Screening Activities
|
Provider Based Sampling
Eligibility Screener (PBS)
|
Pregnant Women
|
Provider Based Sampling
Eligibility Screener
PBS Recruitment
Response Form
|
Provider Based Sampling
Frame Questionnaire (PBS)
|
Healthcare Providers
|
Advance Letter to
Providers
Exemplar
Letter to Accompany Questionnaire
Advance
Letter to Office Manager
PBS
Brochure
Provider
List Revision Letter
Provider-Based
Sampling Frame Questionnaire (Harris County)
Provider-Based
Sampling Frame Questionnaire (Jefferson County)
Provider-Based
Sampling Frame Questionnaire (Worcester County)
|
Continuous Activities
|
Nonrespondent
Questionnaire (PB, EH, TT-HI, TT-LI, PBS)
|
Pregnant Women, Mothers or
Fathers
|
Nonrespondent
Questionnaire
|
Validation Interview - up
to 30 Months (PB,
EH, TT-HI, TT-LI, PBS)
|
Respondents
|
Validation Instrument (up
to 30 Months)^
|
Participant
Verification (PB, EH, TT-HI, TT-LI, PBS)
|
Pregnant Women, Mothers or
Fathers
|
Participant
Verification Questionnaire
|
Tracing Interview (PB,
EH, TT-HI, TT-LI, PBS)
|
Respondents
|
Tracing Interview
|
Pregnancy Activities
|
Low-intensity
Questionnaire (Found Pregnant) (TT-LI)
|
Pregnant Women
|
Low-Intensity
Questionnaire (Non- & Pregnant)
|
Pregnancy Visit 1
Interview (PB, EH, TT-HI, PBS)
|
Pregnant Women
|
Pregnancy Visit 1
Interview^^
Pregnancy
Visit 1 SAQ^^
Pregnancy Visit 1 Visit
Information Sheet^^
|
Pregnancy Visit 2
Interview (PB, EH, TT-HI, PBS)
|
Pregnant Women
|
Pregnancy Visit 2
Interview^^
Pregnancy
Visit 2 SAQ^^
Pregnancy Visit 2 Visit
Information Sheet^^
|
Biological and
Environmental Sample Collection - Prenatal (PB, EH, TT-HI)
|
Pregnant Women
|
Biospecimens Blood and
Urine Instruments
TWF
Participant Collect SAQ
TWQ
Participant Collect SAQ
VBD
Participant Collect SAQ
TWF
Sample Distribution Script
TWQ
Environmental Sample Distribution Script
VBD
Sample Distribution Script
Note
to File - Biological and Environmental Sample Collection
Pre-Visit
Instructions for Blood and Urine Collection
Pre-Visit
Instructions for Fasting Blood, Urine, and Vacuum Collection
Pre-Visit
Instructions for Non Fasting Venous Blood, Adult Urine, and
Vacuum Collection
Urine
Collection Instructions
Vacuum Bag Participant
Instructions
|
Pregnancy Health Care Log
(PB, EH, TT-HI, PBS)
|
Pregnant Women
|
Pregnancy Health Care
Log^^
|
Father Interview (PB, EH,
TT-HI)
|
Alternate Caregiver
|
Father Interview^
Father Visit
Information Sheet
|
Birth-Related
Activities
|
Birth Visit Interview (PB,
EH, TT-HI, PBS)
|
Mother/Baby
|
Birth Visit Interview^^
Birth Visit Information
Sheet (with samples)
Note to File - Birth Visit - Umbilical
Cord Collection
|
Low-intensity
Questionnaire (Birth-focus) (TT-LI)
|
Mother/Baby
|
Low-Intensity Birth Visit
Interview
|
Postnatal Activities
|
Infant Feeding Log (PB,
EH, TT-HI, PBS)
|
Mother/Baby
|
Infant and Child Health
Care Log^^
|
Biological Sample
Collection - Mother/Baby (PB, EH, TT-HI)
|
Mother/Baby
|
1,3 MO Breast Milk Data
Collection SAQ
6,
12 MO Child Urine Collection Instrument
12
MO Child Blood Instrument
12
MO Child Saliva Collection Instrument
12
MO Child Saliva Data Collection SAQ
Biospecimen
Breast Milk Collection Instruments
Biospecimens
Child Urine Collection Instructions
12MO Child Saliva
Collection Instructions
|
3-Month Interview (PB, EH,
TT-HI, TT-LI,
PBS)
|
Mother/Baby
|
3-Month Mother Phone
Interview^^
|
6-Month Interview (PB, EH,
TT-HI, PBS)
|
Mother/Baby
|
6-Month Interview^^
6-Month Infant Feeding
SAQ^^
|
Physical Measures -
Child Anthropometry (6-,12-,24-Month) (PB, EH, TT-HI)
|
Baby/Child
|
6, 12, 24, MO Child
Anthropometry Instrument
|
Physical Measures -
Child Blood Pressure (12-,24-Month) (PB, EH, TT-HI)
|
Baby/Child
|
12, 24, MO Child Blood
Pressure Instrument
|
9-Month Interview (PB, EH,
TT-HI, TT-LI,
PBS)
|
Mother/Baby
|
9-Month Mother
Interview^^
|
12-Month Interview (PB,
EH, TT-HI, PBS)
|
Mother/Baby
|
12-Month Mother
Interview^^
Brief
Infant Toddler Social Emotional Assessment (BITSEA) SAQ
12-Month Mother SAQ^^
|
18-Month Interview (PB,
EH, TT-HI, TT-LI,
PBS)
|
Mother/Child
|
18-Month Interview^^
14-MO
ASQ-3
16-MO
ASQ-3
18-MO
ASQ-3
20-MO
ASQ-3
22-MO ASQ-3
|
24-Month Interview (PB,
EH, TT-HI, TT-LI,
PBS)
|
Mother/Child
|
24-MO Interview^ ^^
Modified
Checklist for Autism in Toddlers
24-
MO ASQ-3
27-MO
ASQ-3
30-MO ASQ-3
|
Core Questionnaire (PB,
EH, TT-HI, TT-LI, PBS)*
|
Mother/Child
|
Core Questionnaire
|
30-Month Visit
Interview (PB, EH, TT-HI, TT-LI, PBS)
|
Mother/Child
|
30-MO Interview
Brief
Symptom Index SAQ
Infant
& Toddler Sensory Profile
Brief Infant Toddler
Social Emotional Assessment (BITSEA) SAQ
|
Formative Research
|
Formative - Developmental
|
Other
|
Note to file - Formative
Research
LOI3-BIO-02
and LOI3-BIO-05 - Exemplar Screening Interview
LOI3-BIO-02
and LOI3-BIO-05 - Exemplar Interview
LOI2-PHYS-15
- Exemplar Participant Experience Survey
LOI3-PHYS-02
Exemplar Demographic Questionnaire (for Non-NCS Vanguard Study
Participants)
LOI3-PHYS-02
Exemplar Measurement Form
LOI2-PHYS-01
Exemplar Screening Questionnaire
LOI3-PHYS-01
Exemplar Contact Information Sheet (for Non-NCS Vanguard Study
Participants)
LOI2-PHYS-01
Exemplar Demographic and Health Questionnaire
LOI2-PHYS-01
Exemplar Health Screen
LOI2-PHYS-01
Exemplar Parental Exit Survey
LOI2-QUEX-14
NCS ASA24 Protocol
LOI2-QUEX-14
Food Record Form
LOI2-QUEX-14
NCS Food Frequency Questionnaire
LOI2-QUEX-14
Acculturation and Food Programs Instrument (Pregnant Women)
LOI2-QUEX-14
The ASA-24 Acceptability Questionnaire (Initial)
LOI2-QUEX-14 The ASA-24
Acceptability Questionnaire (Second)
|