2019 National Health Interview Survey (NHIS) Questionnaire

Content

Introduction

This National Health Interview Survey (NHIS) questionnaire report provides the questions administered to NHIS respondents in the order they were asked. It is organized hierarchically into these parts: Contents, Index, and NHIS questionnaire, which in turn includes the Roster, Adult and Child modules.

Section Index

A section index is provided for each of the three modules: Roster, Adult, and Child. The index can be navigated via the Bookmarks pane to quickly get information about the different sections in the module. The display pane lists information about each section in the module including the three-letter section name, the section description, the type of content in the section (annual core, rotating core, sponsored or emerging content) and the page range in this document for each section for ease of printing.

NHIS questionnaire: Roster, Adult and Child modules

The questionnaire is the main part of the report and provides detailed information about each question in the survey. The hierarchy in the Bookmarks pane has three levels: module (Roster, Adult, Child), sections within each module, and questions within each section represented by the variable name in the instrument. The sections and questions are listed in questionnaire order. Selecting a specific question in the Bookmarks pane will display a detailed report for that question in the display pane while selecting a section abbreviation will display the report for the first question
in the section.

In the question text field of the report, text displayed in bold and in blue font is an interviewer instruction which is sometimes followed by optional text in gray, italic font.

Information provided for each question includes:
Question ID: unique alphanumeric code for each question beginning with the 3-letter section abbreviation
Variable: instrument variable name for the question
Interview Module: module where the question is located: Roster, Adult, or Child
Content Type: indicates whether the question is part of the Annual Core, Rotating Core, Sponsored Content or Emerging Content
Question Text: question wording administered to respondent with indicators for fills; may also include interviewer instructions
Fills: table of contextual text substitutions that are filled into the question text
Response: table of possible responses to the question
Universe: group of respondents who received the question
Skip Instructions: instructions for moving to the next question in the questionnaire

Additional information may include:
Hard Edit: prompt received when response entered is not allowed; response must be changed in order to proceed
Soft Edit: prompt received when response entered is questionable; must follow instructions in order to proceed
Replicate To: indicates family-level information obtained in the Sample Adult interview that is copied to a replicated variable in the Sample Child and vice versa for efficiency
when the Sample Child and the Sample Adult are in the same family.

Navigate to the module of interest in the Bookmarks pane to see information about all the sections in the module in questionnaire order. The display pane will show a table with the following information for each section:

Section abbreviation: a short, 3 letter abbreviation for the section, e.g., INS
Section description: a description of the topic area for questions in the section
Content type: a list of values indicating if the questions in the section come from annual core, rotating core, sponsored content or emerging content
Page Range: range of pages in this document containing the content for each section

Interview Module:Roster

Section Name: ROS

Section Description: Roster
Type: Annual Core
Page range: 8-9

Section Name: HHC

Section Description: Household Composition
Type: Annual Core
Page range: 10-38

Section Name: REL

Section Description: Relationship of children to parents
Type: Annual Core
Page range: 39-42

Section Name: FAM

Section Description: Family Composition
Type: Annual Core
Page range: 43-58

Interview Module:Adult

Section Name: VFY

Section Description: Sample Adult Verification
Type: Annual Core
Page range: 59-94

Section Name: HIS

Section Description: Health Status
Type: Annual Core
Page range: 95-95

Section Name: HYP

Section Description: Hypertension
Type: Annual Core
Page range: 96-100

Section Name: CHL

Section Description: Cholesterol
Type: Annual Core
Page range: 101-103

Section Name: CVC

Section Description: Cardiovascular Conditions
Type: Annual Core
Page range: 104-107

Section Name: ASP

Section Description: Aspirin
Type: Rotating Core
Page range: 108-111

Section Name: AST

Section Description: Asthma
Type: Annual Core
Page range: 112-115

Section Name: CAN

Section Description: Cancer
Type: Annual Core
Page range: 116-129

Section Name: DIB

Section Description: Diabetes
Type: Annual Core Sponsored Content
Page range: 130-139

Section Name: CON

Section Description: Other Chronic Conditions
Type: Annual Core
Page range: 140-144

Section Name: BMI

Section Description: Current pregnant, height, weight
Type: Annual Core
Page range: 145-152

Section Name: VIS

Section Description: Vision
Type: Annual Core
Page range: 153-155

Section Name: HEA

Section Description: Hearing
Type: Annual Core
Page range: 156-158

Section Name: MOB

Section Description: Mobility
Type: Annual Core
Page range: 159-172

Section Name: COM

Section Description: Communication
Type: Annual Core
Page range: 173-173

Section Name: UPP

Section Description: Self-care and Upper Body
Type: Annual Core
Page range: 178-180

Section Name: SOC

Section Description: Social Functioning
Type: Annual Core
Page range: 184-262

Section Name: PAY

Section Description: Difficulty Paying for Health Care
Type: Annual Core
Page range: 263-266

Section Name: DNC

Section Description: Dental Care
Type: Rotating Core
Page range: 267-270

Section Name: UTZ

Section Description: Utilization
Type: Annual Core
Page range: 271-281

Section Name: PMD

Section Description: Prescription Medication
Type: Annual Core
Page range: 282-286

Section Name: OPD

Section Description: Opiod Use - ALL
Type: Emerging Content
Page range: 287-291

Section Name: IMS

Section Description: Immunization with 2020 supplements
Type: Annual Core Sponsered Content
Page range: 335-358

Section Name: PRV

Section Description: Preventative Screening
Type: Rotating Core Sponsered Content
Page range: 292-334

Section Name: PTC

Section Description: Physical and other therapeutic care
Type: Rotating Core
Page range: 359-361

Section Name: ANX

Section Description: Anxiety
Type: Annual Core
Page range: 362-264

Section Name: DEP

Section Description: Depression
Type: Annual Core
Page range: 365-367

Section Name: MHC

Section Description: Mental Health Care
Type: Rotating Core
Page range: 368-372

Section Name: PAI

Section Description: Chronic Pain
Type: Emergency Content Rotating Core
Page range: 389-409

Section Name: PHQ

Section Description: PHQ-8 Depression
Type: Rotating Core
Page range: 373-381

Section Name: GAD

Section Description: GAD-7 Anxiety
Type: Rotating Core
Page range: 382-388

Section Name: ART

Section Description: Arthritis
Type: Sponsored Content
Page range: 410-415

Section Name: CIG

Section Description: Cigarettes and E-cigarettes w/Cigarette History
Type: Annual Core
Page range: 416-423

Section Name: OTB

Section Description: Other Tobacco
Type: Sponsored Content
Page range: 424-430

Section Name: ORN

Section Description: Sexual Orientation
Type: Annual Core
Page range: 431-432

Section Name: MAR

Section Description: Marital Status
Type: Annual Core
Page range: 433-445

Section Name: VET

Section Description: Veterans Status
Type: Annual Core
Page range: 446-451

Section Name: NAT

Section Description: Nativity
Type: Annual Core
Page range: 452-456

Section Name: SCH

Section Description: Schooling
Type: Annual Core
Page range: 457-458

Section Name: EMP

Section Description: Employemtn
Type: Annual Core
Page range: 459-467

Section Name: FEM

Section Description: Employment of family members
Type: Annual Core
Page range: 468-470

Section Name: INC

Section Description: Family Income
Type: Annual Core
Page range: 471-491

Section Name: FOO

Section Description: Food Related Programs
Type: Annual Core Sponsored Content
Page range: 492-499

Section Name: FDS

Section Description: Food Security
Type: Sponsored Content
Page range: 500-510

Section Name: HOU

Section Description: Housing
Type: Annual Core
Page range: 511-513

Section Name: REC

Section Description: Person?s name
Type: Annual Core
Page range: 514-516

Section Name: TEL

Section Description: Telephone Use
Type: Annual Core
Page range: 517-520

Section Name: LNK

Section Description: Linkage
Type: Annual Core
Page range: 521-527

Section Name: THX

Section Description: Thanks!
Type: Annual Core
Page range: 528-528

Interview Module:Child

Section Name: VFY

Section Description: Verification and demographic details
Type: Annual Core
Page range: 529-568

Section Name: HIS

Section Description: Health Status
Type: Annual Core
Page range: 569-569

Section Name: AST

Section Description: Asthma
Type: Annual Core
Page range: 570-574

Section Name: DIB

Section Description: Diabetes
Type: Annual Core
Page range: 575-576

Section Name: OLD

Section Description: Developmental and Learning Disabilities
Type: Annual Core
Page range: 577-586

Section Name: VIS

Section Description: Vision
Type: Annual Core
Page range: 587-589

Section Name: HEA

Section Description: Hearing
Type: Annual Core
Page range: 590-591

Section Name: MOB

Section Description: Mobility
Type: Annual Core
Page range: 592-601

Section Name: UPP

Section Description: Upper Body, Motor skills and self care
Type: Annual Core
Page range: 602-603

Section Name: COM

Section Description: Communication
Type: Annual Core
Page range: 604-607

Section Name: COG

Section Description: Cognition
Type: Annual Core
Page range: 608-609

Section Name: ANX

Section Description: Anxiety
Type: Annual Core
Page range: 610-610

Section Name: DEP

Section Description: Depression
Type: Annual Core
Page range: 611-611

Section Name: BEH

Section Description: Behavior
Type: Annual Core
Page range: 612-617

Section Name: BSC

Section Description: Baby Pediatric Symptom Checklist
Type: Annual Core
Page range: 618-630

Section Name: SCH

Section Description: Schooling
Type: Annual Core
Page range: 631-634

Section Name: INS

Section Description: Health Insurance
Type: Annual Core
Page range: 635-709

Section Name: PAY

Section Description: Difficulty Paying for Health Care
Type: Annual Core
Page range: 710-713

Section Name: DNC

Section Description: Dental Care
Type: Rotating Core
Page range: 714-717

Section Name: UTZ

Section Description: Utilization
Type: Annual Core
Page range: 718-728

Section Name: PMD

Section Description: Prescription medicaitons
Type: Annual Core
Page range: 729-731

Section Name: IMM

Section Description: Immunization
Type: Annual Core
Page range: 732-737

Section Name: PTC

Section Description: Physicial and other therapeutic care
Type: Rotating Core
Page range: 738-740

Section Name: MHC

Section Description: Mental health care
Type: Rotating Core
Page range: 741-744

Section Name: SDQ

Section Description: Child Mental Health - SDQ Questionnaire
Type: Rotating Core
Page range: 745-778

Section Name: SLE

Section Description: Child Mental Health - Child Stressful Life Events
Type: Rotating Core
Page range: 779-783

Section Name: PAR

Section Description: Parent Demographics
Type: Annual Core
Page range: 784-803

Section Name: NAT

Section Description: Nativity
Type: Annual Core
Page range: 804-808

Section Name: FEM

Section Description: Employment of family members
Type: Annual Core
Page range: 809-811

Section Name: INC

Section Description: Family Income
Type: Annual Core
Page range: 812-831

Section Name: FOO

Section Description: Food Related Programs
Type: Annual Core Sponsored Content
Page range: 832-837

Section Name: FDS

Section Description: Food Security
Type: Sponsored Content
Page range: 838-848

Section Name: HOU

Section Description: Housing
Type: Annual Core
Page range: 849-851

Section Name: REC

Section Description: Child?s full name
Type: Annual Core
Page range: 852-854

Section Name: TEL

Section Description: Telephone ownership
Type: Annual Core
Page range: 855-856

Section Name: LNK

Section Description: Linkage
Type: Annual Core
Page range: 857-860

Section Name: THX

Section Description: Thanks
Type: Annual Core
Page range: 861-863

Navigate the hierarchy in the Bookmarks pane to the module and section of interest. Selecting the module or section name will display the detail for the first variable for that module or section, respectively. Expanding the hierarchy further and selecting a question will display the detail for that specific question.The detailed report will show the following information for a question: Question ID, Variable, Content Type, Question Text, Fills, Response, Universe, Skip Instructions, and optionally, Hard Edit, Soft Edit and Replication.

2019 National Health Interview Survey (NHIS) Questionnaire
ROS: Roster

Question ID: ROS.0020.00.1
Variable: HHCLOCK
Interview Module: Roster
Content Type: Annual Core

Question Text:

The demographic information is now locked and cannot be changed.

Enter '1' to continue with the interview.

If reentering the case, press the END key to go to the next unanswered question.

Response:

1 - Enter 1 to Continue

Universe:

HHC section has been locked

Skip Instructions:

= If GEN.PCNTUNDER18 GT 0, [goto REL.WHOPAR]
else [goto SASCSELECT]

Question ID: ROS.0030.00.1
Variable: ROSTERCHECK
Interview Module: Roster
Content Type: Annual Core

Question Text:

The roster will now be locked. If you are confident that it has been recorded accurately, enter 1 to continue. Otherwise go back and correct now.

Response:

1 - Enter 1 to Continue

Universe:

At least one person in the household is greater than 18 and there is at least one child in the household and at least one person's age is not guessed and not all household members in the armed forces and the HHC section has not been locked.

Skip Instructions:

1 = If GEN.PCNTUNDER18 GT 0, [goto tblREL.WHOPAR]
if SURVTYPE eq 'T' and eligible adults [goto SELECT_SA] elseif SURVTYPE eq 'T' and eligible children [goto SELECT_SC] else [goto SASCSELECT]

2019 National Health Interview Survey (NHIS) Questionnaire
HHC: Household Composition

Question ID: HCC.0020.00.1
Variable: NAME_FNAME
Interview Module: Roster
Content Type: Annual Core

Question Text:

^FNAME - Enter 999 if no more persons.

Fills:

^FNAME

Description: NAME_FNAME Instroduction
Instruction:

If first person in roster, fill: "Starting with you, what are the names of all the persons living or staying here?"

Else for next person fill: "What is the name of the next person living or staying here?"

Response:

97 - Refused
99 - Do not know

Universe:

All persons

Skip Instructions:

allow 20 = if name on fake/false name list [goto ERR2_NAME_FNAME];
elseif NAME_FNAME is identical to any other NAME_FNAME or ALIAS [goto ERR3_NAME_FNAME] else [goto NAME_LNAME]
999 = if LNO=1 [goto ERR1_NAME_FNAME]
else [goto USUALRES]
RF,DK = [goto ALIAS]

Hard Edit:

Check Text: ERR3_NAME_FNAME
Check Description: Identical first name hard edit
Check Text:

{check ERR3_NAME_FNAME}

First name cannot be the same as previous
^NameMatch.

Check Text: ERR1_NAME_FNAME
Check Description: 999 for first person hard edit
Check Text:

{check ERR1_NAME_FNAME}

999 not allowed for the first person in the household.

Please correct.

Soft Edit:

Check Text: ERR2_NAME_FNAME
Check Description: Fake name soft edit
Check Text:

{signal ERR2_NAME_FNAME}

You are entering a possible fake/false name.

Please correct.

If this is a legitimate name, suppress this error message and continue. Otherwise, go back to the name field and enter a legitimate name. To enter an alias, enter 'Ctrl D' or 'Ctrl R' for 'Do not Know' or 'Refused' at the name field. Then, enter a matching identifier/alias at the next screen (ALIAS).

Question ID: HCC.0030.00.1
Variable: NAME_LNAME
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter last name if provided. Last name is optional.

Response:

97 - Refused
99 - Do not know

Universe:

A valid first name was entered

Skip Instructions:

allow 20,RF,DK,empty = [If PX less than 25 goto NAME_FNAME for next person, else goto USUALRES]

Question ID: HCC.0040.00.1
Variable: ALIAS
Interview Module: Roster
Content Type: Annual Core

Question Text:

How shall I refer to ^youthisperson for the rest of the interview?

Fills:

^youthisperson

Description: you/this person
Instruction:

If subject=respondedt, fill ?you? else if subject NE respondent, fill ?this person?

Response:

97 - Refused
99 - Do not know

Universe:

Persons who do not know or refused to give first name.

Skip Instructions:

allow 20 = if ALIAS is identical to any other NAME_FNAME or ALIAS [goto ERR1_ALIAS] elseif ALIAS = 999 [goto ERR2_ALIAS]
else [If PX less than 25 goto NAME_FNAME for next person, else goto USUALRES]

Hard Edit:

Check Text: ERR2_ALIAS
Check Description: 999 for alias hard edit
Check Text:

{check ERR2_ALIAS}

*999 not allowed as an alias.

*Please correct

Check Text: ERR1_ALIAS
Check Description: Identical alias hard edit
Check Text:

{check ERR1_ALIAS}

Alias cannot be the same as previous
^NameMatch.

Question ID: HCC.0050.00.1
Variable: USUALRES
Interview Module: Roster
Content Type: Annual Core

Question Text:

^DoDoes ^youALIAS usually live here?

Fills:

^DoDoes

Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not Know

Universe:

All persons where NAME_FNAME ne 999

Skip Instructions:

1 = if (PX less than 25) [goto USUALRES for next person in household] else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP] elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]
2,RF,DK = [goto ASKURE]

Question ID: HCC.0060.00.1
Variable: ASKURE
Interview Module: Roster
Content Type: Annual Core

Question Text:

^DoDoes ^youALIAS have some other place where ^youthey usually live?

Fills:

^DoDoes

Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^youthey

Description: you/they
Instruction: If subject=respondent, fill "you", else if subject NE respondent, fill "they"

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

If the usual residence is not here, or respondent refused or didn't know

Skip Instructions:

1 [goto USUALSCHOOL]
2,RF,DK = if (PX less than 25) [goto USUALRES for next person in the household] else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP] elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]

Question ID: HCC.0070.00.1
Variable: USUALSCHOOL
Interview Module: Roster
Content Type: Annual Core

Question Text:

^AreIs ^youALIAS usually away at school or college?

Fills:

^AreIs

Description: Are/Is
Instruction: If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not Know

Universe:

Person does not usually live in household and usual residence is elsewhere

Skip Instructions:

1 = [goto ONOFFCAMPUS]
2,DK,RF = if (PX less than 25) [goto USUALRES for next person in the household] else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP] elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]

Question ID: HCC.0080.00.1
Variable: ONOFFCAMPUS
Interview Module: Roster
Content Type: Annual Core

Question Text:

^DoDoes ^youALIAS live in on-campus housing or off-campus housing?

Read if necessary: On-campus housing includes residence halls and dorms where students live together. It also includes buildings that are owned, leased, or managed by the school. Fraternities and sororities are on-campus housing.

Fills:

^DoDoes

Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - On campus
2 - Off campus
7 - Refused
9 - Do not know

Universe:

Person's usual residence is not in the household and person has a usual residence other than the place of interview and lives away at school or college

Skip Instructions:

1,2,DK,RF = if (PX less than 25) [goto USUALRES for next person in the household] else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP] elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]

Question ID: HCC.0090.00.1
Variable: MISPERS_MCHILD
Interview Module: Roster
Content Type: Annual Core

Question Text:

^ROSTEREXCEPTION

^HHROSTERINTRO

^HHROSTER

Have I missed any babies or small children?

Fills:

^ROSTEREXCEPTION

Description: Exception to Roster
Instruction: If PCNT TOTPCNT, fill: "Students living in on-campus housing will be included in the interview. Other people who do not usually live here and have another residence elsewhere will not be included in this interview."

^HHROSTERINTRO

Description: I have listed the household members as?
Instruction: If PCNT ne 0, fill:I have listed the household members as...

^HHROSTER

Description: Entire roster of non deleted people
Instruction: entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)

^ALIASNAME

Description: {value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Less than 25 persons listed on roster

Skip Instructions:

1 =[goto NAME_FNAME to add person to roster]
2,RF,DK = [goto MISPERS_MSCHOOL]

Question ID: HCC.0140.00.1
Variable: MISPERS_MSCHOOL
Interview Module: Roster
Content Type: Annual Core

Question Text:

Read if necessary.

I have listed the household members as...

^HHROSTER

Have I missed anyone who USUALLY lives here, but is away now at school or college?

Fills:

^HHROSTER

Description: Entire roster of non deleted people
Instruction: entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)

^ALIASNAME

Description: {value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Less than 25 persons listed on roster

Skip Instructions:

1 = [goto ERR_MISPERS_MSCHOOL]
[goto NAME_FNAME to add person to roster]
2,RF,DK = [goto MISPERS_MELSE]

Soft Edit:

Check Text: ERR_MISPERS_MSCHOOL

Check Text:

{signal ERR_MISPERS_MSCHOOL}

Do not read to the respondent.

After adding the name of the household member who is now away at school or college to the roster, press the END key, enter '2' at USUALRES, enter '1' at ASKURE, and answer the USUALSCHOOL question.

Suppress message to continue.

Question ID: HCC.0160.00.1
Variable: MISPERS_MELSE
Interview Module: Roster
Content Type: Annual Core

Question Text:

Read if necessary.

I have listed the household members as...

^HHROSTER

Have I missed anyone else who USUALLY lives here, including people who are not related to you or people who are away traveling?

Fills:

^HHROSTER

Description: Entire roster of non deleted people
Instruction: entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)

^ALIASNAME

Description: {value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Less than 25 persons listed on roster

Skip Instructions:

1 = [goto NAME_FNAME to add person to roster]
2,RF,DK = if PCNT = 0 [goto EXIT]
elseif PCNT = 1 [goto SEX]
elseif PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]

Question ID: HCC.0180.00.1
Variable: HHRESP
Interview Module: Roster
Content Type: Annual Core

Question Text:

Which adults living here would you say know about the members of this household?

Person(s) selected must be over 18.

You may select someone who is marked as deleted.

Enter all that apply, separate with commas.

Response:

01-25 - Person Number

Universe:

All households with more than one non-deleted person OR there is only one non-deleted person in the household and deleted person is first person on roster and first person on the roster was answering for the household but does not usually live there.

Skip Instructions:

1 not IN HHRESP [goto HHRESPAVAIL]
One Person selected at HHRESP and that person has HHSTAT_D=1 [goto HHRESPPROXY] else [goto tblSex.bPerson.SEX]

Question ID: HCC.0190.00.1
Variable: HHRESPAVAIL
Interview Module: Roster
Content Type: Annual Core

Question Text:

^HHRESP_fill

Select the line number of the person who can continue the interview.
If no one is available press F9 to set up a callback.

Fills:

^HHRESP_fill

Description: Of the people you just mentioned, who can speak with me now?/Can ^ALIASNAME speak with me now?
Instruction: If multiple people are selected, fill "Of the people you just mentioned, who can speak with me now?"
If one person is selected, fill "Can ^ALIASNAME speak with me now?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

01-25 - Person Number

Universe:

Person to whom you are speaking (LNO=1) is not knowledgeable

Skip Instructions:

1-25 = (person selected at HHRESPAVAIL has HHSTAT_D=1) [goto HHRESPPROXY] else [goto tblSex.bPerson.SEX]

Question ID: HCC.0200.00.1
Variable: HHRESPPROXY
Interview Module: Roster
Content Type: Annual Core

Question Text:

*^ALIASNAME does not usually live here.

^DoyouDoesALIAS take care of someone who lives here?

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^DoyouDoesALIAS

Description: Do you/Does ^ALIASNAME
Instruction: For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Person selected at HHRESP or HHRESPAVAIL has been deleted from the roster.

Skip Instructions:

1 = [goto tblSex.bPerson.SEX]
2,DK,RF = [goto ERR_HHRESPPROXY]

Soft Edit:

Check text: ERR_HHRESPPROXY

Check text:

{signal ERR_HHRESPPROXY}

Person was deleted from this household.

Question ID: HCC.0210.00.1
Variable: SEX
Interview Module: Roster
Content Type: Annual Core

Question Text:

^AreIs ^youALIAS male or female?

Fills:

^AreIs

Description: Are/Is
Instruction: If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Male
2 - female
7 - Refused
9 - Do not know

Universe:

All nondeleted persons

Skip Instructions:

If last non-deleted person on roster [goto AGENO] else [goto SEX for next non-deleted person on roster]

Question ID: HCC.0220.01.1
Variable: AGENO
Interview Module: Roster
Content Type: Annual Core

Question Text:

1 of 2

What is ^yourALIAS age?

Enter number for age.

Fills:

^yourALIAS

Description: your/^ALIASNAME?s
Instruction: If PX=LNO_RESP fill "your"; else fill "^ALIASNAME's"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

001-120 - Range of values
997 - Refused
999 - do not know

Universe:

All nondeleted persons

Skip Instructions:

001-120 = [goto AGETP]
RF,DK = [goto AGE18]

Question ID: HCC.0220.02.1
Variable: AGETP
Interview Module: Roster
Content Type: Annual Core

Question Text:

2 of 2

Enter number for age time period.

Response:

1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)

Universe:

Valid number entered at AGENO[PX]

Skip Instructions:

If last non-deleted person on roster AND ((AGENO = RF, DK and AGE18 =1) or AGE LT 018 for everyone) then [goto Exit]
elseif last non-deleted person on roster [goto NATORG] else [goto AGENO for next non-deleted person on roster]

Question ID: HCC.0230.00.1
Variable: AGE18
Interview Module: Roster
Content Type: Annual Core

Question Text:

Certain sections of this interview depend on knowing if a person is 18 years or older. Could you please tell me if ^youALIAS ^areis less than 18 years old or 18 years or older?

Fills:

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^AreIs

Description: Are/Is
Instruction: If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

Response:

1 - Less than 18
2 - 18 or older
7 - Refused
9 - Do not know

Universe:

Refused or did not know age

Skip Instructions:

RF,DK = [goto AGEGUESS]
2 = [goto AGE65]
1 = If last non-deleted person on roster AND ((AGENO=RF,DK and AGE18=1) or AGE LT 018 for everyone then [goto Exit]
Else if last non-deleted person on roster [goto NATORG] Else [goto AGENO for next non-deleted person on roster]

Question ID: HCC.0240.00.1
Variable: AGE65
Interview Module: Roster
Content Type: Annual Core

Question Text:

^AreIs ^youALIAS less than 65 years old or 65 years or older

Fills:

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^AreIs

Description: Are/Is
Instruction: If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

Response:

1 - Less than 65
2 - 65 or older
7 - refused
9 - do not know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = if last non-deleted person on roster [goto NATORG] else [goto AGENO for next non-deleted person on roster]

Question ID: HCC.0250.00.1
Variable: AGEGUESS
Interview Module: Roster
Content Type: Annual Core

Question Text:

Use your judgement to guess if ^ALIASNAME is less than 18 or 18 or older.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - less than 18
2 - 18 or older

Universe:

Refused or do not know if age is 18 or older

Skip Instructions:

If last non-deleted person on roster AND AGEGUESS = 1,2 for everyone then [goto Exit] elseif last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]

Question ID: HCC.0290.00.1
Variable: NATORG
Interview Module: Roster
Content Type: Annual Core

Question Text:

^NATORGAGE

Fills:

^NATORGAGE

Description: Is ^ALIASNAME Hispanic or Latino?/^DoyouDoesALIAS consider
^yourhimherself to be Hispanic or Latino?
Instruction: If person is 17 or younger: "Is ^ALIASNAME Hispanic or Latino?"
If person is 18 or older: "^DoyouDoesALIAS consider
^yourhimherself to be Hispanic or Latino?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^DoyouDoesALIAS

Description: you/Does ^ALIASNAME
Instruction: For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF

Response:

1 - Yes
2 - No
7 - refused
9 - do not know

Universe:

All nondeleted persons

Skip Instructions:

If last non-deleted person on roster [goto RACE]
else [goto NATORG for next non-deleted person on roster]

Question ID: HCC.0300.00.1
Variable: RACE
Interview Module: Roster
Content Type: Annual Core

Question Text:

^RACEAGE

^RACEFILL

Enter all that apply, separate with commas.

Fills:

^RACEAGE

Description: What race or races is ^ALIASNAME/What race or races
^dodoes ^youALIAS} consider ^yourhimherself to be?
Instruction: If person is 17 or younger: "What race or races is
^ALIASNAME?"
If person is 18 or older: "What race or races ^dodoes
^youALIAS consider ^yourhimherself to be?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^dodoes

Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF

^RACEFILL

Description: Race list full
Instruction: For first or only non-deleted person:
Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, Asian, or some other race?

Else fill:
*Read if necessary: Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, Asian, or some other race?F

Response:

01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
06 - Other Pacific Islander
07 - Asian
97 - Refused
99 - Do not Know

Universe:

All nondeleted persons

Skip Instructions:

8 = IN RACE [goto RACE_SP]
1-7,RF,DK = If last non-deleted person on roster AND at least one person with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC] else [goto RACE for next non-deleted person on roster]

Question ID: HCC.0310.00.1
Variable: RACE_SP
Interview Module: Roster
Content Type: Annual Core

Question Text:

^RACESPAGE

Start typing and then select from list. If race is not on the list, type "ZZ" and enter verbatim.

If any of the following are mentioned, back up to previous screen and correct the entry.

White Black
African American American Indian Alaska Native Native Hawaiian Pacific Islander Asian

If respondent provides more than one other race, select 'ZZ' from the lookup table. At the next question, enter ALL the other races in the verbatim field.

Fills:

^RACESPAGE

Description: What other race or races is ^ALIASNAME?/What other race or races ^dodoes ^youALIAS consider ^yourhimherself to be?
Instruction: If person is 17 or younger: "What other race or races is
^ALIASNAME?"
If person is 18 or older: "What other race or races
^dodoes ^youALIAS consider ^yourhimherself to be?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^dodoes

Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF

Response:

ZZ - Other
97 - Refused
99 - Do not know

Universe:

Person identifies as some other race

Skip Instructions:

selection from picklist,DK,RF = If last non-deleted person on roster AND at least one person with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC] else [goto RACE for next non-deleted person on roster]
ZZ = [goto RACE_VRBAT]

Question ID: HCC.0320.00.1
Variable: RACE_VRBAT
Interview Module: Roster
Content Type: Annual Core

Question Text:

Read if necessary.

^RACESPAGE

Fills:

^RACESPAGE

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^dodoes

Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF

Response:

97 - Refused
99 - Do not know

Universe:

Person identifies as some other race and Interviewer does not use pick-list to select this race

Skip Instructions:

allow 8 = If last non-deleted person on roster AND at least one person with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC] else [goto RACE for next non-deleted person on roster]

Question ID: HCC.0330.00.1
Variable: AFNOW
Interview Module: Roster
Content Type: Annual Core

Question Text:

^AreyouIsALIASIsanyone now on full-time active duty with the Armed Forces?

*Read if necessary: Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for service in the U.S. or in a foreign country, in support of military or humanitarian operations.
Fills:

^AretouIsALIASIsanyone

Description: Are you/Is ^ALIASNAME/Is anyone in the household
Instruction: If PCNTAGEAF=1 and that person=respondent, fill "Are you", elseif PCNTAGEAF=1 and that person NE respondent, fill "Is
^ALIASNAME"
elseif PCNTAGEAF GT 1 fill "Is anyone in the household"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

At least one person in the household is greater than 18 and at least one person's age is not guessed and at least one non-deleted person age 17-64 years old or who is greater than or equal to 18 or whose age was guessed to be greater than or equal to 18

Skip Instructions:

1 = if GEN.PCNTAGEAF GT 1 [goto AFNOWWHO]
elseif GEN.PCNTAGEAF=1 and GEN.PCNT=1[goto EXIT] elseif GEN.PCNTAGEAF=1 and GEN.PCNT GT 1[goto EDUC]
2,RF,DK = [goto EDUC]

Question ID: HCC.0340.00.1
Variable: AFNOWWHO
Interview Module: Roster
Content Type: Annual Core

Question Text:

Who is this? (Anyone else?)

Enter all that apply, separate with commas.

Response:

01-25 - Person Number

Universe:

At least 1 person in the Armed Forces and more than 1 person eligible to be in the Armed Forces

Skip Instructions:

1-25 = if all PX have GEN.HHSTAT_D=1 or GEN.HHSTAT_M = 1 [goto EXIT]
else [goto EDUC]

Question ID: HCC.0350.00.1
Variable: EDUC
Interview Module: Roster
Content Type: Annual Core

Question Text:

What is the HIGHEST level of school ^youALIAS ^havehas completed or the highest degree ^youALIAS
^havehas received?

Enter highest level of school completed.

Fills:

^youALIAS

Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^havehas

Description: have/has
Instruction: If subject=respondent, fill "have", else if subject NE respondent fill "has"

Response:

00 - Never attended/kindergarten only
01 - Grade 1-11
02 - 12th grade, no diploma
03 - GED or equivalent
04 - High School Graduate
05 - Some college, no degree
06 - Associate degree: occupational, technical, or vocational program
07 - Associate degree: academic program
08 - Bachelor's degree (Example: BA, AB, BS, BBA)
09 - Master's degree (Example: MA, MS, MEng, MEd, MBA)
10 - Professional School degree (Example: MD, DDS, DVM, JD)
11 - Doctoral degree (Example: PhD, EdD)
97 - Refused
99 - Do not Know

Universe:

All non-deleted persons flagged as aged 18+

Skip Instructions:

0-11,DK,RF = If last non-deleted adult on roster [goto next section] else [goto EDUC for next non-deleted adult on roster]

Question ID: HCC.0360.00.1
Variable: EXIT
Interview Module: Roster
Content Type: Annual Core

Question Text:

Not every household in our survey is asked all questions. I have all the information about your household that I need at this time. Thank you for your assistance.

Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

All armed forces, all usual residence elsewhere, all under age 18, all where aged is guessed

Skip Instructions:

1 [goto BCK.WHOREADLTR]

2019 National Health Interview Survey (NHIS) Questionnaire
REL: Relationship of children to parents

Question ID: REL.0010.00.1
Variable: WHOPAR
Interview Module: Roster
Content Type: Annual Core

Question Text:

Which people living in this household are ^ALIASNAME's parents? Please include biological, step, or adoptive parents, but not foster parents or other relatives who may act as parents.

If respondent is a foster parent or relative who acts as a parent, probe "Does ^ALIASNAME have any biological, step, or adoptive parents living in this household?"

Enter '0' if no biological, step, or adoptive parents live in the household.

Legal guardians who are not biological, step, or adoptive parents should not be selected at this question.

Enter all that apply, separate with commas.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

00 - No biological, step, or adoptive parents
01 - Name of person 1
02 - Name of person 2
03 - Name of person 3
04 - Name of person 4
05 - Name of person 5
06 - Name of person 6
07 - Name of person 7
08 - Name of person 8
09 - Name of person 9
10 - Name of person 10
11 - Name of person 11
12 - Name of person 12
13 - Name of person 13
14 - Name of person 14
15 - Name of person 15
16 - Name of person 16
17 - Name of person 17
18 - Name of person 18
19 - Name of person 19
20 - Name of person 20
21 - Name of person 21
22 - Name of person 22
23 - Name of person 23
24 - Name of person 24
25 - Name of person 25
97 - Refused
99 - Do not know

Universe:

All persons with age less than 18 years old or age was guessed or reported to be less than 18

Skip Instructions:

If 0 selected with any other value [goto ERR4_WHOPAR] If AGEDIFF LT 15 [goto ERR1_WHOPAR]
elseif AGEDIFF GE 50 [goto ERR2_WHOPAR] elseif AGEDIFF LE 0 [goto ERR3_WHOPAR]
0, RF, DK = [goto FOSTPAR]
1-25 = If last non-deleted child on roster [goto next section] else [goto WHOPAR for next non-deleted child on roster]

Hard Edit:

Check Text: ERR4_WHOPAR

Check Description: 0 and another entry
Check text:
{check ERR4_WHOPAR}

Invalid entry. Cannot mark 0 and a valid line number.

Please correct.

Soft Edit:

Check Text: ERR1_WHOPAR

Check Description: Age difference between parent selected and child less than 15 years
Check text:
{signal ERR1_WHOPAR}

Age difference between parent and child is
^AGEDIFF years.

I have recorded the parent ^PARENTNAME is
^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old.
Are these ages and relationships correct? Please correct relationship code or age.

Check Text: Parent is younger than child

Check Description: 0 and another entry
Check text:
{signal ERR3_WHOPAR}

Please verify. Parent is younger than child.

I have recorded the parent ^PARENTNAME is
^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct?

Please correct relationship code or age

Check Text: ERR2_WHOPAR

Check Description: Age difference GE 50 years
Check text:
{signal ERR2_WHOPAR}

Age difference between parent and child is greater than or equal to 50 years.

I have recorded the parent ^PARENTNAME is
^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct?

Please correct relationship code or age.

Question ID: REL.0040.00.1
Variable: WHOFOST
Interview Module: Roster
Content Type: Annual Core

Question Text:

Which people living in this household are ^ALIASNAME's foster parents?

Read if necessary: Please include grandparents or other family members if they are acting as foster parents under the supervision of a state or county child welfare agency.

Enter all that apply, separate with commas.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

Universe:

Child is in foster care

Skip Instructions:

If AGEDIFF LT 15 [goto ERR1_WHOFOST]
elseif AGEDIFF GE 50 [goto ERR2_WHOFOST] elseif AGEDIFF LE 0 [goto ERR3_WHOFOST]
If last non-deleted child on roster [goto next section] else [goto WHOPAR for next non-deleted child on roster]

Soft Edit:

Check Text: ERR3_WHOFOST

Check Description: Foster parent is younger than child
Check text:
{signal ERR3_WHOFOST}

Please verify. Parent is younger than child.

I have recorded the foster parent
^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct?

Please correct relationship code or age.

Check Text: ERR2_WHOFOST

Check Description: Age difference GE 50 years
Check text:
{signal ERR2_WHOFOST}

Age difference between parent and child is greater than or equal to 50 years.

I have recorded the foster parent
^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct?

Please correct relationship code or age

Check Text: ERR1_WHOFOST

Check Description: Age difference between foster parent selected and child less than 15 years
Check text:
{signal ERR1_WHOFOST}

Age difference between parent and child is
^AGEDIFF years.

I have recorded the foster parent
^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old.
Are these ages and relationships correct? Please correct relationship code or age.

2019 National Health Interview Survey (NHIS) Questionnaire
FAM: Family Composition

Question ID: FAM.0050.00.1
Variable: ALLFAM
Interview Module: Roster
Content Type: Annual Core

Question Text:

? [F1]

Is everyone in this household a member of the same family?

*Read if necessary: For this survey, a family is two or more people living together who are related by birth, marriage, or adoption, as well as any unrelated children who are cared for by the family, such as foster children, and any people living together as a couple and their children.

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

The number of unique families as identified in REL section is greater than 1

Skip Instructions:

IF (Roster.PCNTEligibleSA 1 OR Roster.PCNTEligibleSC 1) [goto SASCID] ELSE [goto procSetFAMILY_FLGs]

Question ID: FAM.0040.00.1
Variable: SASCID
Interview Module: Roster
Content Type: Annual Core

Question Text:

One ^SASCID_fill randomly selected from every household in the survey to be asked a series of health related questions. In this household, ^SASCID_fill2 chosen.

Fills:

^SASCID_fill

Description: adult and child are/adult is/child is
Instruction: If PX_A gt 0 and PX_C gt 0, fill "adult and child are" elseif PX_A gt 0, fill "adult is"
else fill "child is"

^SASCID_fill2

Description: you and ^SCNAME were/^SANAME and ^SCNAME were/you were/^SANAME was/^SCNAME was
Instruction: If PX_A gt 0 and PX_C gt 0 and HHRESPAVAIL = PX_A, fill "you and ^SCNAME were"
elseif PX_A gt 0 and PX_C gt 0 and HHRESPAVAIL ne PX_A, fill "^SANAME and ^SCNAME were"
elseif PX_A gt 0 and HHRESPAVAIL = PX_A, fill "you were" elseif PX_A gt 0 and HHRESPAVAIL ne PX_A, fill "^SANAME was"
else fill "^SCNAME was"

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

Response:

1 - Enter 1 to continue

Universe:

Count of all persons eligible to be SA is greater than 1 or count of all persons eligible to be SC is greater than 1 or there are multiple adults or children in the family but only 1 adult or child is eligible to be the SA or SC because the others are in the Armed Forces.

Skip Instructions:

IF ALLFAM IN (2,DK,RF) AND PX_A 0 AND PCNTFX_SA_AfterREL less than PCNT {Not everyone in same family, there's a SA, and not everyone's in SA's famly} [goto FAMINTRO_SA]
ELSEIF ALLFAM IN (2,DK,RF) {Not everyone in same family (and there's a SC)} [goto procSetFX_RELATE_SA]
ELSE [goto procSetFAMILY_FLGs]

Question ID: FAM.0070.00.1
Variable: FAMINTRO_SA
Interview Module: Roster
Content Type: Annual Core

Question Text:

^FAMINTRO_fill

I will now ask you some questions about how other people in this household are related to
^you_SA.

Fills:

^FAMINTRO_fill

Description: FAMINTRO_SA Introduction
Instruction: If PCNTFAMAREL ge 2, fill "Based on questions I asked you earlier, we have that ^SAFAM are in the same family." else leave fill empty.

^SAFAM

Description: List of people in SA's family
Instruction: For all people with FAMA_REL_FLG =1 and are not Household Respondent, fill with their names.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list.

^you_SA

Description: you/^ALIASNAME
Instruction: If HHRESPAVAIL eq PX_A, fill "you" else fill "^ALIASNAME" of Sample Adult

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

1 - Enter 1 to continue

Universe:

Not everyone in same family, there's a SA, and not everyone's in SA's family

Skip Instructions:

1 = [goto tblRelate_SA.bPerson.RELATE for 1st non-deleted person on roster with FX_REL[PX] ne FX_REL[PX_A]]

Question ID: FAM.0140.00.1
Variable: FAMINTRO_SC
Interview Module: Roster
Content Type: Annual Core

Question Text:

I will now ask you some questions about who in this household is related to ^SCNAME. Based on questions I asked you earlier, we have that ^SCNames_fill related to ^SCNAME.

Fills:

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^SCNames_fill

Description: List of people in Sample Child's family
Instruction: For all people with FAMC_REL_FLG =1 OR (SAME_REL_FLG=1 for SC and tblRelate_SA.bPerson.RELATE in (1-13,DK,RF)) OR (FAMA_REL_FLG=1 and 1st person in SC's family has tblRelate_SA.bPerson.RELATE in (1-13,DK,RF), fill with their names.

Description: Person was identified as being in the SC's family at WHOPAR/WHOFOST OR (Sample Child is related to the Sample Adult and person on roster was placed in Sample Adult's family based on answer provided at RELATE), include their name as part of the list of SC's family.

Do not include Sample Child on list.

If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list.
If only one person on the list of names and person ne Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on list and person is Household Respondent (Roster.HHC.HHRESPAVAIL), follow list with "are".

Response:

1 - Enter 1 to continue

Universe:

Not everyone in same family and there is a SC, and there is no SA and not everyone in SC's family or SA/SC in separate families and not everyone in SA or SC's families or SA/SC in same family and not everyone in that family

Skip Instructions:

1 [goto tblRelate_SC.bPerson.RELATE for 1st non-deleted person on roster with FX_RELATESA[PX] ne FX_RELATESA[PX_A] and FX_RELATESA[PX] ne FX_RELATESA[PX_C]]

Question ID: FAM.0240.00.1
Variable: KNOWSC
Interview Module: Roster
Content Type: Annual Core

Question Text:

Who lives here and is knowledgeable about and responsible for ^SCNAME's health care?

^ANYONEELSE

Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

00 - Not on roster
01-25 Person number
97 - Refused
99 Do not know

Universe:

There's a SC and either multiple eligible adults or only one eligible adult but that person is not a parent of the SC

Skip Instructions:

DK,RF [goto NOFAMSC]
1-25 IF Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and (PX_A ne Roster.HHC.HHRESPAVAIL) [goto ONCAMPINTRO_A]
ELSE [goto CASESTATUS]

Question ID: FAM.0250.00.1
Variable: NOFAMSC
Interview Module: Roster
Content Type: Annual Core

Question Text:

Because there are no adults who are related to ^SCNAME living in this household, or respondent refused or did not know who was knowledgeable about and responsible for ^SCNAME's health care, the Sample Child Interview cannot be completed.

Not everyone in our survey is asked all questions. I have all the information that I need from you about ^SCNAME.

Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

No one is knowledgeable about and responsible for the sample child's health or do not know or refused to identify knowledgeable person

Skip Instructions:

1 = if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and (PX_A ne Roster.HHC.HHRESPAVAIL) [goto ONCAMPINTRO_A]
elseif PX_A greater than 0 {there is a Sample Adult} [goto CASESTATUS] else [goto BCK.THANKS_SUF]

Question ID: FAM.0260.00.1
Variable: ONCAMPINTRO_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

As I previously mentioned ^SANAME was randomly selected to be asked a series of health related questions. We would like to contact ^himherthem to complete ^hishertheir portion of this interview.

Fills:

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

^himherthem

Description: him/her/them
Instruction: If GEN.SEX_FINAL=1 fill "him";
else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "them"

^hishertheir

Description: his/her/their
Instruction: If GEN.SEX_FINAL=1 fill "his";
else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their"

Response:

1 - Enter 1 to continue

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not the Household Respondent

Skip Instructions:

1 =[goto TLNO_FAM_DRM]

Question ID: FAM.0280.00.1
Variable: ONCAMPLNAME
Interview Module: Roster
Content Type: Annual Core

Question Text:

Ask or verify: What is ^SANAME's last name?

Fills:

^SANAME

Description: Sample adult's name
Instruction: Sample adult's name

Response:

97 - refused
99 - do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 20,RF,DK = [goto ONCAMPADD1_A]

Question ID: REL.0290.01.1
Variable:ONCAMPADD1_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

What is ^SANAME's exact mailing address on campus?

Enter the house or building number, house or building number suffix and street name.

Fills:

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult?s name

Response:

97 - Refused
99 - do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 54, empty = [goto ONCAMPADD2_A]

Question ID: FAM.0290.02.1
Variable: ONCAMPADD2_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter the unit description.

Response:

97 - Refused
99 - Do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 54, empty = [goto ONCAMPPO_A]

Question ID: FAM.0290.03.1
Variable: ONCPUNTDES_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter the correct unit designation or press "ENTER" if there is none.

Response:

97 - Refused
99 - Do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 20, empty = [goto ONCAMPPO_A]

Question ID: FAM.0290.08.1
Variable: ONCAMPZIP4_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter the zip 4.

Response:

0000-9996 - Range of values
9997 - refused
9999 - do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

0000-9997, RF, DK, empty = if ONCAMPZIP4_A lt 4 characters [goto ERR1_ONCAMPZIP4_A]
elseif (ONCAMPZIP4_A gt 9996 and SURVTYPE ne 'T') or (ONCAMPZIP4_A gt 9997 and SURVTYPE='T') [goto ERR2_ONCAMPZIP4_A]
else [goto ONCAMPADDR_A]

Question ID:FAM.0300.00.1
Variable: ONCAMPADDR_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Please confirm the following information about the Sample Adult living on campus: Name: ^SANAME
Phone Number: ^ONCAMPPHONE_fill

Address:
^ONCAMPADD1_A_fill
^ONCAMPADD2_A_fill
^ONCAMPPO_A_fill, ^ONCAMPST_A_fill ^ONCAMPZIP5_A_fill - ^ONCAMPZIP4_A_fill

Fills:

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult?s name

^ONCAMPPHONE_fill

Description: {Value of DISPLAYSTRING}
Instruction: Fill the phone number associated with the on-campus SA from bContact.arrayPhones [Roster.FAM.TLNO_FAM_DRM].DisplayString

^ONCAMPADD1_A_fill

Description: {Value of ONCAMPADD1_A}
Instruction: Fill ONCAMPADD1_A_fill with value from ONCAMPADD1_A

^ONCAMPADD2_A_fill

Description: {Value of ONCAMPADD2_A}
Instruction: Fill ONCAMPADD2_A_fill with value from ONCAMPADD2_A

^ONCAMPPO_A_fill

Description: {Value of ONCAMPPO_A}
Instruction: Fill ONCAMPPO_A_fill with value from ONCAMPPO_A

^ONCAMPST_A_fill

Description: {Value of ONCAMPST_A}
Instruction: Fill ONCAMPST_A_fill with value collected at ONCAMPST_A

^ONCAMPZIP5_A_fill

Description: {Value of ONCAMPZIP5_A}
Instruction: Fill ONCAMPZIP5_A_fill with value collected at ONCAMPZIP5_A

^ONCAMPZIP4_A_fill

Description: {Value of ONCAMPZIP4_A}
Instruction: Fill ONCAMPZIP4_A_fill will value collected at ONCAMPZIP4_A

Response:

1 - Enter 1 to Continue

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

1 = [goto CASESTATUS]
Question ID: FAM.290.04.1
Variable: ONCAMPPO_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter the city.

Response:

97 - refused
99 - do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 28, empty [goto ONCAMPST_A]

Question ID: FAM.290.05.1
Variable: ONCAMPST_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter the state.

Response:

97 - Refused
99 - Do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 2 = [goto ONCAMPZIP5_A]

Question ID: FAM.290.07.1
Variable: ONCAMPZIP5_A
Interview Module: Roster
Content Type: Annual Core

Question Text:

Enter the zip code.

Response:

01001-99995 - range of values
99997 - refused
99999 - Do not know

Universe:

Sample Adult lives on campus or do not know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

01001-99996, RF, DK, empty -
if ONCAMPZIP5_A lt 5 characters [goto ERR1_ONCAMPZIP5_A] elseif ONCAMPZIP5_A lt 01001 [goto ERR2_ONCAMPZIP5_A]
elseif (ONCAMPZIP5_A gt 99996 and SURVTYPE ne 'T') or (ONCAMPZIP5_A gt 99997 and SURVTYPE='T') [goto ERR3_ONCAMPZIP5_A]
else [goto ONCAMPZIP4_A]

Hard Edit:

Check text: ERR1_ONCAMPZIP5_A

Check description: ONCAMPZIP5_A must have a length of 5
Check text:

{check ERR1_ONCAMPZIP5_A}

The entire zip code must be entered.

Please correct.

Check text: ERR3_ONCAMPZIP5_A

Check description: ONCAMPZIP5_A gt 99996/99997
Check text:

{check ERR3_ONCAMPZIP5_A}

A valid zip code must be entered.

Please correct.

Check text: ERR2_ONCAMPZIP5_A

Check description: ONCAMPZIP5_A must be greater than or equal to 01001
Check text:

{check ERR2_ONCAMPZIP5_A}

A valid zip code must be entered.

Please correct.

2019 National Health Interview Survey (NHIS) Questionnaire
VFY: Sample Adult Verification

Question ID: VFY.0010.00.1
Variable: CURRES_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Enter the line number of the person to whom you are speaking.

Response:

00 - not on roster
01 - name of person 1
02 - name of person 2
03 - name of person 3
04 - name of person 4
05 - name of person 5
06 - name of person 6
07 - name of person 7
08 - name of person 8
09 - name of person 9
10 - name of person 10
11 - name of person 11
12 - name of person 12
13 - name of person 13
14 - name of person 14
15 - name of person 15
16 - name of person 16
17 - name of person 17
18 - name of person 18
19 - name of person 19
20 - name of person 20
21 - name of person 21
22 - name of person 22
23 - name of person 23
24 - name of person 24
25 - name of person 25
97 - refused
99 - do not know

Universe:

The Sample Adult section has not been started or completed or has a Sample Adult callback setup

Skip Instructions:

1-25 = [goto AVAIL_A]

Question ID: VFY.0050.00.1
Variable: PROXYLNO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Select the person in this household who is the proxy for ^SANAME.

Fills:

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult?s name

Response:

01 - ^ALIASNAME[1]
02 - ^ALIASNAME[2]
03 - ^ALIASNAME[3]
04 - ^ALIASNAME[4]
05 - ^ALIASNAME[5]
06 - ^ALIASNAME[6]
07 - ^ALIASNAME[7]
08 - ^ALIASNAME[8]
09 - ^ALIASNAME[9]
10 - ^ALIASNAME[10]
11 - ^ALIASNAME[11]
12 - ^ALIASNAME[12]
13 - ^ALIASNAME[13]
14 - ^ALIASNAME[14]
15 - ^ALIASNAME[15]
16 - ^ALIASNAME[16]
17 - ^ALIASNAME[17]
18 - ^ALIASNAME[18]
19 - ^ALIASNAME[19]
20 - ^ALIASNAME[20]
21 - ^ALIASNAME[21]
22 - ^ALIASNAME[22]
23 - ^ALIASNAME[23]
24 - ^ALIASNAME[24]
25 - ^ALIASNAME[25]
97 - refused
99 - Do not know

Universe:

Sample adult proxy is a relative or non relative who lives in the household

Skip Instructions:

1-25 = if PROXYLNO_A ne CURRES_A [goto INTMODE_A]
elseif PROXYLNO_A=CURRES_A and Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]

Question ID: VFY.0060.00.1
Variable: PROXYCALL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Can a callback with someone knowledgeable about ^SANAME's health be arranged

Fills:

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult?s name

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Knowledgeable proxy is not available.

Skip Instructions:

1 = [goto bCallback.CB_POSSIBLE], then
if there is a Sample child and they have not been interviewed [goto Child.VFY.CURRES_C] else [goto BCK.THANKS_CB]
2 = if there is a Sample child and they have not been interviewed [goto Child.VFY.CURRES_C] elseif GEN.OUTCOME=203 [goto BCK.THANKS_SUF]
else [goto BCK.THANKS_INSUF]

Question ID: VFY.0070.00.1
Variable: INTMODE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How are you contacting ^SARESP?

Fills:

^SARESP

Description: Sample Adult respondent?s name
Instruction: fill sample adult respondent?s name

Response:

1 - Personal visit
2 - telephone

Universe:

Sample Adults 18+ and
Not initially speaking to the Sample Adult but now speaking to the Sample Adult OR
Now speaking to a proxy respondent who is not on the roster or refused or do not know if on the roster OR
Now speaking to a proxy respondent who is on the roster and who wasn't who you were initially speaking to

Skip Instructions:

1 = if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and GEN.HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else[goto VFYALL_A]
2 = [goto TINTRO_A]

Question ID: VFY.0080.00.1
Variable: TINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Hello, my name is (* say your name). I'm calling from the U.S. Census Bureau. We are conducting the National Health Interview Survey on behalf of the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC). This is a nationwide survey about the health of both adults and children. I have some information from ^HHRESP. Now, I would like to ask you some questions.

Read if necessary: I believe I am calling you on a cell phone.

Before we continue, I have to ask: Are you currently driving?

Even if the respondent is using a hands-free device while driving, you must enter '1'

Fills:

^HHRESP

Description: {Value of HHRESPAVAIL}
Instruction: Display the name of the person selected at Roster.HHC.HHRESPAVAIL

Response:

1 - Yes
2 - No
7 - refused
9 - do not know

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent

Skip Instructions:

1,RF,DK = [goto ATTN_A]
2 = [goto LETTER_A]

Question ID: VFY.009.00.1
Variable:ATTN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

For your safety, we will call you back at another time.

Enter 1 to continue.

Response:

1 - Enter 1 to continue

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is driving

Skip Instructions:

1 = [goto bCallback.CB_POSSIBLE]

Question ID: VFY.0100.00.1
Variable: LETTER_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

If sample adult is a new respondent read question below, otherwise enter 1

Read if necessary: A letter describing the National Health Interview Survey was sent to your home recently. Do you remember seeing the letter?

Response:

1 - Yes
2 - no

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1,2,DK,RF = [goto S_INTRO_A]

Question ID: VFY.0110.00.1
Variable: S_INTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

If sample adult is a new respondent read question below, otherwise enter 1

Read if necessary: There are a few things I need to cover before we continue. I'd like you to know that taking part in this survey is voluntary. You may choose not to answer any questions you do not wish to answer, or end the interview at any time without penalty. We are required by Federal law to develop and follow strict procedures to protect the confidentiality of your information and use your answers only for statistical research. I can describe these laws if you wish. Except for the National Center for Health Statistics and Census Bureau employees and specially designated agents, no one can see your answers until all information that could identify you and/or your family has been removed. Only after that will your data be made available to researchers. For most adults, the survey will take less than ^SATIME minutes. I'd like to continue now unless you have any questions.

If respondent asks for more information about the privacy laws, press F1.

Fills:

^SATIME

Description: 35/45
Instruction: If GEN.CSTAT=1 and GEN.SAMEFAM_FLG=1, fill: 35 else, fill: 45

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1 = if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and GEN.HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]

Question ID: VFY.0120.00.1
Variable: VFYONCAMP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

I want to confirm some information.

Do you live in on-campus housing or off-campus housing?

Read if necessary: On-campus housing includes residence halls and dorms where students live together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.

Response:

1 - ON CAMPUS
2 - OFF CAMPUS
7 - REFUSED
9 - DO NOT KNOW

Universe:

Sample Adults living in on-campus housing and the Sample Adult is not the household respondent

Skip Instructions:

1,RF,DK = [goto VFYALL_A]
2 = [goto NOMORE_A]

Question ID: VFY.0130.00.1
Variable: VFYALL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^Verifyintro

I have recorded ^yoursexis, you are ^AGE_A, ^NATORG_A, and ^RACE_A. Would you like to make any changes to this ^additionalinfo_A?

^RACEVRBATvalue_A

If respondent "refuses" or says "do not know", enter "2" for "no."

Fills:

^Verifyintro

Description: I want to confirm some information.
Instruction: If VFYONCAMP_A=empty "I want to confirm some information."

else fill nothing

^yoursexis

Description: your sex is male/your sex is female/you do not know your sex/you do not wish to provide your sex/your sex was not provided
Instruction: If GEN.SEX_FINAL=1 fill "your sex is male" If GEN.SEX_FINAL=2 fill "your sex is female"
If GEN.SEX_FINAL=DK and GEN.HHRESPSA_FLG=1 fill "you do not know your sex"
If GEN.SEX_FINAL=RF and GEN.HHRESPSA_FLG=1 fill "you do not wish to provide your sex"
If GEN.SEX_FINAL IN (DK,RF) and GEN.HHRESPSA_FLG ne 1 fill
"your sex was not provided"

^AGE_A

Description: {Value of AGE}/65 or older/between 18 and 64/18 and older
Instruction: if GEN.AGE_FINAL ne RF, DK fill with age elseif GEN.AGE_FINAL IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2 fill "65 or older"
elseif GEN.AGE_FINAL in (RF,DK) and Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=1 fill "between 18 and 64"
elseif GEN.AGE_FINAL IN (RF, DK) and Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (RF,DK,empty) fill "18 and older"

^NATORG_A

Description: Verify Hispanic or Latino origin
Instruction: If GEN.NATO_FINAL=1 fill: "you are of Hispanic or Latino origin"
If GEN.NATO_FINAL=2 fill: "you are not of Hispanic or Latino origin"
If GEN.NATO_FINAL=DK and GEN.HHRESPSA_FLG=1 fill: "you do
not know if you are of Hispanic or Latino origin"
If GEN.NATO_FINAL=RF and GEN.HHRESPSA_FLG=1 fill: "you do
not wish to provide information about your Hispanic or Latino origin"
If GEN.NATO_FINAL IN (DK,RF) and GEN.HHRESPSA_FLG ne 1
fill "information about your Hispanic or Latino origin was not provided"

^RACE_A

Description: you are ^RACEFILLAND_A/you do not know your race/you do not wish to provide your race/your race was not provided
Instruction: If race or races IN GEN.RACE_FINAL[PX_A].RACE_FINAL fill: "you are ^RACEFILLAND_A."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=DK and
GEN.HHRESPSA_FLG=1 fill "you do not know your race." If GEN.RACE_FINAL[PX_A].RACE_FINAL=RF and
GEN.HHRESPSA_FLG=1 fill: "you do not wish to provide your race."
If GEN.RACE_FINAL[PX_A].RACE_FINAL IN (DK,RF) and
GEN.HHRESPSA_FLG ne 1 fill "your race was not provided."

^RACEFILLAND_A

Description: Categories selected at the RACE screen
Instruction: Fill categories stored in GEN.RACE_FINAL[PX_A].RACE_FINAL. If more than two categories separate the categories with commas. Add the word "and" before the last category.

When GEN.RACE_FINAL[PX_A].RACE_FINAL=8,
if GEN.RACE_FINAL[PX_A].RACE_SP_FINAL not in (ZZ,RF,DK)
display picklist selection from GEN.RACE_FINAL[PX_A].RACE_SP_FINAL
elseif GEN.HHRESPSA_FLG=1 and GEN.RACE_FINAL
[PX_A].RACE_VERBAT_FINAL not in (empty,DK,RF) display GEN.RACE_FINAL[PX_A].RACE_VERBAT_FINAL
else display "some other race"

^additionalinfo_A

Description: if any information is missing "or provide additional information about"
Instruction: See attachment for fill instructions

^RACEVRBATvalue_A

Description: Information collected at RACEVRBAT for Sample adult Instruction: IF GEN.HHRESPSA_FLG ne 1 and GEN.RACE_FINAL
[PX_A].RACE_VRBAT_FINAL ne (empty,RF,DK), fill " If respondent wants information on which other race they are listed as, say ^RACE_VRBAT."

^RACE_VRBAT

Description: {Value of RACE_VRBAT_FINAL}
Instruction: fill with value from GEN.RACE_FINAL[PX].RACE_VRBAT_FINAL

Response:

1 - yes
2 - no
7 - refused
9 - do not know

Universe:

Sample adults 18+ and the Sample Adult or a proxy is available to continue the interview and the Sample Adult is not identified as away at college and living in off-campus housing

Skip Instructions:

1 = [goto VFYDEM_A]
2 = if GEN.SEX_FINAL IN (DK,RF) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A] elseif GEN.RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0140.00.1
Variable: VFYDEM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: What should I change?

Mark all that apply, separate with commas.

Response:

1 - Sex
2 - Age
3 - Hispanic or Latino Origin
4 = Race
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ would like to change demographic information

Skip Instructions:

if 1 IN VFYDEM_A [goto NEWSEX_A]
elseif (2,3,4) IN VFYDEM_A and GEN.SEX_FINAL[PX_A] IN (DK,RF) [goto SEXGUESS_A] elseif 2 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (DK,RF)[goto NEWAGE_A] elseif 3 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (DK,RF) [goto NEWNATORG_A] elseif 4 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (DK,RF) [goto NEWRACE_A]
RF,DK = If GEN.SEX_FINAL[PX_A] IN (DK,RF) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A] elseif GEN.RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0150.00.1
Variable: NEWSEX_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you male or female?

Response:

1 - Male
2 - Female
7 - refused
9 - do not know

Universe:

Respondent said his/her sex is not correct

Skip Instructions:

if GEN.SEX_FINAL[PX_A]=DK,RF and NEWSEX_A=DK,RF [goto SEXGUESS_A]
elseif 2 IN VFYDEM_A [goto NEWAGE_A] elseif 3 IN VFYDEM_A [goto NEWNATORG_A] elseif 4 IN VFYDEM_A [goto NEWRACE_A] elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0160.00.1
Variable: SEXGUESS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Enter your best guess of ^SANAME's sex.

Fills:

^SANAME

Description: Sample Adult?s name
Instruction: Sample Adult?s name

Response:

1 - Male
2 - Female

Universe:

Sample adults for whom there is no sex provided by the household respondent and did not give a sex when asked to verify information

Skip Instructions:

1,2 =
if 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A] elseif 4 IN VFYDEM_A [goto NEWRACE_A] elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A] elseif GEN.RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A] elseif GEN.RACE_FINAL has multiple values selected [goto MLTRACE_A]
else [goto BMONTH_A]

Question ID: VFY.0170.00.1
Variable: NEWAGE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How old are you?

Enter age.

Response:

000-120 - Range of values
997 - refused
999 - do not know

Universe:

Sample Adult 18+ said his/her age is not correct

Skip Instructions:

0-120, RF, DK = if 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A] elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0190.00.1
Variable: NEWNATORG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you consider yourself to be Hispanic or Latino?

Response:

1 - yes
2 - no
7 - refused
9 - do not know

Universe:

Sample Adult 18+ said his/her Hispanic Origin is not correct

Skip Instructions:

1,2,RF,DK = if 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0200.00.1
Variable: NEWRACE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What race or races do you consider yourself to be? Please select 1 or more of these categories:

White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, Asian, or some other race?

Enter all that apply, separate with commas.

Response:

01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
97 - refused
99 - do not know

Universe:

Sample Adult 18+ said his/her race is not correct

Skip Instructions:

1-8,DK,RF = if GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in ('ZZ',RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0210.00.1
Variable: HISPTYPE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is your Hispanic or Latino ancestry or origin, such as Mexican, Mexican American,
^CHICANOA, Central or South American, Puerto Rican, Cuban, Dominican (Republic), or Other Hispanic, ^LATINOA, or Spanish -- and if you have more than one, tell me all of them.

Enter all that apply, separate with commas.

Fills:

^CHICANOA

Description: Chicano/Chicano or Chicana
Instruction: If SEX_FINAL = 1 fill: "Chicano"
if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"

^LATINOA

Description: Latino/Latino or Latina
Instruction: If SEX_FINAL= 1 fill: "Latino"
if SEX_FINAL = 2,DK,RF fill "Latino or Latina"

Response:

01 - Mexican, Mexican American, or Chicano(a)
02 - Central American
03 - South American
04 - Puerto Rican
05 - Cuban
06 - Domincican (Republic)
07 - Other Hispanic, Latino(a), or Spanish (specify)
97 - Refused
99 - Do not know

Universe:

Respondent is of Hispanic Origin

Skip Instructions:

7 = [goto HISPOTHER_A]
1-6,DK,RF =
if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0220.00.1
Variable: HISPOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

What is your Hispanic or Latino ancestry or origin? If you have more than one, tell me all of them.

Start typing and then select from list. If Hispanic or Latino ancestry is not on the list, type "ZZ" and enter verbatim.

If any of the following are mentioned, backup to previous screen and correct the entry. Mexican
Mexican American Chicano/Chicana
Central American (REFER TO HELP SCREEN) South American (REFER TO HELP SCREEN) Puerto Rican (Boricua)
Cuban/Cuban American Dominican (Republic)

If respondent provides more than one other Hispanic or Latino ancestry or origin, select 'ZZ' from the lookup table. At the next question, enter ALL the other Hispanic or Latino ancestries or origins in the verbatim field.

Response:

ZZ - Other
97 - Refused
99 - Do not know

Universe:

Respondent is of Other Hispanic Origin

Skip Instructions:

ZZ = [goto HISPVRBAT_A]
lookup table selection,RF,DK = if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A] elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0230.00.1
Variable: HISPVBRAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: What is your Hispanic or Latino ancestry or origin? If you have more than one, tell me all of them.

Response:

97 - Refused
99 - Do not know

Universe:

Sample Adult 18+ who report some other Hispanic Ancestry and this is not choosen from the picklist

Skip Instructions:

allow 80,RF,DK = if GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A] elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A].RACE_FINAL in (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0240.00.1
Variable: PITYPE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

I have recorded that you are Pacific Islander. What specific ethnic group or groups are you-- such as Guamanian or Chamorro, Samoan, or other Pacific Islander? If you are more than one, tell me all of them.

Enter all that apply, separate with commas.

Response:

1 - Guamanian or Chamorro
2 - Samoan
3 - Other Pacific Islander
7 - Refused
9 - Do not know

Universe:

Respondent identifies race as Pacific Islander

Skip Instructions:

3 = [goto PIOTHER_A]
1,2,RF,DK = if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0250.00.1
Variable: PIOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic group or groups are you? If you are more than one, tell me all of them.

Start typing and then select from list. If Pacific Islander ethnic group is not on the list, type "ZZ" and enter verbatim.

If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the next question, enter ALL the ethnic groups in the verbatim field.

Response:

ZZ - Other
97 - Refused
99 - Do not know

Universe:

Sample Adult 18+ who identifies as Other Pacific Islander

Skip Instructions:

ZZ = [goto PIVRBAT_A]
picklist selection, RF, DK =
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0260.00.1
Variable: PIVRBAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic group or groups are you? If you are more than one, tell me all of them.

Response:

97 - Refused
99 - Do not know

Universe:

Sample Adult 18+ who report some other group of Pacific Islander not on the picklist

Skip Instructions:

allow 80,RF,DK =
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0270.00.1
Variable: ASIANTYPE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

I have recorded that you are Asian. What specific ethnic group or groups are you-- such as Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian? If you are more than one, tell me all of them.

Enter all that apply, separate with commas.

Response:
01 - Asian Indian
02 - Chinese
03 - Filipino
04 - Japanese
05 - Korean
06 - Vietnamese
07 - Other Asian
97 - Refused
99 - Do not know

Universe:

Sample Adult identifies race as Asian

Skip Instructions:

7 = [goto ASIANOTHER_A]
1-6,RF,DK =
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK)))[goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0280.00.1
Variable: ASIANOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is your specific Asian ethnic group or groups? If you have more than one, tell me all of them.

Start typing and then select from list. If Asian ethnic group is not on the list, type "ZZ" and enter verbatim.

If any of the following are mentioned, backup to previous screen and correct the entry. (Asian) Indian
Chinese Filipino Japanese Korean Vietnamese

If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the next question, enter ALL the ethnic groups in the verbatim field.

Response:

ZZ - Other
97 - Refused
99 - Do not know

Universe:

Respondent identifies as other Asian

Skip Instructions:

allow 80, DK,RF = (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0290.00.1
Variable: ASIANVRBAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: What is your specific Asian ethnic group or groups? If you have more than one, tell me all of them.

Response:

97 - Refused
99 - Do not know

Universe:

Sample Adult 18+ who report some other ethnic group of Asian that is not on the picklist

Skip Instructions:

allow 80,RF,DK =
if (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0300.00.1
Variable: RACEOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What other race or races do you consider yourself to be?

Start typing and then select from list. If race is not on the list, type "ZZ" and enter verbatim.

If respondent provides more than one other race, select 'ZZ' from the lookup table. At the next question, enter ALL the other races in the verbatim field.

Response:

ZZ - Other
97 - Refused
99 - Do not know

Universe:

Sample Adults 18+ and race was changed to "some other race" in verification section or where the Sample Adult respondent is not the Household respondent and did not report a new race and were identified by the household respondent as being "some other race" not on the roster other race picklist

Skip Instructions:

ZZ = [goto RACEVRBAT]
picklist selection,RF,DK = if multiple responses to GEN.RACE_FINAL[PX_A].RACE_FINAL [goto MLTRACE_A]
else [goto BMONTH_A]

Question ID: VFY.0310.00.1
Variable: RACEVBRAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: What other race or races do you consider yourself to be?

Response:

97 - Refused
99 - Do not know

Universe:

Sample adults who are some other race and this is not selected from Sample adult picklist

Skip Instructions:

verbatim,RF,DK
if GEN.RACE_FINAL[PX_A].RACE_FINAL has multiple values selected [goto MLTRACE_A] else [goto BMONTH_A]

Question ID: VFY.0320.00.1
Variable: MLTRACE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Which one of these groups, that is ^RACELISTOR_A, would you say BEST represents your race?

Fills:

^RACELISTOR_A

Description: List of answers from Race
Introduction: Fill categories from GEN.RACE_FINAL. Add the word "or" before the last category.

For GEN.RACE_FINAL=8:

if RACEOTHER_A NOT IN (EMPTY,ZZ,RF,DK) display value from RACEOTHER_A

elseif RACEVRBAT_A NOT IN (EMPTY,RF,DK) display value from RACEVRBAT_A

elseif NEWRACE ne 8 and Roster.HHC.tblRACE.bPerson.RACE_SP [PX_A] NOT IN (EMPTY,ZZ,DK,RF) display value from Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A]

elseif GEN.HHRESPSA_FLG=1 and NEWRACE ne 8 and Roster.HHC.tblRACE.bPerson.RACE_VRBAT[PX_A] NOT IN (EMPTY,DK,RF) display value from Roster.HHC.tblRACE.bPerson.RACE_VRBAT[PX_A]

else display "some other race"

Response:

01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
97 - Refused
99 - Do not know

Universe:

Person identified as having multiple races

Skip Instructions:

1-8,RF,DK = [goto BMONTH_A]

Question ID: VFY.0340.00.1
Variable: BMONTH_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

1 of 3

What is your date of birth?

Please give month, day, and year for the date of birth.

Enter month of birth.

Response:

01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
97 - Refused
99 - Do not know

Universe:

Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times

Skip Instructions:

1-12,RF,DK = [goto BDAY_A]

Question ID: VFY.0140.00.1
Variable: BDAY_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

2 of 3

Enter day of birth.

Response:

01-31 - Range of values
97 - Refused
99 - Do not know

Universe:

Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times

Skip Instructions:

1-31,RF,DK = Only allow valid days for month entered. if days not valid [goto ERR_BDAY_A] else [goto BYEAR_A]

Hard Edit:

ERR_BDAY_A

Check Description: Invalid day for selected month hard edit
CheckText: {check ERR_BDAY_A}
^BDAY_A is not a valid day for ^BMONTH_A

Question ID: VFY.0340.00.1
Variable: BYEAR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

3 of 3

Enter year of birth.

If year of birth is before 1900, enter 1900.

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Do not know

Universe:

Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times

Skip Instructions:

1900-current year,RF,DK =
if (BYEAR_A gt current year) or (BYEAR_A=current year and BMONTH_A gt current month) or (BYEAR_A=current year and BMONTH_A=current month and BDAY_A gt current day) [goto ERR_BYEAR_A]

elseif BDAY_A=29 and BMONTH_A=2 and (BYEAR=2000 or BYEAR_A/4 remainder ne 0) [goto ERR_BDAYLEAP_A]

elseif GEN.AGE_FINAL IN (RF,DK) [goto AGEGUESS_A]

elseif ((BYEAR_A not IN (DK,RF) and AGETEMP_A not IN (DK,RF) and AGETEMP_A ne AGE_CALC_A) AND (AGETEMP_A not IN (DK,RF) and AGETEMP_A ne AGE_CALCMINUS1_A)) and DOB_COUNT_A ne 1 [goto VFYDOB_A]

elseif (AGETEMP_A eq (AGE_CALC_A or AGE_CALCMINUS1_A)) or DOB_COUNT_A=1 if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]

else [goto next section]

Hard Edit:

ERR_BDAYLEAP_A

Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAYLEAP_A}
^BDAY_A is not a valid day for ^BMONTH_A

Question ID: VFY.0370.00.1
Variable: AGEGUESS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

An age has not been collected and we are unable to determine an age based upon the date of birth.

What is your best guess at ^ALIASNAME's age?

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

Response:

018-120 - Range of values

Universe:

Sample Adult's age is do not know or refused

Skip Instructions:

18-120 = [goto next section]

Question ID: VFY.0380.00.1
Variable: VFYDOB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

There is a difference between the age the computer calculated from your date of birth of
^AGEDOB_A_fill and the age I had previously recorded of ^TEMPAGE_A. I recorded your ^dateofbirth

Fills:

^AGEDOB_A_fill

Description: {Age(s) calculated from Date of Birth for SA
Instruction: Fill one age calculated from AGE_CALC_A as "(age)" Fill two ages calculated from AGE_CALC_A and AGE_CALCMINUS1_A as "(age) or (age)"

^TEMPAGE_A

Description: {Value of AGETEMP_A}
Instruction: fill value of AGETEMP_A

^dateofbirth

Description: date of birth when any of BDAY_A, BMONTH_A or BYEAR_A are not valid
Instruction: If BDAY_A, BMONTH,A and BYEAR_A are all valid, fill: "date of birth as ^BMONTH_A ^BDAY_A, ^BYEAR_A, is that correct?" If only BMONTH_A and BYEAR_A are valid, fill: "date of birth as ^BMONTH_A ^BYEAR_A, is that correct?"
If only BDAY_A and BYEAR_A are valid, fill: "year of birth as ^BYEAR_A, is that correct?"
If only BYEAR_A is valid, fill: "year of birth as
^BYEAR_A, is that correct?"

^BMONTH_A

Description: {Value of BMONTH_A}
Instruction: Fill value from BMONTH_A

^BDAY_A

Description: {Value of BDAY_A}
Instruction: Fill value from BDAY_A

^BYEAR_A

Description: {Value of BYEAR_A}
Instruction: Fill with value in BYEAR_A

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not Know

Universe:

Sample Adults whose age provided in either HHC or NEWAGE_A does not match either age calculated from date of birth information.

Skip Instructions:

1,RF,DK = if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]

2 = if DOB_COUNT_A le 1 [goto BMONTH_A]
else if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A] else [goto next section]

Question ID: VFY.0390.00.1
Variable: NOMORE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^SANAME is no longer the sample adult for this family. End this interview and begin the Sample Child Interview. If there is no Sample Child or the Sample Child interview has been completed, EXIT

Not everyone in our survey is asked all questions. I have all the information that I need about you at this time.

Enter '1' to Continue.

Fills:

^SANAME

Description: Sample Adult?s name
Instruction: Sample Adult?s name

Response:

1 - Enter 1 to continue

Universe:

Sample adult whose age is now less than 18 or lives off campus

Skip Instructions:

1 = if there is a Sample Child that has not been interviewed [goto Child.VFY.CURRES_C] else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

2019 National Health Interview Survey (NHIS) Questionnaire
HIS: Health Status

Question ID: HIS.0010.00.1
Variable: PHSTAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Would you say your health in general is excellent, very good, good, fair, or poor?

Response:

1 - Excellent
2 - Very Good
3 - Good
4 - Fair
5 - Poor
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
HYP: Hypertension

Question ID: HYP.0010.00.1
Variable: HYPINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Now I am going to ask you about certain medical conditions.

Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto HYPEV_A]

Question ID: HYP.0020.00.1
Variable: HYPEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you EVER been told by a doctor or other health professional that you had

...Hypertension, also called high blood pressure?

Enter '1' if respondent is taking medication to control his/her high blood pressure.

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto HYPDIF_A]
2,RF,DK = [goto next section]

Question ID: HYP.0030.00.1
Variable: HYPDIF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Were you told on two or more DIFFERENT visits that you had hypertension or high blood pressure?

Enter '1' if respondent is taking medication to control his/her high blood pressure.

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they had hypertension

Skip Instructions:

1 = [goto HYP12M_A]
2,RF,DK = [goto HYPMED_A]

Question ID: HYP.0040.00.1
Variable: HYP12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, have you had hypertension or high blood pressure?

Enter '1' if respondent is taking medication to control his/her high blood pressure.

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they had hypertension (2+ visits)

Skip Instructions:

1,2,RF,DK = [goto HYPMED_A]

Question ID: HYP.0050.00.1
Variable: HYPMED_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you NOW taking any medication prescribed by a doctor for your high blood pressure?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they have hypertension

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
CHL: Cholesterol

Question ID: CHL.0010.00.1
Variable: CHLEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you EVER been told by a doctor or other health professional that you had high cholesterol?

Enter '1' if respondent is taking medication to control his/her high cholesterol.

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto CHL12M_A]
2,RF,DK = [goto next section]

Question ID: CHL.0020.00.1
Variable: CHL12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, have you had high cholesterol?

Enter '1' if respondent is taking medication to control his/her high cholesterol.

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they had high cholesterol

Skip Instructions:

1,2,RF,DK = [goto CHLMED_A]

Question ID: CHL.0030.00.1
Variable: CHLMED_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you NOW taking any medication prescribed by a doctor to help lower your cholesterol?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they had high cholesterol

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
CVC: Cardiovascular Conditions

Question ID: CVC.0010.00.1
Variable: CHDEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you EVER been told by a doctor or other health professional that you had

...Coronary heart disease?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto ANGEV_A]

Question ID: CVC.0020.00.1
Variable: ANGEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Angina, also called angina pectoris?

Response:

1 - Yes
2 - Np
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto MIEV_A]

Question ID: CVC.0030.00.1
Variable: MIEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...A heart attack, also called myocardial infarction?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto STREV_A]

Question ID: CVC.0040.00.1
Variable: STREV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...A stroke?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
ASP: Aspirin

Question ID: ASP.0010.00.1
Variable: ASPMEDEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Has a doctor or other health professional EVER told you to take a low-dose aspirin each day to prevent or control heart disease?

If the respondent volunteers they have been told to take an aspirin every other day or "regularly" for these reasons, enter 1 for "yes."

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 40+

Skip Instructions:

1 = [goto ASPMEDNOWN_A]
2,RF,DK = [goto ASPONOWN_A]

Question ID: ASP.0020.00.2
Variable: ASPMEDNOWN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Are you NOW following this advice?

If the respondent provides an answer such as "sometimes," "occasionally," or "from time to time," enter '1' for "yes."

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 40+ who have ever been advised to take a low-dose aspirin every day to prevent or control heart disease

Skip Instructions:

1,RF,DK = [goto next section]
2 = [goto ASPMEDSTP_A]

Question ID: ASP.0030.00.2
Variable: ASPMEDSTP_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Did a doctor or other health professional advise you to stop taking a low-dose aspirin every day?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 40+ who have ever been advised to take aspirin every day, but are not currently following that advice

Skip Instructions:

1,2,RF,DK = [goto next section]

Question ID: ASP.0040.00.2
Variable: ASPONOWN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

On your own, are you now taking a low-dose aspirin each day to prevent or control heart disease?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 40+ who have not been advised to take aspirin every day or refused/do not know if they have been advised to take aspirin every day

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
AST: Asthma

Question ID: AST.0010.00.1
Variable: ASEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you EVER been told by a doctor or other health professional that you had asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto ASTILL_A]
2,RF,DK = [goto next section]

Question ID: AST.0020.00.1
Variable: ASTILL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you still have asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they have asthma

Skip Instructions:

1,2,RF,DK = [goto ASAT12M_A]

Question ID: AST.0030.00.1
Variable: ASAT12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, have you had an episode of asthma or an asthma attack?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they had asthma

Skip Instructions:

1,2,RF,DK = [goto ASER12M_A]

Question ID: AST.0040.00.1
Variable: ASER12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, have you had to visit an emergency room or urgent care center because of asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who were ever told they had asthma

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
CAN: Cancer

Question ID: CAN.0010.00.1
Variable: CANEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you EVER been told by a doctor or other health professional that you had

...Cancer or a malignancy of any kind?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto CANKIND1_A]
2,RF,DK = [goto next section]

Question ID: CAN.0020.00.1
Variable: CANKIND1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What kind of cancer was it?

Enter code for the first kind of cancer.

Response:

01 - Bladder
02 - Blood
03 - Bone
04 - Brain
05 - Breast
06 - Cervix/Cervical
07 - Colon
08 - Esophagus/Esophageal
09 - Gallbladder
10 - Kidney
11 - Larynx-trachea
12 - Leukemia
13 - Liver
14 - Lung
15 - Lymphoma
16 - Melanoma
17 - Mouth/tongue/lip
18 - ovary/ovarian
19 - Pancreas/pancreatic
20 - prostate
21 - Rectum/rectal
22 - skin(melanoma)
23 - skin(non-melanoma)
24 - skin(do not know kind)
25 - stomach
26 - Testis/Testicular
27 - Throat - Pharynx
28 - Thyroid
29 - Uterus/Uterine
30 - Other
97 - Refused
99 - Do not know

Universe:

Sample Adults 18+ who were ever told they had cancer

Skip Instructions:

If SEX_FINAL[PX_A]=1 and CANKIND1_A IN ('6','18','29')[goto ERR1_CANKIND_A] elseif SEX_FINAL[PX_A]=2 and CANKIND1_A IN ('20','26')[goto ERR2_CANKIND_A]
1-30,RF,DK = [goto CANAGE1_A]

Soft Edit:

ERR1_CANKIND_A

Check Description: CANKINS_A male soft edit
Check Text: {signal ERR1_CANKIND_A}

Verify. Code 6 or 18 or 29 is unavailable for males.

ERR2_CANKIND_A

Check Description: CANKIND_A female soft edit
Check Text: {signal ERR2_CANKIND_A}

Verify. Code 20 or 26 is unavailable for females.

Question ID: CAN.0030.00.1
Variable: CANAGE1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND1?

Enter 1 if reported age is 1 or younger.

Fills:

^CANKIND1

Description: {value of CANKIND1_A}
Instuction:

If CANKIND1_A = RF,DK fill "this cancer";
else fill "bladder cancer" if CANKIND1_A = 1;
else fill "blood cancer" if CANKIND1_A = 2;
else fill "bone cancer" if CANKIND1_A = 3;
else fill "brain cancer" if CANKIND1_A = 4;
else fill "breast cancer" if CANKIND1_A = 5;
else fill "cervical cancer" if CANKIND1_A = 6;
else fill "colon cancer" if CANKIND1_A = 7;
else fill "esophageal cancer" if CANKIND1_A = 8;
else fill "gallbladder cancer" if CANKIND1_A = 9;
else fill "kidney cancer" if CANKIND1_A = 10;
else fill "larynx-trachea cancer" if CANKIND1_A = 11;
else fill "leukemia" if CANKIND1_A = 12;
else fill "liver cancer" if CANKIND1_A = 13;
else fill "lung cancer" if CANKIND1_A = 14;
else fill "lymphoma" if CANKIND1_A = 15;
else fill "melanoma" if CANKIND1_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND1_A = 17;
else fill "ovarian cancer" if CANKIND1_A = 18;
else fill "pancreatic cancer" if CANKIND1_A = 19;
else fill "prostate cancer" if CANKIND1_A = 20;
else fill "rectal cancer" if CANKIND1_A = 21;
else fill "skin (melanoma) cancer" if CANKIND1_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND1_A = 23;
else fill "skin (do not know kind) cancer" if CANKIND1_A =
24;
else fill "stomach cancer" if CANKIND1_A = 25;
else fill "testicular cancer" if CANKIND1_A = 26;
else fill "throat/pharynx cancer" if CANKIND1_A = 27;
else fill "thyroid cancer" if CANKIND1_A = 28;
else fill "uterine cancer" if CANKIND1_A = 29;
else fill "other cancer" if CANKIND1_A = 30

Response:

001-120 - Range of values
997 - Refused
999 - Do not Know

Universe:

Sample Adults 18+ who were ever told they had cancer

Skip Instructions:

1-120,DK = [goto CANKIND2_A]
RF = if CANKIND1_A=RF [goto next section] else [goto CANKIND2_A] If number in CANAGE1_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE1_A]

Hard Edit:

ERR_CANAGE1_A

Check Description: CANAGE1_A years with cancer greater than age hard edit
Check Text: {check ERR_CANAGE1_A}

^CANAGE1_A years old is older than age
^SA_AGE.

Please correct.

Question ID: CAN.0040.00.1
Variable: CANKIND2_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you EVER had any other kinds of cancer?

If yes, ask respondent for second kind of cancer, enter code.

If no, enter '96' for no more.

Response:

Universe:

Sample Adults 18+ who were ever told they had cancer and mentioned or didn't know a first type of cancer OR gave a valid age or did not know age for first cancer

Skip Instructions:

If SEX_FINAL[PX_A]=1 and CANKIND2_A IN ('6','18','29') [goto ERR1_CANKIND_A] elseif SEX_FINAL[PX_A]=2 and CANKIND2_A IN ('20','26') [goto ERR2_CANKIND_A]
1-30,DK,RF [goto CANAGE2_A]
96 [goto next section]

Question ID: CAN.0050.00.1
Variable: CANAGE2_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND2?

Enter 1 if reported age is 1 or younger.

Fills:

^CANKIND1

Description: {value of CANKIND1_A}
Instuction:

Response:

001-120 - Range of values
997 - Refused
999 - do not know

Universe:

Sample Adults 18+ who selected a second kind of cancer or do not know the second kind of cancer or refused the second kind of cancer

Skip Instructions:

1-120,DK = [goto CANKIND3_A]
RF = if CANKIND2_A=RF [goto next section] else [goto CANKIND3_A] If CANAGE2_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE2_A]

Hard Edit:

ERR_CANAGE2_A

Check Description: CANAGE2_A age greater than years with cancer hard edit
Check Text: {check ERR_CANAGE2_A}

^CANAGE2_A years old is older than age
^SA_AGE.

Please correct.

Question ID: CAN.0060.00.1
Variable: CANKIND3_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Have you EVER had any other kinds of cancer?

If yes, ask respondent for third kind of cancer, enter code.

If no, enter '96' for no more.

Response:

Universe:

Sample Adults 18+ who selected a second kind of cancer or do not know the second kind of cancer or gave a valid age for second cancer or did not know age for second cancer

Skip Instructions:

If SEX=1 and CANKIND3_A IN ('6','18','29') [goto ERR1_CANKIND_A] elseif SEX=2 and CANKIND3_A IN ('20','26') [goto ERR2_CANKIND_A]
1-30,RF,DK = [goto CANAGE3_A]
96 = [goto next section]

Question ID: CAN.0070.00.1
Variable: CANAGE3_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND3?

Enter 1 if reported age is 1 or younger.

Fills:

^CANKIND1

Description: {value of CANKIND1_A}
Instuction:

Response:

001-120 - Range of values
997 - Refused
999 - do not know

Universe:

Sample Adults 18+ who selected a third kind of cancer or do not know or refused the third kind of cancer

Skip Instructions:

1-120,D = [goto CANMORE_A]
RF = if CANKIND3_A=RF [goto next section] else [goto CANMORE_A] if CANAGE3_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE3_A]

Hard Edit:

ERR_CANAGE2_A

Check Description: CANAGE2_A age greater than years with cancer hard edit
Check Text: {check ERR_CANAGE2_A}

^CANAGE2_A years old is older than age
^SA_AGE.

Please correct.

Question ID: CAN.0080.00.1
Variable: CANMORE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Did you have any other kinds of cancer?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who selected a third kind of cancer or do not know the third kind of cancer or selected a valid age for third type of cancer or did not know age for third type of cancer

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DIB: Diabetes

Question ID: DIB.0010.00.1
Variable: PREDIB_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Has a doctor or other health professional EVER told you that you had prediabetes or borderline diabetes?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who selected a third kind of cancer or do not know the third kind of cancer or selected a valid age for third type of cancer or did not know age for third type of cancer

Skip Instructions:

1,2,RF,DK= If GEN.SEX_FINAL[PX_A]=2 [goto GESDIB_A] elseif GEN.SEX_FINAL[PX_A]=1,RF,DK [goto DIBEV_A]

Question ID: DIB.0020.00.1
Variable: GESDIB_A
Interview Module: Adult
Content Type: Annual Core
Question Text:
Read if necessary: Gestational diabetes is diabetes that you did not have prior to being pregnant and goes away after you are pregnant. Pregnant women are usually screened for gestational diabetes during the 24th to 28th week of pregnancy.

Has a doctor or other health professional EVER told you that you had gestational diabetes, a type of diabetes that occurs ONLY during pregnancy?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Female Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto DIBEV_A]

Question ID: DIB.0030.00.1
Variable: DIBEV_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

^NOTPREGDM a doctor or other health professional EVER told you that you had diabetes?

Fills:

^NOTPREGDM

Description: Has/Not including (gestational diabetes, prediabetes)
Instruction: If GESDIB_A ne 1 AND PREDIB_A ne 1: "Has"
If GESDIB_A=1 AND PREDIB_A ne 1: "Not including gestational diabetes, has"
If PREDIB_A=1 AND GESDIB_A ne 1: "Not including prediabetes, has"
If GESDIB_A=1 AND PREDIB_A=1: "Not including prediabetes or gestational diabetes, has"

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto DIBAGE_A]
2,RF,DK = if PREDIB_A=1 [goto DIBPILL_A]
else [goto next section]

Question ID: DIB.0040.00.1
Variable: DIBAGE_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

How old were you when a doctor or other health professional FIRST told you that you had diabetes^NOTPREGDM2?

Enter 1 if reported age is 1 or younger.

Fills:

^NOTPREGDM1

Description: not including (gestational diabetes, prediabetes)
Instruction: If GESDIB_A ne 1 AND PREDIB_A ne 1: NO FILL
If GESDIB_A=1 AND PREDIB_A ne 1: ", not including gestational diabetes"
If PREDIB_A=1 AND GESDIB_A ne 1: ", not including prediabetes"
If GESDIB_A=1 AND PREDIB_A=1: ", not including prediabetes or gestational diabetes"

Response:

001-120 - Range of values
997 - Refused
999 - Do not know

Universe:

Sample Adults 18+ who were told they had diabetes

Skip Instructions:

1-120 = if DIBAGE_A gt GEN.AGE_FINAL [goto ERR1_DIBAGE_A]
else [goto DIBPILL_A]

Question ID: DIB.0050.00.1
Variable: DIBPILL_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Are you NOW taking diabetic pills to lower your blood sugar? These are sometimes called oral agents or oral hypoglycemic agents.

Response:

1 - yes
2 - no
7 - refused
9 - do not know

Universe:

Sample Adults 18+ who were told they had prediabetes and/or diabetes

Skip Instructions:

1-2,RF,DK = [goto DIBINS_A]

Question ID: DIB.0060.00.1
Variable: DIBINS_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Insulin can be taken by shot or pump. Are you NOW taking insulin?

Response:

1 - yes
2 - no
7 - refused
9 - do not know

Universe:

Sample Adults 18+ who were told they had prediabetes and/or diabetes

Skip Instructions:

1 = if DIBEV_A=1 [goto DIBINSTIME_A]
else [goto next section]
2,RF,DK = if DIBEV_A=1 [goto DIBTYPE_A]
else [goto next section]

Question ID: DIB.0070.00.3
Variable: DIBINSTIME_A
Interview Module: Adult
Content Type: Sponsered Content
Question Text:

Thinking back to when you were first diagnosed with diabetes, how long was it before you started taking insulin?

Response:

1 - Less than 1 month
2 - 1 month to less than 6 months
3 - 6 months to less than 1 year
4 - 1 year or more
7 - refused
9 - do not know

Universe:

Sample Adults 18+ who have diabetes and currently take insulin

Skip Instructions:

1-4,RF,DK = [goto DIBINSSTOP_A]

Question ID: DIB.0080.00.3
Variable: DIBINSSTOP_A
Interview Module: Adult
Content Type: Sponsored Content
Question Text:

Since you started taking insulin, have you ever stopped taking it for more than 6 months?

Response:

1 - Yes
2 - No
7 - Refused
9 - Do not know

Universe:

Sample Adults 18+ who have diabetes and are taking insulin

Skip Instructions:

1 = if DIBINSTIME_A in [1,2,3] [goto DIBINSSTYR_A]
else [goto DIBTYPE_A]
2,RF,DK = [goto DIBTYPE_A]

Question ID: DIB.0090.00.3
Variable: DibinSStyr_a
Interview Module: Adult
Content Type: Sponsored Content
Question Text:

Was this only during the first year after you were diagnosed with diabetes?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have diabetes, who started taking insulin less than 1 year from when they were diagnosed with diabetes, and who stopped taking insulin for more than 6 months.

Skip Instructions:

1,2,RF,DK = [goto DIBTYPE_A]

Question ID: DIB.0100.00.1
Variable: DIBTYPE_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

According to your doctor or other health professional, what type of diabetes do you have? Is it type 1, type 2, or some other type? If you do not remember or were not told, that is OK.

Response:

1 Type 1
2 Type 2
3 Other type of diabetes
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who were told they had diabetes

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
CON: Other Chronic Conditions

Question ID: CON.0010.00.1
Variable: COPDEV_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Have you EVER been told by a doctor or other health professional that you had

...Chronic Obstructive Pulmonary Disease, C.O.P.D., emphysema, or chronic bronchitis?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto ARTHEV_A]

Question ID: CON.0020.00.1
Variable: ARTHEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia (fy-bro-my-AL-jee- uh)?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto DEMENEV_A]

Question ID: CON.0030.00.1
Variable: DEMENEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Dementia, including Alzheimer's disease?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto ANXEV_A]

Question ID: CON.0040.00.1
Variable: ANXEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Any type of anxiety disorder?

Read if necessary: Some common types of anxiety disorders include generalized anxiety disorder, social anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive- compulsive disorder, and phobias.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto DEPEV_A]

Question ID: CON.0050.00.1
Variable: DEPEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Any type of depression?

Read if necessary: Some common types of depression include major depression (or major depressive disorder), bipolar depression, dysthymia, post-partum depression, and seasonal affective disorder.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
BMI: Current pregnant, height, weight

Question ID: BMI.0010.00.1
Variable: PREGNOW_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you currently pregnant?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18-49 or age is do not know or refused

Skip Instructions:

1,2,RF,Dk = [goto HEIGHTFT_A]

Question ID: BMI.0020.01.1
Variable: HEIGHTFT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How tall are you without shoes?

Enter M to record metric measurements.

If ^SANAME's height is less than 2 feet, enter 2. If ^SANAME's height is greater than 7 feet, enter 7.

Fills:

^SANAME

Description Sample Adult's name
Instruction Sample Adult's name

Response:

02 2 feet
03 3 feet
04 4 feet
05 5 feet
06 6 feet
07 7 feet
M Answered in Metric
97 Refused
99 Do not Know

Universe:

Sample Adult 18+

Skip Instructions:

If HEIGHTFT_A NE 2-7,RF,DK,M = [goto ERR1_HEIGHTFT_A] If HEIGHTFT_A = 2,3 = [goto ERR2_HEIGHTFT_A]

2-7 = [goto HEIGHTIN_A]
RF,DK = [goto WEIGHTLB_A]
M = [goto HEIGHTM_A]

Hard Edit:

ERR1_HEIGHTFT_A

Check description: Hard eedit for height in feet
Check text: {check ERR1_HEIGHTFT_A}

Only 2-7, Do not Know/Refused or M allowed in this field.

Please correct.

Soft Edit:

ERR2_HEIGHTFT_A

Check Description: Soft edit to verify height in feet
Check Text {signal ERR2_HEIGHTFT_A}

Respondent's height in feet is ^HEIGHTFT?

Please verify.

2019 National Health Interview Survey (NHIS) Questionnaire
BMI: Current pregnant, height, weight

Question ID: BMI.0020.02.1
Variable: HEIGHTIN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Enter inches.

Enter '0' if exactly ^HEIGHTFT feet tall.

Fills:
^HEIGHTFT

Description: {Value of HEIGHTFT_A}
Instruction: Fill value from HEIGHTFT_A

Response:

00 0 inches
01 1 inch
02 2 inches
03 3 inches
04 4 inches
05 5 inches
06 6 inches
07 7 inches
08 8 inches
09 9 inches
10 10 inches
11 11 inches
97 Refused
99 Do not Know

Universe:

Sample Adult 18+ and height is 2-7ft

Skip Instructions:

0-11,RF,DK = [goto WEIGHTLB_A]

Question ID: BMI.0020.04.1
Variable: HEIGHTM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How tall are you without shoes?

Enter height in metric.

If the height is given in centimeters, press '0' at meters and enter the measure in centimeters (241 centimeters maximum).

Response:

0 0 meters
1 1 meter
2 2 meters
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who choose to give their height in metric measurements

Skip Instructions:

0-2 = [goto HEIGHTCM_A]
RF,DK = [goto WEIGHTLB_A]

Hard Edit:
ERR_HEIGHTM_A

Check Description: Height in meters hard edit
Check Text: {check ERR_HEIGHTM_A}

If height is being given in centimeters only, enter "0"; otherwise enter number of meters.

Question ID:BMI.0020.05.1
Variable: HEIGHTCM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Enter centimeters.

Enter height in metric.

If ^SANAME's height is greater than 241 centimeters, enter 241.

Fills:
^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

Response:

000-241 Range of values
997 Refused
999 Do not Know

Universe:

Sample Adults 18+ who entered 0 to 2 meters for height

Skip Instructions:

0-241,RF,DK = [goto WEIGHTLB_A]

Question ID: BMI.0030.01.1
Variable: WEIGHTLB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^PREGWEIGH

*Enter M to record metric measurements.

If ^SANAME's weight is less than 50 pounds, enter 50. If ^SANAME's weight is greater than 500 pounds, enter 500.

Fills:
^PREGWEIGH

Description: How much did you weigh before your pregnancy?/How much do you weigh?
Instruction: If GEN.SEX_FINAL=2 AND PREGNOW_A=1: "How much did you weigh before your pregnancy?"
else: "How much do you weigh?"

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

Response:

050-500 Range of values
M Answered in Metric
997 Refused
999 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

If WEIGHTLB_A lt 50 or WEIGHTLB_A gt 500 [goto ERR1_WEIGHTLB_A]
elseif ((GEN.SEX_FINAL[PX_A]=1 and (WEIGHTLB_A lt 113 or WEIGHTLB_A gt 316)) or (GEN.SEX_FINAL [PX_A]=2 and (WEIGHTLB_A lt 96 or WEIGHTLB_A gt 293)) or (GEN.SEX_FINAL[PX_A] IN (RF,DK) and (WEIGHTLB_A lt 96 or WEIGHTLB_A gt 316))) [goto ERR2_WEIGHTLB_A]

50-500,RF,DK = [goto next section]
M = [goto WEIGHTKG_A]

Hard Edit:
ERR1_WEIGHTLB_A

Check Description: SA weight pounds hard edit
Check Text: {check ERR1_WEIGHTLB_A}
Weight is out of range. Only "50-500" or "M" or "Do not know/Refused" allowed in this field.

Soft Edit:
ERR2_WEIGHTLB_A

Check Description: SA weight pounds soft edit
Check Text: {signal ERR2_WEIGHTLB_A}
Please verify that the weight was entered correctly. Probe only if necessary.

Question ID: BMI.0030.02.1
Variable: WEIGHTKG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^PREGWEIGH

Enter weight in kilograms.

If ^SANAME's weight is less than 23 kilograms, enter 23. If ^SANAME's weight is greater than
226 kilograms, enter 226.

Fills:
^PREGWEIGH

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

Response:

023-226 Range of values
997 Refused
999 Do not Know

Universe:

Sample Adults 18+ who choose to give their weight in metric measurements

Skip Instructions:

If WEIGHTKG_A lt 23 or WEIGHTKG_A gt 226 [goto ERR1_WEIGHTKG_A]
elseif ((GEN.SEX_FINAL[PX]=1 and (WEIGHTKG_A lt 51 or WEIGHTKG_A gt 143)) or (GEN.SEX_FINAL [PX]=2 and (WEIGHTKG_A lt 43 or WEIGHTKG_A gt 133)) or (GEN.SEX_FINAL[PX] IN (RF,DK) and (WEIGHTKG_A lt 43 or WEIGHTKG_A gt 143)))[goto ERR2_WEIGHTKG_A]

23-226,RF,DK = [goto next section]

Hard Edit:
ERR1_WEIGHTKG_A

Check Description: SA weight KG hard edit
Check Text: {check ERR1_WEIGHTKG_A}

Weight is out of range (23-226).

Please correct.

Soft Edit:
ERR2_WEIGHTKG_A

Check Description: SA weight KG soft edit
Check Text: {signal ERR2_WEIGHTKG_A}

Please verify that the weight was entered correctly. Probe only if necessary.

2019 National Health Interview Survey (NHIS) Questionnaire
VIS: Vision

Question ID: VIS.0010.00.1
Variable: VISINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The next questions ask about difficulties you may have doing certain activities because of a health problem.

Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto WEARGLSS_A]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you wear glasses or contact lenses?

Read if necessary: Persons who wear glasses to read or to do other occasional tasks should answer yes to this question.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto VISIONDF_A]

Question ID: VIS.0030.00.1
Variable: VISIONDF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty ^AGLASSCNTS? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Fills:

^AGLASSCNTS

Description: seeing, even when wearing glasses or contact lenses/seeing
Instruction: If WEARGLSS_A=1 fill "seeing, even when wearing glasses or contact lenses"; else fill "seeing"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
HEA: Hearing

Question ID: HEA.0010.00.1
Variable: HEARAID_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you use a hearing aid?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [HEARAIDFR_A]
2,RF,DK = [HEARINGDF_A]

Question ID: HEA.0020.00.1
Variable: HEARAIDFR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How often do you use your hearing aid(s)? Would you say all of the time, some of the time, rarely, or never?

Response:

1 All of the time
2 Some of the time
3 Rarely
4 Never
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use a hearing aid

Skip Instructions:

1-4,RF,DK = [HEARINGDF_A]

Question ID: HEA.0030.00.1
Variable: HEARINGDF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty hearing^HEARAID? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Fills:

^HEARAID

Description: even when using your hearing aid(s)
Instruction: If HEARAID_A=1, fill: ", even when using your hearing aid (s)"
else NO FILL

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
MOB: Mobility

Question ID: MOB.0010.00.1
Variable: DIFF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty walking or climbing steps? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto EQUIP_A]

Question ID: MOB.0020.00.1
Variable: EQUIP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you use any equipment or receive help for getting around?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto CANEWLKR_A]
2,RF,DK = [goto WLK100_A]

Question ID: MOB.0030.00.1
Variable: WLK100_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty walking 100 yards on level ground, that would be about the length of one football field or one city block? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who do not use equipment or receive help for getting around or refused or do not know

Skip Instructions:

1-3,RF,DK = [goto WLK13M_A]
4 = [goto STEPS_A]

Question ID: MOB.0040.00.1
Variable: WLK13M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty walking a third of a mile on level ground, that would be the length of five football fields or five city blocks?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or refused or do not know

Skip Instructions:

1-4,RF,DK = [goto STEPS_A]

Question ID: MOB.0050.00.1
Variable: STEPS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty walking up or down 12 steps?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who do not use equipment or receive help for getting around or refused or do not know

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: MOB.0060.00.1
Variable: CANEWLKR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you use any of the following...

...Cane or walker?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1,2,RF,DK = [goto WCHAIR_A]

Question ID: MOB.0070.00.1
Variable: WCHAIR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Do you use any of the following?

...Wheelchair or scooter?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1,2,RF,DK = [goto PERASST_A]

Question ID: MOB.0080.00.1
Variable: PERASST_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Do you use any of the following?

...Someone's assistance?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1,2,RF,DK = [goto NOEQWLK100_A]

Question ID: MOB.0090.00.1
Variable: NOEQWLK100_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking 100 yards on level ground, that would be about the length of one football field or one city block? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1-3,RF,DK = [goto NOEQWLK13M_A]
4 = [goto NOEQSTEPS_A]

Question ID: MOB.0100.00.1
Variable: NOEQWLK13M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking a third of a mile on level ground, that would be the length of five football fields or five city blocks?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards without the use of their aid or refused or do not know

Skip Instructions:

1-4,RF,DK = [goto NOEQSTEPS_A]

Question ID: MOB.0110.00.1
Variable: NOEQSTEPS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking up or down 12 steps?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:
1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment

Skip Instructions:

1-4,RF,DK if WCHAIR_A ne 1 [goto EQWLK100_A]
else [goto next section]

Question ID: MOB.0120.00.1
Variable: EQWLK100_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

WHEN USING YOUR AID, do you have difficulty walking 100 yards on level ground, that would be about the length of one football field or one city block?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around but do not use a wheelchair or scooter or refused or do not know

Skip Instructions:

1-3,RF,DK = [goto EQWLK13M_A]
4 = [goto EQSTEPS_A]

Question ID: MOB.0130.00.1
Variable: EQWLK13M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

WHEN USING YOUR AID, do you have difficulty walking a third of a mile on level ground, that would be the length of five football fields or five city blocks?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards, when using their aid or refused or do not know

Skip Instructions:

1-4,RF,DK = [goto EQSTEPS_A]

Question ID: MOB.0140.00.1
Variable: EQSTEPS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

WHEN USING YOUR AID, do you have difficulty walking up or down 12 steps?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around but do not use a wheelchair or scoote

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
COM: Communication

Question ID: COM.0010.00.1
Variable: COMDIFF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Using your usual language, do you have difficulty communicating, for example, understanding or being understood?

