Attachment D - MEPS New Social and Health Experiences SAQ Items Crosswalk

Attachment D - MEPS New Social and Health Experiences SAQ Items Crosswalk

Domain	Source (See more info on page 11)	Source Item # and Question Text	MEPS SDOH SAQ Item # and Question Text	Rationale for Changes to Source Question Text
General Well-Being and Social Support	PSID	A1. How satisfied are you with your life as a whole these days? Completely satisfied, Very satisfied, Somewhat satisfied, A little satisfied, Not at all satisfied	1. How satisfied are you with your life as a whole these days? Completely satisfied, Very satisfied, Somewhat satisfied, A little satisfied, Not at all satisfied	No changes to wording or response options as compared to source questions.
Housing affordability and quality	PSID	A5A. How satisfied are you with each of the following: My house or apartment. Completely satisfied, Very satisfied, Somewhat satisfied, A little satisfied, Not at all satisfied	2. How satisfied are you with the house or apartment where you live? Completely satisfied, Very satisfied, Somewhat satisfied, A little satisfied, Not at all satisfied	Added the phrase “where you live” so ownership is not implied. “PSID has an extra response category – “Does not apply to me” which was excluded. For those, who are not head of household, or roomers/ boarders they may select this, which would be counter to ARHQs intent. Additionally, the PSID also shows a very low incidence of responses for that response category.
Neighborhood	Urban, 2017	Q18. How would you rate the following characteristics of your neighborhood? a. Availability of places to get medical care Excellent, Very Good, Good, Fair, Poor	How would you rate the following characteristics of your neighborhood? 3a. Availability of places to get medical care Excellent, Very Good, Good, Fair, Poor	No changes to wording or response options as compared to source questions. Slight change to order since not all were included in the series (left out items on quality of schools, neighbors helping each other, and child care options)
		b. Availability of parks and playgrounds Excellent, Very Good, Good, Fair, Poor	3b. Availability of parks and playgrounds Excellent, Very Good, Good, Fair, Poor	No changes to wording or response options as compared to source questions.
		d. Availability of places to buy healthy food Excellent, Very Good, Good, Fair, Poor	3c. Availability of places to buy healthy food Excellent, Very Good, Good, Fair, Poor	No changes to wording or response options as compared to source questions.
		g. Safety from crime and violence Excellent, Very Good, Good, Fair, Poor	3d. Safety from crime and violence Excellent, Very Good, Good, Fair, Poor	No changes to wording or response options as compared to source questions.
Neighborhood	Urban, 2017	c. Access to public transportation Excellent, Very Good, Good, Fair, Poor	3e. Access to public transportation Excellent, Very Good, Good, Fair, Poor	No changes to wording or response options as compared to source questions.
		e. Availability of affordable housing Excellent, Very Good, Good, Fair, Poor	3f. Availability of affordable housing Excellent, Very Good, Good, Fair, Poor	No changes to wording or response options as compared to source questions.
Transportation	CMS	5. In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living? Yes/No	4. In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? Yes/No	No changes to wording or response options as compared to source questions.
Housing affordability and quality	Urban, 2017	12a. Was there any time in the past 12 months, that is, since [CURRENT MONTH] [CURRENT YEAR-1], when your household did not pay the full amount of the rent or mortgage or was late with a payment because your household could not afford to pay? Yes, No	5. Was there a time in the past 12 months, when your household did not pay the full amount of the rent or mortgage, or was late with a payment because your household could not afford to pay? Yes, No, Don’t know	Removed month reference since we were administering on paper and could not customize for each respondent. Sampling multiple RU members so added “Don’t know” option to accommodate household members that are not familiar with household finances.
Housing affordability and quality	Urban, 2017	12b. Was there any time in the past 12 months, that is, since [CURRENT MONTH] [CURRENT YEAR-1], when your household was not able to pay the full amount of the gas, oil, or electricity bills? Yes, No	6. Was there any time in the past 12 months when your household was not able to pay the full amount of electric, gas, oil, or water bills on time? Yes, No, Don’t know	Modified Urban wording to add “water” and move “electricity” to match CMS wording used in SDOH question 7 (see next row). Sampling multiple RU members so added “Don’t know” option to accommodate household members that are not familiar with household finances.
	CMS	6. In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home? Yes, No, Already shut off	7. Was there any time in the past 12 months when the electric, gas, oil, or water company threatened to shut off services in your home? Yes, No, Already shut off, Don’t know	Modified prefix slightly to match Urban wording in Q5 and Q6. Sampling multiple RU members so added “Don’t know” option to accommodate household members that are not familiar with household finances.
