Screener

Attachment 3 OMB Statement and Screener (5 minutes)
Page 1 of 1

2013 NHIS Questionnaire - Front
Front
Document Version Date: 10-Aug-12
Question ID:

FRT.020_00.000 Instrument Variable Name:

QuestionText:

COVER1

QuestionnaireFileName:

Front

OMB No. 0920-0214: Approval Expires 08/31/2014
NATIONAL HEALTH INTERVIEW SURVEY
NOTICE- Information contained on this form which would permit identification of any individual or establishment has
been collected with a guarantee that it will be held in strict confidence, will be used only for purposes stated for this study,
and will not be disclosed or released to others without the consent of the individual or establishment in accordance with
Section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and
Statistical Efficiency Act (44 USC 3501 note). Public reporting burden of this collection of information is estimated to
average about an hour 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 Reports, Clearance Officer; Paperwork
Reduction Project (0920-0214), 1600 Clifton Rd., MS D-74, Atlanta, GA 30333.

Enter 1 to
Continue

Enter 1 to Continue

UniverseText:

All

SkipInstructions:

<1> [goto START]

Page 1 of 5

DRAFT 2013 NHIS Questionnaire - Family
Coverage
Document Version Date:

Question ID:

COV.331_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

CURWRK

QuestionnaireFileName:

Family

?[F1]
Is there at least one telephone INSIDE your home that is currently working and is not a cell phone?

1

Yes
No
Refused
Don't know

2
7

9

UniverseText:

All families with a phone

SkipInstructions:

<1,Refused,Don't know> go to RNOSERV
<2> goto RH1LNGDY_1

Question ID:

COV.332_00.000 Instrument Variable Name:

QuestionText:

1
2
7

9

RNOSERV

QuestionnaireFileName:

Family

Not including cell phones, have you or your family been without telephone service for one week or more DURING THE
PAST 12 MONTHS? Do not include interruptions of phone service due to weather or natural disasters.
Yes
No
Refused
Don't know

UniverseText:

No phone in home that is working and not a cellular phone (or refused to provide or said don't know this
information)

SkipInstructions:

<1> goto RH1LNGDY_1
<2, Refused, Don't know> goto TELCEL

Page 2 of 5

DRAFT 2013 NHIS Questionnaire - Family
Coverage
Document Version Date:

Question ID:

COV.333_01.000 Instrument Variable Name:

QuestionText:

08-Aug-12

RH1LNGDY_1

QuestionnaireFileName:

Family

?[F1]
Not including cell phones, how long were you or your family without telephone service in the PAST 12 MONTHS?
* Enter number for time without telephone service.
* If less than one week, enter '0'.

000
001-365
997
999

Less than 1 week
1-365
Refused
Don't know

UniverseText:

Respondents with no phone or who have no working land-line phone or who have been without land-line phone
service for one week or more during the past 12 months.

SkipInstructions:

<1-365> goto RH1LNGDY_2
<0,Refused, Don't know> goto TELCEL

Page 3 of 5

DRAFT 2013 NHIS Questionnaire - Family
Coverage
Document Version Date:

Question ID:

COV.333_02.000 Instrument Variable Name:

QuestionText:

08-Aug-12

RH1LNGDY_2

QuestionnaireFileName:

?[F1]
* Enter time period for time without telephone service.

0
1
2

3
7
9

Less than 1 week
Day(s)
Week(s)
Months(s)
Refused
Don't know

UniverseText:

Gave number at RH1LNGDY_1

SkipInstructions:

<1> if RH1LNGDY_1 gt '7' goto ERR1_RH1LNGDY_2 else goto TELCEL
<2> if RH1LNGDY_1 gt '52' goto ERR2_RH1LNGDY_2 else goto TELCEL
<3> if RH1LNGDY_1 gt '12' goto ERR3_RH1LNGDY_2 else goto TELCEL

Hard Edit:

ERR1_RH1LNGDY_2
* Days should be in the range 7-365.
* Please correct.
ERR2_RH1LNGDY_2
* Weeks should be in the range 1-52.
* Please correct.
ERR3_RH1LNGDY_2
* Months should be in the range 1-12.
* Please correct.

Family

Page 4 of 5

DRAFT 2013 NHIS Questionnaire - Family
Coverage
Document Version Date:

Question ID:

COV.334_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

TELCEL

QuestionnaireFileName:

Do you or anyone in your family have a working cell phone?

1

Yes
No
Refused
Don't know

2
7
9

UniverseText:

All families

SkipInstructions:

<1> goto WRKCEL
<2, Refused, Don't know> if CURWRK = '1' and RNOSERV = '1'
goto CELLOUT
elseif POS2 = '0'
goto hhc.NAME_FNAME
else
goto hhc.ADC

Question ID:

Family

COV.335_00.000 Instrument Variable Name:

QuestionText:
01-10
97
99

WRKCEL

QuestionnaireFileName:

Family

How many working cell phones do you or people in your family have?
1-10 phones
Refused
Don't know

UniverseText:

Families with a working cell phone

SkipInstructions:

<1-10, Refused, Don't know> if CURWRK = '1' and RNOSERV = '1'
goto CELLOUT
elseif CURWRK = '1' and RNOSERV = '2', 'Refused', or 'Don't know'
goto PHONEUSE
elseif POS2 = '0'
goto hhc.NAME_FNAME
else
goto hhc.ADC

Page 5 of 5

DRAFT 2013 NHIS Questionnaire - Family
Coverage
Document Version Date:

Question ID:

COV.336_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

CELLOUT

QuestionnaireFileName:

Family

During the most recent time you or your family were without telephone service, did you have a working cell phone?

