Form Structure: NIH Toolbox Emotion Domain Positive Affect Survey Parent Report Ages 3-7.
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
NIH Toolbox Emotion Domain Positive Affect Survey Parent Report Ages 3-7.
Short Name:
NIHTBPositiveAffectPR3to7
Description:
The NIH Toolbox Positive Affect Survey is a self-report measure that assesses both activated(i.e., happiness, joy) as well as unactivated (i.e., serenity, peace) aspects of Positive Affect. Computer-adaptive testing versions are used for ages 13-17 and 18-85; a 12-item fixed-length form is used for ages 8-12, and a computer-adaptive test is used for the Parent-Report version with ages
3-7. In addition, fixed-length forms are available for ages 18-85 Self-Report and ages 3-12 Parent-Report, as supplemental measures. Copyright 2012 Northwestern University and the National Institutes of Health. http://www.nihtoolbox.org/Pages/NIH-Toolbox-Terms-and-Conditions.aspx
Disease:
General (For all diseases)
Traumatic Brain Injury
Organization:
NIH/CIT/DCB
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Version:
1.0
Date Created:
2016-07-13
Owner:
Number of Data Elements:
47
eForms:
N
Logically grouped data elements with defined frequency at which they repeat.
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | GUID | Global Unique ID which uniquely identifies a subject | GUID | Required | CDE |
| 2 | Subject identifier number | An identification number assigned to the participant/subject within a given protocol or a study. | SubjectIDNum | Optional | CDE |
| 3 | Age in years | Value for participant's subject age recorded in years. | AgeYrs | Recommended | CDE |
| 4 | Vital status | Status of participant/subject as alive or dead | VitStatus | Optional | CDE |
| 5 | Visit date | Actual interview or visit date | VisitDate | Recommended | CDE |
| 6 | Site name | The name of the site for the study | SiteName | Recommended | CDE |
| 7 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE |
| 8 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE |
| 9 | General notes text | General notes | GeneralNotesTxt | Optional | CDE |
Additional Element Groups
Listed below are your additional element groups.
Form Administration (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Language form administration ISO code | Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration | LangCRFAdministratISOCode | Recommended | CDE |
| 2 | Language form administration ISO code other text | The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. | LangCRFAdministratISOCodeOTH | Recommended | CDE |
| 3 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE |
| 4 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE |
| 5 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE |
| 6 | Data source other text | The free-text field related to Data source specifying other text. Source of the data provided on the case report form | DataSourceOTH | Recommended | CDE |
NIH Toolbox Administration (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox - Test domain battery type | Type of domain battery for the NIH Toolbox test being administered, as a part of the NIH Toolbox | NIHTBTestDomainBattryTyp | Recommended | CDE |
| 2 | NIH Toolbox - Test domain battery type other | The free-text related to NIHTBTestDomainBatteryTyp specifying other text, as part of the NIH Toolbox | NIHTBTestDomainBatteryTypOTH | Recommended | CDE |
| 3 | NIH Toolbox - Test name type | Type of NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestNameTyp | Recommended | CDE |
| 4 | NIH Toolbox - Test name type other | The free-text related to NIHTBAdminTestNameTyp specifying other text, as part of the NIH Toolbox | NIHTBAdminTestNameTypOTH | Recommended | CDE |
| 5 | NIH Toolbox - Test administration language type | Type of language for test being administrated, as part of the NIH Toolbox | NIHTBTestAdminLanguageTyp | Recommended | CDE |
| 6 | NIH Toolbox - Test administration language type other | Free-text related to NIHTBTestAdminLanguageTyp specifying other text, as part of the NIH Toolbox | NIHTBTestAdminLanguageTypOTH | Recommended | CDE |
| 7 | NIH Toolbox - Form administered type | Type of NIH Toolbox form being administered, as part of the NIH Toolbox | NIHTBFormAdminTyp | Recommended | CDE |
| 8 | NIH Toolbox - Test administration flag indicator | Indicator of a flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagInd | Recommended | CDE |
| 9 | NIH Toolbox - Test administration flag type | Type of flag for the NIH Toolbox test being administered, as part of the NIH Toolbox | NIHTBAdminTestFlagTyp | Recommended | CDE |
NIH Toolbox Positive Affect Survey Parent Report 3 to 7 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Emotion Positive Affect Parent Report - Cheerful scale | Scale of parent report of child being cheerful in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRCheerfulScl | Recommended | CDE |
