National Health and Nutrition Examination Survey

2011-2012 Questionnaire Variable List

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« Return to NHANES 2011-2012 Questionnaire Data

Variable NameVariable DescriptionData File NameData File DescriptionBegin YearEndYearComponentUse Constraints
SEQNRespondent sequence number.TBQ_GTuberculosis20112012QuestionnaireNone
TBQ010The next questions are about being tested for tuberculosis or TB. The tests could be a skin test with a needle just under your skin, a blood test, or a plastic button with metal prongs pressed on your arm called a tine test. Here are pictures of what the skin test and tine test look like. {Have you/Has SP} ever been tested for TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ015aWhich test or tests did {you/SP} receive-the needle just under the skin, a blood test or the tine testTBQ_GTuberculosis20112012QuestionnaireNone
TBQ015bWhich test or tests did {you/SP} receive-the needle just under the skin, a blood test or the tine test?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ015cWhich test or tests did {you/SP} receive-the needle just under the skin, a blood test or the tine test?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ022{Were you/Was SP} told that {your/his/her} skin test was positive for TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ025{Were you/Was SP} told that {your/his/her} blood test was positive for TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ028{Were you/Was SP} told that {your/his/her} tine test was positive for TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ030After getting a positive TB test, {were you/was SP} prescribed any medicine to keep {you/him/her} from getting sick with TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ035Did {you/SP} complete this treatment?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ040{Were you/Was SP} ever told that {you/s/he} had active tuberculosis or TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ050{Were you/Was SP} ever prescribed any medicine to treat active tuberculosis or TB?TBQ_GTuberculosis20112012QuestionnaireNone
TBQ060{Have you/Has SP} ever lived in the same household with someone while that person was sick with tuberculosis or TB?TBQ_GTuberculosis20112012QuestionnaireNone
HIQ011The (first/next) questions are about health insurance. {Are you/Is SP} covered by health insurance or some other kind of health care plan? [Include health insurance obtained through employment or purchased directly as well as government programs like Medicare and Medicaid that provide medical care or help pay medical bills.]HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031A{Are you/Is SP} covered by private insurance?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031AANo coverage of any type.HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031B{Are you/Is SP} covered by Medicare?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031C{Are you/Is SP} covered by Medi-Gap?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031D{Are you/Is SP} covered by Medicaid?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031E{Are you/Is SP} covered by SCHIP (State Children's Health Insurance Program)?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031F{Are you/Is SP} covered by military health plan (Tricare/VA/Champ-VA)?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031G{Are you/Is SP} covered by Indian Health Service?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031H{Are you/Is SP} covered by state-sponsored health plan?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031I{Are you/Is SP} covered by other government insurance?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ031J{Are you/Is SP} covered by any single service plan?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ105Insurance card available or not.HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ210In the past 12 months, was there any time when {you/SP} did not have any health insurance coverage?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ260{Do you/Does SP} have Medicare?HIQ_GHealth Insurance20112012QuestionnaireNone
HIQ270{Does this plan/Do any of these plans} cover any part of the cost of prescriptions?HIQ_GHealth Insurance20112012QuestionnaireNone
SEQNRespondent sequence number.HIQ_GHealth Insurance20112012QuestionnaireNone
BPD035How old {were you/was SP} when {you were/he/she was} first told that {you/he/she} had hypertension or high blood pressure?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPD058How often {did you check your/did SP check his/her} blood pressure at home during the last 12 months?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ020{Have you/Has SP} ever been told by a doctor or other health professional that {you/s/he} had hypertension, also called high blood pressure?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ030{Were you/Was SP} told on 2 or more different visits that {you/s/he} had hypertension, also called high blood pressure?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ040ABecause of {your/SP's} (high blood pressure/hypertension), {have you/has s/he} ever been told to . . . take prescribed medicine?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ050AHELP AVAILABLE (Are you/Is SP) now taking prescribed medicineBPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ056{Did you/Did SP} take {your/his/her} blood pressure at home during the last 12 months?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ057{Have you/Has SP} ever been told by a doctor or other health professional that {you have/s/he has} high normal blood pressure or borderline hypertension?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ059Did a doctor or other health professional tell {you/SP} to take {your/his/her} blood pressure at home?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ060{Have you/Has SP} ever had {your/his/her} blood cholesterol checked?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ070About how long has it been since {you/SP} last had {your/his/her} blood cholesterol checked? Has it been...BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ080{Have you/Has SP} ever been told by a doctor or other health professional that {your/his/her} blood cholesterol level was high?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ090D[To lower (your/his/her) blood cholesterol, (have/has) (you/SP) ever been told by a doctor or other health professional]... to take prescribed medicine?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
BPQ100D(Are you/Is SP) now following this advice to take prescribed medicine?BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
SEQNRespondent sequence number.BPQ_GBlood Pressure & Cholesterol20112012QuestionnaireNone
CDQ001{Have you/Has SP} ever had any pain or discomfort in {your/her/his} chest?CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ002{Do you/Does she/Does he} get it when {you/she/he} walk uphill or hurry?CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ003{Do you/Does she/Does he} get it when {you/she/he} walk at an ordinary pace on level ground?CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ004What {do you/does she/does he} do if {you/she/he} get it while {you/she/he} are walking? {Do you/Does she/Does he} stop or slow down or continue at the same pace?CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ005If {you/she/he} stand still, what happens to it? Is the pain or discomfort relieved or not relieved?CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ006How soon is the pain relieved? Would you say...CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ008Have {you/she/he} ever had a severe pain across the front of {your/her/his} chest lasting for half an hour or more?CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009APlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009BPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009CPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009DPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009EPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009FPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009GPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ009HPlease look at this card and show me where the pain or discomfort is located.CDQ_GCardiovascular Health20112012QuestionnaireNone
CDQ010{Have you/Has SP} had shortness of breath either when hurrying on the level or walking up a slight hill?CDQ_GCardiovascular Health20112012QuestionnaireNone
SEQNRespondent sequence number.CDQ_GCardiovascular Health20112012QuestionnaireNone
AGQ030During the past 12 months, {have you/has SP} had an episode of hay fever?RDQ_GRespiratory Health20112012QuestionnaireNone
RDD040For how many years {have you/has SP} had this cough?RDQ_GRespiratory Health20112012QuestionnaireNone
RDD060For how many years, {have you/has SP} had trouble with phlegm?RDQ_GRespiratory Health20112012QuestionnaireNone
RDD120[In the past 12 months], how many times {have you/has SP} gone to the doctor's office or the hospital emergency room for one or more of these attacks of wheezing or whistling?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ031{Do you/Does SP} usually cough on most days for 3 consecutive months or more during the year?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ050{Do you/Does SP} bring up phlegm on most days for 3 consecutive months or more during the year?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ070In the past 12 months {have you/has SP} had wheezing or whistling in {your/his/her} chest?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ080[In the past 12 months], how many attacks of wheezing or whistling {have you/has SP} had?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ090[In the past 12 months], how often, on average, has {your/SP's} sleep been disturbed because of wheezing? Would you say this happens . . .RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ100[In the past 12 months], has {your/SP's} chest sounded wheezy during or after exercise or physical activity?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ134(In the past 12 months), (have you/has SP) taken medication, prescribed by a doctor, for wheezing or whistling?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ135During the past 12 months, how much did {you/SP} limit {your/his/her} usual activities due to wheezing or whistling? Would you say...RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ137During the past 12 months, how many days of work or school did {you/SP} miss due to wheezing or whistling?RDQ_GRespiratory Health20112012QuestionnaireNone
RDQ140[In the past 12 months], {have you/has SP} had a dry cough at night not counting a cough associated with a cold or chest infection lasting 14 days or more?RDQ_GRespiratory Health20112012QuestionnaireNone
SEQNRespondent sequence number.RDQ_GRespiratory Health20112012QuestionnaireNone
PAAQUEXQuestionnaire source flag for weightingPAQ_GPhysical Activity20112012QuestionnaireNone
PAD615How much time {do you/does SP} spend doing vigorous-intensity activities at work on a typical day?PAQ_GPhysical Activity20112012QuestionnaireNone
PAD630How much time {do you/does SP} spend doing moderate-intensity activities at work on a typical day?PAQ_GPhysical Activity20112012QuestionnaireNone
PAD645How much time {do you/does SP} spend walking or bicycling for travel on a typical day?PAQ_GPhysical Activity20112012QuestionnaireNone
PAD660How much time {do you/does SP} spend doing vigorous-intensity sports, fitness or recreational activities on a typical day?PAQ_GPhysical Activity20112012QuestionnaireNone
PAD675How much time {do you/does SP} spend doing moderate-intensity sports, fitness or recreational activities on a typical day?PAQ_GPhysical Activity20112012QuestionnaireNone
PAD680The following question is about sitting at work, at home, getting to and from places, or with friends, including time spent sitting at a desk, traveling in a car or bus, reading, playing cards, watching television, or using a computer. Do not include time spent sleeping. How much time {do you/does SP} usually spend sitting on a typical day?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ605Next I am going to ask you about the time {you spend/SP spends} doing different types of physical activity in a typical week. Please answer these questions even if {you do not consider yourself/SP does not consider himself/herself} to be a physically active person. Think first about the time {you spend/SP spends} doing work. Think of work as the things that {you have/SP has} to do such as paid or unpaid work, studying or training, household chores, and yard work. In answering the following questions, 'vigorous-intensity activities' are activities that require hard physical effort and cause large increases in breathing or heart rate, and 'moderate-intensity activities' are activities that require moderate physical effort and cause small increases in breathing or heart rate. Does {your/SP's} work involve vigorous-intensity activity that causes large increases in breathing or heart rate like carrying or lifting heavy loads, digging or construction work for at least 10 minutes continuously?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ610In a typical week, on how many days {do you/does SP} do vigorous-intensity activities as part of your work?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ620Does {your/SP's} work involve moderate-intensity activity that causes small increases in breathing or heart rate such as brisk walking or carrying light loads for at least 10 minutes continuously?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ625In a typical week, on how many days {do you/does SP} do moderate-intensity activities as part of {your/his/her} work?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ635The next questions exclude the physical activity of work that you have already mentioned. Now I would like to ask you about the usual way {you travel/SP travels} to and from places. For example to work, for shopping, to school. {Do you/Does SP} walk or use a bicycle for at least 10 minutes continuously to get to and from places?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ640In a typical week, on how many days {do you/does SP} walk or bicycle for at least 10 minutes continuously to get to and from places?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ650The next questions exclude the work and transportation activities that you have already mentioned. Now I would like to ask you about sports, fitness and recreational activities. {Do you/Does SP} do any vigorous-intensity sports, fitness, or recreational activities that cause large increases in breathing or heart rate like running or basketball for at least 10 minutes continuously?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ655In a typical week, on how many days {do you/does SP} do vigorous-intensity sports, fitness or recreational activities?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ665{Do you/Does SP} do any moderate-intensity sports, fitness, or recreational activities that cause a small increase in breathing or heart rate such as brisk walking, bicycling, swimming, or golf for at least 10 minutes continuously?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ670In a typical week, on how many days {do you/does SP} do moderate-intensity sports, fitness or recreational activities?PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ706Now I'd like to ask you some questions about {SP's} activities. During the past 7 days, on how many days was {SP} physically active for a total of at least 60 minutes per day? Add up all the time {SP} spent in any kind of physical activity that increased {his/her} heart rate and made {him/her} breathe hard some of the time.PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ710Now I will ask you first about TV watching and then about computer use. Over the past 30 days, on average how many hours per day did {you/SP} sit and watch TV or videos? Would you say . . .PAQ_GPhysical Activity20112012QuestionnaireNone
PAQ715Over the past 30 days, on average how many hours per day did {you/SP} use a computer or play computer games outside of work or school? Include Playstation, Nintendo DS, or other portable video games. Would you say . . .PAQ_GPhysical Activity20112012QuestionnaireNone
SEQNRespondent sequence number.PAQ_GPhysical Activity20112012QuestionnaireNone
PFQ020{Do you/Does SP} have an impairment or health problem that limits {your/his/her} ability to {walk, run or play} {walk or run}?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ030Is this an impairment or health problem that has lasted, or is expected to last 12 months or longer?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ041Does {SP} receive Special Education or Early Intervention Services?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ049The next set of questions is about limitations caused by any long-term physical, mental or emotional problem or illness. Please do not include temporary conditions, such as a cold [or pregnancy]. Does a physical, mental or emotional problem now keep {you/SP} from working at a job or business?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ051{Are you/Is SP} limited in the kind or amount of work {you/s/he} can do because of a physical, mental or emotional problem?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ054Because of a health problem, {do you/does SP} have difficulty walking without using any special equipment?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ057{Are you/Is SP} limited in any way because of difficulty remembering or because {you/s/he} experience{s} periods of confusion?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ059{Are you/Is SP} limited in any way in any activity because of a physical, mental or emotional problem?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061AThe next questions ask about difficulties {you/SP} may have doing certain activities because of a health problem. By "health problem" we mean any long-term physical, mental or emotional problem or illness {not including pregnancy}. By {yourself/himself /herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .managing {your/his/her} money [such as keeping track of {your/his/her} expenses or paying bills]?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061BBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .walking for a quarter of a mile [that is about 2 or 3 blocks]?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061CBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .walking up 10 steps without resting?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061DBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .stooping, crouching, or kneeling?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061EBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .lifting or carrying something as heavy as 10 pounds [like a sack of potatoes or rice]?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061FBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .doing chores around the house [like vacuuming, sweeping, dusting, or straightening up]?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061GBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .preparing {your/his/her} own meals?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061HBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .walking from one room to another on the same level?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061IBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .standing up from an armless straight chair?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061JBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .getting in or out of bed?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061KBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .eating, like holding a fork, cutting food or drinking from a glass?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061LBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .dressing {yourself/himself/herself}, including tying shoes, working zippers, and doing buttons?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061MBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .standing or being on {your/his/her} feet for about 2 hours?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061NBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .sitting for about 2 hours?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061OBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .reaching up over {your/his/her} head?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061PBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .using {your/his/her} fingers to grasp or handle small objects?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061QBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .going out to things like shopping, movies, or sporting events?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061RBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .participating in social activities [visiting friends, attending clubs or meetings or going to parties]?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061SBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .doing things to relax at home or for leisure [reading, watching TV, sewing, listening to music]?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ061TBy {yourself/himself/herself} and without using any special equipment, how much difficulty {do you/does SP} have . . .pushing or pulling large objects like a living room chair?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ063AWhat condition or health problem causes {you/SP} to have difficulty with or need help with {NAME OF UP TO 3 ACTIVITIES/these activities}?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ063BWhat condition or health problem causes {you/SP} to have difficulty with or need help with {NAME OF UP TO 3 ACTIVITIES/these activities}?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ063CWhat condition or health problem causes {you/SP} to have difficulty with or need help with {NAME OF UP TO 3 ACTIVITIES/these activities}?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ063DWhat condition or health problem causes {you/SP} to have difficulty with or need help with {NAME OF UP TO 3 ACTIVITIES/these activities}?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ063EWhat condition or health problem causes {you/SP} to have difficulty with or need help with {NAME OF UP TO 3 ACTIVITIES/these activities}?PFQ_GPhysical Functioning20112012QuestionnaireNone
PFQ090{Do you/Does SP} now have any health problem that requires {you/him/her} to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?PFQ_GPhysical Functioning20112012QuestionnaireNone
SEQNRespondent sequence number.PFQ_GPhysical Functioning20112012QuestionnaireNone
RXD530What is the size or dose that {you take/SP takes}?RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
