Questionnaire Public Report 11/30/2012 10:07:55 AM Cohort: NLSY79 Young Adults Round: YAdult Round 25 Instrument : YA2012
1. #### Section 14: Health

 Q14-1-A [] Section: Section 14: Health

***********************SECTION 14 HEALTH******************************************

 Default Next: Q14A-0

 Q14A-0 [] Section: Section 14: Health

If Answer = 1 Then Go To
Q14A-4

 Default Next: Q14A-1 Lead-In: Q14-1-A [Default]

 Q14A-1 [] Section: Section 14: Health

{EV_DLI_ASTHMA} told you that you have asthma?

 1   Yes   ...(Go To Q14A-2) 0   No

 Default Next: Q14A-3 Lead-In: Q14A-0 [Default]

 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.)

 Enter Number:

 Default Next: Q14A-2A Lead-In: Q14A-1 [1:1]

 Q14A-2A [] Section: Section 14: Health

{WASINT04}==1 || {WASINT06}==1||{WASINT08}==1

COMMENT: Machine Check: Was R interviewed in 2004 or 2006?

If Answer = 1 Then Go To
Q14A-4

 Default Next: Q14A-3 Lead-In: Q14A-2 [Default]

 Q14A-3 [] Section: Section 14: Health

Has your biological father ever been told that he has asthma?

 1   Yes 0   No

 Default Next: Q14A-4 Lead-In: Q14A-1 [Default], Q14A-2A [Default]

 Q14A-4 [] Section: Section 14: Health

Has anyone smoked cigarettes or other tobacco products in your home in the past two weeks?

 1   Yes 0   No

 Default Next: Q14A-5 Lead-In: Q14A-0 [1:1], Q14A-2A [1:1], Q14A-3 [Default]

 Q14A-5 [] Section: Section 14: Health

Have you routinely spent time in a place where you smelled cigarette smoke in the past two weeks?

 1   Yes 0   No

 Default Next: Q14A-5A Lead-In: Q14A-4 [Default]

 Q14A-5A [] Section: Section 14: Health

COMMENT: MACHINE CHECK: HAS R EVER HAD ASTHMA?

If Answer = 1 Then Go To
Q14A-6

 Default Next: Q14A-5B Lead-In: Q14A-5 [Default]

 Q14A-5B [] Section: Section 14: Health

{NEWASTHMA}==1

COMMENT: MACHINE CHECK: HAS R EVER HAD ASTHMA?

If Answer = 1 Then Go To
Q14A-6

 Default Next: Q14-1 Lead-In: Q14A-5A [Default]

 Q14A-6 [] Section: Section 14: Health

Do you still have asthma?

 1   YES 0   NO   ...(Go To Q14A-7) 2   NEVER HAD ASTHMA   ...(Go To Q14-1)

If Answer = -2 Then Go To
Q14A-7

 Default Next: Q14A-8 Lead-In: Q14A-5A [1:1], Q14A-5B [1:1]

 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.)

 Enter Number:

 Default Next: Q14A-7A Lead-In: Q14A-6 [-2:-2], Q14A-6 [0:0]

 Q14A-7A [] Section: Section 14: Health

{STILLASTHMA}==-2

If Answer = 1 Then Go To
Q14A-8

 Default Next: Q14-1 Lead-In: Q14A-7 [Default]

 Q14A-8 [] Section: Section 14: Health

During the past 12 months, have you had an episode of asthma or an asthma attack?

 1   Yes 0   No

 Default Next: Q14A-9 Lead-In: Q14A-7A [1:1], Q14A-6 [Default]

 Q14A-9 [] Section: Section 14: Health

During the past 12 months, how many times did you have an unscheduled visit to an emergency room, doctor's office, or urgent care center because of asthma? (Please do not count any visits for routine medical care.)

 ENTER # OF VISITS:

 Default Next: Q14A-10 Lead-In: Q14A-8 [Default]

 Q14A-10 [] Section: Section 14: Health

{ANYEMPS}==1

COMMENT: MACHINE CHECK: HAS R HAD ANY EMPLOYERS?

If Answer = 1 Then Go To
Q14A-11

 Default Next: Q14A-12 Lead-In: Q14A-9 [Default]

 Q14A-11 [] Section: Section 14: Health

During the past 12 months, how many days of work did you miss due to your asthma?

 ENTER # OF DAYS:

 Default Next: Q14A-12 Lead-In: Q14A-10 [1:1]

 Q14A-12 [] Section: Section 14: Health

{ISENROLLED}==1

COMMENT: MACHINE CHECK: IS R ENROLLED IN SCHOOL?

If Answer = 1 Then Go To
Q14A-13

 Default Next: Q14A-14 Lead-In: Q14A-10 [Default], Q14A-11 [Default]

 Q14A-13 [] Section: Section 14: Health

During the past 12 months, how many days of school did you miss due to your asthma?

 Enter Number:

 Default Next: Q14A-14 Lead-In: Q14A-12 [1:1]

 Q14A-14 [] Section: Section 14: Health

During the past 12 months, how much did you limit your usual activities due to your asthma? Would you say:

 1   Not at all 2   A little 3   A fair amount 4   A moderate amount 5   A lot

 Default Next: Q14A-15 Lead-In: Q14A-12 [Default], Q14A-13 [Default]

 Q14A-15 [] Section: Section 14: Health

Now please think about the last month. Symptoms of asthma include cough, wheezing, shortness of breath, chest tightness, and phlegm production. In the past 30 days how often did you have any asthma symptoms either during the day or at night? Would you say:

 0   Not at any time in the past 30 days 1   Less than once a week 2   Once or twice a week 3   More than 2 times a week, but not every day 4   Every day, once per day 5   Every day, more than once per day

 Default Next: Q14A-15A Lead-In: Q14A-14 [Default]

 Q14A-15A [] Section: Section 14: Health

In the past 30 days, how often did your asthma symptoms make it difficult for you to stay asleep at night? Would you say:

 0   Not at any time in the past 30 days 1   Less than once a week 2   Once or twice a week 3   More than 2 times a week, but not every day 4   Every day, once per day 5   Every day, more than once per day

 Default Next: Q14A-16 Lead-In: Q14A-15 [Default]

 Q14A-16 [] Section: Section 14: Health

A quick relief medication is used during an asthma attack to stop it. In the past 30 days how often have you used quick relief medicines when you have an asthma attack? (for example, Airomir, Asmol, Albuterol, Atrovent, Bricanyl, Predmix, Redipred, Respolin, Maxair, Ventolin)
Would you say:

 0   Not at any time in the past 30 days 1   Less than once a week 2   Once or twice a week 3   More than 2 times a week, but not every day 4   Every day, once per day 5   Every day, more than once per day

 Default Next: Q14A-17 Lead-In: Q14A-15A [Default]

 Q14A-17 [] Section: Section 14: Health

Asthma controller medications are used daily to prevent asthma attacks. Do you use a daily asthma controller medication to prevent attacks? (for example Accolate, Advair, Azmacort, Flovent, Fordile, Intal, Oxis, Seretide, Serevent, Singulair, Tilade, Vanceril)

 1   YES 0   NO 2   USE SOMETIMES

 Default Next: Q14-1 Lead-In: Q14A-16 [Default]

 Q14-1 [] Section: Section 14: Health

{^ACTIVEFLAG(1)^}==1 || {ANYEMPS}==1

COMMENT: Machine check: Is R on active duty or reported at least one employer in Section 7?

If Answer = 1 Then Go To
Q14-1A

 Default Next: Q14-1B Lead-In: Q14A-6 [2:2], Q14A-5B [Default], Q14A-7A [Default], Q14A-17 [Default]

 Q14-1A [] Section: Section 14: Health

Are you limited in the kind of work you do on a job for pay because of your health?

 1   Yes   ...(Go To Q14-6B) 0   No

 Default Next: Q14-2A Lead-In: Q14-1 [1:1]

 Q14-1B [] Section: Section 14: Health

Would you be limited in the kind or amount of work you could do on a job for pay because of your health?

 1   Yes   ...(Go To Q14-6B) 0   No

 Default Next: Q14-2A Lead-In: Q14-1 [Default]

 Q14-2A [] Section: Section 14: Health

Do you have any physical, emotional, or mental conditions that limit your ability to attend school regularly or do regular school work?

 1   Yes   ...(Go To Q14-6B) 0   No

 Default Next: Q14-5A Lead-In: Q14-1A [Default], Q14-1B [Default]

 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, crutches, a wheelchair, special shoes, an air filter, a catheter and so on?

 1   Yes   ...(Go To Q14-6B) 0   No

 Default Next: Q14-CARE-1 Lead-In: Q14-2A [Default]

 Q14-6B [] Section: Section 14: Health

{RESP_GENDER}==1

COMMENT: MACHINE CHECK: IF R IS MALE, SKIP PREGNANCY CHECK

If Answer = 1 Then Go To
Q14-8A

 Default Next: Q14-6C Lead-In: Q14-1A [1:1], Q14-1B [1:1], Q14-2A [1:1], Q14-5A [1:1]

 Q14-6C [] Section: Section 14: Health

{ISPREGNANT}==1

COMMENT: check if YA is preg from sect 12

If Answer = 1 Then Go To
Q14-7

 Default Next: Q14-8A Lead-In: Q14-6B [Default]

 Q14-7 [] Section: Section 14: Health

 1   Yes   ...(Go To Q14-CARE-1) 0   No

 Default Next: Q14-8A Lead-In: Q14-6C [1:1]

 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)

 Default Next: Q14-8AA Lead-In: Q14-6B [1:1], Q14-6C [Default], Q14-7 [Default]

 Q14-8AA [] Section: Section 14: Health

INSELECTION([Q14-8A],-1)

If Answer = 1 Then Go To
Q14-CARE-1

 Default Next: Q14-8AB Lead-In: Q14-8A [Default]

 Q14-8AB [] Section: Section 14: Health

INSELECTION([Q14-8A],-2)

If Answer = 1 Then Go To
Q14-10EA

 Default Next: Q14-10AC Lead-In: Q14-8AA [Default]

 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

 Default Next: Q14-10B Lead-In: Q14-8AB [Default]

 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-CARE-1

 Default Next: Q14-10EA Lead-In: Q14-10AC [Default]

 Q14-10EA [] Section: Section 14: Health

How long have you had this limitation, [name of illness]?

 1   SELECT TO ENTER MONTHS   ...(Go To Q14-10FA) 2   SELECT TO ENTER YEARS   ...(Go To Q14-10FB) 0   IF VOLUNTEERED: "ALL MY LIFE"

 Default Next: Q14-CARE-1 Lead-In: Q14-8AB [1:1], Q14-10AC [1:1], Q14-10B [-2:-2], Q14-10B [Default]

 Q14-10FA [] Section: Section 14: Health

(How long have you had this limitation ([name of illness]) (other than pregnancy)?)

 Enter Number:

 Default Next: Q14-CARE-1 Lead-In: Q14-10EA [1:1]

 Q14-10FB [] Section: Section 14: Health

(How long have you had this limitation ([name of illness]) (other than pregnancy)?)

 Enter Number:

 Default Next: Q14-CARE-1 Lead-In: Q14-10EA [2:2]

 Q14-CARE-1 [] Section: Section 14: Health

Is anyone in your household [besides you/blank] disabled or chronically ill?

 1   Yes   ...(Go To Q14-CARE-2) 0   No

 Default Next: Q14-CARE-4 Lead-In: Q14-7 [1:1], Q14-8AA [1:1], Q14-10B [-1:-1], Q14-5A [Default], Q14-10EA [Default], Q14-10FA [Default], Q14-10FB [Default]

 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.)

