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pdfQuestion 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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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."
1.
2.
Yes
No
^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"
^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"
Page 12 of 304
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"
^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?
commas.
Response:
Page 13 of 304
Enter all that apply, separate with
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:
Male
Female
Don't Know
Refused
Page 14 of 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 had a special education or early intervention
plan
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 currently have a special education or early
intervention plan
Question Text:
Does ^SCNAME receive these services to help with ^hisher_C emotions,
concentration, behavior, or mental health?
Response:
Page 84 of 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 KY then fill "Health Insurance Marketplace, such
as Kynect"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If ME then fill "Health Insurance Marketplace, such
as CoverME"
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 NM then fill "Health Insurance Marketplace, such
as beWellnm"
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 VA then fill "Health Insurance Marketplace, such
as Virginia's Insurance Marketplace"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Healthplanfinder"
Page 97 of 304
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 304
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 304
Fills:
^HDHPDED
Fill: $1,650
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 KY then fill "Health Insurance Marketplace, such
as Kynect"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If ME then fill "Health Insurance Marketplace, such
as CoverME"
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 NM then fill "Health Insurance Marketplace, such
as beWellnm"
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 VA then fill "Health Insurance Marketplace, such
as Virginia's Insurance Marketplace"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Healthplanfinder"
Page 110 of 304
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 304
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 304
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 304
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 304
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.
'1' to continue.
Response:
Page 115 of 304
Enter
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 304
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 304
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 304
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 304
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 KY then fill "Health Insurance Marketplace, such
as Kynect"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If ME then fill "Health Insurance Marketplace, such
as CoverME"
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 NM then fill "Health Insurance Marketplace, such
as beWellnm"
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 VA then fill "Health Insurance Marketplace, such
as Virginia's Insurance Marketplace"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Healthplanfinder"
Page 120 of 304
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 304
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: $1,650
Page 122 of 304
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 304
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 KY then fill "Health Insurance Marketplace, such
as Kynect"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If ME then fill "Health Insurance Marketplace, such
as CoverME"
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 NM then fill "Health Insurance Marketplace, such
as beWellnm"
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 VA then fill "Health Insurance Marketplace, such
as Virginia's Insurance Marketplace"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
Page 124 of 304
as Washington Healthplanfinder"
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 304
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: $1,650
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 304
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 304
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 KY then fill "Health Insurance Marketplace, such
as Kynect"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If ME then fill "Health Insurance Marketplace, such
as CoverME"
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 NM then fill "Health Insurance Marketplace, such
as beWellnm"
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 VA then fill "Health Insurance Marketplace, such
as Virginia's Insurance Marketplace"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Healthplanfinder"
^SCNAME
Fill ALIAS of HHSTAT_C=1
Page 128 of 304
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 304
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: $1,650
Skip Instructions: <1,2,RF,DK> if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Page 130 of 304
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 304
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 304
Check Name: ERR1_HILAST_C
Text:
{check ERR1_HILAST_C}
Please correct.
Years since last health coverage exceedchild's age.
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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 304
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:
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 304
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:
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 304
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 304
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]
Question ID: CVL.0010.00.3
Variable name: CVDINTRO_C
Interview module: CVL(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 Continue
Skip Instructions: <1> [goto EVERCOVD_C]
Page 148 of 304
Enter '1' to
Question ID: CVL.0020.00.3
Variable name: EVERCOVD_C
Interview module: CVL(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 or other health professional that ^SCNAME 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 ^SCNAME had close contact
with someone who had COVID-19 and ^SCNAME had symptoms.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1> [goto LONGCOVD2_C]
<2,RF,DK> [goto next section]
Question ID: CVL.0030.00.3
Variable name: LONGCOVD2_C
Interview module: CVL(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:
Did ^SCNAME have any symptoms lasting 3 months or longer that ^heshe_C
did not have before having 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, smell or taste loss or
alteration in ability to smell or taste, ^menstrual and inability to exercise.
Response:
Page 149 of 304
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^menstrual
If
GEN.SEX_FINAL=2,RF,DK
and
GEN.AGE_FINAL=9-58, fill "menstrual changes,"
else fill blank
^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 SYMPNOW1_C]
<2,RF,DK> [goto next section]
Question ID: CVL.0040.00.3
Variable name: SYMPNOW1_C
Interview module: CVL(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: LONGCOVD2_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:
Does ^SCNAME have symptoms NOW?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 150 of 304
Fills:
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1> [goto LCVDACT_C]
<2,RF,DK> [goto next section]
Question ID: CVL.0050.00.3
Variable name: LCVDACT_C
Interview module: CVL(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: SYMPNOW1_C=1
Universe Description: Sample Children 0-17 with COVID-19 symptoms lasting 3 months or longer
that they did not have before having coronavirus or COVID-19 and they have
symptoms now
Question Text:
Response:
Fills:
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 not at all, a little, or a lot?
1.
2.
3.
DK:
RF:
Not at all
A little
A lot
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto next section]
Page 151 of 304
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:
Response:
Fills:
These next questions ask about ^SCNAME's dental care.
1.
Enter '1' to continue.
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:
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.
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Page 152 of 304
3.
4.
5.
6.
DK:
RF:
Fills:
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]
Check Name: ERR1_DENPREV_C
Text:
{check ERR1_DENPREV_C}
Please correct.
Years since last dental cleaning exceedchild's age.
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))
Page 153 of 304
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:
Fills:
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
^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:
During the past 12 months, was there any time when ^SCNAME needed dental
care, but DID NOT GET IT because of the cost?
1.
Yes
Page 154 of 304
2.
DK:
RF:
Fills:
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:
Response:
Fills:
^UTZINTRO2_C
1.
