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[p. 1]


CHILD CORE
Section I -- IDENTIFICATION AND VERIFICATION
Check item CHILD_BEGIN: If call back for Sample Child section is not needed and call back for Immunization is needed. Goto Check item CIMCCI1(beginning of Immunization section); Else goto CID.001. If no sample child or sample child section is completed (not including immunization section), goto CIDCCI2; Else (sample child) if KNOWSC 1-3 (person knows sample child) = 2 or blank, goto KNOAVAIL, others goto CID.001.
CID.001

FR: ENTER THE NUMBER OF THE PERSON TO WHOM YOU ARE SPEAKING.
CURRES _______________ (1-30) Person number
[If the same person in CID.001 is in KNOWSC_1-3, goto CID.005; Else goto CSPEDIT.]

CID.005

The next questions are about {Sample Child name}. Are you able to answer questions about {his/her}health at this time?
CSRESP
(1) Yes (CID.030)
(2) No (Check item CSPEDIT)
(7) Refused (Check item CSPEDIT)
(9) DK (Check item CSPEDIT)
Check item CSPEDIT: Check the content from HHC.470, Household Core: Plug names for variables KNOWSC_1 to KNOWSC_3 in CID.010 {KNOWSC name}. If all KNOWSC for CID.010 equal 2, 7 or 9, goto Check item CSPEDIT2.

Check item CSPEDIT2: Check KNOWSC1 TO KNOWSC3, if has a valid person number, goto CID.015; If answer is 2, then goto check item CIDCCI2; If all the KNOWSC are not available, goto KNOAVAIL; If no one else in the family is available, goto CSPEDIT3.

Check item CSPEDIT3: Goto CSTAT.
CID.010

Is {KNOWSC name} available to answer some questions about {sample child name}'s health?
CSPAVAIL
(1) Available (CID.030)
(2) Not available (Check item CSPEDIT)
(7) Refused (Check item CSPEDIT)
(9) DK (Check itemCSPEDIT)

CID.015

Is there any family member available who can answer questions about {sample child name}'s health?
KNOAVAIL
(1) Yes (CID.020)
(2) No (Check item CIDCCI2)

CID.020

Enter the person number of the respondent.
CSRESPNO _______________ (1-30) Person number
FR: HAND CARD C1. ENTER ONLY 1.
Card C1
1. Parent (Biological, Adoptive or Step)
2. Grandparent
3. Aunt/Uncle
4. Brother/Sister
5. Other relative
6. Legal guardian
7. Foster parent
8. Other non-relative

[p. 2]

CID.030

What is {CSRESPNO name}'s relationship to {sample child name}?
CSRELTIV
(1) Parent (Biological adoptive, or step)
(2) Grandparent
(3) Aunt/Uncle
(4) Brother/Sister
(5) Other relative
(6) Legal guardian
(7) Foster parent
(8) Other non-relative
(97) Refused
(99) DK
Check item CIDCCI1: If CSRESPNO is the household respondent/ family respondent, goto Check item CIDCCI2; Else goto CID.040.
CID.040

FR: PLEASE VERIFY THE FOLLOWING INFORMATION ABOUT THE SAMPLE CHILD BEFORE PROCEEDING:

(1) Yes
(2) No
CSPVERF1 Gender = {male/female} Is it correct?
CSPVERF2 Age = {3 digit format} Is it correct?
CSPVERF3 Birthday = {spoken word format} Is it correct?
[If CSPVERF1 equals 2 then goto CID.042; If CSPVERF2 equals 2 then goto CID.044; If CSPVERF3 equals 2 then goto CID.046; If any changes in age or birthdate have been made in CID.040, goto CAGECHK; If age is 18+, skip the child section and immunization section; Else goto Check item CIDCCI2.]

CID.042

Is {sample child name} Male or Female?
NEWSEX
(1) Male
(2) Female

(Goto CID.040)

CID.044

How old is {sample child name}?
NEWAGE
(00-99) 0-99 years old

(Goto CID.040)

CID.046

What is {sample child name} birthday?

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
NEWDOB_M MONTH: __________
NEWDOB_D DAY: __________
NEWDOB_Y YEAR: __________

Check item CAGECHK: Verify that the age and birthdate are consistent. If not, goto CID.040, re-enter age or birthdate.

