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Data Collection (DCFs)
The ECHO Program aims to foster a community of collaboration by sharing program materials with fellow researchers and others conducting critical science. Please note that the materials published on this site are for reference purposes only and will be updated on a rolling, quarterly basis to reflect the current materials in use. Materials for ECHO cohorts that pursue research questions outside of the ECHO-wide Cohort Data Collection Protocol may vary widely.

Data Collection Forms (DCF)

DCFs capture a subset of the essential and recommended ECHO-wide Cohort Data Collection Protocol (EWCP) data elements using preferred and acceptable measures as listed in the EWCP. Each DCF includes instructions for form-completion that states who should complete the form, the life stages for which the form should be completed, and the participant identification (ID) that should be used (pregnant woman’s participant ID or child’s participant ID). Each DCF has an accompanying MIS for measure-specific instructions.

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Form Short NameUse SHIFT+ENTER to open the menu (new window).
  
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Data ElementUse SHIFT+ENTER to open the menu (new window).
  
Life Stage Options
  
Associated MISUse SHIFT+ENTER to open the menu (new window).
  
Adolescent Occupation and Employment FormOcc-AdolSociodemographicsAdolescent OccupationAdolescenceAdolescent Occupation and Employment
Adverse Childhood Experiences-Adult Alternate Version 18-21 yr oldsACE-aAV-AHome Social EnvironmentChild Negative Life EventsCollect OnceAdverse Childhood Experiences
Adverse Childhood Experiences-Adult Alternate VersionACE-aAVRecommended CaregiverStressful Life Events in Childhood (<18yr)RecallAdverse Childhood Experiences
Adverse Childhood Experiences-Adult Primary Version 18-21 yr oldsACE-aPV-AHome Social EnvironmentChild Negative Life EventsCollect OnceAdverse Childhood Experiences
Adverse Childhood Experiences-Adult Primary VersionACE-aPVRecommended CaregiverStressful Life Events in Childhood (<18yr)RecallAdverse Childhood Experiences
Adverse Childhood Experiences-Child Self ReportACE-CRHome Social EnvironmentChild Negative Life EventsCollect OnceAdverse Childhood Experiences
Adverse Childhood Experiences-Parent ReportACE-PRHome Social EnvironmentChild Negative Life EventsCollect OnceAdverse Childhood Experiences
Airways Questionnaire AdolescenceAir-AdolChild Physical Health & FunctioningAirways-Related Health OutcomesAdolescenceAirways Questionnaire
Airways Questionnaire Early ChildhoodAir-ECChild Physical Health & FunctioningAirways-Related Health OutcomesEarly ChildhoodAirways Questionnaire
Airways Questionnaire InfancyAir-InfChild Physical Health & FunctioningAirways-Related Health OutcomesInfancyAirways Questionnaire
Airways Questionnaire Middle ChildhoodAir-MCChild Physical Health & FunctioningAirways-Related Health OutcomesMiddle ChildhoodAirways Questionnaire
Alabama Parenting Questionnaire Child FormAPQ-CHome Social EnvironmentCaregiving Quality and BehaviorAdolescenceAlabama Parenting Questionnaire Parent and Child Form
Alabama Parenting Questionnaire Parent FormAPQ-PHome Social EnvironmentCaregiving Quality and BehaviorMiddle Childhood, AdolescenceAlabama Parenting Questionnaire Parent and Child Form
Alabama Parenting Questionnaire-9 Item Child FormAPQ-C9Home Social EnvironmentCaregiving Quality and BehaviorAdolescenceAlabama Parenting Questionnaire - 9-Item Parent and Child Form
Alabama Parenting Questionnaire-9 Item Parent FormAPQ-P9Home Social EnvironmentCaregiving Quality and BehaviorMiddle Childhood, AdolescenceAlabama Parenting Questionnaire - 9-Item Parent and Child Form
Assessment of Your Home Health EnvironmentHOMERecommended ChildHome Food & Activity EnvironmentEarly Childhood, Middle Childhood, AdolescenceAssessment of Your Home Health Environment
Caffeine Intake-Parent ReportCaff-PRRecommended ChildChild Caffeine UseMiddle ChildhoodCaffeine Intake - Parent and Self Report
Caffeine Intake-Self ReportCaff-SRRecommended ChildChild Caffeine UseAdolescenceCaffeine Intake - Parent and Self Report
Caregiver Occupation and EmploymentOcc-CGSociodemographicsCaregiver & Partner OccupationPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCaregiver Occupation and Employment
Child and Adolescent Sleep Ecology Questionnaire-ChildSEco-CRRecommended ChildChild Sleep EcologyMiddle Childhood, AdolescenceChild and Adolescent Sleep Ecology Questionnaire Child Self Report
Child and Adolescent Sleep Ecology Questionnaire-Parent ReportSEco-PRRecommended ChildChild Sleep EcologyEarly Childhood, Middle Childhood, AdolescenceChild and Adolescent Sleep Ecology Questionnaire Parent
Child Anthropometry and Physical Examination Child GE2CAPE-CChild Physical Health & FunctioningChild Anthropometric MeasuresEarly Childhood, Middle Childhood, AdolescenceChild Anthropometry and Physical Examination
Child Anthropometry and Physical Examination Child LT2CAPE-IChild Physical Health & FunctioningChild Anthropometric MeasuresInfancy, Early ChildhoodChild Anthropometry and Physical Examination
Child Anthropometry and Physical Examination NewbornCAPE-NChild Physical Health & FunctioningChild Anthropometric MeasuresPerinatalChild Anthropometry and Physical Examination
Child Birth InformationCBIChild & Family Health HxChild Birth InformationCollect OnceChild Birth Information
Child Global HealthCGBChild Well-beingChild Global HealthInfancy, Early ChildhoodChild Global Health
Child K12 EducationCK12ESociodemographicsK12 EducationEarly Childhood, Middle Childhood, AdolescenceChild K12 Education
Child Media Use-Ages 0-12 YearsCMU-PRRecommended ChildHome Screen Media Access & UseInfancy, Early Childhood, Middle ChildhoodChild Media Use – Parent Report for Ages 0-12 Years
Child Media Use-Ages 13plus YearsCMU-SRRecommended ChildHome Screen Media Access & UseMiddle Childhood, AdolescenceChild Media Use - Self Report for Ages 13 plus Years
Child Product Use-Parent ReportCPrU-PRRecommended ChildChild Product UseMiddle ChildhoodChild Product Use – Parent and Self Report
Child Product Use-Self ReportCPrU-SRRecommended ChildChild Product UseAdolescenceChild Product Use – Parent and Self Report
Childhood Trauma QuestionnaireCTQRecommended CaregiverStressful Life Events in Childhood (<18yr)RecallChildhood Trauma Questionnaire
Childrens Eating Behavior QuestionnaireCEBQRecommended ChildCaregiver Feeding Practice and StyleEarly ChildhoodChildren’s Eating Behaviour Questionnaire
Complementary Feeding HistoryCFHChild Health Behaviors & LifestyleInfant Feeding HistoryEarly ChildhoodComplementary Feeding History
Comprehensive Feeding Practices QuestionnaireCFPQRecommended ChildCaregiver Feeding Practice and StyleEarly ChildhoodComprehensive Feeding Practices Questionnaire
COVID-19 Changes in Environmental ExposureC19-CEEChild & Family Health HxCOVID-19 RelatedPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire 2-Adult Alternate VersionC19-2-aAVChild & Family Health HxCOVID-19 RelatedPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire 2-Adult Primary VersionC19-2-aPVChild & Family Health HxCOVID-19 RelatedPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire 2-Child Self-Report Alternate VersionC19-2-cAVChild & Family Health HxCOVID-19 RelatedAdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire 2-Child Self-Report Primary VersionC19-2-cPVChild & Family Health HxCOVID-19 RelatedAdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire 2-Parent-Report Alternate VersionC19-2-pAVChild & Family Health HxCOVID-19 RelatedInfancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire 2-Parent-Report Primary VersionC19-2-pPVChild & Family Health HxCOVID-19 RelatedInfancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire-Adult Alternate VersionC19-aAVChild & Family Health HxCOVID-19 RelatedPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire-Adult Follow-up VersioC19-aFVChild & Family Health HxCOVID-19 RelatedPrenatal, Perinatal, InfancyCOVID-19 Questionnaires
COVID-19 Questionnaire-Adult Primary VersionC19-aPVChild & Family Health HxCOVID-19 RelatedPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire-Child Parent-Report VersionC19-cPRChild & Family Health HxCOVID-19 RelatedInfancy, Early Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire-Child Self-Report Alternate VersionC19-cAVChild & Family Health HxCOVID-19 RelatedAdolescenceCOVID-19 Questionnaires
