4. Not at all well 17. 0=NO (GO TO 22) Do you speak a language 1=YES other than English at home? 8 = DON’T KNOW 9 = REFUSED 18. 1. SPANISH What is the language you 2. SOME OTHER speak at home? LANGUAGE 8 = DON’T KNOW 9 = REFUSED 19. 1. ENGLISH (GO TO #22) Do you prefer to talk with 2. ANOTHER your doctors and child’s LANGUAGE care providers in English or 8 = in another language? DON’T KNOW 9 = REFUSED 20. 1. No visits (GO TO #22) A medical interpreter is a 2. Some visits professional who helps you 3. Most visits talk with doctors and other 4. All visits providers who do not speak 8 = your language. The DON’T KNOW 9 = REFUSED interpreter can do this over the phone or in-person. In the last 12 months, how often did you need an interpreter during a visit to the main provider? 21. 1. Never When you needed a 2. Sometimes professional interpreter 3. Usually during a visit to the main 4. Always provider, how often was an 8 = interpreter available? DON’T KNOW 9 = REFUSED 22. 1. YES, HISPANIC OR Is this child of Hispanic or LATINO Latino origin or descent? 2. NO, NOT HISPANIC OR LATINO 8 = DON’T KNOW 9 = REFUSED 23. 1. White What is this race? child’s 2. Black or African Please choose one or more American from this list: 3. Asian 4. Native Hawaiian or Other Pacific Islander 5. American Indian or Alaska Native 6. Other 8 = DON’T KNOW 9 = REFUSED 24. 18 TO 24 What is your age?
4. Not at all well 17. 0=NO (GO TO 22) 1=YES 8 = DON’T KNOW 9 = REFUSED Do you speak a language other than English at home? 18. 1. SPANISH 2. SOME OTHER LANGUAGE 8 = DON’T KNOW 9 = REFUSED What is the language you speak at home? 19. 1. ENGLISH (GO TO #22) 2. ANOTHER LANGUAGE 8 = DON’T KNOW 9 = REFUSED Do you prefer to talk with your child’s doctors and care providers in English or in another language? 20. 1. No visits (GO TO #22) 2. Some visits 3. Most visits 4. All visits 8 = DON’T KNOW 9 = REFUSED A medical interpreter is a professional who helps you talk with doctors and other providers who do not speak your language. The interpreter can do this over the phone or in-person. In the last 12 months, how often did you need an interpreter during a visit to the main provider? 21. 1. Never 2. Sometimes 3. Usually 4. Always 8 = DON’T KNOW 9 = REFUSED When you needed a professional interpreter during a visit to the main provider, how often was an interpreter available? 22. 1. YES, HISPANIC OR LATINO 2. NO, NOT HISPANIC OR LATINO 8 = DON’T KNOW 9 = REFUSED Is this child of Hispanic or Latino origin or descent? 23. 1. White 2. Black or African American 3. Asian 4. Native Hawaiian or Other Pacific Islander 5. American Indian or Alaska Native 6. Other 8 = DON’T KNOW 9 = REFUSED What is this child’s race? Please choose one or more from this list: 24. 18 TO 24 What is your age?
fecc_nqf_telephone-interview-survey.docx