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Language:
English
WESSQL6.MEPS_V2
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This is the cover page. Additional contents currently project specific.
CS - Page 1 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Rout
Full Detail Spec
BOX_00
Route Details:
(CS1000)
Item Type: Route
Type Class: If Then
01 Box = BOX_00, BOX_10, BOX_20, BOX_30, BOX_40, BOX_50, BOX_60, BOX_
70, BOX_80, BOX_90, BOX_100, BOX_110, BOX_120, BOX_130, BOX_140, BOX_
150
04 Single Select = CS10, CS20, CS30, CS40, CS50, CS60, CS70, CS80, CS90, CS100, CS110,
CS120, CS130, CS140, CS190, CS200, CS210, CS220, CS230, CS240, CS250, CS260, CS270,
CS290, CS300, CS310, CS320, CS340, CS350, CS370, CS380, CS390, CS400, CS410, CS420,
CS430, CS440, CS450, CS460, CS470, CS480, CS490, CS500, CS510, CS520
19 Numeric Field = CS280, CS330_01, CS330_02, CS360
22 Stem and Leaf = CS150A, CS150B, CS150C, CS150D, CS160A, CS160B, CS160C, CS170A,
CS170B, CS170C, CS180A, CS180B, CS180C
BOX_10
Route Details:
(CS1001)
Item Type: Route
Type Class: If Then
This CS section is asked in rounds 2 and 4 only. If it is round 1, 3, or 5, continue to the next
section in the questionnaire.
AHRQ will determine what subsections will be asked during each round. CAPI will need to
be programmed to be configurable to this administration.
The CS section includes four subsections:
1. LWIM (CS10 – CS140)
2. CIS (CS150A - CS180C)
3. CAHPS (CS190-CS300)
4. Prevention (CS310 – CS520)
CAPI will administer the LWIM series every R2/R4 administration
CAPI will administer the CAHPS and CIS series in R2 for Panels whose R1 collection
occurred in an odd year (FirstPanYear=odd), and R4 for Panels whose R1 collection
occurred in an even year (FirstPanYear=even).
CAPI will administer the Prevention series in R2 for Panels whose R1 collection occurred in
an even year (FirstPanYear=even), and R4 for Panels whose R1 collection occurred in an
odd year (FirstPanYear=odd).
Context header display instruction: Display RU member’s first, middle, and last name
(Person.FullName).
CS - Page 2 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Rout
Full Detail Spec
BOX_20
Route Details:
BOX_30
Route Details:
(CS1005)
Item Type: Route
Type Class: If Then
If RU member being asked about is deceased, go to BOX_140. Otherwise (RU member is a
current RU member or institutionalized), continue with BOX_30.
(CS1010)
Item Type: Route
Type Class: If Then
If RU member being asked about is < or = 17 years of age or in age categories 1 through 4,
continue with BOX_40.
Otherwise, go to BOX_140.
BOX_40
Route Details:
(CS1030)
Item Type: Route
Type Class: If Then
Subsection 1: The first subsection is Living with Illness measures (CS10-CS140). This
subsection is asked every R2/R4 administration.
Continue with CS10.
CS - Page 3 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS10
Item Type:
Type Class:
Answer Type:
(CS1065)
Question
Enumerated
TYESNO
Help Available (MEDPRESHelp)
Context Header:
BLAISE NAME: NeedRxMed
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
The next questions are about {your/{PERSON}'s} health needs and whether {you/he/she} {have/has} a health
condition. A health condition can be physical, mental or behavioral. Health conditions may affect a child's
development, daily functioning or need for services.
{Do/Does} {you/{PERSON}} currently need or use medicine prescribed by a doctor, other than vitamins?
HELP: F1
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS10, CS20, and CS30 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 4 of 65
CS20
CS40
CS40
CS40
(CS1070)
(CS1080)
(CS1080)
(CS1080)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS20
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1070)
Question
Enumerated
TYESNO
)
BLAISE NAME: RxMedCond
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this because of any medical, behavioral or other health condition?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
(CS1075)
(CS1080)
(CS1080)
(CS1080)
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1075)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Context Header:
CS30
CS40
CS40
CS40
Display CS10, CS20, and CS30 on the same form pane.
CS30
Item Type:
Help Available (
1
2
RF
DK
)
BLAISE NAME: RxCond12Mon
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this a condition that has lasted or is expected to last for at least 12 months?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 5 of 65
CS40
CS40
CS40
CS40
(CS1080)
(CS1080)
(CS1080)
(CS1080)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Display
Instructions:
Testing/Editing
Notes:
Display CS10, CS20, and CS30 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS40
Item Type:
(CS1080)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: MoreMedical
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
{Do/Does} {you/{PERSON}} need or use more medical care, mental health or educational services than is usual
for most children of the same age?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS40, CS50, and CS60 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 6 of 65
CS50
CS70
CS70
CS70
(CS1085)
(CS1095)
(CS1095)
(CS1095)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS50
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1085)
Question
Enumerated
TYESNO
)
BLAISE NAME: MoreMedCond
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this because of any medical, behavioral or other health condition?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
(CS1090)
(CS1095)
(CS1095)
(CS1095)
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1090)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Context Header:
CS60
CS70
CS70
CS70
Display CS40, CS50, and CS60 on the same form pane.
