Attachment 48 Attachment 48 Health Status Section

SpecWriter Data

Form Version:

10/17/2017 3:55:29 PM

Report Type:

Full Detail

Project Database:
Language:

English

WESSQL6.MEPS_V2

Spec Label:

This is the cover page. Additional contents currently project specific.

HE - Page 1 of 50

MEPS_V2

Health Status (HE) Section
(Rout

Full Detail Spec

BOX_00

Route Details:

(HE1000)

Item Type: Route

Type Class: If Then

01 Box = BOX_10, BOX_20, BOX_30, BOX_40
02 Loop = LOOP_10, LOOP_20, LOOP_30, LOOP_40
03 End Loop = END_LP10, END_LP20, END_LP30, END_LP40
04 Single Select = HE10, HE30, HE40, HE60, HE70, HE90, HE110, HE120, HE130,
HE140, HE150, HE160, HE170, HE180, HE190,HE220, HE230, HE270, HE290, HE310,
HE330, HE350, HE370
08 Multiple Select = HE210
10 Multiple Select with Fill in Answer Text = HE20, HE50, HE80, HE100, HE200,
HE240, HE260, HE280, HE300, HE320, HE340, HE360, HE380
22 Stem and Leaf = HE250A, HE250B, HE250C
Roster 2 = HE20, HE50, HE80, HE100, HE200, HE240, HE260, HE280, HE300, HE320,
HE340, HE360, HE380

BOX_10

Route Details:

(HE1005)

Item Type: Route

Type Class: If Then

Context Header Display Instructions: Display {HOME.RUBEGMM, HOME.RUBEGDD,
HOME.RUBEGYY, HOME.RUENDMM, HOME.RUENDDD,
HOME.RUENDYY/PERS.FULLNAME, PRND.BEGREFMM, PRND.BEGREFDD,
PRND.BEGREFYY, PRND.ENDREFMM, PRND.ENDREFDD, PRND.ENDREFYY}

HE - Page 2 of 50

MEPS_V2

Health Status (HE) Section
(Rout

Full Detail Spec

BOX_20

Route Details:

(HE1010)

Item Type: Route

Type Class: If Then

If Round 1 or Round 3 and there is at least one RU member who is not deceased, continue
with HE10.
If Round 2 or Round 4 and there is at least one RU member who is not deceased, go to
HE270.
If Round 5, go to BOX_40.
Otherwise (e.g., Rounds 1-4 and all RU members are deceased), go to BOX_40.
NOTE: This section is asked for all current RU members and institutionalized persons. This
section includes deceased persons only when there is at least one other current or
institutionalized person listed as part of the RU.
NOTE: Questions HE10 through HE260 are asked in Rounds 1 and 3. Questions HE270
through HE380 are asked in Rounds 2 and 4.
NOTE: Throughout the Health Status (HE) section, age categories are referenced when a
true age was not obtained. The ages for these age categories are as follows:
1 = LESS THAN 1 YEAR OLD
2 = 1-4
3 = 5-15
4 = 16-23
5 = 24-34
6 = 35-44
7 = 45-54
8 = 55-64
9 = 65 YEARS OLD OR OLDER

HE - Page 3 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE10
Item Type:

(HE1015)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

BLAISE NAME: HelpPhone
Field kind: Datafield
ArrayMin:

Help Available (IMPAIRMENTHelp)
Context Header:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Show Card (

)

Max value:

Look Up File (

)

{STR-DT}
{END-DT}

Question Text:
Does anyone in this household receive help or supervision using the telephone, paying bills, taking medications, preparing
light meals, doing laundry, or going shopping (because of an impairment or a physical or mental health problem)?
HELP: F1

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE40
HE40
HE40

If coded '1' (YES) and a single person RU, automatically code person as 'RECEIVES HELP'
at HE20 by CAPI then
- If person is < 13 or in age categories 1-3 go to LOOP_10.
- Otherwise, go to HE40.
If coded '1' (YES) and a multi-person RU, continue with HE20.

Display
Instructions:

Testing/Editing
Notes:

(HE1055)
(HE1055)
(HE1055)

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 4 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE20
Item Type:

(HE1020)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: HelpPhoneRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

)

Min value:
Max value:

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Does anyone else receive help or supervision doing these types of activities [such as using the telephone, paying
bills, taking medications, preparing light meals, doing laundry, or going shopping]?
ENTER ALL THAT APPLY.

Responses:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

2
3
4
5

HE - Page 5 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

Programmer
Instructions:

If any of the persons selected are < 13 or in age categories 1-3, continue with LOOP_10.
Otherwise, go to HE40.
Roster behavior:
1. Multiple select allowed.

Display
Instructions:

Roster 2 – no add/edit/delete
Roster Definition:
This item displays RU-members-roster (FULLNAME) for selection.
Roster Filter:
None. Display all RU members.
Note: Placeholder for MHOP specifications. Throughout the HE section, deceased RU
members in multi-person RUs where there is at least one RU member who is not deceased
will display on rosters for selection. This was done for administration ease so FIs do not have
to back up to re-code a gate question if a deceased person was mentioned. This is a change
from the administration method in WVS. During post-processing, HE data for deceased
persons will need to be cleared out (set to -1) at some point along the process so that the data
patterns are consistent.

Testing/Editing
Notes:

LOOP_10

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

(HE1025)

Item Type: Route

Type Class: Begin Loop

For each element in the RU-Members-Roster, ask HE30 - END_LP10.
LOOP DEFINITION: LOOP_10 determines if persons receive help or supervision with
instrumental activities of daily living because of an impairment or physical or mental health
problem. This loop cycles on RU members who meet the following conditions:
- Person is not deceased
- Person receives help with instrumental activities of daily living (i.e., person selected at
HE20)
- Person is < 13 years of age or in age categories 1-3

HE - Page 6 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE30
Item Type:

(HE1040)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

BLAISE NAME: HelpPhoneBillsHlth
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1

Help Available (IMPAIRMENTHelp)
Context Header:

Min value:

ArrayMax:

Show Card (

Max value:

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
{Do/Does} {you/{PERSON}} receive help or supervision using the telephone, paying bills, taking medications, preparing
light meals, doing laundry or going shopping because of an impairment or a physical or mental health problem?
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

END_LP10
END_LP10
END_LP10
END_LP10

(HE1050)
(HE1050)
(HE1050)
(HE1050)

Display
Instructions:

Testing/Editing
Notes:

END_LP10

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_01[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_01[1..25]

(HE1050)

Item Type: Route

Type Class: End Loop

Cycle on next person in the RU-Members-Roster who meets the conditions stated in the
loop definition.
If no other persons meet the stated conditions, end LOOP_10 and continue with HE40.

HE - Page 7 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE40
Item Type:

(HE1055)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

BLAISE NAME: HelpPersnlCare
Field kind: Datafield
ArrayMin:

Help Available (IMPAIRMENTHelp)
Context Header:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Show Card (

)

Max value:

Look Up File (

)

{STR-DT}
{END-DT}

Question Text:
Does anyone in this household receive help or supervision with personal care such as bathing, dressing, or getting around the
house (because of an impairment or a physical or mental health problem)?
HELP: F1

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE70
HE70
HE70

If coded '1' (YES) and a single-person RU, automatically code person as 'RECEIVES HELP'
at HE50 by CAPI then
- If person is < 13 or in age categories 1-3 go to LOOP_20.
- Otherwise, go to HE70.
If coded '1' (YES) and multi-person RU, continue with HE50.

Display
Instructions:

Testing/Editing
Notes:

(HE1100)
(HE1100)
(HE1100)

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 8 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE50
Item Type:

(HE1060)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: HelpPersnlCareRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

)

Min value:
Max value:

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Does anyone else receive help or supervision with personal care [such as bathing, dressing, or getting around the
house]?
ENTER ALL THAT APPLY.

Responses:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

2
3
4
5

HE - Page 9 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

Programmer
Instructions:

If any of the person(s) selected are < 13 or in age categories 1-3, continue with LOOP_20.
Otherwise, go to HE70.
Roster Behavior:
1. Multiple select allowed.

Display
Instructions:

Roster 2 – no add/edit/delete
Roster Definition:
This item displays RU-members-roster for selection.
Roster Filter:
None. Display all RU members.

Testing/Editing
Notes:

LOOP_20

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

(HE1065)

Item Type: Route

Type Class: Begin Loop

For each element in the RU-Members-Roster, ask HE60 - END_LP20.
LOOP DEFINITION: LOOP_20 determines if persons receive help or supervision with
personal care (i.e., activities of daily living) because of an impairment or physical or mental
health problem. This loop cycles on RU members who meet the following conditions:
- Person is not deceased
- Person receives help or supervision with personal care (i.e., activities of daily living, that
is, the person is selected at HE50)
- Person is < 13 years of age or in age categories 1-3

HE - Page 10 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE60
Item Type:

(HE1080)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

BLAISE NAME: HelpPersnlProb
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1

Help Available (IMPAIRMENTHelp)
Context Header:

Min value:

ArrayMax:

Show Card (

Max value:

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
{Do/Does} {you/{PERSON}} receive help or supervision with personal care such as bathing, dressing or getting around the
house because of an impairment or a physical or mental health problem?
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

END_LP20
END_LP20
END_LP20
END_LP20

(HE1090)
(HE1090)
(HE1090)
(HE1090)

Display
Instructions:

Testing/Editing
Notes:

END_LP20

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_02[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_02[1..25]

(HE1090)

Item Type: Route

Type Class: End Loop

Cycle on next person in the RU-Members-Roster who meets the conditions stated in the
loop definition.
If no other persons meet the stated conditions, end LOOP_20 and continue with HE70.

