2.2.0 - ci-build

VoiceaBiomarkerforAI - Local Development build (v2.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Questionnaire: qgenericdemographicsschema

Official URL: https://kind-lab.github.io/vbai-fhir/Questionnaire-qgenericdemographicsschema Version: 2.2.0
Active as of 2024-05-29 Computable Name:
Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. Questionnairehttps://kind-lab.github.io/vbai-fhir/Questionnaire-qgenericdemographicsschema#2.2.0
... demographics_session_idQuestionnaire - Metadata: Session ID0..1string
... demographics_started_atQuestionnaire Started At0..1string
... demographics_completed_atQuestionnaire Completed At0..1string
... demographics_durationQuestionnaire Duration (seconds)0..1string
... demographics_completed_byWho is completing this survey?0..1string
... cityAddress Information: City0..1string
... state_provinceState/Province0..1string
... zipcodeZipcode0..1string
... countryCountry0..1choiceOptions: 2 options
... gender_identityPatient Demographics: What is your gender identity?0..1choiceOptions: 5 options
... other_gender_identityIf you selected "other" for gender identity, please specify:0..1stringEnable When: gender_identity = 'other'
... specify_gender_identityPlease specify gender identity0..1choiceEnable When:
Options: 2 options
... sexual_orientationWhat is your sexual orientation?0..1choiceOptions: 5 options
... other_sex_orientationIf you selected "other" for sexual orientation, please specify:0..1stringEnable When: sexual_orientation = 'other'
... raceWhich race category best describes you? Choose all that apply0..1string
... native_american_raceAmerican Indian or Alaska Native0..1stringEnable When: race = 1
... asian_raceAsian0..1stringEnable When: race = 2
... black_raceBlack or African American0..1stringEnable When: race = 3
... pacific_islander_raceNative Hawaiian or other Pacific Islander0..1stringEnable When: race = 4
... white_raceWhite0..1stringEnable When: race = 5
... canadian_raceCanadian Indigenous or Aboriginal0..1stringEnable When: race = 6
... other_race_specifyIf race not listed above, please specify:0..1stringEnable When: race = 7
... ethnicityWhat is your ethnic or cultural origin?0..1choiceOptions: 3 options
... hispanic_latino_selectionCheck all that apply0..1stringEnable When: ethnicity = 'yes'
... edu_levelEducation: What is your highest level of education?0..1choiceOptions: 12 options
... other_edu_levelIf you selected "other" level of education, please specify:0..1stringEnable When: edu_level = '11'
... hearingDisability Questions: Are you deaf or do you have serious difficulty hearing?0..1choiceOptions: 3 options
... visionAre you blind or do you have serious difficulty seeing, even when wearing glasses?0..1choiceOptions: 3 options
... cognitionBecause of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?0..1choiceOptions: 3 options
... mobilityDo you have serious difficulty walking or climbing stairs?0..1choiceOptions: 3 options
... self_careDo you have difficulty dressing or bathing?0..1choiceOptions: 3 options
... independent_livingBecause of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping?0..1choiceOptions: 3 options
... employ_statusEmployment Status: What is your employment status? Choose all that apply0..1string
... other_employ_specifyIf you selected "other" employment status, please specify.0..1stringEnable When: employ_status = 9
... occupationWhat is your occupation?0..1string
... veteranAre you a veteran?0..1choiceOptions: 2 options
... household_income_usaDemographics - Optional: What was your total household income last year (USD)? Please include all sources of income, including pensions, dividends, alimony, child support, etc.0..1choiceEnable When: country = '1'
Options: 9 options
... financial_assistance_usaDo you receive a significant portion (>20%) of your income through federally-funded income assistance programs? Some examples of these programs are listed in the question below.0..1choiceEnable When: country = '1'
Options: 3 options
... assistance_programs_usaDo you take advantage of any of the following programs? Choose all that apply0..1stringEnable When: country = '1'
... household_income_caWhat was your total household income last year (CAD)? Please include all sources of income, including pensions, dividends, alimony, child support, etc.0..1choiceEnable When: country = '2'
Options: 9 options
... financial_assistance_caDo you receive a significant portion (>20%) of your income through federally-funded income assistance programs? Some examples of these programs are listed below.0..1choiceEnable When: country = '2'
Options: 3 options
... assistance_programs_caDo you take advantage of any of the following programs? Choose all that apply0..1stringEnable When: country = '2'
... citizenCitizenship: Citizen0..1choiceOptions: 8 options
... marital_statusWhat is your marital status? Choose all that apply0..1string
... housing_statusWhat is your current housing status?0..1choiceOptions: 6 options
... household_countHow many people live in your household?Please specify a number0..1string
... spouse_partner_sig_otherWho lives with you? Choose all that apply: Spouse/partner/significant other0..1choiceEnable When: household_count > 0
Options: 2 options
... childrenOne or more children0..1choiceEnable When: household_count > 0
Options: 2 options
... parentOne or more parent0..1choiceEnable When: household_count > 0
Options: 2 options
... grandparentOne or more grandparent0..1choiceEnable When: household_count > 0
Options: 2 options
... other_live_withOther0..1choiceEnable When: household_count > 0
Options: 2 options
... others_household_specifyIf "others" live in your household, please specify:0..1stringEnable When: other_live_with = '1'
... transportation_ynDo you have a reliable mode of transportation?0..1choiceOptions: 2 options
... primary_transportationWhat is your primary mode of transportation?0..1choiceEnable When: transportation_yn = '1'
Options: 8 options
... other_transportationIf you selected "other" transportation, please specify.0..1stringEnable When: primary_transportation = '8'

