38.7 Survey

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

MajorLifeEventsSAQ

36-Month Interview

OMB: 0925-0593

Document [docx]
Download: docx | pdf

OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

Major Life Events SAQ, Phase 2g

OMB Specification


Major Life Events SAQ


Event Category:

Time-Based

Event:

36M, 60M

Administration:

N/A

Instrument Target:

Primary Caregiver

Instrument Respondent:

Primary Caregiver

Domain:

Neuro-Psychosocial

Document Category:

Scored Assessment

Method:

Self-Administered

Mode (for this instrument*):

In-Person, PAPI

OMB Approved Modes:

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

Estimated Administration Time:

8 minutes

Multiple Child/Sibling Consideration:

Per Event

Special Considerations:

When primary caregiver is female

Version:

1.0

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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Major Life Events SAQ



TABLE OF CONTENTS





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Major Life Events SAQ



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

NUMERIC


ZIP CODE LAST FOUR

4

NUMERIC


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


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.





MAJOR LIFE EVENTS QUESTIONNAIRE


MLE00100. Within the past year, have you...


PARTICIPANT INSTRUCTIONS

  • Listed in the following survey, there are some life experiences that might have occurred during the past year.

  • Please mark "Yes" for those life experiences you have had in the last year and mark "No" for those life experiences you have not had in the last year.

  • If you answer "Yes" to any of the life experiences, mark one of the boxes to show the level of impact.

  • For example, mark the box for "Extremely Negative" if it had an extremely negative impact. Mark the box for "No Impact" if you felt there was no impact. Mark the box for "Extremely Positive" if you felt it had an extremely positive impact.


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

 


MLE01000/(GOTTEN_MARRIED). Gotten married?


Label

Code

Go To

Yes

1


No

2

IN_JAIL


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE02000/(GOTTEN_MARRIED_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE03000/(IN_JAIL). Been in jail or similar institution?


Label

Code

Go To

Yes

1


No

2

PARTNER_DIE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE04000/(IN_JAIL_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE05000/(PARTNER_DIE). Had your spouse or partner die?


Label

Code

Go To

Yes

1


No

2

SLEEP_CHANGE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE06000/(PARTNER_DIE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE07000/(SLEEP_CHANGE). Had a major change in sleeping habits (much more sleep or much less sleep)?


Label

Code

Go To

Yes

1


No

2

DEATH_FAMILY


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE08000/(SLEEP_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE09000/(DEATH_FAMILY). Experienced the death of a close family member (your child, father, mother, sister, brother, grandparent or other)?


Label

Code

Go To

Yes

1


No

2

EAT_CHANGE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE10000/(DEATH_FAMILY_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE11000/(EAT_CHANGE). Had a major change in your eating habits (ate much more or less food)?


Label

Code

Go To

Yes

1


No

2

EXPER_FORCLOSURE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE12000/(EAT_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE13000/(EXPER_FORCLOSURE). Experienced a foreclosure on a mortgage or a loan?


Label

Code

Go To

Yes

1


No

2

DEATH_FRIEND


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

 


MLE14000/(EXPER_FORCLOSURE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE15000/(DEATH_FRIEND). Experienced the death of a close friend?


Label

Code

Go To

Yes

1


No

2

PERSONAL_ACHIEVE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE16000/(DEATH_FRIEND_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE17000/(PERSONAL_ACHIEVE). Had an outstanding personal achievement?


Label

Code

Go To

Yes

1


No

2

MINOR_VIOLATION


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE18000/(PERSONAL_ACHIEVE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE19000/(MINOR_VIOLATION). Had a minor law violation (such as a traffic ticket or disturbing the peace)?


Label

Code

Go To

Yes

1


No

2

WORK_CHANGE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE20000/(MINOR_VIOLATION_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE21000/(WORK_CHANGE). Changed your work situation (such as a different work responsibility, a major change in working conditions or working hours)?


Label

Code

Go To

Yes

1


No

2

NEW_JOB


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE22000/(WORK_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE23000/(NEW_JOB). Started a new job?


Label

Code

Go To

Yes

1


No

2

FAMILY_ILLNESS


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE24000/(NEW_JOB_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE25000/(FAMILY_ILLNESS). Had one of your close family members have a serious injury (your spouse/partner, child, father, mother, sister, brother, grandparent or other)?


Label

Code

Go To

Yes

1


No

2

SEXUAL_DIFF


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE26000/(FAMILY_ILLNESS_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE27000/(SEXUAL_DIFF). Had sexual difficulties?


Label

Code

Go To

Yes

1


No

2

BOSS_TROUBLE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE28000/(SEXUAL_DIFF_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE29000/(BOSS_TROUBLE). Had trouble with your boss (such as you were in danger of losing your job, being suspended or demoted)?


Label

Code

Go To

Yes

1


No

2

TROUBLE_INLAWS


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE30000/(BOSS_TROUBLE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE31000/(TROUBLE_INLAWS). Had trouble with your in-laws?


Label

Code

Go To

Yes

1


No

2

FINANCIAL_CHANGE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE32000/(TROUBLE_INLAWS_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE33000/(FINANCIAL_CHANGE). Had a major change in your financial status (a lot better off or a lot worse off)?


Label

Code

Go To

Yes

1


No

2

CHANGE_FAMILY_CLOSE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE34000/(FINANCIAL_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE35000/(CHANGE_FAMILY_CLOSE). Had a major change in closeness of family members (increased or decreased closeness)?