Housing affordability and quality	CMS	Think about the place you live. Do you have problems with any of the following? Mark all that apply: Pests such as bugs, ants, or mice; Mold; Lead paint or pipes; Lack of heat; Oven or stove not working; Smoke detectors missing or not working; Water leaks; None of the above	8. Think of the place you live. Do you have problems with any of the following? Mark all that apply: Pests such as bugs, ants, or mice; Mold; Lead paint or pipes; Lack of heat; Oven or stove not working; Smoke detectors missing or not working; Water leaks; None of the above	No changes to wording or response options as compared to source questions.
Food Security	CMS	Some people have made the following statements about their food situation. Please answer whether the statements were OFTEN, SOMETIMES, or NEVER true for you and your household in the last 12 months. 3. Within the past 12 months, you worried that your food would run out before you got money to buy more. Often True, Sometimes True, Never True	9a. Some people have made the following statements about their food situation. Please answer whether the statements were often, sometimes, or never true for you in the last 12 months. Within the past 12 months, you worried that your food would run out before you got money to buy more. Often True, Sometimes True, Never True	No changes to wording or response options as compared to source questions.
	CMS	4. Within the past 12 months, the food you bought just didn't last and you didn't have money to get more. Often True, Sometimes True, Never True	9b. Within the past 12 months, the food you bought just didn’t last and you didn’t have the money to get more. Often True, Sometimes True, Never True	No changes to wording or response options as compared to source questions.
Financial Strain	CMS	11. How hard is it for you to pay for the very basics like food, housing, medical care, and heating? Very hard, Somewhat hard, Not hard at all	10. How hard is it for you to pay for the very basics like food, housing, medical care, and heating? Very hard, Somewhat hard, Not hard at all	No changes to wording or response options as compared to source questions.
	Urban, 2017	65. How confident are you that you could come up with $400 if an unexpected expense arose within the next month? Not at all confident, Not too confident, Somewhat confident, Very confident	11. How confident are you that you could come up with $400 if an unexpected expense arose within the next month? Not at all confident, Not too confident, Somewhat confident, Very confident	No changes to wording or response options as compared to source questions.
Financial Strain	Urban, 2017	57. In the past 12 months, that is, since [CURRENT MONTH] [CURRENT YEAR-1], have you or anyone in your family: f. Missed a payment on a credit card? Yes/No g. Missed a payment on a loan (do not include missed payments on a mortgage)? Yes/No	12. In the past 12 months, have you missed a payment on a credit card or a loan (do not include missed payments on a mortgage)? Yes/No	Removed month reference since we were administering on paper and could not customize for each respondent. Sampling at a person rather than household level, so removed reference to “anyone in your family”. Given previous questions about utility payments that should provide context for excluding those types of payments from this item, combined the 2 Urban items.
	Urban, 2017	63. In the past 12 months, have you been contacted by a debt collection agency? Yes/No	13. In the past 12 months, have you been contacted by a debt collection agency? Yes/No	No changes to wording or response options as compared to source questions.
Physical Activity	CMS	17. In the last 30 days, other than the activities you did for work, on average, how many days per week did you engage in moderate exercise (like walking fast, running, jogging, dancing, swimming, biking, or other similar activities)? 0, 1, 2, 3, 4, 5, 6, 7	14. In the last 30 days, other than the activities you did for work, on average, how many days per week did you engage in moderate exercise (like walking fast, running, jobbing, dancing, swimming, biking, or other similar activities)? 0, 1, 2, 3, 4, 5, 6, 7	No changes to wording or response options as compared to source questions.
	CMS	18. On average, how many minutes did you usually spend exercising at this level on one of those days? 0, 10, 20, 30, 40, 50, 60	15. On average, how many minutes did you usually spend exercising at this level on one of those days? 0, 10, 20, 30, 40, 50, 60	No changes to wording or response options as compared to source questions.
General Well-Being and Social Support	CMS	24. Stress means a situation in which a person feels tense, restless, nervous, or anxious, or is unable to sleep at night because his or her mind is troubled all the time. Do you feel this kind of stress these days? Not at all, A little bit, Somewhat, Quite a bit, Very much	16. Stress means a situation in which a person feels tense, restless, nervous, or anxious, or is unable to sleep at night because his or her mind is troubled all the time. Do you feel this kind of stress these days? Not at all, A little bit, Somewhat, Quite a bit, Very much	No changes to wording or response options as compared to source questions.
