Q14-1-A | Section: Section 14: Health |
Now I would like to ask you some questions about your general state of health.
Q14A-0 | Section: Section 14: Health |
[flag indicating R reported having asthma at the date of last interview]==1
If Answer = 1 Then Go To Q14A-4
Q14A-1 | Section: Section 14: Health |
[Since date of last interview, has a doctor, nurse or other health professional/Has a doctor, nurse or other health professional ever] told you that you have asthma?
Q14A-2 | Section: Section 14: Health |
How old were you when you were [first/most recently] told (by a doctor, nurse, or other health professional) that you had asthma?
(INTERVIEWER: ENTER AGE IN YEARS. IF LESS THEN ONE YEAR, ENTER ZERO.)
Q14A-2A | Section: Section 14: Health |
[flag indicating R has been asked asthma questions in previous rounds] ==1
COMMENT: Machine Check: Was R ever asked Asthma Questions in a Previous Survey?
If Answer = 1 Then Go To Q14A-4
Q14A-3 | Section: Section 14: Health |
Has your biological father ever been told that he has asthma?
Q14A-4 | Section: Section 14: Health |
Has anyone smoked cigarettes or other tobacco products in your home in the past two weeks?
Q14A-5 | Section: Section 14: Health |
Have you routinely spent time in a place where you smelled cigarette smoke in the past two weeks?
Q14A-5A | Section: Section 14: Health |
[flag indicating R reported having asthma at the date of last interview]==1
COMMENT: Machine Check: Did R report ever having asthma at date of last interview?
If Answer = 1 Then Go To Q14A-6
Q14A-5B | Section: Section 14: Health |
[flag indicating whether R reported asthma for first time in current survey]==1
COMMENT: MACHINE CHECK: HAS R EVER HAD ASTHMA?
If Answer = 1 Then Go To Q14A-6
Q14A-6 | Section: Section 14: Health |
Do you still have asthma?
| 1 YES |
| 0 NO ...(Go To Q14A-7) |
| 2 NEVER HAD ASTHMA |
If Answer = -2 Then Go To Q14A-7
Q14A-7 | Section: Section 14: Health |
How old were you when you last had any symptoms of asthma?
(INTERVIEWER: ENTER AGE IN YEARS. IF LESS THEN ONE YEAR, ENTER ZERO.)
Q14A-16A | Section: Section 14: Health |
[age of R as of December 31, 2018]==12 || [age of R as of December 31, 2018]==13
COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2018?
If Answer = 1 Then Go To Q14-10G
Q14-COVID-1 | Section: Section 14: Health |
Has a doctor or another healthcare professional told you that you had the coronavirus or COVID-19?
Q14-COVID-2 | Section: Section 14: Health |
Do you suspect that you have ever had the Coronavirus or Covid-19?
Q14-COVID-3 | Section: Section 14: Health |
Were you delayed in getting or unable to get any of the following types of care because of the Coronavirus outbreak?
| - Urgent Care for an Accident or Illness |
| - A Surgical Procedure |
| - Diagnostic or Medical Screening Test |
| - Treatment for Ongoing Condition |
| - A Regular Check-up |
| - Dental Care |
| - Vision Care |
| - Access to Prescription Drugs |
| 1 DELAYED IN GETTING |
| 2 UNABLE TO GET |
| 0 NO |
Q14-COVID-4 | Section: Section 14: Health |
Has [anyone/anyone else] in your household been told that they had the coronavirus or COVID-19?
Q14-COVID-4A | Section: Section 14: Health |
Which household member was this?
(INTERVIEWER: PROBE IF THERE IS MORE THAN ONE HOUSEHOLD MEMBER: "Is there anyone else?")
(INTERVIEWER: IF RESPONDENT SAYS SOMEONE WHO IS NOT ON THE HOUSEHOLD ROSTER, PLEASE ENTER APPROPRIATE INFORMATION IN A COMMENT.)
| 1 HOUSEHOLD MEMBER 1 |
| 2 HOUSEHOLD MEMBER 2 |
| 3 HOUSEHOLD MEMBER 3 |
| 4 HOUSEHOLD MEMBER 4 |
| 5 HOUSEHOLD MEMBER 5 |
| 6 HOUSEHOLD MEMBER 6 |
| 7 HOUSEHOLD MEMBER 7 |
| 8 HOUSEHOLD MEMBER 8 |
| 9 HOUSEHOLD MEMBER 9 |
| 10 HOUSEHOLD MEMBER 10 |
| 11 HOUSEHOLD MEMBER 11 |
| 12 HOUSEHOLD MEMBER 12 |
Q14-COVID-4B | Section: Section 14: Health |
Has any other family member or close friend been told that they had the coronavirus or COVID-19?
Q14-COVID-5 | Section: Section 14: Health |
Has a family member or close friend died from the coronavirus or COVID-19?
Q14-1AA | Section: Section 14: Health |
[number of previously reported limiting health conditions]>=1
COMMENT: Machine check: Is R on active duty or reported at least one employer in Section 7?
If Answer = 1 Then Go To Q14-1AE
Q14-1AE | Section: Section 14: Health |
When we last spoke with you, you indicated you had the following health [condition/conditions]:
[list of previous limiting conditions reported by R]
Do you still have [this condition/these conditions] [condition/conditions]?
| 1 YES ...(Go To Q14-1AF) |
| 2 YES, SOME OF THEM ...(Go To Q14-8A) |
| 0 NO |
Q14-1AF | Section: Section 14: Health |
Besides [list of previous limiting conditions reported by R], do you currently have any other physical, emotional, or mental condition that limits your ability to work or attend school, or requires frequent medical attention, regular use of medication, or the use of special equipment such as a brace, wheelchair, air filter, catheter, and so on?
Q14-1AH | Section: Section 14: Health |
(Besides [list of previous limiting conditions reported by R],) What is/are your additional health condition(s) or limitation(s)?
(PROBE IF NECESSARY:) What is it called?
(INTERVIEWER: CONDITIONS ARE LISTED IN ALPHABETICAL ORDER. CHOICE NUMBER 34 IS 'OTHER (SPECIFY)'- MAKE SURE TO USE THIS CHOICE IF R'S APPROPRIATE CONDITION IS NOT ON LIST.)
