Reinterview Questions

Attachment 2 NHIS Reinterview Questions

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Revised Questions

RIRESP

(Display household roster from original interview)

 Ask if necessaryWith whom am I speaking?

 Enter line number of person you are speaking to or (0) if person is not on roster.

<00-25> [goto ROSTER_1]

______________________________________________________________________

ROSTER_1

Our records indicate that ♦Read above name(s) in blue ♦ was/were living or staying at

[Fill: ADDRESS from original interview] on [Fill: INTDATE].

Is this correct?

1. Yes Refused

2. No Don’t know

<1,R,D> [goto ROSTER_3] <2> [goto ROSTER_2]

ROSTER_2

Enter the line number of the household member(s) (above name(s) in blue) who wasn’t/weren’t living or staying at the household on [Fill: INTDATE].

<01-25> [goto ROSTER_3]

_________________________________________________________________

ROSTER_3

Have I missed any household member who

[Fill: ROSTER_INFO1]?

[Fill: ROSTER_INFO2]?

[Fill: ROSTER_INFO3]?

1. Yes Refused

2. No Don’t know

<1>[goto ROSTER_4]

<2,R,D> If LENGTH_H=D or LENGTH_M=<0-90> then [goto RI_MONTH]

_____________________________________________________________

ROSTER_4

• Enter the name of each missing household member who

[Fill: ROSTER_INFO1]

[Fill: ROSTER_INFO2]

[Fill: ROSTER_INFO3]

• Press Enter after each name and again after last name to continue.

<goto CKANCEST>

_______________________________________________________________

(For screener cases)

CKANCEST

Is [Fill: “your”/ FNAME LNAME“’s”] national ancestry Puerto Rican, Cuban, Mexican/Mexicano, Mexican American, Chicano, other Latin American, or other Spanish?

1. Hispanic Refused

2. Non-Hispanic Don’t know

<1, 2, D, R> [go to CKRACE]

(For screener cases)

CKRACE

What [Fill: “is your race”/ “race is” FNAME LNAME]?

 Read if necessary: White, Black, American Indian, Eskimo, Aleut, or Asian/ Pacific Islander

1. Black or Asian Refused

2. Non-Black and Non-Asian Don’t know

<1, 2, D, R> [repeat this for every person on the roster and then goto THANK_YOU]

______________________________________________________________________

RI_MONTH, RI_DAY, RI_YEAR

What is your date of birth?

*Enter month <01-12,R,D>

*Enter day <01-31,R,D>,

*Enter year <1881-1991,R,D>

<goto HH_1>

____________________________________________________________________ HH_1

Question asked if respondent is the household respondent.

Did the interviewer ask you questions about having a cell phone?

1. Yes Refused

2. No Don’t know

_______________________________________________________________________

FAM_1

Question asked if respondent is the family respondent.

Did the interviewer ask you or someone in your household if anyone in the household

was covered by health insurance or some other kind of health care plan?

1. Yes Refused

2. No Don’t know

FAM_2

Question asked if respondent is the family respondent.

Did the interviewer ask you about the highest level of school that you and other family

members have completed?

1. Yes Refused

2. No Don’t know

______________________________________________________________________

FAM_3

Question asked if respondent is the family respondent.

Did the interviewer ask you about the amount of your total family income?

1. Yes Refused

2. No Don’t know

______________________________________________________________________

SA1_HEALTH

Question asked if respondent is the sample adult.

Did the interviewer ask you about health conditions such as high blood pressure,

asthma, diabetes, a head cold, or a chest cold?

1. Yes Refused

2. No Don’t know

________________________________________________________________________

SA2_ALCOHOL

Question asked if respondent is the sample adult.

Did the interviewer ask you about your use of alcohol?

1. Yes Refused

2. No Don’t know

________________________________________________________________________

SA2_EXERCISE

Question asked if respondent is the sample adult.

Did the interviewer ask you how often you exercise?

1. Yes Refused

2. No Don’t know

SA2_DOCTOR

Question asked if respondent is the sample adult.

Did the interviewer ask you how many times you went to the doctor?

1. Yes Refused

2. No Don’t know

___________________________________________________________________

SA3_EMROOM

Question asked if respondent is the sample adult.

Did the interviewer ask you how many times you went to the emergency room?

1. Yes Refused

2. No Don’t know

____________________________________________________________________

SA3_SHOT

Question asked if respondent is the sample adult.

Did the interviewer ask you whether you received a flu shot?

1. Yes Refused

2. No Don’t know

_____________________________________________________________________

SA3_SLEEP

Question asked if respondent is the sample adult.

Did the interviewer ask you how many hours you sleep?

1. Yes Refused

2. No Don’t know

______________________________________________________________________

I'd like to schedule a date to complete/conduct the quality check. What DATE and TIME would be best to call/visit?

Today is: [Fill: RIDATE].

♦ Enter Date and Time

♦ Enter (0) if this is a break-off case.

♦ Enter (1) if you don’t intend to follow up on this case.

THANK_YOU

Thank you for your cooperation. You’ve been very helpful.

*Enter 1 to continue

CALLBACK

I'd like to schedule a date to complete/conduct the quality check. What DATE and TIME would be best to call/visit?

Today is: [Fill: RIDATE].

♦ Enter Date and Time

♦ Enter (0) if this is a break-off case.

♦ Enter (1) if you don’t intend to follow up on this case.

_______________________________________________________________________

CBTHANK

Thank you for your help.

We will call/visit again at the time suggested.

 Enter 1 to continue.