Enter '1' to continue.
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:
About how long has it been since ^SCNAME last saw a doctor or other health
professional about ^hisher_C health? Read if necessary: Do not include
appointments by video or phone. Read if necessary: Include doctors seen while a
patient in a hospital. Read if necessary: Do not include dental care.
Response:
Page 155 of 304
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Fills:
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"
Skip Instructions: <1-6> [goto WELLNESS_C]
<0,RF,DK> [goto USUALPL_C]
Check Name: ERR1_LASTDR_C
Text:
{check ERR1_LASTDR_C}
Please correct.
Years since last saw a doctor exceedchild's age.
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 156 of 304
Question ID: UTZ.0030.00.1
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
^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"
^SCNAME
Fill ALIAS of HHSTAT_C=1
Page 157 of 304
Skip Instructions: <1> [goto USUALPL_C]
<2,RF,DK> [goto WELLVIS_C]
Question ID: UTZ.0040.00.1
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 158 of 304
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: <0-6,RF,DK> [goto USUALPL_C]
Check Name: ERR1_WELLVIS_C
Text:
{check ERR1_WELLVIS_C}
correct.
Years since wellness visit exceedchild's age.
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 159 of 304
Please
Question ID: UTZ.0050.00.1
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:
Fills:
Is there a place that ^SCNAME USUALLY goes to if ^hesheistheyare_C sick
and needs health care?
1.
2.
3.
DK:
RF:
Yes
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> [goto RETURGINT_C]
Question ID: UTZ.0060.00.1
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.
Page 160 of 304
Response:
Fills:
1.
2.
3.
4.
5.
DK:
RF:
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"
^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"
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-5,RF,DK> [goto RETURGINT_C]
Question ID: UTZ.0065.00.1
Variable name: RETURGINT_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:
The next questions are about ^SCNAME's use of retail health clinics and urgent
care centers. Enter '1' to continue.
Response:
Page 161 of 304
1.
Fills:
Enter 1 to Continue
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1> [goto RETAILHC12M_C]
Question ID: UTZ.0070.00.1
Variable name: RETAILHC12M_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:
Retail health clinics are located in a pharmacy, grocery store, or supercenter.
During the past 12 months, how many times has ^SCNAME gone to a retail
health clinic about ^hisher_C health? Enter 96 if number is 96 or greater.
Read if necessary: Common examples of retail health clinics include places like CVS
Minute Clinic, Walgreens Health Clinic, or clinics in a Walmart or Kroger supermarket.
These clinics can provide common services such as certain vaccinations, as well as
testing for or treatment of minor uncomplicated illnesses.
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> [goto URGCC12M_C]
<40-96> [goto ERR1_RETAILHC12M_C]
Page 162 of 304
Check Name: ERR1_RETAILHC12M_C
Text:
{signal ERR1_RETAILHC12M_C} ^RETAILHC12M_C is an unusually large
number. Did ^SCNAME visit a retail health clinic center about ^hisher_C health
^RETAILHC12M_C times in the past 12 months? Please verify.
Hard / Soft Edit: Soft
Fills:
^RETAILHC12M_C
fill value from RETAILHC12M_C
^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"
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: RETAILHC12M_C=40-96
Universe Description: Sample child reported going to retail health clinic 40-96 times
Question ID: UTZ.0075.00.1
Variable name: URGCC12M_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:
An urgent care center is located in its own building or space. These centers
can provide services such as x-rays and stitches. During the past 12 months,
how many times has ^SCNAME gone to an urgent care center about ^hisher_C
health? Enter 96 if number is 96 or greater. Read if necessary: An urgent care
center can provide common vaccinations, testing for or treatment of illnesses. They
can also treat illnesses or injuries that require immediate care but are not serious
enough to require a visit to a hospital emergency room. Read if necessary: This is
different from a hospital emergency room. Read if necessary: These centers
provide care during business hours, evenings, and weekends.
DK:
Don't Know
Page 163 of 304
RF:
Fills:
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> [goto EMERGE12M_C]
<40-96> [goto ERR1_URGCC12M_C]
Check Name: ERR1_URGCC12M_C
Text:
{signal ERR1_URGCC12M_C} ^URGCC12M_C is an unusually large number.
Did ^SCNAME visit an urgent care center about ^hisher_C health
^URGCC12M_C times in the past 12 months? Please verify.
Hard / Soft Edit: Soft
Fills:
^URGCC12M_C
fill value from URGCC12M_C
^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"
Inherited Universe: GEN.PX_C gt 0 and PCNTunder18 gt 0 and PCNT gt PCNTAGEGUESS and
PCNT ge 2 and PCNT18UP_C gt 0 and NOFAMSC ne 1
Universe: URGCC12M_C=40-96
Universe Description: Sample child reported going to urgent care 40-96 times
Page 164 of 304
Question ID: UTZ.0080.00.1
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 165 of 304
Inherited Universe: GEN.PX_C 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.0090.00.1
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 166 of 304
Question ID: UTZ.0100.00.1
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.0110.00.1
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 167 of 304
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 168 of 304
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 169 of 304
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 170 of 304
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 171 of 304
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 172 of 304
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 173 of 304
[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 174 of 304
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 175 of 304
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 176 of 304
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 177 of 304
Question ID: CVV.0010.00.3
Variable name: SHTCVD192_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. During the
past 12 months, has ^SCNAME had at least one dose of a COVID-19
vaccination? Read if necessary: COVID-19 vaccines approved for use in the
United States are made by Pfizer-BioNTech, also called Comirnaty®
(koe-mir'-na-tee), Moderna, also called Spikevax®, and Novavax. Approved
vaccines vary by age.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1> [goto CVDVAC1M3_C]
<2,RF,DK> [goto next section]
Question ID: CVV.0030.01.3
Variable name: CVDVAC1M3_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: SHTCVD192_C=1
Universe Description: Sample Children who have had one or more COVID-19 vaccinations during
the past 12 months
Question Text:
1 of 2 During what month and year did ^SCNAME receive ^hisher_C MOST
RECENT COVID-19 vaccination? Enter month of most recent COVID-19
vaccination.
Response:
Page 178 of 304
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
^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 CVDVAC1Y3_C]
[goto next section]
Question ID: CVV.0030.02.3
Variable name: CVDVAC1Y3_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: CVDVAC1M3_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
Page 179 of 304
Skip Instructions: [goto next section]
if CVDVAC1M3_C and CVDVAC1Y3_C = a future date [goto
ERR1_CVDVAC1Y3_C];
if CVDVAC1M3_C and CVDVAC1Y3_C = a date before birth [goto
ERR2_CVDVAC1Y3_C];
if CVDVAC1M3_C and CVDVAC1Y3_C = a date before 12 months ago [goto
ERR3_CVDVAC1Y3_C]
Check Name: ERR1_CVDVAC1Y3_C
Text:
{check ERR1_CVDVAC1Y3_C}
Future date 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: (CVDVAC1Y3_C gt current year) or (CVDVAC1Y3_C=current year and
CVDVAC1M3_C gt current month)
Universe Description: Date of most recent COVID-19 vaccination is in the future
Check Name: ERR2_CVDVAC1Y3_C
Text:
{check ERR2_CVDVAC1Y3_C}
Date prior to 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: CVDVAC1M3_C and CVDVAC1Y3_C = date prior to birth date
Universe Description: Date of most recent COVID-19 vaccination is before Sample Child's birth date
Page 180 of 304
Check Name: ERR3_CVDVAC1Y3_C
Text:
{check ERR3_CVDVAC1Y3_C}
Date before 12 months ago. 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: (CVDVAC1Y3_C lt current year-1) or (CVDVAC1Y3_C=current year-1 and
CVDVAC1M3_C lt current month)
Universe Description: Date of most recent covid vaccine is prior to 12 months ago
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 304
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 304
Fills:
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: MHC.0010.00.1
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 304
Question ID: MHC.0020.00.1
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.0030.00.1
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 304
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.0040.00.1
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 304
Question ID: SDQ.0010.00.2
Variable name: SDQCOPY_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
The following statements are not to be read to the respondent. They are displayed
and included here for legal reasons. The next 25 items contained in SDQ1_C
through SDQ25_C as well as 8 impact questions are included in this survey with
permission as indicated below. The SDQ questions are copyrighted by Robert
Goodman, Ph.D., FRCPSYCH, MRCP. State and local agencies may use these
questions without charge and without seeking separate permission provided the
wording is not modified, all the questions are retained, and Dr. Goodman's copyright
is acknowledged. Enter '1' to continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto SDQ1_C]
Question ID: SDQ.0020.00.2
Variable name: SDQ1_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
I am going to read a list of items that describe children. For each item, please
tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for
^SCNAME DURING THE PAST SIX MONTHS. ^SCNAME is considerate of other
people's feelings?
Response:
Page 186 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ2_C]
Question ID: SDQ.0030.00.2
Variable name: SDQ2_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is restless, overactive, cannot stay still for long? Please tell me if it
has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME
DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ3_C]
Page 187 of 304
Question ID: SDQ.0040.00.2
Variable name: SDQ3_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME often complains of headaches, stomach-aches or sickness? Read
if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or
CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ4_C]
Question ID: SDQ.0050.00.2
Variable name: SDQ4_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME shares readily with other ^TOYSGAMES? Read if necessary: Please
tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for
^SCNAME DURING THE PAST SIX MONTHS.
Response:
Page 188 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^TOYSGAMES
if AGE=4-10 fill "children; for example, toys, treats,
pencils"
else if AGE=11-17 fill "youth; for example, books,
games, food"
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ5_C]
Question ID: SDQ.0060.00.2
Variable name: SDQ5_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME often loses ^hisher_C temper? Read if necessary: Please tell me if it
has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME
DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
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 189 of 304
Skip Instructions: <1-3,RF,DK> [goto SDQ6_C]
Question ID: SDQ.0070.00.2
Variable name: SDQ6_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME ^SOLITARY? Read if necessary: Please tell me if it has been NOT
TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE
PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^SOLITARY
If AGE=4-10 fill "is rather solitary, prefers to play
alone"
else if AGE=11-17 fill "would rather be alone than
with other youth"
Skip Instructions: <1-3,RF,DK> [goto SDQ7_C]
Page 190 of 304
Question ID: SDQ.0080.00.2
Variable name: SDQ7_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is generally well behaved, usually does what adults request?
if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or
CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Read
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ8_C]
Question ID: SDQ.0090.00.2
Variable name: SDQ8_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME has many worries, or often seems worried? Read if necessary:
Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE
for ^SCNAME DURING THE PAST SIX MONTHS.
Response:
Page 191 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ9_C]
Question ID: SDQ.0100.00.2
Variable name: SDQ9_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is helpful if someone is hurt, upset or feeling ill? Read if necessary:
Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE
for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ10_C]
Page 192 of 304
Question ID: SDQ.0110.00.2
Variable name: SDQ10_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is constantly fidgeting or squirming? Read if necessary: Please tell
me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for
^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ11_C]
Question ID: SDQ.0120.00.2
Variable name: SDQ11_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME has at least one good friend? Read if necessary: Please tell me if it
has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME
DURING THE PAST SIX MONTHS.
