0920-0950 MEC and Dietary Reminder Call Instrument

[NCHS] National Health and Nutrition Examination Survey (NHANES)

Attachment_6o_MEC_Dietary_ReminderCallInstrument_2024JULY16

Day 1 and Day 2 Telephone Dietary Recall & Follow-up

OMB: 0920-0950

Document [docx]
Download: docx | pdf

Attachment 6o


MEC and Dietary Reminder Call Instrument

Attachment 6o: MEC and Dietary Reminder Call Instrument


Form Approved 

OMB No. 0920-0950 

Exp. Date XX/XX/20XX 

Notice – CDC estimates the average public reporting burden for this collection of information as 5 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road, MS H21-8, Atlanta, GA 30333; ATTN: PRA (0920-0950). 

Assurance of Confidentiality – We take your privacy very seriously.  All information that relates to or describes identifiable characteristics of individuals, a practice, or an establishment will be used only for statistical purposes.  NCHS staff, contractors, and agents will not disclose or release responses in identifiable form without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act or CIPSEA (44 U.S.C. 3561-3583).  In accordance with CIPSEA, every NCHS employee, contractor, and agent has taken an oath and is subject to a jail term of up to five years, a fine of up to $250,000, or both if he or she willfully discloses ANY identifiable information about you. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks. 

 


LEAD_IN

ASK

All respondents

Display:

  • Case Level Status

  • Line Level Status

  • Case-Level Comments

  • Date of last Call

  • Last Appointment

  • [FILL NAME OF PERSON TO CALL (Dietary name/MEC name)]

  • [FILL SP Name of Child] (for reference)

  • [FILL SP Name Adult 18+ who has a proxy] (for reference)

  • SP Age


SPANISH

N/A

QUESTION TYPE

Text display

FILLS

FILL NAME OF PERSON TO CALL:

  • FILL SP NAME IF (SP AGE 18+ YEARS AND NO PROXY)

  • FILL PROXY NAME IF (SP AGE IS <18 YEARS) OR (SP AGE IS 18+ AND YES PROXY)

  • IF MULTIPLE APPOINTMENTS ON SAME DAY AND ALL SAME PHONE NUMBER, THEN LIST ALL SP NAMES (SP AGE 18+ WITHOUT A PROXY) OR PROXY NAMES

NOTES


HELP SCREEN


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

TW




TW

ASK

All Respondents

WHAT DO YOU WANT TO DO?


  1. CONTINUE WITH THIS CASE

  2. REVIEW RECORD OF EVENTS

  3. REVIEW ROSTER OF NUMBERS AND NAMES

  4. REVIEW/ENTER CASE LEVEL COMMENTS

  1. SAVE THE CURRENT CASE; GET ANOTHER CASE OR EXIT CATI-CMS

  2. SCHEDULE A CALLBACK

  3. CHOOSE A NEW NUMBER TO CALL

  1. CALL-IN CASE

  1. SPECIAL OPTIONS

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF TW=1: AUTO_DIAL FOLLOWED BY DIAL1

IF TW=2: RECORD OF EVENTS

IF TW=3 OR 8: ROSTER LINES

IF TW=4: CASE COMMENTS

IF TW=6: SAVE AND EXIT CASE

IF TW=7: LAUNCH WEB SCHEDULER

IF TW=13: REMINDER

IF TW=90: SPECIAL OPTIONS






DIAL1

ASK

IF TW=1

PHONE NUMBER TO CALL: [FILL PHONE NUMBER]


DID A PERSON ANSWER THE PHONE (NOT OPERATOR)?


  1. YES

  2. NO

  1. CALL-IN CASE

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS

FILL PHONE NUMBER FROM PRELOAD – SP PHONE NUMBER

NOTES


HELP SCREEN


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL1=(1, 9), GO TO REMINDER

ELSE, GO TO DIAL2










DIAL2

ASK

IF DIAL1=2

WHAT IS THE RESULT OF THE CALL?


1264. VOICEMAIL

1266. HANG UP / DID NOT SPEAK TO ANYONE

1201. RING NO ANSWER

1202. BUSY SIGNAL / ALL CIRCUITS BUSY

1273. DISCONNECTED NUMBER / CALL CANNOT BE COMPLETED AS DIALED

1274. TEMPORARILY DISCONNECTED / LINE TROUBLE

1271. RECORDING CHANGED NUMBER

1272. WRONG NUMBER

1275. BLOCKED LINE / # DOES NOT ACCEPT INCOMING CALLS

1281. MODEM / FAX MACHINE

1282. BEEPER / PAGER

1287. PRIVACY MANAGER

1543. TDD (DEVICE FOR THE DEAF) REQUIRED.


SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL2 = 1264, GO TO DIAL2C

IF DIAL2 = (1201, 1202, 1266, 1272, 1281, 1282, 1543), GO TO END

IF DIAL2 = (1273, 1274, 1271, 1275), GO TO DIAL2A

IF DIAL2 =1287, GO TO DIAL2E















DIAL2C

ASK

IF DIAL2 = 1264 OR DIAL2A = 1264 OR DIAL2E = 1264

THE RECORDING:


  1. MENTIONED THE SUBJECT’S NAME

  2. VERIFIED ONLY THE PHONE NUMBER

  3. DID NOT PROVIDE ANY INFO

  4. BUSINESS VOICEMAIL (NOT A BUSINESS FROM HOME)

  5. RECORDING IN A FOREIGN LANGUAGE

  6. COULD NOT LEAVE A MESSAGE / VOICEMAIL FULL / NOT SET UP

  1. TDD (TELEPHONE DEVICE FOR THE DEAF) OR TTY (SOUNDS LIKE LITTLE BELLS)


SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL2C = (1, 2, 3), GO TO DIAL2D

IF DIAL2C = (4, 6, 9), GO TO END

IF DIAL2C = 5: GO TO LANG





















DIAL2D

ASK

IF DIAL2C = (1, 2, 3) OR REMINDER = (3, 4) OR DIAL2E = 1264

[THIS IS THE VOICEMAIL MESSAGE SCRIPT]


Hello, my name is {Interviewer Name}. I am calling about a Centers for Disease Control and Prevention national health study. I am calling to remind <TEXT FILL 1> about the <TEXT FILL 5> appointment(s) scheduled for:


INTERVIEWER: READ OFF THE NAME AND APPOINTMENT DATE AND TIME FOR THE LISTED HOUSEHOLD MEMBERS (FROM SCHEDULER). NOTE THAT PARTICIPANTS WITH A DIFFERENT APPOINTMENT DATE AND/OR CONTACT PHONE WILL GET A SEPARATE REMINDER CALL.


  • [First SP –First Name, Appointment Date and Time]

  • [Second SP – First Name, Appointment Date and Time]

  • [Third SP – First Name, Appointment Date and Time]


[MEC ONLY: Please review the appointment reminder letter(s) we mailed or the appointment slip(s) you received during the interview in your home, so that you can review the instructions and the directions to the Mobile Exam Center.]


[MEC ONLY: IF ONLY ONE APPOINTMENT READ: <TEXT FILL 2> prescription medications as directed by <TEXT FILL 3> medical provider <TEXT FILL 4>.]


[MEC ONLY: IF MORE THAN ONE APPOINTMENT READ: Please have everyone take their prescription medications as directed by their medical provider <TEXT FILL 4>.]


[DIETARY DAY 1: We will call you to conduct this interview over the phone. It should take about 30 minutes. Please have the hand card booklet that we left during the interview in your home.]


[DIETARY DAY 2: We will call you for the second phone interview. This should take about 30 minutes.]


For any questions or to reschedule the appointment, call <TEXT FILL 6> toll-free. Thank you.


  1. LEFT VOICEMAIL MESSAGE

  2. PERSON PICKED-UP DURING MESSAGE

  1. UNABLE TO LEAVE MESSAGE

SPANISH

[THIS IS THE VOICEMAIL MESSAGE SCRIPT]


Buenos días/Buenas tardes, mi nombre es {Interviewer Name}. Estoy llamando sobre un estudio nacional de salud de los Centros para el Control y la Prevención de Enfermedades. Estoy llamando para <TEXT FILL 1> sobre la(s) cita(s) programada(s) <TEXT FILL 5> para:


INTERVIEWER: READ OFF THE NAME AND APPOINTMENT DATE AND TIME FOR THE LISTED HOUSEHOLD MEMBERS (FROM SCHEDULER). NOTE THAT PARTICIPANTS WITH A DIFFERENT APPOINTMENT DATE AND/OR CONTACT PHONE WILL GET A SEPARATE REMINDER CALL.


  • [First SP –First Name, Appointment Date and Time]

  • [Second SP – First Name, Appointment Date and Time]

  • [Third SP – First Name, Appointment Date and Time]


[MEC ONLY: Le pedimos que revise la(s) carta(s) de recordatorio de cita que le enviamos por correo o la(s) hoja(s) de cita que recibió durante la entrevista en su hogar, para que pueda revisar las instrucciones y las indicaciones para llegar al centro móvil de examen.]


[MEC ONLY: IF ONLY ONE APPOINTMENT READ: <TEXT FILL 2> medicamentos recetados según las indicaciones de su proveedor médico, <TEXT FILL 4>.]


[MEC ONLY: IF MORE THAN ONE APPOINTMENT READ: Dígales a todos que tomen sus medicamentos recetados según las indicaciones de su proveedor médico, <TEXT FILL 4>.]


[DIETARY DAY 1: Le llamaremos para realizar esta entrevista por teléfono. Debe tomar como 30 minutos. Tenga a mano el libro de tarjetas que le dejamos durante la entrevista en su hogar.]


[DIETARY DAY 2: Le llamaremos para la segunda entrevista telefónica. Debe tomar como 30 minutos.]


Si tiene cualquier pregunta o para cambiar la cita, llame gratis al <TEXT FILL 6>. Gracias.