1

Yes
No
Refused
Don't know

2
7
9

UniverseText:

Families with no cell phone, or Refused or Don't know whether they had working cell phone and have a current
working land-line that was out of service in the past 12 months, or who have a least one working cell phone or
Refused or Don't know number of working cell phones and have current working land-line that was out of service
in the past 12 months

SkipInstructions:

<1, 2, Refused, Don't know> if TELCEL = '1'
goto PHONEUSE
elseif POS2 = '0'
goto hhc.NAME_FNAME
else
goto hhc.ADC

Question ID:

COV.337_00.000 Instrument Variable Name:

QuestionText:

PHONEUSE

Of all the telephone calls that you or your family receives, are…
*Read categories below.

1
2
3

7
9

All or almost all calls received on cell phones
Some received on cell phones and some on regular phones
Very few or none on cell phones
Refused
Don't know

UniverseText:

Working cell phone and working land-line in family

SkipInstructions:

<1-3, Refused, Don't know> if POS2 = '0'
goto hhc.NAME_FNAME
else
goto hhc.ADC

QuestionnaireFileName:

Family

Page 1 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.010_01.000 Instrument Variable Name:

QuestionText:

08-Aug-12

NAME_FNAME

QuestionnaireFileName:

Household
Composition

[fill: What are the names of all the persons living or staying here?
Start with the name of the person, or one of the persons, who owns or rents this home.
/What is the name of the next person living or staying here?]
*Enter 999 if no more persons.

UniverseText:

All persons

SkipInstructions:

<999> if PCNT = 0, [goto ERR1_NAME_FNAME]
elseif POS2 or POS3 ne 0, [goto HHRESP]
else, [goto MISPERS_MCHILD]
if name on fake/false name list
[goto ERR2_NAME_FNAME];
else [goto NAME_MNAME]

Hard Edit:

ERR1_NAME_FNAME
* 999 not allowed for the first person in the household.
* Please correct.
ERR2_NAME_FNAME

Soft Edit:

* You are entering a possible fake/false name.
* Please correct.
* If this is a legitimate name, suppress this error message and continue. Otherwise, go back to the name field and
enter a legitimate name. To enter an alias, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused' at the name field.
Then, enter a matching identifier/alias at the next screen (ALIAS).
Question ID:

HHC.010_02.000 Instrument Variable Name:

QuestionText:

NAME_MNAME

* Enter Middle Name.
* Probe for middle name or middle initial if not reported.
* Press "ENTER" to skip to last name if no middle name.

UniverseText:

First name is not blank

SkipInstructions:

GOTO NAME_LNAME

QuestionnaireFileName:

Household
Composition

Page 2 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.010_03.000 Instrument Variable Name:

QuestionText:

08-Aug-12

NAME_LNAME

QuestionnaireFileName:

Household
Composition

* If last name is the same as displayed, press "ENTER", otherwise, enter the new last name.
*Enter Last Name.

UniverseText:

There is a name entered for 'first name'

SkipInstructions:

<999> GOTO ERR1_NAME_FNAME
if name on fake/false name list
goto ERR2_NAME_LNAME
else if NAME_FNAME and NAME_LNAME ne D, R
Set ALIAS = NAME_FNAME< >NAME _LNAME,
goto USUALRES
else goto ALIAS

Hard Edit:

ERR1_NAME_FNAME
* 999 is not allowed in the last name when there is a first name.

Soft Edit:

ERR2_NAME_LNAME
* You are entering a possible fake/false name.
* Please correct.
* If this is a legitimate name, suppress this error message and continue. Otherwise, go back to the name field and
enter a legitimate name. To enter an alias, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused' at the name field.
Then, enter a matching identifier/alias at the next screen (ALIAS).

Question ID:

HHC.015_00.000 Instrument Variable Name:

QuestionText:

ALIAS

How shall I refer to [fill: you/this person] for the rest of the interview?

UniverseText:

Persons who don't know or refused to give first or last name.

SkipInstructions:

[goto USUALRES]

QuestionnaireFileName:

Household
Composition

Page 3 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.020_00.000 Instrument Variable Name:

QuestionText:

USUALRES

QuestionnaireFileName:

Household
Composition

ASKURE

QuestionnaireFileName:

Household
Composition

[fill: Do you/Does ALIAS] usually live here?

1

Yes
No
Refused
Don't know

2
7

9

UniverseText:

All non-deleted persons

SkipInstructions:

<1> [goto NAME_FNAME]
<2,R,D> [goto ASKURE]

Question ID:

08-Aug-12

HHC.030_00.000 Instrument Variable Name:

QuestionText:

[fill1: Do you/Does ALIAS] have some other place where [fill2: he/she] usually lives?

1

Yes
No
Refused
Don't know

2
7

9

UniverseText:

If the usual residence is not here, or 'don't know', or 'refused'.

