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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

After Study Knowledge Questionnaire

216 Shared Subjects

N/A
Clinical Assessments
Questionnaire
09/15/2015
askq01
02/22/2024
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
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY
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.
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported gender
Query site String 101 Recommended Site Study Site
study String 100 Recommended Study; The code for each individual study
Query daysrz Integer Recommended days since randomization
Query visit String 60 Recommended Visit name
Query completed Integer Recommended Checks if completed 0::3 0=No; 1=Yes; 2=Yes, lost; 3=Unverified
Query ci_enrolled Integer Recommended Participant enrolled 0;1 0=No; 1=Yes
Query relationship Integer Recommended Relationship of respondent to individual
1::94;-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; 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; 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; 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 male; 85=Other/Grandparent/Nanny; 86 = Mother, Father, Guardian; 87 = Daughter, son, grandchild; 88 = Professional (e.g., social worker, nurse, therapist, psychiatrist, or group home staff); -999=Missing; 89 = Biological parent; 90=Other; 91 = Stepparent; 92 = Adoptive parent; 93 = Foster parent; 94 = Co-worker
Query bkgrnd_education String 1,020 Recommended Subject's education (school and preschool)
Query afterstdy_q05 Integer Recommended Main goal of doctors 1::5;9 1 = To find out if a certain medication helps children with autism; 2 = To give free care to children with autism; 3 = To give a medication that is available only in research studies.; 4 = To see if Parent Management Training will produce gains over and above those seen with [medication]; 5 = To find out if medication only helps children with autism
Query stpnm1 String 250 Recommended Study med name1
Query afterstdy_q07 Integer Recommended Informed before child received med. 1::4;9 1 = I was informed by the study doctor(s) and/or other staff of what this study is about and my questions were adequately answered; 2 = There was no information available on the study; 3 = The study doctor(s) or other staff didn't inform me, but I found information elsewhere; 4 = I was told that the purpose needed to be a secret for the study to "work right
Query afterstdy_q08 Integer Recommended Permission before child received med. 1::4;9 1 = Nobody asked me permission to start the study; 2 = I gave only verbal permission to the study staff to enter him/her into the study; 3 = I gave written permission to the study staff to enter him/her into the study; 4 =The study staff members said that permission was assumed, because I would not have to come ...
Query afterstdy_q09 Integer Recommended In this study... 1::4;9 1 = Some children were given "real" medication and other children "inactive" medication (also called placebo) for 2 months; 2 = All children were given "real" medication for 2 months; 3 = All children were given "inactive" medication for 2 months before they could receive "real medication" ; 4 = no medication is involved
Query afterstdy_q10 Integer Recommended ...the chance of being assigned placebo 1::4;9 1 = 0%; 2 = 50%; 3 = 75%; 4 = 100%
Query afterstdy_q11 Integer Recommended When the study started... 1::4;9 1 = Some children were given "real" medication and other children "inactive" medication (also called placebo) for 2 months; 2 = All children were given "real" medication for 2 months; 3 = All children were given "inactive" medication for 2 months before they could receive "real medication" ; 4 = no medication is involved
Query afterstdy_q12 Integer Recommended Before start, risks/benefits... 1::4;9 1 = I understood that there were only advantages and benefits, but no risks at all, in participation in the study; 2 = I understood that there were both possible advantages (benefits) and risks, and the doctors told me which the main risks were.; 3 = I was not informed of any benefits or risks possibly associated with this study; 4 = I was told that there were no possible benefits for my child
