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Questions for 2007
C = Core Question
M = Module Question
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| Alcohol Consumption |
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C
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During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage? (Variable name change)
Variable Name: ALCDAY4
1_ _ =Days per week
2_ _ =Days in past 30
8 8 8=No drinks in past 30 days
7 7 7=DK/NS
9 9 9=Refused
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C
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One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?
Variable Name: AVEDRNK2
_ _=Number of drinks
7 7=DK/NS
9 9=Refused
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C
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Considering all types of alcoholic beverages, how many times during the past 30 days did you have X [CATI X = 5 for men, X = 4 for women] or more drinks on an occasion?
Variable Name: DRNK3GE5
_ _=Number of times
8 8=None
7 7=DK/NS
9 9=Refused
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C
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During the past 30 days, have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
Variable Name: DRNKANY4
1=Yes
2=No
7=DK/NS
9=Refused
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C
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During the past 30 days, what is the largest number of drinks you had on any occasion?
Variable Name: MAXDRNKS
_ _ =Number of drinks
7 7 =DK/NS
9 9 =Refused
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| Diabetes |
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M
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About how often do you check your blood for glucose or sugar? Include times when checked by a family member or friend, but do not include times when checked by a health professional.
Variable Name: BLDSUGAR
1_ _ =Times per day
2_ _ =Times per week
3_ _ =Times per month
4_ _ =Times per year
8 8 8=Never
7 7 7=DK/NS
9 9 9=Refused
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M
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A test for "A one C" measures the average level of blood sugar over the past three months. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for "A one C"?
Variable Name: CHKHEMO3
__ __=Number of times [76=76 or more]
88=None
98=Never heard of "A one C" test
77=DK/NS
99=Refused
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M
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How old were you when you were told you have diabetes? (Variable name change.)
Variable Name: DIABAGE2
_ _=Age in years [97=97 and older]
77=DK/NS
99=Refused
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M
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Have you ever taken a course or class in how to manage your diabetes yourself?
Variable Name: DIABEDU
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Have you ever been told by a doctor that you have diabetes? (If "Yes" and respondent is female, ask "Was this only when you were pregnant?" If respondent says pre-diabetes or borderline diabetes, use response code 4.)
Variable Name: DIABETE2
1=Yes
2=Yes, but female told only during pregnancy
3=No
4=No, pre-diabetes or borderline diabetes
7=DK/Ns
9=Refused
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M
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Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?
Variable Name: DIABEYE
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Are you now taking diabetes pills?
Variable Name: DIABPILL
1=Yes
2=No
7=DK/NS
9=Refused
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M
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About how many times in the past 12 months have you seen a doctor, nurse, or other health professional for your diabetes?
Variable Name: DOCTDIAB
_ _ =Number of times [76=76 or more]
8 8 =None
7 7 =DK/NS
9 9 =Refused
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M
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When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.
Variable Name: EYEEXAM
1=Within the past month (anytime less than 1 month ago)
2=Within the past year (1 month but less than 12 months ago)
3=Within the past 2 years (1 year but less than 2 years ago)
4=2 or more years ago
8=Never
7=DK/NS
9=Refused
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M
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About how many times in the past 12 months has a health professional checked your feet for any sores or irritations?
Variable Name: FEETCHK
_ _=Number of times [76=76 or more]
8 8=None
7 7=DK/NS
9 9=Refused
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M
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About how often do you check your feet for any sores or irritations? Include times when checked by a family member or friend, but do not include times when checked by a health professional.
Variable Name: FEETCHK2
1_ _ =Times per day
2_ _ =Times per week
3_ _ =Times per month
4_ _ =Times per year
8 8 8=Never
5 5 5=No feet
7 7 7=DK/NS
9 9 9=Refused
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M
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Have you ever had any sores or irritations on your feet that took more than four weeks to heal?
Variable Name: FEETSORE
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Are you now taking insulin?
Variable Name: INSULIN
1=Yes
2=No
9=Refused
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| Health Status/Healthy Days |
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C
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Would you say that in general your health is---
Variable Name: GENHLTH
1=Excellent
2=Very good
3=Good
4=Fair
5=Poor
7=DK/NS
9=Refused
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C
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Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? (Moved to Healthy Days in 2004)
Variable Name: MENTHLTH
__ __=Number of days
88=None
77=DK/NS
99=Refused
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C
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Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? (Moved to Healthy Days in 2004)
Variable Name: PHYSHLTH
__ __=Number of days
88=None
77=DK/NS
99=Refused
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C
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During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation? (Moved to Healthy Days in 2004)
Variable Name: POORHLTH
__ __=Number of days
88=None
77=DK/NS
99=Refused
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| HIV/AIDS |
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C
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[Prologue] Was it a rapid test where you could get your results within a couple of hours?
Variable Name: HIVRDTST
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue: The next few questions are about the national health problem of HIV, the virus that causes AIDS. Please remember that your answers are strictly confidential and that you don't have to answer every question if you do not want to. Although we will ask you about testing, we will not ask you about the results of any test you may have had.] Have you ever been tested for HIV? Do not count tests you may have had as part of a blood donation. Include testing fluid from your mouth.
Variable Name: HIVTST5
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue] Not including blood donations, in what month and year was your last HIV test? Note: If response is before January 1985, code "Don't know".
Variable Name: HIVTSTD2
_ _/_ _ _ _=Code month and year
7 7 7 7 7 7=DK/NS
9 9 9 9 9 9=Refused
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C
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[Prologue] Where did you have your last HIV test - at a private doctor or HMO office, at a couseling and testing site, at a hospital, at a clinic, in a jail or prison, at a drug treatment facility, at home, or somewhere else? (Variable name change)
Variable Name: WHRTST8
01=Private doctor or HMO office
02=Counseling and testing site
03=Hospital
04=Clinic
05=Jail or prison (or other correctional facility)
06=Drug treatment facility
07=At home
08=Somewhere else
77=DK/NS
99=Refused
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| Tobacco Use/Smoking Cessation/Secondhand Smoke |
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C
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Do you now smoke cigarettes every day, some days, or not at all?
Variable Name: SMOKDAY2
1=Every day
2=Some days
3=Not at all
7=DK/NS
9=Refused
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C
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Have you smoked at least 100 cigarettes in your entire life? [Note: 5 packs = 100 cigarettes]
Variable Name: SMOKE100
1=Yes
2=No
7=DK/NS
9=Refused
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C
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During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?
Variable Name: STOPSMK2
1=Yes
2=No
7=DK/NS
9=Refused
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| Women's Health |
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M
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[Prologue] Have you had a hysterectomy?
A hysterectomy is an operation to remove the uterus (womb).
Variable Name: HADHYST2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue: The next questions are about breast and cervival cancer.] A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?
Variable Name: HADMAM
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue] A Pap test is a test for cancer of the cervix. Have you ever had a Pap test?
Variable Name: HADPAP2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue] How long has it been since you had your last mammogram?
Variable Name: HOWLONG
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years ago)
3=Within the past 3 years (2 years but less than 3 years ago)
4=Within the past 5 years (3 years but less than 5 years ago)
5=5 or more years ago
7=DK/NS
9=Refused
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M
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[Prologue] How long has it been since you had your last Pap test?
Variable Name: LASTPAP2
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years ago)
3=Within the past 3 years (2 years but less than 3 years ago)
4=Within the past 5 years (3 years but less than 5 years ago)
5=5 or more years ago
7=DK/NS
9=Refused
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M
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[Prologue] How long has it been since your last breast exam?
Variable Name: LENGEXAM
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years ago)
3=Within the past 3 years (2 years but less than 3 years ago)
4=Within the past 5 years (3 years but less than 5 years ago)
5=5 or more years ago
7=DK/NS
9=Refused
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M
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[Prologue] A clinical breast exam is when a doctor, nurse, or other health professional feels the breast for lumps. Have you ever had a clinical breast exam?
Variable Name: PROFEXAM
1=Yes
2=No
7=DK/NS
9=Refused
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| Nutrition/Diet/Fruits and Vegetables |
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C
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[Prologue] How often do you eat carrots?
Variable Name: CARROTS
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555=Never
777=DK/NS
999=Refused
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C
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[Prologue] Not counting juice, how often do you eat fruit?
Variable Name: FRUIT
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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C
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[Prologue: These next questions are about the foods you usually eat or drink. Please tell me how often you eat or drink each one, for example, twice a week, three times a month, and so forth. Remember, I am only interested in the foods you eat. Include all foods you eat, both at home and away from home.] How often do you drink fruit juices such as orange, grapefruit, or tomato?
Variable Name: FRUITJUI
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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C
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[Prologue] How often do you eat green salad?
Variable Name: GREENSAL
1_ _ =Per Day
2_ _ =Per Week
3_ _ =Per Month
4_ _ =Per Year
555=Never
777=DK/NS
999=Refused
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C
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[Prologue] How often do you eat potatoes not including french fries, fried potatoes, or potato chips?
Variable Name: POTATOES
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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C
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[Prologue] Not counting carrots, potatoes, or salad, how many servings of vegetables do you usually eat? (Example: A serving of vegetables at both lunch and dinner would be two servings.)
Variable Name: VEGETABL
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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| Quality Of Life/Healthy Days (Symptoms)/Disability |
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M
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[Prologue: The next few questions are about health-related problems or symptoms.] During the past 30 days, for about how many days did pain make it hard for you to do your usual activities, such as self-care, work, or recreation? (Variable name change)
Variable Name: PAINACT2
_ _ =Number of days
8 8=None
7 7=DK/NS
9 9=Refused
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C
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[Prologue: The following questions are about health problems or impairments you may have.] Are you limited in any way in any activities because of physical, mental, or emotional problems?
Variable Name: QLACTLM2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue] During the past 30 days, for about how many days have you felt very healthy and full of energy? (Screened for physical, mental, emotional problems or use of special equipment because of a health problem.)
Variable Name: QLHLTH2
_ _=Number of days
8 8=None
7 7=DK/NS
9 9=Refused
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M
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[Prologue] During the past 30 days, for about how many days have you felt sad, blue, or depressed? (Screened for physical, mental, emotional problems or use of special equipment because of a health problem.)
Variable Name: QLMENTL2
_ _=Number of days
8 8=None
7 7=DK/NS
9 9=Refused
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M
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[Prologue] During the past 30 days, for about how many days have you felt you did not get enough rest or sleep? (Screened for physical, mental, emotional problems or use of special equipment because of a health problem.)
Variable Name: QLREST2
_ _=Number of days
8 8=None
7 7=DK/NS
9 9=Refused
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M
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[Prologue] During the past 30 days, for about how many days have you felt worried, tense, or anxious? (Screened for physical, mental, emotional problems or use of special equipment because of a health problem.)
Variable Name: QLSTRES2
_ _=Number of days
8 8=None
7 7=DK/NS
9 9=Refused
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C
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[Prologue] Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone? Include occasional use or use in certain circumstances.
Variable Name: USEEQUIP
1=Yes
2=No
7=DK/NS
9=Refused
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| Cholesterol (Awareness) |
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C
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Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
Variable Name: BLOODCHO
1=Yes
2=No
7=DK/NS
9=Refused
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C
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About how long has it been since you last had your blood cholesterol checked?
Variable Name: CHOLCHK
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years ago)
3=Within the past 5 years (2 years but less than 5 years ago)
4=5 or more years ago
7=DK/NS
9=Refused
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C
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Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high? (Change in variable name.)
Variable Name: TOLDHI2
1=Yes
2=No
7=DK/NS
9=Refused
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| Hypertension (Awareness) |
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C
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Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? (If "Yes" and respondent is female, ask "Was this only when you were pregnant?").
Variable Name: BPHIGH4
1=Yes
2=Yes, but female told only during pregnancy
3=No
4=Told borderline high or pre-hypertensive
7=DK/NS
9=Refused
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C
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Are you currently taking medicine for your high blood pressure?
Variable Name: BPMEDS
1=Yes
2=No
7=DK/NS
9=Refused
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| Exercise/Physical Activity |
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C
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During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?
Variable Name: EXERANY2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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When you are at work, which of the following best describes what you do? Would you say--
If respondent has multiple jobs, include all jobs.
Variable Name: JOBACTIV
1=Mostly sitting or standing
2=Mostly walking
3=Mostly heavy labor or physically demanding work
7=DK/NS
9=Refused
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C
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[Prologue: We are interested in two types of physical activity: vigorous and moderate. Vigorous activities cause large increases in breathing or heart rate while moderate activities cause small increases in breathing or heart rate.] Now, thinking about the moderate physical activities you do [fill in "when you are not working" if "employed" or "self-employed"] in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate?
Variable Name: MODPACT
1=Yes
2=No
7=DK/NS
9=Refused
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C
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How many days per week do you do these moderate activities for at least 10 minutes at a time?
Variable Name: MODPADAY
__ __=Days per week
88=Do not do any moderate physical activity for at least 10 minutes at a time
77=DK/NS
99=Refused
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C
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On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Variable Name: MODPATIM
_:_ _=Hours and minutes per day
777=DK/NS
999=Refused
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C
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Now thinking about the vigorous physical activities you do [fill in "when you are not working" if "employed" or self-employed"] in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
Variable Name: VIGPACT
1=Yes
2=No
7=DK/NS
9=Refused
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C
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How many days per week do you do these vigorous activities for at least 10 minutes at a time?
Variable Name: VIGPADAY
_ _ =Days per week
8 8=Do not do any vigorous physical activities for least 10 minutes at a time
7 7=DK/NS
9 9=Refused
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C
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On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Variable Name: VIGPATIM
_:_ _ =Hours and minutes per day
777=DK/NS
999=Refused
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| Health Care Coverage/Access |
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C
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About how long has it been since you last visited a doctor for a routine checkup? A routine checkup is a general physical exam, not an exam for a specific injury, illness, or condition. (Variable name change)
Variable Name: CHECKUP1
1=Within past year (anytime less than 12 months ago)
2=Within past 2 years (1 year but less than 2 years ago)
3=Within past 5 years (2 years but less than 5 years ago)
4=5 or more years ago
7=DK/NS
8=Never
9=Refused
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C
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Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
Variable Name: HLTHPLAN
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Was there a time in the past 12 months when you needed to see a doctor but could not because of the cost?
Variable Name: MEDCOST
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Do you have one person you think of as your personal doctor or health care provider? (If "No" ask: "Is there more than one, or is there no person who you think of as your personal doctor or health care provider?").
Variable Name: PERSDOC2
1=Yes, only one
2=More than one
3=No
7=DK/NS
9=Refused
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| Arthritis (Arthritis Management/Burden) |
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M
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Have you ever taken an educational course or class to teach you how to manage problems related to your arthritis or joint symptoms?
Variable Name: ARTHEDU
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Has a doctor or other health professional ever suggested physical activity or exercise to help your arthritis or joint symptoms? Note: If the respondent is unclear about whether this means an increase or decrease in physical activity, this means increase.
Variable Name: ARTHEXER
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Has a doctor or other health professional ever suggested losing weight to help your arthritis or joint symptoms?
Variable Name: ARTHWGT
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms, which of the following best describes you today?
Variable Name: ARTTODAY
1=I can do everything I would like to do
2=I can do most things I would like to do
3=I can do some things I would like to do
4=I can hardly do anything I would like to do
7=DK/NS
9=Refused
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C
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[Prologue] Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia? Arthritis diagnoses include:...[See Questionnaire for complete list]
Variable Name: HAVARTH2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue] Have you ever seen a doctor or other health professional for these joint symptoms?
Variable Name: JOINTRT2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue] Did your joint symptoms first begin more than 3 months ago?
Variable Name: JOINTSYM
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue] Are you now limited in any of your usual activities because of arthritis or joint symptoms? (Note: If a respondent question arises about medication, then the interviewer should reply: "Please answer the question based on how you are when you are taking any of the medications or treatments you might use.")
Variable Name: LMTJOIN2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue: The next questions refer to the joints in your body. Please do NOT include the back or neck.] During the past 30 days, have you had any symptoms of pain, aching, or stiffness in or around a joint?
Variable Name: PAIN30DY
1=Yes
2=No
7=DK/NS
9=Refused
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| Cardiovascular Disease/Heart Attack and Stroke |
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M
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[Prologue] Do you have a health problem or condition that makes taking aspirin unsafe for you? If "Yes" ask "Is this a stomach condition?" Code upset stomach as stomach problems.
Variable Name: ASPUNSAF
1=Yes, not stomach related
2=Yes, stomach problems
3=No
7=DK/NS
9=Refused
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M
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[Prologue] Do you take aspirin daily or every other day?
Variable Name: CVDASPRN
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue: Now I would like to ask you some questions about cardiovascular disease]. Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me "Yes", "No", or you're "Not sure". (Ever told) you had angina or coronary heart disease? (Variable name change)
Variable Name: CVDCRHD4
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue: Now I would like to ask you some questions about cardiovascular disease]. Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me "Yes", "No", or you're "Not sure".
(Ever told) you had a heart attack, also called a myocardial infarction? (Variable name change)
Variable Name: CVDINFR4
1=Yes
2=No
7=DK/NS
9=Refused
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C
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[Prologue: Now I would like to ask you some questions about cardiovascular disease]. Has a doctor, nurse, or other health professional EVER told you that you had any of the following? For each, tell me "Yes", "No", or you're "Not sure". (Ever told) you had a stroke? (Variable name change)
Variable Name: CVDSTRK4
1=Yes
2=No
7=DK/NS
9=Refused
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M
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If you thought someone was having a heart attack or a stroke, what is the first thing you would do?
Variable Name: FIRSTAID
1=Take them to the hospital
2=Tell them to call their doctor
3=Call 911
4=Call their spouse or a family member
5=Do something else
7=DK/NS
9=Refused
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M
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[Prologue: I would like to ask you a few questions about your cardiovascular or heart health.] After you left the hospital following your heart attack, did you go to any kind of outpatient rehabilitation? This is sometimes called "rehab."
Variable Name: HAREHAB
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue: Now I would like to ask you about your knowledge of the signs and symptoms of a heart attack and stroke. Which of the following do you think is a symptom of a heart attack? For each, tell me "yes", "no", or you're "not sure".] (Do you think) pain or discomfort in the jaw, neck, or back (are symptoms of a heart attack?)
Variable Name: HASYMP1
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue] (Do you think) feeling weak, lightheaded, or faint (are symptoms of a heart attack?)
Variable Name: HASYMP2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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[Prologue] (Do you think) chest pain or discomfort (are symptoms of a heart attack?)
Variable Name: HASYMP3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) sudden trouble seeing in one or both eyes (is a symptom of a heart attack?)
Variable Name: HASYMP4
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) pain or discomfort in the arms or shoulder (are symptoms of a heart attack?)
Variable Name: HASYMP5
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) shortness of breath (is a symptom of a heart attack?)
Variable Name: HASYMP6
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] After you left the hospital following your stroke did you go to any kind of outpatient rehabilitation? This is sometimes called "rehab".
Variable Name: STREHAB
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Which of the following do you think is a symptom of a stroke? For each, tell me "yes", "no", or you're "not sure".] (Do you think) sudden confusion or trouble speaking (are symptoms of a stroke?)
Variable Name: STRSYMP1
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) sudden numbness or weakness of face, arm, or leg, especially on one side, (are symptoms of a stroke?)
Variable Name: STRSYMP2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) sudden trouble seeing in one or both eyes (is a symptom of a stroke?)
Variable Name: STRSYMP3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) sudden chest pain or discomfort (are symptoms of a stroke?)
Variable Name: STRSYMP4
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Do you think) sudden trouble walking, dizziness, or loss of balance (are symptoms of a stroke?)
Variable Name: STRSYMP5
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prolgoue] (Do you think) severe headache with no known cause (is a symptom of a stroke?)
Variable Name: STRSYMP6
1=Yes
2=No
7=DK/NS
9=Refused
|
| Asthma/Adult Asthma History |
|
M
|
[Prologue] During the past 12 months, how many days were you unable to work or carry out your usual activities because of your asthma?
Variable Name: ASACTLIM
_ _ _=Number of days
8 8 8=None
7 7 7=DK/NS
9 9 9=Refused
|
|
M
|
[Prologue] During the past 12 months, have you had an episode of asthma or an asthma attack?
Variable Name: ASATTACK
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[If one or more visits to Q3, fill in "Besides those emergency room visits,"] During the past 12 months, how many times did you see a doctor, nurse, or other health professional for urgent treatment of worsening asthma symptoms?
Variable Name: ASDRVIST
_ _=Number of visits [87=87 or more]
8 8=None
9 8=DK/NS
9 9=Refused
|
|
M
|
[Prologue] During the past 12 months, how many times did you visit an emergency room or urgent care center because of your asthma?
Variable Name: ASERVIST
_ _=Number of visits [87=87 or more]
8 8=None
9 8=DK/NS
9 9=Refused
|
|
M
|
[Prologue] During the past 30 days, how often did you use a prescription asthma inhaler DURING AN ASTHMA ATTACK to stop it?
Variable Name: ASINHALR
8=Never (include no attack in past 30 days)
1=1 to 4 times (in the past 30 days)
2=5 to 14 times (in the past 30 days)
3=15 to 29 times (in the past 30 days)
4=30 to 59 times (in the past 30 days)
5=60 to 99 times (in the past 30 days)
6=100 or more times (in the past 30 days)
7=DK/NS
9=Refused
|
|
M
|
[Prologue] During the past 30 days, how many days did symptoms of asthma make it difficult for you to stay asleep? Would you say--
Variable Name: ASNOSLEP
8=None
1=One or two
2=Three to four
3=Five
4=Six to ten
5=More than ten
7=DK/NS
9=Refused
|
|
M
|
During the past 12 months, how many times did you see a doctor, nurse, or other health professional for a routine checkup for your asthma?
Variable Name: ASRCHKUP
_ _=Number of visits [87=87 or more]
8 8=None
9 8=DK/NS
9 9=Refused
|
|
C
|
Have you ever been told by a doctor, nurse, or other health professional that you had asthma?
Variable Name: ASTHMA2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Previously you said you were told by a doctor, nurse, or other health professional that you had asthma.] How old were you when you were first told by a doctor, nurse, or other health professional that you had asthma?
Variable Name: ASTHMAGE
_ _=Age in years 11 or older [96=96 and older]
9 7=Age 10 or younger
9 8=DK/NS
9 9=Refused
|
|
M
|
[Prologue] During the past 30 days, how many days did you take a prescription asthma medication to PREVENT an asthma attack from occurring? (Variable name change)
Variable Name: ASTHMED3
8=Never
1=1 to 14 days
2=15 to 24 days
3=25 to 30 days
7=DK/NS
9=Refused
|
|
C
|
Do you still have asthma?
Variable Name: ASTHNOW
1=Yes
2=No
7=DK/NS
9=Refused
|
| Prostate Cancer Screening |
|
M
|
[Prologue] A digital rectal exam is an exam in which a doctor, nurse, or other health professional places a gloved finger into the rectum to feel the size, shape, and hardness of the prostate gland. Have you ever had a digital rectal exam?
Variable Name: DIGRECEX
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] How long has it been since your last digital rectal exam?
Variable Name: DRETIME
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years)
3=Within the past 3 years (2 years but less than 3 years)
4=Within the past 5 years (3 years but less than 5 years)
5=5 or more years ago
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Have you ever been told by a doctor, nurse, or other health professional that you had prostate cancer?
Variable Name: PROSTATE
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Now, I will ask you some questions about prostate cancer screening.] A Prostate-Specific Antigen test, also called a PSA test, is a blood test used to check men for prostate cancer. Have you ever had a PSA test?
Variable Name: PSATEST
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] How long has it been since you had your last PSA test?
Variable Name: PSATIME
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years)
3=Within the past 3 years (2 years but less than 3 years)
4=Within the past 5 years (3 years but less than 5 years)
5=5 or more years ago
7=DK/NS
9=Refused
|
| Colorectal Cancer Screening |
|
M
|
A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?
Variable Name: BLDSTOOL
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
For a sigmoidoscopy, a flexible tube is inserted into the rectum to look for problems. A colonoscopy is similar, but uses a longer tube, and you are usually given medication through a needle in your arm to make you sleepy and told to have someone else drive you home after the test. Was your MOST RECENT examination called a sigmoidoscopy or a colonoscopy?
Variable Name: HADSGCOL
1=Sigmoidoscopy
2=Colonoscopy
3=Something else
7=DK/NS
9=Refused
|
|
M
|
Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the colon for signs of cancer or other health problems. Have you ever had either of these exams?
Variable Name: HADSIGM3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
How long has it been since you had your last sigmoidoscopy or colonoscopy?
Variable Name: LASTSIG2
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years ago)
3=Within the past 5 years (2 years but less than 5 years ago)
4=Within the past 10 years (5 years but less than 10 years ago)
5=10 or more years ago
7=DK/NS
9=Refused
|
|
M
|
How long has it been since you had your last blood stool test using a home kit?
Variable Name: LSTBLDS2
1=Within the past year (anytime less than 12 months ago)
2=Within the past 2 years (1 year but less than 2 years ago)
3=Within the past 5 years (2 years but less than 5 years ago)
4=5 or more years ago
7=DK/NS
9=Refused
|
| Immunization/Influenza |
|
C
|
A flu shot is an influenza vaccine injected into your arm. During the past 12 months, have you had a flu shot? (variable name change)
Variable Name: FLUSHOT3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
During the past 12 months, have you had a flu vaccine that was sprayed in your nose? The flu vaccine sprayed in the nose is also called FluMist�.
Variable Name: FLUSPRY2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Tell me if ANY of these statements is true for YOU. Do NOT tell me WHICH statement or statements are true for you, just if ANY of them are: You have hemophilia and have received clotting factor concentrate. You are a man who has had sex with other men, even just one time. You have taken street drugs by needle, even just one time. You traded sex for money or drugs, even just one time. You have tested positive for HIV. You have had sex (even just one time) with someone who would answer "yes" to any of these statements. You had more than two sex partners in the past year. Are any of these statements true for you? (Variable name change)
Variable Name: HEPBRSN2
1=Yes, at least one statement is true
2=No, none of these statements is true
7=DK/NS
9=Refused
|
|
C
|
Have you EVER received the hepatitis B vaccine? The hepatitis B vaccine is completed after the third shot is given.
Variable Name: HEPBVAC
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person's lifetime and is different from the flu shot. Have you ever had a pneumonia shot?
Variable Name: PNEUVAC3
1=Yes
2=No
7=DK/NS
9=Refused
|
| Demographics |
|
C
|
What is your age?
Variable Name: AGE
_ _=Code age in years
0 7=DK/NS
0 9=Refused
|
|
C
|
How many children less than 18 years of age live in your household?
Variable Name: CHILDREN
_ _=Number of children
8 8=None
9 9=Refused
|
|
C
|
What county do you live in?
Variable Name: CTYCODE
_ _ _=FIPS county code
7 7 7=DK/NS
9 9 9=Refused
|
|
C
|
What is the highest grade or year of school you completed?
Variable Name: EDUCA
1=Never attended school or only attended kindergarten
2=Grades 1 through 8 (Elementary)
3=Grades 9 through 11 (Some high school)
4=Grade 12 or GED (High school graduate)
5=College 1 year to 3 years (Some college or technical school)
6=College 4 years or more (College graduate)
9=Refused
|
|
C
|
Are you currently:
Variable Name: EMPLOY
1=Employed for wages
2=Self-employed
3=Out of work for more than 1 year
4=Out of work for less than 1 year
5=A Homemaker
6=A Student
7=Retired
8=Unable to work
9=Refused
|
|
C
|
About how tall are you without shoes? (Note: If respondent answers in metrics, put a "9" in first column)[Round fractions down.] (variable name change)
Variable Name: HEIGHT3
_ _/_ _=Height (ft/inches/centimeters)
7 7 7 7=DK/NS
9 9 9 9=Refused
|
|
C
|
Are you Hispanic or Latino?
Variable Name: HISPANC2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Is your annual household income from all sources:
Variable Name: INCOME2
04=Less than $25,000
($20,000 to less than $25,000)
03=Less than $20,000
($15,000 to less than $20,000)
02=Less than $15,000
($10,000 to less than $15,000)
01=Less than $10,000
05=Less than $35,000
($25,000 to less than $35,000)
06=Less than $50,000
($35,000 to less than $50,000)
07=Less than $75,000
($50,000 to less than $75,000)
08=$75,000 or more
77=Don't know/Not sure
99=Refused
|
|
C
|
Are you: (marital status)
Variable Name: MARITAL
1=Married
2=Divorced
3=Widowed
4=Separated
5=Never married
6=A member of an unmarried couple
9=Refused
|
|
C
|
Which one or more of the following would you say is your race? (Check all that apply)
Variable Name: MRACE
1=White
2=Black or African American
3=Asian
4=Native Hawaiian or Other Pacific Islander
5=American Indian, Alaska Native
6=Other: [specify]__________
8=No additional choices
7=DK/NS
9=Refused
|
|
C
|
Do you have more than one telephone number in your household? Do not include cell phones or numbers that are only used by a computer or fax machine.
Variable Name: NUMHHOL2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
How many of these telephone numbers are residential numbers?
Variable Name: NUMPHON2
_=Residential telephone numbers[6=6 or more]
7=DK/NS
9=Refused
|
|
C
|
Which one of these groups would you say best represents your race?
Variable Name: ORACE2
1=White
2=Black or African American
3=Asian
4=Native Hawaiian or Other Pacific Islander
5=American Indian, Alaska Native
6=Other: [specify]__________
7=DK/NS
9=Refused
|
|
C
|
To your knowledge, are you now pregnant?
(Note: This question was previously in the Women's Health section. This question was only asked of female respondents.)
Variable Name: PREGNANT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Indicate sex of respondent. (Ask only if necessary.)
Variable Name: SEX
1=Male
2=Female
|
|
C
|
During the past 12 months, has your household been without telephone service for 1 week or more? Do not include interruptions of telephone service because of weather or natural disasters. (variable name change)
Variable Name: TELSERV2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War. (Variable name change)(Question sometimes appears in Veteran's Status section)
Variable Name: VETERAN1
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
About how much do you weigh without shoes? [Round fractions up]
Variable Name: WEIGHT2
_ _ _ _=Weight (pounds/kilograms)
7 7 7 7=DK/NS
9 9 9 9=Refused
|
|
C
|
Was the change between your current weight and your weight a year ago intentional?
Variable Name: WTCHGINT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
How much did you weigh a year ago? [If you were pregnant a year ago, how much did you weigh before your pregnancy?] [Round fractions up]
Variable Name: WTYRAGO
_ _ _ _ =Weight(pounds/kilograms)
7 7 7 7 =DK/NS
9 9 9 9 =Refused
|
|
C
|
What is your ZIP Code where you live?
Variable Name: ZIPCODE
_ _ _ _ _=ZIP Code
7 7 7 7 7= DK/NS
9 9 9 9 9= Refused
|
| Reactions to Race |
|
M
|
[Prologue] Within the past 12 months at work, do you feel you were treated worse than, the same as, or better than people of other races?
Variable Name: RRATWRK2
1=Worse than other races
2=The same as other races
3=Better than other races
4=Worse than some races, better than others
5=Only encountered people of the same race
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Earlier I asked you to self-identify your race. Now I will ask how other people identify you and treat you.]
How do other people usually classify you in this country? Would you say: White, Black or African American, Hispanic or Latino, Asian, Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native, or some other group?
Variable Name: RRCLASS2
1=White
2=Black or African American
3=Hispanic or Latino
4=Asian
5=Native Hawaiian or Other Pacific Islander
6=American Indian or Alaska Native
8=Some other group (please specify:_____)
7=DK/NS
9=Refused
|
|
M
|
[Prologue] How often do you think about your race? Would you say never, once a year, once a month, once a week, once a day, once an hour, or constantly?
Variable Name: RRCOGNT2
1=Never
2=Once a year
3=Once a month
4=Once a week
5=Once a day
6=Once an hour
8=Constantly
7=DK/NS
9=Refused
|
|
M
|
During the past 30 days, have you felt emotionally upset, for example angry, sad, or frustrated, as a result of how you were treated based on your race? (Variable name change)
Variable Name: RREMTSM2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Within the past 12 months, when seeking health care, do you feel your experiences were worse than, the same as, or better than for people of other races?
Variable Name: RRHCARE3
1=Worse than other races
2=The same as other races
3=Better than other races
4=Worse than some races, better than others
5=Only encountered people of the same race
6=No health care in past 12 months
7=DK/NS
9=Refused
|
|
M
|
Within the past 30 days, have you experienced any physical symptoms, for example, a headache, an upset stomach, tensing of your muscles, or a pounding heart, as a result of how you were treated based on your race? (Variable name change)
Variable Name: RRPHYSM2
1=Yes
2=No
7=DK/NS
9=Refused
|
| Veteran�s Health Status/Veteran's Status |
|
M
|
In the past 12 months have you received some or all of your health care from VA facilities? (Question formerly located in Demographics section)
Variable Name: VACARE
1=Yes, all of my health care
2=Yes, some of my health care
3=No, no VA health care received
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Since September 11, 2001, have you been deployed to the regions of Afghanistan or Iraq in support of U.S. military operations?
Variable Name: VAIRQAFG
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War. (Variable name change)(Question appears in Demographics Section in 2007)
Variable Name: VETERAN1
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Which of the following best describes your service in the United States military?
Variable Name: VETSTAT2
1=Currently on active duty
2=Currently in a National Guard or Reserve unit
3=Retired from military service
4=Medically discharged from military service
5=Discharged from military service
7=DK/NS
9=Refused
|
| Emotional Support and Life Satisfaction |
|
C
|
[Prologue: The next two questions are about emotional support and your satisfaction with life.] How often do you get the social and emotional support you need? If asked, say "please include support from any source."
Variable Name: EMTSUPRT
1=Always
2=Usually
3=Sometimes
4=Rarely
5=Never
7=DK/NS
9=Refused
|
|
C
|
[Prologue] In general, how satisfied are you with your life?
Variable Name: LSATISFY
1=Very satisfied
2=Satisfied
3=Dissatisfied
4=Very satisfied
7=DK/NS
9=Refused
|
| Visual Impairment and Access to Eye Care |
|
M
|
[Prologue] Have you EVER had an eye injury that occurred at your workplace while you were doing your work? (Variable name change)
Variable Name: VIATWRK2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Have you been told by an eye doctor or other health care professional that you NOW have cataracts? (Variable name change)
Variable Name: VICTRCT2
1=Yes
2=Yes, but had them removed
3=No
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
M
|
[Prologue: I would like to ask you questions about how much difficulty, if any, you have doing certain activities. If you usually wear glasses or contact lenses, please rate your ability to do them while wearing glasses or contact lenses.] How much difficulty, if any, do you have in recognizing a friend across the street? Would you say--
Variable Name: VIDFCLT2
1=No difficulty
2=A little difficulty
3=Moderate difficulty
4=Extreme difficulty
5=Unable to do because of eyesight
6=Unable to do for other reasons
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
M
|
When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporiarly sensitive to bright light? (Variable name change)
Variable Name: VIEYEXM2
1=Within the past month (anytime less than 1 month ago)
2=Within the past year (1 month but less than 12 months ago)
3=Within the past 2 years (1 year but less than 2 years ago)
4=2 or more years ago
5=Never
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
C
|
[Prologue] Have you EVER been told by an eye doctor or other health care professional that you had glaucoma? (Variable name change)
Variable Name: VIGLUMA2
1=Yes
2=No
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
M
|
[Prologue] Do you have any kind of health insurance coverage for eye care? (Variable name change)
Variable Name: VIINSUR2
1=Yes
2=No
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
M
|
[Prologue: Age-related Macular Degeneration (AMD) is a disease that blurs the sharp, central vision you need for "straight-ahead" activities such as reading, sewing, and driving. AMD affects the macula, the part of the eye that allows you to see fine detail.] Have you EVER been told by an eye doctor or other health care professional that you had age-related macular degeneration? (Variable name change)
Variable Name: VIMACDG2
1=Yes
2=No
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
M
|
What is the main reason you have not visited an eye care professional in the past 12 months? (Variable name change)
Variable Name: VINOCRE2
01=Cost/insurance
02=Do not have/know an eye doctor
03=Cannot get to the office/clinic (too far away, no transportation)
04=Could not get an appointment
05=No reason to go (no problem)
06=Have not thought of it
07=Other
08=Not applicable (blind)
77=DK/NS
99=Refused
|
|
M
|
When was the last time you had your eyes examined by any doctor or eye care provider?
Variable Name: VIPRFVS2
1=Within the past month (anytime less than 1 month ago)
2=Within the past year (1 month but less than 12 months ago)
3=Within the past 2 years (1 year but less than 2 years ago
4=2 or more years ago
5=Never
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
|
M
|
[Prologue] How much difficulty, if any, do you have reading print in newspaper, magazine, recipe, menu, or numbers on the telephone? Would you say--
Variable Name: VIREDIF2
1=No difficulty
2=A little difficulty
3=Moderate difficulty
4=Extreme difficulty
5=Unable to do because of eyesight
6=Unable to do for other reasons
7=DK/NS
8=Not applicable (Blind)
9=Refused
|
| Actions to Control High Blood Pressure |
|
M
|
[Prologue](Ever advised you to) reduce alcohol us (to help lower or control your high blood pressure)?
Variable Name: BPALCADV
1=Yes
2=No
3=Do not drink
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Are you) reducing alcohol use (to help lower or control your high blood pressure)?
Variable Name: BPALCHOL
1=Yes
2=No
3=Do not drink
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Has a doctor or other health professional ever advised you to do any of the following to help lower or control your control your high blood pressure?]
(Ever advised you to) change your eating habits (to help lower or control your high blood pressure)?
Variable Name: BPEATADV
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Are you now doing any of the following to help lower or control your high blood pressure?]
(Are you) changing your eating habits (to help lower or control) your high blood pressure?
Variable Name: BPEATHBT
1=Yes
2=No
7-DK/NS
9=Refused
|
|
M
|
[Prologue] (Are you) exercising (to help lower or control your high blood pressure)?
Variable Name: BPEXER
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue](Ever advised you to) exercise (to help lower or control your high blood pressure)?
Variable Name: BPEXRADV
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Were you told on two or more different visits to a doctor or other health professional that you had high blood pressure? If "Yes" and respondent is female, ask: "Was this only when you were pregnant?"
Variable Name: BPHI2MR
1=Yes
2=Yes, but female told only during pregnancy
3=No
4=Told boderline or pre-hypertensive
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Ever advised you to) take medication (to help lower or control your high blood pressure)?
Variable Name: BPMEDADV
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue](Are you) cutting down on salt (to help lower or control your high blood pressure)?
Variable Name: BPSALT
1=Yes
2=No
3=Do not use salt
7=DK/NS
9=Refused
|
|
M
|
[Prologue] (Ever advised you to) cut down on salt (to help lower or control your high blood pressure)?
Variable Name: BPSLTADV
1=Yes
2=No
3=Do not use salt
7=DK/NS
9=Refused
|
| Random Child Selection |
|
M
|
[Prologue] Is the child Hispanic or Latino?
Variable Name: RCHISLAT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: I have some additional questions about one specific child. The child I will be referring to is the "Xth" child in your household. All following questions about children will be about the "Xth" child.] What is the birth month and year of the "Xth" child?
Variable Name: RCSBIRTH
_ _ _ _ _ _=Code month and year
7 7 7 7 7 7=DK/NS
9 9 9 9 9 9=Refused
|
|
M
|
[Prologue] Which one of these groups would you say best represents the child's race?
Variable Name: RCSBRACE
1=White
2=Black or African American
3=Asian
4=Native Hawaiian or Other Pacific Islander
5=American Indian, Alaska Native
6=Other
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Is the child a boy or girl?
Variable Name: RCSGENDR
1=Boy
2=Girl
9=Refused
|
|
M
|
[Prologue] Which one or more of the following would you say is the race of the child? [Check all that apply]
Variable Name: RCSRACE
1=White
2=Black or African American
3=Asian
4=Native Hawaiian or Other Pacific Islander
5=American Indian, Alaska Native
6=Other [specify]
8=No additional choices
7=DK/NS
9=Refused
|
|
M
|
[Prologue] How are you related to the child? (Variable name change)
Variable Name: RCSRLTN2
1=Parent (include biologic, step, or adoptive parent)
2=Grandparent
3=Foster parent or guardian
4=Sibling (include biologic, step, and adoptive sibling)
5=Other relative
6=Not related in any way
7=DK/NS
9=Refused
|
| Childhood Asthma |
|
M
|
[Prologue: The next two questions are about the "Xth" [CATI; please fill in correct number] child. Has a doctor, nurse or other health professional EVER said that the child has asthma?
Variable Name: CASTHDX2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Does the child still have asthma?
Variable Name: CASTHNO2
1=Yes
2=No
7=DK/NS
9=Refused
|
| Sexual Violence |
|
M
|
[Prologue: See questionnaire] Has anyone EVER ATTEMPTED to have sex with you after you said or showed that you didn't want to or without your consent, BUT SEX DID NOT OCCUR?
Variable Name: SVEANOSX
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: See questionnaire] Has anyone EVER had sex with you after you said or showed that you didn't want them to or without your consent?
Variable Name: SVEHDSEX
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: See questionnaire] Was the person who did this male or female?
Variable Name: SVGENDER
1=Male
2=Female
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Has this happended in the past 12 months? (Anyone ever had sex with you after you said or showed that you didn't want them to or without your consent.)
Variable Name: SVHDSX12
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Has this happened in the past 12 months? (Anyone ever attempted to have sex with you after you said or showed that you didn't want to or without your consent, but sex did not occur.)
Variable Name: SVNOSX12
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] In the past 12 months, has anyone exposed you to unwanted sexual situations that did not involve physical touching? Examples include things like sexual harassment, someone exposing sexual parts of their body to you, being seen by a peeping Tom, or someone making you look at sexual photos or movies? (Variable name change)
Variable Name: SVNOTCH2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Think about the time of the most recent incident involving a person who had sex with you -or- attempted to have sex with you after you said or showed that you didn't want to or without your consent? What was that person's relationship to you? (Variable name change)
Variable Name: SVRELAT2
Do not read:
01=Current boyfriend/girlfriend
02=Former boyfriend/girlfriend
03=Fiance
04=Spouse or live-in partner
05=Former spouse or former live-in partner
06=Someone you were dating
07=First date
08=Friend
09=Acquaintance
10=A person known less than 24 hours
11=Complete stranger
12=Parent
13=Step-parent
14=Parent's partner
15=Parent in-law
16=Other relative
17=Neighbor
18=Co-worker
19=Other non-relative
20=Multiple perpetrators
77=DK/NS
99=Refused
|
|
M
|
[Prologue: Now I'd like to ask you some questions about different types of physical and/or sexual violence or other unwanted sexual experiences. This information will allow us to better understand the problem of violence and unwanted sexual contact amy help others in the future. This is a sensitive topic. Some people may feel uncomfortable with these questions. At the end of this section, I will give you phone numbers for organizations thata can provide information and referral for these issues. Please keep in mind that if you are not in a safe place you can ask me to skip any question you do not want to answer.] Are you in a safe place to answer these questions?
Variable Name: SVSAFE
1=Yes
2=No
|
|
M
|
[Prologue: My first questions are about unwanted sexual experiences you may have had.] In the past 12 months, has anyone touched sexual parts of your body after you said or showed that you didn't want them to or without your consent (for example being groped or fondled)?
Variable Name: SVSEXTCH
1=Yes
2=No
7=DK/NS
9=Refused
|
| Intimate Partner Violence |
|
M
|
[Prologue]
Has an intimate partner EVER hit, slapped, pushed, kicked, or physically hurt you in any way?
Variable Name: IPVPHHRT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Has an intimate partner EVER ATTEMPTED physical violence against you? This includes times when they tried to hit, slap, push, kick, or otherwise hurt you, BUT THEY WERE NOT ABLE TO. (Variable name change)
Variable Name: IPVPHYV2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: See questionnaire] In the past 12 months, have you experienced any physical violence or had unwanted sex with an intimate partner?
Variable Name: IPVPVL12
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: See Questionnaire] At the time of the most recent incident involving an intimate partner who was physically violent--or--had unwanted sex with you, what was that person's relationship to you? (Variable name change)
Variable Name: IPVRELT2
Do not read:
01=Current boyfriend
02=Current girlfriend
03=Former boyfriend
04=Former girlfriend
05=Fiance (male)
06=Fiance (female)
07=Male you were dating
08=Female you were dating
09=Female first date
10=Male first date
11=Husband or male live-in partner
12=Wife or female live-in partner
13=Former husband or former male live-in partner
14=Former wife or former female live-in partner
15=Other
77=DK/NS
99=Refused
|
|
M
|
[Prologue: See Questionnaire] Are you in a safe place to answer these questions?
Variable Name: IPVSAFE
1=Yes
2=No
|
|
M
|
[Prologue: See questionnaire] In the past 12 months, have you had any physical injuries, such as bruises, cuts, scrapes, black eyes, vaginal or anal tears, or broken bones, as a result of this physical violence or unwanted sex?
Variable Name: IPVSXINJ
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: See Questionnaire] Has an intimate partner EVER THREATENED you with physical violence? This includes threatening to hit, slap, push, kick, or physically hurt you in any way.
