HEALTHY
PREGNANCY AND PARENTING SURVEY
ROUND
2: POSTPARTUM WOMEN
Prepared by Mathematica Policy Research
OMB Number: 0915-0212
Expiration Date: __/__/__
Public
Burden Statement:
An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this
project is 0915-0212. Public reporting burden for this collection of
information is estimated to average 20
minutes
per respondent annually, including time for reviewing instructions,
searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing
this burden, to HRSA Reports Clearance Officer, 5600 Fisher Lane,
Room 14-33, Rockville, Maryland, 20857.
Section Page
A. Programmer Instructions 1
B. CONTACT THE SAMPLE MEMBER 3
C. Eligibility and Consent 15
D. TEXT4BABY ENROLLMENT AND USE OF SERVICES 20
E. TEXT4BABY DISENROLLMENT AND NEVER ENROLLMENT 30
F. Satisfaction with text4baby 34
G. DELETED.
H. HEALTH CARE ACCESS, UTILIZATION, KNOWLEDGE, AND BEHAVIOR 38
I. health status and birth outcomes 50
J. participant background 55
K. future contact information 61
L. survey backend 62
A. Programmer Instructions
INFORMATION FROM ROUND 1
S1 = T4B Status during Round 1
Programmer: create Round 1 text4baby enrollment status categories
1 = If Round 1, Q1.1 = 0, d, r: R1_NEVER_HEARD (or unknown if ever heard)
2 = If Round 1, Q1.1 = 1 and Q1.2 = 0: R1_NEVER_ENROLLED (heard, but did not enroll)
3 = If Round1, Q1.1 = 1 and Q1.2 = d, r: R1_UNKNOWN_ENROLLMENT (heard, but unknown if ever enrolled)
4 = If Round 1, Q1.1 = 1, Q1.2 = 1, and Q1.10 = 1: R1_USER,
5 = If Round 1, Q1.1 = 1, Q1.2 = 1, Q1.10 = 0,d,r, Q2.1 = 1: R1_DISENROLLEE
6 = If Round 1, Q1.1 = 1, Q1.2 = 1, Q1.10 = 0,d,r, Q2.1 = 0,d,r: R1_UNCLEAR
_USER_STATUS (ever enrolled, but R1 user status unclear)
S2 = R1 State Medicaid name
S3 = R1 State CHIP name
S4 = R1 respondent needs hearing hardware
1 = If AmpTTY = 1 use Amplifier Phone
2 = If AmpTTY = 2 use TTY capability
S5 = R1 Lang requires non-English
1 = Spanish
2 = French
3 = Chinese
4 = Russian
5 = German
6 = Other (see Round 1 OtherLang)
S6 = Respondent’s full name (FULLNAME from Round 1, S1)
S7 = Respondent’s first name (FIRSTNAME from Round 1, S2)
S7a = Parent gave permission for Round 1 interview: YES
INFORMATION FROM ROUND 2 SCREENER – NEEDED FOR FILLS IN ROUND 2
s8 = [CHILD], Baby’s first name from T3 or Box T5.1
S9 = BABY’S GENDER from T3b or Box T5.2
1 = male, he, his, him
2 = female, she, her, her
START UP INSTRUCTIONS
R1_NEVER_HEARD: GO TO Q1.1b
R1_NEVER_ENROLLED: GO TO Q1.1b
R1_UNKNOWN_ENROLLMENT: GO TO Q1.1b
R1_USER: GO TO Q1.1a
R1_DISENROLLEE: GO TO Q1.1a
R1_UNCLEAR_USER_STATUS: GO TO Q1.1a
Proxy respondent is not allowed
IF FIRST CONTACT WITH SAMPLE MEMBER, START AT DOCALLBACK = NO
IF CALLBACK AFTER CONTACT MADE, START AT DOCALLBACK = YES
CB1: DATE OF LAST CONTACT (AT LEAST 10 QUESTIONS ANSWERED)
If S4 = answered, use AmpTTY or Amplifyer
If S5 = 1 (Spanish), schedule interview for Spanish language interviewer.
If S5 = other, send to Supervisor review immediately.
B. CONTACT THE SAMPLE MEMBER
Docallback = No |
AUTOFILL INTVNAME S6 = FULLNAME S7 = FIRSTNAME |
Hello. Hello, my name is [INTVNAME] from Mathematica Policy Research. May I please speak to [FULLNAME]?
SPEAKING TO [FIRSTNAME] 1 GO TO SampMemb
[FIRSTNAME] COMES TO THE PHONE 2 GO TO SampMemb
PERSON ASKS WHAT CALL IS ABOUT 3
NEED TO CALLBACK 4 GO TO Callback
[FIRSTNAME] HAS A HEALTH PROBLEM 5 GO TO HealthProb
[FIRSTNAME] IS IN AN INSTITUTION 6 GO TO Institution
[FIRSTNAME] HAS MOVED 7 GO TO KnowWhere
NEVER HEARD OF [FULLNAME]/WRONG # 8 GO TO End 1
HUNG UP DURING INTRODUCTION 9 Status 640, Exit
REFUSED r Status 220, Exit
HellO = 3 |
S7 = FIRSTNAME |
WhatAbout. Mathematica recently sent [FIRSTNAME] a letter about a brief health survey.This survey is a follow-up to a survey she completed about 9 months ago. I’m calling to ask [FIRSTNAME] to take part in the second round of the survey. May I speak with her now?
[FIRSTNAME] COMES TO THE PHONE 1 GO TO SampMemb
NEED TO CALLBACK 2 GO TO Callback
[FIRSTNAME] HAS HEALTH PROBLEM/
IS DECEASED 3
[FIRSTNAME] IS IN AN INSTITUTION 4 GO TO Institution
[FIRSTNAME] MOVED 5 GO TO KnowWhere
[FIRSTNAME] DOES NOT SPEAK ENGLISH 6 GO TO Lang
[FIRSTNAME] DIDN'T RECEIVE LETTER 7 GO TO NoLetter
HUNG UP DURING INTRODUCTION 8 Status 640, Exit
SUPERVISOR REVIEW 9 Status 380, Exit
REFUSED r Status 220, Exit
Hello = 5 OR WhatAbout = 3 |
HealthProb. ENTER TYPE OF HEALTH PROBLEM.
HEARING PROBLEM 1 GO TO AmpTTY
SPEECH PROBLEM 2 GO TO AmpTTY
PHYSICAL PROBLEM 3 GO TO CallLater
COGNITIVE PROBLEM 4 GO TO End 2
IN A COMA 5 GO TO End 3
DECEASED 6 GO TO Deceased
REFUSED r Status 210, Exit
HealthProb = 1 OR 2 |
S7 = FIRSTNAME |
AmpTTY. I can get on a phone that will amplify my voice or [FIRSTNAME]’s voice, or we could use a TTY service. Would either of these help her to complete the interview?
YES – USE AMPLIFIER PHONE 1 GO TO RespAvail
YES – USE TTY CAPABILITY 2 GO TO RespAvail
NO 0 GO TO End 4
DON’T KNOW d GO TO Callback
REFUSED r GO TO End 4
amptty = 1 or 2 |
S7 = FIRSTNAME |
RespAvail. Is [FIRSTNAME] available now?
YES 1
NO 0 GO TO Callback
PROGRAMMER: IF AmpTTY = 1, GO TO AmpPhone, ELSE GO TO CallTTY
amptty = 1 AND RESPAVAIL = 1 |
AmpPhone. Please hold while I get the amplifier phone.
INTERVIEWER: SET UP AMPLIFIER/WEAK SPEECH EQUIPMENT AND ASK GATEKEEPER TO CALL [FIRSTNAME] TO THE PHONE.