RXQ510Doctors and other health care providers sometimes recommend that {you take/SP takes) a low-dose aspirin each day to prevent heart attacks, strokes, or cancer. {Have you/Has SP} ever been told to do this?RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
RXQ515{Are you/Is SP} now following this advice?RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
RXQ520On {your/SP's} own, {are you/is SP} now taking a low-dose aspirin each day to prevent heart attacks, strokes, or cancer?RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
RXQ525GHow often {do you/does SP} take an aspirin? (ASA taken daily, on alternate days, or another schedule?)RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
RXQ525QHow often {do you/does SP} take an aspirin? (Number of ASA doses taken per day or per week).RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
RXQ525UHow often {do you/does SP} take an aspirin? (ASA doses taken on daily or weekly basis?)RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
SEQNRespondent sequence number.RXQASA_GPreventive Aspirin Use20112012QuestionnaireNone
CKD060In the last 3 days, have {you/SP} had any muscle pain or soreness?CKQ_GCreatine Kinase20112012QuestionnaireNone
CKQ010In the past 3 days, did {you/SP} do any strenuous exercise or heavy physical work?CKQ_GCreatine Kinase20112012QuestionnaireNone
CKQ020Did it make {your/SP's} muscles sore or painful?CKQ_GCreatine Kinase20112012QuestionnaireNone
CKQ030In the past 3 days, {have you/has SP} had a muscle injury, bruise or injection? (Do not include insulin or allergy injections.)CKQ_GCreatine Kinase20112012QuestionnaireNone
CKQ040Did it make {your/SP's} muscles sore or painful?CKQ_GCreatine Kinase20112012QuestionnaireNone
CKQ070QFor how many days, weeks, months or years long {have you/has SP} had this pain, aching or soreness?CKQ_GCreatine Kinase20112012QuestionnaireNone
CKQ070UFor how many days, weeks, months or years long {have you/has SP} had this pain, aching or soreness?CKQ_GCreatine Kinase20112012QuestionnaireNone
SEQNRespondent sequence number.CKQ_GCreatine Kinase20112012QuestionnaireNone
CSQ010The next questions are about {your/SP's} sense of smell. During the past 12 months, {have you/has he/has she} had a problem with {your/his/her} ability to smell, such as not being able to smell things or things not smelling the way they are supposed to?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ020How would {you/SP} rate {your/his/her} ability to smell now as compared to when {you were/he was/she was} 25 years old? Is it better, worse or is there no change?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ030Do some smells bother {you/SP} although they do not bother other people?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ040{Do you/Does SP} sometimes smell an unpleasant, bad or burning odor when nothing is there?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ060How long ago {did you/did SP} first notice a problem with, or a change in, {your/his/her} ability to smell?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ070Is the problem with {your/SP's} ability to smell always there or does it come and go?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ080The next questions are about {your/SP's} sense of taste. During the past 12 months, {have you/has he/has she} had a problem with {your/his/her} ability to taste sweet, sour, salty or bitter foods and drinks?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ090AI am going to read you a list of tastes in everyday foods. How {is your/is SP's} ability to taste each one of these now compared to when {you were/he was/she was} 25 years old? Would you say it is better, worse, or is there no change? salt in foods like potato chips or pretzels.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ090BI am going to read you a list of tastes in everyday foods. How {is your/is SP's} ability to taste each one of these now compared to when {you were/he was/she was} 25 years old? Would you say it is better, worse, or is there no change? sourness in foods like lemons or vinegar.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ090CI am going to read you a list of tastes in everyday foods. How {is your/is SP's} ability to taste each one of these now compared to when {you were/he was/she was} 25 years old? Would you say it is better, worse, or is there no change? sweetness in foods like peaches or ice cream.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ090DI am going to read you a list of tastes in everyday foods. How {is your/is SP's} ability to taste each one of these now compared to when {you were/he was/she was} 25 years old? Would you say it is better, worse, or is there no change? bitterness in drinks like unsweetened black coffee.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ100Is {your/SP's} ability to taste food flavors such as chocolate, vanilla or strawberry as good as when {you were/he was/she was} 25 years old?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ110During the past 12 months {have you/has SP} had a taste or other sensation in {your/his/her} mouth that does not go away?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120APlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120BPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120CPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120DPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120EPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120FPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120GPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ120HPlease describe the taste or other sensation in {your/SP's} mouth that does not go away. Would {you/he/she} say it is...CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ140How long ago {did you/did SP} first notice a problem with, or a change in, {your/his/her} ability to taste?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ160{Have you/Has SP} ever discussed any problem with, or change in {your/his/her} ability to taste or smell with a health care provider?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ170When was the last time {you/SP} /discussed any problem with {your/his/her} ability to taste or smell with a health care provider?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ180The next question refers to treatments {you/SP} may have tried to improve {your/his/her} ability to taste or smell. Please make sure to include any treatments that {your/his/her} health care provider recommended. Also include any other treatments {you/he/she} may have read about and tried. During the past 12 months, {have you/has SP} tried any treatments to improve {your/his/her} ability to taste or smell?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ190During the past 12 months, {have you/has SP} experienced a problem with {your/his/her} general health, work or {your/his/her} enjoyment of life because of a problem with {your/his/her) ability to taste or smell?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ200During the past 12 months, {have you/has SP} had any of the following ...a head cold or flu for longer than a month?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ202During the past 12 months, {have you/has SP} had any of the following ... persistent dry mouth (not enough saliva)?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ204During the past 12 months, {have you/has SP} had any of the following ...frequent nasal congestion from allergies?CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ210{Have you/Has SP} ever had any of the following? wisdom teeth removed.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ220{Have you/Has SP} ever had any of the following? tonsils removed.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ240{Have you/Has SP} ever had any of the following? a loss of consciousness because of a head injury.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ250{Have you/Has SP} ever had any of the following? a broken nose or other serious injury to face or skull.CSQ_GTaste & Smell20112012QuestionnaireNone
CSQ260{Have you/Has SP} ever had any of the following? two or more sinus infections.CSQ_GTaste & Smell20112012QuestionnaireNone
SEQNRespondent sequence number.CSQ_GTaste & Smell20112012QuestionnaireNone
DID040How old {was SP/were you} when a doctor or other health professional first told {you/him/her} that {you/he/she} had diabetes or sugar diabetes?DIQ_GDiabetes20112012QuestionnaireNone
DID060For how long {have you/has SP} been taking insulin?DIQ_GDiabetes20112012QuestionnaireNone
DID250How many times {have you/has SP} seen this doctor or other health professional in the past 12 months?DIQ_GDiabetes20112012QuestionnaireNone
DID260How often {do you check your/does SP check his/her} blood for glucose or sugar? Include times when checked by a family member or friend, but do not include times when checked by a doctor or other health professional.DIQ_GDiabetes20112012QuestionnaireNone
DID310DWhat does {your/SP's} doctor or other health professional say {your/his/her} blood pressure should be?DIQ_GDiabetes20112012QuestionnaireNone
DID310SWhat does {your/SP's} doctor or other health professional say {your/his/her} blood pressure should be?DIQ_GDiabetes20112012QuestionnaireNone
DID320One part of total serum cholesterol in {your/SP's} blood is a bad cholesterol, called LDL, which builds up and clogs {your/his/her} arteries. What was {your/his/her} most recent LDL cholesterol number?DIQ_GDiabetes20112012QuestionnaireNone
DID330What does {your/SP's} doctor or other health professional say {your/his/her} LDL cholesterol should be?DIQ_GDiabetes20112012QuestionnaireNone
DID341During the past 12 months, about how many times has a doctor or other health professional checked {your/SP's} feet for any sores or irritations?DIQ_GDiabetes20112012QuestionnaireNone
DID350How often {do you check your feet/does SP check (his/her) feet} for sores or irritations? Include times when checked by a family member or friend, but do not include times when checked by a doctor or other health professional.DIQ_GDiabetes20112012QuestionnaireNone
DIQ010The next questions are about specific medical conditions. {Other than during pregnancy, {have you/has SP}/{Have you/Has SP}} ever been told by a doctor or health professional that {you have/{he/she/SP} has} diabetes or sugar diabetes?DIQ_GDiabetes20112012QuestionnaireNone
DIQ050{Is SP/Are you} now taking insulinDIQ_GDiabetes20112012QuestionnaireNone
DIQ060UUNIT OF MEASUREDIQ_GDiabetes20112012QuestionnaireNone
DIQ070{Is SP/Are you} now taking diabetic pills to lower {{his/her}/your} blood sugar? These are sometimes called oral agents or oral hypoglycemic agents.DIQ_GDiabetes20112012QuestionnaireNone
DIQ080Has a doctor ever told {you/SP} that diabetes has affected {your/his/her} eyes or that {you/s/he} had retinopathy (ret-in-op-ath-ee)?DIQ_GDiabetes20112012QuestionnaireNone
DIQ160{Have you/Has SP} ever been told by a doctor or other health professional that {you have/SP has} any of the following: prediabetes, impaired fasting glucose, impaired glucose tolerance, borderline diabetes or that {your/her/his} blood sugar is higher than normal but not high enough to be called diabetes or sugar diabetes?DIQ_GDiabetes20112012QuestionnaireNone
DIQ170{Have you/Has SP} ever been told by a doctor or other health professional that {you have/s/he has} health conditions or a medical or family history that increases {your/his/her} risk for diabetes?DIQ_GDiabetes20112012QuestionnaireNone
DIQ172{Do you/Does SP} feel {you/he/she} could be at risk for diabetes or prediabetes?DIQ_GDiabetes20112012QuestionnaireNone
DIQ175AWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175BWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175CWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175DWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175EWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175FWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175GWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175HWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175IWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175JWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175KWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175LWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175MWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175NWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175OWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175PWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175QWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175RWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175SWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175TWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175UWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ175VWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? DIQ_GDiabetes20112012QuestionnaireNone
DIQ175WWhy {Do you/Does SP} think {you are/he is/she is} at risk for diabetes or prediabetes? [Anything else?]DIQ_GDiabetes20112012QuestionnaireNone
DIQ180{Have you/Has SP} had a blood test for high blood sugar or diabetes within the past three years?DIQ_GDiabetes20112012QuestionnaireNone
DIQ230When was the last time {you/SP} saw a diabetes nurse educator or dietitian or nutritionist for {your/his/her} diabetes? Do not include doctors or other health professionals.DIQ_GDiabetes20112012QuestionnaireNone
DIQ240Is there one doctor or other health professional {you usually see/SP usually sees} for {your/his/her} diabetes? Do not include specialists to whom {you have/SP has} been referred such as diabetes educators, dieticians or foot and eye doctors.DIQ_GDiabetes20112012QuestionnaireNone
DIQ260UHow often {do you check your/does SP check his/her} blood for glucose or sugar? Include times when checked by a family member or friend, but do not include times when checked by a doctor or other health professional.DIQ_GDiabetes20112012QuestionnaireNone
DIQ275Glycosylated (GLY-CO-SYL-AT-ED) hemoglobin or the "A one C" test measures your average level of blood sugar for the past 3 months, and usually ranges between 5.0 and 13.9. During the past 12 months, has a doctor or other health professional checked {your/SP's} glycosylated hemoglobin or "A one C"?DIQ_GDiabetes20112012QuestionnaireNone
DIQ280What was {your/SP's} last "A one C" level?DIQ_GDiabetes20112012QuestionnaireNone
DIQ291What does {your/SP's} doctor or other health professional say {your/his/her} "A one C" level should be? (Pick the lowest level recommended by your health care professional.)DIQ_GDiabetes20112012QuestionnaireNone
DIQ300DBlood pressure is usually given as one number over another. What was {your/SP's} most recent blood pressure in numbers?DIQ_GDiabetes20112012QuestionnaireNone
DIQ300SBlood pressure is usually given as one number over another. What was {your/SP's} most recent blood pressure in numbers?DIQ_GDiabetes20112012QuestionnaireNone
DIQ350UHow often {do you check your feet/does SP check (his/her) feet} for sores or irritations? Include times when checked by a family member or friend, but do not include times when checked by a doctor or other health professional.DIQ_GDiabetes20112012QuestionnaireNone
DIQ360When was the last time {you/SP} had an eye exam in which the pupils were dilated? This would have made {you/SP} temporarily sensitive to bright light.DIQ_GDiabetes20112012QuestionnaireNone
SEQNRespondent sequence number.DIQ_GDiabetes20112012QuestionnaireNone
HUD080How many different times did {you/SP} stay in any hospital overnight or longer {during the past 12 months}? (Do not count total number of nights, just total number of hospital admissions for stays which lasted 1 or more nights.)HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ010{First/Next} I have some general questions about {your/SP's} health. Would you say {your/SP's} health in general is . . .HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ020Compared with 12 months ago, would you say {your/SP's} health is now . . .HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ030Is there a place that {you/SP} usually {go/goes} when {you are/he/she is} sick or {you/s/he} need{s} advice about {your/his/her} health?HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ040What kind of place {do you/does SP} go to most often: is it a clinic, doctor's office, emergency room, or some other place?HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ050{During the past 12 months, how/How} many times {have you/has SP} seen a doctor or other health care professional about {your/his/her} health at a doctor's office, a clinic, hospital emergency room, at home or some other place? Do not include times {you were/s/he was} hospitalized overnight.HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ060About how long has it been since {you/SP} last saw or talked to a doctor or other health care professional about {your/his/her} health? Include doctors seen while {you were} {he/she was} a patient in a hospital. Has it been . . .HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ071{During the past 12 months, were you/{Was/was} SP} a patient in a hospital overnight? Do not include an overnight stay in the emergency room.HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
HUQ090During the past 12 months, that is since {DISPLAY CURRENT MONTH} of {DISPLAY LAST YEAR}, {have you/has SP} seen or talked to a mental health professional such as a psychologist, psychiatrist, psychiatric nurse or clinical social worker about {your/his/her} health?HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
SEQNRespondent sequence number.HUQ_GHospital Utilization & Access to Care20112012QuestionnaireNone
OHQ030The next questions are about {your/SP's} teeth and gums. About how long has it been since {you/SP} last visited a dentist? Include all types of dentists, such as, orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists.OHQ_GOral Health20112012QuestionnaireNone
OHQ033What was the main reason {you/SP} last visited the dentist?OHQ_GOral Health20112012QuestionnaireNone
OHQ610In the past 12 months, did a dentist, hygienist or other dental professional have a direct conversation with {you/SP} about... ...the benefits of giving up cigarettes or other types of tobacco to improve {your/SP's} dental health?OHQ_GOral Health20112012QuestionnaireNone
OHQ612(In the past 12 months, did a dentist, hygienist or other dental professional have a direct conversation with {you/SP} about...) ... the dental health benefits of checking {your/his/her} blood sugar?OHQ_GOral Health20112012QuestionnaireNone
OHQ614(In the past 12 months, did a dentist, hygienist or other dental professional have a direct conversation with {you/SP} about...) ...the importance of examining {your/his/her} mouth for oral cancer?OHQ_GOral Health20112012QuestionnaireNone
OHQ620How often during the last year (have you/ has SP) had painful aching anywhere in (your/his/her) mouth? Would you say....OHQ_GOral Health20112012QuestionnaireNone
OHQ640How often during the last year {have you/has SP} had difficulty doing {your/his/her} usual jobs or attending school because of problems with {your/his/her} teeth, mouth or dentures? Would you say . . .OHQ_GOral Health20112012QuestionnaireNone
OHQ680How often during the last year {have you/has SP} been self-conscious or embarrassed because of {your/his/her} teeth, mouth or dentures? Would you say . ..OHQ_GOral Health20112012QuestionnaireNone
OHQ770During the past 12 months was there a time when (you/SP) needed dental care but could not get it at that time?OHQ_GOral Health20112012QuestionnaireNone
OHQ780AWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780BWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780CWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780DWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780EWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780FWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780GWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780HWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780IWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780JWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ780KWhat were the reasons that (you/SP) could not get the dental care (you/she/he) needed?OHQ_GOral Health20112012QuestionnaireNone
OHQ835The next questions will ask about the condition of {your/SP's} teeth and some factors related to gum health. Gum disease is a common problem with the mouth. People with gum disease might have swollen gums, receding gums, sore or infected gums or loose teeth. {Do you/Does SP} think {you/s/he} might have gum disease?OHQ_GOral Health20112012QuestionnaireNone
OHQ845Overall, how would {you/SP} rate the health of {your/his/her} teeth and gums?OHQ_GOral Health20112012QuestionnaireNone
OHQ850{Have you/Has SP} ever had treatment for gum disease such as scaling and root planing, sometimes called "deep cleaning"?OHQ_GOral Health20112012QuestionnaireNone
OHQ855{Have you/Has SP} ever had any teeth become loose on their own, without an injury?OHQ_GOral Health20112012QuestionnaireNone
OHQ860{Have you/Has SP} ever been told by a dental professional that {you/s/he} lost bone around [your/his/her} teeth?OHQ_GOral Health20112012QuestionnaireNone
OHQ865During the past three months, {have you/has SP} noticed a tooth that doesn't look right?OHQ_GOral Health20112012QuestionnaireNone
OHQ870Aside from brushing {your/his/her} teeth with a toothbrush, in the last seven days, how many days did {you/SP} use dental floss or any other device to clean between {your/his/her} teeth?OHQ_GOral Health20112012QuestionnaireNone
OHQ875Aside from brushing {your/his/her} teeth with a toothbrush, in the last seven days, how many days did {you/SP} use mouthwash or other dental rinse product that {you use/s/he uses} to treat dental disease or dental problems?OHQ_GOral Health20112012QuestionnaireNone
OHQ880{Have you/Has SP} ever had an exam for oral cancer in which the doctor or dentist pulls on {your/his/her} tongue, sometimes with gauze wrapped around it, and feels under the tongue and inside the cheeks?OHQ_GOral Health20112012QuestionnaireNone
OHQ885{Have you/Has SP} ever had an exam for oral cancer in which the doctor or dentist feels {your/his/her} neck?OHQ_GOral Health20112012QuestionnaireNone
OHQ895When did {you/SP} have {your/his/her} most recent oral or mouth cancer exam? Was it within the past year, between 1 and 3 years ago, or over 3 years ago?OHQ_GOral Health20112012QuestionnaireNone
OHQ900What type of health care professional performed {your/SP's} most recent oral cancer exam?OHQ_GOral Health20112012QuestionnaireNone
SEQNRespondent sequence number.OHQ_GOral Health20112012QuestionnaireNone
ECD010First I have some questions about {SP NAME's} birth. How old was {SP NAME's} biological mother when {s/he} was born?ECQ_GEarly Childhood20112012QuestionnaireNone
ECD070AHow much did {SP NAME} weigh at birth?ECQ_GEarly Childhood20112012QuestionnaireNone
ECD070BHow much did {SP NAME} weigh at birth?ECQ_GEarly Childhood20112012QuestionnaireNone
ECQ020Did {SP NAME's} biological mother smoke at any time while she was pregnant with {him/her}?ECQ_GEarly Childhood20112012QuestionnaireNone