Check item CIDCCI2: Only non-deleted children 1-4 years old other than the sample child in each family for the rest of this section.
FR: HAND CARD C1.
Card C1
1. Parent (Biological, Adoptive or Step)
2. Grandparent
3. Aunt/Uncle
4. Brother/Sister
5. Other relative
6. Legal guardian
7. Foster parent
8. Other non-relative
[p. 3]

CID.050

What is {CSRESPNO name}'s relationship to {child name}?
ICRELTIV
(1) Parent (Biological, adoptive, or step)
(2) Grandparent
(3) Aunt/Uncle
(4) Brother/Sister
(5) Other relative
(6) Legal guardian
(7) Foster parent
(8) Other non-relative
(97) Refused
(99) DK
Check item IC_CCI1:If CSRESPNO is the household respondent and the family respondent, goto CID.070; Else goto CID.060.
CID.060

FR: PLEASE VERIFY THE FOLLOWING INFORMATION ABOUT THE CHILD.

(1) Yes
(2) No
ICVERF_S Gender = {male/female} Is it correct?
ICVERF_A Age = {3 digit format} Is it correct?
ICVERF_D Birthday = {spoken word format} Is it correct?
[If ICVERF_S equals 2 then goto CID.062; If ICVERF_A equals 2 then goto CID.064; If ICVERF_D then goto CID.068; Else goto CID.070.]

CID.062

Is {child name} Male or Female?
INEWSEX
(1) Male
(2) Female

(Goto CID.060)

CID.064

The age of {child name} is
INEWAGE
(00-99) 0-99 years old

CID.068

Date of birth of {child name} is:

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
INEWDOB1 Month: __________
INEWDOB2 Day: __________
INEWDOB3 Year: __________

Check item IAGECHK: Verify that the age and birthdate are consistent, if not goto CID.060. CAPI calculate children 0-4 years old age in months and store data in ICAGEM. If child's age is 3 or 4 and birthdate is unknown, goto CID.080.

CID.080

Has {child name} had {his/her} 3rd birthday?
IC3BD
(1) Yes (IC3BD1)
(2) No (CID.060)
(7) Refused (IC3BD1)
(9) DK (IC3BD1)
Check item IC3BD1:
If IC3BD = `1', ICAGEM = `88'
[p. 4]
If IC3BD = `R', ICAGEM = `97'
If IC3BD = `D', ICAGEM = `99'

(Goto next section--Conditions, Limitations, Health Status)
[p. 5]


Section II - CONDITIONS, LIMITATION, HEALTH STATUS

Part A -- Conditions, Limitation of Activity and Health Status


CHS.010

What was {S.C.name}'s birth weight?
BWGT_LB
[ ] POUNDS

__________ (1-15) pounds
(97) Refused
(99) DK
BWGT_OZ
[ ] OUNCES

__________ (0-15) ounces
(97) Refused
(99) DK

CHS.020

About how tall is {S.C.name} now?
CHGHT_F
[ ] FEET

__________ (0-7) Feet
(97) Refused
(99) DK
CHGHT_I
[ ] INCHES

__________ (0-36) Inches
(97) Refused
(99) DK

CHS.021

About how much does {S.C.name} weigh now? (without shoes)
CWGHTP
__________ (1-500) pounds
(997) Refused
(998) DK

[If age is greater than or equal to 2 goto CHS.032; If the age is less than 2 then goto CHS.031]


CHS.031

Has a doctor or health professional ever told you that {S.C.name} had:

(1) Yes
(2) No
(7) Refused
(9) DK
ADD1_2 Mental Retardation?
ADD1_3 Any other developmental delay?

(Goto CHS.060)

CHS.032

Has a doctor or health professional ever told you that {S.C.name} had:

(1) Yes
(2) No
(7) Refused
(9) DK
ADD_1 Attention Deficit Disorder?
ADD_2 Mental Retardation?
ADD_3 Any other developmental delay?