[FIRSTNAME] COMES TO THE PHONE 1 GO TO SampMemb
NEED TO CALLBACK 2 GO TO Callback
AMPTTY = 2 AND respavail = 1 |
CallTTY. I will call back in a few minutes after I have the help of the TTY operator.
ARRANGE CALL WITH OPERATOR 1 GO TO SampMemb
UNSUCCESSFUL—NEED TO CALLBACK 2 GO TO Callback
healthprob = 3 |
S7 = FIRSTNAME |
CallLater. Will [FIRSTNAME] be able to talk on the telephone if I call back in a week or two?
YES/MAYBE – CALLBACK 1 GO TO Callback
NO 0 GO TO End 4
DON’T KNOW d GO TO Callback
REFUSED r GO TO End 4
healthprob = 6 |
Deceased. I am very sorry to hear that she passed away. Mathematica recently sent [FIRSTNAME] a letter about taking part in the second round of a survey she completed about 9 months ago. I was calling to follow up. When did she pass away?
Thank you. Please accept my condolences. Good-bye.
| | | / | | | / | | | | | Status 440
MONTH DAY YEAR
1-12 1-31 2009 - 2011
DON’T KNOW d GO TO End 5
REFUSED r GO TO End 5
hello = 6 or whatabout = 4 |
Institution. INTERVIEWER: ENTER TYPE OF INSTITUTION.
HOSPITAL 1
NURSING HOME 2 GO TO End 6
ASSISTED LIVING FACILITY 3 GO TO End 6
GROUP HOME 4 GO TO End 6
JAIL OR PRISON 5 GO TO End 6
institution = 1 |
S7 = FIRSTNAME |
HomeSoon. Do you expect [FIRSTNAME] to come home from the hospital within a week or two?
YES ARRANGE CALLBACK 1 GO TO Callback
NO 2 GO TO End 7
[FIRSTNAME] UNABLE TO RESPOND OVER THE
TELEPHONE 3 Status 410
Hello = 7 or whatabout = 5 |
S7 = FIRSTNAME |
KnowWhere. Do you or anyone there know how we can reach [FIRSTNAME]?
YES 1
NO 0 GO TO End 8
DON’T KNOW d GO TO End 8
REFUSED r GO TO End 8
(Hello = 7 or whatabout = 5) and knowwhere = 1 |
NewPhone.
| | | | - | | | | - | | | | | GO TO NewAddr
RANGE RANGE RANGE
OUT OF COUNTRY 2 GO TO End 9
DON’T KNOW d GO TO NewAddr
REFUSED r GO TO NewAddr
SOFT CHECK: IF CONDITION (e.g. Exchange = 555) I have recorded 555, is that correct? |
Hello = 7 or whatabout = 5 and knowwhere = 1 |
NewAddr. May I please have her address?
STRING (25)
STREET
STRING (25)
CITY
STRING (25)
STATE
| | | | | | - | | | | |
ZIP CODE
00501-99950 0001-9999
DON’T KNOW d GO TO End 8
REFUSED r GO TO End 8
Hello = 8 or whatabout = 6: programmer: 02 - 06 should be reviewed by a supervisor |
hello = 1 or 2 or whatabout = 1 or amphhone = 1 or calltty = 1 |
S6 = FULLNAME |
S7 = FIRSTNAME |
SampMemb. Mathematica recently sent you a letter asking you to take part in a brief health survey about your experiences with your new baby. This survey is a follow-up to a survey you completed 9 months ago about your experiences during your pregnancy. The survey will take about 15 to 20 minutes. To thank you for taking part, we will send you a gift card for $20. Is this a good time for the interview?
PROBE IF NEEDED: I’m calling from Mathematica Policy Research in Princeton, NJ. Mathematica is conducting this health survey for the U.S. Department of Health and Human Services.
Your participation is completely voluntary, but very important. All your answers will be held in complete privacy. Let’s begin.
BEGIN SCREENER 1 GO TO T0
DID NOT RECEIVE OR DOES NOT
RECALL THE LETTER 2 GO TO NoLetter
WANTS MORE INFORMATION 3 GO TO MoreInfo
NOT A GOOD TIME 4 GO TO Callback
HUNG UP DURING INTRODUCTION 5 Status 640, Exit
SUPERVISOR REVIEW 6 Status 380, Exit
REFUSED r Status 200, Exit
sampmemb = 2 or whatabout = 7 |
NoLetter. The letter explained that Mathematica is inviting you to take part in a survey about your experiences with your new baby. This survey follows up on a survey you took part in 9 months ago about your pregnancy. I can mail you a copy of the letter if you’d like. If we start the interview now, it will take 15 to 20 minutes.
BEGIN INTERVIEW 1 GO TO T0
WANTS ANOTHER LETTER 2 GO TO ReadLetter
WANTS MORE INFORMATION 3 GO TO MoreInfo
NOT A GOOD TIME 4 GO TO Callback
HUNG UP DURING INTRODUCTION 5 Status 640, Exit
REFUSED r Status 200, Exit
sampmemb = 3 or noletter = 3 |
MoreInfo. The survey is being done in four sites around the country with only a small number of women—about 960 in total. It asks about your experiences as a new mother, including any parenting information you got. Your participation is really important. Let’s start now.
YES, BEGIN INTERVIEW 1 GO TO T0
NO, WANTS ANOTHER LETTER FIRST 2 GO TO ReadLetter
NOT A GOOD TIME 3 GO TO Callback
HUNG UP DURING INTRODUCTION 4 Status 640, Exit
REFUSED r Status 200, Exit
moreinfo = 2 |
ReadLetter. May I read the letter to you and then we can begin?
YES, READ THE LETTER FROM HARD COPY 1 GO TO T0
NO, WANTS ANOTHER LETTER FIRST 2 GO TO SendLetter
HUNG UP DURING INTRODUCTION 3 Status 640, Exit
REFUSED r Status 200, Exit
ReadLetter = 2 |
SendLetter. Okay, I’ll mail another letter and will call back in a few days.
STREET STRING (25)
CITY STRING (25)
STATE STRING (25)
| | | | | | - | | | | |
ZIP CODE
00501-99950 0001-9999
DON’T KNOW d GO TO End 8
REFUSED r Status 200, Exit
Hello = 4 or whatabout = 2 OR AMPTTY= d OR RESPAVAIL=0 |
Callback. When would be a good time to call back?
INTERVIEWER: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK. USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG.
DOCALLBACK = YES |
AUTOFILL INTVNAME S6 = FULLNAME S7 = FIRSTNAME |
Hello. Hello, my name is [INTVNAME] from Mathematica Policy Research. May I please speak to [FULLNAME]?
SPEAKING TO [FIRSTNAME] 1 GO TO SampMemb
[FIRSTNAME] COMES TO THE PHONE 2 GO TO SampMemb
PERSON ASKS WHAT CALL IS ABOUT 3 GO TO WhatAbout
NEED TO CALLBACK 4 GO TO Callback
NEVER HEARD OF [FULLNAME]/
WRONG NUMBER 5 GO TO PhoneCheck
REFUSED r Status 220, Exit
HELLO = 3 |
S7 = FIRSTNAME |
WhatAbout. I’m calling to finish an interview we started with [FIRSTNAME] on [CB1 DATE]. Is she available now?
[FIRSTNAME] COMES TO THE PHONE 1 GO TO T0
NEED TO CALLBACK 2 GO TO Callback
SUPERVISOR REVIEW 3 Status 380, Exit
REFUSED r Status 220, Exit
HELLO = 1 or 2 OR WhatAbout = 1 |
SampMemb. Hello, my name is [INTVNAME].] I’m calling to finish the health interview we started recently. We will send you a gift card for $20 to thank you for participating. I’m calling to see if this is a good time to finish the interview.
