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45066

Description

The CRISIS Survey is designed to enable the researchers and care providers to examine the extent and impact of life changes induced by the epidemic on the mental health and behavior of individuals and families across diverse international settings. Our hope is that such data will enable the identification of pre-, peri, and post-COVID19 demographic, social, and clinical predictors of both short- and long-term impairment and distress induced by COVID19 and its sequelae. The CRISIS can be used to track impact of the survey in diverse clinical, population and research settings. It may be even more informative for identifying predictors of impact and service needs from studies that have well characterized information from prior to COVID19. A broad range of behaviors and function are probed in the survey, including daily behaviors, emotional status, media usage, and substance use. The survey is designed to allow for follow-ups on a regular basis, with recommended frequencies of twice monthly or monthly. To facilitate multicultural perspectives, translations in a broad range of languages are available. Investigators: K. Merikangas, M. Milham, A. Stringaris Collaborators: E. Bromet, S. Colcombe, V. Zipunnikov The team encourages advanced notification of any media, scientific reports or publications of data that have been collected with the CRISIS (merikank@mail.nih.gov), though this is not required. We also encourage voluntary data sharing for the purpose of psychometric studies that will be led by Dr. Stringaris (argyris.stringaris@nih.gov).

Keywords

Versions (1)
  1. 8/18/22 8/18/22 - Dr. Christian Niklas
Copyright Holder

Kathleen Merikangas, Argyris Stringaris, Michael P. Milham

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August 18, 2022

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License

Creative Commons BY 4.0
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    The CoRonavIruS Health Impact Survey (CRISIS) V0.3 - Youth Self-Report Follow Up Form

    English

    Youth Selfreport Follow Up Form

    1 forms  
    1. StudyEvent: The CoRonavIruS Health Impact Survey (CRISIS) V0.3
      1. Youth Selfreport Follow Up Form
    Background
    Description

    Background

    Alias
    UMLS CUI [1,1]
    C1706907
    UMLS CUI [2,1]
    C0010447
    Identification Number:
    Description

    Record ID

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2348585
    Country:
    Description

    Country

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1562954
    State/ Province/ Region:
    Description

    State/ Province/ Region of residence

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1830433
    Your age (years):
    Description

    age

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0001779
    Exposure status During the PAST TWO WEEKS...
    Description

    Exposure status During the PAST TWO WEEKS...

    Alias
    UMLS CUI [1,1]
    C0332157
    UMLS CUI [1,2]
    C5203676
    UMLS CUI [1,3]
    C4288440
    ...have you been exposed to someone with positive SARS CoV 2 test?
    Description

    exposed___1

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0332157
    UMLS CUI [1,2]
    C0027361
    UMLS CUI [1,3]
    C5244023
    UMLS CUI [1,4]
    C4288440
    ...have you been exposed to someone medical diagnosed with a SARS CoV 2 infection without positive test result?
    Description

    exposed___2

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0332157
    UMLS CUI [1,2]
    C0027361
    UMLS CUI [1,3]
    C0011900
    UMLS CUI [1,4]
    C5203670
    UMLS CUI [1,5]
    C4288440
    ...have you been exposed to someone with possible COVID-19 symptoms during the past two weeks?
    Description

    exposed___3

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0332157
    UMLS CUI [1,2]
    C0027361
    UMLS CUI [1,3]
    C1457887
    UMLS CUI [1,4]
    C0332281
    UMLS CUI [1,5]
    C5203670
    UMLS CUI [1,6]
    C4288440
    ...have you had a fever?
    Description

    symptoms___1

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0015967
    UMLS CUI [1,2]
    C4288440
    ...have you had a cough?
    Description

    symptoms___2

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0010200
    UMLS CUI [1,2]
    C4288440
    ...have you had shortness of breath?
    Description

    symptoms___3

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0013404
    UMLS CUI [1,2]
    C4288440
    ...have you had a sore throat?
    Description

    symptoms___4

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0242429
    UMLS CUI [1,2]
    C4288440
    ...have you had fatigue?
    Description

    symptoms___5

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0015672
    UMLS CUI [1,2]
    C4288440
    ...have you had loss of taste or smell?
    Description

    symptoms___6

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C5382033
    UMLS CUI [1,2]
    C4288440
    ...have you had an eye infection?
    Description

    symptoms___7

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0015403
    UMLS CUI [1,2]
    C4288440
    ...have you had other symptoms?
    Description

    symptoms___8

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C3257980
    UMLS CUI [1,2]
    C4288440
    ... has a family member living in the same household have COVID-19 diagnosis?
    Description

    diagnosedfamily___1

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C4330269
    UMLS CUI [1,2]
    C0086282
    UMLS CUI [1,3]
    C0011900
    UMLS CUI [1,4]
    C5203670
    UMLS CUI [1,5]
    C4288440
    ... has a family member not living in the same household have COVID-19 diagnosis?
    Description

    diagnosedfamily___2

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0011900
    UMLS CUI [1,3]
    C5203670
    UMLS CUI [1,4]
    C4288440
    ...has any of your family members fallen ill physically due to COVID-19?
    Description

    impact___1

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0221423
    UMLS CUI [1,3]
    C5203676
    UMLS CUI [1,4]
    C4288440
    ...has any of your family members been hospitalized due to COVID-19?
    Description

    impact___2

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0019993
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C5203670
    UMLS CUI [1,5]
    C4288440
    ...has any of your family members been put into self-quarantine with symptoms due to COVID-19?
    Description

    impact___3

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C5392942
    UMLS CUI [1,3]
    C5203670
    UMLS CUI [1,4]
    C4288440
    ...has any of your family members been put into self-quarantine without symptoms due to COVID-19?
    Description

    impact___4

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C5392942
    UMLS CUI [1,3]
    C5203676
    UMLS CUI [1,4]
    C0231221
    UMLS CUI [1,5]
    C4288440
    ...has any of your family members lost or been laid off from their job due to COVID-19?
    Description

    impact___5

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0425083
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C5203676
    UMLS CUI [1,5]
    C4288440
    ...has any of your family members have a reduced ability to earn money due to COVID-19?
    Description

    impact___6

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C0392756
    UMLS CUI [1,3]
    C0021162
    UMLS CUI [1,4]
    C0678226
    UMLS CUI [1,5]
    C5203676
    UMLS CUI [1,6]
    C4288440
    ...has any of your family members passed away due to COVID-19?
    Description

    impact___7

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0086282
    UMLS CUI [1,2]
    C1306577
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C5203670
    UMLS CUI [1,5]
    C4288440
    How much are you reading or talking about Coronavirus/ COVID-19?
    Description

    reading/ talking about Coronavirus/ COVID-19 past two weeks

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0034754
    UMLS CUI [1,2]
    C3874886
    UMLS CUI [1,3]
    C5203676
    UMLS CUI [1,4]
    C4288440
    UMLS CUI [2,1]
    C0234856
    UMLS CUI [2,2]
    C3874886
    UMLS CUI [2,3]
    C5203676
    UMLS CUI [2,4]
    C4288440
    Has the Coronavirus/ COIVD-19 crisis in your area led to any positive change in your life?
    Description

    positive change in life due to Coronavirus/ COVID-19 crisis past two weeks

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0376558
    UMLS CUI [1,2]
    C1446409
    UMLS CUI [1,3]
    C0392747
    UMLS CUI [1,4]
    C5392141
    UMLS CUI [1,5]
    C4288440
    ...have you been suspected of having a COVID-19 infection?
    Description

    I.10

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C5203676
    UMLS CUI [1,2]
    C3714514
    UMLS CUI [1,3]
    C0750491
    Other Symptoms:
    Description

    I.1

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C3257980
    UMLS CUI [1,2]
    C4288440
    ...how worried have you been about being infected?
    Description

