Variable Name |
Description |
Visual Aide |
Response Type |
Response Required |
Response Source |
Legal Values |
First Name/Alias |
The reported first name and/or alias of the help-seeker.
NOTE: Not provided to MCHB; for contractor use only. |
#VALUE! |
Free Text |
YES |
Respondent |
- |
Phone Number |
The incoming phone number that the help-seeker uses to contact the Hotline is automatically populated. The phone number is not confirmed or validated by the help-seeker or hotline counselor.
NOTE: Not provided to MCHB, for contractor use only. |
#VALUE! |
Free Text |
YES |
System |
- |
Age |
The reported age of the help-seeker. |
#VALUE! |
Single Selection |
YES |
Respondent |
• Under 13 • 13-17 • 18-24 • 25-29 • 30-39 • 40-49 • 50 and above • Not Applicable (Abandoned/System Error) • Declined to Answer/Respond |
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Gender Identity |
The reported gender identity of the help-seeker. |
#VALUE! |
Single Selection |
YES |
Respondent |
• Female • Male • Transgender Woman/Transgender Female/Transfeminine • Transgender Man/Transgender Male/Transmasculine • Uses a different term • Declined to Answer/Respond • Not Applicable (Abandoned/System Error) |
Geographic Location |
The geographic location/area based upon the reported help-seeker zipcode. |
#VALUE! |
Single Selection |
YES |
Respondent |
• Rural • Urban • Suburban • Decline to Answer/Respond • Not Applicable (Abandoned/System Error) • Not Applicable (International) |
Hotline Awareness |
The reported referral source of the Hotline. |
#VALUE! |
Single Selection |
YES |
Respondent |
• PSI/PSI Helpline • HRSA Home Visiting/Healthy Start • Word of Mouth • TV/Radio/Social Media • Healthcare/Medical Provider • Social Services/Human Services Provider • Internet/Search Engine • Billboard • Other • Not Applicable (Abandoned/System Error) • Declined to Answer/Respond |
Military/Veteran Status |
The reported military/veteran status of help-seeker. |
#VALUE! |
Single Selection |
YES |
Respondent |
• An active U.S. Service Member • A spouse of an active/retired U.S. Service Member • A U.S. Military Veteran • Not an active/retired/veteran service member • Not Applicable (Abandoned/System Error) • Declined to Answer/Respond |
Open to Survey |
In the system, the Hotline Counselor will choose “yes” if the help-seeker consents to receiving the survey via text. If no consent is provided, the Hotline Counselor will choose “no”. Once the case status is closed, the system will automatically send the survey to the help-seeker at the phone number listed within the person account and provided/confirmed by the help-seeker. |
#VALUE! |
Single Selection |
YES |
Respondent |
• Yes, open to receive survey • No, declined to receive survey • Not Applicable (Abandoned/System Error) |
Race/Ethnicity |
The reported race/ethnicity of the help-seeker. |
#VALUE! |
Multi Selection |
YES |
Respondent |
• American Indian or Alaska Native • Asian • Black or African American • Hispanic or Latino • Middle Eastern or North African • Native Hawaiian or Pacific Islander • White • Decline to Respond/Answer • Not Applicable (Abandoned/System Error) |
State/Territory |
The reported state/territory of current residence of the help-seeker. |
#VALUE! |
Single Selection |
YES |
Respondent |
Includes all 50 states, US Territories, District of Columbia, Outside of the United States and US Territories, Unable to Determine, Decline to Answer/Respond, Not Applicable (International) |
ZIP Code |
The reported zipcode of the help-seeker |
|
Free Text |
NO |
Respondent |
- |
Acuity |
The assessment of the help seeker’s current severity of symptom(s) intensity and/or urgency during the interaction. This includes both what is verbally shared and nonverbally perceived. |
#VALUE! |
Single Selection |
YES |
Counselor |
• Low • Medium • High |
Ancillary Needs |
Reported ancillary needs of the help-seeker. Ancillary needs are synonymous with social needs which represent the Social Determinants of Health [https://health.gov/healthypeople/priority-areas/social-determinants-health]. These identifiers are dervied from commonly reported and/expressed social needs and public health discipline. |
#VALUE! |
Multi Selection |
YES |
Counselor |
• Access to Healthcare • Child Care • Employment • Finances • Food Insecurity • Housing • Legal • Medical • Personal Safety • Not Applicable (Abandoned/System Error) • No Ancillary Needs Presented |
Case Origin |
The method of contact the help-seeker used to contact the Hotline. |
#VALUE! |
Single Selection |
YES |
System |
• Text • Phone • Web Chat • Test Text • Test Phone • Test Web Chat |
Case Reason |
The issues reported and/or reasons of contact to the Hotline by the help-seeker. |
#VALUE! |