Label

Code

Go To

Yes

1


No

2

NEW_FAMILY_MEMBER


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE36000/(CHANGE_FAMILY_CLOSE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE37000/(NEW_FAMILY_MEMBER). Gained a new family member (through adoption or a family member moving in, not including your pregnancy)?


Label

Code

Go To

Yes

1


No

2

NEW_PLACE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE38000/(NEW_FAMILY_MEMBER_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE39000/(NEW_PLACE). Moved to a new place?


Label

Code

Go To

Yes

1


No

2

SEPARATION_HUSBAND


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE40000/(NEW_PLACE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE41000/(SEPARATION_HUSBAND). Had a separation from your spouse or partner because you were not getting along?


Label

Code

Go To

Yes

1


No

2

CHURCH_CHANGE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE42000/(SEPARATION_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE43000/(CHURCH_CHANGE). Had a major change in church activities (increased or decreased)?


Label

Code

Go To

Yes

1


No

2

REUNITE_HUSBAND


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE44000/(CHURCH_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE45000/(REUNITE_HUSBAND). Gotten back together with your spouse or partner after a separation?


Label

Code

Go To

Yes

1


No

2

ARGUMENTS_HUSBAND


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE46000/(REUNITE_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE47000/(ARGUMENTS_HUSBAND). Had a major change in number of arguments you have with your spouse or partner (a lot more or a lot fewer arguments)?


Label

Code

Go To

Yes

1


No

2

JOB_CHANGE_HUSBAND


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE48000/(ARGUMENTS_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE49000/(JOB_CHANGE_HUSBAND). Had a change in your spouse's or partner's work (he lost a job or started a new job)?


Label

Code

Go To

Yes

1


No

2

RECREATION_CHANGE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE50000/(JOB_CHANGE_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE51000/(RECREATION_CHANGE). Had a major change in usual type and/or amount of recreation?


Label

Code

Go To

Yes

1


No

2

BORROWED_MORE_15000


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE52000/(RECREATION_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE53000/(BORROWED_MORE_15000). Borrowed more than $15,000 (such as buying a home or business)?


Label

Code

Go To

Yes

1


No

2

BORROWED_LESS_15000


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE54000/(BORROWED_MORE_15000_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE55000/(BORROWED_LESS_15000). Borrowed less than $15,000 (such as buying a car or getting a school loan)?


Label

Code

Go To

Yes

1


No

2

FIRED_JOB


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE56000/(BORROWED_LESS_15000_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE57000/(FIRED_JOB). Been fired from a job?


Label

Code

Go To

Yes

1


No

2

MAJOR_ILLNESS


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE58000/(FIRED_JOB_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE59000/(MAJOR_ILLNESS). Had a major personal illness or injury?


Label

Code

Go To

Yes

1


No

2

CHANGE_SOCIAL_ACTIVITY


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE60000/(MAJOR_ILLNESS_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE61000/(CHANGE_SOCIAL_ACTIVITY). Had a major change in social activities such as parties, movies, visiting (either increased or decreased)?


Label

Code

Go To

Yes

1


No

2

CHANGE_LIVING_COND


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE62000/(CHANGE_SOCIAL_ACTIVITY_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE63000/(CHANGE_LIVING_COND). Had a major change in living conditions of your family (built a new home, remodeled, had your home or neighborhood decline)?


Label

Code

Go To

Yes

1


No

2

DIVORCE


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE64000/(CHANGE_LIVING_COND_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE65000/(DIVORCE). Gotten a divorce?


Label

Code

Go To

Yes

1


No

2

FRIEND_ILLNESS


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE66000/(DIVORCE_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE67000/(FRIEND_ILLNESS). Had a close friend with a serious injury or illness?


Label

Code

Go To

Yes

1


No

2

CHILD_LEAVE_HOME


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE68000/(FRIEND_ILLNESS_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE69000/(CHILD_LEAVE_HOME). Had a son or daughter leave home because of a marriage or school?


Label

Code

Go To

Yes

1


No

2

DROP_GRAD_SCHOOL


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE70000/(CHILD_LEAVE_HOME_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE71000/(DROP_GRAD_SCHOOL). Dropped out or graduated from school?


Label

Code

Go To

Yes

1


No

2

SEPAR_HUSB_WORK


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE72000/(DROP_GRAD_SCHOOL_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE73000/(SEPAR_HUSB_WORK). Had a separation from your spouse or partner because of work, travel, or family needs?


Label

Code

Go To

Yes

1


No

2

ENGAGED


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE74000/(SEPAR_HUSB_WORK_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE75000/(ENGAGED). Gotten engaged to be married?


Label

Code

Go To

Yes

1


No

2

LEFT_HOME


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE76000/(ENGAGED_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE77000/(LEFT_HOME). Left home for the first time?


Label

Code

Go To

Yes

1


No

2

MLE79000


SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE78000/(LEFT_HOME_IMPACT). Negative/Bad or Positive/Good Impact on your life?


Label

Code

Go To

Extremely Negative

1


Moderately Negative

2


Somewhat Negative

3


No Impact

4


Somewhat Positive

5


Moderately Positive

6


Extremely Positive

7



SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences


MLE79000. Thank you for participating in the National Children's Study and for taking the time to complete this survey.



FOR OFFICE USE ONLY:


FOU01000/(P_ID). PARTICIPANT ID:______________________________


FOU02000/(R_P_ID). RESPONDENT ID:____________________________


FOU03000. Click here to insert ROC contact information


Public reporting burden for this collection of information is estimated to average 8 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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