FR: HAND CARD C2.
Card C2
1. Down's Syndrome
2. Cerebral Palsy
3. Muscular Dystrophy
4. Cystic Fibrosis
5. Sickle Cell Anemia
6. Autism
7. Diabetes
8. Arthritis
9. Congenital Heart Disease
10. Other heart condition

CHS.060

Looking at this list, has a doctor or health professional ever told you that {S.C.name} had any of these conditions?
CONDL
(0) None
(1) Down's syndrome
(2) Celebral Palsy
(3) Muscular Dystrophy
(4) Cystic Fibrosis
(5) Sickle cell anemia
(6) Autism
(7) Diabetes
(8) Arthritis
(9) Congenital heart disease
(10) Other heart condition
(97) Refused
(99) DK

[ ]CONDL_1
[ ]CONDL_2
[ ]CONDL_3
[ ]CONDL_4
[ ]CONDL_5
[ ]CONDL_6
[ ]CONDL_7
[ ]CONDL_8
[ ]CONDL_9
[ ]CONDL_10

[p. 6]


CHS.070

Has {S.C.name} EVER had chickenpox?
CPOX
(1) Yes
(2) No
(7) Refused
(9) DK


CHS.080

Has a doctor or other health professional EVER told you that {S.C.name} had asthma?
CASHMEV
(1) Yes (CHS.090)
(2) No (Check item)
(7) Refused (Check item)
(9) DK (Check item)


[If CHS.080 = 1 go to CHS.090. If CHS.080 equals 2, 7, or 9, and the age is greater than or equal to 2 then go to CHS.115; If CHS.080 equals 2, 7, 9 and the age is less than 2 then go to CHS.111]

CHS.090

During the past 12 months, has {S.C.name} had an episode of asthma or an asthma attack?
CASHYR
(1) Yes (CHS.100)
(2) No (Check item)
(7) Refused (Check item)
(9) DK (Check item)


[If CHS.090 = 1 go to CHS.100. If CHS.090 equals 2, 7, or 9, and the age is greater than or equal to 2 then go to CHS.115; If CHS.080 equals 2, 7,9 and the age is less than 2 then go to CHS.111]

CHS.100

During the past 12 months, did {S.C.name} have to visit an emergency room or urgent care center because of asthma?
CASMERYR
(1) Yes
(2) No
(7) Refused
(9) DK


[If the age is greater than or equal to 2 then go to CHS.115; If the age is less than 2 then go to CHS.111]

CHS.111

During the past 12 months, has {S.C.name} had any of the following conditions?

(1) Yes
(2) No
(7) Refused
(9) DK
CCONDT11 Hay fever?
CCONDT12 Any kind of respiratory allergy?
CCONDT13 Any kind of food or digestive allergy?
CCONDT14 Eczema or any kind of skin allergy?
CCONDT15 Frequent or repeated diarrhea or colitis?
CCONDT16 Anemia?
CCONDT17 Three or more ear infections?
CCONDT18 Seizures?

(Go to CHS.210)

CHS.115

During the past 12 months, has {S.C.name} had any of the following conditions?

(1) Yes
(2) No
(7) Refused
(9) DK
CCONDT01 Hay fever?
CCONDT02 Any kind of respiratory allergy?
CCONDT03 Any kind of food or digestive allergy?
CCONDT04 Eczema or any kind of skin allergy?
CCONDT05 Frequent or repeated diarrhea or colitis?
CCONDT06 Anemia?
CCONDT07 Frequent or severe headaches, including migraines?
CCONDT08 Three or more ear infections?
CCONDT09 Seizures?
CCONDT10 Stuttering or stammering?


CHS.210

Compared with 12 months ago, would you say {S.C.name}'s health is now better, worse, or about the same?
CHSTATYR
(1) Better
(2) Worse
(3) About the same
(7) Refused
(9) DK


[If the age is greater than 4 go to CHS.220; If age is less than or equal to 4 go to CHS.230]

CHS.220

During the past 12 months, that is, since {12-month ref. date}, about how many days did {S.C. name} miss school because of illness or injury?
SCHDAYR
(000) none
(001-240) 1-240 Days
(996) Did not goto school
(997) Refused
(999) DK

CHS.230

These next questions are about {S.C.name}'s recent health during the 2 weeks outlined on that calendar. Did {S.C.name} have a head cold or chest cold that started during those two weeks?
CCOLD2W
(1) Yes
(2) No
(7) Refused
(9) DK

