Social Determinants of Health (SD) Section

Fall 2021

BOX_00 (SD1000)

Programmer Instructions: Placeholder for question types.

BOX_10 (SD1005)

BOX_20 (SD1010)

BOX_30 (SD1015)

Programmer Instructions: Determine the number of SDOH SAQs required for this household: Refer to the Global Spec item: AgeCalculation for all age calculations required for the flags. Set flags as described for each RU member that meets the required criteria.

SDOH (Spring 2021, rounds 1, 3, 5 and 7)

-If P26R1, P25R3, P24R5 or P23R7 (RndCycle=Spring) AND

-person is => 18 years of age or in age categories 4-9 AND

-person is a current RU member (included in person array) AND

-person is Key (CtrlPersKey=Yes) AND

-person is not deceased or institutionalized (PersRndStatus ≠Deceased or institutionalized) AND

-person is in the RU on the current round's interview date (EndRefDt = EndRefM, EndRefD, EndRefY)

then set Person.SDOHFlag=YES.

TBD: SDOH Follow-up (Fall 2021, rounds 2, 4, 6, 8?)

- If P26R2, P25R4, P24R6 or P23R8 (RndCycle=Fall) AND

-person is a current RU member (included in person array) AND

-person was prompted for an SDOH in Spring 2021 and that SDOH is outstanding [PL_Person.SDOHRecCtrlStatus= ‘3’ (REFUSED), ‘5’ (BLANK), ‘6’ (WRONG TYPE), '8' (NOT RECEIVED)], then set

Person.SDOHFlagFlwUp=YES.

NOTE: Still need to determine appropriate receipt status codes.

SD10 (SD1020)

BLAISE NAME: SDIntro

Question Text:

We have a special request for {PERSON 1, PERSON 2, PERSON 3, PERSON 4, PERSON N}.

We are asking {you/each of you/them} to participate in a short online survey called the “Social and Health Experiences Survey”.

It asks about factors in people’s lives that may affect their health. The survey is voluntary, but each person who completes it will receive $20 as a thank you. The survey should take less than 10 minutes to complete and all of {your/their} responses will be kept private.

We will send {you an/them an/each person their own} invitation to fill out the web survey, so I’d like to collect the best way to contact {you/each of you/them/each of them}. We will use this contact information specifically for communication about the Social and Health Experiences Survey.

PRESS 1 AND ENTER TO CONTINUE.

Responses: CONTINUE 1 LOOP_10 (SD1025)

Display Instructions: Roster 1 - Report

Roster definition:

This item displays RU-members-roster for display of RU-members. Display RU members’ first, middle, and last names (Person.FullName).

Roster filter:

Display RU-members who meet the following condition:

1. Person is eligible for the SDOH (Person.SDOHFlag=YES)

For ‘{PERSON 1, PERSON 2, PERSON 3, PERSON 4, PERSON N}’, use the roster definition and filter specifications above. Substitute “you” for the person’s full name if the respondent is included in this list. If exactly two names displayed, separate names with the word “and” and no comma. If more than two names listed, separate names using commas, except for between the last two names displayed. Between the last two names displayed, separate names using the word “and”.

Display “you” if the only eligible person for the SDOH is the respondent. Display “each of you” if at least two RU members are eligible for the SDOH and one of them is the respondent. Otherwise, display “them”.

Display “your” if any eligible person for the SDOH includes the respondent. Otherwise, display “their”.

Display “you an” if the only eligible person for the SDOH is the respondent. Display “them an” if only one eligible person for the SDOH and that person is not the respondent. Otherwise, display “each person their own”.

Display “you” if the only eligible person for the SDOH is the respondent. Display “each of you” if at least two RU members are eligible for the SDOH and one of them is the respondent. Display “them” if only one eligible person for the SDOH and that person is not the respondent. Otherwise, display “each of them”.

LOOP_10 (SD1025)

SD20_01 (SD1030)

BLAISE NAME: FNameSDOH

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

INTERVIEWER: CHECK NAME PROVIDED DURING REENUMERATION (BELOW). IF NAME IS NOT AN ALIAS, PRESS ENTER TO GO TO NEXT QUESTION.

{PERSON FIRST NAME} {PERSON LAST NAME}

IF ALIAS, ASK: What name should we use for {you/{PERSON}} to send communication about this survey and to send the $20 thank you payment? We will only use this name for communication specifically about the Social and Health Experiences Survey.

Responses: 1 SD20_02 (SD1035)

EMPTY Empty SD20_02 (SD1035)

Programmer Instructions: Refused and Don’t Know disallowed.

Display Instructions: Display SD20_01 through SD30 vertically on the same form pane.

For “PERSON FIRST NAME”, display person’s first name (Person.FName). For “PERSON LAST NAME”, display person’s last name (Person.LName). Display “PERSON LAST NAME” as grayed out when on SD20_01.

As part of the field name in the form pane, display the person’s first name. This display is uneditable. The entry field should be empty to allow the FI to type a revised name or to leave empty if FName is correct.

SD20_02 (SD1035)

BLAISE NAME: LNameSDOH

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

INTERVIEWER: CHECK NAME PROVIDED DURING REENUMERATION (BELOW). IF NAME IS NOT AN ALIAS, PRESS ENTER TO GO TO NEXT QUESTION.

{PERSON FIRST NAME} {PERSON LAST NAME}

IF ALIAS, ASK: What name should we use for {you/{PERSON}} to send communication about this survey and to send the $20 thank you payment? We will only use this name for communication specifically about the Social and Health Experiences Survey.

Responses: 1 BOX_40 (SD1040)

EMPTY Empty BOX_40 (SD1040)

Programmer Instructions: Refused and Don’t Know disallowed.

If either SD20_01 or SD20_02 were left empty, set Person.SDOHAliasFlag=Yes. Otherwise, leave flag empty.

If SD20_01<>empty, write the response at SD20_01 to Person.SDOHFName. If SD20_01=empty, write Person.FName to Person.SDOHFName.

If SD20_02<>empty, write the response at SD20_02 to Person.SDOHLName. If SD20_02=empty, write Person.LName to Person.SDOHLName.

Display Instructions: Display SD20_01 through SD30 vertically on the same form pane.

For “PERSON FIRST NAME”, display person’s first name (Person.FName). For “PERSON LAST NAME”, display person’s last name (Person.LName).

When cursor is on SD20_02, display all text as grayed out except “IF NAME IS NOT AN ALIAS, PRESS ENTER TO GO TO NEXT QUESTION.” and “PERSON LAST NAME”.

As part of the field name in the form pane, display the person’s last name. This display is uneditable. The entry field should be empty to allow the FI to type a revised name or to leave empty if LName is correct.

BOX_40 (SD1040)

Programmer Instructions: If SD30 is skipped, write “English” to Person.SDOHLanguage.

SD30 (SD1045)

BLAISE NAME: CommLang

Context Header:

{PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

Would {you/{PERSON}} prefer to receive communication about this survey in English or in Spanish?

Responses: ENGLISH 1 BOX_50 (SD1050)

SPANISH 2 BOX_50 (SD1050)

REFUSED RF BOX_50 (SD1050)

DON'T KNOW DK BOX_50 (SD1050)

Programmer Instructions: Display SD20_01 through SD30 vertically on the same form pane.

If SD30 is coded ‘1’ (ENGLISH), ‘RF’ (REFUSED), or ‘DK’ (DON’T KNOW), write “English” to Person.SDOHLanguage. If SD30 is coded ‘2’ (SPANISH), write “Spanish” to Person.SDOHLanguage.

Display Instructions:

BOX_50 (SD1050)

SD40 (SD1055)

BLAISE NAME: EmailConf

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

We have {Preload.PL_Person.EmailAddr} as {your/{PERSON}’s} email address. Is this the best email for {you/him/her}?

IF NECESSARY, SAY: We will use this email to send invitations and reminders about this web survey.

Responses: YES 1

NO, EDIT EMAIL ADDRESS 2 SD50 (SD1060)

NO, DELETE EMAIL ADDRESS 3 SD50 (SD1060)

REFUSED RF SD60 (SD1065)

DON'T KNOW DK SD60 (SD1065)

Programmer Instructions: If coded ‘1’ (YES), write the preloaded email address for this person to Person.SDOHEmail and go to SD60.

Display Instructions: For “Preload.PL_Person.EmailAddr”, display the preloaded email address linked to the person being looped on.

SD50 (SD1060)

BLAISE NAME: EmailNew

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

What is {your/{PERSON}’s} email address?

IF NECESSARY, SAY: We will use this email to send invitations and reminders about this web survey.

CODE DON’T KNOW (F5) IF R VOLUNTEERS PERSON DOESN’T HAVE EMAIL.

Responses: 1

REFUSED RF

DON'T KNOW DK

Programmer Instructions: If SD50<> RF or DK, write the email address recorded at SD50 to Person.SDOHEmail. If SD50=RF or DK, leave Person.SDOHEmail empty.

If person being cycled on is the respondent, and SD50<> RF or DK, write the email address recorded at SD50 to Preload.PL_Person.EmailAddr for this PID. Closing can now use the updated or newly collected email address for the respondent. The email address for other RU members should not be updated.

Go to SD60.

Hard Checks:

1. Email address must contain an '@' symbol. If entry does not include this symbol, display the following message: "EMAIL ADDRESS MUST CONTAIN AN '@' SYMBOL. VERIFY AND RE-ENTER."

2. Email address must not contain spaces. If entry includes a space, display the following message: "EMAIL ADDRESS CANNOT CONTAIN BLANK SPACES. VERIFY AND REENTER."

Display Instructions:

SD60 (SD1065)

BLAISE NAME: TextCell

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

Is it okay to send text messages about the survey to {your/{PERSON}’s} cell phone?

IF NECESSARY, SAY: Text messages will be used to send invitations and reminders about this web survey.

Responses: YES 1 BOX_60 (SD1070)

NO 2 BOX_70 (SD1085)

VOLUNTEERED: DOES NOT HAVE CELL PHONE 3 BOX_70 (SD1085)

REFUSED RF BOX_70 (SD1085)

DON'T KNOW DK BOX_70 (SD1085)

Display Instructions:

BOX_60 (SD1070)

SD70 (SD1075)

BLAISE NAME: CellConf

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

I have {CL_Main.CL_AltPhoneTable.CL_AltPhoneGrid.AltPhoneNum} as {your/{PERSON}’s} cell phone number. Is that correct?

Responses: YES 1

NO 2 SD80 (SD1080)

REFUSED RF BOX_70 (SD1085)

DON'T KNOW DK BOX_70 (SD1085)

Programmer Instructions: If coded ‘1’ (YES), write cell number at preloaded alternate phone number for this PID to Person.SDOHCell and then go to BOX_70.

Display Instructions: For “CL_Main.CL_AltPhoneTable.CL_AltPhoneGrid.AltPhoneNum” display the preloaded cell phone number that is linked to the person being looped on.

SD80 (SD1080)

BLAISE NAME: CellNum

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

May I have {your/{PERSON}’s} cell phone number?

Responses: 1

REFUSED RF

DON'T KNOW DK

Programmer Instructions: 10-digit entry required; use number input mask (xxx-xxx-xxxx) in response field.

If SD80<> RF or DK, write the cell number recorded at SD80 to Person.SDOHCell. If SD80=RF or DK, leave Person.SDOHCell empty.

If person being cycled on is the respondent, and SD80<> RF or DK, write the cell number recorded at SD80 to CL_Main.CL_AltPhoneTable.CL_AltPhoneGrid.AltPhoneNum for this PID. Closing can now use the updated or newly collected cell number for the respondent. The cell numbers for other RU members should not be updated.

Hard check: Exactly 10 digit numeric entry required. If less than 10 numeric digits entered or any characters entered that are not numeric, display the following message: "PHONE ENTRY REQUIRES EXACTLY 10 NUMBERS. PROBE AND RE-ENTER OR ENTER F5 (DON'T KNOW) IF FULL PHONE NUMBER IS NOT KNOWN."

Go to BOX_70.

Display Instructions:

BOX_70 (SD1085)

SD90 (SD1090)

BLAISE NAME: InternetAcc

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

{Do you/Does {PERSON}} have the ability to access the Internet?

AS A LAST RESORT, ALL RESPONSES OTHER THAN ‘YES’ DEFAULT TO A PAPER QUESTIONNAIRE.

Responses: YES 1 BOX_80 (SD1095)

NO 2 BOX_80 (SD1095)

VOLUNTEERED: HAS INTERNET ACCESS BUT WILL NOT USE IT 3 BOX_80 (SD1095)

REFUSED RF BOX_80 (SD1095)

DON'T KNOW DK BOX_80 (SD1095)

Display Instructions:

BOX_80 (SD1095)

Programmer Instructions: Contact Mode 1=Both (Email & SMS)

Rule based on item number:

[(SD40=1 (YES)) or (SD50 <> RF, DK, or empty)]

and

[(SD70=1 (YES)) or (SD80 <> RF, DK, or empty)]

Rule based on constructed variable:

Person.SDOHEmail<>empty

and

Person.SDOHCell<>empty

Contact Mode 2=Email (Email only)

Rule based on item number:

[(SD40=1 (YES)) or (SD50 <> RF, DK, or empty)]

and

[(SD70 <>1 (YES)) and (SD80 = RF, DK, or empty)]

Rule based on constructed variable:

Person.SDOHEmail<>empty

and

Person.SDOHCell=empty

Contact Mode 3=SMS (Texting only)

Rule based on item number:

[(SD70=1 (YES)) or (SD80 <> RF, DK, or empty)]

and

[(SD40 <>1 (YES)) and (SD50 = RF, DK, or empty)]

Rule based on constructed variable:

Person.SDOHEmail=empty

and

Person.SDOHCell<>empty

Contact Mode 4= Push (Letter, Push to Web)

Rule based on item number:

SD90=1 (YES)

Contact Mode 5= Paper (Hardcopy only)

Rule based on item number:

Else

END_LP10 (SD1100)

BOX_90 (SD1105)

SD100_01 (SD1110)

BLAISE NAME: PrepHrdCopy

Question Text:

PREPARE {SPANISH} HARD COPY SDOH SAQ FOR {PERSON}: WRITE IN PERSON’S REGION, RUID, PID, NAME, DOB, AND SEX. {IF NO SPANISH SAQS IN YOUR SUPPLIES, MAKE ARRANGEMENTS TO FEDEX A COPY.}

REGION: {REGION} RU ID: {RU ID} PID: {PID}

NAME: {FIRST NAME} {MIDDLE NAME} {LAST NAME}

{SDOH NAME: {SDOHFNAME} {SDOHLNAME}}

DOB: {MM/DD/YYYY}

HAND PREPARED {SPANISH} SDOH SAQ TO RESPONDENT AND SAY:

Rather than {you/{PERSON}} doing the survey online, I will give you a paper copy of the Social and Health Experiences Survey for {you/him/her} to complete. Once {you are finished, please/he is finished, he should/she is finished, she should} place it back in the return envelope and seal it. {You/He/She} can give it to me before I leave today, or drop it in the mail once it’s completed. We will mail {you/him/her} $20 after the MEPS office receives the completed survey.

PRESS 1 AND ENTER TO CONTINUE.

Responses: CONTINUE 1

Programmer Instructions: After grid completion, continue with BOX_100.

Preloaded grid type 1: forced navigation including SD100_01, SD100_02, SD100_03, SD100_04, SD100_N.

Display Instructions: Roster 1-Report no add/edit/delete allowed.

Format the following columns on the form pane.

Col#1: RU Member Name

Instructions: This column is for display only and not editable. Display RU members’ First Middle and Last name (Person.FullName).

Roster Filter:

Display only those RU members who meet the following conditions:

Person is eligible for the SDOH (Person.SDOHFlag=Yes)

Person is eligible to receive a paper version of the SDOH (Person.SDOHContactMode=’5’ (PAPER))

Col#2: Distribute Form

Instructions: This field is open to code “Continue” once the hard copy SDOH SAQ front cover is filled out and distributed to the respondent/household member Display “SPANISH” and “IF NO SPANISH SAQS IN YOUR SUPPLIES, MAKE ARRANGEMENTS TO FEDEX A COPY.” if the person whose cell the cursor is in requires a Spanish language SDOH (Person.SDOHLanguage= ‘2’ (Spanish)).

Display “SDOH NAME: {SDOHFNAME} {SDOHLNAME}” if the person whose cell the cursor is in has an alias (Person.SDOHAliasFlag=Yes for this person). Otherwise, use a null display.

Display the following fill text in bold black: “REGION”, “RUID”, “PID”, {FIRST NAME} {MIDDLE NAME} {LAST NAME}, “SDOHFNAME”, “SDOHLNAME”, “MM/DD/YYYY”. All other text should adhere to the UI document specifications.

Display region for the current case being asked about for ‘REGION’. Display the RU ID for the current case for 'RUID'. Display PID of RU member being asked about for 'PID'. Display date of birth for RU member being asked about for 'MM/DD/YYYY.' Display the first, middle, and last name from person array for “Name”, and display Person.SDOHFName and Person.SDOHLName for “SDOH Name” if displayed based on the Person.SDOHAliasFlag.

