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Demographics Form. Clinical Trials

demgr

01

Download Definition as
Download Submission Template as
Element NameData TypeSizeRequiredDescriptionValue RangeNotesAliases
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*
src_subject_idString20RequiredSubject ID how it's defined in lab/projectid
interview_dateDateRequiredDate on which the interview/genetic test/sampling/imaging was completed. MM/DD/YYYYRequired field
interview_ageIntegerRequiredAge in months at the time of the interview/test/sampling/imaging.0 :: 1260Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
genderString20RequiredSex of the subjectM;FM = Male; F = Female
days_baselineIntegerRecommendedDays since baselinedayd, daydemo
assbdicString5RecommendedAssessment PointD;14;E;24;LB;36;72;96;120; 9; B; 3; 7; 144; 168;192; CD=MTA baseline assessment; 14=MTA 14 month assessment; E=MTA early termination assessment; B = MTA Pre-Baseline Screening Assessment (579/579); 09 = MTA 9 Month Assessment (530/530); 24=MTA 24 month assessment; LB=LNCG baseline assessment; 36=MTA and LNCG 3 year assessment; 72=MTA and LNCG 6 year assessment; 96=MTA and LNCG 8 year assessment; 03 = MTA 3 Month Assessment (438/687);120=MTA and LNCG 10 year assessment; 7= 7th Grade Assessment (221/276); 144 = MTA & LNCG 12 Month Assessment (578/578); 168 = MTA & LNCG 14 Month Assessment (585/585); 192 = MTA & LNCG 16 Month Assessment (505/505); C = MTA Pre-Baseline Screening Assessment (78/78)assd, assdemo
relationshipString255RecommendedRelationship of respondent to individual
1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30;31;32;33;34;35;36;37;38;39;40;41;42;43;44;45;46;47;48;49;50;51;52;53;54;55;56;57;58;59;60;61;62;63;64;65;66;67;68;69;70;71;72;73;74;75;76;77;78;79;80;81;82;83;84; -999
1 = Biological mom; 2 = Biological dad; 3 = Grandparent; 4 = Special education (sped) teacher; 5 = General education teacher; 6 = Occupational therapist; 7 = Speech and language therapist; 8 = Behavioral therapist; 9 = Paraprofessional; 10 = Aide; 11 = Principal; 12 = Administrator; 13 = Other; 14 = Content teacher; 15 = Parent center director; 16 = Self; 17=Adoptive mother; 18=Adoptive father; 19=Foster mother; 20 = Foster father; 21=Grandmother; 22=Grandfather; 23=Step-mother; 24 = Step-father; 25=Aunt; 26=Uncle; 27=Missing Data; 28=Both parents;31= Grandmother from mother side; 32= Grandfather from mother side; 33= Grandmother from father side; 34= Grandfather from father side; 36= Brother; 37= Sister; 38= Cousin; 39= female caregiver; 40=male caregiver; 41=Female child; 42=Male child; 43=Spouse/Mate; 44=Friend; 45=Parent; 46=Significant other; 47=Sibling; 48=Son/Daughter; 49=Son-in-law/Daughter-in law; 50=Other Relative; 51=Paid caregiver; 52=Friends; 90= Other, specify; -999= Missing; 53=Roommate; 54=Supervisor; 55=mother's boyfriend; 56=other parental figure; 57=Summary; 58=counselor ; 59 = other female relative; 60 = other male relative; 61 = non-relative ;62=Maternal Aunt; 63=Maternal Uncle; 64=Maternal Cousin; 65 = Paternal Aunt; 66=Paternal Uncle; 67=Paternal Cousin ;68=Biological/Adoptive Mother and Grandmother; 69=Biological/Adoptive Mother and Stepmother and Grandmother; 70=Biological/Adoptive Mother and Grandmother and Foster Father; 71=Biological/Adoptive Mother and Stepmother and Foster Mother; 72=Biological/Adoptive Mother and Foster Mother; 73=Biological/Adoptive Mother and Biological/Adoptive Father; 74=Biological/Adoptive Mother and Stepmother and Biological/Adoptive Father; 75=Biological/Adoptive Mother and Other; 76=Biological/Adoptive Mother and Stepmother and Stepfather; 77=Biological/Adoptive Mother and Stepfather; 78=Biological/Adoptive Mother and Grandfather; 79=Biological/Adoptive Mother and Stepmother and Foster Father; 80=Biological/Adoptive Mother and Stepmother; 81=Guardian, female; 82=Other female; 83=Guardian, male; 84=Other malereld, reldemo
actbdicIntegerRecommendedActive status0::50=Inactive-Data collected after the 14 month treatment phase/after early termination from treatment phase/prior to treatment phase; 1=Active-Data collected during the 14 month treatment phase while subject received originally assigned treatment regardless of degree of compliance; 2=Active-This is the last active assessment for subjects who were about to violate treatment arm by receiving alternate treatment; 3=Active-This is the last active assessment for subjects who were about to leave the study by moving away;4=Yes, Active; 5=No, Not Activeactd, actdemo
siteString100RecommendedSiteStudy Sitesitenum
sjtypIntegerRecommendedSubject type1;21=MTA randomized trial subject; 2=Local normative comparison group (LNCG) subject
demo1IntegerRecommendedAdolescent's usual living arrangement (Not where the adolescent is just visiting)1::10;121=In parental family home (include joint custody); 2=In home of other relative; 3=In home of unrelated friend; 4=College or boarding school dormitory; 5=Shared apartment or residence with friends or roommates; 6=In own home/apartment/residence; 7=Shelter/street/homeless/transient; 8=Jail; 9=Hospital/residential treatment center; 10=Halfway house/group home/supervised living arrangement; 12=Otherd5
demo2IntegerRecommendedAdolescent0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo3IntegerRecommendedMother figure0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo4IntegerRecommendedFather figure0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo5IntegerRecommendedBrothers0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo6IntegerRecommendedSisters0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo7IntegerRecommendedOther relatives0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo8IntegerRecommendedNon relatives0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo9IntegerRecommendedSpouse/significant other0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo10IntegerRecommendedChildren of adolescent0::90=none in home; 1= one in home; 2= two in home; 9=9 in home
demo11IntegerRecommendedTotal number of persons in home
das1msString75RecommendedMarital statusdemo12
demo13IntegerRecommendedIf Adolescent's current marital status is 2 (Currently married/common law) or 3 (Currently not married, living together), number of years
demo14IntegerRecommendedAdolescent's current level of physical health1::51=Very poor; 2=Poor; 3=Fair; 4=Good; 5=Excellent
demo15IntegerRecommendedType of middle school or high school adolescent attends1::61=Past high school age or not in middle or high school; 2=Regular public school; 3=Regular private or parochial school; 4=Special school for persons with emotional/behavioral or learning problems; 5=Home schooling; 6=Other
demo16IntegerRecommendedAdolescent's current grade in school (If between grades, e.g., summer vacation, circle last gradecompleted) (If not currently in school, use Code 19.)5::195=5th grade; 6=6th grade; 7=7th grade; 8=8th grade; 9=9th grade; 10=10th grade; 11=11th grade; 12=12th grade or 1st year CEGEP in Canada; 13=1st year college/university/community college (or 2nd year CEGEP in Canada); 14=2nd year college/university/community college; 15=3rd year college/university/community college; 16=4th year or more college/university/community college; 17=Technical/trade/vocational school (e.g. auto mechanic or computer technician school); 18=Un-graded Special Education classroom; 19=Not in middle school, not in high school, not in college, and not in technical school
demo17IntegerRecommendedLast school grade completed by the adolescent5::195=5th grade; 6=6th grade; 7=7th grade; 8=8th grade; 9=9th grade; 10=10th grade; 11=11th grade; 12=12th grade or 1st year CEGEP in Canada; 13=1st year college/university/community college (or 2nd year CEGEP in Canada); 14=2nd year college/university/community college; 15=3rd year college/university/community college; 16=4th year or more college/university/community college; 17=Technical/trade/vocational school (e.g. auto mechanic or computer technician school); 18=Un-graded Special Education classroom; 19=Not in middle school, not in high school, not in college, and not in technical school
demo18IntegerRecommendedHow many years has adolescent attended a technical/trade/vocational school?1::51=Up to 1 year; 2=Up to 2 years; 3=Up to 3 years; 4=Up to 4 years; 5=Never attended a technical/trade/vocational school
demo19String25RecommendedAll schooling degrees earned by adolescent1=No degree or certificate; 2=High school diploma or GED; 3=Certificate from technical school or equivalent; 4=Associate degree from 2 year program usually from community college or DEC in Canada; 5=Bachelors degree from 4 year college or university; 6=Post college graduate degree
demo25String25RecommendedCurrent employment status adolescent1=Working full time; 2=Working part time; 3=Keeping house; 4=Unemployed and looking for work; 5=Unemployed and not looking for work; 6=Disabled; 7=Retired; 8=Full time student; 9=Part time student; 10=Other
demo35String25RecommendedCurrent employment status mother1=Working full time; 2=Working part time; 3=Keeping house; 4=Unemployed and looking for work; 5=Unemployed and not looking for work; 6=Disabled; 7=Retired; 8=Full time student; 9=Part time student; 10=Other; 88=Not in household
demo46String25RecommendedCurrent employment status father1=Working full time; 2=Working part time; 3=Keeping house; 4=Unemployed and looking for work; 5=Unemployed and not looking for work; 6=Disabled; 7=Retired; 8=Full time student; 9=Part time student; 10=Other; 88=Not in household
demo57IntegerRecommendedHow many times in the past two years has the adolescent experienced job losses by parental figures (include being fired, laid off, resigned because threatened with firing)?