CHS.240

Did {S.C.name} have a stomach or intestinal illness with vomiting or diarrhea that started during those two weeks?
CINTIL2W
(1) Yes
(2) No
(7) Refused
(9) DK


CHS.250

Which statement best describes {S.C.name}'s hearing (without a hearing aid): Good, a little trouble, a lot of trouble, or deaf?
CHEARST
(1) Good
(2) Little trouble
(3) Lot of trouble
(4) Deaf
(7) Refused
(9) DK


CHS.260

Does {S.C.name} have any trouble seeing?

[If child's age is 2 or more add:]
Even when wearing glasses or contact lenses?
CVISION
(1) Yes (CHS.270)
(2) No (CHS.290)
(7) Refused (CHS.290)
(9) DK (CHS.290)


CHS.270

Is {S.C.name} blind or unable to see at all?
CBLIND
(1) Yes
(2) No
(7) Refused
(9) DK


CHS.290

Does {S.C.name} have any impairment or health problem that requires {him/her} to use special equipment, such as a brace, a wheelchair, or a hearing aid (excluding ordinary eyeglasses or corrective shoes)?
IHSPEQ
(1) Yes
(2) No
(7) Refused
(9) DK


CHS.300

Does {S.C.name} have an impairment or health problem that limits {his/her} ability to (crawl), walk, run, or play?
IHMOB
(1) Yes (CHS.310)
(2) No (CHS.311)
(7) Refused (CHS.311)
(9) DK (CHS.311)

[p. 9]


CHS.310

Is this an impairment or health problem that has lasted, or is expected to last 12 months or longer?
IHMOBYR
(1) Yes
(2) No
(7) Refused
(9) DK


CHS.311

Does {S.C.name} now have a problem for which {he/she} has regularly taken prescription medication for at least three months?
PROBRX
(1) Yes
(2) No
(7) Refused
(9) DK


[If age is less than or equal to 1 go to CAU.020; If the age is equal to 2 go to CHSCCI3; If the age is greater than or equal to 3 go to CHS.312]

CHS.312

Has a representative from a school or a health professional ever told you that {S.C.name} had a learning disability?
LEARND
(1) Yes
(2) No
(7) Refused
(9) DK

[p. 10]

Part B - Child Behavior


Check item CHSCCI3:
If AGE = 2-3 and RPSEX is male, then goto CHS.321;
If AGE = 2-3 and RPSEX is female, then, goto CHS.361;
If AGE = 4-11 and RPSEX is male, then goto CHS.401;
If AGE = 4-11 and RPSEX is female, then goto CHS.441;
If AGE = 12-17 and RPSEX is male, then goto CHS.481;
If AGE = 12-17 and RPSEX is female, then goto CHS.521.


CHS.321

I am going to read a list of items that describe children. For each one, tell me if it has been NOT TRUE, SOMETIMES TRUE, or OFTEN TRUE, of {S.C.name} during the past 2 months.

FR: HAND CARD C3.
Card C3
0. Not true
1. Sometimes true
2. Often true
(0) Not True
(1) Sometimes True
(2) Often True
(7) Refused
(9) DK

HE:
CMHAGM12 Has been uncooperative?
CMHAGM13 Has trouble getting to sleep?
CMHAGM14 Has speech problems?
CMHAGM15 Has been unhappy, sad, or depressed?

(Goto CAU.020)

CHS.361

I am going to read a list of items that describe children. For each one, tell me if it has been NOT TRUE, SOMETIMES TRUE, or OFTEN TRUE, of {C.S. name} during the past 2 months.

FR: HAND CARD C3.
Card C3
0. Not true
1. Sometimes true
2. Often true
(0) Not True
(1) Sometimes True
(2) Often True
(7) Refused
(9) DK

SHE:
CMHAGF12 Has temper tantrums or a hot temper?
CMHAGF13 Has speech problems?
CMHAGF14 Has been nervous or high-strung?
CMHAGF15 Has been unhappy, sad, or depressed?

