Form 3.1 Survey

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months and Sibling Birth Enrollment

ValidationQuestionnaire

Validation Interview

OMB: 0925-0593

Document [docx]
Download: docx | pdf

OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

Validation Questionnaire, Phase 2g

OMB Specification


Validation Questionnaire

Event Category:

Trigger-Based

Event:

Validation

Administration:

Pre-Pregnancy, PV1, PV2, Pre-Natal Father, Post-Natal Father, Secondary Residence, Birth, 3M, 6M, 9M, 12M, 18M, 24M, 30M, 36M, 42M, 48M, 54M, 60M

Instrument Target:

Data Collector

Instrument Respondent:

Pre-Pregnant Woman;

Pregnant Woman (PV1, PV2);

Biological Mother (Birth);

Father/Father Figure (Pre-Natal Father, Post-Natal Father);

Secondary Residence Caregiver (Secondary Residence);

Primary Caregiver (3M, 6M, 9M, 12M, 18M, 24M, 30M, 36M, 42M, 48M, 54M, 60M)

Domain:

Questionnaire

Document Category:

Questionnaire

Method:

Data Collector Administered

Mode (for this instrument*):

Phone, CAI

OMB Approved Modes:

In-Person, CAI;
Phone, CAI;
Web-Based, CAI

Estimated Administration Time:

2 minutes

Multiple Child/Sibling Consideration:

N/A

Special Considerations:

N/A

Version:

3.0

MDES Release:

4.0

*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.


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Validation Questionnaire



TABLE OF CONTENTS





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Validation Questionnaire



GENERAL PROGRAMMER INSTRUCTIONS:

WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:


DATA ELEMENT FIELDS

MAXIMUM CHARACTERS PERMITTED

DATA TYPE

PROGRAMMER INSTRUCTIONS

ADDRESS AND EMAIL FIELDS

100

CHARACTER


UNIT AND PHONE FIELDS

10

CHARACTER


_OTH AND COMMENT FIELDS

255

CHARACTER

  • Limit text to 255 characters

FIRST NAME AND LAST NAME

30

CHARACTER

  • Limit text to 30 characters

ALL ID FIELDS

36

CHARACTER


ZIP CODE

5

CHARACTER


ZIP CODE LAST FOUR

4

CHARACTER


CITY

50

CHARACTER


DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.)

10

NUMERIC


CHARACTER

  • DISPLAY AS MM/DD/YYYY

  • STORE AS YYYY-MM-DD

  • HARD EDITS:

MM MUST EQUAL 01 TO 12

DD MUST EQUAL 01 TO 31

YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR.

TIME VARIABLES

TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION

NUMERIC

  • HARD EDITS:

HOURS MUST BE BETWEEN 00 AND 12;

MINUTES MUST BE BETWEEN 00 AND 59

NUMBER OF HOURS PER DAY

TWO-DIGIT HOUR

NUMERIC

  • HARD EDITS:

HOURS MUST BE BETWEEN 1 AND 24

NUMBER OF DAYS PER WEEK

ONE-DIGIT

NUMERIC

  • HARD EDITS:

DAYS PER WEEK MUST BE BETWEEN 1 AND 7





Instrument Guidelines for Participant and Respondent IDs:

PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).


POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.



A REMINDER:

ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.





INTERVIEWER INTRODUCTION


(TIME_STAMP_II_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.

  • PRELOAD EVENT_TYPE

  • PRELOAD NAME OF INTERVIEWER, DAY AND DATE OF INTERVIEW, MONTH OF INTERVIEW AND INS_MODE ASSOCIATED WITH EVENT_TYPE.

  • IF EVENT_TYPE = 7 (PPG), 11 (PRE-PREG), 13 (PREG VISIT 1), 15 (PREG VISIT 2), 18 (BIRTH), OR 19 (PRE-NATAL FATHER):

    • PRELOAD PARTICIPANT ID (P_ID).