ECQ080Did {SP NAME} weigh . . .ECQ_GEarly Childhood20112012QuestionnaireNone
ECQ090Did {SP NAME} weigh . . .ECQ_GEarly Childhood20112012QuestionnaireNone
ECQ150Are you now doing anything to help {SP} control {his/her} weight?ECQ_GEarly Childhood20112012QuestionnaireNone
MCQ080EHas a doctor or health professional ever told you that {SP} was overweight?ECQ_GEarly Childhood20112012QuestionnaireNone
SEQNRespondent sequence number.ECQ_GEarly Childhood20112012QuestionnaireNone
WHQ030EHow do you consider {SP} weight?ECQ_GEarly Childhood20112012QuestionnaireNone
SEQNRespondent sequence number.SXQ_GSexual Behavior20112012QuestionnaireNone
SXD021Ever had vaginal, anal, or oral sex.SXQ_GSexual Behavior20112012QuestionnaireNone
SXD031How old were you when you had sex for the first time?SXQ_GSexual Behavior20112012QuestionnaireNone
SXD101In your lifetime, with how many men have you had any kind of sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXD171In your lifetime, with how many women have you had any kind of sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXD450In the past 12 months, with how many men have you had any kind of sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXD510In the past 12 months, with how many women have you had any kind of sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXD621How old were you when you first performed oral sex on a man? Performing oral sex means your mouth on a man's penis or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXD630How long has it been since the last time you performed oral sex on a new male partner? A new sexual partner is someone that you had never had sex with before.SXQ_GSexual Behavior20112012QuestionnaireNone
SXD633How old were you when you first performed oral sex on a woman? Performing oral sex means your mouth on a woman's vagina or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXD642How long has it been since the last time you performed oral sex on a new female partner? A new sexual partner is someone that you had never had sex with before.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ130In your lifetime with how many women have you had sex? By sex, we mean sexual contact with another woman's vagina or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ251In the past 12 months, about how often have you had {vaginal or anal/vaginal/anal} sex without using a condom?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ260Has a doctor or other health care professional ever told you that you had genital herpes?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ265Has a doctor or other health care professional ever told you that you had genital warts?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ270In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ272In the past 12 months, has a doctor or other health care professional told you that you had chlamydia?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ280Are you circumcised or uncircumcised?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ292Do you think of yourself as...SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ294Do you think of yourself as...SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ410In your lifetime, with how many men have you had anal or oral sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ490In the past 12 months, with how many women have you had sex? By sex, we mean sexual contact with another woman's vagina or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ550In the past 12 months, with how many men have you had anal or oral sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ590Of the persons you had any kind of sex with in the past 12 months, how many were five or more years older than you?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ600Of the persons you had any kind of sex with in the past 12 months, how many were five or more years younger than you?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ610In the past 12 months, about how many times have you had {vaginal or anal/vaginal/anal} sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ624In your lifetime, on how many men have you performed oral sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ627In the past 12 months, on how many men have you performed oral sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ636In your lifetime, on how many women have you performed oral sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ639In the past 12 months, on how many women have you performed oral sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ645When you performed oral sex in the past 12 months, how often would you use protection, like a condom or dental dam?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ648In the past 12 months, did you have any kind of sex with a person that you never had sex with before?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ700Have you ever had vaginal sex, also called sexual intercourse, with a man? This means a man's penis in your vagina.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ703Have you ever performed oral sex on a man? This means putting your mouth on a man's penis or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ706Have you ever had anal sex? This means contact between a man's penis and your anus or butt.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ709Have you ever had any kind of sex with a woman? By sex, we mean sexual contact with another woman's vagina or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ724In your lifetime, with how many men have you had vaginal sex? Vaginal sex means a man's penis in your vagina.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ727In the past 12 months, with how many men have you had vaginal sex? Vaginal sex means a man's penis in your vagina.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ741Have you ever performed oral sex on a woman? Performing oral sex means your mouth on a woman's vagina or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ753Has a doctor or other health care professional ever told you that you had human papillomavirus or HPV?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ800Have you ever had vaginal sex, also called sexual intercourse, with a woman? This means your penis in a woman's vagina.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ803Have you ever performed oral sex on a woman? This means putting your mouth on a woman's vagina or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ806Have you ever had anal sex with a woman? Anal sex means contact between your penis and a woman's anus or butt.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ809Have you ever had any kind of sex with a man, including oral or anal?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ824In your lifetime, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman's vagina.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ827In the past 12 months, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman's vagina.SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ836In your lifetime, with how many men have you had anal sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ841In the past 12 months, with how many men have you had anal sex?SXQ_GSexual Behavior20112012QuestionnaireNone
SXQ853Have you ever performed oral sex on a man? Performing oral sex means your mouth on a man's penis or genitals.SXQ_GSexual Behavior20112012QuestionnaireNone
SEQNRespondent sequence number.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD021Ever had vaginal, anal, or oral sex.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD031How old were you when you had sex for the first time?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD101In your lifetime, with how many men have you had any kind of sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD171In your lifetime, with how many women have you had any kind of sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD450In the past 12 months, with how many men have you had any kind of sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD510In the past 12 months, with how many women have you had any kind of sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD621How old were you when you first performed oral sex on a man? Performing oral sex means your mouth on a man's penis or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD630How long has it been since the last time you performed oral sex on a new male partner? A new sexual partner is someone that you had never had sex with before.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD633How old were you when you first performed oral sex on a woman? Performing oral sex means your mouth on a woman's vagina or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXD642How long has it been since the last time you performed oral sex on a new female partner? A new sexual partner is someone that you had never had sex with before.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ130In your lifetime with how many women have you had sex? By sex, we mean sexual contact with another woman's vagina or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ251In the past 12 months, about how often have you had {vaginal or anal/vaginal/anal} sex without using a condom?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ260Has a doctor or other health care professional ever told you that you had genital herpes?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ265Has a doctor or other health care professional ever told you that you had genital warts?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ270In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ272In the past 12 months, has a doctor or other health care professional told you that you had chlamydia?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ280Are you circumcised or uncircumcised?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ410In your lifetime, with how many men have you had anal or oral sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ490In the past 12 months, with how many women have you had sex? By sex, we mean sexual contact with another woman's vagina or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ550In the past 12 months, with how many men have you had anal or oral sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ590Of the persons you had any kind of sex with in the past 12 months, how many were five or more years older than you?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ600Of the persons you had any kind of sex with in the past 12 months, how many were five or more years younger than you?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ610In the past 12 months, about how many times have you had {vaginal or anal/vaginal/anal} sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ624In your lifetime, on how many men have you performed oral sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ627In the past 12 months, on how many men have you performed oral sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ636In your lifetime, on how many women have you performed oral sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ639In the past 12 months, on how many women have you performed oral sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ645When you performed oral sex in the past 12 months, how often would you use protection, like a condom or dental dam?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ648In the past 12 months, did you have any kind of sex with a person that you never had sex with before?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ700Have you ever had vaginal sex, also called sexual intercourse, with a man? This means a man's penis in your vagina.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ703Have you ever performed oral sex on a man? This means putting your mouth on a man's penis or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ706Have you ever had anal sex? This means contact between a man's penis and your anus or butt.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ709Have you ever had any kind of sex with a woman? By sex, we mean sexual contact with another woman's vagina or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ724In your lifetime, with how many men have you had vaginal sex? Vaginal sex means a man's penis in your vagina.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ727In the past 12 months, with how many men have you had vaginal sex? Vaginal sex means a man's penis in your vagina.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ741Have you ever performed oral sex on a woman? Performing oral sex means your mouth on a woman's vagina or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ753Has a doctor or other health care professional ever told you that you had human papillomavirus or HPV?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ800Have you ever had vaginal sex, also called sexual intercourse, with a woman? This means your penis in a woman's vagina.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ803Have you ever performed oral sex on a woman? This means putting your mouth on a woman's vagina or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ806Have you ever had anal sex with a woman? Anal sex means contact between your penis and a woman's anus or butt.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ809Have you ever had any kind of sex with a man, including oral or anal?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ824In your lifetime, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman's vagina.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ827In the past 12 months, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman's vagina.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ836In your lifetime, with how many men have you had anal sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ841In the past 12 months, with how many men have you had anal sex?SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SXQ853Have you ever performed oral sex on a man? Performing oral sex means your mouth on a man's penis or genitals.SXQY_G_RSexual Behavior - Youth20112012QuestionnaireRDC Only
SEQNRespondent sequence number.SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMAQUEXQuestionnaire Mode Flag.SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ680The following questions ask about use of tobacco or nicotine products in the past 5 days. During the past 5 days, did {you/he/she} use any product containing nicotine including cigarettes, pipes, cigars, chewing tobacco, snuff, nicotine patches, nicotine gum, or any other product containing nicotine?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ690AWhich of these products did {you/he/she} use?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ690BWhich of these products did {you/he/she} use?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ690CWhich of these products did {you/he/she} use?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ690DWhich of these products did {you/he/she} use?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ690EWhich of these products did {you/he/she} use?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ690FWhich of these products did {you/he/she} use?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ710During the past 5 days {including today}, on how many days did {you/he/she} smoke cigarettes?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ720During the past 5 days, on the days {you/he/she} smoked, how many cigarettes did {you/he/she} smoke each day?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ725When did {you/he/she} smoke {your/his/her} last cigarette? Was it...SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ740During the past 5 days (including today), on how many days did {you/he/she} smoke a pipe?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ750During the past 5 days, on the days did {you/he/she} smoked a pipe, how many pipes did {you/he/she} smoke each day?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ755When did {you/he/she} smoke {your/his/her} last pipe? Was it...SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ770During the past 5 days (including today), on how many days did {you/he/she} smoke cigars?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ780During the past 5 days, on the days {you/he/she} smoked cigars, how many cigars did {you/he/she} smoke each day?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ785When did {you/he/she} smoke {your/his/her} last cigar? Was it...SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ800During the past 5 days (including today), on how many days did {you/he/she} use chewing tobacco, such as Redman, Levi Garrett or Beechnut?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ815When did {you/he/she} last use chewing tobacco? Was it...SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ817During the past 5 days {including today}, on how many days did {you/he/she} use snuff, such as Skoal, Skoal Bandits, or Copenhagen?SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ819When did {you/he/she} last use snuff? Was it...SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ830During the past 5 days (including today), on how many days did {you/he/she} use any product containing nicotine to help {you/he/she} stop smoking? Include nicotine patches, gum, or any other product containing nicotine.SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SMQ840When did {you/he/she} last use a product containing nicotine? Was it...SMQRTU_GSmoking - Recent Tobacco Use20112012QuestionnaireNone
SEQNRespondent sequence number.SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMAQUEX2Questionnaire Mode FlagSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD030How old {were you/was SP} when {you/s/he} first started to smoke cigarettes fairly regularly?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD055How old {were you/was SP} when {you/s/he} last smoked cigarettes {fairly regularly}?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD057At that time, about how many cigarettes did {you/SP} usually smoke per day?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD093May I please see the pack for the brand of cigarettes {you usually smoke/SP usually smokes}.SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100BRBRAND OF CIGARETTES SMOKED BY SP (SUB-BRAND INCLUDED IF APPLICABLE AND AVAILABLE)SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100COCIGARETTE CARBON MONOXIDE CONTENTSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100FLCIGARETTE PRODUCT FILTERED OR NON-FILTEREDSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100LNCIGARETTE PRODUCT LENGTHSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100MNCIGARETTE PRODUCT MENTHOLATED OR NON-MENTHOLATEDSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100NICIGARETTE NICOTINE CONTENTSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD100TRCIGARETTE TAR CONTENTSMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD630How old were you when you smoked a whole cigarette for the first time?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD641On how many of the past 30 days did {you/SP} smoke a cigarette?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMD650During the past 30 days, on the days that {you/SP} smoked, about how many cigarettes did {you/s/he} smoke per day?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMDUPCACigarette 12-digit Universal Product Code (UPC)SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ020These next questions are about cigarette smoking and other tobacco use. {Have you/Has SP} smoked at least 100 cigarettes in {your/his/her} entire life?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ040{Do you/Does SP} now smoke cigarettes . .SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ050QHow long has it been since {you/SP} quit smoking cigarettes?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ050UUNIT OF MEASURESMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ077How soon after you wake up do you smoke? Would you say...SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ621The following questions are about cigarette smoking and other tobacco use. Do not include cigars or marijuana. About how many cigarettes have you smoked in your entire life?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ660During the past 30 days, on the days that you smoked, which brand of cigarettes did you usually smoke?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ664B{Were/Was} the Benson and Hedges cigarettes menthol or non-menthol?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ664C{Were/Was} the Camel cigarettes menthol or non-menthol?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ664M{Were/Was} the Marlboro cigarettes menthol or non-menthol?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ664O{Were/Was} the other brand cigarettes menthol or non-menthol?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ664W{Were/Was} the Winston cigarettes menthol or non-menthol?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SMQ670During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?SMQ_GSmoking - Cigarette Use20112012QuestionnaireNone
SEQNRespondent sequence number.SMQFAM_GSmoking - Household Smokers20112012QuestionnaireNone
SMD410I would now like to ask you a few questions about smoking. Does anyone who lives here smoke cigarettes, cigars, or pipes anywhere inside this home?SMQFAM_GSmoking - Household Smokers20112012QuestionnaireNone
SMD415Total number of smokers inside home.SMQFAM_GSmoking - Household Smokers20112012QuestionnaireNone
SMD415ATotal number of cigarette smokers inside home. SMQFAM_GSmoking - Household Smokers20112012QuestionnaireNone
SMD430Total number cigarettes per day smoked anywhere inside the home by all cigarette smokers.SMQFAM_GSmoking - Household Smokers20112012QuestionnaireNone
OCD150(SP Interview Version) In this part of the survey I will ask you questions about {your/SP's} work experience. Which of the following {were you/was SP} doing last week . . . (Family Interview Version) The next questions are about {your/NON-SP HEAD'S/NON- SP SPOUSE'S} current job or business. Which of the following {were you/was} {NON-SP HEAD/NON-SP SPOUSE} doing last week . . .OCQ_GOccupation20112012QuestionnaireNone
OCD231What kind of business or industry is this? (For example: TV and radio management, retail shoe store, state labor department, farm.)OCQ_GOccupation20112012QuestionnaireNone
OCD241What kind of work {were you/was SP} doing? (For example: farming, mail clerk, computer specialist.)OCQ_GOccupation20112012QuestionnaireNone
OCD270About how long {have you/has SP} worked for {EMPLOYER} as a(n) {OCCUPATION}?OCQ_GOccupation20112012QuestionnaireNone
OCD390GThinking of all the paid jobs or businesses {you/SP} ever had, what kind of work {were you/was s/he} doing the longest? (For example, electrical engineer, stock clerk, typist, farmer.)OCQ_GOccupation20112012QuestionnaireNone
