BOX_00A
CONTEXT HEADER DISPLAY INSTRUCTIONS:
DISPLAY PERS.FULLNAME, {PRND.BEGREFMM,
PRND.BEGREFDD, PRND.BEGREFYY, PRND.ENDREFMM,
PRND.ENDREFDD, PRND.ENDREFYY}.
LOOP_01
FOR EACH ELEMENT IN THE RU-MEMBERS-ROSTER,
ASK PE00A-END_LP01
LOOP DEFINITION: LOOP_01 COLLECTS GENERAL HEALTH
RATINGS AND ENUMERATES THE PRIORITY HEALTH
CONDITIONS OF EACH PERSON IN THE RU. THIS LOOP
CYCLES ON EACH PERSON IN THE RU-MEMBERS-ROSTER
WHO MEETS THE FOLLOWING CONDITIONS:
- PERSON IS A CURRENT OR INSTITUTIONALIZED RU
MEMBER
- PERSON IS NOT DECEASED
PE00A
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Please think about {your/{PERSON}'s} health between
{START DATE} and
{END DATE}.
In general, compared to other people of {your/his/her}
age, would
you say that {your/his/her} health is excellent, very
good, good,
fair, or poor?
EXCELLENT .............................. 1 {PE00B}
VERY GOOD .............................. 2 {PE00B}
GOOD ................................... 3 {PE00B}
FAIR ................................... 4 {PE00B}
POOR ................................... 5 {PE00B}
REF ................................... -7 {PE00B}
DK .................................... -8 {PE00B}
[Code One]
PE00B
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
In general, would you say that {your/{PERSON}'s}
mental health is
excellent, very good, good, fair, or poor?
EXCELLENT .............................. 1 {BOX_00}
VERY GOOD .............................. 2 {BOX_00}
GOOD ................................... 3 {BOX_00}
FAIR ................................... 4 {BOX_00}
POOR ................................... 5 {BOX_00}
REF ................................... -7 {BOX_00}
DK .................................... -8 {BOX_00}
[Code One]
BOX_00
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
CONTINUE WITH PE01
OTHERWISE, GO TO END_LP01
PE01
{PERSON'S FIRST MIDDLE AND LAST NAME}
Now I’m going to ask you about certain medical
conditions {you/{PERSON}}
may have had. For these questions, please think about
{your/his/her}
health over {your/his/her} lifetime.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
BOX_01
IF PERSON IS > OR = 18 YEARS OF AGE OR IN AGE
CATEGORIES 4-9, CONTINUE WITH BOX_02
OTHERWISE, GO TO BOX_14
BOX_02
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘HYPERTENSION - HI BLOOD PRESSURE’ IN THE PE
SECTION,
CONTINUE WITH PE02
OTHERWISE, GO TO BOX_03
PE02
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Other than during pregnancy, {have/has}/{Have/Has}}
{you/{PERSON}}
ever been told by a doctor or other health
professional that
{you/he/she} had hypertension, also called high blood
pressure?
YES .................................... 1 {PE03}
NO ..................................... 2 {BOX_03}
REF ................................... -7 {BOX_03}
DK .................................... -8 {BOX_03}
HELP AVAILABLE FOR DEFINITION OF HYPERTENSION.
DISPLAY ‘Other than during pregnancy, (have/has)’
IF PERSON BEING ASKED ABOUT IS FEMALE. DISPLAY
‘(Have/Has)’ IF PERSON BEING ASKED ABOUT IS MALE.
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘HYPERTENSION - HI BLOOD PRESSURE’ TO PERSON’S-
MEDICAL-CONDITIONS-ROSTER.
PE03
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the
hypertension, also called
high blood pressure, was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {PE04}
REF ................................... -7 {PE04}
DK .................................... -8 {PE04}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
PE04
{PERSON'S FIRST MIDDLE AND LAST NAME}
{Were/Was} {you/{PERSON}} told on two or more different visits
that {you/he/she} had hypertension, also called high
blood pressure?