CS60
Item Type:
Help Available (
1
2
RF
DK
)
BLAISE NAME: MoreMedCond12Mon
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this a condition that has lasted or is expected to last for at least 12 months?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 7 of 65
CS70
CS70
CS70
CS70
(CS1095)
(CS1095)
(CS1095)
(CS1095)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Display
Instructions:
Testing/Editing
Notes:
Display CS40, CS50, and CS60 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS70
Item Type:
(CS1095)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: LmtAbility
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
{Are/Is} {you/{PERSON}} limited or prevented in any way in {your/his/her} ability to do the things most children
of the same age can do?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS70, CS80, and CS90 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 8 of 65
CS80
CS100
CS100
CS100
(CS1100)
(CS1110)
(CS1110)
(CS1110)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS80
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1100)
Question
Enumerated
TYESNO
)
BLAISE NAME: LmtAbilityCond
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this because of any medical, behavioral or other health condition?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
(CS1105)
(CS1110)
(CS1110)
(CS1110)
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1105)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Context Header:
CS90
CS100
CS100
CS100
Display CS70, CS80, and CS90 on the same form pane.
CS90
Item Type:
Help Available (
1
2
RF
DK
)
BLAISE NAME: LmtAbilityCond12Mon
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this a condition that has lasted or is expected to last for at least 12 months?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 9 of 65
CS100
CS100
CS100
CS100
(CS1110)
(CS1110)
(CS1110)
(CS1110)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Display
Instructions:
Testing/Editing
Notes:
Display CS70, CS80, and CS90 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS100
Item Type:
(CS1110)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: SpeclThrpy
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
{Do/Does} {you/{PERSON}} need or get special therapy such as physical, occupational or speech therapy?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS100, CS110, and CS120 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 10 of 65
CS110
CS130
CS130
CS130
(CS1115)
(CS1125)
(CS1125)
(CS1125)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS110
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1115)
Question
Enumerated
TYESNO
)
BLAISE NAME: SpeclThrpyCond
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this because of any medical, behavioral or other health condition?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
(CS1120)
(CS1125)
(CS1125)
(CS1125)
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1120)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Context Header:
CS120
CS130
CS130
CS130
Display CS100, CS110, and CS120 on the same form pane.
CS120
Item Type:
Help Available (
1
2
RF
DK
)
BLAISE NAME: SpeclThrpyCond12Mon
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this a condition that has lasted or is expected to last for at least 12 months?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 11 of 65
CS130
CS130
CS130
CS130
(CS1125)
(CS1125)
(CS1125)
(CS1125)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Display
Instructions:
Testing/Editing
Notes:
Display CS100, CS110, and CS120 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS130
Item Type:
(CS1125)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: ProbTrtmt
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
{Do/Does} {you/{PERSON}} have any kind of emotional, developmental or behavioral problem for which {you/he/she}
need{s} or get{s} treatment or counseling?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS130 and CS140 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 12 of 65
CS140
BOX_50
BOX_50
BOX_50
(CS1130)
(CS1135)
(CS1135)
(CS1135)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS140
Item Type:
(CS1130)
Question
Enumerated
Type Class:
Answer Type:
TYESNO
Help Available (
Context Header:
BLAISE NAME: ProbTrtmt12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Is this a condition that has lasted or is expected to last for at least 12 months?
Responses:
Display
Instructions:
Testing/Editing
Notes:
BOX_50
Route Details:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
BOX_50
BOX_50
BOX_50
BOX_50
(CS1135)
(CS1135)
(CS1135)
(CS1135)
Display CS130 and CS140 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1135)
Item Type: Route
Type Class: If Then
Subsection 2: The second subsection is the Columbia Impairment Scale (CS150ACS180C) will be administered in round 2 if calendar year of CAPI administration is an odd
year (FirstPanYear=odd) and this subsection will be administered in round 4 if the calendar
year of CAPI administration is an even year (FirstPanYear=even): round 4(panel 23 (2018)
round 4 or panel 24 (2019) round 2)
If RU member being asked about is aged 5-17 years, inclusive, or in age categories 3 or 4
and subsection is on route for inclusion in this round, continue with CS150A.
Otherwise, go to BOX_60.
CS - Page 13 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS150A
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1145)
Question
String
BLAISE NAME: ProbTrouble
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
& CS-1.
{The following questions are about some aspects of {your/{PERSON}'s} health.}
{In this series of questions, please/Please rate {yourself/him/her} on a scale of 0 to 4 where 0 indicates no problem and 4
indicates a very big problem.}
In general, how much of a problem do you think {you/{PERSON}} {have/has} with:
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
a. Getting into trouble?
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 14 of 65
CS150B
(CS1150)
CS150B
CS150B
(CS1150)
(CS1150)
)
MEPS_V2
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Child Preventive Health (CS) Section
(Que
Range check:
The values for TROUBLE should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
The CS150 question series represent a stem and leaf question format. Each leaf in this stem
and leaf series (CS150A – CS150D) should display on the same form pane. Use the same
question stem display.
Display “{The following questions are about some aspects of {your/{PERSON}'s} health.}”
only when presenting the first (stem) question for this person. Otherwise, use a null display.