Query afterstdy_q13 Integer Recommended Side effects 1::5;9 1 = Dizziness, abnormal movements of the head or neck, weight gain; 2 = Hair loss, anemia, weight loss; 3 = Diarrhea, vomiting, and heart problems; 4 = Ringing in the ears and coldness in the extremitites (hands and feet); 5 = Craving for salt, reduced appetite, and sweating
Query afterstdy_q14 Integer Recommended At the time I agreed, study med 1::4;9 1 = I was informed of the possible alternatives for treatment; 2 = I understood that there were no alternatives besides the study; 3 = The study medicine was not available yet outside the study; 4 = Parent Management Training has already been proven effective to cure autism
Query afterstdy_q15 Integer Recommended After consent, drop out was... 1::4;9 1 = It was not possible for my child to drop out of the study before it was completed, even if I wanted him to stop; 2 = I could have taken my child off the study at any time, if I wanted, even if the study was yet not finished; 3 = My child could have stopped the study but only with the permission of the study doctors; 4 = Leaving the study would have resulted in loss of all services at this Medical Center
Query afterstdy_q16 Integer Recommended If dropout, treatment would... 1::9 1 = My child would have to wait for medical care until the study is completed; 2 = My child could not have been treated with the type of medication that is given in this study; 3 = My child would have continued treatment with another doctor; 4 = My child would have to wait for Parent Management Training until the study is completed; 5 = My child could not receive the treatments that are given in this study; 6 = My child could have received these treatments with other therapists in the community; 7 = Parent Management Training would be made available free
Query afterstdy_q17 Integer Recommended Study treatment assignment 1::5;9 1 = Randomly (that is by the tossing of a coin); 2 = By the child; 3 = Based on the individual needs of each child to ensure that each child received the best possible treatment for his/her condition; 4 = Based on the child's age; 5 = Based on the Treatment Preference Form that I completed at the beginning
relation_specify String 20 Recommended Relation Other Specify
Query visnum Float Recommended Numeric Visit Number -1.5 = Pre-Screening; -1 = Screening; 0 = Baseline; ## = Visit ## (from 1 to 10); Whole numbers = standard monthly visits; #.001 - #.009 = Unscheduled; #.1 = End of Phase 1; #.2 = End of Phase 2; #.3 = End of Phase 3; #.4 = End of Open Choice Phase; #.5 = End of Study; #.6 = Genetic Analysis; 1000=all visits
Query ques6 Integer Recommended When I agreed to my child's participation in this study, the chance of his/her being assigned to receive only medication (no Parent Management Training) for the 6-month duration of the study was: 1::4;9 1 = 0%; 2 = 33%; 3 = 50%; 4 = 100%
Query ques10 Integer Recommended A possible risk or disadvantage of the Parent Management Training is: 1::4;9 1 = that it would result in punishment to my child; 2 = that it would require a lot of time and effort; 3 = that it would involve spoiling my child with bribes; 4 = I would have to spend a lot of money to make it work
Query ques15 Integer Recommended Before I stated in this study, I knew that, If I were assisgned to the medication + therapy group: 1::4;9 1 = his/her teacher would have to give rating every two weeks for my child to stay in the study; 2 = I would have homework to do most weeks; 3 = The behavior therapist would visit out home whenever we needed him/her; 4 = Even if the medicine does not help, my child would have to continue it
knowledge8 Integer Recommended What does ''substantial gainful activity'' mean? 1::4; 999 1= c) Making a certain amount of money as determined by the SSA; 2= a) Ability to work in any capacity; 3= b) Ability to make minimum wage; 4= d) Ability to make a livable income; 999= Missing
knowledge9 Integer Recommended With respect to Supplemental Security Income (SSI), what are your options if your young adult cannot manage his/her finances? 1::4; 999 1= c) Become a representative payee; 2= a) Become a guardian; 3= b) Become a conservator; 4= d) Informally manage your child's finances; 999= Missing
