Child Posttraumatic Stress Assessment

Participant Recruitment

Registrants were recruited for enrollment through outreach to eligible individuals and groups, as well as local and regional media. Lists of names and contact information were provided voluntarily by entities such as employers and governmental agencies. Individuals were also contacted through a widespread advertising campaign encouraging enrollment via toll-free number or website preregistration.

Note: A total of 232 lists representing 135,450 potential registrants were provided from rescue/recovery workers, building occupants, students/school staff, and residents

Informed Consent

Informed consent was obtained from all participants prior to interview administration

Eligibility Determination

Determination of eligibility based on proximity by time and place to WTC attack, acute exposure to dust and debris cloud, and chronic exposure to smoke and fumes

Demographic Data Collection

Collection of demographic information from participants

Contact Information Collection

Collection of contact information for follow-up including information on up to three people who would be likely to know future whereabouts of respondent

General Exposure Assessment

Administration of general exposure questions regarding dust and debris cloud exposure

Specific Exposure Assessment by Eligibility Group

Administration of specific exposure assessment sections tailored to each of the four eligibility groups

9/11 Injury Assessment

Assessment of injuries sustained on 9/11

Physical Health Symptoms Assessment

Assessment of physical health symptoms and conditions before and after 9/11, including respiratory symptoms, nonrespiratory symptoms, and physician-diagnosed conditions

Child Posttraumatic Stress Assessment via Proxy Interview

For children under 18 years of age at time of interview, parents and guardians completed proxy interviews using an eight-question scale derived from Hoven et al. to assess possible posttraumatic stress symptoms

Note: A total of 2,635 proxy interviews were completed for children. Interviewers took actions (e.g., suggested breaks, stopped interview, provided referrals) if respondent's answers or behavior indicated emotional distress

Interview Administration Method Selection

Baseline interviews were conducted using either computer-assisted telephone interviewing (CATI) or computer-assisted in-person personal interviewing (CAPI)

Note: 95% of interviews (67,527) were completed via CATI; 5% (3,910) via CAPI. Questionnaire administered in four languages: English (95.2%), Spanish (1.9%), Cantonese (1.5%), and Mandarin (1.0%)

Geographic Information System (GIS) Geocoding

For enrollees who reported being caught in the dust cloud, geographic location information was collected and geocoded using street address, closest cross street intersection, closest landmark, or closest subway stop

Note: Geocoding occurred only if enrollee answered yes to being caught in dust cloud. Street addresses (n=15,167), cross street intersections (n=11,329), landmarks (n=10,732), and subway stops (n=1,119) were used as locator variables

Data Analysis

Descriptive statistics and bivariate associations between health symptoms/conditions and demographic characteristics were computed. Chi-square and Cochran-Armitage tests were used to determine statistical significance. Proportional-to-size Venn diagram was created to depict overlap in eligibility criteria

Note: All enrollees were included in data analysis. Analyses of respiratory and mental health outcomes were restricted to adult enrollees (>18 years) at time of interview