Survey
Questionnaires, Examination Components and
Laboratory Components
1999-2000
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 (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
Household and family level
information is collected here. The sections are labeled to reflect content.
Demographic
Background/Occupation 21KB
Food
Security 30KB
Health
Insurance 32KB
Housing
Characteristics 32KB
Income
38KB
Pesticide
Use 7KB
Smoking
5KB
Tracking
and Tracing 8KB
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
7KB
Audiometry
8KB
Balance
8KB
Blood
Pressure 14KB
Cardiovascular
Disease 5KB
Demographics
Information 21KB
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
Smoking
and Tobacco Use 19KB
Social
Support 6KB
Tuberculosis
5KB
Vision
8KB
Weight
History 15KB
Mental Health
Questionnaires
This
questionnaire was conducted in the Mobile Examination Center (MEC).
Composite
International Diagnostic Interview
(188kb)
consist of the following:
Generalized Anxiety Disorder Module
Major Depression Module
Interview Panic Disorder Module
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
Sexual
Behavior (14-59) 14KB
Tobacco
19KB
Computer Assisted Personal
Interview (CAPI) Questionnaire
Alcohol
(20+) 6KB
Current
Health Status 5KB
Kidney
5KB
Physical
Activity 21KB
Reproductive
Health 69KB
Respondent
Information 4KB
Tobacco
(20+) 19KB
Examination and
Laboratory
Dietary
Recall 18KB
Measuring
Guides for the Dietary Recall Interview
Examination
Components (107KB) consist of the following:
Audiometry
Balance and
Vistibular Testing
Body
Composition
Body
Measurements
Cardiovascular
Fitness
Dermatology
Lower
Extremity Disease
Muscular
Strength
Oral Health
Physician's
Exam
Vision
Laboratory
Components (94KB) consist of the following:
Blood &
Urine
Venipuncture
Urine
Collection
Bone Markers
Diabetes
Profile
Infectious
Disease Profile
Markers of
Immunization Status
Miscellaneous
Laboratory Assays
Kidney Disease
Profile
Hormone
Profile
Nutritional
Biochemistries and Hematologies
Sexually
Transmitted Disease Profile
Tobacco Use
Blood lipids
Environmental
Health Profile
Special
Studies 32KB
This page last reviewed
January 16, 2009
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