37.8 Survey

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

60MQuestionnaireChildCare

60-Month Interview

OMB: 0925-0593

Document [docx]
Download: docx | pdf

OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

60M Questionnaire - Child Care Facility, Phase 2g

OMB Specification


60M Questionnaire - Child Care Facility


Event Category:

Time-Based

Event:

60M

Administration:

N/A

Instrument Target:

Child Care Facility

Instrument Respondent:

Primary Caregiver

Domain:

Questionnaire

Document Category:

Questionnaire

Method:

Data Collector Administered

Mode (for this instrument*):

In-Person, CAI;
Phone, CAI

OMB Approved Modes:

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

Estimated Administration Time:

2 minutes

Multiple Child/Sibling Consideration:

Per Child

Special Considerations:

N/A

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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60M Questionnaire - Child Care Facility



TABLE OF CONTENTS





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60M Questionnaire - Child Care Facility



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.





CHILD CARE DAY CARE EXPOSURES


(TIME_STAMP_CCD_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP

  • PRELOAD PARTICIPANT ID (P_ID) AND RESPONDENT ID (R_P_ID) FOR ADULT CAREGIVER.

  • PRELOAD CHILDCARE, RELATIVE_CARE, FAM_BASED_CARE, CENTER_BASE_CARE, AND HEAD_START FROM CORE QUESTIONNAIRE - CHILD (INSTRUMENT_ID = XX)

  • IF CHILDCARE = 1, GO TO CCD01000.

  • OTHERWISE, GO TO TIME_STAMP_CCD_ET.

  • PRELOAD FIRST NAME OF CHILD (C_FNAME) FROM PARTICIPANT VERIFICATION, SCHEDULING, & TRACING QUESTIONNAIRE (INSTRUMENT_ID = XX) AND DISPLAY APPROPRIATE NAME IN "C_FNAME" THROUGHOUT THE INSTRUMENT.

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

  • IF CHILD_SEX IN PARTICIPANT VERIFICATION, SCHEDULING, & TRACING QUESTIONNAIRE (INSTRUMENT_ID = XX) = 1, DISPLAY "he", "him", "his" or "himself" IN APPROPRIATE FIELDS THROUGHOUT INSTRUMENT.  

  • IF CHILD_SEX IN PARTICIPANT VERIFICATION, SCHEDULING, & TRACING QUESTIONNAIRE (INSTRUMENT_ID = XX) = 2, DISPLAY "she", "her" or "herself" IN APPROPRIATE FIELDS THROUGHOUT INSTRUMENT.  


CCD01000. I'd like to ask some questions about each of the childcare locations, other than your own home, where {C_FNAME/the child} is cared for by relatives, by non-relatives, or in a day care or early childhood program.  Thinking about the {#ARRANGEMENT} arrangement . . .


PROGRAMMER INSTRUCTIONS

  • IF FIRST LOOP DISPLAY "FIRST", IF SECOND DISPLAY "SECOND", IF THIRD DISPLAY "third", AND IF FOURTH DISPLAY "fourth" IN {#ARRANGEMENT}.


CCD02000/(ARRANGEMENT_NAME). What is the name of this arrangement?

 

________________________________________

NAME OF ARRANGEMENT


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



SOURCE

New


PROGRAMMER INSTRUCTIONS

  • FOR EACH LOOP, DISPLAY ARRANGEMENT_NAME THROUGHOUT INSTRUMENT AS APPROPRIATE. 


CCD03000/(SMOKE_IN_CHILD_CARE_CENTER). Is {C_FNAME/the child}  ever exposed to cigarette or cigar smoke when {he/she} is at {ARRANGEMENT_NAME}?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard Phase (6M, 12M) (modified)


CCD04000/(SMOKE_NEAR_BUILDING). Have you ever noticed anyone smoking a cigarette or cigar near the entrance to the building or child care location?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD05000/(CHILDCARE_PLAY_OUTDOORS). Does {C_FNAME/the child} ever spend any time outdoors at {ARRANGEMENT_NAME}?