Response:
Page 193 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ12_C]
Question ID: SDQ.0130.00.2
Variable name: SDQ12_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME often fights with other ^childyouth or bullies them? Read if
necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or
CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^childyouth
If AGE=4-10 fill "children"
else if AGE 11-17 fill "youth"
Page 194 of 304
Skip Instructions: <1-3,RF,DK> [goto SDQ13_C]
Question ID: SDQ.0140.00.2
Variable name: SDQ13_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is often unhappy, depressed or tearful? Read if necessary: Please
tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for
^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ14_C]
Question ID: SDQ.0150.00.2
Variable name: SDQ14_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME is generally liked by other ^childyouth? Read if necessary: Please
tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for
^SCNAME DURING THE PAST SIX MONTHS.
Response:
Page 195 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^childyouth
If AGE=4-10 fill "children"
else if AGE 11-17 fill "youth"
Skip Instructions: <1-3,RF,DK> [goto SDQ15_C]
Question ID: SDQ.0160.00.2
Variable name: SDQ15_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is easily distracted, ^hisher_C concentration wanders? Read if
necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or
CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
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 196 of 304
Skip Instructions: <1-3,RF,DK> [goto SDQ16_C]
Question ID: SDQ.0170.00.2
Variable name: SDQ16_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is nervous ^CLINGY in new situations, ^heshe_C easily lose^s
confidence? Read if necessary: Please tell me if it has been NOT TRUE,
SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX
MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^CLINGY
If AGE=4-10 fill "or clingy"
^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: <1-3,RF,DK> [goto SDQ17_C]
Page 197 of 304
Question ID: SDQ.0180.00.2
Variable name: SDQ17_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is kind to younger children? Read if necessary: Please tell me if it
has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME
DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ18_C]
Question ID: SDQ.0190.00.2
Variable name: SDQ18_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME often lies or cheats? Read if necessary: Please tell me if it has been
NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE
PAST SIX MONTHS.
Response:
Page 198 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ19_C]
Question ID: SDQ.0200.00.2
Variable name: SDQ19_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME is picked on or bullied by other ^childyouth? Read if necessary:
Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE
for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^childyouth
If AGE=4-10 fill "children"
else if AGE 11-17 fill "youth"
Page 199 of 304
Skip Instructions: <1-3,RF,DK> [goto SDQ20_C]
Question ID: SDQ.0210.00.2
Variable name: SDQ20_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME often offers to help others, such as parents, teachers, and ^other
children? Read if necessary: Please tell me if it has been NOT TRUE,
SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX
MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^other
If AGE=4-10 fill "other"
Skip Instructions: <1-3,RF,DK> [goto SDQ21_C]
Page 200 of 304
Question ID: SDQ.0220.00.2
Variable name: SDQ21_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME thinks things out before acting? Read if necessary: Please tell me if
it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME
DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ22_C]
Question ID: SDQ.0230.00.2
Variable name: SDQ22_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME steals from home, school or elsewhere? Read if necessary: Please
tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for
^SCNAME DURING THE PAST SIX MONTHS.
Response:
Page 201 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ23_C]
Question ID: SDQ.0240.00.2
Variable name: SDQ23_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME gets along better with adults than with other ^childyouth? Read if
necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or
CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^childyouth
If AGE=4-10 fill "children"
else if AGE 11-17 fill "youth"
Page 202 of 304
Skip Instructions: <1-3,RF,DK> [goto SDQ24_C]
Question ID: SDQ.0250.00.2
Variable name: SDQ24_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
^SCNAME has many fears, is easily scared? Read if necessary: Please tell me
if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME
DURING THE PAST SIX MONTHS.
1.
2.
3.
DK:
RF:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQ25_C]
Question ID: SDQ.0260.00.2
Variable name: SDQ25_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
^SCNAME has a good attention span, sees work through to the end? Read if
necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or
CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Response:
Page 203 of 304
1.
2.
3.
DK:
RF:
Fills:
Not true
Somewhat true
Certainly true
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto SDQIMP1_C]
Question ID: SDQ.0270.00.2
Variable name: SDQIMP1_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe Description: Sample Children 4-17
Question Text:
Response:
Fills:
Overall, do you think that ^SCNAME has difficulties in one or more of the
following areas: emotions, concentration, behavior, or being able to get along
with other people? Would you say no difficulties, minor difficulties, definite
difficulties, or severe difficulties?
1.
2.
3.
4.
DK:
RF:
No - no difficulties
Yes - minor difficulties
Yes - definite difficulties
Yes - severe difficulties
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1,RF,DK> [goto next section]
<2,3,4> [goto SDQIMP2_C]
Page 204 of 304
Question ID: SDQ.0280.00.2
Variable name: SDQIMP2_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Response:
How long have these difficulties been present? Would you say less than a
month, 1-5 months, 6-12 months, or over a year?
1.
2.
3.
4.
DK:
RF:
Less than a month
1-5 months
6-12 months
Over a year
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto SDQIMP3_C]
Question ID: SDQ.0290.00.2
Variable name: SDQIMP3_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Do the difficulties upset or distress ^SCNAME? Would you say not at all, only a
little, a medium amount, or a great deal?
Response:
Page 205 of 304
1.
2.
3.
4.
DK:
RF:
Fills:
Not at all
Only a little
A medium amount
A great deal
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-4,RF,DK> [goto SDQIMP4_C]
Question ID: SDQ.0300.00.2
Variable name: SDQIMP4_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Response:
Fills:
Do the difficulties interfere with ^SCNAME's everyday life in the following
areas? ...Home life? Would you say not at all, only a little, a medium amount, or
a great deal?
1.
2.
3.
4.