    • PRELOAD R_FNAME (RESPONDENT'S FIRST NAME), SEX (RESPONDENT'S SEX), AND PHONE_NBR (BEST PHONE NUMBER) FOR P_ID FROM INSTRUMENT_ID = XX (PARTICIPANT VERIFICATON, SCHEDULING, AND TRACING (PVST) INSTRUMENT).

  • IF EVENT_TYPE = 18 (BIRTH), 23 (3-MONTH), 24 (6-MONTH), 26 (9-MONTH), XX (POST-NATAL FATHER), XX (SECONDARY RESIDENCE), 27 (12-MONTH), 30 (18-MONTH), 31 (24-MONTH), 36 (30-MONTH), 37 (36-MONTH), 38 (42-MONTH), XX (48-MONTH), XX (54-MONTH), OR XX (60-MONTH):

    • PRELOAD P_ID FOR CHILD AND R_P_ID FOR ADULT CAREGIVER ASSOCIATED WITH EVENT_TYPE.

    • PRELOAD R_FNAME (RESPONDENT'S FIRST NAME), C_FNAME (CHILD'S FIRST NAME), SEX (RESPONDENT'S SEX), CHILD_SEX (CHILD'S SEX), MULTI_BIRTH_ID, AND PHONE_NBR (BEST PHONE NUMBER) FOR P_ID FROM INSTRUMENT_ID = XX (PARTICIPANT VERIFICATON, SCHEDULING, AND TRACING (PVST) INSTRUMENT).

    • IF MULTI_BIRTH_ID = NULL AND: 

      • IF C_FNAME ≠ -1 OR -2, DISPLAY "C_FNAME" AS APPROPRIATE THROUGHOUT THE INSTRUMENT.

      • IF C_FNAME = -1 OR -2, DISPLAY "the child" AS APPROPRIATE THROUGHOUT THE INSTRUMENT.

    • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "the children" AS APPROPRIATE THROUGHOUT THE INSTRUMENT.

  • PRELOAD LOCAL ROC TOLL-FREE NUMBER AND DISPLAY AS APPROPRIATE THROUGHOUT INSTRUMENT.


II01000/(INTRO_1). Hello, my name is [INTERVIEWER’S NAME] and I am calling on behalf of the National Children’s Study. May I please speak with {R_FNAME}?


INTERVIEWER INSTRUCTIONS

  • REPEAT OR CLARIFY YOUR INTRODUCTORY INFORMATION AS NEEDED. 


Label

Code

Go To

YES

1

TIME_STAMP_II_ET

NO

2

II03000

NO SUCH PERSON AT ADDRESS/PHONE

3


REFUSED

-1

II03000

DON'T KNOW

-2

II03000


SOURCE

National Children’s Study, Vanguard Phase (Preg Screener PB) (modified)


PROGRAMMER INSTRUCTIONS

  • DISPLAY R_FNAME.


II02000/(VERIFY_NUMBER). WAS {PHONE_NBR/CORRECT PHONE NUMBER} DIALED?


Label

Code

Go To

YES

1

CS01000

NO

2

CS01000


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF PHONE_NBR IN PARTICIPANT VERIFICATION AND TRACING QUESTIONNAIRE ≠ -1 OR -2, DISPLAY PHONE_NBR.

  • OTHERWISE, DISPLAY "CORRECT PHONE NUMBER."


II03000. What would be a good day and time to reach {him/her}?


INTERVIEWER INSTRUCTIONS

  • ENTER DAY OF WEEK.

  • ENTER HOUR AND MINUTE VALUES.

  • SELECT AM OR PM. 

  • SELECT APPROPRIATE "BEFORE", "AFTER", OR "AT" RESPONSE. 


SOURCE

National Children’s Study, Vanguard Phase (LI Non- and Preg) (modified)


(DAY_WEEK_1) ENTER DAY OF WEEK.

_____________________


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



(BEST_TTC_1) ENTER HOUR AND MINUTE VALUES.

 

|___|___| : |___|___|        

   H     H         M      M


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



(BEST_TTC_2) SELECT AM OR PM. 


