National Health and Nutrition Examination Survey

NHANES 2019-2020 Questionnaire Instruments

Screener Modules

Questionnaire Name Document
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.
[PDF - 176 KB]
Screener Module 2
This establishes the relationship of everyone in the household to everyone else in the household.
[PDF - 72.1 KB]

Family Questionnaire

Household and family level information is collected here. The sections are labeled to reflect content.

Questionnaire Name Document
Consumer Behavior [PDF - 37.7 KB]
Demographic Background [PDF - 28.4 KB]
Family Questionnaire Hand Cards [PDF - 53.7 KB]
Food Security [PDF - 152 KB]
Housing Characteristics [PDF - 14.3 KB]
Income [PDF - 108 KB]
Salt Sample Collection [PDF - 62.7 KB]
Smoking [PDF - 14.9 KB]

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.

Questionnaire Name Document
Acculturation [PDF - 23.2 KB]
Audiometry [PDF - 58.3 KB]
Blood Pressure [PDF - 19.6 KB]
Cardiovascular Disease [PDF - 16.3 KB]
Demographic [PDF - 68.8 KB]
Dermatology [PDF - 18.5 KB]
Diabetes [PDF - 50.9 KB]
Diet Behavior and Nutrition [PDF - 121 KB]
Dietary Supplements and Prescription Medication [PDF - 130 KB]
Early Childhood [PDF - 44.5 KB]
Functioning [PDF - 55.2 KB]
Health Insurance [PDF - 39.8 KB]
Hepatitis [PDF - 15.7 KB]
Hospital Utilization and Access to Care [PDF - 29.3 KB]
Immunization [PDF - 21.4 KB]
Infant Formula Questionnaire [PDF - 51.7 KB]
Kidney Conditions [PDF - 15.1 KB]
Medical Conditions [PDF - 108 KB]
Occupation [PDF - 33.8 KB]
Oral Health [PDF - 39.1 KB]
Osteoporosis [PDF - 43.4 KB]
Physical Activity and Physical Fitness [PDF - 40.9 KB]
Sample Person Questionnaire Hand Cards [PDF - 1.28 MB]
Sleep Disorders [PDF - 19.6 KB]
Smoking and Tobacco Use [PDF - 32.4 KB]
Standing Balance [PDF - 79.9 KB]
Weight History [PDF - 37.5 KB]

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

Questionnaire Name Document
Alcohol Use [PDF - 16.2 KB]
Drug Use [PDF - 33 KB]
Sexual Behavior [PDF - 122 KB]
Tobacco Use [PDF - 52.1 KB]

Computer Assisted Personal Interview (CAPI) Questionnaire

Questionnaire Name Document
Alcohol Use [PDF - 25.8 KB]
Cognitive Functioning [PDF - 27.7 KB]
Current Health Status [PDF - 9.04 KB]
Depression Screen [PDF - 24.5 KB]
Kidney [PDF - 24.5 KB]
Pesticide Use [PDF - 11.8 KB]
Physical Activity [PDF - 12.3 KB]
Reproductive Health [PDF - 90.1 KB]
Sexual Behavior [PDF - 17 KB]
Tobacco [PDF - 38.5 KB]
Weight History [PDF - 24.8 KB]

Special Follow-up Questionnaires

Questionnaire Name Document
Flexible Consumer Behavior Survey (FCBS) Handcards [PDF - 977 KB]
Flexible Consumer Behavior Survey (FCBS) Module [PDF - 292 KB]

Dietary

Questionnaire Name Document
Dietary Recall [PDF - 98.7 KB]
Measuring Guides for the Dietary Recall Interview
Page last reviewed: 2/21/2020