YES .................................... 1 {BOX_03}
NO ..................................... 2 {BOX_03}
REF ................................... -7 {BOX_03}
DK .................................... -8 {BOX_03}
BOX_03
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘CORONARY HEART DISEASE’ IN THE PE SECTION,
CONTINUE WITH PE05
OTHERWISE, GO TO BOX_04
PE05
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had coronary heart
disease?
YES .................................... 1 {PE06}
NO ..................................... 2 {BOX_04}
REF ................................... -7 {BOX_04}
DK .................................... -8 {BOX_04}
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘CORONARY HEART DISEASE’ TO PERSON’S-MEDICAL-
CONDITIONS-ROSTER.
PE06
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the coronary
heart disease
was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_04}
REF ................................... -7 {BOX_04}
DK .................................... -8 {BOX_04}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_04
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘ANGINA’ IN THE PE SECTION,
CONTINUE WITH PE07
OTHERWISE, GO TO BOX_05
PE07
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had angina, also called
angina
pectoris?
YES .................................... 1 {PE08}
NO ..................................... 2 {BOX_05}
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘ANGINA’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER.
PE08
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the angina,
also called angina
pectoris, was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_05}
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_05
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘HEART ATTACK - MYOCARDIAL INFARC’ IN THE PE
SECTION,
CONTINUE WITH PE09
OTHERWISE, GO TO BOX_06
PE09
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had a heart attack,
also called
myocardial infarction or MI?
YES .................................... 1 {PE10}
NO ..................................... 2 {BOX_06}
REF ................................... -7 {BOX_06}
DK .................................... -8 {BOX_06}
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘HEART ATTACK - MYOCARDIAL INFARC’ TO PERSON’S-
MEDICAL-CONDITIONS-ROSTER.
PE10
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the heart
attack, also called
myocardial infarction or MI, was first diagnosed?
IF MORE THAN ONE HEART ATTACK, PROBE FOR AGE WHEN
FIRST HEART
ATTACK DIAGNOSED.
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_06}
REF ................................... -7 {BOX_06}
DK .................................... -8 {BOX_06}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_06
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘OTHER HRT COND – {SPECIFY TEXT}’ IN THE PE
SECTION,
CONTINUE WITH PE11
OTHERWISE, GO TO BOX_07
PE11
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had any other kind of
heart condition
or heart disease, other than coronary heart disease,
angina, or
heart attack?
YES .................................... 1 {PE11OV}
NO ..................................... 2 {BOX_07}
REF ................................... -7 {BOX_07}
DK .................................... -8 {BOX_07}
HELP AVAILABLE FOR DEFINITION OF OTHER HEART
CONDITION.
PE11OV
What did the doctor or other health professional call
it?
[Enter Other Specify-45] ............... {PE12}
REF .................................... -7 {PE12}
DK ..................................... -8 {PE12}
IF CODED ‘1’ (YES) AT PE11, ADD THE PRIORITY
CONDITION ‘OTH HRT COND - {SPECIFY TEXT.....}’ TO
PERSON’S-MEDICAL-CONDITIONS-ROSTER. USE THE FIRST
17 CHARACTERS OF THE OTHER SPECIFY TEXT ENTERED AT
PE11OV AS PART OF THE CONDITION NAME.
PE12
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the other kind
of heart
condition, that is the {OTHER HEART CONDITION SPECIFY
TEXT},
was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_07}
REF ................................... -7 {BOX_07}
DK .................................... -8 {BOX_07}
FOR ‘OTHER HEART CONDITION SPECIFY TEXT’, DISPLAY
THE TEXT ENTERED AT PE11OV.
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_07
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘STROKE-TIA’ IN THE PE SECTION,
CONTINUE WITH PE13
OTHERWISE, GO TO BOX_08
PE13
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had a stroke or TIA? A
TIA is a
transient ischemic attack which is sometimes referred
to as a
ministroke.