  1. LEFT VOICEMAIL MESSAGE

  2. PERSON PICKED-UP DURING MESSAGE

  1. UNABLE TO LEAVE MESSAGE

QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: FILL “you” IF ONLY ONE APPOINTMENT

ELSE, FILL “everyone” IF MORE THAN ONE APPOINTMENT


TEXT FILL 2: “Please take your” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “Please have [SP’s NAME] take their” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)


TEXT FILL 3: “BLANK” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “BLANK” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)


TEXT FILL 4: FILL “unless they are required to be taken with food. Please remember not to eat or drink anything except water for 8 hours prior to the appointment.” IF SP AGE 12+ WITH A MORNING APPOINTMENT

ELSE, FILL IS EMPTY


TEXT FILL 5: FILL “health exam” IF MEC

FILL “dietary telephone interview” IF DIETARY


TEXT FILL 6: FILL “800-344-1386” IF MEC

FILL “844-340-9367” IF DIETARY

FILLS (SPA)

TEXT FILL 1: FILL “recordarle a usted” IF ONLY ONE APPOINTMENT

ELSE, FILL “recordarles a todos” IF MORE THAN ONE APPOINTMENT


TEXT FILL 2: “Tome sus” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “[SP NAME] debe tomar sus” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)


TEXT FILL 3: “de su doctor” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “de ellos(as)” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)


TEXT FILL 4: FILL “a menos que sea necesario tomarlos con comida. Recuerde no comer ni beber nada excepto agua durante las 8 horas antes de la cita.” IF SP AGE 12+ WITH A MORNING APPOINTMENT

ELSE, FILL IS EMPTY


TEXT FILL 5: FILL “del examen de salud” IF MEC

FILL “de la entrevista telefónica sobre alimentación” IF DIETARY


TEXT FILL 6: FILL “800-344-1386” IF MEC

FILL “844-340-9367” IF DIETARY

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL2D = (1, 1201), GO TO END

IF DIAL2D = 2, GO TO REMINDER






DIAL2E

ASK

IF DIAL2 = 1287 OR DIAL2A = 1287

PRIVACY MANAGER SCREEN:


If asked to state name: Centers for Disease Control and Prevention national health study

If asked to state ph#: 800-344-1386


  1. SOMEONE PICKS UP

  1. RING NO ANSWER

  2. BUSY SIGNAL / ALL CIRCUITS BUSY

  1. BLOCKED LINE / # DOES NOT ACCEPT INCOMING CALLS

  1. VOICEMAIL

SPANISH

PRIVACY MANAGER SCREEN:


If asked to state name: Estudio nacional de salud de los Centros para el Control y la Prevención de Enfermedades

If asked to state ph#: 800-344-1386


  1. SOMEONE PICKS UP

  1. RING NO ANSWER

  1. BUSY SIGNAL / ALL CIRCUITS BUSY

  1. BLOCKED LINE / # DOES NOT ACCEPT INCOMING CALLS

  1. VOICEMAIL

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL2E = 1: REMINDER

IF DIAL2E = 1264: DIAL2D

ELSE: END OF MODULE






DIAL2A

ASK

IF DIAL2 = (1273, 1274, 1271, 1275)

PLEASE MANUALLY REDIAL THE NUMBER.


WHAT IS THE RESULT OF THE CALL?


  1. A PERSON ANSWERED THE PHONE (NOT OPERATOR)

  1. VOICEMAIL

  1. DISCONNECTED NUMBER / CALL CANNOT BE COMPLETED AS DIALED

  1. PHONE COMPANY RECORDING GIVES A NEW NUMBER

  1. BEEPER / PAGER

  1. TEMPORARILY DISCONNECTED / LINE TROUBLE

  1. PRIVACY MANAGER

  1. BLOCKED LINE / # DOES NOT ACCEPT INCOMING CALLS

  1. COMPUTER MODEM / FAX MACHINE

  1. TDD (DEVICE FOR THE DEAF) OR TTY (SOUNDS LIKE LITTLE BELLS)

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL2A = 1, GO TO REMINDER

IF DIAL2A = 1264, GO TO DIAL2C

IF DIAL2A = 1273, GO TO DIAL2B

IF DIAL2A = 1287, GO TO DIAL2E

IF DIAL2A = 1271, GO TO END AND ADD A NEW NUMBER ON THE ROSTER LINE SCREEN

ELSE, GO TO END













DIAL2B

ASK

IF DIAL2A = 1273

DID THE PHONE COMPANY RECORDING SAY:


  1. TEMPORARILY DISCONNECTED

  2. DISCONNECTED

  3. CANNOT BE COMPLETED AS DIALED

  4. NUMBER HAS BEEN CHANGED TO A NON-PUBLISHED NUMBER

  5. NUMBER HAS BEEN CHANGED AND GIVES A NEW NUMBER, WILL NEED TO ADD A NEW PHONE NUMBER

  6. NUMBER DOES NOT ACCEPT INCOMING CALLS


SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF DIAL2B = 5, GO TO END AND ADD NEW NUMBER ON THE ROSTER LINE SCREEN

ELSE, GO TO END
















REMINDER

ASK

IF DIAL2E = 1 OR DIAL2A = 1 OR DIAL2D = 2 OR DIAL1 = (1, 9) OR TW = 13

[TALKING TO A LIVE PERSON, EITHER OUTGOING OR INCOMING CALL]


Hello, my name is {Interviewer Name}. <TEXT FILL 1> RTI International about a national health study sponsored by the Centers for Disease Control and Prevention. For training and quality assurance purposes, this call may be monitored or recorded. <TEXT FILL 2>


  1. SPEAKING TO TARGET RESPONDENT

  2. TRANSFERRED TO NAMED PERSON / NAMED PERSON COMING TO PHONE (WAIT FOR R TO COME TO PHONE BEFORE CONTINUING)

  3. TRANSFERRED TO PERSON-SPECIFIC VOICEMAIL

  4. TRANSFERRED TO GENERIC VOICEMAIL

  5. NAMED PERSON NOT AVAILABLE / GATEKEEPER CAN TAKE MESSAGE

  6. NAMED PERSON NOT AVAILABLE / NO ONE TO TAKE MESSAGE

  7. NAMED PERSON UNKNOWN TO GATEKEEPER

  8. MORE CODES


INTERVIEWER: SELECTING “MORE CODES” WILL PROVIDE MORE OPTIONS TO RECORD DETAILED BUT LESS COMMON OUTCOMES SUCH AS MOVED, PASSED AWAY

SPANISH

[TALKING TO A LIVE PERSON, EITHER OUTGOING OR INCOMING CALL]


Buenos días/Buenas tardes, mi nombre {Interviewer Name}. <TEXT FILL 1> RTI International acerca de un estudio nacional de salud patrocinado por los Centros para el Control y la Prevención de Enfermedades. Esta llamada puede ser supervisada o grabada con fines de capacitación y control de calidad. <TEXT FILL 2>


  1. SPEAKING TO TARGET RESPONDENT

  2. TRANSFERRED TO NAMED PERSON / NAMED PERSON COMING TO PHONE (WAIT FOR R TO COME TO PHONE BEFORE CONTINUING)

  3. TRANSFERRED TO PERSON-SPECIFIC VOICEMAIL

  4. TRANSFERRED TO GENERIC VOICEMAIL

  5. NAMED PERSON NOT AVAILABLE / GATEKEEPER CAN TAKE MESSAGE

  6. NAMED PERSON NOT AVAILABLE / NO ONE TO TAKE MESSAGE

  7. NAMED PERSON UNKNOWN TO GATEKEEPER

  8. MORE CODES


INTERVIEWER: SELECTING “MORE CODES” WILL PROVIDE MORE OPTIONS TO RECORD DETAILED BUT LESS COMMON OUTCOMES SUCH AS MOVED, PASSED AWAY

QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: FILL “I am calling from” IF OUTGOING CALL

ELSE, FILL “Thank you for calling” IF CALL IN


TEXT FILL 2: FILL “May I speak with <TEXT FILL 3>?” IF OUTGOING CALL

ELSE, BLANK.


TEXT FILL 3: IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY)

IF MORE THAN ONE APPOINTMENT AND 2 SP (SP AGE 18+ AND NO PROXY), FILL “[SP1 NAME] or [SP2 NAME]”

IF MORE THAN ONE APPOINTMENT AND 3 SP (SP AGE 18+ AND NO PROXY),

FILL “[SP1 NAME], [SP2 NAME] or [SP3 NAME]”

ELSE, FILL “[PROXY’S NAME OR NAMES]”

FILLS (SPA)

TEXT FILL 1: FILL “Estoy llamando de” IF OUTGOING CALL

ELSE, FILL “Gracias por llamar a” IF CALL IN


TEXT FILL 2: FILL “¿Puedo hablar con <TEXT FILL 3>?” IF OUTGOING CALL

ELSE, BLANK.


TEXT FILL 3: IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY)

IF MORE THAN ONE APPOINTMENT AND 2 SP (SP AGE 18+ AND NO PROXY), FILL “[SP1 NAME] o [SP2 NAME]”

IF MORE THAN ONE APPOINTMENT AND 3 SP (SP AGE 18+ AND NO PROXY),

FILL “[SP1 NAME], [SP2 NAME] o [SP3 NAME]”

ELSE, FILL “[PROXY’S NAME OR NAMES]”

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF REMINDER = (1, 2), GO TO CELL_RESP2

IF REMINDER = (3, 4): DIAL2D

IF REMINDER = 5: PROMPT_HHM_MESSAGE

IF REMINDER = 6: RCALLBACK

IF REMINDER = 7: RUNKNOWN

ELSE, GO TO OTHER_CODES






OTHER_CODES

ASK

IF REMINDER = 8 OR OTHER_CODES SELECTED FROM HELP

SP’S NAME: <TEXT FILL 1>


  1. PHONE NUMBER NOT ASSOCIATED WITH SUBJECT

  2. OUT OF THE COUNTRY

  3. INCARCERATED OR INSTITUTIONALIZED

  4. OTHERWISE UNAVAILABLE

  5. DECEASED

  6. LANGUAGE BARRIER

  7. REFUSED

  8. HUNG UP

  9. DISCONNECTED

  10. OTHER, SUPERVISOR REVIEW

  11. HEARING IMPAIRED

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS

TEXT FILL 1: FILL “[SP’s NAME(S)]”

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF OTHER_CODES = (1, 2, 3, 4, 5, 9, 10, 11), GO TO END

IF OTHER_CODES = 6, GO TO LANG

IF OTHER_CODES = (7, 8) GO TO WHO_REF






LANG

ASK

c

INTERVIEWER: CLASSIFY LANGUAGE BARRIER


  1. SPANISH LANGAUGE BARRIER

  2. OTHER LANGUAGE BARRIER

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

WHO_LANG





WHO_LANG

ASK

IF OTHER_CODES = 6 OR DIAL2D = 1537 OR DIAL2C = 5

INTERVIEWER: WAS THE LANGUAGE BARRIER FOR THE…


  1. SP

  2. SP’S PROXY

  3. SOMEBODY ELSE

  4. UNKNOWN


SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

THANK_EVT





















THANK_EVT

ASK

WHO_LANG = (1, 2, 3, 4) OR RUNKNOWN=2

(Thank you very much for your time.)


PLEASE PRESS “NEXT” TO CONTINUE.


SPANISH

(Muchas gracias por su tiempo).


PLEASE PRESS “NEXT” TO CONTINUE.


QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

END
























WHO_REF

ASK

IF OTHER_CODES = (7, 8) OR BACK_FROM_BLAISE = 3

(Thank you very much for your time.)


INTERVIEWER: WAS THE REFUSAL BY THE SP OR SP’S PROXY?



  1. YES, SP OR SP’S PROXY REFUSED. VERIFIED NAME.

  2. NO / DON’T KNOW


SPANISH

(Muchas gracias por su tiempo).


INTERVIEWER: WAS THE REFUSAL BY THE SP OR SP’S PROXY?



