14 2018 MCH Survey Core_Palau_Palauan_Formatted

Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration (HRSA)

2018 MCH Survey Core_Palau_Palauan_Formatted

Title V Maternal and Child Health (MCH) Block Grant Jurisdictional MCH Survey Instrument

OMB: 0915-0379

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Section A.Screener

    1. Ngarngii a rengalk el kiei ra tial delengchokl el 0-17 a rekrir?

      1. Diak [A lsekum eng diak, engdi moritiang e merekong. Tiang a mo ulebengelel tial survey]

      2. Choi

    2. Te telang el ngalek el 0-17 a rekrir a oumesind el kiei er tial delengchokl?

Ildisir a rengalek el kiei er tial basio.

    1. Ngeral tekoi a omousbech el chadecheduch ra elsel tial delengchokl?

      1. Merikel

      2. Belau

      3. Ngodech el tekoi, moutekangel el chouchais, mlechesii

    1. Aikal ker a mora dertang er tirkel ngalk el 0-17 el belechoel el kiei ra elsel tial delengchokl.

Omuchel er ngkel kot el kekerei el ngalek el debo domekedong er ngii el “Ngalek 1” e melemolem el mora ongerung el di merekong sel bomerek el onger a ikel rokui el ker el kirir tirkel ngalek el rokui el blechoel el kiei ma lechub e tekiei er tial basio.

NGALEK 1

Techa ngklel a ngalek (first name, initials, or nickname)?

    1. Ngkal ngalek ng Hispanic, Latino, ma lechub eng chad ra Spain?

      1. Diak, diak el Hispanic, Latino, ma lechub eng kmal chad ra Spain

      2. Choi, Mexican, Mexican American, Chicano

      3. Choi, Puerto Rican

      4. Choi, Cuban

      5. Choi, ngkuk tara Hispanic, Latino, ma lechub eng kmal chad ra Spain, mlechesii





    1. Ngkal ngalek ng kmal ulechell er ker el beluu? Mluches a ikel rokui el merang.

      1. Becheleleu el chad

      2. Edelekelek ma lechub eng African American

      3. Chad ra Merikel el Indian ma lechub eng kmal chad ra Alaska

      4. Asian Indian

      5. China

      6. Philippine

      7. Japan

      8. Korea

      9. Vietnam

      10. Other Asian, mlechesii

      1. Kmal chad ra Hawaii

      2. Chamorro

      3. American Samoan/Samoan

      4. Creole

      5. Micronesia

      6. Caroline

      7. Palau

      8. Pohnpei

      9. Russia

      10. Yap

      11. Chuuk

      12. Marshal

      13. Kosrae

      14. Bebil ra beluu ra Pacific, mlechesii

      1. Puerto Rican

      2. Dominican

      3. Cuban

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. Tela rekil ngkal ngalek? A lsekum a ngalek a ngesonges a rekil ra tal buil, e ke luchesii a rekil el tal buil.

Rak (or) Buil

A lsekum a rekil a ngalek a ngesonges a rekil ra eual rak, e bora ker el A10.

    1. Puerto Rico: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Spain?

A ikel rokui el beluu: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Merikel?

      1. Kmal Ungil

      2. Ungil

      3. Diak el sal ungill

      4. Diak el ungil

    1. Ngkal ngalek ngousbech ma lechub eng melai a kar er chelechal taem el bilsang a toktang ngdi diak el vitamins?

      1. Choi

      2. Diak [Bora A11]

[A lsekum eng choi] e ngkal ngalek ngousbech a ikal kar ele ngii el ngarngii a rektel a bedengel, secherel a uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A11]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek a omomekesiu er ngii el mora re osisiu a rekrir el ngalek, e ngelmuut el ousbech a klou el ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      2. Diak [Bora A12]

[A lsekum eng choi] ngkal ngalek ngmelai a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul ele ngii el ousbech a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      1. Diak [Bora A12]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Sel teletelel a ngkal ngalek el sebechel remuul a tekoi, e ngolngesonges a omomekesiu er ngii el mora re osisiu a rekrir el ngalek?

      1. Choi

      2. Diak [Bora A13]

[A lsekum eng Choi] e ngkal ngalek ngolngesonges ra omeruul tekoi ele ngii el ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Straight Arrow Connector 27 Diak [Bora A13]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A14]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A14]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngarngii a kora secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel el mo uaia luchul e ngousbech a ngesou ra cheldecheduch (counseling)?

      1. Choi

      2. Diak [Bora A15]

[A lsekum eng Choi] tial secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel ng mla mo ungil a lechub eng locha mo ungil ra chelsel a tal rak ma lechub eng kemanget rat al rak?

      1. Choi

      1. Diak

[If respondent has another child, continue with A15. Else continue with Section B.]

    1. NGALEK 2

Techa ngklel a ngalek (first name, initials, or nickname)?

    1. Ngkal ngalek ng Hispanic, Latino, ma lechub eng kmal chad ra Spain?

      1. Diak, diak el Hispanic, Latino, ma lechub eng kmal chad ra Spain

      2. Choi, Mexican, Mexican American, Chicano

      3. Choi, Puerto Rican

      4. Choi, Cuban

      5. Choi, ngkuk tara Hispanic, Latino, ma lechub eng kmal chad ra Spain mlechesii



    1. Ngkal ngalek ng ulechell er ker el beluu? Mulches a ikel rokui el merang.

      1. Becheleleu el chad

      2. Edelekelek ma lechub eng African American

      3. Chad ra Merikel el Indian ma lechub eng kmal chad ra Alaska

      4. Asian Indian

      5. China

      6. Philippine

      7. Japan

      8. Korea

      9. Vietnam

      10. Other Asian, mlechesii

      1. Kmal chad ra Hawaii

      2. Chamorro

      3. American Samoan/Samoan

      4. Creole

      5. Micronesia

      6. Caroline

      7. Palau

      8. Pohnpei

      9. Russia

      10. Yap

      11. Chuuk

      12. Marshal

      13. Kosrae

      14. Bebil ra beluu ra Pacific, mlechesii

      1. Puerto Rican

      2. Dominican

      3. Cuban

    1. Ngjak ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. Tela rekil ngkal ngalek? A lsekum a ngalek a ngesonges a rekil rat al buil, e ke luchesii a rekil el tal buil.

Rak (or) Buil

A lsekum a rekil a ngalek a ngesonges ra eual rak, e bora ker el A21.

    1. Puerto Rico: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Sebangiol?

A ikel rokui el beluu: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Merikel?

      1. Kmal Ungil

      2. Ungil

      3. Diak el sal ungill

      4. Diak el ungil

    1. Ngkal ngalek ngousbech ma lechub eng melai a kar er chelechal taem el bilsang a toktang ngdi diak el vitamins?

      1. Choi

      2. Diak [Bora A22]

[A lsekum eng choi] ngkal ngalek ngousbech a ikal kar ele ngii el ngarngii a rektel a bedengel, secherel a uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A22]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek a omomekesiu er ngii el mora re osisiu a rekrir el ngalek, e ngelmuut el ousbech a klou el ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      2. Straight Arrow Connector 27 Diak [Bora A23]

[A lsekum eng choi] ngkal ngalek ngmelai a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul ele ngii el ousbech a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      1. Straight Arrow Connector 27 Diak [Bora A23]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Straight Arrow Connector 27 Choi

      1. Straight Arrow Connector 27 Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A24]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A24]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A25]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A25]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngarngii a kora secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel el mo uaia luchul e ngousbech a ngesou ra cheldecheduch (counseling)?

      1. Choi

      2. Diak [Bora A26]

[A lsekum eng Choi] tial secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Straight Arrow Connector 27 Choi

      1. Straight Arrow Connector 27 Diak

[If respondent has another child, continue with A26. Else continue with Section B.]

    1. NGALEK 3

Techa ngklel a ngalek (first name, initials, or nickname)?

    1. Ngkal ngalek ng Hispanic, Latino, ma lechub eng kmal chad ra Spain?

      1. Diak, diak el Hispanic, Latino, ma lechub eng kmal chad ra Spain

      2. Choi, Mexican, Mexican American, Chicano

      3. Choi, Puerto Rican

      4. Choi, Cuban

      5. Choi, ngkuk tara Hispanic, Latino, ma lechub eng kmal chad ra Spain mlechesii



    1. Ngkal ngalek ng ulechell er ker el beluu? Mulches a ikel rokui el merang.

      1. Becheleleu el chad

      2. Edelekelek ma lechub eng African American

      3. Chad ra Merikel el Indian ma lechub eng kmal chad ra Alaska

      4. Asian Indian

      5. China

      6. Philippine

      7. Japan

      8. Korea

      9. Vietnam

      10. Other Asian, mlechesii

      1. Kmal chad ra Hawaii

      2. Chamorro

      3. American Samoan/Samoan

      4. Creole

      5. Micronesia

      6. Caroline

      7. Palau

      8. Pohnpei

      9. Russia

      10. Yap

      11. Chuuk

      12. Marshal

      13. Kosrae

      14. Bebil ra beluu ra Pacific, mlechesii

      1. Puerto Rican

      2. Dominican

      3. Cuban

    1. Ngjak ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. Tela rekil ngkal ngalek? A lsekum a ngalek a ngesonges a rekil rat al buil, e ke luchesii a rekil el tal buil.

Rak (or) Buil

A lsekum a rekil a ngalek a ngesonges ra eual rak, e bora ker el A21.

    1. Puerto Rico: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Sebangiol?

A ikel rokui el beluu: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Merikel?