    I.2

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C5203676
    UMLS CUI [1,2]
    C3714514
    UMLS CUI [1,3]
    C0233481
    ...how worried have you been about friends or family being infected?
    Description

    I.4

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0079382
    UMLS CUI [1,2]
    C5203676
    UMLS CUI [1,3]
    C3714514
    UMLS CUI [1,4]
    C0233481
    UMLS CUI [2,1]
    C0086282
    UMLS CUI [2,2]
    C5203676
    UMLS CUI [2,3]
    C3714514
    UMLS CUI [2,4]
    C0233481
    ...how worried have you been about your physical health being influenced by COVID-19?
    Description

    I.5

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0233481
    UMLS CUI [1,2]
    C5203670
    UMLS CUI [1,3]
    C0392760
    UMLS CUI [1,4]
    C0517226
    ...how worried have you been about your mental/emotional health being influenced by COVID-19?
    Description

    I.6

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0233481
    UMLS CUI [1,2]
    C5203670
    UMLS CUI [1,3]
    C0392760
    UMLS CUI [1,4]
    C0025353
    Please specify:
    Description

    I.7

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0376558
    UMLS CUI [1,2]
    C1446409
    UMLS CUI [1,3]
    C0392747
    UMLS CUI [1,4]
    C5392141
    UMLS CUI [1,5]
    C4288440
    Life changes During the PAST TWO WEEKS...
    Description

    Life changes During the PAST TWO WEEKS...

    Alias
    UMLS CUI [1,1]
    C0376558
    UMLS CUI [1,2]
    C0392747
    UMLS CUI [1,3]
    C4288440
    ...has your school building been closed?
    Description

    school closing within previous two weeks

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0036375
    UMLS CUI [1,2]
    C0587267
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C5392141
    UMLS CUI [1,5]
    C4288440
    Are classes in session?
    Description

    classes in session

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0036375
    UMLS CUI [1,2]
    C0038492
    UMLS CUI [1,3]
    C0441833
    UMLS CUI [1,4]
    C1553514
    UMLS CUI [1,5]
    C4288440
    Are you attending classes in-person?
    Description

    attended classes in person within previous two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0036375
    UMLS CUI [1,2]
    C1999232
    UMLS CUI [1,3]
    C1553514
    UMLS CUI [1,4]
    C4288440
    Have classes resumed online?
    Description

    classes resumed online within previous two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0036375
    UMLS CUI [1,2]
    C4505477
    UMLS CUI [1,3]
    C4288440
    Do you have easy access to the internet and a computer?
    Description

    internet and computer access within previous two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C4704731
    UMLS CUI [1,2]
    C0444454
    UMLS CUI [1,3]
    C0009622
    UMLS CUI [1,4]
    C4288440
    Are there assignments for you to complete?
    Description

    assignments within the previous two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0683853
    UMLS CUI [1,2]
    C4288440
    Are you able to receive meals from the school?
    Description

    meals from school

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1998602
    UMLS CUI [1,2]
    C1517320
    UMLS CUI [1,3]
    C0036375
    UMLS CUI [1,4]
    C4288440
    ...how many people, from outside of your household, have you had an in-person conversation with?
    Description

    in-person conversation count within previous two weeks

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0750480
    UMLS CUI [1,2]
    C0871703
    UMLS CUI [1,3]
    C1553514
    UMLS CUI [1,4]
    C4288440
    ...how much time have you spent going outside of the home (e.g., going to stores, parks, etc.)?
    Description

    time outside within previous two weeks

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0040223
    UMLS CUI [1,2]
    C1709359
    UMLS CUI [1,3]
    C4288440
    ...how stressful have the restrictions on leaving home been for you?
    Description

    stress due to restrictions

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0038435
    UMLS CUI [1,2]
    C0678226
    UMLS CUI [1,3]
    C4534363
    UMLS CUI [1,4]
    C4288440
    ...have your contacts with people outside of your home changed relative to before the Coronavirus/COVID-19 crisis in your area?
    Description

    social contact change due to COVID-19 pandemic

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0392747
    UMLS CUI [1,2]
    C0237101
    UMLS CUI [1,3]
    C1711239
    UMLS CUI [1,4]
    C5392141
    UMLS CUI [1,5]
    C4288440
    ...how much difficulty have you had following the recommendations for keeping away from close contact with people?
    Description

    difficulty distancing

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0332218
    UMLS CUI [1,2]
    C5440893
    UMLS CUI [1,3]
    C4288440
    ...has the quality of the relationships between you and members of your family changed?
    Description

    change of family relationships

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0392747
    UMLS CUI [1,2]
    C0439849
    UMLS CUI [1,3]
    C0086282
    UMLS CUI [1,4]
    C4288440
    ...how stressful have these changes in family contacts been for you?
    Description

    stress due to changes in family relationships

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0038435
    UMLS CUI [1,2]
    C0678226
    UMLS CUI [1,3]
    C0392747
    UMLS CUI [1,4]
    C0439849
    UMLS CUI [1,5]
    C0086282
    UMLS CUI [1,6]
    C4288440
    ...has the quality of your relationships with your friends changed?
    Description

    change of relationships to friends

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0392747
    UMLS CUI [1,2]
    C0439849
    UMLS CUI [1,3]
    C0079382
    UMLS CUI [1,4]
    C4288440
    ...how stressful have these changes in social contacts been for you?
    Description

    stress due to changes to relationships to friends

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0038435
    UMLS CUI [1,2]
    C0678226
    UMLS CUI [1,3]
    C0392747
    UMLS CUI [1,4]
    C0439849
    UMLS CUI [1,5]
    C0079382
    UMLS CUI [1,6]
    C4288440
    ...how much has cancellation of important events (such as graduation, prom, vacation, etc.) in your life been difficult for you?
    Description

    difficulty due to event cancellations

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0332218
    UMLS CUI [1,2]
    C0441471
    UMLS CUI [1,3]
    C1553388
    UMLS CUI [1,4]
    C4288440
    ...to what degree have changes related to the Coronavirus/COVID-19 crisis in your area created financial problems for your family?
    Description

    financial difficulties due to COVID-19 pandemic

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0015576
    UMLS CUI [1,2]
    C0549106
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C5392141
    UMLS CUI [1,5]
    C4288440
    ...to what degree are you concerned about the stability of your living situation?
    Description

    concerned about living stability

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2107029
    UMLS CUI [1,2]
    C2184149
    UMLS CUI [1,3]
    C4288440
    ...did you worry whether your food would run out because of a lack of money?
    Description

    worried about food shortage due to financial problems

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0233481
    UMLS CUI [1,2]
    C0598456
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C0549106
    UMLS CUI [1,5]
    C4288440
    How hopeful are you that the Coronavirus/COVID-19 crisis in your area will end soon?
    Description

    hopeful about end of COVID-19 pandemic

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C5224035
    UMLS CUI [1,2]
    C0444930
    UMLS CUI [1,3]
    C5392141
    UMLS CUI [1,4]
    C4288440
    Daily behaviors During the PAST TWO WEEKS...
    Description

    Daily behaviors During the PAST TWO WEEKS...

