Survey Questionnaires, Examination Components and
Laboratory Components
2005-2006

The Questionnaires and Exam Components can be viewed using Adobe Acrobat reader.

Questionnaires
Questionnaires are administered to NHANES participants both at home and in the trailers. The questionnaires and a brief description of each section follows.

Screener Modules

Screener Module 1. This is administered on the doorstep. This set of questions determines if anyone in the household is eligible to be in the sample.

Screener Module 2. This establishes the relationship of everyone in the household to everyone else in the household.

Family Questionnaire
Household and family level information is collected here. The sections are labeled to reflect content.
Demographic Background/Occupation
Food Security
Housing Characteristics
Income
Smoking
Tracking and Tracing

Sample Person Questionnaire

Individual level information on participants is collected here. The sections are labeled to reflect content. Please note that the Medical Conditions section covers many subject areas.

Acculturation

Allergy

Audiometry

Blood Pressure

Cardiovascular Disease

Demographics Information

Dermatology

Diabetes

Dietary Supplements and Prescription Medication

Diet Behavior and Nutrition

Early Childhood

Health Insurance

Hospital Utilization and Access to Care

Immunization

Introduction and Verification

Kidney Conditions

Medical Conditions

Occupation

Oral Health

Osteoporosis

Physical Activity and Physical Fitness

Physical Functioning

Respiratory Health and Disease

Sleep Disorders

Smoking and Tobacco Use

Social Support

Vision

Weight History

Post-Examination Components

MEC ACASI and CAPI Questionnaires

Audio computer assisted personal self interview (ACASI) and  computer assisted personal interview (CAPI) questionnaires are administered in the MEC.  During the visit to the examination center additional questions are administered that cover more sensitive areas such as reproductive health and illegal drug use. The sections are labeled to reflect content.

Audio Computer Assisted Personal Self

Interview (ACASI) Questionnaire

Alcohol (ages 12-19)

Drugs (ages 12-59)

Food Security (ages 12-15)

Sexual Behavior (ages 14-59)

Tobacco (ages 12-19)

Computer Assisted Personal Interview (CAPI) Questionnaire
Alcohol (ages 20+)

Bowel Health (ages 20+)
Current Health Status (ages 12+)

Depression Screen (ages 12+)

Kidney/Urological Health (ages 20+)

Pesticide Use (ages 8+)
Physical Activity (ages 12-15)
Reproductive Health (ages 12+)
Respondent Information
Tobacco (ages 20+)

Volatile Toxicants (ages 12+)

Weight History (ages 8-15)

Examination and Laboratory

Dietary Recall

Measuring Guides for the Dietary Recall Interview

Examination Components consist of the following:
Audiometry
Body Composition
Body Measurements
Cardiovascular Fitness
Ophthalmology
Oral Health
Physical Activity Monitor
Physician's Exam
Vision

Laboratory Components (PDF 1 MB) consist of the following:
Blood & Urine
Venipuncture
Urine Collection
Bone Markers
Diabetes Profile
Infectious Disease Profile
Miscellaneous Laboratory Assays
Kidney Disease Profile
Nutritional Biochemistries and Hematologies
Sexually Transmitted Disease Profile
Tobacco Use
Blood lipids
Environmental Health Profile

This page last reviewed September 04, 2008