Label

Code

Go To

AM

1


PM

2


REFUSED

-1


DON'T KNOW

-2



(BEST_TTC_3) SELECT APPROPRIATE RESPONSE. 


Label

Code

Go To

BEFORE TIME REPORTED

1


AT TIME REPORTED

2


AFTER TIME REPORTED

3


REFUSED

-1


DON'T KNOW

-2


NOT APPLICABLE

-7



PROGRAMMER INSTRUCTIONS

  • IF SEX FOR R_P_ID = 1 (MALE), DISPLAY "him".

  • IF SEX FOR R_P_ID = 2 (FEMALE), DISPLAY "her".

  • OTHERWISE, IF SEX FOR R_P_ID = 3, 6, OR -4, DISPLAY "him/her".


II04000/(PHONE). ​Is this a good phone number to reach {R_FNAME}?


Label

Code

Go To

YES

1

CS02000

NO

2

CS02000

REFUSED

-1

CS02000

DON'T KNOW

-2

CS02000


SOURCE

National Children’s Study, Vanguard Phase (LI Non- and Preg) (modified)


PROGRAMMER INSTRUCTIONS

  • DISPLAY R_FNAME.

  • IF PHONE = 2, -1, OR -2, SET FLAG TO UPDATE PHONE_NBR ​IN PARTICIPANT VERIFICATION AND TRACING QUESTIONNAIRE.


(TIME_STAMP_II_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.



PARTICIPANT IDENTIFICATION


(TIME_STAMP_PI_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.


PI02000/(INTRO_2). You recently spoke with one of our staff members. We routinely re-contact people to see if circumstances have changed.


Label

Code

Go To

CONTINUE

1


RESPONDENT/PARTICIPANT STATES THAT NO INTERVIEW TOOK PLACE

2

CS04000


PROGRAMMER INSTRUCTIONS

  • IF INTRO_2 ​= 2, SET FLAG TO RESCHEDULE THE INTERVIEW WITH PARTICIPANT/RESPONDENT.


PI04000/(INTRO_3). ​Is this a good time to talk?


Label

Code

Go To

YES

1

TIME_STAMP_PS_ST

NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


PI05000. ​What would be a better time for you?


INTERVIEWER INSTRUCTIONS

  • ENTER DAY OF WEEK.

  • ENTER HOUR AND MINUTE VALUES.

  • SELECT AM OR PM. 

  • SELECT APPROPRIATE "AFTER", "BEFORE" OR "AT" TIME REPORTED RESPONSE. 


SOURCE

​National Children’s Study, Vanguard Phase (Preg Screener PB) (modified)


(DAY_WEEK_2) ENTER DAY OF WEEK.

_____________________


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



(R_BEST_TTC_1) ENTER HOUR AND MINUTE VALUES.

 

l___|___| : |___|___|  

  H     H        M    M


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



(R_BEST_TTC_2) ​SELECT AM OR PM. 


Label

Code

Go To

AM

1


PM

2


REFUSED

-1


DON'T KNOW

-2



(R_BEST_TTC_3) ​SELECT APPROPRIATE RESPONSE. 


Label

Code

Go To

BEFORE TIME REPORTED

1


AT TIME REPORTED

2


AFTER TIME REPORTED

3


REFUSED

-1


DON'T KNOW

-2



PROGRAMMER INSTRUCTIONS

  • GO TO ​TIME_STAMP_PSZ_ET.


(TIME_STAMP_PI_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.



PRIVACY STATEMENT


(TIME_STAMP_PS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.


PS01000. ​All information will be kept private and used for Study purposes only. You may refuse to answer any question or stop at any time.


PS02000/(INT_CONFIRM). According to our records, {PREVIOUS INTERVIEWER’S NAME} spoke with you on {DAY AND DATE OF PREVIOUS INTERVIEW}. Do you remember speaking with [him/her]?


PROGRAMMER INSTRUCTIONS

  • DISPLAY NAME OF PREVIOUS INTERVIEWER AND DAY/DATE OF PREVIOUS INTERVIEW.

  • DISPLAY "him" OR "her" BASED ON SEX OF THAT INTERVIEWER.