YES .................................... 1 {PE14}
NO ..................................... 2 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}
HELP AVAILABLE FOR DEFINITION OF TIA.
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘STROKE-TIA’ TO PERSON’S-MEDICAL-CONDITIONS-
ROSTER.
PE14
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the stroke or
TIA was first
diagnosed?
IF MORE THAN ONE STROKE, PROBE FOR AGE WHEN FIRST
STROKE
DIAGNOSED.
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_08
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘EMPHYSEMA’ IN THE PE SECTION,
CONTINUE WITH PE15
OTHERWISE, GO TO BOX_09
PE15
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had emphysema?
YES .................................... 1 {PE16}
NO ..................................... 2 {BOX_09}
REF ................................... -7 {BOX_09}
DK .................................... -8 {BOX_09}
HELP AVAILABLE FOR DEFINITION OF EMPHYSEMA.
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘EMPHYSEMA’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER.
PE16
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the emphysema
was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_09}
REF ................................... -7 {BOX_09}
DK .................................... -8 {BOX_09}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_09
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
CONTINUE WITH PE17
OTHERWISE, GO TO BOX_10
NOTE THAT WHETHER THE PERSON HAS BEEN DIAGNOSED
WITH ‘CHRONIC BRONCHITIS’ IN THE PAST 12 MONTHS IS
ASKED IN ROUNDS 3 AND 5 EVEN IF PERSON REPORTED
‘CHRONIC BRONCHITIS’ IN A PREVIOUS ROUND.
PE17
{PERSON’S FIRST MIDDLE AND LAST NAME}
During the past 12 months, {have/has}
{you/{PERSON}} been told by a
doctor or other health professional that {you/he/she}
had chronic
bronchitis?
Please do not include isolated instances of
acute bronchitis.
YES .................................... 1
NO ..................................... 2 {BOX_10}
REF ................................... -7 {BOX_10}
DK .................................... -8 {BOX_10}
HELP AVAILABLE FOR DEFINITION OF ACUTE AND CHRONIC
BRONCHITIS.
IF CODED ‘1 (YES) AND:
- ROUND 1, 2, OR 4
OR
- THE PRIORITY CONDITION ‘CHRONIC BRONICHITIS’ NOT
REPORTED IN A PREVIOUS ROUND IN THE PE SECTION,
ADD THE PRIORITY CONDITION ‘CHRONIC BRONCHITIS’
TO PERSON’S-MEDICAL-CONDITIONS ROSTER.
IF CODED ‘1’ (YES) AND:
- ROUND 3 OR 5
AND
- THE PRIORITY CONDITION ‘CHRONIC BRONCHITIS’
REPORTED IN A PREVIOUS ROUND IN THE PE SECTION,
THE PRIORITY CONDITION ‘CHRONIC BRONCHITIS’ SHOULD
BE FLAGGED AS ‘SELECTED’ THIS ROUND (WITH THE
ROUND STATUS).
IF:
- PE17 IS CODED ‘1’ (YES)
AND
- ROUND 1 OR [NOT ROUND 1 AND PE18 NOT ASKED IN A
PREVIOUS ROUND]
CONTINUE WITH PE18
OTHERWISE, GO TO BOX_10
PE18
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the chronic
bronchitis was
first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_10}
REF ................................... -7 {BOX_10}
DK .................................... -8 {BOX_10}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_10
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘HIGH CHOLESTEROL’ IN THE PE SECTION,
CONTINUE WITH PE19
OTHERWISE, GO TO BOX_11
PE19
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had high cholesterol?
YES .................................... 1 {PE20}
NO ..................................... 2 {BOX_11}
REF ................................... -7 {BOX_11}
DK .................................... -8 {BOX_11}
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘HIGH CHOLESTEROL’ TO PERSON’S-MEDICAL-CONDITIONS-
ROSTER.