DK:
RF:
Not at all
Only a little
A medium amount
A great deal
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Page 206 of 304
Skip Instructions: <1-4,RF,DK> [goto SDQIMP5_C]
Question ID: SDQ.0310.00.2
Variable name: SDQIMP5_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Response:
Fills:
Read if necessary: Do the difficulties interfere with ^SCNAME's everyday life in the
following areas? ...Friendships?
Read if necessary: Would you say not at all,
only a little, a medium amount, or a great deal?
1.
2.
3.
4.
DK:
RF:
Not at all
Only a little
A medium amount
A great deal
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-4,RF,DK> [goto SDQIMP6_C]
Page 207 of 304
Question ID: SDQ.0320.00.2
Variable name: SDQIMP6_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Response:
Fills:
Read if necessary: Do the difficulties interfere with ^SCNAME's everyday life in the
following areas? ...Classroom learning? Read if necessary: Would you say not at
all, only a little, a medium amount, or a great deal?
1.
2.
3.
4.
DK:
RF:
Not at all
Only a little
A medium amount
A great deal
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-4,RF,DK> [goto SDQIMP7_C]
Question ID: SDQ.0330.00.2
Variable name: SDQIMP7_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Read if necessary: Do the difficulties interfere with ^SCNAME's everyday life in the
following areas? ...Leisure activities? Read if necessary: Would you say not at
all, only a little, a medium amount, or a great deal?
Response:
Page 208 of 304
1.
2.
3.
4.
DK:
RF:
Fills:
Not at all
Only a little
A medium amount
A great deal
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-4,RF,DK> [goto SDQIMP8_C]
Question ID: SDQ.0340.00.2
Variable name: SDQIMP8_C
Interview module: SDQ(Child.SDQ)
Inherited Universe: (AGE_FINAL GE '004' 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 '004' and AGE_FINAL LE '017'))
Universe: SDQIMP1_C IN ('2','3','4')
Universe Description: Sample Children 4-17 who have had minor, definite or severe difficulties with
emotions, concentration, behavior, or being able to get along with other people
Question Text:
Response:
Do the difficulties put a burden on you or the family as a whole? Would you say
not at all, only a little, a medium amount, or a great deal?
1.
2.
3.
4.
DK:
RF:
Not at all
Only a little
A medium amount
A great deal
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Page 209 of 304
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:
Response:
Fills:
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.
1.
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
^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 210 of 304
Skip Instructions: <1,2,RF,DK> [goto JAILEV1_C]
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 211 of 304
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 next section]
Question ID: TBI.0010.00.3
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:
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.
Response:
Page 212 of 304
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:
Fills:
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
^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]
Page 213 of 304
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]
elseif TBILCDCMG_C=2,RF,DK [goto next section]
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:
^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 spontaneously start a
game, like basketball or soccer.
Response:
Page 214 of 304
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^CDCMG_C
If TBILCDCMG_C=1 and TBIHLSBMC_C=2,RF,DK,
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."
else no fill
^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]
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:
Was ^SCNAME participating in an organized team or league sports competition
or practice when ^heshe_C experienced any of these blows or jolts to the
head?
Response:
Page 215 of 304
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: <1,2,RF,DK> [goto TBIEVAL_C]
Question ID: TBI.0060.00.3
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:
Response:
Fills:
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?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Page 216 of 304
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: VSL.0010.00.3
Variable name: VSLVYR_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe Description: Sample Children 3-17
Question Text:
Response:
Fills:
During the past 12 months, did ^SCNAME have problems or difficulty with
^hisher_C VOICE, such as having a hoarse, raspy, tired, or strained voice, or
trouble speaking loud enough to be heard?
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 VSLVDYS_C]
<2,RF,DK> [goto VSLSWYR_C]
Page 217 of 304
Question ID: VSL.0020.00.3
Variable name: VSLVDYS_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLVYR_C=1
Universe Description: Sample Children 3-17 who had a voice problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, about how many days, weeks, or months did
^heshe_C have problems or difficulty with ^hisher_C voice?
Do not read
categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
1.
2.
3.
4.
5.
6.
DK:
RF:
1 to 6 days (“less than a week―)
7 to 13 days (“one week or more, but less than two weeks―)
14 to 29 days (“2 weeks or more, but less than a month―)
30 to 89 days (“a month or more, but less than 3 months―)
90 days to 179 days (“3 months or more, but less than 6 months―)
180 days or more (“6 months or more―)
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"
Page 218 of 304
Skip Instructions: <1-6,RF,DK> [goto VSLVDIF_C]
Question ID: VSL.0030.00.3
Variable name: VSLVDIF_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLVYR_C=1
Universe Description: Sample Children 3-17 who had a voice problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, how much difficulty did ^heshe_C have with
^hisher_C voice? Would you say a little, a lot, or somewhere in between?
1.
2.
3.
DK:
RF:
A little
A lot
Somewhere in between
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"
Skip Instructions: <1-3,RF,DK> [goto VSLSWYR_C]
Page 219 of 304
Question ID: VSL.0040.00.3
Variable name: VSLSWYR_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe Description: Sample Children 3-17
Question Text:
Response:
Fills:
During the past 12 months, did ^SCNAME have problems or difficulty with
SWALLOWING, such as having difficulty eating solid food, taking pills, or
drinking liquids?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1> [goto VSLSWDYS_C]
<2,RF,DK> [goto VSLSPYR_C]
Question ID: VSL.0050.00.3
Variable name: VSLSWDYS_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLSWYR_C=1
Universe Description: Sample Children 3-17 who had a swallowing problem in the past 12 months
Question Text:
During the past 12 months, about how many days, weeks, or months did
^heshe_C have problems or difficulty with swallowing?
Do not read
categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
Response:
Page 220 of 304
1.
2.
3.
4.
5.
6.
DK:
RF:
Fills:
1 to 6 days (“less than a week―)
7 to 13 days (“one week or more, but less than two weeks―)
14 to 29 days (“2 weeks or more, but less than a month―)
30 to 89 days (“a month or more, but less than 3 months―)
90 days to 179 days (“3 months or more, but less than 6 months―)
180 days or more (“6 months or more―)
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: <1-6,RF,DK> [goto VSLSWDIF_C]
Question ID: VSL.0060.00.3
Variable name: VSLSWDIF_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLSWYR_C=1
Universe Description: Sample Children 3-17 who had a swallowing problem in the past 12 months
Question Text:
Response:
During the past 12 months, how much difficulty did ^heshe_C have with
swallowing? Would you say a little, a lot, or somewhere in between?
1.
2.
3.
DK:
RF:
A little
A lot
Somewhere in between
Don't Know
Refused
Page 221 of 304
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: <1-3,RF,DK> [goto VSLSPYR_C]
Question ID: VSL.0070.00.3
Variable name: VSLSPYR_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe Description: Sample Children 3-17
Question Text:
Response:
Fills:
During the past 12 months, did ^SCNAME have problems or difficulty with
^hisher_C SPEECH, such as stuttering, repeating words, or not being able to
pronounce words correctly?
Read if necessary: This refers to the language
^heshe_C is most comfortable with, not a second or third language.
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"
Page 222 of 304
Skip Instructions: <1> [goto VSLSPDYS_C]
<2,RF,DK> [goto VSLLGYR_C]
Question ID: VSL.0080.00.3
Variable name: VSLSPDYS_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLSPYR_C=1
Universe Description: Sample Children 3-17 who had a speech problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, about how many days, weeks, or months did
^heshe_C have problems or difficulty with ^hisher_C speech?
Do not read
categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
1.
2.
3.
4.
5.
6.
DK:
RF:
1 to 6 days (“less than a week―)
7 to 13 days (“one week or more, but less than two weeks―)
14 to 29 days (“2 weeks or more, but less than a month―)
30 to 89 days (“a month or more, but less than 3 months―)
90 days to 179 days (“3 months or more, but less than 6 months―)
180 days or more (“6 months or more―)
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"
^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 223 of 304
Skip Instructions: <1-6,RF,DK> [goto VSLSPDIF_C]
Question ID: VSL.0090.00.3
Variable name: VSLSPDIF_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLSPYR_C=1
Universe Description: Sample Children 3-17 who had a speech problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, how much difficulty did ^heshe_C have with
^hisher_C speech? Would you say a little, a lot, or somewhere in between?
1.
2.
3.
DK:
RF:
A little
A lot
Somewhere in between
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"
Skip Instructions: <1-3,RF,DK> [goto VSLSPST_C]
Page 224 of 304
Question ID: VSL.0100.00.3
Variable name: VSLSPST_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLSPYR_C=1
Universe Description: Sample Children 3-17 who had a speech problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, did ^SCNAME's speech problems or difficulty
include stuttering, trouble pronouncing words correctly, or both?
1.
2.
3.
DK:
RF:
Stuttering
Trouble pronouncing words correctly
Both
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
Skip Instructions: <1-3,RF,DK> [goto VSLLGYR_C]
Question ID: VSL.0110.00.3
Variable name: VSLLGYR_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe Description: Sample Children 3-17
Question Text:
During the past 12 months, did ^SCNAME have problems or difficulty with
LANGUAGE, such as difficulty using, learning, or understanding words,
sentences, or conversational interactions?
Read if necessary: This refers to
the language ^heshe_C is most comfortable with, not a second or third language.
Response:
Page 225 of 304
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 VSLLGDYS_C]
<2,RF,DK> if VSLVYR_C=1 or VSLSWYR_C=1 or VSLSPYR_C=1 [goto
VSLBRAIN_C]
else [goto next section]
Question ID: VSL.0120.00.3
Variable name: VSLLGDYS_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLLGYR_C=1
Universe Description: Sample Children 3-17 who had a language problem in the past 12 months
Question Text:
Response:
During the past 12 months, about how many days, weeks, or months did
^heshe_C have problems or difficulty with language?
Do not read categories
unless the respondent says they don't know, at which time you can read the wording
in parentheses.
1.
2.
1 to 6 days (“less than a week―)
7 to 13 days (“one week or more, but less than two weeks―)
Page 226 of 304
3.
4.
5.
6.
DK:
RF:
Fills:
14 to 29 days (“2 weeks or more, but less than a month―)
30 to 89 days (“a month or more, but less than 3 months―)
90 days to 179 days (“3 months or more, but less than 6 months―)
180 days or more (“6 months or more―)
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: <1-6,RF,DK> [goto VSLLGDIF_C]
Question ID: VSL.0130.00.3
Variable name: VSLLGDIF_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLLGYR_C=1
Universe Description: Sample Children 3-17 who had a language problem in the past 12 months
Question Text:
Response:
During the past 12 months, how much difficulty did ^heshe_C have with
language? Would you say a little, a lot, or somewhere in between?
1.
2.
3.
