111771-2
Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS]
Active
Form Coding Instructions
I'd like to ask you some questions about events that happened during your childhood. This information will allow us to better understand problems that may occur early in life and may help others in the future. This is a sensitive topic and some people may feel uncomfortable with these questions. At the end of this section, I will give you a phone number for an organization that can provide information and referral for these issues. Please keep in mind that you can ask me to skip any question you do not want to answer. All questions refer to the time period before you were 18 years of age.
Source: Centers for Disease Control and Prevention82141-3 Now, looking back before you were 18 years of age---. 1) Did you live with anyone who was depressed, mentally ill, or suicidal?
Observation ID in Form
MACE.01
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- Did you live with anyone who was depressed, mentally ill, or suicidal
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Did you live with anyone who was depressed, mentally ill, or suicidal
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL7294-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | 1 | LA33-6 |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | 0 | LA32-8 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
82142-1 Did you live with anyone who was a problem drinker or alcoholic?
Observation ID in Form
MACE.02
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- Did you live with anyone who was a problem drinker or alcoholic
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Did you live with anyone who was a problem drinker or alcoholic
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL7294-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | 1 | LA33-6 |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | 0 | LA32-8 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
82143-9 Did you live with anyone who used illegal street drugs or who abused prescription medications?
Observation ID in Form
MACE.03
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- Did you live with anyone who used illegal street drugs or who abused prescription medications
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Did you live with anyone who used illegal street drugs or who abused prescription medications
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL7294-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | 1 | LA33-6 |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | 0 | LA32-8 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
82144-7 Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?
Observation ID in Form
MACE.04
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL7294-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | 1 | LA33-6 |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | 0 | LA32-8 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
Member of these Groups Get Info
| LOINC Group | Group Name |
|---|---|
| LG51306-5 | SDOH |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
82145-4 Were your parents separated or divorced?
Observation ID in Form
MACE.05
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- Were your parents separated or divorced
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Long Common Name
Were your parents separated or divorced
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL7294-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | 1 | LA33-6 |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 2 | 0 | LA32-8 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
82146-2 How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up? Was it…
Observation ID in Form
MACE.06
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL4030-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| Once | 2 | 1 | LA14312-5 |
| More than once | 3 | 1 | LA14313-3 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
82147-0 Not including spanking, (before age 18), how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Was it-
Observation ID in Form
MACE.07
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- How often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
How often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL4030-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| Once | 2 | 1 | LA14312-5 |
| More than once | 3 | 1 | LA14313-3 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
82148-8 How often did a parent or adult in your home ever swear at you, insult you, or put you down? Was it…
Observation ID in Form
MACE.08
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- How often did a parent or adult in your home ever swear at you, insult you, or put you down
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
How often did a parent or adult in your home ever swear at you, insult you, or put you down
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL4030-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| Once | 2 | 1 | LA14312-5 |
| More than once | 3 | 1 | LA14313-3 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
82149-6 How often did anyone at least 5 years older than you or an adult, ever touch you sexually? Was it…
Observation ID in Form
MACE.09
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- How often did anyone at least 5Y older than you or an adult, ever touch you sexually
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
How often did anyone at least 5 years older than you or an adult, ever touch you sexually
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL4030-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| Once | 2 | 1 | LA14312-5 |
| More than once | 3 | 1 | LA14313-3 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
82150-4 How often did anyone at least 5 years older than you or an adult, try to make you touch them sexually? Was it…
Observation ID in Form
MACE.10
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- How often did anyone at least 5Y older than you or an adult, try to make you touch sexually
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
How often did anyone at least 5 years older than you or an adult, try to make you touch sexually
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL4030-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| Once | 2 | 1 | LA14312-5 |
| More than once | 3 | 1 | LA14313-3 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
82151-2 How often did anyone at least 5 years older than you or an adult, force you to have sex? Was it…
Observation ID in Form
MACE.11
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- How often did anyone at least 5Y older than you or an adult, force you to have sex
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
How often did anyone at least 5 years older than you or an adult, force you to have sex
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.82 (NAM)
- Change Reason
- Release 2.82: COMPONENT: Removed CHALLENGE ^pre 18Yo as age is now denoted in the Form Context; Previous Releases: Changed TIME to Pt and added CHALLENGE ^pre 18Yo to better represent questions about before patient turned 18
- Order vs. Observation
- Observation
Example Answer List LL4030-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| Once | 2 | 1 | LA14312-5 |
| More than once | 3 | 1 | LA14313-3 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
111772-0 For how much of your childhood was there an adult in your household who made you feel safe and protected? Would you say never, a little of the time, some of the time, most of the time, or all of the time?
Observation ID in Form
MACE.12
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- For how much of your childhood was there an adult in your household who made you feel safe and protected
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
For how much of your childhood was there an adult in your household who made you feel safe and protected
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.82
- Last Updated
- Version 2.82 (ADD)
- Order vs. Observation
- Observation
Example Answer List LL7296-8
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| A little of the time | 2 | 1 | LA14732-4 |
| Some of the time | 3 | 1 | LA14733-2 |
| Most of the time | 4 | 1 | LA14734-0 |
| All of the time | 5 | 1 | LA6154-4 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
| 111804-1 | Positive Childhood Experiences [Positive Childhood Experiences] |
111773-8 For how much of your childhood was there an adult in your household who tried hard to make sure your basic needs were met? Would you say never, a little of the time, some of the time, most of the time, or all of the time?
Observation ID in Form
MACE.13
Observation Required in Panel
Required
Type of Entry
Question expects user entry - requires response [Q]
Fully-Specified Name
- Component
- For how much of your childhood was there an adult in your household who tried hard to make sure your basic needs were met
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
For how much of your childhood was there an adult in your household who tried hard to make sure your basic needs were met
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.82
- Last Updated
- Version 2.82 (ADD)
- Order vs. Observation
- Observation
Example Answer List LL7296-8
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Never | 1 | 0 | LA6270-8 |
| A little of the time | 2 | 1 | LA14732-4 |
| Some of the time | 3 | 1 | LA14733-2 |
| Most of the time | 4 | 1 | LA14734-0 |
| All of the time | 5 | 1 | LA6154-4 |
| Don't know/not sure | 7 | 0 | LA14619-3 |
| Refused | 9 | 0 | LA4389-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
82153-8 Total score [ACE.BRFSS]
Observation Required in Panel
Required
Fully-Specified Name
- Component
- Total score
- Property
- Score
- Time
- Pt
- System
- ^Patient
- Scale
- Qn
- Method
- ACE.BRFSS
Basic Attributes
- Class
- SURVEY.MTLHLTH
- Type
- Surveys
- First Released
- Version 2.56
- Last Updated
- Version 2.58 (MAJ)
- Change Reason
- Changed TIME to Pt to match panel children
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 82152-0 | Behavioral Risk Factor Surveillance System Adverse Childhood Experience Module 2009-2020 [ACE.BRFSS] |
| 111771-2 | Behavioral Risk Factor Surveillance System Adverse Childhood Experiences Module 2021 [ACE.BRFSS] |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |