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Demographics Form For Adults

0 Shared Subjects

N/A
Clinical Assessments
Demographics
07/23/2020
demosfor01
08/30/2023
View Change History
01
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY
interview_age Integer Required Age in months at the time of the interview/test/sampling/imaging. 0::1440 Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported gender
iba_marital Integer Recommended What is your current marital/relationship status? 1::8;77;88;-99 1= Single, Never Married; 2= Married or Living with a Partner; 3= Separated; 4 =Divorced; 5= Widowed; 6 = Cohabitating; 7 = Steady partner, unmarried and not living together; 8 = Other relationship status; 77= Refused; 88= Missing; -99= NA b2_marital
demo_child Integer Recommended Do you have any children living at home?
0;1
0 = No; 1 = Yes
children_household Integer Recommended Number children household
child1_age String 100 Recommended Other Child in Household 1 Age 0-4 years; 5-8 years; 9-12 years; 13-17 years; 18+ years
child2_age String 100 Recommended Other Child in Household 2 Age 0-4 years; 5-8 years; 9-12 years; 13-17 years; 18+ years
child3_age String 100 Recommended Other Child in Household 3 Age 0-4 years; 5-8 years; 9-12 years; 13-17 years; 18+ years
child4_age String 100 Recommended Other Child in Household 4 Age 0-4 years; 5-8 years; 9-12 years; 13-17 years; 18+ years
child5_age String 100 Recommended Other Child in Household 5 Age 0-4 years; 5-8 years; 9-12 years; 13-17 years; 18+ years
child6_age String 100 Recommended Other Child in Household 6 Age 0-4 years; 5-8 years; 9-12 years; 13-17 years; 18+ years
demof_05 Integer Recommended Which of the following would be considered your race of origin or descent (check all that apply)? 1::16 1 = Mexican, Mexican American, Chicano; 2 = Puerto Rican; 3 = Cuban; 4 = White; 5 = Black, African-American; 6 = American Indian or Alaska Native; 7 = Asian Indian ; 8 = Chinese; 9 = Filipino; 10 = Japanese; 11 = Korean; 12 = Vietnamese; 13 = Native Hawaiian; 14 = Guamanian or Chamorro; 15 = Samoan; 16 = other _
otherrace String 100 Recommended specify other race The following questions are about you or the child's family.
demof_06 Integer Recommended Which of the following races do you primarily identify with (check 1::16 1 = Mexican, Mexican American, Chicano; 2 = Puerto Rican; 3 = Cuban; 4 = White; 5 = Black, African-American; 6 = American Indian or Alaska Native; 7 = Asian Indian ; 8 = Chinese; 9 = Filipino; 10 = Japanese; 11 = Korean; 12 = Vietnamese; 13 = Native Hawaiian; 14 = Guamanian or Chamorro; 15 = Samoan; 16 = other _
race_other String 100 Recommended Race of Respondent Specify
country_origin String 100 Recommended Country of Origin
demof_08 Integer Recommended What is your current employment status (check one)? 1::8 1 = Homemaker; 2 = Disabled; 3 = Unemployed; 4 = Retired; 5= Student; 6 = Currently working full-time; 7 = Currently working part-time; 8 = Other
employotr String 200 Recommended Employment situation other, specify
demof_09 Integer Recommended What is the current employment status of your spouse/partner (check one)? 1::8 1 = Homemaker; 2 = Disabled; 3 = Unemployed; 4 = Retired; 5= Student; 6 = Currently working full-time; 7 = Currently working part-time; 8 = Other
demo_partner_emp_status String 100 Recommended Spouse/partner employment status Not employed; Employed part-time; Employed full-time; Full-time student;Part-time student; Other NYU DEMOGRAPHICS: Full-time working is 35 or more hours a week. Part-time working is less than 35 hours a week. Full-time student is 3 or more classes per semester. Part-time student is 1 or 2 classes per semester.
occupation_employed_hours Float Recommended How many hours do you [patient] typically work per week? Hours/week
demof_11 String 15 Recommended How many weeks did you work last year?
demof_12a Integer Recommended Have you worked for pay in the past 30 days?