knowledge10 Integer Recommended Select two pieces of legislation or systems that may fund students with disabilities to receive post-secondary education. 1::4; 999 1= b) Vocational Rehabilitation and Supplemental Security Income (SSI); 2= a) Individuals with Disabilities Education Act (IDEA) and the Americans with Disabilities Act (ADA); 3= c) Americans with Disabilities Act (ADA) and Supplemental Security Income (SSI); 4= d) Americans with Disabilities (ADA) and Vocational Rehabilitation; 999= Missing
knowledge11 Integer Recommended How is a youth eligible for vocational rehabilitation services? 1::4; 999 1= a) The youth has a disability making it difficult to keep a job = the youth wants to work = and the youth is willing to follow an employment plan; 2= b) The youth has a disability making it difficult to keep a job and the youth can follow an employment plan; 3= c) The youth can follow an employment plan; 4= d) The youth has a disability making it difficult to keep a job; 999= Missing
knowledge12 Integer Recommended How can an individual qualify for Social Security Disability Insurance (SSDI)? 1::4; 999 1= a) Has worked enough to have sufficient social security credits; 2= b) Marry someone who receives SSDI; 3= c) Have an intellectual disability; 4= d) Receive Supplemental Security Income (SSI); 999= Missing
knowledge13 Integer Recommended How does an individual qualify for the Supplemental Nutrition Assistance Program (SNAP)? 1::4; 999 1= d) Meet specified income requirements; 2= a) Have an intellectual disability; 3= b) Have a developmental disability; 4= c) Receive Supplemental Security Income (SSI); 999= Missing
knowledge14 Integer Recommended Which of the following automatically qualifies your child for Medicare? 1::4; 999 1= b) Social Security Disability Insurance (SSDI); 2= a) Supplemental Security Income (SSI); 3= c) SSI and SSDI; 4= d) Having an intellectual disability; 999= Missing
knowledge15 Integer Recommended The Affordable Care Act allows children to stay on their parents' insurance plans until what age? 1::4; 999 1= c) 26; 2= a) 18; 3= b) 21; 4= d) Youth with disabilities can stay on their parents' insurance plans indefinitely; 999= Missing
knowledge16 Integer Recommended When an employer and worker design a job, it is called... 1::4; 999 1= c) Customized employment; 2= a) Integrated employment; 3= b) Competitive employment; 4= d) Supported employment; 999= Missing
knowledge17 Integer Recommended Which of the following CANNOT be provided by Home and Community-Based Services (HCBS) Medicaid waiver? 1::4; 999 1= c) State operated developmental center or congregate housing; 2= a) Personal care services; 3= b) Supported living; 4= d) Transportation; 999= Missing
knowledge18 Integer Recommended An ABLE account can hold... 1::4; 999 1= a) Only money; 2= b) Money and assets; 3= c) College funding; 4= d) Only certain assets; 999= Missing
knowledge19 Integer Recommended Who has the sole discretion to make decisions about the use of a special needs trust (SNT)? 1::4; 999 1= c) The trustee; 2= a) The person with a disability; 3= b) The person with a disability and the family; 4= d) The bank; 999= Missing
knowledge20 Integer Recommended What is public housing? 1::4; 999 1= a) Housing that is subsidized; 2= b) Housing that is funded by a housing voucher; 3= c) Housing wherein the landlord accepts a voucher; 4= d) Alternate housing for individuals with disabilities that is the same cost as other houses in the area; 999= Missing
knowledge21 Integer Recommended Which of the following is the MOST restrictive form of decision-making support? 1::4; 999 1= b) Conservatorship or Guardianship (depending on the state you are in); 2= a) Representative Payee; 3= c) Durable Power of Attorney; 4= d) Healthcare Surrogate; 999= Missing
knowledge22 Integer Recommended How can an individual be eligible for a housing voucher? 1::4; 999 1= a) Meet the prescribed income requirements; 2= b) Receive supplemental security income (SSI); 3= c) Have a Home and Community-Based (HCBS) Medicaid waiver; 4= d) Meet the income and benefits requirements; 999= Missing
timepoint_label String 50 Recommended Timepoint/visit label assessment_type
knowledge1 Integer Recommended Which of the following service delivery systems requires person-centered planning? 1::4; 999 1= b) Home and Community-Based Services (HCBS) Medicaid waivers; 2= a) All adult service delivery systems; 3= c) Supplemental Security Income (SSI); 4= d) Social Security Disability Insurance (SSDI); 999= Missing