OCD391What kind of business or industry is this? (For example: TV and radio management, retail shoe store, state labor department, farm.)OCQ_GOccupation20112012QuestionnaireNone
OCD392Thinking of all the paid jobs or businesses {you/SP} ever had, what kind of work {were you/was s/he} doing the longest? (For example, electrical engineer, stock clerk).OCQ_GOccupation20112012QuestionnaireNone
OCD395About how long did {you/SP} work at that job or business?OCQ_GOccupation20112012QuestionnaireNone
OCQ180How many hours did {you/SP} work last week at all jobs or businesses?OCQ_GOccupation20112012QuestionnaireNone
OCQ210{Do you/Does SP} usually work 35 hours or more per week in total at all jobs or businesses?OCQ_GOccupation20112012QuestionnaireNone
OCQ260Looking at the card, which of these best describes this job or work situation?OCQ_GOccupation20112012QuestionnaireNone
OCQ275During the past two weeks, has anyone smoked cigarettes, cigars or pipes in the area in which {you work/SP works}?OCQ_GOccupation20112012QuestionnaireNone
OCQ380(SP Interview Version) What is the main reason {you/SP} did not work last week? (Family Interview Version) What is the main reason {you/NON-SP HEAD/NON-SP SPOUSE} did not work last week?OCQ_GOccupation20112012QuestionnaireNone
OCQ510The next questions ask about being exposed to dust in (your/SPs) work. Being exposed to dust means that {you/SP} breathed in the dust or had dust on {your/his/her} clothes, skin or hair. In any job, {have you/has SP} ever been exposed to dust from rock, sand, concrete, coal, asbestos, silica or soil?OCQ_GOccupation20112012QuestionnaireNone
OCQ520Please give me the total number of years for all jobs where this has happened.OCQ_GOccupation20112012QuestionnaireNone
OCQ530In any job, {have you/has SP} ever been exposed to dust from baking flours, grains, wood, cotton, plants or animals?OCQ_GOccupation20112012QuestionnaireNone
OCQ540Please give me the total number of years for all jobs where this has happened.OCQ_GOccupation20112012QuestionnaireNone
OCQ550The next questions ask about being exposed to fumes in {your/SP's} work. Being exposed to fumes means that {you/SP} breathed in fumes or had a lasting smell on {your/his/her} clothes, skin or hair. In any job, {have you/has SP} ever been exposed to exhaust fumes from trucks, buses, heavy machinery or diesel engines?OCQ_GOccupation20112012QuestionnaireNone
OCQ560Please give me the total number of years for all jobs where this has happened.OCQ_GOccupation20112012QuestionnaireNone
OCQ570In any job, {have you/has SP} ever been exposed to any other gases, vapors or fumes? Examples are vapors from paints, cleaning products, glues, solvents, and acids; or welding/soldering fumes.OCQ_GOccupation20112012QuestionnaireNone
OCQ580Please give me the total number of years for all jobs this has happened.OCQ_GOccupation20112012QuestionnaireNone
SEQNRespondent sequence numberOCQ_GOccupation20112012QuestionnaireNone
HOD050How many rooms are in this home? Count the kitchen but not the bathroom.HOQ_GHousing Characteristics20112012QuestionnaireNone
HOQ065Is this {mobile home/house/apartment} owned, being bought, rented, or occupied by some other arrangement by {you/you or someone else in your family}?HOQ_GHousing Characteristics20112012QuestionnaireNone
SEQNRespondent sequence number.HOQ_GHousing Characteristics20112012QuestionnaireNone
PUQ100In the past 7 days, were any chemical products used in {your/his/her} home to control fleas, roaches, ants, termites, or other insects?PUQMEC_GPesticide Use20112012QuestionnaireNone
PUQ110In the past 7 days, were any chemical products used in {your/his/her} lawn or garden to kill weeds?PUQMEC_GPesticide Use20112012QuestionnaireNone
SEQNRespondent sequence number.PUQMEC_GPesticide Use20112012QuestionnaireNone
MCD093In what year did {you/SP} receive {your/his/her} first transfusion?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ010The following questions are about different medical conditions. Has a doctor or other health professional ever told {you/SP} that {you have/s/he/SP has} asthma (az-ma)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ025How old {were you/was SP} when {you were/s/he was} first told {you/he/she} had asthma (az-ma)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ035{Do you/Does SP} still have asthma (az-ma)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ040During the past 12 months, {have you/has SP} had an episode of asthma (az-ma) or an asthma attack?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ050[During the past 12 months], {have you/has SP} had to visit an emergency room or urgent care center because of asthma (az-ma)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ051During the past 3 months, {have you/has SP} taken medication prescribed by a doctor or other health professionals for asthma?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ053During the past 3 months, {have you/has SP} been on treatment for anemia (a-nee-me-a), sometimes called "tired blood" or "low blood"? [Include diet, iron pills, iron shots, transfusions as treatment.]MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ070{Have you/Has SP} ever been told by a doctor or other health care professional that {you/s/he} had psoriasis (sore-eye-asis)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ075{Do you/Does SP} currently have . . .MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ080Has a doctor or other health professional ever told {you/SP} that {you were/s/he/SP was} overweight?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ082Has a doctor or other health professional ever told {you/SP} that {you have/s/he/SP has} celiac (sele-ak) disease, also called or sprue (sproo)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ084The next question asks about difficulties in thinking or remembering that can make a big difference in everyday activities. This does not refer to occasionally forgetting your keys or the name of someone you recently met. This refers to things like confusion or memory loss that are happening more often or getting worse. We want to know how these difficulties impact {you/SP}. During the past 12 months, {have you/has she/has he} experienced confusion or memory loss that is happening more often or is getting worse?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ086{Are you/is SP} on a gluten-free diet?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ092{Have you/Has SP} ever received a blood transfusion?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ140{Do you/Does SP} have trouble seeing, even when wearing glasses or contact lenses, if {you/he/she} wear{s} them?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ149Have {SP's} periods or menstrual (men-stral) cycles started yet?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160aHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had arthritis (ar-thry-tis)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160bHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had congestive heart failure?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160cHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had coronary (kor-o-nare-ee) heart disease?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160dHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had angina (an-gi-na), also called angina pectoris?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160eHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had a heart attack (also called myocardial infarction (my-o-car-dee-al in-fark-shun))?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160fHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had a stroke?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160gHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had emphysema (emph-phi-see-ma)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160kHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had chronic bronchitis?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160lHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had any kind of liver condition?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160mHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had another thyroid (thigh-roid) problem?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ160nHas a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had gout?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ170k{Do you/Does SP} still . . . have chronic bronchitis?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ170l{Do you/Does SP} still . . . have any kind of liver condition?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ170m{Do you/Does SP} still . . . have another thyroid problem?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180aHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . . had arthritis?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180bHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had congestive heart failure?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180cHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had coronary heart disease?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180dHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had angina, also called angina pectoris?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180eHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had a heart attack (also called myocardial infarction)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180fHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had a stroke?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180gHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had emphysema?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180kHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had chronic bronchitis?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180lHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had any kind of liver condition?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180mHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had another thyroid problem?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ180nHow old {were you/was SP} when {you were/s/he was} first told {you/s/he} . . .had gout?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ195Which type of arthritis was it?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ220{Have you/Has SP} ever been told by a doctor or other health professional that {you/s/he} had cancer or a malignancy (ma-lig-nan-see) of any kind?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ230aWhat kind of cancer was it?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ230bWhat kind of cancer was it?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ230cWhat kind of cancer was it?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ230dWhat kind of cancer was it?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240aHow old (were you/was SP) when bladder cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240aaHow old (were you/was SP) when testicular cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240bHow old {were you/was SP} when blood cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240bbHow old (were you/was SP) when thyroid cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240cHow old (were you/was SP) when bone cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240ccHow old (were you/was SP) when uterine cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240dHow old (were you/was SP) when brain cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240ddHow old (were you/was SP) when some other type of cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240dkHow old {were you/was SP} when cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240eHow old (were you/was SP) when breast cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240fHow old (were you/was SP) when cervical cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240gHow old (were you/was SP) when colon cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240hHow old (were you/was SP) when esophageal cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240iHow old (were you/was SP) when gallbladder cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240jHow old (were you/was SP) when kidney cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240kHow old (were you/was SP) when larynx or windpipe cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240lHow old (were you/was SP) when leukemia was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240mHow old (were you/was SP) when liver cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240nHow old (were you/was SP) when lung cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240oHow old (were you/was SP) when lymphoma or Hodgkins' Disease was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240pHow old (were you/was SP) when melanoma was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240qHow old (were you/was SP) when mouth, tongue, or lip cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240rHow old (were you/was SP) when cancer of the nervous system was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240sHow old (were you/was SP) when ovarian cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240tHow old (were you/was SP) when pancreatic cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240uHow old (were you/was SP) when prostate cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240vHow old (were you/was SP) when rectal cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240wHow old (were you/was SP) when non-melanoma skin cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240xHow old (were you/was SP) when the unknown kind of skin cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240yHow old (were you/was SP) when soft tissue (muscle or fat) cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ240zHow old (were you/was SP) when stomach cancer was first diagnosed?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ300aIncluding living and deceased, were any of {SP's/your} close biological that is, blood relatives including father, mother, sisters or brothers, ever told by a health professional that they had a heart attack or angina (an-gi-na) before the age of 50?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ300bIncluding living and deceased, were any of {SP's/your} close biological that is, blood relatives including father, mother, sisters or brothers, ever told by a health professional that they had asthma (az-ma)?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ300cIncluding living and deceased, were any of {SP's/your} close biological that is, blood relatives including father, mother, sisters or brothers, ever told by a health professional that they had diabetes?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ365aTo lower {your/SP's} risk for certain diseases, during the past 12 months {have you/has s/he} ever been told by a doctor or health professional to: control {your/his/her} weight or lose weight?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ365bTo lower {your/SP's} risk for certain diseases, during the past 12 months {have you/has s/he} ever been told by a doctor or health professional to: increase {your/his/her} physical activity or exercise?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ365cTo lower {your/SP's} risk for certain diseases, during the past 12 months {have you/has s/he} ever been told by a doctor or health professional to: reduce the amount of sodium or salt in {your/his/her} diet?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ365dTo lower {your/SP's} risk for certain diseases, during the past 12 months {have you/has s/he} ever been told by a doctor or health professional to: reduce the amount of fat or calories in {your/his/her} diet?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ370aTo lower {your/his/her} risk for certain diseases, {are you/is s/he} now doing any of the following: controlling {your/his/her} weight or losing weight?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ370bTo lower {your/his/her} risk for certain diseases, {are you/is s/he} now doing any of the following: increasing {your/his/her} physical activity or exercise?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ370cTo lower {your/his/her} risk for certain diseases, {are you/is s/he} now doing any of the following: reducing the amount of sodium or salt in {your/his/her} diet?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ370dTo lower {your/his/her} risk for certain diseases, {are you/is s/he} now doing any of the following: reducing the amount of fat or calories in {your/his/her} diet?MCQ_GMedical Conditions20112012QuestionnaireNone
MCQ380During the past 7 days, how often{have you/has SP} had trouble remembering where {you/he/she} put things, like {your/his/her} keys or {your/his/her} wallet? Would you say...MCQ_GMedical Conditions20112012QuestionnaireNone
SEQNRespondent sequence number.MCQ_GMedical Conditions20112012QuestionnaireNone
IMQ011Hepatitis (Hep-a-ti-tis) A vaccine is given as a two dose series to some children older than 2 years and also to some adults, especially people who travel outside the United States. It has only been available since 1995. {Have you/Has SP} ever received hepatitis A vaccine?IMQ_GImmunization20112012QuestionnaireNone
IMQ020Hepatitis (Hep-a-ti-tis) B vaccine is given in three separate doses and has been recommended for all newborn infants since 1991. In 1995, it was recommended that adolescents be given the vaccine. Persons who may be exposed to other people's blood, such as health care workers, also may have received the vaccine. {Have you/Has SP} ever received the 3-dose series of the hepatitis B vaccine?IMQ_GImmunization20112012QuestionnaireNone
IMQ040Human Papillomavirus (HPV) vaccine is given to prevent cervical cancer in girls and women. There are two HPV vaccines available called Cervarix and Gardasil. It is given in 3 separate doses over a 6 month period. {Have you/Has SP} ever received one or more doses of the HPV vaccine?IMQ_GImmunization20112012QuestionnaireNone
IMQ045How many doses of {Cervarix/Gardasil/the vaccine} {have you/has SP} received?IMQ_GImmunization20112012QuestionnaireNone
IMQ070Human Papillomavirus (HPV) vaccine is given to prevent HPV infection and genital warts in boys and men. It is given in 3 separate doses over a 6 month period. {Have you/Has SP} ever received one or more doses of the HPV vaccine? (The brand name for the vaccine is Gardasil.)IMQ_GImmunization20112012QuestionnaireNone
IMQ080Which of the HPV vaccines did {you/SP} receive, Cervarix or Gardasil?IMQ_GImmunization20112012QuestionnaireNone
IMQ090How old {were you/was SP} when {you/SP} received your first dose of {Cervarix/Gardasil/the vaccine}?IMQ_GImmunization20112012QuestionnaireNone
SEQNRespondent sequence number.IMQ_GImmunization20112012QuestionnaireNone
HSAQUEXSource of Health Status DataHSQ_GCurrent Health Status20112012QuestionnaireNone
HSD010Next I have some general questions about {your/SP's} health. Would you say {your/SP's} health in general is . . .HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ470The next questions are about {your/SP's} recent health during the 30 days outlined on the calendar. Thinking about {your/SP's} physical health, which includes physical illness and injury, for how many days during the past 30 days was {your/his/her} physical health not good?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ480Now thinking about {your/SP's} mental health, which includes stess, depression, and problems with emotions, for how many days during the past 30 days was {your/his/her} mental health not good?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ490During the past 30 days, for about how many days did poor physical or mental health keep {you/SP} from doing {your/his/her} usual activities, such as self-care, work, school or recreation?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ493During the past 30 days, for about how many days did pain make it hard for {you/SP} to do {your/his/her} usual activities, such as self-care, work, or recreation?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ496During the past 30 days, for about how many days {have you/has SP} felt worried, tense, or anxious?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ500Did {you/SP} have a head cold or chest cold that started during those 30 days?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ510Did {you/SP} have a stomach or intestinal illness with vomiting or diarrhea that started during those 30 days?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ520Did {you/SP} have flu, pneumonia, or ear infections that started during those 30 days?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ571During the past 12 months, that is, since (DISPLAY CURRENT MONTH, DISPLAY LAST YEAR), (have you/has SP) donated blood?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ580How long ago was {your/SP's} last blood donation?HSQ_GCurrent Health Status20112012QuestionnaireNone
HSQ590Except for tests {you/SP} may have had as part of blood donations, {have you/has he/has she} ever had {your/his/her} blood tested for the AIDS virus infection?HSQ_GCurrent Health Status20112012QuestionnaireNone
SEQNRespondent sequence number.HSQ_GCurrent Health Status20112012QuestionnaireNone
DUQ200The following questions ask about use of drugs not prescribed by a doctor. Please remember that your answers to these questions are strictly confidential. The first questions are about marijuana and hashish. Marijuana is also called pot or grass. Marijuana is usually smoked, either in cigarettes, called joints, or in a pipe. It is sometimes cooked in food. Hashish is a form of marijuana that is also called 'hash.' It is usually smoked in a pipe. Another form of hashish is hash oil. Have you ever, even once, used marijuana or hashish?DUQ_GDrug Use20112012QuestionnaireNone
DUQ210How old were you the first time you used marijuana or hashish?DUQ_GDrug Use20112012QuestionnaireNone
DUQ211Have you ever smoked marijuana or hashish at least once a month for more than one year?DUQ_GDrug Use20112012QuestionnaireNone
DUQ213How old were you when you started smoking marijuana or hashish at least once a month for one year?DUQ_GDrug Use20112012QuestionnaireNone
DUQ215QHow long has it been since you last smoked marijuana or hashish at least once a month for one year?DUQ_GDrug Use20112012QuestionnaireNone
DUQ215UHow long has it been since you last smoked marijuana or hashish at least once a month for one year?DUQ_GDrug Use20112012QuestionnaireNone
DUQ217During the time that you smoked marijuana or hashish, how often would you usually use it?DUQ_GDrug Use20112012QuestionnaireNone
DUQ219During the time that you smoked marijuana or hashish, how many joints or pipes would you usually smoke in a day?DUQ_GDrug Use20112012QuestionnaireNone
DUQ220QHow long has it been since you last used marijuana or hashish?DUQ_GDrug Use20112012QuestionnaireNone
DUQ220UHow long has it been since you last used marijuana or hashish?DUQ_GDrug Use20112012QuestionnaireNone