General Well-Being and Social Support	Urban, 2017	If you had a problem with which you needed help (for example, sickness or moving), how much help would you expect to get… 19a. From family? (Including any of your relatives or your spouse/partner’s relatives if applicable, whether or not they are living with you.) All of the help needed, Most of the help needed, Very little of the help needed, No help	If you had a problem in with which you needed help (for example, sickness or moving), how much help would you expect to get… 17a. From family? (Including any of your relatives or your spouse/partner’s relatives if applicable, whether or not they are living with you.) All of the help needed, Most of the help needed, Very little of the help needed, No help	No changes to wording or response options as compared to source questions.
		19b. From friends? All of the help needed, Most of the help needed, Very little of the help needed, No help	17b. From friends? All of the help needed, Most of the help needed, Very little of the help needed, No help	No changes to wording or response options as compared to source questions.
General Well-Being and Social Support	Urban, 2017	19c. From other people in the community besides family and friends, such as a social agency or church? All of the help needed, Most of the help needed, Very little of the help needed, No help	17c. From other people in the community besides friends and family, such as a social agency or church? All of the help needed, Most of the help needed, Very little of the help needed, No help	No changes to wording or response options as compared to source questions.
	IOM	In a typical week, how many times do you talk on the telephone with family, friends, or neighbors Never, 1 time, 2 times, 3 times, 4 times, 5 times, 6 or more times	18. In a typical week, how many times do you talk on the telephone (or by video) with family, friends, or neighbors? Never, 1 time, 2 times, 3 times, 4 times, 5 times, 6 or more times	Added parenthetical phrase “or by video” to account for increased communication by video platforms like Zoom during COVID. No changes to response options as compared to source questions.
		In a typical week, how often do you get together with friends or relatives (for example, going out together or visiting in each other’s homes) Never, 1 time, 2 times, 3 times, 4 times, 5 times, 6 or more times	19. In a typical week, how often do you get together with friends or relatives (for example, going out together or visiting each other’s homes)? Never, 1 time, 2 times, 3 times, 4 times, 5 times, 6 or more times	No changes to wording or response options as compared to source questions.
General Well-Being and Social Support	IOM	How often do you attend church or religious services? Never, 1-3 times per year, 4-6 times per year, 7-9 times per year, 10-12 times per year, 13-15 times per year, 16 or more times per year	20. How often do you attend church or religious services (in-person or online)? Never, 1-3 times per year, 4-6 times per year, 7-9 times per year, 10-12 times per year, 13-15 times per year, 16 or more times per year	Added parenthetical phrase “in-person or online” to account for ways individuals may be participating due to COVID restrictions on social distancing. No changes to response options as compared to source questions.
		How often do you attend meetings of the clubs or organizations you belong to? Never, 1-3 times per year, 4-6 times per year, 7-9 times per year, 10-12 times per year, 13-15 times per year, 16 or more times per year	21. How often do you attend meetings of the clubs and organizations you belong to (in person or online)? Never, 1-3 times per year, 4-6 times per year, 7-9 times per year, 10-12 times per year, 13-15 times per year, 16 or more times per year	Added parenthetical phrase “in-person or online” to account for ways individuals may be participating due to COVID restrictions on social distancing. No changes to response options as compared to source questions.
	UCLA/Hughes	The next questions are about how you feel about different aspects of your life. For each one, tell me how often you feel that way. First, how often do you feel that you lack companionship? (Original UCLA scale) Never, Rarely, Sometimes, Often (Hughes revised scale) Hardly ever, some of the time, or often	The next questions are about how you feel about different experts of your life. For each one, mark how often you feel that way. 22a. First, how often do you feel that you lack companionship? Never, Rarely, Sometimes, Often	Includes only 3 of the 20 items in the UCLA loneliness scale. The three items selected were those adapted by Hughes et al., 2004 for a telephone survey for an older population. AHRQ agreed that the original UCLA Loneliness response scale (never, rarely, sometimes, often) should be used as this won’t be administered by phone and isn’t directed only to older populations. Notably, the original UCLA items used first person (e.g. I lack companionship), but to maintain consistency with the rest of the survey, we used the Hughes approach (e.g. you lack companionship).