  1. YES, SP OR SP’S PROXY REFUSED. VERIFIED NAME.

  2. NO / DON’T KNOW


QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

PREREF

















PREREF

ASK

IF OTHER_CODES = (7, 8) OR BACK_FROM_BLAISE = 3

INTERVIEWER: DETERMINE THE STRENGTH OF REFUSAL:


  1. REFUSAL

  2. HOSTILE REFUSAL


SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

REF1_MEC IF MEC

REF1_DIET IF DIETARY

























REF1_MEC

ASK

PREREF = ANY AND MEC

INTERVIEWER: DESCRIBE WHAT HAPPENED DURING REFUSAL (CHECK ALL THAT APPLY):


  1. CONCERN WITH EXAM / DOCTOR ISSUES

  2. GOVERNMENT CONCERNS / MISTRUST OF GOVERNMENT

  3. EXAM TAKES TOO MUCH TIME / EXAM TOO LONG

  4. MEC IS TOO FAR AWAY / TRANSPORTATION PROBLEMS

  5. PRIVACY / CONFIDENTIALITY CONCERNS

  6. QUESTIONS / SUSPICIONS ABOUT LEGITIMACY

  7. THINK SP IS TOO YOUNG/OLD TO PARTICIPATE

  8. TOO BUSY / NO TIME

  9. EXPOSURE TO EMERGING DISEASES / CONCERNS WITH GETTING SICK

  10. OTHER SPECIFY

SPANISH

INTERVIEWER: DESCRIBE WHAT HAPPENED DURING REFUSAL (CHECK ALL THAT APPLY):


  1. PREOCUPACIÓN SOBRE EL EXAMEN / PROBLEMAS CON EL DOCTOR

  2. PREOCUPACIONES SOBRE EL GOBIERNO / DESCONFIANZA EN EL GOBIERNO

  3. EL EXAMEN TOMA DEMASIADO TIEMPO / EXAMEN DEMASIADO LARGO

  4. MEC ESTÁ DEMASIADO LEJOS / PROBLEMAS DE TRANSPORTE

  5. PREOCUPACIONES DE PRIVACIDAD / CONFIDENCIALIDAD

  6. PREGUNTAS / SOSPECHAS SOBRE LEGITIMIDAD

  7. LA PERSONA ENCUESTADA ES DEMASIADO JOVEN/MAYOR PARA PARTICIPAR

  8. DEMASIADO OCUPADO(A) / NO TIENE TIEMPO

  9. EXPONERSE A POSIBLES ENFERMEDADES/ PREOCUPACIÓN POR ENFERMARSE

  10. OTHER SPECIFY

QUESTION TYPE

Multi-select

FILLS


NOTES

IF RESPONSE OPTION 10 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF REF1_MEC = MORE THAN ONE SELECTED: REF2_MEC

ELSE: END




REF2_MEC

ASK

REF1_MEC = MORE THAN ONE SELECTED

SELECT THE MAIN REASON FOR REFUSAL.


  1. CONCERN WITH EXAM / DOCTOR ISSUES

  2. GOVERNMENT CONCERNS / MISTRUST OF GOVERNMENT

  3. EXAM TAKES TOO MUCH TIME / EXAM TOO LONG

  4. MEC IS TOO FAR AWAY / TRANSPORTATION PROBLEMS

  5. PRIVACY / CONFIDENTIALITY CONCERNS

  6. QUESTIONS / SUSPICIONS ABOUT LEGITIMACY

  7. THINK SP IS TOO YOUNG/OLD TO PARTICIPATE

  8. TOO BUSY / NO TIME

  9. EXPOSURE TO EMERGING DISEASES / CONCERNS WITH GETTING SICK

  10. OTHER SPECIFY

SPANISH

SELECT THE MAIN REASON FOR REFUSAL.


  1. PREOCUPACIÓN SOBRE EL EXAMEN / PROBLEMAS CON EL DOCTOR

  2. PREOCUPACIONES SOBRE EL GOBIERNO / DESCONFIANZA EN EL GOBIERNO

  3. EL EXAMEN TOMA DEMASIADO TIEMPO / EXAMEN DEMASIADO LARGO

  4. MEC ESTÁ DEMASIADO LEJOS / PROBLEMAS DE TRANSPORTE

  5. PREOCUPACIONES DE PRIVACIDAD / CONFIDENCIALIDAD

  6. PREGUNTAS / SOSPECHAS SOBRE LEGITIMIDAD

  7. LA PERSONA ENCUESTADA ES DEMASIADO JOVEN/MAYOR PARA PARTICIPAR

  8. DEMASIADO OCUPADO(A) / NO TIENE TIEMPO

  9. EXPONERSE A POSIBLES ENFERMEDADES/ PREOCUPACIÓN POR ENFERMARSE

  10. OTHER SPECIFY

QUESTION TYPE

Radio button

FILLS


NOTES

IF RESPONSE OPTION 10 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

ONLY LIST THE REASONS SELECTED IN REF1.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

END






REF1_DIET

ASK

IF PREREF = ANY AND DIETARY

INTERVIEWER: DESCRIBE WHAT HAPPENED DURING REFUSAL (CHECK ALL THAT APPLY):


  1. SM DOES NOT DO PHONE SURVEYS

  2. SM DOES NOT PARTICIPATE IN SURVEYS

  3. HUNG UP DURING INTRO

  4. HUNG UP DURING SURVEY

  5. “TOO BUSY” / “NO TIME”

  6. “NOT INTERESTED”

  7. PRIVACY CONCERNS

  8. CONCERNED ABOUT LENGTH OF SURVEY

  9. QUESTIONED PURPOSE / LEGITIMACY OF STUDY

  10. ALREADY PARTICIPATED

  11. OTHER SPECIFY

SPANISH

N/A

QUESTION TYPE

Multi-select

FILLS


NOTES

IF RESPONSE OPTION 11 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF REF1_DIET = MORE THAN ONE SELECTED: REF2_DIET

ELSE: END







REF2_DIET

ASK

IF REF1_DIET = MORE THAN ONE SELECTED

SELECT THE MAIN REASON FOR REFUSAL.


  1. SM DOES NOT DO PHONE SURVEYS

  2. SM DOES NOT PARTICIPATE IN SURVEYS

  3. HUNG UP DURING INTRO

  4. HUNG UP DURING SURVEY

  5. “TOO BUSY” / “NO TIME”

  6. “NOT INTERESTED”

  7. PRIVACY CONCERNS

  8. CONCERNED ABOUT LENGTH OF SURVEY

  9. QUESTIONED PURPOSE / LEGITIMACY OF STUDY

  10. ALREADY PARTICIPATED

  11. OTHER SPECIFY

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES

IF RESPONSE OPTION 11 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

ONLY LIST THE REASONS SELECTED IN REF1_DIET.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

END




PROMPT_HHM_MESSAGE

ASK

IF REMINDER = 5

Could you please let <TEXT FILL 1> know that I called on behalf of a health study sponsored by the Centers for Disease Control and Prevention.


We are calling to remind them of <TEXT FILL 2> <TEXT FILL 5> scheduled for <TEXT FILL 3>. Please have <TEXT FILL 4> call us at <TEXT FILL 6>. Again, that number is <TEXT FILL 6>. Any member of our team can assist them. Thank you.


[IF NEEDED: CALL CENTER HOURS

MONDAY – THURSDAY: 9AM – 11PM EST

FRIDAY: 9AM – 9PM EST

SATURDAY: 9:30AM – 6PM EST

SUNDAY: 1PM – 9:30PM EST]

SPANISH

¿Podría avisarle a <TEXT FILL 1> que llamé sobre un estudio de salud patrocinado por los Centros para el Control y la Prevención de Enfermedades?


Llamamos para recordarle acerca <TEXT FILL 5> <TEXT FILL 2>, programado(a) para <TEXT FILL 3>. Por favor, dígale a <TEXT FILL 4> que nos llame al <TEXT FILL 6>. Le repito, ese número es <TEXT FILL 6>. Cualquier miembro de nuestro equipo puede ayudarles. Gracias.


[IF NEEDED: CALL CENTER HOURS

MONDAY – THURSDAY: 9AM – 11PM EST

FRIDAY: 9AM – 9PM EST

SATURDAY: 9:30AM – 6PM EST

SUNDAY: 1PM – 9:30PM EST]

QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY)

IF MORE THAN ONE APPOINTMENT AND 2 SP (SP AGE 18+ AND NO PROXY), FILL “[SP1 NAME] and [SP2 NAME]”

IF MORE THAN ONE APPOINTMENT AND 3 SP (SP AGE 18+ AND NO PROXY),

FILL “[SP1 NAME], [SP2 NAME] and [SP3 NAME]”

ELSE, FILL “[PROXY’S NAME]”


TEXT FILL 2: FILL “their” IF (SP AGE 18+ AND NO PROXY)

FILL “[SP’s NAME]’s” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

FILL “everyone’s” IF MORE THAN ONE APPOINTMENT



TEXT FILL 3: FILL MEC/DIETARY APPOINTMENT DATE.


TEXT FILL 4: IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “one of them” IF ALL (SP AGE 18+ AND NO PROXY)

ELSE, FILL “[PROXY’S NAME OR NAMES]”


TEXT FILL 5: FILL “health exam” IF MEC

FILL “dietary telephone interview” IF DIETARY


TEXT FILL 6: FILL “800-344-1386” IF MEC

FILL “844-340-9367” IF DIETARY

FILLS (SPA)

TEXT FILL 1: IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY)

IF MORE THAN ONE APPOINTMENT AND 2 SP (SP AGE 18+ AND NO PROXY), FILL “[SP1 NAME] y a [SP2 NAME]”

IF MORE THAN ONE APPOINTMENT AND 3 SP (SP AGE 18+ AND NO PROXY),

FILL “[SP1 NAME], [SP2 NAME] y a [SP3 NAME]”

ELSE, FILL “[PROXY’S NAME]”


TEXT FILL 2: FILL “BLANK” IF (SP AGE 18+ AND NO PROXY)

FILL “de [SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

FILL “de todos(as)” IF MORE THAN ONE APPOINTMENT



TEXT FILL 3: FILL MEC/DIETARY APPOINTMENT DATE.


TEXT FILL 4: IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “Uno de ellos” IF ALL (SP AGE 18+ AND NO PROXY)

ELSE, FILL “[PROXY’S NAME OR NAMES]”


TEXT FILL 5: FILL “de su examen de salud” (SP AGE 18+ AND NO PROXY) IF MEC

FILL “del examen de salud” IF SP AGE <18 OR (AGE 18+ AND YES PROXY) IF MEC

FILL “del examen de salud” IF MORE THAN ONE APPOINTMENT IF MEC

FILL “de su entrevista telefónica sobre alimentación” (SP AGE 18+ AND NO PROXY) IF DIETARY

FILL “de la entrevista telefónica sobre alimentación” IF SP AGE <18 OR (AGE 18+ AND YES PROXY) IF DIETARY

FILL “de la entrevista telefónica sobre alimentación” IF MORE THAN ONE APPOINTMENT IF DIETARY


TEXT FILL 6: FILL “800-344-1386” IF MEC

FILL “844-340-9367” IF DIETARY

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

END








CELL_RESP2

ASK

IF REMINDER = (1, 2)

Are you driving a vehicle at the moment?


IF YES, ASK FOR A BETTER TIME TO CALL AND SET A CALLBACK IN WEB SCHEDULER.


IF YES AND RESPONDENT INDICATES S/HE IS WILLING TO TALK NOW, SAY “I’m sorry but for your safety I’m not able to talk to you while you’re driving. When would be a better time to call you?”


  1. YES, SCHEDULE A CALLBACK IN WEB SCHEDULER

  2. NO, CONTINUE WITH THE REMINDER

SPANISH

¿Está conduciendo un vehículo en este momento?


IF YES, ASK FOR A BETTER TIME TO CALL AND SET A CALLBACK IN WEB SCHEDULER.


IF YES AND RESPONDENT INDICATES S/HE IS WILLING TO TALK NOW, SAY “Lo siento, pero por su seguridad no puedo hablarle mientras conduce. ¿Cuándo sería un momento más conveniente para llamarlo(a)?”


  1. YES, SCHEDULE A CALLBACK IN WEB SCHEDULER

  2. NO, CONTINUE WITH THE REMINDER

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF CELL_RESP2 = 1, GO TO RCALLBACK

ELSE, GO TO RINTRO (LAUNCH IN BLAISE)










RCALLBACK

ASK

IF REMINDER = 6 OR RUNKNOWN = 1 OR CELL_RESP2 = 1

When would be a good day and time to call back to speak with <TEXT FILL 1>?


INTERVIEWER: IF ANOTHER TIME IS NOT PROVIDED, THE SYSTEM WILL SCHEDULE A RANDOM CALLBACK AS APPROPRIATE.


INTERVIEWER: SELECT CONTINUE TO SCHEDULE A NEW APPOINTMENT IN WEB SCHEDULER

SPANISH

¿Cuándo sería un día y hora más convenientes para volver a llamar y hablar con <TEXT FILL 1>?


INTERVIEWER: IF ANOTHER TIME IS NOT PROVIDED, THE SYSTEM WILL SCHEDULE A RANDOM CALLBACK AS APPROPRIATE.


INTERVIEWER: SELECT CONTINUE TO SCHEDULE A NEW APPOINTMENT IN WEB SCHEDULER

QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: IF ONLY ONE APPOINTMENT, FILL “you” IF (SP AGE 18+ AND NO PROXY) AND RESPONDENT IS SP

IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY) AND RESPONDENT IS NOT SP

IF MORE THAN ONE APPOINTMENT, FILL “one of them” IF ALL (SP AGE 18+ AND NO PROXY)

ELSE, FILL “[PROXY’S NAME OR NAMES]”

FILLS (SPA)

TEXT FILL 1: IF ONLY ONE APPOINTMENT, FILL “usted” IF (SP AGE 18+ AND NO PROXY) AND RESPONDENT IS SP

IF ONLY ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 18+ AND NO PROXY) AND RESPONDENT IS NOT SP

IF MORE THAN ONE APPOINTMENT, FILL “uno de ellos” IF ALL (SP AGE 18+ AND NO PROXY)

ELSE, FILL “[PROXY’S NAME OR NAMES]”

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

LAUNCH WEB SCHEDULER




RUNKNOWN

ASK

IF REMINDER = 7

xh <TEXT FILL 3>?


  1. YES

  2. NO


SPANISH

Nuestros registros indican que podemos comunicarnos con <TEXT FILL 1> a este número acerca de una próxima cita <TEXT FILL 2>. ¿Usted o alguien en este número de teléfono conoce a <TEXT FILL 3>?


  1. YES

  2. NO


QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: FILL “[SP’s NAME]” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “[PROXY’S NAME]”


TEXT FILL 2: FILL “for [SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

ELSE, BLANK


TEXT FILL 3: FILL “[SP’s NAME]” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “[PROXY’S NAME OR NAMES]”

FILLS (SPA)

TEXT FILL 1: FILL “[SP’s NAME]” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “[PROXY’S NAME]”


TEXT FILL 2: FILL “para [SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

ELSE, BLANK


TEXT FILL 3: FILL “[SP’s NAME]” IF SP AGE 18+ AND NO PROXY

ELSE, FILL “[PROXY’S NAME OR NAMES]”

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF RUNKNOWN=1, GO TO RCALLBACK

ELSE, GO TO THANK_EVT


RINTRO (FIRST BLAISE SCREEN)

ASK

IF REMINDER = 1 or 2 AND CELL_RESP2 = 2

[LIVE CALL WITH SP OR PROXY]


<TEXT FILL 5> I would like to remind you about <TEXT FILL 1> <TEXT FILL 6> appointment for the National Health and Nutrition Examination Survey (NHANES), conducted by the Centers for Disease Control and Prevention. We have the <TEXT FILL 2> scheduled:


INTERVIEWER: READ OFF THE NAME AND APPOINTMENT DATE AND TIME FOR THE LISTED HOUSEHOLD MEMBERS (FROM SCHEDULER). NOTE THAT PARTICIPANTS WITH A DIFFERENT APPOINTMENT DATE AND/OR CONTACT PHONE WILL GET A SEPARATE REMINDER CALL.


  • [First SP –First Name, Age, Appointment Date and Time]

  • [Second SP – First Name, Age, Appointment Date and Time]

  • [Third SP – First Name, Age, Appointment Date and Time]



We look forward to <TEXT FILL 7> <TEXT FILL 3> at <TEXT FILL 4>. Thank you and have a good day.


[MEC ONLY: INTERVIEWER: IF THE SP ASKS, PROVIDE THE MEC LOCATION, MEC ADDRESS AND DRIVING INSTRUCTIONS]


[INTERVIEWER: IF CALLING ABOUT MULTIPLE APPOINTMENTS AND RESPONDENT WANTS TO CANCEL 1 OR MORE, SELECT NO LONGER WANTS TO PARTICIPATE.]




  1. CONTINUE

  2. NEED TO RESCHEDULE

  3. NO LONGER WANTS TO PARTICIPATE

SPANISH

[LIVE CALL WITH SP OR PROXY]


<TEXT FILL 5> Quisiera recordarle acerca <TEXT FILL 6> <TEXT FILL 1> para la Encuesta Nacional de Examen de la Salud y Nutrición (NHANES, por sus siglas en inglés), realizada por los Centros para el Control y la Prevención de Enfermedades. Tenemos programada(s) <TEXT FILL 2>:


INTERVIEWER: READ OFF THE NAME AND APPOINTMENT DATE AND TIME FOR THE LISTED HOUSEHOLD MEMBERS (FROM SCHEDULER). NOTE THAT PARTICIPANTS WITH A DIFFERENT APPOINTMENT DATE AND/OR CONTACT PHONE WILL GET A SEPARATE REMINDER CALL.


  • [First SP –First Name, Age, Appointment Date and Time]

  • [Second SP – First Name, Age, Appointment Date and Time]

  • [Third SP – First Name, Age, Appointment Date and Time]



Esperamos <TEXT FILL 7> <TEXT FILL 3> en <TEXT FILL 4>. Gracias y que tenga un buen día.


[MEC ONLY: INTERVIEWER: IF THE SP ASKS, PROVIDE THE MEC LOCATION, MEC ADDRESS AND DRIVING INSTRUCTIONS]


[INTERVIEWER: IF CALLING ABOUT MULTIPLE APPOINTMENTS AND RESPONDENT WANTS TO CANCEL 1 OR MORE, SELECT NO LONGER WANTS TO PARTICIPATE.]




  1. CONTINUE

  2. NEED TO RESCHEDULE

  3. NO LONGER WANTS TO PARTICIPATE

QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “your” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “[SP’s NAME]’s” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “everyone’s”

TEXT FILL 2: FILL “appointment” IF ONLY ONE HOUSEHOLD MEMBER SCHEDULED

ELSE FILL “appointments”


TEXT FILL 3: IF ONE APPOINTMENT, FILL “you” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “[SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

FILL “everyone” IF MORE THAN ONE APPOINTMENT


TEXT FILL 4: IF ONE APPOINTMENT, FILL “your appointment” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “their appointment” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “their appointments”


TEXT FILL 5: IF REMINDER = 2 (CALL-IN CASE), FILL “Hello. My name is {Interviewer Name}. I work for RTI International.”

ELSE, FILL IS EMPTY


TEXT FILL 6: FILL “health exam” IF MEC

FILL “dietary telephone interview” IF DIETARY


TEXT FILL 7: FILL “seeing” IF MEC

FILL “speaking with” IF DIETARY


FILLS (SPA)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “BLANK” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “de [SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “de todos(as)”

TEXT FILL 2: FILL “su cita” IF ONLY ONE HOUSEHOLD MEMBER SCHEDULED

ELSE FILL “sus citas”


TEXT FILL 3: IF ONE APPOINTMENT, FILL “usted” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “[SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

FILL “todos(as)” IF MORE THAN ONE APPOINTMENT


TEXT FILL 4: IF ONE APPOINTMENT, FILL “su cita” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “su cita” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “sus citas”


TEXT FILL 5: IF REMINDER = 2 (CALL-IN CASE), FILL “Buenos días/Buenas tardes. Mi nombre es {Interviewer Name}. Trabajo para RTI International.”

ELSE, FILL IS EMPTY


TEXT FILL 6: FILL “de su examen de salud” (SP AGE 18+ AND NO PROXY) IF MEC

FILL “del examen de salud” IF SP AGE <18 OR (AGE 18+ AND YES PROXY) IF MEC

FILL “del examen de salud” IF MORE THAN ONE APPOINTMENT IF MEC

FILL “de su entrevista telefónica sobre alimentación” (SP AGE 18+ AND NO PROXY) IF DIETARY

FILL “de la entrevista telefónica sobre alimentación” IF SP AGE <18 OR (AGE 18+ AND YES PROXY) IF DIETARY

FILL “de la entrevista telefónica sobre alimentación” IF MORE THAN ONE APPOINTMENT IF DIETARY


TEXT FILL 7: FILL “verlo(a) a ” (SP AGE 18+ AND NO PROXY) IF MEC

FILL “ver a” IF SP AGE <18 OR (AGE 18+ AND YES PROXY) IF MEC

FILL “ver a” IF MORE THAN ONE APPOINTMENT IF MEC

FILL “hablar con” IF DIETARY

NOTES

CATI CMS WILL LAUNCH BLAISE IN ORDER TO GET TO THE SCHEDULER.


FILL INFORMATION FOR HOUSEHOLD MEMBERS WITH APPOINTMENTS ON THE SAME DAY AND THAT HAVE THE SAME CONTACT PHONE LISTED. NOTE THAT PARTICIPANTS WITH A DIFFERENT APPOINTMENT DATE AND/OR CONTACT PHONE WILL GET A SEPARATE REMINDER CALL.


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF RINTRO=1, GO TO RAPPT_MEC IF MEC

IF RINTRO=1, GO TO RAPPT_DIET IF DIETARY

IF RINTRO=2, GO TO RRESCHEDULE

IF RINTRO=3, GO TO RREFUSAL



RREFUSAL

ASK

IF RINTRO = 3

Are there any questions or concerns that I can help you with?


(DIETARY ONLY: IF RESPONDENT NEEDS REMINDER ABOUT STUDY IMPORTANCE: <TEXT FILL 1> participation is very important to understanding whether what people eat and drink in America meets nutritional needs. The data also helps policymakers create dietary recommendations to promote health and prevent disease.)


(MEC ONLY: IF RESPONDENT NEEDS REMINDER ABOUT STUDY IMPORTANCE: <TEXT FILL 1> participation is very important to understanding not only <TEXT FILL 2> health but also the health and nutritional status of Americans by providing vital health statistics for the nation. It will help doctors, researchers, and policymakers improve people’s health in the United States.)


(MEC ONLY: IF RESPONDENT EXPRESSES CONCERNS ABOUT GETTING TO THE APPOINTMENT: As a reminder, you were provided with a prepaid travel allowance when you scheduled your appointment.)