Label

Code

Go To

YES

1


NO

2

CCD12000

REFUSED

-1

CCD12000

DON'T KNOW

-2

CCD12000


SOURCE

National Children’s Study, Vanguard Phase (6M, 12M) (modified)


CCD06000. I'd like to ask some questions about the outdoor area where the child spends time at this childcare arrangement.


CCD07000/(CHILDCARE_PLAY_SURF). When children are outdoors, they may spend time on different types of ground surfaces.  When {C_FNAME/the child} is outdoors at [ARRANGEMENT_NAME], does {he/she} spend any time on . . .


INTERVIEWER INSTRUCTIONS

  • SELECT ALL THAT APPLY


Label

Code

Go To

Grass

1


Bare soil

2


Mulch

3


Concrete

4


Sand

5


Any other surface or surfaces

-5


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard Phase (6M,12M) (modified)


PROGRAMMER INSTRUCTIONS

  • IF CHILDCARE_PLAY_SURF = ANY COMBINATION OF 1 THROUGH 5, GO TO CHILDCARE_SHADE.

  • IF CHILDCARE_PLAY_SURF = -5, OR ANY COMBINATION OF 1 THROUGH 5 AND -5, GO TO CHILDCARE_PLAY_SURF_OTH.

  • IF CHILDCARE_PLAY_SURF = -1 OR -2, DO NOT ALLOW ANY OTHER RESPONSES AND GO TO CHILDCARE_SHADE.


CCD08000/(CHILDCARE_PLAY_SURF_OTH). What type of surface or surfaces?

 

SPECIFY:  ____________________________________


DATA COLLECTOR INSTRUCTIONS

  • PROBE "Anything else?"

  • LIST ALL OTHER SURFACES SEPARATED BY COMMAS


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard  Phase (6M, 12M) (modified)


CCD09000/(CHILDCARE_SHADE). Is the area where {C_FNAME/the child} spends time outdoors shaded, for example by trees, buildings, or screens?


Label

Code

Go To

YES

1


NO

2


SOMETIMES

3


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD10000/(CHILDCARE_CARS_IDLE). Do cars or trucks frequently drive by, or idle with the engine running, near the area where {C_FNAME/the child} spends time outdoors?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD11000/(CHILDCARE_NESTS). Have you ever noticed any bird, insect, or other animal nests near this outdoor area?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD12000. I'd like to ask some questions about the building at this arrangement.  If there is more than one building associated with this arrangement, please think about the building in which {C_FNAME/the child} spends the most time.


CCD13000/(CHILDCARE_1978). Was this building constructed before 1978?


Label

Code

Go To

YES

1


NO

2

CHILDCARE_BASEMENT

REFUSED

-1

CHILDCARE_BASEMENT

DON'T KNOW

-2

CHILDCARE_BASEMENT


SOURCE

New


CCD14000/(CHILDCARE_PAINT). Have you ever noticed any peeling or chipping paint inside this building?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD15000/(CHILDCARE_BASEMENT). Does {C_FNAME/the child} ever spend time in a classroom or playroom that is in a basement or below ground at {ARRANGEMENT_NAME}?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD16000/(CHILDCARE_WINDOWS). Have you ever seen open windows anywhere in this building?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD17000/(CHILDCARE_MOLD). Have you ever seen or smelled any mold or mildew in this building?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD18000/(CHILDCARE_ODORS). Have you ever noticed any excessive odors in this building, such as those from cleaning products, art supplies, or air fresheners?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD19000/(CHILDCARE_HOT_WATER). Have you ever noticed any sinks without hot water in this arrangement?


Label

Code

Go To

YES

1


NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


CCD20000/(CHILDCARE_WATER_SOURCE). What is the source of {C_FNAME/the child}'s drinking water at {ARRANGEMENT_NAME}?


INTERVIEWER INSTRUCTIONS

  • SELECT ALL THAT APPLY


Label

Code

Go To

Tap water

1


Filtered tap water

2


Bottled water

3


Some other source

-5


REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard Phase (6M, 12M) (modified)


PROGRAMMER INSTRUCTIONS

  • IF CHILDCARE_WATER_SOURCE = ANY COMBINATION OF 1 THROUGH 3, GO TO CCD22000.

  • IF CHILDCARE_WATER_SOURCE = -5, OR ANY COMBINATION OF 1 THROUGH 3 AND -5, GO TO CHILDCARE_WATER_SOURCE_OTH.

  • IF CHILDCARE_WATER_SOURCE = -1 OR -2, DO NOT ALLOW ANY OTHER RESPONSES AND GO TO CCD22000.


CCD21000/(CHILDCARE_WATER_SOURCE_OTH). SPECIFY:   __________________________________________


INTERVIEWER INSTRUCTIONS

  • PROBE "Anything else?"

  • LIST ALL OTHER WATER SOURCES SEPARATED BY COMMAS.


Label

Code

Go To

REFUSED

-1


DON'T KNOW

-2



SOURCE

National Children’s Study, Vanguard Phase (6M, 12M) (modified)


CCD22000. We would now like to ask you some questions about noise at [ARRANGEMENT_NAME].  We understand that you may not be in the child care location for much time, so please consider the noise {C_FNAME/the child} may experience during {his/her} time in the location.


CCD23000/(NOISE_CHILDCARE). Thinking about noise in this child care arrangement, how much do you think the noise bothers, disturbs, or annoys {him/her}?


Label

Code

Go To

Extremely

1


Very much

2


Moderately

3


Slightly

4


Not at all

5


REFUSED

-1


DON'T KNOW

-2



SOURCE

The International Commission on Biological Effects of Noise’s (ICBEN’s) Community Response to Noise Team (in homes) (modified)


PROGRAMMER INSTRUCTIONS

  • IF NOISE_CHILDCARE = 1, 2, 3, OR 4, GO TO NOISE_CHILDCARE_SCALE.

  • OTHERWISE, GO TO PROGRAMMER INSTRUCTIONS FOLLOWING NOISE_CHILDCARE_SCALE.


CCD24000/(NOISE_CHILDCARE_SCALE). What number from zero to ten best shows how much you would say {C_FNAME/the child} is bothered, disturbed, or annoyed by noise at {ARRANGEMENT_NAME}?  Zero means {he/she} is not bothered at all and ten means {he/she} is extremely bothered.


Label

Code

Go To

0

0


1

1


2

2


3

3


4

4


5

5


6

6


7

7


8

8


9

9


10

10


REFUSED

-1


DON'T KNOW

-2



SOURCE

The International Commission on Biological Effects of Noise’s (ICBEN’s) Community Response to Noise Team (in homes) (modified)


PROGRAMMER INSTRUCTIONS

  • IF ALL FOUR OF THE FOLLOWING:  RELATIVE_CARE, FAM_BASED_CARE, CENTER_BASE_CARE, AND HEAD_START =1, AND

    • IF TOTAL NUMBER OF LOOPS ≠ 4, GO TO CCD01000.

    • IF TOTAL NUMBER OF LOOPS = 4, GO TO TIME_STAMP_CCD_ET.

  • IF ONLY THREE OF THE FOLLOWING:  RELATIVE_CARE, FAM_BASED_CARE, CENTER_BASE_CARE, AND/OR HEAD_START = 1, AND

    • IF TOTAL NUMBER OF LOOPS ≠ 3, GO TO CCD01000.

    • IF TOTAL NUMBER OF LOOPS = 3, GO TO TIME_STAMP_CCD_ET.

  • IF ONLY TWO OF THE FOLLOWING:  RELATIVE_CARE, FAM_BASED_CARE, CENTER_BASE_CARE, AND/OR HEAD_START = 1, AND

    • IF TOTAL NUMBER OF LOOPS ≠ 2, GO TO CCD01000.

    • IF TOTAL NUMBER OF LOOPS = 2, GO TO TIME_STAMP_CCD_ET.

  • IF ONLY ONE OF THE FOLLOWING:  RELATIVE_CARE, FAM_BASED_CARE, CENTER_BASE_CARE, OR HEAD_START =1, GO TO TIME_STAMP_CCD_ET.


(TIME_STAMP_CCD_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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