knowledge2 Integer Recommended Select the two pieces of legislation that enable students with disabilities to receive accommodations in post-secondary education 1::4; 999 1= b) Section 504 and Americans with Disabilities Act (ADA); 2= a) Individuals with Disabilities Education Act (IDEA) and Section 504; 3= c) Section 504 and No Child Left Behind (NCLB); 4= d) ADA and IDEA; 999= Missing
knowledge3 Integer Recommended What documentation is necessary for transition-aged youth to qualify to receive services through the Workforce Innovation and Opportunity Act? 1::4; 999 1= c) An Individualized Education Program (IEP) or Section 504 plan; 2= a) An Individualized Education Program (IEP); 3= b) The youth must receive supplemental security income (SSI); 4= d) A desire to work; 999= Missing
knowledge4 Integer Recommended Which of the following describes competitive employment in an integrated work setting with ongoing support services for individuals with disabilities? 1::4; 999 1= a) Supported employment; 2= b) Competitive employment; 3= c) Sheltered workshop; 4= d) Customized employment; 999= Missing
knowledge5 Integer Recommended With respect to long term services and supports, which of the following is an alternative to Home and Community-Based Services (HCBS)? 1::4; 999 1= b) An intermediate care facility (ICF); 2= a) A Community for Integrated Living Arrangement (CILA); 3= c) A group home; 4= d) Public housing; 999= Missing
knowledge6 Integer Recommended Select the two pieces of legislation that enable students with disabilities to receive accommodations in post-secondary education 1::4; 999 1= a) The individual with a disability must re-apply for a waiver; 2= b) If the individual had a waiver in the prior state = the waiver is portable and can be used in a new state; 3= c) The individual always automatically receives the waiver upon moving to a new state; 4= d) Eligibility for the waiver is the same in each state; 999= Missing
knowledge7 Integer Recommended Which of the following is NOT a requirement for Supplemental Security Income (SSI)? 1::4; 999 1= d) To have an intellectual disability; 2= a) To meet the disability eligibility criteria; 3= b) To be unable to work at a substantial level; 4= c) To have less than $2000 in countable resources; 999= Missing
pknowledge1 Integer Recommended Teenagers in therapy usually need just about three or four therapy sessions. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
pknowledge2 Integer Recommended A child tells his therapist about his problem, and then the therapist tells him the answer. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
pknowledge3 Integer Recommended If a teenager does not talk about his problems in his therapy session, he is wasting the time. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
pknowledge4 Integer Recommended If a teenager does not want to go to his therapy sessions, therapy is not helping him. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
pknowledge5 Integer Recommended It does not matter if a teenager misses some therapy sessions. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
pknowledge6 Integer Recommended When a teenager behaves badly, the therapist scolds him to get him to behave better. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
pknowledge7 Integer Recommended The teenager should talk about whatever he wants to talk about in his therapy sessions. 1::5 1= Strongly disagree; 2= Disagree; 3= Neither agree nor disagree; 4= Agree; 5= Strongly agree
sbirtknow1 Integer Recommended The HIV epidemic in South Africa is the largest country epidemic in the world. 1;2 1 = True; 2 = False
sbirtknow2 Integer Recommended Which part of the HIV care cascade is affected by alcohol and drug use? 1::4 1 = Likelihood of becoming HIV infected; 2 = Likelihood of engaging in HIV treatment; 3 = Likelihood of obtaining viral suppression; 4 = All of the above
sbirtknow3 Integer Recommended SBIRT stands for: 1::4 1 = Screening, Briefing, Initial Referral & Treatment; 2 = Skill Building & Initial Resources for Treatment; 3 = Screening, Brief Intervention, and Referral to Treatment; 4 = None of the above
sbirtknow4 Integer Recommended The primary goal of SBIRT is to diagnose patients with a substance use disorder. 1;2 1 = True; 2 = False