(Goto CAU.020)
[p. 11]


CHS.401

I am going to read a list of items that describe children. For each one, tell me if it has been NOT TRUE, SOMETIMES TRUE, or OFTEN TRUE, of {S.C.name} during the past 6 months.

FR: HAND CARD C3.
Card C3
0. Not true
1. Sometimes true
2. Often true
(0) Not True
(1) Sometimes True
(2) Often True
(7) Refused
(9) DK

HE:
CMHAGM22Doesn't get along with other kids?
CMHAGM23Can't concentrate or pay attention long?
CMHAGM24Feels worthless or inferior?
CMHAGM25Has been unhappy, sad, or depressed?

(Goto CAU.020)

CHS.441

I am going to read a list of items that describe children. For each one, tell me if it has been NOT TRUE, SOMETIMES TRUE, or OFTEN TRUE of {S.C.name} during the past 6 months.

FR: HAND CARD C3.
Card C3
0. Not true
1. Sometimes true
2. Often true
(0) Not True
(1) Sometimes True
(2) Often True
(7) Refused
(9) DK

SHE:
CMHAGF22Can't concentrate or pay attention long?
CMHAGF23Has been nervous, high strung or tense?
CMHAGF24Acts too young for her age?
CMHAGF25Has been unhappy, sad, or depressed?

(Goto CAU.020)

CHS.481

I am going to read a list of items that describe children. For each item, please tell me if it has been NOT TRUE, SOMETIMES TRUE, or OFTEN TRUE, that during the past 6 months, {S.C.name}:

FR: HAND CARD C3.
Card C3
0. Not true
1. Sometimes true
2. Often true
(0) Not True
(1) Sometimes True
(2) Often True
(7) Refused
(9) DK

HE:
CMHAGM32Can't concentrate or pay attention long?
CMHAGM33Lies or cheats?
CMHAGM34Doesn't get along with other kids?
CMHAGM35Has been unhappy, sad, or depressed?

(Goto CAU.020)
[p. 12]


CHS.521

I am going to read a list of items that describe children. For each item, please tell me if it has been NOT TRUE, SOMETIMES TRUE, or OFTEN TRUE, that during the past 6 months, {S.C.name}:

FR: HAND CARD C3.
Card C3
0. Not true
1. Sometimes true
2. Often true
(0) Not True
(1) Sometimes True
(2) Often True
(7) Refused
(9) DK

SHE:
CMHAGF32 Lies or cheats?
CMHAGF33 Does poorly at school work?
CMHAGF34 Has trouble sleeping?
CMHAGF35 Has been unhappy, sad, or depressed?

(Goto next section-Health Care Access and Utilization)
[p. 13]


Section III -- HEALTH CARE ACCESS AND UTILIZATION

Part A -- Access To Care

The next questions are about Health Care.


CAU.020

Is there a place that {S.C.name} USUALLY goes when {he/she} is sick or you need advice about {his/her} health?
CUSUALPL
(1) Yes (CAU.030)
(2) There is NO place (CAU.037)
(3) There is MORE THAN ONE place (CAU.030)
(7) Refused (CAU.037)
(9) DK (CAU.037)


CAU.030

[If CAU.020 equal 1, then read:]
What kind of place is it ...

[Else CAU.020 equal 3, then read:]
What kind of place does {S.C.name} go to most often ...
... A clinic, doctor's office, emergency room, or some other place?
CPLKIND
(1) Clinic or health center (CAU.035)
(2) Doctor's office or HMO (CAU.035)
(3) Hospital emergency room (CAU.035)
(4) Hospital outpatient department (CAU.035)
(5) Some other place (CAU.035)
(7) Refused (CAU.037)
(9) DK (CAU.037)


CAU.035

Is that {place selected in CAU.030} the same place {S.C.name} usually goes when {he/she} needs routine or preventive care, such as a physical examination or well baby/child check-up?
CHCPLROU
(1) Yes (CAU.040)
(2) No (CAU.037)
(7) Refused (CAU.037)
(9) DK (CAU.037)


CAU.037

What kind of place does {S.C.name} go to when {he/she} needs routine preventive care, such as a physical examination or well baby/child check-up?
CHCPLKND
(0) Doesn't get preventive care anywhere
(1) Clinic or health center
(2) Doctor's office or HMO
(3) Hospital emergency room
(4) Hospital outpatient department
(5) Some other place
(7) Refused
(9) DK


Check item CAUCCI1: If CAU.020 equals 2, 7, or 9, then goto CAU.080; Else goto CAU.040.