*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
COG: Cognition

Question ID: COG.0010.00.1
Variable: COGMEMDFF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty remembering or concentrating?

*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK = [goto next section]
2-4 = [goto COGTYPEDFF_A]

Question ID: COG.0020.00.1
Variable: COGTYPEDFF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Is that a difficulty with remembering, concentrating, or both?

Response:

1 Difficulty remembering only
2 Difficulty concentrating only
3 Difficulty with both remembering and concentrating
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have some difficulty, a lot of difficulty, or are unable to remember or concentrate

Skip Instructions:

1,3 = [goto COGFRQDFF_A]
2,RF,DK = [goto next section]

Question ID: COG.0030.00.1
Variable: COGFRQDFF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How often do you have difficulty remembering? Would you say sometimes, often or all of the time

Response:

1 Sometimes
2 Often
3 All of the time
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have difficulty remembering or remembering and concentrating

Skip Instructions:

1-3,RF,DK [goto COGAMTDFF_A]

Question ID: COG.0040.00.1
Variable: COGAMTDFF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty remembering a few things, a lot of things, or almost everything?

Response:

1 A few things
2 A lot of things
3 Almost everything
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have difficulty remembering or remembering and concentrating

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
UPP: Self-care and Upper Body

Question ID: UPP.0010.00.1
Variable: UPPSLFCR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto UPPRAISE_A]

Question ID: UPP.0020.00.1
Variable: UPPRAISE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty raising a 2 liter bottle of water or soda from waist to eye level?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto UPPOBJCT_A]

Question ID: UPP.0030.00.1
Variable: UPPOBJCT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have difficulty using your hands and fingers, such as picking up small objects, for example, a button or pencil, or opening or closing containers or bottles?

*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
SOC: Social Functioning

Question ID: SOC.0010.00.1
Variable: SOCERRNDS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto SOCSCLPAR_A]

Question ID: SOC.0020.00.1
Variable: SOCSCLPAR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Because of a physical, mental, or emotional condition, do you have difficulty participating in social activities such as visiting friends, attending clubs and meetings, or going to parties?

Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto SOCWRKLIM_A]

Question ID: SOC.0030.00.1
Variable: SOCWRKLIM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you limited in the kind OR amount of work you can do because of a physical, mental or emotional problem?

Read if necessary: Work includes paid work, volunteer work, school work, and homework.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
INS: Health Insurance

Question ID: INS.0010.00.1
Variable: HICOV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

The next questions are about health insurance. Include health insurance obtained through employment or purchased directly as well as government programs like Medicare, Medicaid, and the Children's Health Insurance Program that provide medical care or help pay medical bills. Are you covered by any kind of health insurance or some other kind of health care plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK = [goto HIKIND_A]
2 = if (GEN.AGE_FINAL[PX_A] ge 65 or Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2) [goto MCAREPRB_A]
else [goto MCAIDPRB_A]

Question ID: INS.0020.00.1Variable: HIKIND_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

What kinds of health insurance or health care coverage do you have? Is it...Private health insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP, military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health Service, a state-sponsored health plan, or an other government program?
Enter all that apply, separate with commas.

Response:

1 Private health insurance
2 Medicare
3 Medigap
4 Medicaid
5 Children's Health Insurance Program (CHIP)
6 Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMP- VA
7 Indian Health Service
8 State-sponsored health plan
9 Other government program
10 No coverage of any type
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/do not know if they have insurance or health care coverage.

Skip Instructions:

if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A] elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A] elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto MCAIDPRB_A]
else [goto SINCOVDE_A]

Hard Edit:
ERR1_HIKIND_A

Check Description: Selecting no coverage and other categories hard edit
Check Text: check ERR1_HIKIND_A

Cannot mark "no coverage of any kind" and another type.

Please correct.

Question ID: INS.0030.00.1
Variable: MCAREPRB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

Are you covered by Medicare?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 65+ who have not indicated they had Medicare in HIKIND_A

Skip Instructions:

1,2,RF,DK = [goto SINCOVDE_A]

Question ID: INS.0040.00.1
Variable: MCAIDPRB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

There is a program called Medicaid that pays for health care for persons in need. ^STATEMA Are you covered by Medicaid?

Fills

^STATEMA

Description: In ^STATENAME it is also called ^STMEDICAID.
Instruction: if STMEDICAID ne empty, fill: "In ^STATENAME it is also called ^STMEDICAID."
else fill: blank

^STATENAME

Description: State Name.
Instruction:If ST=AL, fill: Alabama else if ST=AK, fill: Alaska
else if ST=AR, fill: Arkansas else if ST=AZ, fill: Arizona else if ST=CA, fill: California else if ST=CO, fill: Colorado else if ST=CT, fill: Connecticut else if ST=DE, fill: Delaware
else if ST=DC, fill: District of Columbia else if ST=FL, fill: Florida
else if ST=GA, fill: Georgia else if ST=HI, fill: Hawaii else if ST=ID, fill: Idaho else if ST=IL, fill: Illinois else if ST=IN, fill: Indiana else if ST=IA, fill: Iowa else if ST=KS, fill: Kansas else if ST=KY, fill: Kentucky
else if ST=LA, fill: Louisiana else if ST=ME, fill: Maine else if ST=MD, fill: Maryland
else if ST=MA, fill: Massachusetts else if ST=MI, fill: Michigan
else if ST=MN, fill: Minnesota else if ST=MS, fill: Mississippi else if ST=MO, fill: Missouri else if ST=MT, fill: Montana else if ST=NE, fill: Nebraska else if ST=NV, fill: Nevada
else if ST=NH, fill: New Hampshire else if ST=NJ, fill: New Jersey else if ST=NM, fill: New Mexico else if ST=NY, fill: New York
else if ST=NC, fill: North Carolina else if ST=ND, fill: North Dakota else if ST=OH, fill: Ohio
else if ST=OK, fill: Oklahoma else if ST=OR, fill: Oregon
else if ST=PA, fill: Pennsylvania else if ST=RI, fill: Rhode Island else if ST=SC, fill: South Carolina else if ST=SD, fill: South Dakota else if ST=TN, fill: Tennessee
else if ST=TX, fill: Texas else if ST=UT, fill: Utah else if ST=VT, fill: Vermont else if ST=VA, fill: Virginia
else if ST=WA, fill: Washington else if ST=WV, fill: West Virginia else if ST=WI, fill: Wisconsin else if ST=WY, fill: Wyoming

^STMEDICAID

Description: State Medicaid Name.
Instruction: If AL then fill "Patient 1st, Alabama Coordinated Health Network"
If AK then fill "Alaska Medicaid; DenaliCare"
If AZ then fill "Arizona Health Care Cost Containment System (AHCCCS)"
If AR then fill "ARKids First A; Arkansas Works" If CA then fill "Medi-Cal"
If CO then fill "Health First Colorado"
If CT then fill "HUSKY A, HUSKY C, HUSKY D; Med-Connect" If DE then fill "Diamond State Health Plan; Children's Community Alternative Disabilities Program"
If DC then fill "DC Medicaid"
If FL then fill "Florida Medicaid; Medically Needy Program"
If GA then fill "Georgia Families; Health Insurance Premium Payment Program (HIPP)"
If HI then fill "Med QUEST"
If ID then fill "Idaho Medicaid Program" If IL then fill "Medical Assistance"
If IN then fill "Traditional Medicaid; Healthy Indiana Plan (HIP); Hoosier Healthwise"
If IA then fill "IA Health Link; Iowa Health and Wellness Plan"
If KS then fill "KanCare; Kansas Medical Assistance Program (KMAP)"
If KY then fill "Kentucky Medicaid; Kentucky HEALTH" If LA then fill "Healthy Louisiana; LaCHIP; LaMOMS" If ME then fill "MaineCare"
If MD then fill "HealthChoice; Maryland Children's Health Program (MCHP)"
If MA then fill "MassHealth"
If MI then fill "Medicaid; Healthy Michigan Plan (HMP)" If MN then fill "Medical Assistance (MA)"
If MS then fill "MississippiCAN" If MO then fill "MO Healthnet"
If MT then fill "Passport to Health; Healthy Montana Kids Plus (HMK Plus); HELP Plan"
If NE then fill "Heritage Health" If NV then fill "Nevada Medicaid"
If NH then fill "NH Medicaid; Granite Advantage Health Care Program"
If NJ then fill "NJ Medicaid; NJ Family Care" If NM then fill "Centennial Care"
If NY then fill "Medicaid; Children's Medicaid" If NC then fill "NC Medicaid; Medical Assistance" If ND then fill "North Dakota Medicaid"
If OH then fill "Ohio Medicaid State Plan; Healthy Families; Healthy Start; Alternative Benefit Plan" If OK then fill "SoonerCare"
If OR then fill "Oregon Health Plan (OHP)" If PA then fill "Medical Assistance"
If RI then fill "RIte Care; Affordable Care Coverage (ACC)"
If SC then fill "Healthy Connections" If SD then fill "South Dakota Medicaid" If TN then fill "TennCare"
If TX then fill "Texas Medicaid; State of Texas Access Reform (STAR); STAR+PLUS; Children's Medicaid; STAR Kids" If UT then fill "Utah Medicaid"
If VT then fill "Green Mountain Care" If VA then fill "Medicaid; FAMIS Plus" If WA then fill "Apple Health"
If WV then fill "Mountain Health Trust (MHT)"
If WI then fill "Wisconsin Medicaid; ForwardHealth" If WY then fill "WYhealth"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18-64 who have indicated they are uninsured, refused, or do not know their type of health insurance

Skip Instructions:

1,2,RF,DK= goto SINCOVDE_A

Question ID: INS.0050.00.1
Variable: SINCOVDE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

^INADDITIONARE you covered by a SEPARATE plan that only pays for dental services?

Fills

^INADDITIONARE

Description: In addition to ^HITYPEANOSS, are/Are
Instruction: If (HIKIND_A=1-9 or MCAREPRB_A=1 or MCAIDPRB_A=1), fill
"In addition to ^HITYPEANOSS, are" else fill "Are"

^HITYPEANOSS

Description:Type of health care plans without single service plans
Instruction: fill coverage types from HIKIND_A, except HIKIND_A=10, HIKIND_A=1 fill: "private health insurance"
HIKIND_A=2 fill: "Medicare"
HIKIND_A=3 fill: "Medicare Supplement or Medigap" HIKIND_A=4 fill: "Medicaid"
HIKIND_A=5 fill: "Children's Health Insurance Program (CHIP)"
HIKIND_A=6 fill: "military related health care" HIKIND_A=7 fill: "Indian Health Service" HIKIND_A=8 fill: "a state-sponsored health plan" HIKIND_A=9 fill: "an other government program" if MCAREPRB_A=1, fill "Medicare"
if MCAIDPRB_A=1, fill "Medicaid"

separate choices with a comma and seperate the last two choices with "and"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK= [goto SINCOVVS_A]

Question ID: INS.0060.00.1
Variable: SINCOVVS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

Are you covered by a SEPARATE plan that only pays for vision services?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto SINCOVRX _A]

Question ID: INS.0070.00.1
Variable: SINCOVRX_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

Are you covered by a SEPARATE plan that only pays for prescriptions?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto HICHANGE_A]

Question ID: INS.0080.00.1
Variable: HICHANGE_A
Interview Module: Adult
Content Type: Annual Core
Question Text:
?[F1]

I have recorded you are ^COVEREDA. Is this correct?

Fills:

^COVEREDA

Description:not covered by health insurance/covered by ^HITYPEA
Instruction: if HIKIND_A=10,R,D and (MCAIDPRB_A=2,R,D or MCAREPRB_A= 2,R,D) and SINCOVDE_A=2,R,D and SINCOVVS_A=2,R,D and
SINCOVRX_A=2,R,D fill: "not covered by health insurance" else fill: "covered by ^HITYPEA"
if HIKIND_A=10,R,D and (MCAIDPRB_A=2,R,D or MCAREPRB_A= 2,R,D) and SINCOVDE_A=2,R,D and SINCOVVS_A=2,R,D and
SINCOVRX_A=2,R,D fill: "not covered by health insurance" else fill: "covered by ^HITYPEA"

^HITYPEA

Description: Type of health care plans with single service plans
Instruction: fill coverage types from HIKIND_A, except HIKIND_A=10, HIKIND_A=1 fill: "private health insurance"
HIKIND_A=2 fill: "Medicare"
HIKIND_A=3 fill: "Medicare Supplement or Medigap" HIKIND_A=4 fill: "Medicaid"
HIKIND_A=5 fill: "Children's Health Insurance Program (CHIP)"
HIKIND_A=6 fill: "military related health care" HIKIND_A=7 fill: "Indian Health Service" HIKIND_A=8 fill: "a state-sponsored health plan" HIKIND_A=9 fill: "an other government program" if MCAREPRB_A=1, fill "Medicare";
if MCAIDPRB_A=1, fill "Medicaid"
If SINCOVDE_A=1 and SINCOVRX_A=2,RF,DK and
SINCOVVS_A=2,RF,DK, fill: "a single service dental plan" If SINCOVDE_A=2,RF,DK and SINCOVRX_A=1 and
SINCOVVS_A=2,RF,DK, fill: "a single service prescription plan"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=2,RF,DK and
SINCOVVS_A=1, fill: "a single service vision plan"
If SINCOVDE_A=1 and SINCOVRX_A=1 and SINCOVVS_A=2,RF,DK,
fill: "single service dental and prescription plans"
If SINCOVDE_A=1 and SINCOVRX_A=2,RF,DK and SINCOVVS_A=1,
fill: "single service dental and vision plans"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=1 and SINCOVVS_A=1,
fill: "single service vision and prescription plans"
If SINCOVDE_A=1 and SINCOVRX_A=1 and SINCOVVS_A=1, fill:
"single service dental, vision and prescription plans"

separate choices with a comma and seperate the last two choices with "and"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK =
if 02 in HIKIND_A or MCAREPRB_A=1[goto MCPART_A]
else if 04 in HIKIND_A or MCAIDPRB_A=1[goto MACHMN_A] else if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG] else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A] else if 09 in HIKIND_A [goto OGNAME_A] else if 06 in HIKIND_A [goto MILSPC_A] else if 07 in HIKIND_A [goto HINOTYR_A]
else if 10 in HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN (2,RF,DK))[goto HILAST_A]
else [goto FINISH_A]
2 = [goto ERR1_HICHANGE_A]

Soft Edit:
ERR1_HICHANGE_A

Check Description: Answered health insurance coverage is incorrect it
Check Text: {signal ERR1_HICHANGE_A}

Suppress this error to go back to HIKIND_A and update coverage.

Close this error to change your answer to HICHANGE_A.

Question ID: INS.0090.00.1
Variable: MCPART_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

What type of Medicare coverage do you have? Is it Part A - hospital insurance, Part B - medical insurance, or both?

Response:

1 Part A- hospital only
2 Part B- medical only
3 Both Part A and Part B
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicare

Skip Instructions:

1 = [goto MCPARTD_A]
2-3,RF,DK = [goto MCCHOICE_A]

Question ID: INS.0100.00.1
Variable: MCCHOICE_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Are you enrolled in a Medicare Advantage plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicare that have part B Medicare or do not know or refused if they have part B Medicare

Skip Instructions:

1,2,RF,DK= [goto MCHMO_A]

Question ID: INS.0110.00.1
Variable: MCHMO_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Are you under a Medicare managed care arrangement, such as an HMO, that is, a Health Maintenance Organization?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicare that have part B Medicare or do not know or refused if they have part B Medicare

Skip Instructions:

1 = [goto MCANAME_A]
2,RF,DK = if MCCHOICE_A=1 [goto MCANAME_A] elseif MCCHOICE_A IN (2,RF,DK) [goto MCPARTD_A]

Question ID: INS.0120.00.1
Variable: MCANAME_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

What is the name of your Medicare Advantage or Medicare HMO plan?

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed care arrangement

Skip Instructions:

allow 80,RF,DK [goto MCPARTD_A]

Question ID: INS.0130.00.1
Variable: MCPARTD_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a Medicare

Skip Instructions:

1,2,RF,DK =
if 04 in HIKIND_A or MCAIDPRB_A=1 [goto MACHMN_A] elseif 01 in HIKIND_A [goto SET_INSPRI_FLAG] elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG] elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A] elseif 09 in HIKIND_A [goto OGNAME_A] elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0140.00.1
Variable: MACHMN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The next questions are about Medicaid coverage. What is the name of your Medicaid health plan?

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1,2,RF,DK [goto SINCOVVS_A]

Question ID: INS.0150.00.1
Variable: MAXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your Medicaid obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^MARKETPLACE

Description: Health insurance marketplace names
Instruction: If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:

If CA then fill "Health Insurance Marketplace, such as Covered California"
If CO then fill "Health Insurance Marketplace, such as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as Health Connector"
If MD then fill "Health Insurance Marketplace, such as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as MNsure"
If NY then fill "Health Insurance Marketplace, such as New York State of Health"
If RI then fill "Health Insurance Marketplace, such as HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as Washington Healthplanfinder"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1,2,RF,DK = [goto MAPREM_A]

Question ID: INS.0160.00.1
Variable: MAPREM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

A health insurance premium is the amount you or a family member pay each month for health care coverage. Do you or a family member pay a premium for this Medicaid plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1,2,RF,DK = [goto MADEDUC_A]

Question ID: INS.0170.00.1
Variable: MADEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does your Medicaid plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1 = [goto MAHDHP_A]
2,RF,DK =
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG] else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A] else if 09 in HIKIND_A [goto OGNAME_A] else if 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0180.00.1
Variable: MAHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here.

Fills:
^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction: fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with Medicaid coverage who have a deductible

Skip Instructions:

1,2,RF,DK =
if 01 in HIKIND_A [goto SET_INSPRI_FLAG] elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG] elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A] elseif 09 in HIKIND_A [goto OGNAME_A] elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0270.00.1
Variable: PLANNAME1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that ^SCNAME was covered by ^HIPNAM1_C. Are you covered by this same plan as
^SCNAME?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction: fill value from Child.INS.HIPNAM1_C

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with private health insurance coverage, where the Sample Child interview has already been conducted, the Sample Child is in the same family, and the Sample Child also had private health insurance, and the first private plan is not self only coverage, a plan name was not do not know or refused, and the source and who pays for the coverage is not do not know or refused.

Skip Instructions:

1 = if Child.INS.bPlan[1].POLHLD_C ne 1 [goto POLHLDA1_A] elseif Child.INS.bPlan[1].POLHLD_C=1 [goto PRPOLHP1_A]
2,RF,DK = if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 and
INSPRI_FLG=1 and SAMEFAM_FLG=1 and CHILD.INS.PLANNAME2_C=empty [goto PLANNAME2_A] else [goto HIPNAM1_A]

Question ID: INS.0280.00.1
Variable: POLHLDA1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Health insurance plans are usually obtained in one person's name even if other family members are covered by that plan. That person is called the policyholder. Are you the policyholder for
^HIPNAM1_C?

Fills:
^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction: fill value from Child.INS.HIPNAM1_C

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the child is not the policyholder for their first private plan or refused or do not know.

Skip Instructions:

1 = if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 [goto PLANNAME2_A]
else [goto MORPLAN_A]
2,RF,DK = [goto PRPOLHP1_A]

Question ID: INS.0290.00.1
Variable: PRPOLHP1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How are you related to the policyholder for ^HIPNAM1_C? Are you the policyholder's child, spouse, former spouse, or are you related in some other way?

Fills:
^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction: fill value from Child.INS.HIPNAM1_C

Response:

1 Child
2 Spouse
3 Former spouse
4 Some other relationship
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the Child is the policy holder or where the Sample Adult is not the policyholder for the first plan or refused or do not know.

Skip Instructions:

1-4,RF,DK = if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 [goto PLANNAME2_A]
else [goto MORPLAN_A]

Question ID: INS.0300.00.1
Variable: PLANNAME2_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that ^SCNAME was covered by a second plan: ^HIPNAM2_C. Are you covered by this same plan as ^SCNAME?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction: fill value from Child.INS.HIPNAM2_C

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with private health insurance coverage, where the Sample Child interview has already been conducted, the Sample Child is in the same family, and the Sample Child also had private health insurance, and listed two plans. The second private plan is not self only coverage, a plan name was not do not know or refused, and the source and who pays for the coverage is not do not know or refused.

Skip Instructions:

1 = if Child.INS.bPlan[2].POLHLD_C ne 1 [goto POLHLDA2_A], if Child.INS.bPlan[2].POLHLD_C=1 [goto PRPOLHP2_A]
2,RF,DK = if PLANNAME1_A IN(2,RF,DK,empty) [goto HIPNAM1_A]
else [goto MORPLAN_A]

Question ID: INS.0310.00.1
Variable: POLHLDA2_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Read if necessary: Health insurance plans are usually obtained in one person's name even if other family members are covered by that plan. That person is called the policyholder.

Are you the policyholder for ^HIPNAM2_C?

Fills:
^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction: fill value from Child.INS.HIPNAM2_C

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the child is not the policyholder for their second private plan or refused or do not know.

Skip Instructions:

1 = if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A] elseif 08 in HIKIND_A [goto OPNAME_A] elseif 09 in HIKIND_A [goto OGNAME_A] elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

2,RF,DK = [goto PRPOLHP2_A]

Question ID: INS.0320.00.1
Variable: PRPOLHP2_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How are you related to the policyholder for ^HIPNAM2_C? Are you the policyholder's child, spouse, former spouse, or are you related in some other way?

Fills:
^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction: fill value from Child.INS.HIPNAM2_C

Response:

1 Child
2 Spouse
3 Former spouse
4 Some other relationship
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the Sample Child is the policy holder for the second plan or the Sample Adult is not the policyholder for the second plan or refused or do not know.

Skip Instructions:

1-4,RF,DK = if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A] elseif 08 in HIKIND_A [goto OPNAME_A] elseif 09 in HIKIND_A [goto OGNAME_A] elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0330.00.1
Variable: HIPNAM1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

It is important that we record the complete and accurate name of each private health insurance plan. What is the COMPLETE name of your plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service such as long term care, accidents, or dental care.

Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+ enrolled in a Medigap plan or private health insurance and the sample adult did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample child

Skip Instructions:

allow 80,RF,DK = [goto MORPLAN_A]

Question ID: INS.0340.00.1
Variable: MORPLAN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you covered by any other private health insurance plans?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ enrolled in a private health plan where the name of the plan was given or do not know or refused or the sample adult only shared one private plan with the Sample Child.

Skip Instructions:

1 = [goto HIPNAM2_A]
2,RF,DK =
if (PLANNAME1_A=1 or PLANNAME2_A=1) then
if 05 in HIKIND_A [goto CHNAME_A] elseif 08 in HIKIND_A [goto OPNAME_A] elseif 09 in HIKIND_A [goto OGNAME_A] elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

else [goto bPlan[1].POLHLD_A]

Question ID: INS.0350.00.1
Variable: HIPNAM2_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is the name of that private health insurance plan?

Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with a second private health insurance plan

Skip Instructions:

allow 80,RF,DK = [goto bPlan[1].POLHLD_A]

Question ID: INS.0370.00.1
Variable: POLHLD_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

I am going to ask you some questions about ^FIRSTPLANA. Health insurance plans are usually obtained in one person's name even if other family members are covered by that plan. That person is called the policyholder. Are you the policyholder for ^THISPLANA?

Fills:
^FIRSTPLANA

Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan
Instruction: if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan" else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan" else fill: "this ^HIPNAM2_A plan"

^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction: Fill value from Adult.INS.HIPNAM1_A.

^THISPLANA

Description: this plan/^HIPNAM1_A/^HIPNAM2_A
Instruction: if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) fill: "this plan" else fill: "^HIPNAM1_A"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this plan" Else fill: "^HIPNAM2_A"

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction: Fill value from Adult.INS.HIPNAM2_A.

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know.

Skip Instructions:

1,RF,DK = [goto PRPLCOV_A]
2 = [goto PRPOLH_A]

Question ID: INS.0380.00.1
Variable: PRPLCOV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does this plan cover someone other than yourself?

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know and where the Sample Adult is the policyholder or refused or do not know

Skip Instructions:

1,2,RF,DK = [goto PLNWRK_A]

Question ID: INS.0390.00.1
Variable: PRPOLH_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How are you related to the policyholder? Are you the policyholder's child, spouse, former spouse, or are you related in some other way?

Response:

1 Child
2 Spouse
3 Former spouse
4 Some other relationship

Universe:

Sample Adults 18+ with private health insurance who are not the policyholder

Skip Instructions:

1-4,RF,DK = [goto PLNWRK_A]

Question ID: INS.0400.00.1
Variable: PLNWRK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Which one of these categories best describes how this plan was obtained? Was it obtained through an employer or union, purchased directly, obtained through Healthcare.gov or the Affordable Care Act, also known as Obamacare, obtained through a state or local government or community program or obtained in some other way?

Response:

1 Through an employer, union, or professional association
2 Purchased directly
3 Through Healthcare.gov or the Affordable Care Act, also known as Obamacare
4 Through a state or local government or community program
5 Other

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know

Skip Instructions:

1,3 = [goto PLNPAY_A]
2,4,RF,DK = [goto PLNEXCHG_A]
5 = [goto PLNWKSP_A]

Question ID: INS.0410.00.1
Variable: PLNWSP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: How was this plan obtained?

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know and private health insurance coverage was obtained from an other source

Skip Instructions:

allow 80,RF,DK = [goto PLNEXCHG_A]

Question ID: INS.0420.00.1
Variable: PLNEXCHG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^MARKETPLACE

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know that is directly purchased, or obtained through a state, local, government or community program, or obtained another way, or refused/do not know how obtained

Skip Instructions:

1,2,RF,DK = [goto PLNPAY_A]

Question ID: INS.0430.00.1
Variable: PLNPAY_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Who pays for this health insurance plan?

Enter all that apply, separate with commas.

Response:

1 Self or family (living in the household)
2 Employer or union
3 Someone outside the household
4 Medicare
5 Medicaid
6 Other government program

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know.

Skip Instructions:

if 1= IN PLNPAY_A [goto HICOSTN_A]
else if 2-6= IN PLNPAY_A or PLNPAY_A IN (DK,RF)[goto PRDEDUC_A]

Question ID: INS.0440.00.1
Variable:HICOSTN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

How much ^DOYOUFAM currently spend for health insurance premiums for ^FIRSTPLANA? Please include payroll deductions for premiums.

Fills:
^DOYOUFAM

Description: do you/does your family
Instruction: if PCNT_A=1 fill 'do you', else fill 'does your family'

^FIRSTPLANA

Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan
Instruction:

if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan" else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan" else fill: "this ^HIPNAM2_A plan"

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction: Fill value from Adult.INS.HIPNAM1_A.

Response:

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know who paid for by self or family

Skip Instructions:

20000-99995= [goto ERR1_HICOSTN_A]
1-19999= [goto HICOSTT_A]
RF,DK=[goto PRDEDUC_A]

Soft Edit:

Check Text: ERR1_HICOSTN_A
Check Description:
Check Text:

{signal ERR1_HICOSTN_A}

[^HICOSTN_A] is unusually high. Please verify.
Make corrections if necessary.

Soft Edit:
ERR1_HICOSTN_A

Check Text: {signal ERR1_HICOSTN_A} [^HICOSTN_A] is unusually high. Please verify. Make corrections if necessary.

Question ID: INS.0440.02.1
Variable: HICOSTT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Enter time period for premium payments.

Response:

1 Once a week
2 Once every 2 weeks
3 Once a month
4 Twice a month
5 Every two months
6 Quarterly (every 3 months)
7 Once a year

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know who gave a premium amount.

Skip Instructions:

1-8,RF,DK= [goto PRDEDUC_A]

Question ID: INS.0450.00.1
Variable: PRDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does this health plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).
Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance plans where a plan name was given or refused or do not know.

Skip Instructions:

1= [goto PRHDHP_A]
2,RF,DK= [goto PRRXCOV_A]

Question ID: INS.0460.00.1
Variable: PRHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

Is the ^FAM_A annual deductible for medical care for this plan less than ^HDHPAMT_A, or
^HDHPAMT_A or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here.

Fills:
^FAM_A

Description: family
Instruction: if POLHLD_A=2 or PRPLCOV_A=1, fill 'family'. Else no fill.

^HDHPAMT_A

Description: ^HDHPDED_family/^HDHPDED
Instruction: if POLHLD_A=2 or PRPLCOV_A=1, fill '^HDHPDED_family' Else fill ^HDHPDED.

^FAM_A

Description: NAME_FNAME Instroduction
Instruction:

^FAM_A

Description: Deductible threshold (may change in future year)
Instruction: fill: $1,350

Response:

1 Less than ^HDHPAMT_A
2 ^HDHPAMT_A or more

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know with a deductible

Skip Instructions:

1= [goto PRRXCOV_A]
2,RF,DK= [goto HSAHRA_A]

Question ID: INS.0470.00.1
Variable: HSAHRA_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

There are special accounts or funds that can be used to pay for medical expenses, sometimes referred to as Health Savings Accounts or HSAs, Health Reimbursement Accounts or HRAs, Personal Care accounts, Personal Medical funds, or Choice funds. These are DIFFERENT from Flexible Spending Accounts or FSAs. Is there one of these accounts or funds with this plan?

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know with a high deductible

Skip Instructions:

1,2,RF,DK= [goto PRRXCOV_A]

Question ID: INS.0480.00.1
Variable: PRRXCOV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does ^FIRSTPLANA pay for any of the costs for medications prescribed by a doctor?

Fills:
^FIRSTPLANA

Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan
Instruction:

^HIPNAM1_A

Description: {Value of HIPNAM1_A} Instruction:

Fill value from Adult.INS.HIPNAM1_A.

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where the name of the plan was given or refused or do not know.

Skip Instructions:

1,2,RF,DK= [goto PRDNCOV_A]

Question ID: INS.0490.00.1
Variable: PRDNCOV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does ^FIRSTPLANA pay for any of the costs for dental care?

Fills:
^FIRSTPLANA

Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan
Instruction:

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where the plan name was given or refused or do not know.

Skip Instructions:

1,2,RF,DK= [goto PRVSCOV_A]

Question ID: INS.0500.00.1
Variable: PRVSCOV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does ^FIRSTPLANA pay for any of the costs for routine vision care, such as glasses and contact lenses?

Fills:
^FIRSTPLANA

Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan
Instruction:

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:

Fill value from Adult.INS.HIPNAM1_A.

Response:

1 Yes
2 No

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or do not know.

Skip Instructions:

1,2,RF,DK= If there is another plan [goto bPlan for next plan]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0510.00.1
Variable: CHNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that you are covered by the Children's Health Insurance Program or CHIP. What is the name of the plan?

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

allow 80,RF,DK= [goto CHXCHNG_A]

Question ID: INS.0520.00.1
Variable: CHXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your CHIP plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^MARKETPLACE

Description: Health insurance marketplace names
Instruction:

If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:

If CA then fill "Health Insurance Marketplace, such as Covered California"
If CO then fill "Health Insurance Marketplace, such as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as Health Connector"
If MD then fill "Health Insurance Marketplace, such as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as MNsure"
If NY then fill "Health Insurance Marketplace, such as New York State of Health"
If RI then fill "Health Insurance Marketplace, such as HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as Washington Healthplanfinder"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

1,2,RF,DK [goto CHPREM_A]

Question ID: INS.0530.00.1
Variable: CHPREM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

A health insurance premium is the amount you or a family member pays each month for health care coverage. Do you or a family member pay a premium for this CHIP plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

1,2,RF,DK= [goto CHDEDUC_A]

Question ID: INS.0540.00.1
Variable: CHDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does your CHIP plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

1= [goto CHHDHP_A]
2,RF,DK= if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0550.00.1
Variable: CHHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here.

Fills:
^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction: fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have a CHIP plan deductible

Skip Instructions:

1,2,RF,DK= if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A] elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0560.00.1
Variable: OPNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that you are covered by a state-sponsored plan. What is the name of the plan?

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

allow 80,RF,DK= [goto OPXCHNG_A]

Question ID: INS.0570.00.1
Variable: OPXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your state-sponsored plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^MARKETPLACE

Description: Health insurance marketplace names
Instruction:

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

1,2,RF,DK= [goto OPPREM_A]

Question ID: INS.0580.00.1
Variable: OPPREM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

A health insurance premium is the amount you or a family member pays each month for health care coverage. Do you or a family member pay a premium for this state-sponsored plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

1,2,RF,DK= [goto OPDEDUC_A]

Question ID: INS.0590.00.1
Variable: OPDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does your state-sponsored plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

1=[goto OPHDHP_A]
2,RF,DK= if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0600.00.1
Variable: OPHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Fills:
^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction: fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a state-sponsored plan with a deductible

Skip Instructions:

1,2,RF,K = if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A] else [goto HINOTYR_A]

Question ID: INS.0610.00.1
Variable: OGNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that you are covered by an other government program. What is the name of the plan?

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who have an other government plan

Skip Instructions:

allow 80,RF,DK = [goto OGXCHNG_A]

Question ID: INS.0620.00.1
Variable: OGXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your other government plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^MARKETPLACE

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have an other government plan

Skip Instructions:

1,2,RF,DK = [goto OGPREM_A]

Question ID: INS.0630.00.1
Variable: OGPREM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

A health insurance premium is the amount you or a family member pays each month for health care coverage. Do you or a family member pay a premium for your other government plan?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have an other government plan

Skip Instructions:

1,2,RF,DK = [goto OGDEDUC_A]

Question ID: INS.0640.00.1
Variable: OGDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does your other government plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with an other government plan

Skip Instructions:

1 = [goto OGHDHP_A]
2,RF,DK = if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0650.00.1
Variable: OGHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Fills:
^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction: fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with an other government plan with a deductible

Skip Instructions:

1,2,RF,DK = if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0660.00.1
Variable: MILSPC_A
Interview Module: Adult
Content Type: Annual Core
Question Text:

Question Text:

Earlier I recorded that you are covered by military related health care. What types of military related health care are you covered by?

Enter all that apply, separate with commas.

Response:

1 VA health care
2 TRICARE (CHAMPUS)
3 CHAMP-VA (do not include CHAMPUS)
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with military related health care

Skip Instructions:

1-3,RF,DK = [goto HINOTYR_A]

Question ID: INS.0670.00.1
Variable: HILAST_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How long has it been since you last had health care coverage that paid for doctor's visits or hospital stays?

Response:

0 Never
1 Within the past year (anytime less than 12 months ago)
2 Within the last 2 years (1 year but less than 2 years ago)
3 Within the last 3 years (2 years but less than 3 years ago)
4 Within the last 5 years (3 years but less than 5 years ago)
5 Within the last 10 years (5 years but less than 10 years ago)
6 10 years ago or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicaid probe or the Medicare probe.

Skip Instructions:

1 = [goto HILASTMY_A]
2,3 = [goto HISTOPJOB_A]
4,5,6,0,RF,DK = [goto RSNHICOST_A]

Question ID: INS.0680.00.1
Variable: HILASTMY_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In the past 12 months, how many months were you without coverage?

If less than 1 month, enter '1'.

Response:

01-12 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ without known health insurance who last had insurance at some time within the last 12 months

Skip Instructions:

1-12,RF,DK = [goto HISTOPJOB_A]

Question ID: INS.0690.00.1
Variable: HISTOPJOB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Think about the last time that you did have health care coverage that paid for doctor's visits or hospital stays. I am going to read a list of reasons why someone might no longer be enrolled in coverage. Please tell me, yes or no, if this is a reason why you are no longer enrolled in your last health care plan.

You or the policyholder retired, lost a job, or changed employers?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPMISS_A]

Question ID: INS.0700.00.1
Variable: HISTOPMISS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Are you no longer enrolled in your last health care plan because...

You missed a deadline for signing up or paying for the coverage?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPAGE_A]

Question ID: INS.0710.00.1
Variable: HISTOPAGE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Are you no longer enrolled in your last health care plan because...

You became ineligible because of your age or because you left school?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPCOST_A]

Question ID: INS.0720.00.1
Variable: HISTOPCOST_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Are you no longer enrolled in your last health care plan because...

The cost for your coverage increased?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPELIG_A]

Question ID: INS.0730.00.1
Variable: HISTOPELIG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Are you no longer enrolled in your last health care plan because...

You had Medicaid or other public coverage, but were no longer eligible?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto RSNHICOST_A]

Question ID: INS.0740.00.1
Variable: RSNHICOST_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^INSREASONS Are you currently uninsured because coverage is not afforable?

Fills:
^INSREASONS

Description: RSNHICOST_A Introduction
Instruction: If HILAST_A IN (0,4,5,6,RF,DK) fill: "There are many reasons why people do not have health insurance coverage." If HILAST_A IN (1,2,3) fill: "We just discussed reasons you lost coverage. Now I am going to ask you some questions about why you haven't obtained coverage."

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicare probe or the Medicaid probe.

Skip Instructions:

1,2,RF,DK = [goto RSNHIWANT_A]

Question ID: INS.0750.00.1
Variable: RSNHIWANT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

There are other reasons that people do not have health insurance coverage. ^PLUSCOSTA you currently uninsured because...

...you do not need or want coverage?

Fills:
^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction: if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicare probe or the Medicaid probe.

Skip Instructions:

1,2,RF,DK = [goto RSNHIELIG_A]

Question ID: INS.0760.00.1
Variable: RSNHIELIG_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...

...you are not eligible for coverage?

Fills:
^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction: if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicaid probe or the Medicare probe

Skip Instructions:

1,2,RF,DK = [goto RSNHICONF_A]

Question ID: INS.0770.00.1
Variable: RSNHICONF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...

...the process of signing up for coverage is too difficult or confusing?

Fills:
^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction: if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicaid probe or the Medicare probe

Skip Instructions:

1,2,RF,DK = [goto RSNHIMEET_A]

Question ID: INS.0780.00.1
Variable: RSNHIMEET_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...

...you cannot find a plan that meets your needs?

Fills:
^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction: if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicaid probe or the Medicare probe

Skip Instructions:

1,2,RF,DK = [goto RSNHIWAIT_A]

Question ID: INS.0790.00.1
Variable: RSNHIWAIT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...

...you applied for coverage but it has not started yet?

Fills:
^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction: if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicare probe or the Medicaid probe

Skip Instructions:

1,2,RF,DK = [goto RSNHIOTH_A]

Question ID: INS.0800.00.1
Variable: RSNHIOTH_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Is there another reason that you currently do not have health insurance coverage?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicare probe or the Medicaid probe

Skip Instructions:

1 = [goto RSNHIOTHSP_A]
2,RF,DK = [goto next section]

Question ID: INS.0810.00.1
Variable: RSNHIOTHSP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is your other reason for not having coverage?

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who have another reason for not having coverage

Skip Instructions:

allow 80,RF,DK = [goto next section]

Question ID: INS.0820.00.1
Variable: HINOTYR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In the past 12 months, was there any time when you did NOT have ANY health insurance or coverage?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with known health insurance coverage or responded yes to the medicare probe or medicaid probe

Skip Instructions:

1 = [goto HINOTMYR_A]
2,RF,DK = [goto FINISH_A]

Question ID: INS.0830.00.1
Variable: HINOTMYR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In the past 12 months, about how many months were you without coverage?

If less than 1 month, enter '1'.

Response:

01-12 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with known health insurance coverage and did not have health insurance for some period of time in the past 12 months

Skip Instructions:

1-12,RF,DK = [goto FINISH_A]

Question ID: INS.0840.00.1
Variable: FINISH_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The Sample Adult health insurance section is now complete.

Enter '1' to continue.

Response:

1 Enter 1 to continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PAY: Difficulty Paying for Health Care

Question ID: PAY.0010.00.1
Variable: PAYINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Now I am going to ask you about your medical bills. Include bills for doctors, dentists, hospitals, therapists, medication, equipment, and nursing home or home care.

^Dormfill

Enter '1' to continue.

Fills:

^Dormfill

Description: think about family living in family home
Instruction: If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "When I ask about your family, please think about your family living at ^HNO ^HNOSUF ^STRNAME."
else leave blank

^HNO

Description: {Value of HNO}
Instruction: Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF}
Instruction: Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME}
Instruction: Fill GEN.STRNAME

Response:

1 enter 1 to continue

Universe:

Sample Adults 18+ living in same family as the Sample Child when the Sample Child PAY section has not been completed
or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered do not or refused to PAYBLL12M_C and PAYNOBLLNW_C
or Sample adults living in different families than the Sample Child

Skip Instructions:

1 = [goto PAYBLL12M_A]

Replicate To:

PAYINTRO_C

Question ID: PAY.0020.00.1
Variable: PAYBLL12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

In the past 12 months did ^youanyone have problems paying or were unable to pay any medical bills?

Read if necessary: Include bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing home or home care.

Fills:
^youanyone

Description: you/anyone in the family
Instruction: If GEN.PCNT_A=1 fill "you"; else fill "anyone in the family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ living in same family as the Sample Child when the Sample Child PAY section has not been completed
or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered do not or refused to PAYBILL12M_C and PAYNOBLLNW_C
or Sample adults living in different families than the Sample Child

Skip Instructions:

1,RF,DK = [goto PAYNOBLLNW_A]
2 = [goto PAYWORRY_A]

Replicate To:

PAYBLL12M_C

Question ID: PAY.0030.00.1
Variable: PAYNOBLLNW_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^DoyouDoesanyoneinfam currently have any medical bills that you are unable to pay at all?

Fills:
^DoyouDoesanyoneinfam

Description Do you/Does anyone in your family
Instruction If GEN.PCNT_A=1 fill "Do you"; else fill "Does anyone in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ where anyone in the family has difficulty playing medical bills or do not know or refused and Sample Adult is living in same family as the Sample Child when the Sample Child PAY section has not been completed
or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered do not or refused to PAYBILL12M_C and PAYNOBLLNW_C
or Sample adults living in different families than the Sample Child AND who said they/anyone in their family has problems paying their medical bills or do not know or refuse to answer if they/anyone in their family has problems paying bills

Skip Instructions:

1,2,RF,DK = [goto PAYWORRY_A]

Replicate To:

PAYNOBLLNW_C

Question ID: PAY.0040.00.1
Variable: PAYWORRY_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

If you get sick or have an accident, how worried are you that you will be able to pay your medical bills? Are you very worried, somewhat worried, or not at all worried?

Response:

1 Very worried
2 Somewhat worried
3 Not at all worried
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DNC: Dental Care

Question ID: DNC.0010.00.2
Variable: DNCINTRO_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

These next questions ask about your dental care.

Enter '1' to continue.

Response:

1 enter 1 to continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto DENPREV_A]

Question ID: DNC.0020.00.2
Variable: DENPREV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

About how long has it been since you last had a dental examination or cleaning?

Read if necessary: Include cleanings from all types of dental care providers such as dentists, orthodontists, oral surgeons, dental hygienists, and all other dental specialists.

Response:

Universe:

Sample Adults 18+

Skip Instructions:

0-6,RF,DK = [goto DENDL12M_A]

Question ID: DNC.0030.00.1
Variable: DENDL12M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, have you DELAYED getting dental care because of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto DENNG12M_A]

Question ID: INS.0040.00.2
Variable: DENNG12M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, was there any time when you needed dental care, but DID NOT GET IT because of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
UTZ: Utilization

Question ID: UTZ.0010.00.1
Variable: UTZINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Now that we finished talking about dental care, I would like to ask you about other health care.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto LASTDR_A]

Question ID: UTZ.0020.00.1
Variable: LASTDR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

About how long has it been since you last saw a doctor or other health care professional about your health?

Read if necessary: Include doctors seen while a patient in a hospital.

Read if necessary: Do not include dental care.

Response:

Universe:

Sample Adults 18+

Skip Instructions:

1-6 = [goto WELLNESS_A]
0,RF,DK = [goto USUALPL_A]

Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was this a wellness visit, physical, or general purpose check-up?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have seen a doctor

Skip Instructions:

1 = [goto USUALPL_A]
2,RF,DK = [goto WELLVIS_A]

Question ID: UTZ.0040.00.1
Variable: WELLVIS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

About how long has it been since you last saw a doctor or other health professional for a wellness visit, physical, or general purpose check-up?

Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health professional may also discuss topics related to your health such as smoking, alcohol use, diet and exercise. These visits are usually scheduled in advance and occur when you are not sick or injured.

Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.

Response:

Universe:

Sample Adults 18+ who have seen a doctor, but the last visit was not a wellness visit or they didn't know or refused whether it was a wellness visit

Skip Instructions:

0-6,RF,DK = [goto USUALPL_A]

Question ID: UTZ.0050.00.1
Variable: USUALPL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Is there a place that you USUALLY go to if you are sick and need health care?

Response:

1 Yes
2 There is NO place
3 There is MORE THAN ONE place
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,3,RF,DK = [goto USPLKIND_A]
2 = [goto URGENT12M_A]

Question ID: UTZ.0060.00.1
Variable: USPLKIND_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What kind of place ^ISITGOMSTOFT - a doctor's office or health center; an urgent care center, a clinic in a drug store or grocery store; a hospital emergency room; a VA Medical Center or VA outpatient clinic; or some other place?

Read if necessary: A doctor's office or health center is a place where you see the same doctor or the same group of doctors every visit, where you usually need to make an appointment ahead of time, and where your medical records are on file.

Read if necessary: Urgent care centers and clinics in a drug store or grocery store are places where you do not need to make an appointment ahead of time, and do not usually see the same health care provider at each visit.
Fills:
^ISITGOMSTOFT

Description: is it/do you go to most often
Instruction: If USUALPL_A=1 fill "is it"; else fill "do you go to most often"

Response:

1 A doctor's office or health center
2 Urgent care center or clinic in a drug store or grocery store
3 Hospital emergency room
4 A VA Medical Center or VA outpatient clinic
5 Some other place
6 Does not go to one place most often
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with 1+ usual place of care or who do not know or refused to answer if they have a usual place of care

Skip Instructions:

1-6,RF,DK = [goto URGENT12M_A]

Question ID: UTZ.0070.00.1
Variable: URGENT12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, how many times have you gone to an urgent care center or a clinic in a drug store or grocery store about your health?

Enter 96 if number is 96 or greater.

Read if necessary: Urgent care centers and clinics in drug stores or grocery stores are places where you do not need to make an appointment ahead of time, and do not usually see the same health care provider at each visit.

Read if necessary: This is different from a hospital emergency room.

Response:

00-95 0-95 times
96 96+ times
97 Refused
99 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

0-39,RF,DK = [goto EMERGE12M_A]
40-96 = [goto ERR1_URGENT12M_A]

Soft Edit:

ERR1_URGENT12M_A

Check Description: Urgent care 40-96 times
Check Text: {signal ERR1_URGENT12M_A} ^URGENT12M_A is an unusually large number. Did you visit an urgent care center or clinic in a drug store or grocery store about your health ^URGENT12M_A times in the past 12 months? Please verify.

Question ID: UTZ.0080.00.1
Variable: EMERGE12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, how many times have you gone to a hospital emergency room about your health?

Read if necessary: This includes emergency room visits that resulted in a hospital admission.

Enter 96 if number of times is 96 or more.

Response:

00-95 0-95 times
96 96+ times
97 Refused
99 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

0-39,RF,DK = [goto HOSPONGT_A]
40-96 = [goto ERR1_EMERGE12M_A]

Soft Edit:
ERR1_EMERGE12M_A

Check Description: ER 40-96 times
Check Text: {signal ERR1_EMERGE12M_A}

^EMERGE12M_A is an unusually large number. Did you visit a hospital emergency room about your health ^EMERGE12M_A times in the past 12 months?

Please verify.

Question ID: UTZ.0090.00.1
Variable: HOSPONGT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, have you been hospitalized overnight? ^PAST12MER_A

Fills:
^PAST12MER_A

Description: Do not include an overnight stay in the emergency room.
Instruction: If ((EMERGE12M_A ge 01 and EMERGE12M_A le 96) or EMERGE12M_A IN (RF,DK): Fill: "Do not include an overnight stay in the emergency room."

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto MEDDL12M_A]

Question ID: UTZ.0100.00.1
Variable: MEDDL12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, have you DELAYED getting medical care because of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto MEDNG12M_A]

Question ID: UTZ.0110.00.1
Variable: MEDNG12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, was there any time when you needed medical care, but DID NOT GET IT because of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PMD: Prescription Medication

Question ID: PMD.0010.00.1
Variable: RX12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

At any time in the PAST 12 MONTHS, did you take prescription medication?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto RXSK12M_A]
2,DK,RF = [goto RXDG12M_A]

Question ID: PMD.0020.00.1
Variable: RXSK12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, were any of the following true for you?

...You skipped medication doses to save money.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months

Skip Instructions:

1,2,DK,RF = [goto RXLS12M_A]

Question ID: PMD.0030.00.1
Variable: RXLS12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: During the past 12 months, were any of the following true for you?

...You took less medication to save money.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK = [goto RXDL12M_A]

Question ID: PMD.0040.00.1
Variable: RXDL12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: During the past 12 months, were any of the following true for you?

...You DELAYED filling a prescription to save money.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK = [goto RXDG12M_A]

Question ID: PMD.0050.00.1
Variable: RCDG12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, was there any time when you needed prescription medication, but DID NOT GET IT because of the cost?

Response:
1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
OPD: Opioid Use - ALL

Question ID: OPD.0010.00.4
Variable: OPD12M_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

?[F1]

These next questions are about the use of prescription pain relievers called opioids. When answering these questions, please do not include over-the-counter pain relievers such as aspirin, Tylenol, Advil, or Aleve.

During the past 12 months, have you taken any opioid pain relievers prescribed by a doctor, dentist, or other health professional? Examples include hydrocodone, Vicodin, Norco, Lortab, oxycodone, OxyContin, Percocet, and Percodan. If you are not sure, please tell me the name of the drug and I can look it up.

Press F1 to pull up list of prescription opioids.

Enter '1' for yes, if any medications provided are on the list.

Enter '2' for no, if no medications provided are on the list.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and OPIODALL_FLG=1

Skip Instructions:

1 = [goto OPD3M_A]
2,RF,DK = [goto next section]

Question ID: OPD.0020.00.4
Variable: OPD3M_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

During the past 3 months, have you taken any opioid pain relievers prescribed by a doctor, dentist, or other health professional?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and also have taken any opioids prescribed by a doctor in the past 12 months

Skip Instructions:

1 = [goto OPDACUTE_A]
2,RF,DK = [goto next section]

Question ID: OPD.0030.00.4
Variable: OPDACUTE_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

During the past 3 months, did you take a prescription opioid to treat short-term or acute pain, such as pain due to a broken bone or muscle sprain, pain from dental work, or pain following surgery?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and have also taken any opioids prescribed by a doctor in the past 3 months

Skip Instructions:

1,2,RF,DK = [goto OPDCHRONIC_A]

Question ID: OPD.0040.00.4
Variable: OPDCHRONIC_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

During the past 3 months, did you take a prescription opioid to treat long-term or chronic pain, such as low back pain or neck pain, frequent headaches or migraines, or joint pain or arthritis?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and have also taken any opioids prescribed by a doctor in the past 3 months

Skip Instructions:

1 = [goto OPDFREQ_A]
2,RF,DK = [goto next section]

Question ID: OPD.0050.00.4
Variable: OPDFREQ_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

During the past 3 months, how often did you take a prescription opioid? Would you say some days, most days, or every day?

Response:

1 Some days
2 Most days
3 Every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and have also taken any opioids prescribed by a doctor in the past 3 months for chronic pain

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PRV: Preventive Screening

Question ID: PRV.0170.00.2
Variable: BPLAST_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was the last time you had your blood pressure checked by a doctor, nurse, or other health professional?

Response:

Universe:

Sample Adults 18+

Skip Instructions:

0-6,RF,DK = [goto CHOLLAST_A]

Question ID: PRV.0020.00.2
Variable: CHOLLAST_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was the last time you had your cholesterol checked by a doctor, nurse, or other health professional?

Response:

Universe:

Sample Adults 18+

Skip Instructions:

0-6,RF,DK = [goto DIABLAST_A]

Question ID: PRV.0030.00.2
Variable: DIABLAST_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was the last time you had a blood test for high blood sugar or diabetes by a doctor, nurse, or other health professional?

Response:

Universe:

Sample Adults 18+

Skip Instructions:

0-6,RF,DK = if GEN.AGE_FINAL[PX_A] ge 40 [goto COLORECTEV_A]
elseif (GEN.SEX_FINAL[PX_A]=1 and (GEN.AGE_FINAL[PX_A] lt 40 or GEN.AGE_FINAL[PX_A] IN (DK,RF))
or GEN.SEX_FINAL[PX_A] IN (DK,RF) [goto next section]
elseif (GEN.SEX_FINAL[PX_A]=2 and (GEN.AGE_FINAL[PX_A] lt 40 or GEN.AGE_FINAL[PX_A] IN (DK,RF))
[goto CERVICEV_A]

Question ID: PRV.0040.00.2
Variable: COLORECTEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

These next questions are about colorectal cancer screening. Colonoscopy and sigmoidoscopy are exams to check for colon cancer. Have you ever had either of these exams?

Read if necessary: Colonoscopy (colon-OS-copy) and sigmoidoscopy (sigmoid-OS-copy) are exams in which a doctor inserts a tube into the rectum to look for polyps or cancer.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 40+

Skip Instructions:

1 = [goto COLORECTYP_A]
2,RF,DK = [goto COLOROTH_A]

Question ID: PRV.0050.00.2
Variable: COLORECTYP_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Have you had a colonoscopy, a sigmoidoscopy, or both?

Read if necessary: For a colonoscopy, the doctor checks the entire colon, and you are given medication through a needle in your arm to make you sleepy, and told to have someone take you home. For a sigmoidoscopy, the doctor checks only part of the colon and you are fully awake.

Response:

1 Colonoscopy
2 Sigmoidoscopy
3 Both
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who have had either a colonoscopy or sigmoidoscopy

Skip Instructions:

1,3 = [goto COLWHEN_A]
2 = [goto SIGWHEN_A]
DK = [goto COLSIGWHEN_A]
RF = [goto COLOROTH_A]

Question ID: PRV.0060.00.2
Variable: COLWHEN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

About how long has it been since your MOST RECENT colonoscopy?

Response:

1 Within the past year (anytime less than 12 months ago)
2 Within the past 2 years (1 year but less than 2 years ago)
3 Within the past 3 years (2 years but less than 3 years ago)
4 Within the past 5 years (3 years but less than 5 years ago)
5 Within the past 10 years (5 years but less than 10 year ago)
6 10 years ago or more
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who have ever had a colonoscopy or both a colonoscopy and a sigmoidoscopy

Skip Instructions:

1-6,RF,DK = [goto COLREASON_A]

Question ID: PRV.0070.00.3
Variable: COLREASON_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What was the MAIN reason you had this colonoscopy - was it part of a routine exam, because of a problem, as a follow-up test of an earlier test or screening exam, or some other reason?

Response:

1 Part of a routine exam
2 Because of a problem
3 Follow-up test of an earlier test or screening exam
4 Other reason
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who ever had a colonoscopy or both a colonoscopy and a sigmoidoscopy

Skip Instructions:

1-4,RF,DK = [goto COLPAY_A]

Question ID: PRV.0080.00.3
Variable: COLPAY_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Did you pay none, part, or all of the cost for your most recent colonoscopy?

Response:

1 None of the cost
2 Part of the cost
3 All of the cost
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who ever had a colonoscopy or both a colonoscopy and a sigmoidoscopy

Skip Instructions:

1-3,RF,DK = if COLORECTYP_A=3 [goto SIGWHEN_A]
else [goto COLOROTH_A]

Question ID: PRV.0090.00.2
Variable: COLSIGWHEN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was your MOST RECENT colonoscopy or sigmoidoscopy?

Response:

Universe:

Sample Adults 40+ who have ever had a colonoscopy or sigmoidoscopy but do not know which type

Skip Instructions:

1-6,RF,DK = [goto COLOROTH_A]

Question ID: PRV.0060.00.2
Variable: COLWHEN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was your MOST RECENT sigmoidoscopy?

Response:

Universe:

Sample Adults 40+ who have ever had a sigmoidoscopy

Skip Instructions:

1-6,RF,DK = [goto COLOROTH_A]
Question ID: PRV.010.00.2
Variable: COLOROTH_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Have you ever had any OTHER kind of test for colorectal cancer, such as a virtual colonoscopy, CT colonography, blood stool test, fit DNA or Cologuard test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 40+

Skip Instructions:

1 = [goto CTCOLEV_A]
2,RF,DK = if ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or COLSIGWHEN_A IN (1-4) and GEN.SEX_FINAL[PX_A]=1) [goto PSATEST_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or COLSIGWHEN_A IN (1-4) and GEN.SEX_FINAL [PX_A]=2) [goto CERVICEV_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or COLSIGWHEN_A IN (1-4) and GEN.SEX_FINAL
[PX_A] IN (RF,DK)) [goto next section] else [goto COLPROBLEM_A]

Question ID: PRV.0120.00.2
Variable: CTCOLEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

CT colonography, sometimes called virtual colonoscopy, is a new type of test that looks for cancer in the colon. Unlike regular colonoscopies, you do not need medication to make you sleepy during the test. In this new test, your colon is filled with air and you are moved through a donut-shaped X-ray machine as you lie on your back and then your stomach. Have you ever had a CT colonography or virtual colonoscopy?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who ever had any other tests for colorectal cancer

Skip Instructions:

1 = [goto CTCOLWHEN_A]
2,RF,DK = [goto FITHEV_A]

Question ID: PRV.0130.00.2
Variable: CTCOLWHEN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was your most recent CT colonography or virtual colonoscopy?

Response:

Universe:

Sample Adults 40+ who have had a CT colonography or virtual colonscopy

Skip Instructions:

1-6,RF,DK = [goto FITHEV_A]

Question ID: PRV.0140.00.2
Variable: FITHEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

The following questions are about the blood stool or occult blood test, fecal immunochemical or FIT test. These are tests to determine whether you have blood in your stool or bowel movement and can be done at home using a kit. You use a stick or brush to obtain a small amount of stool at home and send it back to the doctor or lab.

Have you ever had a blood stool or FIT test, using a HOME test kit?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who ever had any other tests for colorectal cancer

Skip Instructions:

1 = [goto FITHWHEN_A]
2,RF,DK = if ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4)) or COLSIGWHEN_A IN (1-4) and GEN.SEX_FINAL[PX_A]=1) [goto PSATEST_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4)) or COLSIGWHEN_A IN (1
-4) and GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV_A]
if ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A in (1-4)) or COLSIGWHEN_A IN (1-4)
and GEN.SEX_FINAL[PX_A] IN (RF,DK)) [goto next section] else [goto COLPROBLEM_A]

Question ID: PRV.0150.00.2
Variable: FITHWHEN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When was your most recent blood stool or FIT test, using a home test kit?

Response:

Universe:

Sample Adults 40+ who have ever had a home blood stool or FIT test

Skip Instructions:

1-6,DK,RF = [goto COLOGUARD_A]

Question ID: PRV.0160.00.3
Variable: COLOGUARD_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Cologuard is a new type of stool test for colon cancer. Unlike other stool tests, Cologuard looks for changes in DNA in addition to checking for blood in your stool. The Cologuard test is shipped to your home in a box that includes a container for your stool sample.

Have you ever had a Cologuard test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who ever had a home FIT test

Skip Instructions:

1 = [goto FITCOLG_A]
2,RF,DK = if ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or or COLSIGWHEN_A IN (1-4) or FITHWHEN_A=1) and GEN.SEX_FINAL[PX_A]=1) [goto PSATEST_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or or COLSIGWHEN_A IN (1-4) or FITHWHEN_A=1) and GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or or COLSIGWHEN_A IN
(1-4) or FITHWHEN_A=1) and GEN.SEX_FINAL[PX_A] in (RF,DK)) [goto next section] else [goto COLPROBLEM_A]

Question ID: PRV.0170.00.3
Variable: FITCOLG_A
Interview Module: Adult
Content Type:Sponsored Content

Question Text:

Was the blood stool or FIT test you reported earlier conducted as part of a Cologuard test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who ever had a Cologuard

Skip Instructions:

1 = [goto CGUARDWHEN_A]
2,RF,DK = if ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or COLSIGWHEN_A IN (1-4) or FITHWHEN_A=1) and GEN.SEX_FINAL[PX_A]=1 [goto PSATEST_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or COLSIGWHEN_A IN (1- 4) or FITHWHEN_A=1) and GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV_A]
elseif ((COLWHEN_A in (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or or COLSIGWHEN_A IN
(1-4) or FITHWHEN_A=1) and GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto next section] else [goto COLPROBLEM_A]

Question ID: PRV.0180.00.3
Variable: CGUARDWHEN_A
Interview Module: Adult
Content Type Sponsored Content

Question Text:

When did you have your most recent Cologuard test?

Response:

Universe:

Sample Adults 40+ who ever had a Cologuard as part of the FIT test

Skip Instructions:

1-6,RF,DK = if ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or COLSIGWHEN_A IN (1-4) or FITHWHEN_A=1 or CGAURDWHEN_A IN (1-3)) and GEN.SEX_FINAL[PX_A]=1) [goto PSATEST_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or COLSIGWHEN_A IN (1- 4) or FITHWHEN_A=1 or CGAURDWHEN_A IN (1-3)) and GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV_A]
elseif ((COLWHEN_A IN (1-5) or SIGWHEN_A IN (1-4) or CTCOLWHEN_A IN (1-4) or COLSIGWHEN_A IN (1- 4) or FITHWHEN_A=1 or CGAURDWHEN_A IN (1-3)) and GEN.SEX_FINAL[PX_A] IN (RF,DK)) [goto next
section]
else [goto COLPROBLEM_A]

Question ID: PRV.0190.00.3
Variable: COLPROBLEM_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the past 12 MONTHS, did a doctor or other health professional RECOMMEND that you be tested to look for problems in your colon or rectum?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 40+ who never had a colonoscopy or had a colonoscopy over 10 years ago, or do not know or refused when they had a colonoscopy,
and never had a sigmoidoscopy or had a sigmoidoscopy over 5 years ago, or do not know or refused when they had a sigmoidoscopy,
or had a sigmoidoscopy or colonoscopy but do not know which over 5 years ago,
and never had a CT colonography or had a CT colonography over 5 years ago, or do not know or refused when they had a CT colonography,
and never had a FIT test or had a FIT test over one year ago, or do not know or refused when they had a FIT test
and never had a Cologuard test or had a Cologuard test more than 3 years ago, or do not know or regused when they had a Cologuard test

Skip Instructions:

1 = [goto COLKIND_A]
2,RF,DK = if GEN.SEX_FINAL[PX_A]=1 [goto PSATEST_A]
elseif GEN.SEX_FINAL[PX_A]=2 [goto CERVICEV_A]
elseif GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto next section]

Question ID: PRV.0200.00.3
Variable: COLKIND_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Which tests to check for colon cancer did the doctor or other health professional recommend to you? Possible tests include stool blood or fecal occult blood or FIT test; Cologuard or FIT DNA test; sigmoidoscopy; colonoscopy; CT colonography or virtual colonoscopy; or other.

Enter all that apply, separate with commas.

Response:

1 Stool blood test/fecal occult blood/FIT test
2 Cologuard or FIT DNA test
3 Sigmoidoscopy
4 Colonoscopy
5 CT colonography/virtual colonoscopy
6 Other
7 Refused
9 Do not Know

Universe:

Sample Adults 40+ who had another type of colon test recommended

Skip Instructions:

1-6,RF,DK = if GEN.SEX_FINAL[PX_A]=1 [goto PSATEST_A]
elseif GEN.SEX_FINAL[PX_A]=2 [goto CERVICEV_A]
elseif GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto next section]

Question ID: PRV.0210.00.3
Variable: PSATEST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

A PSA test is a blood test to detect prostate cancer. It is also called a prostate-specific antigen test. Have you EVER HAD a PSA test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Male Sample Adults 40+

Skip Instructions:

1 = [goto PSAWHEN_A]
2,RF,DK = [goto PSAADVANT_A]

Question ID: PRV.0220.00.3
Variable: PSAWHEN_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

About how long has it been since your MOST RECENT PSA test?

Response:

Universe:

Male Sample Adults 40+ who ever had a PSA test

Skip Instructions:

1-6,RF,DK = [goto PSAREASON_A]

Question ID: PRV.0230.00.3
Variable: PSAREASON_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What was the MAIN reason you had this PSA test - was it part of a routine exam, because of a problem, or some other reason?

Response:

1 Part of a routine exam
2 Because of a problem
3 Other reason
7 Refused
9 Do not Know

Universe:

Male Sample Adults 40+ who ever had a PSA test

Skip Instructions:

1-3,RF,DK = [goto PSASUGGEST_A]

Question ID: PRV.0240.00.3
Variable: PSASUGGEST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Who first suggested this PSA test: you, your doctor, or someone else?

Response:

1 Self
2 Doctor
3 Someone else
7 Refused
9 Do not Know

Universe:

Male Sample Adults 40+ who ever had a PSA test

Skip Instructions:

1-3,RF,DK = [goto PSA5YR_A]

Question ID: PRV.0250.00.3
Variable: PSA5YR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

How many PSA tests have you had in the past 5 years?

Enter 0 for none.
Enter '95' for 95 or more.

Response:

00-95 Range of values
97 Refused
99 Do not Know

Universe:

Male Sample Adults 40+ who ever had a PSA test

Skip Instructions:

0-95,RF,DK = [goto PSAADVANT_A]

Question ID: PRV.0260.00.3
Variable: PSAADVANT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Did a doctor EVER talk with you about the advantages of the PSA test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Male Sample Adults 40+

Skip Instructions:

1,2,RF,DK = [goto PSADISADV_A]

Question ID: PRV.0270.00.3
Variable: PSADISADV_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Did a doctor EVER talk with you about the disadvantages of the PSA test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Male Sample Adults 40+

Skip Instructions:

1,2,RF,DK = [goto next section]

Question ID: PRV.0280.00.2
Variable: CERVICEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

There are two different kinds of tests to check for cervical cancer. One is a Pap smear or Pap test and the other is the HPV or Human Papillomavirus test.

Have you ever had a test to check for cervical cancer?

Read if necessary: These are routine tests for women in which a doctor or other health professional takes a sample from the cervix with a swab or brush and sends it to the lab.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18+

Skip Instructions:

1 = [goto CERVICWHEN_A]
2 = [goto CERVICNOT_A]
RF,DK = [goto HYSTEV_A]

Question ID: PRV.0290.00.2
Variable: CERVICWHEN_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

When did you have your MOST RECENT test to check for cervical cancer?

Response:

Universe:

Female Sample Adults 18+ who have ever had a cervical cancer test

Skip Instructions:

1-6,RF,DK = [goto CERREASON_A]

Question ID: PRV.0300.00.3
Variable: CERREASON_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What was the main reason you had a cervical cancer screening test - was it part of a routine exam, because of a problem, or as a follow-up test of an earlier test or screening exam, or some other reason?

Response:

1 Part of a routine exam
2 Because of a problem
3 Follow-up test of an earlier test or screening exam
4 Other reason
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18+ who have ever had a cervical cancer test

Skip Instructions:

1-4,RF,DK = [goto PAPTEST_A]

Question ID: PRV.0310.00.3
Variable: PAPTEST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

At your most recent cervical cancer screening, did you have a Pap test?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18+ who ever had a cervical cancer test

Skip Instructions:

1,2,RF,DK = [goto HPVTEST_A]

Question ID: PRV.0320.00.3
Variable: HPVTEST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

At your most recent cervical cancer screening, did you have an HPV test?

Read if necessary: HPV stands for Human Papillomavirus.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18+ who ever had a cervical cancer test

Skip Instructions:

1,2,RF,DK = if CERVICWHEN_A IN (1,2,3,4) [goto CERVICRES_A] if CERVICWHEN_A IN (5,6) [goto CERVICNOT_A]
if CERVICWHEN_A IN (RF,DK) [goto HYSTEV_A]

Question ID: PRV.0330.00.3
Variable: CERVICRES_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the PAST 5 years, did any of your cervical cancer screening tests require follow-up to check for cancer or precancerous cells?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18+ who had a cervical cancer test within the past 5 years.

Skip Instructions:

1,2,RF,DK = [goto HYSTEV_A]

Question ID: PRV.0340.00.3
Variable: CERVICNOT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What is the MAIN REASON that you have ^never5yearsPAPHPV?

Do not read choices, select answer category based on respondent's answer.

Fills:
^never5yearsPAPHPV

Description: NEVER had a test to check for cervical cancer/NOT had a test to check for cervical cancer in the last 5 years
Instruction: If CERVICEV_A=2 fill "NEVER had a test to check for cervical cancer"
If CERVICEV_A=1 and CERVICWHEN_A IN (5,6) fill: "NOT had a
test to check for cervical cancer in the last 5 years"

Response:

01 No reason/never thought about it
02 Didn't need it/didn't know I needed this type of test
03 Doctor didn't order it/didn't say I needed it
04 Haven't had any problems
05 Put it off/didn't get around to it
06 Too expensive/no insurance/cost
07 Too painful, unpleasant, or embarrassing
08 Had hysterectomy
09 Do not have a doctor
10 Had HPV vaccine
11 Other
97 Refused
99 Do not Know

Universe:

Female Sample Adults who never had a cervical cancer test or had their last cervical cancer test more than 5 years ago.

Skip Instructions:

1-7,9-11,RF,DK = [goto HYSTEV_A]
8 = if GEN.AGE_FINAL ge 30 [goto MAMEV_A]
elseif GEN.AGE_FINAL lt 30 or GEN.AGE_FINAL IN (DK,RF) [goto next section]

Question ID: PRV.0350.00.2
Variable: HYSTEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Have you had a hysterectomy?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18+ who have not already indicated they had a hysterectomy

Skip Instructions:

1,2,RF,DK = if GEN.AGE_FINAL ge 30 [goto MAMEV_A]
elseif GEN.AGE_FINAL lt 30 or GEN.AGE_FINAL IN (DK,RF) [goto next section]

Question ID: PRV.0360.00.2
Variable: MAMEV_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Have you EVER HAD a mammogram?

Read if necessary: A mammogram is an x-ray taken only of the breast by a machine that presses against the breast.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female Sample Adults 30+

Skip Instructions:

1 = [goto MAMWHEN_A]
2,RF,DK = [goto BREASTEXAM_A]

Question ID: PRV.0370.00.1
Variable: MAMWHEN_S
Interview Module: Adult
Content Type: Rotating Core

Question Text:

About how long has it been since your MOST RECENT mammogram?

Response:

Universe:

Female Sample Adults 30+ who have had a mammogram

Skip Instructions:

1-6,RF,DK = [goto MAMREASON_A]

Question ID: PRV.0380.00.3
Variable: MAMREASON_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What was the MAIN reason you had this mammogram -- was it part of a routine exam, because of a problem, or some other reason?

Response:

1 Part of a routine exam
2 Because of a problem
3 Other reason
7 Refused
9 Do not Know

Universe:

Female Sample Adults 30+ who have ever had a mammogram

Skip Instructions:

1-3,RF,DK = [goto MAMAGE1ST_A]

Question ID: PRV.0390.00.3
Variable: MAMAGE1ST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

About how old were you when you had your first mammogram?

Response:

1 Under 30 years
2 30-39
3 40-49
4 50-59
5 60 years or older
7 Refused
9 Do not Know

Universe:

Female Sample Adults age 30 or older who ever had a mammogram

Skip Instructions:

if((GEN.AGE_FINAL[PX_A] lt 60 and MAMAGE1ST_A=5) or (GEN.AGE_FINAL[PX_A] lt 50 and MAMAGE1ST_A IN (4,5)) or (GEN.AGE_FINAL[PX_A] lt 40 and MAMAGE1ST_A IN (3,4,5)))[goto ERR_MAMAGE1ST_A]
1-3 = [goto MAMWHY1ST_A]
4,5 = [goto BREASTEXAM_A]
RF,DK = if GEN.AGE_FINAL[PX_A] lt 50 [goto MAMWHY1ST_A]
else [goto BREASTEXAM_A]

Hard Edit:
ERR_MAMAGE1ST_A

Check Description: Non-selectable answer chosen hard edit
Check Text: {check ERR_MAMAGE1ST_A} That selection is not valid at this time. Please correct.

Question ID: PRV.0400.00.3
Variable: MAMWHY1ST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What was the MAIN REASON you had your first mammogram?

Put response into correct category below.

Response:

1 Because of a breast problem
2 My healthcare provider told me I was high-risk
3 Family history of breast cancer
4 Part of a routine exam
5 I requested it
6 Other reason
7 Refused
9 Do not Know

Universe:

Female Sample adults 30+ who had their first mammogram under age 50 or do not know or refused to say when they had their first mammogram and are under age 50.

Skip Instructions:

1-6,RF,DK = [goto BREASTEXAM_A]

Question ID: PRV.0410.00.3
Variable: BREASTEXAM_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Have you EVER HAD a breast exam done by a doctor or other health professional to check for lumps or other signs of breast cancer?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female sample adults 30+

Skip Instructions:

1 = [goto BEXAMWHEN_A]
2,RF,DK = [goto next section]

Question ID: PRV.0420.00.3
Variable: BEXAMWHEN_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

About how long has it been since your MOST RECENT breast exam?

Response:

Universe:

Female Sample Adults 30+ who have ever had a breast exam

Skip Instructions:

1-6,RF,DK = [goto BEXAMREAS_A]

Question ID: PRV.0430.00.3
Variable: BEXAMREAS_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What was the MAIN REASON you had this breast exam -- was it part of a routine exam, because of a problem, or some other reason?

Response:

1 Part of a routine exam
2 Because of a problem
3 Other reason
7 Refused
9 Do not Know

Universe:

Female Sample Adults 30+ who ever had a breast exam

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
IMS: Immunization

Question ID: IMS.0010.00.3
Variable: PREGFLUYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Were you pregnant any time ^AUGUSTYEAR?

Fills:
^AUGUSTYEAR

Description period of pregnancy
Instruction

If INTERVIEW_MONTH=1-3 "since August 1st, ^LASTYEAR" If INTERVIEW_MONTH=4-7 "from August ^LASTYEAR through March ^YEAR" If INTERVIEW_MONTH=8-12 "since August 1st, ^YEA

^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YEAR

Description Year of Interview
Instruction Current Year

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female sample adults 18-49 years or age is do not know or refused and who are not currently pregnant or do not know if they are currently pregnant or who are currently pregnant and the interview occurred between April-July.

Skip Instructions:

1,2,DK = [goto LIVEBIRTH_A]
RF = [goto SHTFLU12M_A]

Question ID: IMS.0020.00.3
Variable: LIVEBIRTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

During the past 12 months, did you have a pregnancy that ended in a live birth?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female sample adults aged 18-49 of age or age is do not know or refused who did not refuse to answer if they are currently pregnant or if they were pregnant in between August and March.

Skip Instructions:

1,2,RF,DK = [goto SHTFLU12M_A]

Question ID: IMS.0030.00.3
Variable: SHTFLU12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

There are two types of flu vaccinations. One is a shot and the other is a spray, mist, or drop in the nose. During the past 12 months, have you had a flu vaccination?

Read if necessary: A flu vaccination is usually given in the fall and protects against influenza for the flu season.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto SHTFLUM_A]
2,RF,DK = [goto SHTPNUEV_A]

Question ID: IMS.0040.01.1
Variable: SHTFLUM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

1 of 2

During what month and year did you receive your most recent flu vaccine?

Response:

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who had a flu shot in the past 12 months

Skip Instructions:

1-12,DK = [goto SHTFLUY_A]
RF = if Adult.BMI.PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A] else [goto SHTPNUEV_A]

Question ID: IMS.0040.02.1
Variable: SHTFLUY_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

2 of 2

Enter year of most recent flu vaccine.

Response:

1900-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Adults 18+ who gave a month for their last flu shot or who didn't know the month

Skip Instructions:

valid year,RF,DK
if SHTFLUM_A and SHTFLUY_A = a future date [goto ERR1_SHTFLUY_A]
elseif SHTFLUM_A and SHTFLUY_A = a date before 12 months ago [goto ERR2_SHTFLUY_A] elseif PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A] else [goto SHTPNUEV_A]

Hard Edit:
ERR2_SHTFLUY_A

Check Description: Date 12 months ago hard edit
Check Text: {check ERR2_SHTFLUY_A} Date more than 12 months ago. Please correct.

ERR1_SHTFLUY_A

Check Description: Future date hard edit
Check Text: {check ERR1_SHTFLUY_A} Future date invalid. Please correct.

Question ID: IMS.0050.00.3
Variable: FLUPREG_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Did you get a flu vaccination before or during your current pregnancy?

Response:

1 Before pregnancy
2 During pregnancy
7 Refused
9 Do not Know

Universe:

Female Sample Adults 18-49 (or do not know or refuse their age) who are currently pregnant and received a flu vaccination in the past 12 months and the interview takes place in Jan-March or Aug-Dec.

Skip Instructions:

1,2,RF,DK = [goto SHTPNUEV_A]

Question ID: IMS.0060.00.3
Variable: FLUPREG2_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Earlier you said you were pregnant sometime ^AUGUSTYEAR. Did you get a flu vaccination before, during, or after your pregnancy?

Fills:
^AUGUSTYEAR

Description period of pregnancy
Instruction If INTERVIEW_MONTH=1-3 "since August 1st, ^LASTYEAR" If INTERVIEW_MONTH=4-7 "from August ^LASTYEAR through March ^YEAR" If INTERVIEW_MONTH=8-12 "since August 1st, ^YEAR"

^LAST YEAR

Description Last year
Instruction Fill year prior to current year

^YEAR

Description Year of Interview
Instruction Current Year

Response:

1 Before pregnancy
2 During pregnancy
3 After pregnancy
7 Refused
9 Do not Know

Universe:

Female sample adults 18-49 years of age who reported a pregnancy during August-March and received a flu vaccination in the past 12 months.

Skip Instructions:

1-3,RF,DK = [goto SHTPNUEV_A]

Question ID: IMS.0070.00.1
Variable: SHTPNUEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

A pneumonia shot is also known as a pneumococcal vaccine. Have you ever had a pneumonia shot?

Read if necessary: There are two types of pneumonia shots: polysaccharide, also known as Pneumovax®, and conjugate, also known as Prevnar®.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto SHTPNEUNB_A]
2,RF,DK = if GEN.AGE_FINAL[PX_A] ge 50 [goto SHTSHINGLE_A]
else if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN (DK,RF)) and LIVEBIRTH_A=1 [goto TDAPPREG_A]
else [goto SHTTETANUS_A]

Question ID: IMS.0080.00.1
Variable: SHTPNEUNB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How many pneumonia shots have you ever had?

Response:

1 One pneumonia shot
2 Two pneumonia shots
3 More than two pneumonia shots
7 Refused
9 Do not Know

Universe:

Sample Adults who ever had a pneumonia shot

Skip Instructions:

1,2,3,RF,DK = if GEN.AGE_FINAL[PX_A] ge 50 [goto SHTSHINGLE_A]
elseif LIVEBIRTH_A=1 [goto TDAPPREG_A] else [goto SHTTETANUS_A]

Question ID: IMS.0090.00.3
Variable: SHTSHINGLE_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Have you had a vaccine for shingles?

Read if necessary: Shingles is an illness that results in a rash or blisters on the skin, and is usually painful. There are two vaccines now available for shingles; Zostavax (R), which requires
1 shot, and Shingrix (R), a new vaccine which requires 2 shots.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adult's age is 50 or over

Skip Instructions:

1 = [goto ZOSTAVAX_A]
2,RF,DK = [goto SHTTETANUS_A]

Question ID: IMS.1030.00.3
Variable: ZOSTAVAX_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

There are two vaccines now available for shingles: Zostavax (R), which requires one shot, and Shingrix (R), a new vaccine which requires 2 shots.

Have you ever had Zostavax (R), the shingles vaccine that requires one shot?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults age 50 or older who ever had a vaccine for shingles

Skip Instructions:

1 = [goto ZOSTAVAXYR_A]
2,RF,DK = [goto SHINGRIX_A]

Question ID: IMS.0110.00.3
Variable: ZOSTAVAXYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What year did you get your most recent Zostavax (R) shot?

Response:

1900-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Adults age 50 or older who had Zostavax vaccine

Skip Instructions:

1900-2030 = if future date [goto ERR1_ZOSTAVAXYR_A] elseif date before birth [goto ERR2_ZOSTAVAXYR_A] else [goto SHINGRIX_A]
RF,DK = [goto ZOSTAWHEN_A]

Hard Edit:
ERR2_ZOSTAVAXYR_A

Check Description: Date of most recent Zostavax shot is prior to Sample Adult's birth - hard edit
Check Text: {check ERR2_ZOSTAVAXYR_A} Date of most recent Zostavax (R) shot is prior to Sample Adult's birth. Please correct.

ERR1_ZOSTAVAXYR_A

Check Description: Future date hard edit
Check Text: Future date hard edit {check ERR1_ZOSTAVAXYR_A} Future date invalid. Please correct.

Question ID: IMS.0120.00.3
Variable: ZOSTAWHEN_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Was it before 2018?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults aged 50 and older who do not know or refused the year they had a Zostavax vaccination

Skip Instructions:

1,2,RF,DK = [goto SHINGRIX_A]

Question ID: IMS.0130.00.3
Variable: SHINGRIX_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Have you ever had Shingrix (R), the new shingles vaccine which requires 2 shots?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 50+ who had a shingles vaccine

Skip Instructions:

1 = [goto SHINGRIXNB_A]
2,RF,DK = else [goto SHTTETANUS_A]

Question ID: IMS.0140.00.3
Variable: SHINGRIXNB_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

How many Shingrix (R) shots have you ever had?

Response:

1 One Shingrix shot
2 Two Shingrix shots
7 Refused
9 Do not Know

Universe:

Sample Adults aged 50 or older who had a Shingrix vaccine

Skip Instructions:

1,2,RF,DK = [goto SHINGRIXYR_A]

Question ID: IMS.0150.00.3
Variable: SHINGRIXYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

What year did you get your most recent Shingrix (R) shot?

Response:

1900-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Adults aged 50 or older who had a Shingrix vaccine

Skip Instructions:

1900-2030 = if future date [goto ERR1_SHINGRIXYR_A] elseif date prior to birth [goto ERR2_SHINGRIXYR_A] else [goto SHTTETANUS_A]
RF,DK = [goto SHINGWHEN_A]

Hard Edit:
ERR2_SHINGRIXYR_A

Check Description: Date of most recent Shingrix shot is prior to Sample Adult's birth - hard edit
Check Text: {check ERR2_SHINGRIXYR_A} Date of most recent Shingrix (R) shot is prior to Sample Adult's birth. Please correct.

ERR1_SHINGRIXYR_A

Check Description: Future date hard edit
Check Text: {check ERR1_SHINGRIXYR_A} Future date invalid. Please correct.

Question ID: IMS.0160.00.3
Variable: SHINGWHEN_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Was it before 2018?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults aged 50 and older who had a Shingrix vaccination and do not know or refused the year they had it.

Skip Instructions:

1,2,RF,DK = [goto SHTTETANUS_A]

Question ID: IMS.0170.00.3
Variable: TDAPPREG_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

A Tdap vaccination is a tetanus booster shot that also includes pertussis (per-TUH-sis) or whooping cough vaccine. Earlier you said that you had a pregnancy that ended in a live birth during the past 12 months. Did you receive a Tdap vaccine during this pregnancy?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Female sample adults aged 18-49 or age is do not know or refused who had a live birth in the past
12 months.

Skip Instructions:

1 = if GEN.AGE_FINAL[PX_A] NOT IN (DK,RF) [goto SHTHPV_A] else [goto WORKHEALTH_A]
2,DK,RF = [goto SHTTETANUS_A]

Question ID: IMS.0180.00.3
Variable: SHTTETANUS_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Have you received a tetanus shot in the past 10 years?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who did not have a Tdap vaccine during a recent pregnancy

Skip Instructions:

1 = [goto SHTTDAP_A]
2,DK,RF = if GEN.AGE_FINAL[PX_A] le 64 [goto SHTHPV_A]
else [goto WORKHEALTH_A]

Question ID: IMS.0190.00.3
Variable: SHTTDAP_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

There are currently two types of tetanus shots available. One is the Td or tetanus-diphtheria vaccine and the others are called Tdap or Adacel(R) or Boostrix(R). They are similar except the Tdap shot also includes a pertussis (per-TUH-sis) or whooping cough vaccine. Thinking back to your most recent tetanus shot, did your health care provider tell you or did the vaccine information sheet say the vaccine included the pertussis or whooping cough vaccine?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had a tetanus shot in the past 10 years

Skip Instructions:

1,2,DK,RF = if GEN.AGE_FINAL[PX_A] le 64 [goto SHTHPV_A]
else [goto WORKHEALTH_A]

Question ID: IMS.0200.00.3
Variable: SHTHPV_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

HPV is the Human Papillomavirus. Have you ever received an HPV shot or vaccine?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18-64

Skip Instructions:

1 = [goto SHTHPVAGE_A]
2,RF,DK = [goto WORKHEALTH_A]

Question ID: IMS.0210.00.3
Variable: SHTHPVAGE_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

How old were you when you received your first HPV shot?

Enter 1 if reported age is 1 or younger.

Read if necessary: HPV stands for Human Papillomavirus.

Response:

01-64 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18-64 who had an HPV shot

Skip Instructions:

1-64,RF,DK = if HPVAGE_A gt GEN.AGE_FINAL[PX_A] [goto ERR1_SHTHPVAGE_A]
else [goto WORKHEALTH_A]

Hard Edit:
ERR1_SHTHPVAGE_A

Check Description: Age reported is greater than current age
Check Text: {check ERR1_SHTHPVAGE_A} Age reported at first HPV vaccine is greater than current age.Please correct.

Question ID: IMS.0220.00.3
Variable: WORKHEALTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In your work or volunteer activities, do you provide direct medical care to patients, such as being a doctor, nurse, dentist, therapist, home health care worker, or emergency responder?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto next section]
2,RF,DK = [goto WRKHLTHFC_A]

Question ID: IMS.0230.00.3
Variable: WRKHLTHFC_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Even if you do not provide direct medical care to patients, do you do any kind of work or volunteer activities in a health care facility, such as in a hospital, doctor's office, dentist's office, clinic, nursing home, or residential care home?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who do not provide medical care to patients or do not know or refused if they do

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PTC: Physical and other therapeutic care

Question ID: PTC.0010.00.2
Variable: EYEEX12M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, have you had an eye exam from an eye specialist such as an optometrist, ophthalmologist, or eye doctor?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto THERA12M_A]

Question ID: PTC.0020.00.2
Variable: THERA12M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, did you receive physical therapy, speech therapy, rehabilitative therapy, or occupational therapy?

Read if necessary: Do not include mental health therapy.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto HOMEHC12M_A]

Question ID: PTC.0030.00.2
Variable: HOMEHC12M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, did you receive care at home from a nurse or other health professional?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
ANX: Anxiety

Question ID: ANX.0010.00.2
Variable: ANXFREQ_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How often do you feel worried, nervous or anxious? Would you say daily, weekly, monthly, a few times a year, or never?

If respondent asks whether they are to answer about their emotional states after taking mood- regulating medications, say: "Please answer based on your usual use of medication."

Response:

1 Daily
2 Weekly
3 Monthly
4 A few times a year
5 Never
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK = [goto ANXMED_A]

Question ID: ANX.0020.00.1
Variable: ANXMED_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you take prescription medication for these feelings?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK = [goto ANXLEVEL_A]
2 = if ANXFREQ_A=5 [goto next section] else [goto ANXLEVEL_A]

Question ID: ANX.0030.00.1
Variable: ANXLEVEL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Thinking about the last time you felt worried, nervous or anxious, how would you describe the level of these feelings? Would you say a little, a lot, or somewhere in between?

Response:

1 A little
2 A lot
3 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who feel worried, anxious, or nervous daily, weekly, monthly, a few times a year or do not know or refused how often OR who do take medication for these feelings or do not know or refused if they take medication for these feelings

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DEP: Depression

Question ID: DEP.0010.00.1
Variable: DEPFREQ_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How often do you feel depressed? Would you say daily, weekly, monthly, a few times a year, or never?

If respondent asks whether they are to answer about their emotional states after taking mood- regulating medications, say: "Please answer based on your usual use of medication."

Response:

1 Daily
2 Weekly
3 Monthly
4 A few times a year
5 Never
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK = [goto DEPMED_A]

Question ID: DEP.0020.00.1
Variable: DEPMED_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you take prescription medication for depression?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK = [goto DEPLEVEL_A]
2 = if DEPFREQ_A=5 [goto next section] else [goto DEPLEVEL_A]

Question ID: DEP.0030.00.1
Variable: DEPLEVEL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Thinking about the last time you felt depressed, how depressed did you feel? Would you say a little, a lot, or somewhere in between?

Response:

1 A little
2 A lot
3 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who feel depressed daily, weekly, monthly, a few times a year or refused or do not know how often they feel depressed OR who do take medication or refused or do not know if they take medication for depression.

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
MHC: Mental Health Care

Question ID: MHC.0010.00.2
Variable: MHRX_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, did you take prescription medication to help you with any other emotions or with your concentration, behavior or mental health?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have not taken medication for worry or do not know or refused if they have and have not taken medication for depression or do not know or refused if they have

Skip Instructions:

1,2,RF,DK = [goto MHTHRPY_A]

Question ID: MHC.0020.00.2
Variable: MHTHRPY_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, did you receive counseling or therapy from a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK = [goto MHTPYNOW_A]
2 = [goto MHTHDLY_A]

Question ID: MHC.0030.00.2
Variable: MHTPYNOW_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Are you currently receiving counseling or therapy from a mental health professional?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have received, or refused to answer or do not know if they have received counseling or therapy from a mental health professional in the past 12 months

Skip Instructions:

1,2,RF,DK = [goto MHTHDLY_A]

Question ID: MHC.0040.00.2
Variable: MHTHDLY_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, have you DELAYED getting counseling or therapy from a mental health professional because of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto MHTHND_A]

Question ID: PTC.0050.00.2
Variable: MHTHND_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

During the past 12 months, was there any time when you needed counseling or therapy from a mental health professional, but DID NOT GET IT because of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PHQ: PHQ-8 Depression

Question ID: PHQ.0005.00.2
Variable: PHQINTRO_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Now I'm going to ask you about several problems. Please tell me how often you have been bothered, over the last 2 weeks, by any of the following problems. For each problem there are 4 possible answers: not at all, several days, more than half of the days, or nearly every day.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto PHQ81_A]

Question ID: PHQ.0010.00.2
Variable: PHQ81_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Over the last two weeks, how often have you been bothered by

...Little interest or pleasure in doing things?

Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ82_A]

Question ID: PHQ.0020.00.2
Variable: PHQ82_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Over the last two weeks, how often have you been bothered by

...Feeling down, depressed, or hopeless?

Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ83_A]

Question ID: PHQ.0030.00.2
Variable: PHQ83_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Trouble falling or staying asleep, or sleeping too much?

Read if necessary: Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ84_A]

Question ID: PHQ.0040.00.2
Variable: PHQ84_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Feeling tired or having little energy?

Read if necessary: Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ85_A]

Question ID: PHQ.0050.00.2
Variable: PHQ85_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Poor appetite or overeating?

Read if necessary: Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ86_A]

Question ID: PHQ.0060.00.2
Variable: PHQ86_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Feeling bad about yourself, or that you are a failure, or have let yourself or your family down?

Read if necessary: Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ87_A]

Question ID: PHQ.0070.00.2
Variable: PHQ87_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Trouble concentrating on things, such as reading the newspaper or watching television?

Read if necessary: Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto PHQ88_A]

Question ID: PHQ.0080.00.2
Variable: PHQ88_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual?

Read if necessary: Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
GAD: GAD-7 Anxiety

Question ID: GAD.0010.00.2
Variable: GAD71_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Over the last two weeks, how often have you been bothered by the following problems

...Feeling nervous, anxious, or on edge?

Would you say not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto GAD72_A]

Question ID: GAD.0020.00.2
Variable: GAD72_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Not being able to stop or control worrying?

Read if necessary: Would you say, not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto GAD73_A]

Question ID: GAD.0030.00.2
Variable: GAD73_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Worrying too much about different things?

Read if necessary: Would you say, not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto GAD74_A]

Question ID: GAD.0040.00.2
Variable: GAD74_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Trouble relaxing?

Read if necessary: Would you say, not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto GAD75_A]

Question ID: GAD.0050.00.2
Variable: GAD75_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Being so restless that it's hard to sit still?

Read if necessary: Would you say, not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto GAD76_A]

Question ID: GAD.0060.00.2
Variable: GAD76_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Becoming easily annoyed or irritable?

Read if necessary: Would you say, not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto GAD77_A]

Question ID: GAD.0070.00.2
Variable: GAD77_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the last two weeks, how often have you been bothered by

...Feeling afraid as if something awful might happen?

Read if necessary: Would you say, not at all, several days, more than half the days, or nearly every day?

Response:

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PAI: Chronic Pain

Question ID: PAI.0010.00.2
Variable: PAIINTRO_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

The next question is about pain you may have had in the past 3 months.

Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto PAIFRQ3M_A]

Question ID: PAI.0020.00.2
Variable: PAIFRQ13M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

In the past three months, how often did you have pain? Would you say never, some days, most days, or every day?

If respondent asks whether they are to answer about their pain when taking their medications, say: "Please answer based on your usual use of medication."

Response:

1 Never
2 Some days
3 Most days
4 Every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK = [goto next section]
2,3,4 = [goto PAIAMNT_A]

Question ID: PAI.0030.00.2
Variable: PAIAMNT_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Thinking about the last time you had pain, how much pain did you have? Would you say a little, a lot, or somewhere in between?

Response:

1 A little
2 A lot
3 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-3,RF,DK = [goto PAIWKLM3M_A]

Question ID: PAI.0040.00.2
Variable: PAIWKLM3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Over the past three months, how often did your pain limit your life or work activities? Would you say never, some days, most days, or every day?

Response:

1 Never
2 Some days
3 Most days
4 Every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAIAFFM3M_A]

Question ID: GAD.0050.00.2
Variable: PAIAFFM3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Over the past three months, how often did YOUR pain affect your family and significant others? Would you say never, some days, most days, or every day?

Response:

1 Never
2 Some days
3 Most days
4 Every day
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = if PAINMNG_FLG=1 [goto PAIPHYSTPY_A]
else [goto PAIBACK3M_A]

Question ID: PAI.0060.00.2
Variable: PAIPHYSTPY_A
Interview Module: Adult
Content Type: Emergin Content

Question Text:

Over the past three months, did you use any of the following to manage your pain?

...Physical therapy, rehabilitative therapy, or occupational therapy?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain at least some days in the past 3 months and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAICHIRO_A]

Question ID: PAI.0070.00.4
Variable: PAICHIRO_A
Interview Module: Adult
Content Type: Emergin Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...Spinal manipulation or other forms of chiropractic care?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAITALKTPY_A]

Question ID: PAI.0080.00.4
Variable: PAITALKTPY_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...Talk therapies such as cognitive-behavioral therapy (CBT)?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAIPROGRAM_A]

Question ID: PAI.0090.00.4
Variable: PAIPROGRAM_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...A chronic pain self-management program or workshop?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAIGROUP_A]

Question ID: PAI.0100.00.4
Variable: PAIGROUP_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...Chronic pain peer support groups?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAIYOGA_A]

Question ID: PAI.0110.00.4
Variable: PAIYOGA_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...Yoga or Tai Chi?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAIMASSAGE_A]

Question ID: PAI.0120.00.4
Variable: PAIMASSAGE_A
Interview Module: Adult
Content Type: Emergin Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...Massage?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAIMEDITAT_A]

Question ID: PAI.0130.00.4
Variable: PAIMEDITAT_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Read if necessary: Over the past three months, did you use any of the following to manage your pain?

...Meditation, guided imagery, or other relaxation techniques?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK = [goto PAIMOTHER_A]

Question ID: PAI.0140.00.4
Variable: PAIMOTHER_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Over the past three months, did you use any other approaches to manage your pain?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1 = [goto PAINMEFF_A]
2,RF,DK = if (OPD.OPD3M_A=1 or PAIPHYSTPY_A=1 or PAICHIRO_A=1 or PAITALKTPY_A=1 or PAIPROGRAM_A=1 or PAIGROUP_A=1 or PAIYOGA_A=1 or PAIMASSAGE_A=1 or PAIMEDITAT_A=1) [goto PAINMEFF_A]
else [goto PAIBACK3M_A]

Question ID: PAI.0150.00.4
Variable: PAINMEFF_A
Interview Module: Adult
Content Type: Emerging Content

Question Text:

Over the past three months, how effective do you think you were in managing your pain? Would you say very effective, somewhat effective, only a little effective, or not at all effective?

Response:

1 Very effective
2 Somewhat effective
3 Only a little effective
4 Not at all effective
7 Refused
9 Do not Know

Universe:

Sample adults 18+ who have pain at least some days and who used a prescription opioid pain reliever in the past 3 months; or physical therapy, rehabilitative therapy, or occupational therapy in the past 3 months; or spinal manipulation or other forms of chiropractic care in the past 3 months; or talk therapies such as cognitive-behavioral therapy in the past 3 months; or a chronic pain self-management program or workshop in the past 3 months; or a chronic pain support group in the past 3 months; or Yoga or Tai Chi in the past 3 months; or massage in the past 3 months; or Meditation, guided imagery, or other relaxation techniques in the past 3 months; or some other technique or approach in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAIBACK3M_A]

Question ID: PAI.0160.00.2
Variable: PAIBACK3M_A
Interview Module: Adult
Content Type: Rotating Core
Question Text:

The next set of questions are about the amount of pain you experience in different locations.
Over the past three months, how much have you been bothered by
...Back pain? Would you say not at all, a little, a lot, or somewhere in between?

Response:

1 Not at all
2 A little
3 A lot
4 Somewhere in between a little and a lot
7 Refused
9 Do not know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAIULMB3M_A]

Question ID: PAI.0170.00.2
Variable: PAIULMB3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the past three months, how much have you been bothered by

...Pain in your hands, arms, or shoulders?

Read if necessary: Would you say not at all, a little, a lot, or somewhere in between?

Response:

1 Not at all
2 A little
3 A lot
4 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAILLMB3M_A]

Question ID: PAI.0180.00.2
Variable: PAILLMB3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the past three months, how much have you been bothered by

...Pain in your hips, knees, or feet?

Read if necessary: Would you say not at all, a little, a lot, or somewhere in between?

Response:

1 Not at all
2 A little
3 A lot
4 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAIHDFC3M_A]

Question ID: PAI.0190.00.2
Variable: PAIHDFC3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the past three months, how much have you been bothered by

...Headache or migraine?

Read if necessary: Would you say not at all, a little, a lot, or somewhere in between?

Response:

1 Not at all
2 A little
3 A lot
4 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAIAPG3M_A]

Question ID: PAI.0200.00.2
Variable: PAIAPG3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the past three months, how much have you been bothered by

...Abdominal, pelvic, or genital pain?

Read if necessary: Would you say not at all, a little, a lot, or somewhere in between?

Response:

1 Not at all
2 A little
3 A lot
4 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto PAITOOTH_A]

Question ID: PAI.0210.00.2
Variable: PAITOOTH3M_A
Interview Module: Adult
Content Type: Rotating Core

Question Text:

Read if necessary: Over the past three months, how much have you been bothered by

...Toothache or jaw pain?

Read if necessary: Would you say not at all, a little, a lot, or somewhere in between?

Response:

1 Not at all
2 A little
3 A lot
4 Somewhere in between a little and a lot
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
ART: Arthritis

Question ID: ART.0010.00.3
Variable: JNTSYMP_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

The next questions refer to your joints. Please do NOT include the back or neck.

DURING THE PAST 30 DAYS, have you had any symptoms of pain, aching, or stiffness in or around a joint?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported arthritis or related condition

Skip Instructions:

1 = [goto JNTPN_A]
2,RF,DK = [goto ARTHLMT_A]

Question ID: ART.0020.00.3
Variable: JNTPN_A
Interview Module: Adult

Question Text:

Please think about the past 30 days, keeping in mind all of your joint pain or aching and whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no pain or aching and 10 is pain or aching as bad as it can be.

Response:

00-10 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who have had any symptoms of pain, aching, or stiffness in or around a joint during the past 30 days

Skip Instructions:

0-10,RF,DK = [goto ARTHLMT_A]

Question ID: ART.0030.00.3
Variable: ARTHLMT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Earlier, you said that a doctor or other health professional had told you that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia (fy-bro-my-AL-jee-uh). Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported arthritis or related condition

Skip Instructions:

1,2,RF,DK = [goto ARTHWRK_A]

Question ID: ART.0040.00.3
Variable: ARTHWRK_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In this next question we are referring to work for pay. Do arthritis or joint symptoms now affect whether you work, the type of work you do, or the amount of work you do?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported arthritis or related condition

Skip Instructions:

1,2,RF,DK = [goto ARTHWT_A]

Question ID: ART.0050.00.3
Variable: ARTHWT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Has a doctor or other health professional EVER suggested losing weight to help your arthritis or joint symptoms?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported arthritis or related condition

Skip Instructions:

1,2,RF,DK = [goto ARTHPH_A]

Question ID: ART.0060.00.3
Variable: ARTHPH_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Has a doctor or other health professional EVER suggested physical activity or exercise to help your arthritis or joint symptoms?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported arthritis or related condition

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
CIG: Cigarettes and E-cigarettes

Question ID: CIG.0010.00.1
Variable: CIGINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

These next questions are about cigarette smoking.

*Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto SMKEV_A]

Question ID: CIG.0020.00.1
Variable: SMKEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you smoked at least 100 cigarettes in your ENTIRE LIFE?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto SMKNOW_A]
2,RF,DK = [goto ECIGEV_A]

Question ID: CIG.0030.00.1
Variable: SMKNOW_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you NOW smoke cigarettes every day, some days or not at all?

Response:

1 Every day
2 Some days
3 Not at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who ever smoked 100 cigarettes

Skip Instructions:

1 = [goto CIGNOW_A]
2 = [goto SMK30D_A]
3,RF,DK = [goto ECIGEV_A]

Question ID: CIG.0040.00.1
Variable: CIGNOW_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

On average, about how many cigarettes do you NOW smoke a day?

Enter 1 if less than 1 cigarette.

Enter 95 if 95 or more cigarettes.

Response:

00-95 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who are current every day smokers

Skip Instructions:

1-95,RF,DK = [goto ECIGEV_A]

Question ID: CIG.0050.00.1
Variable: SMK30D_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

On how many of the PAST 30 DAYS did you smoke a cigarette?

Enter 0 for None.

Response:

00-30 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who are current some day smokers

Skip Instructions:

0 = [goto ECIGEV_A]
1-30,RF,DK = [goto CIG30D_A]

Question ID: CIG.0060.00.1
Variable: CIG30D_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

On average, when you smoked during the PAST 30 DAYS, about how many cigarettes did you smoke a day?

Enter 1 if less than 1.

Enter 95 if 95 or more cigarettes.

Response:

00-95 Range of values
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who have smoked any time in the past 30 days, or refused or did not know

Skip Instructions:

1-95,DK,RF = [goto ECIGEV_A]

Question ID: CIG.0070.00.1
Variable: ECIGEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you ever used an e-cigarette or other electronic vaping product, even just one time, in your entire life?

Read if necessary: Electronic cigarettes (e-cigarettes) and other electronic vaping products include electronic hookahs (e-hookahs), vape pens, e-cigars, and others. These products are battery-powered and usually contain nicotine and flavors such as fruit, mint, or candy.

These questions concern electronic vaping products for nicotine use. The use of electronic vaping products for marijuana use is not included in these questions.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto ECIGNOW_A]
2,RF,DK = [goto next section]

Question ID: CIG.0080.00.1
Variable: ECIGNOW_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you now use e-cigarettes or other electronic vaping products every day, some days, or not at all?

These questions concern electronic vaping products for nicotine use. The use of electronic vaping products for marijuana use is not
included in these questions.

Response:

1 Every day
2 Some days
3 Not at all
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have ever used e-cigarettes

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
OTB: Other Tobacco

Question ID: OTB.0010.00.3
Variable: CIGAREV_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Have you ever smoked a regular cigar, cigarillo, or a little filtered cigar EVEN ONE TIME?

Read if necessary: "Cigarillos" are medium cigars that sometimes are sold with plastic or wooden tips. Some common brands are Black and Mild, Swisher Sweets, Dutch Masters and Phillies Blunts. Cigarillos are usually sold individually or in packs of 5 or fewer. Little filtered cigars look like cigarettes and are usually brown in color. Like cigarettes, little filtered cigars have a spongy filter and are sold in packs of 20. Some common brands are Prime Time and Winchester.

Read if necessary: Do not include electronic cigars or e-cigars.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 18+

Skip Instructions:

1 = [goto CIGARCUR_A]
2,RF,DK = [goto PIPEEV_A]

Question ID: OTB.0020.00.3
Variable: CIGARCUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Do you now smoke regular cigars, cigarillos, or little filtered cigars every day, some days, or not at all?

Response:

1 Every day
2 Some days
3 Not at all
7 Refused
9 Do not Know

Universe:

Sample adults 18+ who have ever smoked a regular cigar, cigarillo, or filtered cigar

Skip Instructions:

1,RF,DK = [goto PIPEEV_A]
2,3 = [goto CIGAR30D_A]

Question ID: OTB.0030.00.3
Variable: CIGAR30D_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

On how many of the PAST 30 DAYS have you smoked a regular cigar, cigarillo, or little filtered cigar?

Response:

00-30 Range of values
97 Refused
99 Do not Know

Universe:

Sample adults 18+ who now smoke a regular cigar, cigarillo, or little filtered cigar some days or not at all

Skip Instructions:

0-30,RF,DK = [goto PIPEEV_A]

Question ID: OTB.0040.00.3
Variable: PIPEEV_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Have you EVER smoked a pipe filled with tobacco - either a regular pipe, water pipe, or hookah EVEN ONE TIME?

Read if necessary: A hookah is a type of water pipe. It is sometimes called a "narghile" (NAR- ge-lee) pipe. Do not include electronic hookah or e-hookahs.

Read if necessary: Do not include electronic pipes or e-pipes.

Read if necessary: Do not include pipes filled with substances other than tobacco.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 18+

Skip Instructions:

1 = [goto PIPECUR_A]
2,RF,DK = [goto SMOKELSEV_A]

Question ID: OTB.0050.00.3
Variable: PIPECUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Do you now smoke pipes filled with tobacco - either regular pipes, water pipes, or hookahs, every day, some days, or not at all?

Read if necessary: Do not include pipes filled with substances other than tobacco.

Response:

1 Every day
2 Some days
3 Not at all
7 Refused
9 Do not Know

Universe:

Sample adults 18+ who have ever smoked a regular pipe, water pipe or hookah filled with tobacco

Skip Instructions:

1-3,RF,DK = [goto SMOKELSEV_A]

Question ID: OTB.0060.00.3
Variable: SMOKELSEV_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Smokeless tobacco products are placed in the mouth or nose and can include chewing tobacco, snuff, dip, snus (SNOOSE), or dissolvable tobacco.

Have you ever used smokeless tobacco products EVEN ONE TIME?

Read if necessary: Do not include nicotine replacement therapy products such as patch, gum, lozenge, or spray, which are considered smoking cessation treatments.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 18+

Skip Instructions:

1 = [goto SMOKELSCUR_A]
2,RF,DK = [goto next section]

Question ID: OTB.0070.00.3
Variable: SMOKELSCUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

Do you NOW use smokeless tobacco products every day, some days, or not at all?

Response:

1 Every day
2 Some days
3 Not at all
7 Refused
9 Do not Know

Universe:

Sample adults 18+ who have ever used smokeless tobacco products

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
ORN: Sexual Orientation

Question ID: ORN.0010.00.1
Variable: ORNINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Next we have some questions about your demographic characteristics, including sexual orientation, income, employment, and veteran status. Like all your answers, these will be used to understand the health of different groups in the population and will be kept confidential.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto ORIENT_A]

Question ID: ORN.0020.00.1
Variable: ORIENT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you think of yourself as ^gaylesbian; straight, that is, not ^gaylesbian; bisexual; something else; or you do not know the answer?

Fills:
^gaylesbian

Description Gay/Lesbian or gay
Instruction If SEX=1 fill "Gay"; else if SEX='2',RF,DK fill "Lesbian or gay"

Response:

1 ^GayLesbian
2 Straight, that is, not ^gaylesbian
3 Bisexual
4 Something else
5 I do not know the answer
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
MAR: Marital Status

Question ID: MAR.0070.00.1
Variable: MARITAL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The next questions are about marriage and cohabitation. Are you now married, living with a partner together as an unmarried couple, or neither?

If respondent answers both married and living with a different partner together as an unmarried couple, enter living with partner.

Response:

1 Married
2 Living with a partner together as an unmarried couple
3 Neither
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and the Child PAR section has not been completed for the Sample Adult or the Child PAR section has been completed for the Sample Adult and the Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = [goto SPOUSLIV_A]
2 = if GEN.PCNT16PLUS=1 [got ERR1_MARITAL_A] else [goto PARTNERWHO_A]
3,RF,DK = [goto EVRMARRIED_A]

Soft Edit:
ERR1_MARITAL_A

Check Description: One person eligible to be living with a partner in household soft edit
Check Text: {signal ERR1_MARITAL_A} Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.

Question ID: MAR.0020.00.1
Variable: SPOUSLIV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does your spouse live here?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who are married

Skip Instructions:

1 = if GEN.PCNT16PLUS=1 [goto ERR1_SPOUSLIV_C] else [goto SPOUSWHO_A]
2 = [goto SPOUSEP_A]
RF,DK = [goto next section]

Soft Edit:
ERR1_SPOUSLIV_C

Check Description: Only one person eligible to be married in household soft edit
Check Text: {signal ERR1_SPOUSLIV_C} Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.

Question ID: MAR.0030.00.1
Variable: SPOUSWHO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Which person is your spouse?

Enter line number of spouse.

Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Response:

00 Not on roster
01-25 Person Number
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with spouse in household

Skip Instructions:

0-25 = [goto SPOUSSEX_A]
RF,DK = [goto next section]

Question ID: MAR.0040.00.1
Variable: SPOUSSEX_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

I previously recorded ^SPOUSENAME's ^spousesex. Is this correct?

Fills:
^SPOUSENAME

Description Name of spouse
Instruction Fill name of spouse selected at SPOUSWHO_A

^spousesex

Description sex is male/sex is female/sex was not provided
Instruction if GEN.SEX_FINAL[person selected at SPOUSWHO_A]=1, fill "sex is male"
if GEN.SEX_FINAL[person selected at SPOUSWHO_A]=2, fill "sex is female"
if GEN.SEX_FINAL[person selected at SPOUSWHO_A] IN (DK,RF), fill "sex was not provided"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with spouse in household who entered a line number for their spouse

Skip Instructions:

1,RF,DK = [goto next section]
2 = [goto SPOUNEWSEX_A]

Question ID: MAR.0050.00.1
Variable: SPOUNEWSEX_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Is ^SPOUSENAME male or female?

Fills:
^SPOUSENAME

Description Name of spouse
Instruction Fill name of spouse selected at SPOUSWHO_A

Response:

1 Male
2 Female
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with spouse with incorrect sex

Skip Instructions:

1,2,RF,DK = [goto next section]

Question ID: MAR.0060.00.1
Variable: SPOUSEP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does your spouse not live here because you and your spouse are legally separated?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ whose spouse does not live in the household

Skip Instructions:

1,2,RF,DK = [goto next section]

Question ID: MAR.0070.00.1
Variable: PARTNERWHO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Which person is your partner?

Enter line number of partner.

Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Response:

00 Not on roster
01-25 Person Number
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who are living with unmarried partner in household

Skip Instructions:

0-25 = [goto PARTNERSEX_A]
RF,DK = [goto EVRMARRIED_A]

Question ID: MAR.0080.00.1
Variable: PARTNERSEX_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

I previously recorded ^PARTNERNAME's ^partnersex. Is this correct?

Fills:
^PARTNERNAME

Description Name of partner
Instruction Fill name of partner selected at PARTNERWHO_A

^partnersex

Description sex is male/sex is female/sex was not provided
Instruction if GEN.SEX_FINAL[person selected at PARTNERWHO_A]=1, fill "sex is male"
if GEN.SEX_FINAL[person selected at PARTNERWHO_A]=2, fill "sex is female"
if GEN.SEX_FINAL[person selected at PARTNERWHO_A] IN (DK,RF), fill "sex was not provided"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with partner in household who entered a line number for their partner

Skip Instructions:

1,RF,DK = [goto EVRMARRIED_A]
2 = [goto PARTNEWSEX_A]

Question ID: MAR.0090.00.1
Variable: PARTNEWSEX_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Is ^PARTNERNAME male or female?

Fills:
^PARTNERNAME

Description Name of partner
Instruction Fill name of partner selected at PARTNERWHO_A

Response:

1 Male
2 Female
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with partner with incorrect sex

Skip Instructions:

1,2,RF,DK = [goto EVRMARRIED_A]

Question ID: MAR.100.00.1
Variable: EVRMARRIED_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you ever been married?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who are living with unmarried partner or who are not married or living with an unmarried partner or refused or do not know

Skip Instructions:

1 = if MARITAL_A=2 [goto LEGALSTAT_A]
elseif MARITAL_A=3 [goto WIDIVSEP_A] else [goto next section]
2,RF,DK = [goto next section]

Question ID: MAR.0110.00.1
Variable: LEGALSTAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is your current legal marital status? Are you married, widowed, divorced, or separated?

Response:

1 Married
2 Widowed
3 Divorced
4 Separated
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who are living with a partner but have been married

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: MAR.0120.00.1
Variable: WIDIVSEP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you widowed, divorced, or separated?

Response:

1 Widowed
2 Divorced
3 Separated
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who are neither living with a partner nor married, but have been married

Skip Instructions:

1-3,RF,DK = [goto FINISH_MAR_A]

Question ID: MAR.0130.00.1
Variable: FINISH_MAR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The Sample Adult MAR section is now complete.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+ and the Child PAR section has not been completed for the Sample Adult or the Child PAR section has been completed
for the Sample Adult and the Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
VET: Veterans Status

Question ID: VET.0010.00.1
Variable: AFVET_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Did you ever serve on active duty in the U.S. Armed Forces, military Reserves, or National Guard?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto AFVETTRN_A]
2,RF,DK = [goto next section]

Question ID: VET.0070.00.1
Variable: AFVETTRN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Were you on active duty ONLY for training in the Reserves or National Guard?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have ever served in the armed forces

Skip Instructions:

1 = [goto VADISB_A]
2,RF,DK = [goto COMBAT_A]

Question ID: VET.0030.00.1
Variable: COMBAT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Did you ever serve in a foreign country during a time of armed conflict or on a humanitarian or peace-keeping mission?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have ever served in the armed forces and who were not only activated for training in the Reserves or National Guard

Skip Instructions:

1,2,RF,DK = [goto VADISB_A]

Question ID: VET.0040.00.1
Variable: VADISB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have a VA service-connected disability rating?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have ever served in the armed forces

Skip Instructions:

1,2,RF,DK = [goto VAHOSP_A]

Question ID: VET.0050.00.1
Variable: VAHOSP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, did you receive any care at a Veteran's Health Administration facility or receive any other health care paid for by the VA?

Read if necessary: Veteran's Health Administration facilities include VA hospitals, VA medical centers, VA outpatient clinics, and VA nursing homes.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have ever served in the armed forces

Skip Instructions:

1 = [goto next section]
2,RF,DK = if 1 IN Adult.INS.MILSPC_A [goto next section] else [goto VACAREEV]

Question ID: VET.0060.00.1
Variable: VACAREEV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Have you ever enrolled in or used VA health care?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who have ever served in the armed forces and did not recieve care at a VHA facility or other health care paid for by the VA in the past 12 months and did not report VA health care when asked about insurance

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
NAT: Nativity

Question ID: NAT.0010.00.1
Variable: NATUSBORN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^Askverify_A Were you born in the United States or a U.S. territory?

Fills:
^Askverify_A

Description: FR Instruction
Instruction: If GEN.SARESPSC_FLG=1, fill "* Ask or verify:"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto NATSTBORN_A]
2 = [goto NATUSYR_A]
RF,DK = [goto next section]

Question ID: NAT.0070.00.1
Variable: NATSTBORN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In what state or U.S. territory were you born?

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+ born in the United States or U.S. territory

Skip Instructions:

American Samoa = [goto CITIZEN_A] else [goto next section]

Question ID: NAT.0040.00.1
Variable: NATUSYR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In what year did you come to the United States to stay?

Response:

1900-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Adults 18+ not born in the United States or U.S. territory

Skip Instructions:

1900-Current Year,RF,DK = if NATUSYR_A is a future year [goto ERR1_NATUSYR_A] if NATUSYR_A lt VFY.BYEAR_A [goto ERR2_NATUSYR_A]
else [goto CITIZEN_A]

Hard Edit:
ERR1_NATUSYR_A

Check Description: Future year hard edit
Check Text: {check ERR1_NATUSYR_A} Future year invalid. Please correct.

ERR2_NATUSYR_A

Check Description: Year prior to birth hard edit
Check Text: {check ERR2_NATUSYR_A} Year is prior to date of birth. Please correct.

Question ID: NAT.0050.00.1
Variable: CITIZEN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you a citizen of the United States?

Response:

1 Yes, born in one of the 50 United States or the District of Columbia
2 Yes, born in Puerto Rico, Guam, American Virgin Islands, or other U.S. territory
3 Yes, born abroad to American parent(s)
4 Yes, U.S. citizen by naturalization
5 No, not a citizen of the United States
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ born or not born in US or U.S. territory

Skip Instructions:

1 = [goto NATCTZN_A]
2,RF,DK = [goto next section]

Question ID: NAT.0060.00.1
Variable: NATCTZN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Were you born abroad to an American parent, born abroad and adopted by an American parent, or did you become a U.S. citizen by naturalization?

Response:

1 Born abroad to American parent
2 Born abroad and adopted by an American parent
3 Became U.S. citizen by naturalization
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ not born in the United States or a United States territory or born in the U.S. territory of American Samoa but are U.S. citizens

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
SCH: Schooling

Question ID: SCH.0010.00.1
Variable: SCHCURENR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Are you currently enrolled in or attending school?

Read if necessary: School includes high school, college, trade school, and professional school. Students may be enrolled part-time or full-time.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto SCHDYSMSS_A]
2,RF,DK = [goto next section]

Question ID: SCH.0020.00.1
Variable: SCHDYSMSS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, about how many days of school did you miss because of illness, injury, or disability?

Response:

000-365 Range of values
997 Refused
999 Do not Know

Universe:

Sample Adults 18+ who are currently enrolled in school

Skip Instructions:

0-99,RF,DK = [goto next section]
100-365 = [goto ERR1_SCHDYSMSS_A]

Soft Edit:
ERR1_SCHDYSMSS_A

Check Description: Missed 100-365 days
Check Text: {signal ERR1_SCHDYSMSS_A} ^SCHDYSMSS_A is an unusually large number. Did you miss ^SCHDYSMSS_A days of school because of illness, injury, or disability? Please verify.

2019 National Health Interview Survey (NHIS) Questionnaire
EMP: Employment

Question ID: EMP.0010.00.1
Variable: EMPLASTWK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

LAST WEEK, did you work for pay at a job or business?

If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business, enter '1' for yes.

Fills:
^heshetheywork

Description: he works/she works/they work
Instruction: elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works" elseif GEN.SEX_FINAL=DK,RF fill "they work"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto EMPWRKHRS_A]
2 = [goto EMPNOWRK_A]
RF,DK = [goto next section]

Question ID: EMP.0020.00.1
Variable: EMPNOWRK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Did you have a job or business LAST WEEK, but were temporarily absent due to illness, vacation, family or maternity leave, or some other reason?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who were not working for pay at a job or business last week

Skip Instructions:

1 = [goto EMPWRKHRS_A]
2 = [goto EMPRSNOWK_A]
RF,DK = [goto next section]

Question ID: EMP.0030.00.1
Variable: EMPWRKHRS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

How many hours ^LASTUSUAL in total at ALL jobs or businesses?

Fills:
^LASTUSUAL

Description did you work LAST WEEK/do you USUALLY work per week
Instruction If EMPLASTWK_A=1 fill "did you work LAST WEEK" else if EMPNOWRK_A=1 fill "do you USUALLY work per week"

Response:

001-168 Range of values
997 Refused
999 Do not Know

Universe:

Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week

Skip Instructions:

1-34 = if EMPNOWRK_A =1 [goto EMPPDSKLV_A]
elseif EMPLASTWK_A =1 [goto EMPWKFT_A]
35-94 = [goto EMPPDSKLV_A]
95-168 = [goto ERR_EMPWRKHRS_A], then [goto EMPPDSKLV_A]
RF,DK = [goto EMPWKFT_A]

Soft Edit:
ERR_EMPWRKHRS_A

Check Description: Hours worked last week/usually work per week unusually high
Check Text: {signal ERR_EMPWRKHRS_A} ^EMPWRKHRS_A hours is unusually high. Please verify. Make corrections if necessary

Question ID: EMP.0040.00.1
Variable: EMPWKFT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you USUALLY work 35 hours or more per week in total at ALL jobs or businesses?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who were working for pay at a job or business last week and who worked less than 35 hours last week; or who refused or didn't know how many hours they worked last week.

Skip Instructions:

1,2,RF,DK = [goto EMPPDSKLV_A]

Question ID: EMP.0050.00.1
Variable: EMPRSNOWK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is the MAIN reason you were not working for pay at a job or business last week?

Probe if necessary.

Response:

01 Unemployed, laid off, seasonal/contract work, looking for work
02 Seasonal/contract work
03 Retired
04 Unable to work for health reasons/disabled
05 Taking care of house or family
06 Going to school
07 Working at job business but not for pay
08 Other
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ who were not working for pay, and were not on temporary leave from a job or business last week

Skip Instructions:

1,3,4,5,6,8,RF,DK = [goto EMPLSTWRK_A]
2,7 = [goto EMPPDSKLV_A]

Question ID: EMP.0060.00.1
Variable: EMPLSTWRK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

When was the last time you worked for pay at a job or business, even if only for a few days?

Response:

1 Within the past 12 months
2 1-5 years ago
3 Over 5 years ago
4 Never worked
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ whose main reason for not working last week was because they couldn't find work, were retired, unable to work for health reasons, taking care of the house/family, going to school, or some other reason, or refused or didn't know the main reason they were not working last week.

Skip Instructions:

1 = [goto EMPDYSMSS_A]
2-4,RF,DK = [goto next section]

Question ID: EMP.0070.00.1
Variable: EMPPDSKLV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Regarding your job or work ^LASTWK, is paid sick leave available if you need it?

Fills:
^LASTWK

Description: last week
Instruction: if EMPWRKHRS_A IN (1-168,RF,DK) fill: "last week" else fill: blank

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported working last week; or who were not working last week because they were temporarily absent; or who work, but not for pay, at a family-owned job or business

Skip Instructions:

1,2,RF,DK = [goto EMPOFFHI_A]

Question ID: EMP.0080.00.1
Variable: EMPOFFHI_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Regarding your job or work ^LASTWK, was health insurance offered to you through your workplace?

Fills:
^LASTWK

Description last week
Instruction if EMPWRKHRS_A IN (1-168,RF,DK) fill: "last week" else fill: blank

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who reported working last week; or who were not working last week because they were temporarily absent; or who work, but not for pay, at a family-owned job or business

Skip Instructions:

1,2,RF,DK = [goto EMPDYSMSS_A]

Question ID: EMP.0090.00.1
Variable: EMPDYSMSS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

During the past 12 months, about how many days of work did you miss because of illness, injury or disability?

Read if necessary: Do not include family or ^paternitymaternity leave.
Fills:
^paternitymaternity

Description paternity/maternity/maternity or paternity
Instruction If GEN.SEX_FINAL=1 fill "paternity" else if GEN.SEX_FINAL=2 fill "maternity" else if GEN.SEX_FINAL=DK,RF fill "maternity or paternity"

Response:

000-365 Range of values
997 Refused
999 Do not Know

Universe:

Sample Adults 18+ who were offered health insurance through the workplace, were not offered health insurance through the workplace, or who refused or did not know if they were offered health insurance through the workplace, or Sample Adults 18+ who are not currently working but who had some period of employment in the past 12 months.

Skip Instructions:

0-99,RF,DK = [goto next section]
100-365 = [goto ERR_EMPDYSMSS_A], then [goto next section]

Soft Edit:
ERR_EMPDYSMSS_A

Check Description: Days of work missed in the past 12 months unusually high
Check Text: {signal ERR_EMPDYSMSS_A} ^EMPDYSMSS_A days is unusually high. Please verify. Make corrections if necessary.

2019 National Health Interview Survey (NHIS) Questionnaire
FEM: Employment of family members

Question ID: FEM.0010.00.1
Variable: FEMINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Now I'm going to ask you about some of the other members of your family.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

If Sample Adult lives in a family with at least one other adult AND (Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FEM section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FEM section was answered with RF/DK and the person answering the SC interview and the SA are different people.

Skip Instructions:

1 =[goto tblFEM_A]

Replicate To:

FEMINTRO_C

Question ID: FEM.0030.00.1
Variable: FEMWORK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does ^ALIASNAME work for pay at a job or business?

If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business, enter '1' for yes.

Fills:
^ALIASNAME

Description: {Value of ALIAS}
Instruction: Fill value from ALIAS

^heshetheywork

Description: he works/she works/they work
Instruction: elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works" elseif GEN.SEX_FINAL=DK,RF fill "they work"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1 = [goto FEMWKFT_A]
2,DK,RF = if there is another adult in the family [goto FEMWORK_A] for the next adult 18+ else [goto next section]

Replicate To:

FEMWORK_C

Question ID: FEM.0040.00.1
Variable: FEMWKFT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Does ^ALIASNAME usually work 35 hours or more per week in total at ^hishertheir job or jobs?

Fills:
^ALIASNAME

Description {Value of ALIAS}
instruction Fill value from ALIAS

^hishertheir

Description his/her/their
Instruction If GEN.SEX_FINAL=1 fill "his";else if GEN.SEX_FINAL=2 fill "her";else if GEN.SEX_FINAL IN (DK, RF) fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,DK,RF = if another adult in the family [goto FEMWORK_A] for the next adult 18+ else [goto next section]

Replicate To:

FEMWKFT_C

2019 National Health Interview Survey (NHIS) Questionnaire
INC: Family Income

Question ID: INC.0010.00.1
Variable: INCINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The next questions are about your total ^FAMILY income in ^LASTYEAR BEFORE TAXES. ^INCSAFAM

Read if necessary: Income is important in analyzing the health information we collect. For example, with this information, we can learn whether persons in one income group use certain types of medical services more or less often than those in another group. Please be assured that, like all other information you have provided, these answers will remain confidential.

Enter '1' to continue.

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^INCSAFAM

Description Based on questions asked earlier, we have that ^SAFAM are in your family.
Instruction If more than one person in the Sample Adult's family, fill "Based on questions asked earlier, we have that ^SAFAM are in your family." else no fill

^SAFAM

Description List of people in SA's family
Instruction For all people with FAMA_REL_FLG =1 and are not Household Respondent, fill with their names. If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed
OR the Sample Adult and Sample Child are not in the same family
OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = [goto INCWRKO_A]

Replicate To:

INCINTRO_A

Question ID: INC.0020.00.1
Variable: INCWRKO_
Interview Module: Adult
Content Type: Annual Core

Question Text:

In ^LASTYEAR, did ^YOUFAM18YRS receive income from wages, salaries, commissions, bonuses, tips, or self-employment?

^INCSAFAMoptional

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAM18YRS

Description you/you or any family members 18 or older
Instruction If PCNT18UP_A=1 fill "you" else if PCNT18UP_A GT 1 fill "you or any family members 18 or older"

^INCSAFAMoptional

Description Read if necessary: For the purpose of this survey, your family includes ^FAMVERSA_fill.
Instruction If more than one person in the Sample Adult's family, fill "* Read if necessary: For the purpose of this survey, your family includes ^FAMVERSA_fill."
else no fill
^FAMVERSA_fill
Description List of all people in Sample Adult's family
Instruction Loop through all persons on roster and add to list of names if:

-people related via REL (FAMA_REL_FLG = 1) or
-people who are related to the SA (RELATE = 1-13) or
-people in SC's family and the 1st person in HH in SC's family are related to the SA (RELATE = 1-13)

Do not include Sample Adult on list.

If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list.
If only one person on the list of names and person ne Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on list and person is Household Respondent (Roster.HHC.HHRESPAVAIL), follow list with "are".

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK = [goto INCINTER_A]

Replicate To:

INCWRKO_A

Question ID: INC.0030.00.1
Variable: INCINTER_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In ^LASTYEAR, did ^YOUFAMHERE receive income from interest-bearing accounts or investments, dividends from stocks or mutual funds, net rental income, royalty income, or income from estates and trusts?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE

Description you/you or any family members
Instruction If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,DK = [goto INCSSRR_A]
RF = if INCWRKO_A IN (1,2,DK) [goto INCSSRR_A]
else [goto next section]

Replicate To:

INCINTER_C

Question ID: INC.0040.00.1
Variable: INCSSRR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...

Income from Social Security or Railroad Retirement?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE

Description you/you or any family members
Instruction If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions

Skip Instructions:

1,2,RF,DK = [goto INCSSISSDI_A]

Replicate To:

INCSSRR_C

Question ID: INC.0050.00.1
Variable: INCSSISSDI_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

*Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...

Supplemental Security Income, SSI, or Social Security Disability Income, SSDI, which are different from Social Security?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE

Description you/you or any family members
Instruction If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1 = [goto SSISSDIBTH_A]
2,RF,DK = [goto INCWELF_A]

Replicate To:

INCSSISSDI_C

Question ID: INC.0060.00.1
Variable: SSISSDIBTH_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was this Supplemental Security Income, SSI, Social Security Disability Income, SSDI, or both?

Response:

1 SSI
2 SSDI
3 Both SSI and SSDI
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ where someone in the family gets SSI or SSDI and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1-3,RF,DK = [goto SSISSDIDSB_A]

Replicate To:

SSISSDIBTH_C

Question ID: INC.0070.00.1
Variable: SSISSDIDSB_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was this received as a disability benefit?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 18+ where someone in the family gets SSI or SSDI and Sample Child and Sample Adult are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = if GEN.PCNT_A gt 1 [goto SSISSDIP_A]
elseif GEN.PCNT_A=1 [goto INCWELF_A]
2,RF,DK = [goto INCWELF_A]

Replicate To:

SSISSDIDSB_C

Question ID: INC.0090.00.1
Variable: SSISSDIP_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In ^LASTYEAR, who received this disability benefit?

Read if necessary: Do NOT include a benefit received on behalf of someone else.

Enter all that apply, separate with commas.

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

Response:

00 Not on roster
01-25 Person Number
97 Refused
99 Do not Know

Universe:

Sample Adults 18+ with more than one person in the family where someone in the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1-25,RF,DK = [goto INCWELF_A]

Replicate To:

SSISSDIP_C

Question ID: INC.0100.00.1
Variable: INCWELF_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

In ^LASTYEAR, did ^YOUFAMHERE receive...

Any public assistance or welfare payments from the state or local welfare office?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE

Description you/you or any family members
Instruction If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions

Skip Instructions:

1,2,RF,DK = [goto INCRETIRE_A]

Replicate To:

INCWELF_C

Question ID: INC.0110.00.1
Variable: INCRETIRE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...

Income from retirement, survivor, or disability pensions?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE

Description you/you or any family members
Instruction If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions

Skip Instructions:

1,2,RF,DK = [goto INCOTHR_A]

Replicate To:

INCRETIRE_C

Question ID: INC.0120.00.1
Variable: INCOTHR_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...

Any other sources of income such as VA payments from the Veterans Benefits Administration, unemployment compensation, child support, or alimony?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE

Description you/you or any family members
Instruction If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions

Skip Instructions:

1,2,RF,DK = [goto INCTOTAL_A]

Replicate To:

INCOTHR_C

Question ID: INC.0130.00.1
Variable: INCTOTAL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^INCALLFAM

What is your best estimate of ^TOTALINCOME from all sources, before taxes, in ^LASTYEAR?

Enter '999995' if the reported income $999,995 or greater.

Fills:
^INCALLFAM

Description INCTOTAL_A Introduction
Instruction IF PCNT_A GT 1 fill "When answering this next question, please remember to include your income PLUS the income of all family members living in this household."

^TOTALINCOME

Description your total income/the total income of all family members
Instruction If PCNT_A=1 fill "your total income" else if PCNT_A GT 1 fill "the total income of all family members"

^LASTYEAR

Description Last year
Instruction Fill year prior to current year

Response:

000000-999995 Range of values
999997 Refused
999998 Not Ascertained
999999 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions

Skip Instructions:

0-999 = [goto ERR1_INCTOTAL_A]
250001-999995 = [goto ERR2_INCTOTAL_A]
1000-250000 = [goto next section]
RF,DK = [goto INC250PCT_A]

Soft Edit:
ERR2_INCTOTAL_A

Check Description: Income high soft edit
Check Text: {signal ERR2_INCTOTAL_A} Do not read to the respondent. ^INCTOTAL_A is unusually high. Make corrections if necessary.

ERR1_INCTOTAL_A

Check Description: Income low soft edit
Check Text: {signal ERR1_INCTOTAL_A} Do not read to the respondent. ^INCTOTAL_A is unusually low. Make corrections if necessary.

Replicate To:

INCTOTAL_C

Question ID: INC.0150.00.1
Variable: INC250PCT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than ^250POVERTY_A or ^250POVERTY_A or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

^250POVERTY_A

Description 250% of poverty threshold
Instruction Fill value stored in INC250FILL_A

Response:

1 Less than ^250POVERTY_A
2 ^250POVERTY_A or more
7 Refused
9 Do not Know

Universe:

Sample Adult 18+ who do not know or refuse the total family income and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = [goto INC138PCT_A]
2 = if GEN.PCNT_A IN (1,2) [goto INC75K_A]
else if GEN.PCNT_A=4 or GEN.PCNT_A ge 7 [goto INC400PCT_A] else if GEN.PCNT_A IN (3,5,6) [goto INC100K_A]
RF,DK = [goto next section]

Replicate To:

INC250PCT_C

Question ID: INC.0160.00.1
Variable: INC138PCT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than ^138POVERTY_A or ^138POVERTY_A or more?

Fills:

^FAMILY
Description family
Instruction If PCNT_A 1 fill "family"

^138POVERTY_A

Description 138% of poverty threshold
Instruction Fill value stored in INC138FILL_A

Response:
1 Less than ^138POVERTY_A
2 ^138POVERTY_A or more
7 Refused
9 Do not Know

Universe:

Sample Adult 18+ answered less than 250% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = [goto INC100PCT_A]
2 = [goto INC200PCT_A]
RF,DK = [goto next section]

Replicate To:

INC138PCT_C

Question ID: INC.0170.00.1
Variable: INC100PCT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than ^100POVERTY_A or ^100POVERTY_A or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

^100POVERTY_A

Description 100% of poverty threshold
Instruction Fill value stored in INC100FILL_A

Response:

1 Less than ^100POVERTY_A
2 ^100POVERTY_A or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who answered less than 138% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,RF,DK = [goto next section]

Replicate To:

INC100PCT_C

Question ID: INC.0180.00.1
Variable: INC200PCT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than ^200POVERTY_A or ^200POVERTY_A or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

^200POVERTY_A

Description 200% of poverty threshold
Instruction Fill value stored in INC200FILL_A

Response:

1 Less than ^200POVERTY_A
2 ^200POVERTY_A or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who answered 138% of poverty or more and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,RF,DK = [goto next section]

Replicate To:

INC200PCT_C

Question ID: INC.0190.00.1
Variable: INC75K_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than $75,000 or $75,000 or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

Response:

1 Less than $75,000
2 $75,000 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who answered 250% of poverty threshold or more and is from a 1 or 2 person family and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = [goto INC400PCT_A]
2 = [goto INC100K_A]
RF,DK = [goto next section]

Replicate To:

INC75K_C

Question ID: INC.0200.00.1
Variable: INC100K_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than $100,000 or $100,000 or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

Response:

1 Less than $100,000
2 $100,000 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ who answered $75,000 or more OR answered 250% of poverty threshold or more and is from a 3,5, or 6 person family and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = if GEN.PCNT_A IN (1,2,5,6) [goto next section] elseif GEN.PCNT_A=3 [goto INC400PCT_A]
2 = if GEN.PCNT_A IN (1,2,3) [goto INC150K_A] elseif GEN.PCNT_A IN (5,6) [goto INC400PCT_A]
RF,DK = [goto next section]

Replicate To:

INC100K_C

Question ID: INC.0210.00.1
Variable: INC400PCT_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than ^400POVERTY_A or ^400POVERTY_A or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A 1 fill "family"

^400POVERTY_A

Description 400% of poverty threshold
Instruction Fill value stored in INC400FILL_A

Response:

1 Less than ^400POVERTY_A
2 ^400POVERTY_A or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and answered less than $75,000 OR
answered less than $100,000 and is from a 3 person family OR
answered $100,000 or more and is from a 5 or 6 person family or answered 250% of poverty threshold or more and is from a 4 or 7+ person family
and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 = if GEN.PCNT_A ge 8 [goto INC150K_A] else [goto next section]
2 = if GEN.PCNT_A IN (1,2,3) or GEN.PCNT_A ge 6 [goto next section] else if GEN.PCNT IN (4,5) [goto INC150K_A]
RF,DK = [goto next section]

Replicate To:

INC400PCT_C

Question ID: INC.0220.00.1
Variable: INC150K_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was your total ^FAMILY income from all sources less than $150,000 or $150,000 or more?

Fills:
^FAMILY

Description family
Instruction If PCNT_A greater than 1 fill "family"

Response:

1 Less than $150,000
2 $150,000 or more
7 Refused
9 Do not Know

Universe:

Sample Adults 18+
answered $100,000 or more and is from 1,2 or 3 person family OR
respondent answered 400% of poverty or more and is from 4 or 5 person family OR respondent answered less than 400% of poverty and is from a family of 8 or more persons
and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR
the Sample Adult and Sample Child are not in the same family OR
Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,RF,DK = [goto next section]

Replicate To:

INC150K_C

2019 National Health Interview Survey (NHIS) Questionnaire
FOO: Food Related Programs

Question ID: FOO.0010.00.1
Variable: FSNAP12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

At any time IN THE LAST 12 MONTHS did ^YOUFAMLVHERE_A receive ^FSSNAPNM?

Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy food.
Fills:
^YOUFAMLVHERE_A

Description:you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME
Instruction

If GEN.PCNT_A=1, fill: "you";
elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson [PX_A].ONOFFCAMPUS ne 1, fill: "any family members living here"
elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson [PX_A].ONOFFCAMPUS=1, fill "you or any family members living at ^HNO ^HNOSUF ^STRNAME"

^FSSNAPNM

Description food stamp benefits/[state food stamp program name]
Instruction

If AL then fill "Food Assistance Program or food stamp benefits"
If AK then fill "food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits" If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food stamp benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "Food Assistance Program or food stamp benefits"
If GA then fill "food stamp benefits"
If HI then fill "SNAP or food stamp benefits" If ID then fill "food stamp benefits"
If IL then fill "SNAP or food stamp benefits" If IN then fill "SNAP or food stamp benefits"
If IA then fill "Food Assistance Program or food stamp benefits"
If KS then fill "Food Assistance Program or food stamp benefits"
If KY then fill "SNAP or food stamp benefits" If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food stamp benefits"
If MD then fill "Food Supplement Program or food stamp benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program or food stamp benefits"
If MN then fill "SNAP or food stamp benefits" If MS then fill "SNAP or food stamp benefits" If MO then fill "food stamp benefits"
If MT then fill "SNAP or food stamp benefits" If NE then fill "SNAP or food stamp benefits" If NV then fill "SNAP or food stamp benefits"
If NH then fill "Food Stamp/SNAP or food stamp benefits" If NJ then fill "SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits" If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food stamp benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "Food Assistance Program or food stamp benefits"
If OK then fill "SNAP or food stamp benefits" If OR then fill "SNAP or food stamp benefits" If PA then fill "SNAP or food stamp benefits" If RI then fill "SNAP or food stamp benefits" If SC then fill "SNAP or food stamp benefits" If SD then fill "SNAP or food stamp benefits" If TN then fill "SNAP or food stamp benefits" If TX then fill "SNAP or food stamp benefits" If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits" If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food Washington or food stamp benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp benefits"
If WY then fill "SNAP or food stamp benefits"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Child FOO section was asked to someone other than the Sample Adult respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1 = [goto FSNAP30D_A]
2,RF,DK = if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M_A] else [goto next section]

Replicate To:

FSNAP12M_C

Question ID: FOO.0020.00.3
Variable: FSNAP30D_A
Interview Module: Adult
Content Type:Sponsored Content

Question Text:

Did ^YOUFAMLVHERE_A receive ^FSSNAPNM in the LAST 30 days?

Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy food.
Fills:
^YOUFAMLVHERE_A

Description you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME
Instruction

^FSSNAPNM

Description food stamp benefits/[state food stamp program name]
Instruction

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ living in families where someone received food stamps in the last 12 months AND Sample Adult and Sample Child are in the same family and the FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample child respondent answered refused or do not know to all questions in the sample child FOO section and the sample child respondent is not the sample adult respondent.

Skip Instructions:

1,2,RF,DK = if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M_A]; else [goto next section]

Replicate To:

FSNAP30D_C

Question ID: FOO.0030.00.1
Variable: FWIC12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

At any time in the last 12 months did ^YOUFAMLVHERE_A receive benefits from the WIC program, that is, the Women, Infants, and Children program?

Fills:
^YOUFAMLVHERE_A

Description you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME
Instruction If GEN.PCNT_A=1, fill: "you"; elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson [PX_A].ONOFFCAMPUS ne 1, fill: "any family members living here"; elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson [PX_A].ONOFFCAMPUS=1, fill "you or any family members living at ^HNO ^HNOSUF ^STRNAME"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ living in families with females 12-55 years of age or children 0-5 years of age and Sample Adult and Sample Child are in the same family and the FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample child respondent answered refused or do not know to all questions in the sample child FOO section and the sample child respondent is not the sample adult respondent.

Skip Instructions:

1,2,RF,DK = if PCNTC517_A ge 1 [goto FLUNCH12M_A]
else [goto next section]

Replicate To:

FWIC12M_C

Question ID: FOO.0040.00.1
Variable: FLUNCH12M_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

At any time in the last 12 months, did ^SCCHILDFAM_A receive free or reduced-cost breakfasts or lunches at school?

Read if necessary: The National School Lunch Program and the School Breakfast Program provide cash assistance to states to operate breakfast and lunch programs in schools and residential childcare institutions. The programs provide low-cost or free breakfasts and lunches to low- income children in kindergarten through 12th grade.
Fills:
^SCCHILDFAM_A

Description ^ALIASNAME/any child in your family
Instruction if PCNT517_A=1, fill: ^ALIASNAME of child in Sample Adult family,elseif PCNT517_A gt 1, fill "any child in your family",

^ALIASNAME

Description {Value of ALIAS}
Instruction Fill value from ALIAS

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ living in families with children between the ages of 5-17 and Sample Adult and Sample Child are in the same family and the FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample child respondent answered refused or do not know to all questions in the sample child FOO section and the sample child respondent is not the sample adult respondent.

Skip Instructions:

1,2,RF,DK = [goto next section]

Replicate To:

FLUNCH12M_C

2019 National Health Interview Survey (NHIS) Questionnaire
FDS: Food Security

Question ID: FDS.0010.00.3
Variable: FDSINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

These next questions are about whether ^youyourfamily_A ^waswere always able to afford the food you needed in the last 30 days. I'm going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for ^youyourfamily_A in the last 30 days.

Enter '1' to continue.

Fills:
^youyourfamily_A

Description you/your family
Instruction If PCNT_A=1 "you" else "your family"

^waswere

Description were/was
Instruction If PCNT_A=1 "were" else "was"

Response:

1 Enter 1 to Continue

Universe:

Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people.

Skip Instructions:

1 = [goto FDSRUNOUT_A]

Replicate To:

FDSINTRO_C

Question ID: FDS.0020.00.3
Variable: FDSRUNOUT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

The first statement is "^IWe_A worried whether ^myour_A food would run out before ^Iwe_A got money to buy more." Was that often true, sometimes true, or never true for ^youyourfamily_A in the last 30 days?

Fills:
^IWe_A

Description I/We
Instruction If PCNT_A=1 fill: "I" else fill: "We"

^myour_A

Description my/our
Instruction If PCNT_A=1 fill: "my" else fill: "our"

^youyourfamily_A

Description you/your family
Instruction If PCNT_A=1 "you" else "your family"

Response:

1 Often true
2 Sometimes true
3 Never true
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1-3,RF,DK = [goto FDSLAST_A]

Replicate To:

FDSRUNOUT_C

Question ID: FDS.0030.00.3
Variable: FDSLAST_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

"The food that ^Iwe_A bought just didn't last, and ^Iwe_A didn't have money to get more." Was that often true, sometimes true, or never true for ^youyourfamily_A in the last 30 days?

Fills:
^Iwe_A

Description I/We
Instruction If PCNT_A=1 fill: "I" else fill: "We"

^youyourfamily_A

Description you/your family
Instruction If PCNT_A=1 "you" else "your family"

Response:

1 Often true
2 Sometimes true
3 Never true
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1-3,RF,DK = [goto FDSBALANCE_A]

Replicate To:

FDSLAST_C

Question ID: FDS.0040.00.3
Variable: FDSBALANCE_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

^IWe_A couldn't afford to eat balanced meals." Was that often true, sometimes true, or never true for ^youyourfamily_A in the last 30 days?

Fills:
^IWe_A

Description I/We
Instruction If PCNT_A=1 fill: "I" else fill: "We"

^youyourfamily_A

Description you/your family
Instruction If PCNT_A=1 "you" else "your family"

Response:

1 Often true
2 Sometimes true
3 Never true
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1-2 = [goto FDSSKIP_A]
3,RF,DK = if FDSRUNOUT_A IN (1,2) OR FDSLAST_A IN (1,2) [goto FDSSKIP_A];
else [goto next section]

Replicate To:

FDSBALANCE_C

Question ID: FDS.0050.00.3
Variable: FDSSKIP_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, did ^youorother_A ever cut the size of your meals or skip meals because there wasn't enough money for food?

Fills:
^youorother_A

Description you/you or other adults in your family
Instruction If PCNT18UP_A=1: fill "you";else "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals

Skip Instructions:

1 = [goto FDSSKIPDYS_A]
2,RF,DK = [goto FDSLESS_A]

Replicate To:

FDSSKIP_C

Question ID: FDS.0060.00.3
Variable: FDSSKIPDYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, how many days did this happen?

Response:

01-30 Range of values
97 Refused
99 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent said that they or other adults in their family cut the size of their meals or skipped meals due to cost.

Skip Instructions:

1-30,RF,DK = [goto FDSLESS_A]

Replicate To:

FDSSKIPDYS_C

Question ID: FDS.0070.00.3
Variable: FDSLESS_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, did ^youorother_A ever eat less than you felt you should because there wasn't enough money for food?

Fills:
^youorother_A

Description you/you or other adults in your family
Instruction If PCNT18UP_A=1: fill "you"; else "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK = [goto FDSHUNGRY_A]

Replicate To:

FDSLESS_C

Question ID: FDS.0080.00.3
Variable: FDSHUNGRY_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, were ^youorother_A ever hungry but didn't eat because there wasn't enough money for food?

Fills:
^youorother_A

Description you/you or other adults in your family
Instruction If PCNT18UP_A=1: fill "you"; else "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK = [goto FDSWEIGHT_A]

Replicate To:

FDSHUNGRY_C

Question ID: FDS.0090.00.3
Variable: FDSWEIGHT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, did ^youorother_A lose weight because there wasn't enough money for food?

Fills:
^youorother_A

Description you/you or other adults in your family
Instruction If PCNT18UP_A=1: fill "you"; else "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1 = [goto FDSNOTEAT_A]
2,RF,DK = if FDSSKIP_A=1 or FDSLESS_A=1 or FDSHUNGRY_A=1 [goto FDSNOTEAT_A]; else [goto next section]

Replicate To:

FDSWEIGHT_C

Question ID: FDS.0100.00.3
Variable: FDSNOTEAT_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, did ^youorother_A ever not eat for a whole day because there wasn't enough money for food?

Fills:
^youorother_A

Description you/you or other adults in your family
Instruction If PCNT18UP_A=1: fill "you"; else "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered they cut the size of the meals, skipped meals, were hungry but didn't eat, or lost weight in the last 30 days because there wasn't enough money for food.

Skip Instructions:

1 = [goto FDSNEDAYS_A]
2,RF,DK = [goto next section]

Replicate To:

FDSNOTEAT_C

Question ID: FDS.0110.00.3
Variable: FDSNEDAYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question Text:

In the last 30 days, how many days did this happen?

Response:

01-30 Range of values
97 Refused
99 Do not Know

Universe:

The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent didn't eat for a whole day in last 30 days because there wasn't enough money for food

Skip Instructions:

1-30,RF,DK = [goto next section]

Replicate To:

FDSNEDAYS_C

2019 National Health Interview Survey (NHIS) Questionnaire
HOU: Housing

Question ID: HOU.0010.00.1
Variable: HOUYRSLIV_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

About how long ^YRSLIV?

Fills:
^YRSLIV

Description have you lived at ^HNO ^HNOSUF ^STRNAME/have you lived in this house/apartment
Instruction If Roster.HHC.tblname.bPerson[PX_A]ONOFFCAMPUS=1 fill "have you lived at ^HNO ^HNOSUF ^STRNAME"; else fill "have you lived in this house/apartment"

^HNO

Description {Value of HNO}
Instruction Fill GEN.HNO

^HNOSUF

Description {Value of HNOSUF}
Instruction Fill GEN.HNOSUF

^STRNAME

Description {Value of STRNAME}
Instruction Fill GEN.STRNAME

Response:

1 Less than 1 year
2 1 to 3 years
3 4 to 10 years
4 11 to 20 years
5 More than 20 years
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK = if ((GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=empty) or (GEN.SAMEFAM_FLG ne 1) or (GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=2 and GEN.SARESPSC_FLG ne 1))[goto HOUTENURE_A]
else [goto next section]

Question ID: HOU.0020.00.1
Variable: HOUTENURE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^HOUTEN owned or rented by you ^SOMEFAM_A?

If house has a mortgage, record as owned.

Fills:
^HOUTEN

Description Is the house/apartment at ^HNO ^HNOSUF ^STRNAME/Is this house/apartment
Instruction If Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS=1, fill "Is the house/apartment at ^HNO ^HNOSUF ^STRNAME";else fill "Is this house/apartment"

^HNO

Description {Value of HNO}
Instruction Fill GEN.HNO

^HNOSUF

Description {Value of HNOSUF}
Instruction Fill GEN.HNOSUF

^STRNAME

Description {Value of STRNAME}
Instruction Fill GEN.STRNAME

^SOMEFAM_A

Description or someone in your family
Instruction If PCNT18UP_A=1 fill: blank; If PCNT18UP_A gt 1 fill: "or someone in your family"

Response:

1 Owned or being bought
2 Rented
3 Other arrangement

Universe:

Sample Adults 18+

Skip Instructions:

1,3,RF,DK = [goto next section]
2 = [goto HOUGVASST_A]

Replicate To:

HOUTENURE_C

Question ID: HOU.0030.00.1
Variable: HOUGVASST_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

^HOUGVT paying lower rent because the Federal, State, or local government is paying part of the cost?

Read if necessary: Federal, State, or Local government housing programs for persons with low income may take many forms. Government housing assistance could come from monetary assistance to help pay rent, a program called "Section 8," direct payments to landlords, vouchers, or other types of assistance from a local housing authority. Living in public housing is considered housing assistance from the government.
Fills:
^HOUGVT

Description Are you/Are you or anyone in your family/Is your family at ^HNO ^HNOSUF ^STRNAME
Instruction If Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS ne 1 and GEN.PCNT18UP_A=1, fill "Are you"; elseif Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS ne 1 and PCNT18UP_A gt 1, fill "Are you or anyone in your family"; elseif Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "Is your family at ^HNO ^HNOSUF ^STRNAME"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with a house/apartment that is being rented AND Sample Adult and Sample Child are in the same family and the house/apartment is being owned/rented and the HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family section

Skip Instructions:

1,2,RF,DK = [goto next section]

Replicate To:

HOUGVASST_C

2019 National Health Interview Survey (NHIS) Questionnaire
REC: Person's name

Question ID: REC.0010.00.1
Variable: LNKFNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Ask or verify: What is your full name?

Enter first name.

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

allow 20,RF,DK = [goto LNKMNAME_A]

Question ID: REC.0020.00.1
Variable: LNKMNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Enter middle name.

Press "Enter" to skip to last name if respondent has no middle name.

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

allow 20,RF,DK = [goto LNKLNAME_A]

Question ID: REC.0030.00.1
Variable: LINKLNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Enter last name.

Response:

97 Refused
99 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

allow 20,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
TEL: Telephone Use

Question ID: TEL.0010.00.1
Variable: TELCURWRK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Is there at least one telephone INSIDE ^HOME that is currently working and is not a cell phone?

Fills:
^HOME

Description: your home at ^HNO ^HNOSUF ^STRNAME/your home
Instruction:If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "your home at ^HNO ^HNOSUF ^STRNAME"
else fill "your home"

^HNO

Description: {Value of HNO}
Instruction: Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF }
Instruction: Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME }
Instruction: Fill GEN. STRNAME

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ where the Sample Adult and Sample Child are in the same family but TELCURWRK_C has not been asked OR Sample Adult and Sample Child are in the same family, TELCURWRK_C was answered do not know or refused and the Sample Adult is not the Sample Child Respondent or where the Sample Adult does not live in same family as Sample Child

Skip Instructions:

1,2,RF,DK= [goto TELCEL_A]

Replicate To:

TELCURWRK_C

Question ID: TEL.0020.00.1
Variable: TELCEL_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you have a working cell phone?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1= if TELCURWRK_A=1 or (TELCURWRK_C=1 and GEN.SAMEFAM_FLG=1)[goto PHONEUSE_A]
else[goto TLNO_TEL_SA]

2,RF,DK= if (GEN.SAMEFAM_FLG=1 and PHONELIVE_C=empty) or (GEN.SAMEFAM_FLG=1 and PHONELIVE_C IN (DK,RF) and GEN.SARESPSC_A ne 1) or (GEN.SAMEFAM_FLG ne 1)) and GEN.PCNT_A gt 1 [goto PHONELIVE_A]
else [goto TLNO_TEL_SA]

Question ID: TEL.0030.00.1
Variable: PHONELIVE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you live with anyone ^ATHOME who has a working cell phone?

Fills:
^HOME

Description: your home at ^HNO ^HNOSUF ^STRNAME/your home
Instruction:If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "your home at ^HNO ^HNOSUF ^STRNAME"
else fill "your home"

^HNO

Description: {Value of HNO}
Instruction: Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF }
Instruction: Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME }
Instruction: Fill GEN. STRNAME

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ in a family with at least one other person without working cell phones where Sample Adult does not live in same family as Sample Child or Sample Adult and Sample Child are in the same family but PHONELIVE_C has not been asked OR Sample Adult and Sample Child are in the same family, PHONELIVE_C was answered dk/rf and the Sample Adult is not the Sample Child Respondent.

Skip Instructions:

1,2,RF,DK= [goto TLNO_TEL_SA]

Replicate To:

PHONELIVE_C

Question ID: TEL.0040.00.1
Variable: PHONEUSE_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Of all the telephone calls that you answer, are all or almost all on your cell phones, some on your cell phone and some on your home phone, or very few or none on your cell phones?

Response:

1 All or almost all calls on cell phone
2 Some on cell phone and some on home phone
3 Very few or none on cell phone
7 Refused
9 Do not Know

Universe:

Sample Adults 18+ with working personal cell phone and who said they have a working land-line in household or in the same family as sample child respondent who said they have a working landline in the household.

Skip Instructions:

1-3,RF,DK = [goto TLNO_TEL_SA]

2019 National Health Interview Survey (NHIS) Questionnaire
LNK: Linkage

Question ID: LNK.0010.00.1
Variable: LNKINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

We would like the last four digits of your Social Security Number^medicarenum. This information will help us link your survey data with health-related records of other government agencies, and allow us to conduct additional research without taking up your time with more questions. The National Center for Health Statistics (NCHS) uses this information for research purposes only. Providing this information is voluntary. There will be no effect on your benefits if you do not provide this information. Federal laws authorize us to ask for this information. Like all other answers you have provided, this information will remain confidential.

Read if necessary: The specific federal laws protecting your privacy and the confidentiality of your data are the Public Health Service Act (Title 42, U.S.C., Section 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (Title 5 of Public Law 107- 347), and the Privacy Act of 1974 (5 U.S.C. § 552a).

Read if necessary: NCHS collects health-related data from other government agencies, including records from Medicare and Medicaid Services, Social Security, housing, and death certificates. If you agree, NCHS will attempt to link records such as these with your survey data to give a fuller picture of the kinds of things that affect health. NCHS does this linkage. Your name and your information are not given to these agencies.

Read if necessary: If asked: Your data will not be linked to records from the IRS (Internal Revenue Service) or ICE (Immigration and Customs Enforcement).

Enter '1' to continue.

Fills:
^medicarenum

Description , and the last four characters of your Medicare number
Instruction If INS.HIKIND_A=2 or INS.MCAREPRB_A=1, fill ", and the last four characters of your Medicare number"; else, fill nothing

Response:
Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto SSN4_A]

Question ID: LNK.0020.00.1
Variable: SSN4_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

What are the last four digits of your Social Security Number?

Read if necessary: Providing this information is voluntary. There will be no effect on your benefits if you do not provide this information. Federal laws authorize us to ask for this information. Like all other information you have provided, these answers will remain confidential.

Read if asked about specific laws: The specific federal laws protecting your privacy and the confidentiality of your data are the Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act, which is Title 5 of Public Law 107-347; and the Privacy Act of 1974, which is 5 U.S.C. § 552a.

Enter 'N' for no Social Security Number.

Response:

0001-9999 Range of values
N No Social Security Number
99997 Refused
99999 Do not Know

Skip Instructions:

if SSN4_A=000-999 [goto ERR2_SSN4_A]; elseif SSN4_A NOT IN (N,RF,DK,000-999,0001-9999) [goto ERR3_SSN4_A]
0001-9999 = if Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto NEWNUM_A]; else [goto next section]
N,RF,DK = if Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto NEWNUM_A]; else [goto RLINK_A]

Hard Edit:
ERR2_SSN4_A

Check Description: Entered less than four digits hard edit
Check Text: {check ERR2_SSN4_A}; You must enter all four of the last four digits of the Social Security Number.Please correct.

ERR3_SSN4_A

Check Description: SSN last four digits are 0000 or a letter other than N hard edit
Check Text: {check ERR3_SSN4_A}; The last 4 digits of a SSN should be between 0001-9999. For a respondent who does not want to provide the SSN, enter 'Ctrl D' or 'Ctrl R' for 'Do not Know' or 'Refused?.If a respondent does not have a SSN, enter 'N'. Please correct.

Question ID: LNK.0030.00.1
Variable: NEWNUM_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

Did you receive a new Medicare number after April 1, 2018?

Read if necessary: The new Medicare number is 11 characters long, containing a sequence of letters and numbers. The sequence of the last four characters are letter, letter, number, number.

