Calendar (CA) Section
BOX_01
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| IF ROUND 1 OR IF RESPONDENT FOR THIS ROUND IS NOT |
| THE SAME AS THE RESPONDENT FOR THE PREVIOUS ROUND |
| GO TO CA01 |
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| IF NOT ROUND 1 AND IF RESPONDENT FOR THIS ROUND |
| IS SAME AS RESPONDENT FOR THE PREVIOUS ROUND, |
| CONTINUE WITH BOX_02 |
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BOX_02
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| IF NOT ROUND 1 AND RESPONDENT USED ANY CALENDAR |
| DURING THE PREVIOUS ROUND’S INTERVIEW - CL67_01 |
| CL67_02, CL67_03, OR CL67_05 IS CODED ‘1’ (YES), |
| GO TO CA02 |
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| OTHERWISE, CONTINUE WITH CA01 |
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CA01
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We've talked about health conditions for the family. The next
set of questions is about health care received {in the last few
months/between {START DATE OF REFERENCE PERIOD} and {END DATE OF
REFERENCE PERIOD}}. Some of these questions ask for information
which may be difficult to remember. Because it is important to
the U.S. Public Health Service to get complete and accurate
information, please take your time in answering these
questions.
ASK RESPONDENT TO GET HEALTH EVENTS RECORD (CALENDAR) IF NOT
ALREADY OUT.
HAS HEALTH EVENTS RECORD ............... 1 {CA03}
HAS CALENDAR OTHER THAN HEALTH
EVENTS RECORD .......................... 2 {CA03}
DOES NOT HAVE CALENDAR ................. 3 {CA04}
WILL NOT USE CALENDAR .................. 4 {CA04}
[Code One]
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| DISPLAY ‘in the last few months’ IF NOT ROUND 5. |
| DISPLAY ‘between {START DATE OF REFERENCE PERIOD} |
| and {END DATE OF REFERENCE PERIOD}’ IF ROUND 5. |
| |
| FOR ‘START DATE OF REFERENCE PERIOD’, DISPLAY THE |
| DATE OF THE ROUND 4 INTERVIEW AS MM/DD/YY. FOR |
| ‘END DATE OF REFERENCE PERIOD’, DISPLAY THE RU END|
| DATE FOR ROUND 5 AS MM/DD/YY. |
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CA02
====
We've talked about health conditions for the family. The next
set of questions is about health care received {in the last few
months/between {START DATE OF REFERENCE PERIOD} and {END DATE OF
REFERENCE PERIOD}}. As you may remember from the last interview,
some of these questions ask for information which may be difficult
to remember.
THANK RESPONDENT FOR USING CALENDAR DURING THE PREVIOUS INTERVIEW.
ASK RESPONDENT TO GET CALENDAR IF NOT ALREADY OUT.
HAS HEALTH EVENTS RECORD ............... 1
HAS CALENDAR OTHER THAN HEALTH
EVENTS RECORD .......................... 2
DOES NOT HAVE CALENDAR ................. 3 {CA04}
WILL NOT USE CALENDAR .................. 4 {CA04}
[Code One]
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| DISPLAY ‘in the last few months’ IF NOT ROUND 5. |
| DISPLAY ‘between {START DATE OF REFERENCE PERIOD} |
| and {END DATE OF REFERENCE PERIOD}’ IF ROUND 5. |
| |
| FOR ‘START DATE OF REFERENCE PERIOD’, DISPLAY THE |
| DATE OF THE ROUND 4 INTERVIEW AS MM/DD/YY. FOR |
| ‘END DATE OF REFERENCE PERIOD’, DISPLAY THE RU END|
| DATE FOR ROUND 5 AS MM/DD/YY. |
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CA03
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CODE WITHOUT ASKING IF RESPONDENT HAS ALREADY ANSWERED.
Has anyone in the family been using the calendar to record all
visits to medical providers and medical places, most of the visits,
only some of the visits, or has the calendar not been used?
ALL VISITS RECORDED .................... 1 {BOX_03}
MOST VISITS RECORDED ................... 2 {BOX_03}
SOME VISITS RECORDED ................... 3
DID NOT USE ............................ 4
VOLUNTEERED: NO EVENTS TO RECORD ...... 5 {BOX_03}
REF ................................... -7
DK .................................... -8
[Code One]
CA04
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GIVE RESPONDENT A HEALTH EVENTS RECORD (CALENDAR) IF RESPONDENT
DOES NOT HAVE ONE, OR A CALENDAR WORKSHEET IF RESPONDENT WILL NOT
USE CALENDAR.
Through the rest of the interview, there are questions that
will ask for dates. When you do not remember the date, we can
refer to this calendar for help.
CIRCLE {TODAY'S DATE/12/31/2000} {AND DATE OF LAST INTERVIEW}.
PRESS ENTER TO CONTINUE.
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| DISPLAY ‘TODAY’S DATE’ IF NOT ROUND 5. DISPLAY |
| ‘12/31/2000’ IF ROUND 5. |
| |
| DISPLAY ‘AND DATE OF LAST INTERVIEW’ IF NOT |
| ROUND 1. OTHERWISE, USE A NULL DISPLAY. |
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BOX_03
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| IF ROUND 1, GO TO BOX_05 |
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| IF NOT ROUND 1, CONTINUE WITH BOX_04 |
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BOX_04
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| IF ANY EVENTS (INCLUDING PRESCRIBED MEDICINES) |
| RECORDED DURING PREVIOUS ROUND, CONTINUE WITH |
| CA05 |
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| IF NO EVENTS (INCLUDING PRESCRIBED MEDICINES) |
| RECORDED DURING PREVIOUS ROUND, GO TO BOX_05 |
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CA05
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If at any point it would help you to look at information from
the last interview, I have a computer printed summary of the
health care received during that period. This summary includes
any hospital stays; visits to medical providers; names of doctors,
hospitals, and other providers; and prescribed medicines that were
talked about during the last interview. If you need to refer to a
past visit, date, or provider name, we can use this summary.
HOLD UP SUMMARY OF HEALTH CARE EVENTS FOR THIS RU.
PRESS ENTER TO CONTINUE.
BOX_05
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| GO TO NEXT QUESTIONNAIRE SECTION |
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