      1. Kmal Ungil

      2. Ungil

      3. Diak el sal ungill

      4. Diak el ungil

    1. Ngkal ngalek ngousbech ma lechub eng melai a kar er chelechal taem el bilsang a toktang ngdi diak el vitamins?

      1. Choi

      2. Diak [Bora A33]

[A lsekum eng choi] ngkal ngalek ngousbech a ikal kar ele ngii el ngarngii a rektel a bedengel, secherel a uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A33]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek a omomekesiu er ngii el mora re osisiu a rekrir el ngalek, e ngelmuut el ousbech a klou el ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      2. Diak [Bora A34]

[A lsekum eng choi] ngkal ngalek ngmelai a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul ele ngii el ousbech a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      1. Diak [Bora A34]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng mla mo ungil a lechub eng locha mo ungil ra chelsel a tal rak ma lechub eng kemanget rat al rak?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A35]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A35]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A36]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A36]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngarngii a kora secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel el mo uaia luchul e ngousbech a ngesou ra cheldecheduch (counseling)?

      1. Choi

      2. Diak [Bora A37]

[A lsekum eng Choi] tial secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

[If respondent has another child, continue with A37. Else continue with Section B.]

    1. NGALEK 4

Techa ngklel a ngalek (first name, initials, or nickname)?

    1. Ngkal ngalek ng Hispanic, Latino, ma lechub eng kmal chad ra Spain?

      1. Diak, diak el Hispanic, Latino, ma lechub eng kmal chad ra Spain

      2. Choi, Mexican, Mexican American, Chicano

      3. Choi, Puerto Rican

      4. Choi, Cuban

      5. Choi, ngkuk tara Hispanic, Latino, ma lechub eng kmal chad ra Spain mlechesii





    1. Ngkal ngalek ng ulechell er ker el beluu? Mulches a ikel rokui el merang.

      1. Becheleleu el chad

      2. Edelekelek ma lechub eng African American

      3. Chad ra Merikel el Indian ma lechub eng kmal chad ra Alaska

      4. Asian Indian

      5. China

      6. Philippine

      7. Japan

      8. Korea

      9. Vietnam

      10. Other Asian, mlechesii

      1. Kmal chad ra Hawaii

      2. Chamorro

      3. American Samoan/Samoan

      4. Creole

      5. Micronesia

      6. Caroline

      7. Palau

      8. Pohnpei

      9. Russia

      10. Yap

      11. Chuuk

      12. Marshal

      13. Kosrae

      14. Bebil ra beluu ra Pacific, mlechesii

      1. Puerto Rican

      2. Dominican

Cuban

    1. Ngjak ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. Tela rekil ngkal ngalek? A lsekum a ngalek a ngesonges a rekil rat al buil, e ke luchesii a rekil el tal buil.

Rak (or) Buil

A lsekum a rekil a ngalek a ngesonges ra eual rak, e bora ker el A21.

    1. Puerto Rico: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Sebangiol?

A ikel rokui el beluu: Ng uangerang a dechal ngkal ngalek el melekoi a tekoi ra Merikel?

      1. Kmal Ungil

      2. Ungil

      3. Diak el sal ungill

      4. Diak el ungil

    1. Ngkal ngalek ngousbech ma lechub eng melai a kar er chelechal taem el bilsang a toktang ngdi diak el vitamins?

      1. Choi

      2. Diiak [Bora A44]

[A lsekum eng choi] ngkal ngalek ngousbech a ikal kar ele ngii el ngarngii a rektel a bedengel, secherel a uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A44]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek a omomekesiu er ngii el mora re osisiu a rekrir el ngalek, e ngelmuut el ousbech a klou el ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      2. Diak [Bora A45]

[A lsekum eng choi] ngkal ngalek ngmelai a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul ele ngii el ousbech a ngesou ra ukeruul ra bedengel, ukeruull ra uldesuel, ma lechub eng ngesou ra skuul?

      1. Choi

      1. Diak [Bora A45]

[A lsekum eng choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A46]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora to A46]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngousbech a tokubets el ngesou ra rolel a klisichel a bedengel, ureor el loruul, ma lechub eng omengedecheduch?

      1. Choi

      2. Diak [Bora A47]

[A lsekum eng Choi] e ngkal ngalek ngarngii a secherel a bedengel, uldesuel, ma lechub eng tara bedengel a secher?

      1. Choi

      1. Diak [Bora A47]

[A lsekum eng Choi] tial teletael ma lechub eng secher, ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

    1. Ngkal ngalek ngarngii a kora secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel el mo uaia luchul e ngousbech a ngesou ra cheldecheduch (counseling)?

      1. Choi

      2. Diak [Bora A48]

[A lsekum eng Choi] tial secherel a uldesuel, ulekurulel a bedengel, ma lechub e ngodech el blekerdelel ng meketekaetang ral secher malechub eng secherel el meketeket el taem?

      1. Choi

      1. Diak

[If there are no other children, continue to Section B.]

A lsekum ete betok rar teuang el ngalek el blechoel el kiei er tial basio el tolechoi el mora teruich ma euid (0 – 17 rekrir), e kedi mo lmuches a rekrir e dirrek el uase te sechal ma lechub e te redil. Ng diak bo moluches a uaia ikel nger el mliluches el kirir tirkel Ngalek 1 el mora Ngalk 4.

    1. NGALEK 5

Techa ngklel a ngalek, initials, or nickname?

    1. Tela rekil a ngalek?

Rak (or) Buil

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. NGALEK 6

Techa ngklel a ngalek, initials, or nickname?

    1. Tela rekil a ngalek?

Rak (or) Buil

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. NGALEK 7

Techa ngklel a ngalek, initials, or nickname?

    1. Tela rekil a ngalek?

Rak (or) Buil

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. NGAKEJ 8

Techa ngklel a ngalek, initials, or nickname?

    1. Tela rekil a ngalek?

Rak (or) Buil

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. NGALEK 9

Techa ngklel a ngalek, initials, or nickname?

    1. Tela rekil a ngalek?

Rak (or) Buil

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. NGALEK 10

Techa ngklel a ngalek, initials, or nickname?

    1. Tela rekil a ngalek?

Rak (or) Buil

    1. Ngkal ngalek ng sechal, ng redil?

      1. Sechal

      2. Redil

Section B.Health ra Ngalk

A ker el kibo moker a kmal di Kirel a [NGALEK __] A ikal ker a mo odektak a mui el omesodel a kekerous el telengtengil a health ngkal ngalek el uldimukel er ngii a klisichel a bedengel, osongel er ngii lobenterir a rechad ospitar malechub eng clinic, cheral a ukeruul er ngii, ma ngesou ra udoud el mo harau ra ukeruul er ngii. A kidi mo ngiltii a tal ngalek ra telungalek meng mo kekerie a taem el rukui a ikal ker.

    1. Daitai, e msodii a health er ngkal ngalek?

      1. Kmal ungil el diak a secherel

      2. Kmal Ungil

      3. Ungil

      4. Oikab

      5. Mekngit

      1. Diak Kudengei

      1. Diak a Nger

    1. Kam sodii a teletelel a ungelel ngkal ngalek?

      1. Kmal ungil el diak a secherel

      2. Kmal Ungil

      3. Ungil

      4. Oikab

      5. Mekngit

      6. Ngalek a diak a ungelel

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel a ikal mla mo merek el teruich ma erul buil, ngkal ngalek ngmle mekudem ma lechub eng mle blechoel el ngarngii a mondai er ngii ra ikal beldukl er riou?


      Choi

      Diak

      Diak Kudengei

      Diak a Nger

      B3a. Outeliil ma lechub eng mondai ra louteliil ma telil (kora kora kesengliils)

      1

      2

      77

      99

      B3b. Omengur ma lechub e ngomerkakl el secherel a uchul

      1

      2

      77

      99

      B3c. Omiich ra kall ra elsel a chii rengii, mekngit el tuong malechub eng omachediil

      1

      2

      77

      99

      B3d. Blechoel el ringel ra bedengel ma bdelul, malechub eng meringel a btelul

      1

      2

      77

      99

      B3e. Ousbech a chimal

      1

      2

      77

      99

      B3f. Ungil merael e ousbech chimal

      1

      2

      77

      99

      B3g. Meringel a ungelel

      1

      2

      77

      99

      B3h. Merael a rasech ra techel a ungelel

      1

      2

      77

      99

      B3i. Merael mo mechitechut a ungelel ma lechub eng musiba

      1

      2

      77

      99

      B3j. Rektel a Ding

      1

      2

      77

      99

    2. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Ngkal ngalek ngarngii er ngii a ikal beldukl e riou?


Choi

Diak

Diak Kudengei

Diak a Nger

B4a. Mechad ma lechub eng mekngit a oderngesel

1

2

77

99

B4b. Meuikeu ma lechub eng mekngit a osengel ma lou klas mengdi mekngit

1

2

77

99

    1. A toktang ma lechub eng chad ra ospitar ngmla tang el sbedaau el uase ngkal ngalek a ngarngii er ngii a tara ikal beldukel er iou? A lsekum eng choi, ngkal ngalek ng ngarngii er chelechal taem?


      Mla tang?

      Elechang?

      Diak Kudengei

      Diak a Nger

      B5a. Ngul

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5b. Sukal

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5c. Down Syndrome

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5d. Blechoel meringel a btelul

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5e. Telmellel a no ra btelul, ma lechub eng miltemall abtelul

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5f. Sebekreng

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5g. Secherel a uldasou

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5h. Autism, ASD, Autism Spectrum Disorder (ASD), Asperger’s Disorder, malechub eng Pervasive Developmental Disorder

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5i. Attention Deficit Disorder (ADD ) or Attention Deficit/Hyperactivity Disorder(ADHD)

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5j. Developmental Delay

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5k. Behavior or Conduct Problems

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5l. Intellectual Disability (also known as mental retardation)

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5m. Meoud el mo ungil a ngerel el mengedecheduch ma lechub eng bebil a uchul eng diak lungil melekoi

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5n. Meoud el mo medengelii a tekoi

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

      B5o. Bebil ra rektel a btelud

      1 ☐ Choi

      2 ☐ Diak

      1 ☐ Choi

      2 ☐ Diak

      77

      99

    2. A chelsel a ikal mla mo merek el teruich a erung el buil, aikal secherel ng mla tomer er ngii el meruul a tekoi el uaia re besechel?

