PIAAC National Supplement Data Collection 2013-2014

Appendix A
U.S. PIAAC National Supplement
Screener (Household-based Sample)

SCQ0001

OMBIntro

Item Text: According to the Paperwork Reduction Act of 1995, no persons are required
to respond to a collection of information unless it displays a valid OMB control number.
The valid OMB control number for this voluntary survey is 1850–0870. The time
required to complete this survey is estimated to average two hours per response,
including the time to review instructions, gather the data needed, and complete and
review the PIAAC background questionnaire and exercise. If you have any comments
concerning the accuracy of the time estimate, suggestions for improving this survey, or
any comments or concerns regarding the status of your individual submission of this
survey, please write directly to: PIAAC, National Center for Education Statistics, 1990 K
Street, NW, Washington, DC 20006.

A-1

SCQ1010

SCQAskNumberInHH

Item Type:

Question

Item Class:

Integer

Item Text:

Including yourself, how many people live in this household and have no usual place of
residence elsewhere?

Display:
Notes:

Start enumeration timing here.
Lower Range: 1
Answers Allowed: 1
Response

1
99

Upper Range: 25
Value Label

Skip To

[Enter continuous answer]

SCQ1015

REFUSED

SCQ1015

A-2

SCQ1015
Item Type:

Route

Item Class:

Begin Loop

Item Text:

The following variables -- name, Screener respondent, gender, age, age range, work
variables (PaidWork, AwayJob,UnpaidWork, LookWork) and the misreported field
(SCQ1020-SCQ1090) -- should appear as a grid. All enumeration information is
entered in this grid.

Display:
Notes:

Response
1

[Route executed]

Value Label

Skip To
SCQ1020

A-3

SCQ1020

SCQNameHHM

Item Type:

Question

Item Class:

String

Item Text:

[A] What is the first name of the person, or one of the persons, who is living in the
household who owns or rents this home?
[B] Next, please tell me the names of all other members of this household (starting with
your spouse, if applicable).
[C] Please tell me the names of all other members of this household.
[HOUSEHOLD (HH) MEMBERS INCLUDE PEOPLE WHO THINK OF THIS HH AS THEIR
PRIMARY PLACE OF RESIDENCE. IT INCLUDES PERSONS WHO USUALLY STAY IN
THE HH BUT ARE TEMPORARILY AWAY ON BUSINESS, VACATION, IN A HOSPITAL,
OR LIVING AT SCHOOL IN A DORM, FRATERNITY OR SORORITY.]
[PRESS THE DOW N ARROW KEY TO MOVE TO THE NEXT BLANK LINE. WHEN ALL
NAMES ARE ENTERED, USE ARROW UP AND RIGHT KEYS TO GET TO NEXT
QUESTION.]
[PRESS ENTER ON A BLANK LINE TO EXIT THE GRID.]
[HOUSEHOLD (HH) MEMBERS INCLUDE PEOPLE WHO THINK OF THIS HH AS THEIR
PRIMARY PLACE OF RESIDENCE. IT INCLUDES PERSONS WHO USUALLY STAY IN
THE HH BUT ARE TEMPORARILY AWAY ON BUSINESS, VACATION, IN A HOSPITAL,
OR LIVING AT SCHOOL IN A DORM, FRATERNITY OR SORORITY.]
[PRESS THE DOW N ARROW KEY TO MOVE TO THE NEXT BLANK LINE. WHEN ALL
NAMES ARE ENTERED, USE ARROW UP AND RIGHT KEYS TO GET TO NEXT
QUESTION.]

Display:

Notes:

For the first line on the grid, display text A. For the second line, display text B. For all
subsequent lines, display text C.

Allow 25 characters for names.
This variable should appear as the first column on the grid.
Lower Range:
Answers Allowed:
Response

1

Version Date:

[Enter continuous answer]

1/13/2011

Upper Range:
Value Label

Skip To
SCQ1025

Page 4 of 45

SCQ1025

SCQWhoIsRespondent

Item Type:

Question

Item Class:

Enumerated

Item Text:

[ENTER A '1' NEXT TO THE RESPONDENT.]
[IF NOT OBVIOUS, ASK: Thank you for telling me about all the people who live in this
household. Now, I need to ask your name, so I know which household member you are.]
[ENTER A '1' NEXT TO THE RESPONDENT.]

Display:
Notes:

Allow only one response to this question. This variable should appear as the second
column in the grid.

Answers Allowed: 1

1

Response

Value Label

Skip To

RESPONDENT

Respondent

SCQ1030

A-5

SCQ1030
Item Type:

Route

Item Class:

If Then

Item Text:

Allow open movement through grid. Do not require users to ask all items for each person
before going to the next person.

Display:
Notes:

Response
1

[Route executed]

Value Label

Skip To
SCQ1040

A-6

SCQ1040

SCQGender

Item Type:

Question

Item Class:

Enumerated

Item Text:

[CODE GENDER. IF NOT OBVIOUS, ASK: Is {NAME} male or female?]

Display:
Notes:

Answers Allowed: 1

Version Date:

Response

Value Label

Skip To

1

MALE

Male

SCQ1050

2

FEMALE

Female

SCQ1050

12/11/12

Page 7 of 45

SCQ1050

SCQAge

Item Type:

Question

Item Class:

Integer

Item Text:

How old {are you/is NAME}?
[IF UNDER 1 YEAR, ENTER AS "0"]

Display:
Notes:

This variable should appear as the fourth column on the grid.
Lower Range: 0
Answers Allowed: 1
Response

1

Upper Range: 130
Value Label

Skip To

[Enter continuous answer]

SCQ1055

98

DON’T KNOW

SCQ1062

99

REFUSED

SCQ1062

Version Date:

12/11/12

Page 8 of 45

SCQ1055
Item Type:

Check

Item Class:

Soft

Item Text:

If outside the range of 0 to 99, display the following: "I just need to check that
{your/NAME's} age is {SCQ1050}. Is this right?"
Associated variable: SCQ1050

Display:
Notes:

Response
1

Version Date:

[Check executed]

12/11/12

Value Label

Skip To
SCQ1070

Page 9 of 45

SCQ1062

SCQAgeRange

Item Type:

Question

Item Class:

Enumerated

Item Text:

{Are you/Is NAME}...

Display:
Notes:

This variable should appear as the fifth column on the grid.

Answers Allowed: 1
Response

Value Label

Skip To

1

Under 16 years old?

Under16YearsOld

SCQ1070

2

16 to 24 years old?

F16To24YearsOld

SCQ1070

3

25 to 34 years old?

F25To34YearsOld

SCQ1070

4

35 to 45 years old?

F35To45YearsOld

SCQ1070

5

46 to 55 years old?

F46To55YearsOld

SCQ1070

6

56 to 65 years old?

F56To65YearsOld

SCQ1070

7

66 to 74 years old?

F66To74YearsOld

SCQ1070

8

75 years old or older?

F75YearsOldOrOlder

SCQ1070

98

DON’T KNOW

SCQ1063

99

REFUSED

SCQ1063

Version Date:

12/11/12

Page 10 of 45

SCQ1063

SCQBroadAgeRange

Item Type:

Question

Item Class:

Enumerated

Item Text:

{Are you/Is NAME}…

Display:
Notes:

This variable should appear as the sixth column on the grid.
Answers Allowed:

Version Date:

Response

Value Label

Skip To

1

Under 16 years old?

Under16YearsOld_

SCQ1070

2

16 to 34 years old?

_16To34YearsOld_

SCQ1070

3

35 to 65 years old?

_35To65YearsOld_

SCQ1070

4

66 to 74 years old?

_66To74YearsOld_

SCQ1070

5

75 years old or older?

_75YearsOldorOlder_

SCQ1070

12/11/12

Page 11 of 45

SCQ1070

SCQPaidWork

Item Type:

Question

Item Class:

Enumerated

Item Text:

Last week {were you/was NAME} doing PAID work for at least one hour, either as an
employee or as self-employed?

Display:
Notes:

This item should appear as the seventh column on the grid.
If answer “1” Yes, no more screener questions necessary.
Person considered employed.
(67.73% will stop here based on PIAAC 2011)

Answers Allowed: 1
Response

Value Label

Skip To

1

Yes

Yes

SCQ1090

2

No

No

SCQ1071

98

DON’T KNOW

SCQ1071

99

REFUSED

SCQ1071

A-12

SCQ1071

SCQAwayJob

Item Type:

Question

Item Class:

Enumerated

Item Text:

Last week, {were you/was NAME} away from a job or business that {you /NAME} plan(s)
to return to?

Display:
Notes:

This item should appear as the eighth column on the grid.
If answer “1” Yes, no more screener questions necessary.
Person considered employed.
(3.28% will stop here based on PIAAC 2011)
Answers Allowed: 1
Response

Value Label

Skip To

1

Yes

Yes

SCQ1090

2

No

No

SCQ1072

98

DON’T KNOW

SCQ1072

99

REFUSED

SCQ1072

Version Date:

12/11/12

Page 13 of 45

SCQ1072

SCQUnpaidWork

Item Type:

Question

Item Class:

Enumerated

Item Text:

Last week {were you/was NAME} doing UNPAID work for at least one hour for a business
that {you/NAME} own(s) or a relative owns?

Display:
Notes:

This item should appear as the eighth column on the grid.
If answer “1” Yes, no more screener questions necessary.
Person considered employed.
(1.65% will stop here based on PIAAC 2011)

Answers Allowed: 1
Response

Value Label

Skip To

1

Yes

Yes

SCQ1090

2

No

No

SCQ1073

98

DON’T KNOW

SCQ1073

99

REFUSED

SCQ1073

Version Date:

12/11/12

Page 14 of 45

SCQ1073

SCQLookWork

Item Type:

Question

Item Class:

Enumerated

Item Text:

In the 4 weeks ending last Sunday, {were you/was NAME} looking for paid work at any
time?

Display:
Notes:

This item should appear as the ninth column on the grid.
If answer “1” Yes, person considered unemployed.

Answers Allowed: 1
Response

Value Label

Skip To

1

Yes

Yes

SCQ1090

2

No

No

SCQ1090

98

DON’T KNOW

SCQ1090

99

REFUSED

SCQ1090

A-15

SCQ1090

SCQMisreportedHHM

Item Type:

Instruction

Item Class:

Enumerated

Item Text:

[LEAVE EMPTY UNLESS PERSON WAS MISREPORTED AND IS NOT A HOUSEHOLD
MEMBER. IF MISREPORTED, ENTER "1".]

Display:

Do not allow "MISREPORT" as an option on the first line of the grid, (reference person). If
a person is marked as "MISREPORTED," all other fields on the grid associated with this
person should be "show only."

Notes:

The default for this field is blank - it will only be filled if necessary.
This variable should appear as the tenth column on the grid.

1

Response

Value Label

Skip To

MISREPORTED

Misreported

SCQ1100

A-16

SCQ1100

SCQAllInfoEntered

Item Type:

Question

Item Class:

Enumerated

Item Text:

Check enumeration grid to ensure that all necessary items have been answered. If any
necessary fields are blank, return to grid. Else, go to SCQ1105.

Display:
Notes:

Response

Value Label

Skip To

A-17

SCQ1105 SCQAnyoneElse
Item Type:

Route

Item Class:

If Then

Item Text:

We have listed {NUMBER} household member{s}:
{NAME/GENDER/AGE} Have we missed any other...
- members of this household who are related to {you/REFERENCE PERSON}?
- people living here who are not related to {you/REFERENCE PERSON}, including friends
or boarders?
- household members who usually live here but are not here currently, such as someone
away on vacation, business, in a hospital, or a student living in a dormitory?

Display:

Notes:

Display the number of household members collected in the enumeration grid in {NUMBER}.
Display the name, gender and age of all household members collected in the grid in
{NAME/GENDER/AGE}.

The number of household members collected in the enumeration grid is the value that
should be stored as household size.
End enumeration timing here when all household members information collected in grid and
SCQ1105=2.

Answers Allowed: 1
Response

Value Label

Skip To

1

YES

Yes

SCQ1106

2

NO

No

SCQ1110

99

REFUSED

SCQ1110

A-18

SCQ1106
Item Type:

Check

Item Class:

Hard

Item Text:

PLEASE ADD ADDITIONAL INFORMATION TO THE TABLE.

Display:
Notes:

If SCQ1105 < >Yes

Response
1

[Check executed]

Value Label

Skip To
SCQ1020

A-19

SCQ1110
Item Type:

Route

Item Class:

If Then

Item Text:

Insert sampling messages here. Based on collected household characteristics, determine
if there is at least one eligible person in the household.
If there is at least one eligible person, then go to SCQ1115.
Else, go to SCQ1124.

Display:
Notes:

Eligibility is determined at the time enumeration is completed. SCQ1105 is the final
enumeration question that must be answered to determine eligibility.

Response
1

Value Label

Skip To

[Route executed]

A-20

SCQ1115

SCQEligiblePersons

Item Type:

Instruction

Item Class:

Enumerated

Item Text:

Based on the information you have provided, we have selected the following people to
participate in the study: {PERSON(S)}
[PRESS 1 AND ENTER TO CONTINUE.]

Display:
Notes:

1

Display name, age and gender of eligible SP(s) in "PERSON(S)".

