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2022 National Health Interview Survey (NHIS) Questionnaire
ROS: Roster
Question ID: ROS.0020.00.1
Variable: HHCLock
Interview Module: Roster
Content Type: Annual Core

Question text:

* The demographic information is now locked and cannot be changed.
* Enter '1' to continue with the interview.
* If reentering the case, press the END key to go to the next unanswered question.
Response:
1 - Enter 1 to Continue
Universe:
HHC section has been locked.
Skip Instructions:
1 If GEN.PCNTUNDER18 GT 0, [goto REL.WHOPAR]
else [goto SASCSELECTION]
Question ID: ROS.0030.00.1
Variable: ROSTERCHECK
Interview Module: Roster
Content Type: Annual Core

Question text:

* The roster will now be locked. If you are confident that it has been recorded accurately,
enter 1 to continue. Otherwise go back and correct now.
Response:
1 - Enter 1 to Continue
Universe:
At least one person in the household is greater than 18 and there is at least one child in the household and at least one person's age is not guessed and not all household members in the armed forces and the HHC section has not been locked.
Skip Instructions:
1 If GEN.PCNTUNDER18 GT 0, [goto tblREL.WHOPAR]
if SURVTYPE=T and eligible adults [goto SELECT_SA]
elseif SURVTYPE=T and eligible children [goto SELECT_SC]
else [goto SASCSELECTION]

2022 National Health Interview Survey (NHIS) Questionnaire
HHC: Household Composition
Question ID: HHC.0020.00.1
Variable: NAME_FNAME
Interview Module: Roster
Content Type: Annual Core

Question text:

^FNAME
* Enter 999 if no more persons.
Fills:
^FNAME
Description: NAME_FNAME Introduction
Instruction:
If first person in roster, fill: "Starting with you, what are the names of all the persons living or staying here?"
Else for next person fill: "What is the name of the next
person living or staying here?"
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
All persons
Skip Instructions:
allow 20 if name on fake/false name list [goto ERR2_NAME_FNAME];
elseif NAME_FNAME is identical to any other NAME_FNAME or ALIAS [goto ERR3_NAME_FNAME]
else [goto NAME_LNAME]
999 if PX=01 [goto ERR1_NAME_FNAME]
else [goto USUALRES]
RF,DK [goto ALIAS]
Hard Edit:
Check Text: ERR3_NAME_FNAME
Check Description: Identical first name hard edit
Check Text: {check ERR3_NAME_FNAME}
First name cannot be the same as previous ^NameMatch.

Check Text: ERR1_NAME_FNAME
Check Description: 999 for first person hard edit
Check Text: {check ERR1_NAME_FNAME}
999 not allowed for the first person in the household. Please correct.
Soft Edit:
Check Text: ERR2_NAME_FNAME
Check Description: Fake name soft edit
Check Text: {signal ERR2_NAME_FNAME} You are entering a possible fake/false name. Please correct. If this is a legitimate name, suppress this error message and continue. Otherwise, go back to the name field and enter a legitimate name. To enter an alias, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused' at the name field. Then, enter a matching identifier/alias at the next screen (ALIAS).
Question ID: HHC.0030.00.1
Variable: NAME_LNAME
Interview Module: Roster
Content Type: Annual Core

Question text:

* Enter last name if provided. Last name is optional.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
A valid first name was entered
Skip Instructions:
allow 20,RF,DK,empty [If PX less than 25 goto NAME_FNAME for next person, else goto USUALRES]
Question ID: HHC.0040.00.1
Variable: ALIAS
Interview Module: Roster
Content Type: Annual Core

Question text:

How shall I refer to ^youthisperson for the rest of the interview?
Fills:
^youthisperson
Description: you/this person
Instruction:
If subject=respondent, fill "you", else if subject NE respondent, fill "this person"
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Persons who don't know or refused to give first name.
Skip Instructions:
allow 20 if ALIAS is identical to any other NAME_FNAME or ALIAS [goto ERR1_ALIAS]
elseif ALIAS = 999 [goto ERR2_ALIAS]
else [If PX less than 25 goto NAME_FNAME for next person, else goto USUALRES]
Hard Edit:
Check Text: ERR1_ALIAS
Check Description: Identical alias hard edit
Check Text: {check ERR1_ALIAS} Alias cannot be the same as previous ^NameMatch.

Check Text: ERR2_ALIAS
Check Description: 999 for alias hard edit
Check Text: {check ERR2_ALIAS}*999 not allowed as an alias. *Please correct
Question ID: HHC.0050.00.1
Variable: USUALRES
Interview Module: Roster
Content Type: Annual Core

Question text:

^DoDoes ^youALIAS usually live here?
Fills:
^DoDoes
Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
All persons where NAME_FNAME ne 999
Skip Instructions:
1 if (PX less than 25) [goto USUALRES for next person in household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]
2,RF,DK [goto ASKURE]
Question ID: HHC.0060.00.1
Variable: ASKURE
Interview Module: Roster
Content Type: Annual Core

Question text:

^DoDoes ^youALIAS have some other place where ^youthey usually live?
Fills:
^DoDoes
Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^youthey
Description: you/they
Instruction:
If subject=respondent, fill "you", else if subject NE respondent, fill "they"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
If the usual residence is not here, or respondent refused or didn't know
Skip Instructions:
1 [goto USUALSCHOOL]
2,RF,DK if (PX less than 25) [goto USUALRES for next person in the household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]
Question ID: HHC.0070.00.1
Variable: USUALSCHOOL
Interview Module: Roster
Content Type: Annual Core

Question text:

^AreIs ^youALIAS usually away at school or college?
Fills:
^AreIs
Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Person does not usually live in household and usual residence is elsewhere
Skip Instructions:
1 [goto ONOFFCAMPUS]
2,RF,DK if (PX less than 25) [goto USUALRES for next person in the household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]
Question ID: HHC.0080.00.1
Variable: ONOFFCAMPUS
Interview Module: Roster
Content Type: Annual Core

Question text:

^DoDoes ^youALIAS live in on-campus housing or off-campus housing?
* Read if necessary: On-campus housing includes residence halls and dorms where students live
together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.
Fills:
^DoDoes
Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - On campus
2 - Off campus
7 - Refused
9 - Don't Know
Universe:
Person's usual residence is not in the household and person has a usual residence other than the place of interview and lives away at school or college
Skip Instructions:
1,2,RF,DK if (PX less than 25) [goto USUALRES for next person in the household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]
Question ID: HHC.0090.00.1
Variable: MISPERS_MCHILD
Interview Module: Roster
Content Type: Annual Core

Question text:

^ROSTEREXCEPTION
^HHROSTERINTRO
^HHROSTER
Have I missed any babies or small children?
Fills:
^ROSTEREXCEPTION
Description: Exception to Roster
Instruction:
If PCNT less than TOTPCNT, fill: "Students living in on-campus housing will be included in the interview. Other people
who do not usually live here and have another residence
elsewhere will not be included in this interview."
^HHROSTERINTRO
Description: I have listed the household members as...
Instruction:
If PCNT ne 0, fill: I have listed the household members as...
^HHROSTER
Description: Entire roster of non deleted people
Instruction:
entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Less than 25 persons listed on roster
Skip Instructions:
1[goto NAME_FNAME to add person to roster]
2,RF,DK [goto MISPERS_MSCHOOL]
Question ID: HHC.0140.00.1
Variable: MISPERS_MSCHOOL
Interview Module: Roster
Content Type: Annual Core

Question text:

* Read if necessary.
I have listed the household members as...
^HHROSTER
Have I missed anyone who USUALLY lives here, but is away now at school or college?
Fills:
^HHROSTER
Description: Entire roster of non deleted people
Instruction:
entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Less than 25 persons listed on roster
Skip Instructions:
1 [goto ERR_MISPERS_MSCHOOL]
[goto NAME_FNAME to add person to roster]
2,RF,DK [goto MISPERS_MELSE]
Soft Edit:
Check Text: ERR_MISPERS_MSCHOOL
Check Description:
Check Text: {signal ERR_MISPERS_MSCHOOL}Do not read to the respondent. After adding the name of the household member who is now away at school or college to the roster, press the END key, enter '2' at USUALRES, enter '1' at ASKURE, and answer the USUALSCHOOL question. Suppress message to continue.
Question ID: HHC.0160.00.1
Variable: MISPERS_MELSE
Interview Module: Roster
Content Type: Annual Core

Question text:

* Read if necessary.
I have listed the household members as...
^HHROSTER
Have I missed anyone else who USUALLY lives here, including people who are not related to you or
people who are away traveling?
Fills:
^HHROSTER
Description: Entire roster of non deleted people
Instruction:
entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Less than 25 persons listed on roster
Skip Instructions:
1 [goto NAME_FNAME to add person to roster]
2,RF,DK if PCNT = 0 [goto EXIT]
elseif PCNT = 1 [goto SEX]
elseif PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
Question ID: HHC.0180.00.1
Variable: HHRESP
Interview Module: Roster
Content Type: Annual Core

Question text:

Which adults living here would you say know about the members of this household?
* Person(s) selected must be over 18.
* You may select someone who is marked as deleted.
* Enter all that apply, separate with commas.
Response:
01-25 - Person Number
Universe:
All households with more than one non-deleted person OR there is only one non-deleted person in the household and deleted person is first person on roster and first person on the roster was answering for the household but does not usually live there.
Skip Instructions:
1 not IN HHRESP [goto HHRESPAVAIL]
One Person selected at HHRESP and that person has HHSTAT_D=1 [goto HHRESPPROXY]
else [goto tblSex.bPerson.SEX]
Question ID: HHC.0190.00.1
Variable: HHRESPAVAIL
Interview Module: Roster
Content Type: Annual Core

Question text:

^HHRESP_fill
Select the line number of the person who can continue the interview.
* If no one is available press F9 to set up a callback.
Fills:
^HHRESP_fill
Description: Of the people you just mentioned, who can speak with me now?/Can ^ALIASNAME speak with me now?

Instruction:
If multiple people are selected, fill "Of the people you just mentioned, who can speak with me now?"
If one person is selected, fill "Can ^ALIASNAME speak with
me now?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
01-25 - Person Number
Universe:
Person to whom you are speaking (LNO=1) is not knowledgeable
Skip Instructions:
1-25 (person selected at HHRESPAVAIL has HHSTAT_D=1) [goto HHRESPPROXY]
else [goto tblSex.bPerson.SEX]
Question ID: HHC.0200.00.1
Variable: HHRESPPROXY
Interview Module: Roster
Content Type: Annual Core

Question text:

*^ALIASNAME does not usually live here.
^DoyouDoesALIAS take care of someone who lives here?
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^DoyouDoesALIAS
Description: Do you/Does ^ALIASNAME
Instruction:
For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Person selected at HHRESP or HHRESPAVAIL has been deleted from the roster.
Skip Instructions:
1 [goto tblSex.bPerson.SEX]
2,RF,DK [goto ERR_HHRESPPROXY]
Soft Edit:
Check Text: ERR_HHRESPPROXY
Check Description:
Check Text: {signal ERR_HHRESPPROXY} Person was deleted from this household.
Question ID: HHC.0210.00.1
Variable: SEX
Interview Module: Roster
Content Type: Annual Core

Question text:

^AreIs ^youALIAS male or female?
Read if necessary: What sex ^wereyouwasALIAS assigned at birth, on ^yourtheir original birth
certificate?
Fills:
^AreIs
Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^wereyouwasALIAS
Description: were you/was {Value of ALIAS}
Instruction:
If PX=LNO_HHRESP, fill: "were you" else fill: "was ALIAS[PX]"
^yourtheir
Description: your/their
Instruction:
If PX=LNO_HHRESP, fill: "your" else fill: "their"
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
All nondeleted persons
Skip Instructions:
If last non-deleted person on roster [goto AGENO]
else [goto SEX for next non-deleted person on roster]
Question ID: HHC.0220.01.1
Variable: AGENO
Interview Module: Roster
Content Type: Annual Core

Question text:

* 1 of 2
What is ^yourALIAS age?
* Enter number for age.
Fills:
^yourALIAS
Description: your/^ALIASNAME's
Instruction:
If PX=LNO_RESP fill "your"; else fill "^ALIASNAME's"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
001-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
All nondeleted persons
Skip Instructions:
001-120 [goto AGETP]
RF,DK [goto AGE18]
Question ID: HHC.0220.02.1
Variable: AGETP
Interview Module: Roster
Content Type: Annual Core

Question text:

* 2 of 2
* Enter number for age time period.
Response:
1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)
Universe:
Valid number entered at AGENO[PX]
Skip Instructions:
If last non-deleted person on roster AND ((AGENO = RF, DK and AGE18 =1) or AGE LT 018 for
everyone) then [goto Exit]
elseif last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]
Question ID: HHC.0230.00.1
Variable: AGE18
Interview Module: Roster
Content Type: Annual Core

Question text:

Certain sections of this interview depend on knowing if a person is 18 years or older. Could you
please tell me if ^youALIAS ^areis less than 18 years old or 18 years or older?
Fills:
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^areis
Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"
Response:
1 - Less than 18
2 - 18 or older
7 - Refused
9 - Don't Know
Universe:
Refused or did not know age
Skip Instructions:
RF,DK [goto AGEGUESS]
2 [goto AGE65]
1 If last non-deleted person on roster AND ((AGENO=RF,DK and AGE18=1) or AGE LT 018 for
everyone then [goto Exit]
Else if last non-deleted person on roster [goto NATORG]
Else [goto AGENO for next non-deleted person on roster]
Question ID: HHC.0240.00.1
Variable: AGE65
Interview Module: Roster
Content Type: Annual Core

Question text:

^AreIs ^youALIAS less than 65 years old or 65 years or older?
Fills:
^AreIs
Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Less than 65
2 - 65 or older
7 - Refused
9 - Don't Know
Universe:
No numerical age provided and person is 18 or over
Skip Instructions:
1,2,RF,DK if last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]
Question ID: HHC.0250.00.1
Variable: AGEGUESS
Interview Module: Roster
Content Type: Annual Core

Question text:

* Use your judgement to guess if ^ALIASNAME is less than 18 or 18 or older.
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Less than 18
2 - 18 or older
Skip Instructions:
If last non-deleted person on roster AND AGEGUESS = 1,2 for everyone then [goto Exit]
elseif last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]
Question ID: HHC.0290.00.1
Variable: NATORG
Interview Module: Roster
Content Type: Annual Core

Question text:

^NATORGAGE
Fills:
^NATORGAGE
Description: Is ^ALIASNAME Hispanic or Latino?/^DoyouDoesALIAS consider ^yourhimherself to be Hispanic or Latino?

Instruction:
If person is 17 or younger: "Is ^ALIASNAME Hispanic or Latino?"
If person is 18 or older: "^DoyouDoesALIAS consider
^yourhimherself to be Hispanic or Latino?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^DoyouDoesALIAS
Description: Do you/Does ^ALIASNAME
Instruction:
For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else if SEX=1 fill "himself"
else if SEX=2 fill "herself"
else if SEX=DK or RF fill "themself"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
All nondeleted persons
Skip Instructions:
If last non-deleted person on roster [goto RACE]
else [goto NATORG for next non-deleted person on roster]
Question ID: HHC.0300.00.1
Variable: RACE
Interview Module: Roster
Content Type: Annual Core

Question text:

^RACEAGE
^RACEFILL
* Enter all that apply, separate with commas.
Fills:
^RACEAGE
Description: What race or races is ^ALIASNAME?/What race or races ^dodoes ^youALIAS consider ^yourhimherself to be?

Instruction:
If person is 17 or younger: "What race or races is ^ALIASNAME?"
If person is 18 or older: "What race or races ^dodoes
^youALIAS consider ^yourhimherself to be?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^dodoes
Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else if SEX=1 fill "himself"
else if SEX=2 fill "herself"
else if SEX=DK or RF fill "themself"
^RACEFILL
Description: Race list fill
Instruction:
For first or only non-deleted person: Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska
Native, Native Hawaiian, Pacific Islander, Asian, or some
other race?
Else fill:
*Read if necessary: Please select 1 or more of these
categories:
White, Black, African American, American Indian, Alaska
Native, Native Hawaiian, Pacific Islander, Asian, or some
other race?
Response:
01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
- 97 - Refused
99 - Don't Know
Universe:
All nondeleted persons
Skip Instructions:
8 IN RACE [goto RACE_SP]
1-7,RF,DK If last non-deleted person on roster AND at least one person with AGE18=2 or
AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC]
else [goto RACE for next non-deleted person on roster]
Question ID: HHC.0310.00.1
Variable: RACE_SP
Interview Module: Roster
Content Type: Annual Core

Question text:

^RACESPAGE
Start typing and then select from list. If race is not on the list, type "ZZ" and enter
verbatim.
* If any of the following are mentioned, back up to previous screen and correct the entry.
White
Black
African American
American Indian
Alaska Native
Native Hawaiian
Pacific Islander
Asian
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the
next question, enter ALL the other races in the verbatim field.
Fills:
^RACESPAGE
Description: What other race or races is ^ALIASNAME?/What other race or races ^dodoes ^youALIAS consider ^yourhimherself to be?

Instruction:
If person is 17 or younger: "What other race or races is ^ALIASNAME?"
If person is 18 or older: "What other race or races
^dodoes ^youALIAS consider ^yourhimherself to be?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^dodoes
Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else if SEX=1 fill "himself"
else if SEX=2 fill "herself"
else if SEX=DK or RF fill "themself"
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Person identifies as some other race
Skip Instructions:
selection from picklist,RF,DK If last non-deleted person on roster AND at least one person
with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC]
else [goto RACE for next non-deleted person on roster]
ZZ [goto RACE_VRBAT]
Question ID: HHC.0320.00.1
Variable: RACE_VRBAT
Interview Module: Roster
Content Type: Annual Core

Question text:

* Read if necessary.
^RACESPAGE
Fills:
^RACESPAGE
Description: What other race or races is ^ALIASNAME?/What other race or races ^dodoes ^youALIAS consider ^yourhimherself to be?

Instruction:
If person is 17 or younger: "What other race or races is ^ALIASNAME?"
If person is 18 or older: "What other race or races
^dodoes ^youALIAS consider ^yourhimherself to be?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^dodoes
Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else if SEX=1 fill "himself"
else if SEX=2 fill "herself"
else if SEX=DK or RF fill "themself"
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Person identifies as some other race and Interviewer does not use pick-list to select this race
Skip Instructions:
allow 80 If last non-deleted person on roster AND at least one person with AGE18=2 or
AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC]
else [goto RACE for next non-deleted person on roster]
Question ID: HHC.0330.00.1
Variable: AFNOW
Interview Module: Roster
Content Type: Annual Core

Question text:

^AreyouIsALIASIsanyone now on full-time active duty with the Armed Forces?
*Read if necessary: Active duty does not include training for the Reserves or National Guard,
but DOES include activation, for example, for service in the U.S. or in a foreign country, in
support of military or humanitarian operations.
Fills:
^AreyouIsALIASIsanyon
e
Description Are you/Is ^ALIASNAME/Is anyone in the household
Instruction If PCNTAGEAF=1 and that person=respondent, fill "Are you",
elseif PCNTAGEAF=1 and that person NE respondent, fill "Is
^ALIASNAME"
elseif PCNTAGEAF GT 1 fill "Is anyone in the household"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
At least one person in the household is greater than 18 and at least one person's age is not guessed and at least one non-deleted person age 17-64 years old or who is greater than or equal to 18 or whose age was guessed to be greater than or equal to 18
Skip Instructions:
1 if GEN.PCNTAGEAF GT 1 [goto AFNOWWHO]
elseif GEN.PCNTAGEAF=1 and GEN.PCNT=1[goto EXIT]
elseif GEN.PCNTAGEAF=1 and GEN.PCNT GT 1[goto EDUC]
2,RF,DK [goto EDUC]
Question ID: HHC.0340.00.1
Variable: AFNOWWHO
Interview Module: Roster
Content Type: Annual Core

Question text:

Who is this? (Anyone else?)
* Enter all that apply, separate with commas.
Response:
01-25 - Person Number
Universe:
At least 1 person in the Armed Forces and more than 1 person eligible to be in the Armed Forces
Skip Instructions:
1-25 if all PX have GEN.HHSTAT_D=1 or GEN.HHSTAT_M = 1 [goto EXIT]
else [goto EDUC]
Question ID: HHC.0350.00.1
Variable: EDUC
Interview Module: Roster
Content Type: Annual Core

Question text:

What is the HIGHEST level of school ^youALIAS ^havehas completed or the highest degree ^youALIAS
^havehas received?
* Enter highest level of school completed.
Fills:
^youALIAS
Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^havehas
Description: have/has
Instruction:
If subject=respondent, fill "have", else if subject NE respondent fill "has"
Response:
00 - Never attended/kindergarten only
01 - Grade 1-11
02 - 12th grade, no diploma
03 - GED or equivalent
04 - High School Graduate
05 - Some college, no degree
06 - Associate degree: occupational, technical, or vocational program
07 - Associate degree: academic program
08 - Bachelor's degree (Example: BA, AB, BS, BBA)
09 - Master's degree (Example: MA, MS, MEng, MEd, MBA)
10 - Professional School degree (Example: MD, DDS, DVM, JD)
11 - Doctoral degree (Example: PhD, EdD)
97 - Refused
99 - Don't Know
Universe:
All non-deleted persons flagged as aged 18+
Skip Instructions:
0-11,RF,DK If last non-deleted adult on roster [goto next section]
else [goto EDUC for next non-deleted adult on roster]
Question ID: HHC.0360.00.1
Variable: EXIT
Interview Module: Roster
Content Type: Annual Core

Question text:

Not every household in our survey is asked all questions. I have all the information about your
household that I need at this time. Thank you for your assistance.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
All armed forces, all usual residence elsewhere, all under age 18, all where aged is guessed
Skip Instructions:
1 [goto BCK.WHOREADLTR]

2022 National Health Interview Survey (NHIS) Questionnaire
REL: Relationship of children to parents
Question ID: REL.0010.00.1
Variable: WHOPAR
Interview Module: Roster
Content Type: Annual Core

Question text:

Which people living in this household are ^ALIASNAME's parents? Please include biological, step,
or adoptive parents, but not foster parents or other relatives who may act as parents.
* If respondent is a foster parent or relative who acts as a parent, probe "Does ^ALIASNAME have
any biological, step, or adoptive parents living in this household?"
* Enter '0' if no biological, step, or adoptive parents live in the household.
* Legal guardians who are not biological, step, or adoptive parents should not be selected at
this question.
* Enter all that apply, separate with commas.
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
00 - No biological, step, or adoptive parents
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
- 23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused
99 - Don't Know
Universe:
All persons with age less than 18 years old or age was guessed or reported to be less than 18
Skip Instructions:
If 0 selected with any other value [goto ERR4_WHOPAR]
If AGEDIFF LT 15 [goto ERR1_WHOPAR]
elseif AGEDIFF GE 50 [goto ERR2_WHOPAR]
elseif AGEDIFF LE 0 [goto ERR3_WHOPAR]
0, RF, DK [goto FOSTPAR]
1-25 If last non-deleted child on roster [goto next section]
else [goto WHOPAR for next non-deleted child on roster]
Hard Edit:
Check Text: ERR4_WHOPAR
Check Description: 0 and another entry
Check Text: {check ERR4_WHOPAR} Invalid entry. Cannot mark 0 and a valid line number. Please correct.
Soft Edit:
Check Text: ERR1_WHOPAR
Check Description: Age difference between parent selected and child less than 15 years
Check Text: {signal ERR1_WHOPAR}
Age difference between parent and child is ^AGEDIFF years. I have recorded the parent ^PARENTNAME is ^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

Check Text: ERR2_WHOPAR
Check Description: Age difference GE 50 years
Check Text: {signal ERR2_WHOPAR} Age difference between parent and child is greater than or equal to 50 years. I have recorded the parent ^PARENTNAME is ^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

Check Text: ERR3_WHOPAR
Check Description: Parent is younger than child
Check Text: {signal ERR3_WHOPAR} Please verify. Parent is younger than child. I have recorded the parent ^PARENTNAME is ^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

2022 National Health Interview Survey (NHIS) Questionnaire
REL: Parent Demographics
Question ID: REL.0030.00.1
Variable: FOSTPAR
Interview Module: Roster
Content Type: Annual Core

Question text:

Is ^ALIASNAME currently in foster care? By that I mean is there an adult living in this
household acting as a foster parent to ^ALIASNAME under the supervision of a state or county
child welfare agency?
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Child has no parents identified
Skip Instructions:
1 [goto WHOFOST]
2,RF,DK If last non-deleted child on roster [goto next section]
else [goto WHOPAR for next non-deleted child on roster]

2022 National Health Interview Survey (NHIS) Questionnaire
REL: Relationship of children to parents
Question ID: REL.0040.00.1
Variable: WHOFOST
Interview Module: Roster
Content Type: Annual Core

Question text:

Which people living in this household are ^ALIASNAME's foster parents?
Read if necessary: Please include grandparents or other family members if they are acting as
foster parents under the supervision of a state or county child welfare agency.
* Enter all that apply, separate with commas.
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused
- 99 - Don't Know
Universe:
Child is in foster care
Skip Instructions:
If AGEDIFF LT 15 [goto ERR1_WHOFOST]
elseif AGEDIFF GE 50 [goto ERR2_WHOFOST]
elseif AGEDIFF LE 0 [goto ERR3_WHOFOST]
If last non-deleted child on roster [goto next section]
else [goto WHOPAR for next non-deleted child on roster]
Soft Edit:
Check Text: ERR1_WHOFOST
Check Description: Age difference between foster parent selected and child less than 15 years
Check Text: {signal ERR1_WHOFOST}
Age difference between parent and child is ^AGEDIFF years. I have recorded the foster parent ^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

Check Text: ERR2_WHOFOST
Check Description: Age difference GE 50 years
Check Text: {signal ERR2_WHOFOST} Age difference between parent and child is greater than or equal to 50 years. I have recorded the foster parent ^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

Check Text: ERR3_WHOFOST
Check Description: Foster parent is younger than child
Check Text: {signal ERR3_WHOFOST}
Please verify. Parent is younger than child. I have recorded the foster parent ^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

2022 National Health Interview Survey (NHIS) Questionnaire
FAM: Family Composition
Question ID: FAM.0050.00.1
Variable: ALLFAM
Interview Module: Roster
Content Type: Annual Core

Question text:

? [F1]
Is everyone in this household a member of the same family?
*Read if necessary: For this survey, a family is two or more people living together who are
related by birth, marriage, or adoption, as well as any unrelated children who are cared for by
the family, such as foster children, and any people living together as a couple and their
children.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The number of unique families as identified in REL section is greater than 1
Skip Instructions:
IF (Roster.PCNTEligibleSA > 1 OR Roster.PCNTEligibleSC > 1) [goto SASCID]
ELSE [goto procSetFAMILY_FLGs]
Question ID: FAM.0060.00.1
Variable: SASCID
Interview Module: Roster
Content Type: Annual Core

Question text:

One ^SASCID_fill randomly selected from every household in the survey to be asked a series of
health related questions. In this household, ^SASCID_fill2 chosen.
Fills:
^SASCID_fill
Description: adult and child are/adult is/child is
Instruction:
If PX_A gt 0 and PX_C gt 0, fill "adult and child are" elseif PX_A gt 0, fill "adult is"
else fill "child is"
^SASCID_fill2
Description: you and ^SCNAME were/^SANAME and ^SCNAME were/you were/^SANAME was/^SCNAME was

Instruction:
If PX_A gt 0 and PX_C gt 0 and HHRESPAVAIL = PX_A, fill "you and ^SCNAME were"
elseif PX_A gt 0 and PX_C gt 0 and HHRESPAVAIL ne PX_A,
fill "^SANAME and ^SCNAME were"
elseif PX_A gt 0 and HHRESPAVAIL = PX_A, fill "you were"
elseif PX_A gt 0 and HHRESPAVAIL ne PX_A, fill "^SANAME
was"
else fill "^SCNAME was"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
1 - Enter 1 to Continue
Universe:
Count of all persons eligible to be SA is greater than 1 or count of all persons eligible to be SC is greater than 1 or there are multiple adults or children in the family but only 1 adult or child is eligible to be the SA or SC because the others are in the Armed Forces.
Skip Instructions:
IF ALLFAM IN (2,RF,DK) AND PX_A 0 AND PCNTFX_SA_AfterREL PCNT {Not everyone in same family,
there's a SA, and not everyone's in SA's famly} [goto FAMINTRO_SA]
ELSEIF ALLFAM IN (2,RF,DK) {Not everyone in same family (and there's a SC)} [goto
procSetFX_RELATE_SA]
ELSE [goto procSetFAMILY_FLGs]
Question ID: FAM.0070.00.1
Variable: FAMINTRO_SA
Interview Module: Roster
Content Type: Annual Core

Question text:

^FAMINTRO_fill
I will now ask you some questions about how other people in this household are related to
^you_SA.
Fills:
^FAMINTRO_fill
Description: FAMINTRO_SA Introduction
Instruction:
If PCNTFAMAREL ge 2, fill "Based on questions I asked you earlier, we have that ^SAFAM are in the same family."
else leave fill empty.
^SAFAM
Description: List of people in SA's family
Instruction:
For all people with FAMILYA_FLG =1 and are not Household Respondent, fill with their names.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
Include Sample Adult in this list.
^you_SA
Description: you/^ALIASNAME
Instruction:
If HHRESPAVAIL eq PX_A, fill "you" else fill "^ALIASNAME" of Sample Adult
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Enter 1 to Continue
Universe:
Not everyone in same family, there's a SA, and not everyone's in SA's family
Skip Instructions:
1 [goto tblRelate_SA.bPerson.RELATE for 1st non-deleted person on roster with FX_REL[PX] ne
FX_REL[PX_A]]
Question ID: FAM.0140.00.1
Variable: FAMINTRO_SC
Interview Module: Roster
Content Type: Annual Core

Question text:

I will now ask you some questions about who in this household is related to ^SCNAME.
Based on questions I asked you earlier, we have that ^SCNames_fill related to ^SCNAME.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^SCNames_fill
Description: List of people in Sample Child's family
Instruction:
For all people with GEN.FAMILYC_FLG=1, fill with their names.
Description: Person was identified as being in the SC's
family at WHOPAR/WHOFOST OR (Sample Child is related to
the Sample Adult and person on roster was placed in Sample
Adult's family based on answer provided at RELATE),
include their name as part of the list of SC's family.
Do not Sample Child on list.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
If only one person on the list of names and person ne
Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on
list and person is Household Respondent
(Roster.HHC.HHRESPAVAIL), follow list with "are".
Response:
1 - Enter 1 to Continue
Universe:
Not everyone in same family and there is a SC, and there is no SA and not everyone in SC's family or SA/SC in separate families and not everyone in SA or SC's families or SA/SC in same family and not everyone in that family
Skip Instructions:
1 [goto tblRelate_SC.bPerson.RELATE for 1st non-deleted person on roster with FX_RELATESA[PX]
ne FX_RELATESA[PX_A] and FX_RELATESA[PX] ne FX_RELATESA[PX_C]]
Question ID: FAM.0240.00.1
Variable: KNOWSC
Interview Module: Roster
Content Type: Annual Core

Question text:

Who lives here and is knowledgeable about and responsible for ^SCNAME's health care?
^ANYONEELSE
Enter all that apply, separate with commas.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^ANYONEELSE
Description: Anyone else
Instruction:
If PCNT_EligibleKNOWSC > 1 fill: "Read if necessary: Anyone else?"
Response:
00 - Not on roster
01-25 - Person Number
97 - Refused
99 - Don't Know
Universe:
There's a SC and either multiple eligible adults or only one eligible adult but that person is not a parent of the SC
Skip Instructions:
RF,DK [goto NOFAMSC]
1-25 IF Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and (PX_A ne
Roster.HHC.HHRESPAVAIL) [goto ONCAMPINTRO_A]
ELSE [goto CASESTATUS]
Question ID: FAM.0250.00.1
Variable: NOFAMSC
Interview Module: Roster
Content Type: Annual Core

Question text:

* Because there are no adults who are related to ^SCNAME living in this household, or respondent
refused or did not know who was knowledgeable about and responsible for ^SCNAME's health care,
the Sample Child Interview cannot be completed.
Not everyone in our survey is asked all questions. I have all the information that I need from
you about ^SCNAME.
* Enter '1' to continue.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Enter 1 to Continue
Universe:
No one is knowledgeable about and responsible for the sample child's health or don't know or refused to identify knowledgeable person
Skip Instructions:
1 if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and (PX_A ne
Roster.HHC.HHRESPAVAIL) [goto ONCAMPINTRO_A]
elseif PX_A > 0 {there is a Sample Adult} [goto CASESTATUS]
else [goto BCK.THANKS_SUF]
Question ID: FAM.0260.00.1
Variable: ONCAMPINTRO_A
Interview Module: Roster
Content Type: Annual Core

Question text:

As I previously mentioned ^SANAME was randomly selected to be asked a series of health related
questions. We would like to contact ^himherthem to complete ^hishertheir portion of this
interview.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
^himherthem
Description: him/her/them
Instruction:
If GEN.SEX_FINAL=1 fill "him"; else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "them"
^hishertheir
Description: his/her/their
Instruction:
If GEN.SEX_FINAL=1 fill "his"; else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their"
Response:
1 - Enter 1 to Continue
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not the Household Respondent
Skip Instructions:
1[goto TLNO_FAM_DRM]
Question ID: FAM.0280.00.1
Variable: ONCAMPLNAME
Interview Module: Roster
Content Type: Annual Core

Question text:

* Ask or verify: What is ^SANAME's last name?
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
allow 20,RF,DK [goto ONCAMPADD1_A]
Question ID: FAM.0290.01.1
Variable: ONCAMPADD1_A
Interview Module: Roster
Content Type: Annual Core

Question text:

What is ^SANAME's exact mailing address on campus?
* Enter the house or building number, house or building number suffix and street name.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
allow 54, empty [goto ONCAMPADD2_A]
Question ID: FAM.0290.02.1
Variable: ONCAMPADD2_A
Interview Module: Roster
Content Type: Annual Core

Question text:

* Enter the unit description.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
allow 54, empty [goto ONCAMPPO_A]
Question ID: FAM.0290.03.1
Variable: ONCPUNTDES_A
Interview Module: Roster
Content Type: Annual Core

Question text:

Enter the correct unit designation or press "ENTER" if there is none.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
allow 20, empty [goto ONCAMPPO_A]
Question ID: FAM.0290.04.1
Variable: ONCAMPPO_A
Interview Module: Roster
Content Type: Annual Core

Question text:

* Enter the city.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
allow 28, empty [goto ONCAMPST_A]
Question ID: FAM.0290.05.1
Variable: ONCAMPST_A
Interview Module: Roster
Content Type: Annual Core

Question text:

* Enter the state.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
allow 2 [goto ONCAMPZIP5_A]
Question ID: FAM.0290.07.1
Variable: ONCAMPZIP5_A
Interview Module: Roster
Content Type: Annual Core

Question text:

* Enter the zip code.
Response:
01001-99995 - Range of values
99997 - Refused
99999 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
01001-99996, RF, DK, empty
if ONCAMPZIP5_A lt 5 characters [goto ERR1_ONCAMPZIP5_A]
elseif ONCAMPZIP5_A lt 01001 [goto ERR2_ONCAMPZIP5_A]
elseif (ONCAMPZIP5_A gt 99996 and SURVTYPE ne T) or (ONCAMPZIP5_A gt
99997 and SURVTYPE=T) [goto ERR3_ONCAMPZIP5_A]
else [goto ONCAMPZIP4_A]
Hard Edit:
Check Text: ERR3_ONCAMPZIP5_A
Check Description: ONCAMPZIP5_A gt 99996/99997
Check Text: {check ERR3_ONCAMPZIP5_A} A valid zip code must be entered. Please correct.

Check Text: ERR1_ONCAMPZIP5_A
Check Description: ONCAMPZIP5_A must have a length of 5
Check Text: {check ERR1_ONCAMPZIP5_A}
The entire zip code must be entered. Please correct.

Check Text: ERR2_ONCAMPZIP5_A
Check Description: ONCAMPZIP5_A must be greater than or equal to 01001
Check Text: {check ERR2_ONCAMPZIP5_A}
A valid zip code must be entered. Please correct.
Question ID: FAM.0290.08.1
Variable: ONCAMPZIP4_A
Interview Module: Roster
Content Type: Annual Core

Question text:

* Enter the zip 4.
Response:
0000-9996 - Range of values
9997 - Refused
9999 - Don't Know
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
0000-9997, RF, DK, empty
if ONCAMPZIP4_A lt 4 characters [goto ERR1_ONCAMPZIP4_A]
elseif (ONCAMPZIP4_A gt 9996 and SURVTYPE ne T) or (ONCAMPZIP4_A gt 9997 and SURVTYPE=T) [goto
ERR2_ONCAMPZIP4_A]
else [goto ONCAMPADDR_A]
Hard Edit:
Check Text: ERR1_ONCAMPZIP4_A
Check Description: ONCAMPZIP4_A must have a length of 4
Check Text: {check ERR1_ONCAMPZIP4_A}
The entire zip code must be entered. Please correct.

Check Text: ERR2_ONCAMPZIP4_A
Check Description: ONCAMPZIP4_A gt 9996/9997
Check Text: {check ERR2_ONCAMPZIP4_A} A valid zip code must be entered. Please correct.
Question ID: FAM.0300.00.1
Variable: ONCAMPADDR_A
Interview Module: Roster
Content Type: Annual Core

Question text:

Please confirm the following information about the Sample Adult living on campus:
Name: ^SANAME
Phone Number: ^ONCAMPPHONE_fill
Address:
^ONCAMPADD1_A_fill
^ONCAMPADD2_A_fill
^ONCAMPPO_A_fill, ^ONCAMPST_A_fill ^ONCAMPZIP5_A_fill - ^ONCAMPZIP4_A_fill
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
^ONCAMPPHONE_fill
Description: {Value of DISPLAYSTRING}
Instruction:
Fill the phone number associated with the on-campus SA from bContact.arrayPhones
[Roster.FAM.TLNO_FAM_DRM].DisplayString
^ONCAMPADD1_A_fill
Description: {Value of ONCAMPADD1_A}
Instruction:
Fill value from ONCAMPADD1_A
^ONCAMPADD2_A_fill
Description: {Value of ONCAMPADD2_A}
Instruction:
Fill value from ONCAMPADD2_A
^ONCAMPPO_A_fill
Description: {Value of ONCAMPPO_A}
Instruction:
Fill value from ONCAMPPO_A
^ONCAMPST_A_fill
Description: {Value of ONCAMPST_A}
Instruction:
Fill value from ONCAMPST_A
^ONCAMPZIP5_A_fill
Description: {Value of ONCAMPZIP5_A}
Instruction:
Fill value from ONCAMPZIP5_A
^ONCAMPZIP4_A_fill
Description: {Value of ONCAMPZIP4_A}
Instruction:
Fill value from at ONCAMPZIP4_A
Response:
1 - Enter 1 to Continue
Universe:
Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent
Skip Instructions:
1 [goto CASESTATUS]

2022 National Health Interview Survey (NHIS) Questionnaire
VFY: Sample Adult Verification
Question ID: VFY.0010.00.1
Variable: CURRES_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Enter the line number of the person to whom you are speaking.
Response:
00 - Not on roster
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused
99 - Don't Know
Universe:
The Sample Adult section has not been started or completed or has a Sample Adult callback setup
Skip Instructions:
1-25 [goto AVAIL_A]
Question ID: VFY.0050.00.1
Variable: PROXYLNO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Select the person in this household who is the proxy for ^SANAME.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
01 - ^ALIASNAME[1]
02 - ^ALIASNAME[2]
03 - ^ALIASNAME[3]
04 - ^ALIASNAME[4]
05 - ^ALIASNAME[5]
06 - ^ALIASNAME[6]
07 - ^ALIASNAME[7]
08 - ^ALIASNAME[8]
09 - ^ALIASNAME[9]
10 - ^ALIASNAME[10]
11 - ^ALIASNAME[11]
12 - ^ALIASNAME[12]
13 - ^ALIASNAME[13]
14 - ^ALIASNAME[14]
15 - ^ALIASNAME[15]
16 - ^ALIASNAME[16]
17 - ^ALIASNAME[17]
18 - ^ALIASNAME[18]
19 - ^ALIASNAME[19]
20 - ^ALIASNAME[20]
21 - ^ALIASNAME[21]
22 - ^ALIASNAME[22]
23 - ^ALIASNAME[23]
24 - ^ALIASNAME[24]
25 - ^ALIASNAME[25]
97 - Refused
99 - Don't Know
-
Universe:
Sample adult proxy is a relative or non relative who lives in the household
Skip Instructions:
1-25 if PROXYLNO_A ne CURRES_A [goto INTMODE_A]
elseif PROXYLNO_A=CURRES_A and Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and
HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]
Question ID: VFY.0060.00.1
Variable: PROXYCALL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Can a callback with someone knowledgeable about ^SANAME's health be arranged?
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Knowledgeable proxy is not available.
Skip Instructions:
1 [goto bCallback.CB_POSSIBLE], then
if there is a Sample child and they have not been interviewed [goto Child.VFY.CURRES_C]
else [goto BCK.THANKS_CB]
2 if there is a Sample child and they have not been interviewed [goto Child.VFY.CURRES_C]
elseif GEN.OUTCOME=203 [goto BCK.THANKS_SUF]
else [goto BCK.THANKS_INSUF]
Question ID: VFY.0070.00.1
Variable: INTMODE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* How are you contacting ^SARESP?
Fills:
^SARESP
Description: Sample Adult respondent's name
Instruction:
Fill Sample Adult respondent's name
Response:
1 - Personal visit
2 - Telephone
Universe:
Sample Adults 18+ and Not initially speaking to the Sample Adult but now speaking to the Sample Adult OR Now speaking to a proxy respondent who is not on the roster or refused or don't know if on the roster OR Now speaking to a proxy respondent who is on the roster and who wasn't who you were initially speaking to
Skip Instructions:
1 if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and GEN.HHRESPSA_FLG ne 1 [goto
VFYONCAMP_A]
else[goto VFYALL_A]
2 [goto TINTRO_A]
Question ID: VFY.0080.00.1
Variable: TINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Hello, my name is (* say your name). I'm calling from the U.S. Census Bureau. We are conducting
the National Health Interview Survey on behalf of the National Center for Health Statistics,
part of the Centers for Disease Control and Prevention (CDC). This is a nationwide survey about
the health of both adults and children. I have some information from ^HHRESP. Now, I would like
to ask you some questions.
* Read if necessary: I believe I am calling you on a cell phone.
Before we continue, I have to ask: Are you currently driving a vehicle?
* Even if the respondent is using a hands-free device while driving, you must enter '1'.
Fills:
^HHRESP
Description: {Value of HHRESPAVAIL}
Instruction:
Display the name of the person selected at Roster.HHC.HHRESPAVAIL
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent
Skip Instructions:
1,RF,DK [goto ATTN_A]
2 [goto LETTER_A]
Question ID: VFY.0090.00.1
Variable: ATTN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

For your safety, we will call you back at another time.
* Enter 1 to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is driving
Skip Instructions:
1 [goto bCallback.CB_POSSIBLE]
Question ID: VFY.0100.00.1
Variable: LETTER_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* If sample adult is a new respondent read question below, otherwise enter 1
* Read if necessary: A letter describing the National Health Interview Survey was sent to your
home recently. Do you remember seeing the letter?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is not driving
Skip Instructions:
1,2,RF,DK [goto S_INTRO_A]
Question ID: VFY.0110.00.1
Variable: S_INTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
* If sample adult is a new respondent read question below, otherwise enter 1
* Read if necessary: There are a few things I need to cover before we continue. I'd like you to
know that taking part in this survey is voluntary. You may choose not to answer any questions
you don't wish to answer, or end the interview at any time without penalty. We are required by
Federal law to develop and follow strict procedures to protect the confidentiality of your
information and use your answers only for statistical research. I can describe these laws if you
wish. Except for the National Center for Health Statistics and Census Bureau employees and
specially designated agents, no one can see your answers until all information that could
identify you and/or your family has been removed. Only after that will your data be made
available to researchers. For most adults, the survey will take less than ^SATIME minutes. I'd
like to continue now unless you have any questions.
* If respondent asks for more information about the privacy laws, press F1.
Fills:
^SATIME
Description: 35/45
Instruction:
If GEN.CSTAT=1 and GEN.SAMEFAM_FLG=1, fill: 35 else, fill: 45
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is not driving
Skip Instructions:
1 if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and GEN.HHRESPSA_FLG ne 1 [goto
VFYONCAMP_A]
else [goto VFYALL_A]
Question ID: VFY.0120.00.1
Variable: VFYONCAMP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

I want to confirm some information.
Do you live in on-campus housing or off-campus housing?
Read if necessary: On-campus housing includes residence halls and dorms where students live
together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.
Response:
1 - On campus
2 - Off campus
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ living in on-campus housing and the Sample Adult is not the household respondent
Skip Instructions:
1,RF,DK [goto VFYALL_A]
2 [goto NOMORE_A]
Question ID: VFY.0130.00.1
Variable: VFYALL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^Verifyintro
I have recorded ^yoursexis, you are ^AGE_A, ^NATORG_A, and ^RACE_A. Would you like to make any
changes to this ^additionalinfo_A?
^RACEVRBATvalue_A
* If respondent "refuses" or says "don't know", enter "2" for "no."
* Read if necessary: By sex we mean sex at birth.
Fills:
^Verifyintro
Description: I want to confirm some information.
Instruction:
If VFYONCAMP_A=empty "I want to confirm some information." else fill nothing
^yoursexis
Description: your sex is male/your sex is female/you do not know you sex/you do not wish to provide your sex/your sex was not

Instruction:
Instruction If GEN.SEX_FINAL=1 fill "your sex is male"
If GEN.SEX_FINAL=2 fill "your sex is female"
If GEN.SEX_FINAL=DK and GEN.HHRESPSA_FLG=1 fill "you do
not know your sex"
If GEN.SEX_FINAL=RF and GEN.HHRESPSA_FLG=1 fill "you do
not wish to provide your sex"
If GEN.SEX_FINAL IN (DK,RF) and GEN.HHRESPSA_FLG ne 1 fill
"your sex was not provided"
^AGE_A
Description: {Value of AGE}/65 or older/between 18 and 64/18 and older
Instruction:
if GEN.AGE_FINAL ne RF, DK fill with age elseif GEN.AGE_FINAL IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2 fill "65 or
older"
elseif GEN.AGE_FINAL in (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=1 fill "between 18
and 64"
elseif GEN.AGE_FINAL IN (RF, DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (RF,DK,empty)
fill "18 and older"
^NATORG_A
Description: Verify Hispanic or Latino origin
Instruction:
If GEN.NATO_FINAL=1 fill: "you are of Hispanic or Latino origin"
If GEN.NATO_FINAL=2 fill: "you are not of Hispanic or
Latino origin"
If GEN.NATO_FINAL=DK and GEN.HHRESPSA_FLG=1 fill: "you do
not know if you are of Hispanic or Latino origin"
If GEN.NATO_FINAL=RF and GEN.HHRESPSA_FLG=1 fill: "you do
not wish to provide information about your Hispanic or
Latino origin"
If GEN.NATO_FINAL IN (DK,RF) and GEN.HHRESPSA_FLG ne 1
fill "information about your Hispanic or Latino origin was
not provided"
^RACE_A
Description: you are ^RACEFILLAND_A/you do not know your race/you d not wish to provide your race/your race was not provided

Instruction:
Instruction If race or races IN GEN.RACE_FINAL[PX_A].RACE_FINAL fill:
"you are ^RACEFILLAND_A."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=DK and
GEN.HHRESPSA_FLG=1 fill "you do not know your race."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=RF and
GEN.HHRESPSA_FLG=1 fill: "you do not wish to provide your
race."
If GEN.RACE_FINAL[PX_A].RACE_FINAL IN (DK,RF) and
GEN.HHRESPSA_FLG ne 1 fill "your race was not provided."
^RACEFILLAND_A
Description: Categories selected at the RACE screen
Instruction:
Fill categories stored in GEN.RACE_FINAL[PX_A].RACE_FINAL. If more than two categories separate the categories with
commas. Add the word "and" before the last category.
When GEN.RACE_FINAL[PX_A].RACE_FINAL=8,
if GEN.RACE_FINAL[PX_A].RACE_SP_FINAL not in (ZZ,RF,DK)
display picklist selection from
GEN.RACE_FINAL[PX_A].RACE_SP_FINAL
elseif GEN.HHRESPSA_FLG=1 and GEN.RACE_FINAL
[PX_A].RACE_VERBAT_FINAL not in (empty,DK,RF) display
GEN.RACE_FINAL[PX_A].RACE_VERBAT_FINAL
else display "some other race"
^additionalinfo_A
Description: if any information is missing "or provide additional information about"

Instruction:
See attachment for fill instructions
^RACEVRBATvalue_A
Description: Information collected at RACEVRBAT for Sample Adult
Instruction:
IF GEN.HHRESPSA_FLG ne 1 and GEN.RACE_FINAL [PX_A].RACE_VRBAT_FINAL ne (empty,RF,DK), fill " If
respondent wants information on which other race they are
listed as, say ^RACE_VRBAT."
^RACE_VRBAT
Description: {Value of RACE_VRBAT_FINAL}
Instruction:
Fill value from GEN.RACE_FINAL[PX].RACE_VRBAT_FINAL
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+ and the Sample Adult or a proxy is available to continue the interview and the Sample Adult is not identified as away at college and living in off-campus housing
Skip Instructions:
1 [goto VFYDEM_A]
2 if GEN.SEX_FINAL IN (RF,DK) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0140.00.1
Variable: VFYDEM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: What should I change?
* Enter all that apply, separate with commas.
* Read if necessary: By sex we mean sex at birth.
Response:
1 - Sex
2 - Age
3 - Hispanic or Latino Origin
4 - Race
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ would like to change demographic information
Skip Instructions:
if 1 IN VFYDEM_A [goto NEWSEX_A]
elseif (2,3,4) IN VFYDEM_A and GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto SEXGUESS_A]
elseif 2 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK)[goto NEWAGE_A]
elseif 3 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK) [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK) [goto NEWRACE_A]
RF,DK If GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0150.00.1
Variable: NEWSEX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you male or female?
* Read if necessary: By sex we mean sex at birth.
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
Respondent said his/her sex is not correct
Skip Instructions:
if GEN.SEX_FINAL[PX_A]=RF,DK and NEWSEX_A=RF,DK [goto SEXGUESS_A]
elseif 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0160.00.1
Variable: SEXGUESS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Enter your best guess of ^SANAME's sex.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
1 - Male
2 - Female
Universe:
Sample adults for whom there is no sex provided by the household respondent and did not give a sex when asked to verify information
Skip Instructions:
1,2
if 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0170.00.1
Variable: NEWAGE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How old are you?
* Enter age.
Response:
000-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adult 18+ said his/her age is not correct
Skip Instructions:
0-120, RF, DK if 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0190.00.1
Variable: NEWNATORG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you consider yourself to be Hispanic or Latino?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adult 18+ said his/her Hispanic Origin is not correct
Skip Instructions:
1,2,RF,DK if 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0200.00.1
Variable: NEWRACE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What race or races do you consider yourself to be? Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific
Islander, Asian, or some other race?
Enter all that apply, separate with commas.
Response:
01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+ said his/her race is not correct
Skip Instructions:
1-8,RF,DK if GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0210.00.1
Variable: HISPTYPE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What is your Hispanic or Latino ancestry or origin, such as Mexican, Mexican American,
^CHICANOA, Central or South American, Puerto Rican, Cuban, Dominican (Republic), or Other
Hispanic, ^LATINOA, or Spanish -- and if you have more than one, tell me all of them.
* Enter all that apply, separate with commas.
Fills:
^CHICANOA
Description: Chicano/Chicano or Chicana
Instruction:
If SEX_FINAL = 1 fill: "Chicano" if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"
^LATINOA
Description: Latino/Latino or Latina
Instruction:
If SEX_FINAL= 1 fill: "Latino" if SEX_FINAL = 2,DK,RF fill "Latino or Latina"
Response:
01 - Mexican, Mexican American, or Chicano(a)
02 - Central American
03 - South American
04 - Puerto Rican
05 - Cuban
06 - Dominican (Republic)
07 - Other Hispanic, Latino(a), or Spanish (specify)
97 - Refused
99 - Don't Know
Universe:
Respondent is of Hispanic Origin
Skip Instructions:
7 [goto HISPOTHER_A]
1-6,RF,DK
if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0220.00.1
Variable: HISPOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
What is your Hispanic or Latino ancestry or origin? If you have more than one, tell me all of
them.
* Start typing and then select from list. If Hispanic or Latino ancestry is not on the list,
type "ZZ" and enter verbatim.
* If any of the following are mentioned, backup to previous screen and correct the entry.
Mexican
Mexican American
Chicano/Chicana
Central American (REFER TO HELP SCREEN)
South American (REFER TO HELP SCREEN)
Puerto Rican (Boricua)
Cuban/Cuban American
Dominican (Republic)
* If respondent provides more than one other Hispanic or Latino ancestry or origin, select 'ZZ'
from the lookup table. At the next question, enter ALL the other Hispanic or Latino ancestries
or origins in the verbatim field.
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Respondent is of Other Hispanic Origin
Skip Instructions:
ZZ [goto HISPVRBAT_A]
lookup table selection,RF,DK if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0230.00.1
Variable: HISPVRBAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: What is your Hispanic or Latino ancestry or origin? If you have more than
one, tell me all of them.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+ who report some other Hispanic Ancestry and this is not choosen from the picklist
Skip Instructions:
allow 80,RF,DK if GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A].RACE_FINAL in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0240.00.1
Variable: PITYPE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

I have recorded that you are Pacific Islander. What specific ethnic group or groups are you--
such as Guamanian or Chamorro, Samoan, or other Pacific Islander? If you are more than one, tell
me all of them.
* Enter all that apply, separate with commas.
Response:
1 - Guamanian or Chamorro
2 - Samoan
3 - Other Pacific Islander
7 - Refused
9 - Don't Know
Universe:
Respondent identifies race as Pacific Islander
Skip Instructions:
3 [goto PIOTHER_A]
1,2,RF,DK if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0250.00.1
Variable: PIOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic group
or groups are you? If you are more than one, tell me all of them.
* Start typing and then select from list. If Pacific Islander ethnic group is not on the list,
type "ZZ" and enter verbatim.
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+ who identifies as Other Pacific Islander
Skip Instructions:
ZZ [goto PIVRBAT_A]
picklist selection, RF, DK
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0260.00.1
Variable: PIVRBAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic group or
groups are you? If you are more than one, tell me all of them.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+ who report some other group of Pacific Islander not on the picklist
Skip Instructions:
allow 80,RF,DK
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0270.00.1
Variable: ASIANTYPE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

I have recorded that you are Asian. What specific ethnic group or groups are you-- such as Asian
Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian? If you are more than
one, tell me all of them.
* Enter all that apply, separate with commas.
Response:
01 - Asian Indian
02 - Chinese
03 - Filipino
04 - Japanese
05 - Korean
06 - Vietnamese
07 - Other Asian
97 - Refused
99 - Don't Know
Universe:
Sample Adult identifies race as Asian
Skip Instructions:
7 [goto ASIANOTHER_A]
1-6,RF,DK
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK)))[goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0280.00.1
Variable: ASIANOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What is your specific Asian ethnic group or groups? If you have more than one, tell me all of
them.
Start typing and then select from list. If Asian ethnic group is not on the list, type "ZZ" and
enter verbatim.
* If any of the following are mentioned, backup to previous screen and correct the entry.
(Asian) Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Respondent identifies as other Asian
Skip Instructions:
allow 80,RF,DK (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0290.00.1
Variable: ASIANVRBAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Read if necessary: What is your specific Asian ethnic group or groups? If you have more than
one, tell me all of them.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+ who report some other ethnic group of Asian that is not on the picklist
Skip Instructions:
allow 80,RF,DK
if (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0300.00.1
Variable: RACEOTHER_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What other race or races do you consider yourself to be?
Start typing and then select from list. If race is not on the list, type "ZZ" and enter
verbatim.
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the
next question, enter ALL the other races in the verbatim field.
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ and race was changed to "some other race" in verification section or where the Sample Adult respondent is not the Household respondent and did not report a new race and were identified by the household respondent as being "some other race" not on the roster other race picklist
Skip Instructions:
ZZ [goto RACEVRBAT]
picklist selection,RF,DK [goto BMONTH_A]
Question ID: VFY.0310.00.1
Variable: RACEVRBAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Read if necessary: What other race or races do you consider yourself to be?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample adults 18+ who are some other race and this is not selected from Sample adult picklist
Skip Instructions:
verbatim,RF,DK [goto BMONTH_A]
Question ID: VFY.0340.01.1
Variable: BMONTH_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* 1 of 3
What is your date of birth?
Please give month, day, and year for the date of birth.
* Enter month of birth.
Response:
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
97 - Refused
99 - Don't Know
Universe:
Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times
Skip Instructions:
1-12,RF,DK [goto BDAY_A]
Question ID: VFY.0340.02.1
Variable: BDAY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* 2 of 3
* Enter day of birth.
Response:
01-31 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times
Skip Instructions:
1-31,RF,DK Only allow valid days for month entered. if days not valid [goto ERR_BDAY_A]
else [goto BYEAR_A]
Hard Edit:
Check Text: ERR_BDAY_A
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAY_A}
^BDAY_A is not a valid day for ^BMONTH_A.
Question ID: VFY.0340.03.1
Variable: BYEAR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* 3 of 3
* Enter year of birth.
* If year of birth is before 1900, enter 1900.
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times
Skip Instructions:
1900-current year,RF,DK
if (BYEAR_A gt current year) or (BYEAR_A=current year and BMONTH_A gt current month) or
(BYEAR_A=current year and BMONTH_A=current month and BDAY_A gt current day) [goto ERR_BYEAR_A]
elseif BDAY_A=29 and BMONTH_A=2 and (BYEAR=2000 or BYEAR_A/4 remainder ne 0) [goto
ERR_BDAYLEAP_A]
elseif GEN.AGE_FINAL IN (RF,DK) [goto AGEGUESS_A]
elseif ((BYEAR_A not IN (RF,DK) and AGETEMP_A not IN (RF,DK) and AGETEMP_A ne AGE_CALC_A) AND
(AGETEMP_A not IN (RF,DK) and AGETEMP_A ne AGE_CALCMINUS1_A)) and DOB_COUNT_A ne 1 [goto
VFYDOB_A]
elseif (AGETEMP_A eq (AGE_CALC_A or AGE_CALCMINUS1_A)) or DOB_COUNT_A=1
if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
Hard Edit:
Check Text: ERR_BDAYLEAP_A
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAYLEAP_A}
^BDAY_A is not a valid day for ^BMONTH_A.

Check Text: ERR_BYEAR_A
Check Description: Future date hard edit
Check Text: {check ERR_BYEAR_A}Future date invalid
Question ID: VFY.0370.00.1
Variable: AGEGUESS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* An age has not been collected and we are unable to determine an age based upon the date of
birth.
What is your best guess at ^ALIASNAME's age?
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
018-120 - Range of values
Universe:
Sample Adult's age is don't know or refused
Skip Instructions:
18-120 [goto next section]
Question ID: VFY.0380.00.1
Variable: VFYDOB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

There is a difference between the age the computer calculated from your date of birth of
^AGEDOB_A_fill and the age I had previously recorded of ^TEMPAGE_A.
I recorded your ^dateofbirth
Fills:
^AGEDOB_A_fill
Description: Age(s) calculated from Date of Birth for SA
Instruction:
Fill one age calculated from AGE_CALC_A as "(age)" Fill two ages calculated from AGE_CALC_A and
AGE_CALCMINUS1_A as "(age) or (age)"
^TEMPAGE_A
Description: {Value of AGETEMP_A}
Instruction:
Fill value of AGETEMP_A
^dateofbirth
Description: date of birth when any of BDAY_A, BMONTH_A or BYEAR_A are not valid

Instruction:
If BDAY_A, BMONTH,A and BYEAR_A are all valid, fill: "date of birth as ^BMONTH_A ^BDAY_A, ^BYEAR_A, is that correct?"
If only BMONTH_A and BYEAR_A are valid, fill: "date of
birth as ^BMONTH_A ^BYEAR_A, is that correct?"
If only BDAY_A and BYEAR_A are valid, fill: "year of birth
as ^BYEAR_A, is that correct?"
If only BYEAR_A is valid, fill: "year of birth as
^BYEAR_A, is that correct?"
^BMONTH_A
Description: {Value of BMONTH_A}
Instruction:
Fill value from Adult.VFY.BMONTH_A
^BDAY_A
Description: {Value of BDAY_A}
Instruction:
Fill value from Adult.VFY.BDAY_A
^BYEAR_A
Description: {Value of BYEAR_A}
Instruction:
Fill value from Adult.VFY.BYEAR_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults whose age provided in either HHC or NEWAGE_A does not match either age calculated from date of birth information
Skip Instructions:
1,RF,DK if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
2 if DOB_COUNT_A le 1 [goto BMONTH_A]
else if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
Question ID: VFY.0390.00.1
Variable: NOMORE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* ^SANAME is no longer the sample adult for this family. End this interview and begin the Sample
Child Interview. If there is no Sample Child or the Sample Child interview has been completed,
EXIT
Not everyone in our survey is asked all questions. I have all the information that I need about
you at this time.
* Enter '1' to Continue.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
1 - Enter 1 to Continue
Universe:
Sample adult whose age is now less than 18 or lives off campus
Skip Instructions:
1 if there is a Sample Child that has not been interviewed [goto Child.VFY.CURRES_C]
else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

2022 National Health Interview Survey (NHIS) Questionnaire
HIS: Health Status
Question ID: HIS.0010.00.1
Variable: PHSTAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Would you say your health in general is excellent, very good, good, fair, or poor?
Response:
1 - Excellent
2 - Very Good
3 - Good
4 - Fair
5 - Poor
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-5,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
LSF: Life Satisfaction
Question ID: LSF.0010.00.3
Variable: LSATIS4_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In general, how satisfied are you with your life? Are you very satisfied, satisfied,
dissatisfied, or very dissatisfied?
Response:
1 - Very satisfied
2 - Satisfied
3 - Dissatisfied
4 - Very dissatisfied
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
HYP: Hypertension
Question ID: HYP.0010.00.1
Variable: HYPINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Now I am going to ask you about certain medical conditions.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto HYPEV_A]
Question ID: HYP.0020.00.1
Variable: HYPEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER been told by a doctor or other health professional that you had
...Hypertension, also called high blood pressure?
* Enter '1' if respondent is taking medication to control his/her high blood pressure.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto HYPDIF_A]
2,RF,DK [goto next section]
Question ID: HYP.0030.00.1
Variable: HYPDIF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Were you told on two or more DIFFERENT visits that you had hypertension or high blood pressure?
* Enter '1' if respondent is taking medication to control his/her high blood pressure.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had hypertension
Skip Instructions:
1 [goto HYP12M_A]
2,RF,DK [goto HYPMED_A]
Question ID: HYP.0040.00.1
Variable: HYP12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you had hypertension or high blood pressure?
* Enter '1' if respondent is taking medication to control his/her high blood pressure.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had hypertension (2+ visits)
Skip Instructions:
1,2,RF,DK [goto HYPMED_A]
Question ID: HYP.0050.00.1
Variable: HYPMED_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you NOW taking any medication prescribed by a doctor for your high blood pressure?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they have hypertension
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CHL: Cholesterol
Question ID: CHL.0010.00.1
Variable: CHLEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER been told by a doctor or other health professional that you had high cholesterol?
* Enter '1' if respondent is taking medication to control his/her high cholesterol.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CHL12M_A]
2,RF,DK [goto next section]
Question ID: CHL.0020.00.1
Variable: CHL12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you had high cholesterol?
* Enter '1' if respondent is taking medication to control his/her high cholesterol.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had high cholesterol
Skip Instructions:
1,2,RF,DK [goto CHLMED_A]
Question ID: CHL.0030.00.1
Variable: CHLMED_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you NOW taking any medication prescribed by a doctor to help lower your cholesterol?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had high cholesterol
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CVC: Cardiovascular Conditions
Question ID: CVC.0010.00.1
Variable: CHDEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER been told by a doctor or other health professional that you had
...Coronary heart disease?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ANGEV_A]
Question ID: CVC.0020.00.1
Variable: ANGEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Angina, also called angina pectoris?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto MIEV_A]
Question ID: CVC.0030.00.1
Variable: MIEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...A heart attack, also called myocardial infarction?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto STREV_A]
Question ID: CVC.0040.00.1
Variable: STREV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...A stroke?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
AST: Asthma
Question ID: AST.0010.00.1
Variable: ASEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER been told by a doctor or other health professional that you had asthma?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto ASTILL_A]
2,RF,DK [goto next section]
Question ID: AST.0020.00.1
Variable: ASTILL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you still have asthma?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they have asthma
Skip Instructions:
1,2,RF,DK [goto ASAT12M_A]
Question ID: AST.0030.00.1
Variable: ASAT12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you had an episode of asthma or an asthma attack?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had asthma
Skip Instructions:
1,2,RF,DK [goto ASER12M_A]
Question ID: AST.0040.00.1
Variable: ASER12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you had to visit an emergency room or urgent care center because
of asthma?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had asthma
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CAN: Cancer
Question ID: CAN.0010.00.1
Variable: CANEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER been told by a doctor or other health professional that you had
...Cancer or a malignancy of any kind?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CANKIND1_A]
2,RF,DK [goto next section]
Question ID: CAN.0020.00.1
Variable: CANKIND1_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What kind of cancer was it?
* Enter code for the first kind of cancer.
Response:
01 - Bladder
02 - Blood
03 - Bone
04 - Brain
05 - Breast
06 - Cervix/Cervical
07 - Colon
08 - Esophagus/Esophageal
09 - Gallbladder
10 - Kidney
11 - Larynx-trachea
12 - Leukemia
13 - Liver
14 - Lung
15 - Lymphoma
16 - Melanoma
17 - Mouth/tongue/lip
18 - Ovary/Ovarian
19 - Pancreas/Pancreatic
20 - Prostate
21 - Rectum/Rectal
22 - Skin (melanoma)
23 - Skin (non-melanoma)
24 - Skin (don't know kind)
25 - Stomach
26 - Testis/Testicular
27 - Throat - pharynx
28 - Thyroid
29 - Uterus/Uterine
30 - Other
- 97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had cancer
Skip Instructions:
If GEN.SEX_FINAL[PX_A]=1 and CANKIND1_A IN (6,18,29) [goto ERR1_CANKIND_A]
elseif GEN.SEX_FINAL[PX_A]=2 and CANKIND1_A IN (20,26) [goto ERR2_CANKIND_A]
1-30,RF,DK [goto CANAGE1_A]
Soft Edit:
Check Text: ERR1_CANKIND_A
Check Description: CANKIND_A male soft edit
Check Text: {signal ERR1_CANKIND_A} Verify. Code 6 or 18 or 29 is unavailable for males.