      1. Ngkal ngalek a diak a secherel [Bora B8]

      2. Dirkak a tang [Bora B8]

      3. Al bebil

      4. Mekudem

      5. Blechoel

      1. Diak Kudengei

      1. Diak a Nger

    1. Aikal rektel, ng ngarngii a techall el torbengii el meruul a tekoi?

      1. Kmal Kekerei

      2. Kora Ngarngii

      3. Kmal Klou

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

A toktang ma lechub eng chad ra ospitar ngmla tang el sbedaau el uase ngkal ngalek a ngarngii a secherel ra mekngit el kar? Tial secher (Substance Abuse Disorder) a duubech ra rechad el blechoel e melemolem el ousbech ra rrom ma lechub eng mekngit el kar meng mla morngii a telmellel ra bedengel, mla rullii meng dikeal sebechel remuul a mle sebechel, dikeal sebechel el remuul a ngerchelel ra ureor, skuul, ma lechub eng blai.

      1. Choi

      2. Diak [Bora B9]

      1. Diak Kudengei [Bora B9]

      1. Diak a Nger [Bora B9]

[Al sekum eng choi] e ngkal ngalek ng ngarngii a ikaikid el teletelel er chelechang?

      1. Choi

      2. Diak [Bora B9]

      1. Diak Kudengei [Bora B9]

      1. Diak a Nger [Bora B9]

[Al sekum and choi] eng:

      1. Kekerei

      2. Oikab

      3. Hidoi

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

Ngkal ngalek ng ngarngii er ngii a tara ikal beldukel er riou?


Choi

Diak

Diak Kudengei

Diak a Nger

B9a. Meringel er ngii a mo bellemakl (erellakl a uldesuel), lmatk a tekoi, ma lechub eng melillt eleng ngii el ngarngii secherel a bedengel, uldesuel ma lechub eng omelatk

1

2

77

99

B9b. Meringel er ngii a lorael ma lechub eng melemiakl a terebel

1

2

77

99

B9c. Meringel er ngii a omail er ngii ma lechub eng melechong

1

2

77

99

B9d. Meringel er ngii a meruul a urerel el dingii el tang (mora osongel ra toktang, mo oureor malechub eng shopping leng secherel a bedengel, uldesuel ma omeletkel a uchul

1

2

77

99

B9e. Mechad ma lechub eng mekngit a oderngesel

1

2

77

99

B9f. Meuikeu ma lechub eng mekngit a osengel ma lou klas mengdi mekngit

1

2

77

99

    1. A toktang ma lechub eng chad ra ospitar ngmla tang el sbedaau el uase ngkal ngalek a ngarngii er ngii a…


Choi

Diak

Diak Kudengei

Diak a Nger

B10a. Rheumatic heart disease

1

2

77

99

B10b. Rheumatic fever

1

2

77

99

B10c. Impetigo (or other skin infections)

1

2

77

99

[A lsekum eng rheumatic heart disease malechub eng fever] Ngarngii a kar el lolim el kirel?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

[A lsekum eng choi] Te melim a kar ma lechub eng orus?

      1. Kar el Lolim (Pills) [Bora B11]

      2. Orus [Bora B11]

[A lsekum eng Diak] E ngerang meng diak? Mluches a ikel rokui el merang.

      1. Kmal takai.

      2. Diak a olidiuul.

      3. Diak a sebechel el nguu a ngelkek el mora ospitar.

      4. Diak a ultutelel

      5. Ngodech a uchul:

      1. Diak Kudengei

      1. Diak a Nger

    1. A toktang ma lechub eng chad ra ospitar ngmla tang el sbedaau el uase ngkal ngalek a ngarngii er ngii a mekngit ra rsechel el ua rakt el kasinoma ra rasech ra chelsel a chiuis, ngesonges a malechub eng sickle cell disease? Diak moldak ra Sickle Cell Trait.

[Mchiuii a lsekum eng kirel]: A rengalek el ngarngii a anemia er tir a ngarngii a mekngit ra rsechir el rulleterir mete mo mesaul a bedengir.

      1. Choi

      2. Diak

      1. DIak Kudengei

      1. Diak a Nger

Elechang ea kmo oker a ker el injury prevention ra ngelkem.

    1. Kau ma lechub eng kuk tara klou el chad ra delengchokl a mla mesaod a oliub bedenged ra uldikel ma lechub eng rolel meng diak bo demetemall?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Mla tang el mosaod el mora ngelekem el uase ng sebechel el metemall a loilil ra rael, melemiakl a kerrekar ma dirrek el longedub ra daob?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Kobengkel a ngelekem sel loilil e rrikl, mengedub, ma lechub engdi milil?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

A ngelekem sel lengara rrat, e ngousbech ma lechub eng diak lousbech a helmet?

      1. A ngelkek a diak el ngara rrat

      2. Dirkak a tang e lou helmet

      3. Dertang e lou helmet

      4. A lebebil ra taem e ngou helmet

      5. Oumesind el taem a ngou helmet

      6. Ng blechoel e lou helmet

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑11 YEARS OLD]

A ngelkem sel ngara rrat eng ngara car seat malechub eng booster seat?

      1. Blechoel

      2. Oumesind el taem

      3. Bebil ra taem

      4. Dertang

      5. Dirkak a tang [A lsekum a ngalek a tolechoi el mo eim a rekil, e bora B18; A lsekum a ngalek a elolem el mo teruich ma tang a rekil e bora B18]

      6. A ngelekek a diak el diak el ngara mlai [A lsekum a ngalek a tolechoi el mo eim a rekil, e bora B18; A lsekum a ngalek a elolem el mo teruich ma tang a rekil, e bora B18]

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑11 YEARS OLD]

A car seat ra ngelkem ng ngara keskelel a mlai?

      1. Ngara utendai

      2. Ngara ullel auttendai

      3. Ngara ullel a omekall

      4. Belngel a kingall era uriul

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

A yobo ra ngelekem ng up to date?

      1. Choi

      2. DIak

      1. Diak Kudengei

      1. Diak a Nger

Section C.Ngkal Ngalek ral Tolechoi

    1. Ngkal ngalek ng milechell ra edei el sandei ra uchei er sel temel el mechell?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Ng mle talang a bendel er sera lmechell? Mlchesii a nger el bond ma ons ma lechub eng kilograms ma grams. Mliang sel kot el sebechem el dobedbekii.

Pounds MA Ounces

kilograms MA grams

      1. Diak Kudengei

      1. Diak a Nger

    1. Ng mle telang a rekim e mechellii ngkal ngalek?

Rak

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑1 YEAR OLD, ELSE GO TO I3]

Ng uangerang a teletelel ngkal ngalek sel momechiuaiu er ngii?

      1. Ulitech

      2. Dengarch

      3. Terrob

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD. ELSE GO TO SECTION D]

Mle tal omultut er ngkal ngalek ra tum?

      1. Choi

      2. Diak [Bora C6]

      1. Diak Kudengei [Bora C6]

      1. Diak a Nger [Bora C6]

[A lsekum eng Choi] ng mle tela rekil seral stob el tmut a tut?

sils (lechub)

sandei (lechub)

buil (lechub)

rak

A ngalek a dirk tmut a tuk

      1. Diak Kudengei

      1. DIak a Nger

    1. Mle telang a rekil ngkal ngalek e mo menga ngodech el kall el diak el osechel a tum ma lechub eng milk ra rengalek? Uldimukl ra juice, milk ra kerbou, sukal ma ralm, kelir a retolechoi, ma ngiidil ngerang el mlora ngalek el uldimukl ra ralm.

sils (lechub)

sandei (lechub)

buil

Sera lemechell

Mlia olangch ra box a lsekum ngarngii a ngodech kall/ilumel el mlora ngalek el diak el osechel a tum ma lechub eng deterir a rengalek

      1. Diak Kudengei

      1. Diak a Nger

Section D.Ulekerruio a Ukeruul

    1. Chelsel tial mlo merek teruich ma erul buil, ngkal ngalk mla tal lesa chad ra ospitar leng mle smecher, temel a osongel, physical exam, ng nyuing malechub eng tara tekoi ra ukeruul?

      1. Choi

      2. Diak [Bora D2]

      1. Diak Kudengei [Bora D2]

      1. Duak a Nger [Bora D2]

[A lsekum eng Choi] Chelsel aikal mla mo merek el teruich ma erul buil, Ngkal ngalek ngmlo omes ra toktang, nurse ma lechub eng kuk tara ellimosk el chad ra ukeruul el ikel ukeruul el merrob a secher ra uchei ra leborngii (preventive check‑up)? A preventive check‑up a ukeruul el ngalek a diak el secher ma lechub eng telemall, ngua osengelir a rechad ra undo malechub eng osengelir ar tolechoi el kirel a ulekerulir.