Response

Value Label

Skip To

CONTINUE

Continue

SCQ116a

A-21

SCQ116a

SCQDOB

Item Type:

Question

Item Class:

Integer

Item Text:

Display:

Notes:
CAPI Instr:

Item Type:
Item Class:
Item Text:
Item Class:
Item Text:

What is ^AuxNameYour birth date?

Interviewer Instruction – Enter complete date, including date, month and year. If
respondent does not know complete date enter DK. If respondent refuses to provide
complete date, enter RF.
ENTER AS DD/MM/YYYY.
Soft edit to compare SCQ116a to Screener Age SCQXXXX.If difference is greater than
one year, display the edit: “ I need to verify what I entered. I recorded that ^AuxNameYour
date of birth is SCQ 116aDOB. Is this correct?”

Response

Value Label

Skip To

1

[Enter Continuous answer]

Continue

SCQ1117

9

DON’T KNOW

SCQ116bMM

7

REFUSED

SCQ116bMM

Check
Hard edit
Date cannot be in future
Soft edit
Date cannot be before 1/1/1890
Derived age must be +/- 1 of enumeration age

A-22

SCQ116bMM
Item Type:

Question

Item Class:

Integer

Item Text:

Can you please tell me ^AuxNameYour month of birth?”

Notes:

[ENTER AS MM]
If DON”T KNOW OR REFUSED then current month used

Lower Range : 1
Upper Range : 12
Response

Value Label

Skip To

1

[Enter Continuous answer]

Continue

SCQ116cYY

9

DON’T KNOW

SCQ116cYY

7

REFUSED

SCQ116cYY

A-23

SCQ116cYY
Item Type:

Question

Item Class:

Integer

Item Text:

Can you please tell me ^AuxNameYour year of birth?”

Notes:
CAPI Instr:

[ENTER AS YYYY]
Soft edit to compare SCQ116cYYYY to Screener Age SCQXXXX. If difference is greater
than one year, display the edit: “ I need to verify what I entered. I recorded that
^AuxNameYour year of birth is SCQ 116cYYYY. Is this correct?”
If DON”T KNOW OR REFUSED then backward calculate year from enumeration age.
Day set = 15(mid-month) for date calculations.

Response

Value Label

Skip To

1

[Enter Continuous answer]

Continue

SCQ1117

9

DON’T KNOW

SCQ1117

7

REFUSED

SCQ1117

Item Type:
Item Class:
Item Text:
Item Class:
Item Text:

Check
Hard edit
Year cannot be in future
Soft edit
Year cannot be before 1890
Derived age must be +/- 1 of enumeration age

Note:

When done, the following variables set or derived – SCQ1116Age (derived age);
SCQ1116a (day of derived DOB); SCQ1116b (month of derived DOB); SCQ1116c (year
of derived DOB).

A-24

SCQ1117

SCQSPEthnicity

Item Type:

Question

Item Class:

Enumerated

Item Text:

[SHOW CARD 1]
Do any of the following groups represent {your/NAME's} national origin or ancestry?
Mexican/Mexican-American, Puerto Rican, Cuban, other Hispanic or Latino? You can
select more than one answer.
[SELECT ALL THAT APPLY.]

Display:
Notes:
Answers Allowed:
Response

Value Label

Skip To

1

MEXICAN/MEXICAN-AMERICAN Mexican_Mexican_American SCQ1118

2

PUERTO RICAN

PuertoRican

SCQ1118

3

CUBAN

Cuban

SCQ1118

4

OTHER HISPANIC OR LATINO

OtherHispanicOrLatino

SCQ1118

5

NOT HISPANIC

NotHispanic

SCQ1118

98

DON’T KNOW

SCQ1119

99

REFUSED

SCQ1119

A-25

SCQ1118
Item Type:

Check

Item Class:

Hard

Item Text:

If SCQ1117=5 and another response, display: "I'm sorry, but NOT HISPANIC is not allowed
with any other response."