(CODE ALL THAT APPLY WITHOUT READING CATEGORIES.)
| 35 ADD OR ADHD |
| 1 ALLERGIC CONDITION(S) NOT INCLUDING ASTHMA |
| 36 ANXIETY |
| 2 ASTHMA |
| 37 AUTOIMMUNE PROBLEM/DISORDER |
| 38 BIPOLAR DISORDER |
| 6 BRONCHITIS OR OTHER RESPIRATORY DISORDER |
| 8 CANCER, TUMOR |
| 39 DEPRESSION |
| 10 DIABETES |
| 12 EPILEPSY/SEIZURES |
| 15 HEARING DIFFICULTY OR DEAFNESS |
| 16 HEART TROUBLE |
| 22 LEARNING DISABILITY (I.E. DYSLEXIA) |
| 23 MENTAL RETARDATION |
| 24 MIGRAINE |
| 25 MINIMAL BRAIN DYSFUNCTION, MINIMAL CEREBRAL DYSFUNCTION |
| 31 SPEECH IMPAIRMENT |
| 9 ORTHOPEDIC PROBLEMS OR HANDICAP |
| 34 OTHER (SPECIFY) |
Q14-1AI | Section: Section 14: Health |
Which ONE of your health conditions would you say is the main cause of your limitation?
Q14-2AA | Section: Section 14: Health |
Do you have any physical, emotional, or mental conditions that limit your ability to work or attend school?
Q14-5A | Section: Section 14: Health |
Do you have any physical, emotional, or mental conditions that require frequent medical attention, regular use of medication, or the use of special equipment such as a brace, wheelchair, air filter, catheter and so on?
Q14-6B | Section: Section 14: Health |
[Gender of Respondent]==1
COMMENT: MACHINE CHECK: IF R IS MALE, SKIP PREGNANCY CHECK
If Answer = 1 Then Go To Q14-8A
Q14-6C | Section: Section 14: Health |
[flag indicating if R is pregnant]==1
COMMENT: check if YA is preg from sect 12
If Answer = 1 Then Go To Q14-7
Q14-7 | Section: Section 14: Health |
Is your limitation entirely due to your current pregnancy?
Q14-8A | Section: Section 14: Health |
What is/are your health condition(s) or limitation(s)?
(PROBE IF NECESSARY:) What is it called?
(INTERVIEWER: CONDITIONS ARE LISTED IN ALPHABETICAL ORDER. CHOICE NUMBER 34 IS 'OTHER (SPECIFY)'- MAKE SURE TO USE THIS CHOICE IF R'S APPROPRIATE CONDITION IS NOT ON LIST.)
(CODE ALL THAT APPLY WITHOUT READING CATEGORIES.)
| 35 ADD OR ADHD |
| 1 ALLERGIC CONDITION(S) NOT INCLUDING ASTHMA |
| 36 ANXIETY |
| 2 ASTHMA |
| 37 AUTOIMMUNE PROBLEM/DISORDER |
| 38 BIPOLAR DISORDER |
| 6 BRONCHITIS OR OTHER RESPIRATORY DISORDER |
| 8 CANCER, TUMOR |
| 39 DEPRESSION |
| 10 DIABETES |
| 12 EPILEPSY/SEIZURES |
| 15 HEARING DIFFICULTY OR DEAFNESS |
| 16 HEART TROUBLE |
| 22 LEARNING DISABILITY (I.E. DYSLEXIA) |
| 23 MENTAL RETARDATION |
| 24 MIGRAINE |
| 25 MINIMAL BRAIN DYSFUNCTION, MINIMAL CEREBRAL DYSFUNCTION |
| 31 SPEECH IMPAIRMENT |
| 9 ORTHOPEDIC PROBLEMS OR HANDICAP |
| 34 OTHER (SPECIFY) |
Q14-8AA | Section: Section 14: Health |
INSELECTION([Q14-8A],-1)
If Answer = 1 Then Go To Q14-10FD
Q14-8AB | Section: Section 14: Health |
INSELECTION([Q14-8A],-2)
If Answer = 1 Then Go To Q14-10EA
Q14-10AC | Section: Section 14: Health |
([number of health limitations]==1)
COMMENT: Did R indicate only one health limitation?
If Answer = 1 Then Go To Q14-10EA
Q14-10B | Section: Section 14: Health |
Which ONE of these health conditions would you say is the main cause of your limitation?
INTERVIEWER: PROBE IF NECESSARY. CODE DON'T KNOW ONLY IF PROBING IS UNSUCCESSFUL.
If Answer = -2 Then Go To Q14-10EA
If Answer = -1 Then Go To Q14-10FD
Q14-10EA | Section: Section 14: Health |
How long have you had this limitation, [name of illness]?
INTERVIEWER, PLEASE CHECK TIME FRAME ON THIS PAGE, PRESS "NEXT", AND ENTER NUMERIC ANSWER ON THE NEXT PAGE.
| 1 SELECT TO ENTER MONTHS ...(Go To Q14-10FA) |
| 2 SELECT TO ENTER YEARS ...(Go To Q14-10FB) |
| 0 IF VOLUNTEERED: "ALL MY LIFE" |
Q14-10FA | Section: Section 14: Health |
(How long have you had this limitation ([name of illness]) (other than pregnancy)?)
Q14-10FB | Section: Section 14: Health |
(How long have you had this limitation ([name of illness]) (other than pregnancy)?)
Q14-10FD | Section: Section 14: Health |
[number of people in R's household]==0
If Answer = 1 Then Go To Q14-CARE-4
Q14-CARE-1 | Section: Section 14: Health |
Is anyone in your household [besides you/blank] disabled or chronically ill?
Q14-CARE-2 | Section: Section 14: Health |
Which household member is this?
(INTERVIEWER: PROBE IF THERE IS MORE THAN ONE HOUSEHOLD MEMBER: "Is there anyone else?")
(INTERVIEWER: IF RESPONDENT SAYS SOMEONE WHO IS NOT ON THE HOUSEHOLD ROSTER, PLEASE ENTER APPROPRIATE INFORMATION IN A COMMENT.)
| 1 HOUSEHOLD MEMBER 1 |
| 2 HOUSEHOLD MEMBER 2 |
| 3 HOUSEHOLD MEMBER 3 |
| 4 HOUSEHOLD MEMBER 4 |
| 5 HOUSEHOLD MEMBER 5 |
| 6 HOUSEHOLD MEMBER 6 |
| 7 HOUSEHOLD MEMBER 7 |
| 8 HOUSEHOLD MEMBER 8 |
| 9 HOUSEHOLD MEMBER 9 |
| 10 HOUSEHOLD MEMBER 10 |
| 11 HOUSEHOLD MEMBER 11 |
| 12 HOUSEHOLD MEMBER 12 |
Q14-CARE-3 | Section: Section 14: Health |
Do you regularly spend time helping or taking care of [this person/these people]?
Q14-CARE-3B | Section: Section 14: Health |
About how many hours per week do you spend doing this?
Q14-CARE-4 | Section: Section 14: Health |
Do you regularly spend time helping or taking care of a disabled or chronically ill relative or friend who does not live in your household?
Q14-CARE-4B | Section: Section 14: Health |
About how many hours per week do you spend doing this?