      1. Dirkak a tang

      2. Tang el blal bong

      3. Erung ma lechub eng betok

      1. Diak Kudengei

      1. Diak a Nger

    1. Kau ke bekikl ra berredel ngkal ngalek?

      1. Choi, kmal oberaod

      2. Choi, Kmal mekesai

      3. Diak, Diak bekikl

      1. Diak Kudengei

      1. Diak a Nger

    1. Nge tela klemengetel ngakal ngalek er chelechang? Mlia sel kot el kmeed el sebechem el mdesuii.

feet AND inches

meters AND centimeters

      1. Diak a Kudengei

      1. Diak a Nger

    1. Ng tela bendel ngkal ngalek er chelechang? Mlia sel kot el kmeed el sebechem el mdesuii.

pounds MA ounces

kilograms MA grams

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Chelsel aikal mla mo merek el teruich ma erung el buil, ma lechub eng ellimosk el chad ra ukeruul ngmla oker er kau el uase kekora suebek a regnum el kirel a omesubel, ulekerulel a bedengel ma uldesuel, ma lechub eng blekerdelel ngkal el ngalek?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

[If this child is YOUNGER THAN 9 MONTHS, GO TO D7].

Aikal mla mo merek el teruich ma erul buil, eng ngarngii a toktang malechub eng tal chad loureor ra tekoi ra ukeruul (Health) el milskau malechub eng tara obeteterir ar ngalek, a uai tial ker mengonger rengii el kirel a ulekurulel, omengedechedal, malechub a blekerdelel a ngalek? A le bebil ra tae mea toktang malechub eng chad ra ureor ra health a msa chedam ma chedil a uai tial ker mete meruul a le mera chosongel malechub eteme oldingel ra blai e meskid.

      1. Choi

      2. Ng diak [Bora D7]

      1. Diak kudengei [Bora D7]

      1. Diak a nger [Bora D7]

[If this child is 9‑23 Months]

A ker el mulnger ng kirel aikel momdasu, ma osengem raikal beldukl er riou: Ka mlia olangch el kongei.

      1. A ngalek ng melekoi el uangerang malechub sel oto ra tekingel?

      2. Ngera blekerdelel lobengkem malechub ar bebil ra rechad?

      1. Diak kudengei

      1. Diak a nger

[If this child is 2‑5 Years]

Tial ker mlo ungil kmer aikel mle kirem el mo medengei ma osengem ma uldesuem: Ka mlia olangch raikal beldukl er riou.

      1. Aikel tekoi ma delecherul, a ngalek ng medengei?

      2. Ngkal ngalek ng delodau a lobengkem ma lobengterir ar bebil ra rechad?

      1. Diak kudengei

      1. Diak a nger

    1. Ngarker al blechoel el ngara ukeruul er ngii ngkal ngalek al secher? Kau malechub a tara obeteterir ar ngalek ng ungil bo modengei a kirel a secherel ma ukeruul ra ngalek?

      1. Choi

      2. Ng diak [Bora D8]

      1. Diak kudengei

      1. Diak a nger

[Alsekum ke kmo choi] engkal ngalek ng blechoel el mora ukeruul er ker?

      1. Mo omes ra toktang

      2. Mora Emergency Room ra ospitar

      3. Mora OPD ra ospitar

      4. Mora ikel private clinic ra community health center

      5. Ngara ukeruul ra skuul ma ukeruul ra rechad ra klekool

      6. Mekekeriei el Ospitar ra beluu (Dispensary)

      7. Kuk tara basio ra ukeruul, el ngerang

      1. Diak kudengei

      1. Diak a nger

    1. Ngar ngii a ulterekokl (blechoel) el labor chosongel er ngii a ngalek, el diak el secher eng di kirel a kmong uangera health er ngii?

      1. Choi

      2. Ng diak [Alsekum a rekil a ngalek a 0‑5 el rak, bora D9; 6‑17 el rak a rekil, bora D10]

      1. Diak kudengei

      1. Diak a nger

[Alsekum ke kmo choi] a ngalek ng mo rtial osisiu basio sel le bol secher?

      1. Choi

      2. Ng diak

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Ng mla tal le skeng a medal malechub osengel a ngalek?

      1. Choi

      2. Ng diak [Bora D10]

      1. Diak kudengei

      1. Diak a nger

[Alsekum ke kmo choi] eng mlo ra skeng er chosengel er ker? Mlia olangch ra ikel le mleues er ngii.

      1. Toktang ra mad

      2. Toktang ra rengalek malechub eng ngidil toktang

      3. Ileakel ospitar ra al chad (Private Clinic‑ Health Center)

      4. Skuul

      5. Kuk tara basio, er ker:

    1. Aikal mla mo merek el teruich ma erul buil, ngkal ngalek mlo omes ra toktang ra uingel ma lechub eng chad ra ukeruul ra ngor el kirel a ngiidil rektel a ungelel ma lechub eng ngerel?

      1. Choi, ng milsang a toktang ra uingel

      2. Choi, Ng milsang a di tang el chad ra ukeruul ra ngor

      3. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Aikal mla mo merek el teruich ma erul buil, e ngkal ngalek mla tal ngara ukeruul a lechub ngesou ra cheldecheduch ra meduch el chad ra ukeruul ra uldesued? A chad ra ukeruul ra uldesued a uldimukel er ngii a toktang ra secherel a uldesued, toktang ra uldasou, nurse ra secherel a uldesued, chad el oureor el olengeseu ra chad el mo di ngii, ma olengeseu ra rengalek ra skuul (school counselor).

      1. Choi

      2. Diak, Ngdi ngkal ngaled a kirel el omes ra chad ra ukeruul ra uldasou.

      3. Diak, Ngkal ngalek a diak el ousbech a ngesou ra chad ra ukeruul ra uldasou.

      1. Diak Kudengei

      1. Diak a Nger

    1. Aikal mla mo merek el teruich ma erul buil, ngkal ngalek ng mla tal lousbech alternative health care malechub eng treatment el ngii a mle kirel nguu? Alternative health care malechub eng treatment a uldimukel er ngii a hariku (acupuncture), osumech, relaxation therapies, melim llel a kerrekar (herbal supplements), ma kuk bebil. A bebil ra ukeruul a mle ultuil ra uldesuel a chad ra ukeruul ma bebil a kuk di mle ngii a chad el ngiltii el mo rullii.

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Aikal mla mo merek el teruich ma erul buil, mlarngii a taem el ngkal ngalek a kmal uluusbech ra ukeruul e dimlak el nguu ma lechub eng dimlak lengarngii a ukeruul? A ukeruul a belkul a kmo, ukeruul ra bedenged ma lechub e ngiidil bedengel a ukeruul el ua ukeruul r angered, osenged ma uldesued.

      1. Choi

      2. Diak [Bora D15]

      1. Diak Kudengei [Bora D15]

      1. Diak a Nger [Bora D15]

[A lsekum eng Choi] e ngeral bedengel a ukeruul a mlo diak? Mluches a ikel merang.

      1. Ukeruul ra Bedenged

      2. Ukeruul ra Ungeled

      3. Ukeruul ra Osenged

      4. Ukeruul ra Orrenges

      5. Ukeruul ra Uldasou

      6. Kuk tang ra Bedengel, mlechesii:

    1. Ngerang ra ikang el beldukel er iou e a mle uchul me ngkal ngalek a mlo diak el nguu sel mle kirel ukeruul:


      CHOI

      DIAK

      Diak Kudengei

      Diak a Nger

      D14a. Ngkal ngalek a dimlak el sebechel melai er tiang el ukeruul?

      1

      2

      77

      99

      D14b. Tial ukeruul el uluusbech er ngii ngkal ngalek a dimlak er sel basio el kiei er ngii?

      1

      2

      77

      99

      D14c. Mlarngii a mondai meng mlo diak el meruul a temel el mong er sera lousbech er ngii?

      1

      2

      77

      99

      D14d. Mlarngii a mondai ra olidiuul ra ngalek el mora ukeruul?

      1

      2

      77

      99

      D14e. Tial ukeruul ma obis ra toktang a mle chelsimer?

      1

      2

      77

      99

      D14f. Mlarngii a mondai ra cheral a ukeruul?

      1

      2

      77

      99

    2. Aikal mla mo merek el teruich ma erul buil, ngkmal telal taem el ngkal ngalek a mlora ospitar el mleues lulekiu a bkais emrungel el secher (emergency room)?

      1. Dimlak a tang el Bong

      2. Mle tang el Bong

      3. Mle Erung ma Lechub eng Betok

      1. Diak Kudengei

      1. Diak a Nger

Section E.Experience Lobengterir a Rechad ra Ukeruul Ra Ngalek

    1. Ngarngii a tang malechub te betook el molatk el kmo te toktang ma nurse rengkal ngalek? A toktang ma nurse ra ngalek a blekul a kmo te kmal mui el medengelii a ngalek, rekltel ma ukeruul rengii, ma rekisi ra ukeruul er ngii. Ng sebechel di toktang, toktang ra rengalek, nurse lou babier el lomkar, malechub eng kldemel a toktang.

      1. Choi, ngdi ta el chad

      2. Choi, te betook ra ta el chad

      3. Ng diak

    2. Aikal mla mo teruich ma erul buil, eng mla tal lomes ra toktang malechub eng mlara ukeruul ngkal ngalek?

      1. Choi

      2. Ng diak [Bora E3]

      1. Ng diak kudengei

      1. Diak a nger

[Alsekum eng choi] eng mle uangera klungel a mondai meng mlo meues ra toktang?

      1. Dimlak a mondai

      2. Dimle kekerei

      3. Ng kmal mle klou

    1. [Answer the following questions only if this child had a health care visit IN THE PAST 12 MONTHS. Otherwise, go to E4.]

Tial mla mo merek el teruich ma erul buil, mle uangera temel a ngalek el meues ra toktang malechub a ngidil chad ra ukeruul:


Blechoel

Beblechoel

Bebil ra taem

Kmal diak

Diak kudengei

Diak a nger

E3a. Mle ungil a idisel a taem lobengkel a ngalek?

