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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL
Change History For

Infant Screening Demographics Form

0 Shared Subjects

N/A
Clinical Assessments
Demographics
01/06/2017
asdriskdemo01
01/09/2017
View Data Structure
01
Definition
Submission Template
Element Name Change Description Before Now When
interview_age VALUE_RANGE, VALUE_RANGE: 0 :: 1260 VALUE_RANGE: 0::1440 04/04/2024 13:54 PM
dem_income_12 VALUE_RANGE, VALUE_RANGE: 0::18;777;888 VALUE_RANGE: 0::19;777;888 07/20/2023 10:13 AM
dem_income_12 NOTES, NOTES: 0 = Doesn't know or would rather not say; 1 = Less than $10,000 ; 2 = $10,000 through $19,999 ; 3 = $20,000 through $29,999 ; 4 = $30,000 through $39,999 ; 5 = $40,000 through $49,999 ; 6 = $50,000 through $59,999 ; 7 = $60,000 through $69,999 ; 8 = $70,000 through $79,999 ; 9 = $80,000 through $89,999 ; 10 = $90,000 through $99,999 ; 11 = $100,000 through $119,999 ; 12 = $120,000 through $129,999 ; 13 = $130,000 through $139,999 ; 14 = $140,000 and greater ; 15=$50,000-$74,999; 16=$75,000-$99,999; 17=$100,000-$150,000; 18=over $150,000; 777 = Don't know ; 888 = No response NOTES: 0 = Doesn't know or would rather not say; 1 = Less than $10,000 ; 2 = $10,000 through $19,999 ; 3 = $20,000 through $29,999 ; 4 = $30,000 through $39,999 ; 5 = $40,000 through $49,999 ; 6 = $50,000 through $59,999 ; 7 = $60,000 through $69,999 ; 8 = $70,000 through $79,999 ; 9 = $80,000 through $89,999 ; 10 = $90,000 through $99,999 ; 11 = $100,000 through $119,999 ; 12 = $120,000 through $129,999 ; 13 = $130,000 through $139,999 ; 14 = $140,000 and greater ; 15=$50,000-$74,999; 16=$75,000-$99,999; 17=$100,000-$150,000; 18=over $150,000; 19 = $75,000 or more; 777 = Don't know ; 888 = No response 07/20/2023 10:13 AM
medication9_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 500 05/24/2023 10:47 AM
medication8_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 500 05/24/2023 10:47 AM
medication7_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 500 05/24/2023 10:47 AM
medication4_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 500 05/24/2023 10:47 AM
medication3_name ELEMENT_SIZE, ELEMENT_SIZE: 150 ELEMENT_SIZE: 500 05/24/2023 10:46 AM
medication2_name ELEMENT_SIZE, ELEMENT_SIZE: 200 ELEMENT_SIZE: 500 05/24/2023 10:46 AM
ethnicity VALUE_RANGE, VALUE_RANGE: Hispanic or Latino; Not Hispanic or Latino; Unknown; Prefer not to answer VALUE_RANGE: Hispanic or Latino; Not Hispanic or Latino; Unknown 04/06/2023 12:02 PM
race VALUE_RANGE, VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other; Prefer not to answer VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other 04/06/2023 12:02 PM
ethnicity VALUE_RANGE, VALUE_RANGE: Hispanic or Latino; Not Hispanic or Latino; Unknown VALUE_RANGE: Hispanic or Latino; Not Hispanic or Latino; Unknown; Prefer not to answer 04/06/2023 11:39 AM
race VALUE_RANGE, VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other; Prefer not to answer 04/06/2023 11:39 AM
demo_resp_status VALUE_RANGE, VALUE_RANGE: 1::12 VALUE_RANGE: 1::13 09/09/2022 12:06 PM
demo_resp_status NOTES, NOTES: 1 = Married; 2 = Remarried; 3 = Live with partner (not married); 4 = Separated; 5 = Divorced; 6 = Single (never married); 7 = Widowed; 8=Married or Living Together;9 = Missing/Not Applicable; 10 = Other; 11=Refused to answer; 12= Engaged NOTES: 1 = Married; 2 = Remarried; 3 = Live with partner (not married); 4 = Separated; 5 = Divorced; 6 = Single (never married); 7 = Widowed; 8=Married or Living Together;9 = Missing/Not Applicable; 10 = Other; 11=Refused to answer; 12= Engaged; 13=Civil union 09/09/2022 12:06 PM
race VALUE_RANGE, VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other 07/15/2022 10:00 AM