 Default Next: Q14-CARE-3 Lead-In: Q14-CARE-1 [1:1]

 Q14-CARE-3 [] Section: Section 14: Health

Do you regularly spend time helping or taking care of [this/these_hlth]?

 1   Yes   ...(Go To Q14-CARE-3B) 0   No

 Default Next: Q14-CARE-4 Lead-In: Q14-CARE-2 [Default]

 Q14-CARE-3B [] Section: Section 14: Health

About how many hours per week do you spend doing this?

 ENTER # OF HOURS

 Default Next: Q14-CARE-4 Lead-In: Q14-CARE-3 [1:1]

 Q14-CARE-4 [] Section: Section 14: Health

Do you regularly spend time helping or taking care of a relative or friend who does not live in your household?

 1   Yes   ...(Go To Q14-CARE-4B) 0   No

 Default Next: Q14-10G Lead-In: Q14-CARE-1 [Default], Q14-CARE-3 [Default], Q14-CARE-3B [Default]

 Q14-CARE-4B [] Section: Section 14: Health

About how many hours per week do you spend doing this?

 ENTER # OF HOURS

 Default Next: Q14-10G Lead-In: Q14-CARE-4 [1:1]

 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

 Default Next: Q14-10GA Lead-In: Q14-CARE-4 [Default], Q14-CARE-4B [Default]

 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

 Default Next: Q14-10H Lead-In: Q14-10G [Default]

 Q14-10H [] Section: Section 14: Health

In a typical week, how many times do you eat fruit? (Do not count fruit juice.)

 1   I do not typically eat fruit 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

 Default Next: Q14-10I Lead-In: Q14-10GA [Default]

 Q14-10I [] Section: Section 14: Health

In a typical week, how many times do you eat vegetables other than french fries or potato chips?

 1   I do not typically eat vegetables 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

 Default Next: Q14-10JA Lead-In: Q14-10H [Default]

 Q14-10JA [] 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?

 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 7 times per week

 Default Next: Q14-10JB Lead-In: Q14-10I [Default]

 Q14-10JB [] 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?)

Moderate exercise (exercise that is not exhausting), such as fast walking, easy bicycling, volleyball, easy swimming, etc.

 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 7 times per week

 Default Next: Q14-10JC Lead-In: Q14-10JA [Default]

 Q14-10JC [] 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?)

Mild exercise such as yoga, bowling, golf, easy walking.

 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 7 times per week

 Default Next: Q14-10JD Lead-In: Q14-10JB [Default]

 Q14-10JD [] 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?)

Physical activities specifically designed to strengthen your muscles, such as weight lifting or calisthenics.

 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 7 times per week

 Default Next: Q14-10KA Lead-In: Q14-10JC [Default]

 Q14-10KA [] Section: Section 14: Health

In a typical week, how many hours total do you use a computer or mobile device to do activities related to work or school?

 Enter Number:

 Default Next: Q14-10KB Lead-In: Q14-10JD [Default]

 Q14-10KB [] Section: Section 14: Health

In a typical week, how many hours total do you use a computer or mobile device to do any activities NOT related to work or school, for example, looking up information, playing games, buying or selling items, visiting social networking sites such as Facebook or MySpace, or communicating through texting, instant messaging, skyping or email?

 Enter Number:

 Default Next: Q14-10L Lead-In: Q14-10KA [Default]

 Q14-10L [] Section: Section 14: Health

On a typical weeknight, how many hours of sleep do you usually get?

 Enter Number:

 Default Next: Q14-10M Lead-In: Q14-10KB [Default]

 Q14-10M [] Section: Section 14: Health

When you buy a food item for the first time, how often would you say you read the nutritional information sometimes listed on the label - would you say always, often, sometimes, rarely or never?

 0   Don't buy food 1   Always 2   Often 3   Sometimes 4   Rarely 5   Never

 Q14-10N [] Section: Section 14: Health

When you buy a food item for the first time, how often would you say you read the ingredient list on the package - (would you say always, often, sometimes, rarely or never)?

 0   Don't buy food 1   Always 2   Often 3   Sometimes 4   Rarely 5   Never

 Default Next: Q14-10PA Lead-In: Q14-10M [Default]

 Q14-10PA [] Section: Section 14: Health

In the past seven days, how many times did you...

...Eat food from a fast food restaurant such as McDonalds, Kentucky Fried Chicken, Pizza Hut, or Taco Bell?

 # TIMES:

 Q14-10PB [] Section: Section 14: Health

(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)

 1   Per day 2   Per week

 Default Next: Q14-10QA Lead-In: Q14-10PA [Default]

 Q14-10QA [] Section: Section 14: Health

(In the past seven days, how many times did you...)

...Have a soft drink or soda that contained sugar? (Do not include diet soft drinks or sodas, or carbonated water.)

 # TIMES:

 Q14-10QB [] Section: Section 14: Health

(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)

 1   Per day 2   Per week

 Default Next: Q14-10RA Lead-In: Q14-10QA [Default]

 Q14-10RA [] Section: Section 14: Health

(In the past seven days, how many times did you...)

...Have a soft drink or soda that contained artificial sweeteners, such as Diet Coke, Diet Pepsi, Sprite Zero, or Diet Seven-Up?

 # TIMES:

 Q14-10RB [] Section: Section 14: Health

(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)

 1   Per day 2   Per week

 Default Next: Q14-11 Lead-In: Q14-10RA [Default]

 Q14-11 [] Section: Section 14: Health

During the past 12 months have you had any accidents or injuries that required medical attention?

 1   Yes   ...(Go To Q14-11-AA) 0   No

 Default Next: Q14-13 Lead-In: Q14-10RB [Default]

 Q14-11-AA [] Section: Section 14: Health

How many such accidents or injuries requiring medical attention have you had in the past 12 months?

 Enter Number:
If Answer = 0 Then Go To
Q14-13

 Default Next: Q14-11-B Lead-In: Q14-11 [1:1]

 Q14-11-B [] Section: Section 14: Health

Did any of these accidents or injuries require hospitalization?