1

2

3

4

77

99

E3b. Ungil lorrenges er kau?

1

2

3

4

77

99

E3c. Ochotii a kerkikl reng rengii raikel siukang ma loumerang a telungalek?

1

2

3

4

77

99

E3d. Milskau a ulterekokl el tekoi el mle soam el mo medengei el kirel a ngalek?

1

2

3

4

77

99

E3e. Ngilsukau meke mlo melchesuar a kmo kusbechall el kirel ongetmeklel ma ulekerreuil a ngalk?

1

2

3

4

77

99

    1. Ngarngii a tara chad lolengeseu rekau ra oketmeklel rokui el ukeruul rengkal ngalek ra delongelel a blil a ukeruul mar kakerous el toktang?

      1. Choi

      2. Ng diak

      3. A lemlak lemeues ra betook ra tang el chad ra ukeruul retial merkol tal rak [Bora E7]

    2. Aikal mla mo merek el teruich ma erul buil, ekekora mlo melchesuar a kmo kuluusbech ra tang ma lechub e te bebil ra rechad, malechub a ngesou el sumchokl e orael a teletelel a ukeruul rengkal ngalek?

      1. Choi

      2. Ng diak [Bora E6]

[Alsekum eng choi] Aikal mla mo merek el teruich ma erul buil, eng mle uangera klungel a ngesou el mngiluu el kirel a orretel ma ongetmeklel a ukeruul rengkal ngalek?

      1. Mle blechoel

      2. Bebil ra taem

      3. Kmal dimlak

    1. Ma uldekial rokui, eng kmal uangera klungiolel a regnum el kirel a mle ungil klaodengei ma cheldecheduch ra delongelir tirkel rokui lulmes e meruul ra ukeruul rengkal ngalek?

      1. Ng kmal mle ungil

      2. Kora mle ungil

      3. Dimlak el sal ungil

      4. Kmal mle mekngit

      1. Diak kudengei

      1. Diak a nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 12‑17 YEARS OLD]

Ngarngii er tirkal toktang rengkal ngalek a kmal diulterkokl el diomes rar ngalek?

      1. Choi

      2. Ng diak [Bora E8]

      1. Diak kudengei

      1. Diak a nger

[Alsekum eng choi] eng mla tal longedecheduch rekau, el kmo ngarngii a taem engkal ngalek a kuk mo mesa toktang rar meklou el chad?

      1. Choi

      2. Ng diak

      1. Diak kudengei

      1. Diak a nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 12‑17 YEARS OLD]

A toktang malechub eng chad loungerachel rengkal ngalek, ng blechoel el:


Choi

Ng diak

Diak Kudengei

Diak a nger

E8a. Rullii a ngalek el momdasu el kirel a klengar rengii re ngar medadel taem. Kora kirel, skulel, ureor, deleuill, ma duch er ngii ra ureor el kirel a ileakl el delengchokl?

1

2

77

99

E8b. Ungil luldasu el kirel a mesisiich el bedengel ma uldesuel (health) uaia tabesul blengur, ungil undo, diak lousbech a dekool, rrom ma mesisiich el mekngit el kar, ma tekoi ra cheliuaiu ra redil ma sechal?

1

2

77

99

E8c. Duch er ongetmeklel a ungil e mesisiich el klechad er ngii el uaia, duch ma klemedengei ra rakt ma orrebengel a rakt, al dubech a bkais emrungel el tekoi eng mekerang, a usbechellel a kar el kirel lomkar a rakt?

1

2

77

99

E8d. Medengei aikel kuk mengodech ra tekoi ra ukeruul er ngii sel bol teruich ma eai a rekil el uaia, a llemeltel el di ngii, kengei er ngii, llemeltel di ngii el merritel e melilt?

1

2

77

99

    1. [ONLY ASK THIS QUESTION IF CHILD IS 12‑17 YEARS OLD]

A toktang metirkel chad ra ukeruul rengkal mlatal loureor lobengkem el kutmeklii a llechukl el moktek ra teletelel a osengelel ma ukeruul rengkal ngalek lotireklii sel kmal usbechellel ra ukeruul ma klisichel a bedengel?

      1. Choi

      2. Ng diak [Bora E10]

      1. Diak kudengei

      1. Diak a nger

[Alsekum eng choi] etial plan (moktek) ngocholt e mades e rokui aikel rektel ma usbechellel ra tekoi ra ukeruul ma klisichel a bedengel ma uldesuel luldimukl ra ngesou el kmo sebchel ngmai rker?

      1. Choi

      2. Ng diak

      1. Diak kudengei

      1. Diak a nger

Mekau mengkal ngalek ngarngii a otsusi (copy) er tial plan (moktek) el mobang?

      1. Choi

      2. Ng diak

      1. Diak kudengei

      1. Diak a nger

Me tial plan (moktek) ng atter ra usbechellel ngkal ngalek ma klungel ma rektel er chelechal taem?

      1. Choi

      2. Ng diak

      1. Diak kudengei

      1. Diak a nger

    1. Sel rullii a ngalek mengdi sebechel ngmai a ngesou ra insurance a blechoel mengodech sel le kekerei ma kuk bol klou lechad, ke medengei el kmo ngmo uangera teletelel a ngelsuir a insurance rengkal ngalek a bole klou lechad?

      1. Choi [Bora F]

      2. Ng diak

[Alsekum eng diak] ngarngii a chad el mla subedau ra kmo ngera kuk mo teletelel a ngesou el mora ngalek e sebechel ngmai rker sel bol klou lechad?

      1. Choi

      2. Ng diak

Section F.Udoud (insurance) el Harau a Ukeruul ra Ngalek

    1. Aikal mla mo merek el teruich ma erul buil, engkal ngalek malr ngii a health insurance ele ngarngii malechub eng ngidil health coverage plan?

      1. Choi, ngmle cherrungel tal rak, alsekum ngesonges ra tal rak, disera lemechell [Bora F4]

      2. Choi, engdi mlarngii a dimlak el sebechel, ua blel teleu

      3. Ng diak

    2. Ka mocholt aikel mle uchul meng mlo diak lengara health insurance ngkal ngalek raikal mla mo merek el teruich ma erul buil:


      Choi

      Diak

      F2a. Ng mlengodech a ureor malechub eng mlo diak loureor

      1

      2

      F2b. Mlo diak le harau ra insurance el mlo kemanget el taem

      1

      2

      F2c. Chilitii leng kmal mlo diak el sebechel harau

      1

      2

      F2d. Chilitii leng mlo olngesonges a denguu rengii

      1

      2

      F2e. Chilitii leng mlo mekesai a rechad el meruul ra ukeruul

      1

      2

      F2f. Mlo rengii a mondai ra dolsiseb rkid ma domek beches a babilenged er ngii

      1

      2

      F2g. Kuk mle ngodech luchul, ka mochotii

      1

      2

    3. Ngkal ngalek er chelechang, ngarngii a insurance malechub eng ngidil bedengel a health coverage plan a lengar ngii?

      1. Choi

      2. Ng diak [Bora Section G]

      1. Diak kudengei [Bora Section G]

      1. Diak a nger [Bora Section G]

    1. Ngarngii a tara ikal beldukl riou el insurance malechub eng health coverage plan ele ngar ngii ngkal ngalek?


      Choi

      Diak

      F4a. Insurance lokiu a urerel, mle urerel malechub eng union

      1

      2

      F4b. Mlochar ra kombalii el insurance

      1

      2

      F4c. Medicaid, Medical Assistance malechub eng ngidil bedengel a ngesou ra amt el kirir ar mechitechut mar mekesai a udoud el longereker

      1

      2

      F4d. TRICARE malechub eng mlara tekoi ra kelsoldau

      1

      2

      F4e. Indian Health Service

      1

      2

      F4f. Kuk tara bedengel, mochotii

      1

      2

    2. Ngkmal telal taem etial insurance ra ngalek a msang aikel ngesou el meral kutmokl a usbechellel a ngalek?

      1. Ng kmal blechoel

      2. Blechoel

      3. Bebil ra taem

      4. Ng kmal diak

      1. Diak kudengei

      1. Diak a nger

    1. Ngkmal telal taem etial health insurance ra ngalek a msa kengei meng mo meues er tirkal meral toktang mar chad ra ukeruul el meral kirel usbechellel?

      1. Ng kmal blechoel

      2. Blechoel

      3. Bebil ra taem

      4. Ng kmal diak

      1. Diak kudengei

      1. Diak a nger

Section G.Harau a Ukeruul ra Ngalek

    1. Uldimukel ra ikel rokui el rolel a udoud el mlo harau ra ukeruul ra ngalek, kngmal mle telang a ikel mlechoit ra ukeruul, ukeruul ra ungelel ma osengel er tial merekong el tal rak Ngdiak luldimukel ra ikel oh harau ra insurance ma lechub e ngikel udoud e obom luut el ngmai a medal.

      1. $0 (A lsekum eng dimlak a omchitii el udoud [Bora G4]

      2. $1‑$249

      3. $250‑$499

      4. $500‑$999

      5. $1,000‑$5,000

      6. Betok ra $5,000

      1. Diak Kudengei

      1. Diak a Nger

    1. Ng blechoel el ungil e melemalt e atter?

      1. Kmal Blechoel

      2. Blechoel

      3. Bebil ra Taem

      4. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Kau ma telungalek er kau er tial merekong el rak, ngmlarngii a mondai ra ukeruul ra ngalek?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Tial mlo merek el tal rak, kau ma lechub tara rechad ra telungalek er kau:


      Choi

      Diak

      Diak Kudengei

      Diak a Nger

      G4a. Mlo diak moureor eleng rektel ngkal ngalek a uchul?

      1 ☐

      2 ☐

      77 ☐

      99 ☐

      G4b. Mlo ngosonges atemel a ureriu eleng rektel a ngalek a uchul ?

      1 ☐

      2 ☐

      77 ☐

      99 ☐

      G4c. Mlo diak el somiu el melodech a ureriu eleng mle suebek a rengmiu a llemengodech ma lechub eng mo diak a insurance ra ngalek?

      1 ☐

      2 ☐

      77 ☐

      99 ☐

      G4d. Ngarngii a ngesou el mngilai ra rechedemiu el kirel a rekter a ngalek?

      1 ☐

      2 ☐

      77 ☐

      99 ☐

    2. Elsel a tal sandei, eng locha uaia klungel a ngeral taem a omchitii el ngara blai el olengeseu er ngkal ngalek? Tiang a uldimukel er ngii ra omtechei a hotai ra telemall ra bedengel, omsang a kerul, e omsang a ikel rokui el bedengel a ukeruul el ousbech.

      1. Ngkal ngalek a diak el ousbech a ngesou el mengetmokel er ngii

      2. Ngdiak, ngara blai e ngak mar bebil ra rechad ra blai a mengetmokel er ngii

      3. Ngesonges era tal zikang ra al sandei

      4. Tang el mora euang el zikang ra al sandei

      5. Eiim el mo teruich el zikang ra tal sandei

      6. Teruich ma tal zikang ma lechub eng betok

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel a tal sandei eng kmal telal zikang er kau ma lechub eng chad ra telungalek er kau a omchoit el mesmechokl e merech ra ukeruul er ngkal ngalek el kirel a appointment er ngii ma basio el bora ukeruul er ngii.

      1. Ngkal ngalek a diak el ousbech a ngesou el mengetmokel er ngii

      2. Ngdiak, ngara blai e ngak mar bebil ra rechad ra blai a mengetmokel er ngii

      3. Ngesonges era tal zikang ra al sandei

      4. Tang el mora euang el zikang ra al sandei

      5. Eiim el mo teruich el zikang ra tal sandei

      6. Teruich ma tal zikang ma lechub eng betok

      1. Diak Kudengei

      1. Diak a Nger

Section H.Section H. Omesubel a Ngalek

    1. Chelsel a tal sandei eng kmal uangera klungel taem a lechitii a ngalek el omes a TV, omes a video, ma lechub e ngousekool a video game?

      1. Diak

      2. Ngesonges ra al zikang

      3. Tal zikang

      4. Erung el zikang

      5. Edei el zikang

      6. Euang el mo betook el zikang

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel a tal sandei eng kmal uangera klungel taem a lechitii a ngalek el ngara computer, cell phone, games, ma bebil ra klalou el ousbech a dengki el diak el ngii a subelel ra skuul?

      1. Diak

      2. Ngesonges ra al zikang

      3. Tal zikang

      4. Erung el zikang

      5. Edei el zikang

      6. Euang el mo betook el zikang

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Ngkal ngalek ng uangerang a duch er ngii el di ngii el mengetmokel er ngii?

      1. Kmal Meduch

      2. Kora Sebechel

      3. Metitur

      4. Diak el Sebechel

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Kau ke kmal lulterekokl el medengei el kmo ngkmal sebechel ngkal ngalek el mo ungil ra elementary ma high school?

      1. A Kmal Ulterekokl el Medengei

      2. A Kumdasou el kmo Ngsebechel

      3. Kora Locha Sebechel

      4. Diak sal Medengeiv

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

Aikal mla mo merek el teruich ma erul buil, eng kmal mle telal sils el dimlak el bora skuul a ngalek leng rektel ma lechub eng telmellel a bedengel a uchul?

      1. Dimlak el Chitii a Skuul

      2. Tang el mo Edei el Klebesei

      3. Euang el mora Elolem el Klebesei

      4. Euid el mora Teruich el Klebesei

      5. Teruich ma Tang ma Lechub eng Betok

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

Aikal mla mo merek el teruich ma erul buil eng kmal telal taem el skuul a subedau ma lechub e ngii diltang el chad ra blai el kirel a mondai el ngarngii er ngkal ngaled ra skuul?

      1. Dimlak a Tal Taem

      2. Tal Taem

      3. Erung ma Lechub eng Betok el Taem

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

Sera lomuchel ra yotsiyeng, eng mle tal lomelekl ra osisiu el dauch (grade) ra skuul?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 6‑17 YEARS OLD]

Chelsel tial merekong el tal sandei, ng telal sils el luluu undo ngkal ngalek, uluu sekool a ouedikel el klekool, ma lechub engdi uluuedikel a bedengel al tal zikang?

      1. Dimlak a Tal Sils

      2. Tang el mo Edei el Klebesei

      3. Euang el mo Elolem el Klebesei

      4. Bekel Sils

      1. Diak Kudengei

      1. Diak a Nger

Section I.Kirem Kau ma Ngalek

    1. Ngkmal telal taem el bla lolukl ngkal ngalek el mo kiei ra beches el basio er sera lemechell el mei er elengang?

Ildisel a taem

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Chelsel tial merekong el tal sandei e kau ma lechub eng tara chad ra telungalek a mlenguiu el mora ngalek?

      1. Dimlak a Tal Sils

      2. Tang el mo Edei el Klebesei

      3. Euang el mo Elolem el Klebesei

      4. Bekel Sils

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Chelsel tial mlo merek el tal sandei e kau ma lechub eng tara chad ra telungalek a mlengedecheduch el chelid ma lechub eng milngitakl el mora ngalek?

      1. Dimlak a Tal Sils

      2. Tang el mo Edei el Klebesei

      3. Euang el mo Elolem el Klebesei

      4. Bekel Sils

      1. Diak Kudengei

      1. Diak a Nger

    1. [ONLY ASK THIS QUESTION IF CHILD IS 0‑5 YEARS OLD]

Ngkal ngalek ng dirrek el ngilai a ulekerreu ma lechub eng omengedmokl el kesengil eng teruich el zikang el mlara ngodech el chad el diak el delal ma demal ma lechub eng chad el oungerachel er ngii? Tial ulekerreu a sebechel el mlara basio el obetriri a rengalek, (day care center), yotsiyeng (preschool, Head Start program), ileakel ngesou ra telungalek (family child care home, nanny, au pair, or relative) ma lechub eng udeudel el chad el obang a ngalek (babysitter).

      1. Choi

      2. Dial

      1. Diak Kudengei

      1. Diak a Nger

Section J.Kirel A Telungalek Ma Delengchokl

    1. Ngarngii a chad el kiei era delengcheklem el ousbech a dekool, cigar, omaeb el dekool ma lechub eng melamech a buuch?

      1. Choi

      2. Diak [Bora J3]

      1. Diak Kudengei [Bora J3]

      1. Diak a Nger [Bora J3]

    1. Ngarngii a ngiidil chad el melokoo a dekool ra chelsel a blai?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. A ngelkem ng mla tal lolamech a buuch?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Ke medengei a telmellel a omelamech el buuch?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

A ikal keldei el ker a kirel a udoud.

    1. Sera lemechell ngkal ngalek, ng mle uangerang a renglel a okurulel ngkal ngalek el ousbech a ikel mlarngii el ududel a telungalek el omechar a kall ma siungel a delengchokl?

      1. Diak

      2. Kora Dimlak

      3. Kora mle Blechoel

      4. Blechoel

      1. Diak Kudengei

      1. Diak a Nger

    1. Tial ker a oker er kau el uase, ngmle sebechem el mechar a ikel kall el muluusbech. Ngera ra ikal beldukl e riou a ungil smodii a mle teletelel a omengeliu ma lechub eng rolel a kall el muluusbech ra blai raikal mla mo merek el teruich ma erul buil?

      1. Ng mle blechoel el sebecham el smiik a ungil ra bedenged el kall.

      2. Mle sebecham el smiik a kall ra blai engdi dimlak el blechoel el ikel kall el ungil ra bedenged.

      3. A lebebil ra taem eng mlo diak el sebecham el smiik/mechar a mle ungil a ildisel el kall

      4. Kmal mlo diak el sebecham el smiik ma lechub a ki mechar a ungil a ildisel el kall

      1. Diak Kudengei

      1. Diak a Nger

    1. Ngiidil taem era chelsel aikal mla mo merek el teruich ma erul buil ma lechub e diblel tal buil el mlar ngii a ngii dil chad ra blai el niglai a ikang:


Choi

Diak

Diak Kudengei

Diak a Nger

J7a. Udoud el ngesou el mlara amt?

1 ☐

2 ☐

77 ☐

99 ☐

J7b. Ngesou el udoud ma lechub eng kall el mlara amt (Food Stam, Suplimental Nutrition Assistance Program Benefits)?

1 ☐

2 ☐

77 ☐

99 ☐

J7c. Tada ma lechub eng yasui el kall ra tutau ma sueleb ra skuul?

1 ☐

2 ☐

77 ☐

99 ☐

J7d. Ngesou el mlar WIC Program (Benefits from the Woman, Infants, and Children)?

1 ☐

2 ☐

77 ☐

99 ☐

Section K.Kirem

    1. [Complete the questions for each of the two adults in the household who are this child’s primary caregivers. If there is just one adult, provide answers for that adult.]

Klou el Chad 1

Kau ke keskelel ngkal ngalek?

      1. Meral chedil/chedam ma lechub e merrodel edil/edam

      2. Bechil a chedil/chedam

      3. Delal Mechas/Demal Rubak

      4. Merrodel Chedil/Chedam el okiu a amt

      5. Ochedal/Udelel/Merrengel a Chedil/Chedam ma lechub e Obekul/Ochellel a Chedam

      6. Chedal

      7. Diak mchedal

    1. Ke sechal, ke Redil?

      1. Sechal

      2. Redil

    2. Tela Rekim?

Rak

    1. Ngera kot el ngarbab el skuul el om tilobed er ngii?

      1. Ongeai el skuul ma lechub e ngariou

      2. Ongetiu el mo Ongeteruich ma ongerung el skuul, Diak a babier el cholechotel a kmo ke tilobed ra skuul

      3. Ke tilobed ra ongetruich ma ongerung el skuul ma lechub eng tara skuul el mtechir a ongeteruich ma ongerung el skuul

      4. Ke tilobed ra skulel a ureor ra chim ma lechub eng skulel a siobai

      5. Sesel daingak engdi diak a dikuri

      6. Ke ngiluu a erung el rak el dikuri ra daingak(AA, AS)

      7. Ke ngiluu e euang el rak el dikuri ra daingak (BA, BS, AB)

      8. Ke ngiluu a Master dikuri er kau ra daingak (MA, MS, MSW, MBA)

      9. Ke ngiluu a kltoktang er kau ra daingak (PhD, EdD) ma lechub Berobesong dikuri (MD, DDS, DVM, JD)

    2. Ke bechiil?

      1. Bechiil [Bora K7]

      2. Dirkak a tang el bechiil

      3. Mla mo diak bechiill

      4. Kora mocha diak bechiil

      5. Mlad a bechim

      1. Diak a Nger [Bora K7]

    1. Ke kiei lobengkel a chad el dirke om kasisiik?

      1. Choi

      2. Diak

      1. Diak a Nger

    1. A klisichel a bedengem, ng ungil malechub eng mekngit?

      1. Kot Ungil

      2. Kmal Ungil

      3. Ungil

      4. Oikab

      5. Mekngi

      1. Diak Kudengei

      1. Diak a Nger

    1. A mental health er kau, ng ungil malechub eng mekngit?

      1. Kot Ungil

      2. Kmal Ungil

      3. Ungil

      4. Oikab

      5. Mekngi

      1. Diak Kudengei

      1. Diak a Nger

    1. Tial merekong el tang el rak ma lechub eng okeim ma erung el sandei, eng mlo sebechem el oureor el kesengil eng okeim el sandei?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Ngarngii a kuk tara klou el chad ra blai el dirrek el omtebechel e oungerachel er ngkal ngalek?

      1. Choi

      2. Diak [Bora Section L]

      1. Diak a Nger [Bora Section L]

    1. Ngkaikid el klou el chad oungerachel e omtebechel a mo Klou el Chad 2.

Ngkal Klou el Chad 2, ngera rolel el mora ngalek

      1. Meral chedil/chedam ma lechub e merrodel edil/edam

      2. Bechil a chedil/chedam

      3. Delal Mechas/Demal Rubak

      4. Merrodel Chedil/Chedam el okiu a amt

      5. Ochedal/Udelel/Merrengel a Chedil/Chedam ma lechub e Obekul/Ochellel a Chedam

      6. Chedal

      7. Diak mchedal

    1. Ngkal Klou el Chad 2, Ng sechal, ng redil?

      1. Sechal

      2. Redil

    2. Tela rekil ngkal Klou el Chad 2?

Rak

    1. Ngera kot el ngarbab el skuul el blo tobed er ngii a Klou el Chad 2?

      1. Ongeai el skuul ma lechub e ngariou

      2. Ongetiu el mo Ongeteruich ma ongerung el skuul, Diak a babier el cholechotel a kmo ke tilobed ra skuul

      3. Ke tilobed ra ongetruich ma ongerung el skuul ma lechub eng tara skuul el mtechir a ongeteruich ma ongerung el skuul

      4. Ke tilobed ra skulel a ureor ra chim ma lechub eng skulel a siobai

      5. Sesel daingak engdi diak a dikuri

      6. Ke ngiluu a erung el rak el dikuri ra daingak(AA, AS)

      7. Ke ngiluu e euang el rak el dikuri ra daingak (BA, BS, AB)

      8. Ke ngiluu a Master dikuri er kau ra daingak (MA, MS, MSW, MBA)

      9. Ke ngiluu a kltoktang er kau ra daingak (PhD, EdD) ma lechub Berobesong dikuri (MD, DDS, DVM, JD)

    2. Ngkal Klou el Chad 2, ng bechiil?

      1. Bechiil [Bora K17]

      2. Dirkak a tang el bechiil

      3. Mla mo diak bechiill

      4. Kora mocha diak bechiil

      5. Mlad a bechim

      1. Diak a Nger

    1. Ngkal Klou el Chad 2, ng kiei lobengkel a chad el dirke el kasisiik?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. A klisichel a bedengel, ng ungil malechub eng mekngit?

      1. Kot Ungil

      2. Kmal Ungil

      3. Ungil

      4. Oikab

      5. Mekngi

      1. Diak Kudengei

      1. Diak a Nger

    1. Daitai, a mental health er ngii, ng ungil malechub eng mekngit?

      1. Kot Ungil

      2. Kmal Ungil

      3. Ungil

      4. Oikab

      5. Mekngi

      1. Diak Kudengei

      1. Diak a Nger

    1. Tial merekong el tang el rak ma lechub eng okeim ma erung el sandei, eng ngkal Klou el Chad 2, ng mlo sebechel el oureor el kesengil eng okeim el sandei?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

Section L.Section L. Klisichel a Bedengem

    1. A hutsu el kensa a daitai eng tirterii a bedengem el rokir el diak el belkul a kmong ngarngii a secher, tellemall, ma lechub eng diak. Ng locha bekord el ua klemengetel a ngerang el taem a mle ulebongel el hutsu el kensa er kau el mlara toktang?

      1. Chelsel tiang el merekong el rak (Ngiidil taem el ngesonges ra teruich ma erung el buil ra mla memong)

      2. Chelsel a merekong el erung el rak (tang el rak engdi ngesonges ra erung el rak ra la memong)

      3. Chelsel a merekong el eim el rak (erung el rak engdi ngesonges ra eim el rak ra la memong)

      4. Eim ma lechub eng betook el rak ra la memong

      5. Dirkak a tang

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel aikal mla mo merek el teruich ma erul buil, e ngkal ngalek mla tal ngara ukeruul a lechub ngesou ra cheldecheduch ra meduch el chad ra ukeruul ra uldesued? A chad ra ukeruul ra uldesued a uldimukel er ngii a toktang ra secherel a uldesued, toktang ra uldasou, nurse ra secherel a uldesued, chad el oureor el olengeseu ra chad el mo di ngii.

      1. Choi

      2. Diak, Ngdi kirek el mesang a semmong ra secherel a uldasou

      3. Diak, Dimlak kuusbech el omes ra semmong ra secherel a uldaous [Bora L4]

      1. Diak Kudengei [Bora L4]

      1. Diak a Nger [Bora L4]

    1. Mle ua klungel a ngerang a mondai er kau meke mlo ousbech ra semmong ra ukeruul ra uldasou?

      1. Diak a Mondai

      2. Kekerei el Mondai

      3. Klou el Mondai

    2. Tial dirke mlo merek el kldiull er kau, a toktang ra uingel ng ngilatech a ungelem?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Ker

    1. Ng techang a oungerachel a rokui el telengtengil ukeruul er kau?

      1. Kau

      2. Bechim

      3. Kau ma Bechim

      4. Delam ma Demam

      5. Kuk di tang ra rechad, mlechesii

      1. Monger a ikal medechel el ker el kirir ar dertang er tirkel ngalek el tolechoi el mo teruich

      2. Diak Kudengei

      1. Diak a Nger

    1. Techa oungerangel a bekel telengtengil a ukeruul ra rengelekem?

      1. Kau

      2. Bechim

      3. Kau ma Bechim ma lechub eng aibo er kau

      4. Dleam ma Demam

      5. Kuk di tang ra rechad, mlechesii

      1. Monger a ikal medechel el ker el kirir ar dertang er tirkel ngalek el tolechoi el mo teruich

      1. Diak Kudengei

      1. Diak a Nger

Aikal ker a oker el kirel omelokoo el dekool, omelim, ma usbechellel a mekngit el kar.

    1. Chelsel a ikal mla mo merek el okedei el klebesei, eng telal sils sil el molokoo a dekool?

      1. Diak a tang el sils

      2. Tang el mo erung el sils

      3. Edei el mora eim el sils

      4. Elolem el mo etiu el sils

      5. Teruich el mo teruich ma etiu el sils

      6. Lluich el mo lluich etiu el sils

      7. Rokui el okedei el sils

      1. Diak Kudengei

      1. Diak a Nger

    1. Kau ke melim a rrom, el uldimukl er ngii a ikel di dolengoes ra blai?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel a klengar er kau, e ke mla tal mousbech a ikang:


Choi

Diak

Diak Kudengei

Diak a Nger

L9a. Buuch

1

2

77

99

L9b. Dekool ma lechub e ngikel okesiul a dekool (vape)

1

2

77

99

L9c. Chemadech el dekool

1

2

77

99

L9d. Mariuana (chudel)

1

2

77

99

L9e. Cocaine, including powder, crack, or freebase

1

2

77

99

L9f. Heroin (also called smack, junk, or China White)

1

2

77

99

L9g. Methamphetamines (also called speed, crystal, crank, or ice)

1

2

77

99

L9h. Ecstasy (also called MDMA)

1

2

77

99

L9i. Synthetic marijuana (also called K2, Spice, fake weed, King Kong, Yucatan Fire, Skunk, or Moon Rocks)

1

2

77

99

L9j. Steroid pills or shots without a doctor's prescription

1

2

77

99

L9k. Prescription pain medicine without a doctor's prescription or differently than how a doctor told you to use it? (Count drugs such as codeine, Vicodin, OxyContin, Hydrocodone, and Percocet)

1

2

77

99

[If respondent never chewed betel nut, go to L11.]

