|
subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
|
|
candidateguid, guid, pseudo_guid, subject_key |
|
src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
|
|
case_id, child_id, child_id_full, clinical_barcode, dash_subject_id, demo_study_id, hcpa_id, ibisid, participant_id, participantid, patno, pid, record_id, subject, subject_id |
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
assess_date, assessment_date, assessment_dt, bl_visit_date, chrdemo_interview_date, consentdate, consented_study, date_demographics, date_interview_ses, date_taken, demo_date, demo_rpt_date, interviewdate, intvdate, pds_date, pp_date, profile_date, test_date_tele_screen, testing_date, visit_date |
|
interview_age |
Integer |
|
Required |
Age in months at the time of the interview/test/sampling/imaging. |
0 :: 1260
|
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.
|
age, age_demo, age_months, bslage, ch_age, childs_age, chrdemo_age_mos2, pubc1, pubp1, test_age, total_age_in_months |
|
sex |
String |
20
|
Required |
Sex of subject at birth |
|
M = Male; F = Female; O=Other; NR = Not reported
|
cbcl_informant_gender, ch_sex, demo_sex, dm1, gender, pds_sex_y, sex, sex_at_brith, sex_dem, sexbirth, sexdesc |
Query
|
study_id |
Integer |
|
Recommended |
Study ID number |
|
46=Acute Phase; 47=Stabilization Phase
|
|
Query
|
groups |
Integer |
|
Recommended |
Group |
|
0=Control; 1=Case
|
arm, condition, group |
Query
|
matched_pair |
String |
30
|
Recommended |
Matched Pair |
|
|
|
Query
|
record_ses_f |
Integer |
|
Recommended |
Record Status |
1::7
|
1= Done ; 2= Not Done ; 3= Withdrawn ; 4= Skipped/Missing ; 5= Deceased ; 6= Site could not reach subject ; 7= Refused
|
record_status_a |
Query
|
ethnicity |
String |
30
|
Recommended |
Ethnicity of participant |
|
|
de05am, demo2, demo_ethnicity, ethn, ethnic, ethnic_category, hispanic, hispanic_par, p_latino, sub_ethnicity |
Query
|
race |
String |
30
|
Recommended |
Race of study subject |
|
|
demo3, demo_race, demog_04, race_category, race_ethnicity, race_par |
|
ethnic_group |
String |
255
|
Recommended |
Ethnic group |
|
|
if_yes_ask_for_clarificati, other_race |
Query
|
bio_parent |
Integer |
|
Recommended |
Are you a biological parent to the child |
0;1; -99; 88; 77
|
0=No; 1=Yes; -99= N/A ; 88= Missing ; 77= Refused
|
|
Query
|
bio_parent2 |
Integer |
|
Recommended |
6.a. If yes= which parent are you? |
1;2;-999
|
1= Mother ; 2= Father; -999= Missing
|
|
Query
|
relationship |
Integer |
|
Recommended |
Relationship of respondent to individual |
|
1 = Biological mom; 2 = Biological dad; 3 = Grandparent; 4 = Special education (sped) teacher; 5 = General education teacher; 6 = Occupational therapist; 7 = Speech and language therapist; 8 = Behavioral therapist; 9 = Paraprofessional; 10 = Aide; 11 = Principal; 12 = Administrator; 14 = Content teacher; 15 = Parent center director; 16 = Self; 17=Adoptive mother; 18=Adoptive father; 19=Foster mother; 20 = Foster father; 21=Grandmother; 22=Grandfather; 23=Step-mother; 24 = Step-father; 25=Aunt; 26=Uncle; 28=Both parents;31= Grandmother from mother side; 32= Grandfather from mother side; 33= Grandmother from father side; 34= Grandfather from father side; 36= Brother; 37= Sister; 38= Cousin; 39= female caregiver; 40=male caregiver; 41=Female child; 42=Male child; 43=Spouse/Mate; 44=Friend; 45=Parent; 46=Significant other; 47=Sibling; 48=Son/Daughter; 49=Son-in-law/Daughter-in law; 50=Other Relative; 51=Paid caregiver; 52=Friends; 53=Roommate; 54=Supervisor; 55=mother's boyfriend; 56=other parental figure; 57=Summary; 58=counselor ; 59 = other female relative; 60 = other male relative; 61 = non-relative ; 62=Maternal Aunt; 63=Maternal Uncle; 64=Maternal Cousin; 65 = Paternal Aunt; 66=Paternal Uncle; 67=Paternal Cousin ; 68=Biological/Adoptive Mother and Grandmother; 69=Biological/Adoptive Mother and Stepmother and Grandmother; 70=Biological/Adoptive Mother and Grandmother and Foster Father; 71=Biological/Adoptive Mother and Stepmother and Foster Mother; 72=Biological/Adoptive Mother and Foster Mother; 73=Biological/Adoptive Mother and Biological/Adoptive Father; 74=Biological/Adoptive Mother and Stepmother and Biological/Adoptive Father; 75=Biological/Adoptive Mother and Other; 76=Biological/Adoptive Mother and Stepmother and Stepfather; 77=Biological/Adoptive Mother and Stepfather; 78=Biological/Adoptive Mother and Grandfather; 79=Biological/Adoptive Mother and Stepmother and Foster Father; 80=Biological/Adoptive Mother and Stepmother; 81=Guardian, female; 82=Other female; 83=Guardian, male; 84=Other male; 85=Other/Grandparent/Nanny; 86 = Mother, Father, Guardian; 87 = Daughter, son, grandchild; 88 = Professional (e.g., social worker, nurse, therapist, psychiatrist, or group home staff); -999=Missing; 89 = Biological parent; 90=Other; 91 = Stepparent; 92 = Adoptive parent; 93 = Foster parent; 94 = Co-worker
|
|
|
relation_specify |
String |
20
|
Recommended |
Relation Other Specify |
|
|
cbcl_informant_relation, demo_completed_by, parent_relationship, parstatus_5_text |
Query
|
length_time |
Integer |
|
Recommended |
6.b.1. How long have you been the main caregiver for this child? |
1::4;-999
|
1= Less than 1 year ; 2= 1-2 years ; 3= 3 - 4 years ; 4= 5 years or more; -999= Missing
|
|
Query
|
record_status_b |
Integer |
|
Recommended |
Record Status Section B |
1::7
|
1= Done ; 2= Not Done ; 3= Withdrawn ; 4= Skipped/Missing ; 5= Deceased ; 6= Site could not reach subject ; 7= Refused
|
|
Query
|
bio_mother_ethnicity |
String |
50
|
Recommended |
Biological Mother Ethnicity |
|
|
de01am, mother_ethnicity |
Query
|
bio_mother_race |
String |
150
|
Recommended |
Biological Mother Race |
|
|
mother_race |
|
mother_other_race |
String |
50
|
Recommended |
Mother Other race (please specify): |
|
|
de01bm |
Query
|
acting_mother |
Integer |
|
Recommended |
5. Who is the person now acting as (child)'s mother? |
1::7;90;-999
|
1= Biological mother ; 2= Grandmother ; 3= Stepmother ; 4= Aunt ; 5= Sister ; 6= Cousin ; 7= Friend ; 90= Other= specify; -999= Missing
|
|
|
act_mother_specify |
String |
30
|
Recommended |
Acting Mother Other= specify |
|
|
|
Query
|
bio_mother_education |
String |
75
|
Recommended |
Biological Mother Highest level of education |
|
Less than High School;High School Degree;GED; Less than 7th Grade; Jr. High School; Some High School; Some College;Associates Degree;Bachelors Degree;Some Graduate Work;Graduate Degree; Never attended school ; Primary/all age/ Jnr. Secondary ; Secondary/High/Technical ; H.E.A.R.T/ Vocational ; Tertiary College/University ; Other tertiary- specify ; Other education-specify;99= D/K ; 77= N/A; 999= Missing
|
mother_edu1 |
Query
|
mothertert_specify1 |
String |
30
|
Recommended |
Mother Other tertiary= specify |
|
|
|
|
motheredu_specify1 |
String |
100
|
Recommended |
Mother Other education= specify |
|
|
de010m, demo_mat_edu, educ_m |
Query
|
mother_edu2 |
Integer |
|
Recommended |
7. What is the highest level of school completed or highest degree completed of the person now acting as the child?s mother? (child) was born? |
1::7;77;99;-999
|
1= Never attended school ; 2= Primary/all age/ Jnr. Secondary ; 3= Secondary/High/Technical ; 4= H.E.A.R.T/ Vocational ; 5= Tertiary College/University ; 6= Other tertiary= specify ; 7= Other education= specify ; 99= D/K ; 77= N/A; -999= Missing
|
|
|
mothertert_specify2 |
String |
20
|
Recommended |
Mother Other tertiary= specify |
|
|
|
|
motheredu_specify2 |
String |
20
|
Recommended |
Mother Other education= specify |
|
|
|
Query
|
bio_father_ethnicity |
String |
50
|
Recommended |
Biological Father ethnicity (Hispanic or Latino, Not Hispanic or Latino, No Answer) |
|
|
de03am, father_ethnicity |
Query
|
bio_father_race |
String |
150
|
Recommended |
Biological Father Race |
American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported
|
|
father_race |
|
father_other_race |
String |
35
|
Recommended |
Father Other race (please specify): |
|
|
de03bm |
Query
|
bio_father_education |
String |
75
|
Recommended |
Biological Father Highest level of education |
|
Less than High School;High School Degree;GED; Less than 7th Grade; Jr. High School; Some High School; Some College;Associates Degree;Bachelors Degree;Some Graduate Work;Graduate Degree; Never attended school ; Primary/all age/ Jnr. Secondary ; Secondary/High/Technical ; H.E.A.R.T/ Vocational ; Tertiary College/University ; Other tertiary- specify ; Other education-specify;99= D/K ; 77= N/A; 999= Missing
|
father_edu1 |
|
fathertert_specify1 |
String |
20
|
Recommended |
Father Other tertiary= specify |
|
|
|
|
fatheredu_specify1 |
String |
200
|
Recommended |
Father Other education= specify |
|
|
de011m, demo_pat_edu, educ_f |
Query
|
father_edu2 |
Integer |
|
Recommended |
13. What is the highest level of school completed or highest degree completed of the person now acting as the child?s Father? (child) was born? |
1::7;77;99;-999
|
1= Never attended school ; 2= Primary/all age/ Jnr. Secondary ; 3= Secondary/High/Technical ; 4= H.E.A.R.T/ Vocational ; 5= Tertiary College/University ; 6= Other tertiary= specify ; 7= Other education= specify ; 99= D/K ; 77= N/A; -999= Missing
|
|
|
fathertert_specify2 |
String |
20
|
Recommended |
Father Other tertiary= specify |
|
|
|
|
fatheredu_specify2 |
String |
20
|
Recommended |
Father Other education= specify |
|
|
|
Query
|
maritals_p |
Integer |
|
Recommended |
14. Parents' Marital Status: |
1::8;77;90;-999
|
1= Visiting relationship ; 2= Common law union ; 3= Married ; 4= Divorced ; 5= Separated ; 6= No relationship ; 7= Widow/widower; 8 = Never married ; 90= Other= specify ; 77= N/A; -999= Missing
|
what_is_the_current_relati |
|
other_marital_specify |
String |
150
|
Recommended |
Parents' Marital Status Other specify |
|
|
if_other_please_explain |
Query
|
motherfigures |
Integer |
|
Recommended |
15. How many mother figures has the (child) had since birth? |
1::4;77;99;-999
|
1= 1 ; 2= 2 ; 3= 3 ; 4= >3 ; 99= D/K ; 77= N/A ; -999= Missing
|
|
Query
|
fatherfigures |
Integer |
|
Recommended |
16. How many father figures has the (child) had since birth? |
1::4;77;99;-999
|
1= 1 ; 2= 2 ; 3= 3 ; 4= >3 ; 99= D/K ; 77= N/A ; -999= Missing
|
|
Query
|
under18_household |
Integer |
|
Recommended |
17. How many people living in (child)'s household are under 18 years old? |
1;99;77;-999
|
1= Number of people ; 99= D/K ; 77= N/A; -999= Missing
|
childhome |
Query
|
children_household |
Integer |
|
Recommended |
Number children household |
|
|
children, demog_05, dependent_num |
Query
|
older18_household |
Integer |
|
Recommended |
18.How many people living in (child)'s household are older than 18 years? |
1;99;77;-999
|
1= Number of people ; 99= D/K ; 77= N/A; -999= Missing
|
adulthome |
Query
|
adults_household |
Integer |
|
Recommended |
Number adults in household |
|
|
|
Query
|
major_earner |
Integer |
|
Recommended |
19. What is the relationship of the head of the household (major earner) to (child)? |
1::8;90;-999
|
1= Mother ; 2= Father ; 3= Grandparent ; 4= Stepparent ; 5= Aunt/ Uncle ; 6= Sibling ; 7= Cousin ; 8 = Partner; 90= Other= specify; -999= Missing
|
|
Query
|
major_earn_other_sp |
String |
200
|
Recommended |
Major earner Other= specify |
|
|
major_earner_other_specify |
Query
|
tv |
Integer |
|
Recommended |
20.1. Television set |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
cable |
Integer |
|
Recommended |
20.2. Cable/Satellite connection |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
refrig |
Integer |
|
Recommended |
20.3. Refrigerator |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
freezer |
Integer |
|
Recommended |
20.4. Freezer |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
livingroomset |
Integer |
|
Recommended |
20.5. Living room set |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
radio |
Integer |
|
Recommended |
20.6. Radio |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
stereo |
Integer |
|
Recommended |
Stereotyped/Idiosyncratic Use of Words or Phrases |
0;1;2;3;8
|
0=rarely or never uses stereotyped or idiosyncratic words or phrases.;1=use of words or phrases tends to be more repetitive than most children at the same level of complexity, but not obviously odd. OR occasional stereotyped utterances or use of odd words or use of phrases in an unusual way, with other flexible spontaneous language as well.;2=often uses stereotyped utterances or odd words or phrases with some other language.;3=phrases almost exclusively odd or stereotyped utterances.;8=N/A, no phrase speech.
|
|
Query
|
washingmachine |
Integer |
|
Recommended |
20.8. Washing machine |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
cars |
Integer |
|
Recommended |
20.9. Cars or other vehicles |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
telephone |
Integer |
|
Recommended |
20.10. Telephone/Cell-phone |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
generator |
Integer |
|
Recommended |
20.11. Generator |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
water_heater_electric |
Integer |
|
Recommended |
20.12. Water heater (electric) |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
water_heater_solar |
Integer |
|
Recommended |
20.13. Water heater (solar) |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
water_tank |
Integer |
|
Recommended |
20.14. Water tank |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
airconditioners |
Integer |
|
Recommended |
20.15. Air conditioners |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
internet_connection |
Integer |
|
Recommended |
20.16. Internet connection |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
computers |
Integer |
|
Recommended |
20.17. Computers/Tablets |
0;1;77;99;-999
|
1= Yes ; 0= No ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
home_owned |
Integer |
|
Recommended |
21.a. House - It is owned by you (or someone in the household) |
1;2;99;-999
|
1= Yes ; 2= No ; 99= D/K; -999= Missing
|
|
Query
|
home_rented |
Integer |
|
Recommended |
21.b. House - It is rented by you (or someone in the household) |
1;2;99;-999
|
1= Yes ; 2= No ; 99= D/K; -999= Missing
|
|
Query
|
home_occupied |
Integer |
|
Recommended |
21.c. House - It is occupied without any payments |
1;2;99;-999
|
1= Yes ; 2= No ; 99= D/K; -999= Missing
|
|
Query
|
toilet |
Integer |
|
Recommended |
22. What type of toilet facilities does (child)'s family use at home? |
1::5;90;77
|
1= Pit latrine= shared ; 2= Pit latrine (unshared) in yard ; 3= Water closet (flush type)= shared ; 4= Water closet (flush type)= unshared ; 5= None ; 90= Other= specify ; 77= N/A
|
|
|
toiletother_specify |
String |
20
|
Recommended |
Toilet facilities- Other= specify |
|
|
|
Query
|
cookingfuel |
Integer |
|
Recommended |
23. What is the main source of cooking fuel at (child)'s house? |
1::5;90;99;77;-999
|
1= Wood ; 2= Coal ; 3= Kerosene ; 4= Gas ; 5= Electric ; 90= Other= specify ; 99= D/K ; 77= N/A; -999= Missing
|
|
|
cookfuelother_specify |
String |
20
|
Recommended |
Cooking fuel - Other= specify |
|
|
|
Query
|
house_water_piped |
Integer |
|
Recommended |
24. Is water piped into the house? |
1;2;-999
|
1= Yes ; 2= No; -999= Missing
|
|
Query
|
house_rooms |
Integer |
|
Recommended |
25. How many rooms in (child)'s house are used for sleeping? |
1;99;77;-999
|
1= Number of rooms ; 99= D/K ; 77= N/A; -999= Missing
|
|
Query
|
rooms |
Integer |
|
Recommended |
Number Rooms |
|
|
|
Query
|
sd27d |
Integer |
|
Recommended |
Use of psychoactive substances in past 3 months: Methamphetamine |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd27g |
Integer |
|
Recommended |
Use of psychoactive substances in past 3 months: Hallucinogens |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd27h |
Integer |
|
Recommended |
Use of psychoactive substances in past 3 months: Street opioids |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd27i |
Integer |
|
Recommended |
Use of psychoactive substances in past 3 months: Prescription opioids |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd29 |
Integer |
|
Recommended |
Do you have a smartphone? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd30 |
Integer |
|
Recommended |
Do you use the Internet |
0;1
|
0 = No; 1 = Yes
|
|
|
nsmos27 |
String |
100
|
Recommended |
Where was patient hospitalized, in what institution? |
|
|
|
|
fsprg |
String |
150
|
Recommended |
In your own words, to which race(s) or racial group(s) do you belong? |
|
|
de05bm, p_race, race_other, race_other_par |
|
bkgrnd_education |
String |
1,020
|
Recommended |
Subject's education (school and preschool) |
|
|
b5, cbcl_grade_in_school, demo_childs_edu, demog_07, dm15, education, education_status, education_subject, education_years, p_grade, participant_education, socio_5, sub_grade |
|
area4_explain |
String |
255
|
Recommended |
Employment situation? Explain briefly |
|
|
activity_par, demog_08, employment, occstat_7_text, occup_other, p_job, sub_job |
|
jobh |
String |
150
|
Recommended |
job title |
|
|
occup, p_work, sub_work |
Query
|
thous |
Integer |
|
Recommended |
Total number of persons in household |
|
0=Does not apply (e.g., in institution), 99=unknown
|
socio_6 |
|
das1ms |
String |
200
|
Recommended |
Marital status |
|
|
b3, dm9, marital_other, marital_stat, marital_status, p_marriage, socio_4, sub_marriage |
|
aut_prebasic_insure99 |
String |
255
|
Recommended |
What type(s) of health insurance do you have? |
|
|
|
Query
|
epino |
Integer |
|
Recommended |
Number of MDEs |
|
|
|
Query
|
cmed_antidepressant |
Integer |
|
Recommended |
Current med: antidepressant |
0;1
|
0=no; 1=yes
|
|
Query
|
asap10c |
Integer |
|
Recommended |
outside clinicians/services: Outside psychotherapy for patient |
0;1
|
0 = No;1 = Yes
|
child_out_psych_cur |
|
mb_21 |
String |
10
|
Recommended |
Any self-help group like Alcoholics Anonymous or peer counseling |
Yes; No
|
Outpatient services
|
|
Query
|
alcohol_medication |
Integer |
|
Recommended |
Alcohol Abuse/Dependence: Medication for symptoms |
0;1;-7;-8;-9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
|
|
ksads_21_134_p |
String |
30
|
Recommended |
Symptom - History of traumatic event Present |
|
|
|
Query
|
ksads_ptsd_totalt_1b |
Integer |
|
Recommended |
Number of traumas reported |
|
|
|
Query
|
dawba_e1 |
Integer |
|
Recommended |
Post-Traumatic Stress - has this ever happened? |
0; 1
|
0 = No; 1 = Yes
|
|
Query
|
demo_fam_depression |
Integer |
|
Recommended |
Family Member Depression |
0;1
|
1=Yes; 0=No
|
|
Query
|
deppar |
Integer |
|
Recommended |
Parent history depression |
0;1
|
0=Not checked; 1=Checked
|
|
Query
|
depsib |
Integer |
|
Recommended |
Sibling history depression |
0;1
|
0=Not checked; 1=Checked
|
|
|
major_depression_diagnosis |
String |
10
|
Recommended |
FIGS Y1: Major depressive disorder (N=no diagnosis for any first degree relative; Y=positive lifetime diagnosis for one or more first degree relatives) |
N;Y
|
N = No diagnosis for any first degree relative; Y = Positive lifetime diagnosis for one or more first degree relatives
|
|
Query
|
mental_ill |
Integer |
|
Recommended |
Do you have a family history of mental illness? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
fhi_df_panc_any |
Integer |
|
Recommended |
Family History: Panic or Anxiety Disorder Any |
0;1
|
0=No; 1= Yes
|
|
Query
|
mini_manic1 |
Integer |
|
Recommended |
Manic and Hypomanic: family history of manic depressive illness or bipolar disorder or any member who had mood swigs treated with medication |
0;1;-9997; -9999
|
0=No; 1=Yes;-9997=Not applicable; -9999=Missing
|
|
|
quesmoth_probhighbp |
String |
50
|
Recommended |
Hypertension (High blood pressure) |
Yes;No;Don't Know
|
|
|
Query
|
diab |
Integer |
|
Recommended |
Charlson Comorbidity: have diabetes (high blood sugar) |
0;1
|
0=No; 1=Yes
|
|
Query
|
mhxa7b |
Integer |
|
Recommended |
Other pulmonary disease |
0;1
|
0=No; 1=Yes
|
|
Query
|
wk_arthritis |
Integer |
|
Recommended |
3. Arthritis |
0;1
|
No = 0; Yes = 1;
|
|
Query
|
baseline_k_007 |
Integer |
|
Recommended |
Chronic pain, like headaches, joint pain, neck pain, or back pain that you experience frequently |
0;1; -888; -999
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
|
|
asdos |
String |
100
|
Recommended |
Specify comorbid other |
|
|
|
Query
|
smq3 |
Integer |
|
Recommended |
Smoking or tobacco use history |
1::8
|
1 = Never used, not even a single puff2 = Smoked once or twice, but not in the last month3 = Do not smoke, but in the past I was a regular smoker4 = Smoked regularly but no more than once a month5 = Smoked regularly but no more than once a week6 = Smoked regularly and more than once a week; 7 = current smoker; 8 = Past Smoker
|
|
Query
|
pesq25b |
Integer |
|
Recommended |
Question 25 Subquestion. Indicate whether you have used the drug at least once during the past three months: cocaine? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
pesq25i |
Integer |
|
Recommended |
Question 25 Subquestion. Indicate whether you have used the drug at least once during the past three months: inhalants? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
pesq25f |
Integer |
|
Recommended |
Question 25 Subquestion. Indicate whether you have used the drug at least once during the past three months: tranquilizers? |
0;1
|
0 = No; 1 = Yes
|
|
|
behavobs_referralreason |
String |
255
|
Recommended |
Reason for Referral/Presenting Complaint(s) |
|
|
|
Query
|
phq |
Float |
|
Recommended |
Sum Of PHQ 1-9 |
|
(Patient Health Questionnaire) 1-9
|
|
Query
|
alcq |
Integer |
|
Recommended |
Sum of Alcohol Use Items |
|
|
|
Query
|
ec36 |
Integer |
|
Recommended |
Exclusion criteria EC36: Does the patient have a past or current diagnosis of psychotic disorder, including schizophrenia-spectrum disorder, psychotic major depression, or an organic psychotic disorder? |
0::2
|
0 = No; 1 = Yes; 2 = Not Assessed
|
|
|
scid5_dis1_other_icd10 |
String |
10
|
Recommended |
ICD10 code |
|
|
|
Query
|
ad42 |
Integer |
|
Recommended |
ALCOHOL DEPENDENCE. Withdrawal, as manifested by either of the following: 1) The characteristic withdrawal syndrome for alcohol (Criteria A and B). 2) Alcohol or sedatives taken to relieve or avoid withdrawal symptoms. |
0;1
|
0=no; 1 = Yes
|
|
|
sd08 |
String |
10
|
Recommended |
What is your official strata (as present in your electric/water service bill)? |
|
|
|
|
sd14 |
String |
25
|
Recommended |
Travel time to interview location |
|
|
|
Query
|
sd15 |
Integer |
|
Recommended |
In the past 12 months did cost keep you from going to this health center? |
|
0 = No; 1 = Yes
|
|
Query
|
sd16 |
Integer |
|
Recommended |
How confident are you filling out medical forms? |
1::5
|
1 = Extremely ; 2 = Quite a bit ; 3 = Somewhat ; 4 = A little ; 5 = Not at all
|
|
Query
|
sd17 |
Integer |
|
Recommended |
How often do you have problems learning about your medical conditions because of difficulty understanding written information? |
1::5
|
1 = Never ; 2 = Rarely ; 3 = Sometimes ; 4 = Often ; 5 = Always
|
|
Query
|
sd18 |
Integer |
|
Recommended |
How often do you have someone help you read materials at the clinic, doctor's office, or hospital? |
1::5
|
1 = Never ; 2 = Rarely ; 3 = Sometimes ; 4 = Often ; 5 = Always
|
|
Query
|
sd21c |
Integer |
|
Recommended |
Displacement due to violence |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd23 |
Integer |
|
Recommended |
Family history of alcohol use disorder (general) |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd23a |
Integer |
|
Recommended |
Family history of alcohol use disorder: Parents |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd23b |
Integer |
|
Recommended |
Family history of alcohol use disorder: Siblings |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd23c |
Integer |
|
Recommended |
Family history of alcohol use disorder: 1st-degree relatives |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd24d |
Integer |
|
Recommended |
Family history of mental illness: Schizophrenia |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd25a |
Integer |
|
Recommended |
Comorbidity: General |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd25c |
Integer |
|
Recommended |
Comorbidity: Cardiac disease |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd25f |
Integer |
|
Recommended |
Comorbidity: Migraine |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd25g |
Integer |
|
Recommended |
Comorbidity: Obesity |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd25h |
Integer |
|
Recommended |
Comorbidity: Epilepsy |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd27a |
Integer |
|
Recommended |
Use of psychoactive substances in past 3 months: Cannabis |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
sd27c |
Integer |
|
Recommended |
Use of psychoactive substances in past 3 months: Prescription stimulants |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
ca243 |
Integer |
|
Recommended |
What handedness do you consider yourself? |
1::3
|
1=Right; 2=Left; 3=Mixed
|
handedness, r_l_b, sub_handedness |
|
language |
String |
50
|
Recommended |
Language Spoken at Home |
|
|
demo_prim_lang |
|
dem_2lang_other |
String |
50
|
Recommended |
Second Language: Other, Specify |
|
|
demo_secondary_language |
|
bio_mother_marital_status |
String |
50
|
Recommended |
Biological Mother Marital Status |
Single;Married;Divorced;Divorced and Remarried;Widowed;Separated; Never Married; Other;Living with Partner
|
|
demo_maternal_mari |
|
bio_father_marital_status |
String |
50
|
Recommended |
Biological Father Marital Status |
Single;Married;Divorced;Divorced and Remarried;Widowed;Separated; Never Married; Other;Living with Partner
|
|
demo_patern_mari |
|
version_form |
String |
121
|
Recommended |
Form used/assessment name |
|
|
|
|
fspgod |
String |
70
|
Recommended |
Subject's gender OTHER describe |
|
|
dm2, gender_other, gender_other_par, p_gender, p_gender_different, sub_gender |
|
ch_race |
String |
55
|
Recommended |
Child's/study subject Race specify |
|
|
cbcl_race, race_multipleraces, race_other_specify |
|
currgradelevel |
String |
50
|
Recommended |
Current grade level |
|
|
grade_in_school, particpant_grade_level |
Query
|
eversped |
Integer |
|
Recommended |
Ever: Any other special education class? |
1;2
|
1=No; 2=Yes
|
|
|
asisped |
String |
200
|
Recommended |
Specify special education services |
|
|
|
|
chf_07 |
String |
250
|
Recommended |
Type of psychotherapy |
|
|
|
|
medication1_name |
String |
500
|
Recommended |
Name first medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
|
|
medication2_name |
String |
500
|
Recommended |
Name second medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
|
|
medication3_name |
String |
500
|
Recommended |
Name third medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
|
|
medication4_name |
String |
500
|
Recommended |
Name fourth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
|
|
medication5_name |
String |
500
|
Recommended |
Name fifth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
|
|
medication6_name |
String |
500
|
Recommended |
Name sixth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
|
|
stdate1 |
String |
20
|
Recommended |
Medication start date 1 |
|
mm/dd/yyyy or write out month year
|
|
|
stdate2 |
String |
20
|
Recommended |
Medication start date 2 |
|
mm/dd/yyyy or write out month year
|
|
|
stdate3 |
String |
20
|
Recommended |
Medication start date 3 |
|
mm/dd/yyyy or write out month year
|
|
|
stdate4 |
String |
20
|
Recommended |
Medication start date 4 |
|
mm/dd/yyyy or write out month year
|
|
|
stdate5 |
String |
20
|
Recommended |
Medication start date 5 |
|
mm/dd/yyyy or write out month year
|
|
|
stdate6 |
String |
20
|
Recommended |
Medication start date 6 |
|
mm/dd/yyyy or write out month year
|
|
|
medication1_dosage |
String |
150
|
Recommended |
First medication dosage |
|
0 = No medication; 999 = Missing
|
|
|
medication2_dosage |
String |
100
|
Recommended |
Second medication dosage |
|
0 = No medication; 999 = Missing
|
|
|
medication3_dosage |
String |
100
|
Recommended |
Third medication dosage |
|
0 = No medication; 999 = Missing
|
|
|
medication4_dosage |
String |
100
|
Recommended |
Fourth medication dosage |
|
0 = No medication; 999 = Missing
|
|
|
medication5_dosage |
String |
100
|
Recommended |
Fifth medication dosage |
|
0 = No medication; 999 = Missing
|
|
|
medication6_dosage |
String |
100
|
Recommended |
Sixth medication dosage |
|
0 = No medication; 999 = Missing
|
|
Query
|
dem_39_emo_hosp |
Integer |
|
Recommended |
Has this child ever been hospitalized due to an emotional or psychological problem? |