Display “{In this series of questions, please…}” only when presenting the first (stem)
question for this person in bold, black standard text. Otherwise, display “Please rate
{yourself/him/her} on a scale of 0 to 4…” in grayed-out text for each subsequent (leaf)
question in this series.
Display “In general, how much of a problem do you think {you/{PERSON}} {have/has}
with: ” in bold black standard text for the first question (stem) for this person. Otherwise,
display it in brackets and “grayed-out” text for each subsequent (leaf) question in this series.
Display each leaf in bold black standard text when its entry field is active. Otherwise, always
display in “grayed-out” text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 15 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS150B
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1150)
Question
String
BLAISE NAME: ProbMother
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[In general, how much of a problem do you think {you/{PERSON}} {have/has} with:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
b. Getting along with {your/his/her} mother?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS150C
CS150C
CS150C
(CS1155)
(CS1155)
(CS1155)
Range check:
The values for MOTHPROB should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS150A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 16 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS150C
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1155)
Question
String
BLAISE NAME: ProbFather
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[In general, how much of a problem do you think {you/{PERSON}} {have/has} with:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
c. Getting along with {your/his/her} father?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS150D
(CS1160)
CS150D
CS150D
(CS1160)
(CS1160)
Range check:
The values for FATHPROB should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS150A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 17 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS150D
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1160)
Question
String
BLAISE NAME: ProbSad
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[In general, how much of a problem do you think {you/{PERSON}} {have/has} with:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
d. Feeling unhappy or sad?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS160A
(CS1165)
CS160A
CS160A
(CS1165)
(CS1165)
Range check:
The values for UNHAPSAD should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS150A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 18 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS160A
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1165)
Question
String
BLAISE NAME: ProbSchBehav
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.
How much of a problem would you say {you/{PERSON}} {have/has}:
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
e. With {your/his/her} behavior at school?
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 19 of 65
CS160B
CS160B
CS160B
(CS1170)
(CS1170)
(CS1170)
)
MEPS_V2
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Child Preventive Health (CS) Section
(Que
Range check:
The values for should be between 0 and 4 and should also include 99. A check should be
conducted to ensure that any values outside of these defined produce an error and prohibit
the interviewer from continuing until corrected. If a value entered is outside the allowable
range, display the following hard error message: “VALUE MUST BE BETWEEN 0 AND 4 OR 99
TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
The CS160 question series represent a stem and leaf question format. Each leaf in this stem
and leaf series (CS160A – CS160C) should display on the same form pane. Use the same
question stem display.
Display “Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very
big problem” in bold black text for the first question (stem) in this series, otherwise, display
this text in brackets and grayed-out text for each subsequent (leaf) question in this series.
Display “How much of a problem would you say {you/{PERSON}} {have/has}:” in bold
black standard text for the first (stem) question. Otherwise, display it in brackets and grayed
out text for each subsequent (leaf) question in this series.
Display each leaf in bold black standard text when its entry field is active. Otherwise, always
display in “grayed-out” text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 20 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS160B
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1170)
Question
String
BLAISE NAME: ProbHaveFun
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[How much of a problem would you say {you/{PERSON}} {have/has}:]
f. With having fun?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS160C
CS160C
CS160C
(CS1175)
(CS1175)
(CS1175)
Range check:
The values for HAVFUNPR should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS160A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 21 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS160C
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1175)
Question
String
BLAISE NAME: ProbAdults
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[How much of a problem would you say {you/{PERSON}} {have/has}:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
g. Getting along with adults other than {your/his/her} mother/father?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS170A
CS170A
CS170A
(CS1180)
(CS1180)
(CS1180)
Range check:
The values for ADULPROB should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS160A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 22 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS170A
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1180)
Question
String
BLAISE NAME: ProbFearful
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.
How much of a problem {do/does} {you/{PERSON}} have:
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
h. With feeling nervous or afraid?
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 23 of 65
CS170B
(CS1185)
CS170B
CS170B
(CS1185)
(CS1185)
)
MEPS_V2
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Child Preventive Health (CS) Section
(Que
Range check:
The values for NERVAFRD should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
The CS170 question series represent a stem and leaf question format. Each leaf in this stem
and leaf series (CS170A – CS170C) should display on the same form pane. Use the same
question stem display.
Display “Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very
big problem.” In bold black text for the first question (stem) in this series, otherwise, display
in brackets and grayed-out text for each subsequent (leaf) question in the series.
Display “How much of a problem {do/does} {you/{PERSON}} have:” in bold black standard
text for the first (stem) question. Otherwise, display it in brackets and grayed out text for
each subsequent (leaf) question in the series.
Display each leaf in bold black standard text when its entry field is active. Otherwise, always
display in “grayed-out” text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 24 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS170B
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1185)
Question
String
BLAISE NAME: ProbSiblings
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[How much of a problem {do/does} {you/{PERSON}} have:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
i. Getting along with {your/his/her} brothers and sisters?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS170C
CS170C
CS170C
(CS1190)
(CS1190)
(CS1190)
Range check:
The values for SIBSPROB should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS170A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 25 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS170C
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1190)
Question
String
BLAISE NAME: ProbOthCh
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[How much of a problem {do/does} {you/{PERSON}} have:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
j. Getting along with other kids {your/his/her} age?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
CS180A
(CS1195)
CS180A
CS180A
(CS1195)
(CS1195)
Range check:
The values for KIDSPROB should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS170A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 26 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS180A
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1195)
Question
String
BLAISE NAME: ProbSportHobby
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.