PE20
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the high
cholesterol was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_11}
REF ................................... -7 {BOX_11}
DK .................................... -8 {BOX_11}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_11
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘CANCER – {ANY TYPE}’ AT PE22 OR PE22OV,
CONTINUE WITH PE21
OTHERWISE, GO TO BOX_12
PE21
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had cancer or a
malignancy of any
kind?
YES .................................... 1 {PE22}
NO ..................................... 2 {BOX_12}
REF ................................... -7 {BOX_12}
DK .................................... -8 {BOX_12}
PE22
{PERSON’S FIRST MIDDLE AND LAST NAME}
SHOW CARD PE-1.
What kind of cancer was it?
IF RESPONDENT DOESN’T KNOW OR REFUSES THE KIND OF
CANCER, SELECT
‘OTHER’ AND THEN SELECT ‘DON’T KNOW’ OR ‘REFUSAL.’
CHECK ALL THAT APPLY.
BLADDER ................................ 1
BLOOD .................................. 2
BONE ................................... 3
BRAIN .................................. 4
BREAST ................................. 5
CERVIX ................................. 6
COLON .................................. 7
ESOPHAGUS .............................. 8
GALLBLADDER ............................ 9
KIDNEY ................................ 10
LARYNX-WINDPIPE ....................... 11
LEUKEMIA .............................. 12
LIVER ................................. 13
LUNG .................................. 14
LYMPHOMA .............................. 15
MELANOMA .............................. 16
MOUTH/TONGUE/LIP ...................... 17
OVARY ................................. 18
PANCREAS .............................. 19
PROSTATE .............................. 20
RECTUM ................................ 21
SKIN NON-MELANOMA ..................... 22
SKIN (UNKNOWN TYPE) ................... 23
SOFT TISSUE MUSCLE OR FAT ............. 24
STOMACH ............................... 25
TESTIS ................................ 26
THROAT-PHARYNX ........................ 27
THYROID ............................... 28
UTERUS ................................ 29
OTHER ................................. 91 {PE22OV}
[Code All That Apply]
HARD CHECK:
EDITS: IF PE22 IS CODED ‘6’ (CERVIX), ‘18’
(OVARY), OR ‘29’ (UTERUS), CHECK THAT PERSON IS
FEMALE. IF NOT, DISPLAY THE FOLLOWING MESSAGE:
"AT LEAST ONE CODE UNAVAILABLE FOR MALES. VERIFY
AND RE-ENTER."
IF PE22 IS CODED ‘20’ (PROSTATE) OR ‘26’ (TESTIS),
CHECK THAT PERSON IS MALE. IF NOT, DISPLAY THE
FOLLOWING MESSAGE: "AT LESAT ONE CODE UNAVAILABLE
FOR FEMALES. VERIFY AND RE-ENTER."
FOR EACH TYPE OF CANCER SELECTED AT PE22, ADD THE
PRIORITY CONDITION ‘CANCER-{SPECIFY TYPE........}’
TO PERSON’S-MEDICAL-CONDITIONS-ROSTER, WHERE
‘SPECIFY TYPE’ IS THE NAME OF THE CANCER TYPE
SELECTED. SINCE THE LENGTH OF THE CONDNAM IS
LIMITED TO 30 CHARACTERS, ABBREVIATE ‘SOFT TISSUE’
OPTION TO ‘CANCER - SOFT TISSUE MUSCL/FAT’. FOR
EACH TYPE OF CANCER SELECTED, CREATE A CONDITION
AND CONDITION-BY-ROUND RECORD.
REFUSED AND DON’T KNOW DISALLOWED. INTERVIEWER
MUST SELECT ‘91’ (OTHER) AND ENTER THE APPROPRIATE
TEXT STRING.
IF ‘OTHER’ SELECTED ALONE OR IN COMBINATION WITH
ANY OTHER RESPONSE, CONTINUE WITH PE22OV
OTHERWISE, GO TO LOOP_02
PE22OV
{PERSON’S FIRST MIDDLE AND LAST NAME}
SPECIFY OTHER TYPE OF CANCER:
[Enter Other Specify-23] .............. {LOOP_02}
REF ................................... -7 {LOOP_02}
DK .................................... -8 {LOOP_02}
ALLOW UP TO 23 CHARACTERS FOR THIS FIELD.