0;1
|
1=Yes; 0=No
|
hospitalized, inpatient_psych |
Query
|
hspage |
Integer |
|
Recommended |
Has your child ever been hospitalized because of a behavioral, emotional, or psychiatric problem? If yes, Child's age: |
|
months
|
inpatient_treat_age |
|
insurance |
String |
50
|
Recommended |
child's primary health insurance provider |
|
|
|
Query
|
cg1_age |
Integer |
|
Recommended |
Parent/Caregiver 1 Age, months |
0::1200
|
|
|
|
cg1_occupation |
String |
100
|
Recommended |
Caregiver/Parent 1's Occupation |
|
|
person1_occ_lvl |
|
cg1_relationship_specify |
String |
100
|
Recommended |
Caregiver/Parent 1's Relationship to Participant Other Specify |
|
|
parent_relationship_1 |
|
cg1_race |
String |
100
|
Recommended |
Race of the Caregiver/Parent 1 |
|
|
|
|
cg1_race_specify |
String |
100
|
Recommended |
Race of the Caregiver/Parent 1 Other Specify |
|
|
race_6_text |
|
cg1_ethnicity |
String |
30
|
Recommended |
Caregiver/Parent 1's ethnicity |
|
|
hispanic |
Query
|
cg2_age |
Integer |
|
Recommended |
Parent/Caregiver 2 Age, months |
0::1200
|
|
|
|
cg2_occupation |
String |
100
|
Recommended |
Caregiver/Parent 2's Occupation |
|
|
person2_occ_lvl |
|
cg2_relationship_specify |
String |
100
|
Recommended |
Caregiver/Parent 2's Relationship to Participant Other Specify |
|
|
parent_relationship_2 |
|
cg2_race |
String |
100
|
Recommended |
Race of the Caregiver/Parent 2 |
American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported
|
|
|
|
cg2_race_specify |
String |
50
|
Recommended |
Caregiver2: Specify Other Race |
|
|
|
|
cg2_ethnicity |
String |
30
|
Recommended |
Caregiver/Parent 2's ethnicity |
Hispanic or Latino; Not Hispanic or Latino
|
|
|
|
educational_setting |
String |
50
|
Recommended |
Which of the following best describes [name of child]s most recent school or educational setting? |
|
Public school; Charter school; Private school; Home school program; Early childhood intervention program; Other (specify); Does not currently attend school; Don't Know
|
|
|
cg1_relationship |
String |
100
|
Recommended |
Caregiver/Parent 1's Relationship to Participant |
|
Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother
|
person1_id |
|
cg1_education |
String |
100
|
Recommended |
Caregiver/Prent 1's Highest Level of Education |
|
Some primary school;Some high school;High school diploma;GED;Some college or technical school;Associate degree;Baccalaureate degree;Graduate or professional degree; did not graduate from high school; college graduate; Middle School
|
educ, person1_education |
|
cg2_relationship |
String |
100
|
Recommended |
Caregiver/Parent 2's Relationship to Participant |
|
Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother
|
person2_id |
|
cg2_education |
String |
100
|
Recommended |
Caregiver/Parent 2's Highest Level of Education |
|
Some primary school;Some high school;High school diploma;GED;Some college or technical school;Associate degree;Baccalaureate degree;Graduate or professional degree; did not graduate from high school; college graduate; Middle School
|
person2_education |
Query
|
qaet1 |
Integer |
|
Recommended |
Has your child ever received exposure therapy for mental health concerns? |
0;1
|
0 = No; 1 = Yes
|
|
|
qaet2 |
String |
300
|
Recommended |
If your child has ever received exposure therapy, then describe |
|
|
|
Query
|
qaet3 |
Integer |
|
Recommended |
Has your child ever taken medication for mental health concerns? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
qaet4 |
Integer |
|
Recommended |
Is your child currently taking any medication for mental health concerns? |
0;1
|
0 = No; 1 = Yes
|
|
|
qaet7 |
String |
300
|
Recommended |
If your child has ever been hospitalized because of a behavioral, emotional, or psychiatric problem, specify the reason |
|
|
|
|
qaet8 |
String |
20
|
Recommended |
Does your child have biological family members with a history of any of the following conditions? |
|
1 = OCD ; 2 = Tics/Tourette's ; 3 = Anxiety ; 4 = Depression ; 5 = Drugs/Alcohol ; 6 = Schizophrenia ; 7 = Bipolar Disorder
|
|
|
qaet10 |
String |
100
|
Recommended |
Child's Secondary Insurance Provider |
|
|
|
Query
|
qaet11 |
Integer |
|
Recommended |
Would you say your family is financially better or worse off than other families? |
1::5
|
1 = Much better; 2 = Better; 3 = Same; 4 = Worse/A little worse; 5 = A lot worse
|
|
Query
|
qaet12 |
Integer |
|
Recommended |
Which of these phrases describes best your family's economic status? |
1::5
|
1 = We live very well; 2 = We live comfortably; 3 = We live from check to check; 4 = Almost poor; 5 = Poor
|
|
Query
|
qaet13 |
Integer |
|
Recommended |
Child lives with Caregiver 1 |
1::3
|
1 = Full-time; 2 = Part-time; 3 = Do not live together
|
|
Query
|
qaet14 |
Integer |
|
Recommended |
Child lives with Caregiver 2 |
1::3
|
1 = Full-time; 2 = Part-time; 3 = Do not live together
|
|
Query
|
demog_01 |
Integer |
|
Recommended |
Country of family origin |
1::6
|
1 = Somalia; 2 = Ethiopia; 3 = Sudan; 4 = Eritrea; 5 = Kenya; 6 = Other
|
family_origin |
Query
|
demog_02 |
Integer |
|
Recommended |
Where subject was born |
1::7
|
1 = Somalia; 2 = Ethiopia; 3 = Sudan; 4 = Eritrea; 5 = Kenya; 6 = United States; 7 = Other
|
birth_country |
Query
|
demog_09 |
Integer |
|
Recommended |
Total current household income per year |
1::8
|
1 = $50,000 and up; 2 = $40,001 - 50,000; 3 = $30,001 - 40,000; 4 = $20,001 - 30,000; 5 = $15,001 - 20,000; 6 = $10,001 - 15,000; 7 = $5,001 - 10,000; 8 = $5,000 and less
|
income |
Query
|
fsprels |
Integer |
|
Recommended |
Which category best describes your current relationship status? |
|
1= Single/never married; 2= Married; 3= Living together; 4= Domestic partnership; 5= Separated; 6= Divorced; 7= Widowed; 8= Engaged; 9=Other; 777=Not applicable
|
demog_03, marital_status, rel_status |
Query
|
household_number_in_house |
Integer |
|
Recommended |
Number of people living in primary residence for subject (proband) |
|
|
de019m, demog_06, dm17c, family_size, hh_total, house_size, sub_income_fampl |
Query
|
pubertal_sex_p |
Integer |
|
Recommended |
What sex was your child assigned at birth? ¿Qué sexo le fue asignado a su niño(a) al nacer? |
|
1 = Male Masculino; 2 = Female Femenino
|
childsex |
|
birth_premature |
String |
20
|
Recommended |
Was birth premature? |
|
|
term |
Query
|
fsnumsib |
Integer |
|
Recommended |
How many siblings does your child have? |
|
|
sibling |
|
pad010f |
String |
100
|
Recommended |
What kind of hearing problem did [he/ she] have? (DESCRIBE:) |
|
|
deschear |
Query
|
daycare_yn |
Integer |
|
Recommended |
Does your child attend daycare or some type of child care? |
0::1
|
0 = No; 1 = Yes
|
carestat |
|
premat |
String |
200
|
Recommended |
If child was born prematurely, please note how early: |
|
|
|
Query
|
brthord |
Integer |
|
Recommended |
Is your child the first-born, second-born, etc? - Selected Choice |
0::5
|
0= first-born; 1= second-born; 2= third-born; 3= fourth-born; 4= fifth-born; 5= other
|
|
|
brthord_6_text |
String |
100
|
Recommended |
Is your child the first-born, second-born, etc? - other - Text |
|
|
|
Query
|
hear |
Integer |
|
Recommended |
Does your child have known hearing loss or difficulties? |
0;1
|
0= No; 1= Yes
|
|
Query
|
earinf |
Integer |
|
Recommended |
Has your child had an ear infection in the last six months? |
0;1
|
0= No; 1= Yes
|
|
|
desear |
String |
300
|
Recommended |
If your child has had an ear infection in the last six months, please describe (how many, how severe, treatment). |
|
|
|
|
careloc_6_text |
String |
200
|
Recommended |
If your child attends child care, which best describes the location where he/she spends the most time (please pick only one): - Other (please describe) - Text |
|
|
|
|
carehrs |
String |
200
|
Recommended |
On average, how many hours per week is your child cared for at this location? |
|
|
|
Query
|
numchild |
Integer |
|
Recommended |
number of children |
|
|
|
Query
|
othcare |
Integer |
|
Recommended |
Many families use multiple types of child care. Does your child attend child care other than the one - Selected Choice |
0::5
|
0= Formal child care center (e.g., stand-alone center, or school, or church, etc.); 1= Home-based child care in a non-family member's home; 2= Home-based child care in a family member's home; 3= Caregiver in your own home who is a family member (e.g., older sibling, grandparent, aunt, cousin, etc.); 4= Caregiver in your own home who is not a family member (e.g., nanny, babysitter); 5= Other (please describe)
|
|
|
othcare_6_text |
String |
200
|
Recommended |
Many families use multiple types of child care. Does your child attend child care other than the one - Other (please describe) - Text |
|
|
|
|
othcarhr |
String |
100
|
Recommended |
On average, how many hours per week is your child cared for at this location? |
|
|
|
Query
|
othchnum |
Integer |
|
Recommended |
Approximately how many children (other than your own) also attend care at this location (e.g., # cared for in childcare home, # cared for in your own home, etc.)? |
0::4
|
0= My child is the only one; 1= 1-5 children; 2= 6-10 children; 3= 10-15 children; 4= 16 or more children
|
|
Query
|
employcur |
Integer |
|
Recommended |
current employment status |
1::12;-7
|
1=Full time; 2=Part time for pay; 3=Homemaker; 4=Incarcerated; 5=Disabled; 6=Leave of absence; 7=Unemployed; 8=Retired; 9=Other; 10=Student; 11=Volunteer; -7=Refused; 12 = Maternity leave
|
occstat, p_job1_1, sub_job1_1 |
|
child_nursery_location |
String |
110
|
Recommended |
Where is this child cared for? |
|
|
careloc |
|
custody_other |
String |
250
|
Recommended |
Describe 'other' legal custody |
|
|
custpar |
Query
|
hworked |
Integer |
|
Recommended |
About how many hours a week do/did you usually work? |
|
999 = Missing
|
workhrs |
Query
|
neur1 |
Integer |
|
Recommended |
Is English the patient's first language? |
0;1
|
0=No; 1=Yes
|
natengl |
|
phne_sc_1 |
String |
200
|
Recommended |
1. What is your native language? |
|
|
natlang |
|
nonenglish |
String |
20
|
Recommended |
Non-English language spoken at home |
|
0 = No; 1 = Yes
|
langhome |
|
language_specify |
String |
255
|
Recommended |
Language in the home - Specify if other than standard english |
|
|
lang_otherlanguages, othlang |
|
annual_fam_inc |
String |
200
|
Recommended |
What was your best estimate of the total income of all family members from all sources, before taxes, in last year? PX011101_Annual_Family_Income (Combined family income means your income PLUS the income of all family members living in the household, including cohabitating partners, and armed forces members living at home) |
|
99 = no data; 99999 = Unsure; -999999 = Do Not know or Do not want to say
|
ann_fam_income, de015m, dm17b, family_income, familyincome_par, household_income, income, salary, sub_income_fam |
Query
|
q19_a3 |
Integer |
|
Recommended |
Tanner Stage |
1 :: 5
|
1=pre puberty, 2=early puberty, 3=mid puberty, 4=late puberty, 5=post puberty
|
tannerstage |
|
edu_other |
String |
50
|
Recommended |
Degrees and credentials earned: other |
|
0 = Not applicable
|
education_degree |
Query
|
sh_s1b |
Float |
|
Recommended |
Cumulative GPA - School 1 |
|
|
education_gpa |
Query
|
dem_18b |
Integer |
|
Recommended |
LD dyslexia or learning problems |
|
1=Yes 0=No
|
learning_problem |
Query
|
psy_health |
Integer |
|
Recommended |
Physical health (current) |
1::4
|
1=Excellent (no chronic illness); 2=Good (chronic illness with few or no restrictions); 3=Fair (chronic illness with some restrictions - e.g. epilepsy/can't drive car); 4=Poor (chronic illness with restriction - e.g. exercise intolerance/need to move to Arizona for allergies)
|
health_overall |
|
pre_demo8a |
String |
50
|
Recommended |
Current Residence. Please specify |
|
|
residence |
Query
|
psysoc_92 |
Integer |
|
Recommended |
Months in Military |
0::9999
|
|
service_length |
Query
|
branchofservice |
Integer |
|
Recommended |
Branch of Service |
1::7
|
1=Army; 2=Navy; 3=Air Force; 4=Marines; 5=Coast Guard; 6=Nat. Guard; 7 = Reserves
|
military_branch |
|
blast_injury |
String |
30
|
Recommended |
History of blast exposure or head injury |
|
0 = No; 1 = Yes
|
head_trauma |
Query
|
treatments |
Integer |
|
Recommended |
Number of current treatments |
0::20
|
|
|
|
military_rank_start |
String |
30
|
Recommended |
Starting military rank |
|
|
|
|
military_rank_end |
String |
30
|
Recommended |
Ending military rank |
|
|
|
Query
|
service_era |
Integer |
|
Recommended |
Era of military service |
1::8
|
1=Vietnam theater; 2=Vietnam era; 3=Post-Vietnam era; 4=Desert Storm/Persian Gulf theater; 5=Persian Gulf era; 6=post-Persian Gulf era; 7=OEF/OIF theater; 8=OEF/OIF era ; Afghanistan: Operation Enduring Freedom (OEF) / Iraq: Operation Iraqi Freedom (OIF)
|
|
Query
|
service_location |
Integer |
|
Recommended |
Location of military service |
1::4
|
1=CONUS (Contiguous United States) only; 2=Afghanistan; 3=Iraq; 4=Other
|
|
|
ethnicity_describe_child |
String |
50
|
Recommended |
How would you describe your child's ethnicity (E.g. Haitian, Jewish, Irish, etc)? |
|
|
cbcl_ethnicity |
Query
|
pre_7 |
Integer |
|
Recommended |
Is the child currently attending school or organized group daycare? |
|
0=No; 1=Yes; -7=Refused; -9=Unknown
|
cbcl_attending_school, student |
|
site |
String |
101
|
Recommended |
Site |
|
Study Site
|
|
Query
|
sc_q2 |
Integer |
|
Recommended |
Did the subject withdraw before the end of the study (early withdrawal)? |
0;1
|
0=No; 1=Yes
|
withdrawn_from_study |
|
cmp004 |
String |
500
|
Recommended |
Describe reason for early termination |
|
|
withdrawal_cause |
|
currestx |
String |
100
|
Recommended |
Other living situation, describe |
|
|
de16am, living_situation |
Query
|
fdi_q29___2 |
Integer |
|
Recommended |
Spanish is spoken in the home |
0; 1
|
0=No; 1=Yes
|
lang_spanish |
Query
|
eo4 |
Integer |
|
Recommended |
Are you currently working at a job or business for pay |
0;1;9
|
0=No; 1=Yes; 9 = Missing
|
dm17, work |
Query
|
job_ptcu |
Integer |
|
Recommended |
Level of Occupation. Patient current |
1::9; 99
|
1=Higher executive, proprietor of large concern, major professional; 2=Business manager or large concern, proprietor of medium-sized business, lesser professiona;l 3=Administrative personnel, owner of small independent business, minor professional; 4=Clerical or sales worker, technician, owner of little business;5=Skilled manual employee; 6=Machine operator, semi-skilled employee; 7=Unskilled employee; 8=farm laborers, menial service workers, students, housewives, (dependent on welfare, no regular occupation); 99=Not ascertained; 9 = Not in household
|
occup |
|
momoccuc |
String |
100
|
Recommended |
mother's current occupation |
|
|
occup_m_other |
|
fatherocup |
String |
100
|
Recommended |
Father' occupation |
|
|
occup_f_other |
Query
|
lang_english |
Integer |
|
Recommended |
English spoken at home |
0;1
|
0=No; 1=Yes
|
|
Query
|
occup_m |
Integer |
|
Recommended |
Mother's Occupational status |
1 :: 8
|
1=higher executive, owner of large business, major professional; 2=administrator, owner of medium-sized business (e.g., nurse, pharmacists, teacher); 3=administrative personnel, owner of small business; 4=clerical and sales personnel, technicians; 5=skilled manual laborers (e.g., electrician, mechanic); 6=machine operators, semi-skilled (e.g., bus driver, waiter); 7=unskilled personnel (e.g., construction worker, janitor); 8=other/student
|
|
Query
|
occup_f |
Integer |
|
Recommended |
Father's Occupational status |
1 :: 8
|
1=higher executive, owner of large business, major professional; 2=administrator, owner of medium-sized business (e.g., nurse, pharmacists, teacher); 3=administrative personnel, owner of small business; 4=clerical and sales personnel, technicians; 5=skilled manual laborers (e.g., electrician, mechanic); 6=machine operators, semi-skilled (e.g., bus driver, waiter); 7=unskilled personnel (e.g., construction worker, janitor); 8=other/student
|
|
|
treatment_name |
String |
200
|
Recommended |
treatment name |
|
|