SkipInstructions:

<1> [goto NOLIST]
<2, R, D> [goto NAME_FNAME]

Question ID:

HHC.035_00.000 Instrument Variable Name:

QuestionText:

QuestionnaireFileName:

Household
Composition

Since [fill1: you do/ALIAS does] not usually live here and [fill2: have/has] another residence elsewhere, [fill3:
you/he/she] will not be included in this interview.
* Enter <1> to continue to the next person.

1

NOLIST

To continue

UniverseText:

Person living elsewhere

SkipInstructions:

[goto NAME_FNAME]

Page 4 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.050_01.000 Instrument Variable Name:

QuestionText:

MISPERS_MCHILD

QuestionnaireFileName:

Household
Composition

MISPERS_MLODGE

QuestionnaireFileName:

Household
Composition

I have listed living here ...
[fill roster]
Have I missed any babies or small children?

1

Yes
No
Refused
Don't know

2

7
9

UniverseText:

After completing household roster

SkipInstructions:

<1> empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
<2, R, D> goto MISPERS_MLODGE

Question ID:

08-Aug-12

HHC.050_02.000 Instrument Variable Name:

QuestionText:

1

2
7
9

* Read if necessary.
I have listed living here ...
[fill roster]
Have I missed any lodgers, boarders, or persons you employ who live here?
Yes
No
Refused
Don't know

UniverseText:

Not missing any children or R or D

SkipInstructions:

<1> empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
<2,R,D> goto MISPERS_MAWAY

Page 5 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.050_03.000 Instrument Variable Name:

QuestionText:

MISPERS_MAWAY

QuestionnaireFileName:

Household
Composition

* Read if necessary.
I have listed living here...
[fill roster]
Have I missed anyone who USUALLY lives here, but is now away from home traveling or in a hospital?

1

Yes
No
Refused
Don't know

2
7
9

UniverseText:

No 'lodgers' living here or R or D

SkipInstructions:

<1> empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
<2,R,D> goto MISPERS_MELSE

Question ID:

08-Aug-12

HHC.050_04.000 Instrument Variable Name:

QuestionText:

1
2
7
9

MISPERS_MELSE

* Read if necessary.
I have listed living here...
[fill roster]
Have I missed anyone else staying here?
Yes
No
Refused
Don't know

UniverseText:

Nobody is away from home or R or D

SkipInstructions:

<1> empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
<2,R,D> if PCNT = 0, goto EXIT
elseif PCNT = 1
store Yes (1) in LIVEAT, goto OTHLIV
else goto LIVEAT

QuestionnaireFileName:

Household
Composition

Page 6 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.060_00.000 Instrument Variable Name:

QuestionText:

LIVEAT

08-Aug-12

QuestionnaireFileName:

Household
Composition

QuestionnaireFileName:

Household
Composition

Do all the persons I have listed live AND eat together?
*Read names if necessary.
[fill roster]

1

Yes
No
Refused
Don't know

2
7
9

UniverseText:

Person count is greater than one

SkipInstructions:

<1,R,D> [goto OTHLIV]
<2> [goto XACCESS]

Question ID:

HHC.070_00.000 Instrument Variable Name:

QuestionText:

1
2
7
9

XACCESS

Do the people who do not live and eat here have direct access from the outside or through a common hallway to a separate
living quarters?
Yes
No
Refused
Don't know

UniverseText:

All persons don't eat and live together

SkipInstructions:

<1> [goto TABX]
<2,R,D> [goto OTHLIV]

Page 7 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.090_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

OTHLIV

QuestionnaireFileName:

Household
Composition

Do members of any other household on the property live and eat with members of this household?

1

Yes
No
Refused
Don't know

2
7

9

UniverseText:

All

SkipInstructions:

<1> [goto ERR_OTHLIV]
<2,R D> if PCNT = 1, [goto SEX]
else [goto HHRESP]

Hard Edit:

ERR_OTHLIV
* All such persons should be included in this interview.
* Please correct by adding the additional person(s) to the household.

Question ID:

HHC.100_00.000 Instrument Variable Name:

QuestionText:

HHRESP

QuestionnaireFileName:

Household
Composition

* Ask if necessary
With whom am I speaking?
* Enter the line number of the respondent. If more than one, enter the number of the one you consider to be the main
respondent.

UniverseText:

All households with more than one nondeleted person in parent cases or more than one nondeleted person in
spawn cases and no household/family demographic respondent identified yet.

SkipInstructions:

<1-25>
If deleted PX [goto ERR1_HHRESP]
elseif out of bound [goto ERR2_HHRESP]
elseif ADC = 1 [goto HHREF_A]
else [goto SEX]

Hard Edit:

ERR1_HHRESP:
* Person was deleted from this household.
* Please correct.
ERR2_HHRESP:
*Invalid line number entered.
* Please correct.

Page 8 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.110_00.000 Instrument Variable Name:

08-Aug-12

SEX

QuestionnaireFileName:

Household
Composition

* If don’t know or refused enter your best guess.

QuestionText:

[Are you/Is ALIAS] male or female?
1

Male
Female

2

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<1,2> [goto AGEDOB_1]

Question ID:

HHC.120_01.000 Instrument Variable Name:

QuestionText:

AGEDOB_1

QuestionnaireFileName:

Household
Composition

1 of 5
What is [fill: your/ALIAS's] age?
* Enter number for age.