		How often do you feel left out? (Original UCLA scale) Never, Rarely, Sometimes, Often (Hughes revised scale) Hardly ever, some of the time, or often	22b. How often do you feel left out? Never, Rarely, Sometimes, Often
General Well-Being and Social Support	UCLA/Hughes	How often do you feel isolated from others? (Original UCLA scale) Never, Rarely, Sometimes, Often (Hughes revised scale) Hardly ever, some of the time, or often	22c. How often do you feel isolated from others? Never, Rarely, Sometimes, Often
Smoking	NIH/NIDA/FDA	Have you ever used an electronic nicotine product, even one or two times? (Electronic nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs and hookah pens.) Yes/No	23. Have you ever used an electronic nicotine product, even one or two times? (Electronic nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs and hookah pens.) Yes/No	No changes to wording or response options as compared to source questions.
Discrimination	Urban, 2018	70. Have you ever personally experienced discrimination in any of the following situations? At a doctor’s office, clinic, or hospital Yes/No	Have you ever personally experienced discrimination in any of the following situations? 24a. At a doctor’s office, clinic, or hospital Yes/No	No changes to wording or response options as compared to source questions. Presented as YES/NO series rather than grid form to reduce item non-response in a paper format
		At work Yes/No	24b. At work	No change.
		When applying for jobs Yes/No	24c. When applying for jobs Yes/No	No change.
		When trying to rent a room or apartment or buy a house Yes/No	24d. When trying to rent a room or apartment, or buy a house? Yes/No	No change.
		When interacting with police or law enforcement Yes/No	24e. When interacting with police or law enforcement? Yes/No	No change.
Discrimination	Urban, 2018	When applying for social services or public assistance Yes/No	24f. When applying for social services or public assistance? Yes/No	No change.
		At a restaurant or store Yes/No	24g. At a restaurant or store? Yes/No	No change.
Personal Safety	CMS	7. Because violence and abuse happens to a lot of people and affects their health we are asking the following questions. How often does anyone, including family and friends, physically hurt you? Never, Rarely, Sometimes, Fairly often, Frequently	Violence and abuse happens to many people, which can affect their health. The following questions ask about your experiences with physical violence and abuse to help us better understand how this affects health. 25a. How often does anyone, including family and friends, physically hurt you? Never, Rarely, Sometimes, Fairly often, Frequently	Modified preamble to provide context for self-administration. No other changes to wording or response options as compared to source questions.
		8. How often does anyone, including family and friends, insult or talk down to you? Never, Rarely, Sometimes, Fairly often, Frequently	25b. How often does anyone, including family and friends, insult or talk down to you? Never, Rarely, Sometimes, Fairly often, Frequently	No changes to wording or response options as compared to source questions.
Personal Safety	CMS	9. How often does anyone, including family and friends, threaten you with harm? Never, Rarely, Sometimes, Fairly often, Frequently	25c. How often does anyone, including family and friends, threaten you with harm? Never, Rarely, Sometimes, Fairly often, Frequently	No changes to wording or response options as compared to source questions.
		10. How often does anyone, including family and friends, scream or curse at you? Never, Rarely, Sometimes, Fairly often, Frequently	25d. How often does anyone, including family and friends, scream or curse at you? Never, Rarely, Sometimes, Fairly often, Frequently	No changes to wording or response options as compared to source questions.
Adverse Childhood Experience (ACEs) Adverse Childhood Experience (ACEs)	BRFSS	I'd like to ask you some questions about events that happened during your childhood. This information will allow us to better understand problems that may occur early in life, and may help others in the future. This is a sensitive topic and some people may feel uncomfortable with these questions. At the end of this section, I will give you a phone number for an organization that can provide information and referral for these issues. Please keep in mind that you can ask me to skip any question you do not want to answer. All questions refer to the time period before you were 18 years of age.	The following questions are about events that happened during your childhood. This information will allow us to better understand problems that may occur early in life, and may help others in the future. This is a sensitive topic and some people may feel uncomfortable with these questions. Page 11 includes phone numbers for organizations that can provide information and referrals for these issues. Please keep in mind that you can skip any question you do not want to answer. All questions refer to the time period before you were 18 years of age.	Modified introduction slightly for self-administration.
		M22.01. Now, looking back before you were 18 years of age---Did you live with anyone who was depressed, mentally ill, or suicidal? Yes/No	26. Now, looking back before you were 18 years of age, did you live with anyone who was depressed, mentally ill, or suicidal? Yes/No	No changes to wording or response options as compared to source questions.
