MEPS Quality (Priority Conditions) Supplement (PC) Section

THE PC SECTION IS ASKED IN ROUNDS 1, 3 AND 5 ONLY.
IF IT IS ROUND 2 OR 4, CONTINUE TO THE NEXT
SECTION.

CONTEXT HEADER DISPLAY INSTRUCTIONS:
DISPLAY PERS.FULLNAME

NOTE: CURRENTLY THE QUALITY SUPPLEMENT CONTAINS
QUESTIONS FOR PERSONS FOR WHOM DIABETES OR ASTHMA
WAS REPORTED IN THE PRIORITY CONDITION
ENUMERATION (PE) SECTION DURING ROUNDS 3 AND 5.
THE DISTRIBUTION OF THE CANCER SAQ OCCURS DURING
ROUNDS 1 AND 3. OTHER QUALITY QUESTIONS ARE
LOCATED IN THE PREVENTIVE CARE (AP) SECTION.
HOWEVER, THE QUALITY SECTION COULD INCLUDE
QUESTIONS FOR THE OTHER PRIORITY CONDITIONS AS
THEY ARE NEEDED IN FUTURE PANELS.

IF ROUNDS 3 OR 5 AND PERSON IS => 18 YEARS OF AGE
OR IN AGE CATEGORIES 4-9 AND IF PERSON IS A KEY
RU MEMBER AND IF ‘DIABETES’ ON PERSON’S-MEDICAL-
CONDITIONS-ROSTER AND FLAGGED AS CREATED IN THE
PE SECTION (IN ANY ROUND), CONTINUE WITH BOX_03

OTHERWISE, GO TO BOX_04

IF PERSON BEING ASKED ABOUT IS FLAGGED AS
‘DECEASED’ FOR THE CURRENT ROUND, GO TO BOX_04

OTHERWISE, CONTINUE WITH PC02A

{PERSON'S FIRST MIDDLE AND LAST NAME}

{During an earlier interview, it/It} was mentioned that {you/{PERSON}}
{have/has} diabetes. To obtain more information on the care of adults
with diabetes, we have a short questionnaire for {you/him/her}.

SELECT ‘CONTINUE’ UNLESS RESPONDENT VOLUNTEERS DIABETES REPORTED
IN ERROR.

CONTINUE ............................... 1 {PC03}
{PERSON} DOES NOT HAVE DIABETES ........ 2 {BOX_04}

[Code One]

DISPLAY ‘During an earlier interview, it’ IF
DIABETES WAS NOT CREATED DURING THE CURRENT ROUND.
DISPLAY ‘It’ IF DIABETES CREATED DURING THE
CURRENT ROUND.

DISPLAY ‘NOT’ IN BOLD IN THE ANSWER TEXT.

IF ‘PERSON DOES NOT HAVE DIABETES’ IS SELECTED,
THIS DOES NOT RE-SET THE DATA FROM THE PE SECTION
(PRND.PCDIABET). THE RESPONSE TO PC02A WILL
DETERMINE WHETHER PC03 IS ASKED AND WHETHER THERE
IS DCS FOLLOW-UP FOR THIS PERSON IN THE CL
SECTION

{PERSON'S FIRST MIDDLE AND LAST NAME}

DOB: {MM/DD/YYYY} PID: {PID} RU ID: {RUID-7}
STATUS: {CURRENT/INSTITUTIONALIZED}

DETERMINE IF SELF OR PROXY DIABETES CARE SUPPLEMENT (DCS)
SHOULD BE DISTRIBUTED:

SELF DCS: FOR ANY CURRENT RU MEMBER (18 YEARS OR OLDER) WHO HAS
DIABETES.

PROXY DCS: FOR ANY CURRENT RU MEMBER (18 OR OLDER) WHO IS
INSTITUTIONALIZED OR OTHERWISE INCAPACITATED.

CODE TYPE OF DCS DISTRIBUTED FOR {PERSON}.

SELF ................................... 1 {PC03A}
PROXY .................................. 2 {PC03OV1}

[Code One]

DISPLAY PID OF PERSON BEING ASKED ABOUT FOR ‘PID’.

DISPLAY DATE OF BIRTH FOR PERSON BEING ASKED
ABOUT FOR ‘MM/DD/YYYY’.

DISPLAY THE RU ID FOR THE CURRENT CASE FOR
‘RUID-7’.

DISPLAY ‘CURRENT’ IF PERSON BEING ASKED ABOUT IS
A CURRENT RU MEMBER AND IS NOT DECEASED OR
INSTITUTIONALIZED. DISPLAY ‘INSTITUTIONALIZED’ IF
PERSON BEING ASKED ABOUT IS FLAGGED AS
‘INSTITUTIONALIZED’ FOR THE CURRENT ROUND.

FLAG ALL PERSONS WHO ARE ASKED PC03 FOR DCS
FOLLOW-UP IN THE CLOSING (CL) SECTION.

{PERSON'S FIRST MIDDLE AND LAST NAME}

DOB: {MM/DD/YYYY} PID: {PID} RU ID: {RUID-7}
STATUS: {CURRENT/INSTITUTIONALIZED}

CODE REASON FOR PROXY DCS.