Variable Name: IPVTHRAT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: See questionnaire] Have you EVER experienced any unwanted sex by a current or former intimate partner?
Variable Name: IPVUWSEX
1=Yes
2=No
7=DK/NS
9=Refused
|
| General Preparedness |
|
M
|
[Prologue] Does your household have a 3-day supply of non-perishable food for everyone who lives there? By non-perishable we mean food that does not require refrigeration or cooking.
Variable Name: GP3DYFOD
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Does your household have a 3-day supply of prescription medication for each person who takes prescribed medicines?
Variable Name: GP3DYPRS
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Does your household have a 3-day supply of water for everyone who lives there? A 3-day supply of water is 1 gallon of water per person per day.
Variable Name: GP3DYWTR
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Does your household have a working battery operated radio and working batteries for your use if the electricity is out?
Variable Name: GPBATRAD
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] In a large-scale disaster or emergency, what would be your main method of communicating with relatives and friends?
Variable Name: GPEMRCOM
1=Regular home telephones
2=Cell phones
3=Email
4=Pager
5=2-way radios
6=Other
7=DK/NS
9=Refused
|
|
M
|
[Prologue] What would be your main method of getting information from authorities in a large-scale disaster or emergency?
Variable Name: GPEMRINF
1=Television
2=Radio
3=Internet
4=Print media
5=Neighbors
6=Other
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Does your household have a working flashlight and working batteries for your use if the electricity is out?
Variable Name: GPFLSLIT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] If public authorities announced a mandatory evacuation from your community due to a large-scale disaster or emergency, would you evacuate?
Variable Name: GPMNDEVC
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue] What would be the main reason you might not evacuate if asked to do so?
Variable Name: GPNOTEVC
01=Lack of transportation
02=Lack of trust in public officials
03=Concern about leaving property behind
04=Concern about personal safety
05=Concern about family safety
06=Concern about leaving pets
07=Other
77=DK/NS
99=Refused
|
|
M
|
[Prologue] Does your household have a disaster evacuation plan, a written plan for how you will leave your home, in case of a large-scale disaster or emergency that requires evacuation?
Variable Name: GPVACPLN
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: The next series of questions asks about large-scale disasters or emergencies. By large-scale disaster or emergency we mean any event that leaves you isolated in your home or displaces you from your home for at least 3 days. This might include natural disasters such as hurricanes, tornados, floods, and ice storms, or man-made disasters such as explosions, terrorist events, or blackouts. How prepared do you feel your household is to handle a large-scale disaster or emergency? Would you say...
Variable Name: GPWELPR2
1=Well-prepared
2=Somewhat prepared
3=Not prepared at all
7=DK/NS
9=Refused
|
| Gastrointestinal Disease |
|
C
|
[Prologue] Did you visit a doctor, nurse or other health professional for this diarrheal illness? Note: Do not answer "Yes" if you just had telephone contact with a health professional.
Variable Name: DIADRVST
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
[Prologue: Now I would like to ask you some questions about diarrhea that you may have experienced and about medical care you might have sought for your diarrheal illness.] In the past 30 days, did you have diarrhea that began within the 30 day period? Diarrhea is defined as 3 or more loose stools in a 24-hour period.
Variable Name: DIAR30DY
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
[Prologue] When you visited your health care professional, did you provide a stool sample for testing?
Variable Name: DIARSMP
1=Yes
2=No
7=DK/NS
9=Refused
|
| Mental Illness and Stigma |
|
M
|
[Prologue] During the past 30 days, about how often did you feel so depressed that nothing could cheer you up? [If necessary: all, most, some, a little, or none of the time?]
Variable Name: MISDEPRD
1=All
2=Most
3=Some
4=A little
5=None
7=DK/NS
9=Refused
|
|
M
|
[Prologue] During the past 30 days, about how often did you feel that everything was an effort? [If necessary: all, most, some, a little, or none of the time?]
Variable Name: MISEFFRT
1=All
2=Most
3=Some
4=A little
5=None
7=DK/NS
9=Refused
|
|
M
|
[Prologue] During the past 30 days, about how often did you feel hopeless--all of the time, most of the time, some of the time, a little of the time, or none of the time?
Variable Name: MISHOPLS
1=All
2=Most
3=Some
4=A little
5=None
7=DK/NS
9=Refused
|
|
M
|
[Prologue: Now, I am going to ask you some questions about how you have been feeling during the past 30 days.] About how often during the past 30 days did you feel nervous--would you say all of the time, most of the time, some of the time, a little of the time, or none of the time?
Variable Name: MISNERVS
1=All
2=Most
3=Some
4=A little
5=None
7=DK/NS
9=Refused
|
|
M
|
[Prologue: The next question asks if any type of mental health condition or emotional problem has recently kept you from doing your work or other usual activities.] During the past 30 days, for about how many days did a mental health condition or emotional problem keep you from doing your work or other usual activities? Note: If asked, "usual activities" includes housework, self-care, caregiving, volunteer work, attending school, studies, or recreation.
Variable Name: MISNOWRK
_ _=Number of days
8 8=None
7 7=DK/NS
9 9=Refused
|
|
M
|
[Prologue] People are generally caring and sympathetic to people with mental illness. Do you--agree slightly or strongly, or disagree slightly or strongly?
Variable Name: MISPHLPF
1=Agree strongly
2=Agree slightly
3=Neither agree nor disagree
4=Disagree slightly
5=Disagree strongly
7=DK/NS
9=Refused
|
|
M
|
[Prologue] During the past 30 days, about how often did you feel restless or fidgety? [If necessary: all, most, some, a little, or none of the time?]
Variable Name: MISRSTLS
1=All
2=Most
3=Some
4=A little
5=None
7=DK/NS
9=Refused
|
|
M
|
[Prologue] Are you now taking medicine or receiving treatment from a doctor or other health professional for any type of mental health condition or emotional problem?
Variable Name: MISTMNT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
[Prologue: The next questions ask about peoples' attitudes toward mental illness and its treatment. How much do you agree or disagree with these statements about people with mental illness...] Treatment can help people with mental illness lead normal lives. Do you--agree slightly or strongly, or disagree slightly or strongly?
Variable Name: MISTRHLP
1=Agree strongly
2=Agree slightly
3=Neither agree nor disagree
4=Disagree slightly
5=Disagree strongly
7=DK/NS
9=Refused
|
|
M
|
[Prologue] During the past 30 days, about how often did you feel worthless? [If necessary: all, most, some, a little, or none of the time?]
Variable Name: MISWTLES
1=All
2=Most
3=Some
4=A little
5=None
7=DK/NS
9=Refused
|
|
|