ADD THE PRIORITY CONDITION ‘CANCER - {OTHER
SPECIFY}’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER.
LOOP_02
FOR EACH ELEMENT PERSON’S-MEDICAL-CONDITIONS
ROSTER, ASK NAV_PE02 - END_LP02
LOOP DEFINITION: LOOP_02 CYCLES ON EACH TYPE OF
CANCER ENUMERATED AT PE22 OR PE22OV FOR PERSON.
LOOP_02 COLLECTS THE AGE THE CANCER WAS DIAGNOSED
AND WHETHER IT IS IN REMISSION. THIS LOOP CYCLES
ON EACH CONDITION IN PERSON’S-MEDICAL-CONDITIONS-
ROSTER THAT MEETS THE FOLLOWING CONDITIONS:
- CONDITION WAS CREATED AT PE22 OR PE22OV IN THE
CURRENT ROUND
NAVIGATOR DETAILS: LOOP_02 USES NAV_PE02 TO
CONTROL THE FLOW OF THE LOOP.
NAV_PE02
SERIES: Cancer Detail
USE THE LINKS BELOW TO COMPLETE ALL QUESTIONS WITHIN THIS SERIES.
WHEN ALL LINKS ARE MARKED "DONE," USE [Continue
Interview] TO GO
PAST THIS SERIES.
IF NEEDED, [Previous Page] WILL TAKE YOU TO QUESTIONS
BEFORE THIS
SERIES.
Cancer Type
[1. Person’s Medical Condition-30] [Status-25]
[2. Person’s Medical Condition-30] [Status-25]
[3. Person’s Medical Condition-30] [Status-25]
ROSTER DETAILS:
COL # 1 HEADER: CANCER TYPE
INSTRUCTIONS: DISPLAY PERSON’S MEDICAL CONDITION
COL # 2 HEADER: EMPTY
INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR
STATUS FOR EACH CONDITION EACH TIME THE NAVIGATOR
IS PRESENTED
ROSTER DEFINITION:
THIS ITEM DISPLAYS PERSON’S-MEDICAL-CONDITION
ROSTER FOR SELECTION.
ROSTER BEHAVIOR:
1. SELECT ALLOWED.
2. MULTIPLE SELECT, ADD, DELETE, AND EDIT
DISALLOWED.
ROSTER FILTER:
DISPLAY EACH CONDITION IN PERSON’S-MEDICAL-
CONDITIONS-ROSTER THAT MEETS THE FOLLOWING
CONDITIONS:
- CONDITION WAS CREATED AT PE22 OR PE22OV IN THE
CURRENT ROUND
CONTINUE WITH PE23 FOR SELECTED CONDITION
PE23
{PERSON'S FIRST MIDDLE AND LAST NAME} {PERSON'S
MEDICAL
CONDITION.}
How old {were/was} {you/{PERSON}} when the {CONDITION}
was first
diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {PE25}
REF ................................... -7 {PE25}
DK .................................... -8 {PE25}
{PERSON’S MEDICAL CONDITION}: IN THE HEADER,
DISPLAY THE TYPE OF CANCER ENUMERATED AT PE22 OR
PE22OV THAT IS CURRENTLY BEING CYCLED ON IN
LOOP_02.
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
PE24
OMITTED.
PE25
{PERSON'S FIRST MIDDLE AND LAST NAME} {PERSON'S
MEDICAL
CONDITION.}
Is {your/{PERSON}’s} {CONDITION} in remission, that
is, the {CONDITION}
is under control?
YES .................................... 1 {END_LP02}
NO ..................................... 2 {END_LP02}
REF ................................... -7 {END_LP02}
DK .................................... -8 {END_LP02}
HELP AVAILABLE FOR DEFINITION OF REMISSION.
