40.2 Survey

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

NoiseMeasurementSetUpInstrument

Noise Subsample Study

OMB: 0925-0593

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OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

Noise Measurement Set-Up Instrument, Phase 2g

OMB Specification


Noise Measurement Set-Up Instrument


Event Category:

Time-Based

Event:

36M, 60M

Administration:

N/A

Instrument Target:

Child's Primary Residence

Instrument Respondent:

Primary Caregiver

Domain:

Environmental

Document Category:

Sample Collection

Method:

Data Collector Administered

Mode (for this instrument*):

In-Person, CAI

OMB Approved Modes:

In-Person, CAI

Estimated Administration Time:

3 minutes

Multiple Child/Sibling Consideration:

Per Event

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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Noise Measurement Set-Up Instrument



TABLE OF CONTENTS





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Noise Measurement Set-Up Instrument



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.





NOISE MONITOR SET-UP


(TIME_STAMP_NMS_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP

  • PRELOAD DWELLING_UNIT_ID FOR THE DWELLING UNIT

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

  • PRELOAD MULT_CHILD AND CHILD_NUM (IF MULT_CHILD = 1), FROM PVST INSTRUMENT.

  • IF MULT_CHILD  = 1, PRELOAD CHILD_QNUM


NMS01000/(STAFF_ID). ENTER STAFF ID

_______________________________________

STAFF ID


NMS02000. NOISE BROCHURE DISTRIBUTION


DATA COLLECTOR INSTRUCTIONS

  • DISTRIBUTE THE NOISE BROCHURE IN ACCORDANCE WITH THE ENVIRONMENTAL NOISE MEASUREMENT SOP.


NMS03000/(NOISE_MEASURE_OKAY). We would like to measure noise in your home.  Is that okay?


Label

Code

Go To

YES

1

OUTDOOR_NOISE_SOURCE

NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


NMS04000/(NOISE_REFUSE). RECORD THE REASON FOR REFUSAL IF GIVEN.


Label

Code

Go To

NONE GIVEN

1

MON_SETUP_COMMENTS

NO ONE WILL BE AT HOME

2

MON_SETUP_COMMENTS

NOT INTERESTED IN NOISE MONITORING

3

MON_SETUP_COMMENTS

DO NOT WANT EQUIPMENT LEFT IN THE HOME

4

MON_SETUP_COMMENTS

OTHER

-5



NMS05000/(NOISE_REFUSE_OTH). SPECIFY:  _______________________________________


SOURCE

New


PROGRAMMER INSTRUCTIONS

GO TO MON_SETUP_COMMENTS


NMS06000/(OUTDOOR_NOISE_SOURCE). Are there any of the following nearby?


DATA COLLECTOR INSTRUCTIONS

  • SELECT ALL THAT APPLY.


Label

Code

Go To

Hospital

1


Fire station

2


Rescue squad station

3


Police station

4


Freeway/Interstate

5


Railroad tracks

6


Airport

7


Industries

8


Commercial/Retail/Shopping Centers

9


OTHER

-5


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


PROGRAMMER INSTRUCTIONS

  • IF OUTDOOR_NOISE_SOURCE  =  ANY COMBINATION OF 1 THROUGH 9, GO TO NMS08000.

  • IF OUTDOOR_NOISE_SOURCE  =  -5, OR ANY COMBINATION OF 1 THROUGH 9 AND -5, GO TO OUTDOOR_NOISE_SOURCE_OTH.

  • IF OUTDOOR_NOISE_SOURCE  =  -1 OR -2, DO NOT ALLOW SELECTION OF ANY OTHER RESPONSE AND GO TO NMS08000.


NMS07000/(OUTDOOR_NOISE_SOURCE_OTH). SPECIFY:  _________________________________________________


NMS08000. NOISE MONITOR SET UP INSTRUCTIONS:


DATA COLLECTOR INSTRUCTIONS

  • SET UP THE NOISE MONITOR IN ACCORDANCE WITH THE ENVIRONMENTAL NOISE MEASUREMENT SOP.


NMS09000/(MON_SETUP). WERE YOU ABLE TO SET UP THE NOISE MONITOR?


Label

Code

Go To

YES

1

SAMPLE_ID

NO

2



NMS10000/(MON_NOT_SETUP). WHY WERE YOU NOT ABLE TO SET UP THE NOISE MONITOR?


Label

Code

Go To

SUPPLIES/EQUIPMENT NOT AVAILABLE

1

MON_SETUP_COMMENTS

EQUIPMENT FAILURE

2

NMS12000

RAN OUT OF TIME

3

MON_SETUP_COMMENTS

REFUSAL

4

MON_SETUP_COMMENTS

OTHER

-5



NMS11000/(MON_NOT_SETUP_OTH). SPECIFY:  _________________________________


PROGRAMMER INSTRUCTIONS

  • GO TO MON_SETUP_COMMENTS


NMS12000. NOISE MONITOR FAILURE


DATA COLLECTOR INSTRUCTIONS

  • IF MON_NOT_SETUP  = 2, COMPLETE THE ENVIRONMENTAL EQUIPMENT PROBLEM LOG.


PROGRAMMER INSTRUCTIONS

  • GO TO MON_SETUP_COMMENTS


NMS13000/(SAMPLE_ID). ENVIRONMENTAL NOISE MEASUREMENT SAMPLE ID

 

| E |___|___|___|___|___|___|___| N E 0 1

NOISE-ENVIRONMENTAL ID


PROGRAMMER INSTRUCTIONS

  • ID MUST BE FORMATTED WITH TWO ALPHA 7 NUMERIC DASH NE01.


NMS14000/(EQUIP_ID). NOISE MONITOR ID

_________________________________________


DATA COLLECTOR INSTRUCTIONS

  • ENTER THE ID OF THE NOISE MONITOR


NMS15000. MONITOR SET-UP DATE


(MON_SET_DATE_MM) MONTH:  |____|____|

                  M      M


(MON_SET_DATE_DD) DAY:    |____|____|

               D       D


(MON_SET_DATE_YYYY) YEAR:    |____|____|____|____|

                 Y       Y       Y      Y


PROGRAMMER INSTRUCTIONS

  • DISPLAY HARD EDIT IF MM, DD OR YYYY ARE OUTSIDE CRITERIA DEFINED IN GENERAL PROGRAMMER INSTRUCTIONS.


NMS16000. MONITOR SET-UP TIME


(MON_SET_TIME) |____|____|  :  |____|____|

    H      H              M     M


(MON_SET_TIME_UNIT)


Label

Code

Go To

AM

1


PM

2



NMS18000/(MON_SETUP_ROOM). IN WHICH ROOM WAS THE NOISE MONITOR SET UP?


Label

Code

Go To

COMMON LIVING AREA

1

MON_SETUP_DISTANCE

CHILD'S BEDROOM

2

CHILD_BEDROOM_SHARED

ADULT BEDROOM

3

MON_SETUP_DISTANCE

OTHER

-5



NMS19000/(MON_SETUP_ROOM_OTH). SPECIFY:  ______________________________________


NMS20000/(CHILD_BEDROOM_SHARED). DOES THE CHILD SHARE THE BEDROOM WITH OTHER FAMILY MEMBER(S)?


Label

Code

Go To

YES

1


NO

2


DON'T KNOW

-2



NMS21000/(MON_SETUP_DISTANCE). RECORD THE DISTANCE OF THE NOISE MONITOR FROM THE WALL.


Label

Code

Go To

LESS THAN 2 FT FROM WALL

1


MORE THAN OR EQUAL TO 2 FEET FROM WALL

2



NMS22000/(MON_SETUP_HEIGHT). RECORD THE HEIGHT OF THE NOISE MONITOR FROM THE FLOOR.


Label

Code

Go To

LESS THAN 3 FT FROM FLOOR

1


MORE THAN OR EQUAL TO 3 FT FROM FLOOR

2



NMS23000/(MON_SETUP_ROOM_WINDOW). RECORD WHERE THE WINDOWS IN THE SET-UP ROOM FACE.


DATA COLLECTOR INSTRUCTIONS

  • SELECT ALL THAT APPLY


Label

Code

Go To

NO WINDOW

1


STREET WITH LIGHT TRAFFIC

2


STREET WITH HEAVY TRAFFIC

3


FREEWAY OR HIGHWAY

4


YARD, GARDEN, GREENSPACE, COURTYARD

5


OTHER

-5



PROGRAMMER INSTRUCTIONS

  • IF MON_SETUP_ROOM_WINDOW  =  1, DO NOT ALLOW SELECTION OF ANY OTHER RESPONSE AND GO TO NEIGHBORHOOD_TYPE.

  • IF MON_SETUP_ROOM_WINDOW  =  ANY COMBINATION OF 2 THROUGH 5, GO TO MON_SETUP_ROOM_WINDOW_OPEN.

  • IF MON_SETUP_ROOM_WINDOW  =  -5 OR ANY COMBINATION OF 2 THROUGH 5 AND -5, GO TO MON_SETUP_ROOM_WINDOW_OTH


NMS24000/(MON_SETUP_ROOM_WINDOW_OTH). SPECIFY:  ______________________________________


NMS25000/(MON_SETUP_ROOM_WINDOW_OPEN). RECORD IF WINDOW(S) IN THE SET-UP ROOM ARE OPEN.


Label

Code

Go To

YES

1


NO

2



NMS26000/(NEIGHBORHOOD_TYPE). RECORD THE TYPE OF NEIGHBORHOOD.


DATA COLLECTOR INSTRUCTIONS

  •   RECORD THE TYPE OF NEIGHBORHOOD BASED ON THE HOUSING CHARACTERISTICS WITHIN ONE BLOCK FROM THE PARTICIPANT'S HOME.


