detroit dental health project parenting, social determinants, health services…€¦ · ·...

Detroit Dental Health Project Wave 1 2002-2003 1

Detroit Dental Health Project

Parenting, Social Determinants, Health Services, Quality of Life, and Outcomes Questionnaire

CAREGIVER NAME:___________________________________________ CAREGIVER ID: ______________________________________________ INDEX CHILD NAME: _________________________________________ INDEX CHILD ID: _____________________________________________

VISIT DATE: ____ / ____/ ________ TIME____________ AM/PM (circle) MM DD YYYY

IWR NAME __________________________ IWR ID_________ We are interested in understanding your dental health behaviors and how taking care of

___________ [INDEX CHILD] affects how you take care of his (or her) teeth and mouth. As a

caregiver you may experience hassles in your life and how you cope with them may impact on

your ability to promote the dental health of your child. I will also ask you questions about if and

why you think it is important to promote the dental health of ____________ [INDEX CHILD].

I am also going to ask you about your access to dental care and how you evaluate the quality of

your dental health. I will also ask you about your family life. These factors are associated with

dental health and should be considered in any program that will be designed in the future to

promote the oral health of children.

There is no right or wrong answer to the questions that I will soon ask you. The most important

thing is to give your opinion. Most questions will be answered with a scale or flipchart. (IWR:

Hand respondent the scales so he or she can see what these are.) To make things easier, I’ll

read each question out loud and I’ll tell you what the response alternatives are. You’ll say what

your answer is, and I’ll mark it down in this booklet.


The questions ask about your caregiving relationship with [INDEX CHILD]. Before we begin,

let me check one thing.

A1. What is the best word to use to describe your relationship with _______________ [INDEX

CHILD]? Are you the…

1 Biological mother 2 Biological father 3 Grandmother 4 Someone else, please specify____________________________.

Even though these questions are specifically about [INDEX CHILD], we know that you may have other children in your family that you take care of regularly. A2. How many children less than 18 years old do you take care of regularly? _________


First, I would like to ask you about whether you have access to dental care. Q1. When did you last visit a dentist? Was it…?

1 6 months or less– GO TO Q2

2 more than 6 months but not more than 1 year ago– GO TO Q2

3 more than 1 year ago but not more than 2 years ago– GO TO Q2

4 more than 2 years ago but not more than 3 years ago–GO TO Q2

5 more than 3 years ago but not more than 5 years ago–GO TO Q2

6 more than 5 years ago– GO TO Q3

7 never have been – GO TO Q3

Q2. What was the main reason for your last visit for dental care? (IWR: Read each one and

check all that apply.)

1 Regular checkup– GO TO Q4 2 Teeth cleaning– GO TO Q4 3 To have teeth filled– GO TO Q4 4 To have teeth pulled or other surgery– GO TO Q4 5 Toothache or tooth pain– GO TO Q4 6 To have a denture made or repaired – GO TO Q4 7 Bleeding gums or gum disease– GO TO Q4 8 Loose teeth– GO TO Q4 9 Problems with wisdom teeth– GO TO Q4 10 Jaw pain– GO TO Q4 11 Some other reason– please explain__________________________ GO TO Q4


Q3. If you didn’t go to a dental clinic in the past 5 years, is it because… (IWR: Read each one and check all that apply.)

1 I had no dental problems, no need to go 2 I thought the dental problem would go away 3 I was too busy, unable to take time from work 4 Lack of transportation 5 Dental treatment is very expensive 6 I have no insurance or Medicaid 7 I was unable to make an appointment 8 I was unable to leave my child/children so I could go 9 Other reasons, please specify_________________________________________ ________________________________________________________________

Q4. If you need dental care in the next year, where will you go?

Name of dentist/clinic (Iwr: Write first and last name of dentist): __________________________________________________________________________

2 Do not know

(IWR: This section is for children less than 1 year old. If child is older than 1 year, skip to Q7.) Q5. When do you plan to take _______________ [INDEX CHILD] to see a dentist?