01-120

Age in years

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<001-120> [goto AGEDOB_2]
[goto AGEDOB_3]

Question ID:

HHC.120_02.000 Instrument Variable Name:

QuestionText:

2 of 5
* Enter number for age time period.

1
2
3
4

Days
Weeks
Months
Years

UniverseText:

Valid age - number entered

SkipInstructions:

<1-4> [goto AGEDOB_3]

AGEDOB_2

QuestionnaireFileName:

Household
Composition

Page 9 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.120_03.000 Instrument Variable Name:

QuestionText:

08-Aug-12

AGEDOB_3

QuestionnaireFileName:

Household
Composition

3 of 5
And what is [fill: your/ALIAS's] date of birth?
Please give month, day, and year for the date of birth.
* Enter month of birth.

01

January
February
March
April
May
June
July
August
September
October
November
December
Refused
Don't know

02
03
04

05
06
07
08
09
10

11
12
97
99

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<1-12,R,D> [goto AGEDOB_4]

Question ID:

HHC.120_04.000 Instrument Variable Name:

QuestionText:

AGEDOB_4

QuestionnaireFileName:

4 of 5
* Enter day of birth

01-31

Day of the month

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<1-31,R,D>
Only allow valid days for month entered.
If days not valid, [goto ERR_AGEDOB_4]
ELSE [goto AGEDOB_5]

Hard Edit:

ERR_AGEDOB_4
[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].

Household
Composition

Page 10 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.120_05.000 Instrument Variable Name:

QuestionText:

08-Aug-12

AGEDOB_5

QuestionnaireFileName:

Household
Composition

5 of 5
* Enter year of birth.

1880-2030

Year of birth
Refused

9997

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<1880 - 2030, R,D> [goto AGECAL]

Hard Edit:

ERR1_AGEDOB_5
Future month invalid:AGEDOB_3AGEDOB_4<,> AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:AGEDOB_3AGEDOB_4<,> AGEDOB_5
ERR3_AGEDOB_5
Invalid date:AGEDOB_3AGEDOB_4<,> AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:AGEDOB_3AGEDOB_4<,> AGEDOB_5

Question ID:

HHC.124_00.000 Instrument Variable Name:

QuestionText:

DOBVER

QuestionnaireFileName:

Household
Composition

There is a difference between the age the computer calculated from [fill: your/ALIAS's] date-of-birth and the age that you
gave me.
I recorded [fill: your/ALIAS's] date-of-birth as [AGEDOB_3] [AGEDOB_4], [AGEDOB _5]. Is that [fill: your/ALIAS's]
correct date-of-birth?

1

2
7
9

Yes
No
Refused
Don't know

UniverseText:

Age reported is not equal to age calculated from date of birth.

SkipInstructions:

<1,R,D> [goto INTWKCK1]
<2> [goto AGEDOB_3]

Page 11 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.130_00.000 Instrument Variable Name:

QuestionText:

AGEPIC

QuestionnaireFileName:

Household
Composition

[fill1: Are you/Would you say ALIAS is] [fill2: less than 1 year old/AGE3 years old?]

1

AGE=AGE3 (or less than 1 years old)
AGE=AGE4
Neither is correct
Refused
Don't know

2
3

7
9

UniverseText:

Able to narrow age to two options

SkipInstructions:

<1,2> [goto INTWKCK1]
<3,R,D> if AGEDOB_1 = R, [goto AGEGES2]
elseif AGEDOB_1 = D, [goto AGEGES1_NUM]

Question ID:

08-Aug-12

HHC.150_01.000 Instrument Variable Name:

QuestionText:

AGEGES1_NUM

QuestionnaireFileName:

Household
Composition

1 of 2
What is your best guess of [fill: your/ALIAS's] age?
* If the respondent gives a range of ages, enter "C" to continue to the screen that will compute an age.
* If the respondent does not know the age, enter your best estimate of the person's age.

000-120
997
999

C

Age (number)
Refused
Don't know
Compute from range

UniverseText:

Age unknown and unable to narrow age down to two age choices and respondent did not refuse AGEDOB_1

SkipInstructions:

<0-120> [goto AGEGES1_TP]
elseif outside range, [goto ERR_AGEGES1_NUM]
[goto AGERNG_N1]
[goto AGEGES2]

Hard Edit:

ERR_AGEGES1_NUM
* Invalid entry.
* Please correct.

Page 12 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.150_02.000 Instrument Variable Name:

QuestionText:

08-Aug-12

AGEGES1_TP

QuestionnaireFileName:

Household
Composition

QuestionnaireFileName:

Household
Composition

2 of 2
* Enter time period for age guess.

3

Month(s)
Year(s)

4

UniverseText:

Valid age number

SkipInstructions:

<3, 4> If AGEDOB_5 = D, [goto YEARPIC]
else [goto INTWKCK1]

Question ID:

HHC.152_00.000 Instrument Variable Name:

QuestionText:

AGEGES2

Certain sections of this interview depend on knowing if a person is 18 years old or older.
Could you please tell me if [fill: you are/ALIAS is] at least 18 years old?