DUQ230During the past 30 days, on how many days did you use marijuana or hashish?DUQ_GDrug Use20112012QuestionnaireNone
DUQ240Have you ever used cocaine, crack cocaine, heroin, or methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ250The following questions are about cocaine, including all the different forms of cocaine such as powder, 'crack', 'free base', and coca paste. Have you ever, even once, used cocaine, in any form?DUQ_GDrug Use20112012QuestionnaireNone
DUQ260How old were you the first time you used cocaine, in any form?DUQ_GDrug Use20112012QuestionnaireNone
DUQ270QHow long has it been since you last used cocaine, in any form?DUQ_GDrug Use20112012QuestionnaireNone
DUQ270UHow long has it been since you last used cocaine, in any form?DUQ_GDrug Use20112012QuestionnaireNone
DUQ272During your life, altogether how many times have you used cocaine, in any form?DUQ_GDrug Use20112012QuestionnaireNone
DUQ280During the past 30 days, on how many days did you use cocaine, in any form?DUQ_GDrug Use20112012QuestionnaireNone
DUQ290The following questions are about heroin. Have you ever, even once, used heroin?DUQ_GDrug Use20112012QuestionnaireNone
DUQ300How old were you the first time you used heroin?DUQ_GDrug Use20112012QuestionnaireNone
DUQ310QHow long has it been since you last used heroin?DUQ_GDrug Use20112012QuestionnaireNone
DUQ310UHow long has it been since you last used heroin?DUQ_GDrug Use20112012QuestionnaireNone
DUQ320During the past 30 days, on how many days did you use heroin?DUQ_GDrug Use20112012QuestionnaireNone
DUQ330The following questions are about methamphetamine, also known as crank, crystal, ice or speed. Have you ever, even once, used methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ340How old were you the first time you used methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ350QHow long has it been since you last used methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ350UHow long has it been since you last used methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ352During your life, altogether how many times have you used methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ360During the past 30 days, on how many days did you use methamphetamine?DUQ_GDrug Use20112012QuestionnaireNone
DUQ370The following questions are about the different ways that certain drugs can be used. Have you ever, even once, used a needle to inject a drug not prescribed by a doctor?DUQ_GDrug Use20112012QuestionnaireNone
DUQ380AWhich of the following drugs have you injected using a needle?DUQ_GDrug Use20112012QuestionnaireNone
DUQ380BWhich of the following drugs have you injected using a needle?DUQ_GDrug Use20112012QuestionnaireNone
DUQ380CWhich of the following drugs have you injected using a needle?DUQ_GDrug Use20112012QuestionnaireNone
DUQ380DWhich of the following drugs have you injected using a needle?DUQ_GDrug Use20112012QuestionnaireNone
DUQ380EWhich of the following drugs have you injected using a needle?DUQ_GDrug Use20112012QuestionnaireNone
DUQ390How old were you when you first used a needle to inject any drug not prescribed by a doctor?DUQ_GDrug Use20112012QuestionnaireNone
DUQ400QHow long ago has it been since you last used a needle to inject a drug not prescribed by a doctor?DUQ_GDrug Use20112012QuestionnaireNone
DUQ400UHow long ago has it been since you last used a needle to inject a drug not prescribed by a doctor?DUQ_GDrug Use20112012QuestionnaireNone
DUQ410During your life, altogether how many times have you injected drugs not prescribed by a doctor?DUQ_GDrug Use20112012QuestionnaireNone
DUQ420Think about the period of your life when you injected drugs the most often. How often did you inject then?DUQ_GDrug Use20112012QuestionnaireNone
DUQ430Have you ever been in a drug treatment or drug rehabilitation program?DUQ_GDrug Use20112012QuestionnaireNone
SEQNRespondent sequence number.DUQ_GDrug Use20112012QuestionnaireNone
DUQ200The following questions ask about use of drugs not prescribed by a doctor. Please remember that your answers to these questions are strictly confidential. The first questions are about marijuana and hashish. Marijuana is also called pot or grass. Marijuana is usually smoked, either in cigarettes, called joints, or in a pipe. It is sometimes cooked in food. Hashish is a form of marijuana that is also called 'hash.' It is usually smoked in a pipe. Another form of hashish is hash oil. Have you ever, even once, used marijuana or hashish?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ210How old were you the first time you used marijuana or hashish?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ211Have you ever smoked marijuana or hashish at least once a month for more than one year?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ213How old were you when you started smoking marijuana or hashish at least once a month for one year?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ215QHow long has it been since you last smoked marijuana or hashish at least once a month for one year?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ215UHow long has it been since you last smoked marijuana or hashish at least once a month for one year?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ217During the time that you smoked marijuana or hashish, how often would you usually use it?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ219During the time that you smoked marijuana or hashish, how many joints or pipes would you usually smoke in a day?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ220QHow long has it been since you last used marijuana or hashish?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ220UHow long has it been since you last used marijuana or hashish?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ230During the past 30 days, on how many days did you use marijuana or hashish?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ240Have you ever used cocaine, crack cocaine, heroin, or methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ250The following questions are about cocaine, including all the different forms of cocaine such as powder, 'crack', 'free base', and coca paste. Have you ever, even once, used cocaine, in any form?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ260How old were you the first time you used cocaine, in any form?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ270QHow long has it been since you last used cocaine, in any form?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ270UHow long has it been since you last used cocaine, in any form?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ272During your life, altogether how many times have you used cocaine, in any form?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ280During the past 30 days, on how many days did you use cocaine, in any form?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ290The following questions are about heroin. Have you ever, even once, used heroin?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ300How old were you the first time you used heroin?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ310QHow long has it been since you last used heroin?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ310UHow long has it been since you last used heroin?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ320During the past 30 days, on how many days did you use heroin?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ330The following questions are about methamphetamine, also known as crank, crystal, ice or speed. Have you ever, even once, used methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ340How old were you the first time you used methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ350QHow long has it been since you last used methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ350UHow long has it been since you last used methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ352During your life, altogether how many times have you used methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ360During the past 30 days, on how many days did you use methamphetamine?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ370The following questions are about the different ways that certain drugs can be used. Have you ever, even once, used a needle to inject a drug not prescribed by a doctor?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ380AWhich of the following drugs have you injected using a needle?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ380BWhich of the following drugs have you injected using a needle?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ380CWhich of the following drugs have you injected using a needle?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ380DWhich of the following drugs have you injected using a needle?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ380EWhich of the following drugs have you injected using a needle?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ390How old were you when you first used a needle to inject any drug not prescribed by a doctor?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ400QHow long ago has it been since you last used a needle to inject a drug not prescribed by a doctor?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ400UHow long ago has it been since you last used a needle to inject a drug not prescribed by a doctor?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ410During your life, altogether how many times have you injected drugs not prescribed by a doctor?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ420Think about the period of your life when you injected drugs the most often. How often did you inject then?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DUQ430Have you ever been in a drug treatment or drug rehabilitation program?DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
SEQNRespondent sequence number.DUQY_G_RDrug Use - Youth20112012QuestionnaireRDC Only
DPQ010Over the last 2 weeks, how often have you been bothered by the following problems: little interest or pleasure in doing things? Would you say...DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ020[Over the last 2 weeks, how often have you been bothered by the following problems:] feeling down, depressed, or hopeless?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ030[Over the last 2 weeks, how often have you been bothered by the following problems:] trouble falling or staying asleep, or sleeping too much?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ040[Over the last 2 weeks, how often have you been bothered by the following problems:] feeling tired or having little energy?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ050[Over the last 2 weeks, how often have you been bothered by the following problems:] poor appetite or overeating?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ060[Over the last 2 weeks, how often have you been bothered by the following problems:] feeling bad about yourself - or that you are a failure or have let yourself or your family down?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ070[Over the last 2 weeks, how often have you been bothered by the following problems:] trouble concentrating on things, such as reading the newspaper or watching TV?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ080[Over the last 2 weeks, how often have you been bothered by the following problems:] moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ090Over the last 2 weeks, how often have you been bothered by the following problems: Thoughts that you would be better off dead or of hurting yourself in some way?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
DPQ100How difficult have these problems made it for you to do your work, take care of things at home, or get along with people?DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
SEQNRespondent sequence number.DPQ_GMental Health - Depression Screener20112012QuestionnaireNone
SEQNRespondent sequence number.SLQ_GSleep Disorders20112012QuestionnaireNone
SLD010HThe next set of questions is about your sleeping habits. How much sleep {do you/does SP} usually get at night on weekdays or workdays?SLQ_GSleep Disorders20112012QuestionnaireNone
SLQ050{Have you/Has SP} ever told a doctor or other health professional that {you have/s/he has} trouble sleeping?SLQ_GSleep Disorders20112012QuestionnaireNone
SLQ060{Have you/Has SP} ever been told by a doctor or other health professional that {you have/s/he has} a sleep disorder?SLQ_GSleep Disorders20112012QuestionnaireNone
ALQ101The next questions are about drinking alcoholic beverages. Included are liquor (such as whiskey or gin), beer, wine, wine coolers, and any other type of alcoholic beverage.In any one year, {have you/has SP} had at least 12 drinks of any type of alcoholic beverage? By a drink, I mean a 12 oz. beer, a 5 oz. glass of wine, or one and half ounces of liquor. ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ110In {your/SP's} entire life, {have you/has he/ has she} had at least 12 drinks of any type of alcoholic beverage?ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ120QIn the past 12 months, how often did {you/SP} drink any type of alcoholic beverage? PROBE: How many days per week, per month, or per year did {you/SP} drink?ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ120UUNIT OF MEASURE.ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ130In the past 12 months, on those days that {you/SP} drank alcoholic beverages, on the average, how many drinks did {you/he/she} have?ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ141QIn the past 12 months, on how many days did {you/SP} have {DISPLAY NUMBER} or more drinks of any alcoholic beverage? PROBE: How many days per week, per month, or per year did {you/SP} have {DISPLAY NUMBER} or more drinks in a single day?ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ141UUNIT OF MEASURE.ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ151Was there ever a time or times in {your/SP's} life when {you/he/she} drank {DISPLAY NUMBER} or more drinks of any kind of alcoholic beverage almost every day?ALQ_GAlcohol Use20112012QuestionnaireNone
ALQ155For about how many years did {you/SP} drink {DISPLAY NUMBER} or more drinks of any kind of alcoholic beverage almost every day?ALQ_GAlcohol Use20112012QuestionnaireNone
SEQNRespondent sequence number.ALQ_GAlcohol Use20112012QuestionnaireNone
ALD020During your life, on how many days have you had at least one drink of alcohol?ALQY_G_RAlcohol Use - Youth20112012QuestionnaireRDC Only
ALD030During the past 30 days, on how many days did you have at least one drink of alcohol?ALQY_G_RAlcohol Use - Youth20112012QuestionnaireRDC Only
ALD040During the past 30 days, on how many days did you have 5 or more drinks of alcohol in a row, that is, within a couple of hours?ALQY_G_RAlcohol Use - Youth20112012QuestionnaireRDC Only
ALQ010English Text: The following questions ask about alcohol use. This includes beer, wine, wine coolers, and liquor such as rum, gin, vodka, or whiskey. This does not include drinking a few sips of wine for religious purposes. How old were you when you had your first drink of alcohol, other than a few sips?ALQY_G_RAlcohol Use - Youth20112012QuestionnaireRDC Only
SEQNRespondent sequence number.ALQY_G_RAlcohol Use - Youth20112012QuestionnaireRDC Only
RHD042What is the reason that {you have/SP has} not had a period in the past 12 months?RHQ_GReproductive Health20112012QuestionnaireNone
RHD143{Are you/Is SP} pregnant now?RHQ_GReproductive Health20112012QuestionnaireNone
RHD152Which month of pregnancy {are you/is she} in?RHQ_GReproductive Health20112012QuestionnaireNone
RHD173How old {were you/was SP} when {you/she} delivered a baby that weighed 9 pounds or more? (Please count stillbirths as well as live births.)RHQ_GReproductive Health20112012QuestionnaireNone
RHD180How old {were you/was SP} at the time of {your/her} first live birth?RHQ_GReproductive Health20112012QuestionnaireNone
RHD190How old {were you/was SP} at the time of {your/her} last live birth?RHQ_GReproductive Health20112012QuestionnaireNone
RHD280{Have you/Has SP} had a hysterectomy, including a partial hysterectomy, that is, surgery to remove {your/her} uterus or womb?RHQ_GReproductive Health20112012QuestionnaireNone
RHD442{Are you/Is SP} taking birth control pills now?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ010The next series of questions are about {your/SP's} reproductive history. I will begin by asking about {your/SP's} periods or menstrual cycles. How old {were you/was SP} when {you/SP} had {your/her} first menstrual period?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ020{Were you/Was SP}...RHQ_GReproductive Health20112012QuestionnaireNone
RHQ031{Have you/Has SP} had at least one menstrual period in the past 12 months? (Please do not include bleedings caused by medical conditions, hormone therapy, or surgeries.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ060About how old {were you/was SP} when {you/SP} had {your/her} last menstrual period?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ070{Were you/Was SP}...RHQ_GReproductive Health20112012QuestionnaireNone
RHQ131The next questions are about {your/SP's} pregnancy history. {Have you/Has SP ever been pregnant? Please include (current pregnancy,) live births, miscarriages, stillbirths, tubal pregnancies and abortions.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ160How many times {have you/has SP} been pregnant? ({Again, be/Be} sure to count all {your/her} pregnancies including (current pregnancy,) live births, miscarriages, stillbirths, tubal pregnancies or abortions.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ162During {any/your/SP's} pregnancy, {were you/was SP} ever told by a doctor or other health professional that {you/she} had diabetes, sugar diabetes or gestational diabetes? Please do not include diabetes that {you/SP} may have known about before the pregnancy.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ163How old {were you/was SP} when {you were/she was} first told {you/she} had diabetes during a pregnancy?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ166How many vaginal deliveries {have you/has SP} had? {Please count stillbirths as well as live births}RHQ_GReproductive Health20112012QuestionnaireNone
RHQ169How many cesarean deliveries {have you/has SP} had? (Cesarean deliveries are also known as C-sections.) (Please count stillbirths as well as live births.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ171How many of {your/her} deliveries resulted {Did {your/her} delivery result} in a live birth?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ172{Did {your/SP's} delivery/Did any of {your/SP's} deliveries} result in a baby that weighed 9 pounds (4082 g) or more at birth? (Please count stillbirths as well as live births.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ197How many months ago did {you/SP} have {your/her} baby?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ200{Are you/Is SP} now breast feeding a child?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ205Did {you/SP} breast feed {{your/her} child/any of {your/her} children} for at least one month?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ291How old {were you/was SP} when {you/she} had {your/her} (hysterectomy/uterus removed/womb removed)?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ305{Have you/Has SP} had both of {your/her} ovaries removed (either when {you/she} had {your/her} uterus removed or at another time)?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ332How old {were you/was SP} when {you/she} had {your/her} ovaries removed or last ovary removed if removed at different times?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ395{Do you/Does SP} experience bulging or something falling out that {you/she} can see or feel in the vaginal area?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ420Now I am going to ask you about {your/SP's} birth control history. {Have you/Has SP} ever taken birth control pills for any reason?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ460QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you taken/did you take/has she taken/did she take} birth control pills?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ460UUNIT OF MEASURE.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ510{Have you/Has SP} ever used Depo-Provera or injectables to prevent pregnancy?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ520{Are you/Is SP} now using Depo-Provera or injectables to prevent pregnancy?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ540{Have you/Has SP} ever used female hormones such as estrogen and progesterone? Please include any forms of female hormones, such as pills, cream, patch, and injectables, but do not include birth control methods or use for infertility.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ541AWhich forms of female hormones {have you/has SP} used.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ541BWhich forms of female hormones {have you/has SP} used.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ541CWhich forms of female hormones {have you/has SP} used.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ554{Have you/Has SP} ever taken female hormone pills containing estrogen only (like Premarin)? (Do not include birth control pills.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ558{Are you/Is SP} taking pills containing estrogen only now?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ560QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you taken/did you take/has she taken/did she take} pills containing estrogen only?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ560UUNIT OF MEASURE.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ562{Have you/Has SP} taken female hormone pills containing progestin only (like Provera)? (Do not include birth control pills.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ566{Are you/Is SP} taking pills containing progestin only now?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ568QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you taken/did you take/has she taken/did she take} pills containing progestin only?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ568UUNIT OF MEASURE.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ570{Have you/Has SP} taken female hormone pills containing both estrogen and progestin (like Prempro, Premphase)? (Do not include birth control pills.)RHQ_GReproductive Health20112012QuestionnaireNone
RHQ574{Are you/Is SP} taking pills containing both estrogen and progestin now?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ576QNot counting any time when {you/SP} stopped taking them, for how long altogether {{have you/has SP} taken/did {you/SP} take} pills containing both estrogen and progestin?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ576UUNIT OF MEASURE.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ580{Have you/Has SP} ever used female hormone patches containing estrogen only?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ584{Are you/Is SP} using patches containing estrogen only now?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ586QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you used/did you use/has she used/did she use} patches containing estrogen only?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ586UUNIT OF MEASURE.RHQ_GReproductive Health20112012QuestionnaireNone