    Alias
    UMLS CUI [1,1]
    C0871707
    UMLS CUI [1,2]
    C4288440
    ...on average, what time did you go to bed on WEEKDAYS?
    Description

    bedtime weekdays two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0521112
    UMLS CUI [1,2]
    C0680189
    UMLS CUI [1,3]
    C4288440
    ...on average, what time did you go to bed on WEEKENDS?
    Description

    bedtime weekends two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0521112
    UMLS CUI [1,2]
    C0680190
    UMLS CUI [1,3]
    C4288440
    ...on average, how many hours per night did you sleep on WEEKDAYS?
    Description

    hours of sleep weekdays two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2937255
    UMLS CUI [1,2]
    C0680189
    UMLS CUI [1,3]
    C4288440
    ...on average, how many hours per night did you sleep on WEEKENDS?
    Description

    hours of sleep weekends two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2937255
    UMLS CUI [1,2]
    C0680190
    UMLS CUI [1,3]
    C4288440
    ...how many days per week did you exercise (e.g., increased heart rate, breathing) for at least 30 minutes?
    Description

    exercise frequency weekly two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2230062
    UMLS CUI [1,2]
    C4288440
    ...how many days per week did you spend time outdoors?
    Description

    days/week with time spent outdoors two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0677547
    UMLS CUI [1,2]
    C4534420
    UMLS CUI [1,3]
    C4288440
    Emotions/ Worries During the PAST TWO WEEKS...
    Description

    Emotions/ Worries During the PAST TWO WEEKS...

    Alias
    UMLS CUI [1,1]
    C0013987
    UMLS CUI [1,2]
    C4288440
    UMLS CUI [2,1]
    C0233481
    UMLS CUI [2,2]
    C4288440
    ...how worried were you generally?
    Description

    worried

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0233481
    UMLS CUI [1,3]
    C4288440
    ...how happy versus sad were you?
    Description

    happiness/ sadness two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1821411
    UMLS CUI [1,2]
    C4288440
    UMLS CUI [2,1]
    C0681889
    UMLS CUI [2,2]
    C3536794
    UMLS CUI [2,3]
    C4288440
    ...how much were you able to enjoy your usual activities?
    Description

    joy of usual activities two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C4316940
    UMLS CUI [1,3]
    C0871707
    UMLS CUI [1,4]
    C4288440
    ...how relaxed versus anxious were you?
    Description

    relaxation/ anxiety two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0035028
    UMLS CUI [1,3]
    C4288440
    UMLS CUI [2,1]
    C0681889
    UMLS CUI [2,2]
    C0003467
    UMLS CUI [2,3]
    C4288440
    ...how fidgety or restless were you?
    Description

    fidgety/ restlessness two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0424235
    UMLS CUI [1,3]
    C4288440
    UMLS CUI [2,1]
    C0681889
    UMLS CUI [2,2]
    C3887611
    UMLS CUI [2,3]
    C4288440
    ...how fatigued or tired were you?
    Description

    fatigue two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0015672
    UMLS CUI [1,3]
    C4288440
    ...how well were you able to concentrate or focus?
    Description

    focus/ concentration two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0086045
    UMLS CUI [1,3]
    C4288440
    ...how irritable or easily angered were you?
    Description

    irritable/ angered two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0022107
    UMLS CUI [1,3]
    C4288440
    UMLS CUI [2,1]
    C0681889
    UMLS CUI [2,2]
    C2227997
    UMLS CUI [2,3]
    C4288440
    ...how lonely were you?
    Description

    loneliness two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0681889
    UMLS CUI [1,2]
    C0023974
    UMLS CUI [1,3]
    C4288440
    ...to what extent did you have negative thoughts, thoughts about unpleasant experiences or things that make you feel bad?
    Description

    negative thoughts two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C1142075
    UMLS CUI [1,3]
    C4288440
    Media use During the PAST TWO WEEKS, how much time per day did you spend...
    Description

    Media use During the PAST TWO WEEKS, how much time per day did you spend...

    Alias
    UMLS CUI [1,1]
    C5392110
    UMLS CUI [1,2]
    C0556974
    UMLS CUI [1,3]
    C4288440
    UMLS CUI [2,1]
    C0042649
    UMLS CUI [2,2]
    C0556974
    UMLS CUI [2,3]
    C4288440
    ...watching TV or digital media (e.g., Netflix, YouTube, web surfing)?
    Description

    digital media consumtion two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C3827501
    UMLS CUI [1,2]
    C0556974
    UMLS CUI [1,3]
    C4288440
    ...using social media (e.g., Facetime, Facebook, Instagram, Snapchat, Twitter, TikTok)?
    Description

    social media consumtion two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C3179065
    UMLS CUI [1,2]
    C0556974
    UMLS CUI [1,3]
    C4288440
    ...playing video games?
    Description

    hours/day playing video games two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2047133
    UMLS CUI [1,2]
    C4288440
    Substance use During the PAST TWO WEEKS, how frequently did you use...
    Description

    Substance use During the PAST TWO WEEKS, how frequently did you use...

    Alias
    UMLS CUI [1,1]
    C0237123
    UMLS CUI [1,2]
    C4288440
    ...alcohol?
    Description

    alcohol consumpiton frequency two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C0001948
    UMLS CUI [1,3]
    C4288440
    ...vaping products?
    Description

    vaping frequency two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C4083280
    UMLS CUI [1,3]
    C4288440
    ...cigarettes or other tobacco products?
    Description

    tobacco use frequency two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C0543414
    UMLS CUI [1,3]
    C4288440
    ...marijuana/cannabis (e.g., joint, blunt, pipe, bong)?
    Description

    marijuana/ cannabis use frequency two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C4316909
    UMLS CUI [1,3]
    C4288440
    ...opiates, heroin, or narcotics?
    Description

    opiate/ heroin/ narcotic abuse frequency two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C4551628
    UMLS CUI [1,3]
    C4288440
    UMLS CUI [2,1]
    C4321352
    UMLS CUI [2,2]
    C0600241
    UMLS CUI [2,3]
    C4288440
    UMLS CUI [3,1]
    C4321352
    UMLS CUI [3,2]
    C0524661
    UMLS CUI [3,3]
    C4288440
    ...other drugs including cocaine, crack, amphetamine, methamphetamine, hallucinogens, or ecstasy?
    Description

    frequency of other drug abuse two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C0848734
    UMLS CUI [1,3]
    C4288440
    ...sleeping medications or sedatives/hypnotics?
    Description

    sleeping pill/ sedative/ hypnotic abuse frequency two weeks prior to CRISIS

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C4321352
    UMLS CUI [1,2]
    C0599396
    UMLS CUI [1,3]
    C0013146
    UMLS CUI [1,4]
    C4288440
    UMLS CUI [2,1]
    C4321352
    UMLS CUI [2,2]
    C1456771
    UMLS CUI [2,3]
    C4288440
    UMLS CUI [3,1]
    C4321352
    UMLS CUI [3,2]
    C0338699
    UMLS CUI [3,3]
    C4288440
    Which of the following supports were in place for you before the Coronavirus/COVID-19 crisis in your area and have been disrupted over the PAST TWO WEEKS? (check all that apply)
    Description

    Which of the following supports were in place for you before the Coronavirus/COVID-19 crisis in your area and have been disrupted over the PAST TWO WEEKS? (check all that apply)

    Alias
    UMLS CUI [1,1]
    C0748877
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C0678226
    UMLS CUI [1,4]
    C5392141
    Resource room
    Description

    resource room disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C3846158
    Tutoring
    Description

    tutoring disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0872010
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Mentoring programs
    Description

    mentoring program disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C4255266
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    After school activity programs
    Description

    after school activity programs disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0681383
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Volunteer programs
    Description

    volunteer program disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C2367294
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Psychotherapy
    Description

    psychotherapy disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0033968
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Psychiatric care
    Description

    psychiatric care disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0597312
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Occupational therapy
    Description

    occupational therapy disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1318464
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Physical therapy
    Description

    physical therapy disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0949766
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Speech/language therapy
    Description

    speech/language therapy disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0589155
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Sporting activities
    Description

    sporting activities disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0038039
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Medical care for chronic illnesses
    Description

    medical care for chronic illnesses disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1555457
    UMLS CUI [1,2]
    C0332454
    UMLS CUI [1,3]
    C4288440
    Other
    Description

    other supports disrupted past two weeks

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0748877
    UMLS CUI [1,3]
    C0332454
    UMLS CUI [1,4]
    C4288440
    Other: Specify
    Description

    specify other supports disrupted within the past two weeks

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C3845569
    UMLS CUI [1,2]
    C0748877
    UMLS CUI [1,3]
    C0332454
    UMLS CUI [1,4]
    C4288440
    Additional concerns and comments
    Description

    Additional concerns and comments

    Alias
    UMLS CUI [1,1]
    C3482667
    UMLS CUI [1,2]
    C1830770
    Please describe anything else that concerns you about the impact of Coronavirus/COVID-19 on you, your friends, or your family.
    Description

    anything_else

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C5392141
    UMLS CUI [1,2]
    C4049986
    UMLS CUI [1,3]
    C0205394
    Comment section - Youth Selfreport Follow Up Form
    Description

    Comment section - Youth Selfreport Follow Up Form

    Alias
    UMLS CUI [1,1]
    C4321425
    Please provide any comments that you would like to share about this survey and/or related topics.
    Description

    survey comments

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1830770
    UMLS CUI [1,2]
    C0332281
    UMLS CUI [1,3]
    C0034394
    Back to the top of the page

    Similar models

    Youth Selfreport Follow Up Form

    1 forms
    1. StudyEvent: The CoRonavIruS Health Impact Survey (CRISIS) V0.3
      1. Youth Selfreport Follow Up Form
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Background
    C1706907 (UMLS CUI [1,1])
    C0010447 (UMLS CUI [2,1])
    Record ID
    Item
    Identification Number:
    text
    C2348585 (UMLS CUI [1,1])
    Item
    Country:
    text
    C1562954 (UMLS CUI [1,1])
    country
    Code List
    Country:
    CL Item
    Afghanistan (1)
    CL Item
    Albania (2)
    CL Item
    Algeria (3)
    CL Item
    Andorra (4)
    CL Item
    Angola (5)
    CL Item
    Antigua and Barbuda (6)
    CL Item
    Argentina (7)
    CL Item
    Armenia (8)
    CL Item
    Australia (9)
    CL Item
    Austria (10)
    CL Item
    Azerbaijan (11)
    CL Item
    Bahamas (12)
    CL Item
    Bahrain (13)
    CL Item
    Bangladesh (14)
    CL Item
    Barbados (15)
    CL Item
    Belarus (16)
    CL Item
    Belgium (17)
    CL Item
    Belize (18)
    CL Item
    Benin (19)
    CL Item
    Bhutan (20)
    CL Item
    Bolivia (21)
    CL Item
    Bosnia and Herzegovina (22)
    CL Item
    Botswana (23)
    CL Item
    Brazil (24)
    CL Item
    Brunei (25)
    CL Item
    Bulgaria (26)
    CL Item
    Burkina Faso (27)
    CL Item
    Burundi (28)
    CL Item
    Côte d'Ivoire (29)
    CL Item
    Cabo Verde (30)
    CL Item
    Cambodia (31)
    CL Item
    Cameroon (32)
    CL Item
    Canada (33)
    CL Item
    Central African Republic (34)
    CL Item
    Chad (35)
    CL Item
    Chile (36)
    CL Item
    China (37)
    CL Item
    Colombia (38)
    CL Item
    Comoros (39)
    CL Item
    Congo (Congo-Brazzaville) (40)
    CL Item
    Costa Rica (41)
    CL Item
    Croatia (42)
    CL Item
    Cuba (43)
    CL Item
    Cyprus (44)
    CL Item
    Czechia (Czech Republic) (45)
    CL Item
    Democratic Republic of the Congo (46)
    CL Item
    Denmark (47)
    CL Item
    Djibouti (48)
    CL Item
    Dominica (49)
    CL Item
    Dominican Republic (50)
    CL Item
    Ecuador (51)
    CL Item
    Egypt (52)
    CL Item
    El Salvador (53)
    CL Item
    Equatorial Guinea (54)
    CL Item
    Eritrea (55)
    CL Item
    Estonia (56)
    CL Item
    Eswatini (fmr. "Swaziland") (57)
    CL Item
    Ethiopia (58)
    CL Item
    Fiji (59)
    CL Item
    Finland (60)
    CL Item
    France (61)
    CL Item
    Gabon (62)
    CL Item
    Gambia (63)
    CL Item
    Georgia (64)
    CL Item
    Germany (65)
    CL Item
    Ghana (66)
    CL Item
    Greece (67)
    CL Item
    Grenada (68)
    CL Item
    Guatemala (69)
    CL Item
    Guinea (70)
    CL Item
    Guinea-Bissau (71)
    CL Item
    Guyana (72)
    CL Item
    Haiti (73)
    CL Item
    Holy See (74)
    CL Item
    Honduras (75)
    CL Item
    Hungary (76)
    CL Item
    Iceland (77)
    CL Item
    India (78)
    CL Item
    Indonesia (79)
    CL Item
    Iran (80)
    CL Item
    Iraq (81)
    CL Item
    Ireland (82)
    CL Item
    Israel (83)
    CL Item
    Italy (84)
    CL Item
    Jamaica (85)
    CL Item
    Japan (86)
    CL Item
    Jordan (87)
    CL Item
    Kazakhstan (88)
    CL Item
    Kenya (89)
    CL Item
    Kiribati (90)
    CL Item
    Kuwait (91)
    CL Item
    Kyrgyzstan (92)
    CL Item
    Laos (93)
    CL Item
    Latvia (94)
    CL Item
    Lebanon (95)
    CL Item
    Lesotho (96)
    CL Item
    Liberia (97)
    CL Item
    Libya (98)
    CL Item
    Liechtenstein (99)
    CL Item
    Lithuania (100)
    CL Item
    Luxembourg (101)
    CL Item
    Madagascar (102)
    CL Item
    Malawi (103)
    CL Item
    Malaysia (104)
    CL Item
    Maldives (105)
    CL Item
    Mali (106)
    CL Item
    Malta (107)
    CL Item
    Marshall Islands (108)
    CL Item
    Mauritania (109)
    CL Item
    Mauritius (110)
    CL Item
    Mexico (111)
    CL Item
    Micronesia (112)
    CL Item
    Moldova (113)
    CL Item
    Monaco (114)
    CL Item
    Mongolia (115)
    CL Item
    Montenegro (116)
    CL Item
    Morocco (117)
    CL Item
    Mozambique (118)
    CL Item
    Myanmar (formerly Burma) (119)
    CL Item
    Namibia (120)
    CL Item
    Nauru (121)
    CL Item
    Nepal (122)
    CL Item
    Netherlands (123)
    CL Item
    New Zealand (124)
    CL Item
    Nicaragua (125)
    CL Item
    Niger (126)
    CL Item
    Nigeria (127)
    CL Item
    North Korea (128)
    CL Item
    North Macedonia (129)
    CL Item
    Norway (130)
    CL Item
    Oman (131)
    CL Item
    Pakistan (132)
    CL Item
    Palau (133)
    CL Item
    Palestine State (134)
    CL Item
    Panama (135)
    CL Item
    Papua New Guinea (136)
    CL Item
    Paraguay (137)
    CL Item
    Peru (138)
    CL Item
    Philippines (139)
    CL Item
    Poland (140)
    CL Item
    Portugal (141)
    CL Item
    Qatar (142)
    CL Item
    Romania (143)
    CL Item
    Russia (144)
    CL Item
    Rwanda (145)
    CL Item
    Saint Kitts and Nevis (146)
    CL Item
    Saint Lucia (147)
    CL Item
    Saint Vincent and the Grenadines (148)
    CL Item
    Samoa (149)
    CL Item
    San Marino (150)
    CL Item
    Sao Tome and Principe (151)
    CL Item
    Saudi Arabia (152)
    CL Item
    Senegal (153)
    CL Item
    Serbia (154)
    CL Item
    Seychelles (155)
    CL Item
    Sierra Leone (156)
    CL Item
    Singapore (157)
    CL Item
    Slovakia (158)
    CL Item
    Slovenia (159)
    CL Item
    Solomon Islands (160)
    CL Item
    Somalia (161)
    CL Item
    South Africa (162)
    CL Item
    South Korea (163)
    CL Item
    South Sudan (164)
    CL Item
    Spain (165)
    CL Item
    Sri Lanka (166)
    CL Item
    Sudan (167)
    CL Item
    Suriname (168)
    CL Item
    Sweden (169)
    CL Item
    Switzerland (170)
    CL Item
    Syria (171)
    CL Item
    Tajikistan (172)
    CL Item
    Tanzania (173)
    CL Item
    Thailand (174)
    CL Item
    Timor-Leste (175)
    CL Item
    Togo (176)
    CL Item
    Tonga (177)
    CL Item
    Trinidad and Tobago (178)
    CL Item
    Tunisia (179)
    CL Item
    Turkey (180)
    CL Item
    Turkmenistan (181)
    CL Item
    Tuvalu (182)
    CL Item
    Uganda (183)
    CL Item
    Ukraine (184)
    CL Item
    United Arab Emirates (185)
    CL Item
    United Kingdom (186)
    CL Item
    United States of America (187)
    CL Item
    Uruguay (188)
    CL Item
    Uzbekistan (189)
    CL Item
    Vanuatu (190)
    CL Item
    Venezuela (191)
    CL Item
    Vietnam (192)
    CL Item
    Yemen (193)
    CL Item
    Zambia (194)
    CL Item
    Zimbabwe (195)
    State/ Province/ Region of residence
    Item
    State/ Province/ Region:
    text
    C1830433 (UMLS CUI [1,1])
    age
    Item
    Your age (years):
    integer
    C0001779 (UMLS CUI [1,1])
    Item Group
    Exposure status During the PAST TWO WEEKS...
    C0332157 (UMLS CUI [1,1])
    C5203676 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    exposed___1
    Item
    ...have you been exposed to someone with positive SARS CoV 2 test?
    boolean
    C0332157 (UMLS CUI [1,1])
    C0027361 (UMLS CUI [1,2])
    C5244023 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    exposed___2
    Item
    ...have you been exposed to someone medical diagnosed with a SARS CoV 2 infection without positive test result?
    boolean
    C0332157 (UMLS CUI [1,1])
    C0027361 (UMLS CUI [1,2])
    C0011900 (UMLS CUI [1,3])
    C5203670 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    exposed___3
    Item
    ...have you been exposed to someone with possible COVID-19 symptoms during the past two weeks?
    boolean
    C0332157 (UMLS CUI [1,1])
    C0027361 (UMLS CUI [1,2])
    C1457887 (UMLS CUI [1,3])
    C0332281 (UMLS CUI [1,4])
    C5203670 (UMLS CUI [1,5])
    C4288440 (UMLS CUI [1,6])
    symptoms___1
    Item
    ...have you had a fever?
    boolean
    C0015967 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___2
    Item
    ...have you had a cough?
    boolean
    C0010200 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___3
    Item
    ...have you had shortness of breath?
    boolean
    C0013404 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___4
    Item
    ...have you had a sore throat?
    boolean
    C0242429 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___5
    Item
    ...have you had fatigue?
    boolean
    C0015672 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___6
    Item
    ...have you had loss of taste or smell?
    boolean
    C5382033 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___7
    Item
    ...have you had an eye infection?
    boolean
    C0015403 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    symptoms___8
    Item
    ...have you had other symptoms?
    boolean
    C3257980 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    diagnosedfamily___1
    Item
    ... has a family member living in the same household have COVID-19 diagnosis?
    boolean
    C4330269 (UMLS CUI [1,1])
    C0086282 (UMLS CUI [1,2])
    C0011900 (UMLS CUI [1,3])
    C5203670 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    diagnosedfamily___2
    Item
    ... has a family member not living in the same household have COVID-19 diagnosis?
    boolean
    C0086282 (UMLS CUI [1,1])
    C0011900 (UMLS CUI [1,2])
    C5203670 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    impact___1
    Item
    ...has any of your family members fallen ill physically due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C0221423 (UMLS CUI [1,2])
    C5203676 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    impact___2
    Item
    ...has any of your family members been hospitalized due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C0019993 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C5203670 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    impact___3
    Item
    ...has any of your family members been put into self-quarantine with symptoms due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C5392942 (UMLS CUI [1,2])
    C5203670 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    impact___4
    Item
    ...has any of your family members been put into self-quarantine without symptoms due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C5392942 (UMLS CUI [1,2])
    C5203676 (UMLS CUI [1,3])
    C0231221 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    impact___5
    Item
    ...has any of your family members lost or been laid off from their job due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C0425083 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C5203676 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    impact___6
    Item
    ...has any of your family members have a reduced ability to earn money due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C0392756 (UMLS CUI [1,2])
    C0021162 (UMLS CUI [1,3])
    C0678226 (UMLS CUI [1,4])
    C5203676 (UMLS CUI [1,5])
    C4288440 (UMLS CUI [1,6])
    impact___7
    Item
    ...has any of your family members passed away due to COVID-19?
    boolean
    C0086282 (UMLS CUI [1,1])
    C1306577 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C5203670 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    Item
    How much are you reading or talking about Coronavirus/ COVID-19?
    text
    C0034754 (UMLS CUI [1,1])
    C3874886 (UMLS CUI [1,2])
    C5203676 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    C0234856 (UMLS CUI [2,1])
    C3874886 (UMLS CUI [2,2])
    C5203676 (UMLS CUI [2,3])
    C4288440 (UMLS CUI [2,4])
    CL.1
    Code List
    How much are you reading or talking about Coronavirus/ COVID-19?
    CL Item
    Never (1)
    CL Item
    Rarely (2)
    CL Item
    Occasionally (3)
    CL Item
    Often (4)
    CL Item
    Most of the time (5)
    Item
    Has the Coronavirus/ COIVD-19 crisis in your area led to any positive change in your life?
    text
    C0376558 (UMLS CUI [1,1])
    C1446409 (UMLS CUI [1,2])
    C0392747 (UMLS CUI [1,3])
    C5392141 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    CL.1
    Code List
    Has the Coronavirus/ COIVD-19 crisis in your area led to any positive change in your life?
    CL Item
    None (1)
    CL Item
    Only a few (2)
    CL Item
    Some (3)
    Item
    ...have you been suspected of having a COVID-19 infection?
    text
    C5203676 (UMLS CUI [1,1])
    C3714514 (UMLS CUI [1,2])
    C0750491 (UMLS CUI [1,3])
    CL.3
    Code List
    ...have you been suspected of having a COVID-19 infection?
    CL Item
    Yes, has positive test (1)
    C5244023 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    CL Item
    Yes, medical diagnosis, but no test (2)
    C5203676 (UMLS CUI [1,1])
    C0011900 (UMLS CUI [1,2])
    C3841003 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    CL Item
    Yes, have had some possible symptoms, but no diagnosis by doctor (3)
    C1457887 (UMLS CUI [1,1])
    C5203676 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    C0011900 (UMLS CUI [1,4])
    C0549184 (UMLS CUI [1,5])
    CL Item
    No symptoms or signs (4)
    C5203676 (UMLS CUI [1,1])
    C1457887 (UMLS CUI [1,2])
    C0549184 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    I.1
    Item
    Other Symptoms:
    text
    C3257980 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    Item
    ...how worried have you been about being infected?
    text
    C5203676 (UMLS CUI [1,1])
    C3714514 (UMLS CUI [1,2])
    C0233481 (UMLS CUI [1,3])
    CL.4
    Code List
    ...how worried have you been about being infected?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...how worried have you been about friends or family being infected?
    text
    C0079382 (UMLS CUI [1,1])
    C5203676 (UMLS CUI [1,2])
    C3714514 (UMLS CUI [1,3])
    C0233481 (UMLS CUI [1,4])
    C0086282 (UMLS CUI [2,1])
    C5203676 (UMLS CUI [2,2])
    C3714514 (UMLS CUI [2,3])
    C0233481 (UMLS CUI [2,4])
    CL.4
    Code List
    ...how worried have you been about friends or family being infected?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...how worried have you been about your physical health being influenced by COVID-19?
    text
    C0233481 (UMLS CUI [1,1])
    C5203670 (UMLS CUI [1,2])
    C0392760 (UMLS CUI [1,3])
    C0517226 (UMLS CUI [1,4])
    CL.4
    Code List
    ...how worried have you been about your physical health being influenced by COVID-19?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...how worried have you been about your mental/emotional health being influenced by COVID-19?
    text
    C0233481 (UMLS CUI [1,1])
    C5203670 (UMLS CUI [1,2])
    C0392760 (UMLS CUI [1,3])
    C0025353 (UMLS CUI [1,4])
    CL.4
    Code List
    ...how worried have you been about your mental/emotional health being influenced by COVID-19?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    I.7
    Item
    Please specify:
    text
    C0376558 (UMLS CUI [1,1])
    C1446409 (UMLS CUI [1,2])
    C0392747 (UMLS CUI [1,3])
    C5392141 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    Item Group
    Life changes During the PAST TWO WEEKS...
    C0376558 (UMLS CUI [1,1])
    C0392747 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    Item
    ...has your school building been closed?
    text
    C0036375 (UMLS CUI [1,1])
    C0587267 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C5392141 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    schoolclosed
    Code List
    ...has your school building been closed?
    CL Item
    Yes (1)
    CL Item
    No (0)
    CL Item
    Not Applicable (2)
    classes in session
    Item
    Are classes in session?
    boolean
    C0036375 (UMLS CUI [1,1])
    C0038492 (UMLS CUI [1,2])
    C0441833 (UMLS CUI [1,3])
    C1553514 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    attended classes in person within previous two weeks
    Item
    Are you attending classes in-person?
    boolean
    C0036375 (UMLS CUI [1,1])
    C1999232 (UMLS CUI [1,2])
    C1553514 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    classes resumed online within previous two weeks
    Item
    Have classes resumed online?
    boolean
    C0036375 (UMLS CUI [1,1])
    C4505477 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    internet and computer access within previous two weeks
    Item
    Do you have easy access to the internet and a computer?
    boolean
    C4704731 (UMLS CUI [1,1])
    C0444454 (UMLS CUI [1,2])
    C0009622 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    assignments within the previous two weeks
    Item
    Are there assignments for you to complete?
    boolean
    C0683853 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    meals from school
    Item
    Are you able to receive meals from the school?
    boolean
    C1998602 (UMLS CUI [1,1])
    C1517320 (UMLS CUI [1,2])
    C0036375 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    in-person conversation count within previous two weeks
    Item
    ...how many people, from outside of your household, have you had an in-person conversation with?
    integer
    C0750480 (UMLS CUI [1,1])
    C0871703 (UMLS CUI [1,2])
    C1553514 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    Item
    ...how much time have you spent going outside of the home (e.g., going to stores, parks, etc.)?
    text
    C0040223 (UMLS CUI [1,1])
    C1709359 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    timeoutside
    Code List
    ...how much time have you spent going outside of the home (e.g., going to stores, parks, etc.)?
    CL Item
    Not at all (1)
    CL Item
    1-2 days per week (2)
    CL Item
    A few days per week (3)
    CL Item
    Several days per week (4)
    CL Item
    Every day (5)
    Item
    ...how stressful have the restrictions on leaving home been for you?
    text
    C0038435 (UMLS CUI [1,1])
    C0678226 (UMLS CUI [1,2])
    C4534363 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    restrictionsstress
    Code List
    ...how stressful have the restrictions on leaving home been for you?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...have your contacts with people outside of your home changed relative to before the Coronavirus/COVID-19 crisis in your area?
    text
    C0392747 (UMLS CUI [1,1])
    C0237101 (UMLS CUI [1,2])
    C1711239 (UMLS CUI [1,3])
    C5392141 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    contactschanged
    Code List
    ...have your contacts with people outside of your home changed relative to before the Coronavirus/COVID-19 crisis in your area?
    CL Item
    A lot less (1)
    CL Item
    A little less (2)
    CL Item
    About the same (3)
    CL Item
    A little more (4)
    CL Item
    A lot more (5)
    Item
    ...how much difficulty have you had following the recommendations for keeping away from close contact with people?
    text
    C0332218 (UMLS CUI [1,1])
    C5440893 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    difficultydistancing
    Code List
    ...how much difficulty have you had following the recommendations for keeping away from close contact with people?
    CL Item
    None (1)
    CL Item
    A little (2)
    CL Item
    Moderate (3)
    CL Item
    A lot (4)
    CL Item
    A great amount (5)
    Item
    ...has the quality of the relationships between you and members of your family changed?
    text
    C0392747 (UMLS CUI [1,1])
    C0439849 (UMLS CUI [1,2])
    C0086282 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    familychange
    Code List
    ...has the quality of the relationships between you and members of your family changed?
    CL Item
    A lot worse (1)
    CL Item
    A little worse (2)
    CL Item
    About the same (3)
    CL Item
    A little better (4)
    CL Item
    A lot better (5)
    Item
    ...how stressful have these changes in family contacts been for you?
    text
    C0038435 (UMLS CUI [1,1])
    C0678226 (UMLS CUI [1,2])
    C0392747 (UMLS CUI [1,3])
    C0439849 (UMLS CUI [1,4])
    C0086282 (UMLS CUI [1,5])
    C4288440 (UMLS CUI [1,6])
    familychangestress
    Code List
    ...how stressful have these changes in family contacts been for you?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...has the quality of your relationships with your friends changed?
    text
    C0392747 (UMLS CUI [1,1])
    C0439849 (UMLS CUI [1,2])
    C0079382 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    friendschange
    Code List
    ...has the quality of your relationships with your friends changed?
    CL Item
    A lot worse (1)
    CL Item
    A little worse (2)
    CL Item
    About the same (3)
    CL Item
    A little better (4)
    CL Item
    A lot better (5)
    Item
    ...how stressful have these changes in social contacts been for you?
    text
    C0038435 (UMLS CUI [1,1])
    C0678226 (UMLS CUI [1,2])
    C0392747 (UMLS CUI [1,3])
    C0439849 (UMLS CUI [1,4])
    C0079382 (UMLS CUI [1,5])
    C4288440 (UMLS CUI [1,6])
    friendchangestress
    Code List
    ...how stressful have these changes in social contacts been for you?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...how much has cancellation of important events (such as graduation, prom, vacation, etc.) in your life been difficult for you?
    text
    C0332218 (UMLS CUI [1,1])
    C0441471 (UMLS CUI [1,2])
    C1553388 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    difficultycancellations
    Code List
    ...how much has cancellation of important events (such as graduation, prom, vacation, etc.) in your life been difficult for you?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...to what degree have changes related to the Coronavirus/COVID-19 crisis in your area created financial problems for your family?
    text
    C0015576 (UMLS CUI [1,1])
    C0549106 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C5392141 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    financedifficulty
    Code List
    ...to what degree have changes related to the Coronavirus/COVID-19 crisis in your area created financial problems for your family?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item
    ...to what degree are you concerned about the stability of your living situation?
    text
    C2107029 (UMLS CUI [1,1])
    C2184149 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    livingdifficulty
    Code List
    ...to what degree are you concerned about the stability of your living situation?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    worried about food shortage due to financial problems
    Item
    ...did you worry whether your food would run out because of a lack of money?
    boolean
    C0233481 (UMLS CUI [1,1])
    C0598456 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C0549106 (UMLS CUI [1,4])
    C4288440 (UMLS CUI [1,5])
    Item
    How hopeful are you that the Coronavirus/COVID-19 crisis in your area will end soon?
    text