1 Next month 2 Next three months 3 Next six months 4 _______ [INDEX CHILD] does not need to see a dentist until the age of 3 years. 5 _______ [INDEX CHILD] does not need to see a dentist until the age of 6 years. 6 _______ [INDEX CHILD] will go to see a dentist if he/she has a dental problem.

Q6. Does _____________ [INDEX CHILD] have at least one baby tooth in his/her mouth?

1 Yes – GO TO Q 12 2 No – GO TO Q12 8 Not sure – GO TO Q12


(IWR: This section is for children 1 year old or older.) Q7. Have you taken ___________ [INDEX CHILD] to see a dentist?

1 Yes – GO TO Q8 2 No – GO TO Q10

Q8. Why did you take __________ [INDEX CHILD] to see a dentist?

Reason: _____________________________________________________________ Q9. Does _____________ [INDEX CHILD] have a regular dentist he/she goes to?

1 Yes, Name of dentist/clinic: _______________________________ -GO TO Q12 2 No – GO TO Q12

Q10. When do you plan to take _______________ [INDEX CHILD] to see a dentist?

1 Next month 2 Next three months 3 Next six months 4 Next year 5 _______ [INDEX CHILD] does not need to see a dentist until the age of 3 years. 6 _______ [INDEX CHILD] does not need to see a dentist until the age of 6 years 7 _______ [INDEX CHILD] will go to see a dentist if he/she has a dental problem.

Q11. If ______________ [INDEX CHILD] needs dental care in the next year, where will you

go? Name of dentist/clinic (Iwr: Write first and last name of dentist): __________________________________________________________________________

2 Do not know Q12. Overall how do you rate the availability of dental services/care to you and your family?

1 Excellent 2 Very good 3 Good 4 Fair 5 Bad 6 Very bad


Q13. Do you have any health insurance that covers dental care [including all forms of private and government insurance plans]?

1 Yes – GO TO Q15 2 No – GO TO Q14 8 Do not know – GO TO Q16

Q14. How long has it been since you last had dental insurance?

1 6 months or less– GO TO Q16 2 More than 6 months, but not more than 1 year ago– GO TO Q16 3 More than 1 year, but not more than 3 years ago– GO TO Q16 4 More than 3 years– GO TO Q16 5 Never– GO TO Q16

Q15. What kind of dental insurance do you have?

Name of plan/dental insurance: _______________________________________________

Q16. Is ___________ [INDEX CHILD] covered by a health insurance plan that pays for dental

care (include Medicaid, MIChild)?

1 Yes – GO TO Q17 2 No - GO TO Q18 8 Do not know – GO TO Q18

Q17. What is the name of the plan?

1 Medicaid 2 MIChild 3 Other, please write name__________________________ 8 Do not know

Q18. Comparing finding a dentist with finding a medical doctor to care for you in the City of

Detroit, do you think that …?

1 It is easier to find a dentist than to find a medical doctor 2 It is easier to find a medical doctor than a dentist 3 It is NOT easy to find a dentist or a medical doctor 4 It is easy to find both


The next several questions are about the health care system in general. For each one, please tell me if you strongly disagree, disagree, agree or strongly agree. Strongly

DisagreeDisagree Agree Strongly

Agree Q19. Racial discrimination in a medical doctor’s

office is common. 1 2 3 4

Q20. Racial discrimination in a dentist’s office is common.

1 2 3 4

Q21. Patients have sometimes been deceived or misled by medical doctors.

1 2 3 4

Q22. Patients have sometimes been deceived or misled by dentists.

1 2 3 4

Q23. Medical doctors have sometimes done harmful experiments on patients without their knowledge.

1 2 3 4

Q24. Dentists have sometimes done harmful experiments on patients without their knowledge.

1 2 3 4

Q25. Rich patients receive better health care than poor patients.