HE - Page 11 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE70
Item Type:

(HE1100)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (HelpAidsHelp)
Context Header:

BLAISE NAME: HelpAids
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Show Card (

)

Max value:

Look Up File (

)

{STR-DT}
{END-DT}

Question Text:
Does anyone in this household use any aids such as a walker, grab bars in the bathtub or any other special equipment for
personal care or everyday activities (because of an impairment or a physical or mental health problem)?
HELP: F1

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE90
HE90
HE90

If coded '1' (YES) and a single-person RU, automatically code person as 'USES AIDS' at
HE80 by CAPI and go to HE90.
If coded '1' (YES) and a multi-person RU, continue with HE80.

Display
Instructions:

Testing/Editing
Notes:

(HE1110)
(HE1110)
(HE1110)

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 12 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE80
Item Type:

(HE1105)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: HelpAidsRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Does anyone else use any aids [such as a walker, grab bars in the bathtub or any other special equipment] for
personal care or everyday activities?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

HE90

(HE1110)

2

HE90

(HE1110)

3

HE90

(HE1110)

4

HE90

(HE1110)

5

HE90

(HE1110)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster Definition:
This item displays RU-members-roster (FULLNAME) for selection.
Roster Filter:
None. Display all RU members.

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 13 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE90
Item Type:

(HE1110)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

BLAISE NAME: HelpWalkClimb
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1

Help Available (HelpWalkHelp)
Context Header:

Min value:

ArrayMax:

Show Card (

Max value:

)

Look Up File (

)

{STR-DT} {END-DT}

Question Text:
Does anyone in this household have difficulties walking, climbing stairs, grasping objects, reaching overhead, lifting, bending
or stooping, or standing for long periods of time (because of an impairment or a physical or mental health problem)?
HELP: F1

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE190
HE190
HE190

If coded '1' (YES) and a single-person RU, automatically code person as 'HAVING
DIFFICULTY' at HE100 by CAPI then
- If person is >= 13 or in age categories 4-9 go to LOOP_30.
- Otherwise, go to HE190
If coded '1' (YES) and a multi-person RU, continue with HE100.

Display
Instructions:

Testing/Editing
Notes:

(HE1180)
(HE1180)
(HE1180)

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 14 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE100
Item Type:

(HE1115)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: HelpWalkClimbRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

)

Min value:
Max value:

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Does anyone else have difficulties [walking, climbing stairs, grasping objects, reaching overhead, lifting, bending or
stooping, or standing for long periods of time]?
ENTER ALL THAT APPLY.

Responses:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1
2
3
4
5

HE - Page 15 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

Programmer
Instructions:

If any of the person(s) selected are >= 13 or in age categories 4-9, continue with LOOP_30.
Otherwise, go to HE190.
Roster Behavior:
Multiple select allowed.

Display
Instructions:

Roster 2 – no add/edit/delete Roster Definition:
This item displays RU-members-roster for selection.
Roster Filter:
None. Display all RU members.

Testing/Editing
Notes:

LOOP_30

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

(HE1120)

Item Type: Route

Type Class: Begin Loop

For each element in the RU-Members-Roster, ask HE110 - END_LP30.
LOOP DEFINITION: LOOP_30 collects information on the level of functional limitation
with various physical activities for persons = or > 13 years of age. This loop cycles on RU
members who meet the following conditions:
- Person is not deceased
- Person has functional limitations (i.e., person selected at HE100)
- Person = or > 13 years of age or in age categories 4-9

HE - Page 16 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE110
Item Type:

(HE1130)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltLift
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
{For these next questions, I would like you to think about the time when {you/{PERSON}} entered the institution and what
{you/he/she} was able to do at that time.}
Please look at show card HE-1 and tell me how much difficulty {do/does} {you/{PERSON}} have lifting something as heavy
as 10 pounds, such as a full bag of groceries? Would you say no difficulty, some difficulty, a lot of difficulty, or completely
unable to do it?

Responses:

Display
Instructions:

Testing/Editing
Notes:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

1
2
3
4
RF
DK

HE120
HE120
HE120
HE120
HE120
HE120

(HE1135)
(HE1135)
(HE1135)
(HE1135)
(HE1135)
(HE1135)

Display ‘For these next questions, I would like you to think about the time when {you/{PERSON}}
entered the institution and what {you/he/she} was able to do at that time.’ if person being asked about
coded as being institutionalized at end date. If person being asked about is a current RU member living
in the RU, use a null display.

