Phenx Toolkit Supplemental Information s3

PhenX Toolkit Supplemental Information Domain: Psychosocial Release Date: December 13, 2010 Role Participation

About the Measure

Domain Psychosocial

Measure Role Participation

Definition This measure captures self-reported social roles.

About the Protocol

Description of The respondent is asked a series of 17 questions about current social Protocol roles related to family, friends, employment, hobbies, and volunteer work. The 17 roles are spouse, lover, parent, stepparent, caregiver, worker, student, son/daughter, son/daughter-in-law, relative, friend, neighbor, churchgoer, group member, community volunteer, hobbyist, and athlete.

Protocol Text SOCIAL ROLE QUESTIONS:

1. What is your current marital status? 1 [ ] Married/cohabiting 2 [ ] Separated 3 [ ] Divorced 4 [ ] Widowed 5 [ ] Never married

2. Do you have any children? (INCLUDE ADOPTED, FOSTER, AND STEP-CHILDREN LIVING AT HOME OR ELSEWHERE) 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

2a. (IF YES:) How many children do you have? NUMBER:_____

2b. How many live with you at home? (INCLUDE CHILDREN WHO LIVE WITH PARENT PART-TIME DUE TO CUSTODY ARRANGEMENT) NUMBER:______

3. Are you presently employed? 1 [ ] Yes 5 [ ] No (PROBE: Do you do any work for pay?)→IF STILL "NO," OR IF PRESENT WORK IS ONLY OCCASIONAL AND NOT REGULAR, GO TO NEXT QUESTION. NOTE: SCHOOL FELLOWSHIPS ARE NOT TREATED AS EMPLOYMENT. IF R IS ON LEAVE DUE TO PREGNANCY, ILLNESS, OR SABBATICAL, CODE THIS AS YES, EMPLOYED.

PhenX Toolkit Supplemental Information Role Participation PhenX Toolkit Supplemental Information Domain: Psychosocial Release Date: December 13, 2010 Role Participation

3a. (IF EMPLOYED:) About how many hours do you work in an average week? Number of hours: ______

4. Are you currently in school or in a training program? 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

4a. (IF YES:) Are you a full-time or part-time student? 1 [ ] Full-time 5 [ ] Part-time

5. Do you do any volunteer or community work? 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

5a. About how many hours per week or per month do you do volunteer work? ______OR ______(Hours/week) (Hours/month)

6. At home, who does most of the housework and childcare? 1 [ ] R does most 2 [ ] Spouse/partner does most 3 [ ] R and spouse/partner do equal amounts 4 [ ] Someone else does most (e.g., housekeeper, nanny, other relative)

7. FOR Rs WHO ARE NOT PRESENTLY MARRIED/COHABITING: Are you currently in a romantic or love relationship? 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

7a. (IF YES:) Is it an exclusive relationship, or do you date other people? 1 [ ] Exclusive 2 [ ] Dating others→GO TO NEXT QUESTION 3 [ ] Can't say→GO TO NEXT QUESTION

7b. (IF EXCLUSIVE:) Do you expect this relationship to last for some time? 1 [ ] Yes 2 [ ] No 3 [ ] Not sure

8. This next question is about caregiving for someone who is ill or disabled, without being paid for doing this. Do you provide care on a regular basis for someone who is ill or disabled, someone who is not your own child? (NOTE: CAREGIVING CAN INCLUDE A SPOUSE/PARTNER; CAREGIVING DOES NOT HAVE TO BE DONE IN THE HOME) 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

8a. About how many hours per week or hours per month do you usually spend doing things for (him/her/them)? ______OR ______(Hours/week) (Hours/month)

9. Are one or both of your parents still living? (NOTE: WHOEVER R CONSIDERS TO BE PARENTS SHOULD BE TREATED AS "PARENTS" FOR THESE QUESTIONS, INCLUDING STEP- PARENTS AND GRANDPARENTS WHO RAISED HIM/HER) 1 [ ] Both living 2 [ ] Father only 3 [ ] Mother only 4 [ ] Neither still living→GO TO NEXT QUESTION

9a. (Thinking about the parent you are in contact with most frequently,) How frequently are you in contact with your parent(s), on average?

(NOTE: "CONTACT" INCLUDES SEEING, VISITING, CALLING, TALKING TO, EMAILING, WRITING)

1 [ ] Daily 2 [ ] Several times per week 3 [ ] About once a week 4 [ ] Several times per month 5 [ ] About once a month 6 [ ] Several times per year 7 [ ] About once a year or less

10. FOR Rs WHO ARE CURRENTLY MARRIED/COHABITING: Are one or both of your (husband's/wife's/partner’s) parents still living? 1 [ ] Both living 2 [ ] Father only 3 [ ] Mother only 4 [ ] Neither still living→GO TO NEXT QUESTION

10a. (Thinking about the in-law you are in contact with most frequently,) How frequently are you in contact with your in- law(s), on average? 1 [ ] Daily 2 [ ] Several times per week 3 [ ] About once a week 4 [ ] Several times per month 5 [ ] About once a month 6 [ ] Several times per year 7 [ ] About once a year or less

11. Not counting the parents (and in-laws) we've just talked about, about how many of your other relatives do you stay in contact with?