1 2 3 4

Q26. Rich patients receive better dental care than poor patients.

1 2 3 4

Q27. Male patients receive better health care than female patients.

1 2 3 4

Q28. Male patients receive better dental care than female patients.

1 2 3 4

Now, I will ask you questions about the impact of dental health on your quality of life. Q29. How would you describe the condition of your mouth and teeth? (Including false teeth and

dentures)? Would you say…?

1 Excellent 2 Very good 3 Good 4 Fair 5 Poor


Q30. Have you had any problem with the following activities because of your dental health or the health of your mouth?

No

problem at all

Minor problem that did not impact my daily life

Moderate problem that made me change how I do things

Severe problem that has restricted me from enjoying life

Chewing hard foods 1 2 3 4 Drinking cold or warm fluids

1 2 3 4

Talking 1 2 3 4 Smiling 1 2 3 4 Laughing 1 2 3 4 Kissing 1 2 3 4 Going to work or school

1 2 3 4

Q31. During the past 3 months, how much pain have your teeth and gums caused you?

1 A great deal of pain 2 Some pain 3 A little pain 4 No pain at all

Q32. During the past 3 months, how much have your teeth or gums worried or concerned you?

1 A great deal 2 Somewhat 3 A little 4 Not at all

Now I need to ask you similar questions about ______________ [INDEX CHILD]. (IWR: If child is less than 1 year old, skip to Q35) Q33. How would you describe the condition of his/her mouth and teeth? Would you say…?

1 Excellent 2 Very good 3 Good 4 Fair 5 Poor


Q34. Has ___________ [INDEX CHILD] had any problem with the following activities because his/her dental health or the health of his/her mouth?

NA No problem

at all Minor problem that did not impact his/her daily life

Moderate problem that made him/her change this activity for a few days (less than a week)

Severe problem that made him/her change this activity for a long time

Chewing of foods 8 1 2 3 4 Breastfeeding 8 1 2 3 4 Talking 8 1 2 3 4 Smiling 8 1 2 3 4 Laughing 8 1 2 3 4 Playing 8 1 2 3 4 Going to school or day care

8 1 2 3 4


People differ in what they do to keep their teeth and mouth clean. Some people use many methods, others don’t. I am going to read a list of things people use to keep their teeth and mouth clean. For each one, tell me if you never, rarely, sometimes or usually use this method to help keep ________ [INDEX CHILD] teeth and mouth clean, including things you do, things ________ [INDEX CHILD] does, or things you ask someone else (an older brother or sister, an aunt or babysitter) to do for ___________ [INDEX CHILD]. Some methods are more for older children, others more for younger babies so not all will apply to you. I am also going to ask you the same questions about what you use to keep your teeth or mouth clean? Do you use or __________ [INDEX CHILD] uses or someone else uses the following to keep the teeth and mouth clean? (IWR: If the method cannot be used (such as tooth brushing) a month old infant, check “Never”)

1 NEVER

2 RARELY

3 SOMETIMES

4 USUALLY (IT IS

MY USUAL METHOD)

B1 A cloth to wipe the teeth or mouth ___________ [INDEX CHILD] Caregiver

1

1

2

2

3

3

4

4

B2. Chewing stick to scrape teeth ___________ [INDEX CHILD] Caregiver

1

1

2

2

3

3

4

4

B3. Toothpick ___________ [INDEX CHILD] Caregiver

1

1

2

2

3

3

4

4

B4. Rinse mouth with salt and water or water

alone ___________ [INDEX CHILD] Caregiver

1

1

2

2

3

3

4

4


1 NEVER

2 RARELY

3 SOMETIMES

4 USUALLY (IT IS

MY USUAL METHOD)

B5. Brush teeth with a toothbrush without toothpaste

___________ [INDEX CHILD] Caregiver

1

1

2

2

3

3

4

4

B6. Brush teeth with a toothbrush with toothpaste

___________ [INDEX CHILD] Caregiver

1

1

2

2

3

3

4

4

B7. Do you or __________ [INDEX

CHILD] use other methods to brush or clean the teeth and mouth?

