Survey
Questionnaires, Examination Components and The Questionnaires and Exam Components can be viewed using Adobe Acrobat reader. Questionnaires Screener Module 1 (48KB). 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 (40KB). This establishes the relationship of everyone in the household to everyone else in the household. Family 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 7KB Audiometry 8KB Balance 8KB Blood Pressure 14KB Dermatology 9KB Diabetes 9KB Dietary Supplements and Prescription Medication 47KB Diet Behavior and Nutrition 38KB Digital Symbol Substitution Exercise 9KB Early Childhood 9KB Hospital Utilization and Access to Care 9KB Immunization 4KB Introduction and Verification 7KB Kidney Conditions 11KB Medical Conditions MCQ.010 - MCQ.150 8KB Medical Conditions MCQ.160 - MCQ.190 8KB Medical Conditions MCQ.200 - MCQ.290 14KB Miscellaneous Pain 10KB Physical Activity and Physical Fitness 28KB Physical Functioning 17KB Occupation 23KB Oral Health 10KB Osteoporosis 13KB Respiratory Health and Disease 11KB Social Support 6KB Vision 8KB Weight History 15KB
Post-Examination Questionnaires Hepatitis Follow-up: Telephone Interview
Mental Health Questionnaires This questionnaire was conducted in the Mobile Examination Center (MEC).
Composite
International Diagnostic Interview
(188kb)
consist of the following: 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 (12-19) 5KB DISC Predictive Scale - Youth Conduct Disorder (12-19) 6KB Drugs (12-59) 8KB Kidney Condition (Prostate) 74KB Tobacco 106KB
Computer Assisted Personal Interview (CAPI) Questionnaire Alcohol (20+) 6KB Kidney 5KB Physical Activity 21KB Reproductive Health 69KB Tobacco (20+) 19KB
Dietary Recall 18KB Measuring Guides for the Dietary Recall Interview
Examination
Components (107KB) consist of the following:
This page last reviewed October 15, 2008
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