doco Documentation for this format

Options Sets

Answer options for country

  • USA
  • Canada

Answer options for gender_identity

  • Female gender identity
  • Male gender identity
  • Non-binary or genderqueer gender identity
  • Other
  • Prefer not to answer

Answer options for specify_gender_identity

  • Cis: same gender as the sex assigned at birth
  • Trans

Answer options for sexual_orientation

  • Bisexual
  • Heterosexual
  • Homosexual
  • Other (Please specify)
  • Prefer not to answer

Answer options for ethnicity

  • Hispanic or Latino
  • Not Hispanic or Latino
  • Prefer not to answer

Answer options for edu_level

  • No formal education
  • Some elementary school
  • Some secondary or high school education
  • High School or secondary school degree complete
  • Some college education
  • Associate's or technical degree complete
  • College or baccalaureate degree complete
  • Some post-baccalaureate education
  • Graduate or professional degree complete
  • Doctoral or post graduate education
  • Other
  • Prefer not to answer

Answer options for hearing

  • No
  • Yes
  • Prefer not to answer

Answer options for vision

  • No
  • Yes
  • Prefer not to answer

Answer options for cognition

  • No
  • Yes
  • Prefer not to answer

Answer options for mobility

  • No
  • Yes
  • Prefer not to answer

Answer options for self_care

  • No
  • Yes
  • Prefer not to answer

Answer options for independent_living

  • No
  • Yes
  • Prefer not to answer

Answer options for veteran

  • Yes
  • No

Answer options for household_income_usa

  • < $15,000
  • $15,000 to $29,999
  • $30,000 to $$49,999
  • $50,000 to $99,999
  • $100,000 to $149,999
  • $150,000 to $199,999
  • $200,000 to $249,999
  • >$250,000
  • Prefer not to answer

Answer options for financial_assistance_usa

  • No
  • Yes
  • Prefer not to answer

Answer options for household_income_ca

  • < $15,000
  • $15,000 to $29,999
  • $30,000 to $$49,999
  • $50,000 to $99,999
  • $100,000 to $149,999
  • $150,000 to $199,999
  • $200,000 to $249,999
  • >$250,000
  • Prefer not to answer

Answer options for financial_assistance_ca

  • No
  • Yes
  • Prefer not to answer

Answer options for citizen

  • Citizen
  • Permanent resident (Green card holder)
  • Non-citizen US/Canadian national
  • Refugee
  • Asylum seeker
  • Non-immigrant student
  • Non-immigrant worker
  • Prefer not to answer

Answer options for housing_status

  • Assisted living
  • Own home
  • Rent home
  • Skilled nursing facility/nursing home
  • Unhoused-temporarily
  • Unhoused-permanently

Answer options for spouse_partner_sig_other

  • Yes
  • No

Answer options for children

  • Yes
  • No

Answer options for parent

  • Yes
  • No

Answer options for grandparent

  • Yes
  • No

Answer options for other_live_with

  • Yes
  • No

Answer options for transportation_yn

  • Yes
  • No

Answer options for primary_transportation

  • Personal vehicle
  • Shared vehicle
  • Public transportation
  • Ride with someone else
  • Ride service
  • Bicycle/Motorbike
  • Walking
  • Other (Please specify)