    1. Chelsel aikal mla mo merek elokedei el klebesei, eng mle telal sils el mullamech a buuch?

      1. Diak a tang el sils

      2. Tang el mo erung el sils

      3. Edei el mora eim el sils

      4. Elolem el mo etiu el sils

      5. Teruich el mo teruich ma etiu el sils

      6. Lluich el mo lluich etiu el sils

      7. Rokui el okedei el sils

      1. Diak Kudengei

      1. Diak a Nger

    1. Ng mla tang el modurech el mong ma lechub e kemla ra ukeruul ma lechub e ke millai a ngesou el kirel a terbengel/cheldecheduch/ukeruul ra usbechellel a mekngit el kar?

      1. CHoi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

    1. A toktang er kau ma lechub e ngiidil tang el meduch el chad ra ukeruul ngmla subedau el uase ke smecher el sukal (Type 1 ma Type 2)?

      1. Type 1 diabetes

      2. Type 2 diabetes

      3. Diak [Bora L14]

      1. Diak Kudengei [Bora L14]

      1. Diak a Nger [Bora L14]

    1. Kau ke melim a kerul a sukal?

      1. Orus el Insulin

      2. Melim a Kar

      3. Merus a Insulin e Melim a Kar

      4. Diak Kulai a Kar

      1. Diak Kudengei

      1. Diak a Nger

    1. A toktang ma lechub e ngiidil chad ra ukeruul ngmla subedau el uase ke smecher ra ta raikal rakt?


      CHOI

      DIAK

      Diak Kudengei

      Diak a Nger

      L14a. Rheumatic heart disease

      1

      2

      77

      99

      L14b. Rheumatic fever

      1

      2

      77

      99

      L14c. Kasinoma ra Medal Omecherelled

      1

      2

      77

      99

      L14d. Olngesonges a Rsechem

      1

      2

      77

      99

    2. Kam sodii a berredem?

      1. Ke kmal Kebekakl

      2. Oikab el Kebekakl

      3. Ungil a Berredem

      4. Telkib el Oberaod

      5. Kmal Oberaod

    3. Ngerang ra ikang a omolasem el meruul er ngii el kirel a berredem?

      1. Olngesonges a Bendek

      2. Melechel a Bendek

      3. Di uaisei a Berredek

      4. Diak a Ngerang el Kuruul er Ngii el Kirel a Berredek

    4. Chelsel tial mla mo merek el tal sandei, e ngkmal telal sils el muluu chundo ma lechub e kemeringel el oureor el kesengil eng tal zikang ra tal sils? Ka modak a ikel rokui el taem el mchiloit el ouedikl ma lechub e ke chundo meng kmal mlo mesisiich el omomb a heart er kau meng rirellau el mo kora mesel.

      1. Diak a Tang el Sils

      2. Tang el Sils

      3. Erung el Sils

      4. Edei el Sils

      5. Euang el Sils

      6. Eim el Sils

      7. Elolem el Sils

      8. Euid el Sils

      1. Diak Kudengei

      1. Diak a Nger

    1. Somam el mo medengei el uase, ngarngii a tolechoi el tang a rekil ma lechub eng kekeri ma lechub ekau ke dioll?

      1. Ngarngii a ngelekek el tang a rekil and ngak a diak dioll

      2. Ngarngii a ngelekek el kekerei, engak a dioll er chelechang

      3. Ngak a dioll ngdi diak a kekerei el ngelekek [Bora Section M]

      4. Diak [Bora M]

      1. Diak Kudengei

      1. Diak a Nger

    1. A ikang el ker a oker el kirel a Zika virus. A Zika virus a bekoiuiuul el rakt el rekas a nguu el oiulii el mora tang ma tang ra rechad. Ngdi dirrek el sebechel el imuul el okiu a sechal el smecher a bolebad (ousechelei) el obengkel a redil. Sel mle ulebongel el kldiull er kau, eng kora mle suebek a rengum el kirel a Zika virus?

Kedi ngiltii a di imong el nger.

      1. Kmal mle suebek a renguk

      2. Kora mle suebek a renguk

      3. Dimlak

      4. Dirkak a tang el krengesii a rakt el Zika virus er sel mle ulebongel el kldiull er ngak

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel sel dirke mlo merek el kldiull er kau, eng mle tang el mulngedecheduch ra toktang, nurse, ma lechub e ngiidil chad ra ukeruul el kirel a Zika virus?

      1. Diak

      2. Choi, Ng dimlak kuker engdi chad ra ukeruul a milngedecheduch er ngak el kirel

      3. Choi, A chad ra ukeruul a milngedecheduch er ngak ele ngak a ulker

      1. Diak Kudengei

      1. Diak a Nger

    1. Chelsel sel dirke mlo merek el kldiull er kau, eng mlengai a rsechem el mora skeng el kirel a Zika virus?

      1. Choi

      2. Diak [Bora L23]

      1. Diak Kudengei

      1. Diak a Nger

    1. Ke milteriter el ngarngii a Zika er sel dirke mlo merek el kldiull er kau?

      1. Choi

      2. Diak [Bora M1]

      1. Diak a Nger [Bora M1]

      1. Diak Kunger [Bora M1]

[A lsekum eng Choi] Techang el ngelekem a oblem dioll er ngii?

    1. A ikang el ker a kirel a omerollem er sel sel dirke mlo merek el kldiull er kau.

Chelsel tial dirke mlo merek el kldiull er kau, e ke mlora ikel beluu el ngarngii a Zika virus?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

[A lsekum eng Choi] Tial dirke mlo merek el kldiull er kau, kemle medengei el kmong diak el ungil a obora ikel basio el ngarngii a rakt el Zika virus?

      1. Choi

      2. Diak

      1. Diak Kudengei

      1. Diak a Nger

[A lsekum eng Diak] Tial dirke mlo merek el kldiull er kau, leng kau el mle medengei el kmo ngdiak el ungil a om dioll e bora ikel basio el ngarngii rakt el Zika?

      1. Choi

      1. Diak

      1. Diak Kudengei

      1. Diak a Nger

Section M.Section M. Kirel a Delengchokl

    1. Telang el chad a kiei er tiang el basio? Kosisebii a chad el blechoel el kiei ma lechub e te kiei er tiang el basio. Diak molsiseb ra chad el kiei ra tara basio el mo kemangel ra erung el buil ma lechub e ngalek ra daingak el kiei era tara basio ma lechub e ngara klsoldau me ngara tara beluu.

Ildisir a rechad

      1. Diak Kudengei

      1. Diak a Nger

    1. Telang er tirkang el chad er tiang el delengchol a chad er tiang el telungelek? A telungalek a ngiidil chad el ulak el me rengkal ngalek el okiu a rasech, chebehiil, omerodel, ma lechub eng omerodel el okiu a amt.

Ildisir a Rechad

      1. Diak Kudengei

      1. Diak a Nger

    1. A kimo oker a ker el kirel a ildisel a udoud el siliseb er tiang el delengchokl er tiang el merekong el tang el rak (January 1 ‑ December 31, 2017). Aikel rokui el osisebellel a udoud el mertiang el delengchokl ka beskak sel kot el sebechem el mtebengar a ildisel.


      CHOI

      DIAK

      A lsekum eng Choi, ildisel a udoud

      Diak Kudengei

      Diak a Nger

      M3a. Wages, salary, commissions, bonuses, or tips from all jobs?

      1

      2

      , ,

      77

      99

      M3b. Self-employment income from own nonfarm businesses or farm business, including proprietorships and partnerships?

      1

      2

      , ,

      77

      99

      M3c. Interest, dividends, net rental income, royalty income, or income from estates and trusts?

      1

      2

      , ,

      77

      99

      M3d. Social security or railroad retirement; retirement, survivor, or disability pensions?

      1

      2

      , ,

      77

      99

      M3e. Supplemental security income (SSI); any public assistance or welfare payments from the state or local welfare office?

      1

      2

      , ,

      77

      99

      M3f. Any other sources of income received regularly such as Veterans’ (VA) payments, unemployment compensation, child support, or alimony?

      1

      2

      , ,

      77

      99

    2. Tial ker er chelechang a kirel sel cherrengelel a udoud el siliseb el mertiang el delengchokl e kmal klou a ultutelel. Komdasou a ikel rokui el udoud el siliseb er tiang el telungalek er tiang el merekong el rak ra 2017. Tirkel rokui el ngar tiang el telungalek el mengereker a ulsiseb er tiang. A ildisel a udoud ra uchei ra mengai a tax er ngii. Tiang a uldimukl er ngii a udoud ra omengerker, oketmeklir a rengalek (child support), social security, ma udoud el molai e ritaerment era ureor, kemlo merek el oureor el diak el kau a uchul, ma ngesou ra amt. Ng dirrek el ulsiseb er ngii a olengil a udoud, kab, udoud ra siobai, sers, oleng ra klalou ma lechub eng siobai, ngiidil udoud el siliseb.

, , Ildisel a udoud ($)

      1. Diak Kudengei

      1. Diak a Nger

Ke kmal mesulang el ulengeseu er tiang el ureor.

Ak mo omtechei ra U.S. Department of Health and Human Services, e mereng asulem ra taem ma urerem el mchiloit el meskemam a ikang el meklou a belkul el tekoi el kirel ngkal ngalek me kau ma telungalek er kau. A ikang el nger el bla beskemam a mo ngosukemam ra tekoi ra omerritel ma omeuul el llach ma mo kudmokl a bekel telungalek el mo ungil el melchesuar a usbehellel a ngesou ra klisichel a bedenged ma rengalek ra kakerous el bedengir a rechad.

49

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