(IF RESPONDENT EXPRESSES CONCERNS ABOUT CHILD/ELDER CARE: As a reminder, we can provide $10 an hour for (child/elder) care to assist you in being able to attend the health exam appointment.)


[INTERVIEWER:

  • ADDRESS ANY CONCERNS OR QUESTIONS TO THE BEST OF YOUR ABILITY.

  • OFFER TO RESCHEDULE APPOINTMENT IF THEY WANT TO CANCEL.

  • IF CALLING ABOUT MULTIPLE APPOINTMENTS AND RESPONDENT WANTS TO CANCEL ALL APPOINTMENTS, SELECT REFUSED ALL APPOINTMENTS.

  • IF THEY ONLY WANT TO CANCEL SOME OF THE APPOINTMENTS, SELECT REFUSED SOME APPOINTMENTS.]


  1. REFUSED ALL APPOINTMENTS

  2. REFUSED SOME APPOINTMENTS

  3. WILLING TO PARTICIPATE IN SCHEDULED APPT

  4. WILLING TO PARTICIPATE BUT NEEDS TO RESCHEDULE

SPANISH

¿Tiene alguna pregunta o inquietud con la que pueda ayudarlo(a)?


(DIETARY ONLY: IF RESPONDENT NEEDS REMINDER ABOUT STUDY IMPORTANCE: <TEXT FILL 1> es muy importante para comprender si lo que las personas comen y beben en los Estados Unidos satisface las necesidades nutricionales. Los datos también ayudan a los legisladores a crear recomendaciones nutricionales para promover la salud y prevenir enfermedades).


(MEC ONLY: IF RESPONDENT NEEDS REMINDER ABOUT STUDY IMPORTANCE: <TEXT FILL 1> es muy importante para entender no solo la salud <TEXT FILL 2> , sino también el estado de salud y nutrición de los estadounidenses, ya que proporciona estadísticas vitales de salud para el país. Ayudará a doctores, investigadores científicos y legisladores a mejorar la salud de la población en los Estados Unidos).


(MEC ONLY: IF RESPONDENT EXPRESSES CONCERNS ABOUT GETTING TO THE APPOINTMENT: Como recordatorio, se le dio un subsidio de viaje prepagado cuando programó su cita).


(IF RESPONDENT EXPRESSES CONCERNS ABOUT CHILD/ELDER CARE: Como recordatorio, podemos ofrecerle $10 dólares por hora para el cuidado de niños o ancianos para ayudar a que asista a la cita del examen de salud).


[INTERVIEWER:

  • ADDRESS ANY CONCERNS OR QUESTIONS TO THE BEST OF YOUR ABILITY.

  • OFFER TO RESCHEDULE APPOINTMENT IF THEY WANT TO CANCEL.

  • IF CALLING ABOUT MULTIPLE APPOINTMENTS AND RESPONDENT WANTS TO CANCEL ALL APPOINTMENTS, SELECT REFUSED ALL APPOINTMENTS.

  • IF THEY ONLY WANT TO CANCEL SOME OF THE APPOINTMENTS, SELECT REFUSED SOME APPOINTMENTS.]


  1. REFUSED ALL APPOINTMENTS

  2. REFUSED SOME APPOINTMENTS

  3. WILLING TO PARTICIPATE IN SCHEDULED APPT

  4. WILLING TO PARTICIPATE BUT NEEDS TO RESCHEDULE

QUESTION TYPE

Radio button

FILLS (ENG)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “Your” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “[SP’s NAME]’s” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “Everyone’s”


TEXT FILL 2: IF ONE APPOINTMENT, FILL “your” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “their” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “their”


FILLS (SPA)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “Su participación” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “La participación de [SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “La participación de todos(as)”


TEXT FILL 2: IF ONE APPOINTMENT, FILL “de usted” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “de él/ella” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “de ellos(as)”


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF RREFUSAL = 1, GO TO RREFUSED_MEC IF MEC

IF RREFUSAL = 1, GO TO RREFUSED_DIET IF DIETARY

IF RREFUSAL = 2, GO TO RREFUSEDSOME

IF RREFUSAL =3, GO TO RAPPT_MEC IF MEC

IF RREFUSAL =3, GO TO RAPPT_DIET IF DIETARY

IF RREFUSAL = 4, GO TO RRESCHEDULE





RREFUSED_MEC

ASK

IF RREFUSAL = 1

Can you share why you don’t want <TEXT FILL 1> to participate in the health exam?


INTERVIEWER: ADDRESS ANY CONCERNS OR QUESTIONS TO THE BEST OF YOUR ABILITY. IF THE PARTICIPANT DECIDES TO CONTINUE WITH THE APPOINTMENT, GO BACK TO THE PREVIOUS SCREEN AND CHANGE RESPONSE ACCORDINGLY. IF THE REFUSAL IS NOT CONVERTED, CHECK ALL REFUSAL REASONS THAT APPLY BASED ON PARTICIPANT’S RESPONSE.


  1. CONCERN WITH EXAM / DOCTOR ISSUES

  2. GOVERNMENT CONCERNS / MISTRUST OF GOVERNMENT

  3. EXAM TAKES TOO MUCH TIME / EXAM TOO LONG

  4. MEC IS TOO FAR AWAY / TRANSPORATION PROBLEMS

  5. PRIVACY / CONFIDENTIALITY CONCERNS

  6. QUESTIONS / SUSPICIONS ABOUT LEGITIMACY

  7. THINK SP IS TOO YOUNG/OLD TO PARTICIPATE

  8. TOO BUSY / NO TIME

  9. EXPOSURE TO EMERGING DISEASES / CONCERNS WITH GETTING SICK

  10. OTHER SPECIFY


SPANISH

¿Puede explicarnos por qué no quiere que <TEXT FILL 1> participe en el examen de salud?


INTERVIEWER: ADDRESS ANY CONCERNS OR QUESTIONS TO THE BEST OF YOUR ABILITY. IF THE PARTICIPANT DECIDES TO CONTINUE WITH THE APPOINTMENT, GO BACK TO THE PREVIOUS SCREEN AND CHANGE RESPONSE ACCORDINGLY. IF THE REFUSAL IS NOT CONVERTED, CHECK ALL REFUSAL REASONS THAT APPLY BASED ON PARTICIPANT’S RESPONSE.


  1. PREOCUPACIÓN SOBRE EL EXAMEN / PROBLEMAS CON EL DOCTOR

  2. PREOCUPACIONES SOBRE EL GOBIERNO / DESCONFIANZA EN EL GOBIERNO

  3. EL EXAMEN TOMA DEMASIADO TIEMPO / EXAMEN DEMASIADO LARGO

  4. MEC ESTÁ DEMASIADO LEJOS / PROBLEMAS DE TRANSPORTE

  5. PREOCUPACIONES DE PRIVACIDAD / CONFIDENCIALIDAD

  6. PREGUNTAS / SOSPECHAS SOBRE LEGITIMIDAD

  7. LA PERSONA ENCUESTADA ES DEMASIADO JOVEN/MAYOR PARA PARTICIPAR

  8. DEMASIADO OCUPADO(A) / NO TIENE TIEMPO

  9. EXPONERSE A POSIBLES ENFERMEDADES/ PREOCUPACIÓN POR ENFERMARSE

  10. OTHER SPECIFY


QUESTION TYPE

Multi-select

FILLS (ENG)

TEXT FILL 1: FILL “[SP NAME]” IF RESPONDENT IS A PROXY AND ONLY ONE APPOINTMENT

FILL “anyone” IF MULTIPLE APPOINTMENTS

ELSE, FILL IS EMPTY

FILLS (SPA)

TEXT FILL 1: FILL “[SP NAME]” IF RESPONDENT IS A PROXY AND ONLY ONE APPOINTMENT

FILL “ninguno de ellos(as)” IF MULTIPLE APPOINTMENTS

ELSE, FILL IS EMPTY

NOTES

IF RESPONSE OPTION 10 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RREFUSEDM_MEC






RREFUSEDM_MEC

ASK

RREFUSED_MEC = MORE THAN ONE SELECTED

SELECT THE MAIN REASON FOR REFUSAL.


  1. CONCERN WITH EXAM / DOCTOR ISSUES

  2. GOVERNMENT CONCERNS / MISTRUST OF GOVERNMENT

  3. EXAM TAKES TOO MUCH TIME / EXAM TOO LONG

  4. MEC IS TOO FAR AWAY / TRANSPORTATION PROBLEMS

  5. PRIVACY / CONFIDENTIALITY CONCERNS

  6. QUESTIONS / SUSPICIONS ABOUT LEGITIMACY

  7. THINK SP IS TOO YOUNG/OLD TO PARTICIPATE

  8. TOO BUSY / NO TIME

  9. EXPOSURE TO EMERGING DISEASES / CONCERNS WITH GETTING SICK

  10. OTHER SPECIFY

SPANISH

SELECT THE MAIN REASON FOR REFUSAL.


  1. PREOCUPACIÓN SOBRE EL EXAMEN / PROBLEMAS CON EL DOCTOR

  2. PREOCUPACIONES SOBRE EL GOBIERNO / DESCONFIANZA EN EL GOBIERNO

  3. EL EXAMEN TOMA DEMASIADO TIEMPO / EXAMEN DEMASIADO LARGO

  4. MEC ESTÁ DEMASIADO LEJOS / PROBLEMAS DE TRANSPORTE

  5. PREOCUPACIONES DE PRIVACIDAD / CONFIDENCIALIDAD

  6. PREGUNTAS / SOSPECHAS SOBRE LEGITIMIDAD

  7. LA PERSONA ENCUESTADA ES DEMASIADO JOVEN/MAYOR PARA PARTICIPAR

  8. DEMASIADO OCUPADO(A) / NO TIENE TIEMPO

  9. EXPONERSE A ENFERMEDADES EMERGENTES / PREOCUPACIÓN POR ENFERMARSE

  10. OTHER SPECIFY

QUESTION TYPE

Radio button

FILLS


NOTES

IF RESPONSE OPTION 10 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

ONLY LIST THE REASONS SELECTED IN REF1.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

CANCELAPPT







RREFUSED_DIET

ASK

IF PREREF = ANY AND DIETARY

Can you share why you don’t want <TEXT FILL 1> to participate in the dietary interview?


INTERVIEWER: ADDRESS ANY CONCERNS OR QUESTIONS TO THE BEST OF YOUR ABILITY. IF THE PARTICIPANT DECIDES TO CONTINUE WITH THE APPOINTMENT, GO BACK TO THE PREVIOUS SCREEN AND CHANGE RESPONSE ACCORDINGLY. IF THE REFUSAL IS NOT CONVERTED, CHECK ALL REFUSAL REASONS THAT APPLY BASED ON PARTICIPANT’S RESPONSE.


  1. SM DOES NOT DO PHONE SURVEYS

  2. SM DOES NOT PARTICIPATE IN SURVEYS

  3. HUNG UP DURING INTRO

  4. HUNG UP DURING SURVEY

  5. “TOO BUSY” / “NO TIME”

  6. “NOT INTERESTED”

  7. PRIVACY CONCERNS

  8. CONCERNED ABOUT LENGTH OF SURVEY

  9. QUESTIONED PURPOSE / LEGITIMACY OF STUDY

  10. ALREADY PARTICIPATED

  11. OTHER SPECIFY

SPANISH

¿Puede decirnos por qué no quiere que <TEXT FILL 1> participe en la entrevista sobre alimentación?


