1 Survey

Appendix A A.2.1.o–4

Source: Visits: Within X Days of 6 Month Visit Mode: Self-administered (Mail-in) Estimated Time:		BAR CODE LABEL OR SUBJECT ID HERE |___|___|___|___|___|___|___|___|

Baby (6-month-old)

3-Day Time and Place Diary

6 Month Visit

Instructions

1	This booklet contains instructions for the 6-Mo Baby 3-Day Time and Place Diary.
2	Fill out one Time and Place Diary [PUT LABEL HERE WITH DAYS THE RESPONDENT SHOULD FILL OUT THE DIARY – TWO WEEKDAYS AND ONE WEEKEND DAY] [EITHER TH, F, SA OR SU, M, TU]
3	Each Time and Place Diary asks about how and where your baby spent his/her time (we are most interested in WHERE your baby spent his/her time on each day).
4	In this diary, a day begins at 4:00 am in the early morning and ends at 3:59 am the following morning. For each hour of the day, write in generally what your baby was doing at that time.
5	The diary is designed for you to fill out based on your baby’s activities on the previous day. So, if you are to complete a diary for Sunday, then you should fill it out on Monday and if you are to complete a diary on Monday, you should fill it out on Tuesday, and so on. We would like you to complete the diary for 3 days, 1 weekend day, and 2 weekdays. The appropriate days are listed on the label above and on a label at the top of each day of the diary.
6	Use only a black ball-point pen (not red ink or felt tip) to mark the places where your baby spent his / her time. If your baby make a mistake, cross out the incorrect answer and draw a circle around the correct answer .

How to Complete Your Baby’s Diary

B eginning at 4:00 AM, think of everything your baby did for the next hour. Write in the activity number that corresponds to what your baby was doing for this hour. Check (_) a box for every place your baby was during that hour. Fill this out for 24 hours, ending at 3:59 AM (the next day). Fill out a diary for all of the days listed on page 1, or the cover sheet to this package.

Example 1: Let’s say from 4:00 AM to 5:59 AM, your baby was sleeping at home. Write the word “sleeping” under activities, and check the box for “Inside at home.”

For hours where your baby spent time multiple places, write generally what your baby did under “activities” and check a box for every place that your baby spent time during that hour.

Example 2: Let’s say your baby woke up at about 6:00 AM then you changed her diaper and dressed her for daycare, walked the dog outside with your baby in a stroller, and then you took your baby to daycare you would complete the diary as follows.

For hours where your baby was inside at daycare and did not leave, feel free to draw a line down for all of the hours your baby was at daycare. However, if you or someone else picked your baby up from daycare for an appointment, etc. please record that appropriately. Also, if you know that your baby’s care provider takes the child on a walk at 10:00, check the box for outside, at daycare.

Example 3: Let’s say from 8:00 AM to 11:59 AM, your baby was at daycare. Then at 11:59 AM, you picked up your baby for a doctor’s appointment.

Don’t worry too much if you have difficulty writing multiple activities in the “activities” column. This column is to help you remember what your baby did so you can check the box that corresponds to where he/she was.

It is okay to combine activities under one general title. For example, if your baby spent an hour at home in an exersaucer, or playing on an activity mat, you may write in “playing.”

Example 4: Let’s say that at 5:00 PM you picked your baby up at daycare, when you got home, your baby was playing in an exersaucer, then you fed and bathed your baby and put him/her to bed.

If you have any questions on how to fill out the diary, call 1-800-XXX-XXXX.

[ PUT LABEL HERE THAT LIST THE DAY [EITHER TH, F, SA OR SU, M, TU] AND THE DATE THE RESPONDENT SHOULD FILL OUT THE DIARY]
Now fill in the diary below.

[ PUT LABEL HERE THAT LIST THE DAY [EITHER TH, F, SA OR SU, M, TU] AND THE DATE THE RESPONDENT SHOULD FILL OUT THE DIARY]
Now fill in the diary below.

[ PUT LABEL HERE THAT LIST THE DAY [EITHER TH, F, SA OR SU, M, TU] AND THE DATE THE RESPONDENT SHOULD FILL OUT THE DIARY]
N ow fill in the diary below.

Thank you very much for completing this time and place diary. Your answers are very important to the National Children’s Study.