Q14-10G | Section: Section 14: Health |
How would you describe your present health? Is it...
| 1 Poor |
| 2 Fair |
| 3 Good |
| 4 Very Good |
| 5 Excellent |
Q14-10GA | Section: Section 14: Health |
Which of the following are you trying to do now about your weight?
| 1 Lose weight |
| 2 Gain weight |
| 3 Stay the same weight |
| 4 Not trying to do anything about weight |
Q14-10HAA | Section: Section 14: Health |
In a typical week, how many times do you the following - 1 to 3 times per week, 4 to 6 times per week, 1 time per day, 2 times per day, 3 times per day, 4 or more times per day, less frequently, or not at all?
(INTERVIEWER: REPEAT ANSWER CATEGORIES ONLY IF NECESSARY)
| - ...eat fruit? Do not count fruit juice. |
| - ...eat vegetables other than french fries or potato chips? |
| - ...eat food from a fast food restaurant such as McDonalds, Kentucky Fried Chicken, Pizza Hut, or Taco Bell? |
| - ...eat food from a sit-down restaurant such as Applebee's, Olive Garden, Bob Evans, or Red Lobster? |
| - ...have a soft drink or soda that contains sugar? Do not include diet soft drinks or sodas, or carbonated water. |
| - ...have a soft drink or soda that contain artificial sweeteners, such as Diet Coke, Diet Pepsi, Sprite Zero, or Diet Seven-Up? |
| 0 NOT AT ALL |
| 1 LESS FREQUENTLY |
| 2 1 to 3 TIMES PER WEEK |
| 3 4 to 6 TIMES PER WEEK |
| 4 1 TIME PER DAY |
| 5 2 TIMES PER DAY |
| 6 3 TIMES PER DAY |
| 7 4 OR MORE TIMES PER DAY |
Q14-10JAA | Section: Section 14: Health |
During a typical week (7 days), how many times on average do you do the following kinds of activities for 30 minutes or more during your free time?
(INTERVIEWER: READ ANSWER CATEGORIES ONLY IF NECESSARY)
| - Strenuous exercise where your heart beats rapidly such as running or basketball |
| - Moderate exercise such as fast walking or easy bicycling |
| - Mild exercise such as easy walking |
| - Muscle-strengthening activities such as lifting weights |
| 1 0 TIMES PER WEEK |
| 2 1 TIME PER WEEK |
| 3 2 or 3 TIMES PER WEEK |
| 4 4 or 5 TIMES PER WEEK |
| 5 6 or MORE TIMES PER WEEK |
Q14-10L | Section: Section 14: Health |
On a typical weeknight, how many hours of sleep do you usually get?
Q14-10LA | Section: Section 14: Health |
[age of R as of December 31, 2018]==12 || [age of R as of December 31, 2018]==13
COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2018?
If Answer = 1 Then Go To Q14-20
Q14-13 | Section: Section 14: Health |
[Gender of Respondent]==1
COMMENT: Check to see if R is male; if so branch over menses
If Answer = 1 Then Go To Q14-14D
Q14-13A | Section: Section 14: Health |
VAREXIST ([flag indicating whether R has previously reported onset of menses])
COMMENT: set symbol for next question
If Answer = 1 Then Go To Q14-13B
Q14-13B | Section: Section 14: Health |
[flag indicating whether R has previously reported onset of menses]==1
COMMENT: Check to see if menses information has already been collected.
If Answer = 1 Then Go To Q14-PM-AGECHECK1
Q14-14A | Section: Section 14: Health |
Have you ever had a menstrual period?
If Answer = -1 Then Go To Q14-14D
Q14-14B | Section: Section 14: Health |
How old were you when you had your first menstrual period?
(ENTER AGE:)
If Answer = -1 Then Go To Q14-PM-AGECHECK1
Q14-14C | Section: Section 14: Health |
In what month and year did you have your first period?
(ENTER MONTH AND YEAR:)
Q14-PM-AGECHECK1 | Section: Section 14: Health |
[age of R as of December 31, 2018]>30
If Answer = 1 Then Go To Q14-PM1
Q14-PM1 | Section: Section 14: Health |
Have you had a menstrual period in the past 12 months?
If Answer = -2 Then Go To Q14-PM3
If Answer = -1 Then Go To Q14-14D
Q14-PM2 | Section: Section 14: Health |
What is the reason that your period stopped at that age?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)
| 1 MENOPAUSE |
| 2 HYSTERECTOMY (THAT IS, SURGERY TO REMOVE YOUR UTERUS AND/OR OVARIES) |
| 3 MEDICAL CONDITIONS OR TREATMENTS SUCH AS ESTROGEN BLOCKERS OR CHEMOTHERAPY |
| 4 PREGNANCY/BREASTFEEDING ...(Go To Q14-14D) |
| 5 OTHER (SPECIFY) |
Q14-PM3 | Section: Section 14: Health |
How old were you when you had your [last/most recent] period?
Q14-PM4 | Section: Section 14: Health |
Have there been any changes in your menstrual pattern?
Q14-PM5 | Section: Section 14: Health |
What changes have you noticed?
(INTERVIEWER: PLEASE SELECT ALL THAT APPLY.)
| 1 Heavier bleeding |
| 2 Lighter bleeding |
| 3 Shorter interval |
| 4 Longer interval |
| 5 OTHER (SPECIFY) |
Q14-PM-AGECHECK2 | Section: Section 14: Health |
[age of R as of December 31, 2018]>40
If Answer = 1 Then Go To Q14-PM6
Q14-PM6 | Section: Section 14: Health |
Have you experienced any of the following in the past year?
| - Hot flashes |
| - Vaginal dryness |
| - Mood swings or depression |
| - Decreased ability to concentrate |
| - Loss of interest in sex |
Q14-14D | Section: Section 14: Health |
(([Residence of Respondent]==19) || ([Residence of Respondent]==20) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]>0) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]==0)) && ([age of young adult]<19)
COMMENT: IS R IN HH WITH BOTH PARENTS OR WITH MOTHER ONLY AND UNDER AGE 19?
If Answer = 1 Then Go To Q14-15A
Q14-14G | Section: Section 14: Health |
When you have an illness or injury that requires medical attention, where do you usually go for medical treatment?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 1 PRIVATE DOCTOR'S OFFICE |
| 2 PUBLIC CLINIC |
| 3 PRIVATE CLINIC |
| 10 URGENT CARE FACILITY |
| 4 HEALTH MAINTENANCE ORGANIZATION (HMO) |
| 5 HOSPITAL CLINIC, WALK-IN CLINIC |
| 6 COMMUNITY HEALTH CENTER |
| 7 EMERGENCY ROOM OUT-PATIENT |
| 8 OTHER (SPECIFY) |
| 9 IF VOLUNTEERED DO NOT SEEK TREATMENT FROM MEDICAL PERSONNEL |
Q14-15A | Section: Section 14: Health |
How many illnesses that required medical attention or treatment have you had in the past 12 months?
