Loading...

National Institute of Mental Health Data Archive (NDA) Sign In
NDA

Enter the email address associated with your existing NDA Account and click Continue Linking Process.

If you do not have an existing NDA account, click Go Back.

Warning Notice This is a U.S. Government computer system, which may be accessed and used only for authorized Government business by authorized personnel. Unauthorized access or use of this computer system may subject violators to criminal, civil, and/or administrative action. All information on this computer system may be intercepted, recorded, read, copied, and disclosed by and to authorized personnel for official purposes, including criminal investigations. Such information includes sensitive data encrypted to comply with confidentiality and privacy requirements. Access or use of this computer system by any person, whether authorized or unauthorized, constitutes consent to these terms. There is no right of privacy in this system.
National Institute of Mental Health Data Archive (NDA) Sign In
NDA

Success! An email is on its way!

Please check your email to complete the linking process. The link you receive is only valid for 30 minutes.

Check your spam or junk folder if you do not receive the email in the next few minutes.

Warning Notice This is a U.S. Government computer system, which may be accessed and used only for authorized Government business by authorized personnel. Unauthorized access or use of this computer system may subject violators to criminal, civil, and/or administrative action. All information on this computer system may be intercepted, recorded, read, copied, and disclosed by and to authorized personnel for official purposes, including criminal investigations. Such information includes sensitive data encrypted to comply with confidentiality and privacy requirements. Access or use of this computer system by any person, whether authorized or unauthorized, constitutes consent to these terms. There is no right of privacy in this system.
Create or Link an Existing NDA Account

Warning Notice

This is a U.S. Government computer system, which may be accessed and used only for authorized Government business by authorized personnel. Unauthorized access or use of this computer system may subject violators to criminal, civil, and/or administrative action. All information on this computer system may be intercepted, recorded, read, copied, and disclosed by and to authorized personnel for official purposes, including criminal investigations. Such information includes sensitive data encrypted to comply with confidentiality and privacy requirements. Access or use of this computer system by any person, whether authorized or unauthorized, constitutes consent to these terms. There is no right of privacy in this system.

NIMH Data Archive (NDA) Sign In or Create An Account
Update Password

You have logged in with a temporary password. Please update your password. Passwords must contain 8 or more characters and must contain at least 3 of the following types of characters:

  • Uppercase
  • Lowercase
  • Numbers
  • Special Characters limited to: %,_,!,@,#,$,-,%,&,+,=,),(,*,^,:,;
Update Password

Subscribe to our mailing list

Mailing List(s)
Email Format

You are now leaving the NIMH Data Archive (NDA) web site to go to:

Click on the address above if the page does not change within 10 seconds.

Disclaimer

NDA is not responsible for the content of this external site and does not monitor other web sites for accuracy.

Accept Terms
Data Access Terms - Decline Terms

Are you sure you want to cancel? This will decline terms and you will not be authorized for access.

NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

Psychosocial Intervention Session Tracking Form

1,655 Shared Subjects

N/A
Clinical Assessments
Questionnaire
12/24/2014
psist01
09/20/2023
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project id, record_id, stepid, subjectid
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY datacollecteddate, date_of_interview_contact
interview_age Integer Required Age in months at the time of the interview/test/sampling/imaging. 0::1440 Age 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. age
sex String 20 Required Sex of subject at birth
M;F; O; NR
M = Male; F = Female; O=Other; NR = Not reported gender
Query daysrz Integer Recommended days since randomization
Query pathway Integer Recommended step pathway 1::9 1=SCP; 2=AD-Acute Depression; 3=REFD-Refractory Dep; 4=RELP-Relapse Prevent; 5=Psy-AD-Psychosocial; 6=Psy-REL-Psychosocial; 7=Omega 3; 8=LiMRS; 9=PAD-Psychosocial
Query certcode Integer Recommended stepbd certification code
Query sessno Integer Recommended session number session
Query modality Integer Recommended Session modality 1::4 1=CC plus; 2=CBT; 3=FFT; 4=IPSRT
Query txall Integer Recommended Treatment alliance building 0;1;-7 0=No; 1=Yes; -7=Refused
Query txhx Integer Recommended Treatment history taking 0;1;-7 0=No; 1=Yes; -7=Refused
Query txinv Integer Recommended Treatment interpersonal inventory 0;1;-7 0=No; 1=Yes; -7=Refused
Query txip Integer Recommended Treatment interpersonal problem 0;1;-7 0=No; 1=Yes; -7=Refused
Query txfut Integer Recommended Treatment future problem 0;1;-7 0=No; 1=Yes; -7=Refused
Query txsrm Integer Recommended Treatment social rhythm metric 0;1;-7 0=No; 1=Yes; -7=Refused
Query txped Integer Recommended Treatment psychoeducation 0;1;-7 0=No; 1=Yes; -7=Refused
Query txcomm Integer Recommended Treatment communication 0;1;-7 0=No; 1=Yes; -7=Refused
Query txpsolv Integer Recommended Treatment problem solving 0;1;-7 0=No; 1=Yes; -7=Refused
Query txcog Integer Recommended Treatment cognitive restructing 0;1;-7 0=No; 1=Yes; -7=Refused
Query txact Integer Recommended Treatment activity scheduling 0;1;-7 0=No; 1=Yes; -7=Refused
Query txss Integer Recommended Treatment social skills 0;1;-7 0=No; 1=Yes; -7=Refused
Query txnonad Integer Recommended Treatment nonadherence 0;1;-7 0=No; 1=Yes; -7=Refused
Query txrp Integer Recommended Treatment relapse prevention 0;1;-7 0=No; 1=Yes; -7=Refused
Query txsui Integer Recommended Treatment suicide prevention 0;1;-7 0=No; 1=Yes; -7=Refused
Query txoth Integer Recommended treatment other 1;0;-7 0=No; 1=Yes;-7=Refused
Query txoth2 Integer Recommended treatment other 2 1;0;-7 0=No; 1=Yes;-7=Refused
Query plall Integer Recommended Plan alliance building 0;1;-7 0=No; 1=Yes; -7=Refused
Query plhx Integer Recommended Plan history taking 0;1;-7 0=No; 1=Yes; -7=Refused
Query plinv Integer Recommended Plan interpersonal inventory 0;1;-7 0=No; 1=Yes; -7=Refused
Query plip Integer Recommended Plan interpersonal problem 0;1;-7 0=No; 1=Yes; -7=Refused
Query plfut Integer Recommended Plan future problem 0;1;-7 0=No; 1=Yes; -7=Refused
Query plsrm Integer Recommended Plan social rhythm metric 0;1;-7 0=No; 1=Yes; -7=Refused
Query plped Integer Recommended Plan psychoeducation 0;1;-7 0=No; 1=Yes; -7=Refused
Query plcomm Integer Recommended Plan communication 0;1;-7 0=No; 1=Yes; -7=Refused
Query plpsolv Integer Recommended Plan problem solving 0;1;-7 0=No; 1=Yes; -7=Refused
Query plcog Integer Recommended Plan cognitive restructuring 0;1;-7 0=No; 1=Yes; -7=Refused
Query plact Integer Recommended Plan activity scheduling 0;1;-7 0=No; 1=Yes; -7=Refused
Query plss Integer Recommended Plan social skills 0;1;-7 0=No; 1=Yes; -7=Refused
Query plnonad Integer Recommended Plan nonadherence 0;1;-7 0=No; 1=Yes; -7=Refused
Query plrp Integer Recommended Plan relapse prevention 0;1;-7 0=No; 1=Yes; -7=Refused
Query plsui Integer Recommended Plan suicide prevention 0;1;-7 0=No; 1=Yes; -7=Refused
Query ploth Integer Recommended Plan other 0;1;-7 0=No; 1=Yes; -7=Refused
Query ploth2 Integer Recommended Plan other 2 0;1;-7 0=No; 1=Yes; -7=Refused
Query site String 101 Recommended Site Study Site siteid
Query visday Integer Recommended Number of days from study baseline to date of visit date
Query phase Integer Recommended Phase 9 =follow up
Query week Float Recommended Week in level/study 99=week 10-week 14
Query month Integer Recommended Month in Follow-Up
Query psyther Integer Recommended Is participant only receiving medication management? 0::2;999 0 = No, the patient has been receiving psychotherapy of some type. Complete this form; 1 = Yes. Skip the rest of this form; 2 = No, the patient is not receiving any treatment at all. Skip the rest of this form; 999 = Skipped
Query psyther_individ Integer Recommended Are you receiving this type of psychotherapy? Individual 0;1; 999 0 = No; 1 = Yes; 999 = N/A individ
Query psyther_group Integer Recommended Are you receiving this type of psychotherapy? Group 0;1; 999 0 = No; 1 = Yes; 999 = N/A group
Query psyther_couple Integer Recommended Are you receiving this type of psychotherapy? Couple 0;1; 999 0 = No; 1 = Yes; 999 = N/A couples
Query psyther_family Integer Recommended Are you receiving this type of psychotherapy? Family 0;1; 999 0 = No; 1 = Yes; 999 = N/A family2
Query psyther_cbasp Integer Recommended Are you receiving this type of psychotherapy? cbasp 0;1; 999 0 = No; 1 = Yes; 999 = N/A family
Query psyther_medmngt Integer Recommended Are you receiving this type of psychotherapy? Medication Management 0;1; 999 0 = No; 1 = Yes; 999 = N/A medmgmt
Query psyther_residtx Integer Recommended Are you receiving this type of psychotherapy? Residential Treatment 0;1; 999 0 = No; 1 = Yes; 999 = N/A residtx
Query psyther_daytx Integer Recommended Are you receiving this type of psychotherapy? Day Treatment 0;1; 999 0 = No; 1 = Yes; 999 = N/A daytx
Query psyther_inpttx Integer Recommended Are you receiving this type of psychotherapy? In-Patient Hospital Treatment 0;1; 999 0 = No; 1 = Yes; 999 = N/A inpttx
Query psyther_txother Integer Recommended Are you receiving this type of psychotherapy? Other Psych Treatment 0;1; 999 0 = No; 1 = Yes; 999 = N/A txother
Query deprsion Integer Recommended depression 0;1;-7 0=No; 1=Yes; -7=Refused depress
Query dysth Integer Recommended Dysthymia 1;0;-7 0=No; 1=Yes;-7=Refused dysthym
Query soc_phob Integer Recommended Axis I: Social phobia 0;1 0=Not checked; 1=Checked socphob
Query scrn09e Integer Recommended Obsessive compulsive disorder 0;1 0=No; 1=Yes ocd
Query ptsd Integer Required does participant have post-traumatic stress disorder? 0 = no; 1 = yes 0;1;999 0 = No; 1 = Yes
Query panic Integer Recommended does participant meet for panic disorder? 0 = no; 1 = yes 0;1 0 = No; 1 = Yes
Query marital_1 Integer Recommended Marital difficulties 0;1 0 = No; 1 = Yes
Query dnk Integer Recommended Don't Know 0;1 0 = No; 1 = Yes
other_condname1 String 255 Recommended Name Other Condition - 1
Query psygist Integer Recommended Psychologist 0;1 0=Not checked; 1=Checked psychol
Query psytrist Integer Recommended Psychiatrist 0;1 0=Not checked; 1=Checked psychia
Query socialwk Integer Recommended Social worker 0;1 0=Not checked; 1=Checked socwork
Query nurse Integer Recommended Nurse/nurse practitioner 0;1 0=Not checked; 1=Checked np
Query counsel Integer Recommended Counselor 0;1 0=Not checked; 1=Checked
Query primary Integer Recommended Primary Care Doctor 0;1; -7;-9 0=Not checked; 1=Checked; -7=Refused; -9=Unknown phys
Query relig_aff Integer Recommended Religious Affiliate 0;1 0= Unchecked; 1= Checked
Query dnkwho Integer Recommended Don't Know: who conducted treatment 0;1 0= Unchecked; 1= Checked
Query whooth Integer Recommended Other: who conducted treatment 0;1 0= Unchecked; 1= Checked
Query q4inpt Integer Recommended Treatment session: In Patient 0;1 0= Unchecked; 1= Checked
Query q4outpt Integer Recommended Treatment session: Out Patient 0;1 0= Unchecked; 1= Checked
Query q4cmhc Integer Recommended Treatment session: Community Mental Health 0;1 0= Unchecked; 1= Checked
Query q4spec Integer Recommended Treatment session: Anxiety Disorder Clinic 0;1 0= Unchecked; 1= Checked
Query q4prim Integer Recommended Treatment session: Primary Care Hospital 0;1 0= Unchecked; 1= Checked
Query q4subs Integer Recommended Treatment session: Substance Abuse Clinic 0;1 0= Unchecked; 1= Checked
Query q4priv Integer Recommended Treatment session: Private Practice 0;1 0= Unchecked; 1= Checked
Query q4other Integer Recommended Treatment session: Other place 0;1 0= Unchecked; 1= Checked
Query txfreq Integer Recommended How often did you attend these treatment sessions? 1::5 How often did you attend these treatment sessions? 1 = More than once a week;2 = Once a week;3 = Once every two weeks;4 = Once a month;5 = Less than once a month