RHQ596{Have you/Has SP} used female hormone patches containing both estrogen and progestin?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ600{Are you/Is SP} using patches containing both estrogen and progestin now?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ602QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you used/did you use/has she used/did she use} patches containing both estrogen and progestin?RHQ_GReproductive Health20112012QuestionnaireNone
RHQ602UUNIT OF MEASURE.RHQ_GReproductive Health20112012QuestionnaireNone
SEQNRespondent sequence number.RHQ_GReproductive Health20112012QuestionnaireNone
RHD042What is the reason that {you have/SP has} not had a period in the past 12 months?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHD143{Are you/Is SP} pregnant now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHD152Which month of pregnancy {are you/is she} in?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHD280{Have you/Has SP} had a hysterectomy that is, surgery to remove {your/her} uterus or womb?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHD442{Are you/Is SP} taking birth control pills now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ010The next series of questions are about {your/SP's} reproductive history. I will begin by asking about {your/SP's} periods or menstrual cycles. How old {were you/was SP} when {you/SP} had {your/her} first menstrual period?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ020{Were you/Was SP}...RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ031{Have you/Has SP} had at least one menstrual period in the past 12 months? (Please do not include bleedings caused by medical conditions, hormone therapy, or surgeries.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ060About how old {were you/was SP} when {you/SP} had {your/her} last menstrual period?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ070{Were you/Was SP}...RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ131The next questions are about {your/SP's} pregnancy history. {Have you/Has SP ever been pregnant? Please include (current pregnancy,) live births, miscarriages, stillbirths, tubal pregnancies and abortions.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ160How many times {have you/has SP} been pregnant? ({Again, be/Be} sure to count all {your/her} pregnancies including (current pregnancy,) live births, miscarriages, stillbirths, tubal pregnancies or abortions.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ162During {any/your/SP's} pregnancy, {were you/was SP} ever told by a doctor or other health professional that {you/she} had diabetes, sugar diabetes or gestational diabetes? Please do not include diabetes that {you/SP} may have known about before the pregnancy.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ163How old {were you/was SP} when {you were/she was} first told {you/she} had diabetes during a pregnancy?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ166How many vaginal deliveries {have you/has SP} had? {Please count stillbirths as well as live births}RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ169How many cesarean deliveries {have you/has SP} had? (Cesarean deliveries are also known as C-sections.) (Please count stillbirths as well as live births.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ171How many of {your/her} deliveries resulted {Did {your/her} delivery result} in a live birth?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ172{Did {your/SP's} delivery/Did any of {your/SP's} deliveries} result in a baby that weighed 9 pounds (4082 g) or more at birth? (Please count stillbirths as well as live births.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ173How old {were you/was SP} when {you/she} delivered a baby that weighed 9 pounds or more? (Please count stillbirths as well as live births.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ180How old {were you/was SP} at the time of {your/her} first live birth?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ190How old {were you/was SP} at the time of {your/her} last live birth?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ197How many months ago did {you/SP} have {your/her} baby?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ200{Are you/Is SP} now breast feeding a child?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ205Did {you/SP} breast feed {{your/her} child/any of {your/her} children} for at least one month?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ291How old {were you/was SP} when {you/she} had {your/her} (hysterectomy/uterus removed/womb removed)?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ305{Have you/Has SP} had both of {your/her} ovaries removed (either when {you/she} had {your/her} uterus removed or at another time)?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ332How old {were you/was SP} when {you/she} had {your/her} ovaries removed or last ovary removed if removed at different times?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ395{Do you/Does SP} experience bulging or something falling out that {you/she} can see or feel in the vaginal area?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ420Now I am going to ask you about {your/SP's} birth control history. {Have you/Has SP} ever taken birth control pills for any reason?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ460QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you taken/did you take/has she taken/did she take} birth control pills?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ460UUNIT OF MEASURE.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ510{Have you/Has SP} ever used Depo-Provera or injectables to prevent pregnancy?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ520{Are you/Is SP} now using Depo-Provera or injectables to prevent pregnancy?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ540{Have you/Has SP} ever used female hormones such as estrogen and progesterone? Please include any forms of female hormones, such as pills, cream, patch, and injectables, but do not include birth control methods or use for infertility.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ541AWhich forms of female hormones {have you/has SP} used.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ541BWhich forms of female hormones {have you/has SP} used.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ541CWhich forms of female hormones {have you/has SP} used.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ554{Have you/Has SP} ever taken female hormone pills containing estrogen only (like Premarin)? (Do not include birth control pills.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ558{Are you/Is SP} taking pills containing estrogen only now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ560QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you taken/did you take/has she taken/did she take} pills containing estrogen only?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ560UUNIT OF MEASURE.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ562{Have you/Has SP} taken female hormone pills containing progestin only (like Provera)? (Do not include birth control pills.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ566{Are you/Is SP} taking pills containing progestin only now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ568QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you taken/did you take/has she taken/did she take} pills containing progestin only?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ568UUNIT OF MEASURE.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ570{Have you/Has SP} taken female hormone pills containing both estrogen and progestin (like Prempro, Premphase)? (Do not include birth control pills.)RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ574{Are you/Is SP} taking pills containing both estrogen and progestin now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ576QNot counting any time when {you/SP} stopped taking them, for how long altogether {{have you/has SP} taken/did {you/SP} take} pills containing both estrogen and progestin?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ576UUNIT OF MEASURE.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ580{Have you/Has SP} ever used female hormone patches containing estrogen only?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ584{Are you/Is SP} using patches containing estrogen only now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ586QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you used/did you use/has she used/did she use} patches containing estrogen only?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ586UUNIT OF MEASURE.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ596{Have you/Has SP} used female hormone patches containing both estrogen and progestin?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ600{Are you/Is SP} using patches containing both estrogen and progestin now?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ602QNot counting any time when {you/SP} stopped taking them, for how long altogether {have you used/did you use/has she used/did she use} patches containing both estrogen and progestin?RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
RHQ602UUNIT OF MEASURE.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
SEQNRespondent sequence number.RHQ_G_RReproductive Health - Pregnant Women20112012QuestionnaireRDC Only
AUD148Which was it?AUQ_GAudiometry20112012QuestionnaireNone
AUQ054These next questions are about {your/SP's} hearing. Which statement best describes {your/SP's} hearing (without a hearing aid or other listening devices)? Would you say {your/his/her} hearing is excellent, good, that {you have/s/he has} a little trouble, moderate trouble, a lot of trouble, or {are you/is s/he} deaf?AUQ_GAudiometry20112012QuestionnaireNone
AUQ060These next questions refer to hearing without the use of a hearing aid or any other listening devices. If {you have/SP has} one ear that is better than the other, please answer the questions for the hearing in {your/SP's} better ear. Can {you/SP} usually hear and understand what a person says without seeing his or her face if that person whispers to {you/him/her} from across a quiet room?AUQ_GAudiometry20112012QuestionnaireNone
AUQ070Can {you/SP} usually hear and understand what a person says without seeing his or her face if that person talks in a normal voice to {you/him/her} from across a quiet room?AUQ_GAudiometry20112012QuestionnaireNone
AUQ080Can {you/SP} usually hear and understand what a person says without seeing his or her face if that person shouts to {you/him/her} from across a quiet room?AUQ_GAudiometry20112012QuestionnaireNone
AUQ090Can {you/SP} usually hear and understand what a person says without seeing his or her face if that person speaks loudly into {your/his/her} better ear?AUQ_GAudiometry20112012QuestionnaireNone
AUQ100How often {do you/does SP} find it difficult to follow a conversation if there is background noise, for example, when other people are talking, TV or radio is on, or children are playing? Would you say...AUQ_GAudiometry20112012QuestionnaireNone
AUQ110How often does {your/SP's} hearing cause {you/him/her}to feel frustrated when talking to members of {your/his/her} family or to friends? Would you say...AUQ_GAudiometry20112012QuestionnaireNone
AUQ136{Have you/Has SP} ever had 3 or more ear infections? Please include ear infections {you/he/she} may have had when {you were/he was/she was} a child.AUQ_GAudiometry20112012QuestionnaireNone
AUQ138{Have you/Has SP} ever had a tube placed in {your/his/her} ear to drain the fluid from {your/his/her} ear?AUQ_GAudiometry20112012QuestionnaireNone
AUQ144A hearing test by a specialist is one that is done in a sound proof booth or room, or with headphones. Hearing specialists include audiologists, ear nose and throat doctors, and trained technicians or occupational nurses. When was the last time {you had/SP had} {your/his/her} hearing tested by a hearing specialist?AUQ_GAudiometry20112012QuestionnaireNone
AUQ146{Have you/Has SP} ever worn a hearing aid or cochlear implant?AUQ_GAudiometry20112012QuestionnaireNone
AUQ152In the past 12 months, how often {have you/has SP} worn a hearing aid?AUQ_GAudiometry20112012QuestionnaireNone
AUQ154{Have you/Has SP} ever used assistive listening devices (ALDs), such as FM systems, closed-captioned television, amplified telephone, relay services, or a sign-language interpreter?AUQ_GAudiometry20112012QuestionnaireNone
AUQ191In the past 12 months, {have you/has SP} been bothered by ringing, roaring, or buzzing in {your/his/her} ears or head that lasts for 5 minutes or more?AUQ_GAudiometry20112012QuestionnaireNone
AUQ250How long {have you/has SP} been bothered by this ringing, roaring, or buzzing in {your/his/her} ears or head?AUQ_GAudiometry20112012QuestionnaireNone
AUQ255In the past 12 months, how often {have you/has SP} had this ringing, roaring, or buzzing in {your/his/her} ears or head? Would you say...AUQ_GAudiometry20112012QuestionnaireNone
AUQ260{Are you/Is SP} bothered by ringing, roaring, or buzzing in {your/his/her} ears or head only after listening to loud sounds or loud music?AUQ_GAudiometry20112012QuestionnaireNone
AUQ270{Are you/Is SP} bothered by ringing, roaring, or buzzing in {your/his/her} ears or head when going to sleep?AUQ_GAudiometry20112012QuestionnaireNone
AUQ280How much of a problem is this ringing, roaring, or buzzing in {your/his/her} ears or head?AUQ_GAudiometry20112012QuestionnaireNone
AUQ300This next question is about {your/SP's} use of firearms that {you/he/she} may have used for target shooting, hunting, for {your/his/her} job or in military service. {Have you/Has SP} ever used firearms for any reason?AUQ_GAudiometry20112012QuestionnaireNone
AUQ310How many total rounds {have you/has SP} ever fired?AUQ_GAudiometry20112012QuestionnaireNone
AUQ320How often {did you/did SP} wear hearing protection devices (ear plugs, ear muffs) when shooting firearms?AUQ_GAudiometry20112012QuestionnaireNone
AUQ330These next questions are about noise exposure {you/SP} may have had at work. {Have you/Has SP} ever had a job, or combination of jobs where {you were/s/he was} exposed to loud sounds or noise for 4 or more hours a day, several days a week? Loud means so loud that {you/s/he} must speak in a raised voice to be heard.AUQ_GAudiometry20112012QuestionnaireNone
AUQ340For how many months or years {have you/has SP} been exposed at work to loud sounds or noise for 4 or more hours a day, several days a week?AUQ_GAudiometry20112012QuestionnaireNone
AUQ350In {your/SP's} work {were you/was he/was she} exposed to very loud noise? Very loud noise is noise that is so loud {you have/he has/she has} to shout in order to be understood by someone standing 3 feet away from {you/him/her}.AUQ_GAudiometry20112012QuestionnaireNone
AUQ360This next question is about {your/SP's} work in jobs where there was very loud noise for 4 or more hours a day, several days a week. Please give me the total number of months or years for all jobs where this has happened.AUQ_GAudiometry20112012QuestionnaireNone
AUQ370Outside of a job, {have you/has SP} ever been exposed to very loud noise or music for 10 or more hours a week? This is noise so loud that {you have/s/he has} to shout to be understood or heard 3 feet away. Examples are noise from power tools, lawn mowers, farm machinery, cars, trucks, motorcycles, motor boats or loud music.AUQ_GAudiometry20112012QuestionnaireNone
AUQ380In the past 12 months, how often {did you/did SP} wear hearing protection devices (ear plugs, ear muffs) when exposed to very loud sounds or noise? Please include both on the job and off the job exposures.AUQ_GAudiometry20112012QuestionnaireNone
SEQNRespondent sequence number.AUQ_GAudiometry20112012QuestionnaireNone
SEQNRespondent sequence number.WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ030MDo you consider yourself now to be . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ500Which of the following are you trying to do about your weight:WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510AWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510BWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510CWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510DWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510EWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510FWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510GWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510HWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510IWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510JWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510KWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510LWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510NWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510PWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ510UWhy are you trying to lose weight?WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ520In the past year, how often have you tried to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ530In the past year, how often have you been on a diet to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ540In the past year, how often have you starved (not eaten) for a day or more to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ550In the past year, how often have you cut back on what you ate to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ560In the past year, how often have you skipped meals to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ570In the past year, how often have you exercised to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
WHQ580In the past year, how often have you eaten less sweets or fatty foods to lose weight? Would you say . . .WHQMEC_GWeight History - Youth20112012QuestionnaireNone
DPQ010Over the last 2 weeks, how often have you been bothered by the following problems: little interest or pleasure in doing things? Would you say...DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ020[Over the last 2 weeks, how often have you been bothered by the following problems:] feeling down, depressed, or hopeless?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ030[Over the last 2 weeks, how often have you been bothered by the following problems:] trouble falling or staying asleep, or sleeping too much?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ040[Over the last 2 weeks, how often have you been bothered by the following problems:] feeling tired or having little energy?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ050[Over the last 2 weeks, how often have you been bothered by the following problems:] poor appetite or overeating?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ060[Over the last 2 weeks, how often have you been bothered by the following problems:] feeling bad about yourself - or that you are a failure or have let yourself or your family down?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ070[Over the last 2 weeks, how often have you been bothered by the following problems:] trouble concentrating on things, such as reading the newspaper or watching TV?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ080[Over the last 2 weeks, how often have you been bothered by the following problems:] moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ090Over the last 2 weeks, how often have you been bothered by the following problems: Thoughts that you would be better off dead or of hurting yourself in some way?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DPQ100How difficult have these problems made it for you to do your work, take care of things at home, or get along with people?DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
SEQNRespondent sequence number.DPQY_G_RMental Health - Depression Screener - Youth20112012QuestionnaireRDC Only
DED031If after several months of not being in the sun, {you/SP} then went out in the sun without sunscreen or protective clothing for a half hour, which one of these would happen to {your/his/her} skin?DEQ_GDermatology20112012QuestionnaireNone
DED120The next questions ask about the time you spent outdoors during the past 30 days. By outdoors, I mean outside and not under any shade. How much time did you usually spend outdoors between 9 in the morning and 5 in the afternoon on the days that you worked or went to school?DEQ_GDermatology20112012QuestionnaireNone
DED125During the past 30 days, how much time did you usually spend outdoors between 9 in the morning and 5 in the afternoon on the days when you were not working or going to school?DEQ_GDermatology20112012QuestionnaireNone
DEQ034AWhen {you go/SP goes} outside on a very sunny day, for more than one hour, how often {do you/does SP} Stay in the shade?DEQ_GDermatology20112012QuestionnaireNone
DEQ034CWear a long sleeved shirt? Would you say . . .DEQ_GDermatology20112012QuestionnaireNone
DEQ034DUse sunscreen? Would you say . . .DEQ_GDermatology20112012QuestionnaireNone
DEQ038GHow many times in the past year {have you/has SP} had a sunburn?DEQ_GDermatology20112012QuestionnaireNone
DEQ038QHow many times in the past year {have you/has SP} had a sunburn?DEQ_GDermatology20112012QuestionnaireNone
SEQNRespondent sequence number.DEQ_GDermatology20112012QuestionnaireNone
ACD011AWhat language(s) {do you/does SP} usually speak at home?ACQ_GAcculturation20112012QuestionnaireNone
ACD011BWhat language(s) {do you/does SP} usually speak at home?ACQ_GAcculturation20112012QuestionnaireNone
ACD011CWhat language(s) {do you/does SP} usually speak at home?ACQ_GAcculturation20112012QuestionnaireNone
ACD040Now I'm going to ask you about language use. What language(s) {do you/does SP} usually speak at home? {Do you/Does he/Does she} speak only Spanish, more Spanish than English, both equally, more English than Spanish, or only English?ACQ_GAcculturation20112012QuestionnaireNone
ACD110{Do you/Does SP} speak only (NON-ENGLISH LANGUAGE), more (NON-ENGLISH LANGUAGE) than English, both equally, more English than (NON-ENGLISH LANGUAGE), or only English?ACQ_GAcculturation20112012QuestionnaireNone
SEQNRespondent sequence number.ACQ_GAcculturation20112012QuestionnaireNone
RXDCOUNTThe number of prescription medicines reportedRXQ_RX_GPrescription Medications20112012QuestionnaireNone
RXDDAYSFor how long have you been using or taking {PRODUCT NAME}?RXQ_RX_GPrescription Medications20112012QuestionnaireNone
RXDDRGIDGeneric drug codeRXQ_RX_GPrescription Medications20112012QuestionnaireNone
RXDDRUGGeneric drug nameRXQ_RX_GPrescription Medications20112012QuestionnaireNone
