334 Skip Instructions: <1> [goto SSN4_C] Question ID: LNK.0020.00.1 Variable name: SSN4_C Interview module: LNK(Child.LNK) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Fills: ?[F1] What are the last four digits of ^SCNAME's Social Security Number? Read if necessary: Providing this information is voluntary. There will be no effect on ^SCNAME's benefits if you do not provide this information. Federal laws authorize us to ask for this information. Like all other information you have provided, these answers will remain confidential. Read if asked about specific laws: The specific federal laws protecting ^SCNAME's privacy and the confidentiality of ^hisher_C data are the Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act of 2018, which is Title lll, Public Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks Enter 'N' if no Social Security Number. DK: RF: Don't Know Refused ^SCNAME Fill ALIAS of HHSTAT_C=1 ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" Skip Instructions: if SSN4_C=Adult.LNK.SSN4_A [goto ERR1_SSN4_C] elseif SSN4_C=000-999 [goto ERR2_SSN4_C] elseif SSN4_C NOT IN (N,DK,RF,000-999,0001-9999) [goto ERR3_SSN4_C] <0001-9999> [goto THANKS_C] [goto RLINK_C] Page 314 of 334 Check Name: ERR1_SSN4_C Text: {signal ERR1_SSN4_C} The last four digits of ^SCNAME's Social Security Number are the same as the last four digits of ^SANAME's Social Security Number. Please verify. Hard / Soft Edit: Soft Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 ^SANAME Sample Adult's name Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: Adult.LNK.SSN4_A=SSN4_C Universe Description: The sample adult and the sample child's last four digits are the same Check Name: ERR2_SSN4_C Text: {check ERR2_SSN4_C} You must enter all four of the last four digits of the Social Security Number. Please correct. Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SSN4_C=000-999 Universe Description: Entered less than four digits Page 315 of 334 Check Name: ERR3_SSN4_C Text: {check ERR3_SSN4_C} The last 4 digits of a SSN may be between 0001-9999. For a respondent who does not want to provide the SSN, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused.' If a respondent does not have a SSN, enter 'N'. Please correct. Hard / Soft Edit: Hard Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SSN4_C NOT IN ('N','RF','DK','000-999','0001-9999') Universe Description: SSN last four digits are 0000 or a letter other than N Question ID: LNK.0030.00.1 Variable name: RLINK_C Interview module: LNK(Child.LNK) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe: SSN4_C IN (N,RF,DK) Universe Description: Sample child 0-17 where SSN was refused, don't know or not available. Question Text: Response: ?[F1] May we try to link ^SCNAME's survey data without a Social Security Number? Read if necessary: Any data obtained are protected by strict federal laws, including the Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act of 2018, which is Title lll, Public Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks 1. 2. DK: RF: Yes No Don't Know Refused Page 316 of 334 Fills: ^SCNAME Fill ALIAS of HHSTAT_C=1 Skip Instructions: <1,2,RF,DK> [goto next section] Question ID: WEB.0040.00.4 Variable name: TNMODE_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe Description: Sample Children 12-17 Question Text: Response: How are you contacting the respondent? 1. 2. Personal visit Telephone Skip Instructions: <1,2> [goto TNINTRO_C] Question ID: WEB.0050.00.4 Variable name: TNINTRO_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe Description: Sample Children 12-17 Question Text: ? [F1] Thank you for answering questions about ^InitTNFNAME_C_fill's health. Before we finish, we would like to ask you for permission to contact ^InitTNFNAME_C_fill directly so that ^heshe_C ^havehas_SC an opportunity to answer questions about ^hisher_C own health. With your permission, we will ask ^InitTNFNAME_C_fill to complete a quick online survey that takes 15 minutes or less to complete. The majority of the questions are the same or similar to the ones you just answered, but ^InitTNFNAME_C_fill may have ^hisher_C own unique perspectives. That's why we think it is important to give ^himher_C a chance to tell us about ^hisher_C health. ^TNINFO This survey includes additional questions about ^InitTNFNAME_C_fill's health, health care, physical activities, use of yoga and meditation, demographics, like the race, Page 317 of 334 ethnicity, and gender that ^InitTNFNAME_C_fill considers ^himherthemselves_C, sexual orientation, and experiences with bullying and discrimination. ^InitTNFNAME_C_fill's answers, just like the answers you provided, will be kept strictly confidential. We won't tell ^InitTNFNAME_C_fill the answers that you just provided, and we won't tell you ^hisher_C answers after ^heshe_C ^participate. ^InitTNFNAME_C_fill can skip any questions ^heshe_C ^DoDoes_SC not want to answer and stop the survey at any time. Read if necessary: The answers ^InitTNFNAME_C_fill provides will ONLY be used for statistical purposes. Strict federal laws, including Section 308(d) of the Public Health Service Act (Title 42, U.S.C., Section 242m(d)), the Privacy Act of 1974 (5 U.S.C. § 552a) and the Confidential Information Protection and Statistical Efficiency Act of 2018 (Title III, Public Law No: 115-435) prevent NCHS and its contractors from releasing information that could identify ^InitTNFNAME_C_fill or your family to anyone else without your permission. All identifying information is removed from the data. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks. Enter '1' to continue. Response: Fills: 1. Enter 1 to Continue ^InitTNFNAME_C_fill Fill value from Child.WEB.InitTNFNAME_C ^heshe_C If GEN.SEX_FINAL[PX_C]=1 fill "he" else if GEN.SEX_FINAL[PX_C]=2 fill "she" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "they" ^havehas_SC If GEN.SEX_FINAL[PX_C]=1 or 2, fill "has" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "have" ^TNINFO If TNMODE_C=1, fill: "This card gives you some information about the survey, and I can tell you more about the content if you wish." elseif TNMODE_C=2, fill: "You will receive a card that gives you some information about the survey, and I can tell you more about the content if you wish." ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" Page 318 of 334 ^himherthemselves_C If SEX_FINAL_C=1 fill "himself" else if SEX_FINAL_C=2 fill "herself" elseif SEX_FINAL_C=blank: fill "themselves" ^participate if SEX_FINAL=1 or 2, fill "participates" if SEX_FINAL=RF,DK, fill "participate" ^DoDoes_SC If GEN.SEX_FINAL[PX_C]=1 or 2, fill "does" else if GEN.SEX_FINAL[PX_C] in (RF,DK): fill "do" Skip Instructions: <1> [goto TNPER_C] Question ID: WEB.0060.00.4 Variable name: TNPER_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe Description: Sample Children 12-17 Question Text: Response: ? [F1] May we ask ^InitTNFNAME_C_fill to participate in this survey? Read if necessary: This doesn't mean that ^InitTNFNAME_C_fill has to participate, but we are asking if we can ^LEAVE ^himher_C some more information about the survey. Some parents may respond to this question by asking their teen if they want to participate or having you ask them if they want to participate, only select option 3 if this happens and the teen declines. 1. 2. 3. Yes No Teen declined participation Page 319 of 334 Fills: ^LEAVE if TNMODE_C=1, fill "leave" elseif TNMODE_C=2, fill "mail" ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" ^InitTNFNAME_C_fill Fill value from Child.WEB.InitTNFNAME_C ^dispuesto_C_fill Spanish only Skip Instructions: <1> if TNNAME_FLG_C=1 [goto TNNAME_C] elseif TNNAME_FLG_C=0 [goto TNFNAME_C] <2> [goto TNOPTIN_C] <3> [goto TNLEAVE_C] Question ID: WEB.0061.00.4 Variable name: TNLEAVE_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: TNPER_C=3 Universe Description: Sample Children 12-17 who decline participation Question Text: May we ^LEAVE the initial letter in case ^InitTNFNAME_C_fill changes ^hisher_C mind? Read if necessary: This doesn't mean that ^InitTNFNAME_C_fill has to participate, but we are asking if we can ^LEAVE ^himher_C some more information about the survey. Read if necessary: The letter provides more information about the survey that ^InitTNFNAME_C_fill may want to know, including why we're doing the survey, how long it will take to complete, and the token of appreciation they receive. Response: Page 320 of 334 1. 