Child:_______________________________________________________________________________________________________________________________ Caregiver:_______________________________________________________________________________

People also differ in when and how often they brush their teeth. There is no right or wrong answer; I just want to know what you usually do. C1. During the last week, did ___________ [INDEX CHILD] or you or someone else brush

____________ [INDEX CHILD]’s teeth? (Iwr: Check all that apply)

1 _________ [INDEX CHILD] brushed his (or her) own teeth (IWR: Skip to C2) 2 Caregiver brushed _________ [INDEX CHILD]’s teeth (IWR: Skip to C4) 3 Someone else brushed __________ [INDEX CHILD]’s teeth, please specify

________________ (IWR: Skip to C4) 4 No one brushed his or her teeth (IWR: Skip to C6)

(IWR: If C1 Box #1 is the only box checked skip C4 and C5. If C1 Box #1 and Box#2 or #3 are checked, then ask all the questions starting at C2.) C2. How many times did _____________ [INDEX CHILD] brush his (or her) teeth during the

last week? ____________________ (IWR: insert number). C3. Did he (or she) brush at bedtime during the last week? 1 Yes, If yes, how many times during the last week? __________ times 2 No


C4. During the last week, how many times did you or someone else brush _____________ [INDEX CHILD]’s teeth? ____________________

C5. Did you or someone else brush his (or her) teeth at bedtime during the last week? 1 Yes, If yes, how many times during the last week?__________ times 2 No C6. How many times did you brush your teeth during the last week? _______________ (IWR:

write number; if never write 0 and don’t ask C7). C7. Did you brush your teeth at bedtime during the last week? 1 Yes, If yes, how many times during the last week? __________ times 2 No People also differ in the way they do things. For example, some people exercise once every day, others do not. There are many reasons for why we differ in our behaviors. We are interested to know your opinion of what things may influence the way you do things. Please rate these statements on whether they will strongly influence you, moderately influence you, maybe influence you, or not at all.

4 Strong

influence

3 Moderately

2 Maybe

1 Not at all

D1. TV commercials showing me how to brush my child’s teeth before bed.

4 3 2 1`

D2. My child’s teacher or day care provider informing me about brushing my child’s teeth before bedtime.

4 3 2 1`

D3. My friends or relatives tell me of the need to brush or clean my child’s teeth or mouth before bedtime

4 3 2 1`

D4. A dentist or doctor providing me with information on how to keep my child’s teeth healthy before bedtime

4 3 2 1`


4

Strong influence

3 Moderately

2 Maybe

1 Not at all

D5. Brochures or posters showing me that my child will have bad teeth if he or she does not brush his or her teeth.

4 3 2 1`

D6. A dentist or doctor telling me that my child’s teeth will have cavities if I do not brush his or her teeth.

4 3 2 1`

D8. Pictures showing me how my child can keep his or her teeth free from cavities and healthy.

4 3 2 1`

D9. Brochures or posters from people saying that they value people with good teeth.

4 3 2 1`

D10. Statements from employers saying that they will hire people with good teeth.

4 3 2 1`

D11. A dentist or doctor saying that they like people with good teeth.

4 3 2 1`

D12. Posters or brochures telling me that I would be considered a bad parent if my child’s teeth are not brushed or cleaned.

4 3 2 1`

D13. A dentist or doctor informing me that I am responsible for the health of my child’s mouth and teeth.

4 3 2 1`

D14. A pastor telling me that I am responsible for the health of my child’s mouth and teeth.

4 3 2 1`

D15. If my child reminds me to brush his or her teeth before going to bed.

4 3 2 1`

D16. A dentist or dental hygienist showing me how to brush my child’s teeth.

4 3 2 1`

D17. Developing an evening routine to brush my child’s teeth before bedtime.

4 3 2 1`

D18. Keeping my and my child’s toothbrush and toothpaste out in the open.

4 3 2 1`


Every parent experiences moments (times) when it is difficult to get their children’s teeth brushed. For each situation or feeling that I read please indicate how confident you are that you can get your child’s teeth brush when it is not automatically done at bed time.

When you are __________________ (IWR: insert statements from the first column of the Table) how confident are you that you can have your child’s teeth brushed before bedtime?

4 Very

Confident

3 Moderately Confident

2 Somewhat Confident

1 Not at all Confident

E1. under a lot of stress 4 3 2 1 E2. depressed 4 3 2 1 E3. anxious 4 3 2 1 E4. feeling like you do not have the

time (too busy) 4 3 2 1

E5. tired 4 3 2 1 E6. worrying about other things in

your life 4 3 2 1

E7. bothered by your crying child 4 3 2 1 E8. bothered because your child

doesn’t stay still when you want him or her to brush

4 3 2 1

E9. told by your child that he/she does not feel like brushing right now

4 3 2 1


Below are statements some people make about oral health. I will read each one out loud and ask for your opinion. For each one, say whether you strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, or strongly disagree. (IWR: Be sure the respondent is looking at the right scale. Read each item and the response scale out loud.)

5 STRONGLY

AGREE

4 SOMEWHAT

AGREE

3 NEITHER

AGREE NOR DISAGREE

2 SOMEWHAT DISAGREE

1 STRONGLY DISAGREE

F1. Most children eventually develop dental cavities. 5 4 3 2 1 F2. As I get older, I expect I will lose some of my own teeth. 5 4 3 2 1 F3. Some people get cavities and others don’t, there is not much that can be

done about it. 5 4 3 2 1

F4. Some people have healthy teeth, others don’t. 5 4 3 2 1 F5. Even with all the care in the world, some children will have healthy, bright

teeth, others won’t. 5 4 3 2 1

F6. Cavities in baby teeth don’t matter since they fall out anyway. 5 4 3 2 1 F7. Keeping baby teeth clean is not very important; after all, they fall out. 5 4 3 2 1 F8. There is not much I can do to stop _____ [INDEX CHILD] from

developing dental cavities. 5 4 3 2 1

F9. There is not much I can do to help _____ [INDEX CHILD] have healthy teeth.

5 4 3 2 1

F10. I can tell ____ to brush his/her teeth; it does not mean he/she will actually do it. (IWR: If Index Child is too young now, ask respondent to guess if this would be true when the child is older).

5 4 3 2 1

F11. When _____ [INDEX CHILD] wants something like a snack or a bottle, I better just do it, because otherwise he/she will fall out (have a temper tantrum).

5 4 3 2 1

F12. If I try to brush _____ [INDEX CHILD]’s teeth (clean or wipe his/her mouth) he/she does not behave.

5 4 3 2 1

F13. Skin care and care for teeth are basically cosmetic – children look nicer when their skin is not dry and their teeth are clean.

5 4 3 2 1

F14. Brushing a child’s teeth is like fixing a child’s hair; it helps the child look nice

5 4 3 2 1


5

STRONGLY AGREE

4 SOMEWHAT

AGREE

3 NEITHER

AGREE NOR DISAGREE

2 SOMEWHAT DISAGREE

1 STRONGLY DISAGREE

F15. Cleaning a child’s teeth or mouth before bed is a hassle; it wakes him/her up. 5 4 3 2 1 F16. Putting a baby to bed with a bottle helps the child to be better fed. 5 4 3 2 1 F17. Putting a baby to bed with a bottle helps the child sleep better. 5 4 3 2 1 F18. Putting a baby to bed with a bottle helps the child to gain weight and grow. 5 4 3 2 1 F19. There is nothing wrong with putting a baby to bed with a bottle. 5 4 3 2 1 F20. The best time to give a child a sugary food is after a nap or between meals. 5 4 3 2 1 F21. Children don’t need to brush every day until they get their permanent teeth 5 4 3 2 1 F22. Children can brush on their own as soon as they can hold the toothbrush. 5 4 3 2 1 F23. Babies cannot get cavities before their teeth come in. 5 4 3 2 1 F24. It does not matter if the child uses a cup or a bottle; dental cavities are just as