Read if necessary: The old Medicare number is 10 or 11 characters long, containing first a sequence of 9 consecutive numbers, ending with one or two letters.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 18+ who have Medicare

Skip Instructions:

1 = [goto LAST4C_A]
2,RF,DK = [goto MCNO4_A]

Question ID: LNK.0400.00.1
Variable: LAST4C_A
Interview Module: Adult
Content Type: Annual Core

Question Text:
?[F1]

1 of 2

What are the last four characters of your Medicare or Health Insurance Claim Number?

Reports from memory are acceptable if the Medicare card (or some other form of documentation) is not available.

Enter the last four characters, which should be letter-letter-number-number.

If the last four characters are not this sequence, back-up to NEWNUM_A and enter '2' to enter the old Medicare number.

Response:

9997 Refused
9999 Do not Know

Universe:

Sample adults 18+ who have Medicare and have received a new Medicare number

Skip Instructions:

if anything lt 4 alphanumeric characters [goto ERR1_LAST4C_A] elseif SSN4_A IN (N,RF,DK) or LAST4C_A IN (RF,DK) [goto RLINK_A]
else [goto next section]

Hard Edit:

ERR1_LAST4C_A

Check Description: Medicare number less than 4 characters
Check Text: {check ERR1_LAST4C_A}; You must enter all four of the last four alphanumeric characters of the Medicare number.Please correct.

Question ID:LNK.0050.01.1
Variable: MCNO4_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]
1 of 2

What are the last four numbers and any letters of your Medicare or Health Insurance Claim Number?

Reports from memory are acceptable if the Medicare card (or some other form of documentation) is not available.

Enter the last four numbers.

Response:

0001-9999 Range of values
99997 Refused
99999 Do not Know

Universe:

Sample adults 18+ who have Medicare and do not have a new Medicare number or do not know or refuse if they have a new Medicare number

Skip Instructions:

0-999 = [goto ERR1_MCNO4_A]
0001-9999 = [goto MCLET_A]
RF,DK = [goto RLINK_A]

Hard Edit:

ERR1_MCNO4_A

Check Description: Medicare number less than 4 numbers
Check Text: {check ERR1_MCNO4_A}; You must enter all four of the last four numbers of the Medicare number.Please correct.

Question ID: LNK.0050.02.1
Variable: MCLET_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

2 of 2

Enter the letters that appear after the claim number.

Response:

97 Refused
99 Do not Know

Universe:

Sample adults 18+ who have Medicare, did not get a new Medicare number since
April 2018 or do not know or refused to say if they got a new number and reported the last four numbers of the Medicare number

Skip Instructions:

allow 2,RF,DK = if SSN4_A IN (0001-9999) [goto next section] else if SSN4_A IN (N,RF,DK) [goto RLINK_A]

Question ID: LNK.0060.00.1
Variable: RLINK_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

?[F1]

May we try to link your survey data without a ^SSNMEDNUM?

Read if necessary: Any data obtained are protected by strict federal laws, including the Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act, which is Title 5 of Public Law 107-347; and the Privacy Act of 1974, which is 5 U.S.C. § 552a.
Fills:
^SSNMEDNUM

Description consent by SSN or Medicare number
Instruction if (SSN4_A IN (N,RF,DK) and ((Adult.INS.HIKIND_A ne 2 and Adult.INS.MCAREPRB_A ne 1) or (MCNO4_A ge 001 and MCNO4_A le 9999) or (LAST4C_A NOT IN (empty,RF, DK)))) fill= "social security number"; elseif ((SSN4_A ge 0001 and SSN4_A le 9999) and (Adult.INS.HIKIND_A = 2 or Adult.INS.MCAREPRB_A =1) and (MCNO4_A IN (RF, DK) or (LAST4C_A IN (RF,DK))) fill = "Medicare or Health Insurance Claim Number"; else fill = "social security number, Medicare or Health Insurance Claim Number"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample adults 18+ who answered refused or do not know at last 4 of Medicare numbers/characters or answered no SSN or refused or do not know last 4 digits of SSN

Skip Instructions:

1,2,RF,DK =[goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
THX: Thanks

Question ID: THX.0080.001
Variable: THANKS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Read if necessary: Thank you for answering these questions about yourself.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
VFY: Verification and demographic details

Question ID: VFY.0040.00.1
Variable: CURRES_C
Interview Module: Child
Content Type: Annual Core

Question Text:

The next questions are about ^SCNAME.

Enter the line number of the person to whom you are speaking.

If Sample Child respondent refuses to participate enter CTRL-R

.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

01 Name of Person 1
02 Name of Person 2
03 Name of Person 3
04 Name of Person 4
05 Name of Person 5
06 Name of Person 6
07 Name of Person 7
08 Name of Person 8
09 Name of Person 9
10 Name of Person 10
11 Name of Person 11
12 Name of Person 12
13 Name of Person 13
14 Name of Person 14
15 Name of Person 15
16 Name of Person 16
17 Name of Person 17
18 Name of Person 18
19 Name of Person 19
20 Name of Person 20
21 Name of Person 21
22 Name of Person 22
23 Name of Person 23
24 Name of Person 24
25 Name of Person 25
97 Refused

Universe:

Sample Children 0-17

Skip Instructions:

RF = if CBSTAT_A=1[goto BCK.THANKS_CB] else if OUTCOME=215 [goto BCK.THANKS_INSUF];else [goto BCK.THANKS_SUF]
If CURRES_C not in Roster.FAM.KNOWSC [goto KNOAVAIL_C];Else if CURRES_C ne LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC [goto AVAIL_C]; Else if CURRES_C = LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC AND CURRES_C not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C];Else if CURRES_C = LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC AND CURRES_C in
Roster.bREL.bPerson[PX_C].PARENTS[goto VFYALL_C]

Question ID: VFY.0060.00.1
Variable: KNOAVAIL_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^KNOAVAIL_C_fill

Enter the line number of available respondent from list or press F9 to set up a callback if no one is available or refused.

^KNOAVAIL_C_fill_2

Fills:
^KNOAVAIL_C_fill

Description: FR Instruction/I have recorded that ^KNOWSC ^areis_c knowledgeable about and responsible for ^SCNAME's health care. ^WHOIS currently available and willing to answer these questions?
Instruction: If (KnowSC_Count = ActiveNotKnow_Count); fill : "* If there are no other knowledgeable people to select then press the end key.";ELSE: fill : "I have recorded that ^KNOWSC ^areis_c knowledgeable about and responsible for ^SCNAME's health care. ^WHOIS currently available and willing to answer these questions?"

^KNOWSC

Description List of household members who are knowledgeable about and responsible for the Sample Child
Instruction KNOWSC = list of people identified as being knowledge about and responsible for ^SCNAME's health as selected in Roster.FAM.KNOWSC. Add "and" before last name if list GREATER THAN 1.

^areis_c

Description is/are
Instruction IF KNOAVAIL_Count = 1; Fill 'is', ;ELSE: Fill 'are'

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^WHOIS

Description Is {Value of ALIAS}/Who is
Instruction IF KNOAVAIL_Count = 1; Fill 'Is Alias[I] ELSE: Fill 'Who is'

^KNOAVAIL_C_fill_2

Description FR Instruction
Instruction If (ActiveNotKnow_Count GREATER THAN 0); fill : "* People listed in gray have said that they are not knowledgeable about the SC. If you incorrectly set someone as not knowledgeable then you may select that person and continue the interview."

Response:
01 Name of Person 1
02 Name of Person 2
03 Name of Person 3
04 Name of Person 4
05 Name of Person 5
06 Name of Person 6
07 Name of Person 7
08 Name of Person 8
09 Name of Person 9

10 Name of Person 10
11 Name of Person 11
12 Name of Person 12
13 Name of Person 13
14 Name of Person 14
15 Name of Person 15
16 Name of Person 16
17 Name of Person 17
18 Name of Person 18
19 Name of Person 19
20 Name of Person 20
21 Name of Person 21
22 Name of Person 22
23 Name of Person 23
24 Name of Person 24
25 Name of Person 25
97 Refused
Universe:

Sample Children 0-17 and at least one knowledgeable person is still eligible for selection and speaking to the initial respondent and they are not knowledgeable OR speaking to a new respondent

Skip Instructions:

01-25 = [goto INTMODE_C]
RF = if CBSTAT_A=1[goto BCK.THANKS_CB] else if OUTCOME=215 [goto BCK.THANKS_INSUF]; else [goto BCK.THANKS_SUF]
F9 = [goto bCallback.ARRANGE_CALLBACK]

Question ID: VFY.0080.00.1
Variable: INTMODE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

*How are you contacting ^KNOAVAIL_C?

Fills:
^KNOAVAIL_C

Description Name of person selected at KNOAVAIL_C
Instruction Display name of person whose line number was selected at KNOAVAIL_C

Response:

1 Personal visit
2 Telephone

Universe:

Sample Children 0-17 and interviewer is speaking to a new respondent

Skip Instructions:

1 = if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else if HHRESPSC_FLG=1 and LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C] else [goto VFYALL_C]
2 = [goto TINTRO_C]

Question ID: VFY.0090.00.1
Variable: TINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Hello, my name is (* say your name). I'm calling from the U.S. Census Bureau. We are conducting the National Health Interview Survey on behalf of the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC). This is a nationwide survey about the health of both adults and children. I have some information from ^HHRESP. ^HHSEX told me that you would be a good person to talk to about the health of ^SCNAME.

Read-if-necessary: I believe I am calling you on a cell phone.

Before we continue, I have to ask: Are you currently driving?

Even if the respondent is using a hands-free device while driving, you must enter '1'.

Fills:
^HHRESP

Description {Value of HHRESPAVAIL}
Instruction Display the name of the person selected at Roster.HHC.HHRESPAVAIL

^HHSEX

Description He/She/They
Instruction If GEN.SEX_FINAL[LNO_HHRESP]=1, fill: He
elseif GEN.SEX_FINAL[LNO_HHRESP]=2, fill: She
elseif GEN.SEX_FINAL[LNO_HHRESP] in (DK,RF), fill: They

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent

Skip Instructions:

1,RF,DK = [goto ATTN_C]
2 = [goto LETTER_C]

Question ID: VFY.0100.00.1
Variable: ATTN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

For your safety, we will call you back at another time.

Enter 1 to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is driving

Skip Instructions:

1 = [goto bCallback.CB_POSSIBLE]

Question ID: VFY.0110.00.1
Variable: LETTER_C
Interview Module: Child
Content Type: Annual Core

Question Text:

If sample child respondent is a new respondent read question below, otherwise enter 1

Read if necessary: A letter describing the National Health Interview Survey was sent to your home recently. Do you remember seeing the letter?

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1,2,DK,RF = [goto S_INTRO_C]

Question ID: VFY.0120.00.1
Variable: S_INTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

If sample child respondent is a new respondent read question below, otherwise enter 1

Read if necessary: There are a few things I need to cover before we continue. I'd like you to know that taking part in this survey is voluntary. You may choose not to answer any questions you do not wish to answer, or end the interview at any time without penalty. We are required by Federal law to develop and follow strict procedures to protect the confidentiality of your information and use your answers only for statistical research. I can describe these laws if you wish. Except for the National Center for Health Statistics and Census Bureau employees and specially designated agents, no one can see your answers until all information that could identify you and/or your family has been removed. Only after that will your data be made available to researchers. For most children, the survey will take less than ^SCTIME minutes. I'd like to continue now unless you have any questions.

If respondent asks for more information about the privacy laws, press F1.

Fills:
^SCTIME

Description 20/30
Instruction If ASTAT=1 and SAMEFAM_FLG=1, fill: 20
Else, fill: 30

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1 = if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else if HHRESPSC_FLG=1 and LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C] else [goto VFYALL_C]

Question ID: VFY.0130.00.1
Variable: AVAIL_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I have recorded that you are knowledgeable about and responsible for ^SCNAME's health care. Is that correct?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused

Universe:

Sample Children 0-17 and at least one knowledgeable person is still eligible for section AND initial respondent wasn't the HH Resp and is knowledgeable OR picked a new respondent and respondent is not driving

Skip Instructions:

1 = If (LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS) {respondent is not a parent} [goto RELTIV_C]
Else If Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) {Sample Child is on campus} [goto VFYONCAMP_C]
Else [goto VFYALL_C]
2 = if KNOAVAIL_Count gt 0 [goto KNOAVAIL_C] Else [goto NOMORE_C]
RF = if CBSTAT_A=1[goto BCK.THANKS_CB] else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

Question ID: VFY.0150.00.1
Variable: RELTIV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What is your relationship to ^SCNAME?

Fills:
^SCNAME

Description: Sample child's name
Instruction:Fill ALIAS of HHSTAT_C=1

Response:

01 Parent (Biological, adoptive, or step)
02 Grandparent
03 Aunt/Uncle
04 Brother/Sister
05 Other relative
06 Legal guardian
07 Foster parent
08 Other non-relative
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 where the current respondent has not refused AND at least one person is knowledgeable about and responsible for the sample child AND the respondent is not driving while on the telephone AND the respondent has not refused or said he/she is not available AND the respondent was not identified as a parent in the roster section?

Skip Instructions:

9= [goto ERR_RELTIV_C]
4,5,8,RF,DK= [goto VFYRESP_C]
1,2,3,6,7= if Roster.tblNAME.bPerson.[PX.C].ONOFFCAMPUS IN (1,RF,DK) and HHRESPSC_FLG ne 1 [goto VFYONCAMP_C]
Else [goto VFYALL_C]

Soft Edit:

Check Text: ERR_RELTIV_C
Check Description: RELTIV_C soft edit

Check Text:{signal ERR_RELTIV_C}
The spouse or partner of the Sample Child cannot answer questions about him/her.

Question ID: VFY.0180.00.1
Variable: VFYRESP_C
Interview Module: Child
Content Type: Annual Core
Question Text:

To confirm, are you RESPONSIBLE FOR ^SCNAME's health care?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

2,RF,DK= if KNOAVAIL_Count is bigger than 0 [goto KNOAVAIL_C]
else [goto NOMORE_C]
1= if Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) [goto VFYONCAMP_C] Else [goto VFYALL_C]

Question ID: VFY.0190.00.1
Variable: VFYONCAMP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I want to confirm some information.

Does ^SCNAME live in on-campus housing or off-campus housing?

*Read if necessary: On-campus housing includes residence halls and dorms where students live together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 On campus
2 Off campus
7 Refused
9 Do not Know

Universe:

A person who is knowledgeable or responsible for the sample child's health is available and the Sample Child is living in on-campus housing and the Sample Child respondent is not the household respondent and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1,RF,DK= [goto VFYALL_C]
2= [goto NOMORE_C]

Question ID: VFY.0200.00.1
Variable: VFYALL_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Please verify the following information about the sample child before proceeding:

I have recorded ^childvsex, ^AGE_C, ^NATORG_C, and ^RACE_C. Would you like to make any changes to this ^additionalinfo_C?

^RACEVRBATvalue_C

If respondent "refuses" or says "do not know", enter "2" for "no."

Fills:
^childvsex

Description: SCNAME is male/^SCNAME is female/^SCNAME's sex is not known/^SCNAME's sex was not provided
Instruction:

If SEX_FINAL=1, fill: "^SCNAME is male"
If SEX_FINAL=2, fill: "^SCNAME is female"
If SEX_FINAL=DK, fill: "^SCNAME's sex is not known"
If SEX_FINAL=RF, fill: "^SCNAME's sex was not provided"

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^AGE_C

Description: ^SCNAME is ^AGENO_C ^AGETP_C old/^SCNAME is under 18
Instruction:

If AGE_FINAL NE ('RF', 'DK'), fill: "^SCNAME is ^AGENO_C
^AGETP_C old"
If AGE_FINAL IN ('RF', 'DK'), fill: "^SCNAME is under 18"

^AGENO_C

Description: {Value of AGENO}
Instruction:Insert value from Roster.HHC.AGENO[PX]

^AGETP_C

Description: {Value of AGETP}
Instruction: Fill in value from Roster.HHC.AGETP[PX]

^NATORG_C

Description: Verify Hispanic or Latino origin
Instruction:

If NATO_FINAL=1 fill: "^SCNAME is of Hispanic or Latino Origin"
If NATO_FINAL=2 fill: "^SCNAME is not of Hispanic or Latino Origin"
If NATO_FINAL=DK fill: "whether ^SCNAME is of Hispanic or Latino Origin is not known"
If NATO_FINAL=RF fill: "information about whether ^SCNAME is of Hispanic or Latino Origin was not provided"

^RACE_C

Description: ^SCNAME is ^RACEFILLAND_C/^SCNAME's race is not known/^SCNAME's race was not provided
Instruction:

If GEN.RACE_FINAL[PX_C].RACE_FINAL NE 'RF' OR 'DK', fill: "^SCNAME is ^RACEFILLAND_C."
If GEN.RACE_FINAL[PX_C].RACE_FINAL='DK', fill: ^SCNAME's
race is not known"
If GEN.RACE_FINAL[PX_C].RACE_FINAL='RF', fill: ^SCNAME's
race was not provided"

^RACEFILLAND_C

Description: Categories selected at the RACE screen
Instruction:

Fill categories selected at the GEN.RACE_FINAL [PX_C].RACE_FINAL screen. If more than two categories separate the categories with commas. Add the word "and" before the last category.
For category 8 (GEN.RACE_FINAL[PX_C].RACE_FINAL=8),
if GEN.RACE_FINAL[PX_C].RACE_SP_FINAL not in ['ZZ',RF,DK]
display picklist selection from GEN.RACE_FINAL[PX_C].RACE_SP_FINAL
elseif HHRESPSC_FLG=1 display GEN.RACE_FINAL [PX_C].RACE_VRBAT_FINAL
else display "some other race"

^additionalinfo_C

Description: if any information is missing "or provide additional information about
Instruction: See attachment for fill instructions

^RACEVRBATvalue_C

Description: Information collected at RACE_VRBAT for Sample Child
Instruction:

IF GEN.HHRESPSC_FLG ne 1 and GEN.RACE_FINAL
[PX_C].RACE_VRBAT_FINAL ne (empty,RF,DK), fill "* If respondent wants information on which other race ^SCNAME is listed as, say ^RACE_VRBAT."

^RACE_VRBAT

Description: {Value of RACE_VRBAT_FINAL}
Instruction: fill with value from GEN.RACE_FINAL[PX].RACE_VRBAT_FINAL

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 where a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or do not know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1 [goto VFYDEM_C]
2= if GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0210.00.1
Variable: VFYDEM_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Read if necessary: What should I change?

Mark all that apply, separate with commas.

Response:

1 Sex
2 Age
3 Hispanic or Latino Origin
4 Race
7 Refused
9 Do not Know

Universe:

Sample children 0-17 would like to change demographic information

Skip Instructions:

If '1' NOT IN VFYDEM_C and GEN.SEX_FINAL[PX_C] IN ('DK','RF') [goto SEXGUESS_C]
elseif '1' IN VFYDEM_C [goto NEWSEX_C]
elseif '2' IN VFYDEM_C [goto NEWAGENO_C] elseif '3' IN VFYDEM_C [goto NEWNATORG_C]
elseif '4' IN VFYDEM_C [goto NEWRACE_C]
RF,DK= If GEN.SEX_FINAL[PX_C] IN ('DK','RF') [goto SEXGUESS_C]

elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0220.00.1
Variable: NEWSEX_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is ^SCNAME male or female?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Male
2 Female
7 Refused
9 Do not Know

Universe:

Respondent said sample child's sex is not correct

Skip Instructions:

if GEN.SEX_FINAL[PX_C]=DK,RF and NEWSEX_C=DK,RF [goto SEXGUESS_C]
elseif '2' IN VFYDEM_C [goto NEWAGENO_C]
elseif '3' IN VFYDEM_C [goto NEWNATORG_C]
elseif '4' IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0230.00.1
Variable: SEXGUESS_C
Interview Module: Child
Content Type: Annual Core
Question Text:

*Enter your best guess of ^SCNAME's sex

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Male
2 Female

Universe:

Sample children for whom there is no sex provided by the household respondent and did not give a sex when asked to verify information and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1,2
if '2' IN VFYDEM_C [goto NEWAGENO_C]
elseif '3' IN VFYDEM_C [goto NEWNATORG_C]
elseif '4' IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0240.01.1
Variable: NEWAGENO_C
Interview Module: Child
Content Type: Annual Core
Question Text:
1 of 2

How old is ^SCNAME?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

000-120 Range of values
997 Refused
999 Do not Know

Universe:

Sample Children 0-17 whose age is not correct

Skip Instructions:

goto [NEWAGETP_C]

Question ID: VFY.0240.02.1
Variable: NEWAGETP_C
Interview Module: Child
Content Type: Annual Core
Question Text:
2 of 2

Enter number for age time period.

Response:

1 Day(s)
2 Week(s)
3 Month(s)
4 Year(s)

Universe:

Valid number entered at NEWAGENO_C

Skip Instructions:

1,2,3,4= if '3' IN VFYDEM_C [goto NEWNATORG_C]
elseif '4' IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0260.00.1
Variable: NEWNATORG_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is ^SCNAME Hispanic or Latino?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 whose Hispanic Origin is not correct

Skip Instructions:

1,2,RF,DK= if '4' IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C] e
lseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0270.00.1
Variable: NEWRACE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What race or races is ^SCNAME? Please select 1 or more of these categories:

White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, Asian, or some other race?

Enter all that apply, separate with commas

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

01 White
02 Black/African American
03 American Indian
04 Alaska Native
05 Native Hawaiian
06 Other Pacific Islander
07 Asian
08 Some other race
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 whose race is not correct

Skip Instructions:

if NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
elseif RACE_FINAL has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0280.00.1
Variable: HISPTYPE_C
Interview Module: Child
Content Type: Annual Core
Question Text:

What is ^SCNAME's Hispanic or Latino ancestry or origin, such as Mexican, Mexican American,
^CHICANOA, Central or South American, Puerto Rican, Cuban, Dominican (Republic), or Other Hispanic, ^LATINOA, or Spanish -- and if ^SCNAME has more than one, tell me all of them.

Enter all that apply, separate with commas

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^CHICANOA

Description: Chicano/Chicano or Chicana
Instruction:

If SEX_FINAL = 1 fill: "Chicano"
if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"

^LATINOA

Description: Latino/Latino or Latina
Instruction:

If SEX_FINAL= 1 fill: "Latino"
if SEX_FINAL = 2,DK,RF fill "Latino or Latina"

Response:

01 Mexican, Mexcian American, or Chicano(a)
02 Central American
03 South American
04 Puerto Rican
05 Cuban
06 Dominican (Republic)
07 Other Hispanic, Latino(a), or Spanish (specifiy)
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 are of Hispanic Origin and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or do not know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

7= [goto HISPOTHER_C]
1-6, DK, RF
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (HHRESPSC_FLG ne 1 and RACE_SP[PX_C] in ('ZZ',RF,DK))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0290.00.1
Variable: HISPOTHER_C
Interview Module: Child
Content Type: Annual Core
?[F1]
Question Text:

What is ^SCNAME's Hispanic or Latino ancestry or origin? If ^SCNAME has more than one, tell me all of them.

Start typing and then select from list. If Hispanic or Latino ancestry is not on the list, type "ZZ" and enter verbatim.

If any of the following are mentioned, backup to previous screen and correct the entry. Mexican
Mexican American Chicano/Chicana
Central American (REFER TO HELP SCREEN) South American (REFER TO HELP SCREEN) Puerto Rican (Boricua)
Cuban/Cuban American Dominican (Republic)

If respondent provides more than one other Hispanic or Latino ancestry or origin, select 'ZZ' from the lookup table. At the next question, enter ALL the other Hispanic or Latino ancestries or origins in the verbatim field.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Child is of Other Hispanic Origin

Skip Instructions:

ZZ= [goto HISPVRBAT_C]
lookup table selection,RF,DK
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP [PX_C] in ('ZZ',RF,DK))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C]
else [goto BMONTH_C]

Question ID: VFY.0300.00.1
Variable: HISPVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What other race or races do you consider yourself to be?

Start typing and then select from list. If race is not on the list, type "ZZ" and enter verbatim.
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the next question, enter ALL the other races in the verbatim field.

Response:

Verbatim values
ZZ Other
97 Refused
99 Do not Know

Universe:

Skip Instructions:

ZZ= [goto RACEVRBAT]
picklist selection,RF,DK= if multiple responses to GEN.RACE_FINAL[PX_A].
RACE_FINAL [goto MLTRACE_A]
else [goto BMONTH_A]

Question ID: VFY.0310.00.1
Variable: PITYPE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group or groups is
^SCNAME-- such as Guamanian or Chamorro, Samoan, or other Pacific Islander? If ^SCNAME is more than one, tell me all of them.

Enter all that apply, separate with comma

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Guamanian or Chamorro
2 Samoan
3 Other Pacific Islander
7 Refused
9 Do not Know

Universe:

Sample children 0-17 identified as Pacific Islanders and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or do not know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

3 = [goto PIOTHER_C]
1,2,RF,DK = if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP [PX_C] in ('ZZ',RF,DK))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0320.00.1
Variable: PIOTHER_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of them.

Start typing and then select from list. If Pacific Islander ethnic group is not on the list, type "ZZ" and enter verbatim.

If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the next question, enter ALL the ethnic groups in the verbatim field.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

ZZ Other
97 Refused
99 Do not Know

Universe:

Sample Child who is "Other Pacific Islander"

Skip Instructions:

ZZ = [goto PIVRBAT_C] (lookup table selection, RF, DK)
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP [PX_C] in ('ZZ','RF',DK'))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0330.00.1
Variable: PIVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of them.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Child are some other group of Pacific Islander and this is not chosen from the picklist

Skip Instructions:

allow 80,RF,DK
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP [PX_C] in ('ZZ','RF',DK'))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0340.00.1
Variable: ASIANTYPE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I have recorded that ^SCNAME is Asian. What specific ethnic group or groups is ^SCNAME-- such as Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian? If ^SCNAME is more than one, tell me all of them.

Enter all that apply, separate with commas.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

01 Asian Indian
02 Chinese
03 Filipino
04 Japanese
05 Korean
06 Vietnamese
07 Other Asian
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 identified as Asian and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or do not know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

7 = [goto ASIANOTHER_C]
1-6,RF,DK
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP [PX_C] in ('ZZ','RF',DK'))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0350.00.1
Variable: ASIANOTHER_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has more than one, tell me all of them.

Start typing and then select from list. If Asian ethnic group is not on the list, type "ZZ" and enter verbatim.

If any of the following are mentioned, backup to previous screen and correct the entry. (Asian) Indian
Chinese Filipino Japanese Korean Vietnamese

If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the next question, enter ALL the ethnic groups in the verbatim field.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

ZZ Other
97 Refused
99 Do not Know

Universe:

Sample Child who is "other Asian"

Skip Instructions:

ZZ = [goto ASIANVRBAT_C]
lookup table selection,DK,RF
if GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG ne 1 and ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0360.00.1
Variable: ASIANVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has more than one, tell me all of them.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Child is some other ethnic group of Asian and this is not chosen from the picklist

Skip Instructions:

allow 80,RF,DK
if GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG ne 1 and ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
elseif GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0370.00.1
Variable: RACEOTHER_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What other race or races is ^SCNAME?

Start typing and then select from list. If race is not on the list, type "ZZ" and enter verbatim.

If respondent provides more than one other race, select 'ZZ' from the lookup table. At the next question, enter ALL the other races in the verbatim field.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

ZZ Other
97 Refused
99 Do not Know

Universe:

Sample Child's race was changed to "some other race" in verification section or where the Sample Child respondent is not the Household respondent and were identified by the household respondent as being "some other race" not on the roster other race picklist and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or do not know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

ZZ = [goto RACEVRBAT_C]
lookup table selection, RF,DK = if multiple responses to GEN.RACE_FINAL[PX_C] [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0380.00.1
Variable: RACEVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: What other race or races is ^SCNAME?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Child's race was change to include "some other race" in verification section or where the Sample Child respondent is not the Household respondent and were identified by the household respondent as being "some other race" not on the roster other race picklist and the Sample Child Respondent did not select it from the Sample Adult other race picklist.

Skip Instructions:

verbatim,RF,DK
if GEN.RACE_FINAL[PX_C] has multiple values selected [goto MLTRACE_C] else [goto BMONTH_C]

Question ID: VFY.0390.00.1
Variable: MLTRACE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Which one of these groups, that is ^RACELISTOR_C would you say BEST represents ^SCNAME's race?

Fills:
^RACELISTOR_C

Description List of answers from RACE
Instruction Fill categories from GEN.RACE_FINAL. Add the word "or" before the last category.

For GEN.RACE_FINAL=8:

if RACEOTHER_C NOT IN (ZZ,RF,DK) display value from RACEOTHER_C

elseif RACEVRBAT_C NOT IN (RF,DK) display value from RACEVRBAT_C

elseif NEWRACE ne 8 and Roster.HHC.tblRACE.bPerson.RACE_SP [PX_C] NOT IN (ZZ,DK,RF) display value from Roster.HHC.tblRACE.bPerson.RACE_SP[PX_C]

elseif HHRESPSC_FLG=1 and NEWRACE ne 8 and Roster.HHC.tblRACE.bPerson.RACE_VRBAT[PX_C] NOT IN (DK,RF)
display value from Roster.HHC.tblRACE.bPerson.RACE_VRBAT [PX_C]

else display "some other race"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

01 White
02 Black/African American
03 American Indian
04 Alaska Native
05 Native Hawaiian
06 Other Pacific Islander
07 Asian
08 Some other race
97 Refused
99 Do not Know

Universe:

Sample child identified as having multiple races and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or do not know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1-8,RF,DK = [goto BMONTH_C]

Question ID: VFY.0410.01.1
Variable: BMONTH_C
Interview Module: Child
Content Type: Annual Core

Question Text:

1 of 3

What is ^SCNAME's date of birth?
Please give month, day, and year for the date of birth.

Enter month of birth.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Do not Know

Universe:

A person who is knowledgeable or responsible for the sample child's health is available or there is only one parent over 18 and no other adults in the child's family or there are more than two adults and one of them is a parent who was identified as available at AVAIL_C AND date of birth was verified as incorrect fewer than 2 times and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1-12,RF,DK = [goto BDAY_C]

Question ID: VFY.0410.02.1
Variable: BDAY_C
Interview Module: Child
Content Type: Annual Core

Question Text:

2 of 3

Enter day of birth.

Response:

01-31 Range of values
97 Refused
99 Do not Know

Universe:

Skip Instructions:

1-31,RF,DK = Only allow valid days for month entered. if days not valid [goto ERR_BDAY_C] else [goto BYEAR_C]

Hard Edit:

ERR_BDAY_C

Check Description Invalid day for selected month hard edit
Check Text {check ERR_BDAY_C}

^BDAY_C is not a valid day for ^BMONTH_C.

Question ID: VFY.0410.03.1
Variable: BYEAR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

3 of 3

Enter year of birth.

Response:

1900-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Skip Instructions:

1900-current year,RF,DK
if (BYEAR_C gt current year) or (BYEAR_C=current year and BMONTH_C gt current month) or (BYEAR_C=current year and BMONTH_C=current month and BDAY_C gt current day) [goto ERR_BYEAR_C]

elseif BDAY_C=29 and BMONTH_C=2 and (BYEAR=2000 or BYEAR_C/4 remainder ne 0) [goto ERR_BDAYLEAP_C]

elseif AGETEMP_C in ('RF','DK') AND BYEAR_C in ('RF','DK') [goto NOMORE_C]

elseif ((BYEAR_C not IN (DK,RF) and AGETEMP_C not IN (DK,RF) and AGETEMP_C ne AGE_CALC_C) AND (AGETEMP_C not IN (DK,RF) and AGETEMP_C ne AGE_CALCMINUS1_C)) and DOB_COUNT_C ne 1 [goto VFYDOB_C]

elseif (AGETEMP_C eq AGE_CALC_C or AGE_CALCMINUS1_C) or DOB_COUNT_C=1 if AGE_FINAL ge 18 [goto NOMORE_C]
else [goto next section]

Hard Edit:
ERR_BDAYLEAP_C

Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAYLEAP_C} ^BDAY_C is not a valid day for ^BMONTH_C.

ERR_BYEAR_C

Check Text: {check ERR_BYEAR_C} Future date invalid.

Question ID: VFY.0430.00.1
Variable: VFYDOB_C
Interview Module: Child
Content Type: Annual Core

Question Text:

There is a difference between the age the computer calculated from ^SCNAME's date of birth of
^AGEDOB_C_fill and the age I had previously recorded of ^TEMPAGE_C. I recorded ^SCNAME's ^dateofbirth_C

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^AGEDOB_C_fill

Description Age(s) calculated from Date of Birth for SC
Instruction Fill one age calculated from AGE_CALC_C as "(age) year(s) old"
Fill two ages calculated from AGE_CALC_C and AGE_CALCMINUS1_C as "(age) or (age) year(s) old"
If AGE_CALC_C or AGE_CALCMINUS1_C is equal to 0, then display as "less than 1"

^TEMPAGE_C

Description {Value of AGETEMP_C} year(s) old/less than 1
Instruction fill value of AGETEMP_C as "(age) year(s) old"
If AGETEMP_C is equal to 0, then display as "less than 1"

^dateofbirth_C

Description date of birth when any of BDAY_C, BMONTH_C or BYEAR_C are not valid
Instruction If BDAY_C, BMONTH_C and BYEAR_C are all valid, fill: "date of birth as ^BMONTH_C ^BDAY_C, ^BYEAR_C, is that correct?" If only BMONTH_C and BYEAR_C are valid, fill: "date of birth as ^BMONTH_C ^BYEAR_C, is that correct?"
If only BDAY_C and BYEAR_C are valid, fill: "year of birth as ^BYEAR_C, is that correct?"
If only BYEAR_C is valid, fill: "year of birth as
^BYEAR_C, is that correct?"

^BMONTH_C

Description {Value of BMONTH_C}
Instruction Fill value from BMONTH_C

^BDAY_C

Description {Value of BDAY_C}
Instruction Fill value from BDAY_C

^BYEAR_C

Description {Value of BYEAR_C}
Instruction Fill with value in BYEAR_C

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children whose age provided in either HHC or NEWAGE_C does not match either age calculated from date of birth information and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1,RF,DK = if GEN.AGE_FINAL[PX_C] gt 18 [goto NOMORE_C]
else [goto next section]

2 if DOB_COUNT_C le 1 [goto BMONTH_C]
elseif GEN.AGE_FINAL[PX_C] gt 18 [goto NOMORE_C] else [goto next section]

Question ID: VFY.0440.00.1
Variable: NOMORE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^SCNAME no longer meets the requirements to be sample child for this family. End this interview and begin the Sample Adult Interview. If there is no Sample Adult or the Sample Adult interview has been completed, EXIT

^auxNoMore

Not everyone in our survey is asked all questions. I have all the information that I need from you about ^SCNAME.

Enter '1' to continue.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^auxNoMore

Description If there is still a knowledgeable respondent available, back up and select that person.
Instruction IF KNOAVAIL_Count = 0, fill "* If there is still a knowledgeable respondent available, back up and select that person."

Response:

1 Enter 1 to continue

Universe:

Sample child whose age is now over 17 or whose age is refused or do not know or who lives off- campus or there is no knowledgeable sample child respondent

Skip Instructions:

If there is a callback set for Sample Adult [goto BCK.THANKS_CB] else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

2019 National Health Interview Survey (NHIS) Questionnaire
HIS: Health Status

Question ID: HIS.0010.00.1
Variable: PHSTAT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Would you say ^SCNAME's health in general is excellent, very good, good, fair, or poor?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Excellent
2 Very Good
3 Good
4 Fair
5 Poor
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1-5,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
AST: Asthma

Question ID: AST.0010.00.1
Variable: ASTINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Now I am going to ask you about certain medical conditions.

Enter '1' to continue.

Response:
1 Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto ASEV_C]

Question ID: AST.0020.00.1
Variable: ASEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Has a doctor or other health professional EVER told you that ^SCNAME had asthma?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto ASTILL_C]
2,RF,DK = [goto next section]

Question ID: AST.0030.00.1
Variable: ASTILL_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME still have asthma?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who were ever told they have asthma

Skip Instructions:

1,2,RF,DK = [goto ASAT12M_C]

Question ID: AST.0040.00.1
Variable: ASAT12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, has ^SCNAME had an episode of asthma or an asthma attack?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who were ever told they had asthma

Skip Instructions:

1,2,RF,DK = [goto ASER12M_C]

Question ID: AST.0050.00.1
Variable: ASER12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, did ^SCNAME have to visit an emergency room or urgent care center because of ^hisher_C asthma?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who were ever told they had asthma

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DIB: Diabetes

Question ID: DIB.0010.00.1
Variable: PREDIB_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Has a doctor or other health professional EVER told you that ^SCNAME had prediabetes or borderline diabetes?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample children 0-17

Skip Instructions:

1,2,RF,DK = [goto DIBEV_C]

Question ID: DIB.0020.00.1
Variable: DIBEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^NOTPRED a doctor or other health professional EVER told you that ^SCNAME had diabetes?

Fills:
^NOTPRED

Description Not including prediabetes, has/Has
Instruction If PREDIB_C=1: "Not including prediabetes, has" If PREDIB_C IN ('2','DK','RF'): "Has"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DLD: Developmental and Learning Disabilities

Question ID: DLD.0010.00.1
Variable: ADHDEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Has a doctor or other health professional ever told you that ^SCNAME had Attention- Deficit/Hyperactivity Disorder or ADHD or Attention-Deficit Disorder or ADD?

Fills:

^SCNAME
Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1 = [goto ADHDNW_C]
2,RF,DK = [goto IDEV_C]

Question ID: DLD.0020.00.1
Variable: ADHDNW_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME currently have Attention-Deficit/Hyperactivity Disorder or ADHD or Attention- Deficit Disorder or ADD?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17 who had an ADHD diagnosis

Skip Instructions:

1,2,RF,DK = [goto IDEV_C]

Question ID: DLD.0030.00.1
Variable: IDEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Has a doctor or other health professional ever told you that ^SCNAME had an intellectual disability, also known as mental retardation?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto IDNW_C]
2,RF,DK = [goto ASDEV_C] if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17, else [goto DDEV_C]

Question ID: DLD.0040.00.1
Variable: IDNW_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME currently have an intellectual disability, also known as mental retardation?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who had an intellectual disability diagnosis

Skip Instructions:

1,2,RF,DK = if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto ASDEV_C]
else [goto DDEV_C]

Question ID: DLD.0050.00.1
Variable: ASDEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Has a doctor or other health professional ever told you that ^SCNAME had Autism, Asperger's disorder, pervasive developmental disorder, or autism spectrum disorder?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1 = [goto ASDNW_C]
2,RF,DK = [goto DDEV_C]

Question ID: DLD.0060.00.1
Variable: ASDNW_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME currently have Autism, Asperger's disorder, pervasive developmental disorder, or autism spectrum disorder?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17 who had an autism spectrum disorder diagnosis

Skip Instructions:

1,2,RF,DK = [goto DDEV_C]

Question ID: DLD.0070.00.1
Variable: DDEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^NOTEVER a doctor or other health professional ever told you that ^SCNAME had any other developmental delay?

Fills:
^NOTEVER

Description Has/Not including (ADHD, intellectual disability, autism spectrum disorder), has
Instruction If ADHDEV_C ne 1 AND IDEV_C ne 1 and ASDEV_C ne 1 fill: "Has"
If ADHDEV_C=1 AND IDEV_C ne 1 and ASDEV_C ne 1 fill: "Not including ADHD, has"
If ADHDEV_C ne 1 AND IDEV_C=1 and ASDEV_C ne 1 fill: "Not including an intellectual disability, has"
If ADHDEV_C ne 1 AND IDEV_C ne 1 and ASDEV_C=1 fill: "Not including autism spectrum disorder, has"
If ADHDEV_C=1 AND IDEV_C=1 and ASDEV_C ne fill: "Not including ADHD or an intellectual disability, has"
If ADHDEV_C=1 AND IDEV_C ne 1 and ASDEV_C=1 fill: "Not including ADHD or autism spectrum disorder, has"
If ADHDEV_C ne 1 AND IDEV_C=1 and ASDEV_C=1 fill: "Not including an intellectual disability or autism spectrum disorder, has"
If ADHDEV_C=1 AND IDEV_C=1 and ASDEV_C=1 fill: "Not
including ADHD, an intellectual disability or autism spectrum disorder, has"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto DDNW_C]
2,RF,DK = if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto LDEV_C]
else [goto next section]

Question ID: DLD.0080.00.1
Variable: DDNW_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME still have this other developmental delay?

Fills:

^SCNAME
Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who had any other developmental delay diagnosis

Skip Instructions:

1,2,RF,DK = if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto LDEV_C]
else [goto next section]

Question ID: DLD.0090.00.1
Variable: LDEV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Has a representative from a school or a health professional ever told you that ^SCNAME had a learning disability?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1 = [goto LDNW_C]
2,RF,DK = [goto next section]

Question ID: DLD.0100.00.1
Variable: LDNW_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME currently have a learning disability?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17 who had a learning disability diagnosis

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
VIS: Vision

Question ID: VIS.0010.00.1
Variable: VISINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I would like to ask you some questions about difficulties your child may have.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Children 2-17

Skip Instructions:

1 = [goto WEARGLSS_C]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME wear glasses ^CONTACTS?

Read if necessary: Persons who wear glasses to read or to do other occasional tasks should answer yes to this question.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^CONTACTS

Description or contact lenses
Instruction If AGE=5-17 fill "or contact lenses"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,DK,RF = [goto VISIONDF_C]

Question ID: VIS.0030.00.1
Variable: VISIONDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^GLASSCONTACT ^SCNAME have difficulty seeing? Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:
^GLASSCONTACT

Description When wearing glasses ^CONTACTS does/Does
Instruction If WEARGLSS_C=1 fill "When wearing glasses ^CONTACTS does" else if WEARGLSS_C ne 1 "Does"

^CONTACTS

Description or contact lenses
Instruction If AGE=5-17 fill "or contact lenses"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
HEA: Hearing

Question ID: HEA.0010.00.1
Variable: HEARAID_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME use a hearing aid?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,DK,RF = [goto HEARINGDF_C]

Question ID: HEA.0020.00.1
Variable: HEARINGDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^USEHRAID_C ^SCNAME have difficulty hearing sounds like people's voices or music? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:
^USEHRAID_C

Description When using ^hisher_C hearing aid(s) does/Does
Instruction If HEARAID_C=1 fill "When using ^hisher_C hearing aid(s) does " else fill "Does "

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,DK,RF = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
MOB: Mobility

Question ID: MOB.0010.00.1
Variable: EQUIP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME use any equipment or receive assistance for walking?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1 = if GEN.AGE_FINAL[PX_C]=2-4 [goto NOEQWLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto NOEQWLK100_C]
2,RF,DK = if GEN.AGE_FINAL[PX_C]=2-4 [goto WLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto WLK100_C]

Question ID: MOB.0020.00.1
Variable: NOEQWLKDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Without using ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking? Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:
^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4 who use equipment or assistance for walking

Skip Instructions:

1-4,RF,DK = [goto EQWLKDF_C]

Question ID: MOB.0030.00.1
Variable: EQWLKDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

When using ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4 who use equipment or assistance for walking

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: MOB.0040.00.1
Variable: WLKDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Compared with children of the same age, does ^SCNAME have difficulty walking? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4 who do not use equipment or assistance for walking or Refused or Do not Know

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: MOB.0050.00.1
Variable: NOEQWLK100_C
Interview Module: Child
Content Type: Annual Core

Question Text:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking 100 yards on level ground? That would be about the length of 1 football field or 1 city block. Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:
^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking

Skip Instructions:

1-3,RF,DK = [goto NOEQWLK13M_C]
4 = [goto EQWLK100_C]

Question ID: MOB.0060.00.1
Variable: NOEQWLK13M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking a third of a mile on level ground? That would be about the length of 5 football fields or 5 city blocks.

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking and have no, some or a lot difficulty walking 100 yards when not using their equipment/assistance or Refused or Do not Know

Skip Instructions:

1-4,RF,DK = [goto EQWLK100_C]

Question ID: MOB.0070.00.1
Variable: EQWLK100_C
Interview Module: Child
Content Type: Annual Core

Question Text:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking 100 yards on level ground? That would be about the length of 1 football field or 1 city block.

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking.

Skip Instructions:

1-3,RF,DK = [goto EQWLK13M_C]
4 = [goto next section]

Question ID: MOB.0080.00.1
Variable: EQWLK13M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking a third of a mile on level ground? That would be about the length of 5 football fields or 5 city blocks.

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking and have no, some or a lot of difficulty walking 100 yards when using their equipment/assistance or Refused or Do not Know

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: MOB.0090.00.1
Variable: WLK100_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Compared with children of the same age, does ^SCNAME have difficulty walking 100 yards on level ground? That would be about the length of 1 football field or 1 city block. Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME
Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17 who do not use equipment or assistance for walking or Refused or Do not Know

Skip Instructions:

1-3,RF,DK = [goto WLK13M_C]
4 = [goto next section]

Question ID: MOB.0100.00.1
Variable: WLK13M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Compared with children of the same age, does ^SCNAME have difficulty walking a third of a mile on level ground? That would be about the length of 5 football fields or 5 city blocks.

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17 who do not use equipment or assistance for walking and have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or Refused or Do not Know

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
UPP: Upper Body, Motor skills and self care

Question ID: UPP.0010.00.1
Variable: PICKUPDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Compared with children of the same age, does ^SCNAME have difficulty picking up small objects with ^hisher_C hands?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,DK,RF = [goto next section]

Question ID: UPP.0020.00.1
Variable: SELFCAREDF_C
Interview Module: Child
Content Type: AnnualCore

Question Text:

Does ^SCNAME have difficulty with self care, such as eating or dressing?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,DK,RF = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
COM: Communication

Question ID: COM.0010.00.1
Variable: UNDRSTYOU_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME have difficulty understanding you?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK = [goto UNDRSTCHD_C]

Question ID: COM.0020.00.1
Variable: UNDRSTCHD_C
Interview Module: Child
Content Type: Annual Core

Question Text:

When ^SCNAME speaks, do you have difficulty understanding ^himherthem_C?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^himherthem_C

Description him/her/them
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "him";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "them"

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: COM.0030.00.1
Variable: UNDRSTIHH_C
Interview Module: Child
Content Type: Annual Core

Question Text:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being understood by people inside of this household?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^doesheshedothey_C

Description does he/does she/do they
Instruction If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK = [goto UNDRSTOHH_C]

Question ID: COM.0040.00.0
Variable: UNDRSTOHH_C
Interview Module: Child
Content Type: Annual Core

Question Text:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being understood by people outside of this household?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^doesheshedothey_C

Description does he/does she/do they
Instruction If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
COG: Cognition

Question ID: COG.0010.00.1
Variable: LEARNDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Compared with children of the same age, does ^SCNAME have difficulty learning things?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK = [goto REMEMBERDF_C]

Question ID: COG.0020.00.1
Variable: REMEMBERDF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Compared with children of the same age, does ^SCNAME have difficulty remembering things?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
ANX: Anxiety

Question ID: ANX.0010.00.1
Variable: ANXFREQ_C
Interview Module: Child
Content Type: Annual Core

Question Text:

How often does ^SCNAME seem very anxious, nervous, or worried? Would you say: daily, weekly, monthly, a few times a year, or never?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Daily
2 Weekly
3 Monthly
4 A few times a year
5 Never
7 Refused
9 Do not Know

Universe:

Sample Children 5-17

Skip Instructions:

1-5,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DEP: Depression

Question ID: DEP.0010.00.1
Variable: DEPFREQ_C
Interview Module: Child
Content Type: Annual Core

Question Text:

How often does ^SCNAME seem very sad or depressed? Would you say: daily, weekly, monthly, a few times a year, or never?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Daily
2 Weekly
3 Monthly
4 A few times a year
5 Never
7 Refused
9 Do not Know

Universe:

Sample Children 5-17

Skip Instructions:

1-5,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
BEH: Behavior

Question ID: BEH.0010.00.1
Variable: BEHDFPLYG_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Compared with children of the same age, does ^SCNAME have difficulty playing? Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction: If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK = [goto BEHKBHYG_C]

Question ID: BEH.0020.00.1
Variable: BEHKBHYG_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Compared with children of the same age, how much does ^SCNAME kick, bite, or hit other children or adults? Would you say: not at all, the same or less, more, or a lot more?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 The same or less
3 More
4 A lot more
7 Refused
9 Do not Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK = [goto next section]

Question ID: BEH.0030.00.1
Variable: BEHDFCNTR_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Compared with children of the same age, does ^SCNAME have difficulty controlling ^hisher_C behavior?

Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction: if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^heshe_C

Description: He/She/They
Instruction: If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe: Sample Children 5-17
Skip Instructions: 1-4,RF,DK = [goto BEHDFFCS_C]

Question ID: BEH.0040.00.1
Variable: BEHDFFCS_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have difficulty concentrating on an activity that ^heshe_C enjoy^s doing?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction: If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Description: s
Instruction: if SEX_FINAL[PX_C]=1,2 fill "s" else fill blank

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe: Sample Children 5-17
Skip Instructions: 1-4,RF,DK = [goto BEHDFCHG_C]

Question ID: BEH.0050.00.1
Variable: BEHDFCHG_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have difficulty accepting changes in ^hisher_C routine?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction: if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^heshe_C

Description: He/She/They
Instruction: If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe: Sample Children 5-17
Skip Instructions: 1-4,RF,DK = [goto BEHDFMKFR_C]

Question ID: BEH.0060.00.1
Variable: BEHDFMKFR_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have difficulty making friends?

*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction: If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Universe: Sample Children 5-17
Skip Instructions: 1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
BCS: Baby Pediatric Symptom Checklist

Question ID: BSC.0020.00.1
Variable: BSCNWPPL_C
Interview Module: Child
Content Type: Annual Core
Question Text:

These next questions are about ^SCNAME's behavior. Think about what you would expect of other children the same age, and tell me how much each statement applies to ^SCNAME.
Does ^SCNAME have a hard time being with new people? Would you say not at all, somewhat, or very much?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCNWPLCS_C]

Question ID: BSC.0030.00.1
Variable: BSCNWPLCS_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have a hard time in new places? Would you say not at all, somewhat, or very much?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCCHG_C]

Question ID: BSC.0040.00.1
Variable: BSCCHG_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have a hard time with change?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCHLOPPL_C]

Question ID: BSC.0050.00.1
Variable: BSCHLOPPL_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME mind being held by other people?

Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCCRYALT_C]

Question ID: BSC.0060.00.1
Variable: BSCCRYALT_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME cry a lot?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCCLMDWN_C]

Question ID: BSC.0070.00.1
Variable: BSCCLMDWN_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have a hard time calming down?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCFUSSY_C]

Question ID: BSC.0080.00.1
Variable: BSCFUSSY_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is ^SCNAME fussy or irritable?

Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCSTHE_C]

Question ID: BSC.0090.00.1
Variable: BSCSTHE_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is it hard to comfort ^SCNAME?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCSCHD_C]

Question ID: BSC.0100.00.1
Variable: BSCSCHD_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is it hard to keep ^SCNAME on a schedule or routine?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCPTSLP_C]

Question ID: BSC.0110.00.1
Variable: BSCPTSLP_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is it hard to put ^SCNAME to sleep?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCSTYSLP_C]

Question ID: BSC.0120.00.1
Variable: BSCSTYSLP_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME have trouble staying asleep?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto BSCPRLKSL_C]

Question ID: BSC.0130.00.1
Variable: BSCPRLKSL_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is it hard for ^youmembersoffamily to get enough sleep because of ^SCNAME?

* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^youmembersoffamily

Description: you/members of your family
Instruction: If PCNT='2' fill "you" else fill "members of your family"

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Somewhat
3 Very much
7 Refused
9 Do not Know

Universe: Sample Children with Age under 2 years
Skip Instructions: 1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
SCH: Schooling

Question ID: SCH.0020.00.1
Variable: SCHSPEDEV_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Has ^SCNAME ever had a special education or early intervention plan, such as an Individualized Education Plan, an IEP, or an Individualized Family Service Plan, an IFSP?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe: Sample Children 0-17
Skip Instructions: 1 = [goto SCHSPED_C] 2,RF,DK = [goto next section]

Question ID: SCH.0030.00.1
Variable: SCHSPED_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME currently have a special education or early intervention plan?

*Read if necessary: Consider special education or early intervention plans received during the past school year.
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe: Sample Children 0-17 who ever received special education services
Skip Instructions: 1 = [goto SCHSPEDEM_C] 2,RF,DK = [goto next section]

Question ID: SCH.0040.00.1
Variable: SCHSPEDEM_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does ^SCNAME receive these services to help with ^hisher_C emotions, concentration, behavior, or mental health?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction: if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her"; else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe: Sample Children 0-17 who have received services in the past 12 months
Skip Instructions: 1,2,RF,DK [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
INS: Health Insurance

Question ID: INS.0010.00.1
Variable: HICOV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

The next questions are about health insurance. Include health insurance obtained through employment or purchased directly as well as government programs like Medicare, Medicaid, and the Children's Health Insurance Program that provide medical care or help pay medical bills. Is
^SCNAME covered by any kind of health insurance or some other kind of health care plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,R,D = [goto HIKIND_C]
2 = [goto MCAIDPRB_C]

Question ID: INS.0020.00.1
Variable: HIKIND_C
Interview Module: Child
Content Type: Annual Core
Question Text:
?[F1]

What kinds of health insurance or health care coverage does ^SCNAME have? Is it...Private health insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP, military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health Service, state-sponsored health plan, or an other government program?