Multi Selection |
YES |
Counselor |
• Anger • Anxiety • Depression • Fear • Hotline Inquiry • Infant feeding • Insomnia • Loss • OCD • Overwhelmed • Panic • Pregnancy • Provider Dissatisfaction • Psychoeducation • Psychosis • Relationship Conflict • Substance Use Disorder • Suicide • Trauma • Not Applicable (Abandoned/System Error) • No Case Reasons Presented |
Inappropriate Interaction |
Data entry section that supports documentation of harassing, inappropriate, and operationally insufficient contacts. |
#VALUE! |
Checkbox |
NO |
Counselor |
• Checked (YES) • Unchecked (NO) |
Spoken Language |
The language that the help-seeker utilized during the interaction with the counselor, whether live or through translation service. |
#VALUE! |
Single Selection |
YES |
Counselor |
• English • Spanish • Chinese (Mandarin) • Chinese (Cantonese) • French, Tagalog (Filipino) • Vietnamese • Arabic • Korean • Russian • German • Haitain Creole • Portuguese • American Sign Language • Other • Not Applicable (Abandoned/System Error) |
Referral Provided |
Documents if a referral was consented by the help-seeker and provided within the interaction. |
#VALUE! |
Checkbox (Dependency) |
YES |
Counselor |
• Yes, open to receive referral • No, declined to receive referral • Not Applicable (Abandoned/System Error) |
Resource Provided |
Documents if a resource was consented by the help-seeker and provided within the interaction. |
#VALUE! |
Checkbox (Dependency) |
YES |
Counselor |
• Yes, open to receive resource • No, declined to receive resource • Not Applicable (Abandoned/System Error) |
Type |
The Hotline Counselors capture responses throughout the conversation with the respondent. The classification of type is determined based upon the interaction. |
#VALUE! |
Single Selection |
YES |
Counselor |
•Self •Calling on behalf of someone else (friend/family member) •Provider •Spam •Not Applicable (Abandoned/System Error) |
Self Subcategory |
The Hotline Counselors capture responses throughout the conversation with the respondent. The classification of type is determined based upon the interaction with individuals calling for themselves either reporting being pregnant, postpartum, or not applicable. |
#VALUE! |
Single Selection |
YES |
Counselor |
•Self-postpartum •Self-pregnant •Not Applicable (Partner/Caregiver) •Not Applicable (Abandoned/System Error) •Decline to Answer/Respond |
Variable Name |
Survey Question |
Response Type |
Response Required |
Response Source |
Legal Values |
Demographic: State/Territory |
What State/Territory are you located in? |
Single Selection |
YES |
Respondent |
Includes all 50 states, US Territories, Dictrict of Columbia, Outside of the United States and US Territories, Perfer not to disclose |
Demographic: Age |
What Age group do you fall in? |
Single Selection |
YES |
Respondent |
•Under 13 •13-17 •18-24 •25-29 •30-39 •40-49 •50 and above •I prefer not to disclose |
[Threaded comment]
Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924
Comment:
Delete
Demographic: Gender Identity |
What gender do you identify with? |
Single Selection |
YES |
Respondent |
•Female •Male •Transgender Woman/Transgender Female/Transfeminine •Transgender Man/Transgender Male/Transmasculine •I use a different term •I prefer not to disclose |
Demographic: Race/Ethnicity |
What is your race/ethnicity? |
Multi Selection |
YES |
Respondent |
•American Indian or Alaska Native •Asian •Black or African American •Hispanic or Latino •Middle Eastern or North African •Native Hawaiian or Pacific Islander •White •I prefer not to disclose |
Satisfaction 1 |
I would refer the Hotline to someone I know who is in need of support and services… |
Rating |
YES |
Respondent |
• Strongly Disgree • Disagree • Neutral • Agree • Strongly Agree |
Satisfaction 2 |
I am satisfied with the service I received today… |
Rating |
YES |
Respondent |
• Strongly Disgree • Disagree • Neutral • Agree • Strongly Agree |
Referral Source |
How did you hear about the hotline? |
Single Selection |
YES |
Respondent |
• PSI/PSI Helpline • HRSA Home Visiting/Healthy Start • Word of Mouth • TV/Radio/Social Media • Healthcare/Medical Provider • Social Services/Human Services Provider • Internet/Search Engine • Billboard •Other |
Satisfaction 3 |
I am satisfied with the professionalism and friendliness of the Hotline Counselor I interacted with… |
Rating |
YES |
Respondent |
• Strongly Disgree • Disagree • Neutral • Agree • Strongly Agree |
Quality 1 |
Optional, what can the National Maternal Mental Health Hotline do to better serve your needs? |
Free Text |
NO |
Respondent |
|
Quality 2 |
Did you receive a resource or referral?
|
Single Selection |
YES |
Respondent |
• Yes, I received • No, I did not receive • No, I declined |