    C5224035 (UMLS CUI [1,1])
    C0444930 (UMLS CUI [1,2])
    C5392141 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    hopefullyend
    Code List
    How hopeful are you that the Coronavirus/COVID-19 crisis in your area will end soon?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very (4)
    CL Item
    Extremely (5)
    Item Group
    Daily behaviors During the PAST TWO WEEKS...
    C0871707 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    Item
    ...on average, what time did you go to bed on WEEKDAYS?
    text
    C0521112 (UMLS CUI [1,1])
    C0680189 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    bedtimeweekdays_2_fd7e26
    Code List
    ...on average, what time did you go to bed on WEEKDAYS?
    CL Item
    Before 9 pm (1)
    CL Item
    9 pm - 11 pm (2)
    CL Item
    11 pm - 1 am (3)
    CL Item
    After 1 am (4)
    Item
    ...on average, what time did you go to bed on WEEKENDS?
    text
    C0521112 (UMLS CUI [1,1])
    C0680190 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    bedtimeweekends_2_ba9e58
    Code List
    ...on average, what time did you go to bed on WEEKENDS?
    CL Item
    Before 9 pm (1)
    CL Item
    9 pm - 11 pm (2)
    CL Item
    11 pm - 1 am (3)
    CL Item
    After 1 am (4)
    Item
    ...on average, how many hours per night did you sleep on WEEKDAYS?
    text
    C2937255 (UMLS CUI [1,1])
    C0680189 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    hoursofsleepweekdays_2_500a2e
    Code List
    ...on average, how many hours per night did you sleep on WEEKDAYS?
    CL Item
    <6 hours (1)
    CL Item
    6-8 hours (2)
    CL Item
    8-10 hours (3)
    CL Item
    >10 hours (4)
    Item
    ...on average, how many hours per night did you sleep on WEEKENDS?
    text
    C2937255 (UMLS CUI [1,1])
    C0680190 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    hoursofsleepweekends_2_c9f657
    Code List
    ...on average, how many hours per night did you sleep on WEEKENDS?
    CL Item
    <6 hours (1)
    CL Item
    6-8 hours (2)
    CL Item
    8-10 hours (3)
    CL Item
    >10 hours (4)
    Item
    ...how many days per week did you exercise (e.g., increased heart rate, breathing) for at least 30 minutes?
    text
    C2230062 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    exerciseprior_2
    Code List
    ...how many days per week did you exercise (e.g., increased heart rate, breathing) for at least 30 minutes?
    CL Item
    None (1)
    CL Item
    1-2 days (2)
    CL Item
    3-4 days (3)
    CL Item
    5-6 days (4)
    CL Item
    Daily (5)
    Item
    ...how many days per week did you spend time outdoors?
    text
    C0677547 (UMLS CUI [1,1])
    C4534420 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    outdoorsprior_2
    Code List
    ...how many days per week did you spend time outdoors?
    CL Item
    None (1)
    CL Item
    1-2 days (2)
    CL Item
    3-4 days (3)
    CL Item
    5-6 days (4)
    CL Item
    Daily (5)
    Item Group
    Emotions/ Worries During the PAST TWO WEEKS...
    C0013987 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    C0233481 (UMLS CUI [2,1])
    C4288440 (UMLS CUI [2,2])
    Item
    ...how worried were you generally?
    text
    C0681889 (UMLS CUI [1,1])
    C0233481 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priorworry_2
    Code List
    ...how worried were you generally?
    CL Item
    Not worried at all (1)
    CL Item
    Slightly worried (2)
    CL Item
    Moderately worried (3)
    CL Item
    Very worried (4)
    CL Item
    Extremely worried (5)
    Item
    ...how happy versus sad were you?
    text
    C1821411 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    C0681889 (UMLS CUI [2,1])
    C3536794 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    priorhappyvssad_2
    Code List
    ...how happy versus sad were you?
    CL Item
    Very sad/depressed/unhappy (1)
    CL Item
    Moderately sad/depressed/unhappy (2)
    CL Item
    Neutral (3)
    CL Item
    Moderately happy/cheerful (4)
    CL Item
    Very happy/cheerful (5)
    Item
    ...how much were you able to enjoy your usual activities?
    text
    C0681889 (UMLS CUI [1,1])
    C4316940 (UMLS CUI [1,2])
    C0871707 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    priorenjoyactivities_2_4212c2
    Code List
    ...how much were you able to enjoy your usual activities?
    CL Item
    Not at all (1)
    CL Item
    Slightly (2)
    CL Item
    Moderately (3)
    CL Item
    Very much (4)
    CL Item
    A lot (5)
    Item
    ...how relaxed versus anxious were you?
    text
    C0681889 (UMLS CUI [1,1])
    C0035028 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    C0681889 (UMLS CUI [2,1])
    C0003467 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    priorrelaxedvsanxious_2
    Code List
    ...how relaxed versus anxious were you?
    CL Item
    Very relaxed/calm (1)
    CL Item
    Moderately relaxed/calm (2)
    CL Item
    Neutral (3)
    CL Item
    Moderately nervous/anxious (4)
    CL Item
    Very nervous/anxious (5)
    Item
    ...how fidgety or restless were you?
    text
    C0681889 (UMLS CUI [1,1])
    C0424235 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    C0681889 (UMLS CUI [2,1])
    C3887611 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    priorfidget_2
    Code List
    ...how fidgety or restless were you?
    CL Item
    Not fidgety/restless at all (1)
    CL Item
    Slightly fidgety/restless (2)
    CL Item
    Moderately fidgety/restless (3)
    CL Item
    Very fidgety/restless (4)
    CL Item
    Extremely fidgety/restless (5)
    Item
    ...how fatigued or tired were you?
    text
    C0681889 (UMLS CUI [1,1])
    C0015672 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priorfatigue_2
    Code List
    ...how fatigued or tired were you?
    CL Item
    Not fatigued or tired at all (1)
    CL Item
    Slightly fatigued or tired (2)
    CL Item
    Moderately fatigued or tired (3)
    CL Item
    Very fatigued or tired (4)
    CL Item
    Extremely fatigued or tired (5)
    Item
    ...how well were you able to concentrate or focus?
    text
    C0681889 (UMLS CUI [1,1])
    C0086045 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priorfocus_2
    Code List
    ...how well were you able to concentrate or focus?
    CL Item
    Very focused/attentive (1)
    CL Item
    Moderately focused/attentive (2)
    CL Item
    Neutral (3)
    CL Item
    Moderately unfocused/distracted (4)
    CL Item
    Very unfocused/distracted (5)
    Item
    ...how irritable or easily angered were you?
    text
    C0681889 (UMLS CUI [1,1])
    C0022107 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    C0681889 (UMLS CUI [2,1])
    C2227997 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    priorirritable_2
    Code List
    ...how irritable or easily angered were you?
    CL Item
    Not irritable or easily angered at all (1)
    CL Item
    Slightly irritable or easily angered (2)
    CL Item
    Moderately irritable or easily angered (3)
    CL Item
    Very irritable or easily angered (4)
    CL Item
    Extremely irritable or easily angered (5)
    Item
    ...how lonely were you?
    text
    C0681889 (UMLS CUI [1,1])
    C0023974 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priorlonely_2
    Code List
    ...how lonely were you?
    CL Item
    Not lonely at all (1)
    CL Item
    Slightly lonely (2)
    CL Item
    Moderately lonely (3)
    CL Item
    Very lonely (4)
    CL Item
    Extremely lonely (5)
    Item
    ...to what extent did you have negative thoughts, thoughts about unpleasant experiences or things that make you feel bad?
    text
    C4321352 (UMLS CUI [1,1])
    C1142075 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priornegthoughts_2_aff3aa
    Code List
    ...to what extent did you have negative thoughts, thoughts about unpleasant experiences or things that make you feel bad?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Occasionally (3)