RXDUSEIn the past 30 days, have you used or taken medication for which a prescription is needed? Do not include prescription vitamins or minerals you may have already told me about.RXQ_RX_GPrescription Medications20112012QuestionnaireNone
RXQSEENWas prescription container seen by interviewer?RXQ_RX_GPrescription Medications20112012QuestionnaireNone
SEQNRespondent sequence number.RXQ_RX_GPrescription Medications20112012QuestionnaireNone
HCASCCT1Reasons the interview was not doneHCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCASCST1Interview Status CodeHCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ020There are many types of hepatitis. Before receiving the letter with (your/SP's) test result, had you heard of hepatitis C?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ030Was the test result in our letter the first time you were told (you had/SP has) hepatitis C?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ040For about how long have you known that (you have/SP has) hepatitis C? Would you say ...HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ060Why were you first tested for hepatitis C? Was it because:HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ070Did (you/SP) see a doctor or other health professional about (your/his/her) hepatitis C test result?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ080(Do you/Does SP) have an appointment to see a doctor or other health care professional about (your/his/her) hepatitis C test result?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ090When (you/SP) saw a doctor or other health professional about (your/his/her) hepatitis C test results, did (you/he/she) have other blood tests to check how (your/his/her) liver is working?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ100Which of the following statements describes most closely what (your/SP's) doctor told you about (your/his/her) hepatitis C test result?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ110Did (you/SP) have a liver biopsy (procedure to get a small piece of (your/his/her) liver through a needle)?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ121Did (your/SP's) doctor or health care professional tell you that there are medicines that can be used to treat hepatitis C.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ124Did (your/SP's) doctor or health care professional tell you that your hepatitis C should be treated with medication such as Interferon and Ribavirin?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ126AWhat reason did your doctor or health care professional give you when he/she told you that you should not be treated? Was it because your liver enzymes were normal?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ126BWhat reason did your doctor or health care professional give you when he/she told you that you should not be treated? Was it because you did not have liver disease?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ126CWhat reason did your doctor or health care professional give you when he/she told you that you should not be treated? Was it because you do not need to do anything for hepatitis C?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ126DWhat reason did your doctor or health care professional give you when he/she told you that you should not be treated? Was it because you can wait to be treated at a later time?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ126EWhat reason did your doctor or health care professional give you when he/she told you that you should not be treated? Was it because ... No reason specified.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ130Did (you/SP) get treated with these medicines?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ140AWhy did (you/SP) not get treated? Was it because the side effects to the treatment are unpleasant?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ140BWhy did (you/SP) not get treated? Was it because the treatment shots must be self injected?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ140CWhy did (you/SP) not get treated? Was it because the treatment is too expensive?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ140DWhy did (you/SP) not get treated? Was it because there is a hope of better treatment in the future?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ140EWhy did (you/SP) not get treated? Was it because there is some other reason?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ150Did (your/SP's) doctor or health professional tell (you/him/her) to avoid or limit alcoholic beverages (in the future) because of (your/his/her) hepatitis C?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ160If someone is infected with hepatitus C virus, they will most likely carry the virus all their lives.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ170Infection with the hepatitis C virus can cause the liver to stop working.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ180Someone with hepatitis C can look and feel fine.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ190You can get hepatitis C by getting a blood transfusion from an infected donor.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ200You can get hepatitis C by shaking hands with someone who has hepatitis C.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ210You can get hepatitis C by kissing someone who has hepatitis C.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ220You can get hepatitis C by having sex with someone who has hepatitis C.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ230You can get hepatitis C by being born to a woman who had hepatitis C when she gave birth.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ240You can get hepatitis C by being stuck with a needle or sharp instrument that has hepatitis C infected blood on it.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ250You can get hepatitis C by working with someone who has hepatitis C.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ260You can get hepatitis C by injecting illegal drugs, even if only a few times.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
HCQ270Who was the main respondent for the questionnaire?HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
SEQNRespondent sequence number.HCQ_GHepatitis C Follow Up20112012QuestionnaireNone
SEQNRespondent sequence number.WHQ_GWeight History20112012QuestionnaireNone
WHD010These next questions ask about {your/SP's} height and weight at different times in {your/his/her} life. How tall {are you/is SP} without shoes?WHQ_GWeight History20112012QuestionnaireNone
WHD020How much {do you/does SP} weigh without clothes or shoes? WHQ_GWeight History20112012QuestionnaireNone
WHD045How much {would you/would SP} like to weigh?WHQ_GWeight History20112012QuestionnaireNone
WHD050How much did {you/SP} weigh a year ago?WHQ_GWeight History20112012QuestionnaireNone
WHD080AHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080BHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080CHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080DHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080EHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080FHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080GHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080HHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080IHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080JHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080KHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080LHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080MHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080NHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080OHow did {you/SP} try to lose weight? WHQ_GWeight History20112012QuestionnaireNone
WHD080PHow did {you/SP} try to lose weight? WHQ_GWeight History20112012QuestionnaireNone
WHD080QHow did {you/SP} try to lose weight? WHQ_GWeight History20112012QuestionnaireNone
WHD080RHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080SHow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD080THow did {you/SP} try to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100AWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100BWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100CWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100DWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100EWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100FWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100GWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100HWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100IWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100JWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100KWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100LWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100MWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100NWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100OWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100PWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100QWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100RWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD100SWhat did {you/SP} do to keep from gaining weight? WHQ_GWeight History20112012QuestionnaireNone
WHD100TWhat did {you/SP} do to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHD110How much did {you/SP} weigh 10 years ago? [If you don't know {your/his/her} exact weight, please make your best guess.]WHQ_GWeight History20112012QuestionnaireNone
WHD120How much did {you/SP} weigh at age 25? [If you don't know {your/his/her} exact weight, please make your best guess.] If ( you were/she was) pregnant, how much did (you/she) weigh before (your/her) pregnancy?WHQ_GWeight History20112012QuestionnaireNone
WHD130How tall {were you/was SP} at age 25? [If you don't know {your/his/her} exact height, please make your best guess.]WHQ_GWeight History20112012QuestionnaireNone
WHD140Up to the present time, what is the most {you have/SP has} ever weighed?WHQ_GWeight History20112012QuestionnaireNone
WHD220Weight loss most successful(pounds)WHQ_GWeight History20112012QuestionnaireNone
WHQ030{Do you/Does SP} consider {your/his/her}self now to be . . . [If {you are/she is} currently pregnant, what did {you/she} consider {your/her}self to be before {you were/she was} pregnant?]WHQ_GWeight History20112012QuestionnaireNone
WHQ040Would {you/SP} like to weigh . . .WHQ_GWeight History20112012QuestionnaireNone
WHQ060Was the change between {your/SP's} current weight and {your/his/her} weight a year ago intentional?WHQ_GWeight History20112012QuestionnaireNone
WHQ070During the past 12 months, {have you/has SP} tried to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHQ090During the past 12 months, {have you/has SP} done anything to keep from gaining weight?WHQ_GWeight History20112012QuestionnaireNone
WHQ150How old {were you/was SP} then? [If you don't know {your/his/her} exact age, please make your best guess.]WHQ_GWeight History20112012QuestionnaireNone
WHQ210Have you/Has SP ever tried to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHQ270In the past 12 months, {did you/did SP} seek help from a personal trainer, dietitian, nutritionist, doctor or other health professional to lose weight?WHQ_GWeight History20112012QuestionnaireNone
WHQ280AWas that a...WHQ_GWeight History20112012QuestionnaireNone
WHQ280BWas that a...WHQ_GWeight History20112012QuestionnaireNone
WHQ280CWas that a...WHQ_GWeight History20112012QuestionnaireNone
WHQ280DWas that a...WHQ_GWeight History20112012QuestionnaireNone
WHQ280EWas that a...WHQ_GWeight History20112012QuestionnaireNone
KID028How many times {have you/has SP} passed a kidney stone?KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ005Many people have leakage of urine. The next few questions ask about urine leakage. How often {do you/does SP} have urinary leakage? Would {you/s/he} say . . .KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ010How much urine {do you/does SP} lose each time? Would {you/s/he} say . . .KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ022{Have you/Has SP} ever been told by a doctor or other health professional that {you/s/he} had weak or failing kidneys? Do not include kidney stones, bladder infections, or incontinence.KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ025In the past 12 months, {have you/has SP} received dialysis (either hemodialysis or peritoneal dialysis)?KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ026{Have you/Has SP} ever had kidney stones?KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ042During the past 12 months, {have you/has SP} leaked or lost control of even a small amount of urine with an activity like coughing, lifting or exercise?KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ044During the past 12 months, {have you/has SP} leaked or lost control of even a small amount of urine with an urge or pressure to urinate and {you/he/she} couldn't get to the toilet fast enough?`KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ046During the past 12 months, {have you/has SP} leaked or lost control of even a small amount of urine without an activity like coughing, lifting, or exercise, or an urge to urinate?KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ050During the past 12 months, how much did {your/her/his} leakage of urine bother {you/her/him}? Please select one of the following choices:KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ052During the past 12 months, how much did {your/her/his} leakage of urine affect {your/her/his} day-to-day activities? Please select one of the following choices:KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ430How frequently does this occur? Would {you/s/he} say this occurs . . .KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ450How frequently does this occur? Would {you/s/he} say this occurs. . .KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ470How frequently does this occur? Would {you/s/he} say this occurs . . .KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
KIQ480During the past 30 days, how many times per night did {you/SP} most typically get up to urinate, from the time {you/s/he} went to bed at night until the time {you/he/she} got up in the morning. Would {you/s/he} sayKIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
SEQNRespondent sequence number.KIQ_U_GKidney Conditions - Urology20112012QuestionnaireNone
CBQ595Next I'm going to ask a few questions about the nutritional guidelines recommended for Americans by the federal government. {Have you/Has SP} heard of My Pyramid?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
CBQ600{Have you/Has SP} heard of the Food Pyramid or the Food Guide Pyramid?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
CBQ605{Have you/Has SP} looked up the My Pyramid plan for a {man/woman/person} {your/his/her} age on the internet?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
CBQ610{Have you/Has SP} tried to follow the {My Pyramid Plan/Pyramid plan} recommended for {you/him/her}?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD030How old was {SP} when {he/she} completely stopped breastfeeding or being fed breastmilk?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD041How old was {SP} when {he/she} was first fed formula?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD050How old was {SP} when {he/she} completely stopped drinking formula?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD055This next question is about the first thing that {SP} was given other than breast milk or formula. Please include juice, cow�s milk, sugar water, baby food, or anything else that {SP} might have been given, even water. How old was {SP} when {he/she} was first fed anything other than breast milk or formula? (Days)DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD061How old was {SP} when {he/she} was first fed milk?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD381During the school year, about how many times a week {do you/does SP} usually get a complete school lunch?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD411During the school year, about how many times a week {do you/does SP} usually get a complete breakfast at school?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD895Next I'm going to ask you about meals. By meal, I mean breakfast, lunch and dinner. During the past 7 days, how many meals {did you/did SP} get that were prepared away from home in places such as restaurants, fast food places, food stands, grocery stores, or from vending machines? {Please do not include meals provided as part of the school lunch or school breakfast./Please do not include meals provided as part of the community programs you reported earlier.}DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD900How many of those meals {did you/did SP} get from a fast-food or pizza place?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD905Some grocery stores sell "ready to eat" foods such as salads, soups, chicken, sandwiches and cooked vegetables in their salad bars and deli counters. During the past 30 days, how often did {you/SP} eat "ready to eat" foods from the grocery store? Please do not include sliced meat or cheese you buy for sandwiches and frozen or canned foods.DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBD910During the past 30 days, how often did you {SP} eat frozen meals or frozen pizzas? Here are some examples of frozen meals and frozen pizzas.DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ010Now I'm going to ask you some general questions about {SP's} eating habits. Was {SP} ever breastfed or fed breastmilk?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ073AWhat type of milk was {SP} first fed? Was it . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ073BWhat type of milk was {SP} first fed? Was it . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ073CWhat type of milk was {SP} first fed? Was it . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ073DWhat type of milk was {SP} first fed? Was it . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ073EWhat type of milk was {SP} first fed? Was it . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ073UWhat type of milk was {SP} first fed? Was it . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ197Now I'm going to ask a few questions about milk products. Do not include their use in cooking. In the past 30 days, how often did {you/SP} have milk to drink or on {your/his/her} cereal? Please include chocolate and other flavored milks as well as hot cocoa made with milk. Do not count small amounts of milk added to coffee or tea. Would you say...DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ223AWhat type of milk was it? Was it usually . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ223BWhat type of milk was it? Was it usually . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ223CWhat type of milk was it? Was it usually . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ223DWhat type of milk was it? Was it usually . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ223EWhat type of milk was it? Was it usually . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ223UWhat type of milk was it? Was it usually . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ229The next question is about regular milk use. A regular milk drinker is someone who uses any type of milk at least 5 times a week. Using this definition, which statement best describes {you/SP}?...DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ235ANow, I'm going to ask you how often {you/SP} drank milk at different times in {your/his/her} life. How often did {you/SP} drink any type of milk, including milk added to cereal when {you were/s/he was} a child between the ages of 5 and 12 years old? Would you say...DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ235BNow, I'm going to ask you how often {you/SP} drank milk at different times in {your/his/her} life. How often did {you/SP} drink any type of milk, including milk added to cereal when {you were/s/he was} a teenager between the ages of 13 and 17 years old? Would you say...DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ235CNow, I'm going to ask you how often {you/SP} drank milk at different times in {your/his/her} life. How often did {you/SP} drink any type of milk, including milk added to cereal when {you were/s/he was} a young adult between the ages of 18 and 35 years old? Would you say...DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ301The next questions are about meals provided by community or government programs. In the past 12 months, did {you/SP} receive any meals delivered to {your/his/her} home from community programs, "Meals on Wheels", or any other programs?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ330In the past 12 months, did {you/SP} go to a community program or senior center to eat prepared meals?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ360During the school year, {do you/does SP} attend a kindergarten, grade school, junior or high school?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ370Does {your/SP's} school serve school lunches? These are complete lunches that cost the same every day.DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ390{Do you/Does SP} get these lunches free, at a reduced price, or {do you/does he/she} pay full price?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ400Does {your/SP's} school serve a complete breakfast that costs the same every day?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ421{Do you/Does SP} get these breakfasts free, at a reduced price, or {do you/does he/she} pay full price?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ424(Do you/Does SP) get a free or reduced price meal at any summer program (he/she) attends?DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
DBQ700Next I have some questions about {your/SP?s} eating habits. In general, how healthy is {your/his/her} overall diet? Would you say . . .DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
SEQNRespondent sequence number.DBQ_GDiet Behavior & Nutrition20112012QuestionnaireNone
IND235Monthly family income (reported as a range value in dollars).INQ_GIncome20112012QuestionnaireNone
IND247Total savings or cash assets at this time for {you/NAMES OF OTHER FAMILY/your family}.INQ_GIncome20112012QuestionnaireNone
INDFMMPCFamily monthly poverty level index categories.INQ_GIncome20112012QuestionnaireNone
INDFMMPIFamily monthly poverty level index, a ratio of monthly family income to the HHS poverty guidelines specific to family size.INQ_GIncome20112012QuestionnaireNone
INQ012Did {you/you or any family members 16 and older} receive income in {LAST CALENDAR YEAR} from self-employment including business and farm income? [Self-employment means you worked for yourself.]INQ_GIncome20112012QuestionnaireNone