likely in either case. 5 4 3 2 1

F25. Children don’t really need their own toothbrush until all their teeth are in. 5 4 3 2 1 F26. Teeth are part of the body so if a child’s teeth have decay; this means the child

has a disease. 5 4 3 2 1

F27. Fluoride is not good for my child’s health 5 4 3 2 1


Now, I have some questions about your mood in the past week. I will read a statement and you’ll tell me how often in the last week you felt this way. I will write down if you felt this way 5 to 7 days last week, 3 or 4 days last week, 1 or 2 days last week, or less than a day last week. (IWR: Show respondent the correct scale, read each item fully including the scale.) In the last week, how many days have you felt as follows:

4 5-7 DAYS

LAST WEEK

3 3-4 DAYS

LAST WEEK

2 1-2 DAYS

LAST WEEK

1 NOT AT ALL OR

LESS THAN ONE DAY LAST

WEEK

G1. I was bothered by things that usually don't bother me.

4 3 2 1`

G2. I did not feel like eating; my appetite was poor. 4 3 2 1`

G3. I felt that I could not shake off the blues even with help from my family or friends.

4 3 2 1`

G4. I felt that I was just as good as other people. 4 3 2 1`

G5. I had trouble keeping my mind on what I was doing.

4 3 2 1`

G6. I felt depressed. 4 3 2 1`

G7. I felt that everything I did was an effort (took more energy than before).

4 3 2 1`

G8. I felt hopeful about the future. 4 3 2 1`

G9. I thought my life had been a failure. 4 3 2 1`

G10. I felt fearful. 4 3 2 1`

G11. My sleep was restless. 4 3 2 1`

G12. I was happy. 4 3 2 1`

G13. I talked less than usual. 4 3 2 1`

G14. I felt lonely. 4 3 2 1`

G15. People were unfriendly. 4 3 2 1`

G16. I enjoyed life. 4 3 2 1`

G17. I had crying spells. 4 3 2 1`

G18. I felt sad. 4 3 2 1`

G19. I felt that people dislike me. 4 3 2 1`

G20. I could not get “going.” 4 3 2 1`

G21. I felt angry. 4 3 2 1`


This next set of questions is about situations you may or may not face in your everyday life. In your day-to-day life how often have any of the following things happened to you? Would you say almost everyday, at least once a week, a few times a month, a few times a year, or less than once a year? (IWR: Show respondent the correct scale and read each item fully including the scale.) 6

ALMOST EVERY

DAY

5 AT

LEAST ONCE A WEEK

4 A FEW

TIMES A MONTH

3 A FEW

TIMES A YEAR

2 LESS THAN

ONCE A YEAR

1 NEVER (IWR, IF

VOL)

H1. I was treated with less courtesy than others. Does this happen…

6 5 4 3 2 1

H2. I was treated with less respect than others. Does this happen…

6 5 4 3 2 1

H3. I received poorer service than others. Does this happen…

6 5 4 3 2 1

H4. People acted as if they thought I am not smart. Does this happen…

6 5 4 3 2 1

H5. People acted as if they were afraid of me. Does this happen…

6 5 4 3 2 1

H6. People acted as if they thought I am dishonest. Does this happen…

6 5 4 3 2 1

H7. People acted as if they thought they’re better than me. Does this happen…

6 5 4 3 2 1

H8. I was called names or insulted. Does this happen…

6 5 4 3 2 1

H9. I was threatened or harassed. Does this happen…

6 5 4 3 2 1

H10. I was unfairly stopped, searched, questioned or threatened by the police. Does this happen…

6 5 4 3 2 1

H11. I was unfairly discouraged by a teacher or advisor from continuing my education. Does this happen…

6 5 4 3 2 1

H12. How long have you lived in your neighborhood __________________? (in years. IWR: if

less than a year, write the # of months.) H13. How many times have you moved in the past 5 years? __________________


The following questions have to do with things that ________ (Index Child’s name) does and ways that you react to him (or her). How often …?