As a reminder, your participation is completely voluntary, but very important. All your answers will be held in complete privacy. Let’s begin.
CONTINUE INTERVIEW 1 GO TO T0
NOT A GOOD TIME 2 GO TO Callback
SUPERVISOR REVIEW 3 Status 380, Exit
REFUSED r Status 200, Exit
HELLO=5 |
S3 = PHONE |
PhoneCheck. I’m sorry, I must have misdialed. I thought I dialed [PHONE]. Is that the number I've reached?
RIGHT NUMBER, NO SUCH PERSON 1 GO TO WrongNumber
WRONG CONNECTION/MISDIAL 2 Status 530, Exit
SUPERVISOR REVIEW REQUIRED 3 Status 380, Exit
REFUSED TO CONFIRM NUMBER 4 GO TO End 8
HELLO = 5 PhoneCheck = 1 |
AUTOFILL INTVNAME S6 = FULLNAME |
WrongNumber. I’m [INTVNAME] from Mathematica Policy Research. My information was that we’d recently spoken to someone at your number and we were supposed to call back to interview [FULLNAME]. There must have been some mistake. Thank you for your help. I’ll turn this over to my supervisor.
CONTINUE 1 Status 380
all callback |
Q. When would be a good time to call back?
INTERVIEWER: MAKE AN APPOINTMENT USING THE PARALLEL BLOCK. USE THE ‘APPOINTMENT’ TAB OR PRESS <CTRL-S> TO INVOKE THE APPOINTMENT MAKING DIALOG
C. Eligibility and Consent
ALL |
T0. First, I’d like to ask if you are speaking on a cell phone right now?
YES 1
NO 0 GO TO T1
T0 = 1 |
T0a. Are you driving?
YES 1
NO 0 GO TO T1
T0b. Since you are driving, we will need to call you back.
OKAY 1 Go to Callback DON’T CALL BACK 0 Status 200, Exit
T0 = 0 or T0a = 0 |
T
HS,
A13
1 BABY 1
2 BABIES 2
3 BABIES 3
MORE THAN 3 BABIES 4
NONE, INFANT DIED/MISCARRIAGE 0 GO TO END 5
DON’T KNOW d
REFUSED r
T1 ne 5 |
IF T1 = 1: Is, baby IF T1 = 2- 4, Are, babies |
T
HS
A14e
INTERVIEWER: IF RESPONDENT ANSWERS “NO”, PROBE “CAN YOU SAY A LITTLE MORE?” CODE TO LIVING WITH SOMEONE ELSE OR BABY DIED.
YES 1 GO TO BOX T3
NO (LIVING WITH SOMEONE ELSE) 2 GO TO END 13
NO (BABY DIED) 3 GO TO END 5
DON’T KNOW d
REFUSED r
BOX T3 IF T1 = 1, GO TO T3 IF T1 = 2-4, GO TO T4 |
T1 = 1 |
T
HS,
A14a1
PROBE: IF R ANSWERS DK OR REF, SAY: That’s fine. I’ll refer to the baby as “your baby” when I ask questions.
BABY’S FIRST NAME: ________________________ RECORD IN S8
DON’T KNOW d RECORD IN S8 = your baby
REFUSED r RECORD IN S8 = your baby
T1 = 1 |
T
HS
A14a2
PROBE: IF RESPONDENT ANSWERS DK OR REF, PROBE: THE MONTH AND YEAR IS FINE. THEN IF STILL DK OR REF, PROBE IS YOUR BABY LESS ONE YEAR OLD?
| | | / | | | / | | | | |
MONTH DAY YEAR
1-12 1-31 2009 – 2011
LESS THAN ONE YEAR OLD 0 GO TO Box T3b
ANSWERED 1 GO TO Box T3b DON’T KNOW d GO TO END 14
REFUSED r GO TO END 14
Box T3b. Programmer, calculate baby’s age: interview date minus month/day/year at T3a 1 = If baby is less than 12 months old, go to T6 2 = If baby is 12 months or more, go to T3b |
If Box T3b = 2 |
T3b. Your baby is 12 months or older. This means you are not eligible to participate in the survey. END: STATUS 460 ineligible
T1 = 2 – 4 |
T
HS
A14
PROBE: IF RESPONDENT ANSWERS DK OR REF TO ANY NAME, PROBE: THE MONTH AND YEAR IS FINE. THEN IF STILL DK OR REF, PROBE IS YOUR BABY LESS ONE YEAR OLD?
T4a. What is the [first/next] baby’s name? |
T4b. What is this baby’s birth date? |
1. NAME |
MM DD YYYY |
2. NAME |
MM DD YYYY |
3. NAME |
MM DD YYYY |
n. NAME |
MM DD YYYY |
LESS THAN ONE YEAR OLD 0 GO TO Box T4c
ANSWERED 1 GO TO Box T4c
DON’T KNOW d GO TO END 14
REFUSED r GO TO END 14
Box T4c Programmer calculate age each baby at T4b: date of interview minus each birth date.
1 = Select one baby who is less than 12 months old and record name in S8. 2 = If no baby is less than 12 months old, continue to T4c, else go to T5. |
If Box T4c = 2 |
T4c. None of your babies are under 12 months of age. This means you are not eligible to participate in the survey. END: STATUS 460 ineligible
If Box T4c = 1 Note: If Respondent refuses Gender at T5, record ‘he/she, his/her’ at S9. |
T
New
question
GIRL 1 RECORD IN S9
BOY 2 RECORD IN S9
DON’T KNOW d
REFUSED r
T6. Before I start the survey, I need to give you some information.
We are calling you because you took part in the first half of the Healthy Pregnancy and Parenting survey when you were pregnant about 9 months ago.
Your name and survey answers will be kept private from everyone except the research team unless prescribed by law. At the end of the survey, we will destroy the information.
There are no risks from taking part in the survey, other than the possible disclosure of your name, which we have taken steps to avoid.
While there are no direct benefits to you or your baby from taking part, by answering the questions you may help other women have healthier.
Taking part is voluntary. You may refuse to answer any question you don’t like. You might consider some questions, like your health status or services or those of your baby, to be sensitive.
If you wish to speak to a researcher about the study, I can give you the contact information for Margo Rosenbach, the Principal Investigator.
If you want to speak to someone about your rights as a participant in the survey, I can give you the contact information for Melissia Billarreal at Public/Private Ventures.
We will mail you a $20 gift card, when you complete this survey.
Do you have any questions about anything I just told you?
INSTRUCTIONS: ANSWER ANY QUESTIONS.
YES 1
NO 0 GO TO Start 1
REF R Status 200, Exit
T5. Do you agree to take part in the survey?
YES 1 GO TO Start 1
NO 0
D. TEXT4BABY ENROLLMENT AND USE OF SERVICES
ALL |
S
New question
Do you have your own cell phone?
YES 1
NO 0 GO TO Q1.1
DON’T KNOW d GO TO Q1.1
REFUSED r GO TO Q1.1
ALL |
S
New question
YES 1
NO 0
DON’T KNOW d
REFUSED r
Is Start 1 = 1 |
S
Pew
Cell Phones American Adults Q17 modified
|
CODE ONE RESPONSE FOR EACH ROW |
|||
|
yes |
no |
DK |
REF |
a send or receive text messages? |
1 |
0 |
d |
r |
b look at a social networking site like MySpace, Facebook or LinkedIn.com? |
1 |
0 |
d |
r |
c look at Twitter? |
1 |
0 |
d |
r |
d go to the internet directly on your cell phone |
1 |
0 |
d |
r |
If Start 3a = 1 |
IF START3a = 0, d, r, GO TO BOX1.1 |
S
New
question
english 1
SPANISH 2
OTHER (SPECIFY) __________________________ 9
DON’T KNOW d
REFUSED r
Box 1.1 IF S1 = 4-6, GO TO Q1.1a IF S1 = 1-3, GO TO Q1.1b |
S1 = 4-6 (R1 EVER ENROLLED) |
1.1a Before today, did you ever hear of a program called text4baby that sends pregnant women and new mothers free text messages on their cell phones?
