ATTACHMENT M
Baseline – Session 2 (Modules)
Baseline – Session 2 (Modules)
Section |
Respondent |
Device |
Exposure Questionnaire |
Parent |
Interviewer laptop |
Time & Activity Diary Retrieval |
Parent and Child |
Interviewer laptop/Paper |
Environmental Assessment (Equipment Retrieval) |
Parent and Child |
PDA/Interviewer laptop |
Session 2 Incentive Payment |
Parent and Child |
Interviewer laptop/Paper |
Physical Assessment |
Parent and Child |
Nurse Laptop |
ISAAC Module II: Dermal Assessment |
Child |
Nurse laptop |
Pulmonary Tests |
Child |
Nurse laptop |
|
|
|
Asthma Control Scales |
Parent Child Ages 3-11 Child Age 12 and up |
Nurse laptop |
Urine Collection |
Child |
Nurse laptop |
Blood Collection |
Child |
Nurse laptop |
Form
Approved:
OMB
No. 0920-xxxx Exp.
Date xx/xx/20xx
CHATS Session 2 FI Laptop Specifications
ADULTCHECK INTERVIEWER: DID THIS PARENT/GUARDIAN GIVE WRITTEN CONSENT, EITHER DURING SESSION 1 OR WITH THE NURSE IN SESSION 2?
YES
NO
NODK
NOREF
IF ADULTCHECK=NO, ADMINISTER CONSENT BELOW, ELSE INTRO
KIDCHECK YOU ARE STARTING A SESSION FOR STUDY CHILD, [CHILD].
[HE/SHE] IS [CHILDAGE] YEARS OLD.
WILL YOU BE RESPONSIBLE FOR FORMALLY CONFIRMING THE STUDY CHILD DURING THIS INTERVIEW?
YES, I WILL CONFIRM STUDY CHILD
NO, THE NURSE CONFIRMED CHILD ALREADY
NODK
NOREF
PROGRAMMER:
IF KIDCHECK=NO, ADMINISTER A SOFT-CHECK, SC_KIDCHECK, “YOU HAVE
INDICATED THAT THE NURSE – NOT YOU – CONFIRMED THE STUDY
CHILD. IF THIS IS INCORRECT, PRESS CANCEL ENTER AND
REVISE YOUR ANSWER TO SAY “YES I WILL CONFIRM”.
[IF ADULTCHECK=NO] What is your full name?
PARENT FIRST NAME __________ [ALLOW 30 CHARACTERS]
PARENT MIDDLE NAME _________[ALLOW 30 CHARACTERS]
PARENT LAST NAME ___________[ALLOW 30 CHARACTERS]
ALLOW BLANK, DK, and REF IN PARENT MIDDLE NAME; DISALLOW BLANK, DK AND REF IN PARENT FIRST AND MIDDLE LAST NAMES.
Public
reporting burden of this collection of information is estimated to
average 90 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the
collection of information. An agency may not conduct or sponsor, and
a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this
burden to CDC/ATSDR Information Collection Review Office, 1600
Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA
(0920-XXXX).
[IF ADULTCHECK=NO] What is your relationship to [CHILD]?
MOTHER
FATHER
GRANDMOTHER
GRANDFATHER
LEGAL GUARDIAN
6 OTHER
NEWBA2OTH [IF BA2=6/OTHER] DESCRIBE________ [ALLOW 30 CHARACTERS]
NEWQMOM. [IF NEWBA2=1] Are you [CHILD’s] biological mother?
1 YES
2 NO
[IF BA3=5 OR 6] INTERVIEWER: IS THIS RESPONDENT MALE OR FEMALE?
MALE
FEMALE
INSERT: CONSENT FOR PARENT/GUARDIAN AND CHILD PERMISSION FOR PARTICIPATION - SESSION 2 SCRIPT
INTRO. [INTRODUCE/REINTRODUCE SELF AS NECESSARY AND INTRODUCE NURSE TO PARENT AND CHILD] Thank you for your continued participation in this health study. As you may recall from the interview last week, for this second session I will ask you and [CHILD’S NAME] some questions for you about [his/her] activities in the past [FILL: 5-9] days, and then the nurse will do the health assessment. You have already signed the consent form for the interview and assessment today so there’s no need to review that unless you have any questions for us? ANSWER ANY QUESTIONS.
Just as before, please remember that if there is a question that you do not want to answer, please let me know and we can skip it. Also, all of your responses are kept private and will not affect any of the home or health care services that you currently receive.
If you’re ready, we can begin. I’ll start with the interview questions while the nurse sets up the equipment.
PRESS 1 TO CONTINUE.
CO1. [IF KIDCHECK=YES] My name is NAME and I am a CHATS study interviewer. First, I need to confirm some information with you.
YES
NO
NODK
NOREF
CO2. [IF KIDCHECK=YES] First, I need to confirm some information with you. Please tell me the first, middle, and last name of the child living here who is enrolled in the CHATS study.
INTERVIEWER: WERE YOU GIVEN THE NAME [FILL: CHILD FIRST NAME, MIDDLE NAME, LAST NAME]?
NAME IS AN EXACT MATCH
NAME IS DIFFERENT
NODK
NOREF
PROGRAMMER: FILL WITH CHILD’S FULL NAME COLLECTED IN BA1, SESSION 1 FI LAPTOP
CO2a. [IF CO2=2] I have the child’s full name listed as [FILL: CHILD FIRST NAME, MIDDLE NAME, LAST NAME]. Can you confirm this is the child who was selected for the study?
INTERVIEWER: IF THE SITUATION CALLS FOR A SIMPLE NAME CHANGE, ANSWER YES.
IF IT APPEARS ANOTHER CHILD IS BEING PRESENTED FALSELY AS THE STUDY CHILD, ANSWER NO.
YES
NO
NODK
NOREF
CO2b. [IF CO2a=YES] RECORD CORRECTIONS TO THE CHILD’S NAME AS NEEDED
FIRST NAME: [FIRST NAME FROM BASELINE BA1] _____
MIDDLE NAME: [MIDDLE NAME FROM BASELINE BA1] ______
LASTNAME: [LAST NAME FROM BASELINE BA1] _______
PROGRAMMER: DISPLAY NAME FIELDS FROM BASELINE BA2. BESIDE OR BENEATH EACH DISPLAY ALLOW THE USER TO RECORD CHANGES IN INPUT FIELDS CO2b_FNAME, CO2b_MNAME, CO2b_LNAME. ALLOW BLANKS, BUT PROHIBIT DK/REF. IF USER ENTERS TEXT INTO CO2b_FNAME, THAT TEXT SHOULD DISPLAY INSTEAD OF ORIGINAL VALUE [CHILD] IN LATER QUESTIONS.
CO3. [IF KIDCHECK=YES AND CO2a=YES] Can you please tell me [CHILD’s] birth date?
INTERVIEWER: WERE YOU GIVEN THE BIRTH DATE [SBDAY]?
YES
NO
NODK
NOREF
PROGRAMMER: FILL FROM SBDAY, SESSION 1 FI LAPTOP.
CO3a. [IF CO3=NO] What is [CHILD’s] birth date?
INTERVIEWER: RECORD BIRTHDATE OF CHILD
MM____
DD____
YYYY____
CO4. [IF KIDCHECK=YES OR CO2a = YES OR BLANK] Is [CHILD] available to speak with me?
CHILD LIVES HERE AND IS AVAILABLE
CHILD LIVES HERE, BUT IS NOT CURRENTLY AVAILABLE
CHILD DOES NOT LIVE HERE
CO5. [IF CO4=2] Because the child enrolled in our study lives here but is not currently here, we will not be able to conduct a health assessment at this time.
PRESS 1 TO CONTINUE
CO6. [IF CO2a=NO OR CO4=3] Because the child enrolled in our study is not currently living here at the address where I was sent, I will not be able to conduct a health assessment at this time.
Can you please tell me the address and phone number for where [CHILD] currently lives so that I can attempt to interview them at that location?
YES
NO
CO7. [IF CO6=YES] (Please tell me the address where the child currently lives)
STREET ADDRESS: ALLOW 50 CHARACTERS
CITY: [ALLOW 20 CHARACTERS]
STATE: [LOOK-UP TABLE]
ZIP CODE: REQUIRE 5 DIGITS
PHONE: [REQUIRE 3-3-4 FORMAT]
CO7a. [CO4=3] Thank you for your help. We will contact [CHILD] using the information you have given us and try to set up a new appt for Session 2. Those are all the questions we have for you now.
PRESS 1 TO CONTINUE
CO8. [CO4=2] When may I return at a time that [CHILD] will be here?
INTERVIEWER: RECORD A DATE AND TIME
MM
DD
YYYY
HOUR
MINUTE
AM or PM
PROGRAMMER: IF CO4=2 OR 3, THEN SEND USER TO EXIT SCREEN
EXPOSURE QUESTIONNAIRE
CURRENT EXPOSURE QUESTIONS
AINTRO. I’d like to ask you about [CHILD]’s activity since our previous interview of [SESSION 1 DATE].
PRESS 1 TO CONTINUE
Since [FILL: SESSION 1 DATE], how much time did [CHILD] spend in any FEMA trailer?
1 None
2 Up to 8 hours
Since [FILL: SESSION 1 DATE], how much time did [CHILD] spend in a newly built house, school, or other buildings?
1 None
2 Up to 8 hours
3 8 hours or more
Since [FILL: SESSION 1 DATE], did [CHILD] spend time at stores that sell products such as furniture, wallpaper, curtain, or carpet?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) did [CHILD] spend time at places where space heaters were operated with wood, natural gas, or kerosene?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) was [CHILD] present at any waste or trash burning?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) did [CHILD] spend time with someone who smokes or at places where smoking is allowed?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) was [CHILD] present when a vehicle was getting filled with gasoline?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) was there any installation of new furniture, wallpaper, curtain, or synthetic carpet in the home?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) did [CHILD] have any craft or hobby activities that required use of paint, nail polish, or pressed wood products?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) did [CHILD] participate in a science class that handled animal specimens that were preserved in chemicals such as formaldehyde?
1 YES
2 NO
(Since [FILL: SESSION 1 DATE],) did you thoroughly clean one or more rooms in your home using household cleaning products?
1 YES
NO
A12. (Since [FILL: SESSION 1 DATE],) did [CHILD] attend school?
YES
NO
A12a. [IF A12=Yes] How many days:
____________ DAYS [ALLOW 1 – 9]
A13. (Since [FILL: SESSION 1 DATE],) did [CHILD] spend time at daycare?
YES
NO
A13a. [IF A13=Yes] How many days:
____________ DAYS [ALLOW 1 – 9]
A14. (Since [FILL: SESSION 1 DATE],) did [CHILD] spend time at a caregiver’s home?
YES
NO
A14a. [IF A14=Yes] How many days:
____________ DAYS [ALLOW 1 – 9]
A15. (Since [FILL: SESSION 1 DATE],) did [CHILD] spend time at another location?
YES
NO
A15a. [IF A15=Yes] How many days:
____________ DAYS [ALLOW 1 – 9]
A16. (Since [FILL: SESSION 1 DATE],) on a typical day, how many times per day did you cook meals?
1 None
2 Once
3 Two to three times
4 Four or more times
A16a. [IF A16=2, 3, OR 4] What do you use most often to cook meals?
1 Stove
2 Microwave Oven
3 Oven
4 Grill
5 NONE OF THE ABOVE
A17. (Since [FILL: SESSION 1 DATE],) did you burn any candles or incense?
1 YES
2 NO
A18. The next few questions are about the place where [CHILD] spent most of (his/her) time. Since [FILL: SESSION 1 DATE], have you turned on your heating system?
1 YES
2 NO
A19. (Since [FILL: SESSION 1 DATE],) have you turned on your air conditioning system?
1 YES
2 NO
A20. (Since [FILL: SESSION 1 DATE],) did you open windows/doors for fresh air for 12 hours per day?
1 YES
2 NO
A21. (Since [FILL: SESSION 1 DATE],) did you run any fans for ventilation (not bathroom or kitchen fans)?
1 YES
2 NO
A22. (Since [FILL: SESSION 1 DATE],) did [CHILD] operate or was [CHILD] near any gasoline powered equipment, other than vehicles?
1 YES
2 NO
A23. (Since [FILL: SESSION 1 DATE],) what types of cars, trucks or buses did [CHILD] ride in during the past 7 days? SELECT ALL THAT APPLY
Gasoline sedans, minivans, SUVs, trucks YES NO
Diesel pick-up trucks or SUVs YES NO
School or city buses YES NO
PCPINTRO2 [IF SESSION1.PCPINTRO=YES] Last week I gave you three forms to record contact information for doctors who saw [CHILD] for any breathing problems, allergies, hay fever, or skin problems [FILL IF H28a=YES: or cancer] since the summer of 2003. May I have those now to enter into my computer?
FORMS WERE COMPLETED
FORMS ARE INCOMPLETE, BUT PARENT/GUARDIAN WILL WORK WITH YOU
FORMS ARE INCOMPLETE, AND PARENT WON’T PROVIDE INFORMATION/CONSENT
[IF PCPINTRO=1 OR 2] Thank you, I will enter these and ask a couple questions about when [CHILD] saw these doctors.
_______ LAST NAME, FIRST NAME [ALLOW 20 CHARACTERS ENTRY]
PROGRAMMER NOTE: ALLOW USERS TO ACCESS THE INSTALLED DATABASE OF HEALTH CARE PROVIDERS SO THAT WHILE TYPING LAST NAME, A SMART SEARCH OCCURS BASED ON SPELLING SO THAT LIKELY MATCHES BRING UP LAST NAME, FIRST NAME, SPECIALTY, CITY, STATE. BY PRESSING “ENTER”, THE DOCTOR WILL BE SAVED TO INTERVIEW RECORD.
FOR EXAMPLE, TYPING “ADAMS” MAY DISPLAY A LIST FROM:
ADAMS, DEBORAH, PEDIATRICIAN, NEW ORLEANS, LA
ADAMS, JEREMY, GENERAL PRACTITIONER, PICAYUNE, LA
ADAMSEN, TYSON, PEDIATRICIAN, ADAMSON, BILOXI, MS
ARTHUR, PULMONARY SPECIALIST, HOUSTON, TX, etc.
IF A NAMED DOCTOR IS NOT LISTED, ALLOW USER TO RECORD A NEW, UNLISTED PROVIDER UPON ENTERING THE PHRASE “UNSPECIFIED.” UPON MAKING THAT SELECTION, THE COMPUTER SHOULD ADMINISTER PCP1alt, AND THEN GO TO PCP2.
PCP1alt (Let
me enter information about this doctor. I will record name,
specialty, city, state, and zip code.)
INTERVIEWER: ENTER INFORMATION FROM CONSENT FORM
a_______________DOCTOR FIRST NAME [ALLOW 20 CHARACTERS]
b_______________DOCTOR LAST NAME [ALLOW 20 CHARACTERS]
c_______________DOCTOR SPECIALTY [ALLOW 50 CHARACTERS]
d_______________CITY
e____STATE
f____ZIP CODE
PROGRAMMER: EMPLOY LOOK UP TABLE OF STATES
What was the approximate month and year that [CHILD] first saw this doctor, FILL: FIRST_ NAME LAST_NAME FROM LOOKUP TABLE OR PCP1alt_a PCPalt_b FROM MANUAL ENTRY?
MM/YYYY
What was the approximate last month and year [CHILD] last saw this doctor, FILL: FIRST_ NAME LAST_NAME FROM LOOKUP TABLE OR PCP1alt_a PCPalt_b FROM MANUAL ENTRY?
MM/YYYY
Was
there another doctor who treated [CHILD] for breathing problems,
allergies, hay fever, or skin problems [FILL IF H28a=YES: or cancer]
since the summer of 2003INTERVIEWER: DO YOU HAVE ANOTHER
CONSENT FORM TO ENTER INTO LAPTOP?
YES
NO
PROGRAMMER: IF PCP4=YES, THEN REPEAT PCP1-PCP3. ALLOW UP TO 3 DOCTORS OR CLINICS.
PCP8. INTERVIEWER: VERIFY THAT THE PARENT/GUARDIAN SIGNED FOR EACH DOCTOR, CLINIC, OR HOSPITAL. COLLECT SIGNATURE IF IT IS MISSING FROM ANY FORM.
PRESS 1 TO CONTINUE
TIME & ACTIVITY DIARY RETRIEVAL
TADINTRO. During our Session 1 appointment, I left a Time Activity Diary with you and asked you and [CHILD] to complete the diary each day until I returned. Do you have that completed Time Activity Diary? I will take any pages that were started, even if some slots were not filled in for the entire day. It would be very helpful to get a diary page that describes today, up until this current time. I can work with [IF CHILDAGE>12: FILL “you”] [IF CHILDAGE>=12 FILL: CHILD] to complete that page now if there is no page started yet for today.
INTERVIEWER: WORK WITH PARENT/CHILD TO COMPLETE DIARY FOR TODAY THAT IS CURRENT UP TO YOUR ARRIVAL.
TAD1 DID YOU RETRIEVE THE TIME ACTIVITY DIARY FROM THE PARENT/GUARDIAN AND CHILD?
1 YES, SOME OR ALL DIARY PAGES WERE BEGUN
2 YES, BUT NO DIARY PAGES WERE BEGUN
3 NO, THE RESPONDENTS ARE UNABLE TO LOCATE THE COMPLETED TIME ACTIVITY DIARY
4 OTHER
TAD1a [IF TAD1=OTHER] PLEASE DESCRIBE THE “OTHER” REASON FOR WHY YOU DID NOT RETRIEVE THE TIME ACTIVITY DIARY
___________________ [ALLOW 250 CHARACTERS]
CHATS Time Activity Diary
Day of Week: ____________ Date: ___/___/_____ Completed by: Child Parent
|
|||||||
Time of Day
(6-hour periods)
|
Were You Indoors? |
Were You Traveling in a Car, Bus, Other Vehicle? |
Were You Outdoors? |
||||
Home
|
School
|
Other*
|
Home
|
School |
Other** |
||
Midnight to 6 am
|
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
6 am to Noon |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
Noon to 6 pm |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
6 pm to Midnight |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
______ hour(s) |
*Where were the Other Indoor locations?
**Where were the Other Outdoor locations? |
TAD2. [IF TAD1=YES] Because this is a feasibility study, we’d like some feedback on how easy or difficult it was to complete the form on a daily basis. Were you and [CHILD] able to complete the form each day or did you sometimes have to catch up a day or more later?
1 DIARY COMPLETED EACH DAY
2 DIARY SOMETIMES COMPLETED A DAY OR MORE LATER
TAD3. [IF TAD1=YES] Thank you for completing the time activity diary for the CHATS study. I will enter the diary information into the computer while [CHILD] meets with the nurse to discuss the health assessment, but I may have some questions for you.
PRESS 1 TO CONTINUE
TAD4a. [IF TAD1=2 OR 3 OR 4] Since we don’t have any completed pages for the Time Activity Diary, I’d like to ask just a few questions about [CHILD’s] usual activity. Since our first interview on [FIRST INTERVIEW DATE}, how many days did [CHILD] attend school [IF CHILDAGE<7 FILL: or daycare]?
______ [ALLOW 0-9]
TAD4b. [IF TAD4a >0] On those [TAD4a] days that [CHILD] attended school [IF CHILDAGE<7 FILL: or daycare], how many hours a day was [HE/SHE] in school, on average? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD4c. [IF TAD4a >0] (In those [TAD4a] days that [CHILD] attended school/daycare) how many hours a day was [HE/SHE] outdoors? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD4d. [IF TAD1=2 OR 3 OR 4] (In those [TAD4a] days that [CHILD] attended school/daycare) how many hours a day was she indoors at home? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD4e. [IF TAD1=2 OR 3 OR 4] (In those [TAD4a] days that [CHILD] attended school) how many hours a day was [HE/SHE] indoors somewhere other than at home? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD4f. [IF TAD1=2 OR 3 OR 4] Now think about the days since [INTERVIEW DATE] that [CHILD] was not in school [IF CHILDAGE<7 FILL: or daycare]. On those days, how many hours a day did [HE/SHE] spend outdoors, on average? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD4g. [IF TAD1=2 OR 3 OR 4] On those days that [HE/SHE] was not attending school [IF CHILDAGE<7 FILL: or daycare], how many hours a day was [HE/SHE] indoors at home? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD4h. [IF TAD1=2 OR 3 OR 4] On those days that [HE/SHE] was not attending school [IF CHILDAGE<7 FILL: or daycare], how many hours a day was [HE/SHE] indoors somewhere other than home? INTERVIEWER: WE WANT TO RECORD AVERAGE HOURS/DAY.
_____ [ALLOW 0-12]
TAD5. [IF TAD1=2 OR 4] As I mentioned before, this is a feasibility study and we would like to learn how to improve our procedures in the future. To help us, can you tell me why none of the time activity diary was completed?
____________________ ALLOW 250 CHARACTERS
TAD6. [IF TAD1=2, 3, OR 4] Thank you for your feedback. Those are all the questions I have for you at this time. The CHATS nurse will now talk to you about completing the health assessment with [CHILD].
PROGRAMMER: IF TAD1=2, 3, OR 4, SKIP TO SRINTRO (Environmental Assessment Retrieval)
NUMTADS. [IF TAD1=1] INTERVIEWER: HOW MANY DAILY PAGES HAVE AT LEAST ONE MARK OR ENTRY ON THEM? A TABLE WILL APPEAR FOR EACH DAILY PAGE WHEN YOU MOVE PAST THIS SCREEN.
___ [ALLOW 1-9]
PROGRAMMER: LOOP SERIES TAD7 –TAD12 FOR [NUMTADS] TIMES. NOTE THAT COLLECTED DIARY PAGES MAY NOT BE FOR CONSECUTIVE DAYS, SO USER WILL RECORD DAY AND DATE FOR EACH PAGE.
TAD7. RECORD DAY OF WEEK FOR DAY <#>:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
DK/REF
TAD8. RECORD DATE FOR DAY <#>
<MM/DD/YY>
DK/REF/ DK/REF/ DK/REF
TAD9. RECORD WHO COMPLETED FORM FOR DAY <#>
PARENT
CHILD
DK/REF
TAD10. INTERVIEWER: RECORD DATA IN TABLE BELOW FOR DAY <#>.
ANY EVEN NUMBER OF HOURS CAN BE ENTERED AS AN INTEGER (e.g., “6” for 6 hours)
15 MINUTES = 0.25
30 MINUTES = .50
45 MINUTES = .75
60 MINUTES = 1.00 OR 1
IF SOMETHING IS BLANK OR PARENT/CHILD CANNOT REMEMBER, ENTER F3 FOR “DON’T KNOW.” IF PARENT/CHILD SPECIFICALLY REFUSES TO ANSWER, ENTER F4 FOR “REFUSED.”
Time of Day |
Indoor- Home |
Indoor- School |
Indoor- Other |
Travel |
Outdoor- Home |
Outdoor- School |
Outdoor- Other |
Midnight to 6 am |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
6 am to Noon |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
Noon to 6 pm |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
6 pm to Midnight |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
<0-6> |
PROGRAMMER: EACH CELL ALLOWS 0-6 HOURS. ALLOW ENTRIES OF INTEGERS OR DECIMALS UP TO HUNDREDTHS PLACE. IF TOTAL HRS PER ROW ≠ 6HRS ADMINISTER SOFTCHECK HC_TAD10 “YOUR ENTRIES FOR THIS TIME PERIOD DO NOT EQUAL 6 HOURS.” ALLOW DK, REF IN EACH CELL.
TAD11. RECORD WHERE “OTHER INDOOR” LOCATIONS WERE.
<ALLOW 100>
TAD12. RECORD WHERE “OTHER OUTDOOR” LOCATIONS WERE.
<ALLOW 100>
PROGRAMMER: RECORD TAD11 AND TAD12 ONCE FOR EACH DAY.
TAD13. INTERVIEWER: WHEN YOU PRESS 1 TO CONTINUE, YOU WILL BE INSTRUCTED THROUGH SEVERAL STEPS TO NEXT COLLECT THE ENVIRONMENTAL EQUIPMENT.
PRESS 1 TO CONTINUE
ENVIRONMENTAL ASSESSMENT (EQUIPMENT RETRIEVAL)
THE QUESTIONS ON PAGES M14-M27 ARE REFERENCE QUESTIONS THAT WILL BE PULLED INTO THE SESSION 2 INSTRUMENT FROM THE SESSION 1 ENVIRONMENTAL ASSESSMENT INSTRUMENTS
QUESTIONS PRELOADED FROM BASELINE VISIT SESSION 1
SDINTRO1. [IF THE ID ENTERED IN SDINTRO = A VALID FIID FOUND IN THE INVENTORY] SCAN THE BARCODE ON THE PARTICIPANT BOX. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PARTICIPANT BOX ID NUMBER: ____________[ALLOW 6 CHARACTERS – BX AND 4 NUMBERS]
NODK
NOREF
SDINTRO1d. [IF SDINTRO1c=YES] THIS PARTICIPANT BOX WITH THE ID BELOW HAS BEEN ADDED TO YOUR ASSIGNMENT
[FILL PARTICIPANT BOX ID FROM SDINTRO1a]
PRESS 1 TO CONTINUE
PP27. HAS DEPLOYED PERSONAL PLATFORM BEEN SUCCESSFULLY GIVEN TO THE CHILD?
1 YES
2 NO
HBINTRO10. HAS THE FREESTANDING HOBO BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP34. HAS THE INDOOR PLATFORM BEEN SUCCESSFULLY DEPLOYED AND PLACED IN THE HOME?