Label

Code

Go To

YES

1


NO

2

CS04000

REFUSED

-1

CS04000

DON'T KNOW

-2

CS04000


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF INT_CONFIRM = 2, -1, OR -2, SET FLAG TO RESCHEDULE INTERVIEW WITH PARTICIPANT/RESPONDENT.


(TIME_STAMP_PS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.



VISIT-SPECIFIC ITEMS


(TIME_STAMP_VSI_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.

  • IF EVENT_TYPE = 7 (PREGNANCY PROBABILITY GROUP FOLLOW-UP QUESTIONNAIRE), GO TO PREGNANT_PPG.

  • IF EVENT_TYPE = 11 (PRE-PREG), GO TO EVER_PREG_PP.

  • IF EVENT_TYPE = 13 (PREG VISIT 1), GO TO HOME_TEST_PV1. 

  • IF EVENT_TYPE = 15 (PREG VISIT 2), GO TO WORKING_PV2.

  • IF EVENT_TYPE = 19 (PRE-NATAL FATHER), GO TO F_CANCER_PRNF.

  • IF EVENT TYPE = XX (POST-NATAL FATHER), GO TO DIFF_ROUT_IDEAS_PONF.

  • IF EVENT_TYPE = 18 (BIRTH), GO TO BIRTH_PR_LOG_BIRTH.

  • IF EVENT_TYPE = 23 (3-MONTH), GO TO SLEEP_ROOM_3M.

  • IF EVENT_TYPE = 24 (6-MONTH), GO TO CHILD_HAVE_TEETH_6M.

  • IF EVENT_TYPE = 26 (9-MONTH), GO TO REACH_1_9M.

  • IF EVENT_TYPE = 27 (12-MONTH), GO TO TREATED_LICE_12M.

  • IF EVENT_TYPE = 30 (18-MONTH), GO TO SLEEP_ROOM_18M.

  • IF EVENT_TYPE = 31 (24-MONTH), GO TO DEAF_24M.

  • IF EVENT_TYPE = 36 (30-MONTH), GO TO EAT_NON_FOOD_30M.

  • IF EVENT_TYPE = 37 (36-MONTH), GO TO BIKE_AREA_BACKYARD_36M.

  • IF EVENT_TYPE = 38 (42-MONTH), GO TO PLAY_FIRE_42M.

  • IF EVENT_TYPE = XX (48-MONTH), GO TO TAN_30MIN_SUN_48M.

  • IF EVENT_TYPE = XX (54-MONTH), GO TO PLAY_FIRE_54M.

  • IF EVENT_TYPE = XX (60-MONTH), GO TO BIKE_AREA_BACKYARD_60M.

  • IF EVENT_TYPE = XX (SECONDARY RESIDENCE) GO TO MOLD_SEC_RES.

  • IF EVENT_TYPE = XX(RETROSPECTIVE PREGNANCY) GO TO PREG_VITAMIN_2_RETRO_PREG.


VSI01000/(PREGNANT_PPG). ​Were you asked whether you were pregnant?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI02000/(EVER_PREG_PP). ​Were you asked if you had ever been pregnant, including live births, miscarriages, stillbirths, ectopic pregnancies, and pregnancy terminations?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified - added "​, including live births, miscarriages, stillbirths, ectopic pregnancies, and pregnancy terminations?"


VSI03000/(INSURE_PP). ​Were you asked whether you were currently covered by any kind of health insurance or some other kind of health care plan at the time of the interview?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI04000/(HOME_TEST_PV1). ​Were you asked whether you used a home pregnancy test to help find out you were pregnant?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI04100/(PREG1). In that interview, were you asked about your baby’s due date?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI05000/(PREG2). In that interview, were you asked about where you planned to deliver your baby?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI06000/(HOSPITAL). Since becoming pregnant, had you spent at least one night in the hospital as of {DATE OF INTERVIEW}?  


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument


PROGRAMMER INSTRUCTIONS

  • PRELOAD AND DISPLAY DATE OF MOST RECENT PREGNANCY VISIT 2 INTERVIEW.

