Fall 2021
BOX_00 (EE1000)
Route Details: 01 Box = BOX_00, BOX_10, BOX_20, BOX_30, BOX_40, BOX_50
02 Loop = LOOP_10, LOOP_20
03 End Loop = END_LP10, END_LP20
04 Single Select = EE30, EE40
05 Single Selectwith Display Roster = EE50_01
10 Multiple Select with Fill in Answer Text = EE10
24 Information Screen = EE20
Grid 1 = EE50_01
Roster 2 = EE10
BOX_10 (EE1005)
Route Details: If ‘OTHER RU MEMBER’ selected for the provider probe that launched this instance of the EE section, continue with EE10.
Otherwise, go LOOP_10.
EE10 (EE1010)
BLAISE NAME: RosterProbe
Question Text:
Who else {PROVIDER PROBE QUESTION TEXT}?
ENTER ALL THAT APPLY.
Responses: {FIRST NAME [MIDDLE NAME] LAST NAME} 1 1 LOOP_10 (EE1015)
{FIRST NAME [MIDDLE NAME] LAST NAME}2 2 LOOP_10 (EE1015)
{FIRST NAME [MIDDLE NAME] LAST NAME}3 3 LOOP_10 (EE1015)
{FIRST NAME [MIDDLE NAME] LAST NAME}4 4 LOOP_10 (EE1015)
{FIRST NAME [MIDDLE NAME] LAST NAME}N 5 LOOP_10 (EE1015)
Programmer Instructions: Create event record for this person.
Roster Behavior:
1. Multiple select allowed.
2. RF/DK disallowed.
Display Instructions: Roster 2- no add/edit/delete Roster Definition:
Display RU-Members-Roster in the form pane.
Col #1 Header: RU Members
Display RU members First, Middle and Last Names
Roster Filter:
Display only RU members who are part of the Family Subunit.
Display the following text under specified conditions for {PROVIDER PROBE QUESTION TEXT}:
If coming from PP170 display "had a stay at the hospital"
If coming from PP180 display "had a visit to the hospital emergency room"
If coming from PP190 display "had a visit with the outpatient department"
If coming from PP200 display "received care from a primary care doctor"
If coming from PP210 display "had a visit with a specialist"
If coming from PP213 display “had a visit with a dental care provider"
If coming from PP215 display "had a visit with a mental health professional"
If coming from PP220 display "had a visit with any other type of medical professional"
If coming from PP230 display "received care from a health clinic"
If coming from PP240 display "had a visit to a medical lab or testing facility"
If coming from PP260 display "had a visit with a therapist"
If coming from PP280 display "had a visit with a vision or eye care provider"
If coming from PP290 display "had a visit with someone who practices alternative care"
If coming from PP300 display "received care from a home health care provider"
If coming from PP310 display "had a visit to any type of residential rehabilitation facility or treatment facility"
LOOP_10 (EE1015)
Route Details: For each element in the RU-Members-Roster, Ask LOOP_20-END_LP10.
Loop definition: LOOP_10 cycles on persons who were selected as having an event for the provider probe that launched this instance of the EE section. This loop cycles on RU members who meet the following conditions:
If EE section launched from first cycle through provider probes (PP10-PP160_01-PP160_N) then
-Person marked as ‘1’ (YES) for the probe that launched this instance of the EE section.
OR
-Person selected at PP160_01-PP160_N grid as ‘1’ (YES).
If EE section launched from second cycle through Provider Probes (PP170-PP320_01-320_N, PP325_01-PP325_N), then
-Person selected at the probe that launched this instance of the EE section
OR
-Person selected at EE10.
NOTE: If the respondent is eligible for this loop, CAPI should cycle on the respondent first, followed by eligible RU members in PID order.
LOOP_20 (EE1020)
Route Details: For each of the following:
EVENT 1
EVENT 2
EVENT 3
EVENT 4
EVENT N
Ask BOX_20-END_LP20.
Loop definition: LOOP_20 enumerates each event of this Provider Probes type for this person. The response to EE30 determines if the loop cycles again. If EE30 is coded ‘1’ (YES), the loop cycles to collect the next event. When EE30 is coded ‘2’ (NO), ‘RF’ (REFUSED), ‘DK’ (DON’T KNOW), the loop ends.