INQ020The next questions are about {your/your combined family} income. When answering these questions, please remember that by {"income/combined family income"}, I mean {your income/your income plus the income of {NAMES OF OTHER NHANES FAMILY MEMBERS} for {LAST CALENDAR YEAR}. Did {you/you and OTHER NHANES FAMILY MEMBERS 16+} receive income in {LAST CALENDAR YEAR} from wages and salaries? [Did {you/you or OTHER FAMILY MEMBERS 16+} get paid for work in {LAST CALENDAR YEAR}.]INQ_GIncome20112012QuestionnaireNone
INQ030When answering the next questions about different kinds of income members of your family might have received in {LAST CALENDAR YEAR}, please consider that we also want to know about family members less than 16 years old. Did {you/you or any family members living here, that is: you or NAME(S) OF OTHER NHANES FAMILY MEMBERS} receive income in {LAST CALENDAR YEAR} from Social Security or Railroad Retirement?INQ_GIncome20112012QuestionnaireNone
INQ060Did {you/you or any family members living here} receive any disability pension [other than Social Security or Railroad Retirement] in {LAST CALENDAR YEAR}?INQ_GIncome20112012QuestionnaireNone
INQ080Did {you/you or any family members living here} receive retirement or survivor pension [other than Social Security or Railroad Retirement or disability pension] in {LAST CALENDAR YEAR}?INQ_GIncome20112012QuestionnaireNone
INQ090Did {you/you or any family members living here} receive Supplemental Security Income [SSI] in {LAST CALENDAR YEAR}?INQ_GIncome20112012QuestionnaireNone
INQ132Did {you/you or any family members living here} receive any cash assistance from a state or county welfare program such as welfare, public assistance, AFDC, or some other program in {LAST CALENDAR YEAR}?INQ_GIncome20112012QuestionnaireNone
INQ140Did {you/you or any family members living here} receive interest from savings or other bank accounts or income from dividends received from stocks or mutual funds or net rental income from property, royalties, estates, or trusts in {LAST CALENDAR YEAR}?INQ_GIncome20112012QuestionnaireNone
INQ150Did {you/you or any family members living here} receive income in {LAST CALENDAR YEAR} from child support, alimony, contributions from family or others, VA payments, worker's compensation, or unemployment compensation?INQ_GIncome20112012QuestionnaireNone
INQ244Do {you/NAMES OF OTHER FAMILY/you and NAMES OF FAMILY MEMBERS} have more than $5,000 in savings at this time? Please include money in your checking accounts.INQ_GIncome20112012QuestionnaireNone
SEQNRespondent sequence number.INQ_GIncome20112012QuestionnaireNone
CBD070The next questions are about how much money {your family spends/you spend} on food. First I'll ask you about money spent at supermarkets or grocery stores. Then we will talk about money spent at other types of stores. During the past 30 days, how much money {did your family/did you} spend at supermarkets or grocery stores? Please include purchases made with food stamps.CBQ_GConsumer Behavior20112012QuestionnaireNone
CBD090About how much money was spent on nonfood items?CBQ_GConsumer Behavior20112012QuestionnaireNone
CBD110About how much money {did your family/did you} spend on food at these types of stores? (Please do not include any stores you have already told me about.)CBQ_GConsumer Behavior20112012QuestionnaireNone
CBD120During the past 30 days, how much money {did your family/did you} spend on eating out? Please include money spent in cafeterias at work or at school or on vending machines, for all family members.CBQ_GConsumer Behavior20112012QuestionnaireNone
CBD130During the past 30 days, how much money {did your family/did you} spend on food carried out or delivered? Please do not include money you have already told me about.CBQ_GConsumer Behavior20112012QuestionnaireNone
SEQNRespondent sequence number.CBQ_GConsumer Behavior20112012QuestionnaireNone
FSD032ANow I am going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for {you/your household} in the last 12 months, that is since last {DISPLAY CURRENT MONTH}. The first statement is . . . {I/we} worried whether {my/our} food would run out before {I/we} got money to buy more.FSQ_GFood Security20112012QuestionnaireNone
FSD032B[The next statement is . . .] The food that {I/we} bought just didn't last, and {I/we} didn't have money to get more.FSQ_GFood Security20112012QuestionnaireNone
FSD032C[The next statement is . . .] {I/we} couldn't afford to eat balanced meals.FSQ_GFood Security20112012QuestionnaireNone
FSD032D[The next statement is . . .] (I/we) relied on only a few kinds of low-cost food to feed {CHILD'S NAME / THE CHILDREN} because (I was/we were) running out of money to buy food.FSQ_GFood Security20112012QuestionnaireNone
FSD032E[The next statement is . . .] (I/we) couldn't feed {CHILD'S NAME / THE CHILDREN} a balanced meal, because (I/we) couldn't afford that.FSQ_GFood Security20112012QuestionnaireNone
FSD032F[The next statement is . . .] {CHILD'S NAME WAS /THE CHILDREN WERE} not eating enough because (I/we) just couldn't afford enough food.FSQ_GFood Security20112012QuestionnaireNone
FSD041In the last 12 months, since last {DISPLAY CURRENT MONTH}, did {you/you or other adults in your household} ever cut the size of your meals or skip meals because there wasn't enough money for food?FSQ_GFood Security20112012QuestionnaireNone
FSD052How often did this happen?FSQ_GFood Security20112012QuestionnaireNone
FSD061In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money to buy food?FSQ_GFood Security20112012QuestionnaireNone
FSD071[In the last 12 months], were you ever hungry but didn't eat because you couldn't afford enough food?FSQ_GFood Security20112012QuestionnaireNone
FSD081[In the last 12 months], did you lose weight because you didn't have enough money for food?FSQ_GFood Security20112012QuestionnaireNone
FSD092[In the last 12 months], did {you/you or other adults in your household} ever not eat for a whole day because there wasn't enough money for food?FSQ_GFood Security20112012QuestionnaireNone
FSD102How often did this happen? Would you say . . .FSQ_GFood Security20112012QuestionnaireNone
FSD111In the last 12 months, since {DISPLAY CURRENT MONTH} of last year, did you ever cut the size of {CHILD'S NAME's/any of the children's} meals because there wasn't enough money for food?FSQ_GFood Security20112012QuestionnaireNone
FSD122[In the last 12 months], did {CHILD'S NAME/any of the children} ever skip meals because there wasn't enough money for food?FSQ_GFood Security20112012QuestionnaireNone
FSD132How often did this happen?FSQ_GFood Security20112012QuestionnaireNone
FSD141In the last 12 months, {was CHILD'S NAME/were the children} ever hungry but you just couldn't afford more food?FSQ_GFood Security20112012QuestionnaireNone
FSD146[In the last 12 months], did {CHILD'S NAME/any of the children} ever not eat for a whole day because there wasn't enough money for food?FSQ_GFood Security20112012QuestionnaireNone
FSD151In the last 12 months, did {you/you or any member of your household} ever get emergency food from a church, a food pantry, or a food bank, or eat in a soup kitchen?FSQ_GFood Security20112012QuestionnaireNone
FSD225Number of days between the time the household last received Food Stamp benefit and the date of interview.FSQ_GFood Security20112012QuestionnaireNone
FSD230{Do you/Does any member of your household} currently receive SNAP or Food Stamp benefits?FSQ_GFood Security20112012QuestionnaireNone
FSD650ZCDid {SP} receive benefits from WIC, that is, the Women, Infants, and Children program, in the past 12 months?FSQ_GFood Security20112012QuestionnaireNone
FSD650ZWThese next questions are about participation in programs for women with young children. Did {you/SP} personally receive benefits from WIC, that is, the Women, Infants, and Children Program, in the past 12 months?FSQ_GFood Security20112012QuestionnaireNone
FSD660ZCIs {SP} now receiving benefits from the WIC program?FSQ_GFood Security20112012QuestionnaireNone
FSD660ZW{Are you/Is SP} now receiving benefits from the WIC Program?FSQ_GFood Security20112012QuestionnaireNone
FSD670ZCHow long {did SP receive/has SP been receiving} benefits from the WIC program?FSQ_GFood Security20112012QuestionnaireNone
FSD670ZWThinking about {your/SP's} {pregnancy/recent pregnancy/most recent pregnancy/most recent pregnancies}, how long {did you receive/have you been receiving/did she receive/has she been receiving} benefits from the WIC Program?FSQ_GFood Security20112012QuestionnaireNone
FSD675{Next are a few questions about the WIC program, that is, the Women, Infants, and Children program} Did {SP} receive benefits from WIC when {he/she} was less than one year old?FSQ_GFood Security20112012QuestionnaireNone
FSD680Did {SP} receive benefits from WIC when {he/she} {was/is} between the ages of 1 to {SP AGE} years old?FSQ_GFood Security20112012QuestionnaireNone
FSDADAdult food security category for last 12 monthsFSQ_GFood Security20112012QuestionnaireNone
FSDCHChild food security category for last 12 monthsFSQ_GFood Security20112012QuestionnaireNone
FSDHHHousehold food security category for last 12 monthsFSQ_GFood Security20112012QuestionnaireNone
FSQ162In the last 12 months, did {you/you or any member of your household} receive benefits from the WIC program, that is, the Women, Infants and Children program?FSQ_GFood Security20112012QuestionnaireNone
FSQ165The next questions are about the Food Stamp Program. Food stamps are usually provided on an electronic debit card {or EBT card} {called the {{STATE NAME FOR EBT CARD}} card in {{STATE}}}. Have {you/you or anyone in your household} ever received Food Stamp benefits?FSQ_GFood Security20112012QuestionnaireNone
FSQ171In the last 12 months, did {you/you or any member of your household} receive Food Stamp benefits?FSQ_GFood Security20112012QuestionnaireNone
FSQ235How much did {you/your household} receive in food stamp benefits the last time you got them? ENTER DOLLAR AMOUNT.FSQ_GFood Security20112012QuestionnaireNone
FSQ690Did {SP's} mother receive benefits from WIC, while she was pregnant with {SP}?FSQ_GFood Security20112012QuestionnaireNone
FSQ695What month of the pregnancy did {SP's} mother begin to receive WIC benefits?FSQ_GFood Security20112012QuestionnaireNone
SEQNRespondent sequence number.FSQ_GFood Security20112012QuestionnaireNone
FSD032ANow I am going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for {you/your household} in the last 12 months, that is since last {DISPLAY CURRENT MONTH}. The first statement is . . . {I/we} worried whether {my/our} food would run out before {I/we} got money to buy more.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD032B[The next statement is . . .] The food that {I/we} bought just didn't last, and {I/we} didn't have money to get more.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD032C[The next statement is . . .] {I/we} couldn't afford to eat balanced meals.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD032D[The next statement is . . .] (I/we) relied on only a few kinds of low-cost food to feed {CHILD'S NAME / THE CHILDREN} because (I was/we were) running out of money to buy food.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD032E[The next statement is . . .] (I/we) couldn't feed {CHILD'S NAME / THE CHILDREN} a balanced meal, because (I/we) couldn't afford that.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD032F[The next statement is . . .] {CHILD'S NAME WAS /THE CHILDREN WERE} not eating enough because (I/we) just couldn't afford enough food.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD041In the last 12 months, since last {DISPLAY CURRENT MONTH}, did {you/you or other adults in your household} ever cut the size of your meals or skip meals because there wasn't enough money for food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD052How often did this happen?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD061In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money to buy food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD071[In the last 12 months], were you ever hungry but didn't eat because you couldn't afford enough food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD081[In the last 12 months], did you lose weight because you didn't have enough money for food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD092[In the last 12 months], did {you/you or other adults in your household} ever not eat for a whole day because there wasn't enough money for food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD102How often did this happen? Would you say . . .FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD111In the last 12 months, since {DISPLAY CURRENT MONTH} of last year, did you ever cut the size of {CHILD'S NAME's/any of the children's} meals because there wasn't enough money for food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD122[In the last 12 months], did {CHILD'S NAME/any of the children} ever skip meals because there wasn't enough money for food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD132How often did this happen?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD141In the last 12 months, {was CHILD'S NAME/were the children} ever hungry but you just couldn't afford more food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD146[In the last 12 months], did {CHILD'S NAME/any of the children} ever not eat for a whole day because there wasn't enough money for food?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD151In the last 12 months, did {you/you or any member of your household} ever get emergency food from a church, a food pantry, or a food bank, or eat in a soup kitchen?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD225Number of days between the time the household last received Food Stamp benefit and the date of interview.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD230{Do you/Does any member of your household} currently receive SNAP or Food Stamp benefits?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD650ZCDid {SP} receive benefits from WIC, that is, the Women, Infants, and Children program, in the past 12 months?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD650ZWThese next questions are about participation in programs for women with young children. Did {you/SP} personally receive benefits from WIC, that is, the Women, Infants, and Children Program, in the past 12 months?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD660ZCIs {SP} now receiving benefits from the WIC program?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD660ZW{Are you/Is SP} now receiving benefits from the WIC Program?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD670ZCHow long {did SP receive/has SP been receiving} benefits from the WIC program?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD670ZWThinking about {your/SP's} {pregnancy/recent pregnancy/most recent pregnancy/most recent pregnancies}, how long {did you receive/have you been receiving/did she receive/has she been receiving} benefits from the WIC Program?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD675{Next are a few questions about the WIC program, that is, the Women, Infants, and Children program} Did {SP} receive benefits from WIC when {he/she} was less than one year old?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSD680Did {SP} receive benefits from WIC when {he/she} {was/is} between the ages of 1 to {SP AGE} years old?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSDADAdult food security category for last 12 monthsFSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSDCHChild food security category for last 12 monthsFSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSDHHHousehold food security category for last 12 monthsFSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSQ162In the last 12 months, did {you/you or any member of your household} receive benefits from the WIC program, that is, the Women, Infants and Children program?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSQ165The next questions are about the Food Stamp Program. Food stamps are usually provided on an electronic debit card {or EBT card} {called the {{STATE NAME FOR EBT CARD}} card in {{STATE}}}. Have {you/you or anyone in your household} ever received Food Stamp benefits?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSQ171In the last 12 months, did {you/you or any member of your household} receive Food Stamp benefits?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSQ235How much did {you/your household} receive in food stamp benefits the last time you got them? ENTER DOLLAR AMOUNT.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSQ690Did {SP's} mother receive benefits from WIC, while she was pregnant with {SP}?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
FSQ695What month of the pregnancy did {SP's} mother begin to receive WIC benefits?FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
SEQNRespondent sequence number.FSQ_G_RFood Security - Pregnant Women20112012QuestionnaireRDC Only
CFALANGLanguage - Cognitive FunctioningCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFASTATCognitive functioning statusCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDAPPAnimal Fluency: Sample Practice PretestCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDARNCAnimal Fluency: Reason Not DoneCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDASTAnimal Fluency: Score TotalCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCCSCERAD: Number of recalls completedCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCIRCERAD: Intrusion word count RecallCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCIT1CERAD: Intrusion word count Trial 1 CFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCIT2CERAD: Intrusion word count Trial 2CFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCIT3CERAD: Intrusion word count Trial 3 CFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCRNCCERAD: Reason Not CompleteCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCSRCERAD: Score Delayed RecallCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCST1CERAD: Score Trial 1 RecallCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCST2CERAD: Score Trial 2 RecallCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDCST3CERAD: Score Trial 3 RecallCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDDPPDigit Symbol Coding: Sample Practice PretestCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDDRNCDigit Symbol Coding: Reason Not DoneCFQ_GCognitive Functioning 20112012QuestionnaireNone
CFDDSDigit Symbol Coding: ScoreCFQ_GCognitive Functioning 20112012QuestionnaireNone
SEQNRespondent sequence numberCFQ_GCognitive Functioning 20112012QuestionnaireNone
SEQNRespondent sequence number.VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ200A{Do you/Does she/Does he} store paints or fuels inside {your/her/his} home? Include {your/her/his} basement {and attached garage}.VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ210First, I would like to ask you a few questions about {your/SP's} home. Does {your/her/his} home have an attached garage?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ220Is the source of water for {your/her/his} home from a private well?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ230A{Do you/Does she/Does he} use toilet bowl deodorizers inside {your/her/his} home?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ230B{Do you/Does she/Does he} use moth balls or crystals inside {your/her/his} home?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ240ANow I am going to ask you a few questions about {your/SP's} activities over the last three days. This means today, yesterday, or the day before yesterday. In the last three days, did {you/she/he} pump gas into a car or other motor vehicle {yourself/herself/himself}?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ240BHow long ago, in hours, did {you/she/he} pump gas into a car?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ250AIn the last three days, did {you/she/he} spend any time at a swimming pool, in a hot tub, or in a steam room?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ250BHow long ago, in hours, has it been since {you/she/he} spent time at a swimming pool, in a hot tub, or in a steam room?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ260AIn the last three days, did {you/she/he} visit a dry cleaning shop or wear clothes that had been dry-cleaned within the last week?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ260BIn the last three days, did {you/she/he} spend 10 or more minutes near a person who was smoking a cigarette, cigar, or pipe?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ270AIn the last three days, did {you/she/he} take a hot shower or bath for five minutes or longer?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ270BHow long ago, in hours, has it been since {your/SP's} last shower or hot bath?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280AIn the last three days, did {you/she/he} breathe fumes from any of the following: Paints?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280B[In the last three days, did {you/she/he} breathe fumes from any of the following:] Degreasing cleaners?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280C[In the last three days, did {you/she/he} breathe fumes from any of the following:] Diesel fuel or kerosene?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280D[In the last three days, did {you/she/he} breathe fumes from any of the following:] Paint thinner, brush cleaner, or furniture stripper?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280E[In the last three days, did {you/she/he} breathe fumes from any of the following:] Dry-cleaning fluid or spot remover?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280F[In the last three days, did {you/she/he} breathe fumes from any of the following:] Fingernail polish or fingernail polish remover?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
VTQ280G[In the last three days, did {you/she/he} breathe fumes from any of the following:] Glues or adhesives used for hobbies or crafts?VTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
WTSVOC2YVOC Subsample WeightVTQ_GVolatile Toxicant (Subsample)20112012QuestionnaireNone
OCD231RWhat kind of business or industry is this? (For example: TV and radio management, retail shoe store, state labor department, farm.)OCQ_G_ROccupation - Industry & Occupation Codes20112012QuestionnaireRDC Only
OCD241RWhat kind of work {were you/was SP} doing? (For example: farming, mail clerk, computer specialist.)OCQ_G_ROccupation - Industry & Occupation Codes20112012QuestionnaireRDC Only
OCD391RWhat kind of business or industry is this? (For example: TV and radio management, retail shoe store, state labor department, farm.)OCQ_G_ROccupation - Industry & Occupation Codes20112012QuestionnaireRDC Only
OCD392RThinking of all the paid jobs or businesses {you/SP} ever had, what kind of work {were you/was s/he} doing the longest? (For example, electrical engineer, stock clerk, typist, farmer.)OCQ_G_ROccupation - Industry & Occupation Codes20112012QuestionnaireRDC Only
SEQNRespondent sequence number.OCQ_G_ROccupation - Industry & Occupation Codes20112012QuestionnaireRDC Only
Content source: CDC/National Center for Health Statistics