{PERSON’S MEDICAL CONDITION}: IN THE HEADER,
DISPLAY THE TYPE OF CANCER ENUMERATED AT PE22 OR
PE22OV THAT IS CURRENTLY BEING CYCLED ON IN
LOOP_02.
END_LP02
CYCLE ON NEXT CONDITION IN PERSON’S-MEDICAL-
CONDITIONS-ROSTER THAT MEETS THE CONDITIONS STATED
IN THE LOOP DEFINITION
IF NO OTHER CONDITIONS MEET THE STATED CONDITIONS,
END LOOP_02 AND CONTINUE WITH BOX_12
BOX_12
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘DIABETES’ IN THE PE SECTION,
CONTINUE WITH PE26
OTHERWISE, GO TO BOX_13
PE26
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Other than during pregnancy, {have/has}/{Have/Has}}
{you/{PERSON}}
ever been told by a doctor or other health
professional that
{you/he/she} had diabetes or sugar diabetes?
YES .................................... 1 {PE27}
NO ..................................... 2 {BOX_13}
REF ................................... -7 {BOX_13}
DK .................................... -8 {BOX_13}
HELP AVAILABLE FOR DEFINITION OF DIABETES.
DISPLAY ‘Other than during pregnancy, (have/has)’
IF PERSON BEING ASKED ABOUT IS FEMALE. DISPLAY
‘(Have/Has)’ IF PERSON BEING ASKED ABOUT IS MALE.
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘DIABETES’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER.
PE27
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the diabetes or
sugar diabetes
was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_13}
REF ................................... -7 {BOX_13}
DK .................................... -8 {BOX_13}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_13
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
CONTINUE WITH PE28
OTHERWISE, GO TO BOX_14
NOTE THAT WHETHER THE PERSON HAS HAD JOINT PAIN
IN THE LAST 12 MONTHS IS ASKED IN ROUNDS 3 AND 5
EVEN IF PERSON REPORTED JOINT PAIN IN THE PE
SECTION IN A PREVIOUS ROUND.
PE28
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} had pain, aching, stiffness
or swelling
around a joint in the past 12 months?
YES .................................... 1
NO ..................................... 2
REF ................................... -7
DK .................................... -8
IF:
- ROUND 1, 2, OR 4
OR
- ROUND 3 OR 5 AND THE PRIORITY CONDITION
‘ARTHRITIS’ (OF ANY KIND) NOT REPORTED IN A
PREVIOUS ROUND IN THE PE SECTION,
CONTINUE WITH PE29
OTHERWISE, GO TO BOX_14
PE29
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} had arthritis?
YES .................................... 1 {PE30}
NO ..................................... 2 {BOX_14}
REF ................................... -7 {BOX_14}
DK .................................... -8 {BOX_14}
IF PE28 IS CODED ‘1’ (YES) AND PE29 IS CODED ‘2’
(NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW) AND ONE
OF THE FOLLOWING IS TRUE:
- ROUND 1, 2, OR 4
OR
- ROUND 3 OR 5 AND THE PRIORITY CONDITION ‘JOINT
PAIN’ NOT REPORTED IN A PREVIOUS ROUND IN THE
PE SECTION
ADD THE PRIORITY CONDITION ‘JOINT PAIN’ TO THE
PERSON’S-MEDICAL-CONDITIONS-ROSTER
IF PE28 IS CODED ‘1’ (YES) AND PE29 IS CODED ‘2’
(NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW) IN
ROUND 3 OR 5 AND THE PRIORITY CONDITION ‘JOINT
PAIN’ REPORTED IN A PREVIOUS ROUND IN THE PE
SECTION, THE PRIORITY CONDITION ‘JOINT PAIN’
SHOULD BE FLAGGED AS ‘SELECTED’ THIS ROUND
(WITH ROUND STATUS).
(NOTE THAT CONDITION RECORD FOR ARTHRITIS IS NOT
CREATED HERE BUT AT PE30.)
PE30
{PERSON’S FIRST MIDDLE AND LAST NAME}
What type of arthritis was that?
PROBE: {Were/Was} {you/{PERSON}} diagnosed with
rheumatoid arthritis
or osteoarthritis?
CODE ‘NOT SPECIFIED’ IF RESPONDENT DOES NOT KNOW THE
TYPE
OF ARTHRITIS.
RHEUMATOID ARTHRITIS ................... 1 {PE31}
OSTEOARTHRITIS ......................... 2 {PE31}
NOT SPECIFIED .......................... 3 {PE31}
REF ................................... -7 {PE31}
[Code One]
HELP AVAILAIBLE FOR DEFINITION OF RHEUMATOID ARTHRITIS
AND
OSTEOARTHRITIS.
IF CODED ‘1’ (RHEUMATOID ARTHRITIS), ADD THE
PRIORITY CONDITION ‘RHEUMATOID ARTHRITIS’ TO
PERSON’S-MEDICAL-CONDITIONS-ROSTER.
IF CODED ‘2’ (OSTEOARTHRITIS), ADD THE PRIORITY
CONDITION ‘OSTEOARTHRITIS’ TO PERSON’S-MEDICAL-
CONDITIONS-ROSTER.
IF CODED ‘3’ (NOT SPECIFIED) OR ‘-7’ (REFUSED),
ADD THE PRIORITY CONDITION ‘ARTHRITIS (NOT
SPECIFIED)’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER.
CODE ‘-8’ (DON’T KNOW) DISALLOWED.
PE31
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the {rheumatoid
arthritis/
osteoarthritis/arthritis} was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_14}
REF ................................... -7 {BOX_14}
DK .................................... -8 {BOX_14}
DISPLAY ‘rheumatoid arthritis’ IF PE30 IS CODED
‘1’ (RHEUMATOID ARTHRITIS). DISPLAY
‘osteoarthritis’ IF PE30 IS CODED ‘2’
(OSTEOARTHRITIS). DISPLAY ‘arthritis’ IF PE30 IS
CODED ‘3’ (NOT SPECIFIED) OR ‘-7’ (REFUSED).
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_14
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘ASTHMA’ IN THE PE SECTION,
CONTINUE WITH PE32
OTHERWISE, GO TO BOX_15
PE32
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have/Has} {you/{PERSON}} ever been told by a
doctor or other health
professional that {you/he/she} {have/has} asthma?
YES .................................... 1 {PE33}
NO ..................................... 2 {BOX_15}
REF ................................... -7 {BOX_15}
DK .................................... -8 {BOX_15}
HELP AVAILABLE FOR DEFINITION OF ASTHMA.
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘ASTHMA’ TO PERSON’S-MEDICAL-CONDITIONS-ROSTER.
PE33
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the asthma was
first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {BOX_15}
REF ................................... -7 {BOX_15}
DK .................................... -8 {BOX_15}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
BOX_15
IF:
- ROUND 1, 3 OR 5
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
CONTINUE WITH BOX_16
OTHERWISE, GO TO BOX_17
BOX_16
IF ‘ASTHMA’ (COLLECTED IN PE SECTION IN ANY ROUND)
ON PERSON’S-MEDICAL-CONDITIONS-ROSTER, CONTINUE
WITH PE33A
OTHERWISE, GO TO BOX_17
PE33A
{PERSON’S FIRST MIDDLE AND LAST NAME}
{During an earlier interview, it was mentioned that
{you/{PERSON}}
{have/has} asthma.} {Do/Does} {you/{PERSON}} still
have asthma?
YES .................................... 1 {PE34}
NO ..................................... 2 {PE34}
REF ................................... -7 {PE34}
DK .................................... -8 {PE34}
DISPLAY ‘During an earlier interview, it…’ IF
ASTHMA WAS ADDED DURING A PREVIOUS ROUND.
OTHERWISE (ASTHMA ADDED FOR PERSON IN THE CURRENT
ROUND), USE A NULL DISPLAY.
