Protocol - Marital Status of Primary Caregiver
Description
This protocol includes two self-administered questions from the Silent Cerebral Infarct Multi-Center Clinical Trial (SIT). The first captures the marital status of the primary caregiver and the second captures the relationship of the primary caregiver to the respondent.
Specific Instructions
The PhenX Sickle Cell Disease Research and Scientific Panel (SRSP) notes that this protocol can also be self-administered.
Availability
This protocol is freely available; permission not required for use.
Protocol
1. Marital status of primary caregiver
[ ] Married
[ ] Widowed
[ ] Separated
[ ] Divorced
[ ] Never married
[ ] Living with partner
[ ] Refused to answer
[ ] Unknown
2. Relationship of primary caregiver to patient
[ ] Mother
[ ] Father
[ ] Niece or nephew
[ ] Aunt or uncle
[ ] First cousin
[ ] Second cousin
[ ] Unknown cousin
[ ] Grandparent
[ ] Great grandparent
[ ] Great great grandparent
[ ] Great aunt or uncle
[ ] Great great aunt or great great uncle
[ ] Foster parent
[ ] Other Specify _______________________________
Personnel and Training Required
The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "dont know" response is provided.
Equipment Needs
The PhenX Working Group acknowledges these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Interviewer-administered questionnaire
Lifestage
Infant, Toddler, Child, Adolescent, Adult
Participants
Children and adolescents, age less than 22 years
Selection Rationale
These questions from the Silent Cerebral Infarct Multi-Center Clinical Trial (SIT) were vetted against similar protocols and selected as the best methodology to capture marital status of caregivers. These questions are based on similar questions from the National Health and Nutrition Examination Survey (NHANES).
Language
English
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| caDSR Form | PhenX PX840101 - Marital Status Of Primary Caregiver | 6254262 | caDSR Form |
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
Silent Cerebral Infarct Multi-Center Clinical Trial (SIT), Demographic/Phenotypic Information
Source
U.S. Department of Health and Human Services. National Institutes of Health. National Institute of Neurological Disorders and Stroke (NINDS). Silent Cerebral Infarct Multi-Center Clinical Trial. Form 02: Demographic / Phenotypic Information. Questions 14 and 15.
General References
King, A.A., Rodeghier, M.J., Panepinto, J.A., Strouse, J.J., Casella, J.F., Quinn, C.T., Dowling, M.M., Sarnaik, S.A., Thompson, A.A., Woods, G.M., Minniti, C.P., Redding-Lallinger, R.C., Kirby-Allen, M., Kirkham, F.J., McKinstry, R., Noetzel, M.J., White, D.A., Kwiatkowski, J.K., Howard, T.H., Kalinyak, K.A., Inusa, B., Rhodes, M.M., Heiny, M.E., Fuh, B., Fixler, J.M., Gordon, M.O., & DeBaun, M.R. (2014). Silent cerebral infarction, income, and grade retention among students with sickle cell anemia. American Journal of Hematology 89(10), E188-E192.
Raphael, J.L., Butler, A.M., Rattler, T.L., Kowalkowski, M.A., Mueller, B.U., & Giordano, T.P. (2013). Parental information, motivation, and adherence behaviors among children with sickle cell disease. Pediatric Blood & Cancer 60(7), 1204-1210.
Protocol ID
840101
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX840101_SCD_MartialStatus_PrimaryCaregiver | ||||
| PX840101010000 | Marital status of primary caregiver | N/A | ||
| PX840101_SCD_MartialStatus_PrimaryCaregiver_Relationshipto_Patient | ||||
| PX840101020100 | Relationship of primary caregiver to patient | N/A | ||
| PX840101_SCD_MartialStatus_PrimaryCaregiver_Relationshipto_PatientOther | ||||
| PX840101020200 | Relationship of primary caregiver to more | N/A | ||