PROBE IF R SAYS NOT SURE OR SEEMS UNCERTAIN: Women can sign up to receive free text messages about having a healthy pregnancy and baby. The messages include health tips, reminders, and information about other resources. Did you ever hear of the text4baby program before today?
YES 1 GO TO Q1.8
NO 0
DON’T KNOW d
REFUSED r
S1 = 1-3 (R1 NEVER ENROLLED) OR Q1.1a = 0,d,r |
1
HS
B2 modified
PROBE IF R SAYS NOT SURE OR SEEMS UNCERTAIN: Women can sign up to receive free text messages about having a healthy pregnancy and baby. The messages include health tips, reminders, and information about other resources. Did you ever hear of the text4baby program before today?
YES 1
NO 0 GO TO Q4.1
DON’T KNOW d GO TO Q4.1
REFUSED r GO TO Q4.1
Q1.1b = 1 |
1
SCHIP
Enrollees Disenrollees 2.13 modified
PROBE: Text4baby is a text messaging program gives women tips about having a healthy pregnancy and baby.
INSTRUCTIONS: CODE YES IF R SAYS SOMEONE ELSE SIGNED HER UP.
CODE YES IF R WAS SIGNED UP IN THE PAST BUT IS NOT CURRENTLY SIGNED UP.
YES 1
TRIED BUT WAS UNABLE TO SIGN UP 2 Go to Q1.2c
NO 0 GO TO Q1.4
DON’T KNOW d GO TO Q1.4
REFUSED r GO TO Q1.4
BOX 1.2a IF Q1.2 = 1 and S1 = 4-6, GO TO Q1.8, else continue |
Q.1.2 = 1 and S1 = 1-3 |
1
New
question
CELL PHONE 1
INTERNET 2
someone else signed me up 3
OTHER (SPECIFY) 99
(STRING 200)
DON’T KNOW d
REFUSED r
Q.1.2 = 1 and S1 = 1-3 |
1
New
question
english 1 GO TO Q1.2d
SPANISH 2 GO TO Q1.3
DON’T KNOW d GO TO Q1.3
REFUSED r GO TO Q1.3
Q.1.2=2 |
1
New
question
Specify: ___________________________________ GO TO Q1.4
Q1.2b = 1 and Q1.2=0, 2 |
1
New
question
yes 1
NO 2
DON’T KNOW d
REFUSED r
BOX 1.3 IF Q1.2 = 1, GO TO Q1.3 IF Q1.2 = 0,2 GO TO Q1.4 |
Q.1.2 = 1 and S1 = 1-3 |
1
New
question
PROBE: Your best estimate is fine.
In the past month? 1
Between one and two months ago? 2
Between three and four months ago? 3 GO TO 1.3b
Between five and six months ago? 4 GO TO 1.3b
More than six months ago? 5 GO TO 1.3b
DON’T KNOW d
REFUSED r
Q1.3 = 1,2 |
1
New
question
YES, SIGNED UP BEFORE BABY WAS BORN 1 GO TO 1.4
NO, SIGNED UP AFTER BABY WAS BORN 0 GO TO 1.3c
DON’T KNOW d GO TO 1.4
REFUSED r GO TO 1.4
Q1.3 = 3,4,5,d,r |
1
New
question
YES 1
NO 0 GO TO Q1.4
DON’T KNOW d GO TO Q1.4
REFUSED r GO TO Q1.4
Q1.3b = 1 |
1
New
question
PROBE: Your best estimate is fine.
3 months or less, 1 GO TO Q1.4
4 to 6 months, or 2 GO TO Q1.4
7 to 9 months 3 GO TO Q1.4
DON’T KNOW d GO TO Q1.4
REFUSED r GO TO Q1.4
Q.1.1b=1 |
1
HK
LA Baseline B1 modified
a doctor or midwife? 1
another health care provider? 2
a friend or family member? 3
a billboard, flyer, newspaper, or magazine? 4
on TV or radio? 5
on the internet? 6
something you received in the mail? 7
or from another source? (SPECIFY) 99
(STRING 200)
DON’T KNOW d
REFUSED r
Box 1.5 IF Q1.2 = d,r, GO TO Q4.1 IF Q1.2 = 0, GO TO Q2.6 IF Q1.2=1 and Q1.4 = only one response coded, GO TO Q1.6. |
Q1.2 = 1, S1 = 1-3 AND Q1.4 HAS MORE THAN ONE RESPONSE (1-7 and 99) |
Display in Q1.5 only the responses selected in Q1.4. |
1
1001
CHIP 2.2.1 modified
DISPLAY ONLY MULTIPLE RESPONSES FROM Q1.4 AND ALLOW CODE ONE ONLY
CODE ONE: | | |
DON’T KNOW d
REFUSED r
Q1.2 = 1 and S1 = 1-3 |
In Q1.6 display the 6 reasons in random order for each interview. |
1
New
question
READ EACH REASON FIRST. THEN ASK FOR EACH, Was that very important, somewhat important, or not very important?
|
code one response per row |
||||
REASONS |
VeRY IMPORTANT |
SOMEWHAT IMPORTANT |
NOT very IMPORTANT |
DK |
REF |
a Getting text4baby messages is free |
1 |
2 |
3 |
d |
r |
b Getting text4baby messages is convenient |
1 |
2 |
3 |
d |
r |
c Your doctor or midwife suggested you sign up |
1 |
2 |
3 |
d |
r |
d A friend or family member suggested you sign up |
1 |
2 |
3 |
d |
r |
e You wanted to get tips about having a healthy baby |
1 |
2 |
3 |
d |
r |
f You wanted to get phone numbers to call for information about specific health topics |
1 |
2 |
3 |
d |
r |
g You thought the reminders about well-baby and other appointments would be helpful |
1 |
2 |
3 |
d |
r |
Q1.2 = 1 and S1 = 1-3 |
1
New
question
(STRING 400)
DESCRIPTION
NO OTHER REASON 0
DON’T KNOW d
REFUSED r
Q1.2 = 1 and S1 = 1-3 |
1
New
question
very easy, 1
somewhat easy, 2
somewhat hard, or 3
very hard? 4
DON’T KNOW d
REFUSED r
Q1.2 = 1 or Q1.1a = 1 |
1
New
question
YES 1
NO 0 GO TO Q1.10
DON’T KNOW d GO TO Q1.10
REFUSED r GO TO Q1.10
Q1.8 = 1 |
Display TOPICS AND EVER CALLED COLUMN. FOR EACH YES AT EVER CALLED, DISPLAY Was the information very useful, somewhat useful, or not useful? |
1
New
question
INTERVIEWER: READ EACH TOPIC FIRST, THEN FOR EACH “YES” RESPONSE TO “EVER CALLED,” ASK: Was the information very useful, somewhat useful, or not very useful?
|
ever called? |
HOW USEFUL? |
|||||
TOPICS |
Yes |
NO |
very useful |
somewhat useful |
not very useful |
DK |
REF |
a Getting information about breastfeeding? |
1 |
0 |
1 |
2 |
3 |
d |
r |
b Feeling anxious or sad? |
1 |
0 |
1 |
2 |
3 |
d |
r |
c Finding child care? |
1 |
0 |
1 |
2 |
3 |
d |
r |
d Getting immunizations for your baby? |
1 |
0 |
1 |
2 |
3 |
d |
r |
e Getting information about WIC? |
1 |
0 |
1 |
2 |
3 |
d |
r |
f Some other topic I haven’t mentioned? (SPECIFY) |
1 |
0 |
1 |
2 |
3 |
d |
r |
_____________(STRING 400) |
|
|
|
|
|
|
|
Q1.8 = 1 |
1
New
question
YES 1
NO 0
DON’T KNOW d
REFUSED r
Q1.2 = 1 or Q1.1a = 1 |
1
New
question
Have you received one or more messages from text4baby in the past two weeks?
YES 1
NO 0 GO TO BOX 2.1
DON’T KNOW d GO TO BOX 2.1
REFUSED r GO TO BOX 2.1
Q1.10 = 1 |
1
SMS
Sexual Health 19 modified
one or two, 1
three or four, 2
five or six, or 3
more than six? 4
DON’T KNOW d GO TO BOX 2.1
[Question 1.12 has been moved to question 3.7.]
Q1.11 = 1-4 |
1
SMS
Sexual Health 21 & 22 modified
INTERVIEWER: READ LIST AND CODE ONE RESPONSE PER ROW
|
YES |
NO |
DK |
REF |
a a friend? |
1 |
0 |
d |
r |
b a family member? |
1 |
0 |
d |
r |
c someone you work with? |
1 |
0 |
d |
r |
d. your doctor or midwife? |
1 |
0 |
d |
r |
e. someone else? (SPECIFY) |
1 |
0 |
d |
r |
__________________________(STRING 200) |
|
|
|
|
Q1.11 = 1-4 |
||||
1
New
question
YES 1
NO 0 GO TO BOX 2.1
DON’T KNOW d GO TO BOX 2.1
REFUSED r GO TO BOX 2.1
Q1.14 = 1 |
1
New
question
Your cell phone was lost or stolen? 1
A friend or relative borrowed your cell phone? 2
You didn’t have enough money to continue cell
phone service? 3
You were somewhere with no cell
phone service? 4
You texted STOP to stop receiving messages? 5
Some other reason? (SPECIFY) 99
(STRING 400)
DON’T KNOW d
REFUSED r
E. TEXT4BABY DISENROLLMENT AND NEVER ENROLLMENT
Box 2.1 S1=5, GO TO BOX 3.1 IF Q1.10 = 1, GO TO BOX 3.1 IF Q1.10 = 0,d,r, GO TO Q2.1 |
Q1.10 = 0,d,r |
S8 = Child name |
2
New
question
YES 1
NO 0 GO TO BOX 3.1
DON’T KNOW d GO TO BOX 3.1
REFUSED r GO TO BOX 3.1
Q2.1 = 1 |
2
New
question
you didn’t have time to read the messages, 1
there were too many messages, 2
you didn’t find the messages useful, 3
you had enough information from
other sources, or 4
Another reason? (SPECIFY) 5
(STRING 400)
DON’T KNOW d
REFUSED r
Q2.1 = 1 |
2
New
question
In the past month, 1
2 to 3 months ago, or 2
More than 3 months ago 3
DON’T KNOW d
REFUSED r
Q2.1 = 1 |
2
New
question
(STRING 400)
DESCRIPTION
DON’T KNOW d
REFUSED r
Q2.1=1 |
2
New
question
YES 1
NO 0 GO TO Q2.5b
DON’T KNOW d GO TO BOX 2.6
REFUSED r GO TO BOX 2.6
Q2.5 = 1 |
2
New
question
(STRING 400) GO TO BOX 2.6
DESCRIPTION
DON’T KNOW d GO TO BOX 2.6
REFUSED r GO TO BOX 2.6
Q2.5 = 0 |
2
New
question
(STRING 400)
DESCRIPTION
DON’T KNOW d
REFUSED r
Box 2.6 IF Q1.2 = 1 or Q1.1a = 1, GO TO BOX 3.1 |
Q1.2 = 0 |
Display reasons in random order for each interview. Display reasons and Yes/No column first. For each YES, ask: How important was this reason in your decision not to sign up? Was it very important, somewhat important, or not very important? |
2.6 Did you decide not to sign up for text4baby because…
READ EACH REASON FIRST. FOR EACH ‘YES’ ASK: How important was this reason in your decision not to sign up? Was it very important, somewhat important, or not very important?
|
|
code one response FOR EACH YES |
||||||
REASONS |
YES |
NO |
VeRY IMPORTANT |
SOMEWHAT IMPORTANT |
NOT very IMPORTANT |
DK |
REF |
|
a Your cell phone had no text messaging capability? |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
b You don’t know how to use text messaging? |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
c You don’t like text messaging? |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
d You have other sources of information about having a healthy baby? |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
e A friend or family member advised you not to sign up? |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
f Your doctor, midwife, or another health care provider advised you not to sign up? |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
g Text4baby messages are not available in your preferred language |
1 |
0 |
1 |
2 |
3 |
d |
r |
|
Q1.2=0 |
2
New
question
(STRING 400)
DESCRIPTION
NO OTHER REASON 0
DON’T KNOW d
REFUSED r
Q1.2=0 |
2
New
question
(STRING 400)
DESCRIPTION
NOTHING/NOT INTERESTED 0
DON’T KNOW d
REFUSED r
F. SATISFACTION WITH TEXT4BABY
Box 3.1 IF Q1.2 = 0 or Q1.10 = d,r, GO TO Q4.1 |
Q1.10 = 1 or Q1.10 = 0 |
IF Q1.10 = 0: When you were getting text4baby messages, how satisfied were you with how often you received IF Q1.10 = 1: How satisfied are you with how often you receive |
3
New
question
very satisfied, 1
somewhat satisfied, 2
somewhat dissatisfied, or 3
very dissatisfied? 4
DON’T KNOW d
REFUSED r
Q1.10 = 1 or Q1.10 = 0 |
IF Q1.10 = 0: was, received IF Q1.10 = 1: is, receive |
3
PS
A21B modified
very easy, 1
somewhat easy, 2
somewhat hard, or 3
very hard? 4
DON’T KNOW d
REFUSED r
Q1.10 = 1 or Q1.10 = 0 |
IF Q1.10 = 0: were IF Q1.10 = 1: are |
3
PS
A20 modified
very useful, 1
somewhat useful, or 2
not very useful? 3
DON’T KNOW d
REFUSED r
Q1.10 = 1 or Q1.10 = 0 |
3
HS
B12
YES 1
NO 0 GO TO Q3.4b
DON’T KNOW d GO TO Q3.5
REFUSED r GO TO Q3.5
Q3.4 = 1 |
3
HS
B12a
(STRING 400) GO TO Q3.5
DESCRIPTION
DON’T KNOW d GO TO Q3.5
REFUSED r GO TO Q3.5
Q3.4 = 0 |
3
HS
B12b
(STRING 400)
DESCRIPTION
DON’T KNOW d
REFUSED r
Q1.10 = 1 or Q1.10 = 0 |
3
New
PROBE: “What else” until respondent answers “nothing.”
(STRING 400)
DESCRIPTION
NONE 0
DON’T KNOW d
REFUSED r
Box 3.6 IF Q1.10=0, Go TO 5.1 |
Q1.10 = 1 |
3
Cocosila
modified
PROBE: At this time, text4baby messages are free.