  • DISPLAY DATE AS MM/DD/YYYY.


VSI07000/(F_CANCER_PRNF). Were you asked whether you had been told by a doctor or other health care provider that you had any type of cancer?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI08000/(PLAN_ATTEND_BIRTH_PRNF). ​Were you asked whether you planned to be present at the birth?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument


VSI09000/(DIFF_ROUT_IDEAS_PONF). ​Were you asked whether you and {C_FNAME/the child/the children}’s mother have different ideas regarding {C_FNAME/the child/the children}’s eating, sleeping, and other routines?  


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI10000/(F_CANCER_PONF). ​Were you asked whether you had been told by a doctor or other health care provider that you had any type of cancer?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI11000/(BIRTH). Were you asked about where in your home you planned for {C_FNAME/the child/the children} to sleep?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI12000/(VACCINE). At that time, did you plan for {C_FNAME/the child/the children} to have well-baby shots or vaccinations?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument


VSI13000/(CHILDSLP). Were you asked about {C_FNAME/the child/the children}’s sleeping habits?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI14000/(VCHILDCARE). Were you asked about arrangements for child care?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument


VSI15000/(CHILD_HAVE_TEETH_6M). ​Were you asked whether {C_FNAME/the child/the children} {has/have} teeth?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "has". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "have". 


VSI16000/(SLEEP_ROOM_6M). Were you asked what room {C_FNAME/the child/the children} {sleeps/sleep} in?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "sleeps". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "sleep". 


VSI17000/(CHILDSKILL). Were you asked about things that {C_FNAME/the child/the children} could do like following you with {his/her/their} eyes?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


VSI18000/(R_HCARE_9M). ​Were you asked what kind of place {C_FNAME/the child/the children} usually went to when {he/she/they} needed routine or well-child care, such as a check-up or well-baby shots (immunizations)?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL:

    • AND IF CHILD_SEX = 1, DISPLAY "he".

    • AND IF CHILD_SEX = 2, DISPLAY "she".

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "they".


VSI19000/(TREATED_LICE_12M). ​Were you asked whether you had treated {C_FNAME/the child/the children} for lice or scabies?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI20000/(DEAF_12M). ​Were you asked whether a doctor ever told you that {C_FNAME/the child/the children} {has/have} difficulty hearing or deafness, not including a temporary loss of hearing due to a cold or congestion? 


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "has". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "have". 


VSI21000/(SLEEP_ROOM_18M). Were you asked what room {C_FNAME/the child/the children} {sleeps/sleep} in?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "sleeps". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "sleep".


VSI22000/(TREATED_LICE_18M). ​Were you asked whether you had treated {C_FNAME/the child/the children} for lice or scabies?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI23000/(DEAF_24M). ​Were you asked whether a doctor ever told you that {C_FNAME/the child/the children} {has/have} difficulty hearing or deafness? Do not include a temporary loss of hearing due to a cold or congestion. 


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "has". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "have". 


VSI23100/(TREATED_LICE_24M). ​Were you asked whether you had treated {C_FNAME/the child/the children} for lice or scabies?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI24000/(DIET_30M). In {MONTH OF INTERVIEW}, how much choice did you allow {C_FNAME/the child/the children} in deciding what foods {he/she/they} ate at meals?


Label

Code

Go To

He or she could choose from any food available

1


He or she was given a choice from a few alternatives that I select

2


I decide what he or she will eat

3


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "eats". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "eat". 


VSI25000/(EVALUATE_OVERALL_ACTIVITY_30M). Were you asked whether {C_FNAME/the child/the children} {was/were} more active than other children {his/her/their} age, about as active as children {his/her/their} age, or less active than other children {his/her/their} age? 


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

National Children's Study, Vanguard Phase, Validation Instrument (modified)


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL AND:

    • IF CHILD_SEX = 1, DISPLAY "his" and "was".

    • IF CHILD_SEX = 2, DISPLAY "her" and "was".

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "their" and "were". 


VSI26000/(BIKE_AREA_BACKYARD_36M). Were you asked whether you have access to an area suitable to ride a tricycle, bike or scooter within your backyard or home environment?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI27000/(TAN_30MIN_SUN_36M). ​Were you asked whether {C_FNAME/the child/the children} {tans or burns/tan or burn} after being in direct sunlight for more than 30 minutes?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "tans or burns". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "tan or burn".


VSI28000/(PLAY_FIRE_42M). ​Were you asked how often {C_FNAME/the child/the children} played with fire (matches, candles, lighters, etc.) in the last 6 months?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI29000/(JUMP_SURFACES_42M). Were you asked how often {C_FNAME/the child/the children} jumped off furniture or other structures (playground equipment, etc.) in the last 6 months?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI30000/(TAN_30MIN_SUN_48M). ​Were you asked whether {C_FNAME/the child/the children} {tans or burns/tan or burn} after being in direct sunlight for more than 30 minutes?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


DATA COLLECTOR INSTRUCTIONS

IF MULTI_BIRTH_ID = NULL, DISPLAY "tans or burns". 
IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "tan or burn".


VSI31000/(BIKE_AREA_BACKYARD_48M). Were you asked whether you have access to an area suitable to ride a tricycle, bike or scooter within your backyard or home environment?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI32000/(PLAY_FIRE_54M). ​Were you asked how often {C_FNAME/the child/the children} played with fire (matches, candles, lighters, etc.) in the last 6 months?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI33000/(JUMP_SURFACES_54M). Were you asked how often {C_FNAME/the child/the children} jumped off furniture or other structures (playground equipment, etc.) in the last 6 months?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI34000/(BIKE_AREA_BACKYARD_60M). Were you asked whether you have access to an area suitable to ride a tricycle, bike or scooter within your backyard or home environment?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI35000/(TAN_30MIN_SUN_60M). ​Were you asked whether {C_FNAME/the child/the children} {tans or burns/tan or burn} after being in direct sunlight for more than 30 minutes?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "tans or burns". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "tan or burn".


VSI36000/(MOLD_SEC_RES). ​Were you asked whether in the six months prior to the interview, you had seen any mold or mildew on walls or other surfaces, other than the shower or bathtub, inside your home?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI37000/(NEIGH_TRUST_SEC_RES). ​Were you asked whether people in your neighborhood can be trusted? 


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


VSI39000/(PREG_VITAMIN_2_RETRO_PREG). ​Were you asked whether you regularly took multivitamins, prenatal vitamins, folate, or folic acid during your most recent pregnancy?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


VSI40000/(GOING_WAY_RETRO_PREG). Were you asked how often in the last month you have felt that things were going your way?


Label

Code

Go To

YES

1

TIME_STAMP_VSI_ET

NO

2

TIME_STAMP_VSI_ET

REFUSED

-1

TIME_STAMP_VSI_ET

DON'T KNOW

-2

TIME_STAMP_VSI_ET


SOURCE

New


(TIME_STAMP_VSI_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.



PARTICIPANT SATISFACTION


(TIME_STAMP_PSZ_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.


PSZ01000. ​These next questions are about your experience in the Study. 


PSZ02000/(EXPERIENCE). ​In general, has your experience with the National Children’s Study been…


Label

Code

Go To

Mostly negative

1


Somewhat negative

2


Neither positive nor negative

3


Somewhat positive

4


Mostly positive

5


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard Phase (PV1 SAQ, PV2 SAQ) (modified)


PSZ03000/(INT_LENGTH). Did you think the interview was…


Label

Code

Go To

Too short

1


Just about right

2


Too long

3


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard Phase (PV1 SAQ, PV2 SAQ) (modified)


PSZ04000/(SAT_COMMENTS). ​Is there anything else you would like to tell us about {the {child/children}'s or} your experience with the NCS?


Label

Code

Go To

YES

1


NO

2

TIME_STAMP_PSZ_ET

REFUSED

-1

TIME_STAMP_PSZ_ET

DON'T KNOW

-2

TIME_STAMP_PSZ_ET


SOURCE

National Children’s Study, Vanguard Phase (PV1 SAQ, PV2 SAQ) (modified)


PROGRAMMER INSTRUCTIONS

  • IF EVENT_TYPE = 18 (BIRTH), 23 (3-MONTH), 24 (6-MONTH), 26 (9-MONTH), XX (POST-NATAL FATHER), XX (SECONDARY RESIDENCE), 27 (12-MONTH), 30 (18-MONTH), 31 (24-MONTH), 36 (30-MONTH), 37 (36-MONTH), 38 (42-MONTH), XX (48-MONTH), XX (54-MONTH), OR XX (60-MONTH), DISPLAY "the {child/children}'s or".

  • IF MULTI_BIRTH_ID = NULL, DISPLAY "child". 

  • IF MULTI_BIRTH_ID ≠ NULL, DISPLAY "children".


PSZ05000/(SAT_COMMENTS_OTH). SPECIFY:  ______________________________________________ 


INTERVIEWER INSTRUCTIONS

  • INCLUDE ANY COMMENTS VOLUNTEERED BASED ON "YES" RESPONSE TO PREVIOUS QUESTION.


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



SOURCE

​National Children’s Study, Vanguard Phase (PV1 SAQ, PV2 SAQ) (modified)


(TIME_STAMP_PSZ_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.

  • SKIP TO CLOSING STATEMENT BASED ON THE RESPONSES BELOW​

    • IF INTRO_3 = 2 AND R_BEST_TTC_1 ≠ -1 OR -2, GO TO CS05000.

    • OTHERWISE, GO TO CS06000.



CLOSING STATEMENTS


(TIME_STAMP_CS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.


CS01000. ​I apologize for bothering you. I have the wrong number. Thank you for your time. 


INTERVIEWER INSTRUCTIONS

  • END INTERVIEW AND DISPOSITION CASE AS APPROPRIATE.


PROGRAMMER INSTRUCTIONS

  • GO TO TIME_STAMP_CS_ET.


CS02000. ​I will try to reach {him/her} on the day and time you gave me. Thank you again for speaking with me today. 


INTERVIEWER INSTRUCTIONS

  • END INTERVIEW AND DISPOSITION CASE AS APPROPRIATE.


PROGRAMMER INSTRUCTIONS

  • IF SEX FOR R_P_ID = 1 (MALE), DISPLAY "him".

  • IF SEX FOR R_P_ID = 2 (FEMALE), DISPLAY "her".

  • OTHERWISE, IF SEX FOR R_P_ID = 3, 6, OR -4, DISPLAY "him/her".

  • GO TO TIME_STAMP_CS_ET.


CS04000. Thank you for your time.  Someone will call you back to schedule an appointment to complete the interview.


INTERVIEWER INSTRUCTIONS

  • ​END INTERVIEW AND DISPOSITION CASE AS APPROPRIATE.


PROGRAMMER INSTRUCTIONS

  • GO TO TIME_STAMP_CS_ET.


CS05000. ​Those are all the questions I have. Thank you so much for your time and cooperation. If you have any questions, please contact us at {LOCAL ROC TOLL-FREE NUMBER}. Goodbye.


INTERVIEWER INSTRUCTIONS

  • END INTERVIEW AND DISPOSITION CASE AS APPROPRIATE.


PROGRAMMER INSTRUCTIONS

  • DISPLAY LOCAL ROC TOLL-FREE NUMBER.

  • GO TO TIME_STAMP_CS_ET.


CS06000. ​Thank you so much for your time. If you have any questions, please contact us at {LOCAL ROC TOLL-FREE NUMBER}. Goodbye.


INTERVIEWER INSTRUCTIONS

  • END INTERVIEW AND DISPOSITION CASE AS APPROPRIATE.


PROGRAMMER INSTRUCTIONS

  • DISPLAY LOCAL ROC TOLL-FREE NUMBER.


(TIME_STAMP_CS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP.


Public reporting burden for this collection of information is estimated to average 2 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.

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