0;1
1 = Yes; 0 = No
demof_12b Integer Recommended During the last 30 days, how many whole days of work have you missed because you were sick or injured?
demof_12c Integer Recommended During the last 30 days, how many whole days of work have you missed for other reasons?
demof_12d Integer Recommended During the past 30 days, how many times have you arrived late to work or had to leave early for any reasons?
demof_13 Integer Recommended What is the highest grade you finished in school (check one)? 1::9;999 1 = 1-8 grades (Grade school); 2 = 9-11 grades (High school); 3 = High school graduate (12th grade); 4 = GED; 5 = Some college; 6 = Junior/2-year college degree (e.g., Associate degree); 7 = College/4-year degree (B.A./B.S.); 8 = Some post-college work; 9 = Advanced degree (Ph.D., M.D., M.S.W.); 999= Prefer not to respond
srcwages Integer Recommended source of income wages 0;1;-7 0=No; 1=Yes; -7=Refused
demof_14b Integer Recommended Do you or anyone in your household receive income from investments? 0;1;-7 0=No; 1=Yes; -7=Refused
demof_14c Integer Recommended Do you or anyone in your household receive income from pensions? 0;1;-7 0=No; 1=Yes; -7=Refused
support_alimony Integer Recommended Income received through Child Support or Alimony 0;1 0=No; 1=Yes
srcssi Integer Recommended sources of income ssi 0;1;-7 0=No; 1=Yes; -7=Refused
srcssdi Integer Recommended sources of income ssdi 0;1;-7 0=No; 1=Yes; -7=Refused
srcwlfar Integer Recommended sources of income welfare 0;1;-7 0=No; 1=Yes; -7=Refused
demof_14d Integer Recommended Do you or anyone in your household receive income from food stamps? 0;1;-7 0=No; 1=Yes; -7=Refused
demof_14e Integer Recommended Do you or anyone in your household receive income from a rent supplement (e.g., HUD) 0;1;-7 0=No; 1=Yes; -7=Refused
demof_19 Integer Recommended For your blood relatives (parents or siblings or children only), check one of the following: 1::3 1 = ALCOHOL PROBLEMS if any blood relatives have experienced at least 1 of these problems; 2 = NO ALCOHOL PROBLEMS if all blood relatives haven?t had any of these drinking related problems; 3 = DON?T KNOW if you don?t know whether any blood relatives have experienced at least one of these problems
demof_20 Integer Recommended For other blood relatives (grandparents, grandchildren, uncles, aunts, nieces, nephews, half-siblings), check one of the following. Remember to only include relatives related by blood, not relatives who are related to you by marriage or adoption. Check one of the following: 1::3 1 = ALCOHOL PROBLEMS if any blood relatives have experienced at least 1 of these problems; 2 = NO ALCOHOL PROBLEMS if all blood relatives haven?t had any of these drinking related problems; 3 = DON?T KNOW if you don?t know whether any blood relatives have experienced at least one of these problems
demof_15 Integer Recommended How much are your yearly wage earnings before taxes (check one)? 1::9 1 = Less than $5,000; 2 = $5,000 - $ 9,999; 3 = $10,000 - $14,999; 4 = $15,000 - $19,999; 5 = $20,000 - $39,999; 6 = $40,000 - $59,999; 7 = $60,000 - $79,999; 8 = $80,000 - $100,000; 9 = $Over $100,000
demof_16 Integer Recommended How much are your spouse/partner?s yearly wage earnings, before taxes (check one)? 1::9 1 = Less than $5,000; 2 = $5,000 - $ 9,999; 3 = $10,000 - $14,999; 4 = $15,000 - $19,999; 5 = $20,000 - $39,999; 6 = $40,000 - $59,999; 7 = $60,000 - $79,999; 8 = $80,000 - $100,000; 9 = $Over $100,000