DK:
RF:
A little
A lot
Somewhere in between
Don't Know
Refused
Page 227 of 304
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: <1-3,RF,DK> [goto VSLBRAIN_C]
Question ID: VSL.0140.00.3
Variable name: VSLBRAIN_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLVYR_C=1 or VSLSWYR_C=1 or VSLSPYR_C=1 or VSLLGYR_C=1
Universe Description: Sample Children 3-17 who had a voice, swallowing, speech, or language
problem in the past 12 months
Question Text:
Response:
Fills:
Did any of ^SCNAME's ^VSLTYPE_C problems or difficulty follow a head or
brain injury?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^VSLTYPE_C
IF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLSPYR_C=1 AND VSLLGYR_C=1, fill: "voice,
swallowing, speech, and language"
ELSEIF VSLSWYR_C=1 AND VSLSPYR_C=1 AND
VSLLGYR_C=1,
fill:
"swallowing,
speech,
andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSPYR_C=1 AND
VSLLGYR_C=1, fill: "voice, speech, andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLLGYR_C=1,
fill:
"voice,
swallowing,
andlanguage"
Page 228 of 304
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLSPYR_C=1, fill: "voice, swallowing, and speech"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1, fill:
"voice and swallowing"
ELSEIF VSLVYR_C=1 AND VSLSPYR_C=1, fill:
"voice and speech"
ELSEIF VSLVYR_C=1 AND VSLLGYR_C=1, fill:
"voice andlanguage"
ELSEIF VSLSWYR_C=1 AND VSLSPYR_C=1, fill:
"swallowing and speech"
ELSEIF VSLSWYR_C=1 AND VSLLGYR_C=1, fill:
"swallowing and language"
ELSEIF VSLSPYR_C=1 AND VSLLGYR_C=1, fill:
"speech andlanguage"
ELSEIF VSLVYR_C=1, fill: "voice"
ELSEIF VSLSWYR_C=1, fill: "swallowing"
ELSEIF VSLSPYR_C=1, fill: "speech"
ELSEIF VSLLGYR_C=1, fill: "language"
Skip Instructions: <1,2,RF,DK> [goto VSLPA_C]
Page 229 of 304
Question ID: VSL.0150.00.3
Variable name: VSLPA_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLVYR_C=1 or VSLSWYR_C=1 or VSLSPYR_C=1 or VSLLGYR_C=1
Universe Description: Sample Children 3-17 who had a voice, swallowing, speech, or language
problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, did ^SCNAME see a speech-language pathologist,
doctor, or other health care professional for evaluation, treatment, or
rehabilitation services of ^hisher_C ^VSLTYPE_C problems or difficulty?
Read if necessary: Health care professionals can include early intervention
specialists, ENT doctors, otolaryngologists, audiologists, rehabilitation specialists,
occupational or physical therapists, internal medicine doctors, neurologists,
gerontologists, and others.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^VSLTYPE_C
IF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLSPYR_C=1 AND VSLLGYR_C=1, fill: "voice,
swallowing, speech, and language"
ELSEIF VSLSWYR_C=1 AND VSLSPYR_C=1 AND
VSLLGYR_C=1,
fill:
"swallowing,
speech,
andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSPYR_C=1 AND
VSLLGYR_C=1, fill: "voice, speech, andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLLGYR_C=1,
fill:
"voice,
swallowing,
andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLSPYR_C=1, fill: "voice, swallowing, and speech"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1, fill:
"voice and swallowing"
Page 230 of 304
ELSEIF VSLVYR_C=1 AND VSLSPYR_C=1, fill:
"voice and speech"
ELSEIF VSLVYR_C=1 AND VSLLGYR_C=1, fill:
"voice andlanguage"
ELSEIF VSLSWYR_C=1 AND VSLSPYR_C=1, fill:
"swallowing and speech"
ELSEIF VSLSWYR_C=1 AND VSLLGYR_C=1, fill:
"swallowing and language"
ELSEIF VSLSPYR_C=1 AND VSLLGYR_C=1, fill:
"speech andlanguage"
ELSEIF VSLVYR_C=1, fill: "voice"
ELSEIF VSLSWYR_C=1, fill: "swallowing"
ELSEIF VSLSPYR_C=1, fill: "speech"
ELSEIF VSLLGYR_C=1, fill: "language"
^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 VSLPALF_C]
<2,RF,DK> [goto VSLBTWR_C]
Page 231 of 304
Question ID: VSL.0160.00.3
Variable name: VSLPALF_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLPA_C=1
Universe Description: Sample Children 3-17 saw a speech-language pathologist or doctor for
treatment
Question Text:
Response:
Fills:
How did those evaluation, treatment, or rehabilitation services affect ^hisher_C
life as a whole? Has ^hisher_C life improved greatly, improved somewhat,
stayed the same, or gotten worse?
1.
2.
3.
4.
DK:
RF:
Improved greatly
Improved somewhat
Stayed the same
Gotten worse
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: <1-4,RF,DK> [goto VSLBTWR_C]
Page 232 of 304
Question ID: VSL.0170.00.3
Variable name: VSLBTWR_C
Interview module: VSL(Child.VSL)
Inherited Universe: (GEN.AGE_FINAL[PX_C]=3-17) 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]=3-17))
Universe: VSLVYR_C=1 or VSLSWYR_C=1 or VSLSPYR_C=1 or VSLLGYR_C=1
Universe Description: Sample Children 3-17 who had a voice, speech, swallowing, or language
problem in the past 12 months
Question Text:
Response:
Fills:
During the past 12 months, did ^hisher_C problems or difficulty with
^VSLTYPE_C get a lot better, get a little better, stay the same, get a little worse,
or get a lot worse?
1.
2.
3.
4.
5.
DK:
RF:
Get a lot better
Get a little better
Stay the same
Get a little worse
Get a lot worse
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
^VSLTYPE_C
IF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLSPYR_C=1 AND VSLLGYR_C=1, fill: "voice,
swallowing, speech, and language"
ELSEIF VSLSWYR_C=1 AND VSLSPYR_C=1 AND
VSLLGYR_C=1,
fill:
"swallowing,
speech,
andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSPYR_C=1 AND
VSLLGYR_C=1, fill: "voice, speech, andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1 AND
VSLLGYR_C=1,
fill:
"voice,
swallowing,
andlanguage"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1 AND
Page 233 of 304
VSLSPYR_C=1, fill: "voice, swallowing, and speech"
ELSEIF VSLVYR_C=1 AND VSLSWYR_C=1, fill:
"voice and swallowing"
ELSEIF VSLVYR_C=1 AND VSLSPYR_C=1, fill:
"voice and speech"
ELSEIF VSLVYR_C=1 AND VSLLGYR_C=1, fill:
"voice andlanguage"
ELSEIF VSLSWYR_C=1 AND VSLSPYR_C=1, fill:
"swallowing and speech"
ELSEIF VSLSWYR_C=1 AND VSLLGYR_C=1, fill:
"swallowing and language"
ELSEIF VSLSPYR_C=1 AND VSLLGYR_C=1, fill:
"speech andlanguage"
ELSEIF VSLVYR_C=1, fill: "voice"
ELSEIF VSLSWYR_C=1, fill: "swallowing"
ELSEIF VSLSPYR_C=1, fill: "speech"
ELSEIF VSLLGYR_C=1, fill: "language"
Skip Instructions: <1-5,RF,DK> [goto next section]
Page 234 of 304
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 235 of 304
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 236 of 304
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 237 of 304
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 238 of 304
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 239 of 304
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 240 of 304
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 241 of 304
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 242 of 304
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 243 of 304
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 244 of 304
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 245 of 304
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 246 of 304
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 247 of 304
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 248 of 304
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 249 of 304
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 250 of 304
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 251 of 304
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 252 of 304
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?
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
Enter all that apply, separate with commas.
^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
Page 253 of 304
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 254 of 304
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 255 of 304
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 256 of 304
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 257 of 304
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 258 of 304
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 259 of 304
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 260 of 304
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 261 of 304
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 262 of 304
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 263 of 304
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 264 of 304
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 265 of 304
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 266 of 304
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 267 of 304
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 268 of 304
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 269 of 304
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 270 of 304
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 271 of 304
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 272 of 304
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 273 of 304
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 274 of 304
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 275 of 304
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 276 of 304
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 277 of 304
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 278 of 304
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 279 of 304
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 AGE of both persons is le 65 [goto INC75K_C]
elseif GEN.PCNT_C=2 and AGE of at least 1 person gt 65 or GEN.PCNT_C=4
[goto INC100K_C]
elseif GEN.PCNT_C IN (3,5,6,7,8,9+) [goto INC400PCT_C]
[goto next section
Page 280 of 304
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 281 of 304
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 282 of 304
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_C=8 [goto INC100K_C]
else [goto next section]
<2,RF,DK> [goto next section]
Page 283 of 304
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 all persons AGE le 65
Universe Description: Sample Children 0-17 who answered 250% of poverty threshold or more and
are from a 2-person family and all are 65 or younger 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 next section]
<2> [goto INC100K_C]
[goto next section]
Page 284 of 304
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=2 and AGE of at least
1 person is gt 65 or GEN.PCNT_C=4))
or (INC200PCT_C=1 and
GEN.PCNT_C=8)
Universe Description: Sample Children 0-17 who answered $75,000 or more or answered 250% of
poverty threshold or more and are from a 2-person family and at least 1
person is greater than 65 or from a 4-person family or answered less than
200% of poverty threshold and are from an 8-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=2 [goto INC400PCT_C]
else [goto next section]
<2> if GEN.PCNT_C=2 [goto INC150K_C]
elseif GEN.PCNT_C=4 [goto INC400PCT_C]
elseif GEN.PCNT_C=8 [goto next section]
[goto next section]
Page 285 of 304
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: (INC100K_C=1
and
GEN.PCNT_C=4) or
GEN.PCNT_C ge 5))
GEN.PCNT_C=2)
(INC250PCT_C=2
or
and
(INC100K_C=2
and
(GEN.PCNT_C=3 or
Universe Description: Sample Children 0-17 who answered less than $100,000 and are from a
2-person family or answered $100,000 or more and are from a 4-person family
or answered 250% of poverty threshold or more and are from a 3 or 5+ 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
Skip Instructions: <1> if GEN.PCNT_C IN (6,7) [goto INC150K_C]
else [goto next section]
<2> if GEN.PCNT_C IN (3,4) [goto INC150K_C]
else [goto next section]
[goto next section]
Page 286 of 304
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=2)
or
(INC400PCT_C=2
and
GEN.PCNT_C IN (3,4)) or (INC400PCT_C=1 and GEN.PCNT_C IN (6,7))
Universe Description: Sample Children 0-17 who answered $100,000 or more and are from a
2-person family or answered 400% of poverty or more and are from a 3- or
4-person family or answered less than 400% of poverty and are from a 6- or
7-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 $150,000 or $150,000 or
more?
1.
2.
DK:
RF:
Less than $150,000
$150,000 or more
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 287 of 304
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 "Food Assistance Program 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"
Page 288 of 304
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 "SNAP 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 "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 "Food Assistance Program 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 or food stamp benefits"
If WY then fill "SNAP or food stamp benefits"
Page 289 of 304
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 290 of 304
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 291 of 304
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 292 of 304
Enter '1' to
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 293 of 304
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 294 of 304
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 295 of 304
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 296 of 304
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 297 of 304
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 298 of 304
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 (44 U.S.C. §§
3561-3583); 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 299 of 304
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 (44 U.S.C. §§
3561-3583); 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 300 of 304
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 301 of 304
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:
?[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 (44
U.S.C. §§ 3561-3583); 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.
Response:
Page 302 of 304
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: 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 303 of 304
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 304 of 304
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 2024-10-02 |