How much of a problem would you say {you/{PERSON} {have/has}:
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
k. Getting involved in activities like sports or hobbies?
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 27 of 65
CS180B
CS180B
CS180B
(CS1200)
(CS1200)
(CS1200)
)
MEPS_V2
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Child Preventive Health (CS) Section
(Que
Range check:
The values for SPORTHOB should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
The CS180 question series represent a stem and leaf question format. Each leaf in this stem
and leaf series (CS180A – CS180C) should display on the same form pane. Use the same
question stem display.
Display “Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very
big problem.” In bold black standard text for the first question (stem) in this series,
otherwise, display in brackets and grayed-out text for each subsequent (leaf) question in
this series.
Display “How much of a problem would you say {you/{PERSON}} {have/has}:” in bold
black standard text for the first (stem) question. Otherwise, display it in brackets and grayed
out text for each subsequent (leaf) question in this series.
Display each leaf in bold black standard when its entry field is active. Otherwise, always
display in
“grayed-out” text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 28 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS180B
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1200)
Question
String
BLAISE NAME: ProbSchWork
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem.]
[How much of a problem would you say {you/{PERSON}} {have/has}:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
l. With {your/his/her} school work {or doing {your/his/her} job}}?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
RF
DK
CS180C
(CS1205)
CS180C
CS180C
(CS1205)
(CS1205)
Range check:
The values for SCHLWORK should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS180A for display instructions.
Display ‘or doing {your/his/her}job}}’ if RU member is = or > 16 years old (or in age category
4). Otherwise, use a null display.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 29 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS180C
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1205)
Question
String
BLAISE NAME: ProbHomeBehav
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value:
ArrayMax:
Max value:
Show Card (CS-1)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-1.
[Please rate on a scale of 0 to 4 where 0 indicates no problem and 4 indicates a very big problem]
[How much of a problem would you say {you/{PERSON}} {have/has}:]
CODE 99 IF RESPONDENT INDICATES THE QUESTION IS INAPPLICABLE.
m. With {your/his/her} behavior at home?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
RF
DK
BOX_60
BOX_60
BOX_60
(CS1206)
(CS1206)
(CS1206)
Range check:
The values for BEHVHOME should be between 0 and 4 and should also include 99. A check
should be conducted to ensure that any values outside of these defined produce an error
and prohibit the interviewer from continuing until corrected. If a value entered is outside
the allowable range, display the following hard error message: “VALUE MUST BE BETWEEN 0
AND 4 OR 99 TO INDICATE INAPPLICABLE QUESTION. VERIFY AND CORRECT.”
See CS180A for display instructions.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 30 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Rout
Full Detail Spec
BOX_60
(CS1206)
Route Details:
Item Type: Route
Type Class: If Then
Subsection 3: The third subsection is CAHPS unmet need, provider satisfaction measures
(CS190-CS300) will be administered in round 2 if calendar year of CAPI administration is
an odd year (FirstPanYear=odd) and this subsection will be administered in round 4 if
calendar year of CAPI administration is an even year (FirstPanYear=even): round 4(panel
23 (2018) round 4 or panel 24 (2019) round 2).
If subsection is on route for inclusion in this round, continue with CS190.
Otherwise, go to BOX_70.
CS190
Item Type:
(CS1210)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: AcuteIll12Mon
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
In the last 12 months, did {you/{PERSON}} have an illness, injury or condition that needed care right away in a
clinic, emergency room, or doctor's office?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS190 and CS200 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 31 of 65
CS200
CS210
CS210
CS210
(CS1215)
(CS1220)
(CS1220)
(CS1220)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS200
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1215)
Question
Enumerated
TNUSALWAY
)
BLAISE NAME: AcuteCare12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, when {you/{PERSON}} needed care right away, how often did {you/he/she} get
care as soon as {you/he/she} needed?
Responses:
Display
Instructions:
Testing/Editing
Notes:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
Display CS190 and CS200 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 32 of 65
CS210
CS210
CS210
CS210
CS210
CS210
(CS1220)
(CS1220)
(CS1220)
(CS1220)
(CS1220)
(CS1220)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS210
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1220)
Question
Enumerated
TYESNO
)
BLAISE NAME: RoutnAppt12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
In the last 12 months, did you make any appointments for a check-up or routine care for {yourself/{PERSON}}
at a doctor's office or clinic?
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS210 and CS220 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 33 of 65
CS220
CS230
CS230
CS230
(CS1225)
(CS1230)
(CS1230)
(CS1230)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS220
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1225)
Question
Enumerated
TNUSALWAY
)
BLAISE NAME: OftRoutnAppt12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, how often did you get an appointment for a check-up or routine care
for {yourself/{PERSON}} at a doctor's office or clinic as soon as {you/he/she} needed?
Responses:
Display
Instructions:
Testing/Editing
Notes:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
Display CS210 and CS220 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 34 of 65
CS230
CS230
CS230
CS230
CS230
CS230
(CS1230)
(CS1230)
(CS1230)
(CS1230)
(CS1230)
(CS1230)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS230
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1230)
Question
Enumerated
TMORETIME
BLAISE NAME: SeeProv12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (CS-3)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-3.
Looking at card CS-3, in the last 12 months, not counting times {you/{PERSON}} went to an emergency room,
how many times did {you/he/she} go to a doctor's office or clinic to get health care?
Responses:
NONE
1 TIME
2 TIMES
3 TIMES
4 TIMES
5 TO 9 TIMES
10 OR MORE TIMES
REFUSED
DON'T KNOW
0
1
2
3
4
5
6
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 35 of 65
CS290
CS240
CS240
CS240
CS240
CS240
CS240
CS290
CS290
(CS1270)
(CS1245)
(CS1245)
(CS1245)
(CS1245)
(CS1245)
(CS1245)
(CS1270)
(CS1270)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS240
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1245)
Question
Enumerated
TNUSALWAY
)
BLAISE NAME: ProvExplain12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, how often did {your/{PERSON}'s} doctors or other health
professionals explain things about {your/his/her} health in a way that was easy to understand?
Responses:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 36 of 65
CS250
CS250
CS250
CS250
CS250
CS250
(CS1250)
(CS1250)
(CS1250)
(CS1250)
(CS1250)
(CS1250)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS250
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1250)
Question
Enumerated
TNUSALWAY
)
BLAISE NAME: ProvListen12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, how often did {your/{PERSON}'s} doctors or other health professionals listen
carefully to you?
Responses:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 37 of 65
CS260
CS260
CS260
CS260
CS260
CS260
(CS1255)
(CS1255)
(CS1255)
(CS1255)
(CS1255)
(CS1255)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS260
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1255)
Question
Enumerated
TNUSALWAY
)
BLAISE NAME: ProvRespect12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, how often did {your/{PERSON}'s} doctors or other health professionals show
respect for what you had to say?
Responses:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 38 of 65
CS270
CS270
CS270
CS270
CS270
CS270
(CS1260)
(CS1260)
(CS1260)
(CS1260)
(CS1260)
(CS1260)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS270
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1260)
Question
Enumerated
TNUSALWAY
)
BLAISE NAME: ProvTime12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, how often did {your/{PERSON}'s} doctors or other health
professionals spend enough time with {you/him/her}?
Responses:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 39 of 65
CS280
CS280
CS280
CS280
CS280
CS280
(CS1265)
(CS1265)
(CS1265)
(CS1265)
(CS1265)
(CS1265)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS280
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1265)
Question
Integer
BLAISE NAME: RateHCare12Mon
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
ArrayMin:
Min value: 0
ArrayMax:
Max value: 10
Show Card (CS-4)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-4.
Please look at card CS-4. Using any number from 0 to 10, where 0 is the worst health care possible, and 10 is the best health
care possible, what number would you use to rate all {your/{PERSON}'s} health care in the last 12 months?
ENTER RATING:
Responses:
REFUSED
DON'T KNOW
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 40 of 65
CS290
(CS1270)
CS290
CS290
(CS1270)
(CS1270)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS290
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1270)
Question
Enumerated
TYESNO
)
BLAISE NAME: SpeclAppt12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When you answer the next questions, do not include dental visits or care {you/{PERSON}} got when
{you/he/she} stayed overnight in a hospital.
Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who
specialize in one area of health care.
In the last 12 months, did you make any appointments for {yourself/{PERSON}} to see a specialist?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 41 of 65
CS300
BOX_70
BOX_70
BOX_70
(CS1275)
(CS1276)
(CS1276)
(CS1276)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS300
Item Type:
(CS1275)
Question
Enumerated
Type Class:
Answer Type:
TNUSALWAY
Help Available (
Context Header:
)
BLAISE NAME: OftSpeclAppt12Mon
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (CS-2)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
&CS-2.
Looking at card CS-2, in the last 12 months, how often did you get appointments for {yourself/{PERSON}} to
see a specialist as soon as {you/he/she} needed?
Responses:
NEVER
SOMETIMES
USUALLY
ALWAYS
REFUSED
DON'T KNOW
1
2
3
4
RF
DK
BOX_70
BOX_70
BOX_70
BOX_70
BOX_70
BOX_70
Display
Instructions:
Testing/Editing
Notes:
BOX_70
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1276)
Item Type: Route
Type Class: If Then
CS - Page 42 of 65
(CS1276)
(CS1276)
(CS1276)
(CS1276)
(CS1276)
(CS1276)
)
MEPS_V2
Child Preventive Health (CS) Section
(Rout
Full Detail Spec
Programmer
Instructions:
Subsection 4: The fourth subsection is the MEPS historical series on preventive care (CS310CS520).
If the calendar year of CAPI administration is an even year, this subsection will be
administered in round 2 (FirstPanYear=even),. If the calendar year of CAPI administration is
an odd year (FirstPanYear=odd), this subsection will be administered in round 4 (panel 22
(2017) round 4 or panel 23 (2018) round 2).
If subsection is on route for inclusion in this round, continue with CS310. Otherwise, go to
BOX_140.
CS310
Item Type:
Type Class:
(CS1280)
Question
Answer Type:
TYESNO
Help Available (
Context Header:
Enumerated
)
BLAISE NAME: ProvMeasrHeight
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}
Question Text:
Has a doctor or other health provider ever measured {your/{PERSON}'s} height?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 43 of 65
CS320
(CS1285)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
If coded ‘2’ (NO), ‘RF’ (REFUSED), or ‘DK’ (DON’T KNOW) and RU member is < or =5
years old (or in age categories 1 or 2), go to CS340. Otherwise, if coded ‘2’ (NO), ‘RF’
(REFUSED), or ‘DK’ (DON’T KNOW) and RU member is > or = 6 years old (or in age
categories 3 or 4), go to CS330_01.
Display CS310 and CS320 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS320
Item Type:
(CS1285)
Question
Type Class:
Enumerated
Answer Type:
TWHENWAS
Help Available (
Context Header:
BLAISE NAME: WhenMeasrHeight
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
CS - Page 44 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
If RU member is < or = 5 years old (or in age categories 1 or 2), go to CS340. Otherwise,
continue with CS330_01.
Display CS310 and CS320 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
BLAISE NAME: HeightFeet
Field kind: Datafield
ArrayMin:
CS330_01
Item Type:
(CS1295)
Question
Type Class:
Integer
Answer Type:
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
Min value: 0
Field Size: 1
)
Show Card (
ArrayMax:
Max value: 8
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
About how tall {are/is} {you/{PERSON}} without shoes?
ENTER FEET
PROBE FOR INCHES IF NOT REPORTED.
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 45 of 65
CS330_02
CS340
CS340
(CS1300)
(CS1305)
(CS1305)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
Soft check: If amount is above 7, display the following message: "VALUE IS HIGHER THAN
USUAL. VERIFY AND CORRECT IF NEEDED."
Display CS330_01 and CS330_02 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
BLAISE NAME: HeightInch
Field kind: Datafield
ArrayMin:
CS330_02
Item Type:
(CS1300)
Question
Type Class:
Integer
Answer Type:
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
Min value: 0
Field Size: 2
)
Show Card (
ArrayMax:
Max value: 30
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
[About how tall {are/is} {you/{PERSON}} without shoes?]
ENTER INCHES
[PROBE FOR INCHES IF NOT REPORTED.]
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 46 of 65
CS340
CS340
CS340
(CS1305)
(CS1305)
(CS1305)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Programmer
Instructions:
Soft check:
If amount is above 11 when feet (CS330_01) > 0, display the following message: "VALUE IS
HIGHER THAN USUAL. VERIFY AND CORRECT IF NEEDED."
If feet (CS330_01) = 0, inches (CS330_02) must be 1-30. If feet (CS330_01) > 0, inches (CS330
_02) must be 0-11.
Display
Instructions:
Display CS330_01 and CS330_02 on the same form pane.
Display question text: “About how tall {are/is} {you/{PERSON}} without shoes?” in
brackets and grayed out text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS340
Item Type:
(CS1305)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: ProvMeasrWeight
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}
Question Text:
Has a doctor or other health provider ever measured {your/{PERSON}'s} weight?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 47 of 65
CS350
(CS1310)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
If coded ‘2’ (NO), ‘RF’ (REFUSED), or ‘DK’ (DON’T KNOW) and RU member is < or = 5
years old (or in age categories 1 or 2), go to BOX_80. Otherwise, if coded ‘2’ (NO), ‘RF’
(REFUSED), or ‘DK’ (DON’T KNOW) and RU member is > or = 6 years old (or in age
categories 3 or 4), go to CS360.
Display CS340 and CS350 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS350
Item Type:
(CS1310)
Question
Type Class:
Enumerated
Answer Type:
TWHENWAS
Help Available (
Context Header:
BLAISE NAME: WhenMeasrWeight
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
CS - Page 48 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
If RU member is < or = 5 years old (or in age categories 1 or 2), go to BOX_80. Otherwise,
go to CS360.
Display CS340 and CS350 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
BLAISE NAME: WeightPound
Field kind: Datafield
ArrayMin:
CS360
Item Type:
(CS1320)
Question
Type Class:
Integer
Answer Type:
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
)
Min value: 1
Field Size: 3
Show Card (
ArrayMax:
Max value: 500
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
About how much {do/does} {you/{PERSON}} weigh without shoes?
ENTER POUNDS
Responses:
REFUSED
DON'T KNOW
RF
DK
CS - Page 49 of 65
BOX_80
(CS1330)
BOX_80
BOX_80
(CS1330)
(CS1330)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Soft check:
Programmer
Instructions:
If amount is above 300, display the following message: "VALUE IS HIGHER THAN USUAL.
VERIFY AND CORRECT IF NEEDED."
Display
Instructions:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
Testing/Editing
Notes:
BOX_80
(CS1330)
Route Details:
Item Type: Route
Type Class: If Then
If RU member being asked about is aged 3-6 years, inclusive, or in age categories 2 or 3,
continue with CS370.
Otherwise, go to BOX_90.
CS370
Item Type:
(CS1335)
Question
Type Class:
Enumerated
Answer Type:
TBLDPRSCK
Help Available (
Context Header:
)
BLAISE NAME: ProvCheckVision
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever checked {your/{PERSON}'s} vision?
Responses:
YES
NO
TRIED, BUT {YOU/HE/SHE}
{WERE/WAS} UNCOOPERATIVE
REFUSED
DON'T KNOW
1
2
3
BOX_90
BOX_90
BOX_90
(CS1340)
(CS1340)
(CS1340)
RF
DK
BOX_90
BOX_90
(CS1340)
(CS1340)
CS - Page 50 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Display
Instructions:
Testing/Editing
Notes:
BOX_90
Route Details:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1340)
Item Type: Route
Type Class: If Then
If RU member being asked about is > or = 2 years of age or in age categories 2 through 4,
continue with CS380.
Otherwise, go to BOX_100.
CS380
Item Type:
(CS1365)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (ADVICEYOUHelp)
Context Header:
BLAISE NAME: AdvHlthFood
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you {or {PERSON}} advice about {him/her} eating healthy?
HELP: F1
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS - Page 51 of 65
CS390
CS400
CS400
CS400
(CS1370)
(CS1375)
(CS1375)
(CS1375)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
Display
Instructions:
Display 'or {PERSON}' and '{him/her}' if RU member being asked about is not selected as the
respondent. Otherwise, (RU member being asked about is selected as the respondent), use a null
display.
Display CS380 and CS390 on the same form pane.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS390
Item Type:
Type Class:
(CS1370)
Question
Answer Type:
TWHENWAS
Help Available (
Context Header:
Enumerated
BLAISE NAME: WhenAdvHlthFood
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}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
Display CS380 and CS390 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 52 of 65
CS400
CS400
CS400
CS400
CS400
(CS1375)
(CS1375)
(CS1375)
(CS1375)
(CS1375)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS400
Item Type:
Type Class:
Answer Type:
(CS1375)
Question
Enumerated
TYESNO
Help Available (ADVICEYOUHelp)
Context Header:
BLAISE NAME: AdvExer
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you {or {PERSON}} advice about the amount and kind of exercise, sports,
or physically active hobbies {you/he/she} should have?
HELP: F1
Responses:
Display
Instructions:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
CS410
BOX_100
BOX_100
BOX_100
(CS1380)
(CS1385)
(CS1385)
(CS1385)
Display CS400 and CS410 on the same form pane.
Display ‘or {PERSON}’ if RU member being asked about is NOT selected as the respondent.
Otherwise, (RU member being asked about is selected as the respondent), use a null display.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 53 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS410
Item Type:
(CS1380)
Question
Enumerated
Type Class:
Answer Type:
TWHENWAS
Help Available (
Context Header:
BLAISE NAME: WhenAdvExer
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
BOX_100
Route Details:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
BOX_100
BOX_100
BOX_100
BOX_100
BOX_100
(CS1385)
(CS1385)
(CS1385)
(CS1385)
(CS1385)
Display CS400 and CS410 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1385)
Item Type: Route
Type Class: If Then
If RU member being asked about:
[- (Has a weight at CS360 < or = 40) or
-[(If CS360 is empty) and (person < or = 4 years of age (or in age categories 1 or 2))],
continue with CS420.]
If RU member being asked about:
[-(Has a weight at CS360 > 40 and < or = 80 pounds) or
-[(If CS360 is coded ‘RF’ or 'DK' or empty) and (person > 4 and < or = 9 years of age (or in
age category 3))], go to CS440.]
If RU member being asked about:
[-(Has a weight at CS360> 80 pounds,) or
-[(If CS360 is coded ‘RF’ or 'DK') and (Person > 9 years of age (or in age category 4))], go to
CS460.]
CS - Page 54 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Rout
Full Detail Spec
CS420
Item Type:
(CS1390)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (ADVICEYOUHelp)
Context Header:
BLAISE NAME: AdvSafetySeat
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Show Card (
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you advice about {him/her} using a child safety seat while riding
in the car?
HELP: F1
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS420 and CS430 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 55 of 65
CS430
BOX_120
BOX_120
BOX_120
(CS1395)
(CS1425)
(CS1425)
(CS1425)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS430
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1395)
Question
Enumerated
TWHENWAS
BLAISE NAME: WhenAdvSafetySeat
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
Display CS420 and CS430 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 56 of 65
BOX_120
BOX_120
BOX_120
BOX_120
BOX_120
(CS1425)
(CS1425)
(CS1425)
(CS1425)
(CS1425)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS440
Item Type:
Type Class:
Answer Type:
(CS1400)
Question
Enumerated
TYESNO
Help Available (ADVICEYOUHelp)
Context Header:
BLAISE NAME: AdvBooster
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you advice about {him/her} using a booster seat when riding in
the car?
HELP: F1
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS440 and CS450 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 57 of 65
CS450
BOX_110
BOX_110
BOX_110
(CS1405)
(CS1410)
(CS1410)
(CS1410)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS450
Item Type:
(CS1405)
Question
Enumerated
Type Class:
Answer Type:
TWHENWAS
Help Available (
Context Header:
BLAISE NAME: WhenAdvBooster
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
BOX_110
Route Details:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
BOX_110
BOX_110
BOX_110
BOX_110
BOX_110
(CS1410)
(CS1410)
(CS1410)
(CS1410)
(CS1410)
Display CS440 and CS450 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1410)
Item Type: Route
Type Class: If Then
If CS360 is coded 'RF' or 'DK' for RU member being asked about and person is in age
category 3 (age is unknown), continue with CS460.
Otherwise, go to BOX_120.
CS - Page 58 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS460
Item Type:
Type Class:
Answer Type:
(CS1415)
Question
Enumerated
TYESNO
Help Available (ADVICEYOUHelp)
Context Header:
BLAISE NAME: AdvBelts
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you {or {PERSON}} advice about {{him/her}} using lap and
shoulder belts when driving or riding in a car?
HELP: F1
Responses:
Display
Instructions:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
(CS1420)
(CS1425)
(CS1425)
(CS1425)
Display 'or {PERSON}' and '{him/her}' if RU member being asked about is not selected as the
respondent. Otherwise, (RU member being asked about is selected as the respondent), use a null
display.
Display CS460 and CS470 on the same form pane.
Testing/Editing
Notes:
CS470
BOX_120
BOX_120
BOX_120
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 59 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS470
Item Type:
(CS1420)
Question
Enumerated
Type Class:
Answer Type:
TWHENWAS
Help Available (
Context Header:
BLAISE NAME: WhenAdvBelts
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
BOX_120
Route Details:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
BOX_120
BOX_120
BOX_120
BOX_120
BOX_120
(CS1425)
(CS1425)
(CS1425)
(CS1425)
(CS1425)
Display CS460 and CS470 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1425)
Item Type: Route
Type Class: If Then
If RU member being asked about is > or = 2 years of age or in age categories 2 through 4,
continue with CS480.
Otherwise, go to CS500.
CS - Page 60 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS480
Item Type:
Type Class:
Answer Type:
(CS1430)
Question
Enumerated
BLAISE NAME: AdvHelmet
TYESNO
Help Available (ADVICEHELMHelp)
Context Header:
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you {or {PERSON}} advice about {{him/her}} using a helmet
when riding a bicycle or motorcycle?
HELP: F1
Responses:
Display
Instructions:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
(CS1435)
(CS1440)
(CS1440)
(CS1440)
Display 'or {PERSON}' and '{him/her}' if RU member being asked about is not selected as the
respondent. Otherwise, (RU member being asked about is selected as the respondent), use a null
display.
Display CS480 and CS490 on the same form pane.
Testing/Editing
Notes:
CS490
CS500
CS500
CS500
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 61 of 65
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS490
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(CS1435)
Question
Enumerated
TWHENWAS
BLAISE NAME: WhenAdvHelmet
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
Display CS480 and CS490 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 62 of 65
CS500
CS500
CS500
CS500
CS500
(CS1440)
(CS1440)
(CS1440)
(CS1440)
(CS1440)
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS500
Item Type:
Type Class:
Answer Type:
(CS1440)
Question
Enumerated
TYESNO
Help Available (ADVICEYOUHelp)
Context Header:
BLAISE NAME: AdvSmoking
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
Has a doctor or other health provider ever given you advice about how smoking in the house can be bad for
{your/{PERSON}'s} health?
HELP: F1
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
Display CS500 and CS510 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
CS - Page 63 of 65
CS510
BOX_130
BOX_130
BOX_130
(CS1445)
(CS1450)
(CS1450)
(CS1450)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS510
Item Type:
(CS1445)
Question
Enumerated
Type Class:
Answer Type:
TWHENWAS
Help Available (
Context Header:
BLAISE NAME: WhenAdvSmoking
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
)
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
When was that?
Responses:
Display
Instructions:
Testing/Editing
Notes:
BOX_130
Route Details:
WITHIN PAST YEAR
WITHIN PAST 2 YEARS
MORE THAN 2 YEARS
REFUSED
DON'T KNOW
1
2
3
RF
DK
BOX_130
BOX_130
BOX_130
BOX_130
BOX_130
(CS1450)
(CS1450)
(CS1450)
(CS1450)
(CS1450)
Display CS500 and CS510 on the same form pane.
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1450)
Item Type: Route
Type Class: If Then
If RU member being asked about is > or = 12 years of age or in age category 4, continue
with CS520.
Otherwise, go to BOX_140.
CS - Page 64 of 65
)
MEPS_V2
Child Preventive Health (CS) Section
(Que
Full Detail Spec
CS520
Item Type:
(CS1455)
Question
Enumerated
Type Class:
Answer Type:
TYESNO
Help Available (
Context Header:
)
BLAISE NAME: ProvAlone
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME}
Question Text:
The last time {you/{PERSON}} had a health care visit, did a doctor or other health provider spend any time alone with
{you/him/her} without a parent, relative or guardian in the room?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
BOX_140
BOX_140
BOX_140
BOX_140
Display
Instructions:
Testing/Editing
Notes:
BOX_140
Route Details:
Variable collected at MEPSSpring2018.CS_Main
Variable stored at MEPSSpring2018_PersSect.CS_Main
(CS1465)
Item Type: Route
Type Class: If Then
Go to next questionnaire section.
[End of CS]
CS - Page 65 of 65
(CS1465)
(CS1465)
(CS1465)
(CS1465)
)
| File Type | application/pdf |
| File Modified | 2018-02-21 |
| File Created | 2017-09-15 |