race VALUE_RANGE, VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported VALUE_RANGE: American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White 07/29/2021 12:53 PM
sex DESCRIPTION DESCRIPTION: Sex of the subject DESCRIPTION: Sex of subject at birth 07/09/2021 10:38 AM
respondent VALUE_RANGE, VALUE_RANGE: Mother;Father;Parent;Guardian;Teacher;Child;Self;Caregiver;Other VALUE_RANGE: Mother;Father;Parent;Guardian;Teacher;Child;Self;Caregiver;Partner;Other 03/16/2021 10:46 AM
respondent VALUE_RANGE, VALUE_RANGE: Mother;Father;Parent;Guardian;Teacher;Child;Self;Other VALUE_RANGE: Mother;Father;Parent;Guardian;Teacher;Child;Self;Caregiver;Other 01/29/2021 10:36 AM
respondent VALUE_RANGE, VALUE_RANGE: Mother;Father;Both;Other;Parent;Teacher;Child; Self VALUE_RANGE: Mother;Father;Parent;Guardian;Teacher;Child;Self;Other 01/29/2021 10:26 AM
interview_date NOTES, NOTES: Required field NOTES: 01/08/2021 10:21 AM
respondent VALUE_RANGE, VALUE_RANGE: Mother;Father;Both;Other;Parent;Teacher;Child VALUE_RANGE: Mother;Father;Both;Other;Parent;Teacher;Child; Self 11/13/2020 15:31 PM
demo_preg_vaginal NOTES, NOTES: 1= Vaginal birth ; 2= Cesarean birth (C-section) ; 97= Don't know NOTES: 1= Vaginal birth; 2= Cesarean birth; 97= Do not know; -999= Prefer not to answer 08/06/2020 12:53 PM
demo_preg_vaginal VALUE_RANGE, VALUE_RANGE: 1;2;97 VALUE_RANGE: 1;2;97;-999 08/03/2020 14:53 PM
custody NOTES, NOTES: 0= Biological mom only (dad may or may not have visitation rights) ; 1= Biological dad only (mom may or may not have visitation rights) ; 2= Both biological parents living together ; 3= Shared custody between biological parents (50/50) ; 4= Step mom ; 5= Step dad ; 6= Former step mom ; 7= Former step dad ; 8= Adoptive mom ; 9= Adoptive dad ; 10=0 Both adoptive parents living together ; 11=1 State ; 12=2 Female relative ; 13=3 Male relative ; 14=4 Foster parent(s) ; 15=5 Other ; 16 = Questionnaire Respondent/CG1; 17 = Other Parent/CG2; 18 = Joint; 19= Mother has sole custody; 2= Father has sole custody;-99= N/A ; 77= Refused ; 88= Missing NOTES: 0= Biological mom only (dad may or may not have visitation rights) ; 1= Biological dad only (mom may or may not have visitation rights) ; 2= Both biological parents living together ; 3= Shared custody between biological parents (50/50) ; 4= Step mom ; 5= Step dad ; 6= Former step mom ; 7= Former step dad ; 8= Adoptive mom ; 9= Adoptive dad ; 10=0 Both adoptive parents living together ; 11=1 State ; 12=2 Female relative ; 13=3 Male relative ; 14=4 Foster parent(s) ; 15=5 Other ; 16 = Questionnaire Respondent/CG1; 17 = Other Parent/CG2; 18 = Joint; 19= Mother has sole custody; 20= Father has sole custody;-99= N/A ; 77= Refused ; 88= Missing 07/10/2020 15:54 PM
respondent VALUE_RANGE, VALUE_RANGE: Mother;Father;Both;Other;Parent;Teacher VALUE_RANGE: Mother;Father;Both;Other;Parent;Teacher;Child 07/10/2020 11:13 AM
custody NOTES, NOTES: 0= Biological mom only (dad may or may not have visitation rights) ; 1= Biological dad only (mom may or may not have visitation rights) ; 2= Both biological parents living together ; 3= Shared custody between biological parents (50/50) ; 4= Step mom ; 5= Step dad ; 6= Former step mom ; 7= Former step dad ; 8= Adoptive mom ; 9= Adoptive dad ; 10=0 Both adoptive parents living together ; 11=1 State ; 12=2 Female relative ; 13=3 Male relative ; 14=4 Foster parent(s) ; 15=5 Other ; 16 = Questionnaire Respondent/CG1; 17 = Other Parent/CG2; 18 = Joint; -99= N/A ; 77= Refused ; 88= Missing NOTES: 0= Biological mom only (dad may or may not have visitation rights) ; 1= Biological dad only (mom may or may not have visitation rights) ; 2= Both biological parents living together ; 3= Shared custody between biological parents (50/50) ; 4= Step mom ; 5= Step dad ; 6= Former step mom ; 7= Former step dad ; 8= Adoptive mom ; 9= Adoptive dad ; 10=0 Both adoptive parents living together ; 11=1 State ; 12=2 Female relative ; 13=3 Male relative ; 14=4 Foster parent(s) ; 15=5 Other ; 16 = Questionnaire Respondent/CG1; 17 = Other Parent/CG2; 18 = Joint; 19= Mother has sole custody; 2= Father has sole custody;-99= N/A ; 77= Refused ; 88= Missing 07/10/2020 10:55 AM
custody VALUE_RANGE, VALUE_RANGE: 1::18;-99;77;88 VALUE_RANGE: 1::20;-99;77;88 07/10/2020 10:55 AM
dem_industry_mom_12 DESCRIPTION DESCRIPTION: For your current or most recent job, in what kind of industry did/do you work? (For example: hospital, auto engine manufacturing, newspaper publishing, mail order house) (Parent 1) DESCRIPTION: For your current or most recent job, in what kind of industry did/do you work? (For example: hospital, auto engine manufacturing, newspaper publishing, mail order house) (Parent/Caregiver 1) 07/06/2020 12:37 PM
medication1_dosage ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 150 04/17/2020 12:12 PM
sex VALUE_RANGE, , NOTES, VALUE_RANGE: M;F NOTES: M = Male; F = Female VALUE_RANGE: M;F; O; NR NOTES: M = Male; F = Female; O=Other; NR = Not reported 02/21/2020 13:02 PM
respondent VALUE_RANGE, VALUE_RANGE: Mother;Father;Both; Child; Other; Parent VALUE_RANGE: Mother;Father;Both;Other;Parent;Teacher 02/07/2020 15:56 PM
demo_resp_status NOTES, NOTES: 1 = Married; 2 = Remarried; 3 = Live with partner (not married); 4 = Separated; 5 = Divorced; 6 = Single (never married); 7 = Widowed; 8=Married or Living Together;9 = Missing/Not Applicable; 10 = Other; 11=Refused to answer NOTES: 1 = Married; 2 = Remarried; 3 = Live with partner (not married); 4 = Separated; 5 = Divorced; 6 = Single (never married); 7 = Widowed; 8=Married or Living Together;9 = Missing/Not Applicable; 10 = Other; 11=Refused to answer; 12= Engaged 02/04/2020 13:01 PM
demo_resp_status VALUE_RANGE, VALUE_RANGE: 1 :: 11 VALUE_RANGE: 1::12 02/04/2020 13:01 PM
cg2_relationship VALUE_RANGE, VALUE_RANGE: VALUE_RANGE: 12/04/2019 15:43 PM
cg1_relationship VALUE_RANGE, VALUE_RANGE: VALUE_RANGE: 12/04/2019 15:39 PM
cg1_relationship NOTES, NOTES: NOTES: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother 11/20/2019 12:09 PM
cg2_relationship VALUE_RANGE, VALUE_RANGE: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother VALUE_RANGE: 11/20/2019 12:09 PM
cg2_relationship NOTES, NOTES: NOTES: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother 11/20/2019 12:09 PM
cg1_relationship VALUE_RANGE, VALUE_RANGE: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother VALUE_RANGE: 11/20/2019 12:09 PM
medication1_dosage ELEMENT_SIZE, ELEMENT_SIZE: 50 ELEMENT_SIZE: 100 09/16/2019 12:00 PM
gender PERMANENTLY ALIASED gender sex 04/22/2019 00:00 AM
medication6_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 500 02/28/2019 18:42 PM
medication5_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 500 02/28/2019 18:42 PM
medication1_name ELEMENT_SIZE, ELEMENT_SIZE: 150 ELEMENT_SIZE: 500 02/28/2019 18:42 PM
medication1_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 150 09/13/2018 12:26 PM
gender DESCRIPTION DESCRIPTION: Sex of the subject DESCRIPTION: Sex of the subject 08/22/2018 10:43 AM
gender DESCRIPTION DESCRIPTION: Block Brief 2000: Sex of the subject DESCRIPTION: Sex of the subject 08/20/2018 10:21 AM
gender DESCRIPTION DESCRIPTION: Sex of the subject DESCRIPTION: Block Brief 2000: Sex of the subject 08/14/2018 16:18 PM
cg1_relationship VALUE_RANGE, VALUE_RANGE: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose VALUE_RANGE: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother 06/12/2018 14:22 PM
cg2_relationship VALUE_RANGE, VALUE_RANGE: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose VALUE_RANGE: Parent;Step-parent;Foster parent;Grandparent;Other family member;Other; Biological Mother; Biological Father; Biological Parent; Adoptive Parent; Adoptive/Foster Parent; I do not wish to disclose; Step-father; Step-mother 06/12/2018 14:22 PM
medication1_name NOTES, NOTES: 999= Legitimately skipped; NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication2_name NOTES, NOTES: 999= Legitimately skipped; NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication3_name NOTES, NOTES: 999= Legitimately skipped; NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication4_name NOTES, NOTES: 999= Legitimately skipped; NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication5_name NOTES, NOTES: NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication6_name NOTES, NOTES: NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication7_name NOTES, NOTES: NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication8_name NOTES, NOTES: NOTES: 0 = No medication; 999= Legitimately skipped 02/27/2018 17:14 PM
medication1_dosage NOTES, NOTES: NOTES: 0 = No medication; 999 = Missing 02/27/2018 17:13 PM
dem_income_12 VALUE_RANGE, , NOTES, VALUE_RANGE: 1::14;777;888 NOTES: 1 = Less than $10,000 ; 2 = $10,000 through $19,999 ; 3 = $20,000 through $29,999 ; 4 = $30,000 through $39,999 ; 5 = $40,000 through $49,999 ; 6 = $50,000 through $59,999 ; 7 = $60,000 through $69,999 ; 8 = $70,000 through $79,999 ; 9 = $80,000 through $89,999 ; 10 = $90,000 through $99,999 ; 11 = $100,000 through $119,999 ; 12 = $120,000 through $129,999 ; 13 = $130,000 through $139,999 ; 14 = $140,000 and greater ; 777 = Don't know ; 888 = No response VALUE_RANGE: 0::18;777;888 NOTES: 0 = Doesn't know or would rather not say; 1 = Less than $10,000 ; 2 = $10,000 through $19,999 ; 3 = $20,000 through $29,999 ; 4 = $30,000 through $39,999 ; 5 = $40,000 through $49,999 ; 6 = $50,000 through $59,999 ; 7 = $60,000 through $69,999 ; 8 = $70,000 through $79,999 ; 9 = $80,000 through $89,999 ; 10 = $90,000 through $99,999 ; 11 = $100,000 through $119,999 ; 12 = $120,000 through $129,999 ; 13 = $130,000 through $139,999 ; 14 = $140,000 and greater ; 15=$50,000-$74,999; 16=$75,000-$99,999; 17=$100,000-$150,000; 18=over $150,000; 777 = Don't know ; 888 = No response 02/20/2018 15:02 PM
otherrace NOTES, NOTES: NOTES: The following questions are about you or the child's family. 01/17/2018 13:23 PM
thous NOTES, NOTES: NOTES: 0=Does not apply (e.g., in institution), 99=unknown 01/16/2018 10:08 AM
preg_comp_note ELEMENT_SIZE, ELEMENT_SIZE: 255 ELEMENT_SIZE: 300 01/02/2018 12:59 PM
medication2_name ELEMENT_SIZE, ELEMENT_SIZE: 100 ELEMENT_SIZE: 200 12/22/2017 11:58 AM
otherrace ELEMENT_SIZE, ELEMENT_SIZE: 50 ELEMENT_SIZE: 100 12/22/2017 11:57 AM
race DESCRIPTION DESCRIPTION: Race of participant DESCRIPTION: Race of study subject 12/21/2017 08:54 AM
race DESCRIPTION DESCRIPTION: Race of study subject DESCRIPTION: Race of participant 12/21/2017 08:52 AM
gender DELETED_TRANSLATION_RULE 1 = M 12/19/2017 14:44 PM
gender NEW_TRANSLATION_RULE 1 = M 12/19/2017 14:39 PM
interview_date DESCRIPTION DESCRIPTION: Date on which the interview/genetic test/sampling/imaging was completed. MM/DD/YYYY DESCRIPTION: Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY 08/28/2017 15:10 PM
birth VALUE_RANGE, NOTES VALUE_RANGE: 0::2 NOTES: 0=N/A; 1=no; 2=yes VALUE_RANGE: 0::3 NOTES: 0=N/A; 1=no; 2=yes; 3=NK 01/31/2017 13:58 PM
Data Structure Change History

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