sbirtknow5 Integer Recommended The AUDIT screens for: 1::4 1 = Dependency; 2 = Addiction; 3 = Drug use; 4 = Alcohol use
sbirtknow6 Integer Recommended If the client has an AUDIT score in Zone I (Low Risk), you would provide the following services: 1::4 1 = Provide a positive health message and describe low risk drinking guidelines; 2 = Provide patient with brief advice to cut down drinking; 3 = Provide patient with a brief motivational intervention to reduce drinking; 4 = Provide patient with a brief motivational intervention and refer to specialty substance use treatment
sbirtknow7 Integer Recommended Think about the AUDIT: A patient with Harmful Use (Zone III) is someone who drinks in excess of the low-risk drinking limits and has experienced negative consequences from alcohol use. 1;2 1 = True; 2 = False
sbirtknow8 Integer Recommended Think about the AUDIT: A patient in Zone IV (Possible Dependence) has a score of 16-19. 1;2 1 = True; 2 = False
sbirtknow9 Integer Recommended If the client has an AUDIT score in Zone II, you would provide the following services: 1::4 1 = Provide a positive health message and describe low risk drinking guidelines; 2 = Provide patient with brief advice to cut down drinking; 3 = Provide patient with a brief motivational intervention to reduce drinking; 4 = Provide patient with a brief motivational intervention and refer to specialty substance use treatment
sbirtknow10 Integer Recommended If the client has an AUDIT score in Zone III you would provide the following services: 1::4 1 = Provide a positive health message and describe low risk drinking guidelines; 2 = Provide patient with brief advice to cut down drinking; 3 = Provide patient with a brief motivational intervention to reduce drinking; 4 = Provide patient with a brief motivational intervention and refer to specialty substance use treatment
sbirtknow11 Integer Recommended The DUDIT screens for: 1::4 1 = Dependency; 2 = Addiction; 3 = Drug use; 4 = Alcohol use
sbirtknow12 Integer Recommended How many items does the DUDIT have? 1::4 1 = 10; 2 =11; 3 = 12; 4 = 13
sbirtknow13 Integer Recommended If a client scores an 8 on the DUDIT, this is in a risky drug use zone and you would provide a brief intervention to assist the client in reducing substance intake. 1;2 1 = True; 2 = False
sbirtknow14 Integer Recommended What are the cutoff scores for risky use on the DUDIT? 1::4 1 = Men - 5, Women - 2; 2 = Men - 6, Women - 2; 3 = Men - 5, Women - 3; 4 = Men - 6, Women - 3
sbirtknow15 Integer Recommended Think about the DUDIT: If a client scores in the severe risk level ( greater than 25), you should: 1::4 1 = Provide a positive health message to reinforce abstinence; 2 = Provide patient with a brief intervention to reduce drug use; 3 = Refer patient to specialty substance use treatment; 4 = Options 2 and 3
sbirtknow16 Integer Recommended What does FRAMES stand for? 1::4 1 = Feedback, Reflections, Advice, Make Change, Empathy, Solutions; 2 = Feedback, Responsibility, Ask Questions, Menu of Options, Educate, Self-Efficacy; 3 = Feedback, Reflections, Ask Questions, Make Change, Empathy, Solutions; 4 = Feedback, Responsibility, Advice, Menu of Options, Empathy, Self-Efficacy
sbirtknow17 Integer Recommended Brief interventions can only be used in generalist medical settings 1;2 1 = True; 2 = False
sbirtknow18 Integer Recommended SBIRT is designed to be a reactive strategy that detects individuals who already meet diagnostic criteria for a substance use disorder. 1;2 1 = True; 2 = False
sbirtknow19 Integer Recommended You are performing a brief intervention and assess the client's readiness to change. If the client indicates they are not ready, you will: 1::3 1 = Tell them that there is nothing you can do for them, and they should come back when they are ready; 2 = Try to convince them to move to the next level of change; 3 = Share your concern as a health care provider, reassure them that it is their choice, and state that maybe in the future you can revisit the issue
sbirtknow20 Integer Recommended The ''warm handoff'' approach to referrals means that patients get a list of outside referrals and do the leg work of making contact on their own to build independence. 1;2 1 = True; 2 = False
Data Structure

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