demo58IntegerRecommendedHow many times in the past two years has the adolescent lost a job due to being fired, laid off, or resigned because threatened with firing?
demo59IntegerRecommendedHow many times in the past two years has the adolescent experienced separations, divorces, or deaths of parental figures?
demo60IntegerRecommendedAnnual household income before taxes, including income from all jobs, child support, public assistance, or Social Security payments. (include income from all working members of the household in item 2 who contribute financially)1::101=less than $5,000; 2 = Less than $10,000; 3 = $10,001 to $20,000; 4 = $20,001 to $30,000; 5 = $30,001 to $40,000; 6 = $40,001 to $50,000; 7 = $50,001 to $60,000; 8 = $60,001 to $70,000; 9 = $70,001 to $80,000; 10 = $80,001 or more
demo61IntegerRecommendedDoes any part of your annual household income come from public assistance?1;21=yes; 2=no
demo62IntegerRecommendedAdolescent's annual income before taxes, including income from all jobs, child support, public assistance, or Social Security payments. (Do not include typical weekly allowance from parents or other parental financial support.)1::101 = None, does not work; 2 = Less than $10,000; 3 = $10,001 to $20,000; 4 = $20,001 to $30,000; 5 = $30,001 to $40,000; 6 = $40,001 to $50,000; 7 = $50,001 to $60,000; 8 = $60,001 to $70,000; 9 = $70,001 to $80,000; 10 = $80,001 or mored10
demo63IntegerRecommendedDoes any part of adolescent's annual income come from public assistance?1;21=yes; 2=nod11a
ethnicityString30RecommendedEthnicity of participant
Hispanic or Latino; Not Hispanic or Latino; Unknown
raceString30RecommendedRace of study subjectAmerican Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported
d1aIntegerRecommendedNever made a home with a romantic partner as a couple11=True
d1bIntegerRecommendedNumber of times legally married including common law
d1cIntegerRecommendedNumber of times not married but living together as a couple
d1dIntegerRecommendedNumber of times separated
d1eIntegerRecommendedNumber of times divorced or annulled
d1fIntegerRecommendedNumber of times widowed
d21yIntegerRecommendedYears legally married including common law
d21mIntegerRecommendedMonths legally married including common law
d22yIntegerRecommendedYears not married but living together as a couple
d22mIntegerRecommendedMonths not married but living together as a couple
d3bIntegerRecommendedNumber of biological children
d3cIntegerRecommendedNumber of adopted children
d3dIntegerRecommendedNumber of step children
d3eIntegerRecommendedNumber of foster children
d4aIntegerRecommendedNumber of biological children living with you
d4bIntegerRecommendedNumber of adopted children living with you
d4cIntegerRecommendedNumber of step children living with you
d4dIntegerRecommendedNumber of foster children living with you
d6aIntegerRecommendedHave no full, half, adopted, or step- brothers or sisters11=True
d6b1IntegerRecommendedNumber of full brothers
d6b2IntegerRecommendedNumber of full brothers diagnosed with ADHD
d6c1IntegerRecommendedNumber of full sisters
d6c2IntegerRecommendedNumber of full sisters diagnosed with ADHD
d6d1IntegerRecommendedNumber of half brothers
d6d2IntegerRecommendedNumber of half brothers diagnosed with ADHD
d6e1IntegerRecommendedNumber of half sisters
d6e2IntegerRecommendedNumber of half sisters diagnosed with ADHD
d6f1IntegerRecommendedNumber of adopted brothers
d6f2IntegerRecommendedNumber of adopted brothers diagnosed with ADHD
d6g1IntegerRecommendedNumber of adopted sisters
d6g2IntegerRecommendedNumber of adopted sisters diagnosed with ADHD
dembsbroIntegerRecommendedNumber of step-brothersd6h1
d6h2IntegerRecommendedNumber of step-brothers diagnosed with ADHD
dembssisIntegerRecommendedNumber of step-sistersd6i1
d6i2IntegerRecommendedNumber of step-sisters diagnosed with ADHD
d7aIntegerRecommendedStill in high school11=Yes
d7bIntegerRecommendedEnrolled in GED classes11=Yes
d7cIntegerRecommendedEnrolled in adult education classes11=Yes
d7d1IntegerRecommendedEnrolled in a technical, trade, or vocational school full-time11=Yes
d7d2IntegerRecommendedEnrolled in a technical, trade, or vocational school part-time11=Yes
d7e1IntegerRecommendedEnrolled in a college, university, or community college full-time11=Yes
d7e2IntegerRecommendedEnrolled in a college, university, or community college part-time11=Yes
d7f1IntegerRecommendedEnrolled in a post college graduate school full-time11=Yes
d7f2IntegerRecommendedEnrolled in a post college graduate school part-time11=Yes
d7gIntegerRecommendedNot currently in school11=Yes
d9aFloatRecommendedHow many months were spent in parents household
d9bFloatRecommendedHow many months were spent in other relatives household
d9cFloatRecommendedHow many months were spent in non-relatives household
d9dFloatRecommendedHow many months were spent in own household alone (or living with partner or spouse or minor children)
d9eFloatRecommendedHow many months were spent in own household but shared with friends or roommates
d9fFloatRecommendedHow many months were spent in College or University dormitory, or housing
d9gFloatRecommendedHow many months were spent in military housing
d9hFloatRecommendedHow many months were spent in jail or prison
d9iFloatRecommendedHow many months were spent in homeless, shelter, street, or transient
d9jIntegerRecommendedHow many months were spent hospitalized
d9kIntegerRecommendedHow many months were spent in supervised living arrangement (halfway house or group home)
d9lIntegerRecommendedHow many months were spent in another living arrangement
d9aaIntegerRecommendedHow many times have you moved
d11bIntegerRecommendedHas any part of yearly individual income since leaving high school come from public assistance?1;21=yes; 2=no
d12aIntegerRecommendedAmount received each month from parents1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12bIntegerRecommendedAmount received each month from trust fund income?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12cIntegerRecommendedAmount received each month from investment income?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12dIntegerRecommendedAmount received each month from spouse or partner?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12eIntegerRecommendedAmount received each month from stipends?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12xIntegerRecommendedAmount received each month from public assistance?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12yIntegerRecommendedAmount received each month from unemployment compensation?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d12fIntegerRecommendedAmount received each month from other sources?1::41 = up to $200 a month 2 = $201 to $500 a month 3 = $501 to $1,000 a month 4 = greater than $1,000 a month
d13aIntegerRecommendedAmount of debt currently owed on credit cards1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13bIntegerRecommendedAmount of debt currently owed on car loans1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13cIntegerRecommendedAmount of debt currently owed on bank loans1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13dIntegerRecommendedAmount of debt currently owed on school loans1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13eIntegerRecommendedAmount of debt currently owed on home mortgage
d13fIntegerRecommendedAmount of debt currently owed parents1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13gIntegerRecommendedAmount of debt currently owed friends1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13xIntegerRecommendedAmount of debt currently owed medical bills1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13yIntegerRecommendedAmount of debt currently owed phone company1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d13hIntegerRecommendedAmount of debt currently owed others1::51 = up to $500 owed 2 = $501 to $1,000 owed 3 = $1,001 to $5,000 owed 4 = $5,001 to $10,000 owed 5 = greater than $10,001 owed
d14aIntegerRecommendedTaken out a payday loan or paycheck advance until your next payday1;21=yes; 2=no
d14bIntegerRecommendedTaken out a cash advance on your credit card1;21=yes; 2=no
d14cIntegerRecommendedBeen late on one or more of your debts (delinquency)1;21=yes; 2=no
d14dIntegerRecommendedBecome unable to pay most of your debts as they fall due1;21=yes; 2=no
d14eIntegerRecommendedUsed debt consolidation (pay off all loans with one new loan)1;21=yes; 2=no
d14fIntegerRecommendedDefaulted on a loan or other debt (other than mortgage)1;21=yes; 2=no
d14gIntegerRecommendedBeen contacted by a collection agency1;21=yes; 2=no
d14hIntegerRecommendedLost your home because of inability to pay the mortgage (foreclosure)1;21=yes; 2=no
d14iIntegerRecommendedDeclared legal bankruptcy1;21=yes; 2=no
d14jIntegerRecommendedOther1;21=yes; 2=no
d_8FloatRecommendedHow many months have you been out of high school (or since the last assessment)?0=Still in high schoold8
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Distribution for DataStructure: demgr01 and Element:
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