1 YES
2 NO
OP23. HAS THE OUTDOOR PLATFORM BEEN SUCCESSFULLY DEPLOYED AND PLACED OUTSIDE THE HOME?
1 YES
2 NO
COAER1. [IF SDINTRO3a=YES OR SDINTRO3c=YES] INTERVIEWER: YOU WILL NEED THE FOLLOWING ITEMS AND PIECES OF EQUIPMENT TO CONDUCT THE CO2 AER TEST. DO YOU HAVE THE FOLLOWING? SELECT ALL THAT APPLY
NITRILE GLOVES
TAPE FROM YOUR TOOLKIT
AIRBOXX UNIT
FAN
CO2 CANISTER
FLOW CONTROL ASSEMBLY
PFT TUBES FROM YOUR TOOLKIT
COAER23. HAVE YOU SUCCESSFULLY SET UP THE CO2 AER TEST?
1 YES
2 NO
COAER18aFINAL. DID YOU SUCCESSFULLY PLACE THE PFT TUBE(S) ON THE FOURTH FLOOR OF THE HOME?
1 YES
2 NO
COAER18bFINAL. DID YOU SUCCESSFULLY PLACE THE PFT TUBE(S) ON THE THIRD FLOOR OF THE HOME?
1 YES
2 NO
COAER18cFINAL. DID YOU SUCCESSFULLY PLACE THE PFT TUBE(S) ON THE SECOND FLOOR OF THE HOME?
1 YES
2 NO
COAER18dFINAL. DID YOU SUCCESSFULLY PLACE THE PFT TUBE(S) ON THE FIRST FLOOR OF THE HOME?
1 YES
2 NO
COAER18a1. WHAT IS THE NAME OF THE SELECTED ROOM ON THE FOURTH FLOOR? (EXAMPLE: SISTER’S RED BEDROOM)
IF MORE THAN 1 ROOM HAS BEEN SELECTED, PLEASE START WITH THE FIRST ROOM.
___________________ [ALLOW 100 CHARACTERS]
COAER18a4. [IF COAER18a2=1] IN WHAT EXACT LOCATIONS IN THIS ROOM DID YOU PLACE THE PFT TUBES? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
1. ___________________ [ALLOW 100 CHARACTERS]
2. ___________________ [ALLOW 100 CHARACTERS]
COAER18a6. [IF COAER18a2=2] IN WHAT EXACT LOCATION IN THIS ROOM DID YOU PLACE THE PFT TUBE? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
___________________ [ALLOW 100 CHARACTERS]
COAER18b1. WHAT IS THE NAME OF THE SELECTED ROOM ON THE THIRD FLOOR? (EXAMPLE: SISTER’S RED BEDROOM)
IF MORE THAN 1 ROOM HAS BEEN SELECTED, PLEASE START WITH THE FIRST ROOM.
___________________ [ALLOW 100 CHARACTERS]
COAER18b4. [IF COAER18b2=1] IN WHAT EXACT LOCATIONS IN THIS ROOM DID YOU PLACE THE PFT TUBES? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
1. ___________________ [ALLOW 100 CHARACTERS]
2. ___________________ [ALLOW 100 CHARACTERS]
COAER18b6. [IF COAER18b2=2] IN WHAT EXACT LOCATION IN THIS ROOM DID YOU PLACE THE PFT TUBE? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
___________________ [ALLOW 100 CHARACTERS]
COAER18c1. WHAT IS THE NAME OF THE SELECTED ROOM ON THE SECOND FLOOR? (EXAMPLE: SISTER’S RED BEDROOM)
IF MORE THAN 1 ROOM HAS BEEN SELECTED, PLEASE START WITH THE FIRST ROOM.
___________________ [ALLOW 100 CHARACTERS]
COAER18c4. [IF COAER18c2=1] IN WHAT EXACT LOCATIONS IN THIS ROOM DID YOU PLACE THE PFT TUBES? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
1. ___________________ [ALLOW 100 CHARACTERS]
2. ___________________ [ALLOW 100 CHARACTERS]
COAER18c6. [IF COAER18c2=2] IN WHAT EXACT LOCATION IN THIS ROOM DID YOU PLACE THE PFT TUBE? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
___________________ [ALLOW 100 CHARACTERS]
COAER18d1. WHAT IS THE NAME OF THE SELECTED ROOM ON THE FIRST FLOOR? (EXAMPLE: SISTER’S RED BEDROOM)
IF MORE THAN 1 ROOM HAS BEEN SELECTED, PLEASE START WITH THE FIRST ROOM.
___________________ [ALLOW 100 CHARACTERS]
COAER18d4. [IF COAER18d2=1] IN WHAT EXACT LOCATIONS IN THIS ROOM DID YOU PLACE THE PFT TUBES? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
1. ___________________ [ALLOW 100 CHARACTERS]
2. ___________________ [ALLOW 100 CHARACTERS]
COAER18d6. [IF COAER18d2=2] IN WHAT EXACT LOCATION IN THIS ROOM DID YOU PLACE THE PFT TUBE? (EXAMPLE: ON TOP OF THE LEFT BOOKCASE)
___________________ [ALLOW 100 CHARACTERS]
COAER6. HAS THE AIRBOXX UNIT BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
COAER9. HAS THE FAN BEEN SUCCESSFULLY INSTALLED?
1 YES
2 NO
COAER12. HAS THE CO2 CANISTER AND CO2 FLOW CONTROL ASSEMBLY BEEN SUCCESSFULLY SET UP?
1 YES
2 NO
HBINTRO4d. [IF HBINTRO4=NO OR HBINTRO4b=NO] May I place the HOBO [INTERVIEWER: TELL RESPONDENT AND KEY PROPOSED LOCATION BELOW]
___________________ [ALLOW 100 CHARACTERS]
HBINTRO4e. [FOLLOWS HBINTRO4d] DID THE RESPONDENT AGREE TO HOBO PLACEMENT LOCATION?
1 YES
2 NO
PROGRAMMER: IF HBINTRO4e=YES, SKIP TO HBINTRO5
HBINTRO4d1. [IF HBINTRO4e=NO] May I place the HOBO [INTERVIEWER: TELL RESPONDENT AND KEY A 2ND PROPOSED LOCATION BELOW]
___________________ [ALLOW 100 CHARACTERS]
HBINTRO4e1. [FOLLOWS HBINTRO4d1] DID THE RESPONDENT AGREE TO THE 2ND PROPOSED HOBO PLACEMENT LOCATION?
1 YES
2 NO
PROGRAMMER: IF HBINTRO4e1=YES, SKIP TO HBINTRO5
HBINTRO4d2. [IF HBINTRO4e1=NO] May I place the HOBO [INTERVIEWER: TELL RESPONDENT AND KEY 3RD PROPOSED LOCATION BELOW]
___________________ [ALLOW 100 CHARACTERS]
HBINTRO4e2. [FOLLOWS HBINTRO4d2] DID THE RESPONDENT AGREE TO THE 3RD PROPOSED HOBO PLACEMENT LOCATION?
1 YES
2 NO
IP32e. [IF PI32=YES OR IP32b=YES] INTERVIEWER: PLEASE ENTER THE LOCATION YOU PLACED THE INDOOR PLATFORM (EXAMPLE: A COFFEE TABLE, ETC., IN THE CHILD’S MAIN LIVING AREA)
___________________ [ALLOW 100 CHARACTERS]
IP33d. [IF IP33a=1] INTERVIEWER: IN WHAT LOCATION DID YOU PLACE THE INDOOR PLATFORM CAGE? (EXAMPLE: A TABLE IN THE CHILD’S BEDROOM, A SIDE TABLE IN THE DEN.)
___________________ [ALLOW 100 CHARACTERS]
OP22i. [IF OP21=YES OR OP21b=YES] INTERVIEWER: IN WHAT OUTSIDE LOCATION DID YOU PLACE THE OUTDOOR PLATFORM CAGE? (EXAMPLE: TO THE RIGHT OF THE FRONT DOOR, ON THE LEFT SIDE OF THE HOME, ETC.)
___________________ [ALLOW 100 CHARACTERS]
OP22e. [IF OP22a=1] INTERVIEWER: IN WHAT OUTSIDE LOCATION DID YOU PLACE THE OUTDOOR PLATFORM CAGE? (EXAMPLE: TO THE RIGHT OF THE FRONT DOOR, ON THE LEFT SIDE OF THE HOME, ETC.)
___________________ [ALLOW 100 CHARACTERS]
PP8. [ASK IF COLUMN URTPS IS NOT EMPTY, IF EMPTY SKIP TO PP12] PLACE CAP FROM YOUR SUPPLY BAG ONTO THE MICROPEM OPENING
TURN ON PERSONAL MICROPEM LABELED WITH A RED DOT BY PRESSING BUTTON 1.
SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE PERSONAL MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL MICROPEM SERIAL ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]
PP8d. SCAN BARCODE ON THE PERSONAL MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL MICROPEM FILTER ID NUMBER: ____________[ALLOW 10 CHARACTERS – UP AND 4 NUMBERS]
PP15b. [IF COLUMN AL_PD IS NOT EMPTY] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
PP15. HAS THE ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
PP12a. [DISPLAY IF COLUMN AL_PS IS NOT EMPTY, IF EMPTY SKIP TO PP16] TAKE THE PERSONAL ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A RED DOT
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON PERSONAL ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
PP13e. [IF PP13d=YES] TAKE THE ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLACK DOT.
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK ALDEHYDE BADGE ID NUMBER:
____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
PP19b. [IF COLUMN VC_PD IS NOT EMPTY] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
PP19. HAS THE VOC BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
PP16a. [DISPLAY IF COLUMN VC_PS IS NOT EMPTY, IF EMPTY SKIP TO PP20]TAKE THE PERSONAL VOC (VC) BADGE OUT OF THE CAN LABELED WITH A RED DOT.
PLACE THE SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF THE BADGE
SCAN THE BARCODE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
PP17e. [IF PP17d=YES] TAKE THE FIELD BLANK VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLACK DOT
PEEL SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
PP23b. [IF COLUMN NX_PD IS NOT EMPTY] HAS THE SECOND NO2 BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
PP23. HAS THE NO2 BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
PP20a. [DISPLAY IF COLUMN NX_PS IS NOT EMPTY, IF EMPTY SKIP TO PP24] TAKE THE PERSONAL NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A RED DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON PERSONAL NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
PP21e. [IF PP21d=YES] TAKE THE FIELD BLANK NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A BLACK DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK NO2 BADGE ID NUMBER:
____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
HBINTRO5. [IF HBINTRO3=YES OR HBINTRO4b=YES OR HBINTRO4e=YES OR HBINTRO4e1=YES OR HBINTRO4e2=YES] PUT ON NITRILE GLOVES
REMOVE FROM THE PARTICIPANT BOX THE HOBO LABELED WITH A YELLOW DOT.
SCAN BARCODE ON HOBO. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
HOBO ID NUMBER: ____________[ALLOW 6 CHARACTERS - TR AND 4 NUMBERS]
IP6. HAS THE INDOOR MICROPEM BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP3. [DISPLAY IF COLUMN URTIS IS NOT EMPTY, IF EMPTY SKIP TO IP7] PLACE CAP FROM YOUR SUPPLY BAG ONTO THE MICROPEM OPENING
TURN ON INDOOR MICROPEM LABELED WITH A YELLOW DOT BY PRESSING BUTTON 1.
SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE INDOOR MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR MICROPEM SERIAL ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]
IP3d. SCAN BARCODE ON THE INDOOR MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR MICROPEM FILTER ID NUMBER: ____________[ALLOW 10 CHARACTERS – UP AND 4 NUMBERS]
IP10b. [IF COLUMN AL_ID IS NOT EMPTY] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP10. HAS THE ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP7a. [DISPLAY IF COLUMN AL_IS IS NOT EMPTY, IF EMPTY SKIP TO IP11] TAKE THE INDOOR ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A YELLOW DOT
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON INDOOR ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
IP8e. [IF IP8d=YES] TAKE THE FIELD BLANK ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLACK DOT.
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK ALDEHYDE BADGE ID NUMBER:
____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
IP14b. [IF COLUMN VC_ID IS NOT EMPTY] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP14. HAS THE VOC BADGE BEEN SUCCESSFULLY DEPLOYED?
IP11a. [DISPLAY IF COLUMN VC_IS IS NOT EMPTY, IF EMPTY SKIP TO IP15]TAKE THE INDOOR VOC (VC) BADGE OUT OF THE CAN LABELED WITH A YELLOW DOT.
PLACE THE SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF THE BADGE
SCAN THE BARCODE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
IP12e. [IF IP12d=YES] TAKE THE FIELD BLANK VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLACK DOT
PEEL SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
IP18b. [IF COLUMN NX_ID IS NOT EMPTY] HAS THE SECOND NO2 BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP18. HAS THE NO2 BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP15a. [DISPLAY IF COLUMN NX_IS IS NOT EMPTY, IF EMPTY SKIP TO IP19] TAKE THE INDOOR NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A YELLOW DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON INDOOR NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
IP16e. [IF IP16d=YES] TAKE THE FIELD BLANK NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A BLACK DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
IP22b. [IF COLUMN HS_ID IS NOT EMPTY] HAS THE SECOND H2S BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP22. HAS THE H2S BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP19a. [DISPLAY IF COLUMN HS_IS IS NOT EMPTY, IF EMPTY SKIP TO IP23] INSPECT THE INDOOR H2S (HS) BADGE IN THE SHIPPING VIAL LABELED WITH A YELLOW DOT
SCAN BARCODE ON INDOOR H2S BADGE SHIPPING VIAL. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR H2S BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - HS AND 4 NUMBERS]
IP20e. [IF IP20d=YES] INSPECT THE FIELD BLANK H2S (HS) BADGE IN THE SHIPPING VIAL LABELED WITH A BLACK DOT
SCAN BARCODE ON BLACK DOTTED FIELD BLANK H2S BADGE SHIPPING VIAL. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK H2S BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - HS AND 4 NUMBERS]
IP26b. [IF COLUMN PF_ID IS NOT EMPTY] HAS THE SECOND CATS TUBE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP26. HAS THE CATS TUBE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP23a. [DISPLAY IF COLUMN PF_IS IS NOT EMPTY, IF EMPTY SKIP TO IP27] INSPECT THE INDOOR CATS (PF) TUBE IN THE SHIPPING TUBE LABELED WITH A YELLOW DOT
SCAN BARCODE ON INDOOR CATS TUBE SHIPPING TUBE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR CATS TUBE ID NUMBER: ____________[ALLOW 6 CHARACTERS - PF AND 4 NUMBERS]
IP30. HAS THE INDOOR HOBO BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
IP27. [DISPLAY IF COLUMN URTIS IS NOT EMPTY AND TR_IS IS NOT EMPTY, IF BOTH ARE EMPTY SKIP TO IP31]REMOVE FROM THE PARTICIPANT BOX THE HOBO LABELED WITH A YELLOW DOT.
SCAN BARCODE ON HOBO. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
HOBO ID NUMBER: ____________[ALLOW 6 CHARACTERS - TR AND 4 NUMBERS]
OP3. [DISPLAY IF COLUMN URTOS IS NOT EMPTY, IF EMPTY SKIP TO OP7] PLACE CAP FROM YOUR SUPPLY BAG ONTO THE MICROPEM OPENING
TURN ON OUTDOOR MICROPEM LABELED WITH A BLUE DOT BY PRESSING BUTTON 1.
SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE OUTDOOR MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR MICROPEM SERIAL ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]
OP3d. SCAN BARCODE ON THE OUTDOOR MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR MICROPEM FILTER ID NUMBER: ____________[ALLOW 10 CHARACTERS – UP AND 4 NUMBERS]
OP6. HAS THE OUTDOOR MICROPEM BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP10b. [IF COLUMN AL_OD IS NOT EMPTY] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP10. HAS THE ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP7a. [DISPLAY IF COLUMN AL_OS IS NOT EMPTY, IF EMPTY SKIP TO OP11] TAKE THE OUTDOOR ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLUE DOT
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON OUTDOOR ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
OP8e. [IF OP8d=YES] TAKE THE FIELD BLANK ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLACK DOT.
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
OP11a. [DISPLAY IF COLUMN VC_OS IS NOT EMPTY, IF EMPTY SKIP TO OP15]TAKE THE OUTDOOR VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLUE DOT.
PLACE THE SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF THE BADGE
SCAN THE BARCODE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
OP12e. [IF OP12d=YES] TAKE THE FIELD BLANK VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLACK DOT
PEEL SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
OP14b. [IF COLUMN VC_OD IS NOT EMPTY] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP14. HAS THE VOC BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP15a. [DISPLAY IF COLUMN NX_OS IS NOT EMPTY, IF EMPTY SKIP TO OP19] TAKE THE OUTDOOR NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A BLUE DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON OUTDOOR NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
OP16e. [IF OP16d=YES] TAKE THE FIELD BLANK NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A BLACK DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
OP18b. [IF COLUMN NX_OD IS NOT EMPTY] HAS THE SECOND NO2 BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP18. HAS THE NO2 BADGE BEEN SUCCESSFULLY DEPLOYED?
1 YES
2 NO
OP18a. [IF OP18=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT DEPLOY THE NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
COAER18f. [IF COAER18aFINAL=YES OR COAER18bFINAL=YES OR COAER18cFINAL=YES OR COAER18dFINAL=YES] HOW MAY TOTAL PFT TUBES DID YOU PLACE IN THE HOME?
____________[MIN OF 1 AND MAX OF 6]
ENVIRONMENTAL ASSESSMENT EQUIPMENT RETRIEVAL INTRO
SRINTRO. INTERVIEWER: THE FOLLOWING SCREENS WILL INSTRUCT YOU ON RETRIEVING THE PLATFORMS/DEVICES THAT WERE DEPLOYED DURING SESSION 1.
PRESS 1 TO CONTINUE
SRINTROa. PLEASE ENTER YOUR FIID – LOCATED ON THE BACK OF YOUR PROJECT ID BADGE
FIID NUMBER: ____________[ALLOW 6 CHARACTERS]
PROGRAM: CHECK THE ENTRY AGAINST THE INVENTORY OF VALID FIIDS. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES 1 OR ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT FIID TO PROCEED.
SRINTRO1. SCAN THE BARCODE ON THE PARTICIPANT BOX. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PARTICIPANT BOX ID NUMBER: ____________[ALLOW 6 CHARACTERS – BX AND 4 NUMBERS]
NODK
NOREF
PRESS 1 TO CONTINUE
PROGRAMMER: PARTICIPANT BOX ID SHOULD BE 6 CHARACTERS: BX####
PROGRAMMER: CHECK THE ENTRY/SCAN AGAINST THE INVENTORY OF VALID PARTICIPANT BOX IDS FOR THIS FI AND RECORD THE DATE AND TIME WHEN THE FI PRESSES 1 TO CONTINUE.
SRINTRO1a. [IF THE ID SCANNED/KEYED IN SRINTRO1 DOES NOT EQUAL THE PARTICIPANT BOX BARCODE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 QUESTION SDINTRO1] OUR RECORDS INDICATE THE PARTICIPANT BOX ID YOU [SCANNED/KEYED] IS NOT ASSIGNED TO THIS HOUSEHOLD.
THE PARTICIPANT BOX ID ASSIGNED TO THIS HOUSEHOLD IS [PRELOADED FROM BASELINE VISIT SESSION 1 QUESTION SDINTRO1]
PLEASE CONFIRM THE [SCANNED/KEYED] ID ABOVE MATCHES THE ID ON THE PARTICIPANT BOX YOU PREVIOUSLY SCANNED. IF IT DOES NOT MATCH, PLEASE CHECK YOUR VEHICLE FOR THE BOX CONTAINING THIS ID.
1 THIS ID MATCHES THE PARTICIPANT BOX ID IN YOUR POSSESSION
2 THIS ID DOES NOT MATCH THE PARTICIPANT BOX ID IN YOUR POSSESSION – I HAVE RETRIEVED THE CORRECT BOX TO SCAN/KEY
PROGRAMMER: IF SRINTRO1a=2, RETURN USER TO SRINTRO1
SRINTRO1b. [IF SRINTRO1a=1] DO YOU WANT TO ADD THIS PARTICIPANT BOX TO YOUR ASSIGNMENT? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.
YES
NO
PROGRAMMER: IF SRINTRO1b=NO, RETURN USER TO SRINTRO1
SRINTRO1c. [IF SRINTRO1b=YES] ARE YOU SURE YOU WANT ADD THIS PARTICIPANT BOX TO YOUR ASSIGNMENT? IF YOU USE AN INCORRECT BOX FOR THIS CASE, THE CORRECT QUESTIONS MAY NOT DISPLAY FOR THIS INTERVIEW.
YES – I AM SURE I WANT TO ADD THIS PARTICIPANT BOX TO MY ASSIGNMENT
NO – I DO NOT WANT TO ADD THIS PARTICIPANT BOX AND NEED TO RE-SCAN/KEY A NEW PARTICIPANT BOX ID
PROGRAMMER: IF SRINTRO1c=2, RETURN USER TO SRINTRO1
SRINTRO1d. [IF SRINTRO1c=1] THIS PARTICIPANT BOX WITH THE ID BELOW HAS BEEN ADDED TO YOUR ASSIGNMENT
[FILL PARTICIPANT BOX ID FROM SRINTRO1b]
PLEASE EXPLAIN BELOW WHY YOU ARE USING A DIFFERENT PARTICIPANT BOX FOR RETRIEVAL THAN THE BOX USED FOR DEPLOYMENT
___________________ [ALLOW 100 CHARACTERS]
FOR REFERENCE ONLY: ONCE THE FI SCANS THE BARCODE ON THE PARTICIPANT BOX, THE BARCODE ID SHOULD DRIVE THE TYPES OF SAMPLER PLATFORMS THAT WILL BE RETRIEVED IN THE HOUSEHOLD (AND THEREFORE WHICH SAMPLER PLATFORM RETRIEVAL QUESTIONS THE HOUSEHOLD SHOULD RECEIVE). BELOW ARE THE CURRENT POSSIBLE BOX COMBINATIONS.
A-NORMAL BOX – 270 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL INSTRUCTIONS (PP QUESTION SERIES), HOBO INSTRUCTIONS (HB QUESTION SERIES), AND THE DUST COLLECTION INSTRUCTIONS (DC QUESTION SERIES)
A-W/FIELD BLANKS BOX – 37 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL INSTRUCTIONS (PP QUESTION SERIES), HOBO INSTRUCTIONS (HB QUESTION SERIES), THE DUST COLLECTION INSTRUCTIONS (DC QUESTION SERIES), AND INSTRUCTIONS FOR COLLECTION OF THE FOLLOWING FIELD BLANKS (COLLECTED DURING SESSION 1 RETRIEVAL): FIELD BLANK ALDEHYDE BADGE (SESSION 2 FB1-FB4A), FIELD BLANK VOC BADGE (SESSION 2 FB5-FB8A), AND FIELD BLANK NO2 BADGE (SESSION 2 FB9-FB12A)
A-W/INDOOR VC DUP BOX – 15 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL INSTRUCTIONS (PP QUESTION SERIES), HOBO INSTRUCTIONS (HB QUESTION SERIES), THE DUST COLLECTION INSTRUCTIONS (DC QUESTION SERIES),AND WILL INCLUDE INSTRUCTIONS TO DEPLOY A 2ND/DUPLICATE VOC BADGE SAMPLER (IN THE PP QUESTION SERIES)
A-W/INDOOR AL DUP BOX – 15 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL INSTRUCTIONS (PP QUESTION SERIES), HOBO INSTRUCTIONS (HB QUESTION SERIES), THE DUST COLLECTION INSTRUCTIONS (DC QUESTION SERIES), AND WILL INCLUDE INSTRUCTIONS TO DEPLOY A 2ND/DUPLICATE ALDEHYDE BADGE SAMPLER (IN THE PP QUESTION SERIES)
A-W/INDOOR NX DUP BOX – 15 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL INSTRUCTIONS (PP QUESTION SERIES), HOBO INSTRUCTIONS (HB QUESTION SERIES), THE DUST COLLECTION INSTRUCTIONS (DC QUESTION SERIES), AND WILL INCLUDE INSTRUCTIONS TO DEPLOY A 2ND/DUPLICATE NO2 BADGE SAMPLER (IN THE PP QUESTION SERIES).
B-1 NORMAL BOX + B-2 NORMAL BOX– 74 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL QUESTIONS (PP QUESTION SERIES), THE INDOOR PLATFORM RETRIEVAL QUESTIONS (IP QUESTION SERIES), AND THE OUTDOOR PLATFORM RETRIEVAL QUESTIONS (OP QUESTION SERIES).
B-1 W/INDOOR DUPS +B-NORMAL – 11 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL QUESTIONS (PP QUESTION SERIES), THE INDOOR PLATFORM RETRIEVAL QUESTIONS (IP QUESTION SERIES), THE OUTDOOR PLATFORM RETRIEVAL QUESTIONS (OP QUESTION SERIES), AND WILL INCLUDE INSTRUCTIONS TO DEPLOY A 2ND/DUPLICATE VOC BADGE, ALDEHYDE BADGE, NO2 BADGE ,H2S BADGE, CATS TUBE SAMPLER.
B-1 W/OUTDOOR DUPS (+ HS FB) +B-2 NORMAL - 11 KIDS AGE 7 OR OLDER; WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL QUESTIONS (PP QUESTION SERIES), THE INDOOR PLATFORM RETRIEVAL QUESTIONS (IP QUESTION SERIES), THE OUTDOOR PLATFORM RETRIEVAL QUESTIONS (OP QUESTION SERIES), AND WILL INCLUDE INSTRUCTIONS TO DEPLOY OUTDOORS A 2ND/DUPLICATE VOC BADGE, ALDEHYDE BADGE, AND NO2 BADGE IN THE OP QUESTION SERIES). PLUS, THERE ARE INSTRUCTIONS TO PROCESS A FIELD BLANK H2S BADGE, (IN THE SESSION 2 QUESTION SERIES).