1
2
7

9

Less than 18
18 or older
Refused
Don't know

UniverseText:

(Age unknown and unable to narrow to two age choices and respondent refused or didn't know age at
AGEDOB_1) or (Refused to or did not guess age)

SkipInstructions:

<1> [goto LESS18]
<2,R,D> [goto GREAT18]

Page 13 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.154_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

LESS18

QuestionnaireFileName:

Household
Composition

* Enter your best estimate of [ALIAS's] age.
* Enter age "0" to 17
* Enter "0" if less than 1 year old.

000

Less than one year old
1 to 17 years of age

001 < 17

UniverseText:

Person estimated less than eighteen years of age

SkipInstructions:

<0-17> [goto AGEDOB_1, to collect information about next person in roster]
else, [goto INTWKCK1]

Question ID:

HHC.156_00.000 Instrument Variable Name:

GREAT18

QuestionnaireFileName:

Household
Composition

* Enter your best estimate of [ALIAS’s] age.

QuestionText:

* Enter age 18 or greater.
018-120

Age in years

UniverseText:

Person estimated age (18 or older)

SkipInstructions:

<18-120> [goto AGEDOB_1, to collect information about next person in roster]
else, [goto INTWKCK1]

Question ID:

HHC.165_01.000 Instrument Variable Name:

QuestionText:
1
2
3
7

9

YEARPIC

QuestionnaireFileName:

Would you say that [fill: you were/ALIAS was] born in:
Low guess for year born
High guess for year born
Neither is correct
Refused
Don't know

UniverseText:

Person's age is known and birth year answered with 'don't know'

SkipInstructions:

<1,2,3,R,D> [goto AGEDOB_1, to collect information about next person in roster]
else, [goto INTWKCK1]

Household
Composition

Page 14 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.165_03.000 Instrument Variable Name:

QuestionText:

08-Aug-12

INTWKCK

QuestionnaireFileName:

Was [ALIAS] born on or after [STARTDATE]?

1

Yes
No

2

UniverseText:

Child's age = 0 and date of birth not known

SkipInstructions:

<1> [goto ERR_INTWKCK]
then, [goto AGEDOB_1 to collect information about next person in roster]
else, [goto NATOR]
<2> [goto AGEDOB_1 to collect information about next person in roster]
else, [goto NATOR]

Question ID:

Household
Composition

HHC.170_00.000 Instrument Variable Name:

QuestionText:

NATOR

QuestionnaireFileName:

(book) H1.
[fill1: Do you/Does ALIAS] consider [fill2: yourself/himself/herself] to be Hispanic or Latino?
* Read if necessary.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American
Other Latin American
Other Hispanic/Latino
Where did [your/ALIAS's] ancestors come from?

1
2
7

9

Yes
No
Refused
Don't know

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<1> [goto HISPAN]
<2,R,D> [goto NATOR for next person in roster]
else [goto RACE]

Household
Composition

Page 15 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.180_01.000 Instrument Variable Name:

QuestionText:

08-Aug-12

HISPAN

QuestionnaireFileName:

Household
Composition

(book) H1
Please give me the number of the group that represents [fill: your/ ALIAS’s] Hispanic origin or ancestry.
You may choose up to five (5), if applicable.
* If a nonhispanic group is named, backup to previous screen and change the answer from "yes" to "no".
Enter all that apply, separate with commas.

01
02
03
04
05

06
07
08
97
99

Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American
Other Latin American
Other Hispanic/Latino/Spanish
Refused
Don't know

UniverseText:

National origin was answered yes to being Hispanic or Latino

SkipInstructions:

<1-6> [goto NATOR (for the next person)] else [goto RACE]
<7> [goto HIS_SP2]
<8> [goto HIS_SP3]

Page 16 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.190_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

HIS_SP2

QuestionnaireFileName:

Household
Composition

* Probe for the country.
* If any of the following are mentioned, backup to previous screen and correct the entry.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American (REFER TO HELP SCREEN)
* (F1) For a list of Central or South American countries.
* Specify the other Latin American.

UniverseText:

HISPAN answered from selection 7 for Hispanic origin.

SkipInstructions:

[goto NATOR (for the next person)]
else [goto RACE]

Question ID:

HHC.195_00.000 Instrument Variable Name:

QuestionText:

HIS_SP3

QuestionnaireFileName:

* Probe for the country.
* If any of the following are mentioned, backup to previous screen and correct the entry.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American (REFER TO HELP SCREEN)
* (F1) For a list of Central or South American countries.
* Specify the other Hispanic/Latino.

UniverseText:

HISPAN answer from selection 8 (other Hispanic/Latino) origin

SkipInstructions:

[goto NATOR (for the next person)]
else [goto RACE]

Household
Composition

Page 17 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.200_01.000 Instrument Variable Name:

QuestionText:

RACE

08-Aug-12

QuestionnaireFileName:

Household
Composition

( Book) H2
What race or races [fill1: Do you/Does ALIAS] consider [fill2: yourself/himself/herself] to be? Please select 1 or more of
these categories.
* Enter all that apply, separate with commas.

01
02
03
04
05

06
07
08
09
10
11

12
13
14
15
16

97
99

White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Some other race
Refused
Don't know

UniverseText:

All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.

SkipInstructions:

<1-7, 9-14> If more than one selected, [goto MLTRAC, then goto RACE for next person in roster]
else [goto NOWAF_A]
<8> [goto RAC_SP1]
<15> [goto RAC_SP2]
<16> [goto RAC_SP3]
[goto RACE, for the next person in roster]
else [goto NOWAF_A]

Page 18 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.210_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

RAC_SP1

QuestionnaireFileName:

Household
Composition

* Specify the other pacific islander.
REM * If any of the following are mentioned, go back to RACE screen to correct.
* If the respondent’s answer could not be found, clear entry, type ‘ZZ’.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian or Chamorro
Samoan

Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese

* If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.

UniverseText:

RACE= 8 (other Pacific Islander)

SkipInstructions:

If more than one selected, [goto MLTRAC]
If 'ZZ' entered [goto RAC_SP1A]
then [goto RACE for next person on the roster]
else [goto NOWAF_A]

Question ID:

HHC.212_00.000 Instrument Variable Name:

QuestionText:

RAC_SP2

QuestionnaireFileName:

* Specify the other Asian.
* If any of the following are mentioned, backup to previous item and correct the entry.
White
Asian Indian
Black/African American Chinese
Indian (American)
Filipino
Alaska Native
Japanese
Native Hawaiian
Korean
Guamanian or Chamorro
Vietnamese
Samoan
* If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.

UniverseText:

RACE = other Asian listed

SkipInstructions:

If more than one selected [goto MLTRAC]
then [goto RACE] for next person on the roster
else [goto NOWAF_A]

Household
Composition

Page 19 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.214_00.000 Instrument Variable Name:

QuestionText:

RAC_SP3

08-Aug-12

QuestionnaireFileName:

Household
Composition

* Specify the other race.
* If any of the following are mentioned, backup to previous item and correct the entry.
White
Asian Indian
Black/African American Chinese
Indian (American)
Filipino
Alaska Native
Japanese
Native Hawaiian
Korean
Guamanian or Chamorro
Vietnamese
Samoan
* If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.

UniverseText:

RACE answered some other race.

SkipInstructions:

<30 chars long> If more than one selected [goto MLTRAC] then [goto RACE] for next person on the roster
Else [goto NOWAF_A ]

Page 20 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.220_00.000 Instrument Variable Name:

QuestionText:
01
02
03

04
05
06
07
08
09

10
11
12
13
14

15
16
97
99

MLTRAC

08-Aug-12

QuestionnaireFileName:

Household
Composition

Which one of these groups, that is [Read Groups] would you say BEST represents [fill: your/ALIAS's] race?
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Other Race
Refused
Don't know

UniverseText:

More than on race entered

SkipInstructions:

<1-16,R,D> [goto NOWAF_A]
else, [goto ERR_MLTRAC]

Hard Edit:

ERR_MLTRAC
* Select valid race group number.
* Please correct.

Page 21 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.230_01.000 Instrument Variable Name:

QuestionText:

08-Aug-12

NOWAF_A

QuestionnaireFileName:

Household
Composition

[fill: Is anyone in the household/Are you/Is ALIAS] now on full-time active duty with the Armed Forces?
[display eligible persons]

1

Yes
No
Refused
Don't know

2

7
9

UniverseText:

If household contains 1 or more persons 18-64 years old

SkipInstructions:

If no person eq (18-64) years of age [goto EXIT]
< 2,R,D> if POS2 or POS3 ne 0, [goto ADC]
else [goto HHREF_A]
if NOWAF_A eq <1> and ADULTCNT eq <1> [goto EXIT]
else [goto NOWAF2_B]

Question ID:

HHC.230_03.000 Instrument Variable Name:

QuestionText:

NOWAF2_B

QuestionnaireFileName:

Who is this? (Anyone else)
* Enter line numbers as appropriate.
* Enter all that apply, separate with commas.

UniverseText:

At least 1 person in the AF & more than 1 person eligible to be in the AF

SkipInstructions:

<1-25> if all PX have HHSTAT = D or HHSTAT3 = A [goto EXIT]
elseif POS2 and POS3 ne 0 [goto ADC]
else [goto HHREF_A]
Invalid person # selected [goto ERR_NOWAF2_B]

Hard Edit:

ERR_NOWAF2_B
* Invalid person number selected.
* Please correct.

Household
Composition

Page 22 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.240_00.000 Instrument Variable Name:

QuestionText:

08-Aug-12

EXIT

QuestionnaireFileName:

Household
Composition

Not every household in our survey is asked all questions. I have all the information about your household that I need at
this time. Thank you for your assistance.
* Enter (1) to proceed.

1

Proceed

UniverseText:

All persons are in the Armed Forces or everybody is either deleted or in the AF or All non-Armed Forces persons
are not Black, Hispanic or Asian and not marked for an interview

SkipInstructions:

<1> [goto VISITCNT]

Question ID:

HHC.250_01.000 Instrument Variable Name:

QuestionText:

HHREF_A

* Press shift F1 to see full roster information.

2

Household
Composition

* [fill: You have/ALIAS has] has been selected as the household reference person. Is this household member an
appropriate choice? Preferably a civilian adult?
[Display all non-deleted household members ge 14 years of age]

1

QuestionnaireFileName:

Yes
No

UniverseText:

If more than one non-deleted person in the HH

SkipInstructions:

<1> [goto RPREL]
<2> [goto HHREF_B]

Page 23 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.250_02.000 Instrument Variable Name:

QuestionText:

08-Aug-12

HHREF_B

* Select another household member for the reference person.
* Enter the line number of the Household Reference person.