INTERVIEWER: ADDRESS ANY CONCERNS OR QUESTIONS TO THE BEST OF YOUR ABILITY. IF THE PARTICIPANT DECIDES TO CONTINUE WITH THE APPOINTMENT, GO BACK TO THE PREVIOUS SCREEN AND CHANGE RESPONSE ACCORDINGLY. IF THE REFUSAL IS NOT CONVERTED, CHECK ALL REFUSAL REASONS THAT APPLY BASED ON PARTICIPANT’S RESPONSE.


  1. SM DOES NOT DO PHONE SURVEYS

  2. SM DOES NOT PARTICIPATE IN SURVEYS

  3. HUNG UP DURING INTRO

  4. HUNG UP DURING SURVEY

  5. “TOO BUSY” / “NO TIME”

  6. “NOT INTERESTED”

  7. PRIVACY CONCERNS

  8. CONCERNED ABOUT LENGTH OF SURVEY

  9. QUESTIONED PURPOSE / LEGITIMACY OF STUDY

  10. ALREADY PARTICIPATED

  11. OTHER SPECIFY

QUESTION TYPE

Multi-select

FILLS (ENG)

TEXT FILL 1: FILL “[SP NAME]” IF RESPONDENT IS A PROXY AND ONLY ONE APPOINTMENT

FILL “anyone” IF MULTIPLE APPOINTMENTS

ELSE, FILL IS EMPTY

FILLS (SPA)

TEXT FILL 1: FILL “[SP NAME]” IF RESPONDENT IS A PROXY AND ONLY ONE APPOINTMENT

FILL “ninguno de ellos(as)” IF MULTIPLE APPOINTMENTS

ELSE, FILL IS EMPTY

NOTES

IF RESPONSE OPTION 11 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF RREFUSED_DIET = MORE THAN ONE SELECTED: RREFUSEDM_DIET

ELSE: END





RREFUSEDM_DIET

ASK

IF RREFUSED_DIET = MORE THAN ONE SELECTED

SELECT THE MAIN REASON FOR REFUSAL.


  1. SM DOES NOT DO PHONE SURVEYS

  2. SM DOES NOT PARTICIPATE IN SURVEYS

  3. HUNG UP DURING INTRO

  4. HUNG UP DURING SURVEY

  5. “TOO BUSY” / “NO TIME”

  6. “NOT INTERESTED”

  7. PRIVACY CONCERNS

  8. CONCERNED ABOUT LENGTH OF SURVEY

  9. QUESTIONED PURPOSE / LEGITIMACY OF STUDY

  10. ALREADY PARTICIPATED

  11. OTHER SPECIFY

SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES

IF RESPONSE OPTION 11 (OTHER SPECIFY) IS SELECTED, DISPLAY TEXT BOX TO CAPTURE OTHER REASON. ALLOW 800 CHARACTERS.

ONLY LIST THE REASONS SELECTED IN REF1.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

CANCELAPPT










CANCELAPPT

ASK

IF RREFUSED_MEC = ANY OR RREFUSED_DIET = ANY

[REFUSED ALL/CANCEL ALL APPOINTMENTS]


Please hold while I look up and remove <TEXT FILL 1> appointment from our system.


LAUNCH APPOINTMENT SCHEDULER APPLICATION AND CANCEL THE APPOINTMENT(S). AS NEEDED, CONFIRM PARTICIPANT INFORMATION TO CONFIRM THE CORRECT APPOINTMENT IS CANCELLED. RETURN TO THIS SCREEN WHEN DONE.


Thank you for your time.


SPANISH

[REFUSED ALL/CANCEL ALL APPOINTMENTS]


Por favor, espere mientras busco y borro <TEXT FILL 1> en nuestro sistema.


LAUNCH APPOINTMENT SCHEDULER APPLICATION AND CANCEL THE APPOINTMENT(S). AS NEEDED, CONFIRM PARTICIPANT INFORMATION TO CONFIRM THE CORRECT APPOINTMENT IS CANCELLED. RETURN TO THIS SCREEN WHEN DONE.


Gracias por su tiempo.


QUESTION TYPE

Text display

FILLS (ENG)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “your” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “[SP’s NAME]’s” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “everyone’s”


FILLS (SPA)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “su cita” IF SP AGE 18+ AND NO PROXY

IF ONE APPOINTMENT, FILL “la cita de [SP’s NAME]” IF SP AGE <18 OR (AGE 18+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “de todos(as)”


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RDONE


RREFUSEDSOME

ASK

IF RREFUSAL = 2

We have the following appointments scheduled:


  • (First SP – First Name, Age, Appointment Date and Time)

  • (Second SP – First Name, Age, Appointment Date and Time)

  • (Third SP – First Name, Age, Appointment Date and Time)


Which appointment would you like to cancel?


LAUNCH APPOINTMENT SCHEDULER APPLICATION AND CANCEL THE APPOINTMENT(S). AS NEEDED, CONFIRM PARTICIPANT INFORMATION TO CONFIRM THE CORRECT APPOINTMENT IS CANCELLED. RETURN TO THIS SCREEN WHEN DONE.


I’ve made a note and removed the appointment(s) from our system.

SPANISH

Tenemos programadas las siguientes citas:


  • (First SP – First Name, Age, Appointment Date and Time)

  • (Second SP – First Name, Age, Appointment Date and Time)

  • (Third SP – First Name, Age, Appointment Date and Time)


¿Qué cita desea cancelar?


LAUNCH APPOINTMENT SCHEDULER APPLICATION AND CANCEL THE APPOINTMENT(S). AS NEEDED, CONFIRM PARTICIPANT INFORMATION TO CONFIRM THE CORRECT APPOINTMENT IS CANCELLED. RETURN TO THIS SCREEN WHEN DONE.


He tomado nota y he borrado la(s) cita(s) en nuestro sistema.


QUESTION TYPE

Text display

FILLS


NOTES

FILL INFORMATION FOR HOUSEHOLD MEMBERS WITH APPOINTMENTS ON THE SAME DAY AND THAT HAVE THE SAME CONTACT PHONE LIST. NOTE THAT PARTICIPANTS WITH A DIFFERENT APPOINTMENT DATE AND/OR CONTACT PHONE WILL GET A SEPARATE REMINDER CALL.

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

GO TO RAPPT_MEC IF MEC

GO TO RAPPT_DIET IF DIETARY


RRESCHEDULE

ASK

IF RREFUSAL = 4 OR RINTRO = 2

We have the following appointments scheduled:


  • (First SP – First Name, Age, Appointment Date and Time)

  • (Second SP – First Name, Age, Appointment Date and Time)

  • (Third SP – First Name, Age, Appointment Date and Time)


Which appointment would you like to reschedule?



LAUNCH APPOINTMENT SCHEDULER APPLICATION, ASK, “When would be a better date and time?”


RESCHEDULE EACH APPOINTMENT THEY WANT TO RESCHEDULE AND CONFIRM THE APPOINTMENT(S) OUT LOUD INCLUDING THE DAY, TIME, AND LOCATION.


ONCE APPOINTMENT(S) IS RESCHEDULED, RETURN TO THIS SCREEN, CLICK CONTINUE.

SPANISH

Tenemos programadas las siguientes citas:


  • (First SP – First Name, Age, Appointment Date and Time)

  • (Second SP – First Name, Age, Appointment Date and Time)

  • (Third SP – First Name, Age, Appointment Date and Time)


¿Qué cita desea volver a hacer?


LAUNCH APPOINTMENT SCHEDULER APPLICATION, ASK, “¿Cuándo sería una mejor fecha y hora?”


RESCHEDULE EACH APPOINTMENT THEY WANT TO RESCHEDULE AND CONFIRM THE APPOINTMENT(S) OUT LOUD INCLUDING THE DAY, TIME, AND LOCATION.


ONCE APPOINTMENT(S) IS RESCHEDULED, RETURN TO THIS SCREEN, CLICK CONTINUE.

QUESTION TYPE

Text display

FILLS

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RRESCHEDULED


RRESCHEDULED

ASK

IF RRESCHEDULE = ANY


We will contact you again closer to the new date to remind you of the appointment.


SPANISH


Nos volveremos a comunicar con usted cuando se acerque la nueva fecha para recordarle la cita.


QUESTION TYPE

Text display

FILLS

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RDONE





RAPPT_DIET

ASK

IF RINTRO = 1 OR RREFUSAL = 3 OR RREFUSEDSOME = ANY AND DIETARY


Prior to <TEXT FILL 1> appointment, please make sure <TEXT FILL 2> the two booklets we gave <TEXT FILL 3> during the in-home interview. These booklets are labeled “Dietary Food Model” and “Handcard.” <TEXT FILL 4> will need these during <TEXT FILL 5> phone interview(s). The person administering the interview will give instructions on how to use them.


During the phone interview, questions will be asked about <TEXT FILL 1> food and beverage consumption habits and any dietary supplements or antiacids taken, as well as <TEXT FILL 5> use of nutrition labels on food packages and menus. This phone interview can take 30-45 minutes to complete. <TEXT FILL 10> .


As a reminder, participation is voluntary and the information you provide will be confidential. After completing the interview, <TEXT FILL 7> will receive $30 loaded onto <TEXT FILL 8> gift <TEXT FILL 9>



SPANISH


Antes de <TEXT FILL 1>, asegúrese de <TEXT FILL 2> los dos cuadernillos que le dimos a <TEXT FILL 3> durante la entrevista en el hogar. Estos cuadernillos se llaman “Folleto de Modelo de Alimentos” y “Libro de tarjetas”. <TEXT FILL 4> los necesitará(n) durante <TEXT FILL 5>. La persona que conduzca la entrevista le dará instrucciones sobre cómo usarlos.


Durante la entrevista telefónica, se harán preguntas sobre <TEXT FILL 11> y sobre cualquier suplemento dietético o antiácido que se tome, así como sobre el uso de etiquetas nutricionales en los envases de alimentos y en los menús. Esta entrevista telefónica puede tomar entre 30 y 45 minutos en completarse. <TEXT FILL 10> .


Para recordarle, la participación es voluntaria y la información proporcionada será confidencial. Después de completar la entrevista, <TEXT FILL 7> recibirá(n) $30 dólares agregados a <TEXT FILL 9> de regalo <TEXT FILL 8> .