COVID-19 Questionnaire-Child Self-Report Primary VersionC19-cPVChild & Family Health HxCOVID-19 RelatedAdolescenceCOVID-19 Questionnaires
COVID-19 School And Social Distancing Practices Quesionnaire Child Self-ReportC19SSD-aSRChild & Family Health HxCOVID-19 RelatedMiddle Childhood, AdolescenceCOVID-19 Questionnaires
COVID-19 School and Social Distancing Practices Questionnaire Parent-ReportC19SSD-cPRChild & Family Health HxCOVID-19 RelatedEarly Childhood, Middle Childhood, AdolescenceCOVID-19 Questionnaires
Crisis in the Family Systems-Revised CRISYS-RCRISYSRecommended CaregiverStressful Life Events in Adulthood (18+)Prenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceCrisis in the Family Systems - Revised (CRISYS-R)
Demographics of ChildDem-CSociodemographicsChild DemographicsCollect OnceDemographics of Child
Demographics of the Biological FamilyDem-BSociodemographicsBiological Family DemographicsCollect OnceDemographics of the Biological Family
Dietary Screener Questionnaire-Parent ReportDSQ-PRChild Health Behaviors & LifestyleChild DietEarly Childhood, Middle Childhood, AdolescenceDietary Screener Questionnaire - Parent and Self Report
Dietary Screener Questionnaire-Self ReportDSQ-SRPregnancy Related; Child Health Behaviors & LifestyleMaternal Diet in Pregnancy; Child dietPrenatal, AdolescenceDietary Screener Questionnaire - Parent and Self Report
Early Academic Competencies-Parent ReportEAC-PRChild Social Role Performance & FunctioningAcademic Ability & PerformanceEarly ChildhoodEarly Academic Competencies - Parent Report
Early Care and EducationECESociodemographicsEarly Care and EducationInfancy, Early ChildhoodEarly Care and Education
Edinburgh Postnatal Depression ScaleEPDSCaregiver Neuro-PsychosocialDepressive SymptomsPrenatal, Infancy, Early Childhood, Middle Childhood, Adolescence
Epidemic Pandemic Impacts Inventory-AbbreviatedEPII-ARecommended CaregiverCOVID-19 RelatedPrenatal, Infancy, Early Childhood, Middle Childhood, Adolescence
Gender IdentityGISociodemographicsGender IdentityMiddle Childhood, AdolescenceGender Identity
Harter Global Self-Worth Scale Adolescent Self-Report 14-21yrHGSW-14-21Recommended ChildGlobal Self-WorthAdolescence
Harter Global Self-Worth Scale Child Self-Report 8-13yrHGSW-8-13Recommended ChildGlobal Self-WorthMiddle Childhood, Adolescence
Health Insurance CoverageHICChild & Family Health HxCaregiver and Child Health Insurance StatusPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceHealth Insurance Coverage
Healthy Pathways Academic Performance Scale-Child ReportHPAP-CRChild Social Role Performance & FunctioningAcademic Ability & PerformanceMiddle Childhood, AdolescenceHealthy Pathways Academic Performance Scale-Parent and Child Report
Healthy Pathways Academic Performance Scale-Parent ReportHPAP-PRChild Social Role Performance & FunctioningAcademic Ability & PerformanceMiddle Childhood, AdolescenceHealthy Pathways Academic Performance Scale-Parent and Child Report
Healthy Pathways Bullying ScalesHPBSRecommended ChildBullyingMiddle Childhood, AdolescenceHealthy Pathways Bullying Scales
Household Chemical Exposures-CurrentHCExp-CBuilt-Physical EnvironmentChemical ExposuresEarly Childhood, Middle Childhood, AdolescenceHousehold Chemical Exposure
Household Chemical Exposures-Pregnancy IncrementalHCExp-PIBuilt-Physical EnvironmentChemical ExposuresPrenatalHousehold Chemical Exposure
Household Chemical Exposures-Pre-pregnancy and PregnancyHCExp-PPBuilt-Physical EnvironmentChemical ExposuresPrenatalHousehold Chemical Exposure
Household Chemical Exposures-RecallHCExp-RBuilt-Physical EnvironmentChemical ExposuresRecallHousehold Chemical Exposure
Household Composition-ChildHHC-CSociodemographicsHousehold Composition & Caregiver RelationshipInfancy, Early Childhood, Middle Childhood, AdolescenceHousehold Composition - Child
Household Composition-Pregnant WomanHHC-PSociodemographicsHousehold CompositionPrenatalHousehold Composition - Pregnant Woman
Household Exposure to Secondhand Smoke-CurrentHESHS-CBuilt-Physical EnvironmentHousehold Exposure to Secondhand SmokeInfancy, Early Childhood, Middle Childhood, AdolescenceHousehold Exposure to Secondhand Smoke
Household Exposure to Secondhand Smoke-Pregnancy IncrementalHESHS-PIBuilt-Physical EnvironmentHousehold Exposure to Secondhand SmokePrenatalHousehold Exposure to Secondhand Smoke
Household Exposure to Secondhand Smoke-Pre-pregnancy PregnancyHESHS-PPBuilt-Physical EnvironmentHousehold Exposure to Secondhand SmokePrenatalHousehold Exposure to Secondhand Smoke
Household Exposure to Secondhand Smoke-RecallHESHS-RBuilt-Physical EnvironmentHousehold Exposure to Secondhand SmokeRecallHousehold Exposure to Secondhand Smoke
Income Assistance and Financial Strain-ChildhoodIAFS-CSociodemographicsHousehold Income, Receipt of Federal Assistance, Financial StrainInfancy, Early Childhood, Middle Childhood, AdolescenceIncome Assistance and Financial Strain - Childhood
Income Assistance and Financial Strain-PregnancyIAFS-PSociodemographicsHousehold Income, Receipt of Federal Assistance, Financial StrainPrenatalIncome, Assistance, and Financial Strain - Pregnancy
Infant Feeding PracticesIFPChild Health Behaviors & LifestyleInfant Feeding and Introduction to SolidsInfancyInfant Feeding Practices
Infant Sleep Ecology QuestionnaireSEco-INFRecommended ChildChild Sleep EcologyInfancyInfant Sleep Ecology Questionnaire
Language and Acculturation-ChildhoodLA-CSociodemographicsHousehold Primary Language Spoken, ReadInfancy, Early Childhood, Middle Childhood, AdolescenceLanguage and Acculturation - Childhood
Language and Acculturation-PregnancyLA-PSociodemographicsHousehold Primary Language Spoken, ReadPrenatalLanguage and Acculturation - Pregnancy
Lifestyle-Pregnancy IncrementalLIFE-PIPregnancy RelatedMaternal Substance Use in PregnancyPrenatalLifestyle - Pregnancy Incremental
Lifestyle-Pre-pregnancy and PregnancyLIFE-PPPregnancy RelatedMaternal Substance Use in PregnancyPrenatalLifestyle - Pre-pregnancy and Pregnancy
Lifestyle-RecallLIFE-RPregnancy RelatedMaternal Substance Use in PregnancyRecallLifestyle Recall
Maternal and Paternal Occupation Exposures-RecallOExp-RBuilt-Physical EnvironmentMaternal and Paternal Work ExposuresRecallMaternal and Paternal Occupation Exposures - Pre-pregnancy and Pregnancy and Recall
Maternal Food Source and PreparationMFSPPregnancy RelatedMaternal Food Contaminants in PregnancyPrenatalMaternal Food Source and Preparation
Maternal MR Abstraction AddendumMMRAaGPregnancy RelatedAll Pregnancy-related Except Sleep, Food Contaminants, and DietCollect Once
Maternal MR AbstractionMMRAPregnancy RelatedAll Pregnancy-related Except Sleep, Food Contaminants, and DietCollect Once
Maternal Paternal Occupation Exposures-Pre-pregnancy and PregnancyOExp-PPBuilt-Physical EnvironmentMaternal and Paternal Work ExposuresPrenatalMaternal and Paternal Occupation Exposures - Pre-pregnancy and Pregnancy and Recall
Maternal Sleep Health in PregnancyMSHPrgPregnancy RelatedMaternal Sleep Health in PregnancyPrenatalMaternal Sleep Health in Pregnancy
Maternal Supplements - RecallMSupp-RPregnancy RelatedMaternal Sleep Health in PregnancyRecall
Maternal Supplements-Pregnancy IncrementalMSupp-PIPregnancy RelatedMaternal Sleep Health in PregnancyPrenatalMaternal Supplements
Maternal Supplements-Pre-pregnancy and PregnancyMSupp-PPPregnancy RelatedMaternal Sleep Health in PregnancyPrenatalMaternal Supplements
Maternal Weight and Height - MeasuredMWtHtMPregnancy RelatedMaternal Weight and HeightPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceMaternal Supplements
Medical History-Biological FamilyMH-BFChild & Family Health HxLifetime/Updated First Degree Relative Family Medical ConditionsPrenatal, Infancy, Early Childhood, Middle Childhood, AdolescenceMedical History - Biological Family
Medical History-Early ChildhoodMH-ECChild & Family Health HxChild Medical HistoryEarly ChildhoodMedical History - Early Childhood
Medical History-InfancyMH-IChild & Family Health HxChild Medical HistoryInfancyMedical History - Infancy
Medical History-Middle Childhood and AdolescenceMH-MCAChild & Family Health HxChild Medical HistoryMiddle Childhood, AdolescenceMedical History - Middle Childhood and Adolescence
Modified Checklist for Autism in Toddlers RevisedMCHATRRecommended ChildChild ASD ScreenerEarly ChildhoodModified Checklist for Autism in Toddlers Revised
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