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 17 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE120
Item Type:

(HE1135)
Question

Type Class:

Enumerated

Answer Type:

TSTEPDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltStair
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have walking up 10 steps without resting?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?
IF RESPONDENT VOLUNTEERS THAT PERSON IS COMPLETELY UNABLE TO WALK, SELECT 'COMPLETELY
UNABLE TO WALK.'

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
COMPLETELY UNABLE TO WALK
REFUSED
DON'T KNOW

Programmer
Instructions:

If coded '5' (COMPLETELY UNABLE TO WALK), automatically code HE130, HE140,
HE150, and HE160 as '4' (COMPLETELY UNABLE TO DO IT) by CAPI.

1
2
3
4
5
RF
DK

HE130
HE130
HE130
HE130
HE170
HE130
HE130

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 18 of 50

(HE1140)
(HE1140)
(HE1140)
(HE1140)
(HE1160)
(HE1140)
(HE1140)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE130
Item Type:

(HE1140)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltWalkABlock
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have walking about 3 city blocks or about a
quarter of a mile?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

Programmer
Instructions:

If coded '4' (COMPLETELY UNABLE TO DO IT), automatically code HE140 as '4'
(COMPLETELY UNABLE TO DO IT) by CAPI.

1
2
3
4
RF
DK

HE140
HE140
HE140
HE150
HE140
HE140

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 19 of 50

(HE1145)
(HE1145)
(HE1145)
(HE1150)
(HE1145)
(HE1145)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE140
Item Type:

(HE1145)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltWalkMile
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have walking a mile?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

1
2
3
4
RF
DK

HE150
HE150
HE150
HE150
HE150
HE150

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 20 of 50

(HE1150)
(HE1150)
(HE1150)
(HE1150)
(HE1150)
(HE1150)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE150
Item Type:

(HE1150)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltStand20Min
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have standing for about 20 minutes?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

1
2
3
4
RF
DK

HE160
HE160
HE160
HE160
HE160
HE160

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 21 of 50

(HE1155)
(HE1155)
(HE1155)
(HE1155)
(HE1155)
(HE1155)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE160
Item Type:

(HE1155)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltBendStoop
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have bending down or stooping from a
standing position to pick up an object from the floor or tie a shoe?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

1
2
3
4
RF
DK

HE170
HE170
HE170
HE170
HE170
HE170

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 22 of 50

(HE1160)
(HE1160)
(HE1160)
(HE1160)
(HE1160)
(HE1160)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE170
Item Type:

(HE1160)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltReachUp
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have reaching up overhead, for example to
remove something from a shelf?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

1
2
3
4
RF
DK

HE180
HE180
HE180
HE180
HE180
HE180

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

HE - Page 23 of 50

(HE1165)
(HE1165)
(HE1165)
(HE1165)
(HE1165)
(HE1165)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE180
Item Type:

(HE1165)
Question

Type Class:

Enumerated

Answer Type:

TDIFF

Help Available (
Context Header:

)

BLAISE NAME: DfcltGrasp
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (HE-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
HE-1.
Looking at show card HE-1, how much difficulty {do/does} {you/{PERSON}} have using fingers to grasp or handle
something such as picking up a glass from a table or using a pencil to write?
PROBE: Would you say no difficulty, some difficulty, a lot of difficulty, or completely unable to do it?

Responses:

NO DIFFICULTY
SOME DIFFICULTY
A LOT OF DIFFICULTY
COMPLETELY UNABLE TO DO IT
REFUSED
DON'T KNOW

1
2
3
4
RF
DK

END_LP30
END_LP30
END_LP30
END_LP30
END_LP30
END_LP30

(HE1175)
(HE1175)
(HE1175)
(HE1175)
(HE1175)
(HE1175)

Display
Instructions:

Testing/Editing
Notes:

END_LP30

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_03[1..25]

(HE1175)

Item Type: Route

Type Class: End Loop

Cycle on next person in the RU-Members-Roster who meets the conditions stated in the
loop definition.
If no other persons meet the stated conditions, end LOOP_30 and continue with HE190.

HE - Page 24 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE190
Item Type:

(HE1180)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (LmtWorkHelp)
Context Header:

BLAISE NAME: LmtWork
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Show Card (

Max value:

)

Look Up File (

)

{STR-DT}
{END-DT}

Question Text:
Is anyone in this household limited in any way in the ability to work at a job, do housework, or go to school because of an
impairment or a physical or mental health problem?
HELP: F1

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE230
HE230
HE230

If coded '1' (YES) and a single-person RU, automatically code person as 'LIMITED
ABILITY' at HE200 by CAPI then
- If person is >= 5 or in age categories 3-9 go to LOOP_40.
- Otherwise, go to HE230
If coded '1' (YES) and a multi-person RU, continue with HE200.