Enter all that apply, separate with commas.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

01 Private health insurance
02 Medicare
03 Medigap
04 Medicaid
05 Children's Health Insurance Program (CHIP)
06 Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMP- VA
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 No coverage of any type
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 covered by any kind of health insurance or health care coverage or refused/do not know if they have insurance or health care coverage.

Skip Instructions:

if 1 answer selected and (10 in HIKIND_C) [goto ERR1_HIKIND_C] else if HIKIND_C=RF,DK or (10 in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]

Hard Edit:

Check Text: ERR1_HIKIND_C
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_C}

Cannot mark "no coverage of any kind" and another type. Please correct.

Question ID: INS.0030.00.1
Variable: MCAIDPRB_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

There is a program called Medicaid that pays for health care for persons in need. ^STATEMA Is
^SCNAME covered by Medicaid?

Fills:
^STATEMA

Description: In ^STATENAME it is also called ^STMEDICAID.
Instruction: if STMEDICAID ne empty, fill: "In ^STATENAME it is also called ^STMEDICAID." else fill: blank

^STATENAME

Description: State name
Instruction:If ST=AL, fill: Alabama else if ST=AK, fill: Alaska
else if ST=AR, fill: Arkansas else if ST=AZ, fill: Arizona else if ST=CA, fill: California else if ST=CO, fill: Colorado else if ST=CT, fill: Connecticut else if ST=DE, fill: Delaware
else if ST=DC, fill: District of Columbia else if ST=FL, fill: Florida
else if ST=GA, fill: Georgia else if ST=HI, fill: Hawaii else if ST=ID, fill: Idaho else if ST=IL, fill: Illinois else if ST=IN, fill: Indiana else if ST=IA, fill: Iowa else if ST=KS, fill: Kansas else if ST=KY, fill: Kentucky
else if ST=LA, fill: Louisiana else if ST=ME, fill: Maine else if ST=MD, fill: Maryland
else if ST=MA, fill: Massachusetts else if ST=MI, fill: Michigan
else if ST=MN, fill: Minnesota else if ST=MS, fill: Mississippi else if ST=MO, fill: Missouri else if ST=MT, fill: Montana else if ST=NE, fill: Nebraska else if ST=NV, fill: Nevada
else if ST=NH, fill: New Hampshire else if ST=NJ, fill: New Jersey else if ST=NM, fill: New Mexico else if ST=NY, fill: New York
else if ST=NC, fill: North Carolina else if ST=ND, fill: North Dakota else if ST=OH, fill: Ohio
else if ST=OK, fill: Oklahoma else if ST=OR, fill: Oregon
else if ST=PA, fill: Pennsylvania else if ST=RI, fill: Rhode Island else if ST=SC, fill: South Carolina else if ST=SD, fill: South Dakota else if ST=TN, fill: Tennessee
else if ST=TX, fill: Texas else if ST=UT, fill: Utah else if ST=VT, fill: Vermont else if ST=VA, fill: Virginia
else if ST=WA, fill: Washington else if ST=WV, fill: West Virginia else if ST=WI, fill: Wisconsin else if ST=WY, fill: Wyoming

^STMEDICAID

Description: State Medicaid name
Instruction: If AL then fill "Patient 1st, Alabama Coordinated Health Network"
If AK then fill "Alaska Medicaid; DenaliCare"
If AZ then fill "Arizona Health Care Cost Containment System (AHCCCS)"
If AR then fill "ARKids First A; Arkansas Works" If CA then fill "Medi-Cal"
If CO then fill "Health First Colorado"
If CT then fill "HUSKY A, HUSKY C, HUSKY D; Med-Connect" If DE then fill "Diamond State Health Plan; Children's Community Alternative Disabilities Program"
If DC then fill "DC Medicaid"
If FL then fill "Florida Medicaid; Medically Needy Program"
If GA then fill "Georgia Families; Health Insurance Premium Payment Program (HIPP)"
If HI then fill "Med QUEST"
If ID then fill "Idaho Medicaid Program" If IL then fill "Medical Assistance"
If IN then fill "Traditional Medicaid; Healthy Indiana Plan (HIP); Hoosier Healthwise"
If IA then fill "IA Health Link; Iowa Health and Wellness Plan"
If KS then fill "KanCare; Kansas Medical Assistance Program (KMAP)"
If KY then fill "Kentucky Medicaid; Kentucky HEALTH" If LA then fill "Healthy Louisiana; LaCHIP; LaMOMS" If ME then fill "MaineCare"
If MD then fill "HealthChoice; Maryland Children's Health Program (MCHP)"
If MA then fill "MassHealth"
If MI then fill "Medicaid; Healthy Michigan Plan (HMP)" If MN then fill "Medical Assistance (MA)"
If MS then fill "MississippiCAN" If MO then fill "MO Healthnet"
If MT then fill "Passport to Health; Healthy Montana Kids Plus (HMK Plus); HELP Plan"
If NE then fill "Heritage Health" If NV then fill "Nevada Medicaid"
If NH then fill "NH Medicaid; Granite Advantage Health Care Program"
If NJ then fill "NJ Medicaid; NJ Family Care" If NM then fill "Centennial Care"
If NY then fill "Medicaid; Children's Medicaid" If NC then fill "NC Medicaid; Medical Assistance" If ND then fill "North Dakota Medicaid"
If OH then fill "Ohio Medicaid State Plan; Healthy Families; Healthy Start; Alternative Benefit Plan" If OK then fill "SoonerCare"
If OR then fill "Oregon Health Plan (OHP)" If PA then fill "Medical Assistance"
If RI then fill "RIte Care; Affordable Care Coverage (ACC)"
If SC then fill "Healthy Connections" If SD then fill "South Dakota Medicaid" If TN then fill "TennCare"
If TX then fill "Texas Medicaid; State of Texas Access Reform (STAR); STAR+PLUS; Children's Medicaid; STAR Kids" If UT then fill "Utah Medicaid"
If VT then fill "Green Mountain Care" If VA then fill "Medicaid; FAMIS Plus" If WA then fill "Apple Health"
If WV then fill "Mountain Health Trust (MHT)"
If WI then fill "Wisconsin Medicaid; ForwardHealth" If WY then fill "WYhealth"

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have indicated they are uninsured, refused, or do not know if they are insured

Skip Instructions:

1,2,RF,DK= [goto SINCOVDE_C]

Question ID: INS.0040.00.1
Variable: SINCOVDE_C
Interview Module: Child
Content Type: Annual Core
Question Text:
?[F1]

^INADDITIONIS ^SCNAME covered by a SEPARATE plan that only pays for dental services?

Fills:
^INADDITIONIS

Description: In addition to ^HITYPECNOSS, is/Is
Instruction: If (HIKIND_C=1-9 or MCAIDPRB_C=1), fill "In addition to
^HITYPECNOSS, is"
else fill "Is"

^HITYPECNOSS

Description: Type of health care plans without single service plans
Instruction: fill coverage types from HIKIND_C, except HIKIND_C=10, HIKIND_C=1 fill: "private health insurance"
HIKIND_C=2 fill: "Medicare"
HIKIND_C=3 fill: "Medicare Supplement or Medigap" HIKIND_C=4 fill: "Medicaid"
HIKIND_C=5 fill: "Children's Health Insurance Program (CHIP)"
HIKIND_C=6 fill: "military related health care" HIKIND_C=7 fill: "Indian Health Service" HIKIND_C=8 fill: "a state-sponsored health plan" HIKIND_C=9 fill: "an other government program" if MCAIDPRB_C=1, fill "Medicaid"

separate choices with a comma and seperate the last two choices with "and"

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK= [goto SINCOVVS_C]

Question ID: INS.0050.00.1
Variable: SINCOVVS_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

Is ^SCNAME covered by a SEPARATE plan that only pays for vision services?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK= [goto SINCOVRX_C]

Question ID: INS.0060.00.1
Variable: SINCOVRX_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

Is ^SCNAME covered by a SEPARATE plan that only pays for prescriptions?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK= [goto HICHANGE_C]

Question ID: INS.0070.00.1
Variable: HICHANGE_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

I have recorded ^SCNAME is ^COVEREDC. Is this correct?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^COVEREDC

Description: not covered by health insurance/covered by ^HITYPEC
Instruction: if HIKIND_C=10,R,D and MCAIDPRB_C=2,R,D and SINCOVDE_C=2,R,D and SINCOVVS_C=2,R,D and SINCOVRX_C=2,R,D
fill: "not covered by health insurance" else fill: "covered by ^HITYPEC"

^HITYPEC

Description: Type of health care plans with single service plans
Instruction: fill coverage types from HIKIND_C, except HIKIND_C=10, HIKIND_C=1 fill: "private health insurance"
HIKIND_C=2 fill: "Medicare"
HIKIND_C=3 fill: "Medicare Supplement or Medigap" HIKIND_C=4 fill: "Medicaid"
HIKIND_C=5 fill: "Children's Health Insurance Program (CHIP)"
HIKIND_C=6 fill: "military related health care" HIKIND_C=7 fill: "Indian Health Service" HIKIND_C=8 fill: "a state-sponsored health plan" HIKIND_C=9 fill: "an other government program" if MCAIDPRB_C=1, fill "Medicaid"
If SINCOVDE_C=1 and SINCOVRX_C=2,RF,DK and
SINCOVVS_C=2,RF,DK, fill: "a single service dental plan" If SINCOVDE_C=2,RF,DK and SINCOVRX_C=1 and
SINCOVVS_C=2,RF,DK, fill: "a single service prescription plan"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=2,RF,DK and
SINCOVVS_C=1, fill: "a single service vision plan"
If SINCOVDE_C=1 and SINCOVRX_C=1 and SINCOVVS_C=2,RF,DK,
fill: "single service dental and prescription plans"
If SINCOVDE_C=1 and SINCOVRX_C=2,RF,DK and SINCOVVS_C=1,
fill: "single service dental and vision plans"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=1 and SINCOVVS_C=1,
fill: "single service vision and prescription plans"
If SINCOVDE_C=1 and SINCOVRX_C=1 and SINCOVVS_C=1, fill:
"single service dental, vision, and prescription plans"

separate choices with a comma and separate the last two choices with "and"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,RF,DK=
if 2 in HIKIND_C [goto MCPART_C]
else if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C] else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG] else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else if 7 in HIKIND_C [goto HINOTYR_C]
else if 10 in HIKIND_C and MCAIDPRB_C IN (2,RF,DK) [goto HILAST_C] else [goto FINISH_C]
2= [goto ERR1_HICHANGE_C]

Hard Edit:

Check Text: ERR1_HICHANGE_C
Check Description:
Check Text: {check ERR1_HICHANGE_C}

Press Enter to go back to HIKIND_C and update coverage.

Question ID: INS.0080.00.1
Variable: MCPART_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What type of Medicare coverage does ^SCNAME have? Is it Part A - hospital insurance, Part B - medical insurance, or both?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Part A- hospital only
2 Part B- medical only
3 Both Part A and Part B
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicare

Skip Instructions:

2,3,RF,DK= [goto MCCHOICE_C]
1 =[goto MCPARTD_C]

Question ID: INS.0090.00.1
Variable: MCCHOICE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is ^SCNAME enrolled in a Medicare Advantage plan?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicare part B only or both parts A and B

Skip Instructions:

1,2,RF,DK= [goto MCHMO_C]

Question ID: INS.0100.00.1
Variable: MCHMO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is ^SCNAME under a Medicare managed care arrangement, such as an HMO, that is, a Health Maintenance Organization?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused

Universe:

Sample Children 0-17 with Medicare part B only or both parts A and B

Skip Instructions:

1= [goto MCANAME_C]
2,RF,DK= if MCCHOICE_C=1 [goto MCANAME_C]
else if MCCHOICE_C=2,RF,DK, [goto MCPARTD_C]

Question ID: INS.0110.00.1
Variable: MCANAME_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What is the name of ^SCNAME's Medicare Advantage or Medicare HMO plan?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with a Medicare Advantage plan or a Medicare managed care arrangement

Skip Instructions:

verbatim, RF, DK= [goto MCPARTD_C]

Question ID: INS.0120.00.1
Variable: MCPARTD_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is ^SCNAME enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicare

Skip Instructions:

1,2,RF,DK=
if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C] else if 1 in HIKIND_C [goto SET_INSPRI_FLAG] else if 3 in HIKIND_C [goto SET_INSPRI_FLAG] else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0130.00.1
Variable: MACHMN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

The next questions are about Medicaid coverage. What is the name of ^SCNAME's Medicaid health plan?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

allow 80, RF, DK= [goto MAXCHNG_C]

Question ID: INS.0140.00.1
Variable: MAXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was ^SCNAME's Medicaid obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

1,2,RF,DK= [goto MAPREM_C]

Question ID: INS.0150.00.1
Variable: MAPREM_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

A health insurance premium is the amount ^SCNAME or a family member pays each month for health care coverage. Does ^SCNAME or a family member pay a premium for this Medicaid plan?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

1,2,RF,DK= [goto MADEDUC_C]

Question ID: INS.0160.00.1
Variable: MADEDUC_C
Interview Module: Child
Content Type: Annual Core
Question Text:
?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does ^SCNAME's Medicaid plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

1= [goto MAHDHP_C]
2,RF,DK=
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG] else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0170.00.1
Variable: MAHDHP_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

Fills:
^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction: fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with Medicaid coverage who have a deductible

Skip Instructions:

1,2,RF,DK=
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG] else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0260.00.1
Variable: PLANNAME1_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by ^HIPNAM1_A. Is ^SCNAME covered by this same plan as ^YOUSANAME?

Fills:
^YOUSANAME

Description: you/^SANAME
Instruction: If GEN.SARESPSC_FLG=1, fill "you" else fill "^SANAME"

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

^WEREWAS

Description: were/was
Instruction: If SARESPSC_FLG=1, fill "were", else "was"

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction: Fill value from Adult.INS.HIPNAM1_A.

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with private health insurance coverage, where the Sample Adult interview has already been conducted, the Sample Adult is in the same family, and the Sample Adult also had private health insurance, and the first private plan is not self only coverage, a plan name was not do not know or refused, and the source and who pays for the coverage is not do not know or refused.

Skip Instructions:

1= if Adult.INS.bPlan[1].POLHLD_A ne 1 [goto POLHLDA1_C],
if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1 [goto
PLANNAME2_C] else [goto MORPLAN_C]
2,RF,DK= if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1
[goto PLANNAME2_C] else [goto HIPNAM1_C]

Question ID: INS.0270.00.1
Variable: POLHLDA1_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]

Health insurance plans are usually obtained in one person's name even if other family members are covered by that plan. That person is called the policyholder. Is ^SCNAME the policyholder for ^HIPNAM1_A?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction: Fill value from Adult.INS.HIPNAM1_A.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a shared private health plan with the Sample Adult, where the Sample Adult is not the policyholder for their first private plan or refused or do not know.

Skip Instructions:

1,2,RF,DK= if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1 [goto PLANNAME2_C]
else [goto MORPLAN_C]

Question ID: INS.0280.00.1
Variable: PLANNAME2_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by a second plan ^HIPNAM2_A. Is ^SCNAME covered by this same plan as ^YOUSANAME?

Fills:
^YOUSANAME

Description: you/^SANAME
Instruction: If GEN.SARESPSC_FLG=1, fill "you" else fill "^SANAME"

^SANAME

Description: Sample Adult's name
Instruction: Sample Adult's name

^WEREWAS

Description: were/was
Instruction: If SARESPSC_FLG=1, fill "were", else "was"

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction: Fill value from Adult.INS.HIPNAM2_A.

^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with private health insurance coverage, where the Sample Adult interview has already been conducted, the Sample Adult is in the same family, and the Sample Adult also had private health insurance, and listed two plans. The second private plan is not self only coverage, a plan name was not do not know or refused, and the source and who pays for the coverage is not do not know or refused.

Skip Instructions:

1= if Adult.INS.bPlan[2].POLHLD_A ne 1 [goto POLHLDA2_C], else if PLANNAME1_C IN(2,RF,DK) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C] else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]
2,RF,DK= if PLANNAME1_C IN (2,RF,DK,empty) [goto HIPNAM1_C]
else [goto MORPLAN_C]

Question ID: INS.0290.00.1
Variable: POLHLDA2_C
Interview Module: Child
Content Type: Annual Core

Question Text:
?[F1]
Read if necessary: Health insurance plans are usually obtained in one person's name even if other family members are covered by that plan. That person is called the policyholder.

Is ^SCNAME the policyholder for ^HIPNAM2_A?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction: Fill value from Adult.INS.HIPNAM2_A.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a shared private health plan with the Sample Adult, where the adult is not the policyholder for their second private plan or refused or do not know

Skip Instructions:

1,2,RF,DK= if PLANNAME1_C IN(2,RF,DK,empty) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C] else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0300.00.1

Variable: HIPNAM1_C
Interview Module: Child
Content Type: Annual Core

Question Text:

It is important that we record the complete and accurate name of each private health insurance plan. What is the COMPLETE name of ^SCNAME's plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service such as long term care, accidents, or dental care.

Read if necessary: Do you have a health plan card or something with the plan name on it?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 enrolled in a Medigap plan or private health insurance and the sample child did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample adult

Skip Instructions:

allow 80,RF,DK= [goto MORPLAN_C]

Question ID: INS.0310.00.1
Variable: MORPLAN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is ^SCNAME covered by any other private health insurance plans?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 enrolled in a private health plan where the name of the plan was given or do not know or refused or the sample child only shared one private plan with the Sample Adult

Skip Instructions:

1 = [goto HIPNAM2_C]
2,RF,DK =
if (PLANNAME1_C = 1 or PLANNAME2_C = 1) then
if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

else [goto bPlan[1].POLHLD_C]

Question ID: INS.0320.00.1
Variable: HIPNAM2_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What is the name of that private health insurance plan?

Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with a second private health insurance plan

Skip Instructions:

allow 80,RF,DK = [goto bPlan[1].POLHLD_C]

Question ID: INS.0340.00.1
Variable: POLHLD_C
Interview Module: Child
Content Type: Annual COre

Question Text:

?[F1]

I am going to ask you some questions about ^FIRSTPLANC. Health insurance plans are usually obtained in one person's name even if other family members are covered by that plan. That person is called the policyholder. Is ^SCNAME the policyholder for ^THISPLANC?

Fills:
^FIRSTPLANC

Description this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan
Instruction If PlanNum = 1 then
if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan" else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan" else fill: "this ^HIPNAM2_C plan"

^HIPNAM1_C

Description {Value of HIPNAM1_C}
Instruction fill value from Child.INS.HIPNAM1_C

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^THISPLANC

Description this plan/^HIPNAM1_C/^HIPNAM2_C
Instruction if PlanNum=1 then
if HIPNAM1_C IN('RF','DK') fill: 'this plan' Else fill: '^HIPNAM1_C'
if PlanNum=2 then
if HIPNAM2_C IN('RF','DK') fill: 'this plan' Else fill: '^HIPNAM2_C'

^HIPNAM2_C

Description {Value of HIPNAM2_C}
Instruction fill value from Child.INS.HIPNAM2_C

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know.

Skip Instructions:

1,RF,DK = [goto PRPLCOV_C]
2 = [goto PLNWRK_C]

Question ID: INS.0350.00.1
Variable: PRPLCOV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does this plan cover someone other than ^SCNAME?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know and where the Sample Child is the policyholder or refused or do not know.

Skip Instructions:

1,2,RF,DK = [goto PLNWRK_C]

Question ID: INS.0360.00.1
Variable: PLNWRK_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Response:

Universe:

Sample Children with private health insurance coverage where a plan name was given or refused or do not know.

Skip Instructions:

1,3 = [goto PLNPAY_C]
2,4,RF,DK = [goto PLNEXCHG_C]
5 = [goto PLNWKSP_C]

Question ID: INS.0370.00.1
Variable: PLNWKSP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: How was this plan obtained?

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know and private health insurance coverage was obtained from an other source

Skip Instructions:

allow 80,RF,DK = [goto PLNEXCHG_C]

Question ID: INS.0380.00.1
Variable: PLNEXCHG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^MARKETPLACE

Description Health insurance marketplace names
Instruction If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:

If CA then fill "Health Insurance Marketplace, such as Covered California"
If CO then fill "Health Insurance Marketplace, such as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as Health Connector"
If MD then fill "Health Insurance Marketplace, such as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as MNsure"
If NY then fill "Health Insurance Marketplace, such as New York State of Health"
If RI then fill "Health Insurance Marketplace, such as HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as Washington Healthplanfinder"

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know and who have private coverage that is directly purchased, or obtained through a state, local, government or community program, or obtained another way, or refused/do not know how obtained

Skip Instructions:

1,2,RF,DK = [goto PLNPAY_C]

Question ID: INS.0390.00.1
Variable: PLNPAY_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

Who pays for this health insurance plan?

Enter all that apply, separate with commas.

Response:

1 ^SCNAME or family (living in the household)
2 Employer or union
3 Someone outside the household
4 Medicare
5 Medicaid
6 Other government program

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know and were enrolled in a private health plan where a plan name was given or refused or do not know.

Skip Instructions:

1-6,RF,DK = if 1 IN PLNPAY_C [goto HICOSTN_C]
else [goto PRDEDUC_C]

Question ID: INS.0400.01.1
Variable: HICOSTN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

How much does ^SCNAME's family currently spend for health insurance premiums for ^FIRSTPLANC? Please include payroll deductions for premiums.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^FIRSTPLANC

^HIPNAM1_C

Description {Value of HIPNAM1_C}
Instruction fill value from Child.INS.HIPNAM1_C

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know who paid for by self or family

Skip Instructions:

20000-99995 = [goto ERR1_HICOSTN_C]
1-19999 = [goto HICOSTT_C]
RF,DK = [goto PRDEDUC_C]

Soft Edit:

ERR1_HICOSTN_C

Check Description: Premium unusually high soft edit {signal ERR1_HICOSTN_C}

Check Text: [^HICOSTN_C] is unusually high. Please verify. Make corrections if necessary.

Question ID: INS.0400.02.1
Variable: HICOSTT_C
Interview Module: Child
Content Type: Annual COre

Question Text:

?[F1]

Enter time period for premium payments.

Response:

1 Once a week
2 Once every 2 weeks
3 Once a month
4 Twice a month
5 Every two months
6 Quarterly (every 3 months)
7 Once a year

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know who gave a premium amount.

Skip Instructions:

1-8,RF,DK = [goto PRDEDUC_C]

Question ID: INS.0410.00.1
Variable: PRDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: A deductible is different from a copay (copayment).

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance plans where a plan name was given or refused or do not know.

Skip Instructions:

1 = [goto PRHDHP_C]
2,RF,DK = [goto PRRXCOV_C]

Question ID: INS.0420.00.1
Variable: PRHDHP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

Is the ^FAM_C annual deductible for medical care for this plan less than ^HDHPAMT_C, or
^HDHPAMT_C or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here.

Fills:
^FAM_C

Description family
Instruction if POLHLD_C=2 or PRPLCOV_C=1, fill 'family'. Else no fill.

^HDHPAMT_C

Description ^HDHPDED_family/^HDHPDED
Instruction if POLHLD_C=2 or PRPLCOV_C=1, fill '^HDHPDED_family' Else fill '^HDHPDED'.

^HDHPDED_family

Description Family deductible threshold (may change in future year)
Instruction fill: $2,700

^HDHPDED

Description Deductible threshold (may change in future year)
Instruction fill: $1,350

Response:

1 Less than ^HDHPAMT_C
2 ^HDHPAMT_C or more

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know with a deductible

Skip Instructions:

1 = [goto PRRXCOV_C]
2,RF,DK = [goto HSAHRA_C]

Question ID: INS.0430.00.1
Variable: HSAHRA_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know with a high deductible

Skip Instructions:

1,2,RF,DK = [goto PRRXCOV_C]

Question ID: INS.0440.00.1
Variable: PRRXCOV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^FIRSTPLANC pay for any of the costs for medications prescribed by a doctor?

Fills:
^FIRSTPLANC

^HIPNAM1_C

Description {Value of HIPNAM1_C}
Instruction fill value from Child.INS.HIPNAM1_C

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where the name of the plan was given or refused or do not know.

Skip Instructions:

1,2,RF,DK = [goto PRDNCOV_C]

Question ID: INS.0450.00.1
Variable: PEDNCOV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^FIRSTPLANC pay for any of the costs for dental care?

Fills:
^FIRSTPLANC

^HIPNAM1_C

Description {Value of HIPNAM1_C}
Instruction fill value from Child.INS.HIPNAM1_C

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where the plan name was given or refused or do not know.

Skip Instructions:

1,2,RF,DK = [goto PRVSCOV_C]

Question ID: INS.0460.00.1
Variable: PRVSCOV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^FIRSTPLANC pay for any of the costs for routine vision care, such as glasses and contact lenses?

Fills:
^FIRSTPLANC

^HIPNAM1_C

Description {Value of HIPNAM1_C}
Instruction fill value from Child.INS.HIPNAM1_C

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or do not know.

Skip Instructions:

1,2,RF,DK = If there is another plan [goto bPlan for next plan] else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C] else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0470.00.1
Variable: CHNAME_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Earlier I recorded that ^SCNAME is covered by the Children's Health Insurance Program or CHIP. What is the name of the plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

allow 80,RF,DK = [goto CHXCHNG_C]

Question ID: INS.0480.00.1
Variable: CHXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was ^SCNAME's CHIP plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

1,2,RF,DK = [goto CHPREM_C]

Question ID: INS.0490.00.1
Variable: CHPREM_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

A health insurance premium is the amount ^SCNAME or a family member pays each month for health care coverage. Does ^SCNAME or a family member pay a premium for this CHIP plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

1,2,RF,DK = [goto CHDEDUC_C]

Question ID: INS.0500.00.1
Variable: CHDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does ^SCNAME's CHIP plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

1 = [goto CHHDHP_C]
2,RF,DK = if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0510.00.1
Variable: CHHDHP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Fills:
^HDHPDED

Description Deductible threshold (may change in future year)
Instruction fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Children with a CHIP plan who have a deductible

Skip Instructions:

1,2,RF,DK = if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C] else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0520.00.1
Variable: OPNAME_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Earlier I recorded that ^SCNAME is covered by a state-sponsored plan. What is the name of the plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

verbatim,RF,DK = [goto OPXCHNG_C]

Question ID: INS.0530.00.1
Variable: OPXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was ^SCNAME's state-sponsored plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

1,2,RF,DK = [goto OPPREM_C]

Question ID: INS.0540.00.1
Variable: OPPREM_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

A health insurance premium is the amount ^SCNAME or a family member pays each month for health care coverage. Does ^SCNAME or a family member pay a premium for this state-sponsored plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

1,2,RF,DK = [goto OPDEDUC_C]

Question ID: INS.0550.00.1
Variable: OPDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does ^SCNAME's state-sponsored plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

1 =[goto OPHDHP_C]
2,RF,DK = if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0560.00.1
Variable: OPHDHP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

Fills:
^HDHPDED

Description Deductible threshold (may change in future year)
Instruction fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with a state-sponsored plan with a deductible

Skip Instructions:

1,2,RF,DK = if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C] else [goto HINOTYR_C]

Question ID: INS.0570.00.1
Variable: OGNAME_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Earlier I recorded that ^SCNAME is covered by an other government program. What is the name of the plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Children 0-17 who have an other government plan

Skip Instructions:

allow 80,RF,DK = [goto OGXCHNG_C]

Question ID: INS.0580.00.1
Variable: OGXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was ^SCNAME's other government plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have an other government plan

Skip Instructions:

1,2,RF,DK = [goto OGPREM_C]

Question ID: INS.0590.00.1
Variable: OGPREM_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

A health insurance premium is the amount ^SCNAME or a family member pays each month for health care coverage. Does ^SCNAME or a family member pay a premium for this other government plan?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have an other government plan

Skip Instructions:

1,2,RF,DK = [goto OGDEDUC_C]

Question ID: INS.0600.00.1
Variable: OGDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

A deductible is the amount you have to pay for health care before your health insurance or health coverage plan will start paying your medical bills. Does ^SCNAME's other government plan have an annual deductible?

Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with an other government plan

Skip Instructions:

1 = [goto OGHDHP_C]
2,RF,DK = if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0610.00.1
Variable: OGHDHP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Fills:
^HDHPDED

Description Deductible threshold (may change in future year)
Instruction fill: $1,350

Response:

1 Deductible is less than $1,350
2 Deductible is $1,350 or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with an other government plan with a deductible

Skip Instructions:

1,2,RF,DK = if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0620.00.1
Variable: MILSPC_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Earlier I recorded that ^SCNAME is covered by military related health care. What types of military related health care ^areisSEX_C ^heshe_C covered by?

Enter all that apply, separate with commas.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^areisSEX_C

Description is/are
Instruction if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is" elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

2 TRICARE (CHAMPUS)
3 CHAMP-VA (do not include CHAMPUS)
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with military related health care

Skip Instructions:

2-3,RF,DK = [goto HINOTYR_C]

Question ID: INS.0630.00.1
Variable: HILAST_C
Interview Module: Child
Content Type: Annual Core

Question Text:

How long has it been since ^SCNAME last had health care coverage that paid for doctor's visits or hospital stays?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe.

Skip Instructions:

1 = [goto HILASTMY_C]
2,3 = [goto HISTOPJOB_C]
4,5,6,0,RF,DK = [goto RSNHICOST_C]

Question ID: INS.0640.00.1
Variable: HILASTMY_C
Interview Module: Child
Content Type: Annual Core

Question Text:

In the past 12 months, how many months was ^SCNAME without coverage?

If less than 1 month, enter '1'.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

01-12 Range of values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 without known health insurance who last had insurance at some time within the last 12 months

Skip Instructions:

1-12,RF,DK = [goto HISTOPJOB_C]

Question ID: INS.0650.00.1
Variable: HISTOPJOB_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Think about the last time that ^SCNAME did have health care coverage. I am going to read a list of reasons why someone might no longer be enrolled in coverage. Please tell me, yes or no, if this is a reason why ^SCNAME is no longer enrolled in ^hisher_C last health care plan.

The policyholder retired, lost a job, or changed employer?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPMISS_C]

Question ID: INS.0660.00.1
Variable: HISTOPMISS_C
Interview Module: Child
Content Type: Annual Core

Question Text:

*Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...

A deadline was missed for signing up or paying for ^hisher_C coverage?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPAGE_C]

Question ID: INS.0670.00.1
Variable: HISTOPAGE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

*Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...

^HeShe_C became ineligible because of ^hisher_C age or because ^heshe_C left school?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^HeShe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPCOST_C]

Question ID: INS.0680.00.1
Variable: HISTOPCOST_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...

The cost for the coverage increased?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto HISTOPELIG_C]

Question ID: INS.0690.00.1
Variable: HISTOPELIG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...

^HeShe_C had Medicaid, CHIP, or other public coverage, but ^werewas_C no longer eligible?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^HeShe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

^werewas_C

Description was/were
Instruction If SEX_FINAL_C=1,2 fill "was"
else if SEX_FINAL_C=DK, RF fill "were"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK = [goto RSNHICOST_C]

Question ID: INS.0700.00.1
Variable: RSNHICOST_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^INSREASONS_C Is ^SCNAME currently uninsured because coverage is not affordable?

Fills:
^INSREASONS_C

Description RSNHICOST_C Introduction
Instruction If HILAST_C=0,4,5,6,RF,DK, fill: "There are many reasons why people do not have health insurance coverage."
If HILAST_C=1,2,3, fill: "We just discussed reasons you lost coverage, now I am going to ask you some questions about why ^SCNAME hasn't obtained coverage."

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe.

Skip Instructions:

1,2,RF,DK = [goto RSNHIWANT_C]

Question ID: INS.0710.00.1
Variable: RSNHIWANT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

There are other reasons that people do not have health insurance coverage. ^PLUSCOSTC ^SCNAME currently uninsured because...

...your family does not need or want coverage for ^SCNAME?

Fills:
^PLUSCOSTC

Description In addition to cost, is/Is
Instruction if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe.

Skip Instructions:

1,2,RF,DK = [goto RSNHIELIG_C]

Question ID: INS.0720.00.1
Variable: RSNHIELIG_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...

...^heshe_C ^areisSEX_C not eligible for coverage?

Fills:
^PLUSCOSTC

Description In addition to cost, is/Is
Instruction if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

^areisSEX_C

Description is/are
Instruction if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is" elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe

Skip Instructions:

1,2,RF,DK = [goto RSNHICONF_C]

Question ID: INS.0730.00.1
Variable: RSNHICONF_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...

...the process of signing up for coverage for ^SCNAME is too difficult or confusing?

Fills:
^PLUSCOSTC

Description In addition to cost, is/Is
Instruction if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe

Skip Instructions:

1,2,RF,DK = [goto RSNHIMEET_C]

Question ID: INS.0740.00.1
Variable: RSNHIMEET_C
Interview Module: Child
Content Type: Annual Core

Question Text:

*Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...

...your family cannot find a plan that meets ^SCNAME's needs?

Fills:
^PLUSCOSTC

Description In addition to cost, is/Is
Instruction if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe

Skip Instructions:

1,2,RF,DK = [goto RSNHIWAIT_C]

Question ID: INS.0750.00.1
Variable: RSNHIWAIT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

*Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...

...you applied for coverage for ^SCNAME but it has not started yet?

Fills:
^PLUSCOSTC

Description In addition to cost, is/Is
Instruction if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe

Skip Instructions:

1,2,RF,DK = [goto RSNHIOTH_C]

Question ID: INS.0760.00.1
Variable: RSNHIOTH_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is there another reason that ^SCNAME currently does not have health insurance coverage?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe

Skip Instructions:

1= [goto RSNHIOTHSP_C]
2,RF,DK= [goto FINISH_C]

Question ID: INS.0770.00.1
Variable: RSNHIOTHSP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What is the other reason for not having coverage?

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 who have another reason for not having coverage

Skip Instructions:

allow 80,RF,DK= [goto FINISH_C]

Question ID: INS.0780.00.1
Variable: HINOTYR_C
Interview Module: Child
Content Type: Annual Core
Question Text:

In the past 12 months, was there any time when ^SCNAME did NOT have ANY health insurance or coverage?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with known health insurance coverage or responded yes to the medicaid probe

Skip Instructions:

1= [goto HINOTMYR_C]
2,RF,DK= [goto FINISH_C]

Question ID: INS.0790.00.1
Variable: HINOTMYR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

In the past 12 months, about how many months was ^SCNAME without coverage?

If less than 1 month, enter '1'.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

01-12 Range of values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with known health insurance coverage and did not have health insurance for some period of time in the past 12 months

Skip Instructions:

1-12,RF,DK= [goto FINISH_C]

Question ID: INS.0800.00.1
Variable: FINISH_C
Interview Module: Child
Content Type: Annual Core

Question Text:

The Sample Child health insurance section is now complete.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PAY: Difficulty Paying for Health Care

Question ID: PAY.0010.00.1
Variable: PAYINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

?[F1]

Now I am going to ask you about your family's medical bills. Include bills for doctors, dentists, hospitals, therapists, medication, equipment, and nursing home or home care.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17 living in same family as the Sample Adult when the PAY section of the Sample Adult has not been completed
or Sample Children living in same family as Sample Adult when the Sample Child respondent is not the Sample Adult and the Sample Adult answered do not or refused to PAYBLL12M_A and PAYNOBLLNW_A or Sample children living in different families than the Sample Adult.

Skip Instructions:

1 = [goto PAYBILL12M_C]

Replicate To:

PAYINTRO_C

Question ID: PAY.0020.00.1
Variable: PAYBLL12M_C
Interview Module: Child
Content Type: Annual Core
Question Text:

In the past 12 months did anyone in your family have problems paying or were unable to pay any medical bills?

Read if necessary: Include bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing home or home care.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 living in same family as the Sample Adult when the PAY section of the Sample Adult has not been completed
or Sample Children living in same family as Sample Adult when the Sample Child respondent is not the Sample Adult and the Sample Adult answered do not or refused to PAYBILL12M_A and PAYNOBLLNW_A or Sample children living in different families than the Sample Adult.

Skip Instructions:

1,RF,DK= [goto PAYNOBLLNW_C]
2= [goto PAYWORRY_C]

Replicate:

PAYBLL12M_A

Question ID: PAY.0030.00.1
Variable: PAYNOBLLNW_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Does anyone in your family currently have any medical bills that you are unable to pay at all?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who said someone in their family had trouble paying bills and Sample Adult and Sample Child are in the same family and Sample Adult PAY section has not been completed OR the Sample Child and Sample Adult are not in the same family AND said anyone in the their family had problems paying medical bills in the past 12 months or refused or didn't know if they had problems paying medical bills.

Skip Instructions:

1,2,RF,DK= [goto PAYWORRY_C]

Question ID: PAY.0040.00.1
Variable: PAYWORRY_C
Interview Module: Child
Content Type: Annual Core
Question Text:

If ^SCNAME gets sick or has an accident, how worried are you that your family will be able to pay ^hisher_C medical bills? Are you very worried, somewhat worried, or not at all worried?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Very worried
2 Somewhat worried
3 Not at all worried
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1-3,RF,DK= [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
DNC: Dental Care

Question ID: DNC.0010.00.2
Variable: DNCINTRO_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

These next questions ask about ^SCNAME's dental care.

Enter '1' to continue.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Enter 1 to Continue

Universe:

Sample children 1-17

Skip Instructions:

1= [goto DENPREV_C]

Question ID: DNC.0020.00.2
Variable: DENPREV_C
Interview Module: Child
Content Type: Rotating Core
Question Text:

About how long has it been since ^SCNAME last had a dental examination or cleaning?

Read if necessary: Include cleanings from all types of dental care providers such as dentists, orthodontists, oral surgeons, dental hygienists, and all other dental specialists.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample Children 1-17

Skip Instructions:

0-6,RF,DK= [goto DENDL12M_C]

Question ID: DNC.0030.00.2
Variable: DENDL12M_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, has ^SCNAME been DELAYED in getting dental care because of the cost?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 1-17

Skip Instructions:

1,2,RF,DK= [goto DENNG12M_C]

Question ID: DNC.0040.00.2
Variable: DENNG12M_C
Interview Module: Child
Content Type: Rotating Core
Question Text:

During the past 12 months, was there any time when ^SCNAME needed dental care, but DID NOT GET IT because of the cost?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 1-17

Skip Instructions:

1,2,RF,DK= [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
UTZ: Utilization

Question ID: UTZ.0010.00.1
Variable: UTZINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^UTZINTRO_C

Enter '1' to continue.

Fills:
^UTZINTRO_C

Description UTZ Introduction
Instruction If AGE LT 1 fill "I would like to ask you about ^SCNAME's health care." else fill "Now that we finished talking about dental care, I would like to ask you about ^SCNAME's other health care."

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto LASTDR_C]

Question ID: UTZ.0020.00.1
Variable: LASTDR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

About how long has it been since ^SCNAME last saw a doctor or other health professional about
^hisher_C health?

Read if necessary: Include doctors seen while a patient in a hospital.

Read if necessary: Do not include dental care.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

Universe:

Sample Children 0-17

Skip Instructions:

1-6 = [goto WELLNESS_C]
0,RF,DK = [goto USUALPL_C]

Question ID: UTZ.0030.00.1
Variable: WELLNESS_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was this a well ^babychild visit, physical, or general purpose check-up?

Fills:
^babychild

Description baby/child
Instruction If AGE LE 2 fill "baby";
else if AGE GE 3 or AGE IN ('DK','RF')
fill "child"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample children 0-17 who have seen a doctor

Skip Instructions:

1 = [goto USUALPL_C]
2,RF,DK = [goto WELLVIS_C]

Question ID: UTZ.0040.00.1
Variable: WELLVIS_C
Interview Module: Child
Content Type: Annual Core

Question Text:

About how long has it been since ^SCNAME last saw a doctor or other health professional for a well ^babychild visit, physical, or general purpose check-up?

Read if necessary: This kind of visit typically includes: height and weight measurements, vaccinations, and vision or hearing checks. The doctor or other health professional may also discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur when ^hesheistheyare_C not sick.

Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^babychild

Description baby/child
Instruction If AGE LE 2 fill "baby";
else if AGE GE 3 or AGE IN ('DK','RF') fill "child

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^hesheistheyare_C

Description he is/she is/they are
Instruction If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"

Response:

Universe:

Sample Children 0-17 who did not have a baby/child visit, physical, or general purpose check-up, or who dont' know or refused.

Skip Instructions:

0,1,2,3,4,5,6,RF,DK = [goto USUALPL_C]

Question ID: UTZ.0050.00.1
Variable: USUALPL_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is there a place that ^SCNAME USUALLY goes to if ^hesheistheyare_C sick and needs health care?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hesheistheyare_C

Description he is/she is/they are
Instruction If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"

Response:

1 Yes
2 There is NO place
3 There is MORE THAN ONE place
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,3,RF,DK = [goto USPLKIND_C]
2 = [goto URGENT12M_C]

Question ID: UTZ.0600.00.1
Variable: USPLKIND_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What kind of place ^isitgomostoften - a doctor's office or health center; an urgent care center, a clinic in a drug store or grocery store; a hospital emergency room; or some other place?

Read if necessary: A doctor's office or health center is a place where ^heshe_C see^s the same doctor or the same group of doctors every visit, where you usually need to make an appointment ahead of time, and where ^hisher_C medical records are on file.

Read if necessary: Urgent care centers, and clinics in a drug store or grocery store are places where you do not need to make an appointment ahead of time, and do not usually see the same health care provider at each visit.
Fills:
^isitgomostoften
Description is it/^doesheshedothey go to most often
Instruction If USUALPL_C=1, fill: "is it"
else fill: "^doesheshedothey go to most often"

^doesheshedothey

Description does he/does she/do they
Instruction If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('DK','RF") fill: "do they"

^heshe_C

Description He/She/They
Instruction If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Description s
Instruction if SEX_FINAL[PX_C]=1,2 fill "s" else fill blank

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 A doctor's office or health center
2 Urgent care center or clinic in a drug store or grocery store
3 Hospital emergency room
4 Some other place
5 Does not go to one place most often
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with 1+ usual place of care or who do not know or refused to answer if they have a usual place of care

Skip Instructions:

1-5,RF,DK = [goto URGENT12M_C]

Question ID: UTZ.0070.00.1
Variable: URGENT12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, how many times has ^SCNAME gone to an urgent care center or clinic in a drug store or grocery store about ^hisher_C health?

Enter '96' if number is 96 or greater.

Read if necessary: This is different from a hospital emergency room.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

00-95 0-95 times
96 96+ times
97 Refused
99 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

0-39,RF,DK = [goto EMERGE12M_C]
40-96 = [goto ERR1_URGENT12M_C]

Soft Edit:
ERR1_URGENT12M_C

Check Description: Urgent care 40-96 times
Check Text: {signal ERR1_URGENT12M_C} ^URGENT12M_C is an unusually large number. Did ^SCNAME visit an urgent care center or clinic in a drug store or grocery store about ^hishertheir health ^URGENT12M_C times in the past 12 months? Please verify.

Question ID: UTZ.0080.00.1
Variable: EMERGE12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, how many times has ^SCNAME gone to a hospital emergency room about
^hisher_C health?

Read if necesary: This includes emergency room visits that resulted in a hospital admission.

Enter '96' if number is 96 or more.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

00-95 0-95 times
96 96+ times
97 Refused
99 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

0-39,RF,DK = if AGE GE '001'[goto HOSPONGT_C]
else [goto MEDDL12M_C]
40-96 = [goto ERR1_EMERGE12M_C]

Soft Edit:

ERR1_EMERGE12M_C

Check Description: ER 40-96 times
Check Text : {signal ERR1_EMERGE12M_C}

^EMERGE12M_C is an unusually large number. Did ^SCNAME visit a hospital emergency room about ^hishertheir health ^EMERGE12M_C times in the past 12 months?

Please verify.

Question ID: UTZ.0090.00.1
Variable: HOSPONGT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, has ^SCNAME been hospitalized overnight? ^PAST12MER_C

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^PAST12MER_C

Description Do not include an overnight stay in the emergency room.
Instruction If ((EMERGE12M_C GE '01' and EMERGE12M_C LE '96') or
EMERGE12M_C='RF','DK'): Fill: "Do not include an overnight stay in the emergency room."

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 1-17

Skip Instructions:

1,2,RF,DK = [goto MEDDL12M_C]

Question ID: UTZ.0100.00.1
Variable: MEDDL12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, has medical care BEEN DELAYED for ^SCNAME because of the cost?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto MEDNG12M_C]

Question ID: UTZ.0110.00.1
Variable: MEDNG12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, was there any time when ^SCNAME needed medical care, but DID NOT GET IT because of the cost?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PMD: Prescription medications

Question ID: PMD.0010.00.1
Variable: RX12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

At any time in the PAST 12 MONTHS, did ^SCNAME take prescription medication?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto RXDL12M_C]
2,RF,DK = [goto RXDG12M_C]

Question ID: PMD.0020.00.1
Variable: RXDL12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, did you DELAY filling a prescription for ^SCNAME to save money?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who had been prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK = [goto RXDG12M_C]

Question ID: PMD.0030.00.1
Variable: RXDG12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

During the past 12 months, was there any time when ^SCNAME needed prescription medication, but DID NOT GET IT because of the cost?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
IMM: Immunization

Question ID: IMM.0010.00.1
Variable: SHTFLU12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

There are two types of flu vaccinations. One is a shot and the other is a spray, mist, or drop in the nose. DURING THE PAST 12 MONTHS, has ^SCNAME had a flu vaccination

Read if necessary: A flu vaccination is usually given in the fall and protects against influenza for the flu season.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto SHTFLUNUM_C]
2,RF,DK = [goto next section]

Question ID: IMM.0020.00.1
Variable: SHTFLUNUM_C
Interview Module: Child
Content Type: Annual Core

Question Text:

DURING THE PAST 12 MONTHS, how many flu vaccinations has ^SCNAME received?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 1 vaccination
2 2 or more vaccinations
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who have had a flu shot in the past 12 months

Skip Instructions:

1,2 = [goto FLUVAC1M_C]
RF,DK = [goto next section]

Question ID: IMM.0030.01.1
Variable: FLUVAC1M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

1 of 2

During what month and year did ^SCNAME receive ^hisher_C most recent flu vaccine?

Enter month of most recent flu vaccine.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 who have had one or more shots in the past 12 months

Skip Instructions:

1-12,DK = [goto FLUVAC1Y_C]
RF = if SHTFLUNUM_C='2'[goto FLUVAC2M_C]
else if SHTFLUNUM_C='1' [goto next section]

Question ID: IMM.0030.02.1
Variable: FLUVAC1Y_C
Interview Module: Child
Content Type: Annual Core

Question Text:

2 of 2

Enter year of most recent flu vaccine.

Response:

2000-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Children 0-17 who have had one or more shots in the past 12 months and gave month/do not know month of flu shot

Skip Instructions:

current year, current year-1,RF,DK = and SHTFLUNUM_C = 2 [goto FLUVAC2M_C] else [goto next section]
if FLUVAC1M_C and FLUVAC1Y_C = a future date [goto ERR1_FLUVAC1Y_C];
if FLUVAC1M_C and FLUVAC1Y_C = a date prior to birth [goto ERR2_FLUVAC1Y_C];
if FLUVAC1M_C and FLUVAC1Y_C = a date prior to 12 months ago [goto ERR3_FLUVAC1Y_C]

Hard Edit:
ERR3_FLUVAC1Y_C

Check Description: ERR3_FLUVAC1Y_C 1st flu vaccine before 12 mos
Check Text: {check ERR3_FLUVAC1Y_C}

Date before 12 months ago

ERR1_FLUVAC1Y_C

Check Description: ERR3_FLUVAC1Y_C 1st flu vaccine in future
Check Text: {check ERR1_FLUVAC1Y_C}

Future date invalid

ERR2_FLUVAC1Y_C

Check Description: ERR3_FLUVAC1Y_C 1st flu vaccine before dob
Check Text: {check ERR2_FLUVAC1Y_C}

Date prior to birth

Question ID: IMM.0040.01.1
Variable: FLUVAC2M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

1 of 2

During what month and year did ^SCNAME receive the flu vaccine before that one?

Enter month of the flu vaccine.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 who have had two or more flu shots in the past 12 months

Skip Instructions:

1-12,DK = [goto FLUVAC2Y_C]
RF = [goto next section]

Question ID: IMM.0040.02.1
Variable: FLUVAC2Y_C
Interview Module: Child
Content Type: Annual Core

Question Text:

2 of 2

Enter year of next most recent flu vaccine.

Response:

2000-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Children 0-17 who have had two or more flu shots and gave month/do not know month of 2nd vaccine dose

Skip Instructions:

current year, current year-1,RF,DK+ [goto next section]
If FLUVAC2M_C and FLUVAC2Y_C = a date in the future [goto ERR1_FLUVAC2Y_C] If FLUVAC2M_C and FLUVAC2Y_C = a date prior to birth [goto ERR2_FLUVAC2Y_C]
If FLUVAC2M_C and FLUVAC2Y_C = a date prior to 12 months ago [goto ERR3_FLUVAC2Y_C] If FLUVAC2M_C and FLUVAC2Y_C = a date more recent than answer given in (FLUVAC1M_C and FLUVA1Y_C) [goto ERR4_FLUVAC2Y_C]

Hard Edit:
ERR3_FLUVAC2Y_C

Check Description: 2nd flu vaccine before 12 mos
Check Text: {check ERR3_FLUVAC2Y_C}

Date before 12 months ago

ERR3_FLUVAC2Y_C

Check Description: 2nd flu vaccine in future
Check Text: {check ERR1_FLUVAC2Y_C}

Future date invalid

ERR3_FLUVAC2Y_C

Check Description: 2nd flu vaccine before dob
Check Text: {check ERR2_FLUVAC2Y_C}

Date prior to birth

Soft Edit:
ERR4_FLUVAC2Y_C

Check Description: 2nd flu vaccine after 1st flu vaccine
Check Text: {check ERR4_FLUVAC2Y_C}; The date entered for the second most recent flu vaccine is after the date of the most recent flu vaccine. Please verify.

2019 National Health Interview Survey (NHIS) Questionnaire
PTC: Physical and other therapeutic care

Question ID: PTC.0010.00.2
Variable: EYEEX12M_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, has ^SCNAME had an eye exam from an eye specialist such as an optometrist, ophthalmologist, or eye doctor?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto THERA12M_C]

Question ID: PTC.0020.00.2
Variable: THERA12M_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, did ^SCNAME receive physical therapy, speech therapy, rehabilitative therapy, or occupational therapy?