Every day

A few times a week

Once a Week

1-2 times a month

Never

I1. Do you praise [INDEX CHILD] by saying something like “good for you” or “what a nice thing you did” or “that’s good going!”?

5 4 3 2 1

I2. How often do you and [INDEX CHILD] laugh together?

5 4 3 2 1

I3. How often do you do something special with [INDEX CHILD] that he (or she) enjoys?

5 4 3 2 1

I4. How often do you play sports, hobbies or games with [INDEX CHILD]

5 4 3 2 1

I5. How often have you read a book with [INDEX CHILD]

5 4 3 2 1


Now I want to ask you some questions about feelings you may have in your role as a mother or caregiver for (child/children) now living with you, and how often you experience these feelings.

5 Almost Always

4 Often

3 Sometimes

2 Rarely

1 Never

J1. How often do you feel that you have too little time to spend by yourself?

5 4 3 2 1

J2. How often do you wish you didn’t have so many responsibilities?

5 4 3 2 1

J3. How often would you say that your child gets (or children get) on your nerves?

5 4 3 2 1

J4. How often do you feel that your (child is/children are) making too many demands on you?

5 4 3 2 1

J5. Many women (or men) feel that they are not as good a mother (or father) as they would like to be. How often do you feel this way?

5 4 3 2 1

J6. How often do you find that being a mother (or father) is much more work than pleasure?

5 4 3 2 1

J7. How often do you feel that you are doing everything you can to give your child(ren) a good life?

5 4 3 2 1

J8. How often do you feel tired, worn out, or exhausted from raising a family?

5 4 3 2 1

Religious beliefs may impact how people promote their health and seek health care… K1. How religious would you say you are --Would you say very religious, fairly religious, not

too religious, or not religious at all?

1 Very religious 2 Fairly religious 3 Not too religious 4 Not religious at all


And now some questions about help from others. Is there someone…

Yes No L1. you could count on to run errands for you if you needed them to? 1 2 L2. you could count on to lend you some money if you really needed

it in a time of financial crisis? 1 2

L3. you could count on to give you encouragement and reassurance if you really needed it?

1 2

L4. you could count on to watch your (child/children) for you if you needed them to?

1 2

L5. you could count on to lend you a car or give you a ride if you needed them to?

1 2

As the ___________ (insert the relationship between the index child and the caregiver from A1) of ___________ [INDEX CHILD] please rate the level of support in taking care ______________ [INDEX CHILD] that you receive from the following individuals—is it very strong, moderate, little support, or no support at all (IWR: Use NA (non-applicable) for relationships that do not apply to the caregiver. For example, use NA if you are interviewing the biological mother for N1 and N2). Relationship to index child 4

Strong support

3 Moderate support

2 Little

support

1 No

support

NA

M1. Biological mother 4 3 2 1 8 M2. Adopted mother (IWR: if applicable) 4 3 2 1 8 M3. Biological father 4 3 2 1 8 M4. Adopted father (IWR: if applicable) 4 3 2 1 8 M5. Aunt(s) 4 3 2 1 8 M6. Uncles(s) 4 3 2 1 8 M7. Grandmother(s) 4 3 2 1 8 M8. Grandfather(s) 4 3 2 1 8 M9. Your neighbors 4 3 2 1 8 M10. Your friends 4 3 2 1 8 M11. Others, please specify_________ 4 3 2 1 8 Thank you for your time!

detroit dental health project parenting, social determinants, health services…€¦ · ·...

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