CS. Coversheet

CS. Coversheet module of AHEAD 1993

item label type description
5-1 Question ATTEMPT TO SPEAK WITH R
5-2 Question ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED
5-3 Question VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH
5-4 Question DECIDE WHETHER R IS ABLE TO BE INTERVIEWED OR NEEDS PROXY
7-1 Question ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT
7-2 Question VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH
7-3 Question DECIDE WHETHER Rs ARE ABLE TO BE INTERVIEWED OR NEED PROXY
7-4 Question TWO RESPONDENTS TO BE INTERVIEWED
LANG Question LANGUAGE TO DO THE INTERVIEW
P1 Question ENTER THE SAMPLE ID FROM THE COVERSHEET
P2 Question ENTER YOUR IWER ID
P3 Question MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT
P4 Question MARK IF R IS FINANCIAL OR NON-FINANCIAL R
P5 Question CONFIDENTIALITY STATEMENT
P6 Question MARK SEX OF R
P7 Question MARK MODE OF INTERVIEW
6 Question RESPONDENT LISTING BOX
Start of CS. Coversheet
 
If NOT "TWO RESPONDENTS IDENTIFIED ON INITIAL HOUSEHOLD COVERSHEET" »
 
   
 
5-1

ATTEMPT TO SPEAK WITH R

ATTEMPT TO SPEAK WITH R
expand
   
 
If ATTEMPT TO SPEAK WITH R = "R RESIDES includes HOUSEHOLD" »
 
     
   
5-2

ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED

ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED."
expand
     
   
If ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED = "R NOT MARRIED" »
 
       
     
5-3

VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH

VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH
expand
       
     
If VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH = "R IS AGE-ELIGIBLE BORN 1880-1923" »
 
         
       
5-4

DECIDE WHETHER R IS ABLE TO BE INTERVIEWED OR NEEDS PROXY

DECIDE WHETHER R IS ABLE TO BE INTERVIEWED OR NEEDS PROXY
expand
         
       
6

RESPONDENT LISTING BOX

RESPONDENT LISTING BOX
         
7-1

ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT

ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT
expand
 
If ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT = "BOTH Rs includes HOUSEHOLD" »
 
   
 
7-2

VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH

VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH

[IWER: RECORD YEAR FOR EACH R IN THE 'YEAR OF BIRTH' COLUMN,LISTING BOX, 6D]
expand
   
7-3

DECIDE WHETHER Rs ARE ABLE TO BE INTERVIEWED OR NEED PROXY

DECIDE WHETHER RS ARE ABLE TO BE INTERVIEWED OR NEED PROXY
expand
 
7-4

TWO RESPONDENTS TO BE INTERVIEWED

I WOULD LIKE TO INTERVIEW BOTH YOU AND YOUR (HUSBAND/WIFE/PARTNER).I
WILL BE ASKING SOME QUESTIONS ABOUT YOUR FINANCIAL SITUATION AND HEALTH
CARE COSTS. WHICH OF YOU WOULD KNOW MORE ABOUT THIS, YOU OR YOUR
(HUSBAND/WIFE/PARTNER)?

ASSIGN FINANCIAL R:

[THE OTHER R BECOMES THE NON-FINANCIAL R]
expand
 
6

RESPONDENT LISTING BOX

RESPONDENT LISTING BOX
 
LANG

LANGUAGE TO DO THE INTERVIEW

LANG. LANGUAGE TO DO THE INTERVIEW

expand
 
P1

ENTER THE SAMPLE ID FROM THE COVERSHEET

ENTER THE SAMPLE ID FROM THE COVERSHEET

SAMPLE ID:
 
P2

ENTER YOUR IWER ID

ENTER YOUR IWER ID

IWER ID:

 
P3

MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT

MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT
expand
 
If MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT != 3 ONLY R »
 
   
 
P4

MARK IF R IS FINANCIAL OR NON-FINANCIAL R

MARK IF R IS FINANCIAL OR NON-FINANCIAL R
expand
   
P5

CONFIDENTIALITY STATEMENT

THIS INTERVIEW IS COMPLETELY CONFIDENTIAL AND VOLUNTARY. IF WE SHOULD
COME TO ANY QUESTION YOU DON'T WANT TO ANSWER, JUST LET ME KNOW AND WE
WILL GO ON TO THE NEXT QUESTION.

[IWER: CHECK TYPE OF "R" IN UPPER LEFT CORNER]

 
P6

MARK SEX OF R

MARK SEX OF R
expand
 
P7

MARK MODE OF INTERVIEW

MARK MODE OF INTERVIEW
expand
 
End of CS. Coversheet
Start of CS. Coversheet

If NOT "TWO RESPONDENTS IDENTIFIED ON INITIAL HOUSEHOLD COVERSHEET" »

|  ========================================================================
5-1
ATTEMPT TO SPEAK WITH R

ATTEMPT TO SPEAK WITH R
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R RESIDES IN HOUSEHOLD
2 R DECEASED
3 R INSTITUTIONALIZED LONG TERM

If ATTEMPT TO SPEAK WITH R (5-1) = "R RESIDES IN HOUSEHOLD" »

| |  ========================================================================
| | 
5-2
ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED

ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED."
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R NOT MARRIED
2 R MARRIED/LIVING WITH PARTNER

| |  If ASK IF R IS MARRIED OR "LIVING WITH A PARTNER AS IF MARRIED (5-2) = "R NOT MARRIED" »

| | |  ========================================================================
| | | 
5-3
VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH

VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R IS AGE-ELIGIBLE BORN 1880 - 1923
2 R IS INELIGIBLE BORN 1924 - 1993

| | |  If VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH (5-3) = "R IS AGE-ELIGIBLE BORN 1880-1923" »

| | | |  ========================================================================
| | | | 
5-4
DECIDE WHETHER R IS ABLE TO BE INTERVIEWED OR NEEDS PROXY

DECIDE WHETHER R IS ABLE TO BE INTERVIEWED OR NEEDS PROXY
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R CAN BE INTERVIEWED
2 R IS INCAPABLE OF BEING INTERVIEWED

| | | |  ========================================================================
| | | | 
6
RESPONDENT LISTING BOX

RESPONDENT LISTING BOX

========================================================================
7-1
ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT

ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT
- - - - - - - - - - - - - - - - - - - - - - - - -
1 BOTH Rs IN HOUSEHOLD
2 SPOUSE DECEASED, SURVIVING R NOT REMARRIED/PARTNERED
3 SPOUSE DECEASED, SURVIVING R REMARRIED/PARTNERED
4 BOTH Rs DECEASED

If ATTEMPT TO SPEAK WITH EITHER R AND VERIFY MARITAL/PARTNER STATUS AND RESIDENCE IN HOUSEHOLD UNIT (7-1) = "BOTH Rs IN HOUSEHOLD" »

|  ========================================================================
7-2
VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH

VERIFY AGE-ELIGIBILITY BY ASKING YEAR OF BIRTH

[IWER: RECORD YEAR FOR EACH R IN THE 'YEAR OF BIRTH' COLUMN,LISTING BOX, 6D]
- - - - - - - - - - - - - - - - - - - - - - - - -
1 ONE OR BOTH SPOUSES AGE-ELIGIBLE BORN 1880 - 1923
2 BOTH SPOUSES INELIGIBLE BOTH BORN 1924 - 1993

========================================================================
7-3
DECIDE WHETHER Rs ARE ABLE TO BE INTERVIEWED OR NEED PROXY

DECIDE WHETHER RS ARE ABLE TO BE INTERVIEWED OR NEED PROXY
- - - - - - - - - - - - - - - - - - - - - - - - -
1 BOTH Rs ABLE TO BE INTERVIEWED
2 ONE R INCAPABLE OF BEING INTERVIEWED
3 NEITHER R IS CAPABLE OF BEING INTERVIEWED

========================================================================
7-4
TWO RESPONDENTS TO BE INTERVIEWED

I WOULD LIKE TO INTERVIEW BOTH YOU AND YOUR (HUSBAND/WIFE/PARTNER).I
WILL BE ASKING SOME QUESTIONS ABOUT YOUR FINANCIAL SITUATION AND HEALTH
CARE COSTS. WHICH OF YOU WOULD KNOW MORE ABOUT THIS, YOU OR YOUR
(HUSBAND/WIFE/PARTNER)?

ASSIGN FINANCIAL R:

[THE OTHER R BECOMES THE NON-FINANCIAL R]
- - - - - - - - - - - - - - - - - - - - - - - - -
1 PERSON NUMBER 010
2 PERSON NUMBER 020

========================================================================
6
RESPONDENT LISTING BOX

RESPONDENT LISTING BOX

========================================================================
LANG
LANGUAGE TO DO THE INTERVIEW

LANG. LANGUAGE TO DO THE INTERVIEW

- - - - - - - - - - - - - - - - - - - - - - - - -
0 ENGLISH
1 SPANISH


========================================================================
P1
ENTER THE SAMPLE ID FROM THE COVERSHEET

ENTER THE SAMPLE ID FROM THE COVERSHEET

SAMPLE ID:

========================================================================
P2
ENTER YOUR IWER ID

ENTER YOUR IWER ID

IWER ID:


========================================================================
P3
MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT

MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT
- - - - - - - - - - - - - - - - - - - - - - - - -
1 LEAD R
2 SECOND R
3 ONLY R

If MARK IF LEAD, 2ND OR ONLY R INTERVIEWED IN HOUSEHOLD UNIT (P3) != 3 ONLY R »

|  ========================================================================
P4
MARK IF R IS FINANCIAL OR NON-FINANCIAL R

MARK IF R IS FINANCIAL OR NON-FINANCIAL R
- - - - - - - - - - - - - - - - - - - - - - - - -
1 FINANCIAL R
2 NON-FINANCIAL R


========================================================================
P5
CONFIDENTIALITY STATEMENT

THIS INTERVIEW IS COMPLETELY CONFIDENTIAL AND VOLUNTARY. IF WE SHOULD
COME TO ANY QUESTION YOU DON'T WANT TO ANSWER, JUST LET ME KNOW AND WE
WILL GO ON TO THE NEXT QUESTION.

[IWER: CHECK TYPE OF "R" IN UPPER LEFT CORNER]


========================================================================
P6
MARK SEX OF R

MARK SEX OF R
- - - - - - - - - - - - - - - - - - - - - - - - -
1 MALE
2 FEMALE


========================================================================
P7
MARK MODE OF INTERVIEW

MARK MODE OF INTERVIEW
- - - - - - - - - - - - - - - - - - - - - - - - -
1 TELEPHONE
2 FACE-TO-FACE

End of CS. Coversheet