CAU.040

At any time in the past 12 months did you CHANGE the place(s) to which {S.C.name} USUALLY goes for health care?
CHCCHGYR
(1) Yes (CAU.050)
(2) No (CAU.080)
(7) Refused (CAU.080)
(9) DK (CAU.080)

CAU.050

Was this change for a reason related to health insurance?
CHCCHGHI
(1) Yes
(2) No
(7) Refused
(9) DK


CAU.080

There are many reasons people delay getting medical care. Have you delayed getting care for {S.C.name} for any of the following reasons in the past 12 months?

(1) Yes
(2) No
(7) Refused
(9) DK
CHCDLYR1 You couldn't get through on the telephone.
CHCDLYR2 You couldn't get an appointment for {S.C.name} soon enough.
CHCDLYR3 Once you get there, {S.C.name} has to wait too long to see the doctor.
CHCDLYR4 The clinic/doctor's office wasn't open when you could get there.
CHCDLYR5 You didn't have transportation:


[If age is greater than or equal to 2 goto CAU.135; Else goto CAU.130]

CAU.130

During the past 12 months, was there any time when {S.C.name} needed any of the following, but didn't get it because you couldn't afford it?
Prescription medicines?
CHCAFYR
(1) Yes
(2) No
(7) Refused
(9) DK
(Goto CAU.170)


CAU.135

During the past 12 months, was there any time when {S.C.name} needed any of the following, but didn't get it because you couldn't afford it:

(1) Yes
(2) No
(7) Refused
(9) DK
CHCAFYR1 Prescription medicines?
CHCAFYR2 Mental health care or counseling?
CHCAFYR3 Dental care (including check-ups)?

[p. 15]


Part B -- Dental Care

FR: HAND CARD T.
Card T
1. 6 months or less
2. More than 6 months, but not more than 1 year ago
3. More than 1 year, but not more than 3 years ago
4. More than 3 years
5. Never

CAU.160

About how long has it been since {S.C.name} last saw or talked to a dentist? Include all types of dentists, such as orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists.
CDENLONG
(1) 6 months or less
(2) More than 6 months, but not more than 1 year ago
(3) More than 1 year, but not more than 3 years ago
(4) More than 3 years
(5) Never
(7) Refused
(9) DK

[If age is greater than or equal to 2 goto CAU.175; Else goto CAU.170.]
[p. 16]


Part C -- Health Care Provider Contacts

CAU.170

During the past 12 months, that is since {12-month ref. date}, has anyone in the family seen or talked to any of the following health care providers about {S.C.name}'s health?

(1) Yes
(2) No
(7) Refused
(9) DK
CHCSYR11 An optometrist, optician, or eye doctor (someone who prescribes eyeglasses)?
CHCSYR12 A foot doctor?
CHCSYR13 A physical therapist, speech therapist,respiratory therapist, audiologist, or occupational therapist?
CHCSYR14 A nurse practitioner, physician assistant or midwife?
[If female and age is greater than 14 then goto CAU.230; Else goto CAU.240]

CAU.175

During the past 12 months, that is since {12-month ref. date}, have you seen or talked to any of the following health care providers about {S.C.name}'s health?

(1) Yes
(2) No
(7) Refused
(9) DK
CHCSYR1 A mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?
CHCSYR2 An optometrist, optician, or eye doctor (someone who prescribes eyeglasses)?
CHCSYR3 A foot doctor?
CHCSYR4 A chiropractor?
CHCSYR5 A physical therapist, speech therapist, respiratory therapist, audiologist, or occupational therapist?
CHCSYR6 A nurse practitioner, physician assistant or midwife?


[If female and age is greater than 14 then goto CAU.230; Else goto CAU.240]

CAU.230

During the past 12 months, have you seen or talked to a doctor who specializes in women's health (an obstetrician/gynecologist) about {S.C.name}'s health?
CHCSYR7
(1) Yes
(2) No
(7) Refused
(9) DK


CAU.240

During the past 12 months, have you seen or talked to the following about {S.C.name}'s health?