UniverseText:

Selecting another Reference person

SkipInstructions:

<1-25> GOTO RPREL

Soft Edit:

ERR1_HHREF_B
* You have selected an Armed Forces person.
* Please select another person.
ERR2_HHREF_B
* You have selected a person less than 18 years old.
* Please select another person.

QuestionnaireFileName:

Household
Composition

Page 24 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

QuestionText:

HHC.260_00.000 Instrument Variable Name:

RPREL

08-Aug-12

QuestionnaireFileName:

(book) H3.
What is [fill1: your/ALIAS's] relationship to [fill2: Reference Person's name/you]

01
02

03
04
05
06
07
08

09
10
11
12
13

14
15
16
17
97
99

Household reference person
Spouse (husband/wife)
Unmarried Partner
Child (biological/adoptive/in-law/step/foster)
Child of partner
Grandchild
Parent (biological/adoptive/in-law/step/foster)
Brother/sister (biological/adoptive/in-law/step/foster)
Grandparent (Grandmother/Grandfather)
Aunt/Uncle
Niece/Nephew
Other relative
Housemate/roommate
Roomer/Boarder
Other nonrelative
Legal guardian
Ward
Refused
Don't know

Household
Composition

Page 25 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

08-Aug-12

UniverseText:

All where RPREL NE Reference Person

SkipInstructions:

Loop through all non-deleted PX
<2, 3> if selected for more than one PX [goto ERR4_RPREL]
elseif AGE < 14 [goto ERR1_RPREL]
<4> [goto DEGREE1]
<5> if loop is completed and no PX has RPREL = 3 [goto ERR5_RPREL] endif
<6> if AGEDIFF < 25 [goto ERR2_RPREL] endif
<7> [goto DEGREE2]
<8> [goto DEGREE3]
<9> if AGEDIFF < 25 [goto ERR3_RPREL] endif
<10-17,R,D> end loop
if UNRELTAL > 1 [GOTO FAMNUM]
else [goto HHCHANGE]

Hard Edit:

ERR1_RPREL:
*Spouse/partner must be 14 years old or older.
*Please correct.
ERR4_RPREL:
I have recorded that [fill 3] and [fill 2] are spouses or unmarried partners of [fill 6].
Which one is correct?
*First GOTO is for [fill 3]
*Second GOTO is for [fill 2]
Questions involved
Value
Rprel: Relationship to Ref Person
Spouse (husband/wife) or Unmarried Partner
Rprel: Relationship to Ref Person
Spouse (husband/wife) or Unmarried Partner
***THE 1ST LINE HERE SHOULD REFER TO THIS PERSON: [fill 3]
***THE 2ND LINE HERE SHOULD REFER TO THIS PERSON: [fill 2]
ERR5_RPREL
I have recorded that [fill 2] is a child of a partner. However, no one in the family was picked as an unmarried
partner in order to have this response.
* Please correct .

Soft Edit:

ERR2_RPREL
I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill:his/her] grandchild [fill 2] is [AGE(PX)] years old.
Are these ages and relationships correct?
ERR3_RPREL
I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill:his/her] grandparent [fill 2] is [AGE(PX)] years
old.
Are these ages and relationships correct?
ERR6_RPREL
*Do not read this message to the respondent.
*The married couple [ALIAS(PX)] and [ALIAS(HHREF_B)] are both [SEX (PX)].
*Suppress message if correct.
*Otherwise, correct SEX of either person or choose different spouse.
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change SEX of spouse [fill 2]
*Third GOTO is to change SEX of Ref Person [fill 6]
Questions involved
RPREL: Relationship to Ref Person
SEX
SEX

Value
Spouse (husband/wife)
SEX (PX)
SEX (HHREF_B)

Page 26 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

08-Aug-12

ERR7_RPREL
*Age difference between spouses is greater than or equal to 30 years.
I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill: his/her] spouse [ALIAS(PX)] is [AGE(PX)] years
old. Are these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of spouse [fill 2]
*Third GOTO is to change AGE of Ref Person [fill 6]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Spouse (husband/wife)
AGE (PX)
AGE (HHREF_B)

ERR9_RPREL
*Age difference between [fill 7] and child is only [AGEDIFF] years.
I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill:his/her] child [fill 2] is [AGE(PX)] years old. Are
these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of child [fill 2]
*Third GOTO is to change AGE of parent [fill 6]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Child
AGE (PX)
AGE (HHREF_B)

ERR10_RPREL
* Age difference between [fill 7] and child is greater than or equal to 50 years.
I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill:his/her] child [ALIAS(PX)] is [AGE(PX)] years
old. Are these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of child [fill 2]
*Third GOTO is to change AGE of parent [fill 6]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Child
AGE (PX)
AGE (HHREF_B)

ERR12_RPREL
*Age difference between [fill 8] and child is only [AGEDIFF] years.
I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill:his/her] [fill 8] [fill 2] is [AGE(PX)] years old.
Are these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of parent [fill 2]
*Third GOTO is to change AGE of child [fill 6]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Parent
AGE (PX)
AGE (HHREF_B)

ERR13_RPREL
* Age difference between [fill 8] and child is greater than or equal to 50 years.

