Q-BANK Fields and Categories

06/22/06

Color Codes: New field in development

Existing field needing revision

Completed field

+--------+-------+--------------+-------------+-----------+-----------+
| **St   | **Fie | **           | **C         | **Field   | **        |
| atus** | lds** | Definition** | ategories** | Type &    | Example** |
|        |       |              |             | *Default  |           |
|        |       |              |             | Value***  |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | S     | The survey   | NHIS        | Pull down | NHIS      |
| pleted | urvey | for which    |             | menu with |           |
|        | Title | the question | NHANES      | "other"   |           |
|        |       | was tested;  |             | category  |           |
|        |       | this will be | SLAITS      | that can  |           |
|        |       | specific to  |             | specify   |           |
|        |       | the survey   | NSFG        | verbatim  |           |
|        |       | and not      |             | a survey  |           |
|        |       | reflect the  | NIS         | not on    |           |
|        |       | program      |             | the list  |           |
|        |       | producing    | Not         |           |           |
|        |       | the survey   | Applicable  | *         |           |
|        |       |              |             | Default - |           |
|        |       |              |             | none*     |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | S     | Year that    | Year        | \_ \_ \_  | 2002      |
| pleted | urvey | the question |             | \_        |           |
|        | Year  | is fielded   |             |           |           |
|        |       | in the       |             | *Defa     |           |
|        |       | survey       |             | ult-none* |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Evalu | Type of      | 1.          | Pull down | Cognitive |
| pleted | ation | documented   |   Cognitive | menu/mark | interview |
|        | Type  | evaluation   |             | all that  |           |
|        |       | conducted on |   interview | apply     |           |
|        |       | question     |             |           |           |
|        |       |              | 2.  Focus   | *         |           |
|        |       |              |     group   | Default - |           |
|        |       |              |             | none*     |           |
|        |       |              | 3.  Split   |           |           |
|        |       |              |     Sample  |           |           |
|        |       |              |     *test*  |           |           |
|        |       |              |             |           |           |
|        |       |              | 4.          |           |           |
|        |       |              |  Respondent |           |           |
|        |       |              |             |           |           |
|        |       |              |  Debriefing |           |           |
|        |       |              |             |           |           |
|        |       |              | 5           |           |           |
|        |       |              | .  Behavior |           |           |
|        |       |              |     Coding  |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.  Expert  |           |           |
|        |       |              |     review  |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.  Other   |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Co     | Surv  | Month and    | Year/Month  | \_ \_ /   | 2         |
|        | Test  | year that    |             | \_ \_     | 002/March |
| Com    | Date  | testing      |             |           |           |
| pleted |       | interviews   |             | *         |           |
|        |       | (the initial |             | Default - |           |
|        |       | project)     |             | none*     |           |
|        |       | began.       |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Sp    | The          | CDC         | Optional  | CDC       |
| pleted | onsor | ag           |             |           |           |
|        |       | ency/program | NIH         | Mark all  |           |
|        |       | requesting   |             | that      |           |
|        |       | or           | EPA         | apply     |           |
|        |       | sponsoring   |             |           |           |
|        |       | the question | FDA         | Pull down |           |
|        |       | testing.     |             | menu with |           |
|        |       |              | Census -    | "other"   |           |
|        |       | Include      | DMD         | category  |           |
|        |       | department   |             | that can  |           |
|        |       | acronyms     |             | specify   |           |
|        |       | when         |             | verbatim  |           |
|        |       | applicable.  |             | a survey  |           |
|        |       |              |             | not on    |           |
|        |       |              |             | the list  |           |
|        |       |              |             |           |           |
|        |       |              |             | *         |           |
|        |       |              |             | Default - |           |
|        |       |              |             | none*     |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Te    | Specifies    | BLS         | Mark all  | BLS       |
| pleted | sting | the agency   |             | that      |           |
|        | A     | that         | Census      | apply     |           |
|        | gency | conducted    |             |           |           |
|        |       | the          | NCHS        |           |           |
|        |       | evaluation   |             |           |           |
|        |       | work         | NCI         |           |           |
|        |       |              |             |           |           |
|        |       | Include      | NSF         |           |           |
|        |       | department   |             |           |           |
|        |       | acronyms     | Census -    |           |           |
|        |       | when         | SRD         |           |           |
|        |       | applicable.  |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Uni   | Specifies    | Population  | Estab     | Esta      |
| pleted | verse | whether the  |             | lishment/ | blishment |
|        |       | question     | Es          |           |           |
|        |       | derives from | tablishment | P         |           |
|        |       | an           |             | opulation |           |
|        |       | e            |             | Check     |           |
|        |       | stablishment |             |           |           |
|        |       | survey or a  |             |           |           |
|        |       | population   |             |           |           |
|        |       | (household)  |             |           |           |
|        |       | survey.      |             |           |           |
|        |       |              |             |           |           |
|        |       | E            |             |           |           |
|        |       | stablishment |             |           |           |
|        |       | surveys      |             |           |           |
|        |       | include      |             |           |           |
|        |       | surveys of   |             |           |           |
|        |       | o            |             |           |           |
|        |       | rganizations |             |           |           |
|        |       | such as      |             |           |           |
|        |       | for-profit   |             |           |           |
|        |       | businesses,  |             |           |           |
|        |       | non-profit   |             |           |           |
|        |       | or           |             |           |           |
|        |       | ganizations, |             |           |           |
|        |       | educational  |             |           |           |
|        |       | i            |             |           |           |
|        |       | nstitutions, |             |           |           |
|        |       | and          |             |           |           |
|        |       | a            |             |           |           |
|        |       | ssociations. |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | P     | Mode in      | 1.  CAPI    | mark all  | CAPI      |
| pleted | re-te | which the    |             | that      | (*        |
|        | sting | question was | (*computer- | apply     | computer- |
|        | Mode  | pre-tested   |             |           | a         |
|        |       |              |  assisted,* |           | ssisted,* |
|        |       | *If the      |             |           | in        |
|        |       | question was | interviewer |           | terviewer |
|        |       | pre-tested   |     adm     |           | admin     |
|        |       | in multiple  | inistered - |           | istered - |
|        |       | modes, check |     in      |           | in        |
|        |       | multiple     |     person) |           | person)   |
|        |       | modes.*      |             |           |           |
|        |       |              | 2.  CATI    |           |           |
|        |       | *Enter the   |             |           |           |
|        |       | method that  | (*computer- |           |           |
|        |       | was          |             |           |           |
|        |       | pre-tested.  |  assisted,* |           |           |
|        |       | For example, |             |           |           |
|        |       | if you       | interviewer |           |           |
|        |       | tested a     |     adm     |           |           |
|        |       | self-        | inistered - |           |           |
|        |       | administered |             |           |           |
|        |       | survey,      |  telephone) |           |           |
|        |       | enter that,  |             |           |           |
|        |       | even though  | 3.          |           |           |
|        |       | it may have  | Interviewer |           |           |
|        |       | also been a  |     a       |           |           |
|        |       | cognitive    | dministered |           |           |
|        |       | interview.*  |     paper   |           |           |
|        |       |              |     qu      |           |           |
|        |       | *If the      | estionnaire |           |           |
|        |       | survey is a  |     (in     |           |           |
|        |       | CATI or CAPI |     person) |           |           |
|        |       | survey, but  |             |           |           |
|        |       | you tested   | 4.          |           |           |
|        |       | using a      | Interviewer |           |           |
|        |       | paper-pencil |     a       |           |           |
|        |       | version,     | dministered |           |           |
|        |       | chose option |     paper   |           |           |
|        |       | 3 or 4       |     qu      |           |           |
|        |       | instead of 1 | estionnaire |           |           |
|        |       | or 2. This   |     (over   |           |           |
|        |       | more         |     phone)  |           |           |
|        |       | accurately   |             |           |           |
|        |       | reflects the | 5.  Self-a  |           |           |
|        |       | instrument   | dministered |           |           |
|        |       | that was     |     web     |           |           |
|        |       | tested.*     |     qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.  Self-a  |           |           |
|        |       |              | dministered |           |           |
|        |       |              |     paper   |           |           |
|        |       |              |     qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.          |           |           |
|        |       |              |  Audio-CASI |           |           |
|        |       |              |             |           |           |
|        |       |              | 8.  IVR/TDE |           |           |
|        |       |              |             |           |           |
|        |       |              | 9.  Other   |           |           |
|        |       |              |             |           |           |
|        |       |              |  electronic |           |           |
|        |       |              |     surveys |           |           |
|        |       |              |     (CD,    |           |           |
|        |       |              |     email,  |           |           |
|        |       |              |             |           |           |
|        |       |              |   download) |           |           |
|        |       |              |             |           |           |
|        |       |              | 10. OTHER   |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Field | Field Mode   | 1.  CAPI    | mark all  | CAPI      |
| pleted | Mode  | refers to    |             | that      | (in       |
|        |       | the mode in  |   (*compute | apply     | terviewer |
|        |       | which the    | r-assisted* |           | admin     |
|        |       | survey will  |             |           | istered - |
|        |       | be           | interviewer |           | in        |
|        |       | administered |     adm     |           | person)   |
|        |       | when it goes | inistered - |           |           |
|        |       | into the     |     in      |           |           |
|        |       | field.       |     person) |           |           |
|        |       |              |             |           |           |
|        |       |              | 2.  CATI    |           |           |
|        |       |              |             |           |           |
|        |       |              |   (*compute |           |           |
|        |       |              | r-assisted* |           |           |
|        |       |              |             |           |           |
|        |       |              | interviewer |           |           |
|        |       |              |     adm     |           |           |
|        |       |              | inistered - |           |           |
|        |       |              |             |           |           |
|        |       |              |  telephone) |           |           |
|        |       |              |             |           |           |
|        |       |              | 3.          |           |           |
|        |       |              | Interviewer |           |           |
|        |       |              |     a       |           |           |
|        |       |              | dministered |           |           |
|        |       |              |     paper   |           |           |
|        |       |              |     qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |     (in     |           |           |
|        |       |              |     person) |           |           |
|        |       |              |             |           |           |
|        |       |              | 4.          |           |           |
|        |       |              | Interviewer |           |           |
|        |       |              |     a       |           |           |
|        |       |              | dministered |           |           |
|        |       |              |     paper   |           |           |
|        |       |              |     qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |     (over   |           |           |
|        |       |              |     phone)  |           |           |
|        |       |              |             |           |           |
|        |       |              | 5.  Self-a  |           |           |
|        |       |              | dministered |           |           |
|        |       |              |     web     |           |           |
|        |       |              |     qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.  Self-a  |           |           |
|        |       |              | dministered |           |           |
|        |       |              |     paper   |           |           |
|        |       |              |     qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.          |           |           |
|        |       |              |  Audio-CASI |           |           |
|        |       |              |             |           |           |
|        |       |              | 8.  IVR/TDE |           |           |
|        |       |              |             |           |           |
|        |       |              | 9.  Other   |           |           |
|        |       |              |             |           |           |
|        |       |              |  electronic |           |           |
|        |       |              |     surveys |           |           |
|        |       |              |     (CD,    |           |           |
|        |       |              |     email,  |           |           |
|        |       |              |             |           |           |
|        |       |              |   download) |           |           |
|        |       |              |             |           |           |
|        |       |              | 10. *OTHER* |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Prin  | The lead     | Verbatim    | C         | Kristen   |
| pleted | cipal | investigator | Text        | haracters | Miller,   |
|        | In    | of the       |             |           | Ph.D.     |
|        | vesti | cognitive    |             | *         |           |
|        | gator | testing      |             | Default - |           |
|        |       | project      |             | none*     |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Doc   | D            | 1.  Final   | mark all  | Final     |
| pleted | ument | ocumentation |     report  | that      | Report    |
|        | ation | available    |             | apply     | (pdf      |
|        |       |              | 2.  Audio   |           | file)     |
|        |       |              |     tapes   | *         |           |
|        |       |              |             | Default - | Video     |
|        |       |              | 3.  Video   | none*     | tapes     |
|        |       |              |     tapes   |           |           |
|        |       |              |             |           | Trans     |
|        |       |              | 4.  Tra     |           | criptions |
|        |       |              | nscriptions |           |           |
|        |       |              |             |           |           |
|        |       |              | 5.  Video   |           |           |
|        |       |              |     library |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.          |           |           |
|        |       |              |   Interview |           |           |
|        |       |              |             |           |           |
|        |       |              |   summaries |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.  Pilot   |           |           |
|        |       |              |     test    |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | G     | Instructions | Verbatim    | C         | "Start    |
| pleted | lobal | that appear  | text        | haracters | Here. Use |
|        |       | at the start |             |           | a blue or |
|        | In    | of the       |             | ##        | black     |
|        | struc | qu           |             |  Default  | pen."     |
|        | tions | estionnaire, |             | = nothing |           |
|        |       | which apply  |             |           | "Please   |
|        | **(S  | to all or    |             |           | center    |
|        | elf-A | the majority |             |           | numbers   |
|        | dmin. | of the       |             |           | in their  |
|        | On    | questions    |             |           | r         |
|        | ly)** |              |             |           | espective |
|        |       |              |             |           | boxes."   |
|        |       |              |             |           |           |
|        |       |              |             |           | "The      |
|        |       |              |             |           | reporting |
|        |       |              |             |           | unit for  |
|        |       |              |             |           | this form |
|        |       |              |             |           | is an     |
|        |       |              |             |           | estab     |
|        |       |              |             |           | lishment. |
|        |       |              |             |           | An        |
|        |       |              |             |           | esta      |
|        |       |              |             |           | blishment |
|        |       |              |             |           | is        |
|        |       |              |             |           | gene      |
|        |       |              |             |           | rally..." |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Sep   | Does form    | Yes         | Yes/No    | No        |
| pleted | arate | have         |             | check     |           |
|        | In    | separate     | No          |           |           |
|        | struc | i            |             | *Default  |           |
|        | tions | nstructions? |             | No*       |           |
|        |       |              |             |           |           |
|        | **    | Instructions |             |           |           |
|        | (Self | that are not |             |           |           |
|        | A     | near the     |             |           |           |
|        | dmin. | associated   |             |           |           |
|        | On    | question but |             |           |           |
|        | ly)** | are          |             |           |           |
|        |       | item-by-item |             |           |           |
|        |       | in nature.   |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | T     | Specifies    | *           | Mark all  | I         |
| pleted | arget | who the      | *Population | that      | ndividual |
|        | popul | question is  | Only:**     | apply     |           |
|        | ation | inquiring    |             |           |           |
|        |       | about---the  | Individual  |           |           |
|        |       | individual,  |             |           |           |
|        |       | household of | Household   |           |           |
|        |       | another type |             |           |           |
|        |       | of           | **Es        |           |           |
|        |       | e            | tablishment |           |           |
|        |       | stablishment | Only:**     |           |           |
|        |       |              |             |           |           |
|        |       |              | Type of     |           |           |
|        |       |              | Est         |           |           |
|        |       |              | ablishment. |           |           |
|        |       |              | . .         |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Respo | Specifies    | **Po        | Mark all  | Self      |
| pleted | ndent | who gives    | pulation:** | that      |           |
|        | role  | the answer - |             | apply     |           |
|        |       | whether the  | Self        |           |           |
|        |       | report is    |             |           |           |
|        |       | self or      | Proxy       |           |           |
|        |       | proxy for a  |             |           |           |
|        |       | household    | Self and    |           |           |
|        |       | survey and   | Proxy       |           |           |
|        |       | the job      |             |           |           |
|        |       | title of the | **Estab     |           |           |
|        |       | person       | lishment:** |           |           |
|        |       | targeted for |             |           |           |
|        |       | an           | Accountant  |           |           |
|        |       | e            |             |           |           |
|        |       | stablishment | Dean        |           |           |
|        |       | survey       |             |           |           |
|        |       |              | Principal   |           |           |
|        |       |              |             |           |           |
|        |       |              | President   |           |           |
|        |       |              |             |           |           |
|        |       |              | Etc.        |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Que   | Refers to    | Q-topics    | Pull down | Poison    |
| pleted | stion | the general  | are         | menu with | and       |
|        | Topic | topic of the | currently   | "other"   | Injury    |
|        |       | question.    | organized   | category  |           |
|        |       | The topic is | in the      | that can  |           |
|        |       | typically    | a           | specify   |           |
|        |       | determined   | lphabetical | verbatim  |           |
|        |       | by the       | order.      | a         |           |
|        |       | section in   | Q-topics    | category  |           |
|        |       | which it     | need to be  | not       |           |
|        |       | appears in   | modified as | listed    |           |
|        |       | the survey.  | a           |           |           |
|        |       |              | drill-down  | *         |           |
|        |       |              | option for  | Default - |           |
|        |       |              | data entry  | none*     |           |
|        |       |              | and search  |           |           |
|        |       |              | purposes    | Reprogram |           |
|        |       |              |             | as a      |           |
|        |       |              | Appendix A  | drill     |           |
|        |       |              | provides a  | down      |           |
|        |       |              | list of     |           |           |
|        |       |              | question    |           |           |
|        |       |              | topics      |           |           |
|        |       |              | entered in  |           |           |
|        |       |              | Q-bank.     |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | I     | Question     | 1.  Events, | Pull down | Events,   |
| pleted | nform | Type refers  |             | menu      | Actions,  |
|        | ation | to the kind  |    Actions, |           | and       |
|        |       | of           |     and     | *         | Behaviors |
|        | Type  | information  |             | Default - |           |
|        |       | elicited by  |   Behaviors | none*     |           |
|        |       | the          |             |           |           |
|        |       | question.    | 2.          |           |           |
|        |       |              |   Objective |           |           |
|        |       | See Appendix |     char    |           |           |
|        |       | for          | acteristics |           |           |
|        |       | definitions  |             |           |           |
|        |       |              | 3.          |           |           |
|        |       |              |  Subjective |           |           |
|        |       |              |     char    |           |           |
|        |       |              | acteristics |           |           |
|        |       |              |             |           |           |
|        |       |              | 4.  S       |           |           |
|        |       |              | peculations |           |           |
|        |       |              |             |           |           |
|        |       |              | 5.  Attitud |           |           |
|        |       |              | es/Opinions |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.          |           |           |
|        |       |              |   Knowledge |           |           |
|        |       |              |     tests   |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.  Other   |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Index | Scale status | Yes         | Yes/No    | Yes       |
| pleted | S     | refers to    |             | check     |           |
|        | tatus | whether or   | No          |           |           |
|        |       | not the      |             | *Default  |           |
|        |       | question is  |             | -- no*    |           |
|        |       | part of a    |             |           |           |
|        |       | scale or a   |             |           |           |
|        |       | ma           |             |           |           |
|        |       | thematically |             |           |           |
|        |       | linked set   |             |           |           |
|        |       | of questions |             |           |           |
|        |       |              |             |           |           |
|        |       | If you don't |             |           |           |
|        |       | know, mark   |             |           |           |
|        |       | no.          |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | M     | Matrix       | Yes         | Yes/No    |           |
| pleted | atrix | status       |             | check     |           |
|        | S     | refers to    | No          |           |           |
|        | tatus | whether or   |             | *Default  |           |
|        |       | not the      |             | -- no*    |           |
|        | **(S  | question is  |             |           |           |
|        | elf-A | part of a    |             |           |           |
|        | dmin. | matrix       |             |           |           |
|        | On    |              |             |           |           |
|        | ly)** |              |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | I     | Directions   | Verbatim    | C         | N/A       |
| pleted | nterv | to the       | Text        | haracters |           |
|        | iewer | interviewer  |             |           | Read if   |
|        | In    |              |             | *         | Necessary |
|        | struc |              |             | Default - | (?)       |
|        | tions |              |             | none*     |           |
|        | (if   |              |             |           |           |
|        | a     |              |             |           |           |
|        | pplic |              |             |           |           |
|        | able) |              |             |           |           |
|        |       |              |             |           |           |
|        | *     |              |             |           |           |
|        | *(Int |              |             |           |           |
|        | ervie |              |             |           |           |
|        | wer-A |              |             |           |           |
|        | dmin. |              |             |           |           |
|        | On    |              |             |           |           |
|        | ly)** |              |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Flash | The flash    | Yes/No      | Scanned   |           |
| pleted | Card  | card that    |             | in        |           |
|        |       | accompanies  | There       | picture   |           |
|        | **(I  | the question | should be a |           |           |
|        | nterv |              | direct link | *         |           |
|        | iewer |              | to the      | Default - |           |
|        | A     |              | flashcard   | none*     |           |
|        | dmin. |              |             |           |           |
|        | On    |              |             |           |           |
|        | ly)** |              |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | In    | If           | Verbatim    | C         | In this   |
| pleted | trodu | applicable,  | Text        | haracters | next set  |
|        | ctory | the text     |             |           | of        |
|        | text  | that occurs  |             | *         | q         |
|        |       | before the   |             | Default - | uestions, |
|        | (for  | actual       |             | none*     | I will    |
|        | ma    | question.    |             |           | ask about |
|        | trix, | The          |             | *Intro    | INJURIES  |
|        | r     | introductory |             | text will | AND       |
|        | ename | text         |             | be bolded | P         |
|        | **Ov  | provides the |             | if it     | OISONINGS |
|        | erall | context for  |             | occurs    | that      |
|        | que   | coming set   |             | directly  | happened  |
|        | stion | of           |             | before    | in the    |
|        | or    | questions,   |             | the       | PAST      |
|        | instr | and is       |             | current   | THREE     |
|        | uctio | likely to    |             | core      | MONTHS    |
|        | ns**) | contain a    |             | question; | that      |
|        |       | description  |             | however,  | REQUIRED  |
|        |       | of the       |             | if it is  | MEDICAL   |
|        |       | subject      |             | second or | ADVICE OR |
|        |       | matter, or   |             | more in a | T         |
|        |       | specific     |             | series    | REATMENT, |
|        |       | instructions |             | (i.e.,    | including |
|        |       | including,   |             | the intro | call to a |
|        |       | the response |             | text is   | poison    |
|        |       | categories   |             | implied), | control   |
|        |       | for the      |             | the intro | center.   |
|        |       | series of    |             | text will |           |
|        |       | questions or |             | be        | "NOTE:    |
|        |       | the time     |             | faded.*   | Please    |
|        |       | frame to     |             |           | answer    |
|        |       | consider. In |             |           | BOTH      |
|        |       | the case of  |             |           | questions |
|        |       | a matrix, a  |             |           | 5 and 6." |
|        |       | heading,     |             |           |           |
|        |       | i            |             |           | "Include: |
|        |       | nstructions, |             |           | ....      |
|        |       | or question  |             |           | Exclude:  |
|        |       | that apply   |             |           | ..."      |
|        |       | to the       |             |           |           |
|        |       | overall      |             |           | What are  |
|        |       | matrix.      |             |           | the ISI   |
|        |       |              |             |           | codes     |
|        |       |              |             |           | d         |
|        |       |              |             |           | escribing |
|        |       |              |             |           | the       |
|        |       |              |             |           | acti      |
|        |       |              |             |           | vity(ies) |
|        |       |              |             |           | of the US |
|        |       |              |             |           | Af        |
|        |       |              |             |           | fliliate, |
|        |       |              |             |           | and the   |
|        |       |              |             |           | sales or  |
|        |       |              |             |           | gross     |
|        |       |              |             |           | operating |
|        |       |              |             |           | revenues  |
|        |       |              |             |           | and       |
|        |       |              |             |           | employee  |
|        |       |              |             |           | figures   |
|        |       |              |             |           | corr      |
|        |       |              |             |           | esponding |
|        |       |              |             |           | to each   |
|        |       |              |             |           | code?     |
+--------+-------+--------------+-------------+-----------+-----------+
| New    | In    | The format   | He          | Mark all  | Heading:  |
| Field  | trodu | of the       | ading/label | that      | Part 1    |
|        | ctory | introductory |             | apply     | Ident     |
| Lower  | Text  | text. Does   | Instruction |           | ification |
| pr     | F     | the text     |             |           | of U.S.   |
| iority | ormat | appear as a  | N           |           | Affiliate |
|        |       | question, or | avigational |           | --        |
|        | **(S  | as a single  | Direction   |           | Continued |
|        | elf-A | word or      |             |           |           |
|        | dmin. | phrase       | Question    |           | Ins       |
|        | On    | (i.e.,       |             |           | truction: |
|        | ly)** | hea          |             |           | Industry  |
|        |       | ding/label), |             |           | class     |
|        |       | or as some   |             |           | ification |
|        |       | kind of      |             |           | of fully  |
|        |       | instructions |             |           | con       |
|        |       | or           |             |           | solidated |
|        |       | directions?  |             |           | U.S.      |
|        |       |              |             |           | affiliate |
|        |       | Contextual   |             |           | (based on |
|        |       | Instructions |             |           | sales or  |
|        |       | tell the     |             |           | gross     |
|        |       | respondent   |             |           | operating |
|        |       | something    |             |           | revenues  |
|        |       | about How to |             |           | )---Enter |
|        |       | answer the   |             |           | the       |
|        |       | question.    |             |           | 4-digit   |
|        |       |              |             |           | Inte      |
|        |       | Navigational |             |           | rnational |
|        |       | directions   |             |           | Surveys   |
|        |       | tell the     |             |           | Industry  |
|        |       | respondent   |             |           | (ISI)     |
|        |       | Where to go  |             |           | code(s)   |
|        |       | -- either to |             |           | and the   |
|        |       | answer or    |             |           | sales (as |
|        |       | after they   |             |           | defined   |
|        |       | answer.      |             |           | in item   |
|        |       |              |             |           | 55 on     |
|        |       |              |             |           | page 6)   |
|        |       |              |             |           | and       |
|        |       |              |             |           | e         |
|        |       |              |             |           | mployment |
|        |       |              |             |           | a         |
|        |       |              |             |           | ssociated |
|        |       |              |             |           | with each |
|        |       |              |             |           | code.     |
|        |       |              |             |           |           |
|        |       |              |             |           | Question: |
|        |       |              |             |           | What      |
|        |       |              |             |           | amounts   |
|        |       |              |             |           | were paid |
|        |       |              |             |           | to FAFPs  |
|        |       |              |             |           | (or were  |
|        |       |              |             |           | entered   |
|        |       |              |             |           | into      |
|        |       |              |             |           | inte      |
|        |       |              |             |           | r-company |
|        |       |              |             |           | accounts, |
|        |       |              |             |           | whichever |
|        |       |              |             |           | came      |
|        |       |              |             |           | first)    |
|        |       |              |             |           | during    |
|        |       |              |             |           | the       |
|        |       |              |             |           | quarter,  |
|        |       |              |             |           | by        |
|        |       |              |             |           | country,  |
|        |       |              |             |           | and what  |
|        |       |              |             |           | were the  |
|        |       |              |             |           | debt      |
|        |       |              |             |           | balances  |
|        |       |              |             |           | with the  |
|        |       |              |             |           | FAFP at   |
|        |       |              |             |           | the       |
|        |       |              |             |           | beginning |
|        |       |              |             |           | and end   |
|        |       |              |             |           | of the    |
|        |       |              |             |           | quarter,  |
|        |       |              |             |           | by        |
|        |       |              |             |           | country?  |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Seq   | Number of    | Number      | Not       | 1         |
| pleted | uence | the question |             | required  |           |
|        | n     | within one   |             |           |           |
|        | umber | introductory |             |           |           |
|        |       | phrase or    |             |           |           |
|        |       | number of    |             |           |           |
|        |       | the question |             |           |           |
|        |       | in the       |             |           |           |
|        |       | matrix.      |             |           |           |
|        |       |              |             |           |           |
|        |       | *For         |             |           |           |
|        |       | example, if  |             |           |           |
|        |       | there are 4  |             |           |           |
|        |       | core         |             |           |           |
|        |       | questions in |             |           |           |
|        |       | a matrix,    |             |           |           |
|        |       | they would   |             |           |           |
|        |       | be numbered  |             |           |           |
|        |       | 1-4 for this |             |           |           |
|        |       | field.*      |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Core  | Core text of | Verbatim    | C         | Have you  |
| pleted | Que   | the question | Text        | haracters | ever      |
|        | stion | is the       |             |           | eaten...  |
|        |       | "meat" of    |             | Select    |           |
|        |       | the          |             | One       | ..        |
|        |       | question.    |             |           | .lobster? |
|        |       |              |             |           | Y/N       |
|        |       | Every part   |             |           |           |
|        |       | of the       |             |           | ...steak  |
|        |       | question     |             |           | tartar?   |
|        |       | (minus the   |             |           | Y/N       |
|        |       | response     |             |           |           |
|        |       | categories)  |             |           | ...sea    |
|        |       | should be    |             |           | urchin?   |
|        |       | included so  |             |           | Y/N       |
|        |       | that it      |             |           |           |
|        |       | makes sense  |             |           | Record:   |
|        |       | on its own.  |             |           |           |
|        |       | Therefore,   |             |           | Have you  |
|        |       | if the front |             |           | ever      |
|        |       | part of the  |             |           | eaten     |
|        |       | question is  |             |           | ..        |
|        |       | broken apart |             |           | .lobster? |
|        |       | and used for |             |           |           |
|        |       | several      |             |           | Have you  |
|        |       | questions,   |             |           | ever      |
|        |       | then that    |             |           | eaten     |
|        |       | first part   |             |           | ...steak  |
|        |       | must be      |             |           | tartar?   |
|        |       | included     |             |           |           |
|        |       | when         |             |           | Have you  |
|        |       | recording    |             |           | ever      |
|        |       | each         |             |           | eaten...  |
|        |       | question.    |             |           | sea       |
|        |       | Include      |             |           | urchin?   |
|        |       | definitions  |             |           |           |
|        |       | when they    |             |           | Sales,    |
|        |       | are embedded |             |           | Number of |
|        |       | in the       |             |           | e         |
|        |       | question     |             |           | mployees, |
|        |       | (not as      |             |           | etc.      |
|        |       | instructions |             |           |           |
|        |       | but as       |             |           | Enter     |
|        |       | d            |             |           | this      |
|        |       | efinitions). |             |           | person's  |
|        |       |              |             |           | sex.      |
|        |       | In a matrix, |             |           | Enter     |
|        |       | core         |             |           | this      |
|        |       | questions    |             |           | person's  |
|        |       | are either   |             |           | age.      |
|        |       | in the rows  |             |           |           |
|        |       | or columns.  |             |           |           |
|        |       | The core     |             |           |           |
|        |       | question     |             |           |           |
|        |       | solicits     |             |           |           |
|        |       | information  |             |           |           |
|        |       | across       |             |           |           |
|        |       | several      |             |           |           |
|        |       | objects. The |             |           |           |
|        |       | difference   |             |           |           |
|        |       | between the  |             |           |           |
|        |       | question and |             |           |           |
|        |       | the object   |             |           |           |
|        |       | is where the |             |           |           |
|        |       | most focus   |             |           |           |
|        |       | goes. The    |             |           |           |
|        |       | core         |             |           |           |
|        |       | question is  |             |           |           |
|        |       | the topic of |             |           |           |
|        |       | the          |             |           |           |
|        |       | question.    |             |           |           |
|        |       | The object   |             |           |           |
|        |       | is the       |             |           |           |
|        |       | dimension    |             |           |           |
|        |       | that is      |             |           |           |
|        |       | being        |             |           |           |
|        |       | measured of  |             |           |           |
|        |       | that topic.  |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| New    | Core  | The format   | Hea         | Pull down | Heading   |
| Field  | Que   | of the 'core | dings/label | menu      | s/labels: |
|        | stion | question'    |             |           | Sales,    |
| Lower  | F     | text. Does   | Instructio  | Select    | Number of |
| pr     | ormat | the text     | n/statement | one       | e         |
| iority |       | appear as a  |             |           | mployees, |
|        | **(S  | question, or | Question    |           | etc.      |
|        | elf-A | as a single  |             |           |           |
|        | dmin. | word or      |             |           | Ins       |
|        | On    | phrase       |             |           | truction: |
|        | ly)** | (i.e.,       |             |           | Enter     |
|        |       | hea          |             |           | this      |
|        |       | ding/label), |             |           | person's  |
|        |       | or as some   |             |           | sex.      |
|        |       | kind of      |             |           | Enter     |
|        |       | instructions |             |           | this      |
|        |       | or           |             |           | person's  |
|        |       | directions?  |             |           | age.      |
|        |       |              |             |           |           |
|        |       |              |             |           | Question: |
|        |       |              |             |           | What is   |
|        |       |              |             |           | this      |
|        |       |              |             |           | person's  |
|        |       |              |             |           | sex? What |
|        |       |              |             |           | is this   |
|        |       |              |             |           | person's  |
|        |       |              |             |           | age?      |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | O     | Location of  | Rows        | Pull down | Link to   |
| pleted | rient | core         |             | menu      | picture   |
|        | ation | questions    | Columns     |           | depicting |
|        | of    | within       |             |           | two       |
|        | Core  | matrix       |             |           | examples  |
|        | Ques  |              |             |           | with      |
|        | tions | In a matrix, |             |           | identical |
|        |       | core         |             |           | in        |
|        | **(M  | questions    |             |           | formation |
|        | atrix | are either   |             |           | and       |
|        | Only; | in the rows  |             |           | opposing  |
|        | S     | or columns.  |             |           | ori       |
|        | elf-A | The core     |             |           | entations |
|        | dmin. | question     |             |           |           |
|        | On    | solicits     |             |           |           |
|        | ly)** | information  |             |           |           |
|        |       | across       |             |           |           |
|        |       | several      |             |           |           |
|        |       | objects. The |             |           |           |
|        |       | difference   |             |           |           |
|        |       | between the  |             |           |           |
|        |       | question and |             |           |           |
|        |       | the object   |             |           |           |
|        |       | is where the |             |           |           |
|        |       | most focus   |             |           |           |
|        |       | goes. The    |             |           |           |
|        |       | core         |             |           |           |
|        |       | question is  |             |           |           |
|        |       | the topic of |             |           |           |
|        |       | the          |             |           |           |
|        |       | question.    |             |           |           |
|        |       | The object   |             |           |           |
|        |       | is the       |             |           |           |
|        |       | dimension    |             |           |           |
|        |       | that is      |             |           |           |
|        |       | being        |             |           |           |
|        |       | measured of  |             |           |           |
|        |       | that topic.  |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Ob    | This is a    | Verbatim    | C         | Person 1; |
| pleted | jects | list of what | text        | haracters | Person    |
|        |       | the          |             |           | 2...      |
|        | **(M  | questions    |             |           |           |
|        | atrix | refer to or  |             |           | United    |
|        | Only; | are being    |             |           | Kingdom;  |
|        | S     | asked about. |             |           | Canada;   |
|        | elf-A | Write them   |             |           | Russia    |
|        | dmin. | in verbatim  |             |           |           |
|        | On    | with         |             |           | Enter     |
|        | ly)** | semicolons   |             |           | code with |
|        |       | separating   |             |           | largest   |
|        |       | them.        |             |           | sales;    |
|        |       |              |             |           | enter     |
|        |       | Matrices can |             |           | code with |
|        |       | have either  |             |           | 2^nd^     |
|        |       | response     |             |           | largest   |
|        |       | options or   |             |           | sales;    |
|        |       | objects.     |             |           | etc.      |
|        |       | When there   |             |           |           |
|        |       | are objects, |             |           |           |
|        |       | there will   |             |           |           |
|        |       | typically be |             |           |           |
|        |       | open text.   |             |           |           |
|        |       | Response     |             |           |           |
|        |       | options will |             |           |           |
|        |       | usually be   |             |           |           |
|        |       | multiple     |             |           |           |
|        |       | choice in a  |             |           |           |
|        |       | matrix/grid  |             |           |           |
|        |       | format.      |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | In    | Instructions | Verbatim    | C         | "Mark *X* |
| pleted | struc | that appear  | text        | haracters | only      |
|        | tions | immediately  |             |           | one."     |
|        | Foll  | after a      |             | ##        |           |
|        | owing | question,    |             |           | "Trade    |
|        | Core  | which apply  |             | ## Defau  | accounts, |
|        | Que   | to that      |             | lt = none | trade     |
|        | stion | question.    |             |           | notes,    |
|        |       |              |             |           | other     |
|        | **(S  |              |             |           | current   |
|        | elf-A |              |             |           | lia       |
|        | dmin. |              |             |           | bilities, |
|        | On    |              |             |           | long-term |
|        | ly)** |              |             |           | debt, and |
|        |       |              |             |           | s         |
|        |       |              |             |           | ecurities |
|        |       |              |             |           | that are  |
|        |       |              |             |           | debt per  |
|        |       |              |             |           | FAS 150." |
|        |       |              |             |           |           |
|        |       |              |             |           | "If the   |
|        |       |              |             |           | gr        |
|        |       |              |             |           | andparent |
|        |       |              |             |           | is        |
|        |       |              |             |           | fi        |
|        |       |              |             |           | nancially |
|        |       |              |             |           | re        |
|        |       |              |             |           | sponsible |
|        |       |              |             |           | for more  |
|        |       |              |             |           | than one  |
|        |       |              |             |           | gr        |
|        |       |              |             |           | andchild, |
|        |       |              |             |           | answer    |
|        |       |              |             |           | the       |
|        |       |              |             |           | question  |
|        |       |              |             |           | for the   |
|        |       |              |             |           | g         |
|        |       |              |             |           | randchild |
|        |       |              |             |           | for whom  |
|        |       |              |             |           | the       |
|        |       |              |             |           | gr        |
|        |       |              |             |           | andparent |
|        |       |              |             |           | has been  |
|        |       |              |             |           | re        |
|        |       |              |             |           | sponsible |
|        |       |              |             |           | for the   |
|        |       |              |             |           | longest   |
|        |       |              |             |           | period of |
|        |       |              |             |           | time."    |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | RO    | Response     | Verbatim    | C         | "White;   |
| pleted | text  | text is      | Text        | haracters | Black;    |
|        |       | whatever     |             |           | American  |
|        |       | text written |             | *         | Indian or |
|        |       | on the       |             | Default - | Alaska    |
|        |       | q            |             | none*     | N         |
|        |       | uestionnaire |             |           | ative..." |
|        |       | and/or read  |             |           |           |
|        |       | to the       |             |           | "Yes; No" |
|        |       | participant. |             |           |           |
|        |       |              |             |           | "Number   |
|        |       | Interviewer  |             |           | of        |
|        |       | A            |             |           | People"   |
|        |       | dministered: |             |           |           |
|        |       | Do not       |             |           | "         |
|        |       | include      |             |           | Telephone |
|        |       | "don't know" |             |           | Number"   |
|        |       | or "refused" |             |           |           |
|        |       | unless those |             |           |           |
|        |       | categories   |             |           |           |
|        |       | are          |             |           |           |
|        |       | explicitly   |             |           |           |
|        |       | offered to   |             |           |           |
|        |       | the          |             |           |           |
|        |       | respondent   |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Res   | Response     | 1\. Yes/no  | Pull down | Yes/No    |
| pleted | ponse | category     |             | menu      |           |
|        | Cat   | refers to    | 2\. Select  |           |           |
|        | egory | the          | one textual | *         |           |
|        |       | structure of |             | Default - |           |
|        |       | the response | 3\. Select  | none*     |           |
|        |       | categories.  | one numeric |           |           |
|        |       |              |             |           |           |
|        |       | If the       | 4\. Mark    |           |           |
|        |       | question     | all that    |           |           |
|        |       | asks for a   | apply       |           |           |
|        |       | number, it   |             |           |           |
|        |       | is numeric.  | 5\.         |           |           |
|        |       | If it asks   | Allocation  |           |           |
|        |       | for text, it |             |           |           |
|        |       | is textual   | 6\.         |           |           |
|        |       | (even if the | Open-ended  |           |           |
|        |       | text is      | Textual     |           |           |
|        |       | "none" or "a |             |           |           |
|        |       | few").       | a\.         |           |           |
|        |       |              | Delineated  |           |           |
|        |       | Delineated   |             |           |           |
|        |       | means that   | b\.         |           |           |
|        |       | there are    | Non         |           |           |
|        |       | markings to  | -delineated |           |           |
|        |       | tell the     |             |           |           |
|        |       | respondent   | 7\.         |           |           |
|        |       | where each   | Open-ended  |           |           |
|        |       | number or    | Numeric     |           |           |
|        |       | each letter  |             |           |           |
|        |       | goes. E.g.   | a\.         |           |           |
|        |       | phone        | Delineated  |           |           |
|        |       | number:      |             |           |           |
|        |       |              | b\.         |           |           |
|        |       | \_ \_ \_ -   | Non         |           |           |
|        |       | \_ \_ \_ -\_ | -delineated |           |           |
|        |       | \_ \_ \_;    |             |           |           |
|        |       |              | 8\. Other   |           |           |
|        |       | Name \_ \_   |             |           |           |
|        |       | \_ \_ \_ \_  |             |           |           |
|        |       | \_ \_ \_ \_  |             |           |           |
|        |       | \_ \_        |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| New    | L     | Description  | 1\. Q above | Hie       | Link to a |
| Field  | ayout | of the       | ROs         | rarchical | picture   |
|        | of Q  | location of  |             | pull down | depicting |
| Lower  | and   | question and | a\. One RO  | menu)     | examples. |
| pr     | ROs   | response     |             |           |           |
| iority |       | options      | b\.         | Select    |           |
|        | **    |              | Vertical    | one       |           |
|        | (Self |              | ROs         |           |           |
|        | A     |              |             |           |           |
|        | dmin. |              | c\.         |           |           |
|        | Only  |              | Horizontal  |           |           |
|        | --    |              | ROs         |           |           |
|        | Not   |              |             |           |           |
|        | for   |              | d\.         |           |           |
|        | matr  |              | Vertical    |           |           |
|        | ix)** |              | and         |           |           |
|        |       |              | horizontal  |           |           |
|        |       |              | ROs         |           |           |
|        |       |              |             |           |           |
|        |       |              | 2\. Q left  |           |           |
|        |       |              | of ROs      |           |           |
|        |       |              |             |           |           |
|        |       |              | a\. One RO  |           |           |
|        |       |              |             |           |           |
|        |       |              | b\.         |           |           |
|        |       |              | Vertical    |           |           |
|        |       |              | ROs         |           |           |
|        |       |              |             |           |           |
|        |       |              | c\.         |           |           |
|        |       |              | Horizontal  |           |           |
|        |       |              | ROs         |           |           |
|        |       |              |             |           |           |
|        |       |              | d\.         |           |           |
|        |       |              | Vertical    |           |           |
|        |       |              | and         |           |           |
|        |       |              | horizontal  |           |           |
|        |       |              | ROs         |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| New    | RO    | Location of  | Right       | Pull down | Link to   |
| Field  | text  | response     |             | menu      | picture   |
|        | loc   | options text | Left        |           | of        |
| Lower  | ation | in relation  |             | Select    | examples  |
| pr     |       | to the       | Above       | One       |           |
| iority | **    | response box |             |           |           |
|        | (Self | or answer    | Below       |           |           |
|        | A     | space.       |             |           |           |
|        | dmin. |              |             |           |           |
|        | Only  |              |             |           |           |
|        | --    |              |             |           |           |
|        | Not   |              |             |           |           |
|        | for   |              |             |           |           |
|        | matr  |              |             |           |           |
|        | ix)** |              |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | In    | Instructions | Verbatim    | C         | "Other -- |
| pleted | struc | that follow  | text        | haracters | Specify"  |
|        | tions | the response |             |           |           |
|        | Foll  | options or   |             |           | "Yes --   |
|        | owing | the answer   |             |           | Mark *X*  |
|        | ROs   | space --     |             |           | all       |
|        |       | these are    |             |           | reasons   |
|        | **    | often for    |             |           | that      |
|        | (Self | follow-up    |             |           | apply."   |
|        | A     | questions or |             |           |           |
|        | dmin. | are skip     |             |           | "Print    |
|        | On    | instructions |             |           | race"     |