(1) Yes
(2) No
(7) Refused
(9) DK
CHCSYR81 A medical doctor who specializes in a particular medical disease or problem (other than obstetrician/gynecologist, psychiatrist or ophthalmologist)?
CHCSYR82 A general doctor who treats a variety of illnesses (a doctor in general practice, pediatrics, family medicine, or internal medicine)?


[If CHCSYR82 = 1 goto CAU.260; Else goto CAU.270]

CAU.260

Does that doctor treat children and adults (a doctor in general practice or family medicine)?
CHCSYR10
(1) Yes
(2) No
(7) Refused
(9) DK

[p. 17]


CAU.270

During the past 12 months did {S.C.name} receive a physical examination or well baby/child check-up?
CHPEXYR
(1) Yes
(2) No
(7) Refused
(9) DK


CAU.280

During the past 12 months, how many times has {S.C.name} gone to a hospital emergency room about {his/her} health? (This includes emergency room visits that resulted in a hospital admission.)

FR: HAND CARD C4.
Card C4
0. None
1. 1
2. 2-3
3. 4-9
4. 10-12
5. 13 or more
CHERNOYR
(0) None
(1) 1
(2) 2-3
(3) 4-9
(4) 10-12
(5) 13 or more
(7) Refused
(9) DK


CAU.290

DURING THE PAST 12 MONTHS, did {S.C. name} receive care at home from a nurse or other health care professional?
CHCHYR
(1) Yes (CAU.300)
(2) No (CAU.320)
(7) Refused (CAU.320)
(9) DK (CAU.320)


CAU.300

During how many of the past 12 months did {S.C.name} receive care at home from a health care professional?
CHCHMOYR
(01-12) 1-12 months
(97) Refused
(99) DK


CAU.310

What was the total number of home visits received for {S.C.name} during that/those months?

FR: HAND CARD C5
Card C5
1. 1
2. 2-3
3. 4-9
4. 10-12
5. 13 or more
CHCHNOYR
(1) 1
(2) 2-3
(3) 4-9
(4) 10-12
(5) 13 or more
(7) Refused
(9) DK


CAU.320

During the past 12 months, how many times has {S.C.name} seen a doctor or other health care professional about {his/her} health at a doctor's office, a clinic, or some other place? DO NOT INCLUDE TIMES {S.C.name} WAS HOSPITALIZED OVERNIGHT, VISITS TO HOSPITAL EMERGENCY ROOMS, HOME VISITS, OR TELEPHONE CALLS.

FR: HAND CARD C4
Card C4
0. None
1. 1
2. 2-3
3. 4-9
4. 10-12
5. 13 or more
CHCNOYR
(0) None
(1) 1
(2) 2-3
(3) 4-9
(4) 10-12
(5) 13 or more
(7) Refused
(9) DK

[p. 18]


CAU.330

During the past 12 months has {S.C.name} had surgery or other surgical procedures either as an inpatient or outpatient?
CSRGYR
(1) Yes (CAU.340)
(2) No (Check item CAUCCI3)
(7) Refused (Check item CAUCCI3)
(9) DK (Check item CAUCCI3)


CAU.340

Including any times you may have already told me about, how many different times has {S.C. name} had surgery done as an outpatient during the past 12 months?
CSRGNOYR
(00-94) 0-94 times
(95) 95+ times
(97) Refused
(99) DK


Check item CAUCCI3:If sample child had a doctor visit in the last 2 weeks as indicated in the family core, that is: If FAU.180 equals 1 and sample child's person number is in FAU.190, then CAU.345 equals 1 and goto next section; Else goto CAU.345.

CAU.345

About how long has it been since anyone in the family last saw or talked to a doctor or other health care professional about {S.C.name}'s health? Include doctors seen while {he/she} was a patient in a hospital.
CMDLONG
(1) 6 months or less
(2) More than 6 months, but not more than 1 year ago
(3) More than 1 year, but not more than 3 years ago
(4) More than 3 years
(5) Never
(7) Refused
(9) DK

(Goto next section -- Immunization)