Appendix A

U.S. PIAAC National Supplement 

Screener (Household-based Sample)
A-1

SCQ0001 OMBIntro

Item Text: According to the Paperwork Reduction Act of 1995, no persons are required 

to respond to a collection of information unless it displays a valid OMB control number. 

The valid OMB control number for this voluntary survey is 1850–0870. The time 

required to complete this survey is estimated to average two hours per response, 

including the time to review instructions, gather the data needed, and complete and 

review the PIAAC background questionnaire and exercise. If you have any comments 

concerning the accuracy of the time estimate, suggestions for improving this survey, or 

any comments or concerns regarding the status of your individual submission of this 

survey, please write directly to: PIAAC, National Center for Education Statistics, 1990 K 

Street, NW, Washington, DC 20006.
A-2

SCQ1010 SCQAskNumberInHH

Item Type: Question

Item Class: Integer

Item Text: Including yourself, how many people live in this household and have no usual place of 

residence elsewhere?

Display:

Notes: Start enumeration timing here.

Lower Range: 1

Answers Allowed: 1 Upper Range: 25

Response Value Label Skip To

1 [Enter continuous answer] SCQ1015

99 REFUSED SCQ1015
A-3

SCQ1015

Item Type: Route

Item Class: Begin Loop

Item Text: The following variables -- name, Screener respondent, gender, age, age range, work 

variables (PaidWork, AwayJob,UnpaidWork, LookWork) and the misreported field

(SCQ1020-SCQ1090) -- should appear as a grid. All enumeration information is 

entered in this grid.

Display:

Notes:

Response Value Label Skip To

1 [Route executed] SCQ1020
Version Date: 1/13/2011 Page 4 of 45

SCQ1020 SCQNameHHM

Item Type: Question

Item Class: String 

Item Text: [A] What is the first name of the person, or one of the persons, who is living in the 

household who owns or rents this home?

[B] Next, please tell me the names of all other members of this household (starting with 

your spouse, if applicable).

[C] Please tell me the names of all other members of this household. 

[HOUSEHOLD (HH) MEMBERS INCLUDE PEOPLE WHO THINK OF THIS HH AS THEIR 

PRIMARY PLACE OF RESIDENCE. IT INCLUDES PERSONS WHO USUALLY STAY IN 

THE HH BUT ARE TEMPORARILY AWAY ON BUSINESS, VACATION, IN A HOSPITAL, 

OR LIVING AT SCHOOL IN A DORM, FRATERNITY OR SORORITY.] 

[PRESS THE DOWN ARROW KEY TO MOVE TO THE NEXT BLANK LINE. WHEN ALL 

NAMES ARE ENTERED, USE ARROW UP AND RIGHT KEYS TO GET TO NEXT 

QUESTION.] 

[PRESS ENTER ON A BLANK LINE TO EXIT THE GRID.] 

[HOUSEHOLD (HH) MEMBERS INCLUDE PEOPLE WHO THINK OF THIS HH AS THEIR 

PRIMARY PLACE OF RESIDENCE. IT INCLUDES PERSONS WHO USUALLY STAY IN 

THE HH BUT ARE TEMPORARILY AWAY ON BUSINESS, VACATION, IN A HOSPITAL, 

OR LIVING AT SCHOOL IN A DORM, FRATERNITY OR SORORITY.] 

[PRESS THE DOWN ARROW KEY TO MOVE TO THE NEXT BLANK LINE. WHEN ALL 

NAMES ARE ENTERED, USE ARROW UP AND RIGHT KEYS TO GET TO NEXT 

QUESTION.] 

Display: For the first line on the grid, display text A. For the second line, display text B. For all 

subsequent lines, display text C.

Notes: Allow 25 characters for names.

This variable should appear as the first column on the grid.

Lower Range:

Answers Allowed: Upper Range:

Response Value Label Skip To

1 [Enter continuous answer] SCQ1025
A-5

SCQ1025 SCQWhoIsRespondent

Item Type: Question

Item Class: Enumerated

Item Text: [ENTER A '1' NEXT TO THE RESPONDENT.]

[IF NOT OBVIOUS, ASK: Thank you for telling me about all the people who live in this 

household. Now, I need to ask your name, so I know which household member you are.]

[ENTER A '1' NEXT TO THE RESPONDENT.]

Display:

Notes: Allow only one response to this question. This variable should appear as the second 

column in the grid.

Answers Allowed: 1

Response Value Label Skip To

1 RESPONDENT Respondent SCQ1030
A-6

SCQ1030

Item Type: Route

Item Class: If Then

Item Text: Allow open movement through grid. Do not require users to ask all items for each person 

before going to the next person.

Display:

Notes:

Response Value Label Skip To

1 [Route executed] SCQ1040
Version Date: 12/11/12 Page 7 of 45

SCQ1040 SCQGender

Item Type: Question

Item Class: Enumerated

Item Text: [CODE GENDER. IF NOT OBVIOUS, ASK: Is {NAME} male or female?]

Display:

Notes:

Answers Allowed: 1

Response Value Label Skip To

1 MALE Male SCQ1050

2 FEMALE Female SCQ1050
Version Date: 12/11/12 Page 8 of 45

SCQ1050 SCQAge

Item Type: Question

Item Class: Integer

Item Text: How old {are you/is NAME}?

[IF UNDER 1 YEAR, ENTER AS "0"]

Display:

Notes: This variable should appear as the fourth column on the grid.

Lower Range: 0

Answers Allowed: 1 Upper Range: 130

Response Value Label Skip To

1 [Enter continuous answer] SCQ1055

98 DON’T KNOW SCQ1062

99 REFUSED SCQ1062
Version Date: 12/11/12 Page 9 of 45

SCQ1055

Item Type: Check

Item Class: Soft

Item Text: If outside the range of 0 to 99, display the following: "I just need to check that 

{your/NAME's} age is {SCQ1050}. Is this right?"

Associated variable: SCQ1050

Display:

Notes:

Response Value Label Skip To

1 [Check executed] SCQ1070
Version Date: 12/11/12 Page 10 of 45

SCQ1062 SCQAgeRange

Item Type: Question

Item Class: Enumerated

Item Text: {Are you/Is NAME}...

Display:

Notes: This variable should appear as the fifth column on the grid.

Answers Allowed: 1

Response Value Label Skip To

1 Under 16 years old? Under16YearsOld SCQ1070

2 16 to 24 years old? F16To24YearsOld SCQ1070

3 25 to 34 years old? F25To34YearsOld SCQ1070

4 35 to 45 years old? F35To45YearsOld SCQ1070

5 46 to 55 years old? F46To55YearsOld SCQ1070

6 56 to 65 years old? F56To65YearsOld SCQ1070

7 66 to 74 years old? F66To74YearsOld SCQ1070

8 75 years old or older? F75YearsOldOrOlder SCQ1070

98 DON’T KNOW SCQ1063

99 REFUSED SCQ1063
Version Date: 12/11/12 Page 11 of 45

SCQ1063 SCQBroadAgeRange

Item Type: Question

Item Class: Enumerated

Item Text: {Are you/Is NAME}...

Display:

Notes: This variable should appear as the sixth column on the grid.

Answers Allowed:

Response Value Label Skip To

1 Under 16 years old? Under16YearsOld_ SCQ1070

2 16 to 34 years old? _16To34YearsOld_ SCQ1070

3 35 to 65 years old? _35To65YearsOld_ SCQ1070

4 66 to 74 years old? _66To74YearsOld_ SCQ1070

5 75 years old or older? _75YearsOldorOlder_ SCQ1070
A-12

SCQ1070 SCQPaidWork

Item Type: Question

Item Class: Enumerated

Item Text: Last week {were you/was NAME} doing PAID work for at least one hour, either as an 

employee or as self-employed?

Display:

Notes: This item should appear as the seventh column on the grid.

If answer “1” Yes, no more screener questions necessary.

Person considered employed.

(67.73% will stop here based on PIAAC 2011)

Answers Allowed: 1

Response Value Label Skip To

1 Yes Yes SCQ1090

2 No No SCQ1071

98 DON’T KNOW SCQ1071

99 REFUSED SCQ1071
Version Date: 12/11/12 Page 13 of 45

SCQ1071 SCQAwayJob

Item Type: Question

Item Class: Enumerated

Item Text: Last week, {were you/was NAME} away from a job or business that {you /NAME} plan(s)

to return to?

Display:

Notes: This item should appear as the eighth column on the grid.

If answer “1” Yes, no more screener questions necessary.

Person considered employed.

(3.28% will stop here based on PIAAC 2011)

Answers Allowed: 1

Response Value Label Skip To

1 Yes Yes SCQ1090

2 No No SCQ1072

98 DON’T KNOW SCQ1072

99 REFUSED SCQ1072
Version Date: 12/11/12 Page 14 of 45

SCQ1072 SCQUnpaidWork

Item Type: Question

Item Class: Enumerated

Item Text: Last week {were you/was NAME} doing UNPAID work for at least one hour for a business 

that {you/NAME} own(s) or a relative owns?

Display:

Notes: This item should appear as the eighth column on the grid.

If answer “1” Yes, no more screener questions necessary.

Person considered employed.

(1.65% will stop here based on PIAAC 2011)

Answers Allowed: 1

Response Value Label Skip To

1 Yes Yes SCQ1090

2 No No SCQ1073

98 DON’T KNOW SCQ1073

99 REFUSED SCQ1073
A-15

SCQ1073 SCQLookWork

Item Type: Question

Item Class: Enumerated

Item Text: In the 4 weeks ending last Sunday, {were you/was NAME} looking for paid work at any 

time?

Display:

Notes: This item should appear as the ninth column on the grid.

If answer “1” Yes, person considered unemployed.

Answers Allowed: 1

Response Value Label Skip To

1 Yes Yes SCQ1090

2 No No SCQ1090

98 DON’T KNOW SCQ1090

99 REFUSED SCQ1090
A-16

SCQ1090 SCQMisreportedHHM

 Item Type: Instruction

Item Class: Enumerated

Item Text: [LEAVE EMPTY UNLESS PERSON WAS MISREPORTED AND IS NOT A HOUSEHOLD 

MEMBER. IF MISREPORTED, ENTER "1".]

Display: Do not allow "MISREPORT" as an option on the first line of the grid, (reference person). If 

a person is marked as "MISREPORTED," all other fields on the grid associated with this 

person should be "show only."

Notes: The default for this field is blank - it will only be filled if necessary.

This variable should appear as the tenth column on the grid.

Response Value Label Skip To

1 MISREPORTED Misreported SCQ1100
A-17

SCQ1100 SCQAllInfoEntered

Item Type: Question

Item Class: Enumerated

Item Text: Check enumeration grid to ensure that all necessary items have been answered. If any 

necessary fields are blank, return to grid. Else, go to SCQ1105.

Display:

Notes:

Response Value Label Skip To
A-18

SCQ1105 SCQAnyoneElse

Item Type: Route

Item Class: If Then

Item Text: We have listed {NUMBER} household member{s}:

{NAME/GENDER/AGE} Have we missed any other... 

- members of this household who are related to {you/REFERENCE PERSON}?

- people living here who are not related to {you/REFERENCE PERSON}, including friends 

or boarders? 

- household members who usually live here but are not here currently, such as someone 

away on vacation, business, in a hospital, or a student living in a dormitory?

Display: Display the number of household members collected in the enumeration grid in {NUMBER}.

Display the name, gender and age of all household members collected in the grid in

{NAME/GENDER/AGE}.

Notes: The number of household members collected in the enumeration grid is the value that 

should be stored as household size.

End enumeration timing here when all household members information collected in grid and 

SCQ1105=2.

Answers Allowed: 1

Response Value Label Skip To

1 YES Yes SCQ1106

2 NO No SCQ1110

99 REFUSED SCQ1110
A-19

SCQ1106

Item Type: Check

Item Class: Hard

Item Text: PLEASE ADD ADDITIONAL INFORMATION TO THE TABLE. 

Display:

Notes: If SCQ1105 < >Yes

Response Value Label Skip To

1 [Check executed] SCQ1020
A-20

SCQ1110

Item Type: Route

Item Class: If Then

Item Text: Insert sampling messages here. Based on collected household characteristics, determine 

if there is at least one eligible person in the household.

If there is at least one eligible person, then go to SCQ1115. 

Else, go to SCQ1124.

Display:

Notes: Eligibility is determined at the time enumeration is completed. SCQ1105 is the final 

enumeration question that must be answered to determine eligibility.

Response Value Label Skip To

1 [Route executed]
A-21

SCQ1115 SCQEligiblePersons

Item Type: Instruction

Item Class: Enumerated

Item Text: Based on the information you have provided, we have selected the following people to 

participate in the study: {PERSON(S)}

[PRESS 1 AND ENTER TO CONTINUE.]

Display:

Notes: Display name, age and gender of eligible SP(s) in "PERSON(S)".

Response Value Label Skip To

1 CONTINUE Continue SCQ116a
A-22

SCQ116a SCQDOB

Item Type: Question

Item Class: Integer

Item Text: What is ^AuxNameYour birth date?

Display: Interviewer Instruction – Enter complete date, including date, month and year. If 

respondent does not know complete date enter DK. If respondent refuses to provide 

complete date, enter RF.

Notes: ENTER AS DD/MM/YYYY.

 CAPI Instr: Soft edit to compare SCQ116a to Screener Age SCQXXXX.If difference is greater than 

one year, display the edit: “ I need to verify what I entered. I recorded that ^AuxNameYour 

date of birth is SCQ 116aDOB. Is this correct?”

Response Value Label Skip To

1 [Enter Continuous answer] Continue SCQ1117

9 DON’T KNOW SCQ116bMM

7 REFUSED SCQ116bMM

Item Type: Check

Item Class: Hard edit

Item Text: Date cannot be in future

Item Class: Soft edit

Item Text: Date cannot be before 1/1/1890

Derived age must be +/- 1 of enumeration age
A-23

SCQ116bMM

Item Type: Question

Item Class: Integer

Item Text: Can you please tell me ^AuxNameYour month of birth?”

Notes: [ENTER AS MM]

 If DON”T KNOW OR REFUSED then current month used

Lower Range : 1

Upper Range : 12

Response Value Label Skip To

1 [Enter Continuous answer] Continue SCQ116cYY

9 DON’T KNOW SCQ116cYY

7 REFUSED SCQ116cYY
A-24

SCQ116cYY

Item Type: Question

Item Class: Integer

Item Text: Can you please tell me ^AuxNameYour year of birth?”

Notes: [ENTER AS YYYY]

 CAPI Instr: Soft edit to compare SCQ116cYYYY to Screener Age SCQXXXX. If difference is greater 

than one year, display the edit: “ I need to verify what I entered. I recorded that 

^AuxNameYour year of birth is SCQ 116cYYYY. Is this correct?”

If DON”T KNOW OR REFUSED then backward calculate year from enumeration age.

Day set = 15(mid-month) for date calculations.

Response Value Label Skip To

1 [Enter Continuous answer] Continue SCQ1117

9 DON’T KNOW SCQ1117

7 REFUSED SCQ1117

Item Type: Check

Item Class: Hard edit

Item Text: Year cannot be in future

Item Class: Soft edit

Item Text: Year cannot be before 1890

Derived age must be +/- 1 of enumeration age

Note: When done, the following variables set or derived – SCQ1116Age (derived age); 

SCQ1116a (day of derived DOB); SCQ1116b (month of derived DOB); SCQ1116c (year 

of derived DOB).
A-25

SCQ1117 SCQSPEthnicity

Item Type: Question

Item Class: Enumerated

Item Text: [SHOWCARD 1] 

Do any of the following groups represent {your/NAME's} national origin or ancestry? 

Mexican/Mexican-American, Puerto Rican, Cuban, other Hispanic or Latino? You can 

select more than one answer. 

[SELECT ALL THAT APPLY.] 

Display:

Notes:

Answers Allowed:

Response Value Label Skip To

1 MEXICAN/MEXICAN-AMERICAN Mexican_Mexican_American SCQ1118

2 PUERTO RICAN PuertoRican SCQ1118

3 CUBAN Cuban SCQ1118

4 OTHER HISPANIC OR LATINO OtherHispanicOrLatino SCQ1118

5 NOT HISPANIC NotHispanic SCQ1118

98 DON’T KNOW SCQ1119

99 REFUSED SCQ1119
A-26

SCQ1118

Item Type: Check

Item Class: Hard

Item Text: If SCQ1117=5 and another response, display: "I'm sorry, but NOT HISPANIC is not allowed

with any other response."

Display:

Notes:

Response Value Label Skip To

1 [Check executed] SCQ1121
A-27

SCQ1119 SCQEthnicityObserve

Item Type: Question

Item Class: Enumerated

Item Text: [RECORD SP'S ETHNICITY BY OBSERVATION, IF POSSIBLE] 

Display:

Notes:

Answers Allowed:

Response Value Label Skip To

1 MEXICAN/MEXICAN-AMERICAN Mexican_Mexican_American SCQ1121

2 PUERTO RICAN PuertoRican SCQ1121

3 CUBAN Cuban SCQ1121

4 OTHER HISPANIC OR LATINO OtherHispanicOrLatino SCQ1121

5 NOT HISPANIC NotHispanic SCQ1121

98 DON’T KNOW SCQ1121
A-28

SCQ1121 SCQSPRace

Item Type: Question

Item Class: Enumerated

Item Text: [SHOWCARD 2]

What race do you consider {yourself/NAME} to be? White, Black or African American, 

Asian, Native Hawaiian or other Pacific Islander, or American Indian or Alaska Native? You

can select more than one answer. 

[SELECT ALL THAT APPLY.] 

Display:

Notes:

Answers Allowed:

Response Value Label Skip To

1 WHITE White SCQ1123

2 BLACK/AFRICAN AMERICAN Black_AfricanAmerican SCQ1123

3 ASIAN Asian SCQ1123

4 NATIVE HAWAIIAN/PACIFIC NativeHawaiian_PacificIslander SCQ1123

ISLANDER

5 AMERICAN INDIAN/ALASKA AmericanIndian_AlaskaNative SCQ1123

NATIVE

98 DON’T KNOW SCQ1122

99 REFUSED SCQ1122
A-29

SCQ1122 SCQRaceObserve

Item Type: Question

Item Class: Enumerated

Item Text: [RECORD SP’S RACE BY OBSERVATION, IF POSSIBLE]

Display:

Notes:

Answers Allowed:

Response Value Label Skip To

1 WHITE White SCQ1123

2 BLACK/AFRICAN AMERICAN Black_AfricanAmerican SCQ1123

3 ASIAN Asian SCQ1123

4 NATIVE HAWAIIAN/PACIFIC NativeHawaiian_PacificIslander SCQ1123

ISLANDER

5 AMERICAN INDIAN/ALASKA AmericanIndian_AlaskaNative SCQ1123

NATIVE

98 DON’T KNOW SCQ1123
A-30

SCQ1123

Item Type: Question

Item Class: If then

Item Text: If another SP, go to SCQ1117.

Else, go to SCQ1124.

Display:

Notes:

Response Value Label Skip To

1 [Route executed]
A-31

SCQ1124 SCQHomePhone

Item Type: Question

Item Class: Enumerated

Item Text: What is your home telephone number (in case my office wants to check my work)?

Display:

Notes:

Answers Allowed: 1

Response Value Label Skip To

1 ENTER PHONE NUMBER EnterPhoneNumber SCQ1125

2 NO HOME PHONE NoHomePhone SCQ1150

99 REFUSED SCQ1150
A-32

SCQ1125 SCQPhoneNo

Item Type: Question

Item Class: Integer

Item Text: What is your home telephone number (in case my office wants to check my work)?]

NUMBER: ({AREA}) {EXCHANGE}-{LOCAL}

 Display: 10-digit string

Notes:

Lower Range:

Answers Allowed: Upper Range:

Response Value Label Skip To

1 [Enter continuous answer] SCQ1140
A-33

SCQ1140 SCQPhoneConfirm

Item Type: Question

Item Class: Enumerated

Item Text: CONFIRM TELEPHONE NUMBER: ({AREA}){EXCHANGE}-{LOCAL}

 

Display:

 

Notes:

Response Value Label Skip To

1 YES Yes SCQ1150

2 NO No SCQ1145
A-34

SCQ1145

Item Type: Check

Item Class: Hard

Item Text: RE-ENTER TELEPHONE NUMBER

Display:

Notes:

Response Value Label Skip To

1 [Check executed] SCQ1150
A-35

SCQ1150 SCQOtherNumber

Item Type: Question

Item Class: Enumerated

Item Text: Is there {a/another} phone number where you could be reached?

Display: If SCQ1124=1, display "another". Else, display "a".

Notes:

Answers Allowed:

Response Value Label Skip To

1 YES Yes SCQ1155

2 NO OTHER PHONE NoOtherPhone SCQ2005

99 REFUSED SCQ2005
A-36

SCQ1155 SCQOthPhNo

Item Type: Question

Item Class: Integer

Item Text: [What is that phone number?}

NUMBER: ({AREA}) {EXCHANGE}-{LOCAL}

Display: 10-digit string

Notes:

Lower Range:

Answers Allowed: Upper Range:

Response Value Label Skip To

1 [Enter continuous answer] SCQ1170
A-37

SCQ1170 SCQOtherConfirm

Item Type: Question

Item Class: Enumerated

Item Text: I have the phone number as: ({AREA}) {EXCHANGE}-{LOCAL} 

Is this correct?

Display:

Notes:

Lower Range:

Answers Allowed: 1 Upper Range:

Response Value Label Skip To

1 YES Yes SCQ1180

2 NO No SCQ1175
A-38

SCQ1175

Item Type: Check

Item Class: Hard

Item Text: RE-ENTER TELEPHONE NUMBER

Display:

Notes:

Response Value Label Skip To

1 [Check executed] SCQ1180

99 REFUSED SCQ1015
A-39

SCQ1180 SCQOtherPhoneLocated

Item Type: Question

Item Class: Enumerated

Item Text: Where is this phone located? Is it in your home, at work, someplace else, or is it a cellular 

phone?

Display:

Notes:

Answers Allowed:

Response Value Label Skip To

1 OWN HOME OwnHome SCQ2005

2 WORK Work SCQ2005

3 CELLULAR PHONE CellPhone SCQ2005

91 OTHER, SPECIFY OthSpecify SCQ2005

98 DON’T KNOW SCQ2005

99 REFUSED SCQ2005
A-40

SCQ2005 SCQLanguage

Item Type: Question

Item Class: Enumerated

Item Text: [THIS SCREENER INTERVIEW WAS CONDUCTED IN:]

Display:

Notes:

Answers Allowed: 1

Response Value Label Skip To

1 ENGLISH English SCQ3010

2 SPANISH Spanish SCQ3010

91 OTHER, SPECIFY OthSpecify SCQ3010
A-41

SCQ3010

Item Type: Route

Item Class: If Then

Item Text: If hidden DU procedure is required, go to SCQ3012.

Else, go to SCQ3015.

Display:

Notes:

Response Value Label Skip To

1 [Route executed]
A-42

SCQ3012 SCQHiddenDU

Item Type: Instruction

Item Class: Enumerated

Item Text: We want to be sure that every household in this area has been given a chance to 

participate in this important study. Are there any other living quarters, like a basement or 

garage apartment that we may have missed?

IF NO -----> CODE 2

IF YES -----> DO THE DUs THAT R MENTIONED APPEAR ON THE LISTING SHEETS? 

IF YES -----> CODE 2

IF NO -----> DO DUs MEET DEFINITION OF DU? [PERSONS LIVE/EAT 

SEPARATELY AND HAVE ENTRANCE DIRECTLY FROM OUTSIDE OR THROUGH 

COMMON HALL] 

IF YES -----> CODE 1

IF NO -----> CODE 2

Display:

Notes:

Response Value Label Skip To

1 HIDDEN DU PROCEDURE HiddenDuProcedureRequired SCQ3013

REQUIRED

2 NO, HIDDEN DU PROCEDURE No_HiddenDuProcedureNotR SCQ3013

NOT REQUIRED equired

98 DON’T KNOW DK SCQ3013
A-43

SCQ3013

Item Type: Route

Item Class: If Then

Item Text: If SCQ3012 is YES then update tblCaseInfo.HiddenCasePendingYN to Y; 

If SCQ3012 is DK then update tblCaseInfo.HiddenCasePendingYN to Y; 

If SCQ3012 is NO then update tblCaseInfo.HiddenCasePendingYN to N.

Display:

Notes:

Response Value Label Skip To

1 [Route executed] SCQ3015
A-44

SCQ3015

Item Type: Route

Item Class: If Then

Item Text: If household contains SP(s), go to SCQ4005. 

Else, go to SCQ 4010.

Display:

Notes:

Response Value Label Skip To

1 [Route executed]
A-45

SCQ4005 SCQCompleteEligible

Item Type: Instruction

Item Class: Enumerated

Item Text: [END OF SCREENER. ATTEMPT TO ADMINISTER BQ WITH SP. IF NOT AVAILABLE, 

SET APPOINTMENT FOR BQ AND EXERCISE] 

[PRESS F10 AND ENTER TO CONTINUE] 

[PRESS 1 AND ENTER TO CONTINUE]

Display:

Notes: End instrument timing here.

COMPLETE SCREENER, 1-2 SAMPLE PERSONS SELECTED

Response Value Label Skip To

1 F10 F10 END
A-46

SCQ4010 SCQCompleteInelig

Item Type: Instruction

Item Class: Enumerated

Item Text: Thank you very much for your time today. Based on the information you have given us, no 

one in your household is eligible to participate in our study. Thank you. 

[PRESS F10 AND ENTER TO CONTINUE.] 

[PRESS 1 AND ENTER TO CONTINUE.]

Display:

Notes: End instrument timing here. 

COMPLETE SCREENER, NO ELIGIBLE SAMPLE PERSON(S)

Response Value Label Skip To

1 F10 F10 END