Text Message - Chinese

Green Housing Study Form Approved

OMB No. 0920-XXXX

Child’s ID# _______________

Text messages (Child 7-12 with asthma) House ID# _____________

Green Housing Study

綠色住房研究

Text messages (Children 7-12 with asthma)

電子短訊 （7-12嵗有哮喘的小孩）

1. During the past month, has [Child’s name] had at least 3 of the following: feverish, stuffy/runny nose, cough, sore throat, body aches or tiredness, for more than 24 hours)?

Yes No DK

在過去的一個月裏，[小孩名字]有沒有持續24小時以上出現至少三种以下的症狀：發燒，鼻塞/流鼻涕，咳嗽，喉嚨發炎，身體痛或者乏力？

有 沒有 不知道

2. During the past month, did [Child’s name] have an episode of asthma or an asthma attack?

Yes No DK

在過去的一個月裏，[小孩名字]有沒有出現哮喘或者哮喘症狀？

有 沒有 不知道

3. During the past month, did [Child’s name] have an emergency or urgent care visit because of asthma attack?

Yes No DK

在過去的一個月裏，[小孩名字]有沒有因爲哮喘而到急診科或搶救室？

有 沒有 不知道

Public reporting burden of this collection of information is estimated to average 1 minute 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 Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).

這個數據收集所造成的回答負擔大約在１分鐘左右，其中包括閲讀指示，搜索現有信息庫，集合和保持所需數據，以及完成並檢查收集的數據。任何單位不能進行或贊助，任何人也沒有必要回答沒有國家管理和經費預算辦公室（OMB）批復編號的數據收集問卷。發送有關回答負擔的評論或者建議到美國疾病控制與方中心(CDC/ATSDR)信息收集審查辦公室：1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXX).