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Peds - Family Biographical History Form (0:0 - 4:5 y:m)

peds_family_bio

01

Family Biographical History Form (0:0 to 4:5 y:m) as defined by the NIH Pediatric MRI Project

Download Definition as
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Element NameData TypeSizeRequiredDescriptionValue RangeNotesAliases
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*
src_subject_idString20RequiredSubject ID how it's defined in lab/projectSubject_ID
timepoint_labelString5RecommendedTimepoint/visit label
admin_statusString20RecommendedInstrument administration statusComplete;Partial;Not Administered;Not ApplicableFamily_Bio_Administration_Status
family_bio_relation_resp_coiString10RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Relationship, to the Child of Interest (COI), of the person filling out the form (Mother, Father, Other, No Answer)Mother;Father;Other;No AnswerFamily_Bio_Relationship_of_Respondent_to_COI
family_bio_coi_biol_mother_ageIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IA1 Child of Interest (COI) Biological Mother current age in years at brain scan timepointFamily_Bio_IA1_COI_Biol_Mother_Current_Age_in_Years
family_bio_coi_biol_mothr_handString20RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IA2 Child of Interest (COI) Biological Mother hand preference (Right, Left, No Preference, No Answer)Right;Left;No Preference;No AnswerFamily_Bio_IA2_COI_Biol_Mother_Hand_Preference
family_bio_coi_biol_mothr_ethnString30RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IA3 Child of Interest (COI) Biological Mother Ethnicity (Hispanic or Latino, Not Hispanic or Latino, No Answer)Hispanic or Latino;Not Hispanic or Latino;No AnswerFamily_Bio_IA3_COI_Biol_Mother_Ethnicity
family_bio_coi_biol_mothr_raceString50RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IA4 Child of Interest (COI) Biological Mother Race (American Indian or Alaska Native, African American or Black, Asian, Native Hawaiian or Other Pacific Islander, White, No Answer)American Indian or Alaska Native;African American or Black;Asian;Native Hawaiian or Other Pacific Islander;White;No AnswerFamily_Bio_IA4_COI_Biol_Mother_Race
family_bio_coi_biol_mother_edString30RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IA5 Child of Interest (COI) Biological Mother education at brain scan timepointLess than High School;High School Degree;Some College;College Degree;Some Graduate Work;Graduate Degree;No AnswerFamily_Bio_IA5_COI_Biol_Mother_Education
family_bio_coi_biol_mother_msString20RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IA6 Child of Interest (COI) Biological Mother marital status at brain scan timepoint (Single, Married, Widowed, Divorced, No Answer)Single;Married;Widowed;Divorced;No AnswerFamily_Bio_IA6_COI_Biol_Mother_Marital_Status
family_bio_coi_biol_father_ageIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IB1 Child of Interest (COI) Biological Father current age in years at brain scan timepointFamily_Bio_IB1_COI_Biol_Father_Current_Age_in_Years
family_bio_coi_biol_fathr_handString20RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IB3 Child of Interest (COI) Biological Father hand preference (Right, Left, No Preference, No Answer)Right;Left;No Preference;No AnswerFamily_Bio_IB3_COI_Biol_Father_Hand_Preference
family_bio_coi_biol_fathr_ethnString30RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IB4 Child of Interest (COI) Biological Father ethnicity (Hispanic or Latino, Not Hispanic or Latino, No Answer)Hispanic or Latino;Not Hispanic or Latino;No AnswerFamily_Bio_IB4_COI_Biol_Father_Ethnicity
family_bio_coi_biol_fathr_raceString50RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IB5 Child of Interest (COI) Biological Father Race (American Indian or Alaska Native, African American or Black, Asian, Native Hawaiian or Other Pacific Islander, White, No Answer)American Indian or Alaska Native;African American or Black;Asian;Native Hawaiian or Other Pacific Islander;White;No AnswerFamily_Bio_IB5_COI_Biol_Father_Race
family_bio_coi_biol_father_edString30RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IB6 Child of Interest (COI) Biological Father education at brain scan timepointLess than High School;High School Degree;Some College;College Degree;Some Graduate Work;Graduate Degree;No AnswerFamily_Bio_IB6_COI_Biol_Father_Education
family_bio_coi_biol_father_msString20RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IB7 Child of Interest (COI) Biological Father marital status at brain scan timepoint (Single, Married, Widowed, Divorced, No Answer)Single;Married;Widowed;Divorced;No AnswerFamily_Bio_IB7_COI_Biol_Father_Marital_Status
family_bio_parent_rep_coi_handString20RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IC1 Parent Report of Child of Interest (COI) hand preference at brain scan timepoint (Right, Left, No Preference, No Answer)Right;Left;No Preference;No AnswerFamily_Bio_IC1_Parent_Report_COI_Hand_Preference
family_bio_parent_rep_coi_ethnString30RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IC2 Parent Report of Child of Interest (COI) ethnicity (Hispanic or Latino, Not Hispanic or Latino, No Answer)Hispanic or Latino;Not Hispanic or Latino;No AnswerFamily_Bio_IC2_Parent_Report_COI_Ethnicity
family_bio_coi_biol_child_raceString50RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IC3 Child of Interest Race (American Indian or Alaska Native, African American or Black, Asian, Native Hawaiian or Other Pacific Islander, White, No Answer)American Indian or Alaska Native;African American or Black;Asian;Native Hawaiian or Other Pacific Islander;White;No AnswerFamily_Bio_IC3_COI_Biol_Child_Race
family_bio_coi_lives_bio_mothrString2RecommendedFamily Biographical History Form (0:0 to 4:5 yrs:mo): Question ID1a Child of Interest (COI) lives with Biological Mother (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_ID1a_COI_Lives_with_Biol_Mother
family_bio_coi_lives_bio_fathrString2RecommendedFamily Biographical History Form (0:0 to 4:5 yrs:mo): Question ID1b Child of Interest (COI) lives with Biological Father (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_ID1b_COI_Lives_with_Biol_Father
family_bio_coi_lives_stepmothrString2RecommendedFamily Biographical History Form (0:0 to 4:5 yrs:mo): Question ID1c Child of Interest (COI) lives with Stepmother (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_ID1c_COI_Lives_with_Stepmother
family_bio_coi_lives_stepfathrString2RecommendedFamily Biographical History Form (0:0 to 4:5 yrs:mo): Question ID1d Child of Interest (COI) lives with Stepfather (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_ID1d_COI_Lives_with_Stepfather
family_bio_coi_total_house_incString30RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question ID2 Total Income for Child of Interest (COI) Household at brain scan timepointZero to 5000;5001 to 10000;10001 to 15000;15001 to 25000;25001 to 35000;35001 to 50000;50001 to 75000;75001 to 100000;100001 to 150000;over 150000;No AnswerIn dollarsFamily_Bio_ID2_COI_Family_Total_Household_Income
family_bio_coi_tot_depend_headString5RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question ID3 Total Number of Dependents in the Child of Interest (COI) Household (i.e., Total Number of Dependents Plus Head of Household (as per tax declaration)) at the brain scan timepoint.2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;17;18;19;20;NANA = No answerFamily_Bio_ID3_COI_Family_Total_Dependents_Plus_Head
family_bio_coi_born_in_hospString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIB1a Was Child of Interest (COI) born in a hospital? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_IIB1a_COI_Born_in_Hospital
family_bio_coi_birth_inducedString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIB2a Was labor induced for Child of Interest (COI)? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_IIB2a_COI_Birth_Induced
family_bio_days_bio_mothr_hospIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIB3a How many days did the Biological Mother spend in the hospital following the delivery of the Child of Interest (COI)?Family_Bio_IIB3a_Days_Biol_Mother_Hospitalized_at_Birth_of_COI
family_bio_days_coi_hosp_birthIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIB3b How many days did the Child of Interest (COI) spend in the hospital following delivery?Family_Bio_IIB3b_Days_COI_Hospitalized_at_Birth
family_bio_coi_breastfeedingString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC1 Did the Biological Mother breastfeed the Child of Interest (COI)? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_IIC1_COI_Breastfeeding
family_bio_coi_age_bf_beganIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC2a How old, in days, was the Child of Interest (COI) when breast milk feeding began?Family_Bio_IIC2a_COI_Age_in_Days_Breastfeeding_Began
family_bio_coi_age_bf_frst_supIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC2b How old, in days, was the Child of Interest (COI) when formula or other solid food was used to supplement breast milk?Family_Bio_IIC2a_COI_Age_in_Days_Breastfeeding_First_Suppl, Family_Bio_IIc2a_Age_in_Days_Breastfeeding_First_Suppl
family_bio_coi_still_breastfdString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC3a Was the Child of Interest (COI) still receiving breast milk at the brain scan timepoint? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_IIC3a_COI_Still_Breastfeeding
family_bio_coi_last_breastfeedIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC3b How old (in days) was the Child of Interest (COI) when the last (final) breast milk feeding was done?Family_Bio_IIC3b_COI_Age_in_Days_at_Last_Breastfeeding
family_bio_coi_smo_breastfeedString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC4a Did the Child of Interest (COI) Biological Mother ever smoke while the COI was receiving breast milk? (Yes, No, No Answer)
Y;N;NA;DK
Y = Yes; N = No; NA = No answer; DK = Don't KnowFamily_Bio_IIC4a_COI_Biol_Mother_Smoking_Breastfeeding
family_bio_num_cig_breastfeedIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC4b How many cigarettes were smoked by the Biological Mother per week while the Child of Interest (COI) was receiving breast milk?Family_Bio_IIC4b_Number_of_Cigarettes_Biol_Mother_Breastfeeding
family_bio_coi_alc_breastfeedString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC5a Did the Child of Interest (COI) Biological Mother ever drink alcohol while the COI was receving breast milk? (Yes, No, No Answer)
Y;N;NA;DK
Y = Yes; N = No; NA = No answer; DK = Don't KnowFamily_Bio_IIC5a_COI_Biol_Mother_Alcohol_Breastfeeding
family_bio_num_alc_breastfeedFloatRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC5b How many alcoholic drinks were consumed per week by the Biological Mother while breastfeeding the Child of Interest (COI)?Family_Bio_IIC5b_Number_Alcohol_Drink_Biol_Mother_Breastfeeding
family_bio_coi_breastfeed_medsString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question IIC6a Did the Child of Interest (COI) Biological Mother use any medication (over-the-counter or prescription) while the child was on breast milk? (Yes, No, No Answer)
Y;N;NA;DK
Y = Yes; N = No; NA = No answer; DK = Don't KnowFamily_Bio_IIC6a_COI_Breastfeeding_Biol_Mother_Meds
family_bio_coi_ear_tubesString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III1a At the brain scan timepoint had the Child of Interest (COI) ever had ear tubes placed? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III1a_COI_Ear_Tubes
family_bio_coi_age_ear_tubesIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III1b Child of Interest (COI) age (in days) when ear tubes first placed.Family_Bio_III1b_COI_Age_in_Days_Ear_Tubes_Placed
family_bio_coi_gen_anesthesiaString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III2a At the brain scan timepoint had the Child of Interest (COI) ever had general anesthesia? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III2a_COI_General_Anesthesia_Use
family_bio_coi_age_gen_anesIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III2b Child of Interest (COI) age (in days) when general anesthesia first used.Family_Bio_III2b_COI_Age_in_Days_General_Anesthesia_Used
family_bio_coi_lead_lvl_checkString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III3a At the brain scan timepoint had the Child of Interest (COI) ever had their lead level checked? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III3a_COI_Lead_Level_Checked
family_bio_icoi_age_lead_checkIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III3b Child of Interest (COI) age (in days) when screened for lead.Family_Bio_III3b_COI_Age_in_Days_Lead_Level_Checked
family_bio_coi_lead_levelString10RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III3c What was Child of Interest (COI) lead level, when screened? (High, Marginal, Normal (low), Unknown, No Answer)High;Marginal;Normal;Unknown;NANA = No answerFamily_Bio_III3c_COI_Lead_Level
family_bio_coi_hit_head_physString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III4a At the brain scan timepoint had the Child of Interest (COI) ever hit their head seriously enough that a physician, clinic, or hospital was contacted or visited? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III4a_COI_Hit_Head_and_Physician_Contacted
family_bio_coi_hit_head_numberIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III4b Number of occurrences where Child of Interest (COI) hit their head seriously enough that a phsycian, clinic, or hospital was contacted or visited.Family_Bio_III4b_COI_Hit_Head_Number_of_Occurrences
family_bio_coi_strep_throatString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III5a At the brain scan timepoint had the Child of Interest (COI) ever been diagnosed with strep throat? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III5a_COI_Strep_Throat
family_bio_coi_strep_num_timesString20RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III5b Number of times the Child of Interest (COI) has had Strep Throat (1-2 Times, 3-5 Times, 6 or More Times, No Answer)1-2 Times;3-5 Times;6 or More Times;NANA = No answerFamily_Bio_III5b_COI_Strep_Throat_Number_of_Times
family_bio_coi_ever_childcareString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III6a At the brain scan timepoint had the Child of Interest (COI) ever participated in a child care program? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III6a_COI_Ever_Attended_Childcare
family_bio_coi_childcare_daysIntegerRecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III6b On average, how many days per week of childcare did the Child of Interest (COI) participate in?Family_Bio_III6b_COI_Childcare_Number_of_Days_per_Week
family_bio_coi_preschool_progString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III7 At the brain scan timepoint, had the Child of Interest (COI) ever participated in Parents as Teachers, Head Start, or any other type of Preschool program? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III7_COI_Participated_in_Preschool_Program
family_bio_coi_form_schl_progString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III8 At the brain scan timepoint, had the Child of Interest (COI) ever attended a formal school program (e.g., Kindergarten)? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III8_COI_Attended_Formal_School_Programs
family_bio_coi_organized_sportString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III9 At the brain scan timepoint, had the Child of Interest (COI) participated in organized sports (T-Ball, soccer)? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III9_COI_Participated_in_Organized_Sports
family_bio_coi_part_music_progString2RecommendedFamily Biographical History Form (0:0 to 4:5 y:m) Question III10 At the brain scan timepoint, had the Child of Interest (COI) ever had any music training or lessons? (Yes, No, No Answer)
Y;N;NA
Y = Yes; N = No; NA = No answerFamily_Bio_III10_COI_Participated_in_Music_Programs
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

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Distribution for DataStructure: peds_family_bio01 and Element:
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