| 2 | NIH Toolbox Emotion Positive Affect Parent Report - Enthusiastic scale | Scale of parent report of child being enthusiastic in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPREnthusiasticScl | Recommended | CDE |
| 3 | NIH Toolbox Emotion Positive Affect Parent Report - Delighted scale | Scale of parent report of child being delighted in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRDelightedScl | Recommended | CDE |
| 4 | NIH Toolbox Emotion Positive Affect Parent Report - Inspired scale | Scale of parent report of child being inspired in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRInspiredScl | Recommended | CDE |
| 5 | NIH Toolbox Emotion Positive Affect Parent Report - Happy scale | Scale of parent report of child being happy in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRHappyScl | Recommended | CDE |
| 6 | NIH Toolbox Emotion Positive Affect Parent Report - Joyful scale | Scale of parent report of child being joyful in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRJoyfulScl | Recommended | CDE |
| 7 | NIH Toolbox Emotion Positive Affect Parent Report - Alert scale | Scale of parent report of child being alert in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRAlertScl | Recommended | CDE |
| 8 | NIH Toolbox Emotion Positive Affect Parent Report - Excited scale | Scale of parent report of child being excited in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRExcitedScl | Recommended | CDE |
| 9 | NIH Toolbox Emotion Positive Affect Parent Report - Interested scale | Scale of parent report of child being interested in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRInterestedScl | Recommended | CDE |
| 10 | NIH Toolbox Emotion Positive Affect Parent Report - Confident scale | Scale of parent report of child being confident in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRConfidentScl | Recommended | CDE |
| 11 | NIH Toolbox Emotion Positive Affect Parent Report - Proud scale | Scale of parent report of child being proud in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRProudScl | Recommended | CDE |
| 12 | NIH Toolbox Emotion Positive Affect Parent Report - Strong scale | Scale of parent report of child being strong in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRStrongScl | Recommended | CDE |
| 13 | NIH Toolbox Emotion Positive Affect Parent Report - Lively scale | Scale of parent report of child being lively in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRLivelyScl | Recommended | CDE |
| 14 | NIH Toolbox Emotion Positive Affect Parent Report - Active scale | Scale of parent report of child being active in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRActiveScl | Recommended | CDE |
| 15 | NIH Toolbox Emotion Positive Affect Parent Report - Determined scale | Scale of parent report of child being determined in the past 7 days, for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPRDeterminedScl | Recommended | CDE |
| 16 | NIH Toolbox Emotion Positive Affect Parent Report 3 to 7 - Rides scale | Scale of parent report of child not wanting to go on the frightening rides at the fair , for ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPR3to7RidesScl | Recommended | CDE |
NIH Toolbox Positive Affect Prt Rpt 3 to 7 Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | NIH Toolbox Emotion Positive Affect Parent Report 3 to 7 - Raw score | Raw score, ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPR3to7RawScore | Recommended | CDE |
| 2 | NIH Toolbox Emotion Positive Affect Parent Report 3 to 7 - Theta score | Theta score, ages 3 to 7 as part of the NIH Toolbox Emotion Positive Affect Parent Report | NIHTBPAPR3to7ThetaScore | Recommended | CDE |
| 3 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted scale score | Age-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROAgeAdjSclScore | Recommended | CDE |
| 4 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Age-adjusted national percentile value | Value of age-adjusted national percentile, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROAgeAdjNationalPctVal | Recommended | CDE |
| 5 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Fully-adjusted scale score | Fully-adjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROFullyAdjSclScore | Recommended | CDE |
| 6 | NIH Toolbox Patient Reported Outcome (PRO) Measures - Unadjusted scale score | Unadjusted scale score, as part of the NIH Toolbox Patient Reported Outcome (PRO) Measures, including iPad app | NIHTBPROUnadjSclScore | Recommended | CDE |
| 7 | NIH Toolbox - Standard error | Standard error (a statistical measure of variance that represents the margin of error for the Tscore), as part of the NIH Toolbox Web, Cat and iPad Cognition measures such as: Picture Vocabulary Test and Oral Reading Recognition Test. | NIHTBStandardError | Optional | CDE |
Keywords