QUESTION TYPE

Click NEXT to continue

FILLS (ENG)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “your” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “[SP’s NAME]’s” IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “everyone’s”


TEXT FILL 2: IF ONE APPOINTMENT, FILL “you have” IF (SP AGE 18+ AND NO PROXY) OR IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “everyone has”


TEXT FILL 3: FILL “you”


TEXT FILL 4: IF ONE APPOINTMENT, FILL “You” IF (SP AGE 18+ AND NO PROXY) OR IF PROXY

IF MORE THAN ONE APPOINTMENT, FILL “Everyone”


TEXT FILL 5: IF ONE APPOINTMENT, FILL “your” IF (SP AGE 18+ AND NO PROXY)

ELSE, FILL “their”


TEXT FILL 6: IF ONE APPOINTMENT, FILL “You” IF (SP AGE 18+ AND NO PROXY) OR YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “Everyone”


TEXT FILL 7: IF ONE APPOINTMENT, FILL “you” IF (SP AGE 18+ AND NO PROXY)

IF SP AGE 0-5 AND YES PROXY, FILL “you”

IF ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 6+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “everyone”


TEXT FILL 8: IF ONE APPOINTMENT, FILL “your” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “[SP’s NAME]’s” IF YES PROXY

ELSE, FILL “their”


TEXT FILL 9: FILL “card” IF ONLY ONE APPOINTMENT

ELSE “cards”


TEXT FILL 10: FILL “Note that this is the first of two phone interviews. <TEXT FILL 6> can schedule the second at the end of our first interview.” IF REMINDER FOR DAY 1 INTERVIEW

ELSE, FILL IS EMPTY

FILLS (SPA)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “su cita” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “la cita de [SP’s NAME]” IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “de la cita de todos(as)”


TEXT FILL 2: IF ONE APPOINTMENT, FILL “tener” IF (SP AGE 18+ AND NO PROXY) OR IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “que todos(as) tengan”


TEXT FILL 3: FILL “usted”


TEXT FILL 4: IF ONE APPOINTMENT, FILL “Usted” IF (SP AGE 18+ AND NO PROXY) OR IF PROXY

IF MORE THAN ONE APPOINTMENT, FILL “Todos(as)”


TEXT FILL 5: IF ONE APPOINTMENT, FILL “su entrevista telefónica” IF (SP AGE 18+ AND NO PROXY)

ELSE, FILL “sus entrevistas telefónicas”


TEXT FILL 6: IF ONE APPOINTMENT, FILL “Usted” IF (SP AGE 18+ AND NO PROXY) OR YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “Todos(as)”


TEXT FILL 7: IF ONE APPOINTMENT, FILL “usted” IF (SP AGE 18+ AND NO PROXY)

IF SP AGE 0-5 AND YES PROXY, FILL “usted”

IF ONE APPOINTMENT, FILL “[SP’s NAME]” IF (SP AGE 6+ AND YES PROXY)

IF MORE THAN ONE APPOINTMENT, FILL “todos(as)”


TEXT FILL 8: IF ONE APPOINTMENT, FILL “de usted” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “de [SP’s NAME]” IF YES PROXY

ELSE, FILL “de ellos(as)”


TEXT FILL 9: FILL “la tarjeta” IF ONLY ONE APPOINTMENT

ELSE “las tarjetas”


TEXT FILL 10: FILL “Recuerde que esta es la primera de dos entrevistas telefónicas.
<TEXT FILL 6> puede(n) programar la segunda al final de nuestra primera entrevista.”
IF REMINDER FOR DAY 1 INTERVIEW

ELSE, FILL IS EMPTY


TEXT FILL 11: IF ONE APPOINTMENT, FILL “sus hábitos de consumo de alimentos y bebidas” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “los hábitos de consumo de alimentos y bebidas de [SP’s NAME]” IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “los hábitos de consumo de alimentos y bebidas de todos(as)”


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RQUESTIONS






RAPPT_MEC

ASK

IF RINTRO = 1 OR RREFUSAL = 3 OR RREFUSEDSOME = ANY AND MEC

Do you still have your reminder letter that we mailed to you? If so, please take a moment now to locate it so I can review the instructions with you. 

 

INTERVIEWER: PAUSE TO ALLOW TIME FOR RESPONDENT TO FIND THEIR REMINDER LETTER. IF REMINDER LETTER IS UNAVAILABLE, CONTINUE READING INSTRUCTIONS ALOUD.


<TEXT FILL 1> appointment will take place at a mobile examination center. This examination center will be located at <TEXT FILL 2>. As a reminder, you received a prepaid travel allowance when you scheduled your appointment. If you need to hire someone to care for children, older adults, or others in order to attend your appointment, we will also give you an allowance at the end of your appointment to help cover these costs. <TEXT FILL 3> 

SPANISH

¿Todavía tiene la carta de recordatorio que le enviamos por correo? Si es así, quisiera que la busque ahora para poder revisar las instrucciones con usted. 

 

INTERVIEWER: PAUSE TO ALLOW TIME FOR RESPONDENT TO FIND THEIR REMINDER LETTER. IF REMINDER LETTER IS UNAVAILABLE, CONTINUE READING INSTRUCTIONS ALOUD.


<TEXT FILL 1> será en un centro móvil de examen. Este centro de examen estará en <TEXT FILL 2>. Para recordarle, usted recibió un pago por adelantado para su transporte cuando hizo su cita. Si necesita contratar a alguien que cuide a sus hijos(as), personas mayores u otras personas para venir a su cita, también le daremos un pago al final de su cita para ayudarle a cubrir estos gastos. <TEXT FILL 3> 

QUESTION TYPE

Text display

FILLS (ENG)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “Your” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “[SP’s NAME]’s” IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “Everyone’s”


TEXT FILL 2: FILL MEC ADDRESS BASED ON REGION


TEXT FILL 3: FILL “Though you were not selected for this study, you will receive $20 for bringing <TEXT FILL 4> to their <TEXT FILL 5>.” IF NO SPs IN THE HOUSEHOLD ARE (18+ AND NO PROXY)

ELSE, FILL IS EMPTY


TEXT FILL 4: FILL “[SP NAME]” IF ONLY ONE SP

IF 2 SP’s, FILL “[SP1 NAME] and [SP2 NAME]”

IF 3 SP’s, FILL “[SP1 NAME], [SP2 NAME] and [SP3 NAME]”


TEXT FILL 5: FILL “appointment” IF ONLY ONE SP

ELSE, FILL “appointments”

FILLS (SPA)

TEXT FILL 1: IF ONE APPOINTMENT, FILL “Su cita” IF (SP AGE 18+ AND NO PROXY)

IF ONE APPOINTMENT, FILL “La cita de [SP’s NAME]” IF YES PROXY

IF MORE THAN ONE APPOINTMENT, FILL “La cita de todos(as)”


TEXT FILL 2: FILL MEC ADDRESS BASED ON REGION


TEXT FILL 3: FILL “A pesar de que no fue seleccionado(a) para este estudio, recibirá $20 dólares por traer a <TEXT FILL 4> a su(s) <TEXT FILL 5>.” IF NO SPs IN THE HOUSEHOLD ARE (18+ AND NO PROXY)

ELSE, FILL IS EMPTY


TEXT FILL 4: FILL “[SP NAME]” IF ONLY ONE SP

IF 2 SP’s, FILL “[SP1 NAME] y [SP2 NAME]”

IF 3 SP’s, FILL “[SP1 NAME], [SP2 NAME] y [SP3 NAME]”


TEXT FILL 5: FILL “cita” IF ONLY ONE SP

ELSE, FILL “citas”

NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF AT LEAST ONE SP >= 12, GO TO RAPPT_BLOOD_MEC

ELSE, GO TO RAAPT2_MEC






RAPPT_BLOOD_MEC

ASK

IF RAPPT_MEC = ANY AND AT LEAST ONE SP >=12 AND MEC

{I IF ALL APPOINTMENTS ARE FASTING: For the blood draw, <TEXT FILL 1> will need to fast for at least 8 hours prior to the appointment. <TEXT FILL 2> should drink water, but please do not consume any other food or beverages including candy, gum, soda, coffee, alcohol or tea. Do not take cough or cold remedies, non-prescription antacids, laxatives, anti-diarrheals, or dietary supplements such as vitamins or minerals before the blood draw. <TEXT FILL 2> should continue to take any medications as prescribed, unless they are required to be taken with food, in which case bring them to take after the blood draw.}


{IF NO APPOINTMENTS ARE FASTING For the blood draw, <TEXT FILL 3> to fast prior to <TEXT FILL 4>. <TEXT FILL 2> should continue to take any medications as prescribed; do not stop taking them for the blood draw.} 


{IF SOME APPOINTMENTS ARE FASTING BUT NOT ALL: For the blood draw, some people will need to fast while others do not. This is due to the age of some people and the morning time of their appointment. <TEXT FILL 5> should fast for at least 8 hours prior to the appointment. <TEXT FILL 6> can and should drink water, but <TEXT FILL 7> should not consume any other food or beverages, including candy, gum, soda, coffee, alcohol or tea. <TEXT FILL 6> should not take cough or cold remedies, non-prescription antacids, laxatives, anti-diarrheals, or dietary supplements such as vitamins or minerals before the blood draw. <TEXT FILL 6> should continue to take any medications as prescribed unless they are required to be taken with food, in which case <TEXT FILL 7> should bring them to take after the blood draw.}


{FOR EACH FASTING APPOINTMENT: <TEXT FILL 8> should not eat or drink anything other than water after <TEXT FILL 9>.}


As a reminder, there will be juice and crackers available after the blood draw, but please feel free to bring a snack if you wish.

SPANISH

{I IF ALL APPOINTMENTS ARE FASTING: Para sacar la muestra de sangre, <TEXT FILL 1> deberá ayunar al menos 8 horas antes de la cita. <TEXT FILL 2> deberá(n) beber agua, pero le(s) pedimos que no consuma(n) ningún otro alimento o bebida, incluidos dulces, chicles, refrescos, café, alcohol ni té. No tome(n) remedios para la tos o el resfriado, ni antiácidos, laxantes, antidiarreicos ni suplementos alimenticios como vitaminas o minerales sin receta antes de sacarle la sangre. <TEXT FILL 2> debe(n) continuar tomando los medicamentos que le(s) hayan recetado, a menos que deban tomarse con comida; y si fuera así, puede(n) traerlos para tomarlos después de sacar la sangre.}


{IF NO APPOINTMENTS ARE FASTING Para sacar la sangre, <TEXT FILL 3> ayunar antes de <TEXT FILL 4>. <TEXT FILL 2> debe(n) seguir tomando los medicamentos que le(s) hayan recetado; no deje(n) de tomarlos para sacar la sangre.} 


{IF SOME APPOINTMENTS ARE FASTING BUT NOT ALL: Para sacar la sangre, algunas personas necesitarán ayunar y otras no. Esto se debe a la edad de algunas personas y a la hora de su cita. <TEXT FILL 5> debe ayunar al menos durante 8 horas antes de la cita. <TEXT FILL 6> puede(n) y debe(n) beber agua, pero <TEXT FILL 7> no debe(n) consumir ningún otro alimento o bebida, incluidos dulces, chicles, refrescos, café, alcohol ni té. <TEXT FILL 6> no debe(n) tomar remedios para la tos o el resfriado, antiácidos sin receta, laxantes, antidiarreicos ni suplementos alimenticios como vitaminas o minerales antes de sacar la sangre. <TEXT FILL 6> debe(n) seguir tomando sus medicamentos hayan sido recetados, a menos que deba(n) tomarlos con comida, en cuyo caso <TEXT FILL 7> debe(n) traerlos para tomarlos después de sacar la sangre.}


{FOR EACH FASTING APPOINTMENT: <TEXT FILL 8> no debe comer ni beber nada que no sea agua después de la(s) <TEXT FILL 9>.}


Para recordarle, habrá jugo y galletas saladas disponibles después de sacar la sangre, pero puede traer un refrigerio o “snack” si lo desea.

