PIAAC Field Test Screener

Appendix A
PIAAC Field Test Screener

SCQ1010

SCQAskNumberInHH

Item Type: Question
Item Class: Integer
Item Text: Including yourself, how many people live in this household and have no usual place of
residence elsewhere?
Display:
Notes: Start enumeration timing here.
Lower Range: 1
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

1

Upper Range: 25
Value Label

990 REFUSED

Version Date:

Skip To
SCQ1015
SCQ1015

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SCQ1015
Item Type: Route
Item Class: Begin Loop
Item Text: The following variables -- name, Screener respondent, gender, age, age range, and the
misreported field (SCQ1020-SCQ1090) -- should appear as a grid. All enumeration
information is entered in this grid.
Display:
Notes:

Response
1 [Route executed.]

Version Date:

Value Label

Skip To
SCQ1020

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SCQ1020

SCQNameHHM

Item Type: Question
Item Class: String
Item Text: [A] What is the first name of the person, or one of the persons, who is living in the
household who owns or rents this home?
[B] Next, please tell me the names of all other members of this household (starting with
your spouse, if applicable).
[C] Please tell me the names of all other members of this household.
[HOUSEHOLD (HH) MEMBERS INCLUDE PEOPLE WHO THINK OF THIS HH AS
THEIR PRIMARY PLACE OF RESIDENCE. IT INCLUDES PERSONS WHO USUALLY
STAY IN THE HH BUT ARE TEMPORARILY AWAY ON BUSINESS, VACATION, IN A
HOSPITAL, OR LIVING AT SCHOOL IN A DORM, FRATERNITY OR SORORITY.]
[PRESS THE DOWN ARROW KEY TO MOVE TO THE NEXT BLANK LINE. WHEN ALL
NAMES ARE ENTERED, USE ARROW UP AND RIGHT KEYS TO GET TO NEXT
QUESTION.]
[PRESS ENTER ON A BLANK LINE TO EXIT THE GRID.]
Display: For the first line on the grid, display text A. For the second line, display text B. For all
subsequent lines, display text C.
Notes: Allow 25 characters for names.
This variable should appear as the first column on the grid.
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

Upper Range:
Value Label

Skip To
SCQ1025

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SCQ1025

SCQWhoIsRespondent

Item Type: Question
Item Class: Enumerated
Item Text: [ENTER A '1' NEXT TO THE RESPONDENT.]
[IF NOT OBVIOUS, ASK: Thank you for telling me about all the people who live in this
household. Now, I need to ask your name, so I know which household member you are.]
Display:
Notes: Allow only one response to this question. This variable should appear as the second
column in the grid.

CATA: NO

Answers Allowed:

Response
1 RESPONDENT

Version Date:

1
Value Label
Respondent

Skip To
SCQ1030

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SCQ1030
Item Type: Route
Item Class: If Then
Item Text: Allow open movement through grid. Do not require users to ask all items for each person
before going to the next person.
Display:
Notes:

Response
1 [Route executed.]

Version Date:

Value Label

Skip To
SCQ1040

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SCQ1040

SCQGender

Item Type: Question
Item Class: Enumerated
Item Text: [CODE GENDER. IF NOT OBVIOUS, ASK: Is {NAME} male or female?]
Display:
Notes: This variable should appear as the third column on the grid.

CATA: NO

Version Date:

Answers Allowed:

1

Response
1 MALE

Value Label
Male

Skip To
SCQ1050

2 FEMALE

Female

SCQ1050

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SCQ1050

SCQAge

Item Type: Question
Item Class: Integer
Item Text: How old {are you/is NAME}?
[IF UNDER 1 YEAR, ENTER AS "0"]
Display:
Notes: This variable should appear as the fourth column on the grid.
Lower Range: 0
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

1

Upper Range: 130
Value Label

Skip To
SCQ1055

980 DON'T KNOW

SCQ1060

990 REFUSED

SCQ1060

Version Date:

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SCQ1055
Item Type: Check
Item Class: Soft
Item Text: If outside the range of 0 to 99, display the following: "I just need to check that
{your/NAME's} age is {SCQ1050}. Is this right?"

Associated variable: SCQ1050
Display:
Notes:

Response
1 [Check executed.]