    CL Item
    Often (4)
    CL Item
    A lot of the time (5)
    Item Group
    Media use During the PAST TWO WEEKS, how much time per day did you spend...
    C5392110 (UMLS CUI [1,1])
    C0556974 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    C0042649 (UMLS CUI [2,1])
    C0556974 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    Item
    ...watching TV or digital media (e.g., Netflix, YouTube, web surfing)?
    text
    C3827501 (UMLS CUI [1,1])
    C0556974 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priortvmedia_2
    Code List
    ...watching TV or digital media (e.g., Netflix, YouTube, web surfing)?
    CL Item
    No TV or digital media (1)
    CL Item
    Under 1 hour (2)
    CL Item
    1-3 hours (3)
    CL Item
    4-6 hours (4)
    CL Item
    More than 6 hours (5)
    Item
    ...using social media (e.g., Facetime, Facebook, Instagram, Snapchat, Twitter, TikTok)?
    text
    C3179065 (UMLS CUI [1,1])
    C0556974 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    priorsocialmedia_2
    Code List
    ...using social media (e.g., Facetime, Facebook, Instagram, Snapchat, Twitter, TikTok)?
    CL Item
    No social media (1)
    CL Item
    Under 1 hour (2)
    CL Item
    1-3 hours (3)
    CL Item
    4-6 hours (4)
    CL Item
    More than 6 hours (5)
    Item
    ...playing video games?
    text
    C2047133 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    priorvideogames_2
    Code List
    ...playing video games?
    CL Item
    No video games (1)
    CL Item
    Under 1 hour (2)
    CL Item
    1-3 hours (3)
    CL Item
    4-6 hours (4)
    CL Item
    More than 6 hours (5)
    Item Group
    Substance use During the PAST TWO WEEKS, how frequently did you use...
    C0237123 (UMLS CUI [1,1])
    C4288440 (UMLS CUI [1,2])
    Item
    ...alcohol?
    text
    C4321352 (UMLS CUI [1,1])
    C0001948 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    twoweeksalcohol
    Code List
    ...alcohol?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item
    ...vaping products?
    text
    C4321352 (UMLS CUI [1,1])
    C4083280 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    twoweeksvaping
    Code List
    ...vaping products?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item
    ...cigarettes or other tobacco products?
    text
    C4321352 (UMLS CUI [1,1])
    C0543414 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    twoweekstobacco
    Code List
    ...cigarettes or other tobacco products?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item
    ...marijuana/cannabis (e.g., joint, blunt, pipe, bong)?
    text
    C4321352 (UMLS CUI [1,1])
    C4316909 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    twoweeksmarijuana
    Code List
    ...marijuana/cannabis (e.g., joint, blunt, pipe, bong)?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item
    ...opiates, heroin, or narcotics?
    text
    C4321352 (UMLS CUI [1,1])
    C4551628 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    C4321352 (UMLS CUI [2,1])
    C0600241 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    C4321352 (UMLS CUI [3,1])
    C0524661 (UMLS CUI [3,2])
    C4288440 (UMLS CUI [3,3])
    twoweeksopiates_a2078c
    Code List
    ...opiates, heroin, or narcotics?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item
    ...other drugs including cocaine, crack, amphetamine, methamphetamine, hallucinogens, or ecstasy?
    text
    C4321352 (UMLS CUI [1,1])
    C0848734 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    twoweeksother
    Code List
    ...other drugs including cocaine, crack, amphetamine, methamphetamine, hallucinogens, or ecstasy?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item
    ...sleeping medications or sedatives/hypnotics?
    text
    C4321352 (UMLS CUI [1,1])
    C0599396 (UMLS CUI [1,2])
    C0013146 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    C4321352 (UMLS CUI [2,1])
    C1456771 (UMLS CUI [2,2])
    C4288440 (UMLS CUI [2,3])
    C4321352 (UMLS CUI [3,1])
    C0338699 (UMLS CUI [3,2])
    C4288440 (UMLS CUI [3,3])
    twoweeksleeping_5290cb
    Code List
    ...sleeping medications or sedatives/hypnotics?
    CL Item
    Not at all (1)
    CL Item
    Rarely (2)
    CL Item
    Once a month (3)
    CL Item
    Several times a month (4)
    CL Item
    Once a week (5)
    CL Item
    Several times a week (6)
    CL Item
    Once a day (7)
    CL Item
    More than once a day (8)
    Item Group
    Which of the following supports were in place for you before the Coronavirus/COVID-19 crisis in your area and have been disrupted over the PAST TWO WEEKS? (check all that apply)
    C0748877 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C0678226 (UMLS CUI [1,3])
    C5392141 (UMLS CUI [1,4])
    resource room disrupted past two weeks
    Item
    Resource room
    boolean
    C3846158 (UMLS CUI [1,1])
    tutoring disrupted past two weeks
    Item
    Tutoring
    boolean
    C0872010 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    mentoring program disrupted past two weeks
    Item
    Mentoring programs
    boolean
    C4255266 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    after school activity programs disrupted past two weeks
    Item
    After school activity programs
    boolean
    C0681383 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    volunteer program disrupted past two weeks
    Item
    Volunteer programs
    boolean
    C2367294 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    psychotherapy disrupted past two weeks
    Item
    Psychotherapy
    boolean
    C0033968 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    psychiatric care disrupted past two weeks
    Item
    Psychiatric care
    boolean
    C0597312 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    occupational therapy disrupted past two weeks
    Item
    Occupational therapy
    boolean
    C1318464 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    physical therapy disrupted past two weeks
    Item
    Physical therapy
    boolean
    C0949766 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    speech/language therapy disrupted past two weeks
    Item
    Speech/language therapy
    boolean
    C0589155 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    sporting activities disrupted past two weeks
    Item
    Sporting activities
    boolean
    C0038039 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    medical care for chronic illnesses disrupted past two weeks
    Item
    Medical care for chronic illnesses
    boolean
    C1555457 (UMLS CUI [1,1])
    C0332454 (UMLS CUI [1,2])
    C4288440 (UMLS CUI [1,3])
    other supports disrupted past two weeks
    Item
    Other
    boolean
    C0205394 (UMLS CUI [1,1])
    C0748877 (UMLS CUI [1,2])
    C0332454 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    specify other supports disrupted within the past two weeks
    Item
    Other: Specify
    text
    C3845569 (UMLS CUI [1,1])
    C0748877 (UMLS CUI [1,2])
    C0332454 (UMLS CUI [1,3])
    C4288440 (UMLS CUI [1,4])
    Item Group
    Additional concerns and comments
    C3482667 (UMLS CUI [1,1])
    C1830770 (UMLS CUI [1,2])
    anything_else
    Item
    Please describe anything else that concerns you about the impact of Coronavirus/COVID-19 on you, your friends, or your family.
    text
    C5392141 (UMLS CUI [1,1])
    C4049986 (UMLS CUI [1,2])
    C0205394 (UMLS CUI [1,3])
    Item Group
    Comment section - Youth Selfreport Follow Up Form
    C4321425 (UMLS CUI [1,1])
    survey comments
    Item
    Please provide any comments that you would like to share about this survey and/or related topics.
    text
    C1830770 (UMLS CUI [1,1])
    C0332281 (UMLS CUI [1,2])
    C0034394 (UMLS CUI [1,3])
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