Display:
Notes:

Response
1

[Check executed]

Value Label

Skip To
SCQ1121

A-26

SCQ1119

SCQEthnicityObserve

Item Type:

Question

Item Class:

Enumerated

Item Text:

[RECORD SP'S ETHNICITY BY OBSERVATION, IF POSSIBLE]

Display:
Notes:
Answers Allowed:
Response

Value Label

Skip To

1

MEXICAN/MEXICAN-AMERICAN Mexican_Mexican_American SCQ1121

2

PUERTO RICAN

PuertoRican

SCQ1121

3

CUBAN

Cuban

SCQ1121

4

OTHER HISPANIC OR LATINO

OtherHispanicOrLatino

SCQ1121

5

NOT HISPANIC

NotHispanic

SCQ1121

98

DON’T KNOW

SCQ1121

A-27

SCQ1121

SCQSPRace

Item Type:

Question

Item Class:

Enumerated

Item Text:

[SHOWCARD 2]
What race do you consider {yourself/NAME} to be? White, Black or African American,
Asian, Native Hawaiian or other Pacific Islander, or American Indian or Alaska Native? You
can select more than one answer.
[SELECT ALL THAT APPLY.]

Display:
Notes:
Answers Allowed:
Response

Value Label

Skip To

1

WHITE

White

SCQ1123

2

BLACK/AFRICAN AMERICAN

Black_AfricanAmerican

SCQ1123

3

ASIAN

Asian

SCQ1123

4

NATIVE HAWAIIAN/PACIFIC
ISLANDER

NativeHawaiian_PacificIslander SCQ1123

5

AMERICAN INDIAN/ALASKA
NATIVE

AmericanIndian_AlaskaNative

SCQ1123

98

DON’T KNOW

SCQ1122

99

REFUSED

SCQ1122

A-28

SCQ1122

SCQRaceObserve

Item Type:

Question

Item Class:

Enumerated

Item Text:

[RECORD SP’S RACE BY OBSERVATION, IF POSSIBLE]

Display:
Notes:
Answers Allowed:
Response

Value Label

Skip To

1

WHITE

White

SCQ1123

2

BLACK/AFRICAN AMERICAN

Black_AfricanAmerican

SCQ1123

3

ASIAN

Asian

SCQ1123

4

NATIVE HAWAIIAN/PACIFIC
ISLANDER

NativeHawaiian_PacificIslander SCQ1123

5

AMERICAN INDIAN/ALASKA
NATIVE

AmericanIndian_AlaskaNative

98

DON’T KNOW

SCQ1123
SCQ1123

A-29

SCQ1123
Item Type:

Question

Item Class:

If then

Item Text:

If another SP, go to SCQ1117.
Else, go to SCQ1124.

Display:
Notes:

Response
1

Value Label

Skip To

[Route executed]

A-30

SCQ1124

SCQHomePhone

Item Type:

Question

Item Class:

Enumerated

Item Text:

What is your home telephone number (in case my office wants to check my work)?

Display:
Notes:

Answers Allowed: 1
Response

Value Label

Skip To

1

ENTER PHONE NUMBER

EnterPhoneNumber

SCQ1125

2

NO HOME PHONE

NoHomePhone

SCQ1150

99

REFUSED

SCQ1150

A-31

SCQ1125

SCQPhoneNo

Item Type:

Question

Item Class:

Integer

Item Text:

What is your home telephone number (in case my office wants to check my work)?]
NUMBER: ({AREA}) {EXCHANGE}-{LOCAL}

Display:

10-digit string

Notes:
Lower Range:
Answers Allowed:
Response
1

[Enter continuous answer]

Upper Range:
Value Label

Skip To
SCQ1140

A-32

SCQ1140

SCQPhoneConfirm
Question

Item Type:
Item Class:
Item Text:

Enumerated
CONFIRM TELEPHONE NUMBER: ({AREA}){EXCHANGE}-{LOCAL}

Display:
Notes:

Response

Value Label

Skip To

1

YES

Yes

SCQ1150

2

NO

No

SCQ1145

A-33

SCQ1145
Item Type:

Check

Item Class:

Hard

Item Text:

RE-ENTER TELEPHONE NUMBER

Display:
Notes:

Response
1

[Check executed]

Value Label

Skip To
SCQ1150

A-34

SCQ1150

SCQOtherNumber

Item Type:

Question

Item Class:

Enumerated

Item Text:
Display:

Is there {a/another} phone number where you could be reached?
If SCQ1124=1, display "another". Else, display "a".

Notes:
Answers Allowed:
Response

Value Label

Skip To

1

YES

Yes

SCQ1155

2

NO OTHER PHONE

NoOtherPhone

SCQ2005

99

REFUSED

SCQ2005

A-35

SCQ1155

SCQOthPhNo

Item Type:

Question

Item Class:

Integer

Item Text:

[What is that phone number?}
NUMBER: ({AREA}) {EXCHANGE}-{LOCAL}

Display:

10-digit string

Notes:
Lower Range:
Answers Allowed:
Response
1

[Enter continuous answer]

Upper Range:
Value Label

Skip To
SCQ1170

A-36

SCQ1170

SCQOtherConfirm

Item Type:

Question

Item Class:

Enumerated

Item Text:

I have the phone number as: ({AREA}) {EXCHANGE}-{LOCAL}
Is this correct?