Page 27 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

08-Aug-12

I have recorded [fill 6] is [AGE(HHREF_B)] years old and [fill:his/her] [fill 8] [fill 2] is [AGE(PX)] years old.
Are these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of parent [fill 2]
*Third GOTO is to change AGE of child [fill 6]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Parent
AGE (PX)
AGE (HHREF_B)

Page 28 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.270_00.000 Instrument Variable Name:

QuestionText:

1
2
3

4
5
7
9

08-Aug-12

DEGREE1

QuestionnaireFileName:

Household
Composition

[fill1: Are you/Is ALIAS] [fill2: Reference Person's name's/your] biological (natural), adoptive, step, or foster [fill3:
son/daughter] or [fill4: son/daughter]-in-law?
Biological (natural) {son/daughter]
Adoptive {son/daughter}
Step {son/daughter]
Foster {son/daughter}
{son/daughter]-in-law
Refused
Refused
Don't know

UniverseText:

RPREL=(4) child

SkipInstructions:

<1> if AGEDIFF < 12 [goto ERR1_DEGREE1]
else [goto RPREL]
<2-5,R,D> [goto RPREL]

Hard Edit:

ERR1_DEGREE1
*Age difference between [fill 6] and child is [AGEDIFF] years.
I have recorded [fill 7] is [AGE(HHREF_B)] years old and [fill:his/her] child [fill 2] is [AGE(PX)] years old.
Are these ages and relationships correct?
* Please correct relationship code or age.
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of child [fill 2]
*Third GOTO is to change AGE of parent [fill 7]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Soft Edit:

Value
Child
AGE (PX)
AGE(HHREF_B)

ERR2_DEGREE1
*Age difference between [fill 6] and child is [AGEDIFF] years.
I have recorded [fill 7] is [AGE(HHREF_B)] years old and [fill:his/her] child [fill 2] is [AGE(PX)] years old.
Are these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 2]
*Second GOTO is to change AGE of child [fill 2]
*Third GOTO is to change AGE of parent [fill 7]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Child
AGE (PX)
AGE(HHREF_B)

Page 29 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.280_00.000 Instrument Variable Name:

QuestionText:

1
2
3

4
5
7
9

08-Aug-12

DEGREE2

QuestionnaireFileName:

Household
Composition

[fill1: Are you/Is ALIAS] [fill2: Reference Person's name's/your] biological (natural), adoptive, step, or foster [fill3:
mother/father] or [fill4: mother/father]-in-law?
Biological (natural) {mother/father]
Adoptive {mother/father}
Step {mother/father]
Foster {mother/father}
{mother/father]-in-law
Refused
Don't know

UniverseText:

RPREL=(7) parent

SkipInstructions:

<1> if AGEDIFF <12 [goto ERR_DEGREE2]
elseif additional PX's remain [goto RPREL]
elseif UNRELTAL >1 [goto FAMNUM]
else [goto HHCHANGE]
<2-5,R,D> if additional PX's remain [goto RPREL]
elseif UNRELTAL >1 [goto FAMNUM]
else [goto HHCHANGE]

Hard Edit:

ERR1_DEGREE2
*Age difference between [fill 2] and child is [AGEDIFF] years.
I have recorded [fill 7] is [AGE(HHREF_B)] years old and [fill:his/her] [fill 2] [fill 8] is [AGE(PX)] years old.
Are these ages and relationships correct?
* Please correct relationship code or age.
*First GOTO is to change Relationship code of [fill 8]
*Second GOTO is to change AGE of parent [fill 8]
*Third GOTO is to change AGE of child [fill 7]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Soft Edit:

Value
Parent
AGE (PX)
AGE(HHREF_B)

ERR2_DEGREE2
*Age difference between [fill 2] and child is only [AGEDIFF] years.
I have recorded [fill 7] is [AGE(HHREF_B)] years old and [fill:his/her] [fill 2] [fill 8] is [AGE(PX)] years old.
Are these ages and relationships correct?
*First GOTO is to change Relationship code of [fill 8]
*Second GOTO is to change AGE of parent [fill 8]
*Third GOTO is to change AGE of child [fill 7]
Questions involved
RPREL: Relationship to Ref Person
AGE
AGE

Value
Parent
AGE (PX)
AGE (HHREF_B)

Page 30 of 30

DRAFT 2013 NHIS Questionnaire - Household Composition
Household Composition
Document Version Date:

Question ID:

HHC.290_01.000 Instrument Variable Name:

QuestionText:

1
2
3

4
5
6
7
9

DEGREE3

08-Aug-12

QuestionnaireFileName:

Household
Composition

[fill1: Are you/Is ALIAS] [fill2: Reference Person's name's/your] full, half, adoptive, step, or foster [fill3: brother/sister] or
[fill4: brother/sister]-in-law?
Full {brother/sister}
Half {brother/sister}
Adopted {brother/sister}
Step {brother/sister]
Foster {brother/sister}
{brother/sister]-in-law
Refused
Don't know

UniverseText:

All siblings

SkipInstructions:

<1-6,R,D> [goto RPREL]