INSTITUTIONALIZED ...................... 2 {PC03A}
OTHER .................................. 3 {PC03OV2}

[Code One]

THIS ITEM IS A SEPARATE SCREEN RATHER THAN AN
OVERLAY AS IMPLIED BY THE ITEM NAME.

SPECIFY OTHER REASON FOR PROXY DCS.

[Enter Other Specify] .................. {PC03A}

{PERSON'S FIRST MIDDLE AND LAST NAME}

DOB: {MM/DD/YYYY} PID: {PID} RU ID: {RUID-7}

PREPARE {SELF/PROXY} DIABETES CARE SUPPLEMENT (DCS): WRITE IN
PERSON NAME, PID, DATE OF BIRTH, AND RUID.

HAND PREPARED {SELF/PROXY} DCS TO RESPONDENT AND SAY:

We hope that {you/{PERSON}}/you or someone else in the family} would
be able to fill out this short questionnaire on the care {you/{PERSON}}
{get/gets} for diabetes. {You/He/She} can give it to me before I leave
today, or I can pick it up later.

PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.

DISPLAY ‘SELF’ AND ‘{you/{PERSON}}’ IF PC03 IS
CODED '1' (SELF). DISPLAY ‘PROXY’ AND ‘you or
someone else in the family’ IF PC03 IS CODED '2'
(PROXY)

DISPLAY PID OF PERSON BEING ASKED ABOUT FOR ‘PID’.

DISPLAY DATE OF BIRTH FOR PERSON BEING ASKED
ABOUT FOR ‘MM/DD/YYYY’.

DISPLAY THE RU ID FOR THE CURRENT CASE FOR
‘RUID-7’.

IF PANEL 22 ROUND 1 OR PANEL 21 ROUND 3, CONTINUE
WITH BOX_05

OTHERWISE, GO TO BOX_07

NOTE: THE DISTRIBUTION AND COLLECTION OF THE
CANCER SAQ OCCURS ONLY DURING PANEL 16 ROUND 3,
PANEL 15 ROUND 5, PANEL 21 ROUND 1, PANEL 20
ROUND 3, PANEL 22 ROUND 1, AND PANEL 21 ROUND 3
(BUT ONLY FOR NEWLY IDENTIFIED CANCER).

IF PERSON IS => 18 YEARS OF AGE OR IN AGE
CATEGORIES 4-9 AND IF PERSON IS A KEY RU MEMBER
AND ‘CANCER – {ANY TYPE}’ (CODED AT PE22 OR
PE22OV) ON PERSON’S-MEDICAL-CONDITIONS-ROSTER AND
FLAGGED AS CREATED IN THE PE SECTION (IN ROUND 1
IF PANEL 22 OR IN ROUNDS 2 OR 3 IF PANEL 21),
CONTINUE WITH BOX_06

OTHERWISE, GO TO BOX_07

IF PERSON BEING ASKED ABOUT IS FLAGGED AS
‘DECEASED’ OR ‘INSTITUTIONALIZED’ FOR THE CURRENT
ROUND, GO TO BOX_07

OTHERWISE, CONTINUE WITH PC04

{PERSON'S FIRST MIDDLE AND LAST NAME}

{During an earlier interview, it/It} was mentioned that {you/
{PERSON}} {(have/has)/had} cancer. To obtain more information
about experiences with cancer, we have a short questionnaire for
{you/{PERSON}}.

SELECT ‘CONTINUE’ UNLESS RESPONDENT VOLUNTEERS CANCER REPORTED IN
ERROR.

CONTINUE ............................... 1 {PC04A}
{PERSON} {DOES/DID} NOT HAVE CANCER .... 2 {BOX_07}

[Code One]

DISPLAY ‘During an earlier interview, it’ IF
CANCER WAS NOT CREATED DURING THE CURRENT ROUND.
DISPLAY ‘It’ IF CANCER WAS CREATED DURING THE
CURRENT ROUND.

DISPLAY ‘(have/has)’ AND ‘DOES’ IF PE25 IS CODED
‘2’ (NO) FOR THIS PERSON FOR AT LEAST ONE CANCER
TYPE. OTHERWISE, DISPLAY ‘had’ AND ‘DID’.

DISPLAY ‘PERSON’ IN PURPLE IN THE ANSWER TEXT.

DISPLAY ‘NOT’ IN BOLD IN THE ANSWER TEXT.

IF ‘PERSON DOES NOT HAVE CANCER’ IS SELECTED,
THIS DOES NOT RE-SET THE DATA FROM THE PE SECTION
(PRND.CANCERML). THE RESPONSE TO PC04 WILL
DETERMINE WHETHER PC04A IS ASKED AND WHETHER
THERE IS CANCER SAQ FOLLOW-UP FOR THIS PERSON IN
THE CL SECTION.

{PERSON'S FIRST MIDDLE AND LAST NAME}

DOB: {MM/DD/YYYY} PID: {PID} RU ID: {RUID-7}

PREPARE ‘YOUR EXPERIENCES WITH CANCER’ (CANCER SAQ):
WRITE IN PERSON NAME, DATE OF BIRTH, PID, AND RUID.