 1   Yes   ...(Go To Q14-11-LOOP-BEGIN) 0   No

 Default Next: Q14-13 Lead-In: Q14-11-AA [Default]

 Q14-11-LOOP-BEGIN [] Section: Section 14: Health

REPEAT

 Default Next: Q14-11-AB Lead-In: Q14-11-B [1:1]

 Q14-11-AB [] Section: Section 14: Health

{ACCIDENT-LOOP1}

COMMENT: check to see if this is the first loop through

If Answer = 1 Then Go To
Q14-11A

 Default Next: Q14-11B Lead-In: Q14-11-LOOP-BEGIN [Default]

 Q14-11A [] Section: Section 14: Health

How many such accidents or injuries requiring hospitalization have you had in the past 12 months?

 Enter Number:
Q14-11-LOOP-END
If Answer = 0 Then Go To Q14-11-LOOP-END

 Default Next: Q14-11B Lead-In: Q14-11-AB [1:1]

 Q14-11B [] Section: Section 14: Health

Thinking of your [label to differentiate between R's most recent accident and any previous accidents([loop number])] accident or injury in what month and year did it occur?

 Enter Date: Month Year

 Default Next: Q14-11C_VERBATIM Lead-In: Q14-11-AB [Default], Q14-11A [Default]

 Q14-11C_VERBATIM [] Section: Section 14: Health

What was the cause of the [label to differentiate between R's most recent accident and any previous accidents([loop number])] accident or injury?

(RECORD VERBATIM AND CODE ONLY ONE BELOW)

 RECORD VERBATIM

 Q14-11C [] Section: Section 14: Health

(INTERVIEWER: CODE ONLY ONE FROM THE FOLLOWING CATEGORIES WITHOUT READING ALOUD.)

 1   MOTOR VEHICLE ACCIDENT AS OCCUPANT 2   MOTOR VEHICLE ACCIDENT AS PEDESTRIAN 3   CYCLING 4   FALL UNRELATED TO ATHLETICS OR SPORTS ACTIVITY 5   FALL/CONTACT RELATED TO ATHLETICS/SPORTS ACTIVITY 6   FIRE OR SMOKE 7   HOT LIQUID 8   TOY OR ITEM INTENDED FOR CHILD USE 9   EQUIPMENT OR DEVICE NOT INTENDED FOR A CHILD 10   POISONING 11   SMASHED BODY PART: CAR/DOOR/WINDOW BRUISE/CONTUSION 12   ADULT INJURED CHILD ACCIDENTLY (PULL/LIFT INJURY) 13   INTENTIONAL VIOLENT INJURY 14   "ROUGH HOUSING,"/IMPACT INJURY: WRESTLING, ETC. 16   FIGHTING: BROKE BONE/NOSE, HIT IN FACE, SHOT, STABBED, ETC. 17   STRUCK BY OBJECT FROM OTHER PERSON (INTENT UNKNOWN) 18   INSECT STING OR BITE 19   STEPPED ON SHARP OBJECT, I.E. GLASS/NAILS/METAL 20   RAN INTO STATIONARY OBJECT (NOT IN HOME ENVIRONMENT) 22   RAN INTO STATIONARY OBJECT (HOME ENVIRONMENT) 21   ANIMAL BITE 23   CUT BY SHARP OBJECT, I.E. KNIFE/GLASS/TOOL 24   BURN, I.E. FROM HEATER/CIGARETTE/OVEN/STOVE 25   JUMP/FALL ACCIDENT, I.E. OFF FURNITURE/OTHER OBJECT 26   "TEMPER" INJURIES, I.E. FELL, KICKED FURNITURE, ETC. 15   OTHER (SPECIFY)

 Default Next: Q14-11D Lead-In: Q14-11C_VERBATIM [Default]

 Q14-11D [] Section: Section 14: Health

What specific injury or conditions resulted from this accident or injury?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

(CODE ALL THAT APPLY)

 1   Broken or dislocated bones 2   Sprain, strain or pulled muscle 3   Wound: cuts, scrape, puncture 4   Head injury, concussion 5   Bruise, contusion or internal bleeding 6   Burn, Scald 7   Illness or effect from poisons, medicine (drugs), etc.. 8   Other (SPECIFY)

 Default Next: Q14-11E Lead-In: Q14-11C [Default]

 Q14-11E [] Section: Section 14: Health

Where did the accident or injury happen?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

 1   At home (any, not necessarily respondent's) 2   School (including grounds and athletic areas) 3   Place of work 4   Street or highway 5   Public building or space (other than streets or schools) 6   Place of recreation and sports except school 7   Farm or agricultural area, except farm house 8   Other (SPECIFY)

 Default Next: Q14-11-LOOP-END Lead-In: Q14-11D [Default]

 Q14-11-LOOP-END [] Section: Section 14: Health

UNTIL (([loop number]==[number of accidents or injuries requiring hospitalization]) || ([number of accidents or injuries requiring hospitalization]<=0))

 Default Next: Q14-13 Lead-In: Q14-11A [-2:-1], Q14-11A [0:0], Q14-11E [Default]

 Q14-13 [] Section: Section 14: Health

{RESP_GENDER}==1

COMMENT: Check to see if R is male; if so branch over menses

If Answer = 1 Then Go To
Q14-14D

 Default Next: Q14-13A Lead-In: Q14-11-AA [0:0], Q14-11 [Default], Q14-11-B [Default], Q14-11-LOOP-END [Default]

 Q14-13A [] Section: Section 14: Health

VAREXIST ([whether R has had menses])

COMMENT: set symbol for next question

If Answer = 1 Then Go To
Q14-13B

 Default Next: Q14-14A Lead-In: Q14-13 [Default]

 Q14-13B [] Section: Section 14: Health

{MENSES}==1

COMMENT: Check to see if menses information has already been collected.

If Answer = 1 Then Go To
Q14-14D

 Default Next: Q14-14A Lead-In: Q14-13A [1:1]

 Q14-14A [] Section: Section 14: Health

Have you ever had a menstrual period?

 1   Yes 0   No   ...(Go To Q14-14D)

If Answer = -1 Then Go To
Q14-14D

 Default Next: Q14-14B Lead-In: Q14-13A [Default], Q14-13B [Default]

 Q14-14B [] Section: Section 14: Health

(ENTER AGE:)

 Enter Number:
If Answer = -1 Then Go To
Q14-14D

 Default Next: Q14-14C Lead-In: Q14-14A [Default]

 Q14-14C [] Section: Section 14: Health

In what month and year did you have your first period?

(ENTER MONTH AND YEAR:)

 Enter Date: Month Year

 Default Next: Q14-14D Lead-In: Q14-14B [Default]

 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
Q14-20

 Default Next: Q14-14E Lead-In: Q14-13 [1:1], Q14-13B [1:1], Q14-14A [-1:-1], Q14-14A [0:0], Q14-14B [-1:-1], Q14-14C [Default]

 Q14-14E [] Section: Section 14: Health

{INGRANT}==1

COMMENT: Machine check: Is R 21 or over by end of 2010?

If Answer = 1 Then Go To
Q14-14F

 Default Next: Q14-15 Lead-In: Q14-14D [Default]

 Q14-14F [] Section: Section 14: Health

Some injuries or illnesses are not treated by a doctor or nurse. During the past 12 months, how many times were you injured or ill so that you missed at least one full day of usual activities such as work or school, but were not treated by a doctor or nurse?

 1   None 2   1 time 3   2 times 4   3 times 5   4 or more times

 Default Next: Q14-14G Lead-In: Q14-14E [1:1]

 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?

 1   Private doctor's office 2   Public clinic 3   Private clinic 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 PERSONELL

 Default Next: Q14-15 Lead-In: Q14-14F [Default]

 Q14-15 [] Section: Section 14: Health

In the past 12 months have you had any illnesses that required medical attention or treatment?

 1   Yes   ...(Go To Q14-15A) 0   No

 Default Next: Q14-16 Lead-In: Q14-14E [Default], Q14-14G [Default]

 Q14-15A [] Section: Section 14: Health

How many such illnesses have you had in the past 12 months?

(ENTER NUMBER OF ILLNESSES:)

 Enter Number:

 Default Next: Q14-16 Lead-In: Q14-15 [1:1]

 Q14-16 [] Section: Section 14: Health

When did you last see a doctor for treatment of an illness?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

 1   Less than 1 month ago 2   1 - 3 months ago 3   4 - 6 months ago 4   7 - 11 months ago 5   1 year - 23 month ago (less than 2 years) ago 6   2 or more years ago 7   Never

 Default Next: Q14-17 Lead-In: Q14-15 [Default], Q14-15A [Default]

 Q14-17 [] Section: Section 14: Health

When did you last see a doctor for a routine health check-up?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

 1   Less than 1 month ago 2   1 - 3 months ago 3   4 - 6 months ago 4   7 - 11 months ago 5   1 year - 23 month ago (less than 2 years) ago 6   2 or more years ago 7   Never

 Default Next: Q14-17A Lead-In: Q14-16 [Default]

 Q14-17A [] Section: Section 14: Health

When did you last see a dentist for a routine dental check-up?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

 1   Less than 1 month ago 2   1 - 3 months ago 3   4 - 6 months ago 4   7 - 11 months ago 5   1 year - 23 month ago (less than 2 years) ago 6   2 or more years ago 7   Never

 Default Next: Q14-17B Lead-In: Q14-17 [Default]

 Q14-17B [] Section: Section 14: Health

When did you last see an optometrist or ophthalmologist for a routine eye exam?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

 1   Less than 1 month ago 2   1 - 3 months ago 3   4 - 6 months ago 4   7 - 11 months ago 5   1 year - 23 month ago (less than 2 years) ago 6   2 or more years ago 7   Never

 Default Next: Q14-20 Lead-In: Q14-17A [Default]

 Q14-20 [] Section: Section 14: Health

How tall are you?

(ENTER NUMBER OF FEET:)

 Enter Number:

 Q14-20A [] Section: Section 14: Health

 (ENTER NUMBER OF INCHES:)

 Q14-21 [] Section: Section 14: Health

How much do you weigh?

(ENTER NUMBER OF POUNDS)

 Enter Number:

 Default Next: Q14-21A Lead-In: Q14-20A [Default]

 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]<21)

COMMENT: IS R IN HH WITH BOTH PARENTS OR WITH MOTHER ONLY AND UNDER AGE 21?

If Answer = 1 Then Go To
Q14-25

 Default Next: Q14-22 Lead-In: Q14-21 [Default]

 Q14-22 [] Section: Section 14: Health

Now we have a couple of questions about health care plans.

First, is your health care now covered by health insurance provided by an employer, the military, a student plan or by an individual plan that pays part or all of a hospital or doctor's bill?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, HMO.

(THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.)

 1   Yes 0   No   ...(Go To Q14-24)

 Default Next: Q14-23 Lead-In: Q14-21A [Default]

 Q14-23 [] Section: Section 14: Health

What is the source of your health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?

 1   Your Parent's policy 2   Your or your spouse/partner's policy bought directly from insurance company 3   Your employer's policy 4   Your spouse/partner's employer policy 6   Military health insurance 7   Student insurance through school, college or university 8   Other relative's policy 5   Other (SPECIFY)

 Default Next: Q14-24 Lead-In: Q14-22 [Default]

 Q14-24 [] Section: Section 14: Health

There is a national program called Medicaid (or Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is your health care now covered by Medicaid or one of these public assistance health care programs?

 1   Yes 0   No

 Default Next: Q14-24AA Lead-In: Q14-22 [0:0], Q14-23 [Default]

 Q14-24AA [] Section: Section 14: Health

[Q14-22]==0&&[Q14-24]==0

COMMENT: Did R indicate having no kind of health care coverage?

If Answer = 1 Then Go To
Q14-24AB

 Default Next: Q14-24AC Lead-In: Q14-24 [Default]

 Q14-24AB [] Section: Section 14: Health

Not including single service plans, about how long has it been since you last had health care coverage?

 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 year 4   Never

 Default Next: Q14-24AF Lead-In: Q14-24AA [1:1]

 Q14-24AC [] Section: Section 14: Health

In the past 12 months, have you ever been without health care coverage?

 1   YES   ...(Go To Q14-24AD) 0   NO

 Default Next: Q14-25 Lead-In: Q14-24AA [Default]

 Q14-24AD [] Section: Section 14: Health

About how many months were you without coverage?

 Enter Number:

 Default Next: Q14-24AF Lead-In: Q14-24AC [1:1]

 Q14-24AF [] Section: Section 14: Health

Which of these 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.]

Is there anyone that you felt especially close to who has died?

 1   Yes   ...(Go To Q14-26) 0   No

 Default Next: Q14-30 Lead-In: Q14-21A [1:1], Q14-24AC [Default], Q14-24AF [Default]

 Q14-26 [] Section: Section 14: Health

How was the person who died related to you?

(INTERVIEWER: PLEASE SELECT ALL THAT APPLY.)

 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)

 Default Next: Q14-27-LOOP-BEGIN Lead-In: Q14-25 [1:1]

 Q14-27-LOOP-BEGIN [] Section: Section 14: Health

REPEAT

COMMENT: start loop about deaths of significant people

 Default Next: Q14-27A Lead-In: Q14-26 [Default]

 Q14-27A [] Section: Section 14: Health

INSELECTION([Q14-26], [loop number])

COMMENT: CHECK TO DETERMINE IF THIS RELATIONSHIP WAS CHOSEN BY RESPONDENT IN Q14-26

If Answer = 1 Then Go To
Q14-28

 Default Next: Q14-29A-LOOP-END Lead-In: Q14-27-LOOP-BEGIN [Default]

 Q14-28 [] Section: Section 14: Health

In what month and year did your [relationship to R([loop number])] die?

 Enter Date: Month Year

 Default Next: Q14-28C Lead-In: Q14-27A [1:1]

 Q14-28C [] Section: Section 14: Health

{^DEATHDATE_MON({DEATH-LOOP1})^}==-2 || {^DEATHDATE_MON({DEATH-LOOP1})^}==-1

COMMENT: Machine Check: Did R indicate DK or refusal on month of death?

If Answer = 1 Then Go To
Q14-29

 Default Next: Q14-28D Lead-In: Q14-28 [Default]

 Q14-28D [] Section: Section 14: Health

{^DEATHDATE_YRN({DEATH-LOOP1})^}==-2 || {^DEATHDATE_YRN({DEATH-LOOP1})^}==-1

COMMENT: Machine Check: Did R indicate DK or refusal on year of death?

If Answer = 1 Then Go To
Q14-29

 Default Next: Q14-29A-LOOP-END Lead-In: Q14-28C [Default]

 Q14-29 [] Section: Section 14: Health

About how old were you when your [relationship to R([loop number])] died?

 Enter Number:

 Default Next: Q14-29A-LOOP-END Lead-In: Q14-28C [1:1], Q14-28D [1:1]

 Q14-29A-LOOP-END [] Section: Section 14: Health

UNTIL ( [loop number]==29)

COMMENT: End loop about deaths of significant people

 Default Next: Q14-30 Lead-In: Q14-27A [Default], Q14-28D [Default], Q14-29 [Default]

 Q14-30 [] Section: Section 14: Health

{EVER_DLI_CAT} been the victim of a violent crime, for example, physical or sexual assault, robbery or arson?

 1   Yes   ...(Go To Q14-31) 0   No

 Default Next: Q14-34 Lead-In: Q14-25 [Default], Q14-29A-LOOP-END [Default]

 Q14-31 [] Section: Section 14: Health

Have you been the victim of a violent crime more than once?

 1   Yes   ...(Go To Q14-32) 0   No

 Default Next: Q14-33 Lead-In: Q14-30 [1:1]

 Q14-32 [] Section: Section 14: Health

How old were you the first time [(since date of last interview)?/?] you were the victim of a violent crime?

 Enter Number:

 Default Next: Q14-32A Lead-In: Q14-31 [1:1]

 Q14-32A [] Section: Section 14: Health

How old were you the most recent time you were the victim of a violent crime?

 Enter Number:

 Default Next: Q14-34 Lead-In: Q14-32 [Default]

 Q14-33 [] Section: Section 14: Health

How old were you when you were the victim of a violent crime[(since date of last interview)?/?]

 Enter Number:

 Default Next: Q14-34 Lead-In: Q14-31 [Default]

 Q14-34 [] Section: Section 14: Health

{SINCE10_DLI_2} 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?

 1   Yes   ...(Go To Q14-35) 0   No

 Default Next: Q14-40 Lead-In: Q14-30 [Default], Q14-32A [Default], Q14-33 [Default]

 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 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)

 Default Next: Q14-36-LOOP-BEGIN Lead-In: Q14-34 [1:1]

 Q14-36-LOOP-BEGIN [] Section: Section 14: Health

REPEAT

 Default Next: Q14-36A Lead-In: Q14-35 [Default]

 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

 Default Next: Q14-39A-LOOP-END Lead-In: Q14-36-LOOP-BEGIN [Default]

 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?

 1   Yes   ...(Go To Q14-38) 0   No

 Default Next: Q14-39 Lead-In: Q14-36A [1:1]

 Q14-38 [] Section: Section 14: Health

How old were you the first time [(since date of last interview)?/?] your [relationship to R([loop number])] was sent to jail or prison (while you living were in the same household)?

 Enter Number:

 Default Next: Q14-38A Lead-In: Q14-37 [1:1]

 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)?

 Enter Number:

 Default Next: Q14-39A-LOOP-END Lead-In: Q14-38 [Default]

 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)?/?]

 Enter Number:

 Default Next: Q14-39A-LOOP-END Lead-In: Q14-37 [Default]

 Q14-39A-LOOP-END [] Section: Section 14: Health

UNTIL ( [loop number]==18)

 Default Next: Q14-40 Lead-In: Q14-36A [Default], Q14-38A [Default], Q14-39 [Default]

 Q14-40 [] Section: Section 14: Health

COMMENT: Check: Does R need to complete additional health module?

If Answer = 1 Then Go To
Q14-41

 Default Next: Q15-1A Lead-In: Q14-34 [Default], Q14-39A-LOOP-END [Default]

 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 chloresterol? - ...stroke?
 1   YES 0   NO

 Default Next: Q14-41A Lead-In: Q14-40 [1:1]

 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

 Default Next: Q14-43 Lead-In: Q14-41 [Default]

 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

 Default Next: Q14-43 Lead-In: Q14-41A [1:1]

 Q14-43 [] Section: Section 14: Health

Have any of your biological grandparents been told by a doctor that they have diabetes?

 1   YES   ...(Go To Q14-43A) 0   NO

 Default Next: Q14-44 Lead-In: Q14-41A [Default], Q14-42 [Default]

 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

 Default Next: Q14-44 Lead-In: Q14-43 [1:1]

 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

 Default Next: Q14-45 Lead-In: Q14-43 [Default], Q14-43A [Default]

 Q14-44A [] Section: Section 14: Health

What caused your biological father's death?

 1   Heart Attack/Stroke 2   Accident 3   Cancer 4   Old Age 5   Emphysema 6   Other (specify)

 Default Next: Q14-44B Lead-In: Q14-44 [1:1]

 Q14-44B [] Section: Section 14: Health

How old was he when he died?

 Enter Number:

 Default Next: Q14-45 Lead-In: Q14-44A [Default]

 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

 Default Next: Q14-46 Lead-In: Q14-44 [Default], Q14-44B [Default]

 Q14-45A [] Section: Section 14: Health

What caused your biological mother's death?

 1   Heart Attack/Stroke 2   Accident 3   Cancer 4   Old Age 5   Emphysema 6   Other (specify)

 Default Next: Q14-45B Lead-In: Q14-45 [1:1]

 Q14-45B [] Section: Section 14: Health

How old was she when she died?

 Enter Number:

 Default Next: Q14-46 Lead-In: Q14-45A [Default]

 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

 Default Next: Q14-46A Lead-In: Q14-45 [Default], Q14-45B [Default]

 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

 Default Next: Q14-47 Lead-In: Q14-46 [Default]

 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

 Default Next: Q14-48 Lead-In: Q14-46A [Default]

 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

 Default Next: Q14-49 Lead-In: Q14-47 [Default]

 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

 Default Next: Q14-50 Lead-In: Q14-48 [Default]

 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

 Default Next: Q14-51 Lead-In: Q14-49 [Default]

 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...

 - 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

 Default Next: Q14-52 Lead-In: Q14-50 [Default]

 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?
 1   YES 0   NO

 Default Next: Q14-53 Lead-In: Q14-51 [Default]

 Q14-53 [] Section: Section 14: Health

{RESP_GENDER}==2

COMMENT: Is R female?

If Answer = 1 Then Go To
Q14-53A

 Default Next: Q14-54A Lead-In: Q14-52 [Default]

 Q14-53A [] Section: Section 14: Health

Have you had a PAP smear in the past 2 years?

 1   YES 0   NO

 Default Next: Q14-54A Lead-In: Q14-53 [1:1]

 Q14-54A [] Section: Section 14: Health

During a usual week, how many times a day do you...

 Enter Number:

 Q14-54B [] Section: Section 14: Health

(During a usual week, how many times a day do you...)

....use dental floss?

 Enter Number:

 Default Next: Q14-55 Lead-In: Q14-54A [Default]

 Q14-55 [] Section: Section 14: Health

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?

 1   YES   ...(Go To Q14-55A) 0   NO

 Default Next: COGNITION-C1 Lead-In: Q14-54B [Default]

 Q14-55A [] Section: Section 14: Health

How many times has this happened?

 Enter Number:
If Answer = 0 Then Go To
COGNITION-C1

 Default Next: Q14-55B Lead-In: Q14-55 [1:1]

 Q14-55B [] Section: Section 14: Health

 ENTER AGE:

 Default Next: Q14-55C Lead-In: Q14-55A [Default]

 Q14-55C [] Section: Section 14: Health

Did you loose consciousness?

 1   YES   ...(Go To Q14-55D) 0   NO

 Default Next: COGNITION-C1 Lead-In: Q14-55B [Default]

 Q14-55D [] Section: Section 14: Health

How long were you unconscious?

 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

 Default Next: COGNITION-C1 Lead-In: Q14-55C [1:1]

 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

 Default Next: COGNITION-C2 Lead-In: Q14-55A [0:0], Q14-55 [Default], Q14-55C [Default], Q14-55D [Default]

 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

 Default Next: COGNITION-3_TEST1 Lead-In: COGNITION-C1 [Default]

 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 <SUBMIT AND CONTINUE> TO PROCEED.)

 1   CONTINUE WITH WORD LIST 2   REFUSED WORD LIST   ...(Go To COGNITION-6)

 Default Next: COG_RANDOM_TEST1 Lead-In: COGNITION-C2 [Default]

 COG_RANDOM_TEST1 [] Section: Section 14: Health

INT(RAND(0)*5)

If Answer = 1 Then Go To
COG_LIST1A_TEST1_M1
If Answer = 2 Then Go To COG_LIST2A_TEST1_M2
If Answer = 3 Then Go To COG_LIST3A_TEST1_M3
If Answer = 4 Then Go To COG_LIST4A_TEST1_M4

 Default Next: COG_LIST1A_TEST1_M1 Lead-In: COGNITION-3_TEST1 [Default]

 COG_LIST1A_TEST1_M1 [] Section: Section 14: Health

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Hotel - River - Tree - Skin - Gold - Market - Paper - Child - King - Book
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-4A_2 Lead-In: COG_RANDOM_TEST1 [1:1], COG_RANDOM_TEST1 [Default]

 COGNITION-4A_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: COGNITION-4_CHK4 Lead-In: COG_LIST1A_TEST1_M1 [Default]

 COG_LIST2A_TEST1_M2 [] Section: Section 14: Health

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Sky - Ocean - Flag - Dollar - Wife - Machine - Home - Earth - College - Butter
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-4B_2 Lead-In: COG_RANDOM_TEST1 [2:2]

 COGNITION-4B_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: COGNITION-4_CHK4 Lead-In: COG_LIST2A_TEST1_M2 [Default]

 COG_LIST3A_TEST1_M3 [] Section: Section 14: Health

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Woman - Rock - Blood - Corner - Shoes - Letter - Girl - House - Valley - Engine
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-4C_2 Lead-In: COG_RANDOM_TEST1 [3:3]

 COGNITION-4C_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: COGNITION-4_CHK4 Lead-In: COG_LIST3A_TEST1_M3 [Default]

 COG_LIST4A_TEST1_M4 [] Section: Section 14: Health

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Water - Church - Doctor - Palace - Fire - Garden - Sea - Village - Baby - Table
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-4D_2 Lead-In: COG_RANDOM_TEST1 [4:4]

 COGNITION-4D_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: COGNITION-4_CHK4 Lead-In: COG_LIST4A_TEST1_M4 [Default]

 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

 Default Next: COGNITION-6 Lead-In: COGNITION-4A_2 [Default], COGNITION-4B_2 [Default], COGNITION-4C_2 [Default], COGNITION-4D_2 [Default]

 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.

(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

COGNITION-6G

 Default Next: COGNITION-6A Lead-In: COGNITION-3_TEST1 [2:2], COGNITION-4_CHK4 [Default]

 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

COGNITION-6G

 Default Next: COGNITION-6C Lead-In: COGNITION-6 [Default]

 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

 Default Next: COGNITION-6G Lead-In: COGNITION-6A [Default]

 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

COGNITION-6G

 Default Next: COGNITION-6D_Y1 Lead-In: COGNITION-6C [6:6]

 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

COGNITION-6G

 Default Next: COGNITION-6F Lead-In: COGNITION-6D [Default]

 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

 Default Next: COGNITION-6G Lead-In: COGNITION-6D_Y1 [Default]

 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.

(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

COGNITION-7A

 Default Next: COGNITION-6G_Y1 Lead-In: COGNITION-6 [-2:-1], COGNITION-6A [-2:-1], COGNITION-6D [-2:-1], COGNITION-6D_Y1 [-2:-1], COGNITION-6C [Default], COGNITION-6F [Default]

 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

COGNITION-7A

 Default Next: COGNITION-6J Lead-In: COGNITION-6G [Default]

 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

 Default Next: COGNITION-7A Lead-In: COGNITION-6G_Y1 [Default]

 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

COGNITION-7A

 Default Next: COGNITION-6K_Y1 Lead-In: COGNITION-6J [6:6]

 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

COGNITION-7A

 Default Next: COGNITION-6N Lead-In: COGNITION-6K [Default]

 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

 Default Next: COGNITION-7A Lead-In: COGNITION-6K_Y1 [Default]

 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 <SUBMIT AND CONTINUE> TO PROCEED.)

 ENTER NUMBER:

 COGNITION-7B [] Section: Section 14: Health

And 7 from that?

 ENTER NUMBER:

 COGNITION-7C [] Section: Section 14: Health

And 7 from that?

 ENTER NUMBER:

 COGNITION-7D [] Section: Section 14: Health

And 7 from that?

 ENTER NUMBER:

 COGNITION-7E [] Section: Section 14: Health

And 7 from that?

 ENTER NUMBER:

 Default Next: COGNITION-8_CHK Lead-In: COGNITION-7D [Default]

 COGNITION-8_CHK [] Section: Section 14: Health

{word_list_refused1} == 1 || {correct_words_cnt1} > 0

If Answer = 0 Then Go To
Q15-1A

 Default Next: COGNITION-CHK4 Lead-In: COGNITION-7E [Default]

 COGNITION-CHK4 [] Section: Section 14: Health

{cog_word_list_flag}

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
If Answer = 4 Then Go To COGNITION-8D_1

 Default Next: COGNITION-8A_1 Lead-In: COGNITION-8_CHK [Default]

 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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Hotel - River - Tree - Skin - Gold - Market - Paper - Child - King - Book
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-8A_2 Lead-In: COGNITION-CHK4 [1:1], COGNITION-CHK4 [Default]

 COGNITION-8A_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: Q15-1A Lead-In: COGNITION-8A_1 [Default]

 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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Sky - Ocean - Flag - Dollar - Wife - Machine - Home - Earth - College - Butter
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-8B_2 Lead-In: COGNITION-CHK4 [2:2]

 COGNITION-8B_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: Q15-1A Lead-In: COGNITION-8B_1 [Default]

 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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Woman - Rock - Blood - Corner - Shoes - Letter - Girl - House - Valley - Engine
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-8C_2 Lead-In: COGNITION-CHK4 [3:3]

 COGNITION-8C_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: Q15-1A Lead-In: COGNITION-8C_1 [Default]

 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 <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 - Water - Church - Doctor - Palace - Fire - Garden - Sea - Village - Baby - Table
 1   RECALLED 0   NOT RECALLED

 Default Next: COGNITION-8D_2 Lead-In: COGNITION-CHK4 [4:4]

 COGNITION-8D_2 [] Section: Section 14: Health

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

 Default Next: Q15-1A Lead-In: COGNITION-8D_1 [Default]