(ENTER NUMBER OF ILLNESSES:)
Q14-17AA | Section: Section 14: Health |
Did you have a routine health check-up in the last 12 months?
Q14-17AB | Section: Section 14: Health |
During the past 24 months, have you had...
| - ...a routine dental check-up? |
| - ...a routine eye exam? |
Q14-20 | Section: Section 14: Health |
How tall are you?
(ENTER NUMBER OF FEET:)
Q14-20A | Section: Section 14: Health |
Q14-21 | Section: Section 14: Health |
How much do you weigh?
(ENTER NUMBER OF POUNDS)
Q14-21-JUMP | Section: Section 14: Health |
[age of R as of December 31, 2018]==12 || [age of R as of December 31, 2018]==13
COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2018?
If Answer = 1 Then Go To Q16-0
Q14-21A | Section: Section 14: Health |
(([Residence of Respondent]==19) || ([Residence of Respondent]==20) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]>0) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]==0)) && ([age of young adult]<19)
COMMENT: IS R IN HH WITH BOTH PARENTS OR WITH MOTHER ONLY AND UNDER AGE 21?
If Answer = 1 Then Go To Q14-25
Q14-22A | Section: Section 14: Health |
Are you currently covered by any kind of health insurance or health care plan?
(PROBE IF NECESSARY:) This could be health insurance obtained through employment or purchased directly as well as government programs like Medicaid that provide medical care or help pay medical bills.
If Answer = -2 Then Go To Q14-24AC
If Answer = -1 Then Go To Q14-25
Q14-23 | Section: Section 14: Health |
(INTERVIEWER: IF R PROVIDES NAMES OF HMOs OR INSURANCE COMPANIES, PROBE FOR THE SOURCE OF FUNDING.)
What is the source of your health plan?
(INTERVIEWER: IF NECESSARY, READ:) Is it your own policy bought directly from a medical insurance company, an employer policy, your parent's policy, or something else?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 3 YOUR EMPLOYER'S POLICY |
| 4 SPOUSE/PARTNER'S EMPLOYER POLICY |
| 2 POLICY BOUGHT DIRECTLY FROM INSURANCE COMPANY |
| 1 A PARENT'S POLICY |
| 10 MEDICAID OR MEDICAID PROVIDER/MEDI-CAL/MEDICAL ASSIST/WELFARE/MEDICAL SERVICE |
| 9 OBAMACARE/AFFORTABLE CARE ACT/HEALTH INSURANCE MARKETPLACE |
| 6 MILITARY HEALTH INSURANCE |
| 7 STUDENT INSURANCE THROUGH SCHOOL, COLLEGE OR UNIVERSITY |
| 8 OTHER RELATIVE'S POLICY |
| 5 OTHER (SPECIFY) |
Q14-24AB | Section: Section 14: Health |
About how long has it been since you last had health care coverage?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 0 6 MONTHS OR LESS |
| 1 MORE THAN 6 MONTHS, BUT LESS THAN 1 YEAR |
| 2 MORE THAN 1 YEAR, BUT NOT MORE THAN 3 YEARS |
| 3 MORE THAN 3 YEARS |
| 4 NEVER |
Q14-24AC | Section: Section 14: Health |
Have you been without health care coverage in any of the past 12 months?
Q14-24AD | Section: Section 14: Health |
About how many months were you without coverage?
Q14-24AF | Section: Section 14: Health |
What are the reasons you [do/did] not have health insurance?
(INTERVIEWER: SELECT ALL THAT APPLY.)
| 1 PERSON IN FAMILY WITH HEALTH INSURANCE LOST JOB OR CHANGED EMPLOYERS |
| 2 GOT DIVORCED OR SEPARATED/DEATH OF SPOUSE OR PARTNER |
| 3 EMPLOYER DOES NOT OFFER COVERAGE/OR NOT ELIGIBLE FOR COVERAGE |
| 4 COST IS TOO HIGH |
| 5 INSURANCE COMPANY REFUSED COVERAGE |
| 6 [FEMALE ONLY] MEDICAID/MEDICAL PLAN STOPPED AFTER PREGNANCY |
| 7 LOST MEDICAID/MEDICAL PLAN BECAUSE OF NEW JOB OR INCREASE IN INCOME |
| 8 LOST MEDICAID (OTHER) |
| 9 OTHER (SPECIFY) |
Q14-25 | Section: Section 14: Health |
Now we are going to ask you about events that you may have experienced [Since date of last interview./since you were 10 years old.]
[Earlier you said you have lost friends or family to COVID-19. Is there anyone else/Is there anyone] that you felt especially close to who has died?
Q14-25-CHECK | Section: Section 14: Health |
[Flag for whether or not R reported deaths of family or friends due to COVID-19]==1
If Answer = 1 Then Go To Q14-25A
Q14-25A | Section: Section 14: Health |
Have you experienced more than one such loss [Since date of last interview./since you were 10 years old.]?
Q14-27-LOOP-BEGIN | Section: Section 14: Health |
REPEAT
COMMENT: start loop about deaths of significant people
Q14-26 | Section: Section 14: Health |
How was the [first/next/blank] person who died related to you?
| 20 MOTHER |
21 FATHER |
| 1 STEPMOTHER |
2 STEPFATHER |
| 3 BROTHER |
4 SISTER |
| 5 GRANDMOTHER (MOTHER'S SIDE) |
6 GRANDFATHER (MOTHER'S SIDE) |
| 7 GRANDMOTHER (FATHER'S SIDE) |
8 GRANDFATHER (FATHER'S SIDE) |
| 9 STEP-GRANDMOTHER |
10 STEP-GRANDFATHER |
| 26 GREAT GRANDMOTHER |
27 GREAT GRANDFATHER |
| 28 GREAT AUNT |
29 GREAT UNCLE |
| 11 SPOUSE OR PARTNER |
22 SON |
| 23 DAUGHTER |
24 NEPHEW |
| 25 NIECE |
12 AUNT |
| 13 UNCLE |
14 COUSIN |
| 15 OTHER RELATIVE (SPECIFY) |
16 FRIEND |
| 17 TEACHER |
18 OTHER NONRELATIVE - ADULT (SPECIFY) |
| 19 OTHER NONRELATIVE - CHILD (SPECIFY) |
Q14-28 | Section: Section 14: Health |
In what month and year did your [relationship to R([loop number])] die?
Q14-28C | Section: Section 14: Health |
[month of death([loop number])]==-2 || [month of death([loop number])]==-1
COMMENT: Machine Check: Did R indicate DK or refusal on month of death?
If Answer = 1 Then Go To Q14-29
Q14-28D | Section: Section 14: Health |
[year of death([loop number])]==-2 || [year of death([loop number])]==-1
COMMENT: Machine Check: Did R indicate DK or refusal on year of death?
If Answer = 1 Then Go To Q14-29
Q14-29 | Section: Section 14: Health |
About how old were you when your [relationship to R([loop number])] died?
Q14-29-BRANCH1 | Section: Section 14: Health |
[loop number]==1
If Answer = 1 Then Go To Q14-29A-LOOP-END
Q14-29A | Section: Section 14: Health |
Has anyone else you felt especially close to died [Since date of last interview./since you were 10 years old.]?
Q14-29A-LOOP-END | Section: Section 14: Health |
UNTIL ( [Does R have another death to report?]==0)
COMMENT: End loop about deaths of significant people
Q14-30 | Section: Section 14: Health |
[Since date of last interview have you/Have you ever] been the victim of a violent crime, for example, physical or sexual assault, robbery or arson?
Q14-31 | Section: Section 14: Health |
[Since [date of last interview] have/Have] you been the victim of a violent crime more than once?
Q14-32 | Section: Section 14: Health |
How old were you the first time [since the date of last interview/blank] you were the victim of a violent crime?
Q14-32A | Section: Section 14: Health |
How old were you the most recent time you were the victim of a violent crime?
Q14-33 | Section: Section 14: Health |
How old were you when you were the victim of a violent crime[(since date of last interview)?/?]
Q14-34 | Section: Section 14: Health |
[Since date of last interview,/Since you were 10 years old,] has an adult member of your household (other than yourself), that is someone who was living in the same household as you at the time, been sent to jail or prison?
Q14-35 | Section: Section 14: Health |
How was the person who went to jail or prison related to you?
(INTERVIEWER: PLEASE SELECT ALL THAT APPLY.)
| 1 MOTHER |
| 2 FATHER |
| 3 STEPMOTHER |
| 4 STEPFATHER |
| 5 BROTHER |
| 6 SISTER |
| 19 SON |
| 20 DAUGHTER |
| 7 GRANDMOTHER (MOTHER'S SIDE) |
| 8 GRANDFATHER (MOTHER'S SIDE) |
| 9 GRANDMOTHER (FATHER'S SIDE) |
| 10 GRANDFATHER (FATHER'S SIDE) |
| 11 STEP-GRANDMOTHER |
| 12 STEP-GRANDFATHER |
| 13 SPOUSE OR PARTNER |
| 14 AUNT |
| 15 UNCLE |
| 16 COUSIN |
| 17 OTHER RELATIVE (SPECIFY) |
| 18 OTHER NONRELATIVE (SPECIFY) |
Q14-36-LOOP-BEGIN | Section: Section 14: Health |
REPEAT
COMMENT: start loop about imprisonment of adults in household
Q14-36A | Section: Section 14: Health |
INSELECTION([Q14-35], [loop number])
COMMENT: CHECK TO DETERMINE IF THIS RELATIONSHIP WAS CHOSEN BY RESPONDENT IN Q14-35
If Answer = 1 Then Go To Q14-37
Q14-37 | Section: Section 14: Health |
Was your [relationship to R([loop number])] sent to jail or prison more than once while you were living in the same household?
Q14-38 | Section: Section 14: Health |
How old were you the first time [since the date of last interview/blank] your [relationship to R([loop number])] was sent to jail or prison (while you were living in the same household)?
Q14-38A | Section: Section 14: Health |
How old were you the most recent time your [relationship to R([loop number])] was sent to jail or prison (while you living were in the same household)?
Q14-39 | Section: Section 14: Health |
How old were you when your [relationship to R([loop number])] was sent to jail or prison[(since date of last interview)?/?]
Q14-39A-LOOP-END | Section: Section 14: Health |
UNTIL ( [loop number]==18)
COMMENT: End loop about imprisonment of adults in household
Q14-40-CHECK1 | Section: Section 14: Health |
[age of R as of December 31, 2018]==27 || [age of R as of December 31, 2018]==28
COMMENT: Check: Does R need to complete additional health module?
If Answer = 1 Then Go To COGNITION-C1
Q14-40-CHECK2 | Section: Section 14: Health |
[age of R as of December 31, 2018]==29 || [age of R as of December 31, 2018]==30 ||[age of R as of December 31, 2018]==41 || [age of R as of December 31, 2018]==42 ||[age of R as of December 31, 2018]==49 || [age of R as of December 31, 2018]==50|| [Does R need to take the extended health module?]==1
COMMENT: Check: Does R need to complete additional health module?
If Answer = 1 Then Go To Q14-41
Q14-41 | Section: Section 14: Health |
Have either of your biological parents or any of your biological brothers or sisters ever been told by a doctor that they have any of the following:
| - ...cancer? |
| - ...heart disease? |
| - ...diabetes? |
| - ...asthma? |
| - ...high blood pressure? |
| - ...high cholesterol? |
| - ...stroke? |
Q14-41A | Section: Section 14: Health |
INSELECTION([Q14-41],3)
COMMENT: Did R indicate a family member has diabetes?
If Answer = 1 Then Go To Q14-42
Q14-42 | Section: Section 14: Health |
You mentioned that a doctor has told someone in your immediate family that they have diabetes. Was that your mother, your father, or a brother or sister?
| 1 MOTHER |
| 2 FATHER |
| 3 BROTHER OR SISTER |
Q14-43 | Section: Section 14: Health |
Have any of your biological grandparents been told by a doctor that they have diabetes?
Q14-43A | Section: Section 14: Health |
Which of your grandparents has been told they have diabetes?
INTERVIEWER: IF NECESSARY PROBE TO DETERMINE RELATIONSHIP.
| 1 MOTHER'S MOTHER |
| 2 MOTHER'S FATHER |
| 3 FATHER'S MOTHER |
| 4 FATHER'S FATHER |
Q14-44 | Section: Section 14: Health |
([flag indicating if R's father is deceased]==1) || ([flag indicating if R lives with biological father]==2) || ([flag indicating if R's father is alive]==0)
COMMENT: Is R's father deceased?
If Answer = 1 Then Go To Q14-44A
Q14-44A | Section: Section 14: Health |
What caused your biological father's death?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 1 HEART ATTACK/STROKE |
| 2 ACCIDENT |
| 3 CANCER |
| 4 OLD AGE |
| 5 EMPHYSEMA |
| 7 CORONAVISUS/COVID-19 |
| 6 OTHER (SPECIFY) |
| 8 IF VOLUNTEERED: PARENT IS NOT DECEASED |
Q14-44B | Section: Section 14: Health |
How old was he when he died?
Q14-45 | Section: Section 14: Health |
([flag indicating that R reported mother deceased in Q2-18]==1) || ([flag indicating that R reported mother deceased in Q2-18]==1) || ([flag indicating that R reported mother deceased in Q2-23b]==15) || ([flag indicating if R's mother is deceased]==1) || ([flag indicating if R lives with biological mother]==2)
COMMENT: Is R's mother deceased?
If Answer = 1 Then Go To Q14-45A
Q14-45A | Section: Section 14: Health |
What caused your biological mother's death?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 1 HEART ATTACK/STROKE |
| 2 ACCIDENT |
| 3 CANCER |
| 4 OLD AGE |
| 5 EMPHYSEMA |
| 7 CORONAVISUS/COVID-19 |
| 6 OTHER (SPECIFY) |
| 8 IF VOLUNTEERED: PARENT IS NOT DECEASED |
Q14-45B | Section: Section 14: Health |
How old was she when she died?
Q14-45C | Section: Section 14: Health |
[age of young adult] >=40
COMMENT: Check: Does R need to complete additional health module?
If Answer = 1 Then Go To Q14-45E
Q14-45E | Section: Section 14: Health |
Has a doctor ever told you that you have high blood pressure or hypertension?
Q14-45F | Section: Section 14: Health |
Do you have high blood pressure or hypertension at the present time?
Q14-45G | Section: Section 14: Health |
[flag indicating R has reported having diabetes]==1
If Answer = 1 Then Go To Q14-45I
Q14-45H | Section: Section 14: Health |
Has a doctor ever told you that you have diabetes or high blood sugar?
Q14-45I | Section: Section 14: Health |
Do you have diabetes or high blood sugar at the present time?
Q14-45K | Section: Section 14: Health |
Has a doctor ever told you that you had skin cancer?
Q14-45L | Section: Section 14: Health |
Has a doctor ever told you that you had cancer or malignant tumor of any kind except skin cancer?
Q14-45M | Section: Section 14: Health |
[flag indicatig R has reported having skin cancer]==1||[has R reported cancer (other than skin)]==1
If Answer = 1 Then Go To Q14-45N
Q14-45N | Section: Section 14: Health |
Do you currently have any such cancer?
Q14-45O | Section: Section 14: Health |
[flag indicating R has reported having bronchitis]==1
If Answer = 1 Then Go To Q14-45Q
Q14-45P | Section: Section 14: Health |
Not including asthma, has a doctor ever told you that you have chronic lung disease such as chronic bronchitis or emphysema?
Q14-45Q | Section: Section 14: Health |
Has a doctor ever told you that you had a heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems?
Q14-45R | Section: Section 14: Health |
Did you have a heart attack or myocardial infarction?
Q14-45S | Section: Section 14: Health |
Do you currently have any angina or chest pains due to your heart?
Q14-45T | Section: Section 14: Health |
Has a doctor ever told you that you have congestive heart failure?
Q14-45U | Section: Section 14: Health |
Has a doctor ever told you that you had a stroke?
Q14-45V | Section: Section 14: Health |
[flag indicating R has reported having depression]==1
If Answer = 1 Then Go To Q14-45X
Q14-45W | Section: Section 14: Health |
Has a doctor ever diagnosed you as suffering from depression?
Q14-45X | Section: Section 14: Health |
During the last 12 months, have you suffered from depression?
Q14-45XA | Section: Section 14: Health |
[flag indicating R has reported having anxiety]==1
If Answer = 1 Then Go To Q14-45XC
Q14-45XB | Section: Section 14: Health |
Has a doctor ever diagnosed you as suffering from anxiety?
Q14-45XC | Section: Section 14: Health |
During the last 12 months, have you suffered from anxiety?
Q14-45Y | Section: Section 14: Health |
[flag indicating R has reported having bipolar disorder]==1
If Answer = 1 Then Go To Q14-45AA
Q14-45Z | Section: Section 14: Health |
Has a doctor ever told you that you had emotional, nervous, or psychiatric problems other than depression or anxiety?
Q14-45AA | Section: Section 14: Health |
During the last 12 months, have you had any emotional, nervous, or psychiatric problems other than depression or anxiety?
Q14-45BB | Section: Section 14: Health |
Have you ever had, or has a doctor ever told you that you have, arthritis or rheumatism?
Q14-45CC | Section: Section 14: Health |
Do you sometimes have pain, stiffness, or swelling in your joints?
Q14-45DD | Section: Section 14: Health |
Has a doctor ever told you that you had osteopenia or osteoporosis?
Q14-46 | Section: Section 14: Health |
During the past 4 weeks, have you accomplished less than you would like with your work or other regular daily activities as a result of any emotional problems such as feeling depressed or anxious?
IF YES, PROBE: Did you accomplish a lot less or a little less?
| 1 YES, A LOT |
| 2 YES, A LITTLE |
| 0 NO, NOT AT ALL |
Q14-46A | Section: Section 14: Health |
During the past 4 weeks, have you accomplished less than you would like with your work or other regular daily activities as a result of your physical health?
IF YES, PROBE: Did you accomplish a lot less or a little less?
| 1 YES, A LOT |
| 2 YES, A LITTLE |
| 0 NO, NOT AT ALL |
Q14-46B | Section: Section 14: Health |
[age of young adult] >=40
COMMENT: Check: Does R need to complete additional health module?
If Answer = 1 Then Go To Q14-46C
Q14-46C | Section: Section 14: Health |
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside of the home and housework)?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 1 NOT AT ALL |
| 2 A LITTLE BIT |
| 3 MODERATELY |
| 4 QUITE A BIT |
| 5 EXTREMELY |
Q14-47 | Section: Section 14: Health |
How often during the past 4 weeks...
...did you have a lot of energy?
Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?
| 1 ALL OF THE TIME |
| 2 MOST OF THE TIME |
| 3 A GOOD BIT OF THE TIME |
| 4 SOME OF THE TIME |
| 5 A LITTLE OF THE TIME |
| 6 NONE OF THE TIME |
Q14-48 | Section: Section 14: Health |
How often during the past 4 weeks...
...have you felt calm and peaceful?
(Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?)
| 1 ALL OF THE TIME |
| 2 MOST OF THE TIME |
| 3 A GOOD BIT OF THE TIME |
| 4 SOME OF THE TIME |
| 5 A LITTLE OF THE TIME |
| 6 NONE OF THE TIME |
Q14-49 | Section: Section 14: Health |
(How often during the past 4 weeks...)
...have you felt down-hearted and blue?
(Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?)
| 1 ALL OF THE TIME |
| 2 MOST OF THE TIME |
| 3 A GOOD BIT OF THE TIME |
| 4 SOME OF THE TIME |
| 5 A LITTLE OF THE TIME |
| 6 NONE OF THE TIME |
Q14-50 | Section: Section 14: Health |
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, family, etc.)?
(Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?)
| 1 ALL OF THE TIME |
| 2 MOST OF THE TIME |
| 3 A GOOD BIT OF THE TIME |
| 4 SOME OF THE TIME |
| 5 A LITTLE OF THE TIME |
| 6 NONE OF THE TIME |
Q14-50A | Section: Section 14: Health |
[age of young adult] >=40
COMMENT: Check: Does R need to complete additional health module?
If Answer = 1 Then Go To Q14-51A
Q14-51 | Section: Section 14: Health |
We are interested in how much difficulty people have with various activities because of a health or physical problem. How difficult is it for you to do the following - not at all difficult, a little difficult, somewhat difficult or very difficult?
(INTERVIEWER: REPEAT ANSWER CATEGORIES ONLY IF NECESSARY)
| - Walk several blocks? |
| - Climb several fights of stairs without resting? |
| - Stoop, kneel, or crouch? |
| - Pull or push large objects like a living room chair? |
| 1 NOT AT ALL DIFFICULT |
| 2 A LITTLE DIFFICULT |
| 3 SOMEWHAT DIFFICULT |
| 4 VERY DIFFICULT/CAN'T DO |
| 5 IF VOLUNTEERED, DON'T DO |
Q14-51A | Section: Section 14: Health |
We are interested in how much difficulty people have with various activities because of a health or physical problem. How difficult is it for you to do the following - not at all difficult, a little difficult, somewhat difficult or very difficult?
(INTERVIEWER: REPEAT ANSWER CATEGORIES ONLY IF NECESSARY)
| - Walk several blocks? |
| - Walk one block? |
| - Sit for about 2 hours? |
| - Get up from a chair after sitting for long periods? |
| - Climb several fights of stairs without resting? |
| - Climb one flight of stairs without resting? |
| - Lift or carry weights OVER 10 pounds, like a heavy bag of groceries? |
| - Stoop, kneel, or crouch? |
| - Pick up a dime from a table? |
| - Reach or extend your arms above shoulder level? |
| - Pull or push large objects like a living room chair? |
| 1 NOT AT ALL DIFFICULT |
| 2 A LITTLE DIFFICULT |
| 3 SOMEWHAT DIFFICULT |
| 4 VERY DIFFICULT/CAN'T DO |
| 5 IF VOLUNTEERED, DON'T DO |
Q14-52 | Section: Section 14: Health |
During the past 2 years, have you had any of the following medical tests or procedures?
| - A flu shot? |
| - A blood test for cholesterol? |
| - A blood test for diabetes or blood sugar levels? |
| - Your blood pressure measured? |
Q14-53 | Section: Section 14: Health |
[Gender of Respondent]==2
COMMENT: Is R female?
If Answer = 1 Then Go To Q14-53A
Q14-53A | Section: Section 14: Health |
Have you had a PAP smear in the past 2 years?
Q14-53B | Section: Section 14: Health |
[age of young adult] >=40
COMMENT: Check: Does R need to complete additional health module?
If Answer = 1 Then Go To Q14-53C
Q14-53C | Section: Section 14: Health |
Have you had a mammogram in the past 2 years?
Q14-54A | Section: Section 14: Health |
During a usual week, how many times a day do you...
....brush your teeth?
Q14-54B | Section: Section 14: Health |
(During a usual week, how many times a day do you...)
....use dental floss?
Q14-55 | Section: Section 14: Health |
[Since age 30, have you/Have you ever] had a blow to the head or a similar type of head injury that was severe enough to require medical attention, or to cause loss of consciousness or memory loss for a period of time?
Q14-55A | Section: Section 14: Health |
[Since age 30, how/How] many times has this happened?
If Answer = 0 Then Go To COGNITION-CHECK
Q14-55B | Section: Section 14: Health |
[How old were you at the time?/Now I want you to think about your most recent head injury or trauma. How old were you at the time?]
Q14-55C | Section: Section 14: Health |
Did you lose consciousness?
Q14-55D | Section: Section 14: Health |
How long were you unconscious?
(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)
| 1 LESS THAN 5 MINUTES |
| 2 5 TO 29 MINUTES |
| 3 30 TO 59 MINUTES |
| 4 1 TO 24 HOURS |
| 5 MORE THAN 1 DAY |
COGNITION-CHECK | Section: Section 14: Health |
[flag indicating whether respondent needs to complete the cognition items]==1
If Answer = 1 Then Go To COGNITION-C1
COGNITION-C1 | Section: Section 14: Health |
Part of this study is concerned with people's memory, and ability to think about things. First, how would you rate your memory at the present time? Would you say it is excellent, very good, good, fair or poor?
| 1 EXCELLENT |
| 2 VERY GOOD |
| 3 GOOD |
| 4 FAIR |
| 5 POOR |
COGNITION-C2 | Section: Section 14: Health |
Compared to two years ago, would you say your memory is better now, about the same, or worse now than it was then?
| 1 BETTER |
| 2 ABOUT THE SAME |
| 3 WORSE |
COGNITION-SKIP | Section: Section 14: Health |
[check for proxy interview code from INTRO]==4
If Answer = 1 Then Go To Q15-2
COGNITION-3_TEST1 | Section: Section 14: Health |
I'll read a set of 10 words and ask you to recall as many as you can. We have purposely made the list long so that it will be difficult for anyone to recall all the words. Most people recall just a few. Please listen carefully as I read the set of words because I cannot repeat them. When I finish, I will ask you to recall aloud as many of the words as you can, in any order. Is this clear?
(INTERVIEWER: PROBE AS NEEDED FOR UNDERSTANDING OF TASK. READ ITEMS ON FOLLOWING SCREEN AT A SLOW STEADY RATE, AS THEY FLASH ON THE SCREEN.
IF R REFUSES DURING OR AFTER THE INTRODUCTION AND BEFORE ANY WORDS ARE READ, SELECT "REFUSED WORD LIST" BELOW AND SELECT <NEXT> TO PROCEED.)
| 1 CONTINUE WITH WORD LIST |
| 2 REFUSED WORD LIST ...(Go To COGNITION-6) |
COG_RANDOM_TEST1 | Section: Section 14: Health |
INT(RAND(0)*4)
If Answer = 1 Then Go To COG_LIST1A_TEST1_M1-INTRO
If Answer = 2 Then Go To COG_LIST2A_TEST1_M2-INTRO
If Answer = 3 Then Go To COG_LIST3A_TEST1_M3-INTRO
COG_LIST1A_TEST1_M1-INTRO | Section: Section 14: Health |
INTERVIEWER: ON THE FOLLOWING SCREEN A VIDEO WILL PLAY, FLASHING 10 WORDS. READ THESE WORDS TO THE RESPONDENT AS THEY FLASH ON THE SCREEN.
COG_LIST1A_TEST1_M1 | Section: Section 14: Health |
(INTERVIEWER: READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Hotel |
| - River |
| - Tree |
| - Skin |
| - Gold |
| - Market |
| - Paper |
| - Child |
| - King |
| - Book |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4A_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COG_LIST2A_TEST1_M2-INTRO | Section: Section 14: Health |
INTERVIEWER: ON THE FOLLOWING SCREEN A VIDEO WILL PLAY, FLASHING 10 WORDS. READ THESE WORDS TO THE RESPONDENT AS THEY FLASH ON THE SCREEN.
COG_LIST2A_TEST1_M2 | Section: Section 14: Health |
(INTERVIEWER: READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Sky |
| - Ocean |
| - Flag |
| - Dollar |
| - Wife |
| - Machine |
| - Home |
| - Earth |
| - College |
| - Butter |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4B_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COG_LIST3A_TEST1_M3-INTRO | Section: Section 14: Health |
INTERVIEWER: ON THE FOLLOWING SCREEN A VIDEO WILL PLAY, FLASHING 10 WORDS. READ THESE WORDS TO THE RESPONDENT AS THEY FLASH ON THE SCREEN.
COG_LIST3A_TEST1_M3 | Section: Section 14: Health |
(INTERVIEWER: READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Woman |
| - Rock |
| - Blood |
| - Corner |
| - Shoes |
| - Letter |
| - Girl |
| - House |
| - Valley |
| - Engine |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4C_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COG_LIST4A_TEST1_M4-INTRO | Section: Section 14: Health |
INTERVIEWER: ON THE FOLLOWING SCREEN A VIDEO WILL PLAY, FLASHING 10 WORDS. READ THESE WORDS TO THE RESPONDENT AS THEY FLASH ON THE SCREEN.
COG_LIST4A_TEST1_M4 | Section: Section 14: Health |
(INTERVIEWER: READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NWW ENTRY> AND TYPING THE WORD.)
| - Water |
| - Church |
| - Doctor |
| - Palace |
| - Fire |
| - Garden |
| - Sea |
| - Village |
| - Baby |
| - Table |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4D_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COGNITION-4_CHK4 | Section: Section 14: Health |
(INTERVIEWER: PLEASE INDICATE WHETHER ANY OF THE FOLLOWING PROBLEMS OCCURRED IN RELATION TO WORD RECALL.)
(SELECT ALL THAT APPLY.)
| 1 R HAD DIFFICULTY HEARING ANY OF THE WORDS |
| 2 INTERRUPTION OCCURRED WHILE YOU WERE READING LIST |
| 3 OTHER PROBLEM (PLEASE SPECIFY) |
| 4 NO PROBLEMS OCCURRED |
COGNITION-6 | Section: Section 14: Health |
For this next question, please try to count backward as quickly as you can from the number I will give you. I will tell you when to stop.
Please start with: 20
(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6A | Section: Section 14: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.
R CAN CORRECTLY COUNT DOWN FROM 19 TO 10 OR FROM 20 TO 11.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6C | Section: Section 14: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)
| 1 CORRECT |
| 5 INCORRECT |
| 6 WANTS TO START OVER ...(Go To COGNITION-6D) |
| 97 REFUSED |
COGNITION-6D | Section: Section 14: Health |
Let's try again.
The number to count backward from is : 20
(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6D_Y1 | Section: Section 14: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6F | Section: Section 14: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)
| 1 CORRECT |
| 5 INCORRECT |
| 97 REFUSED |
COGNITION-6G | Section: Section 14: Health |
Now please try counting backward from a different number. Remember to count as quickly as you can from the number I mention.
Please start with: 86
(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6G_Y1 | Section: Section 14: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.
R CAN CORRECTLY COUNT DOWN FROM 86 TO 77 OR FROM 85 TO 76.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6J | Section: Section 14: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 85 TO 76 OR FROM 86 TO 77 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. ALLOW R TO START OVER IF S/HE WISHES TO DO SO.)
| 1 CORRECT |
| 5 INCORRECT |
| 6 WANTS TO START OVER ...(Go To COGNITION-6K) |
| 97 REFUSED |
COGNITION-6K | Section: Section 14: Health |
Let's try again.
The number to count backward from is : 86
(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6K_Y1 | Section: Section 14: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6N | Section: Section 14: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 85 TO 76 OR FROM 86 TO 77 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)
| 1 CORRECT |
| 5 INCORRECT |
| 97 REFUSED |
COGNITION-7A | Section: Section 14: Health |
Now let's try some subtraction of numbers. One hundred minus 7 equals what?
(INTERVIEWER: IF R ADDS 7 INSTEAD, YOU MAY REPEAT THE QUESTION. IF DON'T KNOW OR REFUSED ANY NUMBER, SELECT <NEXT> TO PROCEED.)
COGNITION-7B | Section: Section 14: Health |
And 7 from that?
COGNITION-7C | Section: Section 14: Health |
And 7 from that?
COGNITION-7D | Section: Section 14: Health |
And 7 from that?
COGNITION-7E | Section: Section 14: Health |
And 7 from that?
COGNITION-8_CHK | Section: Section 14: Health |
[first flag indicating whether or not word list was refused] == 1 || [first count of correct words] > 0
If Answer = 0 Then Go To COG_TRAINING_SKIP2
COGNITION-CHK4 | Section: Section 14: Health |
[flag to determine which word list R gets]
If Answer = 0 Then Go To COGNITION-8D_1
If Answer = 1 Then Go To COGNITION-8A_1
If Answer = 2 Then Go To COGNITION-8B_1
If Answer = 3 Then Go To COGNITION-8C_1
COGNITION-8A_1 | Section: Section 14: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Hotel |
| - River |
| - Tree |
| - Skin |
| - Gold |
| - Market |
| - Paper |
| - Child |
| - King |
| - Book |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8A_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COGNITION-8B_1 | Section: Section 14: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Sky |
| - Ocean |
| - Flag |
| - Dollar |
| - Wife |
| - Machine |
| - Home |
| - Earth |
| - College |
| - Butter |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8B_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COGNITION-8C_1 | Section: Section 14: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Woman |
| - Rock |
| - Blood |
| - Corner |
| - Shoes |
| - Letter |
| - Girl |
| - House |
| - Valley |
| - Engine |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8C_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COGNITION-8D_1 | Section: Section 14: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <NEXT> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
| - Water |
| - Church |
| - Doctor |
| - Palace |
| - Fire |
| - Garden |
| - Sea |
| - Village |
| - Baby |
| - Table |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8D_2 | Section: Section 14: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD NEW ENTRY> AND TYPING THE WORD.)
COGNITION-8F | Section: Section 14: Health |
VAREXIST ([COGNITION-8A_1]) ||
VAREXIST ([COGNITION-8B_1]) ||
VAREXIST ([COGNITION-8C_1]) ||
VAREXIST ([COGNITION-8D_1])
If Answer = 0 Then Go To Q15-2
COG_TRAINING_SKIP2 | Section: Section 14: Health |
([NORC ID NUMBER] >= 66666301 && [NORC ID NUMBER] <= 66666399)
If Answer = 1 Then Go To NIL