Display
Instructions:

Testing/Editing
Notes:

(HE1215)
(HE1215)
(HE1215)

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 25 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE200
Item Type:

(HE1185)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: LmtWorkRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

)

Min value:
Max value:

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Is anyone else limited in the ability to work at a job, do housework, or go to school because of an impairment or a
physical or mental health problem?
ENTER ALL THAT APPLY.

Responses:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1
2
3
4
5

HE - Page 26 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

Programmer
Instructions:

If any of the persons selected are >= 5 or in age categories 3-9, continue
with LOOP_40.
Otherwise, go to HE230.
Roster behavior:
1. Multiple select allowed.

Display
Instructions:

Roster 2 – no add/edit/delete.
Roster definition:
This item displays RU-members-roster for selection.
Roster filter:
None. Display all RU members.

Testing/Editing
Notes:

LOOP_40

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

(HE1190)

Item Type: Route

Type Class: Begin Loop

For each element in the RU-Members-Roster, ask HE210 - END_LP40.
LOOP DEFINITION: LOOP_40 collects information on work/housework/school
limitations because of an impairment or physical or mental health problem for persons =
or > 5 years of age. This loop cycles on RU members who meet the following conditions:
- Person is not deceased
- Person is limited in ability to work at a job, do housework, or go to school (i.e., person
selected at HE200)
- Person = or > 5 years of age or in age categories 3-9

HE - Page 27 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE210
Item Type:

(HE1200)
Question

Type Class:

Enumerated

Answer Type:

TBW_HE20A

Help Available (
Context Header:

BLAISE NAME: LmtWhichActiv
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 3

)

Show Card (

ArrayMax:

Max value:

)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
Which activities {are/is} {you/{PERSON}} limited in doing because of an impairment or a physical or mental health
problem - working at a job, doing housework, or going to school?
ENTER ALL THAT APPLY.

Responses:

WORKING AT A JOB
DOING HOUSEWORK
GOING TO SCHOOL
REFUSED
DON'T KNOW

1
2
3
RF
DK

HE220
HE220
HE220
HE220
HE220

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_04[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_04[1..25]

HE - Page 28 of 50

(HE1205)
(HE1205)
(HE1205)
(HE1205)
(HE1205)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE220
Item Type:

(HE1205)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (
Context Header:

)

BLAISE NAME: UnableWork
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}

Question Text:
{At the time {you/{PERSON}} entered the institution, was / {Are/Is}} {you/{PERSON}} completely unable to {work at a
job}, {,/ and} {do housework} { and} { go to school}?

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE - Page 29 of 50

END_LP40
END_LP40
END_LP40
END_LP40

(HE1210)
(HE1210)
(HE1210)
(HE1210)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

Display
Instructions:

Display ‘At the time {you/{PERSON}} entered the institution, was’ if person being asked about coded
as being institutionalized at end date.
Display ‘{Are/Is}’ if person being asked about is a current RU member living in the RU.
Display ‘work at a job’ if HE210 is coded ‘1’ (WORKING AT A JOB), either alone or in combination
with other codes or if HE210 is coded ‘RF’ (REFUSED) or ‘DK’ (DON'T KNOW). If HE210 is not
coded ‘1’ (WORKING AT A JOB), ‘RF’ (REFUSED), or ‘DK’ (DON'T KNOW), use a null display.
Display ‘,’ if HE210 is coded ‘1’ (WORKING AT A JOB), ‘2’ (DOING HOUSEWORK), and ‘3’
(GOING TO SCHOOL) or if HE210 is coded either ‘RF’ (REFUSED) or ‘DK’ (DON'T KNOW).
Display ‘ and’ if HE210 is coded ‘1’ (WORKING AT A JOB) and either ‘2’ (DOING HOUSEWORK)
or ‘3’ (GOING TO SCHOOL) . Otherwise, use a null display.
Display ‘do housework’ if HE210 is coded ‘2’ (DOING HOUSEWORK), either alone or in
combination with other codes or if HE210 is coded ‘RF’ (REFUSED) or ‘DK’ (DON'T KNOW). If
HE210 is not coded ‘2’ (DOING HOUSEWORK), ‘RF’ (REFUSED), or ‘DK’ (DON'T KNOW), use a
null display.
Display ‘and’ if only codes ‘2’ (DOING HOUSEWORK) and ‘3’ (GOING TO SCHOOL) are selected
at HE210 or if codes ‘1’ (WORKING AT A JOB), ‘2’ (DOING HOUSEWORK), and ‘3’ (GOING TO
SCHOOL) are all selected at HE210 or if coded either ‘RF’ (REFUSED) or ‘DK’ (DON'T KNOW) at
HE210. Otherwise, use a null display.
Display ‘go to school’ if HE210 is coded ‘3’ (GOING TO SCHOOL), either alone or in combination
with other codes or if HE210 is coded ‘RF’ (REFUSED) or ‘DK’ (DON'T KNOW). If HE210 is not
coded ‘3’ (GOING TO SCHOOL), ‘RF’ (REFUSED), or ‘DK’ (DON'T KNOW), use a null display.

Testing/Editing
Notes:

END_LP40

Route Details:

Variable collected at MEPSSpring2018.HE_Main.Rnds13.Loop_04[1..25]
Variable stored at MEPSSpring2018.HE_Main.Rnds13.Loop_04[1..25]

(HE1210)

Item Type: Route

Type Class: End Loop

Cycle on next person in the RU-Members-Roster who meets the conditions stated in the
loop definition.
If no other persons meet the stated conditions, end LOOP_40 and continue with HE230.

HE - Page 30 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE230
Item Type:

(HE1215)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (LmtSocial)
Context Header:

BLAISE NAME: LmtSocial
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Show Card (

Max value:

)

Look Up File (

)

{STR-DT}
{END-DT}

Question Text:
(Besides the limitations we just talked about,) is anyone in this household limited in participating in social, recreational or
family activities because of an impairment or a physical or mental health problem?
HELP: F1

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

BOX_30
BOX_30
BOX_30

If coded '1' (YES) and a single person RU, automatically code person as 'LIMITED IN
PARTICIPATION' at HE240 by CAPI and go to BOX_30.
If coded '1' (YES) and a multi-person RU, continue with HE240.

Display
Instructions:

Testing/Editing
Notes:

(HE1225)
(HE1225)
(HE1225)

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 31 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE240
Item Type:

(HE1220)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: LmtSocialRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

)

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Is anyone else limited in participating in social, recreational, or family activities because of an impairment or a
physical or mental health problem?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

BOX_30

(HE1225)

2

BOX_30

(HE1225)

3

BOX_30

(HE1225)

4

BOX_30

(HE1225)

5

BOX_30

(HE1225)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete.
Roster definition:
This item displays RU-members-roster for selection. Display RU member's first, middle, and
last names (FULLNAME).
Roster filter:
None. Display all RU members.

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 32 of 50

MEPS_V2

Health Status (HE) Section
(Rout

Full Detail Spec

BOX_30

(HE1225)

Route Details:

Item Type: Route

Type Class: If Then

HE250A through HE250C represent a stem and leaf series.
Cycle through the leaf text in the A-# sequence until all rows are displayed.
Each leaf in this stem and leaf series, should display on the same form pane. Use the same
question stem display.
Display the question stem “{Do any of the adults in this household...}” only when
presenting the first question for this household. Otherwise always display question stem in
brackets and “grayed out” text.
Display each leaf in bold black when its entry field is active. Otherwise always display in
“grayed-out” text.
Go to HE250A.

HE250A
Item Type:

(HE1230)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (
Context Header:

)

BLAISE NAME: DfcltMmry
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Do any of the adults in this household...
a. Experience confusion or memory loss such that it interferes with daily activities?

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE - Page 33 of 50

HE250B
HE250B
HE250B
HE250B

(HE1235)
(HE1235)
(HE1235)
(HE1235)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE250B
Item Type:

(HE1235)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltDecision
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

Question Text:
[Do any of the adults in this household...]
b. Have problems making decisions to the point that it interferes with daily activities?

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE250C
HE250C
HE250C
HE250C

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 34 of 50

(HE1240)
(HE1240)
(HE1240)
(HE1240)

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE250C
Item Type:

(HE1240)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

BLAISE NAME: DfcltSup
Field kind: Datafield
ArrayMin:

)

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

)

Max value:

Look Up File (

)

Question Text:
[Do any of the adults in this household...]
c. Require supervision for their own safety?

Responses:

YES
NO
REFUSED
DON'T KNOW

Programmer
Instructions:

If HE250A, HE250B, or HE250C is coded '1' (YES) and a single-person RU, automatically
code as 'EXPERIENCES CONFUSION' at HE260 by CAPI and go to BOX_40.

1
2
RF
DK

If HE250A, HE250B, and HE250C are all coded '2' (NO), 'RF' (REFUSED), or 'DK' (DON'T
KNOW), go to BOX_40.
Otherwise, continue with HE260.

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 35 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE260
Item Type:

(HE1245)
Question

Type Class:

Enumerated

Answer Type:

Help Available (
Context Header:

BLAISE NAME: DfcltMDSRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

{STR-DT}
{END-DT}

Question Text:
Who is that?
PROBE: Does anyone else {experience confusion or memory loss such that it interferes with daily activities} {{or } have
problems making decisions to the point that it interferes with daily activities} {{or } require supervision for their own
safety}?
ENTER ALL THAT APPLY.

Responses:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

BOX_40

(HE1495)

2

BOX_40

(HE1495)

3

BOX_40

(HE1495)

4

BOX_40

(HE1495)

5

BOX_40

(HE1495)

HE - Page 36 of 50

)

MEPS_V2
Full Detail Spec

Health Status (HE) Section
(Que

Programmer
Instructions:

Roster behavior:
1. Multiple select allowed.

Display
Instructions:

Roster 2- no add/edit/delete
Roster definition:
This item displays RU-members-roster for selection.
Roster filter:
None. Display all RU members..
Display 'experience confusion or memory loss such that it interferes with daily activities' if
HE250A coded '1' (YES).
Display '{or} have problems making decisions to the point that it interferes with daily
activities' if HE250B coded '1' (YES). Display the 'or' only if HE250A is also coded ‘1’ (YES).
Display '{or} require supervision for their own safety' if HE250C is coded '1' (YES). Display 'or'
only if HE250A and/or HE250B are also coded ‘1’ (YES).

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds13
Variable stored at MEPSSpring2018.HE_Main.Rnds13

HE - Page 37 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE270
Item Type:

(HE1250)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltHear
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

Question Text:
With this next set of questions we want to learn about people who have physical, mental, or emotional conditions that cause
serious difficulties with their daily activities.
{Please answer the next few questions for family members age 1 or older.}
Is anyone in this household deaf or does anyone have serious difficulty hearing?

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE290
HE290
HE290

(HE1280)
(HE1280)
(HE1280)

If coded '1' (YES) and a single-person RU, automatically code person at HE280 by CAPI and
go to HE290.
If coded '1' (YES) and a multi-person RU, continue with HE280.

Display
Instructions:

Testing/Editing
Notes:

Display the sentence ‘Please answer...age 1 or older.’ if any RU members are < 1 year of age or in age
category 1. Otherwise, use a null display.

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 38 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE280
Item Type:

(HE1255)
Question

Type Class:

Enumerated

Answer Type:

BLAISE NAME: DfcltHearRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

Help Available (

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

Question Text:
Who is that?
PROBE: Anyone else?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

HE290

(HE1280)

2

HE290

(HE1280)

3

HE290

(HE1280)

4

HE290

(HE1280)

5

HE290

(HE1280)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster definition:
This item displays RU-members-roster (RU_MEMBERS_1/FULLNAME) for selection
Roster filter:
Display only RU members who meet the following conditions:
person is > or = 1 year of age or in age categories 2-9

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 39 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE290
Item Type:

(HE1280)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltSee
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

Question Text:
Is anyone in this household blind or does anyone have serious difficulty seeing, even when wearing glasses?

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE310
HE310
HE310

If coded '1' (YES) and a single-person RU, automatically code person at HE300 by CAPI and
go to HE310.
If coded '1' (YES) and a multi-person RU, continue with HE300.

Display
Instructions:

Testing/Editing
Notes:

(HE1310)
(HE1310)
(HE1310)

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 40 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE300
Item Type:

(HE1285)
Question

Type Class:

Enumerated

Answer Type:

BLAISE NAME: DfcltSeeRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

Help Available (

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

Question Text:
Who is that?
PROBE : Anyone else?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

HE310

(HE1310)

2

HE310

(HE1310)

3

HE310

(HE1310)

4

HE310

(HE1310)

5

HE310

(HE1310)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster definition:
This item displays RU-members-roster (RU_MEMBERS_1/FULLNAME) for selection.
Roster filter:
Display only RU members who meet the following conditions:
person is > or = 1 year of age or in age categories 2-9

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 41 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE310
Item Type:

(HE1310)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltMind
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

Question Text:
{Please answer the next few questions for family members age 5 or older.}
Because of a physical, mental, or emotional condition, does anyone in this household have serious difficulty concentrating,
remembering, or making decisions?

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE330
HE330
HE330

(HE1320)
(HE1320)
(HE1320)

If coded '1' (YES) and a single-person RU, automatically code person at HE320 by CAPI and
go to HE330.
If coded '1' (YES) and a multi-person RU, continue with HE320.

Display
Instructions:

Testing/Editing
Notes:

Display the sentence ‘Please answer … age 5 or older.’ if any RU members are < 5 years of age or in
age categories 1 or 2. Otherwise, use a null display.

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 42 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE320
Item Type:

(HE1315)
Question

Type Class:

Enumerated

Answer Type:

BLAISE NAME: DfcltMindRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

Help Available (

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

Question Text:
Who is that?
PROBE : Anyone else?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

HE330

(HE1320)

2

HE330

(HE1320)

3

HE330

(HE1320)

4

HE330

(HE1320)

5

HE330

(HE1320)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster definition:
This item displays RU-members-roster (RU_MEMBERS_1/FULLNAME) for selection.
Roster filter:
Display only RU members who meet the following conditions:
person is > or = 5 years of age or in age categories 3-9

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 43 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE330
Item Type:

(HE1320)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltWalk
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

Question Text:
Does anyone in this household have serious difficulty walking or climbing stairs?

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE350
HE350
HE350

If coded '1' (YES) and a single-person RU, automatically code person at HE340 by CAPI and
go to HE350.
If coded '1' (YES) and a multi-person RU, continue with HE340.

Display
Instructions:

Testing/Editing
Notes:

(HE1330)
(HE1330)
(HE1330)

.

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 44 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE340
Item Type:

(HE1325)
Question

Type Class:

Enumerated

Answer Type:

BLAISE NAME: DfcltWalkRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

Help Available (

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

Question Text:
Who is that?
PROBE: Anyone else?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

HE350

(HE1330)

2

HE350

(HE1330)

3

HE350

(HE1330)

4

HE350

(HE1330)

5

HE350

(HE1330)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster definition:
This item displays RU-members-roster (RU_MEMBERS_1/FULLNAME) for selection.
Roster filter:
Display only RU members who meet the following conditions:
person is > or = 5 years of age or in age categories 3-9

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 45 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE350
Item Type:

(HE1330)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltDress
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

Question Text:
Does anyone in this household have difficulty dressing or bathing?

Responses:

Programmer
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

HE370
HE370
HE370

If coded '1' (YES) and a single-person RU, automatically code person at HE360 by CAPI and
go to HE370.
If coded '1' (YES) and a multi-person RU, continue with HE360.

Display
Instructions:

Testing/Editing
Notes:

(HE1345)
(HE1345)
(HE1345)

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 46 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE360
Item Type:

(HE1335)
Question

Type Class:

Enumerated

Answer Type:

BLAISE NAME: DfcltDressRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

Help Available (

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

Question Text:
Who is that?
PROBE : Anyone else?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

HE370

(HE1345)

2

HE370

(HE1345)

3

HE370

(HE1345)

4

HE370

(HE1345)

5

HE370

(HE1345)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster definition:
This item displays RU-members-roster (RU_MEMBERS_1/FULLNAME) for selection.
Roster filter:
Display only RU members who meet the following conditions:
person is > or = 5 years of age or in age categories 3-9

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 47 of 50

)

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE370
Item Type:

(HE1345)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (

)

BLAISE NAME: DfcltErrand
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

Question Text:
{Please answer the next few questions for family members age 15 or older.}
Because of a physical, mental, or emotional condition, does anyone in this household have difficulty doing errands alone such
as visiting a doctor's office or shopping?

Responses:

YES
NO
REFUSED
DON'T KNOW

Programmer
Instructions:

If coded '1' (YES) and a single-person RU, automatically code person at HE380 by CAPI and
go to BOX_40.

1
2
RF
DK

If coded '1' (YES) and a multi-person RU, continue with HE380.

Display
Instructions:

Testing/Editing
Notes:

Display the sentence ‘Please answer...age 15 or older.’ if any RU members are < 15 years of age or in
age categories 1 - 3. Otherwise, use a null display.

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 48 of 50

MEPS_V2

Health Status (HE) Section
(Que

Full Detail Spec

HE380
Item Type:

(HE1350)
Question

Type Class:

Enumerated

Answer Type:

BLAISE NAME: DfcltErrandRoster
Field kind: Datafield
ArrayMin:

Field Size:
TFIRSTMIDLASTNA Answers allowed: 1

Help Available (

)

Show Card (

ArrayMax:

Min value:
Max value:

)

Look Up File (

Question Text:
Who is that?
PROBE : Anyone else?
ENTER ALL THAT APPLY.

Responses:

Programmer
Instructions:

Display
Instructions:

{FIRST NAME [MIDDLE NAME] LAST
NAME}1
{FIRST NAME [MIDDLE NAME] LAST
NAME}2
{FIRST NAME [MIDDLE NAME] LAST
NAME}3
{FIRST NAME [MIDDLE NAME] LAST
NAME}4
{FIRST NAME [MIDDLE NAME] LAST
NAME}N

1

BOX_40

(HE1495)

2

BOX_40

(HE1495)

3

BOX_40

(HE1495)

4

BOX_40

(HE1495)

5

BOX_40

(HE1495)

Roster behavior:
1. Multiple select allowed.

Roster 2 – no add/edit/delete
Roster definition:
This item displays RU-members-roster (RU_MEMBERS_1/FULLNAME) for selection.
Roster filter:
Display only RU members who meet the following conditions:
person is > or = 15 years of age or in age categories 4-9

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.HE_Main.Rnds24
Variable stored at MEPSSpring2018.HE_Main.Rnds24

HE - Page 49 of 50

)

MEPS_V2

Health Status (HE) Section
(Rout

Full Detail Spec

BOX_40

Route Details:

(HE1495)

Item Type: Route

Type Class: If Then

Go to next questionnaire section.

[End of HE]

HE - Page 50 of 50