YES 1
NO 0
DON’T KNOW d
REFUSED r
Q1.10 = 1 |
3
SMS
Sexual Health 20 modified
FOR EACH STATEMENT, Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?
|
STRONGLY AGREE |
SOMEWHAT AGREE |
SOMEWHAT DISAGREE |
STRONGLY DISAGREE |
DK |
REF |
a You learned something from them |
1 |
2 |
3 |
4 |
d |
r |
b You trusted them |
1 |
2 |
3 |
4 |
d |
r |
c They were interesting |
1 |
2 |
3 |
4 |
d |
r |
d They were annoying |
1 |
2 |
3 |
4 |
d |
r |
BOX 3.8 IF Q3.7d = 3, 4, d, r, GO TO Q5.1 |
||||||
Q3.7d = 1 or 2 |
3.8 Why were the text4baby messages annoying?
New
question
(STRING 400)
DESCRIPTION
DON’T KNOW d
REFUSED r
G. SECTION G DELETED.
H. HEALTH CARE ACCESS, UTILIZATION, KNOWLEDGE, AND BEHAVIOR
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
5
HS
F1 [PS
adapted]
YES 1 GO TO Q5.2
NO 0
DON’T KNOW d
REFUSED r
Q5.1 = 0,d, or r |
5
HS
F2 [PS
adapted]
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
5
HS
F3 [SLAITS]
PROBE: A personal doctor or nurse is a health care provider who knows you well and is familiar with your health history. This can be a general doctor, an obstetrician, a nurse practitioner, or a physician assistant. This does not include visits to an emergency room.
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
5
HS
G7 [PRAMS]
YES 1 GO TO Q5.4
NO 0
DON’T KNOW d
REFUSED r
Q5.3 = 0, d, r |
[CHILD] = CHILD’S NAME FROM S8 |
5
HS
G8 [PRAMS]
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 |
5
HS
G9
PROBE: A personal doctor or nurse is a health care provider who knows your baby well and is familiar with your baby’s health history. This can be a general doctor, a pediatrician, a nurse practitioner, or a physician assistant.
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
Rotate sources of information If Q1.10 = 0,1, display Q5.5f, ELSE do not. |
5
New
question
|
used source |
|||
SOURCE OF INFORMATION |
Yes |
NO |
dk |
ref |
a A doctor or midwife |
1 |
0 |
d |
r |
b Your partner or spouse |
1 |
0 |
d |
r |
c A parent |
1 |
0 |
d |
r |
d A friend |
1 |
0 |
d |
r |
e Books or online sources |
1 |
0 |
d |
r |
f text4baby |
1 |
0 |
d |
r |
g Another source (SPECIFY) |
1 |
0 |
d |
r |
______________________(STRING 400) |
|
|
|
|
Box 5.6 If response to Q5.5a-Q5.5g is all ‘NO’ or only one ‘YES’ response, GO TO Q5.7 |
Q5.5 = More than one ‘YES’ response |
5
New
question
INTERVIEWER: READ THE LIST.
Response #1..n 1
DON’T KNOW d
REFUSED r
All |
Rotate topics in each interview. |
5
New
question
|
got information about… |
|||
TOPIC |
YES |
NO |
dk |
r |
a Getting well-baby visits |
1 |
0 |
d |
r |
b Getting immunizations for [CHILD] |
1 |
0 |
d |
r |
c Understanding [CHILD]’s development |
1 |
0 |
d |
r |
d Breastfeeding your baby |
1 |
0 |
d |
r |
e Taking care of postpartum depression/ baby blues |
1 |
0 |
d |
r |
f How to lay [CHILD] down to sleep |
1 |
0 |
d |
r |
g Using an infant car seat |
1 |
0 |
d |
r |
h Choosing a family planning or birth control option |
1 |
0 |
d |
r |
i Calling a hotline if you or someone you know is being abused |
1 |
0 |
d |
r |
j Protecting your baby from secondhand smoke |
1 |
0 |
d |
r |
IF Q1.10 = 1,0 |
IF Q1.1=0,D,R or Q1.2=0, D, R or Q1.10=D,R, GO TO 5.8 |
1) FOR ANY YES IN q5.7, DISPLAY ANSWERS IN Q5.7A AND ask column A: Did you get this information from text4baby? 2) FOR ANY YES IN COLUMN A of Q5.7A, ask COLUMN B: Was the text4baby message about [TOPIC] very useful, somewhat useful, or not very useful? |
5
New
question
FOR ANY YES IN Q5.7, ASK: Did you get information about [TOPIC] from text4baby?
FOR ANY YES IN COLUMN A, ASK: Was the text4baby message about [TOPIC] very useful, somewhat useful, or not very useful?
|
Column A Got info from text4baby |
Column B USEFULNESS OF INFO FROM TEXT4BABY |
|||||
|
Very useful |
SOMEWHAT USEFUL |
Not very useful |
DK |
REF |
||
TOPIC |
YES |
NO |
|||||
a Topic #1 |
1 |
0 |
1 |
2 |
3 |
d |
r |
b Topic #2 |
1 |
0 |
1 |
2 |
3 |
d |
r |
c Topic #3 |
1 |
0 |
1 |
2 |
3 |
d |
r |
d Topic #4 |
1 |
0 |
1 |
2 |
3 |
d |
r |
ALL |
[CHILD] = CHILD’S NAME FROM S8 |
5
Healthy
Start C.2 modified
YES 1
NO 0 GO TO Q5.9
DON’T KNOW d GO TO Q5.9
REFUSED r GO TO Q5.9
Q5.8 = 1 |
[CHILD] = CHILD’S NAME FROM S8 |
5
Healthy
Start C.2 modified
(STRING 400)
DESCRIPTION
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 |
5
Healthy Start
E7
About how many alcoholic drinks do you have in an average week now? Would you say…
PROMPT IF NEEDED, ‘in an average week.’ STOP WHEN RESPONDENT INDICATES NUMBER OF DRINKS.
RESPONDENT HAS NO DRINKS IN AN AVERAGE WEEK 1
Less than 1 drink in an average week, 2
1 to 3 drinks, 3
4 to 6 drinks, or 4
7 or more? 5
DON’T KNOW d
REFUSED r
ALL |
5
Healthy
Start E3 [PRAMS]
INSTRUCTION: STOP WHEN YOU REACH ONE CODED CATEGORY
PROBE: A pack has 20 cigarettes.
RESPONDENT DOES NOT SMOKE 1
1 to 5 per day, 2
6 to 10, 3
11 to 20, or 4
more than 20? 5
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 |
5
Healthy
Start G16 [PRAMS] modified
PROBE: IF RESPONDENT SAYS 2 OR 3, ASK: “Is that 2 or 3?”
| | | HOURS (00-24)
LESS THAN 1 HOUR A DAY 1
[CHILD] IS NEVER IN THE SAME ROOM OR VEHICLE WITH SOMEONE WHO IS SMOKING 2
DON’T KNOW d
REFUSED r
ALL |
5
PRAMS
Standard Phase 6 S4 modified
always, 1
usually, 2
sometimes, 3
rarely, or 4
never? 5
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
5
PRAMS
Standard Phase 6 S6 modified
always, 1
usually, 2
sometimes, 3
rarely, or 4
never? 5
DON’T KNOW d
REFUSED r
ALL |
5.14 During the past 12 months, have you had a flu shot?
PRAMS
Standard Phase 6 L13 modified
PROBE: IF R SAYS SHE TOOK A LIQUID OR PILL, CODE YES.
YES 1
NO 0 GO TO Q5.14b
DON’T KNOW d GO TO Q5.15
REFUSED r GO TO Q5.15
BOX 5.14a IF Q5.14 = 1 AND (Q1.1b = 0,D,R or Q1.2 = 0,D,R or Q1.8 = 0,D,R), GO TO Q5.15 |
Q5.14 = 1 and Q1.2 = 1 |
5
New
YES 1 GO TO Q5.15
NO 0 GO TO Q5.15
DON’T KNOW d GO TO Q5.15
REFUSED r GO TO Q5.15
Q5.14=0 |
5
PRAMS
Your doctor or midwife didn’t mention anything about getting a flu shot? 1
You were worried that it might harm your baby? 2
You were worried about side effects for your own health? 3
You didn’t know where to get a flu shot? 4
Were there any other reasons you didn’t get a flu shot? (SPECIFY) 5
________________________________(STRING 400)
DON’T KNOW d
REFUSED r
ALL |
5
NSCH
K4Q21 modified
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
5
HS
G2 [PRAMS/ ECLS adapted]
YES 1
NO 0 GO TO Q5.17
DON’T KNOW d GO TO Q5.17
REFUSED r GO TO Q5.17
Q5.16 = 1 |
5
HS
G3[PRAMS/ ECLS adapted]
YES 1 GO TO Q5.17
NO 0
DON’T KNOW d GO TO Q5.17
REFUSED r GO TO Q5.17
Q5.16a = 0 |
[CHILD] = CHILD’S NAME FROM S8 |
5
HS
G4[ PRAMS/ ECLS adapted]
PROBE: Was that days, weeks, or months?
AGE: | | | |
DAYS 1
WEEKS 2
MONTHS 3
DON’T KNOW d GO TO Q5.17
REFUSED r GO TO Q5.17
Q5.16b = 1,2,3 |
[CHILD] = CHILD’S NAME FROM S8 |
5
HS
G4[ PRAMS/ECLS adapted]
CORRECT 1
WRONG 2 CORRECT Q5.16b
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
5
HS
G13[ PRAMS/ ECLS
adapted]
side, 1
back, 2
or stomach? 3
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 |
5
HE
102 modified [ECLS]
not at all, 1
once or twice, 2
3 to 6 times, or 3
every day? 4
DON’T KNOW d
REFUSED r
ALL |
5
HS
H6 [PRAMS]
PROBE: For example, not having sex at certain times of the month, or using birth control methods such as the pill, the patch, condoms, cervical ring, IUD, having your tubes tied, or your partner having a vasectomy.
INSTRUCTION: IF R SAYS NOT HAVING SEX OR ABSTINENT, CODE 1.
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
5
New
YES 1
NO 0 GO TO Q6.1
DON’T KNOW d GO TO Q6.1
REFUSED r GO TO Q6.1
Q5.21 = 1 |
5
New
at least 6 months, 1
at least 12 months, 2
at least 18 months, 3
at least 2 years, or 4
Do you not remember? d
REFUSED r
ALL |
5
NSCH K4Q27.
Adapted
PROBE: This is health care for you, not for your baby.
YES 1
NO 0 GO TO Q5.24
DON’T KNOW d GO TO Q5.24
REFUSED r GO TO Q5.24
IF Q5.21 = 1 |
5
NSCH K4Q28.
Adapted
|
unmet need |
|||
TYPE OF SERVICE |
Yes |
NO |
dk |
ref |
a Medical care |
1 |
0 |
d |
r |
b Dental care |
1 |
0 |
d |
r |
c Vision care |
1 |
0 |
d |
r |
d Mental health services |
1 |
0 |
d |
r |
e Another kind of care (SPECIFY) ______________________(STRING 200) |
1 |
0 |
d |
r |
IF Q5.21 = 1 |
5
New
question
A big problem 1
A small problem 2
Not a problem 3
DON’T KNOW d
REFUSED r
ALL |
Rotate reasons for delayed care (a-g) |
5
NHIS
2011 AHCDLY Adapted
|
DELAYED CARE |
|||
REASON FOR DELAYED CARE |
Yes |
NO |
dk |
ref |
a You couldn’t get through on the telephone |
1 |
0 |
d |
r |
b You couldn’t get an appointment soon enough |
1 |
0 |
d |
r |
c You would have to wait too long at the clinic or doctor’s office |
1 |
0 |
d |
r |
d The clinic or doctor’s office wasn’t open when you could get there |
1 |
0 |
d |
r |
e You didn’t have transportation |
1 |
0 |
d |
r |
f You couldn’t afford it |
1 |
0 |
d |
r |
g You didn’t have child care |
1 |
0 |
d |
r |
h Another reason for delaying care (SPECIFY) |
1 |
0 |
d |
r |
______________________(STRING 200) |
|
|
|
|
ALL |
5
CAHPS
Medicaid Survey Q8 Adapted
| | |
DON’T KNOW d
REFUSED r
I. HEALTH STATUS AND BIRTH OUTCOMES
ALL |
6
NSCH,
K9Q20
EXCELLENT 1
VERY GOOD 2
GOOD 3
FAIR 4
POOR 5
DON’T KNOW d
REFUSED r
ALL |
6
NSCH
K9Q23 modified
EXCELLENT 1
VERY GOOD 2
GOOD 3
FAIR 4
POOR 5
DON’T KNOW d
REFUSED r
ALL |
6
HS
I2
YES 1
NO 0 GO TO Q6.4
DON’T KNOW d GO TO Q6.4
REFUSED r GO TO Q6.4
Q6.3 = 1 |
6
HS
I2a modified
PROBE, IF ASKED: This includes any pregnancy.
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
6
HS
I3 modified
YES 1
NO 0 GO TO Q6.5
DON’T KNOW d GO TO Q6.5
REFUSED r GO TO Q6.5
Q6.4 = 1 |
6
HS
I3a modified
PROBE, IF ASKED: This includes any pregnancy.
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
6
HS
I7
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
6
ECLS
Parent 9-month Interview FH060-063
PROBE: Your best estimate will be fine.
| | | FEET AND | | | INCHES OR
(NUMBER RANGE) (NUMBER RANGE)
| | | | CENTIMETERS (NUMBER RANGE)
DON’T KNOW d
REFUSED r
ALL |
6
ECLS
Parent 9-month Interview FH0655-056
PROBE: Your best estimate will be fine.
| | | POUNDS OR
(NUMBER RANGE)
| | | | KILOGRAMS (NUMBER RANGE)
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
6
New
Thinking back to when [he/she] was born… was [he/she] born more than three weeks before the due date?
PROBE: The due date is the date the doctor estimated the baby would be born.
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 |
Programmer: for Pounds/Ounces or Kilograms, GO TO Q6.9a |
6
HS
D5
PROBE IF RESPONDENT SAYS ‘DON’T KNOW’: Your best estimate is fine.
| | | POUNDS AND | | | OUNCES
(NUMBER RANGE) (NUMBER RANGE)
OR
| | | | KILOGRAMS (NUMBER RANGE)
DON’T KNOW d GO TO Q6.9b
REFUSED r GO TO Q6.9b
Q6.9 = answered |
[CHILD] = CHILD’S NAME from S8 |
6
HS
D5
CORRECT 1 GO TO Q6.10
INCORRECT 2 GO TO Q6.9b
Q6.9 = d, r |
[CHILD] = CHILD’S NAME from S8 |
6
HS
D5
INSTRUCTION: 5 ½ POUNDS = 5 POUNDS, 8 OUNCES
instruction: 2.5 kilos = 250 kilograms
5 1/2 pounds or more, 1
less than 5 1/2 pounds, 2
250 kilograms or more, 3
less than 250 kilograms, or 4
Do you not remember? d
REFUSED r
ALL |
[CHILD] = CHILD’S NAME FROM S8 GENDER FROM S9 = IF MALE, he ELSE she |
6
HS
G6 [Ped Care]
Excellent, 1
very good, 2
good, 3
fair, or 4
poor? 5
DON’T KNOW d
REFUSED r
J. Participant background
ALL |
7
HS
J1
married, 1
separated, 2
divorced, 3
widowed, 4
never married, or 5
living with a partner? 6
DON’T KNOW d
REFUSED r
ALL |
7
2001
CHIP 7.70.1
Are you currently covered by insurance from a current or past employer or union?