Display:
Notes:
Lower Range:
Answers Allowed: 1

Upper Range:

Response

Value Label

Skip To

1

YES

Yes

SCQ1180

2

NO

No

SCQ1175

A-37

SCQ1175
Item Type:

Check

Item Class:

Hard

Item Text:

RE-ENTER TELEPHONE NUMBER

Display:
Notes:

Response
1
99

Value Label

Skip To

[Check executed]

SCQ1180

REFUSED

SCQ1015

A-38

SCQ1180

SCQOtherPhoneLocated

Item Type:

Question

Item Class:

Enumerated

Item Text:

Where is this phone located? Is it in your home, at work, someplace else, or is it a cellular
phone?

Display:
Notes:

Answers Allowed:
Response

Value Label

Skip To

1

OWN HOME

OwnHome

SCQ2005

2

WORK

Work

SCQ2005

3

CELLULAR PHONE

CellPhone

SCQ2005

91

OTHER, SPECIFY

OthSpecify

SCQ2005

98

DON’T KNOW

SCQ2005

99

REFUSED

SCQ2005

A-39

SCQ2005

SCQLanguage

Item Type:

Question

Item Class:

Enumerated

Item Text:

[THIS SCREENER INTERVIEW WAS CONDUCTED IN:]

Display:
Notes:

Answers Allowed: 1
Response

Value Label

Skip To

1

ENGLISH

English

SCQ3010

2

SPANISH

Spanish

SCQ3010

OTHER, SPECIFY

OthSpecify

SCQ3010

91

A-40

SCQ3010
Item Type:

Route

Item Class:

If Then

Item Text:

If hidden DU procedure is required, go to SCQ3012.
Else, go to SCQ3015.

Display:
Notes:

Response
1

Value Label

Skip To

[Route executed]

A-41

SCQ3012

SCQHiddenDU

Item Type:

Instruction

Item Class:

Enumerated

Item Text:

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

Display:
Notes:

Response

Value Label

1

HIDDEN DU PROCEDURE
REQUIRED

HiddenDuProcedureRequired SCQ3013

2

NO, HIDDEN DU PROCEDURE
NOT REQUIRED

No_HiddenDuProcedureNotR SCQ3013
equired

DON’T KNOW

DK

98

Skip To

SCQ3013

A-42

SCQ3013
Item Type:

Route

Item Class:

If Then

Item Text:

If SCQ3012 is YES then update tblCaseInfo.HiddenCasePendingYN to Y;
If SCQ3012 is DK then update tblCaseInfo.HiddenCasePendingYN to Y;
If SCQ3012 is NO then update tblCaseInfo.HiddenCasePendingYN to N.

Display:
Notes:

Response
1

[Route executed]

Value Label

Skip To
SCQ3015

A-43

SCQ3015
Item Type:

Route

Item Class:

If Then

Item Text:

If household contains SP(s), go to SCQ4005.
Else, go to SCQ 4010.

Display:
Notes:

Response
1

Value Label

Skip To

[Route executed]

A-44

SCQ4005

SCQCompleteEligible

Item Type:

Instruction

Item Class:

Enumerated

Item Text:

[END OF SCREENER. ATTEMPT TO ADMINISTER BQ WITH SP. IF NOT AVAILABLE,
SET APPOINTMENT FOR BQ AND EXERCISE]
[PRESS F10 AND ENTER TO CONTINUE]
[PRESS 1 AND ENTER TO CONTINUE]

Display:
Notes:

End instrument timing here.
COMPLETE SCREENER, 1-2 SAMPLE PERSONS SELECTED

1

Response

Value Label

Skip To

F10

F10

END

A-45

SCQ4010

SCQCompleteInelig

Item Type:

Instruction

Item Class:

Enumerated

Item Text:

Thank you very much for your time today. Based on the information you have given us, no
one in your household is eligible to participate in our study. Thank you.
[PRESS F10 AND ENTER TO CONTINUE.]
[PRESS 1 AND ENTER TO CONTINUE.]

Display:
Notes:

1

End instrument timing here.
COMPLETE SCREENER, NO ELIGIBLE SAMPLE PERSON(S)
Response
Value Label

Skip To

F10

END

F10

A-46