alc_drug_treatments, rx |
Query
|
au1 |
Integer |
|
Recommended |
Thinking about the past 6 months, how often do you have a drink containing alcohol? |
0::4
|
0 = never; 1 = monthly or less; 2 = 2 to 4 times a month; 3 = 2 or 3 times a week; 4 = 4 or more times a week
|
|
Query
|
audit12_02a |
Integer |
|
Recommended |
On a day when you drink alcohol or use other drugs, how many drinks (alcohol) do you have? |
1::6
|
1= None; 2= 1 or 2; 3= 3 or 4; 4= 5 or 6; 5= 7 or 9; 6= 10 or more
|
alcohol_quantity |
Query
|
baseline_j_003 |
Integer |
|
Recommended |
How often do you have four (six for male) or more drinks on one occasion? |
0::7; -888; -999
|
0=Never; 1=Less than monthly; 2=Monthly; 3=Weekly; 4=2-3 times a week; 5=4-6 times a week; 6=daily; -888=Not Applicable; -999=Missing;7 = daily or almost daily
|
alcohol_4_drinks |
|
psqb20d |
String |
1,000
|
Recommended |
Which tobacco products and how often |
|
|
tobacco_use |
|
cig_smoke |
String |
200
|
Recommended |
The amount of cigarettes you smoke and ages you have smoked |
|
|
cigarettes_daily |
Query
|
mht |
Integer |
|
Recommended |
Have you received any mental health treatment? |
0;1;2;888
|
0= No; 1= Yes; 2 = Not Sure; 888 = non applicable
|
treatment_mental |
Query
|
hc_util6a_t2 |
Integer |
|
Recommended |
Are you currently receiving mental health treatment either through VA or in the community? |
|
0 = No; 1= Yes
|
treatment_mental_now |
Query
|
atrq_02ect |
Integer |
|
Recommended |
Electro-convulsive treatment (ECT) |
0;1
|
0=No; 1=Yes
|
ect |
|
equest30 |
String |
15
|
Recommended |
What is your height? (Please give your best estimate.) |
|
|
height |
Query
|
anthro_weight_calc |
Float |
|
Recommended |
Average Measured Weight (lbs) |
|
|
weight |
Query
|
charc23 |
Integer |
|
Recommended |
CCI question 23: Ever been told has problem with thyroid;0=No,1=Yes |
0;1;9
|
0=No; 1=Yes; 9=Missing
|
thyroid_condition |
Query
|
charc23a |
Integer |
|
Recommended |
CCI question 23a: If CharC23=1, thyroid was underactive or overactive;1=Underactive,2=Overactive |
1;2;9
|
1=Underactive; 2=Overactive; 9=Missing
|
over_under_thyroid |
|
scq_37_sp |
String |
300
|
Recommended |
Specify any other medical condition |
|
|
other_med_con_descrip |
|
drug_alcohol_use |
String |
200
|
Recommended |
Drug/Alcohol use: describe and include year of diagnosis |
|
|
|
Query
|
alcohol_consumption_more |
Integer |
|
Recommended |
Was there ever a time when you drank more than you do now? |
0::1
|
0= No; 1= Yes
|
|
Query
|
alcohol_consumption_most |
Integer |
|
Recommended |
How much/often did you drink at the time you drank the most? |
1::5
|
1= Not applicable, I have never drank; 2= Monthly or less; 3= 2-4 times per month; 4= 2-3 times per week; 5= Daily or almost daily
|
|
Query
|
smoked_more |
Integer |
|
Recommended |
Was there ever a time when you smoked more than you do now? |
0::1
|
0= No; 1= Yes
|
|
Query
|
smoked_most |
Integer |
|
Recommended |
How much/often did you smoke at the time you smoked the most? |
1::5
|
1= Not applicable, I have never smoked; 2= Monthly or less; 3= 2-4 times per month; 4= 2-3 times per week; 5= Daily or almost daily
|
|
Query
|
marijuana_hashish |
Integer |
|
Recommended |
When did you last use: Marijuana / Hashish |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
crack_cocaine |
Integer |
|
Recommended |
When did you last use: Crack-Cocaine |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
powder_cocaine |
Integer |
|
Recommended |
When did you last use: Powder Cocaine |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
amphetamine |
Integer |
|
Recommended |
When did you last use: Amphetamine |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
methamphetamine |
Integer |
|
Recommended |
When did you last use: Methamphetamine |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
ecstasy_molly |
Integer |
|
Recommended |
When did you last use: Ecstasy / Molly |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
ketamine_specialk |
Integer |
|
Recommended |
When did you last use: Ketamine / 'Special K' |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
synthetic_drugs |
Integer |
|
Recommended |
When did you last use: Synthetic Drugs (e.g., K2, Spice, Bath Salts) |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
rx_stimulants |
Integer |
|
Recommended |
When did you last use: Rx Stimulants (e.g., Adderall, Ritalin) |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
rx_sedatives |
Integer |
|
Recommended |
When did you last use: Rx Sedatives (e.g., Xanax, Ativan) |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
rx_opiates |
Integer |
|
Recommended |
When did you last use: Rx Opiates (e.g., Vicodin, Percocet) |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
|
Query
|
treatment_past_types |
Integer |
|
Recommended |
If you have ever received treatment for a mental health or psychiatric condition, then what kind(s) did you receive? |
1::3
|
1= Talk therapy / counseling; 2= Medications; 3= Both
|
|
Query
|
treatment_type_now |
Integer |
|
Recommended |
If you are currently receiving treatment for your mental health or a psychiatric condition, then what kind(s)? |
1::3
|
1= Talk therapy / counseling; 2= Medications; 3= Both
|
|
Query
|
inflammatory_condition |
Integer |
|
Recommended |
Do you currently have a fever, infection, or other inflammatory condition? |
0::1
|
0= No; 1= Yes
|
|
Query
|
headtrauma_consciousness |
Integer |
|
Recommended |
If you have suffered head trauma, did you lose consciousness? |
0;1;3
|
1= Yes; 0= No; 3= Not applicable, I have never suffered head trauma
|
|
Query
|
patient_seizure |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Seizure Disorder |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_stroke |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Stroke |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_cancer |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Cancer |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_heartcondition |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Heart Condition |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_bloodpressure |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Hypertension / High Blood Pressure |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_cholesterol |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: High Cholesterol |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_diabetes |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Diabetes |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_endocrine |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Endocrine Problem |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_liver |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Liver Problems (e.g., hepatitis) |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_stoma_intestinal |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Stomach / Intestinal Problems |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_chronic_pain |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Chronic Pain |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_chronic_fatigue |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Chronic Fatigue |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_genit_gynec |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Genitourinary / Gynecological |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_blood |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Blood Condition (e.g., anemia) |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_lung_resp |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Lung or Respiratory Condition (e.g., asthma, bronchitis, emphysema) |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_kidney_urinary |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Kidney or Urinary Condition |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_joint_muscle |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Joint or Muscle problems (e.g., arthritis, lower back pain) |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_chronic_headaches |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Chronic Headaches |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
patient_ear_nose_throat |
Integer |
|
Recommended |
Please indicate whether you have suffered from any of the following conditions: Ear/Nose/Throat Condition (e.g., sinusitis) |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
other_med_condition |
Integer |
|
Recommended |
Have you experienced any medical condition that we have not asked about? |
1::4
|
1= Never; 2= Past; 3= Current; 4= Prefer not to answer
|
|
Query
|
hallucinogens_lastused |
Integer |
|
Recommended |
When did you last use: Hallucinogens (e.g., LSD, Mushrooms) |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
hallucinogens |
Query
|
heroin_lastused |
Integer |
|
Recommended |
When did you last use: Heroin |
1::6
|
1= Never; 2= Prior to the Past Year; 3= Past Year; 4= Past Month; 5= Past Week; 6= Prefer not to answer
|
heroin |
Query
|
drug_alcohol_treatment |
Integer |
|
Recommended |
Have you ever been in treatment for drug or alcohol use? |
0::1
|
0= No; 1= Yes
|
|
Query
|
audit1 |
Integer |
|
Recommended |
How often do you have a drink containing alcohol? |
0::6; 555;777;888;999;-5;-999
|
0= Never; 1= Monthly (or less); 2= 2 to 4 times a month; 3= 2 to 3 times a week; 4= 4 or more times a week; 5= NA; 6= Monthly or less; 999= No Answer; 888= Skipped; 777= Condition Skipped; 555= Missing; -5= Item seen but not answered; -999= Data not submitted (Incomplete, item not seen)
|
alcohol_consumption |
Query
|
dembfbro |
Integer |
|
Recommended |
Number of full or half brothers |
|
|
de08am |
Query
|
dembfsis |
Integer |
|
Recommended |
Number of full or half sisters |
|
|
de08bm |
Query
|
a2d_yn |
Integer |
|
Recommended |
Do you do any of the following kinds of work? Self-employed? |
0;1
|
0 = No; 1 = Yes
|
de14am |
Query
|
live2 |
Integer |
|
Recommended |
Live with romantic partner |
0;1
|
0=No; 1=Yes
|
de16bm |
|
family_bio_coi_born_in_hosp |
String |
2
|
Recommended |
Family Biographical History Form (0:0 to 4:5 y:m) Question IIB1a Was Child of Interest (COI) born in a hospital? (Yes, No, No Answer) |
|
Y = Yes; N = No; NA = No answer
|
de09am |
Query
|
de04bm |
Integer |
|
Recommended |
Are any of the twins' biological mother or father's parents Hispanic or Latino? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de04dm |
Integer |
|
Recommended |
Maternal grandmother ethnicity Hispanic or Latino? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de04fm |
Integer |
|
Recommended |
Maternal grandfather ethnicity Hispanic or Latino? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de04hm |
Integer |
|
Recommended |
Paternal grandmother ethnicity Hispanic or Latino? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de04jm |
Integer |
|
Recommended |
Paternal grandfather ethnicity Hispanic or Latino? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de06am |
Integer |
|
Recommended |
Is (Name) the biological mother of the twins? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de07am |
Integer |
|
Recommended |
Is (Name) the biological father of the twins? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de12am |
Integer |
|
Recommended |
Is the twins' mother currently working for pay or profit? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de12bm |
Float |
|
Recommended |
If twins' mother currently working for pay or profit, How many hours per week does the twins' mother work for pay or profit? |
|
|
|
Query
|
de12cm |
Float |
|
Recommended |
If twins' mother currently working for pay or profit, How many of these hours does the twins' mother work inside of the home? |
|
|
|
Query
|
de12hm |
Integer |
|
Recommended |
If twins' mother is not currently working for pay or profit, Which of the following best describes why the twins' mother is not working? |
1::4
|
1 = Looking for work; 2 = Homemaker; 3 = Unable to work; 4 = Other
|
|
Query
|
de13am |
Integer |
|
Recommended |
Is the twins' father currently working for pay or profit? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de13bm |
Float |
|
Recommended |
If twins' father currently working for pay or profit, How many hours per week does the twins' father work for pay or profit? |
|
|
|
Query
|
de13cm |
Float |
|
Recommended |
If twins' father currently working for pay or profit, How many of these hours does the twins' father work inside of the home? |
|
|
|
Query
|
de13hm |
Integer |
|
Recommended |
If twins' father is not currently working for pay or profit, Which of the following best describes why the twins' father is not working? |
1::4
|
1 = Looking for work; 2 = Homemaker; 3 = Unable to work; 4 = Other
|
|
Query
|
de14bm |
Integer |
|
Recommended |
If you own your own business/farm, What is the estimated value (that is what would it be worth if you were to sell the business)? |
4::9
|
4 = less than $80,000; 5 = $80,001 to $160,000; 6 = $160,001 to $240,000; 7 = $240,001 to $320,000; 8 = $320,001 to $810,000; 9 = over $810,001
|
|
Query
|
de16cm |
Integer |
|
Recommended |
If you live with a partner, Do you live with the twins' biological parent or another partner? |
1;2
|
1 = twins' biological parent; 2 = another partner
|
|
Query
|
de17am |
Integer |
|
Recommended |
Has the mother's marital status changed during the twins' lives? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
de17cm |
Integer |
|
Recommended |
If mother's marital status changed during the twins' lives, How old were the twins when this change occurred? ______ years |
|
|
|
Query
|
de18am |
Integer |
|
Recommended |
If twins' biological parents are not living together, Do the twins live primarily with their biological mother, their biological father, or with another caregiver? |
1::3
|
1 = biological mother; 2 = biological father; 3 = another caregiver
|
|
Query
|
de18cm |
Float |
|
Recommended |
If twins currently have any contact with their non-residential biological parent, On average, how many hours per week does Twin A spend with him/her? |
|
|
|
Query
|
de18dm |
Float |
|
Recommended |
If twins currently have any contact with their non-residential biological parent, On average, how many hours per week does Twin B spend with him/her? |
|
|
|
Query
|
de21am |
Integer |
|
Recommended |
How many times has Twin A moved since they were born? |
|
|
|
Query
|
de21bm |
Integer |
|
Recommended |
How many times has Twin B moved since they were born? |
|
|
income_source_other |
Query
|
de22am |
Integer |
|
Recommended |
How many times has Twin A changed schools in their lives (including transitions to next level school)? |
|
|
|
Query
|
de22bm |
Integer |
|
Recommended |
How many times has Twin B changed schools in their lives (including transitions to next level school)? |
|
|
|
Query
|
de18bm |
Integer |
|
Recommended |
If twins' biological parents are not living together, Do the twins currently have any contact with their non-residential biological parent? |
|
1 = yes; 0 = no; 3 = one twin does while the other twin does not
|
|
|
de04em |
String |
35
|
Recommended |
Maternal grandmother race |
|
|
|
|
de04gm |
String |
35
|
Recommended |
Maternal grandfather race |
|
|
|
|
de04im |
String |
35
|
Recommended |
Paternal grandmother race |
|
|
|
|
de04km |
String |
35
|
Recommended |
Paternal grandfather race |
|
|
|
|
mentalt_diag |
String |
150
|
Recommended |
What is the diagnosis? |
|
|
confirmed_primary_dx |
|
pls4_measure |
String |
100
|
Recommended |
Measure Used |
PLS-4
|
|
primarydx_measure |
|
qa18 |
Integer |
|
Recommended |
Section A - Demographics. A18. How many times have you been legally married? |
|
#=TIMES
|
dm11 |
|
qa19 |
Integer |
|
Recommended |
Section A - Demographics. A19. How many times have you been divorced? |
|
|
dm12 |
|
pregnancy_no |
Integer |
|
Recommended |
1. How many times have you/ (child)'s mother been pregnant? |
|
|
dm14 |
|
qa22 |
Integer |
|
Recommended |
Section A - Demographics. A22. How many children have you (fathered/given birth to)? That is, not including adopted, foster, or step children. |
|
#=# CHILDREN
|
dm14_kidnum |
|
test_ged |
Integer |
|
Recommended |
Did you pass a high school equivalency test? |
|
0 = No; 1 = Yes; 9 = Missing
|
dm15b |
|
ed_1_y |
Integer |
|
Recommended |
Are you currently in school? |
|
0= No; 1= Yes; 77= Refused; 88= Missing; -99= NA
|
dm15e |
|
a2b_yn |
Integer |
|
Recommended |
Do you do any of the following kinds of work? Working a full-time paying job? |
0;1
|
0 = No; 1 = Yes
|
dm17a |
|
comments_misc |
String |
4,000
|
Recommended |
Miscellaneous comments on study, interview, methodology relevant to this form data |
|
|
ac_demo, dm_notes, notes |
|
sh_hs |
Integer |
|
Recommended |
Subject has a High School Diploma |
|
1=Yes; 0=No
|
dm15a |
|
dm9_wyr |
String |
10
|
Recommended |
What year were you widowed? |
|
|
|
|
dm15f |
Integer |
|
Recommended |
What is the highest grade in school your mother completed? |
0::17;9999
|
0 = Unschooled ; 1 = 1ST ; 2 = 2ND ; 3 = 3RD ; 4 = 4TH ; 5 = 5TH ; 6 = 6TH ; 7 = 7TH ; 8 = 8TH ; 9 = 9TH ; 10 = 10TH ; 11 = 11TH ; 12 = 12TH ; 13 = TECHNICAL SCHOOL OR 1 YR COLLEGE ; 14 = 2 YRS COLLEGE ; 15 = 3 YRS COLLEGE ; 16 = 4 YRS COLLEGE: B.A., B.S ; 17 = GRADUATE SCHOOL: M.A., M.S., J.D., M.D., Ph.D ; 9999 = Don't know
|
|
|
dm15g |
Integer |
|
Recommended |
What is the highest grade in school your father completed? |
0::17;9999
|
0 = Unschooled ; 1 = 1ST ; 2 = 2ND ; 3 = 3RD ; 4 = 4TH ; 5 = 5TH ; 6 = 6TH ; 7 = 7TH ; 8 = 8TH ; 9 = 9TH ; 10 = 10TH ; 11 = 11TH ; 12 = 12TH ; 13 = TECHNICAL SCHOOL OR 1 YR COLLEGE ; 14 = 2 YRS COLLEGE ; 15 = 3 YRS COLLEGE ; 16 = 4 YRS COLLEGE: B.A., B.S ; 17 = GRADUATE SCHOOL: M.A., M.S., J.D., M.D., Ph.D ; 9999 = Don't know
|
|
|
dm__16 |
Float |
|
Recommended |
Now I want to ask you about work for pay. In the past twelve months, how many months have you been employed? COUNT SELF-EMPLOYMENT OR SALARIED. IF NONE, CODE 0. IF LESS THAN 1 MONTH, CODE 1. |
|
|
dm16 |
|
paofwork5 |
Integer |
|
Recommended |
39. Are you a student |
1::3; -9
|
1 = Yes, Full-time; 2 = Yes, Part-time; 3 = No, -9 = Missing Data
|
p_job7_1, sub_job7_1 |
|
ind_type |
String |
65
|
Recommended |
Industry/Type of Business (Subject) |
|
|
p_business, sub_business |
|
preg_age_mom |
Integer |
|
Recommended |
Age of mother at the time of birth |
|
In years; 999=Unknown
|
sub_momage |
|
preg_age_dad |
Integer |
|
Recommended |
Age of father at the time of birth |
|
In years; 999=Unknown
|
sub_dadage |
|
dembadpt |
Integer |
|
Recommended |
Is the child/teen adopted? |
|
0 = No 1 = Yes
|
sub_adopt |
|
birthcountry_dad |
String |
100
|
Recommended |
What is the country of birth of the child's father? |
|
|
p_bio_f_country, sub_bio_f_country |
|
birthcountry_mom |
String |
100
|
Recommended |
What is the country of birth of the child's mother? |
|
|
p_bio_m_county, sub_bio_m_county |
|
country_origin |
String |
100
|
Recommended |
Country of Origin |
|
|
p_country, sub_country |
|
calm_inc1 |
Integer |
|
Recommended |
How much income did you earn from work in the last year |
|
98 = Refused to answer
|
sub_income_num |
|
mother_edu_cat |
Integer |
|
Recommended |
Mother's highest educational level category completed |
|
0 = Never attended or Kindergarten only; 1-11 = Grades 1=11; 12 = High school No diploma; 13 = GED or equivalent; 14 = High school graduate; 15 = Completed 12 years of school (but unable to determine if code 12, 13, or 14); 16 = Some college, no degree; 17 = Associate degree: occupational/technical/vocational program; 18 = Associate degree: academic program (includes non-US post high school/pre college levels); 19 = Associate degree (but unable to determine if code 16 or 17); 20 = Bachelor degree (e.g., BA, AB, BS, BBA); 21 = Completed 16 years of school (but unable to determine if code 16-20); 22 = Master¿s degree (e.g., MA, MS, MEng, MEd, MBA); 23 = Professional school degree (e.g., MD, DDS, DVM, JD); 24 = Doctoral degree (e.g., PhD, EdD); 25 = Post Master degree (but unable to determine if code 20 or 21); 26 = Unknown/Missing; 98 = Refused to answer
|
sub_mgrade |
|
father_edu_cat |
Integer |
|
Recommended |
Father's highest educational level category completed |
|
0 = Never attended or Kindergarten only; 1-11 = Grades 1=11; 12 = High school No diploma; 13 = GED or equivalent; 14 = High school graduate; 15 = Completed 12 years of school (but unable to determine if code 12, 13, or 14); 16 = Some college, no degree; 17 = Associate degree: occupational/technical/vocational program; 18 = Associate degree: academic program (includes non-US post high school/pre college levels); 19 = Associate degree (but unable to determine if code 16 or 17); 20 = Bachelor degree (e.g., BA, AB, BS, BBA); 21 = Completed 16 years of school (but unable to determine if code 16-20); 22 = Master¿s degree (e.g., MA, MS, MEng, MEd, MBA); 23 = Professional school degree (e.g., MD, DDS, DVM, JD); 24 = Doctoral degree (e.g., PhD, EdD); 25 = Post Master degree (but unable to determine if code 20 or 21); 26 = Unknown/Missing; 98 = Refused to answer
|
sub_fgrade |
|
ustime_coded |
Integer |
|
Recommended |
About how long have you been in the United States? PX011201_Years_living_in_US_Coded |
0::95;97;99
|
0=less than 1 year; 95= 95+ years; 97=Refused; 99=Don't Know
|
sub_yrs_in_usa |
|
sub_adopt_1 |
String |
20
|
Recommended |
How old were when you were adopted? |
|
|
|
|
sub_income |
Integer |
|
Recommended |
With regard to your current or most recent job activity: If not sure, is your income: |
1::10; 99; 999
|
1 =Less than $5,000 ; 2 =$5,000 through $11,999 ; 3 =$12,000 through $15,999 ; 4 =$16,000 through $24,999 ; 5 =$25,000 through $34,999 ; 6 =$35,000 through $49,999 ; 7 =$50,000 through $74,999 ; 8 =$75,000 through $99,999 ; 9 =$100,000 through $199,999 ; 10 =$200,000 and greater; 99 = Don't Know; 999 = Don't wish to answer
|
p_income |
|
sub_income_famcode |
Integer |
|
Recommended |
With regard to your current or most recent job activity: If not sure, was your family income: |
1::10
|
1 =Less than $5,000 ; 2 =$5,000 through $11,999 ; 3 =$12,000 through $15,999 ; 4 =$16,000 through $24,999 ; 5 =$25,000 through $34,999 ; 6 =$35,000 through $49,999 ; 7 =$50,000 through $74,999 ; 8 =$75,000 through $99,999 ; 9 =$100,000 through $199,999 ; 10 =$200,000 and greater
|
family_income_question |
|
family_income_dfct1 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: a. Needed food but couldn't afford to buy it or couldn't afford to go out to get it? |
|
0 = No; 1 = Yes
|
|
|
family_income_dfct2 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: b. Were without telephone service because you could not afford it? |
|
0 = No; 1 = Yes
|
|
|
family_income_dfct3 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: c. Didn't pay the full amount of the rent or mortgage because you could not afford it? |
|
0 = No; 1 = Yes
|
|
|
family_income_dfct4 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: d. Were evicted from your home for not paying the rent or mortgage? |
|
0 = No; 1 = Yes
|
|
|
family_income_dfct5 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: e. Had services turned off by the gas or electric company, or the oil company wouldn't deliver oil because payments were not made? |
|
0 = No; 1 = Yes
|
|
|
family_income_dfct6 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: f. Had someone who needed to see a doctor or go to the hospital but didn't go because you could not afford it? |
|
0 = No; 1 = Yes
|
|
|
family_income_dfct7 |
Integer |
|
Recommended |
In the past 12 months, has there been a time when you and your immediate family experienced any of the following: g. Had someone who needed a dentist but couldn't go because you could not afford it? |
|
0 = No; 1 = Yes
|
|
|
smoker |
Integer |
|
Recommended |
Smoker? |
0 :: 4; 9
|
0=No; 1=Yes; 2= Yes, but not regularly (less than 10 per day); 3= Yes, regularly (10 or more a day); 4= Former smoker; 9=NK/missing
|
|
|
other_phenotype_details |
String |
255
|
Recommended |
Details of other phenotype(s) |
|
|
other |
|
phenotype |
String |
200
|
Recommended |
Phenotype/diagnosis for the subject |
|
|
group |
|
smoke_current_packs |
Float |
|
Recommended |
how many packs per day if yes? |
0::10
|
|
smoke_frequency |
|
saps_ad13 |
Integer |
|
Recommended |
Medication status |
0;1;2
|
0=No medication; 1=Medication; 2 = Drug Naive
|
medsta |
|
th1b |
Integer |
|
Recommended |
Total Duration of Outpatient Treatment (weeks) |
|
|
outpatient_treat_weeks |
|
scda17 |
Integer |
|
Recommended |
How many times have you (or subject if informant) been hospitalized for psychiatric reasons? (Best estimate) |
0::300
|
|
inpatient_treatments |
|
sldc227 |
Float |
|
Recommended |
Total Duration of Inpatient Treatment (Weeks) |
|
|
inpatient_treat_dur |
|
femenst |
Float |
|
Recommended |
Age (in years) at First Menstrual Period |
1::100; 888; 999
|
888=N/A; 999=missing data
|
menarche_start |
|
race_category_informant |
Integer |
|
Recommended |
Racial Category/categories of informant |
|
1 = American Indian/Alaska Native ; 2 = Asian ; 3 = Hawaiian or Pacific Islander ; 4 = Black or African American ; 5 = White ; 6 = More than one race ; 7 = Unknown or not reported
|
|
|
ethnic_category_informant |
Integer |
|
Recommended |
Ethnic Category/categories of informant |
1::3
|
1 = Hispanic or Latino; 2 = Not Hispanic or Latino; 3 = Unknown
|
|
|
person2_exist |
Integer |
|
Recommended |
Is there another person who significantly contributes to the participant's current living expenses? |
0::1
|
0 = No; 1 = Yes
|
|
|
child_out_psych_ever |
Integer |
|
Recommended |
Has your child who will be participating in study ever been in outpatient psychiatric/psychological treatment? |
0::1
|
0 = No; 1 = Yes
|
|
|
outpatient_treatments |
Integer |
|
Recommended |
If subject has ever been in outpatient psychiatric/psychological treatment, how many times? |
|
|
|
|
area5_explain |
String |
360
|
Recommended |
Church, religion or spiritual orientation? Explain briefly |
|
|
religion, religious_category |
|
date_of_enrollment |
String |
10
|
Recommended |
Date of enrollment |
|
|
doe |
|
labsample29 |
String |
10
|
Recommended |
Date of last menstrual period |
|
NA=if male or pre-puberty
|
demo4, last_period |
|
sis9 |
String |
40
|
Recommended |
Who else was present during the interview? (select all that apply) |
|
1 = No one; 2 = Other adults; 3 = Child(ren); 4 = Adults and child(ren) under 18
|
interviewed_who |
|
ksads_outpt_age |
String |
100
|
Recommended |
Age at first outpatient treatment |
|
|
outpatient_treat_age |
|
pds6g |
Integer |
|
Recommended |
Girls only : Have you begun to menstruate? |
0;1;99
|
0=No; 1=Yes; 99 = Refused
|
meneses |
|
phi1 |
Integer |
|
Recommended |
Type of interview |
1::5
|
1 = In person; 2 = Phone; 3 = Mail; 4 = SIG-O only; 5 = Carp only
|
interview_type |
|
yoga |
Integer |
|
Recommended |
Have you practiced meditation or yoga regularly over the past three years? |
0;1
|
0 = No; 1 = Yes
|
|
|
yogahowoften |
String |
250
|
Recommended |
Have you practiced meditation or yoga regularly over the past three years? If you answered yes, how often? |
|
|
|
|
visnum |
Float |
|
Recommended |
Numeric Visit Number |
|
-1.5 = Pre-Screening; -1 = Screening; 0 = Baseline; ## = Visit ## (from 1 to 10); Whole numbers = standard monthly visits; #.001 - #.009 = Unscheduled; #.1 = End of Phase 1; #.2 = End of Phase 2; #.3 = End of Phase 3; #.4 = End of Open Choice Phase; #.5 = End of Study; #.6 = Genetic Analysis; 1000=all visits
|
sesscode |
|
relation_stat |
Integer |
|
Recommended |
Relationship status: |
0;1
|
0= Not currently in a long-term relationship ; 1= Currently in a long-term relationship
|
|
|
dependent_home |
Integer |
|
Recommended |
Number of children/dependents living at home: |
|
|
|
|
religion_important |
Integer |
|
Recommended |
How important is religion in your life? |
1::7
|
1= Not at all important ; 2= 2 ; 3= 3 ; 4= 4 ; 5= 5 ; 6= 6 ; 7= Extremely important
|
|
|
therapy_count |
Integer |
|
Recommended |
How many times before now have you participated in therapy/counseling for depression? |
1::4
|
1= Never ; 2= 1 or 2 times ; 3= 3 or 4 times ; 4= 5 or more times
|
|
|
therapy_helpful |
Integer |
|
Recommended |
How helpful did you find therapy in treating your depression? |
1::5
|
1= I have never been in therapy before ; 2= Not helpful at all ; 3= Not very helpful ; 4= Somewhat helpful ; 5= Very helpful
|
|
|
meds_count |
Integer |
|
Recommended |
How many times have you used medication for one month or longer to treat your depression? |
1::4
|
1= Never ; 2= 1 or 2 times ; 3= 3 or 4 times ; 4= 5 or more times
|
|
|
meds_helpful |
Integer |
|
Recommended |
How helpful did you find medication in treating your depression? |
1::5
|
1= I have never taken medication for depression before ; 2= Not helpful at all ; 3= Not very helpful ; 4= Somewhat helpful ; 5= Very helpful
|
|
|
rater_title |
String |
50
|
Recommended |
Rater's Title |
|
|
therapist |
Query
|
visit |
String |
60
|
Recommended |
Visit name |
|
|
evalcode, eventname |
|
time_assess |
String |
20
|
Recommended |
Time of day the assessment was taken. Hour:minutes |
|
|
assess_time |
|
demoginfo15 |
String |
50
|
Recommended |
Which religion do you currently practice? |
|
|
religion_other |
|
hx_psymeds_spec |
String |
300
|
Recommended |
Please describe your history of taking psychiatric medication. |
|
|
psychmeds |
|
saps_ad10 |
Integer |
|
Recommended |
Rater number |
|
|
diagnostician |
|
aescode |
Integer |
|
Recommended |
Staff code number of person completing this form |
|
999= Missing Data
|
ra, rs_demo, screening_administrator_in |
|
bio_father |
Integer |
|
Recommended |
Are you the Child''s Biological Father? |
|
0 = No; 1 = Yes
|
|
|
cust_parent |
Integer |
|
Recommended |
If you are not a biological parent to the child, then are you the child''s custodial parent? |
|
0 = No; 1 = Yes
|
|
|
p_c_grade |
String |
100
|
Recommended |
What grade is your child in? (if it is summer, indicate their grade starting in the fall)? |
|
|
|
|
p_c_adopt_when_unit |
Integer |
|
Recommended |
Adoption age given in months or years? |
|
1 = Months ; 2 = Years
|
|
|
p_c_gender_different |
String |
100
|
Recommended |
Please state if your child has different gender identity: |
|
|
|
|
p_c_country |
String |
100
|
Recommended |
In which country was your child born? |
|
|
|
|
p_c_yrs_in_usa |
Integer |
|
Recommended |
How many years has your child lived in the United States: |
|
|
|
|
ptner_yn |
Integer |
|
Recommended |
Do you have a partner? |
|
0 = No; 1 = Yes
|
|
|
ptner_grade |
String |
100
|
Recommended |
What is the highest grade or level of school your partner completed or the highest degree they received? |
|
|
|
|
ptner_job |
Float |
|
Recommended |
We would like to know about what your partner does--are they working now, looking for work, retired, taking care of children, a student, or what? |
|
1 = WORKING NOW ; 2 = ONLY TEMPORARILY LAID OFF ; 2.1 = SICK LEAVE ; 2.2 = MATERNITY LEAVE ; 3.1 = UNEMPLOYED, LOOKING FOR WORK ; 3.2 = UNEMPLOYED, NOT LOOKING FOR WORK ; 4 = RETIRED ; 5 = DISABLED, PERMANENTLY OR TEMPORARILY ; 6 = TAKING CARE OF CHILDREN AND/OR RAISING CHILDREN AND/OR CARING FOR AGING PARENTS ; 7 = STUDENT ; 8 = OTHER
|
|
|
ptner_job1_1 |
Integer |
|
Recommended |
If your partner is working now, are they |
|
1 = FULL TIME ; 2 = PART TIME
|
|
|
ptner_job7_1 |
Integer |
|
Recommended |
If your partner is a student, are they |
|
1 = FULL TIME ; 2 = PART TIME
|
|
|
ptner_job8_1 |
String |
300
|
Recommended |
Specify partner''s/their other employment situation |
|
|
|
|
ptner_business |
String |
100
|
Recommended |
In what kind of business or industry does (did) your partner work? |
|
|
|
|
ptner_work |
String |
100
|
Recommended |
What kind of work does (did) your partner do? (Job Title)? |
|
|
|
|
ptner_income |
Integer |
|
Recommended |
How much did your partner earn, before taxes and other deductions, during the past 12 months? |
|
1 = Less than $5,000 ; 2 = $5,000 through $11,999 ; 3 = $12,000 through $15,999 ; 4 = $16,000 through $24,999 ; 5 = $25,000 through $34,999 ; 6 = $35,000 through $49,999 ; 7 = $50,000 through $74,999 ; 8 = $75,000 through $99,999 ; 9 = $100,000 through $199,999 ; 10 = $200,000 and greater ; 99 = Don''t Know ; 999 = Do not want to answer
|
|
|
comqother |
String |
255
|
Recommended |
Respondent - Other (text) |
|
|
other_parent |
|
demo_adopt_age |
String |
20
|
Recommended |
Reporting parent: At what age was your child adopted? |
|
|
p_c_adopt_when |
|
employotr |
String |
200
|
Recommended |
Employment situation other, specify |
|
|
activity_other_par, p_job8_1 |
|
nimh_rv_dem_03 |
Integer |
|
Recommended |
Current gender identity |
0 :: 9;999
|
0=Male; 1=Female; 2=Trans male/Trans man; 3=Trans female/Trans woman; 4=Genderqueer or Gender non-conforming; 5=Different identity; 6 = Non-binary; 7 = Refused/prefer not to answer; 8 = Do not know; 9= Not listed; 999= Missing
|
p_c_gender |
|
p_partnerbio |
Integer |
|
Recommended |
Is partner child's biological parent? |
|
0= No ; 1= Yes ; -99= N/A ; 88= Missing ; 77= Refused
|
ptner_bio_parent |
|
ustime |
String |
100
|
Recommended |
How long you lived in US, years |
|
|
p_yrs_in_usa |
|
bio_mother |
Integer |
|
Recommended |
Are you the Child''s Biological Mother? |
|
0 = No; 1 = Yes
|
|
|
sample |
Integer |
|
Recommended |
Training or randomized case |
1::5
|
1 = randomized; 2 = training; 3=randomized-control; 4=randomized-intervention; 5=concurrent cohort-intervention
|
|
|
mother_cod |
String |
50
|
Recommended |
Mother's cause of death |
|
|
mother_cause_of_death |
|
father_cause_of_death |
String |
50
|
Recommended |
Father's cause of death |
|
|
|
|
demobmdage |
Integer |
|
Recommended |
If mother deceased, age in years at death |
0::100
|
|
mother_age_death |
|
demobfdage |
Integer |
|
Recommended |
If father deceased, age in years at death |
0::100
|
|
father_age_death |
|
father_alive |
Integer |
|
Recommended |
Is your biological father still alive? |
|
0 = No; 1 = Yes; 3 = Unknown; 777=Not applicable
|
father_still_living |
|
mother_alive |
Integer |
|
Recommended |
Is your biological mother still alive? |
|
0 = No; 1 = Yes; 3 = Unknown; 777=Not applicable
|
mother_still_living |
|
educat |
Float |
|
Recommended |
Number of years in formal education |
|
999=Unknown/Missing
|
edu_yrs |
|
birthstate |
String |
2
|
Recommended |
State of Birth, Abbreviation |
|
|
birthplace_state |
|
sex_other |
String |
75
|
Recommended |
Describe other sex assigned at birth |
|
|
|
|
subject_pronouns |
String |
50
|
Recommended |
Participant's pronouns used to describe themselves |
|
|
pronoun_other |
|
sexual_orientation |
Integer |
|
Recommended |
Sexual Orientation- Do you identify as: |
|
1= Asexual; 2= Bisexual; 3= Gay; 4= Lesbian; 5= Pansexual; 6= Queer; 7= Questioning; 8= Straight or heterosexual; 9= Other; 10=Homosexual; 11 = I am not sure yet
|
sexual_orient |
|
sexual_or_descrip |
String |
100
|
Recommended |
What is your sexual orientation? |
|
|
sexual_orient_other |
|
edfirst_scid |
String |
100
|
Recommended |
Education first person (intervewee/first parent) |
|
|
education_par |
|
caregiver_edu |
String |
200
|
Recommended |
Caregiver: Education level and major |
|
|
education_other_par |
|
respond |
Integer |
|
Recommended |
Respondent |
|
1 = Parent; 2 = Teacher; 3=Self; 4= Other; 5= Significant other; 6 = Parent 1; 7 = Parent 2; 999 = Not available
|
form_ext |
|
hh_grandma |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Grandmother |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_grandpa |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Grandfather |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_parentso |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Parent-Significant Other |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_other |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Other |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_other_spc |
String |
100
|
Recommended |
Specify other member of household |
|
|
|
|
hh_mom_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_dad_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_brother_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_sister_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_stepmom_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_stepdad_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_grandma_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_grandpa_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_parentso_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
hh_other_count |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Number |
|
|
|
|
pronoun |
Integer |
|
Recommended |
Subject's preferred pronouns |
1::3;99
|
1 = He; 2 = She; 3 = Them/They; 99 = Other (specify)
|
|
|
hh_mom |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Mom |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_dad |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Dad |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_brother |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Brother |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_sister |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Sister |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_stepmom |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Step-mother |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
hh_stepdad |
Integer |
|
Recommended |
Who lives in your household (family member or equivalent figure)? Step-father |
0;1
|
0 = Absent from household; 1 = Checked/Present
|
|
|
socio_11 |
Integer |
|
Recommended |
Do you have your own mobile phone? |
|
1 = Yes ; 0 = No ; 3 = Yes, but currently it is damaged or not working
|
|
|
socio_11_1 |
Integer |
|
Recommended |
If you have your own mobile phone, what type of mobile phone do you have? |
1 ; 2
|
1 = Smartphone ; 2 = Other
|
|
|
socio_12 |
Integer |
|
Recommended |
Have you ever used a Smartphone? |
|
0 = No; 1 = Yes
|
|
|
socio_12_1 |
String |
20
|
Recommended |
If you have ever used a smartphone, whose smartphone have you used? |
|
1 = Own ; 2 = Family Member's ; 3 = Friend's ; 4 = Relative's ; 5 = Co-worker's ; 6 = Any other's
|
|
|
gfsr_21 |
String |
25
|
Recommended |
How long have you been at your current job |
|
|
socio_7 |
|
socio_2 |
Integer |
|
Recommended |
What is your designation? |
1 ; 2
|
1 = Accredited Social Health Activist (ASHA) ; 2 = ASHA Facilitator
|
|
|
socio_8 |
String |
60
|
Recommended |
Which Community Health Center (CHC) are you working with? |
|
|
|
|
socio_9 |
Integer |
|
Recommended |
Have you participated in any training program on mental health? |
|
0 = No; 1 = Yes
|
|
|
socio_9_1 |
String |
60
|
Recommended |
Have you participated in any training program on mental health? If yes, then how many months/years ago was this? |
|
|
|
|
socio_9_2 |
String |
60
|
Recommended |
Have you participated in any training program on mental health? If yes, then what was the name or subject of this training program? |
|
|
|
|
socio_10 |
Integer |
|
Recommended |
How much time did it take you to travel to reach this place? (i.e., where the data collection is currently taking place) |
1 :: 1440
|
In minutes
|
|
|
cg1_employcur |
Integer |
|
Recommended |
Caregiver/Parent 1: If working now, what is your current employment status? |
1::12;-7
|
1=Full time; 2=Part time for pay; 3=Homemaker; 4=Incarcerated; 5=Disabled; 6=Leave of absence; 7=Unemployed; 8=Retired; 9=Other; 10=Student; 11=Volunteer; -7=Refused; 12 = Maternity leave
|
|
|
cg1_paofwork5 |
Integer |
|
Recommended |
Caregiver/Parent 1: If student, what type of student are you? |
1::3; -9
|
1 = Yes, Full-time; 2 = Yes, Part-time; 3 = Not a student, -9 = Missing Data
|
|
|
cg1_ind_type |
String |
100
|
Recommended |
Caregiver/Parent 1: In what kind of business or industry do (did) you work? |
|
|
|
|
cg1_sub_income |
Integer |
|
Recommended |
Caregiver/Parent 1: How much did you earn, before taxes and other deductions, during the past 12 months? |
1::10; 99; 999
|
1 =Less than $5,000 ; 2 =$5,000 through $11,999 ; 3 =$12,000 through $15,999 ; 4 =$16,000 through $24,999 ; 5 =$25,000 through $34,999 ; 6 =$35,000 through $49,999 ; 7 =$50,000 through $74,999 ; 8 =$75,000 through $99,999 ; 9 =$100,000 through $199,999 ; 10 =$200,000 and greater; 99 = Don't Know; 999 = Don't wish to answer
|
|
|
cg1_bkgrnd_education |
String |
65
|
Recommended |
Caregiver/Parent 1: What is the highest grade or level of school you have completed or the highest degree you have received? |
|
|
|
|
dem_industry_mom_12 |
String |
200
|
Recommended |
For your current or most recent job, in what kind of industry did/do you work? (For example: hospital, auto engine manufacturing, newspaper publishing, mail order house) (Parent/Caregiver 1) |
|
|
cg1_jobh |
|
cg1_country_origin |
String |
70
|
Recommended |
Caregiver/Parent 1: In which country were you born? |
|
|
|
|
cg1_ustime |
String |
50
|
Recommended |
Caregiver/Parent 1: How many years have you lived in the United States: |
|
|
|
|
cg1_nimh_rv_dem_03 |
Integer |
|
Recommended |
Caregiver/Parent 1: What is your current gender identity? |
0::5; 7; 8
|
0=Male; 1=Female; 2=Trans male/Trans man; 3=Trans female/Trans woman; 4=Genderqueer or Gender non-conforming; 5=Different identity; 7 = Refused; 8 = Don't Know
|
|
|
cg1_fspgod |
String |
100
|
Recommended |
Caregiver/Parent 1: Please state if you have a different gender identity: |
|
|
|
|
cg1_das1ms |
String |
100
|
Recommended |
Caregiver/Parent 1: Are you now married, widowed, divorced, separated, never married or living with a partner? |
|
|
|
|
cg1_area4_explain |
String |
150
|
Recommended |
Caregiver/Parent 1: We would like to know about what you do - are you working now, looking for work, retired, taking care of children, a student, or what? |
|
|
|
|
reading_recognizing |
Integer |
|
Recommended |
Do you have problems reading a newspaper or recognizing someone from across the room related to macular degeneration? |
|
0 = No; 1 = Yes
|
|
|
both_eyes |
Integer |
|
Recommended |
Is your macular degeneration in both eyes? |
|
0 = No; 1 = Yes
|
|
|
left_eye_diagnosis |
Integer |
|
Recommended |
Left Eye Diagnosis (type of macular degeneration) |
1::3
|
1 = Dry ; 2 = Wet ; 3 = Other
|
|
|
right_eye_diagnosis |
Integer |
|
Recommended |
Right Eye Diagnosis (type of macular degeneration) |
1::3
|
1 = Dry ; 2 = Wet ; 3 = Other
|
|
|
drive_yourself |
Integer |
|
Recommended |
Are you able to drive yourself? |
|
0 = No; 1 = Yes
|
|
|
distance_from_bhm |
String |
15
|
Recommended |
About how far away from Birmingham do you live? |
|
|
|
|
mr_compatible |
Integer |
|
Recommended |
In order to ensure your comfort in the MRI scanner - is your weight above 300 pounds or your waist circumference (belt size) greater than 60 inches? (If yes to either, then patient is ineligible). |
0;1
|
0 = No; 1 = Yes
|
|
|
lie_flat_in_scanner |
Integer |
|
Recommended |
Do you have any neck problems that would make it difficult to lie flat on a bed with no pillow? |
0;1
|
0 = No; 1 = Yes
|
|
|
doctor_referral |
Integer |
|
Recommended |
Are you calling because you heard about us through your eye doctor? |
|
0 = No; 1 = Yes
|
|
|
visualacuity1 |
Float |
|
Recommended |
Visual acuity from doctor |
|
out of 20
|
visual_acuity |
|
voicemail |
String |
25
|
Recommended |
Time and date the voicemail was left. |
|
|
|
|
when_could_i_call_you_back |
String |
20
|
Recommended |
When could I call you back to finish the questionnaire? |
|
|
|
|
md_diagnosis |
Integer |
|
Recommended |
Have you ever been diagnosed with Macular Degeneration? |
|
0 = No; 1 = Yes
|
|
|
type_of_md |
Integer |
|
Recommended |
Is your Macular Degeneration age-related or juvenile? |
1::3
|
1 = Age Related ; 2 = Juvenile ; 3 = Other
|
|
|
kind_of_md_if_other |
String |
20
|
Recommended |
What kind of Macular Degeneration if other? |
|
|
|
|
time_since_diagnosis |
String |
15
|
Recommended |
How long have you been diagnosed with macular degeneration? |
|
in months
|
|
|
studyinfo |
Integer |
|
Recommended |
Would you like me to tell you about our study? |
1::3
|
1 = Yes, Now ; 2 = Yes, Later ; 3 = No
|
study_info |
|
ps_prime_income |
Integer |
|
Recommended |
Family income at year 1 |
1::8;-999
|
1 = less than $25,000 ; 2 = $25,000 - $34,999 ; 3 = $35,000 - $49,999 ; 4 = $50,000 - $74,999 ; 5 = $75,000 - $99,999 ; 6 = $100,000 - $129,999 ; 7 = $130,000 - $149,999 ; 8 = higher than $150,000 ; -999 = Declined to answer/Respondent does not know
|
|
|
year_mta |
Integer |
|
Recommended |
Year in study |
|
|
visit_year |
|
longform_id |
String |
50
|
Recommended |
Long form of Subject ID |
|
|
|
|
chrdemo_age_yrs_chr |
Integer |
|
Recommended |
Age in years |
|
round(datediff([screening_arm_1][chric_consent_date],[baseline_arm_1][chrdemo_dob]=''y'')=0) ;-900=Missing;-300=N/A
|
|
|
chrdemo_age_yrs_hc |
Integer |
|
Recommended |
Age in years |
|
round(datediff([screening_arm_2][chric_consent_date],[baseline_arm_2][chrdemo_dob]=''y'')=0) ;-900=Missing;-300=N/A
|
|
|
chrdemo_age_mos_chr |
Integer |
|
Recommended |
Age in months |
|
round(datediff([screening_arm_1][chric_consent_date],[baseline_arm_1][chrdemo_dob]=''M'')=0) ;-900=Missing;-300=N/A
|
|
|
chrdemo_age_mos_hc |
Integer |
|
Recommended |
Age in months |
|
round(datediff([baseline_arm_2][chrdemo_dob],[screening_arm_2][chric_consent_date]=''''M'''')=0) ;-900=Missing;-300=N/A
|
|
|
chrdemo_firstlang |
String |
50
|
Recommended |
3. What is your first language (mother tongue)? |
|
|
|
|
chrdemo_assess_lang |
Integer |
|
Recommended |
4. In what language will assessments be conducted? (Rater to answer) |
1::10;-900;-300
|
1=Cantonese; 2=Danish; 3=Dutch; 4=English; 5=French; 6=German; 7=Italian; 8=Korean; 9=Mandarin (TBC); 10=Spanish ;-900=Missing;-300=N/A
|
|
|
chrdemo_lang_comprehension |
Integer |
|
Recommended |
5. How well can you speak and understand [chrdemo_assess_lang]? |
1;2;-900;-300
|
1=Very well, it is my native language; 2=I speak and understand it, but it is my second language ;-900=Missing;-300=N/A
|
|
|
chrdemo_cob |
Integer |
|
Recommended |
In which country were you born? |
1::197;-900;-300
|
1=Afghanistan; 2=Albania; 3=Algeria; 4=Andorra; 5=Angola; 6=Antigua and Barbuda; 7=Argentina; 8=Armenia; 9=Australia; 10=Austria; 11=Azerbaijan; 12=Bahamas; 13=Bahrain; 14=Bangladesh; 15=Barbados; 16=Belarus; 17=Belgium; 18=Belize; 19=Benin; 20=Bhutan; 21=Bolivia; 22=Bosnia and Herzegovina; 23=Botswana; 24=Brazil; 25=Brunei; 26=Bulgaria; 27=Burkina Faso; 28=Burundi; 29=C?te d''Ivoire; 30=Cabo Verde; 31=Cambodia; 32=Cameroon; 33=Canada; 34=Central African Republic; 35=Chad; 36=Chile; 37=China; 38=Colombia; 39=Comoros; 40=Congo (Congo-Brazzaville); 41=Costa Rica; 42=Croatia; 43=Cuba; 44=Cyprus; 45=Czechia (Czech Republic); 46=Democratic Republic of the Congo; 47=Denmark; 48=Djibouti; 49=Dominica; 50=Dominican Republic; 51=Ecuador; 52=Egypt; 53=El Salvador; 54=Equatorial Guinea; 55=Eritrea; 56=Estonia; 57=Eswatini (fmr=''''Swaziland''''); 58=Ethiopia; 59=Fiji; 60=Finland; 61=France; 62=Gabon; 63=Gambia; 64=Georgia; 65=Germany; 66=Ghana; 67=Greece; 68=Grenada; 69=Guatemala; 70=Guinea; 71=Guinea-Bissau; 72=Guyana; 73=Haiti; 74=Holy See; 75=Honduras; 76=Hong Kong; 77=Hungary; 78=Iceland; 79=India; 80=Indonesia; 81=Iran; 82=Iraq; 83=Ireland; 84=Israel; 85=Italy; 86=Jamaica; 87=Japan; 88=Jordan; 89=Kazakhstan; 90=Kenya; 91=Kiribati; 92=Kuwait; 93=Kyrgyzstan; 94=Laos; 95=Latvia; 96=Lebanon; 97=Lesotho; 98=Liberia; 99=Libya; 100=Liechtenstein; 101=Lithuania; 102=Luxembourg; 103=Madagascar; 104=Malawi; 105=Malaysia; 106=Maldives; 107=Mali; 108=Malta; 109=Marshall Islands; 110=Mauritania; 111=Mauritius; 112=Mexico; 113=Micronesia; 114=Moldova; 115=Monaco; 116=Mongolia; 117=Montenegro; 118=Morocco; 119=Mozambique; 120=Myanmar (formerly Burma); 121=Namibia; 122=Nauru; 123=Nepal; 124=Netherlands; 125=New Zealand; 126=Nicaragua; 127=Niger; 128=Nigeria; 129=North Korea; 130=North Macedonia; 131=Norway; 132=Oman; 133=Pakistan; 134=Palau; 135=Palestine State; 136=Panama; 137=Papua New Guinea; 138=Paraguay; 139=Peru; 140=Philippines; 141=Poland; 142=Portugal; 143=Qatar; 144=Romania; 145=Russia; 146=Rwanda; 147=Saint Kitts and Nevis; 148=Saint Lucia; 149=Saint Vincent and the Grenadines; 150=Samoa; 151=San Marino; 152=Sao Tome and Principe; 153=Saudi Arabia; 154=Senegal; 155=Serbia; 156=Seychelles; 157=Sierra Leone; 158=Singapore; 159=Slovakia; 160=Slovenia; 161=Solomon Islands; 162=Somalia; 163=South Africa; 164=South Korea; 165=South Sudan; 166=Spain; 167=Sri Lanka; 168=Sudan; 169=Suriname; 170=Sweden; 171=Switzerland; 172=Syria; 173=Tajikistan; 174=Tanzania; 175=Thailand; 176=Timor-Leste; 177=Togo; 178=Tonga; 179=Trinidad and Tobago; 180=Tunisia; 181=Turkey; 182=Turkmenistan; 183=Tuvalu; 184=Uganda; 185=Ukraine; 186=United Arab Emirates; 187=United Kingdom; 188=United States of America; 189=Uruguay; 190=Uzbekistan; 191=Vanuatu; 192=Venezuela; 193=Vietnam; 194=Yemen; 195=Zambia; 196=Zimbabwe; 197=Other ;-900=Missing;-300=N/A
|
|
|
chrdemo_cob_other |
String |
50
|
Recommended |
If other, please specify: |
|
|
|
|
chrdemo_current_country |
Integer |
|
Recommended |
6a. In which country are you currently living? |
1::197;-900;-300
|
1=Afghanistan; 2=Albania; 3=Algeria; 4=Andorra; 5=Angola; 6=Antigua and Barbuda; 7=Argentina; 8=Armenia; 9=Australia; 10=Austria; 11=Azerbaijan; 12=Bahamas; 13=Bahrain; 14=Bangladesh; 15=Barbados; 16=Belarus; 17=Belgium; 18=Belize; 19=Benin; 20=Bhutan; 21=Bolivia; 22=Bosnia and Herzegovina; 23=Botswana; 24=Brazil; 25=Brunei; 26=Bulgaria; 27=Burkina Faso; 28=Burundi; 29=C?te d''Ivoire; 30=Cabo Verde; 31=Cambodia; 32=Cameroon; 33=Canada; 34=Central African Republic; 35=Chad; 36=Chile; 37=China; 38=Colombia; 39=Comoros; 40=Congo (Congo-Brazzaville); 41=Costa Rica; 42=Croatia; 43=Cuba; 44=Cyprus; 45=Czechia (Czech Republic); 46=Democratic Republic of the Congo; 47=Denmark; 48=Djibouti; 49=Dominica; 50=Dominican Republic; 51=Ecuador; 52=Egypt; 53=El Salvador; 54=Equatorial Guinea; 55=Eritrea; 56=Estonia; 57=Eswatini (fmr=''''Swaziland''''); 58=Ethiopia; 59=Fiji; 60=Finland; 61=France; 62=Gabon; 63=Gambia; 64=Georgia; 65=Germany; 66=Ghana; 67=Greece; 68=Grenada; 69=Guatemala; 70=Guinea; 71=Guinea-Bissau; 72=Guyana; 73=Haiti; 74=Holy See; 75=Honduras; 76=Hong Kong; 77=Hungary; 78=Iceland; 79=India; 80=Indonesia; 81=Iran; 82=Iraq; 83=Ireland; 84=Israel; 85=Italy; 86=Jamaica; 87=Japan; 88=Jordan; 89=Kazakhstan; 90=Kenya; 91=Kiribati; 92=Kuwait; 93=Kyrgyzstan; 94=Laos; 95=Latvia; 96=Lebanon; 97=Lesotho; 98=Liberia; 99=Libya; 100=Liechtenstein; 101=Lithuania; 102=Luxembourg; 103=Madagascar; 104=Malawi; 105=Malaysia; 106=Maldives; 107=Mali; 108=Malta; 109=Marshall Islands; 110=Mauritania; 111=Mauritius; 112=Mexico; 113=Micronesia; 114=Moldova; 115=Monaco; 116=Mongolia; 117=Montenegro; 118=Morocco; 119=Mozambique; 120=Myanmar (formerly Burma); 121=Namibia; 122=Nauru; 123=Nepal; 124=Netherlands; 125=New Zealand; 126=Nicaragua; 127=Niger; 128=Nigeria; 129=North Korea; 130=North Macedonia; 131=Norway; 132=Oman; 133=Pakistan; 134=Palau; 135=Palestine State; 136=Panama; 137=Papua New Guinea; 138=Paraguay; 139=Peru; 140=Philippines; 141=Poland; 142=Portugal; 143=Qatar; 144=Romania; 145=Russia; 146=Rwanda; 147=Saint Kitts and Nevis; 148=Saint Lucia; 149=Saint Vincent and the Grenadines; 150=Samoa; 151=San Marino; 152=Sao Tome and Principe; 153=Saudi Arabia; 154=Senegal; 155=Serbia; 156=Seychelles; 157=Sierra Leone; 158=Singapore; 159=Slovakia; 160=Slovenia; 161=Solomon Islands; 162=Somalia; 163=South Africa; 164=South Korea; 165=South Sudan; 166=Spain; 167=Sri Lanka; 168=Sudan; 169=Suriname; 170=Sweden; 171=Switzerland; 172=Syria; 173=Tajikistan; 174=Tanzania; 175=Thailand; 176=Timor-Leste; 177=Togo; 178=Tonga; 179=Trinidad and Tobago; 180=Tunisia; 181=Turkey; 182=Turkmenistan; 183=Tuvalu; 184=Uganda; 185=Ukraine; 186=United Arab Emirates; 187=United Kingdom; 188=United States of America; 189=Uruguay; 190=Uzbekistan; 191=Vanuatu; 192=Venezuela; 193=Vietnam; 194=Yemen; 195=Zambia; 196=Zimbabwe; 197=Other ;-900=Missing;-300=N/A
|
|
|
chrdemo_current_country_other |
String |
50
|
Recommended |
If other, please specify: |
|
|
|
|
chrdemo_country_situation |
Integer |
|
Recommended |
7. Which of the following situation applies to you? |
1::4;-900;-300
|
1=Born in <country where assessment is conducted> and not 1st or 2nd generation immigrant; 2=1st generation immigrant (you and your parents were born abroad and you came to < country where assessment is conducted> after age 5); 3=1st generation immigrant plus (you and your parents were born abroad=but you came to country where assessment is conducted> before age 5); 4=2nd generation immigrant (born in <country where assessment conducted> one or both parents born abroad) ;-900=Missing;-300=N/A
|
|
|
chrdemo_refugee_status |
Integer |
|
Recommended |
8. Do you have refugee status? |
0;1;-99;-900;-300
|
0=No; 1=Yes; -99=Prefer not to say ;-900=Missing;-300=N/A
|
|
|
chrdemo_racial_back |
Integer |
|
Recommended |
9. How would you describe your racial background (i.e., not necessarily your country of birth)? |
1::12;99;-900;-300
|
1=Indigenous/Aboriginal Persons (e.g.=North American Indian=First Nation=Metis=Inuit=Aboriginal people=Torres Strait Islander); 2=East Asian (e.g.=China=Japan=Korea); 3=Southeast Asian (e.g.=Cambodia=Indonesia=Vietnam); 4=South Asian (e.g.=India=Pakistan=Sri Lanka); 5=Black/African/African American; 6=West/Central Asian and Middle Eastern (e.g.=Egypt=Lebanon=United Arab Emirates=Afghanistan=Iran); 7=White/European/North American/Australian; 8=Native Hawaiian or Pacific Islander; 9=Mexican American; 10=Two or more races/mixed race; 11=Prefer to self-describe; 12=Central / South American; 99=Prefer not to answer; -900=Missing;-300=N/A
|
|
|
chrdemo_hispanic_latino |
Integer |
|
Recommended |
10. Are you Hispanic or Latino? |
0;1;-99;-900;-300
|
0=No; 1=Yes; -99=Prefer not to say ;-900=Missing;-300=N/A
|
|
|
chrdemo_marital_status |
Integer |
|
Recommended |
11. What is your current relationship/marital status? |
1::6;99;-900;-300
|
1=Never married or Single; 2=In a relationship; 3=Married/Common law/de facto (two people who live together as partners); 4=Separated but not divorced; 5=Divorced; 6=Widowed; 99=Other ;-900=Missing;-300=N/A
|
|
|
chrdemo_marital_status_other |
String |
50
|
Recommended |
If Other, please specify relationship/marital status: |
|
|
|
|
chrdemo_children |
Integer |
|
Recommended |
12. How many children do you have? |
0::5;-900;-300
|
0=0; 1=1; 2=2; 3=3; 4=4; 5=5 or more ;-900=Missing;-300=N/A
|
|
|
chrdemo_housing |
Integer |
|
Recommended |
13. What is your current living situation? |
1::7;99;-900;-300
|
1=House/flat/apartment with family of origin; 2=Rented room; 3=Rented flat/house/apartment; 4=Owned flat/house/apartment; 5=Boarding house/hostel; 6=Supported residential home; 7=Homeless or couch surfing; 99=Other ;-900=Missing;-300=N/A
|
|
|
ampscz_missing |
Integer |
|
Recommended |
Please click if this form is missing all of its data |
0;1
|
0 = Not clicked; 1 = Clicked
|
chrdemo_missing |
|
chrdemo_housing_other |
String |
50
|
Recommended |
If Other, please specify housing: |
|
|
|
|
chrdemo_living_situtation |
String |
50
|
Recommended |
14. Who do you currently live with? (tick all that apply) |
|
1=Alone; 2=Both parents; 3=Mother/step-mother/foster mother only; 4=Father/step-father/foster father only; 5=Sibling(s); 6=Partner; 7=Son(s)/daughter(s); 8=Friend(s); 9=Housemate; 10=Grandparents or extended family; 11=Support workers; 99=Other;-900=Missing;-300=N/A ;-900=Missing;-300=N/A
|
|
|
chrdemo_living_situtationother |
String |
50
|
Recommended |
If other, please specify: |
|
|
chrdemo_living_situtation_other |
|
chrdemo_income |
Integer |
|
Recommended |
15. What is the main source of your personal income? |
1::7;99;-900;-300
|
1=Contributions from family/spouse/partner; 2=Disability Income; 3=Gross Earnings (self); 4=Social Support; 5=Pension/Insurance; 6=Personal Needs Allowance (e.g.=if living in a shelter); 7=Student Loan; 99=Other ;-900=Missing;-300=N/A
|
|
|
chrdemo_income_other |
String |
50
|
Recommended |
If other please specify: |
|
|
|
|
chrdemo_education |
Integer |
|
Recommended |
16. How many years of education have you completed after preschool/ kindergarten ? (Select your choice) |
0::20;-900;-300
|
0=0; 1=1; 2=2; 3=3; 4=4; 5=5; 6=6; 7=7; 8=8; 9=9; 10=10; 11=11; 12=12; 13=13; 14=14; 15=15; 16=16; 17=17; 18=18; 19=19; 20=20 plus ;-900=Missing;-300=N/A
|
|
|
chrdemo_edu_max |
Integer |
|
Recommended |
17. What is the highest level of formal education that you have achieved? |
1::7;-900;-300
|
1=Less than seven years of school; 2=Junior high school (up to and including 8th grade); 3=Some high school/secondary school (grade 9-11); 4=Completed high school/secondary school (12th grade); 5=Partial college training; 6=College or university education; 7=Graduate or professional training ;-900=Missing;-300=N/A
|
|
|
chrdemo_student |
Integer |
|
Recommended |
18. Are you currently enrolled or were you enrolled as a student within the past 6 months? |
0;1;-900;-300
|
0=No; 1=Yes ;-900=Missing;-300=N/A
|
|
|
chrdemo_working |
Integer |
|
Recommended |
19. Are you currently working in paid employment? |
0::2;-900;-300
|
0=No; 1=Yes,working full-time; 2=Yes,working part-time ;-900=Missing;-300=N/A
|
|
|
chrdemo_volwork |
Integer |
|
Recommended |
20. Are you currently volunteering? |
0;1;-900;-300
|
0=No; 1=Yes ;-900=Missing;-300=N/A
|
|
|
ampscz_missing_spec |
Integer |
|
Recommended |
Please specify the reason for missing data on this form |
0::6
|
0 = Evaluation not necessary because the screening visit was less than 21 days from baseline visit; 1 = Measure refusal (no reason provided); 2 = No show; 3 = Research assistant forgot; 4 = Uncontrollable circumstance; 5 = Participant dropped out; 6 = Evaluation not necessary because the screening visit was less than 21 days from baseline visit
|
chrdemo_missing_spec |
|
chrdemo_sibling |
Integer |
|
Recommended |
21. Do you have a biological sibling in the study? |
1::6;-900;-300
|
1=No; 2=An identical twin; 3=A brother; 4=A sister; 5=A half-brother; 6=A half-sister ;-900=Missing;-300=N/A
|
|
|
chrdemo_sibling_id |
String |
50
|
Recommended |
Please enter the sibling''s Study ID |
|
|
|
|
chrdemo_parent_occupation |
Integer |
|
Recommended |
22. Thinking about one of your (child-rearing) parents/guardians, what is their occupation (or more recent occupation if retired or deceased)? |
1::9;-900;-300
|
1=Higher executives,Proprietors of Large Businesses,Major Professionals; 2=Administrators,Proprietors of Medium-Sized Businesses,Lesser Professionals; 3=Smaller Business Owners,Farm Owners,Managers,Minor Professionals; 4=Technicians,Semiprofessionals,Small Business Owners; 5=Clerical and Sales Workers,Small Farm and Business Owners; 6=Smaller Business Owners,Skill Manual Workers,Craftsmen,Tenant Farmers; 7=Semi-skilled Workers,Machine Operators; 8=Unskilled Workers; 9=Farm Laborers=Service Workers; -300=N/A - I did not have a primary caregiver; -900=Missing ;-900=Missing;-300=N/A
|
|
|
chrdemo_parent_occupation2 |
Integer |
|
Recommended |
23. Thinking about the other of your (child-rearing) parents/guardians, what is their occupation (or more recent occupation if retired or deceased)? |
1::9;-900;-300
|
1=Higher executives,Proprietors of Large Businesses,Major Professionals; 2=Administrators,Proprietors of Medium-Sized Businesses,Lesser Professionals; 3=Smaller Business Owners,Farm Owners,Managers,Minor Professionals; 4=Technicians=Semiprofessionals=Small Business Owners; 5=Clerical and Sales Workers=Small Farm and Business Owners; 6=Smaller Business Owners,Skill Manual Workers,Craftsmen,Tenant Farmers; 7=Semi-skilled Workers,Machine Operators; 8=Unskilled Workers; 9=Farm Laborers,Service Workers;-300=N/A - I was raised by only one parent/guardian; -900=Missing ;-900=Missing;-300=N/A
|
|
|
chrdemo_parent_edu_first |
Integer |
|
Recommended |
24. What is the highest level of formal education that your first mentioned (child-rearing) parent/guardian achieved? |
1::7;-900;-300
|
1=Less than seven years of school; 2=Junior high school (up to and including 8th grade); 3=Some high school/secondary school (grade 9-11); 4=Completed high school/secondary school (12th grade); 5=Partial college training; 6=College or university education; 7=Graduate or professional training; -300=N/A or I did not have a primary caregiver; -900=Missing
|
|
|
chrdemo_parent_edu_other |
Integer |
|
Recommended |
25. What is the highest level of formal education that your other (child-rearing) parent/guardian achieved? |
1::7;-900;-300
|
1=Less than seven years of school; 2=Junior high school (up to and including 8th grade); 3=Some high school/secondary school (grade 9-11); 4=Completed high school/secondary school (12th grade); 5=Partial college training; 6=College or university education; 7=Graduate or professional training; -300=N/A or I was raised by only one parent or did not have a primary caregiver; -900=Missing
|
|
|
ampscz_entry_date |
Date |
|
Recommended |
Date of Data Entry |
|
MM/DD/YYYY
|
chrdemo_entry_date |
|
chrdemo_gender_identity |
Integer |
|
Recommended |
What is your gender identity? |
1 :: 8;-99;99;-900;-300
|
1=Male; 2=Female; 3= Transgender male; 4=Non binary; 5= Transgender female; 6= Agender; 7= Gender Queer; 8= Other/Prefer to self-identify; -99=Prefer not to say; 99=Other ;-900=Missing;-300=N/A
|
|
|
chrdemo_gender_other |
String |
50
|
Recommended |
If Other, please specify gender: |
|
|
|
|
chrdemo_sexassigned |
Integer |
|
Recommended |
1b. What sex were you assigned at birth, what was on your original birth certificate? |
1::3;-900;-300; -5; -999
|
1=Male; 2=Female; 3=Intersex; -900=Missing;-300=N/A; -999 =data not submitted (incomplete); -5=item seen but not answered
|
|
|
chrdemo_age_mos3 |
String |
50
|
Recommended |
Age in years (Please only fill this out if you are unable to enter DOB above) |
|
|
|
|
ses_cur_wic |
Integer |
|
Recommended |
In the last year, did anyone in your household, including yourself, receive any of the following public benefits? WIC |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_cur_welfare |
Integer |
|
Recommended |
In the last year, did anyone in your household, including yourself, receive any of the following public benefits? Welfare (AFDC or TANF) |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_cur_disability |
Integer |
|
Recommended |
In the last year, did anyone in your household, including yourself, receive any of the following public benefits? Disability |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_mother_edu |
Integer |
|
Recommended |
What is the highest grade of school your MOTHER completed? |
1::10
|
1= No formal schooling; 2= Less than a high school diploma; 3= A high school diploma or GED; 4= Technical certificate or degree; 5= Some college or a 2 year degree; 6= 4 year college degree; 7= Some post graduate work; 8= Post graduate or advanced professional degree; 9= Unsure; 10= Prefer not to answer
|
|
|
ses_father_edu |
Integer |
|
Recommended |
What is the highest grade of school your FATHER completed? |
1::10
|
1= No formal schooling; 2= Less than a high school diploma; 3= A high school diploma or GED; 4= Technical certificate or degree; 5= Some college or a 2 year degree; 6= 4 year college degree; 7= Some post graduate work; 8= Post graduate or advanced professional degree; 9= Unsure; 10= Prefer not to answer
|
|
|
ses_community_childhood |
Integer |
|
Recommended |
Think of this ladder as representing ALL THE PEOPLE IN YOUR COMMUNITY during your childhood. At the top of the ladder are the people IN YOUR COMMUNITY who were the best off-the most money, the highest status in town, and the most influential. At the bottom of the ladder are the people who were the worst off-who have the least money, the least prestige, and the least influential. The higher up you are on this ladder the closer you are to the people at the very top. The lower you are, the closer you are to the people at the very bottom. Thinking back to YOUR CHILDHOOD, which number best describes where you would place yourself/your family on this ladder? |
1::10
|
1= Bottom of the ladder; 10= Top of the ladder
|
|
|
ses_community_cur |
Integer |
|
Recommended |
Think of this ladder as representing ALL THE PEOPLE IN YOUR COMMUNITY during your childhood. At the top of the ladder are the people IN YOUR COMMUNITY who were the best off-the most money, the highest status in town, and the most influential. At the bottom of the ladder are the people who were the worst off-who have the least money, the least prestige, and the least influential. The higher up you are on this ladder the closer you are to the people at the very top. The lower you are, the closer you are to the people at the very bottom. Thinking about YOUR CURRENT SITUATION, which number best describes where you would place yourself on this ladder? |
1::10
|
1= Bottom of the ladder; 10= Top of the ladder
|
|
|
ses_us_childhood |
Integer |
|
Recommended |
Think of this ladder as representing ALL THE PEOPLE IN THE UNITED STATES. At the top of the ladder are the people IN THE UNITED STATES who were the best off-the most money, the highest status in town, and the most influential. At the bottom of the ladder are the people who were the worst off-who have the least money, the least prestige, and the least influential. The higher up you are on this ladder the closer you are to the people at the very top. The lower you are, the closer you are to the people at the very bottom. Thinking back to YOUR CHILDHOOD, which number best describes where you would place yourself/your family on this ladder? |
1::10
|
1= Bottom of the ladder; 10= Top of the ladder
|
|
|
ses_us_cur |
Integer |
|
Recommended |
Think of this ladder as representing ALL THE PEOPLE IN THE UNITED STATES. At the top of the ladder are the people IN THE UNITED STATES who were the best off-the most money, the highest status in town, and the most influential. At the bottom of the ladder are the people who were the worst off-who have the least money, the least prestige, and the least influential. The higher up you are on this ladder the closer you are to the people at the very top. The lower you are, the closer you are to the people at the very bottom. Thinking about YOUR CURRENT SITUATION, which number best describes where you would place yourself on this ladder? |
1::10
|
1= Bottom of the ladder; 10= Top of the ladder
|
|
|
ses_childhood_lunch |
Integer |
|
Recommended |
During your childhood, did anyone in your household, including yourself, receive any of the following public benefits? Free or reduced price school lunch |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_childhood_foodstamps |
Integer |
|
Recommended |
During your childhood, did anyone in your household, including yourself, receive any of the following public benefits? Food stamps (SNAP) |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_chlidhood_wic |
Integer |
|
Recommended |
During your childhood, did anyone in your household, including yourself, receive any of the following public benefits? WIC |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_childhood_welfare |
Integer |
|
Recommended |
During your childhood, did anyone in your household, including yourself, receive any of the following public benefits? Welfare (AFDC or TANF) |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_childhood_disability |
Integer |
|
Recommended |
During your childhood, did anyone in your household, including yourself, receive any of the following public benefits? Disability |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_cur_lunch |
Integer |
|
Recommended |
In the last year, did anyone in your household, including yourself, receive any of the following public benefits? Free or reduced price school lunch |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
ses_cur_foodstamps |
Integer |
|
Recommended |
In the last year, did anyone in your household, including yourself, receive any of the following public benefits? Food stamps (SNAP) |
0::3
|
0= No; 1= Yes; 2= Do not know; 3= Prefer not to answer
|
|
|
yc_partner_drug___0 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Cannabis/Marijuana/THC |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___1 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Alcohol |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___2 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Cigarettes |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___3 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? E-cigarettes (nicotine) |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___4 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Sedatives (e.g., sleeping pills, valium, Ativan, Xanax) |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___5 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Painkillers (e.g., codeine, oxycontin, dilaudid) |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___6 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Stimulants (e.g., Adderall, Ritalin, amphetamines) |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___7 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Cocaine or crack |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___8 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Hallucinogens (e.g., Ecstasy/MDMA, LSD, PCP, angel dust) |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___9 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Inhalants or solvents (e.g., nitrous oxide) |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___10 |
Integer |
|
Recommended |
Does your partner use any of the following substances (other than if prescribed)? Heroin |
0;1
|
1=yes; 0=no
|
|
|
yc_partner_drug___11 |
Integer |
|
Recommended |
Any other drug (other than as prescribed) |
0;1
|
1=yes; 0=no
|
|
|
yc_indp_finances |
Integer |
|
Recommended |
Are you financially independent (for example, pay own housing and living expenses without assistance from relatives or others)? |
0;1
|
1=yes; 0=no
|
|
|
yc_income_grew_up |
Integer |
|
Recommended |
What is the annual income in the household you grew up? |
1::6
|
1=Less than $25,000; 2=$25,000 to less than $50,000; 3=$50,000 to less than $75,000; 4=$75,000 to less than $100,000; 5=$100,000 or more; 6=Don't Know/Prefer not to answer
|
|
|
yc_sex |
Integer |
20
|
Recommended |
Sex of subject at birth |
1::4
|
1=female; 2=male; 3=intersex; 4=none of these describe me
|
|
|
yc_ethnic_group |
Integer |
|
Recommended |
Are you of Hispanic, Latino, or Spanish origin? |
0;1
|
1 = Hispanic; 0 = not Hispanic
|
|
|
edu_cbd |
Integer |
|
Recommended |
What is the highest grade or level of school you have completed or the highest degree you have received? |
0::21
|
0=Never Attended/Kindergarten Only;1=1st Grade;2=2nd Grade;3=3rd Grade;4=4th Grade;5=5th Grade;6=6th Grade;7=7th Grade;8=8th Grade;9=9th Grade;10=10th Grade;11=11th Grade;12=12th Grade, No Diploma;13=High School Graduate;14=GED or Equivalent;15=Some College, No Degree;16=Associate Degree: Occupational, Technical, or Vocational Program;17=Associate Degree: Academic Program;18=Bachelor's Degree (Example: BA, AB, BS, BBA);19=Master's Degree (Example: MA, MS, MEng, MEd, MBA);20=Professional School Degree (Example: MD, DDS, DVM, JD);21=Doctoral Degree (Example: PhD, EdD)
|
|
|
yc_gpa |
Float |
|
Recommended |
What are your most recent grades like (estimate GPA on a 4-point scale)? |
0::4
|
0 = F; 1 = D; 2 = C; 3 = B; 4 = A; NOTE: If you are not currently in school, please report your most recent GPA. x.xx
|
|
|
yc_employment |
Integer |
|
Recommended |
We would like to know about what you do-are you working now, looking for work, retired, keeping house, a student, or what? |
1::8
|
1=working now; 2=only temporarily laid off, sick leave, or maternity leave; 3=looking for work, unemployed; 4=retired; 5=disabled, permanently or temporarily; 6=keeping house; 7=student; 8=other (specify)
|
|
|
yc_employment_other |
String |
255
|
Recommended |
We would like to know about what you do-are you working now, looking for work, retired, keeping house, a student, or what? Other (specify) |
|
(if yc_employment = 8)
|
|
|
yc_partner |
Integer |
|
Recommended |
Do you have a romantic partner? |
0;1;-99
|
0 = No; 1 = Yes; -99 = Not Applicable
|
|
|
chrdemo_living_situtation___3 |
Integer |
|
Recommended |
Who do you currently live with? - Mother/step-mother/foster mother only |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_living_situtation___4 |
Integer |
|
Recommended |
Who do you currently live with? - Father/step-father/foster father only |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_living_situtation___5 |
Integer |
|
Recommended |
Who do you currently live with? - Sibling(s) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
campus25 |
Integer |
|
Recommended |
Whom do you live with? Spouse, partner, or significant other |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_living_situtation___6 |
|
campus27 |
Integer |
|
Recommended |
Whom do you live with? Children |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_living_situtation___7 |
|
chrdemo_living_situtation___8 |
Integer |
|
Recommended |
Who do you currently live with? - Friend(s) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
campus26 |
Integer |
|
Recommended |
Whom do you live with? Roomate(s) |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_living_situtation___9 |
|
chrdemo_living_situtation___10 |
Integer |
|
Recommended |
Who do you currently live with? - Grandparents or extended family |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_living_situtation___11 |
Integer |
|
Recommended |
Who do you currently live with? - Support workers |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
campus30 |
Integer |
|
Recommended |
Whom do you live with? Other |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_living_situtation___99 |
|
chrdemo_racial_back___1 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Indigenous/Aboriginal Persons (e.g. North American Indian, First Nation, Metis, Inuit, Aboriginal people, Torres Strait Islander) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___2 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - East Asian (e.g. China, Japan, Korea) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___3 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Southeast Asian (e.g. Cambodia, Indonesia, Vietnam) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___4 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - South Asian (e.g. India, Pakistan, Sri Lanka) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___5 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Black/African/African American |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___6 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - West/Central Asian and Middle Eastern (e.g. Egypt, Lebanon, United Arab Emirates, Afghanistan=Iran) |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___7 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - White/European/North American/Australian |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
d_race05 |
Integer |
|
Recommended |
What is your racial background? Native Hawaiian, Pacific Islander |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_racial_back___8 |
|
chrdemo_racial_back___9 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Mexican American |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___10 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Two or more races/mixed race |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
demog1_1 |
Integer |
|
Recommended |
What is your current gender identity? Please select all that apply. (Choice: Male) |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_gender_identity___1 |
|
chrdemo_racial_back___11 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Prefer to self-describe |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___12 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Central/South American |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
chrdemo_racial_back___99 |
Integer |
|
Recommended |
How would you describe your racial background (i.e., not necessarily your country of birth)? - Prefer not to answer |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
demog1_2 |
Integer |
|
Recommended |
What is your current gender identity? Please select all that apply. (Choice: Female) |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_gender_identity___2 |
|
ctan5demo_5b3 |
Integer |
|
Recommended |
What terms best express how you describe your gender identity: Non-binary |
0;1; 99;-900;-300
|
0 = No; 1 = Yes; 99 = no data; -900 = Missing; -300 = N/A
|
chrdemo_gender_identity___4 |
|
demog1_7 |
Integer |
|
Recommended |
What is your current gender identity? Please select all that apply. (Choice: Prefer not to answer) |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_gender_identity____99 |
|
demog1_6 |
Integer |
|
Recommended |
What is your current gender identity? Please select all that apply. (Choice: Different identity (please state)) |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_gender_identity___99 |
|
campus24 |
Integer |
|
Recommended |
Whom do you live with? Alone |
0;1;-900;-300
|
0= No; 1= Yes; -900 = Missing; -300 = N/A
|
chrdemo_living_situtation___1 |
|
chrdemo_living_situtation___2 |
Integer |
|
Recommended |
Who do you currently live with? - Both parents |
0;1;-900;-300
|
0 = No; 1 = Yes; -900 = Missing; -300 = N/A
|
|
|
info_qn3 |
Integer |
|
Recommended |
How old are you? |
0::100; 9997; -9999
|
-9997=Not applicable; -9999=Missing
|
|
|
svsedu |
Integer |
|
Recommended |
What is the HIGHEST level of schooling you have completed? |
1::9;888
|
1=Less than a high school diploma; 2=High school diploma/GED; 3=Trade school; 4=Some college(no degree); 5=Completed Associate or other Techinical 2-year degree; 6=Completed Bachelor?s degree or other 4-year degree program; 7=Some Graduate or Professional studies (completed Bachelor?s degree but did not complete Graduate degree); 8=Completed Graduate or Professional degree (Master?s degree or higher); 9=Other; 888=Choose not to respond
|
|
|
dem_income_12 |
Integer |
|
Recommended |
Which of these categories best describes your total combined family income for the past 12 months? This should include income (before taxes) from all sources, wages, rent from properties, social security, disability and/or veteran's benefits, unemployment benefits, worker's compensation, help from relatives (including child payments and alimony), and so on. |
0::19;777;888
|
0 = Doesn't know or would rather not say; 1 = Less than $10,000 ; 2 = $10,000 through $19,999 ; 3 = $20,000 through $29,999 ; 4 = $30,000 through $39,999 ; 5 = $40,000 through $49,999 ; 6 = $50,000 through $59,999 ; 7 = $60,000 through $69,999 ; 8 = $70,000 through $79,999 ; 9 = $80,000 through $89,999 ; 10 = $90,000 through $99,999 ; 11 = $100,000 through $119,999 ; 12 = $120,000 through $129,999 ; 13 = $130,000 through $139,999 ; 14 = $140,000 and greater ; 15=$50,000-$74,999; 16=$75,000-$99,999; 17=$100,000-$150,000; 18=over $150,000; 19 = $75,000 or more; 777 = Don't know ; 888 = No response
|
|
|
house_number |
Integer |
|
Recommended |
How many people live in the subject's household? |
|
|
|
|
chartreview016c_10 |
Integer |
|
Recommended |
What type of insurance does the patient have? Medicare |
0;1; -888;-999
|
0=Unchecked; 1=Checked; -888=Not Applicable; -999=Missing;
|
|
|
chartreview016c_3 |
Integer |
|
Recommended |
What type of insurance does the patient have? Medicaid |
0;1; -888;-999
|
0=Unchecked; 1=Checked; -888=Not Applicable; -999=Missing;
|
|
|
chartreview016c_5 |
Integer |
|
Recommended |
What type of insurance does the patient have? Military Health Care (Tricare/VA/CHAMP-VA) |
0;1; -888;-999
|
0=Unchecked; 1=Checked; -888=Not Applicable; -999=Missing;
|
|
|
chartreview016c_1 |
Integer |
|
Recommended |
What type of insurance does the patient have? Private Health Insurance |
0;1; -888;-999
|
0=Unchecked; 1=Checked; -888=Not Applicable; -999=Missing;
|
|