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
s6 = 1: state chip program name |
7
2001
CHIP 7.70.2
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
7
2001
ChIP 7.70.3
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
state chip program name |
7
2001
CHIP 7.70.4
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
7
2001
CHIP 7.70.5
YES (SPECIFY)_______________(STRING 100) 1
NO 0
DON’T KNOW d
REFUSED r
Box 7.2F If any question Q7.2a–e=1 (R has some type of health insurance), go to box 7.2h; else go to Q7.2f. |
If Q7.2a-e = 0, d, r |
7
HS
K8
CORRECT, HAS NO COVERAGE 1 GO TO Q7.3
WRONG, HAS SOME COVERAGE 0 GO TO Q7.2g
DON’T KNOW d GO TO Q7.3
REFUSED r GO TO Q7.3
Q7.2e=0 |
7
HS
K9
INTERVIEWER: Read and Code All That Apply
|
yes |
no |
DK |
REF |
a Insurance through an employer or union |
1 |
0 |
d |
r |
b Insurance you purchased from a private insurance company |
1 |
0 |
d |
r |
c State CHIP insurance |
1 |
0 |
d |
r |
d Medicaid or Medicaid HMO |
1 |
0 |
d |
r |
e Some other coverage (SPECIFY) |
1 |
0 |
d |
r |
___________________________(STRING 200) |
|
|
|
|
IF Q7.2d = 1 (has Medicaid coverage, ask Q7.2 h, else go to 7.3 |
7
HS
K10
ALL TYPES OF MEDICAL CARE 1
FAMILY PLANNING SERVICES ONLY 2
DON’T KNOW d
REFUSED r
ALL |
[CHILD] = CHILD’s NAME FROM S8 S2 = STATE MEDICAID NAME |
7
2001
CHIP 7.70.1
Is [CHILD] currently covered by insurance from a current or past employer or union?
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
s6 = 1: state chip program name |
7
2001
CHIP 7.70.2
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
7
2001
CHIP 7l70.3
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
state chip program name |
7
2001
CHIP 7.70.4
YES 1
NO 0
DON’T KNOW d
REFUSED r
ALL |
7
2001
CHIP 7.70.5
YES (SPECIFY)_______________(STRING 100) 1
NO 0
DON’T KNOW d
REFUSED r
Box 7.3f If any question Q7.3a–e = 1 (R has some type of health insurance), go to box 7.3h; else go to Q7.3f. |
If Q7.3a-e = 0, d, r |
7
HS
K8
CORRECT, HAS NO COVERAGE 1 GO TO Q7.11
WRONG, HAS SOME COVERAGE 0 GO TO Q7.10g
DON’T KNOW d GO TO Q7.11
REFUSED r GO TO Q7.11
Q7.10e=0 |
7
HS
K9
INTERVIEWER: Read and Code All That Apply
|
yes |
no |
DK |
REF |
a Insurance through an employer or union |
1 |
0 |
d |
r |
b Insurance you purchased from a private insurance company |
1 |
0 |
d |
r |
c State CHIP insurance |
1 |
0 |
d |
r |
d Medicaid or Medicaid HMO |
1 |
0 |
d |
r |
e Some other coverage (SPECIFY) |
1 |
0 |
d |
r |
___________________________(STRING 200) |
|
|
|
|
ALL |
||||
7
HS
J9
PROBE: If R says on maternity leave or on vacation, probe if she is usually employed full- or part-time.
35 OR MORE HOURS PER WEEK 1 GO TO 8.1
LESS THAN 35 HOURS PER WEEK 2
NOT WORKING (INCLUDES RETIRED, HOMEMAKER, STUDENT, DISABLED) 3
DON’T KNOW d
REFUSED r
iF q7.4 = 2, 3, D, R |
7.5 Are you currently actively looking for work?
YES 1
NO 0
DON’T KNOW d
REFUSED r
K. FUTURE CONTACT INFORMATION
all |
8
LA
Healthy Families, P1, modified
INTERVIEWER:
(STRING 80)
FIRST NAME
(STRING 80)
MIDDLE INITIAL/NAME
(STRING 80)
LAST NAME
(STRING 160)
ADDRESS 1
(STRING 160)
ADDRESS 2
(STRING 80)
CITY
STATE
(STRING 10)
ZIP CODE
DON’T KNOW d
REFUSED r
END. Those are all the questions I have. Thank you for speaking with me today. If you have any questions please call ____________ at Mathematica. Her toll-free number is 800-xxx-xxxx. Have a very nice (day/night/weekend). Good-bye.
L. SURVEY BACKEND
HELLO = 9 |
End 1 = Sorry for disturbing you. Thanks for your time. Good-bye. Status 530
HealthProb = 4 |
End 2 = Thanks for explaining about [NAME]’s condition. We won’t be able to interview her and will remove her name from our call list. Good-bye.
If HealthProb = 4 (COGNITIVE PROBLEM) Status 412
HealthProb = 5 |
End 3 = Thanks for explaining about [NAME]’s condition. We won’t be able to interview her and will remove her name from our call list. Good-bye.
If HealthProb = 5 (COMA) Status 420
AmpTTY = 0 or 4, CallLater = 0 or r |
End 4 = Thanks for your time. Good-bye. Status 210
(Gatekeeper refusal for R to use AmpTTY etc., will be called back by converter)
Deceased = d, r |
End 5 = I’m very sorry for your loss. Please accept my condolences. Status 440
[If needed, I can give you a phone number to call if you’d like to receive grief counseling.]
Institution = 2, 3, 4, or 5 |
End 6 = Since [NAME] does not live at home, we are not able to interview her. We will remove her name from our call list.
If Institution = 2,3,4 Status 420
If Institution = 5 (jail/prison) Status 421
HomeSoon = 0 |
End 7 = I’m sorry to hear [NAME] won’t be home anytime soon. We’ll call back later to learn if she’s home yet. Status 380
KnowWhere = 0,d,r or NewPhone = 2 or NewAddr = d,r or SendLetter = d or PhoneCheck = 4 |
End 8 = Thank you for your time. Good-bye Status 530
NewPhone = 2 |
End 9 = Thank you for your time. We won’t be able to interview [NAME] as she’s out of the country. We’ll remove her name from our call list Status 450
Lang = 1 |
End 10 = Please wait while I call an interviewer who speaks Spanish.
[IF MUST CALL BACK LATER Status 401]
Lang = 2-7 or OtherLang = d,r |
End 11 = Thanks for your time. An interpreter will call back later Status 400
T1 = 0,d,r (woman not currently pregnant) |
End 12 = Thanks for your time. We are not interviewing women have not recently had a baby. Good-bye. Status 460
So, 460 = does not meet
T2 = 2 (baby not living with mother) |
End 13 = Thanks for explaining. In that case we won’t be able to interview you.
Goodbye Status 380 (Sup Rev)
T1 = 0,d,r or T3a = d, r |
End 14 = Thank you. I don’t have any more questions Status 380 (Sup Rev)
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Healthy Pregnancy and Parenting Survey Round Two: Postpartum Women |
| Subject | CATI |
| Author | Margo Rosenbach, Julie Ingels |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |