Preventive Care (AP) Section
BOX_00A
=======
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| THE AP SECTION IS ASKED IN ROUNDS 3 AND 5 ONLY. IF|
| IT IS ROUND 1, 2, OR 4, CONTINUE TO THE NEXT |
| SECTION. |
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BOX_00
======
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| CONTEXT HEADER DISPLAY INSTRUCTIONS: |
| DISPLAY PERS.FULLNAME. |
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AP01
====
OMITTED.
AP02
====
OMITTED.
AP03
====
OMITTED.
AP04
====
OMITTED.
AP04A
=====
OMITTED.
AP05
====
OMITTED.
AP06
====
OMITTED.
AP07
====
OMITTED.
AP08
====
OMITTED.
AP09
====
OMITTED.
AP10
====
OMITTED.
AP11
====
OMITTED.
AP11A
=====
OMITTED.
AP11B
=====
OMITTED.
AP11C
=====
OMITTED.
BOX_01
======
OMITTED.
AP12
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
The next few questions ask about the amounts and types of
preventive care (PERSON) may receive.
On average, how often (do/does) (PERSON) receive a dental
check-up?
TWICE A YEAR OR MORE ................... 1
ONCE A YEAR ............................ 2
LESS THAN ONCE A YEAR .................. 3
NEVER GO TO DENTIST .................... 4
REF ................................... -7
DK .................................... -8
[Code One]
HELP AVAILABLE FOR DEFINITION OF DENTAL CHECK-UP.
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| IF PERSON BEING ASKED ABOUT IS 18 YEARS OF AGE OR |
| OLDER (OR IN AGE CATEGORIES 4-9), CONTINUE WITH |
| AP15 |
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| IF PERSON BEING ASKED ABOUT IS 16 OR 17 YEARS OF |
| AGE, GO TO AP32 |
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| OTHERWISE (THAT IS, PERSON BEING ASKED ABOUT IS |
| LESS THAN 16 YEARS OF AGE OR IN AGE CATEGORIES |
| 1-3), GO TO BOX_02 |
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AP13
====
OMITTED.
AP14
====
OMITTED.
AP15
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
About how long has it been since (PERSON) had (PERSON)’s blood
pressure checked by a doctor, nurse or other health professional?
WITHIN PAST YEAR ....................... 1 {AP15OV}
WITHIN PAST 2 YEARS .................... 2 {AP15OV}
WITHIN PAST 3 YEARS .................... 3 {AP16}
WITHIN PAST 5 YEARS .................... 4 {AP16}
MORE THAN 5 YEARS ...................... 5 {AP16}
NEVER .................................. 6 {AP16}
REF ................................... -7 {AP16}
DK .................................... -8 {AP16}
HELP AVAILABLE FOR DEFINITION OF BLOOD PRESSURE CHECK.
[Code One]
AP15OV
======
IF NOT ALREADY GIVEN, ASK: About how long ago in months
has it been?
IF LESS THAN ONE MONTH AGO, ENTER 0.
NUMBER:
[Enter Small Number] ................... {AP16}
REF ................................... -7 {AP16}
DK .................................... -8 {AP16}
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| HARD CHECK: |
| 0 – 24 |
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AP16
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
About how long has it been since (PERSON) had (PERSON)’s blood
cholesterol checked by a doctor or other health professional?
WITHIN PAST YEAR ....................... 1 {AP17}
WITHIN PAST 2 YEARS .................... 2 {AP17}
WITHIN PAST 3 YEARS .................... 3 {AP17}
WITHIN PAST 5 YEARS .................... 4 {AP17}
MORE THAN 5 YEARS ...................... 5 {AP17}
NEVER .................................. 6 {AP17}
REF ................................... -7 {AP17}
DK .................................... -8 {AP17}
HELP AVAILABLE FOR DEFINITION OF BLOOD CHOLESTEROL CHECK.
[Code One]
AP17
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
A routine check-up is a visit with a doctor or other health
professional for assessing overall health, usually not prompted
by a specific illness or complaint. It usually includes a blood
pressure check, and may include taking a blood sample for
analysis and questions about health behaviors such as smoking.
About how long has it been since (PERSON) had a routine
check-up by a doctor or other health professional?
WITHIN PAST YEAR ....................... 1 {AP17A}
WITHIN PAST 2 YEARS .................... 2 {AP17A}
WITHIN PAST 3 YEARS .................... 3 {AP17A}
WITHIN PAST 5 YEARS .................... 4 {AP17A}
MORE THAN 5 YEARS ...................... 5 {AP17A}
NEVER .................................. 6 {AP17A}
REF ................................... -7 {AP17A}
DK .................................... -8 {AP17A}
[Code One]
AP17A
=====
{PERSON’S FIRST MIDDLE AND LAST NAME}
Doctors or other health professionals often advise people
to make a change to their lifestyles to lower their risk
of developing a number of diseases, including heart disease.
Has a doctor or other health professional ever advised
(PERSON) to...
YES NO
AP17A_01
========
...Eat fewer high fat or high
cholesterol foods? 1 2 ( ) AP17A_02
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| REFUSED (-7) AND DON’T KNOW (-8) ALLOWED. |
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AP17A_02
========
...Exercise more? 1 2 ( ) {AP18}
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| REFUSED (-7) AND DON’T KNOW (-8) ALLOWED. |
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AP18
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
About how long has it been since (PERSON) had a flu vaccination
(shot or nasal spray)?
WITHIN PAST YEAR ....................... 1 {AP18A}
WITHIN PAST 2 YEARS .................... 2 {AP18A}
WITHIN PAST 3 YEARS .................... 3 {AP18A}
WITHIN PAST 5 YEARS .................... 4 {AP18A}
MORE THAN 5 YEARS ...................... 5 {AP18A}
NEVER .................................. 6 {AP18A}
REF ................................... -7 {AP18A}
DK .................................... -8 {AP18A}
[Code One]
HELP AVAILABLE FOR DEFINITION OF FLU VACCINATION.
AP18A
=====
{PERSON'S FIRST MIDDLE AND LAST NAME}
(Do/Does) (PERSON) take aspirin every day or every other
day?
YES .................................... 1 {AP18B}
NO ..................................... 2 {AP18AA}
REF ................................... -7 {AP18B}
DK .................................... -8 {AP18B}
AP18AA
======
{PERSON'S FIRST MIDDLE AND LAST NAME}
(Do/Does) (PERSON) have a health problem or condition that
makes taking aspirin unsafe for (PERSON)?
YES .................................... 1 {AP18AAA}
NO ..................................... 2 {AP18B}
REF ................................... -7 {AP18B}
DK .................................... -8 {AP18B}
AP18AAA
=======
{PERSON'S FIRST MIDDLE AND LAST NAME}
Is that problem stomach related or something else?
STOMACH RELATED ........................ 1 {AP18B}
SOMETHING ELSE ......................... 2 {AP18B}
REF ................................... -7 {AP18B}
DK .................................... -8 {AP18B}
[Code One]
AP18B
=====
{PERSON'S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) lost all of (PERSON)’s upper and lower
natural (permanent) teeth?
YES .................................... 1 {BOX_01A}
NO ..................................... 2 {BOX_01A}
REF ................................... -7 {BOX_01A}
DK .................................... -8 {BOX_01A}
BOX_01A
=======
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| IF PERSON BEING ASKED ABOUT IS MALE AND IS 40 |
| YEARS OF AGE OR OLDER (OR IN AGE CATEGORIES 6-9), |
| CONTINUE WITH AP19 |
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| IF PERSON BEING ASKED ABOUT IS MALE AND IS LESS |
| THAN 40 YEARS OF AGE (OR IN AGE CATEGORIES 4-5), |
| GO TO AP23 |
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| OTHERWISE (I.E., PERSON BEING ASKED ABOUT IS |
| FEMALE), GO TO AP20A |
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AP19
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
A "P-S-A" or prostate specific antigen is a blood test for
prostate cancer. About how long has it been since (PERSON) had a
"P-S-A"?
WITHIN PAST YEAR ....................... 1 {AP23}
WITHIN PAST 2 YEARS .................... 2 {AP23}
WITHIN PAST 3 YEARS .................... 3 {AP23}
WITHIN PAST 5 YEARS .................... 4 {AP23}
MORE THAN 5 YEARS ...................... 5 {AP23}
NEVER .................................. 6 {AP23}
REF ................................... -7 {AP23}
DK .................................... -8 {AP23}
[Code One]
AP20A
=====
{PERSON'S FIRST MIDDLE AND LAST NAME}
(Have/Has) (PERSON) had a hysterectomy?
YES .................................... 1 {AP20}
NO ..................................... 2 {AP20}
REF ................................... -7 {AP20}
DK .................................... -8 {AP20}
HELP AVAILABLE FOR DEFINITION OF HYSTERECTOMY.
AP20
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
About how long has it been since (PERSON) had a pap smear test?
WITHIN PAST YEAR ....................... 1 {AP21}
WITHIN PAST 2 YEARS .................... 2 {AP21}
WITHIN PAST 3 YEARS .................... 3 {AP21}
WITHIN PAST 5 YEARS .................... 4 {AP21}
MORE THAN 5 YEARS ...................... 5 {AP21}
NEVER .................................. 6 {AP21}
REF ................................... -7 {AP21}
DK .................................... -8 {AP21}
HELP AVAILABLE FOR DEFINITION OF PAP SMEAR TEST.
[Code One]
AP21
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
During a breast exam a doctor or other health professional feels
the breast for lumps. About how long has it been since (PERSON)
had a breast exam?
WITHIN PAST YEAR ....................... 1
WITHIN PAST 2 YEARS .................... 2
WITHIN PAST 3 YEARS .................... 3
WITHIN PAST 5 YEARS .................... 4
MORE THAN 5 YEARS ...................... 5
NEVER .................................. 6
REF ................................... -7
DK .................................... -8
[Code One]
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| IF PERSON BEING ASKED ABOUT IS 30 YEARS OF AGE OR |
| OLDER (OR IN AGE CATEGORIES 5-9), CONTINUE WITH |
| AP22 |
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| OTHERWISE, GO TO AP23 |
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AP22
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
A mammogram is an x-ray taken only of the breast by a machine
that presses the breast against a plate. About how long has it
been since (PERSON) had a mammogram?
WITHIN PAST YEAR ....................... 1 {AP23}
WITHIN PAST 2 YEARS .................... 2 {AP23}
WITHIN PAST 3 YEARS .................... 3 {AP23}
WITHIN PAST 5 YEARS .................... 4 {AP23}
MORE THAN 5 YEARS ...................... 5 {AP23}
NEVER .................................. 6 {AP23}
REF ................................... -7 {AP23}
DK .................................... -8 {AP23}
[Code One]
AP23
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
A blood stool test is a test that you do at home using a special
kit or cards provided by a doctor or other health professional
to determine whether the stool contains blood. (Have/Has)
(PERSON) ever had this test using a home kit?
YES .................................... 1 {AP24}
NO ..................................... 2 {AP25}
REF ................................... -7 {AP25}
DK .................................... -8 {AP25}
AP24
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
When did (PERSON) have (PERSON)'s last blood stool test using a
home kit?
WITHIN PAST YEAR ....................... 1 {AP25}
WITHIN PAST 2 YEARS .................... 2 {AP25}
WITHIN PAST 3 YEARS .................... 3 {AP25}
WITHIN PAST 5 YEARS .................... 4 {AP25}
MORE THAN 5 YEARS ...................... 5 {AP25}
REF ................................... -7 {AP25}
DK .................................... -8 {AP25}
[Code One]
AP25
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
A sigmoidoscopy or colonoscopy is when a tube is inserted in the
rectum to view the bowel for signs of cancer or other health
problems. (Have/Has) (PERSON) ever had this exam?
YES .................................... 1 {AP26}
NO ..................................... 2 {AP28}
REF ................................... -7 {AP28}
DK .................................... -8 {AP28}
AP26
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
When did (PERSON) have (PERSON)'s last sigmoidoscopy or
colonoscopy?
WITHIN PAST YEAR ....................... 1 {AP28}
WITHIN PAST 2 YEARS .................... 2 {AP28}
WITHIN PAST 3 YEARS .................... 3 {AP28}
WITHIN PAST 5 YEARS .................... 4 {AP28}
MORE THAN 5 YEARS ...................... 5 {AP28}
REF ................................... -7 {AP28}
DK .................................... -8 {AP28}
[Code One]
AP27
====
OMITTED.
AP28
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
(Do/Does) (PERSON) now spend half an hour or more in moderate
or vigorous physical activity at least three times a week?
YES .................................... 1 {AP29}
NO ..................................... 2 {AP29}
REF ................................... -7 {AP29}
DK .................................... -8 {AP29}
HELP AVAILABLE FOR DEFINITION OF MODERATE OR VIGOROUS
PHYSICAL ACTIVITY.
AP29
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
About how tall (are/is) (PERSON) without shoes?
PROBE FOR INCHES IF NOT REPORTED.
AP29_01
=======
FEET:
[Enter Feet] ........................... {AP29_02}
REF ................................... -7 {AP30}
DK .................................... -8 {AP30}
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| SOFT CHECK: |
| SOFT RANGE CHECK: 2 TO 6 |
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AP29_02
=======
INCHES:
[Enter Inches] ......................... {AP30}
REF ................................... –7 {AP30}
DK .................................... –8 {AP30}
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| HARD CHECK: |
| HARD RANGE CHECK: 0 TO 11 |
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AP30
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
About how much (do/does) (PERSON) weigh without shoes?
ENTER CURRENT WEIGHT TO THE NEAREST POUND.
[Enter Pounds] ......................... {AP32}
REF ................................... -7 {AP32}
DK .................................... -8 {AP31}
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| SOFT CHECK: |
| SOFT RANGE CHECK: 50 TO 500 |
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AP31
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
SHOW CARD AP-1.
Looking at this card, what is your best guess of (PERSON)'s
weight?
99 POUNDS OR LESS ..................... 1 {AP32}
100 - 149 POUNDS ...................... 2 {AP32}
150 - 199 POUNDS ...................... 3 {AP32}
200 - 249 POUNDS ...................... 4 {AP32}
250 - 299 POUNDS ...................... 5 {AP32}
300 POUNDS OR MORE .................... 6 {AP32}
REF ................................... -7 {AP32}
DK .................................... -8 {AP32}
[Code One]
AP32
====
{PERSON'S FIRST MIDDLE AND LAST NAME}
When (PERSON) drive(s) or ride(s) in a car, would (PERSON) say
(PERSON) wear(s) a seat belt...
Always, ................................ 1 {BOX_02}
Nearly Always, ......................... 2 {BOX_02}
Sometimes, ............................. 3 {BOX_02}
Seldom, or ............................. 4 {BOX_02}
Never? ................................. 5 {BOX_02}
IF VOLUNTEERED: NEVER DRIVES OR RIDES
IN A CAR/ALWAYS USES PUBLIC
TRANSPORTATION OR WALKS ........... 6 {BOX_02}
REF ................................... -7 {BOX_02}
DK .................................... -8 {BOX_02}
[Code One]
BOX_02
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