Read if necessary: Do not include mental health therapy.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto HOMEHC12M_C]

Question ID: PTC.0030.00.2
Variable: HOMEHC12M_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, did ^SCNAME receive care at home from a nurse or other health professional?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
MHC: Mental health care

Question ID: MHC.0010.00.2
Variable: MHRX_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, did ^SCNAME take any prescription medication to help with ^hisher_C emotions, concentration, behavior or mental health?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK = [goto MHTHRPY_C]

Question ID: MHC.0020.00.2
Variable: MHTHRPY_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, did ^SCNAME receive counseling or therapy from a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK = [goto MHTHDLY_C]

Question ID: MHC.0030.00.2
Variable: MHTHDLY_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, has ^SCNAME been DELAYED in getting counseling or therapy from a mental health professional because of the cost?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK = [goto MHTHND_C]

Question ID: MHC.0040.00.2
Variable: MHTHND_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

During the past 12 months, was there any time when ^SCNAME needed counseling or therapy from a mental health professional, but DID NOT GET IT because of the cost?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
SDQ: Child Mental Health - SDQ Questionnaire

Question ID: SDQ.0010.00.2
Variable: SDQCOPY_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

The following statements are not to be read to the respondent. They are displayed and included here for legal reasons.
The next 25 items contained in SDQ1_C through SDQ25_C as well as 8 impact questions are included in this survey with permission as indicated below.
The SDQ questions are copyrighted by Robert Goodman, Ph.D., FRCPSYCH, MRCP. State and local agencies may use these questions without charge and without seeking separate permission provided the wording is not modified, all the questions are retained, and Dr. Goodman's copyright is acknowledged.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Sample Children 4-17

Skip Instructions:

1 = [goto SDQ1_C]

Question ID: SDQ.0020.00.2
Variable: SDQ1_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

I am going to read a list of items that describe children. For each item, please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

^SCNAME is considerate of other people's feelings?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ2_C]

Question ID: SDQ.0030.00.2
Variable: SDQ2_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is restless, overactive, cannot stay still for long? Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ3_C]

Question ID: SDQ.0040.00.2
Variable: SDQ3_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME often complains of headaches, stomach-aches or sickness?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ4_C]

Question ID: SDQ.0050.00.2
Variable: SDQ4_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME shares readily with other ^TOYSGAMES?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^TOYSGAMES

Description: children; for example, toys, treats, pencils/youth; for example, books, games, food
Instruction: if AGE=4-10 fill "children; for example, toys, treats, pencils"
else if AGE=11-17 fill "youth; for example, books, games, food"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ5_C]

Question ID: SDQ.0060.00.2
Variable: SDQ5_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME often loses ^hisher_C temper?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction: if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ6_C]

Question ID: SDQ.0070.00.2
Variable: SDQ6_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME ^SOLITARY?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^SOLITARY

Description: is rather solitary, prefers to play alone/would rather be alone than with other youth
Instruction: If AGE=4-10 fill "is rather solitary, prefers to play alone"
else if AGE=11-17 fill "would rather be alone than with other youth"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ7_C]

Question ID: SDQ.0080.00.2
Variable: SDQ7_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is generally well behaved, usually does what adults request?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ8_C]

Question ID: SDQ.0090.00.2
Variable: SDQ8_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME has many worries, or often seems worried?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ9_C]

Question ID: SDQ.0100.00.2
Variable: SDQ9_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is helpful if someone is hurt, upset or feeling ill?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ10_C]

Question ID: SDQ.0110.00.2
Variable: SDQ10_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is constantly fidgeting or squirming?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ11_C]

Question ID: SDQ.0120.00.2
Variable: SDQ11_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME has at least one good friend?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ12_C]

Question ID: SDQ.0130.00.2
Variable: SDQ12_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME often fights with other ^childyouth or bullies them?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^childyouth

Description: children/youth
Instruction: If AGE=4-10 fill "children" else if AGE 11-17 fill "youth"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ13_C]

Question ID: SDQ.0140.00.2
Variable: SDQ13_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is often unhappy, depressed or tearful?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ14_C]

Question ID: SDQ.0150.00.2
Variable: SDQ14_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is generally liked by other ^childyouth?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^childyouth

Description: children/youth
Instruction: If AGE=4-10 fill "children" else if AGE 11-17 fill "youth"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

-3,RF,DK= [goto SDQ15_C]

Question ID: SDQ.0160.00.2
Variable: SDQ15_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is easily distracted, ^hisher_C concentration wanders?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction: if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ16_C]

Question ID: SDQ.0170.00.2
Variable: SDQ16_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is nervous ^CLINGY in new situations, ^heshe_C easily lose^s confidence?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^CLINGY

Description: or clingy
Instruction: If AGE=4-10 fill "or clingy"

^heshe_C

Description: He/She/They
Instruction: If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Description: S
Instruction: if SEX_FINAL[PX_C]=1,2 fill "s" else fill blank

Response:

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK= [goto SDQ17_C]

Question ID: SDQ.0180.00.2
Variable: SDQ17_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is kind to younger children?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:
1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ18_C]

Question ID: SDQ.0190.00.2
Variable: SDQ18_C
Interview Module: Child
Content Type: Rotating COre

Question Text:

^SCNAME often lies or cheats?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ19_C]

Question ID: SDQ.0200.00.2
Variable: SDQ19_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME is picked on or bullied by other ^childyouth?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^childyouth

Description children/youth
Instruction If AGE=4-10 fill "children" else if AGE 11-17 fill "youth"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ20_C]

Question ID: SDQ.0210.00.2
Variable: SDQ20_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME often offers to help others, such as parents, teachers, and ^other children?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^other

Description other
Instruction If AGE=4-10 fill "other"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ21_C]

Question ID: SDQ.0220.00.2
Variable: SDQ21_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME thinks things out before acting?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ22_C]

Question ID: SDQ.0230.00.2
Variable: SDQ22_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME steals from home, school or elsewhere?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ23_C]

Question ID: SDQ.0420.00.2
Variable: SDQ23_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME gets along better with adults than with other ^childyouth?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^childyouth

Description children/youth
Instruction If AGE=4-10 fill "children" else if AGE 11-17 fill "youth"

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ24_C]

Question ID: SDQ.0250.00.2
Variable: SDQ24_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME has many fears, is easily scared?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQ25_C]

Question ID: SDQ.0260.00.2
Variable: SDQ25_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

^SCNAME has a good attention span, sees work through to the end?

Read if necessary: Please tell me if it has been NOT TRUE, SOMEWHAT TRUE, or CERTAINLY TRUE for ^SCNAME DURING THE PAST SIX MONTHS.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not true
2 Somewhat true
3 Certainly true
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1-3,RF,DK = [goto SDQIMP1_C]

Question ID: SDQ.0270.00.2
Variable: SDQIMP1_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Overall, do you think that ^SCNAME has difficulties in one or more of the following areas: emotions, concentration, behavior, or being able to get along with other people? Would you say no difficulties, minor difficulties, definite difficulties, or severe difficulties?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 No - no difficulties
2 Yes - minor difficulties
3 Yes - definite difficulties
4 Yes - severe difficulties
7 Refused
9 Do not Know

Universe:

Sample Children 4-17

Skip Instructions:

1,RF,DK = [goto next section]
2,3,4 = [goto SDQIMP2_C]

Question ID: SDQ.0280.00.2
Variable: SDQIMP2_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

How long have these difficulties been present? Would you say less than a month, 1-5 months, 6-12 months, or over a year?

Response:

1 Less than a month
2 1-5 months
3 6-12 months
4 Over a year
7 Refused
9 Do not Know

Universe:

Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people

Skip Instructions:

1-4,RF,DK = [goto SDQIMP3_C]

Question ID: SDQ.0290.00.2
Variable: SDQIMP3_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Do the difficulties upset or distress ^SCNAME? Would you say not at all, only a little, a medium amount, or a great deal?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Only a little
3 A medium amount
4 A great deal
7 Refused
9 Do not Know

Universe:

Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people

Skip Instructions:

1-4,RF,DK = [goto SDQIMP4_C]

Question ID: SDQ.0300.00.2
Variable: SDQIMP4_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Do the difficulties interfere with ^SCNAME's everyday life in the following areas?

...Home life? Would you say not at all, only a little, a medium amount, or a great deal?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Only a little
3 A medium amount
4 A great deal
7 Refused
9 Do not Know

Universe:

Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people

Skip Instructions:

1-4,RF,DK = [goto SDQIMP5_C]

Question ID: SDQ.0310.00.2
Variable: SDQIMP5_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Do the difficulties interfere with ^SCNAME's everyday life in the following areas?

...Friendships? Would you say not at all, only a little, a medium amount, or a great deal?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Only a little
3 A medium amount
4 A great deal
7 Refused
9 Do not Know

Universe:

Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people

Skip Instructions:

1-4,RF,DK = [goto SDQIMP6_C]

Question ID: SDQ.0320.00.2
Variable: SDQIMP6_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Read if necessary: Do the difficulties interfere with ^SCNAME's everyday life in the following areas?

...Classroom learning?

Read if necessary: Would you say not at all, only a little, a medium amount, or a great deal?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Only a little
3 A medium amount
4 A great deal
7 Refused
9 Do not Know

Universe:

Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people

Skip Instructions:

1-4,RF,DK = [goto SDQIMP7_C]

Question ID: SDQ.0330.00.2
Variable: SDQIMP7_C
Interview Module: Child
Content Type: Rotating Core
Question Text:
* Read if necessary: Do the difficulties interfere with ^SCNAME's everyday life in the following areas?
...Leisure activities?
* Read if necessary: Would you say not at all, only a little, a medium amount, or a great deal?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Not at all
2 Only a little
3 A medium amount
4 A great deal
7 Refused
9 Do not Know

Universe: Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people
Skip Instructions: 1-4,RF,DK = [goto SDQIMP8_C]

Question ID: SDQ.0340.00.2
Variable: SDQIMP8_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Do the difficulties put a burden on you or the family as a whole? Would you say not at all, only a little, a medium amount, or a great deal?

Response:

1 Not at all
2 Only a little
3 A medium amount
4 A great deal
7 Refused
9 Do not Know

Universe:

Sample Children 4-17 who have had minor, definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people

Skip Instructions:

1-4,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
SLE: Child Mental Health - Child Stressful Life Events

Question ID: SLE.0010.00.2
Variable: SLEINTRO_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

The next four questions are about events that may have happened during ^SCNAME's life. These things can happen in any family, but some people may feel uncomfortable with these questions. You may skip any questions you do not want to answer.
*Enter '1' to continue.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Enter 1 to Continue

Universe:

Sample children 0-17

Skip Instructions:

1 = [goto VIOLENEV_C]

Question ID: SLE.0020.00.2
Variable: VIOLENEV_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Has ^SCNAME ever been the victim of violence or witnessed violence in ^hisher_C neighborhood?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^hisher_C

Description his/her/their
Instruction if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto JAILEV_C]

Question ID: SLE.0030.00.2
Variable: JAILEV_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Did ^SCNAME ever live with a parent or guardian who served time in jail or prison after ^SCNAME was born?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto MENTDEPEV_C]

Question ID: SLE.0040.00.2
Variable: MENTDEPEV_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Did ^SCNAME ever live with anyone who was mentally ill or severely depressed?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto ALCDRUGEV_C]

Question ID: SLE.0050.00.2
Variable: ALCDRUGEV_C
Interview Module: Child
Content Type: Rotating Core

Question Text:

Did ^SCNAME ever live with anyone who had a problem with alcohol or drugs?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
PAR: Parent Demographics

Question ID: PAR.0010.00.1
Variable: PARINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Now I'm going to ask questions about ^SCNAME's parents living here.

Enter '1' to continue.

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17 with at least one resident parent who is a biological, adoptive, or step parent.

Skip Instructions:

1 = [goto tblPARREL]

Question ID: PAR.0030.00.1
Variable: RELCHPAR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^AreyouIspar ^SCNAME's biological, adoptive, or step ^fathermother?

Fills:
^AreyouIspar

Description Are you/Is {Value of ALIAS}
Instruction If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^fathermother

Description father/mother/parent
Instruction If GEN.SEX_FINAL[PX]='1', fill: "father" If GEN.SEX_FINAL[PX]='2', fill: "mother"
If GEN.SEX_FINAL[PX]='('DK','RF')', fill: "parent"

Response:

1 Biological
2 Adoptive
3 Step
4 Other
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 with at least one resident parent who is a biological, adoptive, or step parent.

Skip Instructions:

1-4,RF,DK = if last parent in GEN.PARENTS_FINAL[PX_C].NONFOST_FINAL [goto MARINTRO_C if any parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has MAR_FLG_A ne 1]

else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL [PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]

else [goto next section]

else [goto RELCHPAR_C for next parent listed at GEN.PARENTS_FINAL[PX_C].NONFOST_FINAL]

**Note: update skip instructions to tblPARBORN**

Question ID: PAR.0040.00.1
Variable: MARINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

The next set of questions are about marriage and cohabitation.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

At least one parent has marital flag of 3 or blank, or at least one parent has marital flag of 2 and the parent is the sample adult and not the sample child respondent

Skip Instructions:

For the first parent in GEN.PARENTS_FINAL[PX_C].PARENTS _FINAL with GEN.MAR_FLG_A ne 1, If GEN.MAR_FLG_A=blank or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1) [goto tblMAR.bParent.MARITAL_C]
Elseif GEN.MAR_FLG_A=3 [goto tblMAR.bPARENT.EVRMARRIED_C]

Question ID: PAR.0090.00.1
Variable: MARITAL_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^AreyouIspar married, living with a partner together as an unmarried couple, or neither?

Fills:
^AreyouIspar

Description Are you/Is {Value of ALIAS}
Instruction If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]"

Response:

1 Married
2 Living with a partner as an unmarried couple
3 Neither

Universe:

Sample Children 0-17 where parent's marital status is not determined in the Sample Adult section OR the parent's marital status is do not know or refused in the Sample adult section and the parent is the sample adult but not the sample child respondent OR the parent's marital status has not been obtained in this block

Skip Instructions:

1 = [goto SPOUSLIV_C]
2 = if GEN.PCNT16PLUSNOSC=1 [got ERR1_MARITAL_C] else [goto PARTNERWHO_C]
3,RF,DK = [goto EVRMARRIED_C]

Soft Edit:
ERR1_MARITAL_C

Check Description: One person eligible to be living with a partner in household soft edit
Check Text: {signal ERR1_MARITAL_C}

Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.

Question ID: PAR.0100.00.1
Variable: SPOUSLIV_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^yourPARspouse currently live in the household?

Fills:

^yourPARspouse
Description your spouse/{Value of ALIAS}'s spouse
Instruction if PX=LNO_SCRESP, fill: "your spouse" else fill: "ALIAS[PX]'s spouse"

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 where one parent is married

Skip Instructions:

1 = if GEN.PCNT16PLUSNOSC=1 [goto ERR1_SPOUSLIV_C] else [goto SPOUSWHO_C]
2 = [goto SPOUSEP_C]
RF,DK = loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]]

Question ID: PAR.0110.00.1
Variable: SPOUSEP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^yourPAR spouse not live here because ^youPAR and ^yourPAR spouse are legally separated?

Fills:
^yourPAR

Description your/{Value of ALIAS}'s
Instruction If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

^youPAR

Description you/{Value of ALIAS}
Instruction If PX=LNO_SCRESP, fill: "you" else fill ALIAS[PX]

Response:

1 Yes
2 No

Universe:

Sample children 0-17 where parent is married and their spouse doesn't live in the household

Skip Instructions:

1,2,RF,DK = loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]

Question ID: PAR.0120.00.1
Variable: SPOUSWHO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Which person is ^yourPAR spouse?

Enter line number of spouse.

Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Fills:
^yourPAR

Description your/{Value of ALIAS}'s
Instruction If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

Response:

00 Not on roster
01 ^ALIASNAME[1]
02 ^ALIASNAME[2]
03 ^ALIASNAME[3]
04 ^ALIASNAME[4]
05 ^ALIASNAME[5]
06 ^ALIASNAME[6]
07 ^ALIASNAME[7]
08 ^ALIASNAME[8]
09 ^ALIASNAME[9]
10 ^ALIASNAME[10]
11 ^ALIASNAME[11]
12 ^ALIASNAME[12]
13 ^ALIASNAME[13]
14 ^ALIASNAME[14]
15 ^ALIASNAME[15]
16 ^ALIASNAME[16]
17 ^ALIASNAME[17]
18 ^ALIASNAME[18]
19 ^ALIASNAME[19]
20 ^ALIASNAME[20]
21 ^ALIASNAME[21]
22 ^ALIASNAME[22]
23 ^ALIASNAME[23]
24 ^ALIASNAME[24]
25 ^ALIASNAME[25]

Universe:

Sample Children 0-17 where parent is married and spouse lives in the household

Skip Instructions:

1-25 = if MARITAL_C=3 "Neither" for person selected at SPOUSWHO_C [goto ERR1_SPOUSWHO_C]
{person selected at SPOUSWHO_C has conflicting answer of "Neither" married or living with a partner at MARITAL_C}

elseif SPOUSLIV_C=2 "Outside household" for person selected at SPOUSWHO_C [goto ERR2_SPOUSWHO_C]
{person selected at SPOUSWHO_C has conflicting answer of married with a spouse living outside the household at SPOUSLIV_C}

elseif person selected at SPOUSWHO_C ((was already selected previously at SPOUSWHO_C or PARTNERWHO_C) or (already chose a spouse/partner)) [goto ERR3_SPOUSWHO_C]
{person selected at SPOUSWHO_C is already indicated as married to someone else/a partner of someone else}

else if GEN.SEX_FINAL[SPOUSWHO_C] IN('1','2') and GEN.SEX_FINAL[PX] IN ('1','2') [goto SPOUSSEX_C]
else loop through table for remaining parents
else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL [PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

0,RF,DK = loop through table for remaining parents
else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL [PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

Soft Edit:
ERR2_SPOUSWHO_C

Check description: Person selected has conflicting answer of married with a spouse living outside the household
Check text: {signal ERR2_SPOUSWHO_C}

Person selected was indicated to have a spouse living outside the household.

Please correct.

ERR3_SPOUSWHO_C

Check description: Person selected is already indicated as married to/a partner of someone else
Check text: {signal ERR3_SPOUSWHO_C}

Person selected is already indicated as
^marriedpartner someone else.

Please correct.

ERR1_SPOUSWHO_C

Check description: Person selected has conflicting answer of "Neither" married or living with a partner
Check text: {signal ERR1_SPOUSWHO_C}

Person selected also has answer of "Neither" married or living together as an unmarried couple.

Please correct.

Question ID: PAR.0130.00.1
Variable: SPOUSSEX_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I have previously recorded that ^ParentX ^sex_ParentX and that ^fillSPOUSWHO_C ^sex_SPOUSWHO_C. Is that correct?

Fills:
^ParentX

Description you are/{Value of ALIAS} is
Instruction If PX=LNO_SCRESP, fill: "you are" else fill: "ALIAS[PX] is"

^sex_ParentX

Description male/female
Instruction If SEX[PX]=1, fill: "male" If SEX[PX]=2, fill: "female"

^fillSPOUSWHO_C

Description you are/{Value of ALIAS} is
Instruction If SPOUSWHO_C=LNO_SCRESP, fill: "you are" else fill "ALIAS[SPOUSWHO_C] is"

^sex_SPOUSWHO_C

Description male/female
Instruction If SEX[SPOUSWHO_C]=1 fill: "male" If SEX[SPOUSWHO_C]=2 fill: "female"

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 where parent is married and spouse lives in the household and the sex of the residential parent of interest is not refused/do not know and the sex of the spouse of this parent is not refused/do not know.

Skip Instructions:

1,RF,DK = loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]
2 = [goto FIXSPOUSSEX_C]

Question ID: PAR.0140.00.1
Variable: FIXSPOUSSEX_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Which was not correct?
Enter all that apply, separate with commas.

Response:

01 ^ALIASNAME[1]
02 ^ALIASNAME[2]
03 ^ALIASNAME[3]
04 ^ALIASNAME[4]
05 ^ALIASNAME[5]
06 ^ALIASNAME[6]
07 ^ALIASNAME[7]
08 ^ALIASNAME[8]
09 ^ALIASNAME[9]
10 ^ALIASNAME[10]
11 ^ALIASNAME[11]
12 ^ALIASNAME[12]
13 ^ALIASNAME[13]
14 ^ALIASNAME[14]
15 ^ALIASNAME[15]
16 ^ALIASNAME[16]
17 ^ALIASNAME[17]
18 ^ALIASNAME[18]
19 ^ALIASNAME[19]
20 ^ALIASNAME[20]
21 ^ALIASNAME[21]
22 ^ALIASNAME[22]
23 ^ALIASNAME[23]
24 ^ALIASNAME[24]
25 ^ALIASNAME[25]

Universe:

Skip Instructions:

1-25 = loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]

Question ID: PAR.0150.00.1
Variable: PARTNERWHO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Which person is ^yourPAR partner?

Enter line number of partner.

Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Fills:
^yourPAR

Description your/{Value of ALIAS}'s
Instruction If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

Response:

Universe:

Sample Children 0-17 where parent is cohabitating with a partner and there are at least two people eligible to be cohabitating in the household

Skip Instructions:

1-25 = if MARITAL_C=3 "Neither" for person selected at PARTNERWHO_C [goto ERR1_PARTNERWHO_C]
{person selected at PARTNERWHO_C has conflicting answer of "Neither" married or living with a partner at MARITAL_C}

elseif SPOUSLIV_C=2 "Outside household" for person selected at PARTNERWHO_C [goto ERR2_PARTNERWHO_C]
{person selected at PARTNERWHO_C has conflicting answer of married with a spouse living outside the household at SPOUSLIV_C}

elseif person selected at PARTNERWHO_C ((was already selected previously at SPOUSWHO_C or PARTNERWHO_C) or (already chose a spouse/partner)) [goto ERR3_PARTNERWHO_C]
{person selected at PARTNERWHO_C is already indicated as married to someone else/a partner of someone else}

elseif GEN.SEX_FINAL[PX] IN ('1','2') and GEN.SEX_FINAL[PARTNERWHO_C] IN ('1','2')[goto PARTNERSEX_C]
else [goto EVRMARRIED_C]

0,RF,DK = [goto EVRMARRIED_C]

Soft Edit:
ERR2_PARTNERWHO_C

Check Description: Person selected has conflicting answer of married with a spouse living outside the household
Check Text: {signal ERR2_PARTNERWHO_C} Person selected was indicated to have a spouse living outside the household. Please correct.

ERR1_PARTNERWHO_C

Check Description: Person selected has conflicting answer of "Neither" married or living with a partner
Check Text: {signal ERR1_PARTNERWHO_C} Person selected also has answer of "Neither" married or living together as an unmarried couple. Please correct.

ERR3_PARTNERWHO_C

Check Description: Person selected is already indicated as married to/a partner of someone else
Check Text: {signal ERR3_PARTNERWHO_C} Person selected is already indicated as ^marriedpartner someone else. Please correct.

Question ID: PAR.0160.00.1
Variable: PARTNERSEX_C
Interview Module: Child
Content Type: Annual Core

Question Text:

I have previously recorded that ^ParentX ^sex_ParentX and that ^fillPARTNERWHO_C
^sex_PARTNERWHO_C. Is that correct?

Fills:
^ParentX

Description you are/{Value of ALIAS} is
Instruction If PX=LNO_SCRESP, fill: "you are" else fill: "ALIAS[PX] is"

^sex_ParentX

Description male/female
Instruction If SEX[PX]=1, fill: "male" If SEX[PX]=2, fill: "female"

^fillPARTNERWHO_C

Description you are/{Value of ALIAS} is
Instruction If PARTNERWHO_C=LNO_SCRESP, fill: "you are" else fill "ALIAS[PARTNERWHO_C] is"

^sex_PARTNERWHO_C

Description male/female
Instruction If GEN.SEX_FINAL[PARTNERWHO_C]=1 fill: "male" If GEN.SEX_FINAL[PARTNERWHO_C]=2 fill: "female"

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 where parent is cohabitating with a partner and the partner lives in the household and the sex for the residential parent is not refused/do not and the sex for the partner is not refused/do not know

Skip Instructions:

1,RF,DK = [goto EVRMARRIED_C]
2 = [goto FIXPARTSEX_C]

Question ID: PAR.0170.00.1
Variable: FIXPARTSEX_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Which was not correct?

Enter all that apply, separate with commas.

Response:

Universe:

Skip Instructions:

1-25 = [goto EVRMARRIED_C]

Question ID: PAR.0180.00.1
Variable: EVRMARRIED_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^HaveyouHasPAR ever been married?

Fills:
^HaveyouHasPAR

Description Have you/Has {Value of ALIAS}
Instruction If PX=LNO_SCRESP, fill: "Have you" else, fill: "Has ALIAS[PX]"

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 where parent is either cohabitating or not in relationship with anyone else in the household, or the marriage/cohabitation status is refused/do not know in the Adult section or the parent is reported as cohabitating with another parent

Skip Instructions:

1 = if (MARITAL_C=2 or GEN.PAR_FLG_C[PX]=3 or GEN.MAR_FLG_A[PX]=3) [goto LEGALSTAT_A]
elseif MARITAL_C=3 [goto WIDIVSEP_A]
else loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]
2,RF,DK = loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]

Question ID: PAR.0190.00.1
Variable: LEGALSTAT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

What is ^yourPAR current legal marital status?

Fills:
^yourPAR

Description your/{Value of ALIAS}'s
Instruction If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

Response:

1 Married
2 Widowed
3 Divorced
4 Separated

Universe:

Sample Children 0-17 where parent has been married and is living with a partner or person selected as a cohabitating partner in PAR or person selected as a cohabitating partner in MAR

Skip Instructions:

1-4,RF,DK = loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto next section]

Question ID: PAR.0200.00.1
Variable: WIDIVSEP_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^AreyouIspar widowed, divorced, or separated?

Fills:
^AreyouIspar

Description Are you/Is {Value of ALIAS}
Instruction If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]"

Response:

1 Widowed
2 Divorced
3 Separated

Universe:

Sample Children 0-17 where parent is neither living with a partner nor married, but has been married

Skip Instructions:

1-3,RF,DK = loop through table for remaining parents else [goto FINISH_MAR_C]

Question ID: PAR.0210.00.1
Variable: FINISH_MAR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

The Sample Child MAR section is now complete.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Skip Instructions:

1 = [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

Question ID: PAR.0230.00.1
Variable: PARBORN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^WereyouWaspar born in the United States or a U.S. territory?

Fills:
^WereyouWaspar

Description Were you/Was {Value of ALIAS}
Instruction If PX=LNO_SCRESP, fill: "Were you" else fill: "Was ALIAS[PX]"

Response:

1 Yes
2 No

Universe:

Sample Children 0-17 where whether the parent was born in the US or US territory is unknown

Skip Instructions:

1,2,RF,DK = loop through table for remaining parents else [goto next section]

Question ID: REL.0030.00.1
Variable: FOSTPAR
Interview Module: Child
Content Type: Annual Core

Question Text:

Is ^ALIASNAME currently in foster care? By that I mean is there an adult living in this household acting as a foster parent to ^ALIASNAME under the supervision of a state or county child welfare agency?

Fills:
^ALIASNAME

Description {Value of ALIAS}
Instruction Fill value from ALIAS

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Child has no parents identified

Skip Instructions:

1 = [goto WHOFOST]
2,RF,DK = If last non-deleted child on roster [goto next section] else [goto WHOPAR for next non-deleted child on roster]

2019 National Health Interview Survey (NHIS) Questionnaire
NAT: Nativity

Question ID: NAT.0010.00.1
Variable: NATUSBORN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was ^SCNAME born in the United States or a U.S. territory?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

1 = [goto NATSTBORN_C]
2 = [goto NATUSYR_C]
RF,DK = [goto next section]

Question ID: NAT.0020.00.1
Variable: NATSTBORN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

In what state or U.S. territory was ^SCNAME born?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

97 Refused
99 Do not Know

Universe:

Sample Children 0-17 born in the United States or U.S. terriority

Skip Instructions:

American Samoa = [goto CITIZEN_C] else [goto next section]

Question ID: NAT.0040.00.1
Variable: NATUSYR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

In what year did ^SCNAME come to the United States to stay?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

2000-2030 Range of values
9997 Refused
9999 Do not Know

Universe:

Sample Children 0-17 not born in the United States or U.S. territory

Skip Instructions:

2000-Current Year,RF,DK
if NATUSYR_C gt current year [goto ERR1_NATUSYR_C] if NATUSYR_C lt VFY.DEMBIRYR_C [goto ERR2_NATUSYR_C]
else [goto CITIZEN_C]

Hard Edit:
ERR2_NATUSYR_C

Check Description: The year reported in NATUSYR_C is a year prior to child's birth
Check Text: {check ERR2_NATUSYR_C} Year is prior to date of birth. Please correct.

ERR1_NATUSYR_C

Check Description: The year reported in NATUSYR_C is a year in the future
Check Text: {check ERR1_NATUSYR_C} Future year invalid. Please correct.

Question ID: NAT.0050.001
Variable: CITIZEN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Is ^SCNAME a citizen of the United States?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample children 0-17 born or not born in the United States or U.S. territory

Skip Instructions:

1 = [goto NATCTZN_C]
2,RF,DK = [goto next section]

Question ID: NAT.0060.00.1
Variable: NATCTZN_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was ^SCNAME born abroad to an American parent, born abroad and adopted by an American parent, or did ^SCNAME become a U.S. citizen by naturalization?

Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Born abroad to American parent
2 Born abroad and adopted by an American parent
3 Became U.S. citizen by naturalization
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 are United States citizens

Skip Instructions:

1-3,RF,DK = [goto next section]

2019 National Health Interview Survey (NHIS) Questionnaire
FEM: Employment of family members

Question ID: FEM.0010.00.1
Variable: FEMINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Now I have a few questions about ^youandothfam.

Enter '1' to continue.

Fills:
^youandothfam

Description you/other members of your family/you and other members of your family
Instruction IF LNO_SCRESP PX_A OR
( LNO_SCRESP = PX_A AND ( (SARESPSC_FLG 1 AND EMP_FLG_A=2) OR (EMP_FLG_A = EMPTY) ) )THEN
fill: "you" ENDIF

IF PCNT18UP_C = 2 THEN IF fill = EMPTY THEN
fill: "other members of your family"
ELSEIF (PCNT18UP_C = 2 AND ( (SAMEFAM_FLG 1) OR ( (SAMEFAM_FLG = 1) AND ( (SARESPSC_FLG 1 AND EMP_FLG_A=2)
OR (EMP_FLG_A = EMPTY) ) ) ) ) OR (PCNT18UP_C 2)THEN

fill: "you and other members of your family" ENDIF
ENDIF

Response:

1 Enter 1 to Continue

Universe:

Sample Child is not in the same family as the Sample Adult OR
Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked
OR
Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked
OR
Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has do not know/refused responses for all questions and the sample adult isn't the sample child respondent.

Skip Instructions:

[goto tblFEM_C]

Replicate To:

FEMINTRO_A

Question ID: FEM.0030.00.1
Variable: FEMWORK_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^DoesDoyouALIASNAME work for pay at a job or business?

If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business, enter '1' for yes.

Fills:
^DoesDoyouALIASNAME

Description Do you/Does ^ALIASNAME
Instruction If PX=LNO_SCRESP, fill: "Do you" (that is if the subject of the question is the sample child respondent, fill: "Do you")
else fill: "Does ^ALIASNAME"

^ALIASNAME

Description {Value of ALIAS}
Instruction Fill value from ALIAS

^heshetheywork

Description he works/she works/they work
Instruction elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works" elseif GEN.SEX_FINAL=DK,RF fill "they work"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

(Sample Child is not in the same family as the Sample Adult OR
Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked
OR
Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked
OR
Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has do not know/refused responses for all questions and the sample adult isn't the sample child respondent.)
AND
Person is in Sample Child's family and over the age of 18

Skip Instructions:

1 = [goto FEMWKFT_C]
2,DK,RF = if there is another adult in the family [goto FEMWORK_C] for the next adult 18+ else [goto next section]

Replicate To:

FEMWORK_A

Question ID: FEM.0040.00.1
Variable: FEMWKFT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

^DoesDoyouALIASNAME usually work 35 hours or more per week in total at ^hisheryour job or jobs?

Fills:
^DoesDoyouALIASNAME

Description Do you/Does ^ALIASNAME
Instruction If PX=LNO_SCRESP, fill: "Do you" (that is if the subject of the question is the sample child respondent, fill: "Do you")
else fill: "Does ^ALIASNAME"

^ALIASNAME

Description {Value of ALIAS}
Instruction Fill value from ALIAS

^hisheryour

Description your/his/her/their
Instruction If PX=LNO_SCRESP, fill: "your"
(that is, if the subject of the question is the sample child respondent, fill: "your")
else if SEX_FINAL[PX] = 1, fill "his" else if SEX_FINAL[PX] = 2, fill "her"
else if SEX_FINAL[PX] in (DK,RF), fill "their"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,DK,RF = if another adult in the family [goto FEMWORK_C] for the next adult 18+ else [goto next section]

Replicate To:

FEMWKFT_A

2019 National Health Interview Survey (NHIS) Questionnaire
INC: Family Income

Question ID: INC.0010.00.1
Variable: INCINTRO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

The next questions are about your total family income in ^LASTYEAR BEFORE TAXES. Based on questions asked earlier, we have that ^SCNAME's family consists of ^INCINTRO_C_fill.

Enter '1' to continue.

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^SCNames_fill

Description List of people in Sample Child's family
Instruction For all people with FAMC_REL_FLG =1 OR (SAME_REL_FLG=1 for SC and tblRelate_SA.bPerson.RELATE in (1-13,DK,RF)) OR (FAMA_REL_FLG=1 and 1st person in SC's family has tblRelate_SA.bPerson.RELATE in (1-13,DK,RF), fill with their names.

Description: Person was identified as being in the SC's family at WHOPAR/WHOFOST OR (Sample Child is related to the Sample Adult and person on roster was placed in Sample Adult's family based on answer provided at RELATE), include their name as part of the list of SC's family.

Do not include Sample Child on list.

If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list.
If only one person on the list of names and person ne Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on list and person is Household Respondent (Roster.HHC.HHRESPAVAIL), follow list with "are".

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

Response:

1 Enter 1 to Continue

Universe:

Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1 = [goto INCWRKO_C]

Replicate To:

INCINTRO_A

Question ID: INC.0020.00.1
Variable: INCWRKO_C
Interview Module: Child
Content Type: Annual Core

Question Text:

In ^LASTYEAR, did ^YOUFAM18YRS_C receive income from wages, salaries, commissions, bonuses, tips, or self-employment?

Read if necessary: For the purpose of this survey, ^SCNAME's family includes ^FAMVERSC_fill
Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAM18YRS_C

Description you/you or any family members 18 or older
Instruction If GEN.PCNT18UP_C=1 fill "you" else if GEN.PCNT18UP_C GT 1 fill "you or any family members 18 or older"

^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^FAMVERSC_fill

Description List of all people in Sample Child's family
Instruction Loop through all persons on roster and add to list of names if FAMILYC_flg = 1

Do not include Sample Child on list.

If Household Respondent (Roster.HHC.HHRESPAVAIL) is on list of names, fill "you" for name and place name at the beginning of the list.
If only one person on the list of names and person ne Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on list and person is Household Respondent (Roster.HHC.HHRESPAVAIL), follow list with "are".

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK = [goto INCINTER_C]

Replicate To:

INCWRKO_A

Question ID: INC.0030.00.1
Variable: INCINTER_C
Interview Module: Child
Content Type: Annual Core

Question Text:

In ^LASTYEAR, did ANY FAMILY MEMBERS receive income from interest-bearing accounts or investments, dividends from stocks or mutual funds, net rental income, royalty income, or income from estates and trusts?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK = [goto INCSSRR_C]

Replicate To:

INCINTER_A

Question ID: INC.0031.00.1
Variable: INCSSRR_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive...

Income from Social Security or Railroad Retirement?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

^YOUFAMHERE_C

Description you/you or any family members
Instruction If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK = [goto INCSSISSDI_C]

Replicate To:

INCSSRR_A

Question ID: INC.0040.00.1
Variable: INCSSISSDI_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Read if necessary: In ^LASTYEAR, did ANY FAMILY MEMBERS receive...

Supplemental Security Income, SSI, or Social Security Disability Income, SSDI, which are different from Social Security?

Fills:
^LASTYEAR

Description Last year
Instruction Fill year prior to current year

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1 = [goto SSISSDIBTH_C]
2,RF,DK = [goto INCWELF_C]

Replicate To:

INCSSISSDI_A

Question ID: INC.0050.00.1
Variable: SSISSDIBTH_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was this Supplemental Security Income, SSI, Social Security Disability Income, SSDI, or both?

Response:

1 SSI
2 SSDI
3 Both SSI and SSDI
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 where someone in the family gets SSI or SSDI and
Sample Child INC section has not been completed OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused OR the Sample Adult and Sample Child are not in the same family

Skip Instructions:

1-3,RF,DK = [goto SSISSDIDSB_C]

Replicate To:

SSISSDIBTH_A

Question ID: INC.0060.00.1
Variable: SSISSDIBSB_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was this received as a disability benefit?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 living in families where someone in the family gets SSI or SSDI and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1 = [goto SSISSDIP_C]
2,RF,DK = [goto INCWELF_C]

Replicate To:

SSISSDIDSB_A

Question ID: INC.0070.00.1
Variable: SSISSDIP_C
Interview Module: Child
Content Type: Annual Core

In ^LASTYEAR, who received this disability benefit?

Read if necessary: Do NOT include a benefit received on behalf of someone else.

Fills:
^LASTYEAR

Description: Last year
Instruction: Fill year prior to current year

Response:

00 Not on roster
01-25 Person Number
97 Refused
99 Do not Know

Universe:

Sample Children 0-17 with more than one person in the family where someone in the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1-25,RF,DK= [goto INCWELF_C]

Replicate To

SSISSDIP_A

Question ID: INC.0090.00.1
Variable: INCWELF_C
Interview Module: Child
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ^YOUFAMHERE_C receive...

Any public assistance or welfare payments from the state or local welfare office?

Fills:
^LASTYEAR

Description: Last year
Instruction: Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction: If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK = [goto INCRETIRE_C]

Replicate To

INCWELF_A

Question ID: INC.0100.00.1
Variable: INCRETIRE_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Income from retirement, survivor, or disability pensions?

Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive...

Fills:
^LASTYEAR

Description: Last year
Instruction: Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction: If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK= [goto INCOTHR_C]

Replicate To

INCRETIRE_A

Question ID: INC.0110.00.1
Variable: INCOTHR_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Any other sources of income such as VA payments from the Veterans Benefits Administration, unemployment compensation, child support, or alimony?

Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive...

Fills:
^LASTYEAR

Description: Last year
Instruction: Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction: If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1,2,RF,DK= [goto INCTOTAL_C]

Replicate To

INCOTHR_A

Question ID: INC.0120.00.1
Variable: INCTOTAL_C
Interview Module: Child
Content Type: Annual Core
Question Text:

When answering this next question, please remember to include your income PLUS the income of all family members living in this household.

What is your best estimate of the total income of all family members from all sources, before taxes, in the last calendar year?

Enter '999995' if the reported income is $999,995 or greater.

Response:

000000-999995 Range of values
999997 Refused
999998 Not Ascertained
999999 Do not Know

Universe:

Skip Instructions:

0-999= [goto ERR1_INCTOTAL_C]
250001-999995= [goto ERR2_INCTOTAL_C]
1000-250000= [goto next section]
RF,DK= [goto INC250PCT_C]

Soft Edit:

Check Text: ERR2_INCTOTAL_C
Check Description: Income high soft edit
Check Text:{signal ERR2_INCTOTAL_C}
Do not read to the respondent.
^INCTOTAL_C is unusually high. Make corrections if necessary.

Check Text: ERR1_INCTOTAL_C
Check Description: Income low soft edit
Check Text:{signal ERR1_INCTOTAL_C}
Do not read to the respondent.
^INCTOTAL_C is unusually low. Make corrections if necessary.

Replicate To

INCTOTAL_A

Question ID: INC.0140.01.1
Variable: INC250PCT_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Was your total family income from all sources less than ^250POVERTY_C or ^250POVERTY_C or more?

Fills:
^250POVERTY_C

Description: 250% of poverty threshold
Instruction: fill value stored in Child.INC.INC250PCT_C

Response:

1 Less than ^250POVERTY_C
2 ^250POVERTY_C or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who do not know or refuse the total family income and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1= [goto INC138PCT_C]
2= if GEN.PCNT_C=2 [goto INC75K_C];
else if GEN.PCNT_C=4 OR GEN.PCNT_C ge 7 [goto INC400PCT_C]; else if GEN.PCNT_C IN (3,5,6) [goto INC100K_C]
RF,DK= [goto next section]

Replicate To

INC250PCT_A

Question ID: INC.0150.01.
Variable: INC138PCT_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than ^138POVERTY_C or ^138POVERTY_C or more?

Fills:
^138POVERTY_C

Description: 138% of poverty threshold
Instruction: fill value stored in Child.INC.INC138PCT_C

Response:

1 Less than ^138POVERTY_C
2 ^138POVERTY_C or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 answered less than 250% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1= [goto INC100PCT_C]
2= [goto INC200PCT_C]
RF,DK= [goto next section]

Replicate To

INC138PCT_A

Question ID: INC.0160.01.1
Variable: INC100PCT_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than ^100POVERTY_C or ^100POVERTY_C or more?

Fills:
^100POVERTY_C

Description: 100% of poverty threshold
Instruction: fill value stored in Child.INC.INC100PCT_C

Response:

1 Less than ^100POVERTY_C
2 ^100POVERTY_C or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who answered less than 138% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1,2,RF,DK= [goto next section]

Replicate To

INC100PCT_A

Question ID: INC.0170.01.1
Variable: INC200PCT_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than ^200POVERTY_C or ^200POVERTY_C or more?

Fills:
^200POVERTY_C

Description: 200% of poverty threshold
Instruction: fill value stored in Child.INC.INC138PCT_C

Response:

1 Less than ^200POVERTY_C
2 ^200POVERTY_C or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who answered 138% of poverty or more and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1,2,RF,DK= [goto next section]

Replicate To

INC200PCT_A

Question ID: INC.0180.00.1
Variable: INC75K_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than $75,000 or $75,000 or more?

Response:

1 Less than $75,000
2 $75,000 or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who answered 250% of poverty threshold or more and is from a 2 person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1= [goto INC400PCT_C]
2= [goto INC100K_C]
RF,DK= [goto next section]

Replicate To

INC75K_A

Question ID: INC.0190.00.1
Variable: INC100K_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than $100,000 or $100,000 or more?

Response:

1 Less than $100,000
2 $100,000 or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who answered $75,000 or more OR answered 250% of poverty or more and is from a 3,5, or 6 person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1= if GEN.PCNT_C IN (2,5,6) [goto next section] else if GEN.PCNT_C=3 [goto INC400PCT_C]
2= if GEN.PCNT_C IN (2,3) [goto INC150K_C] else if GEN.PCNT_C IN (5,6) [goto INC400PCT_C]
RF,DK= [goto next section]

Replicate To

INC100K_A

Question ID: INC.0200.01.1
Variable: INC400PCT_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than ^400POVERTY_C or ^400POVERTY_C or more?

Fills:
^400POVERTY_C

Description: 400% of poverty threshold
Instruction: Fill value stored in Child.INC.INC400PCT_C

Response:

1 Less than ^400POVERTY_C
2 ^400POVERTY_C or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who answered less than $75,000 OR
answered less than $100,000 and is from a 3 person family OR answered $100,000 or more and from a 5 or 6 person family OR
answered 250% of poverty threshold or more and is from a 4 or 7+ person family and
Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1= if GEN.PCNT_C ge 8 [goto INC150K_C] else [goto next section]
2= if GEN.PCNT_C IN (2,3) or GEN.PCNT_C ge 7[goto next section] else if GEN.PCNT_C IN (4,5,6) [goto INC150K_C]
RF,DK= [goto next section]

Replicate To

INC400PCT_A

Question ID: INC.0210.00.1
Variable: INC150K_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Was your total family income from all sources less than $150,000 or $150,000 or more?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Less than $150,000
2 $150,000 or more
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who answered $100,000 or more and is from 2 or 3 person family OR answered 400% of poverty or more and is from 4 or 5 person family OR answered less than 400% of poverty and is from a family of 8 or more persons and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was do not know or refused

Skip Instructions:

1,2,RF,DK= [goto next section]

Replicate To

INC150K_A

2019 National Health Interview Survey (NHIS) Questionnaire
FOO: Food Related Programs

Question ID: FOO.0010.00.1
Variable: FSNAP12M_C
Interview Module: Child
Content Type: Annual Core
Question Text:

At any time IN THE LAST 12 MONTHS did any family members living here receive ^FSSNAPNM?

Fills:
^FSSNAPNM

Description: food stamp benefits/[state food stamp program name]
Instruction: If AL then fill "Food Assistance Program or food stamp benefits"
If AK then fill "food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits" If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food stamp benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "Food Assistance Program or food stamp benefits"
If GA then fill "food stamp benefits"
If HI then fill "SNAP or food stamp benefits" If ID then fill "food stamp benefits"
If IL then fill "SNAP or food stamp benefits" If IN then fill "SNAP or food stamp benefits"
If IA then fill "Food Assistance Program or food stamp benefits"
If KS then fill "Food Assistance Program or food stamp benefits"
If KY then fill "SNAP or food stamp benefits" If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food stamp benefits"
If MD then fill "Food Supplement Program or food stamp benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program or food stamp benefits"
If MN then fill "SNAP or food stamp benefits" If MS then fill "SNAP or food stamp benefits" If MO then fill "food stamp benefits"
If MT then fill "SNAP or food stamp benefits" If NE then fill "SNAP or food stamp benefits" If NV then fill "SNAP or food stamp benefits"
If NH then fill "Food Stamp/SNAP or food stamp benefits" If NJ then fill "SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits" If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food stamp benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "Food Assistance Program or food stamp benefits"
If OK then fill "SNAP or food stamp benefits" If OR then fill "SNAP or food stamp benefits" If PA then fill "SNAP or food stamp benefits" If RI then fill "SNAP or food stamp benefits" If SC then fill "SNAP or food stamp benefits" If SD then fill "SNAP or food stamp benefits" If TN then fill "SNAP or food stamp benefits" If TX then fill "SNAP or food stamp benefits" If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits" If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food Washington or food stamp benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp benefits"
If WY then fill "SNAP or food stamp benefits"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was not the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1= [goto FSNAP30D_C]
2,RF,DK= if PCNTF1255_C GE 1 or PCNTC05_C GE 1, [goto FWIC12M_C]
else if PCNTC517_C GE 1 [goto FLUNCH12M_C] else [goto next section]

Replicate To

FSNAP12M_A

Question ID: FOO.0020.00.3
Variable: FSNAP30D_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

Did any family members living here receive ^FSSNAPNM in the LAST 30 days?

*Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy food.

Fills:
^FSSNAPNM

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and someone in the family received food stamps in the past 12 months and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1,2,RF,DK= if PCNTF1255_C GE 1 or PCNTC05_C GE 1, [goto FWIC12M_C]
else if PCNTC517_C GE 1 [goto FLUNCH12M_C] else [goto next section]

Replicate To

FSNAP30D_A

Question ID: FOO.0030.00.1
Variable: FWIC12M_C
Interview Module: Child
Content Type: Annual Core

Question Text:

At any time in the last 12 months did any family members living here receive benefits from the WIC program, that is, the Women, Infants, and Children program?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 living in families with females 12-55 years of age or children 0-5 years of age and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1,2,RF,DK= If PCNTC517_C GE 1 [goto FLUNCH12M_C]
else [goto next section]

Replicate To

FWIC12M_A

Question ID: FOO.0040.00.1
Variable: FLUNCH12M_C
Interview Module: Child
Content Type: Annual Core
Question Text:

At any time in the last 12 months, did ^SCCHILDFAM_C receive free or reduced-cost breakfasts or lunches at school?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

^SCCHILDFAM_C

Description: ^SCNAME/any child in your family
Instruction: if PCNTC517_C=1, fill "^SCNAME",
elseif PCNTC517_C gt 1, fill "any child in your family",

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children living in families with children between the ages of 5-17 and and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1,2,RF,DK= [goto next section]

Replicate To

FLUNCH12M_A

2019 National Health Interview Survey (NHIS) Questionnaire
FDS: Food Security

Question ID: FDS.0010.00.3
Variable: FDSINTRO_C
Interview Module: Child
Content Type: Sponsored Content

Question Text:

These next questions are about whether you were always able to afford the food you needed in the last 30 days. I'm going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for your family in the last 30 days.

Enter '1' to continue.

Response:

1 Enter 1 to Continue

Universe:

Skip Instructions:

1= [goto FDSRUNOUT_C]

Replicate To

FDSINTRO_A

Question ID: FDS.0020.00.3
Variable: FDSRUNOUT_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

The first statement is "We worried whether our food would run out before we got money to buy more." Was that often true, sometimes true, or never true for your family in the last 30 days?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Often true
2 Sometimes true
3 Never true
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1-3,RF,DK= [goto FDSLAST_C]

Replicate To

FDSRUNOUT_A

Question ID: FDS.0030.00.3
Variable: FDSLAST_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

"The food that we bought just didn't last, and we didn't have money to get more." Was that often true, sometimes true, or never true for your family in the last 30 days?

Response:

1 Often true
2 Sometimes true
3 Never true
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1-3,RF,DK= [goto FDSBALANCE_C]

Replicate To

FDSLAST_A

Question ID: FDS.0040.00.3
Variable: FDSBALANCE_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

"We couldn't afford to eat balanced meals." Was that often true, sometimes true, or never true for your family in the last 30 days?

Response:

1 Often true
2 Sometimes true
3 Never true
7 Refused
9 Do not Know

Universe:

Skip Instructions:

1-2= [goto FDSSKIP_C]
3,RF,DK= if FDSRUNOUT_C IN (1,2) OR FDSLAST_C IN (1,2) [goto FDSSKIP_C];
else [goto next section]

Replicate To

FDSBALANCE_A

Question ID: FDS.0050.00.3
Variable: FDSSKIP_C
Interview Module: Child
Content Type: Sponsored Content

Question Text:

In the last 30 days, did ^youorother_C ever cut the size of your meals or skip meals because there wasn't enough money for food?

Fills:
^youorother_C

Description: you/you or other adults in your family
Instruction: If PCNT18UP_C=1 fill "you"
else fill: "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or do not know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1= [goto FDSSKIPDYS_C]
2,RF,DK= [goto FDSLESS_C]

Replicate To

FDSSKIP_A

Question ID: FDS.0060.00.3
Variable: FDSSKIPDYS_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

In the last 30 days, how many days did this happen?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

01-30 Range of values
97 Refused
99 Do not Know

Universe:

Skip Instructions:

1-30,RF,DK= [goto FDSLESS_C]

Replicate To

FDSSKIPDYS_A

Question ID: FDS.0070.00.3
Variable: FDSLESS_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

In the last 30 days, did ^youorother_C ever eat less than you felt you should because there wasn't enough money for food?

Fills:
^youorother_C

Description: you/you or other adults in your family
Instruction: If PCNT18UP_C=1 fill "you"
else fill: "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or do not know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK= [goto FDSHUNGRY_C]

Replicate To

FDSLESS_A

Question ID: FDS.0080.00.3
Variable: FDSHUNGRY_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

In the last 30 days, were ^youorother_C ever hungry but didn't eat because there wasn't enough money for food?

Fills:
^youorother_C

Description: you/you or other adults in your family
Instruction: If PCNT18UP_C=1 fill "you"
else fill: "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or do not know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK= [goto FDSWEIGHT_C]

Replicate To

FDSHUNGRY_A

Question ID: FDS.0090.00.3
Variable: FDSWEIGHT_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

In the last 30 days, did ^youorother_C lose weight because there wasn't enough money for food?

Fills:
^youorother_C

Description: you/you or other adults in your family
Instruction: If PCNT18UP_C=1 fill "you"
else fill: "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or do not know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1= [goto FDSNOTEAT_C]
2,RF,DK= if FDSSKIP_C=1 or FDSLESS_C=1 or FDSHUNGRY_C=1 [goto FDSNOTEAT_C]; else [goto next section]

Replicate To

FDSWEIGHT_A

Question ID: FDS.0100.00.3
Variable: FDSNOTEAT_C
Interview Module: Child
Content Type: Sponsored Content
Question Text:

In the last 30 days, did ^youorother_C ever not eat for a whole day because there wasn't enough money for food?

Fills:
^youorother_C

Description: you/you or other adults in your family
Instruction: If PCNT18UP_C=1 fill "you"
else fill: "you or other adults in your family"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or do not know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered they cut the size of the meals, skipped meals, were hungry but didn't eat, or lost weight in the last 30 days because there wasn't enough money for food.

Skip Instructions:

1= [goto FDSNEDAYS_C]
2,RF,DK= [goto next section]

Replicate To

FDSNOTEAT_A

Question ID: FDS.0110.00.3
Variable: FDSNEDAYS_C
Interview Module: Child
Content Type: Sponsored Content

Question Text:

In the last 30 days, how many days did this happen?

Response:

01-30 Range of values
97 Refused
99 Do not Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or do not know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and adults in the family have ever not eaten for a whole day because there wasn't enough money for food in the last 30 days

Skip Instructions:

1-30,RF,DK= [goto next section]

Replicate To

FDSNEDAYS_A

2019 National Health Interview Survey (NHIS) Questionnaire
HOU: Housing

Question ID: HOU.0010.00.1
Variable: HOUYRSLIV_C
Interview Module: Child
Content Type: Annual Core
Question Text:

About how long has ^SCNAME lived in this house/apartment?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Less than 1 year
2 1 to 3 years
3 4 to 10 years
4 More than 10 years
7 Refused
9 Do not Know

Universe:

Sample Children 1-17

Skip Instructions:

1-4,RF,DK= if ((SAMEFAM_FLG=1 and HOU_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and HOU_FLG_A=2 and SARESPSC_FLG ne 1)) [goto HOUTENURE_C]
else [goto next section]

Question ID: HOU.0020.00.1
Variable: HOUTENURE_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is this house/apartment owned or rented by you ^SOMEFAM_C?

If house has a mortgage, record as owned.

Fills:
^SOMEFAM_C

Description: or someone in your family
Instruction: If PCNT_C=2 fill: blank
If PCNT_C gt 2 fill: "or someone in your family"

Response:

1 Owned or being bought
2 Rented
3 Other arrangement
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult HOU section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the HOU section with RF or DK.

Skip Instructions:

1,3,RF,DK= [goto next section]
2= [got HOUGVASST_C]

Replicate To

HOUTENNURE_A

Question ID: HOU.0030.00.1
Variable: HOUGVASST_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is anyone in your family paying lower rent because the Federal, State, or local government is paying part of the cost?

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 living in a house/apartment that is being rented and Sample Adult and Sample Child are in the same family and the Sample Adult HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult HOU section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the HOU section with RF or DK.

Skip Instructions:

1,2,RF,DK= [goto next section]

Replicate To

HOUGVASST_A

2019 National Health Interview Survey (NHIS) Questionnaire
REC: Child's full name

Question ID: REC.0010.00.1
Variable: LNKFNAME_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Ask or verify: What is ^SCNAME's full name?

Enter first name.

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK= [goto LNKMNAME_C]

Question ID: REC.0020.00.1
Variable: LNKMNAME_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Enter middle name.

Press "Enter" to skip to last name if child has no middle name.

Response:

Verbatim Verbatim values
97 Refused
99 Do not Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK= [goto LNKLNAME_C]

2019 National Health Interview Survey (NHIS) Questionnaire
TEL: Telephone ownership

Question ID: TEL.0010.00.1
Variable: TELCURWRK_C
Interview Module: Child
Content Type: Annual Core
Question Text:

Is there at least one telephone INSIDE ^SCNAME's home that is currently working and is not a cell phone?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 0-17 who live in the same family as a sample adult, where TELCURWRK_A has not be asked
OR who live in the same family as a sample adult, where TELCURWRK_A was answered dk/rf and the sample child respondent is not the sample adult
OR who do not live in the same family as the sample adult.

Skip Instructions:

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