		M22.02. Did you live with anyone who was a problem drinker or alcoholic? Yes/No	27. Did you live with anyone who was a problem drinker or alcoholic? Yes/No	No changes to wording or response options as compared to source questions.
		M22.03. Did you live with anyone who used illegal street drugs or who abused prescription medications? Yes/No	28. Did you live with anyone who used illegal street drugs or who abused prescription medications? Yes/No	No changes to wording or response options as compared to source questions.
		M22.04. Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility? Yes/No	29. Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility? Yes/No	No changes to wording or response options as compared to source questions.
Adverse Childhood Experience (ACEs) Adverse Childhood Experience (ACEs)	BRFSS	M22.05. Were your parents separated or divorced? Yes, No, Parents not married	30. Were your parents separated or divorced? Yes, No, Parents not married	No changes to wording or response options as compared to source questions.
		M22.06. How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up? Was it… Never, Once, More than once	31. How often did your parents or adults in your home ever slap, hit, kick, punch, or beat each other up? Was it… Never, Once, More than once	No changes to wording or response options as compared to source questions.
		M22.07. Not including spanking, (before age 18), how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Was it… Never, Once, More than once	32. Not including spanking, (before age 18), how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Was it… Never, Once, More than once	No changes to wording or response options as compared to source questions.
		M22.08. How often did a parent or adult in your home ever swear at you, insult you, or put you down? Was it… Never, Once, More than once	33. How often did a parent or adult in your home ever swear at you, insult you, or put you down? Was it… Never, Once, More than once	No changes to wording or response options as compared to source questions.
		M22.09. How often did anyone at least 5 years older than you or an adult, ever touch you sexually? Was it… Never, Once, More than once	34. How often did anyone at least 5 years older than you or an adult, ever touch you sexually? Was it… Never, Once, More than once	No changes to wording or response options as compared to source questions.
		M22.10. How often did anyone at least 5 years older than you or an adult, try to make you touch them sexually? Was it… Never, Once, More than once	35. How often did someone at least 5 years older than you or an adult, try to make you touch them sexually? Was it… Never, Once, More than once	No changes to wording or response options as compared to source questions.
		M22.11. How often did anyone at least 5 years older than you or an adult, force you to have sex? Was it… Never, Once, More than once	36. How often did anyone at least 5 years older than you or an adult, force you to have sex? Was it… Never, Once, More than once	No changes to wording or response options as compared to source questions.

Source Surveys

Reference Name in Table	Survey Name	SDOH Question Numbers Drawn From This Survey	Source Link
PSID	Panel Study of Income Dynamics/ 2016: Wellbeing and Daily Life Supplement	1,2	https://psidonline.isr.umich.edu/
Urban, 2017	Urban Institute Well-Being and Basic Needs Survey (2017)	3a-f, 5, 11, 17a-17b	https://www.urban.org/sites/default/files/2018/11/19/wbns_2017_questionnaire.pdf
Urban, 2018	Urban Institute Well-Being and Basic Needs Survey (2018)	24a-g	https://www.urban.org/sites/default/files/2019/06/10/well-being_and_basic_needs_survey_2018_questionnaire.pdf
CMS	Accountable Health Communities (ACH) Health-Related Social Needs Screening	4, 7, 8, 9a-9b, 10, 14, 15, 16, 25a-25d	https://innovation.cms.gov/Files/worksheets/ahcm-screeningtool.pdf
IOM	Institute of Medicine Measures of Social and Behavioral Determinants of Health: A Feasibility Study	18, 19, 20, 21	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253326/
UCLA/Hughes	UCLA Loneliness Scale M.E. Hughes, L.J. Waite, L.C. Hawkley, J.T. Cacioppo. A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26 (2004), pp. 655-672, 10.1177/0164027504268574	22a-c	UCLA: https://fetzer.org/sites/default/files/images/stories/pdf/selfmeasures/ Self_Measures_for_Loneliness_and_Interpersonal_Problems_UCLA_LONELINESS.pdf Hughes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394670/
NIH/NIDA/FDA	Population Assessment of Tobacco and Health (PATH) Study	23	https://www.drugabuse.gov/research/nida-research-programs-activities/population-assessment-tobacco-health-path-study
BRFSS	Behavioral Risk Factor Surveillance System, 2019	27, 28, 29, 30, 31, 32, 33, 34, 35, 36	https://www.cdc.gov/brfss/questionnaires/pdf-ques/2019-BRFSS-Questionnaire-508.pdf

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