PE34
{PERSON’S FIRST MIDDLE AND LAST NAME}
During the past 12 months, {have/has}
{you/{PERSON}} had an episode
of asthma or an asthma attack?
YES .................................... 1 {BOX_17}
NO ..................................... 2
REF ................................... -7 {BOX_17}
DK .................................... -8 {BOX_17}
HELP AVAILABLE FOR DEFINITION OF ASTHMA ATTACK.
IF:
- PE34 IS CODED ‘2’ (NO)
AND
- ROUND 1 OR NOT ROUND 1 AND PE35 NOT ASKED IN A
PREVIOUS ROUND
CONTINUE WITH PE35
OTHERWISE, GO TO BOX_17
PE35
{PERSON’S FIRST MIDDLE AND LAST NAME}
When did {you/{PERSON}} last have an episode of asthma
or an asthma
attack?
WITHIN PAST 2 YEARS .................... 1 {BOX_17}
WITHIN PAST 3 YEARS .................... 2 {BOX_17}
WITHIN PAST 5 YEARS .................... 3 {BOX_17}
MORE THAN 5 YEARS ...................... 4 {BOX_17}
NEVER .................................. 5 {BOX_17}
REF ................................... -7 {BOX_17}
DK .................................... -8 {BOX_17}
[Code One]
BOX_17
IF PERSON IS 5 - 17 YEARS OF AGE INCLUSIVE OR IN
AGE CATEGORIES 3 OR 4, CONTINUE WITH BOX_18
OTHERWISE, GO TO END_LP01
BOX_18
IF:
- ROUND 1
OR
- ROUND 2 OR 4 AND PERSON ADDED TO DU-MEMBERS-
ROSTER DURING THE CURRENT ROUND
OR
- ROUND 3 OR 5 AND PERSON DID NOT REPORT IN A
PREVIOUS ROUND EVER HAVING BEEN DIAGNOSED WITH
‘ATTEN DEFICIT/HYPERACTIVITY’ IN THE PE
SECTION,
CONTINUE WITH PE36
OTHERWISE, GO TO END_LP01
PE36
{PERSON’S FIRST MIDDLE AND LAST NAME}
{Have you/Have you or {PERSON}} ever been told
by a doctor or
other health professional that {you/he/she} had
Attention Deficit
Hyperactivity Disorder (ADHD) or Attention Deficit
Disorder (ADD)?
YES .................................... 1 {PE37}
NO ..................................... 2 {END_LP01}
REF ................................... -7 {END_LP01}
DK .................................... -8 {END_LP01}
DISPLAY ‘Have you’ IF PERSON BEING ASKED ABOUT IS
SELECTED AS THE RESPONDENT.
OTHERWISE, DISPLAY ‘Have you or {PERSON}’.
IF CODED ‘1’ (YES), ADD THE PRIORITY CONDITION
‘ATTEN DEFICIT/HYPERACTIVITY’ TO PERSON’S-MEDICAL-
CONDITIONS-ROSTER.
PE37
{PERSON’S FIRST MIDDLE AND LAST NAME}
How old {were/was} {you/{PERSON}} when the Attention
Deficit
Hyperactivity Disorder (ADHD) or Attention Deficit
Disorder
(ADD) was first diagnosed?
IF LESS THAN ONE YEAR OLD WHEN DIAGNOSED, ENTER 0 FOR
AGE.
[Enter Age-3] ......................... {END_LP01}
REF ................................... -7 {END_LP01}
DK .................................... -8 {END_LP01}
HARD CHECK:
RANGE CHECK: 0 TO PERSON’S CURRENT AGE
END_LP01
CYCLE ON NEXT PERSON IN RU-MEMBERS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION
IF NO OTHER PERSONS MEET THE STATED CONDITIONS,
END LOOP_01 AND CONTINUE WITH BOX_19
BOX_19
GO TO NEXT QUESTIONNAIRE SECTION
Return to Top
|