BOX_100 (SD1115)

SD110 (SD1120)

BLAISE NAME: SurvInv

Question Text:

{Other than the paper questionnaire(s) I just gave you,} {{you/{PERSON}/each person}/{You/{PERSON}/Each person}} will get {your/a/their} survey invitation in the next few days.

{Would you please share this card with {{PERSON}/them} so they know to expect the survey? {If you’d like, I can give you

multiple copies.}}

RU Member SDOH Name ___Contact Mode (office use only)

{FULLNAME_1} {SDOHFName, SDOHLName 1} {SDOH CONTACT MODE}

{FULLNAME_2} {SDOHFName, SDOHLName 2} {SDOH CONTACT MODE}

{FULLNAME_3} {SDOHFName, SDOHLName 3} {SDOH CONTACT MODE}

{FULLNAME_4} {SDOHFName, SDOHLName 4} {SDOH CONTACT MODE}

{FULLNAME_N} {SDOHFName, SDOHLName N} {SDOH CONTACT MODE}

{DISTRIBUTE SDOH CARD(S) TO RESPONDENT. PERSONALIZE EACH CARD AS NEEDED. WORK WITH RESPONDENT TO DETERMINE HOW RESPONDENT WILL COMMUNICATE TASK TO OTHER HOUSEHOLD MEMBERS.}

PRESS 1 AND ENTER TO CONTINUE.

Responses: CONTINUE 1

Display Instructions: Roster 1 - Report

Roster definition:

This item displays RU-members-roster for display of RU-members. Display RU members’ first, middle, and last names (Person.FullName).

Roster filter:

Display RU-members who meet the following conditions:

1. Person is eligible for the SDOH (Person.SDOHFlag=YES)

2. Person is eligible to complete a web version of the SDOH (Person.SDOHContactMode< >’5’ (PAPER))

Display the following columns formatted in the info in nonproportional text:

Column Header #1: RU Member

Display the first name (Person.FullName) of each RU member meeting the roster filter definition.

Column Header #2: SDOH Name

Display Person.SDOHFName and Person.SDOHLName for each RU member where there was an alias (Person.SDOHAliasFlag=Yes). If Person.SDOHAliasFlag<>Yes, leave these fields null for this person.

Column Header #3: Contact Mode (office use only)

Display the SDOH contact mode (Person.SDOHContactMode) of each RU member. Display “Email/Text” if SDOHContactMode=1. Display “Email” if SDOHContactMode=2. Display “Text” if SDOHContactMode=3. Display “Letter, push to web” if SDOHContactMode=4.

Display “Other than the paper questionnaire(s) I just gave you,” if at least one person in the RU eligible for the SDOH has paper as the contact mode, continue with SD100 (Person.SDOHContactMode=5 for at least one PID). Otherwise, use a null display.

Display “{you/{PERSON}/each person}” if at least one person in the RU eligible for the SDOH has paper as the contact mode, continue with SD100 (Person.SDOHContactMode=5 for at least one PID). Otherwise, display “{You/{PERSON}/Each person}”.

Display “you” or “You” and “your” if the only eligible person for the SDOH with a contact mode other than paper is the respondent (use roster filter definition). Display “{PERSON}”or “{PERSON}” and “a” if only one person eligible for the SDOH with a contact mode other than paper and that person is not the respondent. Otherwise, display “each person” or “Each person” and “their”.

Display “Would you please share this card with {{PERSON}/them} so they know to expect the survey? {If you’d like, I can give you multiple copies.}” and “DISTRIBUTE SDOH CARD(S) TO RESPONDENT.

PERSONALIZE EACH CARD AS NEEDED. WORK WITH RESPONDENT TO DETERMINE HOW RESPONDENT WILL COMMUNICATE TASK TO OTHER HOUSEHOLD MEMBERS.” if at least one eligible person for the SDOH with a contact mode other than paper is not the respondent (use roster filter definition). Otherwise, use a null display.

Display “If you’d like, I can give you multiple copies.” if at least two eligible persons for the SDOH with a contact mode other than paper is not the respondent (use roster filter definition). Otherwise, use a null display.

Display “{PERSON}” if only one person eligible for the SDOH with a contact mode other than paper and that person is not the respondent. Otherwise, display “them.”

BOX_110 (SD1125)

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