Query attendtx Integer Recommended Did you attend every scheduled treatment session? 0;1 0= Unchecked; 1= Checked
Query misstx Integer Recommended How many treatment sessions did you miss?
Query behave Integer Recommended Over the last 3 months, did your treatment consist of behavioral treatment, which includes such things as relaxation exercises,exposing yourself to fearful situations, completing homework assignments, or rewarding yourself for accomplishing a task? 0;1 0= Unchecked; 1= Checked
Query cognit Integer Recommended Over the last 3 months, did your treatment cosist of Cognitive treatment, which includes such things as writing down and, discussing distressing thoughts, teaching you how to control your thoughts, or discussing the relationship between your thoughts and your actions? 0;1 0= Unchecked; 1= Checked
Query dynamic Integer Recommended Over the last 3 months, did your treatment consist of Dynamic treatment, which includes such things as discussing the underlying significance of your symptoms and feelings, discussing your childhood experiences, your relationship with your parents or therapist, or interpreting the significance of your dreams and fantasies with you? 0;1 0= Unchecked; 1= Checked
Query inter Integer Recommended Over the last 3 months, did your treatment consist of interpersonal treatment, which includes such things as discussing things like grief, struggles with other people, or major life changes? 0;1 0= Unchecked; 1= Checked
Query reaction_q12 Integer Recommended In the last 3 months, did you feel that you knew what you were supposed to be doing in your treatment? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q12
Query reaction_q13 Integer Recommended In the last 3 months, have a good or positive feelings about your therapist, doctor, or counselor? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q13
Query reaction_q14 Integer Recommended In the last 3 months, believe that your treatment was really helping you? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q14
Query reaction_q15 Integer Recommended In the last 3 months, get angry at the things your therapist, doctor, or conselor said or did? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q15
Query reaction_q16 Integer Recommended In the last 3 months, find that you didnt like to say much in your sessions? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q16
Query reaction_q17 Integer Recommended In the last 3 months, find yourself eager to get to treatment sessions? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q17
Query reaction_q18 Integer Recommended In the last 3 months, actively think about your treatment or do assignmed homework assignments between sessions? 0::2 0=Never or Rarely;1=Sometimes;2=Frequently or a lot q18
Query txbegdt Integer Recommended Psychotherapy treatment beginning date
Query txenddt Integer Recommended Psychotherapy treatment end date
Query subabuse Integer Recommended curr substance abuse or depend 0;1;-7 0=No; 1=Yes; -7=Refused subsuse
Query rescue Integer Recommended Was this a rescue session 0;1 0=No; 1=Yes
Query q145_gaf Integer Recommended Global Assessment of Functioning 0::100; 999 999=NA/NK/Missing gaf
Query acute Integer Recommended In need of acute intervention 0;1 0=No; 1=Yes
Query cmd010 Integer Recommended Continuing? (If No, complete Q11. If Yes, end questionnaire.) 0;1; -9 0=No; 1=Yes; -9=Unknown protocol
Query lst_date Integer Recommended Date of last session
Query lst_sess Integer Recommended Last session
Query sess_count Integer Recommended Count of sessions
Query sa Integer Recommended Was SA administered during this session
Query step1 Integer Recommended PPRF: Step 1 0;1 0=No; 1=Yes
Query step2 Integer Recommended PPRF: Step 2 0;1 0=No; 1=Yes
Query step3 Integer Recommended PPRF: Step 3 0;1 0=No; 1=Yes
Query step4 Integer Recommended PPRF: Step 4 0;1 0=No; 1=Yes
Query step5 Integer Recommended PPRF: Step 5 0;1 0=No; 1=Yes
Query steptot Integer Recommended PPRF: Step 6
Query therapy_code1 Integer Recommended Therapy 1 code 0::11 0=Receiving no therapy; 1=regular case management; 2=supportive; 3=CBT; 4=psychodynamic; 5=interpersonal; 6=stress management; 7=school counselling; 8=family therapy; 9=blinded in a study; 10=cognitive remediation; 11=multiple/combined/milieu psych_therapy_code
Query therapy_code2 Integer Recommended Therapy 2 code 0::11 0=Receiving no therapy; 1=regular case management; 2=supportive; 3=CBT; 4=psychodynamic; 5=interpersonal; 6=stress management; 7=school counselling; 8=family therapy; 9=blinded in a study; 10=cognitive remediation; 11=multiple/combined/milieu
Query therapy_code3 Integer Recommended Therapy 3 code 0::11 0=Receiving no therapy; 1=regular case management; 2=supportive; 3=CBT; 4=psychodynamic; 5=interpersonal; 6=stress management; 7=school counselling; 8=family therapy; 9=blinded in a study; 10=cognitive remediation; 11=multiple/combined/milieu
Query therapy_code4 Integer Recommended Therapy 4 code 0::11 0=Receiving no therapy; 1=regular case management; 2=supportive; 3=CBT; 4=psychodynamic; 5=interpersonal; 6=stress management; 7=school counselling; 8=family therapy; 9=blinded in a study; 10=cognitive remediation; 11=multiple/combined/milieu
Query thrpy_modality1 Integer Recommended Therapy 1 modality code 0::4 0=no modality because no therapy; 1=individual format; 2=group format; 3=blinded in a study; 4=multiple/milieu psych_therapy_mode
Query thrpy_modality2 Integer Recommended Therapy 2 modality code 0::4 0=no modality because no therapy; 1=individual format; 2=group format; 3=blinded in a study; 4=multiple/milieu
Query thrpy_modality3 Integer Recommended Therapy 3 modality code 0::4 0=no modality because no therapy; 1=individual format; 2=group format; 3=blinded in a study; 4=multiple/milieu
Query thrpy_modality4 Integer Recommended Therapy 4 modality code 0::4 0=no modality because no therapy; 1=individual format; 2=group format; 3=blinded in a study; 4=multiple/milieu
Query ptsess Integer Recommended number of psychosocial session psych_therapy_num_sessions
Query ptsess2 Integer Recommended number of psychosocial session 2
Query ptsess3 Integer Recommended number of psychosocial session 3
Query ptsess4 Integer Recommended number of psychosocial session 4
Query trial_code1 Integer Recommended Trial code 1 0;1 0=No therapy or no trial; 1=therapy within a research trial ptherapy_06
Query trial_code2 Integer Recommended Trial code 2 0;1 0=No therapy or no trial; 1=therapy within a research trial
Query trial_code3 Integer Recommended Trial code 3 0;1 0=No therapy or no trial; 1=therapy within a research trial
Query trial_code4 Integer Recommended Trial code 4 0;1 0=No therapy or no trial; 1=therapy within a research trial
Query thrpy_set1 Integer Recommended Therapy 1 setting code 0::7 0=no setting because no therapy; 1=community outpatient setting; 2=affiliated or specialized outpatient clinic/service; 3=therapeutic (non-residential) educational classroom/setting; 4=intensive outpatient/day treatment/hospital program; 5=inpatient unit; 6=residential treatment center; 7=educational setting (non-therapeutic) ptherapy_07
Query thrpy_set2 Integer Recommended Therapy 2 setting code 0::7 0=no setting because no therapy; 1=community outpatient setting; 2=affiliated or specialized outpatient clinic/service; 3=therapeutic (non-residential) educational classroom/setting; 4=intensive outpatient/day treatment/hospital program; 5=inpatient unit; 6=residential treatment center; 7=educational setting (non-therapeutic)
Query thrpy_set3 Integer Recommended Therapy 3 setting code 0::7 0=no setting because no therapy; 1=community outpatient setting; 2=affiliated or specialized outpatient clinic/service; 3=therapeutic (non-residential) educational classroom/setting; 4=intensive outpatient/day treatment/hospital program; 5=inpatient unit; 6=residential treatment center; 7=educational setting (non-therapeutic)
Query thrpy_set4 Integer Recommended Therapy 4 setting code 0::7 0=no setting because no therapy; 1=community outpatient setting; 2=affiliated or specialized outpatient clinic/service; 3=therapeutic (non-residential) educational classroom/setting; 4=intensive outpatient/day treatment/hospital program; 5=inpatient unit; 6=residential treatment center; 7=educational setting (non-therapeutic)
thrpy_start1 Date Recommended Therapy 1 start date psych_therapy_start_date
thrpy_start2 Date Recommended Therapy 2 start date
thrpy_start3 Date Recommended Therapy 1 start date
thrpy_start4 Date Recommended Therapy 4 start date
thrpy_stop1 Date Recommended Therapy 1 stop date psych_therapy_stop_date
thrpy_stop2 Date Recommended Therapy 2 stop date
thrpy_stop3 Date Recommended Therapy 1 stop date
thrpy_stop4 Date Recommended Therapy 4 stop date
prev_date Date Recommended Date of Previous Assessment
Query elig_inclusion_check Integer Recommended Checks for a pass/fail on Elig for Inclusion 0::3 0=Failed (Ineligible); 1=Passed (Eligible); 2=In screening; 3=NA
Query dataquality Integer Recommended Data quality 0::5 0=No data (cancelled); 1=Data entered but only once, has missing data; 2=Data entered but only once, no missing data; 3=Double entered; 4=Data frozen for cleaning; 5=Data clean/locked
visit_name String 20 Recommended session ID/screening ID visitnumber
Query visit String 60 Recommended Visit name visitlabel
Query instance Integer Recommended Instance 0::100 The number of instance of the first degree relative.
Query subjecttype String 20 Recommended Subject Type Control;Prodromal; Enhanced; Non-Enhanced
completed Integer Recommended Checks if completed 0::3 0=No; 1=Yes; 2=Yes, lost; 3=Unverified gaf_complete
name_study String 50 Recommended Name of initial study
visit_reason7 Integer Recommended What was the main reason for your visit today? (check all that apply): Other 0;1 0=No; 1=Yes
card_received Integer Recommended Today, did your counselor or student health provider give you one of these palm-sized cards (pictured below)? 0;1 0=No; 1=Yes
card_received2 Integer Recommended Have you received one of these cards in the past? 0;1 0=No; 1=Yes
card_received3a Integer Recommended Where did you receive this card previously? (check all that apply): Here at the counseling and/or student health center 0;1 0=No; 1=Yes
card_received3b Integer Recommended Where did you receive this card previously? (check all that apply): Someplace else on campus 0;1 0=No; 1=Yes
card_received3c Integer Recommended Where did you receive this card previously? (check all that apply): From a friend 0;1 0=No; 1=Yes
card_received3d Integer Recommended Where did you receive this card previously? (check all that apply): Other 0;1 0=No; 1=Yes
card_received3_other String 50 Recommended Where did you receive this card previously? If you chose Other, please specify
card_review Integer Recommended Today, did your counselor or student health provider open up the card and review it with you? 0;1 0=No; 1=Yes
card_share Integer Recommended How likely is it that you would share this card with another college student or friend? 1::5 1= Very Unlikely; 2=Somewhat Unlikely; 3= Neutral; 4= Somewhat Likely; 5= Very Likely
card_disclose Integer Recommended During your visit, did you share with your counselor or student health provider any experiences like these you may have had? 0::2 0=No; 1=Yes; 2= Does not apply to me
visit_refferal1 Integer Recommended During your visit, did you receive a referral to any of the following: (check all that apply): Alcohol and other drug rehabilitation and treatment centers 0;1 0=No; 1=Yes
visit_refferal2 Integer Recommended During your visit, did you receive a referral to any of the following: (check all that apply): Sexual violence services on campus 0;1 0=No; 1=Yes
visit_refferal3 Integer Recommended During your visit, did you receive a referral to any of the following: (check all that apply): Intimate partner violence services on campus 0;1 0=No; 1=Yes
visit_refferal4 Integer Recommended During your visit, did you receive a referral to any of the following: (check all that apply): Sexual and partner violence services off campus 0;1 0=No; 1=Yes
visit_refferal5 Integer Recommended During your visit, did you receive a referral to any of the following: (check all that apply): Intimate partner violence services off campus 0;1 0=No; 1=Yes
visit_refferal6 Integer Recommended During your visit, did you receive a referral to any of the following: (check all that apply): I did not receive any referrals 0;1 0=No; 1=Yes
visit_talk_q1 Integer Recommended Today, did your counselor or student health center provider talk to you about healthy relationships? 0;1 0=No; 1=Yes
visit_talk_q2 Integer Recommended Today, did your counselor or student health center provider talk to you about unhealthy relationships? 0;1 0=No; 1=Yes
visit_talk_q3 Integer Recommended Today, did your counselor or student health center provider talk to you about having sex when you don''t want to? 0;1 0=No; 1=Yes
appointment Integer Recommended Today, did you have a counseling appointment, a student health center appointment, or both? 1::3 1= Counseling; 2= Health center; 3= Both
visit_talk_q4 Integer Recommended Today, did your counselor or student health center provider talk to you about sexual assault on campus? 0;1 0=No; 1=Yes
visit_talk_q5 Integer Recommended Today, did your counselor or student health center provider talk to you about how having an unwanted sexual experience can impact alcohol and drug use? 0;1 0=No; 1=Yes
visit_talk_q6 Integer Recommended Today, did your counselor or student health center provider talk to you about how having an unhealthy relationship can impact alcohol and drug use? 0;1 0=No; 1=Yes
visit_talk_q7 Integer Recommended Today, did your counselor or student health center provider talk to you about how alcohol and drug use can increase the risk of having unwanted or nonconsensual sex? 0;1 0=No; 1=Yes
visit_talk_q8 Integer Recommended Today, did your counselor or student health center provider talk to you about how alcohol and drug use can make it difficult to avoid unwanted sexual experiences? 0;1 0=No; 1=Yes
visit_talk_q9 Integer Recommended Today, did your counselor or student health center provider talk to you about how to help a friend and/or another college student who has experienced sexual assault or intimate partner violence? 0;1 0=No; 1=Yes
visit_talk_q10 Integer Recommended Today, did your counselor or student health center provider talk to you about local and national resources available for you or a friend affected by sexual assault or intimate partner violence? 0;1 0=No; 1=Yes
visit_counselor_q1 Integer Recommended Please tell us how much you agree or disagree with the statement: My counselor and/or student health center practitioner cares about my safety. 1::5 1= Strongly Disagree; 2= Disagree; 3= Undecided; 4= Agree; 5= Strongly Agree
visit_counselor_q2 Integer Recommended Please tell us how much you agree or disagree with the statement: If I told my counselor and/or student health center practitioner that I was in an unhealthy relationship, they would know what to do. 1::5 1= Strongly Disagree; 2= Disagree; 3= Undecided; 4= Agree; 5= Strongly Agree
visit_counselor_q3 Integer Recommended Please tell us how much you agree or disagree with the statement: If I told my counselor and/or student health center practitioner that I had an unwanted sexual experience, they would know what to do. 1::5 1= Strongly Disagree; 2= Disagree; 3= Undecided; 4= Agree; 5= Strongly Agree
visit_reason1 Integer Recommended What was the main reason for your visit today? (check all that apply): Sick (Cold, flu, stomach pain, fever, nausea, vomiting, diarrhea, etc.) 0;1 0=No; 1=Yes
visit_counselor_q4 Integer Recommended Please tell us how much you agree or disagree with the statement: I feel safe coming here (to this counseling/student health center). 1::5 1= Strongly Disagree; 2= Disagree; 3= Undecided; 4= Agree; 5= Strongly Agree
visit_reason2 Integer Recommended What was the main reason for your visit today? (check all that apply): Sexual health care (gynecological exam, birth control, STD test or treatment, condoms, emergency contraception, pregnancy testing, etc.) 0;1 0=No; 1=Yes
visit_reason3 Integer Recommended What was the main reason for your visit today? (check all that apply): Behavioral health care (counseling, medication, alcohol and drug counseling, etc.) 0;1 0=No; 1=Yes
visit_reason4 Integer Recommended What was the main reason for your visit today? (check all that apply): Experiencing violence (injury, sexual assault, etc.) 0;1 0=No; 1=Yes
visit_reason5 Integer Recommended What was the main reason for your visit today? (check all that apply): Gender affirming care 0;1 0=No; 1=Yes
visit_reason6 Integer Recommended What was the main reason for your visit today? (check all that apply): Well visit/prevention (physical/annual checkup, immunizations, vaccinations, travel prep, etc.) 0;1 0=No; 1=Yes
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:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

Please email the The NDA Help Desk with any questions.

Additional Information
Training Privacy Policy Disclaimer Contact Us
External Resources
Accessibility FOIA OIG HHS Vulnerability Disclosure
NIH Logo HHS Logo USA Gov Logo
c725efb98f608e6bc0136950f08b0c3af2bde994