B-1 W/DF FIELD BLANK + B-2 NORMAL . 24 KIDS AGE 7 OR OLDER WILL HAVE THE SAME SERIES OF QUESTIONS AS SCHEDULE 6, ABOVE, WITH ADDITIONAL OF A DUST FIELD BLANK IN SESSION 1. – NOT A SEPARATE LOADING SCHEDULE.
C-NORMAL. 79 KIDS AGED 3 THROUGH 6 WILL RECEIVE THE INDOOR PLATFORM RETRIEVAL QUESTIONS (IP SERIES) WITH THE EXCEPTION THAT THERE WILL NOT BE AN H2S BADGE DEPLOYED.
SRINTRO2. [DISPLAY IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES OR HBINTRO10=YES OR IP34=YES OR OP23=YES, OR (SDINTRO3a =YES OR SDINTRO3c=YES); IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=NO AND HBINTRO10=NO AND IP34=NO AND OP23=NO AND (SDINTRO3a =NO OR SDINTRO3c=NO) AND (AL_FB IS NOT EMPTY OR COLUMN VC_FB IS NOT EMPTY OR COLUMN NX_FB IS NOT EMPTY OR COLUMN HS_FB IS NOT EMPTY) SKIP TO FBINTRO] Today I will be collecting the environmental equipment left here during session 1. As mentioned during that visit, this equipment collects air samples and measures for different types of pollutants that may be in the air your child breathes. Today I will collect:
1 [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES “the personal exposure measuring device we call a PEM, from [CHILD]
2 [IF PRELOADED FROM BASELINE VISIT SESSION 1 HBINTRO10=YES “the small indoor air sampling device”]
3 [IF PRELOADED FROM BASELINE VISIT SESSION 1 IP34=YES “the indoor air sampling device”]
4 [IF PRELOADED FROM BASELINE VISIT SESSION 1 OP23=YES “the outdoor air sampling device.”]
5 [IF PRELOADED FROM BASELINE VISIT SESSION 1 COAER23=YES OR NO) “the small PFT tubes”]
PRESS 1 TO CONTINUE
SRINTRO3. After I collect this equipment today, I will then ship it and the samples collected to the CHATS lab staff for analysis.
PRESS 1 TO CONTINUE
SRINTRO4. Just as was mentioned during Session 1, in about 5 months, we will send you some information about the air quality in your home along with the results from [CHILD]’s [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES personal air measurements, and] blood and urine test results if [HE/SHE] participates in the CHATS health assessment. These letters will include some information about how to understand what the test results mean. If the air quality results suggest that improvements can be made in your home, the letter will provide suggestions for how to do that.
PRESS 1 TO CONTINUE
SRINTRO5. If it is all right with you, I would like to get started! Do you have any questions before I begin?
PRESS 1 TO CONTINUE
SRINTRO6. [DISPLAY IF THE FIID MATCHES THE 5 FIS THAT WILL HAVE THE CO2 MONITOR AND IF PRELOADED FROM BASELINE VISIT SESSION 1 COAER23=NO OR YES] INTERVIEWER: YOU WILL NOW ATTEMPT TO COMPLETE THE CO2 AER TEST THAT WAS STARTED DURING SESSION 1.
PRESS 1 TO CONTINUE
SRINTRO6a. During Session 1, you agreed to allow CHATS to conduct a test to measure how much the air moves in your home. As a part of the test, we placed small PFT tubes around you home, but unfortunately we were unable to complete the test due to some equipment issues. If you are agreeable, I would like to try again to complete this test.
(FI NOTE IF ASKED FOR MORE DETAILS: We call this measuring your home’s air exchange rate and we do this in two different ways. In order to do this, last week we placed several small tubes throughout your home, and today we will release a small amount of carbon dioxide gas, which is what you exhale, and then measure how fast carbon dioxide escapes from inside to outside of your home. This test will cause no harm to those living in your home.)
(If MORE DETAILS ARE REQUESTED: Last week, we placed several tubes throughout your home, which will release a harmless tracer into the air that is then captured in another, single tube. Today, we will release a very small amount of carbon dioxide gas in the room to a level, which is harmless, and then measure how fast it disappears. The amount of carbon dioxide that is release is the same as if a group of people were in your home breathing out normally with the doors and windows closed. )
DOES THE PARENT/GUARDIAN AGREE TO THE AER TESTING?
1 YES
2 NO
PRESS 1 TO CONTINUE
SRINTRO6b. [IF SRINTRO6a=NO] Can you tell me why you do not want to participate in the air exchange rate test?
___________________ [ALLOW 100 CHARACTERS]
SRINTRO6c. [IF SRINTRO6a=NO] INTERVIEWER: ADDRESS CONCERNS ABOUT THE AER TESTING PROCESS
(After having spoken about the air exchange rate testing process, would you now allow us to perform this test in your home?)
1 YES
2 NO
SRINTRO6d. [IF SRINTRO6c=NO] Thank you for your feedback. We will move on to the next part of the study, but if you change your mind at any time today while I am still here, we can still perform this important test.
PRESS 1 TO CONTINUE
SRINTRO6e. [IF SRINTO6a=YES OR SRINTRO6c=YES] Just as during Session 1, I will wear sterile gloves so that I don’t accidently affect or contaminate your samples by touching the equipment with my bare hands.
PROGRAMMER: IF SRINTRO6a=YES OR SRINTRO6c=YES, SKIP TO COAER2S1, IF SRINTRO6c=NO SKIP TO SRINTRO7KID
SRINTRO7KID. [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES, IF PP27=NO SKIP TO SRINTRO7] For this part of the interview, we need to have [CHILD] join us so that I can collect the PEM from [HIM/HER]. (Is [CHILD] available right now?)
CHILD IS HERE
CHILD IS UNAVAILABLE
SRINTRO7KIDa. [IF SRINTRO7KID=2] Because [CHILD] is not available right now, we will come back to [HIS/HER] part later if [HE/SHE] returns. For now, let’s move on.
PRESS 1 TO CONTINUE
PROGRAMMER: Implement Lilia’s skip mechanism if child is unavailable.
SRINTRO7. While I am packing up my equipment, the CHATS nurse will talk to you about completing the health assessment with [CHILD], but I may have some questions for you later.
[DISPLAY IF SRINTRO7KID=1] I would like to collect the PEM from [CHILD] and later I will ask [HIM/HER] a few questions regarding [HIS/HER] PEM wearing experience. I will also collect any other CHATS environmental equipment I left in your home during Session 1 and bring them back here to pack up the items.
[DISPLAY IF SRINTRO7KID=2] Because [CHILD] is not here right now, I will collect the PEM from [HIM/HER] when [HE/SHE] returns home. In the mean time, I will collect any other CHATS environmental equipment I left in your home during Session 1 and bring them back here to pack up the items.
PRESS 1 TO CONTINUE
PR1. TO PARENT/GUARDIAN: Now I would like to retrieve and pack up the equipment left here with you during Session 1. If I have any questions for you later, I will let you know.
INTERVIEWER: LET THE PARENT KNOW OF YOUR WHEREABOUTS IN THE HOME AS YOU MOVE FROM ROOM TO ROOM COLLECTING THE ENVIRONMENTAL ASSESSMENT EQUIPMENT.
PRESS 1 TO CONTINUE
SRINTRO8. PUT ON NITRILE GLOVES IF YOU HAVEN’T ALREADY
COLLECT ALL SAMPLER PLATFORMS FROM THE RESPONDENT AND THE HOME DEPLOYED DURING SESSION 1 LISTED BELOW
1 [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES FILL “PERSONAL PLATFORM FROM CHILD”]
2 [IF PRELOADED FROM BASELINE VISIT SESSION 1 HBINTRO10=YES FILL “FREESTANDING HOBO FROM” ][PRELOADED FROM BASELINE VISIT SESSION 1 HOBOPLACE]]
3 [IF PRELOADED FROM BASELINE VISIT SESSION 1 IP34=YES FILL “INDOOR PLATFORM FROM”] [PRELOADED FROM BASELINE VISIT SESSION 1 INDOORPLACE]
4 [IF PRELOADED FROM BASELINE VISIT SESSION 1 OP23=YES FILL” OUTDOOR PLATFORM FROM”] [PRELOADED FROM BASELINE VISIT SESSION 1 OUTDOORPLACE]
5 [IF PRELOADED FROM BASELINE VISIT SESSION 1 COAER23 IS NOT EMPTY FILL “PFT TUBE LOCATIONS WILL BE DISPLAYED ON THE NEXT SCREEN”
PRESS 1 TO CONTINUE
SRINTRO8a. [IF COAER23 IS NOT EMTPY] COLLECT PFT TUBES LOCATED IN:
1ST FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18d1]; LOCATION - COAER18d4 OR COAER18d6]
2ND FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18c1]; LOCATION - COAER18c4 OR COAER18c6]
3RD FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18b1]; LOCATION - COAER18b4 OR COAER18b6]
4TH FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18a1]; LOCATION - COAER18a4 OR COAER18a6]
PRESS 1 TO CONTINUE
PR2. OPEN THE PARTICIPANT BOX AND REMOVE SAMPLER TRAY
IF FIELD BLANK CONTAINERS LABELED WITH A BLACK DOT WERE INCLUDED IN THE PARTICIPANT BOX USED FOR DEPLOYMENT, THE NEXT SCREENS WILL GUIDE YOU THROUGH THE FIELD BLANK COLLECTION PROCESS
THE SCREENS THAT FOLLOW WILL INCLUDE STEPS ON RETRIEVING THE DEVICES DEPLOYED DURING SESSION 1.
PRESS 1 TO CONTINUE
PERSONAL PLATFORM RETRIEVAL FEEDBACK
PPR1. [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES AND SRINTRO7KID=1, IF SRINTRO7KID=2, SKIP TO PR1 AND Implement Lilia’s skip mechanism WITH TAG TO RETURN TO THESE QUESTIONS WHEN THE CHILD RETURNS.] Thank you so much, [CHILD], for wearing the PEM for the CHATS study! I hope you enjoyed the experience and learned a little about what it is like to be a researcher. We would like to hear what you thought about the experience and if we should look into making improvements to the PEM for future visits.
PRESS 1 TO CONTINUE
PPR1a. Did you wear the PEM all day since Session 1, removing it only when sleeping, bathing, or playing intense sports?
1 YES
2 NO
PPR1aa [IF PPR1a=NO] Did you wear the PEM at all since Session 1?
YES
2 NO
PPR1b. [If PPR1a=NO] Can you tell me why you were not able to wear the PEM for these time periods?
___________________ [ALLOW 300 CHARACTERS]
PPR1c. Did you have any problems wearing the PEM at school?
1 YES
2 NO
PPR1d. [If PPR1c=YES] Can you tell me about the problems you had wearing the PEM at school?
___________________ [ALLOW 300 CHARACTERS]
PPR1e. Did you have any problems wearing the PEM during physical activities, such as when you played inside or outside your home?
1 YES
2 NO
PPR1f. [If PPR1e=YES] Can you tell me about the problems you had wearing the PEM during physical activities?
___________________ [ALLOW 300 CHARACTERS]
PPR1g. Is there anything else you would like us to know about your experiences wearing the PEM?
___________________ [ALLOW 2000 CHARACTERS]
PPR2. Thank you for this feedback. It will help us to make any needed improvements to the CHATS study.
PRESS 1 TO CONTINUE
PR1. [ALL RESPONDENTS GET PR1] TO PARENT/GUARDIAN: Now I would like to retrieve and pack up the equipment left here with you during Session 1. The CHATS nurse should be ready to discuss the health assessment with you at this time. If I have any questions for you later, I will let you know.
PRESS 1 TO CONTINUE
PPR1h. During Session 1, we provided you with 3 ways to wear the PEM: around your neck using the lanyard, around your waist using the waist pack, and you could also attach the yellow/gray PEM bag directly to your backpack strap. Which did you wear most of the time?
Lanyard
Waist Pack
Backpack
Other
PPR1ha. DESCRIBE THE OTHER WAY(S) THE PARTICIPANT WORE THE PEM
___________________ [ALLOW 300 CHARACTERS]
PPR2. Thank you for this feedback. It will help us to make any needed improvements to the CHATS study.
PRESS 1 TO CONTINUE
SRINTRO8. (PUT ON NITRILE GLOVES)
COLLECT ALL SAMPLER PLATFORMS FROM THE RESPONDENT AND THE HOME DEPLOYED DURING SESSION 1 LISTED BELOW
1 [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES FILL “PERSONAL PLATFORM FROM CHILD”]
2 [IF PRELOADED FROM BASELINE VISIT SESSION 1 HBINTRO10=YES FILL “FREESTANDING HOBO FROM” ][PRELOADED FROM BASELINE VISIT SESSION 1: IF HBINTRO4e=YES, DISPLAY TEXT KEYED IN HBINTRO4d; IF HBINTRO4e1=YES, DISPLAY TEXT KEYED IN HBINTRO4d1; IF HBINTRO4e2=YES, DISPLAY TEXT KEYED IN HBINTRO4d2]
3 [IF PRELOADED FROM BASELINE VISIT SESSION 1 IP34=YES FILL “INDOOR PLATFORM FROM”] [PRELOADED FROM BASELINE VISIT SESSION 1 IP32e OR IP33d]
4 [IF PRELOADED FROM BASELINE VISIT SESSION 1 OP23 FILL” OUTDOOR PLATFORM FROM”] [PRELOADED FROM BASELINE VISIT SESSION 1 OP22i OR OP22e ]
5 [IF PRELOADED FROM BASELINE VISIT SESSION 1 COAER23=YES OR NO FILL “PFT TUBE LOCATIONS WILL BE DISPLAYED ON THE NEXT SCREEN”
SRINTRO8a. [IF COAER23=YES OR NO] COLLECT PFT TUBES LOCATED IN:
1ST FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18d1 OR COAER18d6]; LOCATION - COAER18d4 OR COAER18d6]
2ND FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18c1]; LOCATION - COAER18c4 OR COAER18c6]
3RD FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18b1]; LOCATION - COAER18b4 OR COAER18b6]
4TH FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18a1]; LOCATION - COAER18a4 OR COAER18a6]
PR2. OPEN THE PARTICIPANT BOX AND REMOVE SAMPLER TRAY
IF FIELD BLANKS WERE INCLUDED IN THE PARTICIPANT BOX USED FOR DEPLOYMENT, THE NEXT SCREENS WILL GUIDE YOU THROUGH THE FIELD BLANK COLLECTION PROCESS
THE SCREENS THAT FOLLOW WILL INCLUDE STEPS ON RETRIEVING THE DEVICES DEPLOYED DURING SESSION 1.
PRESS 1 TO CONTINUE
FIELD BLANK COLLECTION
FIELD BLANK ALDEHYDE BADGE
FBINTRO. [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=NO AND HBINTRO10=NO AND IP34=NO AND OP23=NO AND (SDINTRO3a =NO OR SDINTRO3c=NO) AND (AL_FB IS NOT EMPTY OR COLUMN VC_FB IS NOT EMPTY OR COLUMN NX_FB IS NOT EMPTY OR COLUMN HS_FB IS NOT EMPTY] Now I would like to collect a few samples to test if any contamination occurred while I handled the equipment and devices. This will take only few minutes. The CHATS nurse should be ready to discuss the health assessment with you at this time. If I have any questions for you later, I will let you know.
OPEN THE PARTICIPANT BOX AND REMOVE SAMPLER TRAY
PRESS 1 TO CONTINUE
FBINTROa. [DISPLAY IF COLUMN AL_FB IS NOT EMPTY, IF EMPTY SKIP TO FB5INTRO] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK ALDEHYDE BADGE IN YOUR PARTICIPANT BOX. DO YOU HAVE THIS SAMPLER?
YES
NO, THERE IS NO FIELD BLANK IN THE BOX
PROGRAMMER: IF FBINTROa=2, SKIP TO FB5INTRO
FB1. [IF FBINTROa=YES] TAKE THE FIELD BLANK ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLACK DOT
PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: FIELD BLANK ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED
PROGRAMMER: IF SCANNED/KEYED BARCODE ON ALDEHYDE BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK ALDEHYDE BADGE AS SET IN THE SYSTEM), GO TO FB2. IF SCANNED BARCODE ON ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK ALDEHYDE BADGE AS SET IN THE SYSTEM), GO TO FB1a.
FB1a. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK (BLACK DOTTED) ALDEHYDE BADGE? OUR RECORDS SHOW YOU HAVE SCANNED A [FILL NOTE BELOW] WITH THE ID [FILL NOTE BELOW]
1 YES
2 NO
PROGRAMMER: FILL FB1a WITH TYPE OF SAMPLER AND ID THE SYSTEM SHOWS ASSIGNED TO THAT ID. IF FB1a=NO, LOOP BACK TO FB1INTRO.
FB1b. [IF FB1a=YES] DO YOU WANT TO ADD THIS FIELD BLANK ALDEHYDE BADGE TO YOUR PARTICIPANT BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.
1 YES
2 NO
PROGRAMMER: IF FB1b=NO, LOOP BACK TO FB1INTRO
FB1c. [IF FB1b=YES] THIS FIELD BLANK ALDEHYDE BADGE HAS BEEN ADDED TO THE PARTICIPANT BOX ASSIGNED TO THIS CASE.
PRESS 1 TO CONTINUE
FB2. WHAT IS THE CONDITION OF THE FIELD BLANK ALDEHYDE BADGE? SELECT ALL THAT APPLY.
NO DAMAGE
POUCH WAS ALREADY OPEN
GREEN SLIDE OPEN ALREADY OR MISSING
CLIP BROKEN/NOT PRESENT
MINOR SCRATCH TO BADGE
MAJOR CRACK TO BADGE
OTHER
FB2a. [IF FB2=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
FB2b. SLIDE THE GREEN COVER DOWN TO OPEN THE BADGE AND THEN QUICKLY SLIDE IT UP TO CLOSE THE BADGE
PRESS 1 TO CONTINUE
FB3. PLACE THE BADGE BACK IN THE POUCH, RESEAL THE POUCH AND PUT THE POUCH BACK INTO THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER: RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
FB4. HAS THE FIELD BLANK ALDEHYDE BADGE BEEN SUCCESSFULLY COLLECTED?
YES
NO
FB4a. [IF FB4=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT COMPLETE COLLECTION FOR THE FIELD BLANK ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
FIELD BLANK VOC BADGE
FB5INTRO. [DISPLAY IF COLUMN VC_FB IS NOT EMPTY, IF EMPTY SKIP TO FB9INTRO] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK VOC BADGE IN YOUR PARTICIPANT BOX. DO YOU HAVE THIS SAMPLER?
YES
NO, THERE IS NO FIELD BLANK IN THE BOX
PROGRAMMER: IF FB5INTRO=2, SKIP TO FB9INTRO
FB5. [IF FB5INTRO=YES] TAKE THE FIELD BLANK VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLACK DOT
PEEL SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF BADGE
SCAN BARCODE ON THE BLACK DOTTED FIELD BLANK VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: FIELD BLANK VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED
PROGRAMMER: IF SCANNED/KEYED BARCODE ON VOC BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK VOC BADGE AS SET IN THE SYSTEM), GO TO FB6. IF SCANNED BARCODE ON VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK VOC BADGE AS SET IN THE SYSTEM), GO TO FB5a.
FB5a. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK (BLACK DOTTED) VOC BADGE? OUR RECORDS SHOW YOU HAVE SCANNED A [FILL NOTE BELOW] WITH THE ID [FILL NOTE BELOW]
YES
NO
PROGRAMMER: FILL FB5a WITH TYPE OF SAMPLER AND ID THE SYSTEM SHOWS ASSIGNED TO THAT ID. IF FB5a=NO, LOOP BACK TO FB5INTRO.
FB5b. [IF FB5a=YES] DO YOU WANT TO ADD THIS FIELD BLANK VOC BADGE TO YOUR PARTICIPANT BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.
1 YES
2 NO
PROGRAMMER: IF FB5b=NO, LOOP BACK TO FB5INTRO
FB5c. [IF FB5b=YES] THIS FIELD BLANK VOC BADGE HAS BEEN ADDED TO THE PARTICIPANT BOX ASSIGNED TO THIS CASE.
PRESS 1 TO CONTINUE
FB6. WHAT IS THE CONDITION OF THE FIELD BLANK VOC BADGE? SELECT ALL THAT APPLY.
NO DAMAGE
CAN WAS ALREADY OPEN
TORN MEMBRANE
CLIP BROKEN/NOT PRESENT
MINOR SCRATCH TO BADGE
MAJOR CRACK TO BADGE (NOT DEPLOYABLE)
OTHER
FB6a. [IF FB6=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
FB7. PLACE THE FIELD BLANK VOC BADGE BACK IN THE CAN.
PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
FB8. HAS THE FIELD BLANK VOC BADGE BEEN SUCCESSFULLY COLLECTED?
YES
NO
FB8a. [IF FB8=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT COMPLETE COLLECTION FOR THE FIELD BLANK VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
FIELD BLANK NO2 BADGE
FB9INTRO. [DISPLAY IF COLUMN NX_FB IS NOT EMPTY, IF EMPTY SKIP TO FB13INTRO] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK NO2 BADGE IN YOUR PARTICIPANT BOX. DO YOU HAVE THIS SAMPLER?
YES
NO, THERE IS NO FIELD BLANK IN THE BOX
PROGRAMMER: IF FB9INTRO=2, SKIP TO FB13INTRO
FB9. [IF FB9INTRO=YES] TAKE THE FIELD BLANK NO2 (NX) BADGE OUT OF THE JAR LABELED WITH A BLACK DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: FIELD BLANK NO2 BADGE ID SHOULD BE 6 CHARACTERS: NX####. ####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED
PROGRAMMER: IF SCANNED/KEYED BARCODE ON NO2 BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK NO2 BADGE AS SET IN THE SYSTEM), GO TO FB10. IF SCANNED BARCODE ON NO2 BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK NO2 BADGE AS SET IN THE SYSTEM), GO TO FB9a.
FB9a. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK (BLACK DOTTED) NO2 BADGE? OUR RECORDS SHOW YOU HAVE SCANNED A [FILL NOTE BELOW] WITH ID [FILL NOTE BELOW]
1 YES
2 NO
PROGRAMMER: FILL FB9a WITH TYPE OF SAMPLER AND ID THE SYSTEM SHOWS ASSIGNED TO THAT ID. IF FB9a=NO, LOOP BACK TO FB9INTRO.
FB9b. [IF FB9a=YES] DO YOU WANT TO ADD THIS FIELD BLANK NO2 BADGE TO YOUR PARTICIPANT BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.
1 YES
2 NO
PROGRAMMER: IF FB9b=NO, LOOP BACK TO FB9INTRO
FB9c. [IF FB9b=YES] THIS FIELD BLANK NO2 BADGE HAS BEEN ADDED TO THE PARTICIPANT BOX ASSIGNED TO THIS CASE.
PRESS 1 TO CONTINUE
FB10. WHAT IS THE CONDITION OF THE FIELD BLANK NO2 BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 JAR WAS ALREADY OPEN
CLIP BROKEN/NOT PRESENT
MINOR SCRATCH TO BADGE
MAJOR CRACK TO BADGE
OTHER
FB10a. [IF FB10=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
FB11. PLACE THE FIELD BLANK NO2 BADGE BACK IN THE JAR.
PLACE LID BACK ON JAR AND PUT THE JAR BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
FB12. HAS THE FIELD BLANK NO2 BADGE BEEN SUCCESSFULLY COLLECTED?
1 YES
2 NO
FB12a. [IF FB12=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT COMPLETE COLLECTION FOR THE FIELD BLANK NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
FIELD BLANK H2S BADGE
FB13INTRO. [DISPLAY IF COLUMN HS_FB IS NOT EMPTY, IF EMPTY SKIP TO PPR3] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK H2S BADGE IN YOUR PARTICIPANT BOX. DO YOU HAVE THIS SAMPLER?
YES
NO, THERE IS NO FIELD BLANK IN THE BOX
PROGRAMMER: IF FB13INTRO=2, SKIP TO PPR3
FB13. [IF FB13INTRO=YES] TAKE THE FIELD BLANK H2S (HS) BADGE OUT OF THE VIAL LABELED WITH A BLACK DOT
PLACE THE SECOND BARCODE LABEL FROM THE JAR LID ONTO THE BACK OF THE BADGE
SCAN BARCODE ON BLACK DOTTED FIELD BLANK H2S BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
BLACK DOTTED FIELD BLANK H2S BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - HS AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: FIELD BLANK H2S BADGE ID SHOULD BE 6 CHARACTERS: HS####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED
PROGRAMMER: IF SCANNED/KEYED BARCODE ON H2S BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK H2S BADGE AS SET IN THE SYSTEM), GO TO FB14. IF SCANNED BARCODE ON H2S BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK H2S BADGE AS SET IN THE SYSTEM), GO TO FB13a.
FB13a. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK (BLACK DOTTED) H2S BADGE? OUR RECORDS SHOW YOU HAVE SCANNED A [FILL NOTE BELOW] WITH THE ID [FILL NOTE BELOW]
YES
NO
PROGRAMMER: FILL FB13a WITH TYPE OF SAMPLER AND ID THE SYSTEM SHOWS ASSIGNED TO THAT ID. IF FB13a=NO, LOOP BACK TO FB13INTRO.
FB13b [IF FB13a=YES] DO YOU WANT TO ADD THIS FIELD BLANK H2S BADGE TO YOUR PARTICIPANT BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.
YES
NO
PROGRAMMER: IF FB13b=NO, LOOP BACK TO FB13INTRO
FB13c [IF FB13b=YES] THIS FIELD BLANK H2S BADGE HAS BEEN ADDED TO THE PARTICIPANT BOX ASSIGNED TO THIS CASE.
PRESS 1 TO CONTINUE
FB14. WHAT IS THE CONDITION OF THE FIELD BLANK H2S BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 VIAL WAS ALREADY OPEN
3 MINOR SCRATCH TO BADGE
4 MAJOR CRACK TO BADGE
5 OTHER
FB14a [IF FB14=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK H2S BADGE
___________________ [ALLOW 100 CHARACTERS]
FB15. MOUNT THE H2S TUBE ON THE TRIANGLE PLATE AND THEN QUICKLY REMOVE THE TUBE
PLACE THE TUBE BACK IN THE VIAL, RECAP THE VIAL, AND PUT THE VIAL BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
FB16. HAS THE FIELD BLANK H2S BADGE BEEN SUCCESSFULLY COLLECTED?
YES
NO
FB16a [IF FB16=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT COMPLETE COLLECTION FOR THE H2S BADGE
___________________ [ALLOW 100 CHARACTERS]
PERSONAL PLATFORM RETRIEVAL
PPR3. [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES, IF PP27=NO SKIP TO PPR25] THE FOLLOWING SCREENS WILL INSTRUCT YOU ON HOW TO RETRIEVE AND PACKAGE THE PERSONAL PLATFORM
PRESS 1 TO CONTINUE
PPR4. FOR PERSONAL PLATFORM RETRIEVAL AND PACKAGING, REMOVE FROM THE PARTICIPANT BOX THE FOLLOWING CONTAINERS LABELED WITH A RED DOT:
PERSONAL ALDEHYDE BADGE POUCH
PERSONAL VOC BADGE CAN
PERSONAL NO2 BADGE JAR
PRESS 1 TO CONTINUE
PERSONAL MICROPEM
PPR5. IS THE PERSONAL MICROPEM IN THE STRAP, OR IS IT MISSING? IF IN THE STRAP, REMOVE THE MICROPEM FROM THE STRAP.
YES, THE PERSONAL MICROPEM IS IN THE STRAP
NO, THE PERSONAL MICROPEM IS MISSING
[DISPLAY IF PR5a=3, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING PERSONAL MICROPEM
PROGRAMMER: IF PPR5=2, SKIP TO QUESTION PPR10INTRO (SKIP TO NEXT SAMPLER)
PPR6. SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE PERSONAL MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL MICROPEM SERIAL ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]
PROGRAMMER: PERSONAL MICROPEM SERIAL ID SHOULD BE 10 CHARACTERS: UCC32#### AND 1 LETTER. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP8. IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE, GO TO PPR6b. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A PERSONAL MICROPEM UNIT AS SET IN THE SYSTEM), GO TO PPR6a.
PPR6a. ARE YOU SURE YOU SCANNED/KEYED THE SERIAL ID ON A PERSONAL (RED DOTTED) MICROPEM UNIT? OUR RECORDS SHOW YOU HAVE SCANNED
[CHECK ID AGAINST FILTER ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP8d IF A MATCH DISPLAY “THE PERSONAL MICROPEM FILTER DEPLOYED DURING SESSION 1. PLEASE SCAN THE PERSONAL MICROPEM UNIT ON THE BARCODE STARTING WITH UCC”, IF NO MATCH DISPLAY “SOMETHING OTHER THAN THE PERSONAL MICROPEM DEPLOYED DURING SESSION 1”]
YES
NO
PROGRAMMER: IF PPR6a=NO, LOOP BACK TO PPR5. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
PPR6d. SCAN BARCODE ON THE PERSONAL MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL MICROPEM FILTER ID NUMBER: ____________[ALLOW 6 CHARACTERS – UP AND 4 NUMBERS]
PROGRAMMER: PERSONAL MICROPEM FILTER ID SHOULD BE 6 CHARACTERS: UP####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP8d. IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE, GO TO PPR7. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A PERSONAL MICROPEM UNIT AS SET IN THE SYSTEM), GO TO PPR6e.
PPR6e. ARE YOU SURE YOU SCANNED/KEYED THE ID ON A PERSONAL (RED DOTTED) MICROPEM FILTER? OUR RECORDS SHOW YOU HAVE SCANNED
[CHECK ID AGAINST UNIT ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP8 IF A MATCH DISPLAY “THE PERSONAL MICROPEM UNIT DEPLOYED DURING SESSION 1. PLEASE SCAN THE PERSONAL MICROPEM FILTER WITH A BARCODE STARTING WITH UP”, IF NO MATCH DISPLAY “SOMETHING OTHER THAN THE PERSONAL MICROPEM DEPLOYED DURING SESSION 1”]
YES
NO
PROGRAMMER: IF PPR6e =NO, LOOP BACK TO PPR6d. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
PPR7. WHAT IS THE CONDITION OF THE PERSONAL MICROPEM? SELECT ALL THAT APPLY
1 MICROPEM STILL OPERATING
2 LIGHT ON MICROPEM IS NOT BLINKING
3 CANNOT HEAR HUMMING SOUND COMING FROM MICROPEM
4 CRACKS TO THE MICROPEM CASE
5 OTHER
PPR7a [IF PPR7=OTHER] PLEASE DESCRIBE THE CONDITION OF THE PERSONAL MICROPEM
___________________ [ALLOW 100 CHARACTERS]
PPR7b. [IF PPR7=1] PUT THE CAP ON THE MICROPEM FOR 1 MINUTE. AFTER 1 MINUTE, TURN OFF MICROPEM
PRESS 1 TO CONTINUE
PPR8. PLACE THE MICROPEM BACK IN THE PARTICIPANT BOX IN THE SPOT LABELED WITH A RED DOT
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
PPR9. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE PERSONAL MICROPEM?
YES
NO
PPR9a [IF PPR9=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE PERSONAL MICROPEM
___________________ [ALLOW 100 CHARACTERS]
PERSONAL ALDEHYDE BADGE
PPR10INTRO. [IF PRELOADED FROM BASELINE SESSION 1 PP15b=YES, IF PP15b=NO, SKIP TO PPR10] YOU WILL RETRIEVE 2 ALDEHYDE BADGES FROM THE PERSONAL PLATFORM STRAP.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
PPR10 [IF PRELOADED FROM BASELINE SESSION 1 PP15=YES OR PP15b=YES, IF PP15=NO OR PP15b=NO SKIP TO PPR15INTRO] IS THE PERSONAL ALDEHYDE (AL) BADGE ON THE STRAP, OR IS IT MISSING? IF ON STRAP, REMOVE THE ALDEHYDE BADGE FROM THE STRAP.
[IF PRELOADED FROM BASELINE SESSION 1 PP15b=NO, IF PP15b=YES LEAVE BLANK] YES, THE PERSONAL ALDEHYDE BADGE IS ON THE STRAP
[IF PRELOADED FROM BASELINE SESSION 1 PP15b=NO, IF PP15b=YES LEAVE BLANK] NO, THE PERSONAL ALDEHYDE BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 PP15b=YES, IF PP15b=NO LEAVE BLANK] YES, THE 2 EXPECTED PERSONAL ALDEHYDE BADGES ARE ON THE STRAP
[IF PRELOADED FROM BASELINE SESSION 1 PP15b=YES, IF PP15b=NO LEAVE BLANK] NO, THE 2 EXPECTED PERSONAL ALDEHYDE BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 PP15b=YES, IF PP15b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED PERSONAL ALDEHYDE BADGES IS MISSING
[DISPLAY IF PR5B=3 AND PRELOADED FROM BASELINE SESSION 1 PP15b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE PERSONAL ALDEHYDE BADGE
[DISPLAY IF PR5B=3 AND PRELOADED FROM BASELINE SESSION 1 PP15b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING PERSONAL ALDEHYDE BADGE
PROGRAMMER: IF PPR10=2 OR 4, SKIP TO QUESTION PPR15INTRO (SKIP TO NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 PP15b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 ALDEHYDE BADGES. IF PPR10=3 PLEASE DUPLICATE THE STEPS FOR PPR10 THROUGH PPR14 AND ADD QUESTION PPR14b FOR RETRIEVING THE SECOND ALDEHYDE BADGE.
PPR11. [IF PPR10=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON PERSONAL ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
PROGRAMMER: PERSONAL ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP12a and PP13e. IF SCANNED/KEYED BARCODE ON PERSONAL ALDEHYDE BADGE MATCHES EXPECTED BARCODE, GO TO PPR12. IF SCANNED BARCODE ON PERSONAL ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A PERSONAL ALDEHYDE BADGE AS SET IN THE SYSTEM), GO TO PPR11a.
PPR11a. ARE YOU SURE YOU SCANNED/KEYED THE PERSONAL (RED DOTTED) ALDEHYDE BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF PPR11a=NO, LOOP BACK TO PPR10. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
PPR12. WHAT IS THE CONDITION OF THE PERSONAL ALDEHYDE BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 GREEN SLIDE CLOSED (UP) ALREADY
3 GREEN SLIDE MISSING
4 CLIP BROKEN/NOT PRESENT
5 MINOR SCRATCH TO BADGE
6 MAJOR CRACK TO BADGE
7 OTHER
PP12a [IF PP12=OTHER] PLEASE DESCRIBE THE CONDITION OF THE PERSONAL ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
PPR12b. [IF PPR12=1, 4, 5, 6, OR 7] SLIDE THE GREEN COVER UP TO CLOSE THE PERSONAL ALDEHYDE BADGE
PRESS 1 TO CONTINUE
PPR13. PLACE THE PERSONAL ALDEHYDE BADGE BACK IN THE POUCH LABELED WITH A RED DOT
RESEAL THE POUCH AND PLACE THE POUCH BACK IN THE PARTICIPANT BOX
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
PPR14. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE PERSONAL ALDEHYDE BADGE?
YES
NO
PPR14a [IF PPR14=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE PERSONAL ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
PPR14b. [IF PRELOADED FROM BASELINE SESSION 1 PP15b=YES AND PPR10= 3 OR 6] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
PPR14c [IF PPR14b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
PERSONAL VOC BADGE
PPR15INTRO. [IF PRELOADED FROM BASELINE SESSION 1 PP19b=YES, IF PP19b=NO, SKIP TO PPR15] YOU WILL RETRIEVE 2 VOC BADGES FROM THE PERSONAL PLATFORM STRAP.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
PPR15. [IF PRELOADED FROM BASELINE SESSION 1 PP19=YES OR PP19b=YES, IF PP19=NO OR PP19b=NO SKIP TO PPR20INTRO] IS THE PERSONAL VOC (VC) BADGE ON THE STRAP, OR IS IT MISSING? IF ON STRAP, REMOVE THE VOC BADGE FROM THE STRAP.
[IF PRELOADED FROM BASELINE SESSION 1 PP19b=NO, IF PP19b=YES LEAVE BLANK] YES, THE PERSONAL VOC BADGE IS ON THE STRAP
[IF PRELOADED FROM BASELINE SESSION 1 PP19b=NO, IF PP19b=YES LEAVE BLANK] NO, THE PERSONAL VOC BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 PP19b=YES, IF PP19b=NO LEAVE BLANK] YES, THE 2 EXPECTED PERSONAL VOC BADGES ARE ON THE STRAP
[IF PRELOADED FROM BASELINE SESSION 1 PP19b=YES, IF PP19b=NO LEAVE BLANK] NO, THE 2 EXPECTED PERSONAL VOC BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 PP19b=YES, IF PP19b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED PERSONAL VOC BADGES IS MISSING
[DISPLAY IF PR5c=3 AND PRELOADED FROM BASELINE SESSION 1 PP19b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE PERSONAL VOC BADGE
[DISPLAY IF PR5c=3 AND PRELOADED FROM BASELINE SESSION 1 PP19b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING PERSONAL VOC BADGE
PROGRAMMER: IF PPR15=2 OR 4, SKIP TO QUESTION PPR20INTRO (SKIP TO NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 PP19b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 VOC BADGES. IF PPR15=3 PLEASE DUPLICATE THE STEPS FOR PPR15 THROUGH PPR19 AND ADD QUESTION PPR19b FOR RETRIEVING THE SECOND VOC BADGE.
PPR16. [IF PPR15=1 OR 3 OR 5 OR 6 OR 7] SCAN THE BARCODE ON PERSONAL VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: PERSONAL VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP16a and PP17e. IF SCANNED/KEYED BARCODE ON PERSONAL VOC BADGE MATCHES EXPECTED BARCODE, GO TO PPR17. IF SCANNED BARCODE ON PERSONAL VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A PERSONAL VOC BADGE AS SET IN THE SYSTEM), GO TO PPR16a.
PPR16a. ARE YOU SURE YOU SCANNED/KEYED THE PERSONAL (RED DOTTED) VOC BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF PPR16a=NO, LOOP BACK TO PPR15. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
PPR17. WHAT IS THE CONDITION OF THE PERSONAL VOC BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 TORN MEMBRANE
3 CLIP BROKEN/NOT PRESENT
4 MINOR SCRATCH TO BADGE
5 MAJOR CRACK TO BADGE
6 OTHER
PPR17a [IF PPR17=OTHER] PLEASE DESCRIBE THE CONDITION OF THE PERSONAL VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
PPR18. PLACE THE PERSONAL VOC BADGE BACK IN THE CAN LABELED WITH A RED DOT.
PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
PPR19. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE PERSONAL VOC BADGE?
YES
NO
PPR19a [IF PPR19=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE PERSONAL VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
PPR19b. [IF PRELOADED FROM BASELINE SESSION 1 PP19b=YES AND PPR15=3 OR 6] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
PPR19c [IF PPR19b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
PERSONAL NO2 BADGE
PPR20INTRO. [IF PRELOADED FROM BASELINE SESSION 1 PP23b=YES, IF PP23b=NO SKIP TO PPR20] YOU WILL RETRIEVE 2 NO2 BADGES FROM THE PERSONAL PLATFORM STRAP.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
PPR20. [IF PRELOADED FROM BASELINE SESSION 1 PP23=YES OR PP23b=YES, IF PP23=NO OR PP23b=NO SKIP TO PPR25] IS THE PERSONAL NO2 (NX) BADGE ON THE STRAP, OR IS IT MISSING? IF ON STRAP, REMOVE THE NO2 BADGE FROM THE STRAP.
[IF PRELOADED FROM BASELINE SESSION 1 PP23b=NO, IF PP23b=YES LEAVE BLANK] YES, THE PERSONAL NO2 BADGE IS ON THE STRAP
[IF PRELOADED FROM BASELINE SESSION 1 PP23b=NO, IF PP23b=YES LEAVE BLANK] NO, THE PERSONAL NO2 BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 PP23b=YES, IF PP23b=NO LEAVE BLANK] YES, THE 2 EXPECTED PERSONAL NO2 BADGES ARE ON THE STRAP
[IF PRELOADED FROM BASELINE SESSION 1 PP23b=YES, IF PP23b=NO LEAVE BLANK] NO, THE 2 EXPECTED PERSONAL NO2 BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 PP23b=YES, IF PP23b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED PERSONAL NO2 BADGES IS MISSING
[DISPLAY IF PR5d=3 AND PRELOADED FROM BASELINE SESSION 1 PP23b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE PERSONAL NO2 BADGE
[DISPLAY IF PR5d=3 AND PRELOADED FROM BASELINE SESSION 1 PP23b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING PERSONAL NO2 BADGE
PROGRAMMER: IF PPR20=2 OR 4, SKIP TO QUESTION PPR25 (SKIP TO NEXT PLATFORM)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 PP23b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 NO2 BADGES. IF PPR20=3 PLEASE DUPLICATE THE STEPS FOR PPR20 THROUGH PPR24 AND ADD QUESTION PPR24b FOR RETRIEVING THE SECOND NO2 BADGE.
PPR21. [IF PPR20=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON PERSONAL NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: PERSONAL NO2 BADGE ID SHOULD BE 6 CHARACTERS: NX####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 PP20a and PP21e. IF SCANNED/KEYED BARCODE ON PERSONAL NO2 BADGE MATCHES EXPECTED BARCODE, GO TO PPR22. IF SCANNED BARCODE ON PERSONAL NO2 BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A PERSONAL NO2 BADGE AS SET IN THE SYSTEM), GO TO PPR21a.
PPR21a. ARE YOU SURE YOU SCANNED/KEYED THE PERSONAL (RED DOTTED) NO2 BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF PPR21a=NO, LOOP BACK TO PPR20. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
PPR22. WHAT IS THE CONDITION OF THE PERSONAL NO2 BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 CLIP BROKEN/NOT PRESENT
3 MINOR SCRATCH TO BADGE
4 MAJOR CRACK TO CASE
5 OTHER
PPR22a [IF PPR22=OTHER] PLEASE DESCRIBE THE CONDITION OF THE PERSONAL NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
PPR23. PLACE THE NO2 BADGE BACK IN THE JAR LABELED WITH A RED DOT.
PLACE LID BACK ON THE JAR AND PUT THE JAR BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
PPR24. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE PERSONAL NO2 BADGE?
YES
NO
PPR24a [IF PPR24=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE PERSONAL NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
PPR24b. [IF PRELOADED FROM BASELINE SESSION 1 PP23b=YES AND PPR20=3 OR 6] HAS THE SECOND NO2 BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
PPR24c [IF PPR24b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
PERSONAL FREESTANDING HOBO RETRIEVAL
PPR25. [IF PRELOADED FROM BASELINE VISIT SESSION 1 HBINTRO10=YES, IF HBINTRO10=NO, SKIP TO IPRINTRO] DID YOU RETRIEVE THE PERSONAL FREESTANDING HOBO (TR) FROM THE HOME, OR IS IT MISSING?
YES, THE PERSONAL FREESTANDING HOBO WAS RETRIEVED FROM THE HOME
NO, THE PERSONAL FREESTANDING HOBO IS MISSING
[DISPLAY IF PR9=3, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING FREESTANDING HOBO
PROGRAMMER: IF PPR25=2, SKIP TO QUESTION IPRINTRO (SKIP TO NEXT SAMPLER)
PPR26. SCAN BARCODE ON PERSONAL FREESTANDING HOBO. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
PERSONAL FREESTANDING HOBO ID NUMBER: ____________[ALLOW 6 CHARACTERS - TR AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: PERSONAL FREESTANDING HOBO ID SHOULD BE 6 CHARACTERS: TR####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 HBINTRO5. IF SCANNED/KEYED BARCODE ON PERSONAL FREESTANDING HOBO MATCHES EXPECTED BARCODE, GO TO PPR27. IF SCANNED BARCODE ON PERSONAL FREESTANDING HOBO IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A PERSONAL FREESTANDING HOBO UNIT AS SET IN THE SYSTEM), GO TO PPR26a.
PPR26a. ARE YOU SURE YOU SCANNED/KEYED THE PERSONAL (RED DOTTED) FREESTANDING HOBO? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A MICROPEM OR SAMPLER
YES
NO
PROGRAMMER: IF PPR26a=NO, LOOP BACK TO PPR25.
PPR27. WHAT IS THE CONDITION OF THE PERSONAL FREESTANDING HOBO? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 LIGHT IS NOT BLINKING
3 LIGHT IS BLINKING TOO FAST
4 MAJOR CRACK TO CASE
5 OTHER
PPR27a [IF PPR27=OTHER] PLEASE DESCRIBE THE CONDITION OF THE PERSONAL FREESTANDING HOBO
___________________ [ALLOW 100 CHARACTERS]
PPR28. PLACE THE PERSONAL FREESTANDING HOBO BACK IN THE PARTICIPANT BOX IN THE SPOT LABELED WITH A RED DOT.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
PPR29. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE PERSONAL FREESTANDING HOBO?
YES
NO
PPR29a [IF PPR29=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE PERSONAL FREESTANDING HOBO
___________________ [ALLOW 100 CHARACTERS]
INDOOR PLATFORM RETRIEVAL
IPRINTRO. [IF PRELOADED FROM BASELINE VISIT SESSION 1 IP34=YES, IF IP34=NO SKIP TO OPRINTRO] THE FOLLOWING SCREENS WILL INSTRUCT YOU ON HOW TO RETRIEVE AND PACKAGE THE INDOOR PLATFORM
PRESS 1 TO CONTINUE
IPR1. FOR INDOOR PLATFORM RETRIEVAL AND PACKAGING, REMOVE FROM THE PARTICIPANT BOX THE FOLLOWING CONTAINERS LABELED WITH A YELLOW DOT:
INDOOR ALDEHYDE BADGE POUCH
INDOOR VOC BADGE CAN
INDOOR NO2 BADGE JAR
INDOOR H2S BADGE VIAL
INDOOR CATS TUBE TEST TUBE
PRESS 1 TO CONTINUE
IPR2. SCAN BARCODE ID ON INDOOR PLATFORM CAGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR PLATFORM CAGE ID NUMBER: ____________[ALLOW 6 CHARACTERS – IP AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR PLATFORM CAGE ID SHOULD BE 6 CHARACTERS: IP####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED
INDOOR MICROPEM
IPR3. [IF PRELOADED FROM BASELINE SESSION 1 IP6=YES, IF IP6=NO, SKIP TO IPR8INTRO] IS THE INDOOR MICROPEM IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE MICROPEM FROM THE CAGE.
YES, THE INDOOR MICROPEM IS IN THE INDOOR CAGE
NO, THE INDOOR MICROPEM IS MISSING
[DISPLAY IF PR7a=3, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR MICROPEM
PROGRAMMER: IF IPR3=2, SKIP TO QUESTION IPR8INTRO (SKIP TO NEXT SAMPLER)
IPR4. SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE INDOOR MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR MICROPEM ID NUMBER: ____________[ ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]
PROGRAMMER: INDOOR MICROPEM ID SHOULD BE 10 CHARACTERS: UCC32#### AND 1 LETTER. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP3. IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE, GO TO IPR4b. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR MICROPEM UNIT AS SET IN THE SYSTEM), GO TO IPR4a.
IPR4a. ARE YOU SURE YOU SCANNED/KEYED THE SERIAL ID ON THE INDOOR (YELLOW DOTTED) MICROPEM? OUR RECORDS SHOW YOU HAVE SCANNED
[CHECK ID AGAINST FILTER ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP3c, IF A MATCH DISPLAY “THE INDOOR MICROPEM FILTER DEPLOYED DURING SESSION 1. PLEASE SCAN THE INDOOR MICROPEM UNIT WITH A BARCODE STARTING WITH UCC”, IF NO MATCH DISPLAY “SOMETHING OTHER THAN THE INDOOR MICROPEM DEPLOYED DURING SESSION 1”]
YES
NO
PROGRAMMER: IF IPR4a=NO, LOOP BACK TO IPR3. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR4b. SCAN BARCODE ON THE INDOOR MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR MICROPEM FILTER ID NUMBER: ____________[ALLOW 6 CHARACTERS – UP AND 4 NUMBERS]
PROGRAMMER: INDOOR MICROPEM FILTER ID SHOULD BE 6 CHARACTERS: UP####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP3d. IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE, GO TO IPR5. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR MICROPEM UNIT AS SET IN THE SYSTEM), GO TO IPR4c.
IPR4c. ARE YOU SURE YOU SCANNED/KEYED THE ID ON AN INDOOR (YELLOW DOTTED) MICROPEM FILTER? OUR RECORDS SHOW YOU HAVE SCANNED
[CHECK ID AGAINST UNIT ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP3 IF A MATCH DISPLAY “THE INDOOR MICROPEM UNIT DEPLOYED DURING SESSION 1. PLEASE SCAN THE INDOOR MICROPEM FILTER WITH A BARCODE STARTING WITH UP”, IF NO MATCH DISPLAY “SOMETHING OTHER THAN THE INDOOR MICROPEM DEPLOYED DURING SESSION 1”]
YES
NO
PROGRAMMER: IF IPR4c =NO, LOOP BACK TO IPR4b. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR5. WHAT IS THE CONDITION OF THE INDOOR MICROPEM? SELECT ALL THAT APPLY
1 MICROPEM STILL OPERATING
2 LIGHT ON MICROPEM IS NOT BLINKING
3 CANNOT HEAR HUMMING SOUND COMING FROM MICROPEM
4 CRACKS TO THE MICROPEM CASE
5 OTHER
IPR5a [IF IPR5=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR MICROPEM
___________________ [ALLOW 100 CHARACTERS]
IPR5b. [IF IPR5=1] PUT THE CAP ON THE MICROPEM FOR 1 MINUTE. AFTER 1 MINUTE, TURN OFF MICROPEM
PRESS 1 TO CONTINUE
IPR6. PLACE THE INDOOR MICROPEM BACK IN THE PARTICIPANT BOX IN THE SPOT LABELED WITH A YELLOW DOT
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR7. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR MICROPEM?
YES
NO
IPR7a [IF IPR7=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR MICROPEM
___________________ [ALLOW 100 CHARACTERS]
INDOOR ALDEHYDE BADGE
IPR8INTRO [IF PRELOADED FROM BASELINE SESSION 1 IP10b=YES, IF IP10b=NO, SKIP TO IPR8] YOU WILL RETRIEVE 2 ALDEHYDE BADGES FROM THE INDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
IPR8. [IF PRELOADED FROM BASELINE SESSION 1 IP10=YES OR IP10b=YES, IF IP10=NO OR IP10b=NO SKIP TO IPR13INTRO] IS THE INDOOR ALDEHYDE (AL) BADGE IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE ALDEHYDE BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 IP10b=NO, IF IP10b=YES LEAVE BLANK] YES, THE INDOOR ALDEHYDE BADGE IS IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP10b=NO, IF IP10b=YES LEAVE BLANK] NO, THE INDOOR ALDEHYDE BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP10b=YES, IF IP10b=NO LEAVE BLANK] YES, THE 2 EXPECTED INDOOR ALDEHYDE BADGES ARE IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP10b=YES, IF IP10b=NO LEAVE BLANK] NO, THE 2 EXPECTED INDOOR ALDEHYDE BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP10b=YES, IF IP10b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED INDOOR ALDEHYDE BADGES IS MISSING
[DISPLAY IF PR7B=3 AND PRELOADED FROM BASELINE SESSION 1 IP10b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE INDOOR ALDEHYDE BADGE
[DISPLAY IF PR7B=3 AND PRELOADED FROM BASELINE SESSION 1 IP10b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR ALDEHYDE BADGE
PROGRAMMER: IF IPR8=2 OR 4, SKIP TO QUESTION IPR13INTRO (SKIP TO NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 IP10b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 ALDEHYDE BADGES. IF IPR8=3 PLEASE DUPLICATE THE STEPS FOR IPR8 THROUGH IPR12 AND ADD QUESTION IPR12b FOR RETRIEVING THE SECOND ALDEHYDE BADGE.
IPR9. [IF IPR8=1 OR 3 OR 5 OR 6 OR 7]SCAN BARCODE ON INDOOR ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP7a and IP8e. IF SCANNED/KEYED BARCODE ON INDOOR ALDEHYDE BADGE MATCHES EXPECTED BARCODE, GO TO IPR10. IF SCANNED BARCODE ON INDOOR ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR ALDEHYDE BADGE AS SET IN THE SYSTEM), GO TO IPR9a.
IPR9a. ARE YOU SURE YOU SCANNED/KEYED THE INDOOR (YELLOW DOTTED) ALDEHYDE BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF IPR9a=NO, LOOP BACK TO IPR8. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR10. WHAT IS THE CONDITION OF THE INDOOR ALDEHYDE BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 GREEN SLIDE CLOSED (UP) ALREADY
3 GREEN SLIDE MISSING
4 CLIP BROKEN/NOT PRESENT
5 MINOR SCRATCH TO BADGE
6 MAJOR CRACK TO BADGE
7 OTHER
IPR10a [IF IPR10=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR10b. [IF IPR10=1, 4, 5, 6, OR 7] SLIDE THE GREEN COVER UP TO CLOSE THE INDOOR ALDEHYDE BADGE
PRESS 1 TO CONTINUE
IPR11. PLACE THE INDOOR ALDEHYDE BADGE BACK IN THE POUCH LABELED WITH A YELLOW DOT
RESEAL THE POUCH AND PLACE THE POUCH BACK IN THE PARTICIPANT BOX
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR12. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR ALDEHYDE BADGE?
YES
NO
IPR12a [IF IPR12=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR12b. [IF PRELOADED FROM BASELINE SESSION 1 IP10b=YES AND IPR8=3 OR 6] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
IPR12c [IF IPR12b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
INDOOR VOC BADGE
IPR13INTRO. IF PRELOADED FROM BASELINE SESSION 1 IP14b=YES, IF IP14b=NO SKIP TO IPR13] YOU WILL RETRIEVE 2 VOC BADGES FROM THE INDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
IPR13. [IF PRELOADED FROM BASELINE SESSION 1 IP14=YES OR IP14b=YES, IF IP14=NO OR IP14b=NO SKIP TO IPR18INTRO] IS THE INDOOR VOC (VC) BADGE IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE VOC BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 IP14b=NO, IF IP14b=YES LEAVE BLANK] YES, THE INDOOR VOC BADGE IS IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP14b=NO, IF IP14b=YES LEAVE BLANK] NO, THE INDOOR VOC BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP14b=YES, IF IP14b=NO LEAVE BLANK] YES, THE 2 EXPECTED INDOOR VOC BADGES ARE IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP14b=YES, IF IP14b=NO LEAVE BLANK] NO, THE 2 EXPECTED INDOOR VOC BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP14b=YES, IF IP14b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED INDOOR VOC BADGES IS MISSING
[DISPLAY IF PR7C=3 AND PRELOADED FROM BASELINE SESSION 1 IP14b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE INDOOR VOC BADGE
[DISPLAY IF PR7C=3 AND PRELOADED FROM BASELINE SESSION 1 IP14b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR VOC BADGE
PROGRAMMER: IF IPR13=2 OR 4, SKIP TO QUESTION IPR18INTRO (SKIP TO NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 1P14b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 VOC BADGES. IF IPR13=3 PLEASE DUPLICATE THE STEPS FOR IPR13 THROUGH IPR17 AND ADD QUESTION IPR17b FOR RETRIEVING THE SECOND VOC BADGE.
IPR14. [IF IPR13=1 OR 3 OR 5 OR 6 OR 7] SCAN THE BARCODE ON INDOOR VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP11a and IP12e. IF SCANNED/KEYED BARCODE ON INDOOR VOC BADGE MATCHES EXPECTED BARCODE, GO TO IPR15. IF SCANNED BARCODE ON INDOOR VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR VOC BADGE AS SET IN THE SYSTEM), GO TO IPR14a.
IPR14a. ARE YOU SURE YOU SCANNED/KEYED THE INDOOR (YELLOW DOTTED) VOC BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF IPR14a=NO, LOOP BACK TO IP13. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR15. WHAT IS THE CONDITION OF THE INDOOR VOC BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 TORN MEMBRANE
3 CLIP BROKEN/NOT PRESENT
4 MINOR SCRATCH TO BADGE
5 MAJOR CRACK TO BADGE
6 OTHER
IPR15a [IF IPR15=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR16. PLACE THE INDOOR VOC BADGE BACK IN THE CAN LABELED WITH A YELLOW DOT.
PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR17. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR VOC BADGE?
YES
NO
IPR17a [IF IPR17=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR17b. [IF PRELOADED FROM BASELINE SESSION 1 IP14b=YES AND IPR13=3 OR 6] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
IPR17c [IF IPR17b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
INDOOR NO2 BADGE
IPR18INTRO. [IF PRELOADED FROM BASELINE SESSION 1 IP18b=YES] YOU WILL RETRIEVE 2 NO2 BADGES FROM THE INDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
IPR18. [IF PRELOADED FROM BASELINE SESSION 1 IP18=YES OR IP18b=YES, IF IP18=NO OR IP18b=NO SKIP TO IPR23INTRO] IS THE INDOOR NO2 (NX) BADGE IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE NO2 BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 IP18b=NO, IF IP18b=YES LEAVE BLANK] YES, THE INDOOR NO2 BADGE IS IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP18b=NO, IF IP18b=YES LEAVE BLANK] NO, THE INDOOR NO2 BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP18b=YES, IF IP18b=NO LEAVE BLANK] YES, THE 2 EXPECTED INDOOR NO2 BADGES ARE IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP18b=YES, IF IP18b=NO LEAVE BLANK] NO, THE 2 EXPECTED INDOOR NO2 BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP18b=YES, IF IP18b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED INDOOR NO2 BADGES IS MISSING
[DISPLAY IF PR7D=3 AND PRELOADED FROM BASELINE SESSION 1 IP18b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE INDOOR NO2 BADGE
[DISPLAY IF PR7D=3 AND PRELOADED FROM BASELINE SESSION 1 IP18b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR NO2 BADGE
PROGRAMMER: IF IPR18=2 OR 4, SKIP TO QUESTION IPR23INTRO (NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 IP18b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 NO2 BADGES. IF IPR18=3 PLEASE DUPLICATE THE STEPS FOR IPR18 THROUGH IPR22 AND ADD QUESTION IPR22b FOR RETRIEVING THE SECOND NO2 BADGE.
IPR19. [IF IPR18=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON INDOOR NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR NO2 BADGE ID SHOULD BE 6 CHARACTERS: NX####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP15a and IP16e. IF SCANNED/KEYED BARCODE ON INDOOR NO2 BADGE MATCHES EXPECTED BARCODE, GO TO IPR20. IF SCANNED BARCODE ON INDOOR NO2 BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR NO2 BADGE AS SET IN THE SYSTEM), GO TO IPR19a.
IPR19a. ARE YOU SURE YOU SCANNED/KEYED THE INDOOR (YELLOW DOTTED) NO2 BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF IPR19a=NO, LOOP BACK TO IPR18. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR20. WHAT IS THE CONDITION OF THE INDOOR NO2 BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 CLIP BROKEN/NOT PRESENT
3 MINOR SCRATCH TO BADGE
4 MAJOR CRACK TO CASE
5 OTHER
IPR20a [IF IPR20=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR21. PLACE THE INDOOR NO2 BADGE BACK IN THE JAR LABELED WITH A YELLOW DOT.
PLACE LID BACK ON THE JAR AND PUT THE JAR BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR22. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR NO2 BADGE?
YES
NO
IPR22a [IF IPR22=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR22b. [IF PRELOADED FROM BASELINE SESSION 1 IP18b=YES AND IPR18=3 OR 6] HAS THE SECOND NO2 BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
IPR22c [IF IPR22b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
INDOOR H2S BADGE
IPR23INTRO. [IF PRELOADED FROM BASELINE SESSION 1 IP22b=YES, IF IP22b=NO, SKIP TO IPR23] YOU WILL RETRIEVE 2 H2S BADGES FROM THE INDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
IPR23. [IF PRELOADED FROM BASELINE SESSION 1 IP22=YES OR IP22b=YES, IF IP22=NO OR IP22b=NO SKIP TO IPR28INTRO] IS THE INDOOR H2S (HS) BADGE IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE H2S BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 IP22b=NO, IF IP22b=YES LEAVE BLANK] YES, THE INDOOR H2S BADGE IS IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP22b=NO, IF IP22b=YES LEAVE BLANK] NO, THE INDOOR H2S BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP22b=YES, IF IP22b=NO LEAVE BLANK] YES, THE 2 EXPECTED INDOOR H2S BADGES ARE IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP22b=YES, IF IP22b=NO LEAVE BLANK] NO, THE 2 EXPECTED INDOOR H2S BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP22b=YES, IF IP22b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED INDOOR H2S BADGES IS MISSING
[DISPLAY IF PR7E=3 AND PRELOADED FROM BASELINE SESSION 1 IP22b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE INDOOR H2S BADGE
[DISPLAY IF PR7E=3 AND PRELOADED FROM BASELINE SESSION 1 IP22b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR H2S BADGE
PROGRAMMER: IF IPR23=2 OR 4, SKIP TO QUESTION IPR28INTRO (NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 IP22b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 H2S BADGES. IF IPR23=3 PLEASE DUPLICATE THE STEPS FOR IPR23 THROUGH IPR27 AND ADD QUESTION IPR27b FOR RETRIEVING THE SECOND H2S BADGE.
IPR24. [IF IPR23=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON INDOOR H2S BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR H2S BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - HS AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR NO2 BADGE ID SHOULD BE 6 CHARACTERS: HS####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP19a and IP20e. IF SCANNED/KEYED BARCODE ON INDOOR H2S BADGE MATCHES EXPECTED BARCODE, GO TO IPR25. IF SCANNED BARCODE ON INDOOR H2S BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR H2S BADGE AS SET IN THE SYSTEM), GO TO IPR24a.
IPR24a. ARE YOU SURE YOU SCANNED/KEYED THE INDOOR (YELLOW DOTTED) H2S BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF IPR24a=NO, LOOP BACK TO IPR23. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR25. WHAT IS THE CONDITION OF THE INDOOR H2S BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 VIAL IS OPEN
3 MINOR SCRATCH TO BADGE
4 MAJOR CRACK TO BADGE
5 OTHER
IPR25a [IF IPR25=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR H2S BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR26. REMOVE THE H2S TUBE FROM THE TRIANGLE PLATE IN THE INDOOR CAGE
PLACE THE TUBE BACK IN THE VIAL LABELED WITH A YELLOW DOT, RECAP THE VIAL, AND PUT THE VIAL BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR27. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR H2S BADGE?
YES
NO
IPR27a [IF IPR27=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR H2S BADGE
___________________ [ALLOW 100 CHARACTERS]
IPR27b. [IF PRELOADED FROM BASELINE SESSION 1 IP22b=YES AND IPR23=3 OR 6] HAS THE SECOND H2S BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
IPR27c [IF IPR27b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
INDOOR CATS TUBE
IPR28INTRO. [IF PRELOADED FROM BASELINE SESSION 1 IP26b=YES, IF IP26b=NO, SKIP TO IPR28] YOU WILL RETRIEVE 2 CATS TUBES FROM THE INDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH TUBES. YOU WILL RETRIEVE EACH TUBE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
IPR28. [IF PRELOADED FROM BASELINE SESSION 1 IP26=YES OR IP26b=YES, IF IP26=NO OR IP26b=NO SKIP TO IPR33] IS THE INDOOR CATS (PF) TUBE IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE CATS TUBE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 IP26b=NO, IF IP26b=YES LEAVE BLANK] YES, THE INDOOR CATS TUBE IS IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP26b=NO, IF IP26b=YES LEAVE BLANK] NO, THE INDOOR CATS TUBE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP26b=YES, IF IP26b=NO LEAVE BLANK] YES, THE 2 EXPECTED INDOOR CATS TUBES ARE IN THE INDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 IP26b=YES, IF IP26b=NO LEAVE BLANK] NO, THE 2 EXPECTED INDOOR CATS TUBES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 IP26b=YES, IF IP26b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED INDOOR CATS TUBES IS MISSING
[DISPLAY IF PR7F=3 AND PRELOADED FROM BASELINE SESSION 1 IP26b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE INDOOR CATS TUBE
[DISPLAY IF PR7F=3 AND PRELOADED FROM BASELINE SESSION 1 IP26b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR CATS TUBE
PROGRAMMER: IF IPR28=2 OR 4, SKIP TO QUESTION IPR33 (NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 IP26b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 CATS TUBES. IF IPR28=3 PLEASE DUPLICATE THE STEPS FOR IPR28 THROUGH IPR32 AND ADD QUESTION IPR32b FOR RETRIEVING THE SECOND CATS TUBE.
IPR29. [IF IPR28=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON INDOOR CATS TUBE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR CATS TUBE ID NUMBER: ____________[ALLOW 6 CHARACTERS - PF AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR CATS TUBE ID SHOULD BE 6 CHARACTERS: PF####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP23a. IF SCANNED/KEYED BARCODE ON INDOOR CATS TUBE MATCHES EXPECTED BARCODE, GO TO IPR30. IF SCANNED BARCODE ON INDOOR CATS TUBE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR CATS TUBE AS SET IN THE SYSTEM), GO TO IPR29a.
IPR29a. ARE YOU SURE YOU SCANNED/KEYED THE INDOOR (YELLOW DOTTED) CATS TUBE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF IPR29a=NO, LOOP BACK TO IPR28. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR30. WHAT IS THE CONDITION OF THE INDOOR CATS TUBE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 RUBBER STOPPER IS MISSING FROM BOTH ENDS
3 GLASS TUBE IS BROKEN
4 OTHER
IPR30a [IF IPR30=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR CATS TUBE
___________________ [ALLOW 100 CHARACTERS]
IPR31. REMOVE THE CATS TUBE FROM THE INDOOR CAGE
REMOVE RUBBER STOPPER FROM INSIDE CATS SHIPPING TUBE. ATTACH RUBBER STOPPER TO END OF CATS TUBE THAT CONTAINS PRINTED NUMBERS.
PLACE THE CATS TUBE BACK IN THE SHIPPING TUBE LABELED WITH A YELLOW DOT, RECAP THE SHIPPING TUBE, AND PLACE BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR32. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR CATS TUBE?
YES
NO
IPR32a [IF IPR32=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR CATS TUBE
___________________ [ALLOW 100 CHARACTERS]
IPR32b. [IF PRELOADED FROM BASELINE SESSION 1 IP26b=YES AND IPR28=3 OR 6] HAS THE SECOND CATS TUBE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
IPR32c [IF IPR32b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND CATS TUBE
___________________ [ALLOW 100 CHARACTERS]
INDOOR HOBO
IPR33. [IF PRELOADED FROM BASELINE VISIT SESSION 1 IP30=YES, IF IP30=NO, SKIP TO OPRINTRO] IS THE INDOOR HOBO (TR) IN THE INDOOR CAGE, OR IS IT MISSING? IF IN THE INDOOR CAGE, REMOVE THE HOBO FROM THE CAGE.
YES, THE INDOOR HOBO IS IN THE INDOOR CAGE
NO, THE INDOOR HOBO IS MISSING
[DISPLAY IF PR7g=3, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING INDOOR HOBO
PROGRAMMER: IF IPR33=2, SKIP TO QUESTION OPRINTRO (NEXT PLATFORM)
IPR34. SCAN BARCODE ON INDOOR HOBO. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
INDOOR HOBO ID NUMBER: ____________[ALLOW 6 CHARACTERS - TR AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: INDOOR HOBO ID SHOULD BE 6 CHARACTERS: TR####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 IP27. IF SCANNED/KEYED BARCODE ON INDOOR HOBO MATCHES EXPECTED BARCODE, GO TO IPR35. IF SCANNED BARCODE ON INDOOR HOBO IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN INDOOR HOBO UNIT AS SET IN THE SYSTEM), GO TO IPR34a.
IPR34a. ARE YOU SURE YOU SCANNED/KEYED THE INDOOR (YELLOW DOTTED) HOBO? OUR RECORDS SHOW YOU HAVE SCANNED SOME OTHER SAMPLER
YES
NO
PROGRAMMER: IF IPR34a=NO, LOOP BACK TO IPR33. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
IPR35. WHAT IS THE CONDITION OF THE INDOOR HOBO? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 LIGHT IS NOT BLINKING
3 LIGHT IS BLINKING TOO FAST
4 MAJOR CRACK TO CASE
4 OTHER
IPR35a [IF IPR35=OTHER] PLEASE DESCRIBE THE CONDITION OF THE INDOOR HOBO
___________________ [ALLOW 100 CHARACTERS]
IPR36. REMOVE THE INDOOR HOBO FROM THE METAL PLATE IN INDOOR CAGE
PLACE THE INDOOR HOBO BACK IN THE PARTICIPANT BOX IN THE SPOT LABELED WITH A YELLOW DOT.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
IPR37. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE INDOOR HOBO?
YES
NO
IPR37a [IF IPR37=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE INDOOR HOBO
___________________ [ALLOW 100 CHARACTERS]
OUTDOOR PLATFORM RETRIEVAL
OPRINTRO. [IF PRELOADED FROM BASELINE VISIT SESSION 1 OP23=YES, IF OP23=NO SKIP TO PFTR1] THE FOLLOWING SCREENS WILL INSTRUCT YOU ON HOW TO RETRIEVE AND PACKAGE THE OUTDOOR PLATFORM
PRESS 1 TO CONTINUE
OPR1. FOR OUTDOOR PLATFORM RETRIEVAL AND PACKAGING, REMOVE FROM THE PARTICIPANT BOX THE FOLLOWING CONTAINERS LABELED WITH A BLUE DOT:
OUTDOOR ALDEHYDE BADGE POUCH
OUTDOOR VOC BADGE CAN
OUTDOOR NO2 BADGE JAR
PRESS 1 TO CONTINUE
OPR2. PLEASE SCAN BARCODE ID ON OUTDOOR PLATFORM CAGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR PLATFORM CAGE ID NUMBER: ____________[ALLOW 6 CHARACTERS – OP AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: OUTDOOR PLATFORM CAGE ID SHOULD BE 6 CHARACTERS: OP####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED
OUTDOOR MICROPEM
OPR3. [IF PRELOADED FROM BASELINE SESSION 1 OP6=YES, IF OP6=NO, SKIP TO OPR8INTRO] IS THE OUTDOOR MICROPEM IN THE OUTDOOR CAGE, OR IS IT MISSING? IF IN THE OUTDOOR CAGE, REMOVE THE MICROPEM FROM THE CAGE.
YES, THE OUTDOOR MICROPEM IS IN THE OUTDOOR CAGE
NO, THE OUTDOOR MICROPEM IS MISSING
[DISPLAY IF PR11a=3, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING OUTDOOR MICROPEM
PROGRAMMER: IF OPR3=2, SKIP TO QUESTION OPR8INTRO (SKIP TO NEXT SAMPLER)
OPR4. SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE OUTDOOR MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR MICROPEM ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]
PRESS 1 TO CONTINUE
PROGRAMMER: OUTDOOR MICROPEM ID SHOULD BE 10 CHARACTERS: UCC32#### AND 1 LETTER. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP3. IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE, GO TO OPR4b. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN OUTDOOR MICROPEM UNIT AS SET IN THE SYSTEM), GO TO OPR4a.
OPR4a. ARE YOU SURE YOU SCANNED/KEYED THE SERIAL ID ON THE OUTDOOR (BLUE DOTTED) MICROPEM? OUR RECORDS SHOW YOU HAVE SCANNED
[CHECK ID AGAINST FILTER ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP3d, IF A MATCH DISPLAY “THE OUTDOOR MICROPEM FILTER DEPLOYED DURING SESSION 1. PLEASE SCAN THE OUTDOOR MICROPEM UNIT BARCODE STARTING WITH UCC”, IF NO MATCH DISPLAY “SOMETHING OTHER THAN THE OUTDOOR MICROPEM DEPLOYED DURING SESSION 1”]
YES
NO
PROGRAMMER: IF OPR4a=NO, LOOP BACK TO OPR3. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
OPR4b. SCAN BARCODE ON THE OUTDOOR MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR MICROPEM FILTER ID NUMBER: ____________[ALLOW 6 CHARACTERS – UP AND 4 NUMBERS]
PROGRAMMER: OUTDOOR MICROPEM FILTER ID SHOULD BE 6 CHARACTERS: UP####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP3d. IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE, GO TO OPR5. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN OUTDOOR MICROPEM UNIT AS SET IN THE SYSTEM), GO TO OPR4c.
OPR4c. ARE YOU SURE YOU SCANNED/KEYED THE ID ON AN OUTDOOR (BLUE DOTTED) MICROPEM FILTER? OUR RECORDS SHOW YOU HAVE SCANNED
[CHECK ID AGAINST UNIT ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP3 IF A MATCH DISPLAY “THE OUTDOOR MICROPEM UNIT DEPLOYED DURING SESSION 1. PLEASE SCAN THE OUTDOOR MICROPEM FILTER BARCODE STARTING WITH UP”, IF NO MATCH DISPLAY “SOMETHING OTHER THAN THE OUTDOOR MICROPEM DEPLOYED DURING SESSION 1”]
YES
NO
PROGRAMMER: IF IPR4c =NO, LOOP BACK TO IPR4b. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
OPR5. WHAT IS THE CONDITION OF THE OUTDOOR MICROPEM? SELECT ALL THAT APPLY
1 MICROPEM STILL OPERATING
2 LIGHT ON MICROPEM IS NOT BLINKING
3 CANNOT HEAR HUMMING SOUND COMING FROM MICROPEM
4 CRACKS TO THE MICROPEM CASE
5 OTHER
OPR5a [IF OPR5=OTHER] PLEASE DESCRIBE THE CONDITION OF THE OUTDOOR MICROPEM
___________________ [ALLOW 100 CHARACTERS]
OPR5b. [IF OPR5=1] PUT THE CAP ON THE MICROPEM FOR 1 MINUTE. AFTER 1 MINUTE, TURN OFF MICROPEM
PRESS 1 TO CONTINUE
OPR6. PLACE THE OUTDOOR MICROPEM BACK IN THE PARTICIPANT BOX IN THE SPOT LABELED WITH A BLUE DOT
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
OPR7. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE OUTDOOR MICROPEM?
YES
NO
OPR7a [IF OPR7=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE OUTDOOR MICROPEM
___________________ [ALLOW 100 CHARACTERS]
OUTDOOR ALDEHYDE BADGE
OPR8INTRO. [IF PRELOADED FROM BASELINE SESSION 1 OP10b=YES, IF OP10b=NO, SKIP TO OPR8] YOU WILL RETRIEVE 2 ALDEHYDE BADGES FROM THE OUTDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
OPR8. [IF PRELOADED FROM BASELINE SESSION 1 OP10=YES OR OP10b=YES, IF OP10=NO OR IP10b=NO SKIP TO OPR13INTRO] IS THE OUTDOOR ALDEHYDE (AL) BADGE IN THE OUTDOOR CAGE, OR IS IT MISSING? IF IN THE OUTDOOR CAGE, REMOVE THE ALDEHYDE BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 OP10b=NO, IF OP10b=YES LEAVE BLANK] YES, THE OUTDOOR ALDEHYDE BADGE IS IN THE OUTDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 OP10b=NO, IF OP10b=YES LEAVE BLANK] NO, THE OUTDOOR ALDEHYDE BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 OP10b=YES, IF OP10b=NO LEAVE BLANK] YES, THE 2 EXPECTED OUTDOOR ALDEHYDE BADGES ARE IN THE OUTDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 OP10b=YES, IF OP10b=NO LEAVE BLANK] NO, THE 2 EXPECTED OUTDOOR ALDEHYDE BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 OP10b=YES, IF OP10b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED OUTDOOR ALDEHYDE BADGES IS MISSING
[DISPLAY IF PR11B=3 AND PRELOADED FROM BASELINE SESSION 1 OP10b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE OUTDOOR ALDEHYDE BADGE
[DISPLAY IF PR11B=3 AND PRELOADED FROM BASELINE SESSION 1 OP10b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING OUTDOOR ALDEHYDE BADGE
PROGRAMMER: IF OPR8=2 OR 4, SKIP TO QUESTION OPR13INTRO (SKIP TO NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 OP10b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 ALDEHYDE BADGES. IF OPR8=3 PLEASE DUPLICATE THE STEPS FOR OPR8 THROUGH OPR12 AND ADD QUESTION OPR12b FOR RETRIEVING THE SECOND ALDEHYDE BADGE.
OPR9. [IF OPR8=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON OUTDOOR ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: OUTDOOR ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP7a and OP8e. IF SCANNED/KEYED BARCODE ON OUTDOOR ALDEHYDE BADGE MATCHES EXPECTED BARCODE, GO TO OPR10. IF SCANNED BARCODE ON OUTDOOR ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN OUTDOOR ALDEHYDE BADGE AS SET IN THE SYSTEM), GO TO OPR9a.
OPR9a. ARE YOU SURE YOU SCANNED/KEYED THE OUTDOOR (BLUE DOTTED) ALDEHYDE BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF OPR9a=NO, LOOP BACK TO OPR8. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
OPR10. WHAT IS THE CONDITION OF THE OUTDOOR ALDEHYDE BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 GREEN SLIDE CLOSED (UP) ALREADY
3 GREEN SLIDE MISSING
4 CLIP BROKEN/NOT PRESENT
5 MINOR SCRATCH TO BADGE
6 MAJOR CRACK TO BADGE
7 OTHER
OP10a [IF OPR10=OTHER] PLEASE DESCRIBE THE CONDITION OF THE OUTDOOR ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
OPR10b. [IF OPR10=1, 4, 5, 6, OR 7] SLIDE THE GREEN COVER UP TO CLOSE THE OUTDOOR ALDEHYDE BADGE
PRESS 1 TO CONTINUE
OPR11. PLACE THE OUTDOOR ALDEHYDE BADGE BACK IN THE POUCH LABELED WITH A BLUE DOT
RESEAL THE POUCH AND PLACE THE POUCH BACK IN THE PARTICIPANT BOX
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
OPR12. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE OUTDOOR ALDEHYDE BADGE?
YES
NO
OPR12a [IF OPR12=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE OUTDOOR ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
OPR12b. [IF PRELOADED FROM BASELINE SESSION 1 OP10b=YES AND OPR8=3 OR 6] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
OPR12c [IF OPR12b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND ALDEHYDE BADGE
___________________ [ALLOW 100 CHARACTERS]
OUTDOOR VOC BADGE
OPR13INTRO. IF PRELOADED FROM BASELINE SESSION 1 OP14b=YES, IF OP14b=NO SKIP TO OPR13] YOU WILL RETRIEVE 2 VOC BADGES FROM THE INDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
OPR13. [IF PRELOADED FROM BASELINE SESSION 1 OP14=YES OR OP14b=YES, IF OP14=NO OR OP14b=NO SKIP TO OPR18INTRO] IS THE OUTDOOR VOC (VC) BADGE IN THE OUTDOOR CAGE, OR IS IT MISSING? IF IN THE OUTDOOR CAGE, REMOVE THE VOC BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 OP14b=NO, IF OP14b=YES LEAVE BLANK] YES, THE OUTDOOR VOC BADGE IS IN THE OUTDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 OP14b=NO, IF OP14b=YES LEAVE BLANK] NO, THE OUTDOOR VOC BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 OP14b=YES, IF OP14b=NO LEAVE BLANK] YES, THE 2 EXPECTED OUTDOOR VOC BADGES ARE IN THE OUTDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 OP14b=YES, IF OP14b=NO LEAVE BLANK] NO, THE 2 EXPECTED OUTDOOR VOC BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 OP14b=YES, IF OP14b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED OUTDOOR VOC BADGES IS MISSING
[DISPLAY IF PR11c=3 AND PRELOADED FROM BASELINE SESSION 1 OP14b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE OUTDOOR VOC BADGE
[DISPLAY IF PR11c=3 AND PRELOADED FROM BASELINE SESSION 1 OP14b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING OUTDOOR VOC BADGE
PROGRAMMER: IF OPR13=2 OR 4, SKIP TO QUESTION OPR18INTRO (SKIP TO NEXT SAMPLER)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 OP14b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 VOC BADGES. IF OPR13=3 PLEASE DUPLICATE THE STEPS FOR OPR13 THROUGH OPR17 AND ADD QUESTION OPR17b FOR RETRIEVING THE SECOND VOC BADGE.
OPR14. [IF OPR13=1 OR 3 OR 5 OR 6 OR 7] SCAN THE BARCODE ON OUTDOOR VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: OUTDOOR VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP11a and OP12e. IF SCANNED/KEYED BARCODE ON OUTDOOR VOC BADGE MATCHES EXPECTED BARCODE, GO TO OPR15. IF SCANNED BARCODE ON OUTDOOR VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN OUTDOOR VOC BADGE AS SET IN THE SYSTEM), GO TO OPR14a.
OPR14a. ARE YOU SURE YOU SCANNED/KEYED THE OUTDOOR (BLUE DOTTED) VOC BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF OPR14a=NO, LOOP BACK TO OP13. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
OPR15. WHAT IS THE CONDITION OF THE OUTDOOR VOC BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 TORN MEMBRANE
3 CLIP BROKEN/NOT PRESENT
4 MINOR SCRATCH TO BADGE
5 MAJOR CRACK TO BADGE
6 OTHER
OPR15a [IF OPR15=OTHER] PLEASE DESCRIBE THE CONDITION OF THE OUTDOOR VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
OPR16. PLACE THE OUTDOOR VOC BADGE BACK IN THE CAN LABELED WITH A BLUE DOT.
PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
OPR17. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE OUTDOOR VOC BADGE?
YES
NO
OPR17a [IF OPR17=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE OUTDOOR VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
OPR17b. [IF PRELOADED FROM BASELINE SESSION 1 OP14b=YES AND OPR13=3 OR 6] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
OPR17c [IF OPR17b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND VOC BADGE
___________________ [ALLOW 100 CHARACTERS]
OUTDOOR NO2 BADGE
OPR18INTRO. [IF PRELOADED FROM BASELINE SESSION 1 OP18b=YES, IF OP18b=NO, SKIP TO OPR18] YOU WILL RETRIEVE 2 NO2 BADGES FROM THE OUTDOOR CAGE.
THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.
PRESS 1 TO CONTINUE
OPR18. [IF PRELOADED FROM BASELINE SESSION 1 OP18=YES OR OP18b=YES, IF OP18=NO OR OP18b=NO SKIP TO PFTR1] IS THE OUTDOOR NO2 (NX) BADGE IN THE OUTDOOR CAGE, OR IS IT MISSING? IF IN THE OUTDOOR CAGE, REMOVE THE NO2 BADGE FROM THE CAGE.
[IF PRELOADED FROM BASELINE SESSION 1 OP18b=NO, IF OP18b=YES LEAVE BLANK] YES, THE OUTDOOR NO2 BADGE IS IN THE OUTDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 OP18b=NO, IF OP18b=YES LEAVE BLANK] NO, THE OUTDOOR NO2 BADGE IS MISSING
[IF PRELOADED FROM BASELINE SESSION 1 OP18b=YES, IF OP18b=NO LEAVE BLANK] YES, THE 2 EXPECTED OUTDOOR NO2 BADGES ARE IN THE OUTDOOR CAGE
[IF PRELOADED FROM BASELINE SESSION 1 OP18b=YES, IF OP18b=NO LEAVE BLANK] NO, THE 2 EXPECTED OUTDOOR NO2 BADGES ARE MISSING
[IF PRELOADED FROM BASELINE SESSION 1 OP18b=YES, IF OP18b=NO LEAVE BLANK] NO, ONE OF THE 2 EXPECTED OUTDOOR NO2 BADGES IS MISSING
[DISPLAY IF PR11d=3 AND PRELOADED FROM BASELINE SESSION 1 OP18b=YES, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING DUPLICATE OUTDOOR NO2 BADGE
[DISPLAY IF PR11d=3 AND PRELOADED FROM BASELINE SESSION 1 OP18b=NO, OTHERWISE LEAVE BLANK] YOU HAVE RETRIEVED THE PREVIOUSLY MISSING OUTDOOR NO2 BADGE
PROGRAMMER: IF OPR18=2 OR 4, SKIP TO QUESTION PFTR1 (NEXT SECTION)
PROGRAMMER: IF PRELOADED FROM BASELINE SESSION 1 OP18b=YES, THIS INDICATES THE FI SHOULD RETRIEVE 2 NO2 BADGES. IF OPR18=3 PLEASE DUPLICATE THE STEPS FOR OPR18 THROUGH OPR22 AND ADD QUESTION OPR22b FOR RETRIEVING THE SECOND NO2 BADGE.
OPR19. [IF OPR18=1 OR 3 OR 5 OR 6 OR 7] SCAN BARCODE ON OUTDOOR NO2 BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.
OUTDOOR NO2 BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - NX AND 4 NUMBERS]
PRESS 1 TO CONTINUE
PROGRAMMER: OUTDOOR NO2 BADGE ID SHOULD BE 6 CHARACTERS: NX####. CHECK THE ENTERED ID AGAINST THE ID ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 OP15a and OP16e. IF SCANNED/KEYED BARCODE ON OUTDOOR NO2 BADGE MATCHES EXPECTED BARCODE, GO TO OPR20. IF SCANNED BARCODE ON OUTDOOR NO2 BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT AN OUTDOOR NO2 BADGE AS SET IN THE SYSTEM), GO TO OPR19a.
OPR19a. ARE YOU SURE YOU SCANNED/KEYED THE OUTDOOR (BLUE DOTTED) NO2 BADGE? OUR RECORDS SHOW YOU HAVE SCANNED SOMETHING ELSE, POSSIBLY A DIFFERENT SAMPLER
YES
NO
PROGRAMMER: IF OPR19a=NO, LOOP BACK TO OPR18. IF YES, RECORD THE KEYED/SCANNED ID IN THE SYSTEM FOR LATER REVIEW BY IN-HOUSE STAFF.
OPR20. WHAT IS THE CONDITION OF THE OUTDOOR NO2 BADGE? SELECT ALL THAT APPLY.
1 NO DAMAGE
2 CLIP BROKEN/NOT PRESENT
3 MINOR SCRATCH TO BADGE
4 MAJOR CRACK TO CASE
5 OTHER
OPR20a [IF OPR20=OTHER] PLEASE DESCRIBE THE CONDITION OF THE OUTDOOR NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
OPR21. PLACE THE OUTDOOR NO2 BADGE BACK IN THE JAR LABELED WITH A BLUE DOT.
PLACE LID BACK ON THE JAR AND PUT THE JAR BACK IN THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
OPR22. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE OUTDOOR NO2 BADGE?
YES
NO
OPR22a [IF OPR22=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE OUTDOOR NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
OPR22b. [IF PRELOADED FROM BASELINE SESSION 1 OP18b=YES AND OPR18=3 OR 6] HAS THE SECOND NO2 BADGE BEEN SUCCESSFULLY RETRIEVED?
YES
NO
OPR22c [IF OPR22b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND NO2 BADGE
___________________ [ALLOW 100 CHARACTERS]
PFT TUBES RETRIEVAL
PFTR1. [IF (PRELOADED FROM BASELINE VISIT SESSION 1 COAER23=(YES OR NO)). IF PRELOADED FROM BASELINE VISIT SESSION 1 COAER18aFINAL=NO AND COAER18bFINAL=NO AND COAER18cFINAL=NO AND COAER18dFINAL=NO) SKIP TO PR3] PLEASE PREPARE TO PACKAGE THE PFT TUBES YOU RETRIEVED FROM THE HOME.
IN TOTAL, HOW MANY PFT TUBES DID YOU RETRIEVE?
____________[MIN OF 0 AND MAX OF 6]
PFTR2. [DISPLAY IF PFTR1 DOES NOT EQUAL FIGURE ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 COAER18f, OTHERWISE SKIP TO PFTR4] OUR RECORDS INDICATE YOU SHOULD HAVE RECEIVED [ENTER PRELOADED FROM BASELINE VISIT SESSION 1 COAER18f FIGURE] PFT TUBES. PLEASE LOOK FOR THE MISSING PFT TUBES IN THE LOCATIONS LISTED BELOW.
1ST FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18d1 OR COAER18d6]; LOCATION - COAER18d4 OR COAER18d6]
2ND FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18c1]; LOCATION - COAER18c4 OR COAER18c6]
3RD FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18b1]; LOCATION - COAER18b4 OR COAER18b6]
4TH FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18a1]; LOCATION - COAER18a4 OR COAER18a6]
PFTR2a. IN TOTAL, HOW MANY PFT TUBES HAVE YOU NOW RETRIEVED?
____________[MIN OF 0 AND MAX OF 6]
PFTR2b. [IF PFTR2a DOES NOT EQUAL FIGURE ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 COAER18f]. IT APPEARS YOU HAVE NOT BEEN ABLE TO LOCATE EACH PFT TUBE DEPLOYED DURING SESSION 1. AT THIS TIME, YOU WILL PACKAGE THE PFT TUBES YOU HAVE RETRIEVED. AT THE END OF THIS SECTION YOU WILL ASK THE PARENT/GUARDIAN FOR HELP LOCATING THE MISSING PFT TUBES.
PRESS 1 TO CONTINUE
PROGRAMMER: IF PFTR2a=0, SKIP TO QUESTION PR3 (NEXT PLATFORM), IF PFTR2a =>1, SKIP TO PFTR4
PFTR3. [DISPLAY IF PR13=3] YOU HAVE RETRIEVED PREVIOUSLY MISSING PFT TUBES. HOW MANY TOTAL PFT TUBES HAVE YOU NOW RETRIEVED (INCLUDING THE PFT TUBES YOU HAVE ALREADY PACKED)?
____________[MIN OF 0 AND MAX OF 6]
PFTR3a. [IF PFTR3 DOES NOT EQUAL FIGURE ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 COAER18f] PLEASE RECORD WHY YOU DID NOT RETRIEVE ALL [ENTER PRELOADED FROM BASELINE VISIT SESSION 1 COAER18f FIGURE] DEPLOYED PFT TUBES FROM THIS HOME
____________[ALLOW 100 CHARACTERS]
PFTR4. PLACE THE PFT TUBE(S) BACK IN THE JAR AND PLACE THE JAR IN THE TOOL BOX UNTIL YOU RETURN TO YOUR VEHICLE.
ONCE IN YOUR VEHICLE, PLACE THE JAR IN THE GLOVE BOX OF YOUR VEHICLE. MAKE SURE TO KEEP THE JAR SEPARATE FROM THE PARTICIPANT BOX.
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
PFTR5. HAVE YOU SUCCESSFULLY PACKAGED THE PFT TUBE(S)?
YES
NO
PFTR5a [IF PFTR5=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY PACKAGE THE PFT TUBE(S).
___________________ [ALLOW 100 CHARACTERS]
FINAL PLATFORM RETRIEVAL QUESTIONS FOR RESPONDENTS
PR3. INTERVIEWER: LOCATE PARENT/GUARDIAN OF [CHILD] FOR A REMAINING QUESTIONS
I have just a few remaining questions to ask you.
FINAL PERSONAL PLATFORM RETRIEVAL QUESTIONS FOR RESPONDENTS
PR4. [IF PRELOADED FROM BASELINE VISIT SESSION 1 PP27=YES, IF PP27=NO SKIP TO PR6] To the best of your knowledge, was the PEM strap and/or the devices attached to the strap tampered with or damaged in any way?
YES
NO
PR4a. [IF PR4=YES] Please describe how the PEM strap and/or the devices attached to the strap were tampered with or damaged.
___________________ [ALLOW 100 CHARACTERS]
PR5. [IF PPR5=2, OR PPR10=2, 4, OR 5, OR PPR15=2, 4, OR 5, OR PPR20=2, 4, OR 5] Thank you for your feedback. It looks like one or more of the devices attached to the PEM are missing. I am hoping you can help me locate them.
PR5a. [IF PPR5=2] SHOW PICTURE OF MICROPEM TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that was held in the PEM strap [CHILD] wore. Do you or [CHILD] know where this missing device is?
PARTICIPANTS DO NOT KNOW WHERE THE PERSONAL MICROPEM IS
PARTICIPANTS INDICATE THE PERSONAL MICROPEM IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE PERSONAL MICROPEM
PRESS 1 TO CONTINUE
PR5b. [IF PPR10=2, 4, OR 5] SHOW PICTURE OF PERSONAL ALDEHYDE BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that was attached to the PEM strap [CHILD] wore. Do you or [CHILD] know where this missing device is? [IF PPR10=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE PERSONAL ALDEHYDE BADGE(S) IS
PARTICIPANTS INDICATE THE PERSONAL ALDEHYDE BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE PERSONAL ALDEHYDE BADGE(S)
PRESS 1 TO CONTINUE
PR5c. [IF PPR15=2, 4, OR 5] SHOW PICTURE OF PERSONAL VOC BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that was attached to the PEM strap [CHILD] wore. Do you or [CHILD] know where this missing device is? [IF PPR15=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE PERSONAL VOC BADGE(S) IS
PARTICIPANTS INDICATE THE PERSONAL VOC BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE PERSONAL VOC BADGE(S)
PRESS 1 TO CONTINUE
PR5d. [IF PPR20=2, 4, OR 5] SHOW PICTURE OF PERSONAL NO2 BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that was attached to the PEM strap [CHILD] wore. Do you or [CHILD] know where this missing device is? [IF PPR20=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE PERSONAL NO2 BADGE(S) IS
PARTICIPANTS INDICATE THE PERSONAL NO2 BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE PERSONAL NO2 BADGE (S)
PRESS 1 TO CONTINUE
FINAL INDOOR PLATFORM RETRIEVAL QUESTIONS FOR RESPONDENTS
PR6. [IF PRELOADED FROM BASELINE VISIT SESSION 1 IP34=YES, IP34=NO SKIP TO PR8] To the best of your knowledge, was the Indoor cage and/or the devices attached to the cage tampered with or damaged in any way?
YES
NO
PR6a. [IF PR6=YES] Please describe how the indoor cage and/or the devices attached to the cage were tampered with or damaged.
___________________ [ALLOW 100 CHARACTERS]
PR6b. To the best of your knowledge has the indoor cage been moved to different locations inside your home?
YES
NO
PR6c. [IF PR6b=YES] Please tell me where the indoor cage was moved to and for how long it was in a different location.
___________________ [ALLOW 100 CHARACTERS]
PR7. [IF IPR3=2, OR IPR8=2, 4, OR 5, OR IPR13=2, 4, OR 5, OR IPR18=2, 4, OR 5, OR IPR23=2, 4, OR 5, OR IPR28=2, 4, OR 5, OR IPR33=2] Thank you for your feedback. It looks like one or more of the devices attached to the indoor cage I left in your home are missing. I am hoping you can help me locate them.
PR7a. [IF IPR3=2] SHOW PICTURE OF MICROPEM TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that was attached to the indoor cage. Do you or [CHILD] know where this missing device is?
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR MICROPEM IS
PARTICIPANTS INDICATE THE INDOOR MICROPEM IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR MICROPEM
PRESS 1 TO CONTINUE
PR7b. [IF IPR8=2, 4, OR 5] SHOW PICTURE OF INDOOR ALDEHYDE BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the indoor cage.) Do you or [CHILD] know where this missing device is? [IF IPR8=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR ALDEHYDE BADGE(S) IS
PARTICIPANTS INDICATE THE INDOOR ALDEHYDE BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR ALDEHYDE BADGE(S)
PRESS 1 TO CONTINUE
PR7c. [IF IPR13=2, 4, OR 5] SHOW PICTURE OF INDOOR VOC BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the indoor cage. ) Do you or [CHILD] know where this missing device is? [IF IPR13=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR VOC BADGE(S) IS
PARTICIPANTS INDICATE THE INDOOR VOC BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR VOC BADGE(S)
PRESS 1 TO CONTINUE
PR7d. [IF IPR18=2, 4, OR 5] SHOW PICTURE OF INDOOR NO2 BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the indoor cage. ) Do you or [CHILD] know where this missing device is? [IF IPR18=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR NO2 BADGE(S) IS
PARTICIPANTS INDICATE THE INDOOR NO2 BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR NO2 BADGE(S)
PRESS 1 TO CONTINUE
PR7e. [IF IPR23=2, 4, OR 5] SHOW PICTURE OF INDOOR H2S BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the indoor cage.) Do you or [CHILD] know where this missing device is? [IF IPR23=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR H2S BADGE(S) IS
PARTICIPANTS INDICATE THE INDOOR H2S BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR H2S BADGE(S)
PRESS 1 TO CONTINUE
PR7f. [IF IPR28=2, 4, OR 5] SHOW PICTURE OF INDOOR CATS TUBE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the indoor cage.) Do you or [CHILD] know where this missing device is? [IF IPR28=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR CATS TUBE(S) IS
PARTICIPANTS INDICATE THE INDOOR CATS TUBE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR CATS TUBE(S)
PRESS 1 TO CONTINUE
PR7g. [IF IPR33=2] SHOW PICTURE OF INDOOR HOBO TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the indoor cage.) Do you or [CHILD] know where this missing device is?
PARTICIPANTS DO NOT KNOW WHERE THE INDOOR HOBO IS
PARTICIPANTS INDICATE THE INDOOR HOBO IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE INDOOR HOBO
PRESS 1 TO CONTINUE
FINAL PERSONAL FREESTANDING HOBO RETRIEVAL QUESTIONS FOR RESPONDENTS
PR8. [IF PRELOADED FROM BASELINE VISIT SESSION 1 HBINTRO10=YES, IF HBINTRO10=NO SKIP TO PR10] SHOW PICTURE OF HOBO TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
To the best of your knowledge, was this device that I left in your home tampered with or damaged in any way?
YES
NO
PR8a. [IF PR8=YES] Please describe how the device was tampered with or damaged.
___________________
[ALLOW 100 CHARACTERS]
PR8b. To the best of your knowledge has this device been moved to different locations inside your home?
YES
NO
PR8c. [IF PR8b=YES] Please tell me where the device was moved to and for how long it was in a different location.
___________________ [ALLOW 100 CHARACTERS]
PR9. [IF PPR25=2] (It looks like a device I left in your home during Session 1 is missing. I am hoping you can help me locate it.)
SHOW PICTURE OF HOBO TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that I placed in your home. Do you or [CHILD] know where this missing device is?
PARTICIPANTS DO NOT KNOW WHERE THE PERSONAL FREESTANDING HOBO IS
PARTICIPANTS INDICATE THE PERSONAL FREESTANDING HOBO IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE PERSONAL FREESTANDING HOBO
PRESS 1 TO CONTINUE
FINAL OUTDOOR PLATFORM RETRIEVAL QUESTIONS FOR RESPONDENTS
PR10. [IF PRELOADED FROM BASELINE VISIT SESSION 1 OP23=YES, IF OP23=NO SKIP TO PR12INTRO ] To the best of your knowledge, was the outdoor cage and/or the devices attached to the cage tampered with or damaged in any way?
YES
NO
PR10a. [IF PR10=YES] Please describe how the outdoor cage and/or the devices attached to the cage were tampered with or damaged.
___________________ [ALLOW 100 CHARACTERS]
PR11. [IF OPR3=2, OR OPR8=2, 4, OR 5, OR OPR13=2, 4, OR 5, OR OPR18=2, 4, OR 5] Thank you for your feedback. It looks like one or more of the devices attached to the outdoor cage I left outside of your home are missing. I am hoping you can help me locate them.
PR11a. [IF OPR3=2] SHOW PICTURE OF MICROPEM TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
I am unable to find this device that was attached to the outdoor cage. Do you or [CHILD] know where this missing device is?
PARTICIPANTS DO NOT KNOW WHERE THE OUTDOOR MICROPEM IS
PARTICIPANTS INDICATE THE OUTDOOR MICROPEM IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE OUTDOOR MICROPEM
PRESS 1 TO CONTINUE
PR11b. [IF OPR8=2, 4, OR 5] SHOW PICTURE OF OUTDOOR ALDEHYDE BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the outdoor cage.) Do you or [CHILD] know where this missing device is? [IF OPR8=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE OUTDOOR ALDEHYDE BADGE(S) IS
PARTICIPANTS INDICATE THE OUTDOOR ALDEHYDE BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE OUTDOOR ALDEHYDE BADGE(S)
PRESS 1 TO CONTINUE
PR11c. [IF OPR13=2, 4, OR 5] SHOW PICTURE OF OUTDOOR VOC BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the outdoor cage.) Do you or [CHILD] know where this missing device is? [IF OPR13=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE OUTDOOR VOC BADGE(S) IS
PARTICIPANTS INDICATE THE OUTDOOR VOC BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE OUTDOOR VOC BADGE(S)
PRESS 1 TO CONTINUE
PR11d. [IF OPR18=2, 4, OR 5] SHOW PICTURE OF OUTDOOR NO2 BADGE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
(I am unable to find this device that was attached to the outdoor cage. ) Do you or [CHILD] know where this missing device is? [IF OPR18=4 DISPLAY “We are missing 2 of these devices”
PARTICIPANTS DO NOT KNOW WHERE THE OUTDOOR NO2 BADGE(S) IS
PARTICIPANTS INDICATE THE OUTDOOR NO2 BADGE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE OUTDOOR NO2 BADGE(S)
PRESS 1 TO CONTINUE
FINAL PFT TUBE RETRIEVAL QUESTIONS FOR RESPONDENTS
PR12. [IF PRELOADED FROM BASELINE VISIT SESSION 1 COAER23=(YES OR NO). IF PRELOADED FROM BASELINE VISIT SESSION 1 (COAER18aFINAL=NO AND COAER18bFINAL=NO AND COAER18cFINAL=NO AND COAER18dFINAL=NO) SKIP TO PR14] SHOW PICTURE OF PFT TUBE TO PARENT/GUARDIAN FROM JOB AIDS BOOKLET
To the best of your knowledge, were these tubes that I left in your home tampered with or damaged in any way?
YES
NO
PR12a. [IF PR12=YES] Please describe how the device was tampered with or damaged.
___________________ [ALLOW 100 CHARACTERS]
PR13. [IF PFTR1 OR PFTR2a DOES NOT EQUAL FIGURE ENTERED IN PRELOADED FROM BASELINE VISIT SESSION 1 COAER18f] It looks like some or all of these tubes I left in your home during Session 1 are missing. I am hoping you can help me locate them. During Session 1 they were placed:
1ST FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18d1 OR COAER18d6]; LOCATION - COAER18d4 OR COAER18d6]
2ND FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18c1]; LOCATION - COAER18c4 OR COAER18c6]
3RD FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18b1]; LOCATION - COAER18b4 OR COAER18b6]
4TH FLOOR: ROOM – [PRELOADED FROM BASELINE VISIT SESSION 1 COAER18a1]; LOCATION - COAER18a4 OR COAER18a6]
Do you or [CHILD] know where these missing tubes are?
PARTICIPANTS DO NOT KNOW WHERE THE PFT TUBE(S) IS
PARTICIPANTS INDICATE THE PFT TUBE(S) IS IN ANOTHER LOCATION
PARTICIPANTS LOCATED AND GAVE YOU THE PFT TUBE(S)
PRESS 1 TO CONTINUE
PR13END. Thank you for your assistance. Those are all the questions I have for you at this time.
PRESS 1 TO CONTINUE
PACKAGING NEWLY LOCATED DEVICES/SAMPLERS
PR14. [IF PR5a =3] YOU WILL NOW PACKAGE THE NEWLY LOCATED PERSONAL MICROPEM.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO PPR5 THROUGH PPR9 TO PACKAGE LOCATED PERSONAL MICROPEM. FI SHOULD THEN BE ROUTED TO PR14a.
PR14a. [IF PR5b=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED PERSONAL ALDEHYDE BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO PPR10 THROUGH PPR14 TO PACKAGE LOCATED PERSONAL ALDEHYDE BADGE. FI SHOULD THEN BE ROUTED TO PR14b
PR14b. [IF PR5c=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED PERSONAL VOC BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO PPR15 THROUGH PPR19 TO PACKAGE NEWLY LOCATED PERSONAL VOC BADGE. FI SHOULD THEN BE ROUTED TO PR14c
PR14c. [IF PR5d=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED PERSONAL NO2 BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO PPR20 THROUGH PPR24 TO PACKAGE NEWLY LOCATED PERSONAL NO2 BADGE. FI SHOULD THEN BE ROUTED TO PR14d
PR14d. [IF PR7a =3] YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR MICROPEM.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR3 THROUGH IPR7 TO PACKAGE NEWLY LOCATED INDOOR MICROPEM. FI SHOULD THEN BE ROUTED TO PR14e
PR14e. [IF PR7b=3], YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR ALDEHYDE BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR8 THROUGH IPR12 TO PACKAGE NEWLY LOCATED INDOOR ALDEHYDE BADGE. FI SHOULD THEN BE ROUTED TO PR14f.
PR14f. [IF PR7c=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR VOC BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR13 THROUGH IPR17 TO PACKAGE NEWLY LOCATED INDOOR VOC BADGE. FI SHOULD THEN BE ROUTED TO PR14g.
PR14g. [IF PR7d=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR NO2 BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR18 THROUGH IPR22 TO PACKAGE NEWLY LOCATED INDOOR NO2 BADGE. FI SHOULD THEN BE ROUTED TO PR14h.
PPR14h. [IF PR7e=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR H2S BADGE.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR23 THROUGH IPR27 TO PACKAGE NEWLY LOCATED INDOOR H2S BADGE. FI SHOULD THEN BE ROUTED TO PR14i.
PR14I. [IF PR7f=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR CATS TUBE(S)
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR28 THROUGH IPR32 TO PACKAGE LOCATED INDOOR CATS TUBE(S). FI SHOULD THEN BE ROUTED TO PR14j.
PR14j. [IF PR7g=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED INDOOR HOBO
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO IPR33 THROUGH IPR37 TO PACKAGE NEWLY LOCATED INDOOR HOBO. FI SHOULD THEN BE ROUTED TO PR14k.
PR14k. [IF PR9=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED PERSONAL FREESTANDING HOBO.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO PPR25 THROUGH PPR29 TO PACKAGE NEWLY LOCATED PERSONAL FREESTANDING HOBO. FI SHOULD THEN BE ROUTED TO PR14l
PR14l. [IF PR11a =3] YOU WILL NOW PACKAGE THE NEWLY LOCATED OUTDOOR MICROPEM
PRESS 1 TO CONTINUE, RETURN USER TO OPR3 THROUGH OPR7 TO PACKAGE NEWLY LOCATED OUTDOOR MICROPEM. FI SHOULD THEN BE ROUTED TO PR14m.
PR14m. [IF PR11b=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED OUTDOOR ALDEHYDE BADGE
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO OPR8 THROUGH OPR12 TO PACKAGE LOCATED OUTDOOR ALDEHYDE BADGE. FI SHOULD THEN BE ROUTED TO PR14n.
PR14n. [IF PR11c=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED OUTDOOR VOC BADGE
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO OPR13 THROUGH OPR17 TO PACKAGE LOCATED OUTDOOR VOC BADGE. FI SHOULD THEN BE ROUTED TO PR14o.
PR14o. [IF PR11d=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED OUTDOOR NO2 BADGE
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO OPR18 THROUGH OPR22 TO PACKAGE LOCATED OUTDOOR NO2 BADGE. FI SHOULD THEN BE ROUTED TO PR14p.
PR14p. [IF PR13=3] YOU WILL NOW PACKAGE THE NEWLY LOCATED PFT TUBE(S)
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN TO PFTR3a THROUGH PFTR5 TO PACKAGE LOCATED PFT TUBE(S). FI SHOULD THEN BE ROUTED TO PR15
PREPARING PACKAGE FOR FEDEX
PR15. YOU WILL NOW PREPARE YOUR PACKED PARTICIPANT BOX(ES) FOR FEDEX SHIPMENT.
HOW MANY PARTICIPANT BOXES WERE USED TO DEPLOY AND RETRIEVE ENVIRONMENTAL PLATFORMS FOR THIS HOUSE?
1 BOX
2 BOXES
PR15a. SEE YOUR JOB AIDS BOOKLET FOR INSTRUCTIONS ON HOW TO PREPARE THE BOX(ES) FOR FEDEX SHIPMENT.
SCAN THE FEDEX TRACKING NUMBER ON THE COMPLETED FEDEX LABEL FOR BOX #1. IF THE BARCODE DOES NOT SCAN, KEY THE FEDEX TRACKING NUMBER.
BOX #1 FEDEX TRACKING NUMBER: ____________[ ALLOW 12 DIGIT NUMBER or F4]
IF YOU DO NOT HAVE A FEDEX LABEL WITH YOU IN THE HOME ENTER F4 FOR REFUSED. YOU WILL NEED TO PROVIDE THE FEDEX LABEL TRACKING NUMBER TO YOUR FS WHEN YOU RETURN HOME.
PR15b. [IF PR15=2]. SCAN THE FEDEX TRACKING NUMBER ON THE COMPLETED FEDEX LABEL FOR BOX #2. IF THE BARCODE DOES NOT SCAN, KEY THE FEDEX TRACKING NUMBER.
BOX #2 FEDEX TRACKING NUMBER: ____________[ ALLOW 12 DIGIT NUMBER or F4]
IF YOU DO NOT HAVE A FEDEX LABEL WITH YOU IN THE HOME ENTER F4 FOR REFUSED. YOU WILL NEED TO ENTER THE FEDEX LABEL TRACKING NUMBER DURING THE COMPLETION OF THE FI REPORT FOR THIS CASE!
PR15c. HAVE YOU SUCCESSFULLY PREPARED YOUR PARTICIPANT BOX(ES) FOR FEDEX SHIPMENT?
YES
NO
PR15d. [IF PR15c=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY PREPARE THE PARTICIPANT BOX(ES) FOR FEDEX SHIPMENT
___________________ [ALLOW 100 CHARACTERS]
HOME AIR EXCHANGE RATE TEST EQUIPMENT PACK UP
COAER2SEND. [DISPLAY IF COAER2S18=YES] INTERVIEWER PLEASE PACK UP THE CO2 AER EQUIPMENT
TURN OFF THE FAN AND PACK AWAY
REMOVE THE CO2 FLOW CONTROL ASSEMBLY FROM THE CO2 CANISTER AND PACK IN TOOLKIT
PACK AWAY THE CO2 CANISTER
TURN OFF THE AIRBOXX UNIT AND PACK AWAY (IF AIRBOXX WON’T TURN OFF, REMOVE BATTERIES FROM AIRBOXX BEFORE PACKING AWAY)
PLEASE SEE YOUR JOB AIDS BOOKLET IF YOU HAVE QUESTIONS
PRESS 1 TO CONTINUE
PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE
COAER2SENDa. ENTER THE NUMBER OF PEOPLE (INCLUDE YOURSELF AND ALL ADULTS AND CHILDREN) IN THE ROOM WHEN YOU TURNED OFF THE AIRBOXX UNIT.
___________________ [ALLOW MIN OF 1 AND MAX OF 20]
SESSION 2 INCENTIVE PAYMENT
REVIEWER: PPR1a=1 WHEN PARENT AND CHILD HAVE ACCEPTED PEM
INCENT1. Thank you for your participation in the CHATS Baseline Session 2 interview. At this time, I’d like to give [IF PPR1a=1 AND CHILDAGE>=12 FILL: both you and {CHILD} a token of our appreciation for completing today’s interview.] [IF PPR1a=1 AND CHILDAGE=<11 FILL: you a token of our appreciation for completing today’s interview, and also give you [CHILD’s] token of appreciation so you can give it to {HIM/HER} later.]
INCENT2. [IF PPR1a=1] Is [CHILD] available right now?
CHILD IS HERE
CHILD IS UNAVAILABLE
INCENT 2a. [IF INCENT2 = 2] Because [CHILD] is not here right now, I will give [HIS/HER] token of appreciation to you so that you can give it to [HIM/HER] later.
PRESS 1 TO CONTINUE
INCENT3. INTERVIEWER: GIVE PARENT/GUARDIAN $65 IN CASH. COMPLETE THE INCENTIVE RECEIPT FORM.
I have signed this receipt form and marked the second box to show that I have paid you the promised $65 for completing today’s interview [IF SRINTRO8b=1, 2, 3, 4, OR 5 and allowing us to collect the environmental equipment from your home].
INTERVIEWER: IF THE PARENT/GUARDIAN WILL NOT ACCEPT THE CASH INCENTIVE, MARK THE APPROPRIATE BOX ON THE CASH PAYMENT RECEIPT FORM.
PRESS 1 TO CONTINUE
INCENT4. Would you please help me by both printing and signing your name on this receipt form? I will then give you a copy of the receipt to keep for your records.
PRESS 1 TO CONTINUE
INCENT5. [IF PPR1a=1 AND CHILD AGE = 3 TO 7] As a token of appreciation, the CHATS study would like to give your child an activity book as thanks for completing [HIS/HER] part of the interview.
INTERVIEWER: GIVE PARENT/GUARDIAN ACTIVITY BOOK.
PRESS 1 TO CONTINUE
PROGRAMMER: CALCULATE THE SUM OF TOTALPAYM BASED ON COMPONENT PAYMENTS: PEMPAY=30 IF PPR1A=1 AND CHILD AGE>=13
PEMPAY=30 IF PPR1A=1 AND 7<CHILDAGE<13
ELSE PEMPAY=0.
TOTALPAYM=PEMPAY+65
INCENT6. [IF PPR1a=1] As a token of appreciation, the CHATS study would like to give the following as thanks for [CHILD] completing [HIS/HER] part of the study:
[IF PPR1a=1 and CHILDAGE>=13 THEN FILL: $30 to [CHILD] for wearing the Personal Exposure Measuring Device or PEM]
[IF PPR1a=1 and 7<CHILDAGE<13 THEN FILL: $10 to [CHILD] for wearing the Personal Exposure Measuring Device or PEM]
[IF PPR1a=1 and CHILDAGE=<7 THEN FILL: $20 to you for [CHILD] wearing the PEM
Would you please help me by printing your child’s name and then signing your own name on this receipt form? I will then give you a copy of the receipt to keep for your records.
INCENT6a. That is $[TOTALPAYM] total in cash as thanks for participating in our study.
INTERVIEWER: GIVE PARENT/GUARDIAN MONEY AMOUNT PRESENTED ON SCREEN.
COMPLETE THE INCENTIVE RECEIPT FORM.
PRESS 1 TO CONTINUE
INCENT7. That is all we have for this session. Thanks so much for your time and assistance. We will contact you 6 months from now to schedule a follow-up.
PRESS 1 TO CONTINUE
CHATS Session 2 Nurse Laptop Specifications
KIDCHECK. NURSE: DID THE FI CONFIRM THIS CHILD DURING THIS VISIT?
YES
NO
NODK
NOREF
ADULTCHECK. DID THE FI OBTAIN CONSENT FOR THIS PARENT/GUARDIAN, EITHER IN SESSION 1 OR SESSION 2?
YES
NO
NODK
NOREF
CO1. [IF ADULTCHECK=YES] PARENT My name is NAME and I am a registered nurse with the CHATS study. An interviewer conducted the first interview for this study about a week ago and a second one earlier today. May I confirm that you are a parent or guardian who has completed an earlier interview?
YES
NO
NODK
NOREF
NEWBA1N [IF CON1=NO] Since you are a new participant in the study, can you tell me your full name?
NEW PARENT FIRST NAME __________ [ALLOW 30 CHARACTERS]
NEW PARENT MIDDLE NAME _________[ALLOW 30 CHARACTERS]
NEW PARENT LAST NAME ___________[ALLOW 30 CHARACTERS]
ALLOW BLANK, DK, and REF IN NEW PARENT MIDDLE NAME; DISALLOW BLANK, DK AND REF IN NEW PARENT FIRST AND MIDDLE NAMES.
NEWBA2N [IF ADULTCHECK=NO] What is your relationship to [CHILD]?
MOTHER
FATHER
GRANDMOTHER
GRANDFATHER
LEGAL GUARDIAN
6 OTHER
NEWBA2NOTH [IF NEWBA2N=6/OTHER] DESCRIBE________ [ALLOW 30 CHARACTERS]
NEWQMOMN. [IF NEWBA2N=1] Are you [CHILD’s] biological mother?
YES
2 NO
NEWBA3N [IF NEWBA2N=5 OR 6] INTERVIEWER: IS THIS RESPONDENT MALE OR FEMALE?
MALE
2 FEMALE
CO2. [IF KIDCHECK=NO] PARENT First, I need to confirm some information with you. Please tell me the first, middle, and last name of the child living here who is enrolled in the CHATS study.
NURSE: WERE YOU GIVEN THE NAME [FILL: CHILD FIRST NAME, MIDDLE NAME, LAST NAME]?
1 NAME IS AN EXACT MATCH
2 NAME IS DIFFERENT
NODK
NOREF
PROGRAMMER: FILL WITH CHILD’S FULL NAME COLLECTED IN BA1, SESSION 1 FI LAPTOP
CO2a. [IF CO2=2] I have the child’s full name listed as [FILL: CHILD FIRST NAME, MIDDLE NAME, LAST NAME]. Can you confirm this is the child who was selected for the study?
NURSE: IF THE SITUATION CALLS FOR A SIMPLE NAME CHANGE, ANSWER YES.
IF IT APPEARS ANOTHER CHILD IS BEING PRESENTED FALSELY AS THE STUDY CHILD, ANSWER NO.
YES
NO
NODK
NOREF
CO2b. [IF CO2a=YES] RECORD CORRECTIONS TO THE CHILD’S NAME AS NEEDED
FIRST NAME: [FIRST NAME FROM BASELINE BA1] _____
MIDDLE NAME: [MIDDLE NAME FROM BASELINE BA1] ______
LASTNAME: [LAST NAME FROM BASELINE BA1] _______
PROGRAMMER: DISPLAY NAME FIELDS FROM BASELINE BA2. BESIDE OR BENEATH EACH DISPLAY ALLOW THE USER TO RECORD CHANGES IN INPUT FIELDS CO2b_FNAME, CO2b_MNAME, CO2b_LNAME. ALLOW BLANKS, BUT PROHIBIT DK/REF. IF USER ENTERS TEXT INTO CO2b_FNAME, THAT TEXT SHOULD DISPLAY INSTEAD OF ORIGINAL VALUE [CHILD] IN LATER QUESTIONS.
CO3. [IF KIDCHECK=NO AND CO2a=YES] PARENT Can you please tell me [CHILD’s] birth date?
NURSE: WERE YOU GIVEN THE BIRTH DATE [SBDAY]?
YES
NO
NODK
NOREF
PROGRAMMER: FILL FROM SBDAY, SESSION 1 FI LAPTOP.
CO3a. [IF CO3=NO] PARENT What is [CHILD’s] birth date?
NURSE: RECORD BIRTHDATE OF CHILD
MM____
DD____
YYYY____
CO4. PARENT [IF KIDCHECK=YES OR CO2a = YES OR BLANK] Is [CHILD] available to speak with me?
CHILD LIVES HERE AND IS AVAILABLE
CHILD LIVES HERE, BUT IS NOT CURRENTLY AVAILABLE
CHILD DOES NOT LIVE HERE
CO5. [IF CO4=2] PARENT Because the child enrolled in our study lives here but is not currently here, we will not be able to conduct a health assessment at this time.
PRESS 1 TO CONTINUE
CO6. [IF CO2a=NO OR CO4=3] PARENT Because the child enrolled in our study is not currently living here at the address where I was sent, I will not be able to conduct a health assessment at this time.
Can you please tell me the address and phone number for where [CHILD] currently lives so that I can attempt to interview them at that location?
YES
NO
CO7. [IF CO6=YES] PARENT (Please tell me the address where the child currently lives)
STREET ADDRESS: ALLOW 50 CHARACTERS
CITY: [ALLOW 20 CHARACTERS]
STATE: [LOOK-UP TABLE]
ZIP CODE: REQUIRE 5 DIGITS
PHONE: [REQUIRE 3-3-4 FORMAT]
CO7a. [CO4=3] PARENT Thank you for your help. We will contact [CHILD] using the information you have given us and try to set up a new appt for Session 2. Those are all the questions we have for you now.
PRESS 1 TO CONTINUE
CO8. [CO4=2] PARENT When may I return at a time that [CHILD] will be here?
NURSE: RECORD A DATE AND TIME
MM
DD
YYYY
HOUR
MINUTE
AM or PM
PROGRAMMER: IF CO4=2 OR 3, THEN SEND USER TO EXIT SCREEN
PRELOGIC FOR INTRO1 (NEW PARENT CONSENT)
IF CO1=YES, SKIP TO AUTHORIZATION FOR RELEASE
IF CO1=NO, OBTAIN CONSENT FOR NEW SESSION 2 PARENT/GUARDIAN
ALL PARENTS/GUARDIANS GET AUTHORIZATION FOR RELEASE OF HEALTH ASSESSMENT RESULTS SCRIPT
INSERT: CONSENT FOR PARENT/GUARDIAN AND CHILD PERMISSION FOR PARTICIPATION - SESSION 2 SCRIPT
INSERT: AUTHORIZATION FOR RELEASE OF HEALTH ASSESSMENT RESULTS SCRIPT
PRELOGIC FOR PREPF1 (PRELIMINARY QUESTIONS FOR PULMONARY FUNCTION)
IF CONSENT6=YES OR CONSENT6b=YES THEN CONTINUE WITH PREPF1.
ELSE SKIP TO PRELOGIC FOR DA1.
PREPF1. PARENT Thank you for your help
PREPF2. PARENT In the past 3 days, has [CHILD] had a cold, cough, or other acute illness?
YES
NO
PREPF3. PARENT In the past 3 weeks, has [CHILD] had the flu, bronchitis, pneumonia, or a severe cold?
YES
NO
PREPF4. PARENT In the past 3 weeks, has [CHILD] had any surgery on [his/her] chest or abdomen?
YES
NO
PREPF5. [IF PREPF4 NE YES] PARENT In the past 6 weeks, has [CHILD] had a heart attack?
1 YES
2 NO
ASK4KID. [IF PREPF4 NE NO, OR PREPF5 NE NO] PARENT We will not administer the pulmonary function assessment at this time, but can proceed with other aspects of the health assessment. Can you ask [CHILD] to come over now?
STUDY CHILD AVAILABLE
STUDY CHILD UNAVAILABLE
NODK
NOREF
KIDCO1. CHILD ADDRESS THE CHILD DIRECTLY:
Hello, my name is (NAME) and I am here for the children’s study that you started about a week ago. I am a nurse and will do a health exam with you. I will explain each step to you as we go along. But first I need you to tell me your full name?
NURSE: DID CHILD TELL YOU THAT [HIS/HER] NAME IS [CHILD FNAME, MNAME, LNAME]? IF CHILD DOES NOT REMEMBER MIDDLE NAME, PROMPT THE CHILD BY OFFERING IT. IF IT APPEARS ANOTHER CHILD IS BEING PRESENTED FALSELY AS STUDY CHILD, ANSWER NO.
YES
NO
NODK
NOREF
KIDCO1a. [IF KIDCO1=NO] I am supposed to interview [CHILD FNAME, MNAME, LNAME], who completed two interviews already for this study. Is [HE/SHE] available?
STUDY CHILD AVAILABLE
STUDY CHILD UNAVAILABLE
NODK
NOREF
PROGRAMMER: IF KIDCO1a=1, SEND USER BACK TO KIDCO1. DO THIS AS MANY TIMES AS NEEDED; THERE IS NO NEED TO MAINTAIN A RECORD/HISTORY OF ANSWERS IN THIS LOOP. IF KIDCO1a=2, SEND USER TO NOKID.
KIDCO2. ADDRESS THE CHILD DIRECTLY:
Thank you, and tell me how old you are?
NURSE: DID CHILD TELL YOU THAT [HIS/HER] AGE IS [CHILDAGE]?
IF IT APPEARS ANOTHER CHILD IS BEING PRESENTED FALSELY AS STUDY CHILD, ANSWER NO.
YES
NO
NODK
NOREF
KIDCO2a. [IF KIDCO2=NO] I am supposed to interview [CHILD FNAME, MNAME, LNAME], who completed an interview already for this study. Is [HE/SHE] available?
STUDY CHILD AVAILABLE
STUDY CHILD UNAVAILABLE
NODK
NOREF
PROGRAMMER: IF KIDCO2a=1, SEND USER BACK TO KIDCO2. DO THIS AS MANY TIMES AS NEEDED; THERE IS NO NEED TO MAINTAIN A RECORD/HISTORY OF ANSWERS IN THIS LOOP. IF KIDCO2a=2, SEND USER TO NOKID.
NOKID. [IF PREPF5=2 OR KIDCO1a=NO] PARENT Without the child, I am unable to conduct today’s session.
NURSE: STAY ON THIS SCREEN AND WORK WITH PARENT UNTIL YOU DETERMINE WHETHER CHILD IS REALLY UNAVAILABLE. BY PRESSING 1, YOU WILL EXIT THE INTERVIEW AND PAY NO INCENTIVES. IF CHILD APPEARS, GO BACK AND CHANGE YOUR ANSWER TO SAY STUDY CHILD IS AVAILABLE.
PRESS 1 TO EXIT
PROGRAMMER: IF NOKID=1, SEND USER TO EXIT SCREEN.
PREPBC1 CHILD/PARENT For the first part of the assessment, I am going to put on some sterile gloves, just like those used at the doctor’s office.
PUT ON STERILE GLOVES
PRESS 1 TO CONTINUE
PREPBC2 [IF CONSENT_BLOOD=YES] CHILD/PARENT Last week you said it was okay to take a little bit of blood for our children’s study. I will do that in a little while, but right now I want to put some special cream on your arms so that the needle will not hurt so much. We want to put it on your arms now because it takes a little time to work. I’m not sure yet which arm will be the easiest to get blood from, so right now I’m going to put it on both your arms. With the cream, some kids say they only feel a small pinch during the blood draw and some kids say they don’t feel anything at all.
NURSE: APPLY CREAM TO BOTH ANTECUBITAL AREAS.
PRESS 1 TO CONTINUE
PHYSICAL ASSESSMENT
NURSE:PRELOGIC FOR DA1 (DERMAL ASSESSMENT)
IF (H42=YES OR H44=YES) THEN CONTINUE WITH DA1. ELSE SKIP TO PRELOGIC FOR AS1.
ISAAC MODULE II: DERMAL ASSESSMENT
DA2. IS THERE EVIDENCE OF FLEXURAL DERMATITIS AROUND THE EYES?
1 YES
2 NO
3 NOT MEASURED
NODK
NOREF
DA3. IS THERE EVIDENCE OF FLEXURAL DERMATITIS AROUND THE SIDES AND FRONT OF NECK?
