Document
1-CID Update
ICR 200610-0920-005 · OMB 0920-0214 · Object 1205001.
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Document Metadata
| File Type | application/msword |
|---|---|
| File Title | 1-CID Update |
| Author | Howard Riddick |
| Last Modified By | Writer |
| File Modified | 2006-12-15 |
| File Created | 2026-11-08 |
| Conversion State | complete |
Extracted Text
Page 1 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Question ID: CID.001_00.000 Instrument Variable Name: CURRES QuestionnaireFileName: Sample Child
QuestionText: * Enter the line number of the person to whom you are speaking.
01-25 Person number of the respondent for Sample Child
UniverseText: Sample child section not started or not completed
SkipInstructions: if CSTAT <> empty and CSTAT <> 2 THEN
if ASTAT = empty or ASTAT = 2 THEN
goto adult.aid.SADULT
elseif recontact.RCIFLAG <> 1 THEN
goto recontact.RCI_BEGIN procedure
else
goto back.OUTCOMEB1 procedure
endif
goto back.OUTCOMEB1 procedure
endif
<01-25> if this is NOT an allowable line number
goto ERR_CURRES
elseif CURRES = a line number entered in KNOWSC2
store CURRES in CSPAVAIL and CSRESP
goto CSRELTIV
elseif KNOWSC2 = 'Don't know' or 'Refused' or empty (no line numbers in KNOWSC2)
goto KNOAVAIL
else
goto CSPAVAIL
endif
Page 2 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Question ID: CID.010_00.000 Instrument Variable Name: CSPAVAIL QuestionnaireFileName: Sample Child
QuestionText: The next questions are about [fill1: S.C. name].
Is [fill2:KNOWSC2 names] available to answer some questions about [fill3: HISHER] health?
* Enter line number of available respondent from list or enter '96' if no one is available.
* If refused enter CTRL_R.
01-25 Person # of person available to answer questions about Sample Child
96 No person available
UniverseText: Someone identified as knowledgeable about child's health and knowledgeable person(s) not entered in CURRES
SkipInstructions: <01-25> if line number not equal one of the line numbers in KNOWSC2
goto child.cid.ERR_CSPAVAIL
else
store child.cid.CSPAVAIL in child.cid.CSRESP
goto child.cid.CSRELTIV
endif
<96> store child.cid.CSPAVAIL in child.cid.CSRESP
goto cbk.CCALLBK1
<R> store <4> in CSTAT(FAMINT)
if ASTAT = empty or ASTAT = 2 THEN
goto adult.aid.SADULT
elseif recontact.RCIFLAG <> 1 THEN
goto recontact.RCI_BEGIN procedure
else
goto back.OUTCOMEB1 procedure
endif
Question ID: CID.030_00.000 Instrument Variable Name: CSRELTIV QuestionnaireFileName: Sample Child
QuestionText: (book) C1
[fill1: The next questions are about [fill2: S.C. name]
What is your relationship to [fill2: S.C. name]?
01 Parent (Biological, adoptive, or step)
02 Grandparent
03 Aunt/Uncle
UniverseText: Someone identified as knowledgeable about child's health
SkipInstructions: <1-8,R,D> If CSRESP = demographics.hhc.RELRESP_A
goto child.chs.BWGT_LB
elseif CSRESP = demographics.hhc.HHRESP
goto child.chs.BWGT_LB
else]
goto CSPVERF_S
endif]
Page 3 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Question ID: CID.040_00.000 Instrument Variable Name: CSPVERF_S QuestionnaireFileName: Sample Child
QuestionText: * Please verify the following information about the sample child before proceeding:
I have recorded [fill1: S.C. name]'s sex as [fill2: Sex of Sample Child]. Is this correct?
* If respondent "refuses" or says "don't know", enter "1" for "yes".
1 Yes
2 No
UniverseText: Respondent is not the person entered in HHRESP or RELRESP_A.
SkipInstructions: <1> goto CSPVERF_A
<2> goto NEWSEX
Question ID: CID.041_00.000 Instrument Variable Name: NEWSEX QuestionnaireFileName: Sample Child
QuestionText: * Ask if appropriate; otherwise, enter your best guess of the person's sex.
Is [fill: S.C. name] Male or Female?
1 Male
2 Female
UniverseText: Respondent said child's sex is not correct.
SkipInstructions: <1,2> store NEWSEX in SEX
goto ERR_NEWSEX
reset CSPVERF_S
goto CSPVERF_S
Question ID: CID.042_00.000 Instrument Variable Name: CSPVERF_A QuestionnaireFileName: Sample Child
QuestionText: * Please verify the following information about the sample child before proceeding:
I have recorded [fill1: S.C name]'s age as [fill2: Age of Sample Child] old. Is this correct?
* If respondent "refuses" or says "don't know", enter "1" for "yes".
1 Yes
2 No
UniverseText: Respondent verified child's sex
SkipInstructions: <1> goto CSPVERF_D
<2> goto NEWAGE
Page 4 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Question ID: CID.043_00.000 Instrument Variable Name: NEWAGE QuestionnaireFileName: Sample Child
QuestionText: How old is [fill1: S.C. name]?
* If age given in months, weeks, or days, convert age to appropriate year. If less than one year old, enter "0".
000-120 Age in years
UniverseText: Respondent said child's age is not correct
SkipInstructions: <0-120, Refused, Don't know>
if NEWAGE = Refused or NEWAGE = Don't know or NEWAGE = AGE
reset CSPVERF_A
goto ERR_NEWAGE
else
store NEWAGE in AGE
goto NEWDOB_M
Question ID: CID.044_00.000 Instrument Variable Name: CSPVERF_D QuestionnaireFileName: Sample Child
QuestionText: * Please verify the following information about the sample child before proceeding:
I have recorded [fill1: S.C. name]'s birthday as [fill2: Birthday of Sample Child]. Is this correct?
* If respondent "refuses" or says "don't know", enter "1" for "yes".
1 Yes
2 No
UniverseText: Respondent verified child's sex
SkipInstructions: <1> if AGE of Sample Child ge <18>
goto CNO_MORE
else
goto child.chs.BWGT_LB
endif
<2> goto NEWDOB_M
Page 5 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Question ID: CID.046_01.000 Instrument Variable Name: NEWDOB_M QuestionnaireFileName: Sample Child
QuestionText: 1 of 3
What is [fill: S.C. name]'s birthday?
*Enter month of birth.
1 January
10 October
11 November
12 December
2 February
3 March
4 April
5 May
6 June
7 July
8 August
9 September
UniverseText: Respondent said child's date of birth is not correct or child's age is not correct
SkipInstructions: <01-12, Refused, Don't know> goto NEWDOB_D
Question ID: CID.046_02.000 Instrument Variable Name: NEWDOB_D QuestionnaireFileName: Sample Child
QuestionText: 2 of 3
* Enter day of birth.
01-31 Day of the month
UniverseText: Respondent said child's date of birth is not correct or child's age is not correct
SkipInstructions: <01-31,Refused,Don't know> goto NEWDOB_Y
If days not valid, goto ERR_NEWDOB_D
Page 6 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Question ID: CID.046_03.000 Instrument Variable Name: NEWDOB_Y QuestionnaireFileName: Sample Child
QuestionText: 3 of 3
* Enter year of birth.
1880-2020 Year of birth
UniverseText: Respondent said child's date of birth is not correct or child's age is not correct
SkipInstructions: <1880-2020, Refused, Don't know> if CSPVERF_A = No then reset CSPVERF_A to empty
goto CSPVERF_A
elseif CSPVERF_D = No then reset CSPVERF_D to empty
goto CSPVERF_D
endif
(if year GT current year) or (if year = current year and month GT current month) or (if year = current year and month
= current month and day GT current day)
goto ERR1_NEWDOB_Y
endif
(if birth month = <02> and birth day = <29> and this is not a leap year)
goto ERR2_NEWDOB_Y
endif
(if NEWDOB_M = Ref or DK) or (if NEWDOB_D = Ref or DK) or (if NEWDOB_Y = Ref or DK)
goto ERR3_NEWDOB_Y
else
store NEWDOB_M in DOBM
store NEWDOB_D in DOBD
store NEWDOB_Y in DOBY
if CSPVERF_A = No then reset CSPVERF_A to empty
goto CSPVERF_A
elseif CSPVERF_D = No then reset CSPVERF_D to empty
goto CSPVERF_D
endif
endif
Calculate age from NEWDOB_M, NEWDOB_D, and NEWDOB_Y.
if age from NEWDOB items is ne AGE and age from NEWDOB items is valid
reset CSPVERF_A or CSPVERF_D
goto ERR4_NEWDOB_Y
endif
Page 7 of 7
2007 NHIS Questionnaire - Sample Child
Child Identification
Document Version Date: 12-Jul-06
Split sample 1. Linkage permission question prior to question for SSN: sample
child
Question ID cID.051
Question Text Finally, we would like to link (child’s name)’s survey data with health-related records of other
government agencies. This will allow us to conduct additional research without taking up
your time with more questions. Any data obtained will be kept strictly private as
required by law. May we try to link (child’s name)’s survey data with other health-related records?
* Read if necessary: The specific federal laws are the Public Health Service Act (Title 42, United States Code, Section 242K)
Answer Codes 1. Yes
2. No
Refused
Don’t know
Skip Instructions <1> [goto AID.052]
<2,R,D> [goto beginning of Recontact or Back section]
Question ID cID.052
Question Text
To help us link (child’s name)’s survey data with vital statistics and health-related records of other government agencies, we would like the last four digits of (child’s)’s Social Security Number. The National Center for Health Statistics uses this information for research purposes only. Providing this information is voluntary. Federal laws authorize us to ask for this information and require us to keep it strictly private. There will be no effect on (child’s name)’s benefits if you do not provide this information.
* Read if necessary: The specific federal laws are the Public
Health Service Act (Title 42, United States Code, Section 242K) and the Confidential Information Protection and Statistical Efficiency Act (Title V of Public Law 107-347).
What are the last four digits of (child’s name)’s Social Security Number?
• Enter 'N' if no Social Security Number.
Question ID cID.053
Question Text * Enter how the last four digits of the Social Security Number were reported.
Answer Codes 1. From memory
2. From records
Question ID cID.054
Question Text * Select one category below to indicate reporting of the last four digits of the Social
Security Number.
Answer Codes 1. In person
2. Telephone
SkipInstructions: <1,2> goto beginning of Sample Adult, Recontact, or Back section
Split sample 2. Linkage permission question after questions for SSN: sample child
Question ID cID.051
Question Text Finally, we would like the last four digits of your Social Security Number [if sample adult has Medicare: , and the last four numbers and any letters of your Medicare number]. This information will help us link your survey data with 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 uses this information for research purposes only Providing this information is voluntary. Federal laws authorize us to ask for this information and require us to keep it strictly private. There will be no effect on your benefits if you do not provide this
information.
* Read if necessary: The specific federal laws are the Public Health Service Act (Title 42, United States Code, Section 242K) and the Confidential Information Protection and Statistical Efficiency Act (Title V of Public Law 107-347).
* Enter '1' to continue.
Question ID cID.052
Question Text What are the last four digits of (child’s name)’s Social Security Number?
Skip Instructions SSN given, go to CID.053
SSN refused or don’t know, go to CID.055
Question ID cID.053
Question Text * Enter how the last four digits of the Social Security Number were reported.
Answer Codes 1. From memory
2. From records
Question ID cID.054
Question Text * Select one category below to indicate reporting of the last four digits of the Social
Security Number.
Answer Codes 1. In person
2. Telephone
Skip Instructions Go to beginning of Sample Adult, Recontact, or Back section
Question ID cID.055
Question Text May we try to link (child’s name)’s survey data without (child’s name)’s Social Security number?
Read if necessary: Any data obtained will be kept strictly private as required by law (Public Health Service Act, which is Title 42, United States Code, Section 242K; and the Confidential Information Protection and Statistical Efficiency Act, which is Title V of Public Law 107-347).
Answer Codes 1. Yes
2. No
Refused
Don’t know
Skip Instructions Go to beginning of Sample Adult, Recontact, or Back section