BOX_20 (EE1025)
Route Details: If this is the first cycle of LOOP_20 for this person, go to EE20, otherwise go to BOX_30.
EE20 (EE1030)
BLAISE NAME: EvntIntro
Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
{I’m going to first ask a few more questions about/Now, let’s talk about} {your/{PERSON}’s} {PROVIDER PROBE QUESTION TEXT}.
PRESS 1 AND ENTER TO CONTINUE.
Responses: CONTINUE 1 BOX_30 (EE1035)
Programmer Instructions: Create event record for this person.
Display Instructions: Display "I’m going to first ask a few more questions about" if first cycle through LOOP_10 (first person to be asked about for this probe.) Otherwise, display "Now, let’s talk about"
Display the following text under specified conditions for {PROVIDER PROBE QUESTION TEXT}:
If coming from PP10 or PP170 display "stay at the hospital"
If coming from PP20 or PP180 display "visit to the hospital emergency room"
If coming from PP30 or PP190 display "visit with the outpatient department"
If coming from PP40 or PP200 display "care from a primary care doctor"
If coming from PP50 or PP210 display "visit with a specialist"
If coming from PP53 or PP213 display "visit with a dental care provider"
If coming from PP55 or PP215 display "visit with a mental health professional"
If coming from PP60 or PP220 display "visit with any other type of medical professional"
If coming from PP70 or PP230 display "care received from a health clinic"
If coming from PP80 or PP240 display "visit to a medical lab or testing facility"
If coming from PP100 or PP260 display "visit with a therapist"
If coming from PP120 or PP280 display "visit with a vision or eye care provider"
If coming from PP130 or PP290 display "visit with someone who practices alternative care"
If coming from PP140 or PP300 display "care received from a home health care provider"
If coming from PP150 or PP310 display "visit to any type of residential rehabilitation facility or treatment facility"
If coming from PP160_01-PP160_N or PP320_01-PP320_N, display "other health care received"
BOX_30 (EE1035)
Route Details: Ask the Event Roster (EV) section for record collection.
At completion of the EV section, continue with EE30.
EE30 (EE1040)
BLAISE NAME: AnyOthCare
Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
Other than what we just talked about, {have/has}{you/{PERSON} {PROVIDER PROBE QUESTION TEXT} {between {START DATE} and {END DATE}/since {START DATE}?
Responses: YES 1 END_LP20 (EE1060)
NO 2
REFUSED RF
DON'T KNOW DK
Programmer Instructions: If coming from PP120 or PP280 and EE30 is coded ‘2’ (NO), ‘RF’ (REFUSED), ‘DK’ (DON’T KNOW), go to EE40.
Otherwise, if coming from all other probes, and EE30 is coded ‘2’ (NO), ‘RF’ (REFUSED) or ‘DK’ (DON’T KNOW), the provider probe for the current person is no longer on path. Go to END_LP20.
If EE30 is coded ‘1’ (YES), create event q from the probe that launched this instance of EE and go to END_LP20.
Display Instructions: Display "since {START DATE} if current round is not the final round of the panel (RndType<>Final), otherwise display "between {START DATE} and {END DATE}"
Display the following text for {PROVIDER PROBE QUESTION TEXT}:
If coming from PP10 or PP170 display "been admitted to the hospital at any other time, looking at card PP-1"
If coming from PP20 or PP180 display "received any other care in a hospital emergency room, looking at card PP-2"
If coming from PP30 or PP190 display "had any other care from a hospital outpatient department, looking at card PP-3"
If coming from PP40 or PP200 display "received care from any other medical doctor such as a primary care provider, general practitioner, family medicine provider, pediatrician or internist, as shown on card PP-4"
If coming from PP50 or PP210 display "had any other care from any kind of health care specialist shown on card PP-5"
If coming from PP53 or PP213 display “"had any other care from a dentist, oral surgeon, orthodontist, or any type of dental care provider shown on card PP-6"
If coming from PP55 or PP215 display "had any other care from a psychiatrist, psychologist, a licensed clinical social worker, a mental health therapist or counselor or any type of mental health professional shown on card PP-7"
If coming from PP60 or PP220 display "had any other care from any kind of medical professional shown on card PP-8"
If coming from PP70 or PP230 display "received care from any other kind of health clinic, family planning center, walk-in urgent care or retail clinic shown on card PP-9"
If coming from PP80 or PP240 display "had any other visits to a medical lab or testing facility shown on card PP-10"
If coming from PP100 or PP260 display "had any other visits with a physical therapist, occupational therapist, speech therapist, chiropractor or any other type of health care therapist shown on card PP-11"
If coming from PP120 or PP280 and display "had any other care from a vision or eye care provider shown on card PP-12"
If coming from PP130 or PP290 display "had any other care from someone who practices alternative care shown on card PP-13"
If coming from PP140-PP300 display "had any other type of home care services as shown on card PP-14"
If coming from PP150 or PP310 display "received any other care at a residential rehabilitation facility or treatment facility as shown on card PP-15"
If coming from PP160_01-PP160_N or PP320_01-PP320_N display "received any other kind of care, as shown on the records job aid"
EE40 (EE1045)
BLAISE NAME: GlassesPers
Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
Did {you/{PERSON}} purchase eye glasses or contact lenses as part of {that visit/any of those visits}, or at any other time between {START DATE} and {END DATE}?
Responses: YES 1 END_LP20 (EE1060)
NO 2 END_LP20 (EE1060)
REFUSED RF END_LP20 (EE1060)
DON'T KNOW DK END_LP20 (EE1060)
Programmer Instructions: Note to programmer: a person level variable needs to be stored with the value at EE40. If EE40 has a value, OM10 will use the information to determine the correct fill to display to verify the purchase of glasses or contact lenses during the reference period.
Display Instructions: Display “that visit” if cycled through LOOP_20 only once for this person (only one event was added for this PERSON so far). Otherwise, display “any of those visits.”
END_LP20 (EE1060)
Route Details: If EE30 is coded ‘1’ (YES), cycle to collect next event for person at LOOP_20.
If EE30 is coded ‘2’ (NO), ‘RF’ (REFUSED), ‘DK’ (DON’T KNOW), end LOOP_20 and continue with END_LP10.
END_LP10 (EE1065)
Route Details: Cycle on next person in RU-Members-Roster who meets the conditions stated in the loop definition.
If no more persons meet the stated conditions, end LOOP_10 and continue with BOX_40.
BOX_40 (EE1066)
Route Details: Check to make sure that the RU members in the subunit they are in that coded ‘1’ (YES) to PP120 or PP280 have been cycled on. If all members who coded ‘1’ (YES) have cycled to collect event (glasses or contact lenses) information, check to see if there are remaining members of the specific subfamily currently looping that coded ‘2’ (NO) to PP120 or persons not selected at PP280. If so, go to EE50_01; otherwise, go to BOX_50.
EE50_01 (EE1067)
BLAISE NAME: Glasses1
Question Text:
Did {DISPLAY NAME} purchase eye glasses or contact lenses between {START DATE} and {END DATE}?
Responses: YES 1
NO 2
REFUSED RF
DON'T KNOW DK
Programmer Instructions: Preloaded grid type 1: forced navigation including EE50_01, EE, 50_02, EE50_03, EE50_04…, EE50_N.
Note to programmer: a person level variable needs to be stored with the response for each person at EE50. If EE50 has a value, OM10 will use the information to determine the correct fill to display to verify the purchase of glasses or contact lenses during the reference period for each person.
Go to BOX_50.
Display Instructions: Roster 1-Report
Col #1: RU Members’ Names
Instructions: Display First, Middle, Last name of RU member
Roster Filter:
Display names of all persons within the subunit who did not report any vision care (PP120 coded ‘2’ (NO) or person not selected at PP280).
Variable question text display for each person in the roster, display the following:
EE50_02: 2nd person on the roster: How about {DISPLAY NAME 2}?
EE50_03: 3rd person on the roster: How about {DISPLAY NAME 3}?
EE50_04: 4th person on the roster: Did {DISPLAY NAME 4} purchase glasses or contact lenses between {START DATE} and {END DATE}?
EE50_N: N person on the roster: repeat question text in order from EE50_01-EE50_04.
Display question stem ‘Did {DISPLAY NAME} purchase eye glasses…” in brackets and grayed-out text when displaying the variable question text display for the 2nd person to the Nth person.
BOX_50 (EE1070)
Route Details: Return to next probe in the Provider Probes (PP) section.