1 YES
2 NO
3 NOT MEASURED
NODK
NOREF
DA4. IS THERE EVIDENCE OF FLEXURAL DERMATITIS ON THE FRONTS OF THE ELBOWS?
1 YES
2 NO
3 NOT MEASURED
NODK
NOREF
DA5. IS THERE EVIDENCE OF FLEXURAL DERMATITIS BEHIND THE KNEES?
1 YES
2 NO
3 NOT MEASURED
NODK
NOREF
DA6. IS THERE EVIDENCE OF FLEXURAL DERMATITIS ON THE FRONTS OF THE ANKLES?
1 YES
2 NO
3 NOT MEASURED
NODK
NOREF
PRELOGIC FOR NIOX1 (PULMONARY/NIOX MACHINE)
IF PREPF3 ≠NO OR PREPF4 ≠ NO, GO TO HW1.
ELSE CONTINUE.
PULMONARY TESTS
EXHALED NITRIC OXIDE ASSESSMENT
NIOX1. PARENT/CHILD
NURSE: ASK QUESTIONS OF CHILD, BUT ALLOW PARENT TO HELP ANSWER.
Now we will do the first breathing test. This should not feel uncomfortable, but please let me know if you need to stop or just a short break. Before we begin, I need to ask you what you have eaten in the past hour and what medicines you have taken today. In the past hour, have you eaten or had a drink of any of the following?
Beets
Carrots
Green beans
Spinach
Collard greens
Hot dogs
Cured ham
Bacon
Bologna
Salami
Lettuce
Water
Caffeine, such as coffee, tea, soda, or chocolate
Alcohol
YES
NO
NIOX2. [IF CHILDAGE>=10] CHILD Have you ever smoked tobacco?
YES
NO
NIOX2a. [IF NIOX2=YES] CHILD Have you smoked tobacco in the past week?
YES
NO
NIOX2b. [IF NIOX2a=YES] CHILD When was the last time you smoked a cigarette or cigar? Would you say it was…
1 in the past hour?
2 in the past 4 hours?
3 in the past 8 hours?
4 in the past 24 hours?
5 in the past 3 days?
6 in the past 7 days?
7 NOT IN THE PAST WEEK
NIOX2c. [IF NIOX2b ne 7] CHILD During the past week, about how much did you smoke each day?
1 Less than one cigarette or cigar
2 1 per day
3 2 to 5 per day
4 6 to 15 per day (about ½ pack)
5 16 to 25 per day (about 1 pack)
6 26 to 35 per day (about 1 ½ packs)
7 More than 35 per day (about 2 packs or more)
NIOX3. CHILD Thank you. This first breathing test I will give you is called an Exhaled Nitric Oxide test. This test checks if there is irritation in the lungs. Let me explain what will happen during the nitric oxide test and demonstrate it for you. This test measures how much nitric oxide is in the air you breathe out of your lungs. Some nitric oxide is normal in the air we breathe out. There are a lot of reasons there may be more nitric oxide in your breath than is expected. It could be because of irritation in the lungs or it could be diet, medications, or the environment, that’s why we asked you about what you’ve had to eat.
PRESS 1 TO CONTINUE
NIOX4. ADMINISTER NIOX MACHINE TEST TO CHILD.
DID TEST RESULTS DOWNLOAD TO LAPTOP?
YES, TEST RESULTS DOWNLOADED
2 NO, TEST RESULTS DID NOT DOWNLOAD
NODK
NOREF
NIOX4a. [IF NIOX4=NO] RECORD A BRIEF COMMENT ABOUT FAILURE.
________ [ALLOW 100 CHARACTERS]
NIOX5. RECORD RESULTS OF TEST:
SATISFACTORY TEST
INCOMPLETE TEST
UNSATISFACTORY TEST
TEST NOT DONE
NODK
NOREF
NIOX6. [IF NIOX5 = 2, 3, or 4] RECORD REASONS WHY THE EXHALED NITROUS OXIDE MEASUREMENT TEST WAS NOT SATISFACTORY.
EQUIPMENT FAILURE
COUGH DETECTED
EARLY TERMINATION OF EXPIRATION, INSUFFICIENT EFFORT
ACUTE ILLNESS (FLU, PNEUMONIA)
COPD (SEVERE BRONCHITIS, ASTHMA)
CHILD UNABLE TO UNDERSTAND INSTRUCTION
CHILD UNCOOPERATIVE OR REFUSED
CHILD EXCLUDED FOR MEDICAL REASONS
OTHER
NIOX6a. [IF NIOX6=OTHER] PLEASE DESCRIBE REASON THE NITRIC OXIDE MEASUREMENT TEST WAS NOT SATISFACTORY.
___________________ [ALLOW 100 CHARACTERS]
PRELOGIC HW1 (HEIGHT/WEIGHT)
PROGRAMMER: ALL SUBJECTS ARE ELIGIBLE FOR HEIGHT, WEIGHT MEASUREMENT
HW1. CHILD Now I would like to measure your height and weight without shoes. First we measure height. We will do this a couple times.
IF NEEDED, ASK CHILD TO REMOVE HAIR ACCESSORIES, MOVE PONYTAIL OR “UPDO” SO THAT THE TOP OF SCALP IS NOT OBSTRUCTED FROM MEASUREMENT.
____ FEET
____ INCHES
HW1a [IF HW1.FEET NE REF] NURSE: ENTER SECOND HEIGHT. IF NO MEASUREMENT TAKEN, ENTER F4 FOR REFUSED FOR FEET AND INCHES.
____ FEET
____ INCHES
REF
NODK
PROGRAMMER: IF HW1.FEET NE REF AND HW1a.FEET NE REF AND THE ABSOLUTE VALUE OF DIFFERENCE BETWEEN HW1 AND HW1a>0.25 INCHES, ADMINISTER HW1b, ELSE GO TO HW2.
HW1b NURSE: ENTER THIRD HEIGHT. IF NO MEASUREMENT TAKEN, ENTER F4 FOR REFUSED FOR FEET AND INCHES.
____ FEET
____ INCHES
REF
NODK
HW2. CHILD Now we will record weight.
WEIGH THE CHILD AND RECORD BELOW
____POUNDS
HW2a [IF HW2 NE REF] NURSE: ENTER SECOND WEIGHT. IF NO MEASUREMENT TAKEN, ENTER F4 FOR REFUSED.
____POUNDS
REF
NODK
PROGRAMMER: IF THE ABSOLUTE VALUE OF DIFFERENCE BETWEEN HW2 AND HW2a>0.20 POUNDS, ADMINISTER HW2b, ELSE GO TO HW3.
HW2b [IF HW2 NE REF AND HW2a NE REF] NURSE: ENTER THIRD WEIGHT. IF NO MEASUREMENT TAKEN, ENTER F4 FOR REFUSED.
____ POUNDS
REF
NODK
HW2MISS [IF H2=REF] NURSE: EXPLAIN WHY WEIGHT WAS NOT MEASURED.
_____________ [ALLOW 100 CHARACTERS]
HW3. NURSE: DID THE CHILD WEAR SHOES OR HAIRSTYLE, ETC., SUCH THAT HEIGHT OR WEIGHT MEASUREMENT WAS INACCURATE?
YES
NO
NODK
NOREF
HW4. [IF HW3= NO] DESCRIBE WHAT AFFECTED HEIGHT OR WEIGHT MEASUREMENT.
________ [ALLOW 50 CHARACTERS]
PRELOGIC FOR SPIRO1 (PULMONARY/SPIROMETRY)
IF (PREPF1 ≠ NO) OR (PREPF2 ≠ NO) OR (PREPF3 ≠ NO) OR (PREPF4 ≠ NO), SKIP TO PRELOGIC ACT1
ELSE CONTINUE TO SPIRO3
SPIRO3. The second breathing test I’m going to ask you to do is called a spirometry test. For this test the mouthpiece will be attached to my computer. I would also like you to wear a nose clip during this test; it is very soft and shouldn’t hurt at all. The nose clip is used because when we breathe out very fast and strong air can come through our nose as well as our mouth. The spirometry test works best if you only breathe out through your mouth.
PRESS 1 TO CONTINUE
SPIRO4. The end of the mouthpiece tube needs to stay covered up with the plastic until the computer tells us to start the test. When you take the plastic off and put the mouthpiece in your mouth close your lips tightly around it and make sure you are not blocking the opening with your tongue or teeth. Breathe in so your lungs are completely full of air and then breathe out as hard and fast as you can and keep blowing until all the air is out of your lungs and I tell you it is OK to stop.
PRESS 1 TO CONTINUE
SPIRO5. This is a little bit like blowing up a balloon. You can watch a cartoon on the computer that shows a boy blowing up a balloon while you are blowing into the mouthpiece. Try to blow long enough to make the balloon pop. I will ask you to do this test more than one time as well. We would like to have three good tests to make sure the results are accurate. Now I’ll show you how to do the spirometry test and answer any questions you have.
SPIRO6. NURSE: DESCRIBE TEST RESULTS FROM SCREEN DISPLAY
No interpretation, not enough acceptable maneuvers
Normal Spirometry
Mild Obstruction
Moderate Obstruction
Severe Obstruction
Very Severe Obstruction
Restriction probable; further examination recommended
No interpretation, no predicted values
NODK
NOREF
SPIRO6a. [IF SPIRO6=2] RECORD A BRIEF COMMENT ABOUT FAILURE.
________ [ALLOW 100 CHARACTERS]
SPIRO8. [IF SPIRO4 ≠ 1] INDICATE WHY SPIROMETRY TEST WAS NOT SATISFACTORY.
EQUIPMENT FAILURE
COUGH DETECTED
EARLY TERMINATION OF EXPIRATION, INSUFFICIENT EFFORT
ACUTE ILLNESS (FLU, PNEUMONIA)
COPD (SEVERE BRONCHITIS, ASTHMA)
CHILD UNABLE TO UNDERSTAND INSTRUCTION
CHILD UNCOOPERATIVE OR REFUSED
CHILD EXCLUDED FOR MEDICAL REASONS
OTHER
SPIRO6. [IF SPIRO5=9/OTHER] PLEASE DECRIBE REASON THE SPIROMETRY ASSESSMENT TEST WAS NOT SATISFACTORY.
___________________ [ALLOW 100 CHARACTERS]
NHLBI ASTHMA SEVERITY SCALE
Module deleted 12/2011
PRELOGIC FOR ACT1 (ASTHMA CONTROL)
IF BASELINE H1= YES, CONTINUE WITH ACT1.
ELSE GO TO PRELOGIC FOR UC1.
ASTHMA CONTROL SCALES
ACT1. PARENT During the last 4 weeks, how many days did [CHILD] have any daytime asthma symptoms?
5 Not at all
4 1-3 days
3 4-10 days
2 11-18 days
1 19-24 days
0 Everyday
ACT 2. PARENT During the last 4 weeks, how many days did [CHILD] wheeze during the day because of asthma?
5 Not at all
4 1-3 days
3 4-10 days
2 11-18 days
1 19-24 days Everyday
0 Everyday
ACT3. PARENT During the last 4 weeks, how many days did [CHILD] wake up during the night because of asthma?
5 Not at all
4 1-3 days
3 4-10 days
2 11-18 days
1 19-24 days Everyday
0 Everyday
ACT4. PARENT Next, I have a few questions to ask [CHILD] about [HIS/HER] asthma. NURSE: IF [CHILD] NEEDS HELP READING OR UNDERSTANDING THE QUESTION, YOU MAY HELP, BUT LET HIM/HER SELECT THE RESPONSE FROM THE SHOWCARD “ACT4-11.”
ACT5. [IF 4=<CHILDAGE=<11] CHILD Please look at this card for me and see the different answers it has for my questions. My first question is, how is your asthma today?
ADMINISTER SHOW CARD “ACT 4-11” TO THE CHILD.
0 Very bad
1 Bad
2 Good
3 Very good
ACT7. [IF 4=<CHILDAGE=<11] CHILD How much of a problem is your asthma when you run, exercise or play sports?
0 It's a big problem, I can't do what I want to do.
1 It's a problem and I don't like it.
2 It's a little problem but it’s okay.
3 It’s not a problem
ACT8. [IF 4=<CHILDAGE=<11] CHILD Do you cough because of your asthma?
Yes, all of the time.
Yes, most of the time.
Yes, some of the time.
No, none of the time.
ACT9. [IF 4=<CHILDAGE=<11] CHILD Do you wake up during the night because of your asthma?
Yes, all of the time.
Yes, most of the time.
Yes, some of the time.
No, none of the time.
ACT10. CHILD [IF CHILDAGE>=12] In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?
All of the time
Most of the time
Some of the time
A little of the time
None of the time
ACT11. CHILD [IF CHILDAGE>=12] During the past 4 weeks, how often have you had shortness of breath?
More than once a day
Once a day
3 to 6 times a day
Once or twice a day
Not at all
ACT12. CHILD [IF CHILDAGE>=12] During the past 4 weeks, how often did your asthma symptoms such as wheezing, coughing, shortness of breath, chest tightness or pain wake you up at night or earlier than usual in the morning?
4 or more nights a week
2 or 3 nights a week
Once a week
Once or twice
Not at all
ACT13. CHILD [IF CHILDAGE>=12] During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication, such as albuterol?
3 or more times per day
1 or 2 times per day
2 to 3 times a week
Once a week or less
Not at all
ACT14. CHILD [IF CHILDAGE>=12] How would you rate your asthma control during the past 4 weeks? Would you say it was…
Not controlled at all
Poorly controlled
Somewhat controlled
Well controlled
Completely controlled
PRELOGIC FOR UC1 (URINE COLLECTION)
IF CONSENT_URINE=YES, CONTINUE.
ELSE SKIP TO PRELOGIC FOR BC1.
URINE COLLECTION
UC1. CHILD As part of this study, we want to collect a small urine or pee sample from you. You may have done this before at a doctor’s office. I will ask that you collect the urine sample privately in the bathroom while I wait outside—just like in a doctor’s office or clinic. (If you need any help, your parent/guardian or I can help you. Just let us know.). I will need just a few minutes to prepare the things we need before beginning.
PRESS 1 TO CONTINUE
UC2. NURSE: YOU WILL NEED THE FOLLOWING ITEMS
PAIR OF GLOVES
URINE COLLECTION JAR
SECONDARY PACKAGING
ABSORBENT MATERIAL
SHIPPING CARTON
FROZEN GEL PACKS
PRESS 1 TO CONTINUE
UC3. NURSE: FOLLOW THESE STEPS
REMOVE A COLLECTION JAR FROM YOUR SUPPLIES
PUT ON LATEX OR RUBBER GLOVES
MARK THE 15 ML MARK ON COLLECTION JAR WITH A SHARPIE PEN
PRESS 1 TO CONTINUE
UC4. CHILD Here is the jar you will collect the urine sample in. When you go to the bathroom, you may collect the urine sample at any time while you are peeing, but it is best to begin when you first start to pee. I have marked a fill line on this jar. This line shows how much urine you should try to collect in the jar. If you collect more urine than the fill line, that is okay. Do not pour out the extra urine. When you are finished collecting the sample, screw the lid on the jar, wipe the jar off with a tissue, and return the jar to me. [IF PRELOAD GENDER=FEMALE, FILL: To collect a urine sample, it is easier to slide the jar in between your legs from the front of your body and pull it away from the front of your body when you are done.]
Do you have any questions for me before you begin?
PRESS 1 TO CONTINUE
UC5. NURSE: DID THE CHILD PROVIDE A URINE SAMPLE?
YES
NO
NODK
NOREF
UC6. [IF UC5=2] WHY WAS A URINE SAMPLE NOT COLLECTED?
REFUSAL BY PARENT
REFUSAL BY CHILD
CHILD UNABLE TO VOID
OTHER
Uc6a. [IF UC6=4/OTHER] DESCRIBEWHY A URINE SAMPLE WAS NOT COLLECTED
___________________ [ALLOW 50 CHARACTERS]
UC7. NURSE: GET A SHEET OF SPECIMEN LABELS AND WAND THE SPECIMEN ID. IF THE BARCODE DOES NOT SCAN, KEY THE SPECIMEN ID.
SPECIMEN ID: ________________________[ALLOW 8 CHARACTERS]
PROGRAMMER: IF UC7 DOES NOT MATCH A NUMBER FROM THE PRELOADED LIST OF SPECIMEN ID NUMBERS, THEN ADMINISTER HARDCHECK, HC_UC7: “THE SPECIMEN ID NUMBER YOU ENTERED IS NOT IN THE DATABASE OF VALID NUMBERS. PRESS OK AND RE-ENTER A CORRECT SPECIMEN ID.”
UC8. NURSE: DID YOU SCAN OR KEY THE SPECIMEN ID?
SCAN
KEY
UC8a. [IF UC8=KEY] NURSE: RE-ENTER SPECIMEN ID.
SPECIMEN ID: ____________
UC8b. [IF UC8=KEY AND UC8a DOES NOT EQUAL UC8] THE SPECIMEN ID YOU JUST RE-ENTERED DOES NOT MATCH THE FIRST ENTRY.
PRESS 1 TO RE-ENTER THE SPECIMEN ID
PROGRAMMER RETURN USER TO UC7 UNTIL UC8a=UC7. ALLOW USER TO BACKSPACE AS FAR AS UC7 TO REVISE, IF THAT IS THE VARIABLE WITH ERROR.
UC9. NURSE: PACKAGE THE URINE SAMPLE FOR SHIPMENT TO LSU. SEE YOUR JOB AIDS BOOKLET FOR PACKAGING INSTRUCTIONS.
SCAN THE URINE SPECIMEN FEDEX TRACKING NUMBER. IF YOU DO NOT HAVE A FEDEX LABEL WITH YOU, ENTER F4 FOR REFUSED. You will need to enter the FedEx label tracking number during the completion of your report for this case!
If scanner does not work, enter the number using keyboard __________________
ALLOW 12 DIGIT NUMBER or F4
PRELOGIC FOR BC1 (BLOOD COLLECTION)
IF CONSENT_BLOOD=NO, GO TO NURSECLOSE1.
ELSE, CONTINUE WITH BC1.
BLOOD COLLECTION
BC1. PARENT We have now reached the last step in the CHATS health assessment. At this time I would like to collect a small blood sample from [CHILD]. Before we begin, I have two questions for you, [CHILD]’s parent/guardian. First of all, is [CHILD] a hemophiliac?
1 YES
2 NO
NODK
NOREF
BC2. [IF BC1=NO] PARENT Has [CHILD] undergone chemotherapy within the last 4 weeks?
1 YES
2 NO
NODK
NOREF
BC3. [IF BC2=NO] PARENT /CHILD I am going to examine [CHILD’s] arms now.
OBSERVE THE CHILD’S ARMS FOR THE FOLLOWING
RASHES
GAUZE DRESSINGS
CASTS
EDEMA
PARALYSIS
TUBES OR SHUNT OR INTRAVENOUS LINE(S)
OPEN SORES OR WOUNDS
SIGNS OF WITHERING OR BURNS
IS AT LEAST ONE ARM FREE OF ALL THESE CONDITIONS?
1 YES
2 NO
NODK
NOREF
BC5 [IF BC1=YES OR BC2=YES OR BC3=NO] Based on [IF BC1=YES OR BC2=YES FILL: what you’ve mentioned just now,] [IF BC3=YES FILL: my examination of [CHILD]’s arms,] I won’t collect a blood sample today.
PRESS 1 TO CONTINUE
PROGRAMMER: IF BC5=1 THEN SKIP TO NURSECLOSE1.
BC6. [IF BC4=NO] CHILD Okay, we are ready to take a small blood sample. I will need to take a small amount of your blood using a tiny needle. The cream we applied earlier will help the needle not hurt so much. You may feel a slight pinch during the blood draw and this could leave a small bruise on your arm. I will draw your blood in the same way that most doctors do in their office, and I will not make more than two tries to collect a blood sample. If at any point you feel dizzy or uncomfortable before or after the blood collection, let me know so that I can help you.
PROCEED WITH VENIPUNCTURE ACCORDING TO PROTOCOL. IF NEEDED, SEE JOB AIDS BOOKLET FOR FAINTING PROTOCOL.
PRESS 1 TO CONTINUE
BC7. [IF BC4=NO] DID YOU OBTAIN A BLOOD SAMPLE?
1 YES
2 NO
NODK
NOREF
BC8. [IF BC7=NO] WHY WAS BLOOD SAMPLE NOT COLLECTED?
REFUSAL BY PARENT
REFUSAL BY CHILD
TECHNICALLY UNABLE TO OBTAIN SPECIMEN
OTHER (DESCRIBE)_______________________________________
BC8a. [IF BC8=4] DESCRIBE WHY A BLOOD SAMPLE WAS NOT COLLECTED
___________________ [ALLOW 50 CHARACTERS]
BC9. NURSE: GET A SHEET OF SPECIMEN LABELS AND WAND THE BLOOD SAMPLE ID FOR THE RED CAP. IF THE BARCODE DOES NOT SCAN, KEY THE BLOOD SAMPLE ID.
BLOOD SAMPLE ID: ____________
PROGRAMMER: IF BC7 DOES NOT MATCH A NUMBER FROM THE PRELOADED LIST OF BLOOD SAMPLE ID NUMBERS, THEN ADMINISTER HARDCHECK, HC_BC7: “THE BLOOD SAMPLE ID YOU ENTERED IS NOT IN THE DATABASE OF VALID NUMBERS. PRESS OK AND RE-ENTER A CORRECT BLOOD SAMPLE ID.”
BC10. NURSE: Did you scan or key the blood sample ID?
SCAN
KEY
BC10a. [IF BC8=KEY] NURSE: Re-enter BLOOD SAMPLE ID.
SPECIMEN ID: ____________
BC10b. [IF BC9=KEY AND BC9a DOES NOT EQUAL BC8] THE SPECMIN ID YOU JUST RE-ENTERED DOES NOT MATCH THE FIRST ENTRY. PLEASE PRESS 1 TO RE-ENTER.
PRESS 1 TO CONTINUE
PROGRAMMER: RETURN USER TO BC10a UNTIL BC10a=BC9. ALLOW USER TO BACKSPACE AS FAR AS BC9 TO REVISE, IF THAT IS THE VARIABLE WITH ERROR.
BC11. [IF UC5=YES] NURSE: PACKAGE THE BLOOD SAMPLE FOR SHIPMENT IN THE SAME BOX AS URINE SAMPLE. SEE YOUR JOB AIDS BOOKLET FOR PACKAGING INSTRUCTIONS.
PRESS 1 TO CONTINUE
BC11alt. [IF UC5=NO] NURSE: PACKAGE THE BLOOD SAMPLE FOR SHIPMENT TO LSU. SEE YOUR JOB AIDS BOOKLET FOR PACKAGING INSTRUCTIONS.
SCAN THE BLOOD SPECIMEN FEDEX TRACKING NUMBER. IF YOU DO NOT HAVE A FEDEX LABEL WITH YOU, ENTER F4 FOR REFUSED. You will need to enter the FedEx label tracking number during the completion of your report for this case!
If scanner does not work, enter the number using keyboard __________________
ALLOW 12 DIGIT NUMBER or F4
RESULTS NURSE: COMPLETE THE RESULTS FORM FOR PARENT/GUARDIAN AS FOLLOWS:
HEIGHT: [FILL MEASUREMENT, OR “NOT MEASURED/ASSESSED]
WEIGHT: [FILL MEASUREMENT, OR “NOT MEASURED/ASSESSED]
BMI (BODY MASS INDEX): [FILL MEASUREMENT, OR “NOT MEASURED/ASSESSED]
CLASSIFICATION OF BMI: {FILL: UNDERWEIGHT, HEALTHY WEIGHT, OVERWEIGHT, OBESE, “NOT MEASURED OR ASSESSED]
FACE EXAMINATION RESULT: {WITHIN NORMAL LIMITS, OUTSIDE NORMAL LIMITS, “NOT MEASURED OR ASSESSED” }
SKIN EXAMINATION RESULT: {WITHIN NORMAL LIMITS, OUTSIDE NORMAL LIMITS, “NOT MEASURED OR ASSESSED” }
NIOX: {WITHIN NORMAL LIMITS, OUTSIDE NORMAL LIMITS, “NOT MEASURED OR ASSESSED”}
SPIROMETRY: {WITHIN NORMAL LIMITS, OUTSIDE NORMAL LIMITS, “NOT MEASURED OR ASSESSED”}
NURSE: REVIEW THE COMPLETED RESULTS FORM WITH THE PARENT/GUARDIAN. ANSWER ANY QUESTIONS PARENT/GUARDIAN HAS FOR YOU.
PRESS 1 TO CONTINUE
NURSECLOSE1. Thank you. That’s all I need with [CHILD] for this visit. The blood and urine samples that I collected today will be sent to the Louisiana State University (LSU) Public Hospital. Within five months we will send you a results letter with important information about the current health of your child based on the tests performed on the samples. These letters will give you valuable information about your child’s health related to the tests that we have done today. If you have any questions about the letter, there will be a number included that you can call. If the child needs rapid health care, we will contact you immediately.
And, as a reminder, all of the samples we will collect for CHATS from [CHILD] and your home will not be used for any purposes other than this study and will be destroyed at the end of the study.
NURSECLOSE2. Before I leave, I have a general question to ask about [CHILD]’s health. Do you have any concerns about his/her health that we haven’t discussed already? I can record any comments you have for me at this time.
_____________ ALLOW 1,000 CHARACTERS
Baseline
– Session 2 (Modules) M-
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Kim Adcock |
File Modified | 0000-00-00 |
File Created | 2021-01-31 |