Label

Code

Go To

RURAL - FEW OR NO OTHER NEARBY HOMES WITHIN HALF MILE RADIUS

1

MON_SETUP_COMMENTS

SUBURB - MOSTLY DETACHED SINGLE FAMILY HOMES

2

MON_SETUP_COMMENTS

SUBURB - MOSTLY MULTI-RESIDENCE BUILDINGS

3

MON_SETUP_COMMENTS

SUBURB - MIXED RESIDENTIAL/COMMERCIAL

4

MON_SETUP_COMMENTS

URBAN - MOSTLY DETACHED SINGLE FAMILY HOMES

5

MON_SETUP_COMMENTS

URBAN - MOSTLY MULTI-RESIDENCE BUILDINGS

6

MON_SETUP_COMMENTS

URBAN - MIXED RESIDENTIAL/COMMERCIAL

7

MON_SETUP_COMMENTS

URBAN - MIXED RESIDENTIAL/INDUSTRIAL

8

MON_SETUP_COMMENTS

URBAN - COMMERCIAL - MORE STORES THAN RESIDENTIAL UNITS

9

MON_SETUP_COMMENTS

MOSTLY MANUFACTURED/MOBILE HOMES

10

MON_SETUP_COMMENTS

OTHER

-5


DON'T KNOW

-2

MON_SETUP_COMMENTS


NMS27000/(NEIGHBORHOOD_TYPE_OTH). SPECIFY:  ________________________________________


NMS28000/(MON_SETUP_COMMENTS). RECORD ANY COMMENTS ABOUT THE NOISE MONITOR SET UP.

COMMENTS:  _____________________________________________________________________


(TIME_STAMP_NMS_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP

  • IF NOISE_MEASURE_OKAY  =  2, -1 OR -2, OR IF MON_SETUP  = 2, GO TO TIME_STAMP_NMM_ET.

  • OTHERWISE, GO TO TIME_STAMP_NMM_ST.



NOISE MONITOR MAILING INSTRUCTIONS


(TIME_STAMP_NMM_ST).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


NMM01000/(MON_PARTICIPANT_MAILBACK). AT THIS VISIT, WILL THE RESPONDENT BE ASKED TO MAIL BACK THE NOISE MONITOR?


DATA COLLECTOR INSTRUCTIONS

  • CHECK THE SITE OFFICE VISIT SPECIFICATIONS.


Label

Code

Go To

YES

1


NO

2

TIME_STAMP_NMM_ET


NMM01100. NOISE SAQ AND SHIPPING INSTRUCTION DISTRIBUTION


DATA COLLECTOR INSTRUCTIONS

  • DISTRIBUTE THE NOISE MEASUREMENT SAQ AND NOISE MONITOR SHIPPING INSTRUCTIONS IN ACCORDANCE WITH THE NOISE MEASUREMENT SOP.


NMM02000/(PARTICIPANT_MAILBACK_OKAY). At the end of the noise monitoring period, we would like you to send the noise monitor back to us.  We have a kit with a pre-paid shipper to help you with that.  Is that okay?


Label

Code

Go To

YES

1

SHIPMENT_TRACKING_NUM

NO

2


REFUSED

-1


DON'T KNOW

-2



SOURCE

New


NMM03000/(PARTICIPANT_MAILBACK_REF). RECORD REASON FOR REFUSAL.


Label

Code

Go To

NONE GIVEN

1

KIT_DISTRIB_COMMENTS

WANT DATA COLLECTOR TO PICK UP

2

KIT_DISTRIB_COMMENTS

TOO MUCH TROUBLE TO MAIL STUFF BACK

3

KIT_DISTRIB_COMMENTS

OTHER

-5



NMM04000/(PARTICIPANT_MAILBACK_REF_OTH). SPECIFY:  _____________________________________


SOURCE

New


PROGRAMMER INSTRUCTIONS

  • GO TO KIT_DISTRIB_COMMENTS.


NMM05000/(SHIPMENT_TRACKING_NUM). TRACKING NUMBER: _________________________________________


DATA COLLECTOR INSTRUCTIONS

  • DISTRIBUTE THE NOISE MONITOR SHIPPING KIT IN ACCORDANCE WITH THE ENVIRONMENTAL NOISE MEASUREMENT SOP.

  • ENTER THE SHIPMENT TRACKING NUMBER THAT IS PRINTED ON THE SHIPPING LABEL INCLUDED IN THE KIT.


NMM06000. RECORD THE EXPECTED SHIPMENT DATE FOR THE NOISE MONITOR:


(TARGET_SHIP_DATE_MM) MONTH:  |____|____|

                  M      M


(TARGET_SHIP_DATE_DD) DAY:    |____|____|

               D      D


(TARGET_SHIP_DATE_YYYY) YEAR:  |____|____|____|____|

               Y       Y      Y       Y


PROGRAMMER INSTRUCTIONS

  • DISPLAY HARD EDIT IF MM, DD, OR YYYY ARE OUTSIDE CRITERIA DEFINED IN GENERAL PROGRAMMER INSTRUCTIONS.


NMM07000/(KIT_DISTRIB_COMMENTS). RECORD ANY COMMENTS ABOUT DISTRIBUTING THE NOISE MONITOR SHIPPING KIT.

COMMENTS:   _____________________________________________________


(TIME_STAMP_NMM_ET).


PROGRAMMER INSTRUCTIONS

  • INSERT DATE/TIME STAMP


Public reporting burden for this collection of information is estimated to average 3 minutes per response, including the time for 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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