Version Date:

Value Label

Skip To
SCQ1090

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SCQ1060

SCQAgeRange

Item Type: Question
Item Class: Enumerated
Item Text: {Are you/Is NAME}...
Display:
Notes: This variable should appear as the fifth column on the grid.

CATA: NO

Answers Allowed:

1

Response
1 Under 16 years old?

Value Label
Under16YearsOld

Skip To
SCQ1090

2 16 to 25 years old?

F16To25YearsOld

SCQ1090

3 26 to 35 years old?

F26To35YearsOld

SCQ1090

4 36 to 45 years old?

F36To45YearsOld

SCQ1090

5 46 to 55 years old?

F46To55YearsOld

SCQ1090

6 56 to 65 years old?

F56To65YearsOld

SCQ1090

7 66 years old or older?

F66YearsOldOrOlder

SCQ1090

980 DON'T KNOW

SCQ1061

990 REFUSED

SCQ1061

Version Date:

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SCQ1061

SCQBroadAgeRange

Item Type: Question
Item Class: Enumerated
Item Text: {Are you/Is NAME}…
Display:
Notes: This variable should appear as the sixth column on the grid.

CATA: NO

Version Date:

Answers Allowed:

Response
1 Under 16 years old?

Value Label
Under16YearsOld_

Skip To
SCQ1090

2 16 to 39 years old?

_16To39YearsOld_

SCQ1090

3 40 to 65 years old?

_40To65YearsOld

SCQ1090

4 66 years old or older?

_66YearsOldOrOlder

SCQ1090

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SCQ1090

SCQMisreportedHHM

Item Type: Instruction
Item Class: Enumerated
Item Text: [LEAVE EMPTY UNLESS PERSON WAS MISREPORTED AND IS NOT A HOUSEHOLD
MEMBER. IF MISREPORTED, ENTER "1".]
Display: Do not allow "MISREPORT" as an option on the first line of the grid, (reference person).
If a person is marked as "MISREPORTED," all other fields on the grid associated with
this person should be "show only."
Notes: The default for this field is blank - it will only be filled if necessary.
This variable should appear as the seventh column on the grid.

Response
1 MISREPORTED

Version Date:

Value Label
Misreported

Skip To
SCQ1100

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SCQ1100

SCQAllInfoEntered

Item Type: Question
Item Class: Enumerated
Item Text: [HAVE YOU ENTERED ALL NECESSARY INFORMATION ON THE GRID?]
Display:
Notes: This item should appear in the first column of the first empty row.

CATA: NO

Version Date:

Answers Allowed:

1

Response
1 YES

Value Label
Yes

Skip To
SCQ1102

2 NO

No

SCQ1102

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SCQ1102
Item Type: Route
Item Class: If Then
Item Text: Check enumeration grid to ensure that all necessary items have been answered. If any
necessary fields are blank, return to grid. Else, go to SCQ1105.
Display:
Notes:

Response

Version Date:

Value Label

Skip To

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SCQ1105

SCQAnyoneElse

Item Type: Question
Item Class: Enumerated
Item Text: We have listed {NUMBER} household member{s}:
{NAME/GENDER/AGE}
Have we missed any other...
- members of this household who are related to {you/REFERENCE PERSON}?
- people living here who are not related to {you/REFERENCE PERSON}, including
friends or boarders?
- household members who usually live here but are not here currently, such as someone
away on vacation, business, in a hospital, or a student living in a dormitory?
Display: Display the number of household members collected in the enumeration grid in
{NUMBER}. Display the name, gender and age of all household members collected in
the grid in {NAME/GENDER/AGE}.
Notes: The number of household members collected in the enumeration grid is the value that
should be stored as household size.
End enumeration timing here when SCQ1105=2.

CATA: NO

Answers Allowed:

1

Response
1 YES

Value Label
Yes

Skip To
SCQ1106

2 NO

No

SCQ1110

990 REFUSED

Version Date:

SCQ1110

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SCQ1106
Item Type: Check
Item Class: Hard
Item Text: PLEASE ADD ADDITIONAL INFORMATION TO THE TABLE.
Display:
Notes:

Response
1 [Check executed.]

Version Date:

Value Label

Skip To
SCQ1020

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SCQ1110
Item Type: Route
Item Class: If Then
Item Text: Insert sampling messages here. Based on collected household characteristics,
determine if there is at least one eligible person in the household.
If there is at least one eligible person, then go to SCQ1115.
Else, go to SCQ1124.
Display:
Notes: Eligibility is determined at the time enumeration is completed. SCQ1105 is the final
enumeration question that must be answered to determine eligibility.

Response
1 [Route executed.]

Version Date:

Value Label

Skip To

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SCQ1115

SCQEligiblePersons

Item Type: Instruction
Item Class: Enumerated
Item Text: Based on the information you have provided, we have selected the following people to
participate in the study: {PERSON(S)}
[PRESS 1 AND ENTER TO CONTINUE.]
Display:
Notes: Display name, age and gender of eligible SP(s) in "PERSON(S)".

Response
1 CONTINUE

Version Date:

Value Label
Continue

Skip To
SCQ1117

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SCQ1117

SCQSPEthnicity

Item Type: Question
Item Class: Enumerated
Item Text: [SHOWCARD 1]
Do any of the following groups represent {your/NAME's} national origin or ancestry?
Mexican/Mexican-American, Puerto Rican, Cuban, other Hispanic or Latino? You can
select more than one answer.
[SELECT ALL THAT APPLY.]
Display:
Notes:
CATA: YES

Answers Allowed:

Response
1 MEXICAN/MEXICAN-AMERICAN

Value Label
Mexican_Mexican_American

Skip To
SCQ1118

2 PUERTO RICAN

PuertoRican

SCQ1118

3 CUBAN

Cuban

SCQ1118

4 OTHER HISPANIC OR LATINO

OtherHispanicOrLatino

SCQ1118

5 NOT HISPANIC

NotHispanic

SCQ1118

980 DON'T KNOW

SCQ1119

990 REFUSED

SCQ1119

Version Date:

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SCQ1118
Item Type: Check
Item Class: Hard
Item Text: If SCQ1117=5 and another response, display: "I'm sorry, but NOT HISPANIC is not
allowed with any other response."
Display:
Notes:

Response
1 [Check executed.]

Version Date:

Value Label

Skip To
SCQ1121

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SCQ1119

SCQEthnicityObserve

Item Type: Question
Item Class: Enumerated
Item Text: [RECORD SP'S ETHNICITY BY OBSERVATION, IF POSSIBLE.]
Display:
Notes:
CATA: NO

Answers Allowed:

Response
1 MEXICAN/MEXICAN-AMERICAN

Value Label
Mexican_Mexican_American

Skip To
SCQ1121

2 PUERTO RICAN

PuertoRican

SCQ1121

3 CUBAN

Cuban

SCQ1121

4 OTHER HISPANIC OR LATINO

OtherHispanicOrLatino

SCQ1121

5 NOT HISPANIC

NotHispanic

SCQ1121

980 DON'T KNOW

Version Date:

SCQ1121

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SCQ1121

SCQSPRace

Item Type: Question
Item Class: Enumerated
Item Text: [SHOWCARD 2]
What race do you consider {yourself/NAME} to be? White, Black or African American,
Asian, Native Hawaiian or other Pacific Islander, or American Indian or Alaska Native?
You can select more than one answer.
[SELECT ALL THAT APPLY.]
Display:
Notes:
CATA: YES

Answers Allowed:

Response
1 WHITE

Value Label
White

Skip To
SCQ1123

2 BLACK/AFRICAN AMERICAN

Black_AfricanAmerican

SCQ1123

3 ASIAN

Asian

SCQ1123

4 NATIVE HAWAIIAN/PACIFIC
ISLANDER
5 AMERICAN INDIAN/ALASKA
NATIVE
980 DON'T KNOW

NativeHawaiian_PacificIsland SCQ1123
er
AmericanIndian_AlaskaNativ SCQ1123
e
SCQ1122

990 REFUSED

Version Date:

SCQ1122

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SCQ1122

SCQRaceObserve

Item Type: Question
Item Class: Enumerated
Item Text: [RECORD SP'S RACE BY OBSERVATION, IF POSSIBLE.]
Display:
Notes:
CATA: NO

Answers Allowed:

Response
1 WHITE

Value Label
White

Skip To
SCQ1123

2 BLACK/AFRICAN AMERICAN

Black_AfricanAmerican

SCQ1123

3 ASIAN

Asian

SCQ1123

4 NATIVE HAWAIIAN/PACIFIC
ISLANDER
5 AMERICAN INDIAN/ALASKA
NATIVE
980 DON'T KNOW

Version Date:

NativeHawaiian_PacificIsland SCQ1123
er
AmericanIndian_AlaskaNativ SCQ1123
e
SCQ1123

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SCQ1123
Item Type: Route
Item Class: If Then
Item Text: If another SP, go to SCQ1117.
Else, go to SCQ1124.
Display:
Notes:

Response
1 [Route executed.]

Version Date:

Value Label

Skip To

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SCQ1124

SCQHomePhone

Item Type: Question
Item Class: Enumerated
Item Text: What is your home telephone number (in case my office wants to check my work)?
Display:
Notes:
CATA: NO

Answers Allowed:

1

Response
1 ENTER PHONE NUMBER

Value Label
EnterPhoneNumber

Skip To
SCQ1125

2 NO HOME PHONE

NoHomePhone

SCQ1150

990 REFUSED

Version Date:

SCQ1150

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SCQ1125

SCQPhoneArea

Item Type: Question
Item Class: Integer
Item Text: [What is your home telephone number (in case my office wants to check my work)?]
NUMBER: ()ENTER THE AREA CODE
Display:
Notes:
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

Upper Range:
Value Label

Skip To
SCQ1130

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SCQ1130

SCQPhoneExchange

Item Type: Question
Item Class: Integer
Item Text: NUMBER: ({AREA})-ENTER THE EXCHANGE
Display:
Notes:
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

1

Upper Range:
Value Label

Skip To
SCQ1135

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SCQ1135

SCQPhoneLocal

Item Type: Question
Item Class: Integer
Item Text: NUMBER: (AREA)-{EXCHANGE}
ENTER THE LOCAL
Display:
Notes:
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

1

Upper Range:
Value Label

Skip To
SCQ1140

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SCQ1140

SCQPhoneConfirm

Item Type: Question
Item Class: Enumerated
Item Text: CONFIRM TELEPHONE NUMBER: ({AREA}) {EXCHANGE}-{LOCAL}
Is this correct?
Display:
Notes:
CATA: NO

Version Date:

Answers Allowed:

1

Response
1 YES

Value Label
Yes

Skip To
SCQ1150

2 NO

No

SCQ1145

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SCQ1145
Item Type: Check
Item Class: Hard
Item Text: SELECT FIELD TO RE-ENTER.
Display:
Notes:

Response
1 [Check executed.]

Version Date:

Value Label

Skip To
SCQ1150

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SCQ1150

SCQOtherNumber

Item Type: Question
Item Class: Enumerated
Item Text: Is there {a/another} phone number where you could be reached?
Display: If SCQ1124=1, display "another". Else, display "a".
Notes:
CATA: NO

Answers Allowed:

Response
1 YES

Value Label
Yes

Skip To
SCQ1155

2 NO OTHER PHONE

NoOtherPhone

SCQ2005

990 REFUSED

Version Date:

SCQ2005

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SCQ1155

SCQOtherArea

Item Type: Question
Item Class: Integer
Item Text: [What is that phone number?]
NUMBER: ()ENTER THE AREA CODE
Display:
Notes:
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

Upper Range:
Value Label

Skip To
SCQ1160

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SCQ1160

SCQOtherExchange

Item Type: Question
Item Class: Integer
Item Text: NUMBER: ({AREA})-ENTER THE EXCHANGE
Display:
Notes:
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

Upper Range:
Value Label

Skip To
SCQ1165

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SCQ1165

SCQOtherLocal

Item Type: Question
Item Class: Integer
Item Text: NUMBER: (AREA)-{EXCHANGE}
ENTER THE LOCAL
Display:
Notes:
Lower Range:
CATA: NO

Answers Allowed:

Response
1 [Enter continuous answer.]

Version Date:

Upper Range:
Value Label

Skip To
SCQ1170

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SCQ1170

SCQOtherConfirm

Item Type: Question
Item Class: Enumerated
Item Text: I have the phone number as: ({AREA}) {EXCHANGE}-{LOCAL}
Is this correct?
Display:
Notes:
CATA: NO

Version Date:

Answers Allowed:

1

Response
1 YES

Value Label
Yes

Skip To
SCQ1180

2 NO

No

SCQ1175

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SCQ1175
Item Type: Check
Item Class: Hard
Item Text: SELECT FIELD TO RE-ENTER.
Display:
Notes:

Response
1 [Check executed.]

