Draft
date:
03/
31/
05
1
Proposed
Interview
Domains
for
NCS
Pilot
Cohort
Assessment
at:

Domains
Prepregnancy
visits
Pregnancy
visits
Birth/
childhood
visits
Acceptability
Questionnaire
length
Sensitivity
of
questions
Reasons
for
refusal
or
participation
W,
M
W
W,
M
Activity
Work
Recreation/
sports
Household
(
e.
g.,
childcare)
Activity
at
different
points
prior
to
pregnancy
Activity
during
pregnancy
Child's
activities
(
e.
g.,
developmental,
handto
mouth,
pica
behavior)
W,
M
W,
M
W,
M
Alcohol
Frequency/
quantity
Changes
in
consumption
after
pregnancy
Knowledge
of
effects
of
alcohol
consumption
during
pregnancy
W,
M
W,
M
W,
M
Chemical
exposures
Occupation
(
specific
chemicals,
smoking
policy,
use
of
protective
equipment?)
Home
(
age
of
home,
lead,
radon,
mold)
Other
(
e.
g.,
hobbies)
W,
M
W,
M
W,
M
Child
development
Behavioral
Social
Injuries
Sleep
patterns/
difficulties
­­
­­
W
Demographics
Age/
DOB
Race/
ethnicity
Marital
status
Nativity
Education
Income
Occupation
(
updated
as
necessary)
W,
M
­­
­­

Dental
health
W
W
Diet
­
Maternal
Foods
Fast
foods
Beverages
(
diet,
caffeine)
Nutritional
awareness
Special
diet
(
e.
g.,
low
sodium,
low
fat,
organic
food)
Changes
in
diet
after
pregnancy
W
W
W
Diet
­
Child
Breastfeeding:
knowledge
of
benefits,
when
stopped,
problems
breastfeeding
Formulas
Vitamins,
supplements
Solid
foods:
when
started,
types
Fast
food
­­
W
Draft
date:
03/
31/
05
2
Assessment
at:

Domains
Prepregnancy
visits
Pregnancy
visits
Birth/
childhood
visits
Drugs
Prescription
OTC
Vitamins/
supplements
(
e.
g.,
folic
acid,
herbal)
Fertility
W
W
W
Family
history
Parental
marital
status
Family
composition
Stability
as
a
child
Mother/
Father
health
history
W,
M
­­
­­

Financial
security
Economic
assistance
Food
security
Economic
stressors
W
W
W
Household
composition
Number
Relationship
to
respondent
Household
responsibilities
W
­­
­­

Medical
history
and
health
conditions
Allergies
Asthma
Diabetes
Hypertension?
Hypercholesterol?
Specific
conditions
of
interest
during
pregnancy
(
e.
g.,
infections,
fever,
vaginal
bleeding,
pre­
eclampsia)
STDs
Other
conditions
W,
M
W
W
Medical
health
conditions
 
Child
Allergies
Asthma
Etc.
­­
­­
W
Medical
care
Availability
Prenatal
care
Health
insurance
Special
healthcare
programs
for
low­
income
Care
at
delivery
Vaccinations/
regular
check­
ups
for
child
­­
W
W
Mental
health
Feelings
about
pregnancy
Depression
Stress
Anxiety
Major
life
events
Social
support
­­
W
W
Neighborhood
conditions
Traffic
Safety
Poverty
level
Factors
affecting
mental
health
W
W
­­
Draft
date:
03/
31/
05
3
Assessment
at:

Domains
Prepregnancy
visits
Pregnancy
visits
Birth/
childhood
visits
Pets
and
pests
W
W
W
Reproductive
health
Current
contraception
Pregnancy
status
Reproductive
history
W
­­
­­

Tobacco
ETS
Self
Changes
in
tobacco
use
during/
after
pregnancy
Changes
in
ETS
after
pregnancy
W
W
W,
M
NOTE:
Respondent
types
are
noted
in
each
cell
for
each
domain
and
visit
type.
M
indicates
Man
(
i.
e.
father);
W
indicates
Woman
(
i.
e.
mother).
Draft
date:
03/
31/
05
4
Proposed
Non­
Interview
Domains
for
NCS
Pilot
Cohort
Assessment
at:

Domains
Prepregnancy
visits
Pregnancy
visits
Birth/
childhood
visits
Physical
exam
Blood
pressure
W
W
W
Anthropometry
W,
M
W
W,
C
Fetal
ultrasound
­­
W
W,
M
Biologic
samples
Blood
W,
M
W
W,
C
Cord
blood
­­
­­
W
Cord
sample
­­
­­
W
Hair
W,
M
Meconium
­­
­­
W
Nails
W,
M
W
C
Placenta
­­
­­
W
Placental
photo
­­
­­
W
Saliva
W
W
C
Semen
M
­­
­­
Urine
W
W
­­
Vaginal
swab
W
W
W
Breast
Milk
­­
­­
W
Dermal
W,
M
­­
C
Environmental
samples
Personal
Air:
Assess
sample
integrity
resulting
from
participant­
deployed
and
collected
sample;
comparison
of
techniciancollected
and
participant­
collected
samples
­­
W
W
Personal
Air:
Assess
feasibility
of
using
an
active
sampler
for
collecting
personal
air
samples
for
particles
and
dust;
incorporate
motion
sensing
feature
to
assess
participant
compliance
­­
W
W
Surface
Dust:
Compare
participant
and
technician­
collected
samples
for
wipes
on
various
painted
surfaces;
compare
to
direct
xray
fluorescence
technique
for
measuring
lead
in
painted
surfaces
W
­­
­­

Floor
Dust:
Determine
participant
ability
to
collect
vacuum
and
wipe
samples
from
floor
surfaces;
employ
pre­
deposited
plates
and
carpets
and
compare
with
techniciancollection
­­
W
W
Soil:
Assessment
of
participant
proficiency
in
collection
of
surface
soil
samples
by
video
review
of
actual
collection
­­
W
­­

Water:
Investigate
participant
compliance
with
sample
storage
protocol
­­
W
­­

NOTE:
Respondent
types
are
noted
in
each
cell
for
each
domain
and
visit
type.
M
indicates
Man
(
i.
e.
father);
W
indicates
Woman
(
i.
e.
mother);
C
indicates
Child