2. Fills: Yes No ^LEAVE if TNMODE_C=1, fill "leave" elseif TNMODE_C=2, fill "mail" ^SCNAME Fill ALIAS of HHSTAT_C=1 ^InitTNFNAME_C_fill Fill value from Child.WEB.InitTNFNAME_C ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" Skip Instructions: <1> if TNNAME_FLG_C=1 [goto TNNAME_C] elseif TNNAME_FLG_C=0 [goto TNFNAME_C] <2> [goto TNOPTIN_C] Question ID: WEB.0080.00.4 Variable name: TNNAME_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: (TNPER_C=1 or TNLEAVE_C=1) and TNNAME_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted or who declined participation and whose parents gave permission to leave a letter and who have a valid first name Question Text: Ask or verify: Invitations to participate are sent by mail. Can you confirm ^ InitTNFNAME_C_fill's name as it should appear on a mailed envelope? I have ^InitTNFNAME_C_fill ^InitTNLNAME_C_fill. Select 'Yes' to confirm name. Select 'No' to update name. Response: Page 321 of 334 1. 2. Fills: Yes No ^InitTNFNAME_C_fill Fill value from Child.WEB.InitTNFNAME_C ^InitTNLNAME_C_fill Fill value from Child.WEB.InitTNLNAME_C Skip Instructions: <1> [goto NHISLINKID] <2> [goto TNFNAME_C] Question ID: WEB.0090.00.4 Variable name: TNFNAME_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: (TNPER_C=1 or TNNAME_FLG_C=0) TNLEAVE_C=1) and (TNNAME_C=2 or Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted or who declined participation and whose parents gave permission to leave a letter and who need updated first name Question Text: Response: Fills: ^TNNAMEFIX Can you provide your child's first name? Enter first name. A first name is needed to ensure the teenager receives the initial invitation letter and future communications, if parent/guardian is unwilling to provide a first name, enter "Refused" DK: RF: Don't Know Refused ^TNNAMEFIX If TNPER_C=1 and TNNAME_FLG_C=0, fill: Invitations to participate are sent by mail. In order for your child to participate in this study, we need at least their first name. ^ALIASORNOT. Page 322 of 334 Skip Instructions: if NAMEOK_FLG_C=1 [goto TNLNAME_C] else if NAMEOK_FLG_C=0 [goto TNOPTIN_C] Question ID: WEB.0110.00.4 Variable name: TNLNAME_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: (TNPER_C=1 or TNLEAVE_C=1) and NAMEOK_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted or who declined participation and whose parents gave permission to leave a letter and who have valid first name Question Text: Response: Enter last name if provided, last name is optional. DK: RF: Don't Know Refused Skip Instructions: [Goto NHISLINKID] Question ID: WEB.0130.00.4 Variable name: NHISLINKID Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: PER_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted and have valid first name Question Text: Enter the 8-digit NHIS link ID printed on the left-hand side of the envelope just above the barcode. Response: Page 323 of 334 Skip Instructions: [goto CHECKDIGIT] Question ID: WEB.0140.00.4 Variable name: CHECKDIGIT Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: PER_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted and have valid first name Question Text: ** Instrument Variable ** Response: Skip Instructions: <1> if TNPER_C=1 [goto TNPHONE_C] <1> if TNLEAVE_C=1 [goto TNLETTER_C] <0> [goto ERR1_CHECKDIGIT] Check Name: ERR1_CHECKDIGIT Text: {check ERR1_CHECKDIGIT} NHIS Link ID invalid. Please correct. Hard / Soft Edit: Hard Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: CHECKDIGIT=0 or NHISLINKID is all the same digit Universe Description: NHISLINKID is invalid Skip Instructions: [goto NHISLINKID] Page 324 of 334 Question ID: WEB.0150.00.4 Variable name: TNPHONE_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: TNPER_C=1 and NAMEOK_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted and have valid first name Question Text: Response: Fills: Invitations to participate in this online survey may also be sent by text messages directly from the Census Bureau. Does ^TNNAME_fill have ^hisher_C own cell phone number we may use to text ^himher_C? Read if necessary: The survey is mobile friendly and can be completed easily over the phone. Read if necessary: I will not be contacting ^TNNAME_fill. ^TNNAME_fill's cell phone number will only be used to receive automated invitations and reminders to participate in the survey. No one will use this information to contact ^himher_C other than through automated messages sent from the Census Bureau. NCHS and the Census Bureau are not responsible for any text-related charges. Read if necessary: NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks. NCHS cannot promise protection related to information shared while using a personal device. NCHS can only protect information once it is in the NCHS system. 