Version Date:

Value Label

Skip To
SCQ1180

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SCQ1180

SCQOtherPhoneLocated

Item Type: Question
Item Class: Enumerated
Item Text: Where is this phone located? Is it in your home, at work, someplace else, or is it a
cellular phone?
Display:
Notes:
CATA: NO

Answers Allowed:

Response
1 OWN HOME

Value Label
OwnHome

Skip To
SCQ2005

2 WORK

Work

SCQ2005

3 CELLULAR PHONE

CellPhone

SCQ2005

OthSpecify

SCQ2005

910 OTHER, SPECIFY
980 DON'T KNOW

SCQ2005

990 REFUSED

SCQ2005

Version Date:

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SCQ2005

SCQLanguage

Item Type: Question
Item Class: Enumerated
Item Text: [THIS SCREENER INTERVIEW WAS CONDUCTED IN:]
Display:
Notes:
CATA: NO

Answers Allowed:

Response
1 ENGLISH

Value Label
English

Skip To
SCQ3010

2 SPANISH

Spanish

SCQ3010

OthSpecify

SCQ3010

910 OTHER, SPECIFY

Version Date:

1

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SCQ3010
Item Type: Route
Item Class: If Then
Item Text: If hidden DU procedure is required, go to SCQ3012.
Else, go to SCQ3015.
Display:
Notes:

Response
1 [Route executed.]

Version Date:

Value Label

Skip To

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SCQ3012

SCQHiddenDU

Item Type: Instruction
Item Class: Enumerated
Item Text: We want to be sure that every household in this area has been given a chance to
participate in this important study. Are there any other living quarters, like a basement or
garage apartment that we may have missed?
IF NO -----> CODE 2
IF YES -----> DO THE DUs THAT R MENTIONED APPEAR ON THE LISTING SHEETS?
IF YES -----> CODE 2
IF NO -----> DO DUs MEET DEFINITION OF DU? [PERSONS LIVE/EAT
SEPARATELY AND HAVE ENTRANCE DIRECTLY FROM OUTSIDE OR THROUGH
COMMON HALL]
IF YES -----> CODE 1
IF NO -----> CODE 2
Display:
Notes:

Response
1 HIDDEN DU PROCEDURE
REQUIRED
2 NO, HIDDEN DU PROCEDURE
NOT REQUIRED
980 DON'T KNOW

Version Date:

Value Label
Skip To
HiddenDuProcedureRequired SCQ3013
No_HiddenDuProcedureNotR SCQ3013
equired
DK
SCQ3013

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SCQ3013
Item Type: Route
Item Class: If Then
Item Text: If SCQ3012 is YES then update tblCaseInfo.HiddenCasePendingYN to Y;
If SCQ3012 is DK then update tblCaseInfo.HiddenCasePendingYN to Y;
If SCQ3012 is NO then update tblCaseInfo.HiddenCasePendingYN to N.
Display:
Notes:

Response
1 [Route executed.]

Version Date:

Value Label

Skip To
SCQ3015

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SCQ3015
Item Type: Route
Item Class: If Then
Item Text: If household contains SP(s), go to SCQ4005.
Else, go to SCQ 4010.
Display:
Notes:

Response
1 [Route executed.]

Version Date:

Value Label

Skip To

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SCQ4005

SCQCompleteEligible

Item Type: Instruction
Item Class: Enumerated
Item Text: [END OF SCREENER. ATTEMPT TO ADMINISTER BQ WITH SP. IF NOT AVAILABLE,
SET APPOINTMENT FOR BQ AND EXERCISE.]
[PRESS F10 AND ENTER TO CONTINUE.]
Display:
Notes: End instrument timing here.
COMPLETE SCREENER, 1-2 SAMPLE PERSONS SELECTED

Response
1 F10

Version Date:

Value Label
F10

Skip To
END

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SCQ4010

SCQCompleteInelig

Item Type: Instruction
Item Class: Enumerated
Item Text: Thank you very much for your time today. Based on the information you have given us,
no one in your household is eligible to participate in our study. Thank you.
[PRESS F10 AND ENTER TO CONTINUE.]
Display:
Notes: End instrument timing here.
COMPLETE SCREENER, NO ELIGIBLE SAMPLE PERSON(S)

Response
1 F10

Version Date:

Value Label
F10

Skip To
END

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