demof_17 Integer Recommended What is your family?s total yearly income (from all sources - Wages/salary; Investments/real estate; Pensions; Child support/alimony; Social Security (SSA or SSI); Social Security Disability (SSDI); Welfare (State welfare[SAGA], temporary aid to need families [TANF]); Food stamps; Rent supplement (e.g., HUD) before taxes (check one)? 1::9 1 = Less than $5,000; 2 = $5,000 - $ 9,999; 3 = $10,000 - $14,999; 4 = $15,000 - $19,999; 5 = $20,000 - $39,999; 6 = $40,000 - $59,999; 7 = $60,000 - $79,999; 8 = $80,000 - $100,000; 9 = $Over $100,000
demof_18a Integer Recommended What kind of primary health coverage do you have (check one)? 1::4 1 = Medicaid; 2 = Medicare; 3 = Private; 4 = None
demof_18b Integer Recommended If you have health coverage, is it an. 1;2 1 = HM0; 2 = Managed care arrangement
demof_19a Integer Recommended Have any of your blood relatives EVER had what you would call a significant drinking problem? 0;1 0 = No; 1 = Yes
demof_19b Integer Recommended If any of your blood relatives has a drinking problem, has any of the following due to their drinking behavior: 1::6 1 = Legal problems (e.g. traffic violations, disorderly conduct, public intoxication); 2 = Health Problems (e.g., blackouts, DTs, cirrhosis of the liver); 3 = Marital or family problems; 4 = Work problems or difficulties with responsibilities around the house; 5 = Received treatment for alcoholism (e.g., AA, Antabuse, detox); 6 = Social problems, fights, loss of friends
custom_src_id String 30 Recommended Subject ID how it's defined in lab/project (used for source IDs that change depending on timepoint/visit/etc.)
b7_urbanicity Integer Recommended What type of setting do you currently live in? 1 :: 4;888 1= Urban (large city); 2= Suburban (near a large city); 3= Rural town (not near a large city); 4= Rural area (where homes and buildings are far apart); 888= Did Not Answer
hhincome Integer Recommended Annual Household Income 1 :: 14 1= $10,000 or less; 2= $10,001 to 15,000; 3= $15,001 to 20,000; 4= $20,001 to 30,000; 5= $30,001 to 40,000; 6= $40,001 to 50,000; 7= Below $50,000 (unspecified); 8= Income was about $50,000; 9= Above $50,000 (unspecified); 10= $50,001 to 60,000; 11= $60,001 to 80,000; 12= $80,001 to 100,000; 13= $100,001 to 120,000; 14= More than $120,000
whoqol1 Integer Recommended How would you rate your quality of life? 1::5 1=Very poor 2=Poor; 3=Neither poor nor good; 4=Good; 5=Very good
j1_religid Integer Recommended Which of the following categories best describes you today? 1 :: 5;888 1= Atheist, I do not believe in God; 2= Agnostic, I believe we cannot really know about the existence of God; 3= Unsure, I do not know what to believe about God; 4= Spiritual, I believe in God, but I am not religious; 5= Religious, I believe in God and practice a religion; 888= No Response
j4_imprelig Integer Recommended How important is religion in your life? 1 :: 5;888 1= Not At All Important; 2= A Little Important; 3= Somewhat Important; 4= Very Important; 5= Extremely Important; 888= No Response
j5_impspir Integer Recommended How important is spirituality in your life? 1 :: 5;888 1= Not At All Important; 2= A Little Important; 3= Somewhat Important; 4= Very Important; 5= Extremely Important; 888= No Response
whoqol2 Integer Recommended How satisfied are you with your health? 1::5 1=Very dissatisfied; 2=Dissatisfied; 3=Neither satisfied nor dissatisfied; 4=Satisfied; 5=Very satisfied
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

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