HAND PREPARED CANCER SAQ TO RESPONDENT AND SAY:

We hope that {you/{PERSON}} would be able to fill out this short
questionnaire on {your/{PERSON}}’s experiences with cancer.
{You/He/She} can give it to me before I leave today, or I can
pick it up later.

PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.

DISPLAY DATE OF BIRTH FOR PERSON BEING ASKED
ABOUT FOR ‘MM/DD/YYYY’.

DISPLAY PID OF PERSON BEING ASKED ABOUT FOR ‘PID’.

DISPLAY THE RU ID FOR THE CURRENT CASE FOR
‘RUID-7’.

FLAG ALL PERSONS WHO ARE ASKED PC04A FOR CANCER
SAQ FOLLOW-UP IN THE CLOSING (CL) SECTION.

CONTINUE WITH BOX_07

IF ROUNDS 3 OR 5 AND ‘ASTHMA’ ON PERSON’S-MEDICAL-
CONDITIONS-ROSTER, AND FLAGGED AS CREATED IN THE
PE SECTION (IN ANY ROUND), CONTINUE WITH PC04B

OTHERWISE, GO TO BOX_08

PERSON'S FIRST MIDDLE AND LAST NAME}

{During an earlier interview, it was mentioned that {you/{PERSON}}
{have/has} asthma.}

Now I would like to ask you a few questions about {your/{PERSON}’s}
asthma and the course of treatment {you/he/she} received.

SELECT ‘CONTINUE’ UNLESS RESPONDENT VOLUNTEERS ASTHMA REPORTED IN
ERROR.

CONTINUE ............................... 1 {PC05A}
{PERSON} DOES NOT HAVE ASTHMA .......... 2 {BOX_08}

[Code One]

DISPLAY ‘During an earlier interview....’ IF
ASTHMA WAS NOT CREATED DURING THE CURRENT ROUND.
IF ASTHMA WAS CREATED DURING THE CURRENT ROUND,
USE A NULL DISPLAY.

DISPLAY ‘NOT’ IN BOLD IN THE ANSWER TEXT.

IF ‘PERSON DOES NOT HAVE ASTHMA’ IS SELECTED,
THIS DOES NOT RE-SET THE DATA AS RECORDED IN THE
PE SECTION (PRND.PCASTHMA). THE RESPONSE TO PC04B
WILL DETERMINE WHETHER SUBSEQUENT DETAILED ASTHMA
QUESTIONS ARE ASKED IN THIS PC SECTION.

{PERSON’S FIRST MIDDLE AND LAST NAME}

I am going to ask you about two different kinds of asthma medicine.
One is for quick relief. The other does not give quick relief but
protects your lungs and prevents symptoms over the long term.

During the past 3 months, {have/has} {you/{PERSON}} used the kind of
prescription inhaler that you breathe in through your mouth that
gives quick relief from asthma symptoms?

YES .................................... 1 {PC05B}
NO ..................................... 2 {PC06A}
REF ................................... -7 {PC06A}
DK .................................... -8 {PC06A}

{PERSON’S FIRST MIDDLE AND LAST NAME}

During the past 3 months, did {you/{PERSON}} use more than three
canisters of this type of inhaler?

YES .................................... 1 {PC06A}
NO ..................................... 2 {PC06A}
REF ................................... -7 {PC06A}
DK .................................... -8 {PC06A}

{PERSON’S FIRST MIDDLE AND LAST NAME}

{Have/Has} {you/{PERSON}} ever taken the preventive kind of asthma
medicine used every day to protect your lungs and keep you from
having attacks? Include both oral medicine and inhalers. This is
different from inhalers used for quick relief.

YES .................................... 1 {PC06B}
NO ..................................... 2 {PC08}
REF ................................... -7 {PC08}
DK .................................... -8 {PC08}

{PERSON’S FIRST MIDDLE AND LAST NAME}

{Are/Is} {you/{PERSON}} now taking this medication (that protects
the lungs) daily or almost daily?

YES .................................... 1 {PC08}
NO ..................................... 2 {PC08}
REF ................................... -7 {PC08}
DK .................................... -8 {PC08}

{PERSON’S FIRST MIDDLE AND LAST NAME}

A peak flow meter measures how hard you can blow air out of your
lungs. {Do/Does} {you/{PERSON}} currently have a peak flow meter
at home?

YES .................................... 1 {PC08A}
NO ..................................... 2 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

{PERSON’S FIRST MIDDLE AND LAST NAME}

Did {you/{PERSON}} ever use the peak flow meter?

YES .................................... 1 {PC08B}
NO ..................................... 2 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

{PERSON’S FIRST MIDDLE AND LAST NAME}

SHOW CARD PC-1.

When did {you/{PERSON}} last use the peak flow meter? Was it within
the last seven days, more than seven days ago but within the last
thirty days, or more than thirty days ago?

WITHIN LAST 7 DAYS ..................... 1 {BOX_08}
MORE THAN 7, BUT WITHIN LAST 30 DAYS ... 2 {BOX_08}
MORE THAN 30 DAYS AGO .................. 3 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

[Code One]