1. 2. DK: RF: Yes No Don't Know Refused ^TNNAME_fill Fill values from TNFNAME_C ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" Page 325 of 334 Skip Instructions: <1> [goto TNPHONENUM_C] <2,RF,DK> [goto TNEMAIL_C] Question ID: WEB.0160.00.4 Variable name: TNPHONENUM_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: TNPHONE_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted and have valid first name and agree to provide a phone number Question Text: Response: Fills: What is ^TNNAME_fill's cell phone number? DK: RF: Don't Know Refused ^TNNAME_fill Fill values from TNFNAME_C Skip Instructions: If TNPHONENUM_C LT 2000000000 or GT 9999999996 [goto ERR1_TNPHONENUM_C] elseif all 10 digits the same in TNPHONENUM_C or first three digits 555 or 911 [goto ERR2_TNPHONENUM_C] elseif duplicate phone number entered [goto ERR3_TNPHONENUM_C] else [TNEMAIL_C] Page 326 of 334 Check Name: ERR1_TNPHONENUM_C Text: {check ERR1_TNPHONENUM_C} Enter the entire telephone number. invalid area code (000-200). Please correct. Check for Hard / Soft Edit: Hard Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: If TNPHONENUM_C LT 2000000000 or GT 9999999996 Check Name: ERR2_TNPHONENUM_C Text: {signal ERR2_TNPHONENUM_C} Please confirm. Are you sure this is the correct phone number? Hard / Soft Edit: Soft Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: IF all 10 digits the same of TNPHONENUM_C or first three digits '555' or '911' Universe Description: IF all 10 digits the same of TNPHONENUM_C or the area code is invalid Page 327 of 334 Check Name: ERR3_TNPHONENUM_C Text: {signal ERR3_TNPHONENUM_C} I have ^TNPHONENUM_fill as ^TNNAME_fill's personal cell phone number, is that correct? Hard / Soft Edit: Soft Fills: ^TNNAME_fill Fill values from TNFNAME_C ^TNPHONENUM_fill Fill value from Child.WEB.TNPHONENUM_C Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe Description: If phone number entered matches phone number already collected Question ID: WEB.0170.00.4 Variable name: TNEMAIL_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: TNPER_C=1 and NAMEOK_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted and who have valid first name Question Text: Invitations to participate may also be sent by e-mail directly from the Census Bureau. Does ^TNNAME_fill have ^hisher_C own e-mail address we may use to e-mail ^himher_C? Read if necessary: I will not be contacting ^TNNAME_fill. ^TNNAME_fill's e-mail address will only be used to receive automated invitations and reminders to participate in the survey. No one will use this information to contact ^himher_C other than through automated messages sent from the Census Bureau. Read if necessary: NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks. NCHS cannot promise protection related to information shared while using a personal device. NCHS can only protect information once it is in the NCHS system. Page 328 of 334 Response: Fills: 1. 2. DK: RF: Yes No Don't Know Refused ^TNNAME_fill Fill values from TNFNAME_C ^hisher_C if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their" ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" Skip Instructions: <1> [goto TNEADDRESS_C] <2,RF,DK>[goto TNLETTER_C] Question ID: WEB.0180.00.4 Variable name: TNEADDRESS_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: TNEMAIL_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted and who have valid first name and whose parents gave permission for the child to be contacted by e-mail Question Text: What is ^TNNAME_fill's e-mail address? Enter e-mail address. Enter 'N' if ^TNNAME_fill does not have a personal e-mail address. Read if necessary: ^TNNAME_fill's e-mail address will only be used to receive automated invitations and reminders to participate in the survey. No one will use this information to contact ^himher_C other than through automated messages sent from the Census Bureau. Read if necessary: NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks. NCHS cannot promise protection related to information shared while using a personal device. NCHS can only protect information once it is in the NCHS system. Page 329 of 334 Response: Fills: DK: RF: Don't Know Refused ^TNNAME_fill Fill values from TNFNAME_C ^himher_C if SEX_FINAL=1, fill "him" if SEX_FINAL=2, fil "her" if SEX_FINAL=RF,DK, fill "them" Skip Instructions: if response is ne 'N' and lt 6 characters [goto ERR1_TNEADDRESS_C] else if response is ne 'N' and is missing '.' and/or '@' [goto ERR2_TNEADDRESS_C] else [goto TNLETTER_C] Check Name: ERR1_TNEADDRESS_C Text: {signal ERR1_TNEADDRESS_C} Enter entire email address. Please correct. Hard / Soft Edit: Soft Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: If TNEADDRESS_C <> 'N' AND TNEADDRESS_C LT 6 characters Universe Description: Email address entered is less than 6 characters Page 330 of 334 Check Name: ERR2_TNEADDRESS_C Text: {check ERR2_TNEADDRESS_C} Enter entire email address. Please correct. Hard / Soft Edit: Hard Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: If TNEADDRESS_C <> 'N' AND Email address is missing '.' and/or '@' Universe Description: Email address is missing '.' and/or '@' Question ID: WEB.0190.00.4 Variable name: TNLETTER_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: PER_FLG_C=1 Universe Description: Sample Children 12-17 whose parents gave permission for the child to be contacted or who declined participation but parents allowed a letter to be left and who have valid first name Question Text: ^TNLETTER Response: Page 331 of 334 1. Fills: Enter 1 to Continue ^TNLETTER If TNMODE_C=1, fill " Write the teen's name on the initial letter envelope. Hand the envelope to the parent or guardian, or directly to the teenager if they are available." ^TNFNAME_C ^TNLNAME_C" elseif TNMODE_C=2, fill: "We will mail the initial invitation letter to ^TNNAME_fill." Skip Instructions: <1> [goto next section] Question ID: WEB.0200.00.4 Variable name: TNOPTIN_C Interview module: WEB(Child.WEB) Inherited Universe: (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017)) AND ((GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.QTYPE2=1 and (GEN.AGE_FINAL ge 012 and GEN.AGE_FINAL le 017))) Universe: TNPER_C=2 or (TNPER_C=1 and NAMEOK_FLG_C=0) or TNLEAVE_C=2 Universe Description: Sample Children 12-17 whose parents did not give permission for the child to be contacted or whose parents did give permission for the child to be contacted but do not have valid first name or who declined participation and whose parents did not give permission to leave a letter Question Text: If you change your mind, you can call the phone number on the card ^MODENUM. Response: Page 332 of 334 Fills: ^MODENUM If TNMODE_C=1, fill: "that was given to you, 1-800-618-5888" If TNMODE_C=2, fill: "that is being mailed to you, 1-800-618-5888" Skip Instructions: <1> [goto next section] Question ID: THX.0010.00.1 Variable name: THANKS_C Interview module: THX(Child.THX) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Thank respondent for answering these questions. If there is a Sample Adult interview to complete, ask for appropriate person to respond to these questions. Enter '1' to continue. 1. Enter 1 to Continue Skip Instructions: <1> [goto SCRESP_FNAME] Question ID: THX.0020.01.1 Variable name: SCRESP_FNAME Interview module: THX(Child.THX) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Ask or verify: In case I or someone from my office needs to get in touch with you, we need your full name. What is your full name? Enter first name. DK: RF: Don't Know Refused Page 333 of 334 Skip Instructions: [goto SCRESP_LNAME] Question ID: THX.0020.02.1 Variable name: SCRESP_LNAME Interview module: THX(Child.THX) Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1 Universe Description: Sample Children 0-17 Question Text: Response: Enter last name. DK: RF: Don't Know Refused Skip Instructions: [goto next section] Check Name: Child parallel tab finished Text: You have finished the Child parallel tab. Press "Enter" or click OK to go back to the main interview path. Then press the "END" key to jump to the next unanswered question. Hard / Soft Edit: Soft Inherited Universe: (GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) AND (GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1) Skip Instructions: Closing the box takes the user to the CASESTATUS screen Page 334 of 334
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