|        | ly)** | for the next |             |           |           |
|        |       |              |             |           | "Include  |
|        |       |              |             |           | in this   |
|        |       |              |             |           | number:   |
|        |       |              |             |           |           |
|        |       |              |             |           | -foster   |
|        |       |              |             |           | children, |
|        |       |              |             |           | roomers,  |
|        |       |              |             |           | or        |
|        |       |              |             |           | h         |
|        |       |              |             |           | ousemates |
|        |       |              |             |           |           |
|        |       |              |             |           | \- people |
|        |       |              |             |           | staying   |
|        |       |              |             |           | here on   |
|        |       |              |             |           | April 1,  |
|        |       |              |             |           | 2000...   |
+--------+-------+--------------+-------------+-----------+-----------+
| New    | Loc   | Code only    | Top         | Pull down | Link to a |
| Field  | ation | the          |             | menu      | picture.  |
|        | of    | questions in | Top left    |           |           |
| Lower  | Que   | the extreme  |             | Select    |           |
| pr     | stion | positions on | Top right   | one       |           |
| iority |       | the page as  |             |           |           |
|        | **    | top or       | Middle      |           |           |
|        | (Self | bottom. Only |             |           |           |
|        | A     | the first    | Middle left |           |           |
|        | dmin. | question in  |             |           |           |
|        | On    | the left     | Middle      |           |           |
|        | ly)** | column is to | right       |           |           |
|        |       | be called    |             |           |           |
|        |       | "top left."  | Bottom      |           |           |
|        |       | Similarly,   |             |           |           |
|        |       | only the     | Bottom left |           |           |
|        |       | last         |             |           |           |
|        |       | question at  | Bottom      |           |           |
|        |       | the bottom   | right       |           |           |
|        |       | left of the  |             |           |           |
|        |       | column will  |             |           |           |
|        |       | be coded     |             |           |           |
|        |       | "bottom      |             |           |           |
|        |       | left;" all   |             |           |           |
|        |       | others will  |             |           |           |
|        |       | be coded as  |             |           |           |
|        |       | middle.      |             |           |           |
|        |       |              |             |           |           |
|        |       | Describe the |             |           |           |
|        |       | location of  |             |           |           |
|        |       | the          |             |           |           |
|        |       | beginning of |             |           |           |
|        |       | the          |             |           |           |
|        |       | question.    |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Page  | Number of    | Page X of Y | C         | Page      |
| pleted | N     | page in      |             | haracters | Number    |
|        | umber | which        |             |           |           |
|        |       | question     |             |           |           |
|        | **    | appears in   |             |           |           |
|        | (Self | q            |             |           |           |
|        | A     | uestionnaire |             |           |           |
|        | dmin. |              |             |           |           |
|        | On    |              |             |           |           |
|        | ly)** |              |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Cor   |              |             |           |           |
| pleted | respo |              |             |           |           |
|        | nding |              |             |           |           |
|        | Que   |              |             |           |           |
|        | stion |              |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Res   | The type(s)  | 1.          | Pull down | Difficult |
| pleted | ponse | of errors    | Interviewer | menu      | terms;    |
|        | Error | identified   |             |           | Ambiguous |
|        |       | in testing   |  Difficulty | Mark all  | concepts  |
|        |       |              |     **(in   | that      |           |
|        |       | \* See       | terviewer-a | apply     |           |
|        |       | attachment E | dministered |           |           |
|        |       | for          |     only)** | *         |           |
|        |       | definitions. |             | Default - |           |
|        |       |              | 2.          | none*     |           |
|        |       |              | Problematic |           |           |
|        |       |              |     Visual  |           |           |
|        |       |              |     Cues    |           |           |
|        |       |              |             |           |           |
|        |       |              | > **(self-a |           |           |
|        |       |              | dministered |           |           |
|        |       |              | > only)**   |           |           |
|        |       |              |             |           |           |
|        |       |              | 3.  Not     |           |           |
|        |       |              |             |           |           |
|        |       |              |   seen/read |           |           |
|        |       |              |             |           |           |
|        |       |              | > **(self-a |           |           |
|        |       |              | dministered |           |           |
|        |       |              | > only)**   |           |           |
|        |       |              |             |           |           |
|        |       |              | 4.          |           |           |
|        |       |              | Problematic |           |           |
|        |       |              |     terms   |           |           |
|        |       |              |             |           |           |
|        |       |              | 5.          |           |           |
|        |       |              |   Ambiguous |           |           |
|        |       |              |             |           |           |
|        |       |              |    concepts |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.  Overly  |           |           |
|        |       |              |     complex |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.  Assump  |           |           |
|        |       |              | tion/Double |           |           |
|        |       |              |     barrel  |           |           |
|        |       |              |             |           |           |
|        |       |              | 8.  Qu      |           |           |
|        |       |              | estionnaire |           |           |
|        |       |              |     effects |           |           |
|        |       |              |             |           |           |
|        |       |              | 9.  Recall  |           |           |
|        |       |              |             |           |           |
|        |       |              | /Estimation |           |           |
|        |       |              |             |           |           |
|        |       |              |  difficulty |           |           |
|        |       |              |             |           |           |
|        |       |              | 10. Biase   |           |           |
|        |       |              | d/sensitive |           |           |
|        |       |              |             |           |           |
|        |       |              | 11.         |           |           |
|        |       |              |  Inadequate |           |           |
|        |       |              |             |           |           |
|        |       |              |    response |           |           |
|        |       |              |     options |           |           |
|        |       |              |             |           |           |
|        |       |              | 12.         |           |           |
|        |       |              | Problematic |           |           |
|        |       |              |     answer  |           |           |
|        |       |              |     space   |           |           |
|        |       |              |             |           |           |
|        |       |              |   **(self-a |           |           |
|        |       |              | dministered |           |           |
|        |       |              |     only)** |           |           |
|        |       |              |             |           |           |
|        |       |              | 13. None as |           |           |
|        |       |              |     tested  |           |           |
|        |       |              |             |           |           |
|        |       |              | **Es        |           |           |
|        |       |              | tablishment |           |           |
|        |       |              | only:**     |           |           |
|        |       |              |             |           |           |
|        |       |              | 1           |           |           |
|        |       |              | .  Mismatch |           |           |
|        |       |              |     between |           |           |
|        |       |              |             |           |           |
|        |       |              |   reporting |           |           |
|        |       |              |     unit    |           |           |
|        |       |              |     and org |           |           |
|        |       |              |     unit    |           |           |
|        |       |              |             |           |           |
|        |       |              | 2           |           |           |
|        |       |              | .  Mismatch |           |           |
|        |       |              |     between |           |           |
|        |       |              |             |           |           |
|        |       |              |   requested |           |           |
|        |       |              |     data    |           |           |
|        |       |              |     and     |           |           |
|        |       |              |     records |           |           |
|        |       |              |             |           |           |
|        |       |              | 3.          |           |           |
|        |       |              |   Requested |           |           |
|        |       |              |     data    |           |           |
|        |       |              |     not     |           |           |
|        |       |              |     kept in |           |           |
|        |       |              |     records |           |           |
|        |       |              |             |           |           |
|        |       |              | 4.  Lack of |           |           |
|        |       |              |     access  |           |           |
|        |       |              |     to      |           |           |
|        |       |              |             |           |           |
|        |       |              |   requested |           |           |
|        |       |              |     data    |           |           |
|        |       |              |             |           |           |
|        |       |              | 5.  De      |           |           |
|        |       |              | centralized |           |           |
|        |       |              |     data    |           |           |
|        |       |              |             |           |           |
|        |       |              | 6.  Release |           |           |
|        |       |              |     of data |           |           |
|        |       |              |             |           |           |
|        |       |              |  prohibited |           |           |
|        |       |              |             |           |           |
|        |       |              | 7.  Not     |           |           |
|        |       |              |     willing |           |           |
|        |       |              |     to      |           |           |
|        |       |              |     divulge |           |           |
|        |       |              |             |           |           |
|        |       |              | proprietary |           |           |
|        |       |              |             |           |           |
|        |       |              | information |           |           |
|        |       |              |             |           |           |
|        |       |              | 8.  Release |           |           |
|        |       |              |     of data |           |           |
|        |       |              |             |           |           |
|        |       |              | conditional |           |           |
|        |       |              |     upon    |           |           |
|        |       |              |     au      |           |           |
|        |       |              | thorization |           |           |
|        |       |              |             |           |           |
|        |       |              | 9.          |           |           |
|        |       |              |  Estimation |           |           |
|        |       |              |             |           |           |
|        |       |              | 10. Calc    |           |           |
|        |       |              | ulation/tra |           |           |
|        |       |              | nsformation |           |           |
|        |       |              |     of data |           |           |
|        |       |              |             |           |           |
|        |       |              | 11. P       |           |           |
|        |       |              | erpetuating |           |           |
|        |       |              |     prior   |           |           |
|        |       |              |             |           |           |
|        |       |              |   incorrect |           |           |
|        |       |              |             |           |           |
|        |       |              |   reporting |           |           |
|        |       |              |             |           |           |
|        |       |              |    strategy |           |           |
+--------+-------+--------------+-------------+-----------+-----------+
| Com    | Where | If there is  | He          | Mark all  |           |
| pleted | error | a response   | ading/label | that      |           |
|        | o     | error, does  |             | apply     |           |
|        | ccurs | the error    | Qu          |           |           |
|        |       | occur in the | estion/item | *Default: |           |
|        |       | question     |             | none*     |           |
|        |       | itself, or   | Contextual  |           |           |
|        |       | does it      | instruction |           |           |
|        |       | occur in     |             |           |           |
|        |       | another      | N           |           |           |
|        |       | component of | avigational |           |           |
|        |       | the item?    | direction   |           |           |
|        |       |              |             |           |           |
|        |       | non-verbal   | Response    |           |           |
|        |       | components   | options     |           |           |
|        |       | are defined  |             |           |           |
|        |       | as including | Non-verbal  |           |           |
|        |       | the          | components  |           |           |
|        |       | \'numeric,   |             |           |           |
|        |       | symbolic and |             |           |           |
|        |       | graphic      |             |           |           |
|        |       | information  |             |           |           |
|        |       | (color,      |             |           |           |
|        |       | brightness,  |             |           |           |
|        |       | shape, and   |             |           |           |
|        |       | location of  |             |           |           |
|        |       | information) |             |           |           |
+--------+-------+--------------+-------------+-----------+-----------+

**Appendix A -**

**Household Surveys**

Demographics

     Household Roster and Composition Question

     Relationship

     Race

     Ethnicity

     Education

     Marital Status

     Sexual Identity

Sex

Occupation

Citizenship

Family Composition

Parental Education Attainment

Employment

Employment Status

    Working

    Looking for Work

    Contingent Workers

    Displaced Workers

Employment

> Occupation
>
> Industry

Work Activities

Employer

Job Change

Job Satisfaction

Compensation

Salary/Wages

Benefits (Retirement, Health, Other)

Public Assistance Programs

    TANF (formerly AFDC)

    SSI

    Child care subsidies

    Transportation subsidies

    Job training programs

Income Sources

    Household Income

    Earnings

    Interest and Dividends

    Child Support and Alimony

Expenditures/Prices

Goods/Commodities

Services

Housing

Finances/Wealth/Spending Habits

Unpaid work/other non-market activities

Crime Victimization

    Computer Crime

    Identity theft

Health

    Access to Health Care

    Alternative Health

    Cancer

    Chronic Conditions

        Arthritis

        Asthma

        Chronic

        Bronchitis

        Coronary Heart Disease

        Congestive Heart Failure

        Emphysema

     Disability

     Nutrition

     Dietary Supplements

     Food Sufficiency

*General Health (e.g., health status?)*

     Tobacco Use

         Injury and Poisoning

    Men's Health

*Physical Activity/Exercise*

    Sexual Behavior

    Well Being Outcomes *(what is this?)*

         Adult

         Child

    Women's Health

Education

Pre-K

K-12

Postsecondary

Educational Attainment

Degree Information

Financial Support

Transition from school to work

GPA

Training and Adult Education

Public Attitudes and Understanding of S&T

Public attitudes about S&T

Public interest in S&T

Factual knowledge about S&T

Source of information/media usage

Confidence in institutions

**Establishment Surveys**

Business and Industry Establishments

   Employment (counts)

    Unemployment

Layoffs

Hours

Revenues (\$)

Sales/receipt

    Expenditures (\$)

Capital

Payroll R&D

Payroll/Wages/Earnings

Benefits

Compensation

Occupational Safety and Health

> Injury
>
> Illness

Productivity

Domestic

International

Foreign Labor

Projections

Economic Growth

Employment demand

Prices

Domestic Production

Import/Exports

International

Inventory

     Business Type

Industry

        Manufacturing

        Services

        Retail

        Wholesale

        Mining

        Construction

    Foreign Trade

   Governments

Educational Institutions

   Ownership

Educational Institutions

Pre-K

K-12

Postsecondary

Institutional Characteristics

Public vs. Private

Highest Degree Granted

Staff (counts)

Faculty/Teachers

Other Staff (non-faculty research, postdocs)

Enrollment (counts)

Financial assistance for students (counts)

Revenue (\$)

Government

Tuition and Fees

Private Gifts/Grants/Contracts

Endowments

Expenditures (\$)

Academic R&D

Financial Aid

Facilities (Sq.Ft)

Government

Characteristics

Expenditures

**Question Type Taxonomy**

+----------+----------------------------+------------------------------+
| ## Type  | ## Definition              | **Examples**                 |
+----------+----------------------------+------------------------------+
| *        | -   **Describes an action  | # Have you ev                |
| *Events, |     or event**             | er smoked a whole cigarette? |
| Actions, |                            |                              |
| and      | -   **Includes reports of  | When did your                |
| Beh      |     past and present       | injury/poisoning happen?     |
| aviors** |     actions, habits,       |                              |
|          |     behaviors, events and  | Did you ever have a heart    |
|          |     practices**            | attack?                      |
|          |                            |                              |
|          | These reports are          | Do you currently take        |
|          | externally observable.     | insulin for your diabetes?   |
|          | They are not               |                              |
|          | characteristics of people, | In the past 12 months, how   |
|          | households, or             | many times have you seen or  |
|          | institutions, but          | talked to a nurse for care   |
|          | represent some action that | or advice?                   |
|          | was taken. This category   |                              |
|          | includes non-event         | In the last 12 months, have  |
|          | questions, that is, when a | you had surgery?             |
|          | respondent is asked to     |                              |
|          | report whether an action   | In the last 12 months, have  |
|          | or event did *not* take    | your tonsils been removed?   |
|          | place. It also includes    |                              |
|          | the naming of something    | What type of vehicle struck  |
|          | related to an event.       | your vehicle?                |
|          |                            |                              |
|          |                            | During the past 12 months,   |
|          |                            | has medical care been        |
|          |                            | delayed because of worry     |
|          |                            | about the cost?              |
|          |                            |                              |
|          |                            | Are you paying an additional |
|          |                            | premium for a supplemental   |
|          |                            | health insurance plan?       |
|          |                            |                              |
|          |                            | How old were you when you    |
|          |                            | first started to smoke       |
|          |                            | fairly regularly?            |
|          |                            |                              |
|          |                            | Has a doctor ever told you   |
|          |                            | that you have asthma?        |
+----------+----------------------------+------------------------------+
| **Obj    | -   **Describes            | Do you have diabetes?        |
| ective** |     characteristics of the |                              |
|          |     respondent, household, | Do you have insurance that   |
| **C      |     household member,      | you purchase directly?       |
| haracter |     establishment,         |                              |
| istics** |     employee or some other | Do you have any type of      |
|          |     group**                | government-sponsored         |
|          |                            | insurance such as medicare,  |
|          | -   **Is verifiable        | medicaid, medi-GAP, or CHIP? |
|          |     information**          |                              |
|          |                            | How old are you?             |
|          | Objective characteristics  |                              |
|          | are traits of individuals, | What is your weight?         |
|          | households, or             |                              |
|          | institutions. It can       | Because of a health problem, |
|          | include something they     | are you unable to walk       |
|          | have, received, are aware  | without using any special    |
|          | of, or were told about.    | equipment?                   |
|          | For example, questions     |                              |
|          | fitting into this category |                              |
|          | would include questions    |                              |
|          | about whether people       |                              |
|          | "have" a chronic           |                              |
|          | condition, health          |                              |
|          | insurance plan or whether  |                              |
|          | they are aware of another  |                              |
|          | kind of condition that     |                              |
|          | they might have.           |                              |
|          | Question coding is         |                              |
|          | assessing whether the      |                              |
|          | question content is        |                              |
|          | objective, regardless of   |                              |
|          | question design intent.    |                              |
+----------+----------------------------+------------------------------+
| **Subj   | -   **Describes            | In general, how would you    |
| ective** |     characteristics of the | rate your health today?      |
|          |     respondent, household, |                              |
| **C      |     household member,      | Do you consider yourself to  |
| haracter |     establishment,         | have a disability?           |
| istics** |     employee or some other |                              |
|          |     group**                | Do you need the help of      |
|          |                            | another person with          |
|          | -   **Is [not]{.underline} | preparing meals? *(as        |
|          |     verifiable             | opposed to: Does another     |
|          |     information**          | person prepare your meals    |
|          |                            | for you?)*                   |
|          | A subjective               |                              |
|          | characteristic is a        | By yourself, and without     |
|          | personal state that is a   | using any special equipment, |
|          | matter of perception. Even | how difficult is it for you  |
|          | if these characteristics   | to stand or be on your feet  |
|          | were well-defined, they    | for about 2 hours?           |
|          | could not be externally    |                              |
|          | verified, and there is no  | Overall in the last 30 days, |
|          | "true" answer. Question    | how much distress, sadness   |
|          | coding is assessing        | or worry did you experience? |
|          | whether the question       |                              |
|          | content is subjective,     | Because of a health problem, |
|          | regardless of question     | do you have difficulty       |
|          | design intent.             | walking without using any    |
|          |                            | special equipment?           |
+----------+----------------------------+------------------------------+
| **Specul | -   **Ask about            | Do you plan to visit the     |
| ations** |     intentions,            | dentist in the next six      |
|          |     predictions or         | months?                      |
|          |     hypothetical           |                              |
|          |     situations**           | How likely are you to lose   |
|          |                            | 10 pounds over the next      |
|          | Speculative questions are  | year?                        |
|          | about events, behaviors,   |                              |
|          | practices that have not    | If you were in a car         |
|          | yet occurred, or they      | accident, who would you call |
|          | present hypothetical       | first?                       |
|          | situations to which the    |                              |
|          | respondent must evaluate   | John cannot wash, groom or   |
|          | or provide prediction.     | dress himself without        |
|          | Unlike "report" questions  | personal help. He has no     |
|          | that inquire into past or  | problems with feeding. How   |
|          | present events, the tense  | would you rate his           |
|          | of speculations is future  | difficulty with self-care?   |
|          | or subjunctive.            |                              |
|          |                            | What are your chances of     |
|          |                            | getting HIV?                 |
+----------+----------------------------+------------------------------+
| **Att    | -   **Ask about Attitudes  | On a scale from 0 to 5 (with |
| itudes** |     and opinions**         | 0 being not at all and 5     |
|          |                            | being very strong), how      |
|          | The general format of      | strongly do you believe that |
|          | these questions is to ask  | children should be           |
|          | for an opinion, a          | immunized?                   |
|          | preference, or a           |                              |
|          | particular position. The   | Would you like to weigh      |
|          | response options generally | more?                        |
|          | appear in the form of a    |                              |
|          | scale.                     |                              |
|          |                            |                              |
|          | []{.mark}                  |                              |
+----------+----------------------------+------------------------------+
| **K      | -   **Tests respondents'   | Does trans fat raise blood   |
| nowledge |     knowledge**            | cholesterol, lower it or     |
| Tests**  |                            | have no effect on blood      |
|          | Knowledge questions verify | cholesterol?                 |
|          | the level of knowledge     |                              |
|          | respondents have regarding | Do you believe that          |
|          | a particular subject       | immunizations are harmful to |
|          | matter. They ask about     | children under 2 years old?  |
|          | externally verifiable      |                              |
|          | facts, where some outside  | Can you name the mayor of    |
|          | source of information will | Baltimore?                   |
|          | be considered as a "gold   |                              |
|          | standard" and the point of | Have you ever heard of       |
|          | the question is to see how | Medicare?                    |
|          | well respondent knowledge  |                              |
|          | compares to that standard  |                              |
|          |                            |                              |
|          | Include awareness about    |                              |
|          | events or questions asking |                              |
|          | if someone has ever "heard |                              |
|          | of" a particular program.  |                              |
+----------+----------------------------+------------------------------+
| *        | -   **Question types that  |                              |
| *Other** |     do not fit any of the  |                              |
|          |     above categories.**    |                              |
+----------+----------------------------+------------------------------+

Appendix E

**Response Error Indicators (for non-establishment surveys)**

+------------------+---------------------------+-----------------------+
| PERCEPTION       |                           |                       |
+------------------+---------------------------+-----------------------+
| 1.  Interviewer  | **Question is difficult   | 1\. What was the date |
|     Difficulty   | to administer from        | of your most recent   |
|     **(intervie  | interviewer perspective** | injury/poisoning?     |
| wer-administered |                           |                       |
|     only)**      | 1\. Cannot be read in a   | 2\. In the last year, |
|                  | standardized manner       | was anyone in your    |
|                  |                           | household poisoned?   |
|                  | 2\. Unclear what parts of | Read when necessary:  |
|                  | the question should be    | Do not include sun or |
|                  | read                      | food poisoning or     |
|                  |                           | reaction to poison    |
|                  | 3\. Interviewer cannot    | ivy.                  |
|                  | administer without        |                       |
|                  | obtaining information not | 3\. (Without asking   |
|                  | previously collected.     | if R works) Do you    |
|                  |                           | work full-time or     |
|                  |                           | part-time?            |
+------------------+---------------------------+-----------------------+
| 2.  Problematic  | **Ambiguous, inadequate,  | Sometimes using SKIP  |
|     Visual Cues  | or inconsistent visual or | TO; other times using |
|                  | navigational cues**       | GO TO to mean the     |
| > **(s           |                           | same thing.           |
| elf-administered | Includes respondent or    |                       |
| > only)**        | interviewer problems with |                       |
|                  |                           |                       |
|                  | -   skip patterns         |                       |
|                  |                           |                       |
|                  | -   bold/italics          |                       |
|                  |                           |                       |
|                  | -   color contrast        |                       |
|                  |                           |                       |
|                  | -   difficulty reading    |                       |
|                  |     due to typography     |                       |
|                  |                           |                       |
|                  | This also occurs when the |                       |
|                  | same cue is used to mean  |                       |
|                  | different things, or      |                       |
|                  | different                 |                       |
+------------------+---------------------------+-----------------------+
| 3.  Not          | **Instructions or         |                       |
|     seen/read    | definitions or part of    |                       |
|                  | the question text was     |                       |
| > **(s           | unnoticed by respondent   |                       |
| elf-administered | or interviewer**          |                       |
| > only)**        |                           |                       |
|                  | Part or all of the        |                       |
|                  | question, definition, or  |                       |
|                  | instructions associated   |                       |
|                  | with the question were    |                       |
|                  | not seen or not read by   |                       |
|                  | the respondent or by the  |                       |
|                  | interviewer.              |                       |
+------------------+---------------------------+-----------------------+
| COMPREHENSION    |                           |                       |
+------------------+---------------------------+-----------------------+
| 1.  Problematic  | **Contains inappropriate  | 1\. Have you ever     |
|     Terms        | or unfamiliar terms**     | used a dental         |
|                  |                           | sealant?              |
|                  | -   Unknown terms         |                       |
|                  |                           |                       |
|                  | -   Terms used out of     |                       |
|                  |     context or            | 2\. How often do you  |
|                  |     inappropriately       | use a dosimeter?      |
|                  |                           |                       |
|                  | -   Overly technical      |                       |
|                  |     language/jargon       |                       |
+------------------+---------------------------+-----------------------+
| 2.  Ambiguous    | **Contains vague or       | 1\. How many hours a  |
|     Concepts     | ambiguous concepts**      | week do you [work     |
|                  |                           | near]{.underline} a   |
|                  | -   Ambiguous or vague    | [large electrical     |
|                  |     concepts or terms     | machine]{.underline}? |
|                  |                           | (If a respondent      |
|                  | -   missing reference     | constantly passes by  |
|                  |     period                | a machine for a few   |
|                  |                           | seconds, is that      |
|                  | -   concepts with         | *working near*?       |
|                  |     multiple              | *Large* is vague;     |
|                  |     interpretations -     | some people might     |
|                  |     answer could vary     | categorize a drill    |
|                  |     depending upon which  | press as large, while |
|                  |     interpretation was    | others would not.)    |
|                  |     taken                 |                       |
|                  |                           | 2\. Do you need the   |
|                  | -   Instructions or       | help of other persons |
|                  |     definitions are       | in handling personal  |
|                  |     missing or inadequate | care needs?           |
|                  |                           | (Respondent may "get  |
|                  |                           | help" but not "need   |
|                  |                           | help"; they may not   |
|                  |                           | be sure which answer  |
|                  |                           | is most appropriate.) |
|                  |                           |                       |
|                  |                           | 13\. Did you have sex |
|                  |                           | with your current     |
|                  |                           | partner? (Could refer |
|                  |                           | to intercourse or     |
|                  |                           | other forms of        |
|                  |                           | intimate contact;     |
|                  |                           | answer might vary     |
|                  |                           | depending upon        |
|                  |                           | interpretation.)      |
+------------------+---------------------------+-----------------------+
| 3.  Overly       | **Question is long or     |   1. Do you have any  |
|     Complex      | overly complex  **        | [di                   |
|                  |                           | fficulty]{.underline} |
|                  | -   Respondents are       | hearing, seeing,      |
|                  |     unable to remember or | communicating,        |
|                  |     synthesize the        | walking, climbing     |
|                  |     details in the        | stairs, bending,      |
|                  |     question because of   | learning or doing any |
|                  |     the length            | similar activities?   |
|                  |                           |                       |
|                  | -   Overuse of            |  2. What kind of      |
|                  |     qualifiers, such as   | health insurance or   |
|                  |     "including" and "not  | health care coverage  |
|                  |     counting"             | do you have? Include  |
|                  |                           | those that pay for    |
|                  | -   Important ideas are   | only one type of      |
|                  |     missed because they   | service (nursing home |
|                  |     are buried within the | care, accidents, or   |
|                  |     question              | dental care). Exclude |
|                  |                           | private plans that    |
|                  | -   Unnecessary           | only provide extra    |
|                  |     grammatical           | cash while            |
|                  |     complications (e.g.   | hospitalized.         |
|                  |     double-negatives) or  |                       |
|                  |     awkward structure     |  3. In the past 12    |
|                  |                           | months, how many      |
|                  |                           | times have you seen   |
|                  |                           | or talked on the      |
|                  |                           | telephone about your  |
|                  |                           | physical, emotional   |
|                  |                           | or mental health with |
|                  |                           | a family doctor or    |
|                  |                           | general practitioner? |
|                  |                           | (Many do not hear     |
|                  |                           | "seen" and respond    |
|                  |                           | with only the number  |
|                  |                           | of times spoken on    |
|                  |                           | the telephone)        |
+------------------+---------------------------+-----------------------+
| 4.  A            | **Question makes          | Do you think women    |
| ssumption/Double | inaccurate assumption     | and children should   |
|     Barrel       | about respondents'        | have universal health |
|                  | experiences**             | care coverage?        |
|                  |                           | (Respondents who      |
|                  | **Question asks about two | think children        |
|                  | different concepts, but   | should, but not       |
|                  | assumes a single answer** | necessarily women,    |
|                  |                           | might be unsure how   |
|                  |                           | to answer.)           |
|                  |                           |                       |
|                  |                           | When did you stop     |
|                  |                           | beating your wife?    |
|                  |                           | (Assumes the          |
|                  |                           | respondent has done   |
|                  |                           | this.)                |
|                  |                           |                       |
|                  |                           | When riding in the    |
|                  |                           | back seat of a car,   |
|                  |                           | how often do you wear |
|                  |                           | a seat belt? (Assumes |
|                  |                           | the respondent ever   |
|                  |                           | rides in the back     |
|                  |                           | seat of a car.)       |
|                  |                           |                       |
|                  |                           | As a result of this   |
|                  |                           | injury/poisoning, how |
|                  |                           | much work did you     |
|                  |                           | miss?                 |
+------------------+---------------------------+-----------------------+
| RETRIEVAL        |                           |                       |
+------------------+---------------------------+-----------------------+
| 1.  R            | **Respondent does not     | What is the dosage of |
| ecall/Estimation | know or has difficulty    | your asthma           |
|     Difficulty   | recalling information.**  | medication?           |
|                  |                           |                       |
|                  | **Response is subject to  | In your lifetime,     |
|                  | error because of          | with how many people  |
|                  | calculation or estimation | have you had sex?     |
|                  | difficulty.**             |                       |
|                  |                           | Do you think the Lt.  |
|                  | The difficulty may be     | Governor of Delaware  |
|                  | because of memory trouble | has been doing a good |
|                  | or because the respondent | job?                  |
|                  | never knew the            |                       |
|                  | information to begin      | * *                   |
|                  | with.                     |                       |
|                  |                           | On what date did you  |
|                  | -   Topic is of low       | first ride a bicycle? |
|                  |     salience to R         |                       |
|                  |     (especially for       | In the past three     |
|                  |     attitude questions)   | years, how many times |
|                  |                           | did you visit a       |
|                  | ```{=html}                | doctor?               |
|                  | <!-- -->                  |                       |
|                  | ```                       | In your lifetime, how |
|                  | -   Question asks about   | many cigarettes have  |
|                  |     information the       | you smoked?           |
|                  |     respondent is         |                       |
|                  |     unlikely to know      | Asking floor manager  |
|                  |                           | about hours that the  |
|                  | -   Telescoping: Specific | office staff works.   |
|                  |     recall problem where  |                       |
|                  |     events before the     | Asking proxy for      |
|                  |     reference period are  | information proxy is  |
|                  |     recalled as being     | not likely to have.   |
|                  |     within the reference  |                       |
|                  |     period.               |                       |
|                  |                           |                       |
|                  | -   Requires broad        |                       |
|                  |     reliance on           |                       |
|                  |     estimation (a wild    |                       |
|                  |     guess is the best     |                       |
|                  |     possible result).     |                       |
|                  |                           |                       |
|                  | -   Guessing or assuming  |                       |
|                  |     the answer --         |                       |
|                  |     ballparking           |                       |
|                  |                           |                       |
|                  | -   Trouble making        |                       |
|                  |     calculations in head  |                       |
+------------------+---------------------------+-----------------------+
| JUDGEMENT        |                           |                       |
+------------------+---------------------------+-----------------------+
| 1.               | **Response process is     |  1.  Are you in favor |
|   Sensitive/Bias | influenced by either the  | of allowing the       |
|                  | sensitive or social       | interests of big      |
|                  | context of the question   | business to dominate  |
|                  | topic.**                  | the Congressional     |
|                  |                           | agenda, or are you in |
|                  |                           | favor of sensible     |
|                  |                           | legislation to        |
|                  |                           | moderate the          |
|                  |                           | influence of outside  |
|                  |                           | lobbyists?            |
|                  |                           |                       |
|                  |                           | 2\. With how many men |
|                  |                           | have you had sex?     |
|                  |                           |                       |
|                  |                           |                       |
+------------------+---------------------------+-----------------------+
| 1                | **Question problem        |   1. Do you have      |
| .  Questionnaire | related to the            | asthma?               |
|     Effects      | questionnaire**           |                       |
|                  |                           | Do you have chronic   |
|                  | Question would not        | bronchitis?           |
|                  | necessarily have a        |                       |
|                  | problem independently,    | Do you have coronary  |
|                  | but there is a problem    | heart disease?        |
|                  | related to the entire     |                       |
|                  | questionnaire.            | What was you total    |
|                  |                           | household income      |
|                  | -   Illogical             | before taxes in       |
|                  |     juxtaposition of      | 2002?                 |
|                  |     topics/awkward flow   |                       |
|                  |                           | 2\. Series of         |
|                  | -   Response of question  | questions about       |
|                  |     is impacted by        | exercise where "no"   |
|                  |     previous questions    | responses start to    |
|                  |     (i.e. context or      | create an image of    |
|                  |     order effects)        | inactivity that makes |
|                  |                           | the respondent        |
|                  | -   Inconsistent verbal   | uncomfortable;        |
|                  |     format across similar | questions that        |
|                  |     or related questions  | respondents seem      |
|                  |                           | reluctant to answer   |
|                  | -   Questions are         |                       |
|                  |     perceived to be       |  3. Most questions in |
|                  |     repetitive            | the series ask        |
|                  |                           | "agree/disagree," but |
|                  | -   Burdensome length of  | then a few switch to  |
|                  |     the questionnaire     | "true/false."         |
|                  |                           |                       |
|                  | -   Apparent omissions    |  4. In the 2 years    |
|                  |     that confuse or       | before your first     |
|                  |     irritate respondents. | positive HIV test,    |
|                  |                           | how many times were   |
|                  |                           | you tested for HIV?   |
|                  |                           |                       |
|                  |                           | How often did you get |
|                  |                           | tested for HIV in the |
|                  |                           | 2 years before your   |
|                  |                           | first positive HIV    |
|                  |                           | test?                 |
|                  |                           |                       |
|                  |                           |  5. R complains about |
|                  |                           | length or does not    |
|                  |                           | concentrate to        |
|                  |                           | provide accurate      |
|                  |                           | information           |
|                  |                           |                       |
|                  |                           |  6. In a              |
|                  |                           | questionnaire for     |
|                  |                           | truck drivers about   |
|                  |                           | toxic exposures, R    |
|                  |                           | comments that there   |
|                  |                           | were no questions     |
|                  |                           | about exhaust from    |
|                  |                           | other cars, which is  |
|                  |                           | one of the worst      |
|                  |                           | problems.             |
+------------------+---------------------------+-----------------------+
| []{.mark}        |                           |                       |
|                  |                           |                       |
| RESPONSE         |                           |                       |
+------------------+---------------------------+-----------------------+
| 1.  Inadequate   | **Response options are    |    1. Do you NOW      |
|     Response     | incomplete, inadequate or | smoke cigarettes      |
|     Options      | overlapping**             | every day, some days  |
|                  |                           | or not at all? (Many  |
|                  | -   R cannot adequately   | people want to report |
|                  |     express their         | "many days" because   |
|                  |     response given the    | "some days" seems not |
|                  |     categories provided   | enough)               |
|                  |                           |                       |
|                  | -   Non-mutually          |   2. What was the     |
|                  |     exclusive response    | reason that you had   |
|                  |     options; two          | a mammogram?\[Pick    |
|                  |     categories could      | one: Regular check    |
|                  |     apply, but only one   | up, doctor suggested  |
|                  |     can be selected       | it, had concern that  |
|                  |                           | there was a problem,  |
|                  | -   Response options do   | thought it was time   |
|                  |     not fit the question  | to get one.           |
|                  |                           |                       |
|                  | -   Response units are    |  3.Does a long-term   |
|                  |     inappropriate         | physical condition or |
|                  |                           | mental condition or   |
|                  | -   Response categories   | health problem,       |
|                  |     include a problematic | reduce the amount or  |
|                  |     term, are ambiguous,  | the kind of activity  |
|                  |     or are overly complex | you can do at home?   |
|                  |                           | Sometimes. Often or   |
|                  | -   Length of response    | Never.                |
|                  |     options places burden |                       |
|                  |     on respondent,        | 4\. How many          |
|                  |     causing respondents   | canisters of asthma   |
|                  |     to overlook           | medications do you    |
|                  |     appropriate responses | use per month?        |
|                  |     or to choose the      |                       |
|                  |     first response that   | \_\_\_\_\_\_ Number   |
|                  |     appears to be         | of canisters          |
|                  |     appropriate without   |                       |
|                  |     considering           | (Most use no more     |
|                  |     subsequent responses  | than one canister per |
|                  |                           | month)                |
+------------------+---------------------------+-----------------------+
| 1.  Problematic  | **Format of response      |                       |
|     Answer Space | options induce error**    |                       |
|     (se          |                           |                       |
| lf-administered) | Error is induced by the   |                       |
|                  | space given for a         |                       |
|                  | respondent to provide an  |                       |
|                  | answer                    |                       |
|                  |                           |                       |
|                  | -   Inappropriate space   |                       |
|                  |     (not enough or too    |                       |
|                  |     much) for recording   |                       |
|                  |     answers               |                       |
|                  |                           |                       |
|                  | -   Unclear locations for |                       |
|                  |     answer space          |                       |
+------------------+---------------------------+-----------------------+

**Establishment Response Error Indicators (Under evaluation)**

+--------------+-------------+-------------------+-------------------+
| **Retrieval  | **Mismatch  | The structural    | Decennial census  |
| from         | between     | unit for which    | asks for          |
| Records**    | reporting   | data are          | information about |
|              | unit and    | requested does    | a household, but  |
|              | org         | not match the     | respondents may   |
|              | anizational | respondent's      | naturally         |
|              | unit**      | natural or        | organize          |
|              |             | structural way of | information by    |
|              |             | organizing the    | family, which     |
|              |             | information.      | includes children |
|              |             |                   | living at college |
|              |             |                   | and excludes      |
|              |             |                   | boarders.         |
|              |             |                   |                   |
|              |             |                   | Company records   |
|              |             |                   | information for   |
|              |             |                   | two subsidiaries, |
|              |             |                   | both of which     |
|              |             |                   | have retail and   |
|              |             |                   | service           |
|              |             |                   | operations.       |
|              |             |                   | Question asks     |
|              |             |                   | about only the    |
|              |             |                   | retail.           |
|              |             |                   |                   |
|              |             |                   | Wholesale company |
|              |             |                   | combines merchant |
|              |             |                   | wholesale offices |
|              |             |                   | and               |
|              |             |                   | manufacturer's    |
|              |             |                   | sales or branch   |
|              |             |                   | offices;          |
|              |             |                   | questions want    |
|              |             |                   | them separated.   |
+--------------+-------------+-------------------+-------------------+
|              | **Mismatch  | Data for topic of | Question asks for |
|              | between     | interest exists   | calendar year     |
|              | requested   | in records, but   | information, but  |
|              | data and    | not in the manner | data is kept on a |
|              | records**   | requested.        | fiscal year       |
|              |             |                   | basis.            |
|              |             |                   |                   |
|              |             |                   | Question asks     |
|              |             |                   | about one week,   |
|              |             |                   | but records are   |
|              |             |                   | kept on a monthly |
|              |             |                   | basis.            |
|              |             |                   |                   |
|              |             |                   | Question asks for |
|              |             |                   | sales of polo     |
|              |             |                   | shirts and        |
|              |             |                   | button-down       |
|              |             |                   | shirts, but       |
|              |             |                   | records only      |
|              |             |                   | contain sales for |
|              |             |                   | all "shirts," not |
|              |             |                   | broken down by    |
|              |             |                   | type.             |
+--------------+-------------+-------------------+-------------------+
|              | **Requested | survey asks for   | What was the      |
|              | data not    | information that  | approximate       |
|              | kept in     | is not tracked in | percentage of     |
|              | records**   | records           | 2002 mileage that |
|              |             |                   | was accounted for |
|              |             |                   | by travel on      |
|              |             |                   | interstate        |
|              |             |                   | highways, other   |
|              |             |                   | divided highways, |
|              |             |                   | and undivided     |
|              |             |                   | roadways?         |
+--------------+-------------+-------------------+-------------------+
|              | **Lack of   | Data exists in    | Human Resources   |
|              | access to   | records, but      | respondent does   |
|              | requested   | respondent has    | not have access   |
|              | data**      | not been granted  | to sales          |
|              |             | access to that    | information.      |
|              |             | information       |                   |
|              |             |                   | Respondent in     |
|              |             |                   | Financial         |
|              |             |                   | Accounting Office |
|              |             |                   | does not have     |
|              |             |                   | access to         |
|              |             |                   | inventory         |
|              |             |                   | information.      |
+--------------+-------------+-------------------+-------------------+
|              | **De        | Data requested    | Question asks     |
|              | centralized | does not reside   | about actual      |
|              | data**      | in one location   | hours worked in a |
|              |             | or within one     | reference week    |
|              |             | respondent. It is | for marketing and |
|              |             | necessary to      | sales             |
|              |             | consult multiple  | departments. A    |
|              |             | sources to        | representative    |
|              |             | retrieve          | from each         |
|              |             | information.      | department must   |
|              |             |                   | be asked to       |
|              |             |                   | generate this     |
|              |             |                   | information.      |
+--------------+-------------+-------------------+-------------------+
| **Policy     | **P         | Instead of        |                   |
| imposed      | erpetuating | reading           |                   |
| Judgment**   | prior       | instructions and  |                   |
|              | incorrect   | generating the    |                   |
|              | reporting   | requested data,   |                   |
|              | strategy**  | respondent uses   |                   |
|              |             | an erroneous      |                   |
|              |             | strategy that has |                   |
|              |             | been used in the  |                   |
|              |             | past for          |                   |
|              |             | reporting this    |                   |
|              |             | data.             |                   |
+--------------+-------------+-------------------+-------------------+
|              | **Release   | Written or        |                   |
|              | of data     | unwritten policy  |                   |
|              | p           | prohibits release |                   |
|              | rohibited** | of requested      |                   |
|              |             | data.             |                   |
+--------------+-------------+-------------------+-------------------+
|              | **Not       | Question asks for |                   |
|              | willing to  | data that is      |                   |
|              | divulge     | proprietary.      |                   |
|              | proprietary | Respondent may    |                   |
|              | in          | either lie or     |                   |
|              | formation** | fudge the truth   |                   |
|              |             | to avoid giving   |                   |
|              |             | away              |                   |
|              |             | market-sensitive  |                   |
|              |             | information.      |                   |
+--------------+-------------+-------------------+-------------------+
|              | **Release   | Data can be       |                   |
|              | of data     | released, but not |                   |
|              | conditional | until management  |                   |
|              | upon        | reviews it, or    |                   |
|              | auth        | until it is       |                   |
|              | orization** | announced         |                   |
|              |             | publicly. This    |                   |
|              |             | could result in   |                   |
|              |             | late reporting or |                   |
|              |             | non-response.     |                   |
+--------------+-------------+-------------------+-------------------+
|              |             |                   |                   |
+--------------+-------------+-------------------+-------------------+
|              |             |                   |                   |
+--------------+-------------+-------------------+-------------------+