Number: ______→IF ZERO, GO TO NEXT QUESTION

(NOTE: THE COUNT SHOULD EXCLUDE R'S OWN SPOUSE AND CHILDREN; IT CAN INCLUDE GRANDKIDS AND NEPHEWS/NIECES, IF THEY ARE IMPORTANT TO R)

11a. Please think about the relatives you are in contact with most frequently. How frequently are you in contact with them, on average? 1 [ ] Daily 2 [ ] Several times per week 3 [ ] About once a week 4 [ ] Several times per month 5 [ ] About once a month 6 [ ] Several times per year 7 [ ] About once a year or less

12. Do you have any close friends? (NOTE: FRIENDS CAN BE LIVING IN OR OUT OF R’S TOWN) 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

12a. Please think about the friend you are in contact with most frequently. How frequently are you in contact with this friend, on average? 1 [ ] Daily 2 [ ] Several times per week 3 [ ] Once per week 4 [ ] Several times per month 5 [ ] Once per month 6 [ ] Several times a year 7 [ ] Once a year or less

13. Do you have contacts with any of your neighbors? 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

13a. (IF YES:) Thinking of the neighbors you stay in contact with most frequently, how frequently are you in contact, on average? 1 [ ] Daily 2 [ ] Several times per week 3 [ ] Once per week 4 [ ] Several times per month 5 [ ] Once per month 6 [ ] Several times a year 7 [ ] Once a year or less

14. Now I'm interested in the groups that you participate in. First, do you attend a church, synagogue, or prayer group? 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

14a. (IF YES:) How frequently do you attend, on average? 1 [ ] More than once a week 2 [ ] Once a week 3 [ ] Twice a month 4 [ ] Once a month 5 [ ] Every few months 6 [ ] On religious holidays only

15. Do you participate in other organizations, clubs, or groups—such as a parent-teacher organization, a labor union, a political organization, a civic group, a professional organization, or other such groups? 1 [ ] Yes 5 [ ] No→GO TO NEXT QUESTION

15a. Thinking about the group or organization you attend most frequently, how frequently do you go to meetings of this group? 1 [ ] Daily 2 [ ] Several times per week 3 [ ] Once per week 4 [ ] Several times per month 5 [ ] Once per month 6 [ ] Several times per year 7 [ ] Once a year or less 8 [ ] Never attend

16. Over the last 2 months, how many days per week have you engaged in sports or fitness activities, on average?

Number of days/week: ______→IF "ZERO," GO TO NEXT QUESTION

16a. Do you usually do these activities by yourself or with other people? (NOTE: AGAIN ON AVERAGE, OVER THE LAST 2 MONTHS) 1 [ ] By myself 2 [ ] With other people 3 [ ] It varies; sometimes alone, sometimes with others

17. Do you get together with other people for a hobby or for leisure

time activities—such as playing cards, birdwatching, having a beer, having lunch or dinner? (NOTE: EXCLUDE SPORTS OR FITNESS ACTIVITIES; GET-TOGETHERS CAN BE FORMAL OR INFORMAL WITH FAMILY MEMBERS OR FRIENDS) 1 [ ] Yes 5 [ ] No

17a. (IF YES:) How frequently do you get together with other people for such activities, on average? 1 [ ] Daily 2 [ ] Several times per week 3 [ ] Once per week 4 [ ] Several times per month 5 [ ] Once per month 6 [ ] Several times per year 7 [ ] Once per year or less

Participant Ages 18 years and older

Source Thoits, P. A. (1992). Identity structures and psychological well-being: Gender and marital status comparisons. Social Psychology Quarterly, 55(3), 236–256.

Language of English Source

Personnel and None Training Required

Equipment Needs None

Protocol Type Interviewer-administered questionnaire

General References Leary, M. A., & Tangney, J. P. (2003). The handbook of self and identity. New York, New York: Guilford Press.

Thoits, P. A. (1983). Multiple identities and psychological well-being: A reformulation and test of the social isolation hypothesis. American Sociological Review, 48(2), 174–187.

Thoits, P. A. (1986). Multiple identities: Examining gender and marital status differences in distress. American Sociological Review, 51(2), 259–272.

Thoits, P. A. (1992). Identity structures and psychological well-being: Gender and marital status comparisons. Social Psychology Quarterly, 55(3), 236–256.

Process and Expert Review Panel 4 (ERP 4) reviewed the measures in the Review: Neurology, Psychiatric, and Psychosocial domains.

Guidance from ERP 4 included the following:  Revised description of the measure

PhenX Toolkit Supplemental Information Role Participation