QUESTION TYPE

Text display

FILLS (ENG)

TEXT FILL 1: FILL “you” IF ONLY ONE APPOINTMENT AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME]” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

FILL “anyone aged 12 and older” IF MORE THAN ONE APPOINTMENT SCHEDULED


TEXT FILL 2: FILL “You” IF ONLY ONE APPOINTMENT SCHEDULED AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME]” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

ELSE, FILL “Everyone”


TEXT FILL 3: FILL “you do not need” IF ONLY ONE APPOINTMENT SCHEDULED AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME] does not need” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

ELSE, FILL “nobody needs”


TEXT FILL 4: FILL, “your appointment” IF ONLY ONE APPOINTMENT AND (SP AGE 18+ AND NO PROXY)

FILL, “their appointment” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

FILL, “their appointments” IF MORE THAN ONE APPOINTMENT SCHEDULED


TEXT FILL 5: IF ONLY ONE SP AND FASTING APPOINTMENT AND NO PROXY AND SP IS RESPONDENT, FILL “You”

IF 1 SP WITH FASTING APPOINTMENT AND YES PROXY OR SP IS NOT RESPONDENT, FILL “[SP NAME]”

IF 2 SP WITH FASTING APPOINTMENT AND RESPONDENT IS NOT ONE OF THEM, FILL “[SP1 NAME] and [SP2 NAME]”

IF 2 SP WITH FASTING APPOINTMENTS AND RESPONDENT IS ONE OF THEM, FILL “You and [SP2 NAME]”


TEXT FILL 6: IF ONLY ONE SP WITH FASTING APPOINTMENT AND NO PROXY, FILL “You”

IF 1 SP WITH FASTING APPOINTMENT AND YES PROXY OR SP IS NOT RESPONDENT, FILL “They”

IF 2 SPs WITH FASTING APPOINTMENTS AND RESPONDENT IS NOT ONE OF THEM, FILL “They”

IF 2 SPs FASTING APPOINTMENTS AND RESPONDENT IS ONE OF THEM, FILL “You all”


TEXT FILL 7: IF ONLY ONE SP WITH FASTING APPOINTMENT AND NO PROXY AND SP IS RESPONDENT, FILL “you”

IF 1 SP WITH FASTING APPOINTMENT AND YES PROXY OR SP IS NOT RESPONDENT, FILL “they”

IF 2 SPs WITH FASTING APPOINTMENTS AND RESPONDENT IS NOT ONE OF THEM, FILL “they”

IF 2 SPs WITH FASTING APPOINTMENTS AND RESPONDENT IS ONE OF THEM, FILL “you all”





TEXT FILL 8: FILL “You” IF ONLY ONE APPOINTMENT AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME]” IF MORE THAN ONE MORNING APPOINTMENT SCHEDULED OR (ONLY ONE APPOINTMENT AND YES PROXY)


TEXT FILL 9: FILL APPOINTMENT TIME MINUS 8 HOURS

FILLS (SPA)

TEXT FILL 1: FILL “usted” IF ONLY ONE APPOINTMENT AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME]” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

FILL “las personas de 12 años o más” IF MORE THAN ONE APPOINTMENT SCHEDULED


TEXT FILL 2: FILL “Usted” IF ONLY ONE APPOINTMENT SCHEDULED AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME]” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

ELSE, FILL “Todos”


TEXT FILL 3: FILL “no necesita” IF ONLY ONE APPOINTMENT SCHEDULED AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME] no necesita” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

ELSE, FILL “nadie necesita”


TEXT FILL 4: FILL, “su cita” IF ONLY ONE APPOINTMENT AND (SP AGE 18+ AND NO PROXY)

FILL, “su cita” IF ONLY ONE APPOINTMENT SCHEDULED AND YES PROXY

FILL, “sus citas” IF MORE THAN ONE APPOINTMENT SCHEDULED


TEXT FILL 5: IF ONLY ONE SP AND FASTING APPOINTMENT AND NO PROXY AND SP IS RESPONDENT, FILL “Usted”

IF 1 SP WITH FASTING APPOINTMENT AND YES PROXY OR SP IS NOT RESPONDENT, FILL “[SP NAME]”

IF 2 SP WITH FASTING APPOINTMENT AND RESPONDENT IS NOT ONE OF THEM, FILL “[SP1 NAME] y [SP2 NAME]”

IF 2 SP WITH FASTING APPOINTMENTS AND RESPONDENT IS ONE OF THEM, FILL “Usted y [SP2 NAME]”


TEXT FILL 6: IF ONLY ONE SP WITH FASTING APPOINTMENT AND NO PROXY, FILL “Usted”

IF 1 SP WITH FASTING APPOINTMENT AND YES PROXY OR SP IS NOT RESPONDENT, FILL “Ellos(as)”

IF 2 SPs WITH FASTING APPOINTMENTS AND RESPONDENT IS NOT ONE OF THEM, FILL “Ellos(as)”

IF 2 SPs FASTING APPOINTMENTS AND RESPONDENT IS ONE OF THEM, FILL “Todos(as) ustedes”


TEXT FILL 7: IF ONLY ONE SP WITH FASTING APPOINTMENT AND NO PROXY AND SP IS RESPONDENT, FILL “usted”

IF 1 SP WITH FASTING APPOINTMENT AND YES PROXY OR SP IS NOT RESPONDENT, FILL “ellos(as)”

IF 2 SPs WITH FASTING APPOINTMENTS AND RESPONDENT IS NOT ONE OF THEM, FILL “ellos(as)”

IF 2 SPs WITH FASTING APPOINTMENTS AND RESPONDENT IS ONE OF THEM, FILL “todos(as) ustedes”


TEXT FILL 8: FILL “Usted” IF ONLY ONE APPOINTMENT AND (SP AGE 18+ AND NO PROXY)

FILL “[SP NAME]” IF MORE THAN ONE MORNING APPOINTMENT SCHEDULED OR (ONLY ONE APPOINTMENT AND YES PROXY)


TEXT FILL 9: FILL APPOINTMENT TIME MINUS 8 HOURS

NOTES

DISPLAY PARAGRAPH 1 IF NUMBER OF FASTING APPOINTMENTS IS >=1


DISPLAY PARAGRAPH 2 IF NUMBER OF FASTING APPOINTMENTS IS 0


DISPLAY PARAGRAPH 3 IF SOME SPs ARE FASTING


DISPLAY PARAGRAPH 4 FOR EACH SP (AGED 12+) THAT HAS A FASTING APPOINTMENT

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RAAPT2_MEC





RAAPT2_MEC

ASK

IF RAPPT_BLOOD_MEC = ANY OR RAPPT_MEC = ANY AND MEC

{ONLY SP AGE 3-5: Children ages 3 to 5 years old will be asked to provide a urine sample at their appointment. We will ask that you assist them in obtaining this sample while in the bathroom at the mobile exam center. If you could ensure they drink something prior to the exam, then it might be easier to obtain a urine sample while at the mobile exam center. Any drink you would like to give them is fine as it will not interfere with any tests that are done.”}

 

Please leave jewelry and hair accessories at home so they do not need to be removed for the exam. Please also wear clothes that are easy to change into and out of and bring a sweater or something warm to wear because the mobile exam centers are kept cold due to the equipment.  

 

{EACH SP: As a reminder, <TEXT FILL 1> $<MEC EXAM INCENTIVE FILL> loaded onto <TEXT FILL 2> gift card for completing the medical examination portion of the study.}  

SPANISH

{ONLY SP AGE 3-5: Se pedirá a los(as) niño(as) de 3 a 5 años que den una muestra de orina en su cita. Le pediremos que los ayude a obtener esta muestra mientras estén en el baño del centro móvil de examen. Sería más fácil obtener una muestra de orina si usted pudiera asegurarse de que beban algo antes del examen, mientras se encuentran en el centro móvil de examen. Está bien si les da cualquier tipo de bebida, ya que esto no causará problemas con las pruebas que se hagan.”}

 

Le pedimos que deje las joyas y los accesorios para el cabello en casa para que no sea necesario quitárselos para el examen. También le pedimos que use ropa que sea fácil de poner y quitar y traiga un suéter o algo de abrigo para ponerse porque los centros móviles de examen tienen temperatura fría debido al equipo.  

 

{EACH SP: Para recordarle, <TEXT FILL 1> $<MEC EXAM INCENTIVE FILL> dólares que se agregarán a <TEXT FILL 2> por completar la parte del estudio correspondiente al examen médico.}  

QUESTION TYPE

Text display

FILLS (ENG)

TEXT FILL 1: FILL “you will receive” IF (SP AGE 18+ AND NO PROXY) AND ONLY ONE APPOINTMENT SCHEDULED

ELSE, FILL “[SP NAME] will receive”


TEXT FILL 2: FILL “your” IF (SP AGE 18+ AND NO PROXY) AND ONLY ONE APPOINTMENT SCHEDULED

ELSE, FILL “their”


FILLS (SPA)

TEXT FILL 1: FILL “usted recibirá” IF (SP AGE 18+ AND NO PROXY) AND ONLY ONE APPOINTMENT SCHEDULED

ELSE, FILL “[SP NAME] recibirá”


TEXT FILL 2: FILL “su tarjeta de regalo” IF (SP AGE 18+ AND NO PROXY) AND ONLY ONE APPOINTMENT SCHEDULED

ELSE, FILL “la tarjeta de regalo de ellos(as)”


NOTES

DISPLAY PARAGRAPH 1 IF SP IS 3 TO 5 YEARS OLD


DISPLAY PARAGRAPH 2 IF SP IS 40+ YEARS OLD


DISPLAY PARAGRAPH 4 FOR EACH SP

HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RQUESTIONS





RQUESTIONS

ASK

IF RAAPT2_MEC = ANY OR RAPPT_DD1 = ANY

Do you have any questions for me?



INTERVIEWER: IF RESPONDENT HAS QUESTIONS, ANSWER TO THE BEST OF YOUR ABILITY.

SPANISH

¿Tiene alguna pregunta para mí?



INTERVIEWER: IF RESPONDENT HAS QUESTIONS, ANSWER TO THE BEST OF YOUR ABILITY.

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

RDONE






















RDONE

ASK

IF CANCELAPPT = ANY OR RRESCHEDULED = 1 OR RQUESTIONS = 1 OR RUNKNOWN = 2

(Thank you for your time. Have a good {day/evening}).


SPANISH

(Gracias por su tiempo. Que tenga un(a) buen(a) {día/tarde}).


QUESTION TYPE

Text display

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

BACK_FROM_BLAISE






BACK_FROM_BLAISE

ASK

IF RDONE = ANY

INTERVIEWER: WHAT WAS THE OUTCOME OF THE REMINDER CALL?


  1. REMINDER CALL COMPLETE

  2. NOT COMPLETE, SET CALLBACK

  3. REFUSAL


SPANISH

N/A

QUESTION TYPE

Radio button

FILLS


NOTES


HARD CHECK


SOFT CHECK


VERSION NOTES


NEXT

IF BACK_FROM_BLAISE = 1: END OF REMINDER CALL

IF BACK_FROM_BLAISE = 2: CALLBACK SCHEDULER

IF_BACK_FROM_BLAISE = 3: WHO_REF, IF WHO_REF = BLANK

ELSE, END.


6o-36


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJeanne Snodgrass
File Modified0000-00-00
File Created2024-10-28
© 2024 OMB.report | Privacy Policy