National Maternal Mental Health Hotline

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

B_0906-0084_MCHB_Hotline_Data Dictionary_Redline 03052025.xlsx

National Maternal Mental Health Hotline

OMB: 0906-0084

Document [xlsx]
Download: xlsx | pdf

Overview

Hotline Interaction
Post Conversation Survey


Sheet 1: Hotline Interaction

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
[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 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

Sheet 2: Post Conversation Survey

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
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