Check Text: ERR2_CANKIND_A
Check Description: CANKIND_A female soft edit
Check Text: {signal ERR2_CANKIND_A} Verify. Code 20 or 26 is unavailable for females.
Question ID: CAN.0030.00.1
Variable: CANAGE1_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND1?
* Enter 1 if reported age is 1 or younger.
Fills:
^CANKIND1
Description: {Value of CANKIND1_A}
Instruction:
If CANKIND1_A = RF,DK fill "this cancer"; else fill "bladder cancer" if CANKIND1_A = 1;
else fill "blood cancer" if CANKIND1_A = 2;
else fill "bone cancer" if CANKIND1_A = 3;
else fill "brain cancer" if CANKIND1_A = 4;
else fill "breast cancer" if CANKIND1_A = 5;
else fill "cervical cancer" if CANKIND1_A = 6;
else fill "colon cancer" if CANKIND1_A = 7;
else fill "esophageal cancer" if CANKIND1_A = 8;
else fill "gallbladder cancer" if CANKIND1_A = 9;
else fill "kidney cancer" if CANKIND1_A = 10;
else fill "larynx-trachea cancer" if CANKIND1_A = 11;
else fill "leukemia" if CANKIND1_A = 12;
else fill "liver cancer" if CANKIND1_A = 13;
else fill "lung cancer" if CANKIND1_A = 14;
else fill "lymphoma" if CANKIND1_A = 15;
else fill "melanoma" if CANKIND1_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND1_A = 17;
else fill "ovarian cancer" if CANKIND1_A = 18;
else fill "pancreatic cancer" if CANKIND1_A = 19;
else fill "prostate cancer" if CANKIND1_A = 20;
else fill "rectal cancer" if CANKIND1_A = 21;
else fill "skin (melanoma) cancer" if CANKIND1_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND1_A = 23;
else fill "skin (don't know kind) cancer" if CANKIND1_A =
24;
else fill "stomach cancer" if CANKIND1_A = 25;
else fill "testicular cancer" if CANKIND1_A = 26;
else fill "throat/pharynx cancer" if CANKIND1_A = 27;
else fill "thyroid cancer" if CANKIND1_A = 28;
else fill "uterine cancer" if CANKIND1_A = 29;
else fill "other cancer" if CANKIND1_A = 30
Response:
001-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had cancer
Skip Instructions:
1-120,DK [goto CANKIND2_A]
RF if CANKIND1_A=RF [goto next section] else [goto CANKIND2_A]
If number in CANAGE1_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE1_A]
Hard Edit:
Check Text: ERR_CANAGE1_A
Check Description: CANAGE1_A years with cancer greater than age hard edit
Check Text: {check ERR_CANAGE1_A}
^CANAGE1_A years old is older than age ^SA_AGE. Please correct.
Question ID: CAN.0040.00.1
Variable: CANKIND2_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER had any other kinds of cancer?
* If yes, ask respondent for second kind of cancer, enter code.
* If no, enter '96' for no more.
Response:
01 - Bladder
02 - Blood
03 - Bone
04 - Brain
05 - Breast
06 - Cervix/Cervical
07 - Colon
08 - Esophagus/Esophageal
09 - Gallbladder
10 - Kidney
11 - Larynx-trachea
12 - Leukemia
13 - Liver
14 - Lung
15 - Lymphoma
16 - Melanoma
17 - Mouth/tongue/lip
18 - Ovary/Ovarian
19 - Pancreas/Pancreatic
20 - Prostate
21 - Rectum/Rectal
22 - Skin (melanoma)
23 - Skin (non-melanoma)
24 - Skin (don't know kind)
25 - Stomach
26 - Testis/Testicular
27 - Throat - pharynx
28 - Thyroid
29 - Uterus/Uterine
- 30 - Other
96 - No more
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who were ever told they had cancer and mentioned or didn't know a first type of cancer OR gave a valid age or did not know age for first cancer
Skip Instructions:
If GEN.SEX_FINAL[PX_A]=1 and CANKIND2_A IN (6,18,29) [goto ERR1_CANKIND_A]
elseif GEN.SEX_FINAL[PX_A]=2 and CANKIND2_A IN (20,26) [goto ERR2_CANKIND_A]
1-30,RF,DK [goto CANAGE2_A]
96 [goto next section]
Question ID: CAN.0050.00.1
Variable: CANAGE2_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND2?
* Enter 1 if reported age is 1 or younger.
Fills:
^CANKIND2
Description: {Value of CANKIND2_A}
Instruction:
If CANKIND2_A = R,D fill "this cancer"; else fill "bladder cancer" if CANKIND2_A = 1;
else fill "blood cancer" if CANKIND2_A = 2;
else fill "bone cancer" if CANKIND2_A = 3;
else fill "brain cancer" if CANKIND2_A = 4;
else fill "breast cancer" if CANKIND2_A = 5;
else fill "cervical cancer" if CANKIND2_A = 6;
else fill "colon cancer" if CANKIND2_A = 7;
else fill "esophageal cancer" if CANKIND2_A = 8;
else fill "gallbladder cancer" if CANKIND2_A = 9;
else fill "kidney cancer" if CANKIND2_A = 10;
else fill "larynx-trachea cancer" if CANKIND2_A = 11;
else fill "leukemia" if CANKIND2_A = 12;
else fill "liver cancer" if CANKIND2_A = 13;
else fill "lung cancer" if CANKIND2_A = 14;
else fill "lymphoma" if CANKIND2_A = 15;
else fill "melanoma" if CANKIND2_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND2_A = 17;
else fill "ovarian cancer" if CANKIND2_A = 18;
else fill "pancreatic cancer" if CANKIND2_A = 19;
else fill "prostate cancer" if CANKIND2_A = 20;
else fill "rectal cancer" if CANKIND2_A = 21;
else fill "skin (melanoma) cancer" if CANKIND2_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND2_A = 23;
else fill "skin (don't know kind) cancer" if CANKIND2_A =
24;
else fill "stomach cancer" if CANKIND2_A = 25;
else fill "testicular cancer" if CANKIND2_A = 26;
else fill "throat/pharynx cancer" if CANKIND2_A = 27;
else fill "thyroid cancer" if CANKIND2_A = 28;
else fill "uterine cancer" if CANKIND2_A = 29;
else fill "other cancer" if CANKIND2_A = 30
Response:
001-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who selected a second kind of cancer or don't know the second kind of cancer or refused the second kind of cancer
Skip Instructions:
1-120,DK [goto CANKIND3_A]
RF if CANKIND2_A=RF [goto next section] else [goto CANKIND3_A]
If CANAGE2_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE2_A]
Hard Edit:
Check Text: ERR_CANAGE2_A
Check Description: CANAGE2_A age greater than years with cancer hard edit
Check Text: {check ERR_CANAGE2_A}
^CANAGE2_A years old is older than age ^SA_AGE. Please correct.
Question ID: CAN.0060.00.1
Variable: CANKIND3_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER had any other kinds of cancer?
* If yes, ask respondent for third kind of cancer, enter code.
* If no, enter '96' for no more.
Response:
01 - Bladder
02 - Blood
03 - Bone
04 - Brain
05 - Breast
06 - Cervix/Cervical
07 - Colon
08 - Esophagus/Esophageal
09 - Gallbladder
10 - Kidney
11 - Larynx-trachea
12 - Leukemia
13 - Liver
14 - Lung
15 - Lymphoma
16 - Melanoma
17 - Mouth/tongue/lip
18 - Ovary/Ovarian
19 - Pancreas/Pancreatic
20 - Prostate
21 - Rectum/Rectal
22 - Skin (melanoma)
23 - Skin (non-melanoma)
24 - Skin (don't know kind)
25 - Stomach
26 - Testis/Testicular
27 - Throat - pharynx
28 - Thyroid
29 - Uterus/Uterine
- 30 - Other
96 - No more
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who selected a second kind of cancer or don't know the second kind of cancer or gave a valid age for second cancer or did not know age for second cancer
Skip Instructions:
If GEN.SEX_FINAL=1 and CANKIND3_A IN (6,18,29) [goto ERR1_CANKIND_A]
elseif GEN.SEX_FINAL=2 and CANKIND3_A IN (20,26) [goto ERR2_CANKIND_A]
1-30,RF,DK[goto CANAGE3_A]
96 [goto next section]
Question ID: CAN.0070.00.1
Variable: CANAGE3_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND3?
* Enter 1 if reported age is 1 or younger.
Fills:
^CANKIND3
Description: {Value of CANKIND3_A}
Instruction:
If CANKIND3_A = R,D fill "this cancer"; else fill "bladder cancer" if CANKIND3_A = 1;
else fill "blood cancer" if CANKIND3_A = 2;
else fill "bone cancer" if CANKIND3_A = 3;
else fill "brain cancer" if CANKIND3_A = 4;
else fill "breast cancer" if CANKIND3_A = 5;
else fill "cervical cancer" if CANKIND3_A = 6;
else fill "colon cancer" if CANKIND3_A = 7;
else fill "esophageal cancer" if CANKIND3_A = 8;
else fill "gallbladder cancer" if CANKIND3_A = 9;
else fill "kidney cancer" if CANKIND3_A = 10;
else fill "larynx-trachea cancer" if CANKIND3_A = 11;
else fill "leukemia" if CANKIND3_A = 12;
else fill "liver cancer" if CANKIND3_A = 13;
else fill "lung cancer" if CANKIND3_A = 14;
else fill "lymphoma" if CANKIND3_A = 15;
else fill "melanoma" if CANKIND3_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND3_A = 17;
else fill "ovarian cancer" if CANKIND3_A = 18;
else fill "pancreatic cancer" if CANKIND3_A = 19;
else fill "prostate cancer" if CANKIND3_A = 20;
else fill "rectal cancer" if CANKIND3_A = 21;
else fill "skin (melanoma) cancer" if CANKIND3_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND3_A = 23;
else fill "skin (don't know kind) cancer" if CANKIND3_A =
24;
else fill "stomach cancer" if CANKIND3_A = 25;
else fill "testicular cancer" if CANKIND3_A = 26;
else fill "throat/pharynx cancer" if CANKIND3_A = 27;
else fill "thyroid cancer" if CANKIND3_A = 28;
else fill "uterine cancer" if CANKIND3_A = 29;
else fill "other cancer" if CANKIND3_A = 30
Response:
001-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who selected a third kind of cancer or don't know or refused the third kind of cancer
Skip Instructions:
1-120,DK [goto CANMORE_A]
RF if CANKIND3_A=RF [goto next section] else [goto CANMORE_A]
if CANAGE3_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE3_A]
Hard Edit:
Check Text: ERR_CANAGE3_A
Check Description: CANAGE3_A age with cancer greater than age
Check Text: {check ERR_CANAGE3_A}
^CANAGE3_A years old is older than age ^SA_AGE. Please correct.
Question ID: CAN.0080.00.1
Variable: CANMORE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Did you have any other kinds of cancer?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who selected a third kind of cancer or don't know the third kind of cancer or selected a valid age for third type of cancer or did not know age for third type of cancer
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DIB: Diabetes
Question ID: DIB.0010.00.1
Variable: PREDIB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Has a doctor or other health professional EVER told you that you had prediabetes or borderline
diabetes?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK If GEN.SEX_FINAL[PX_A]=2 [goto GESDIB_A]
elseif GEN.SEX_FINAL[PX_A]=1,RF,DK [goto DIBEV_A]
Question ID: DIB.0020.00.1
Variable: GESDIB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Has a doctor or other health professional EVER told you that you had gestational diabetes, a
type of diabetes that occurs ONLY during pregnancy?
* Read if necessary: Gestational diabetes is diabetes that you did not have prior to being
pregnant and goes away after you are pregnant. Pregnant women are usually screened for
gestational diabetes during the 24th to 28th week of pregnancy.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Female Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto DIBEV_A]
Question ID: DIB.0030.00.1
Variable: DIBEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^NOTPREGDM a doctor or other health professional EVER told you that you had
diabetes?
Fills:
^NOTPREGDM
Description: Has/Not including (gestational diabetes, prediabetes), has
Instruction:
If GESDIB_A ne 1 AND PREDIB_A ne 1: "Has" If GESDIB_A=1 AND PREDIB_A ne 1: "Not including
gestational diabetes, has"
If PREDIB_A=1 AND GESDIB_A ne 1: "Not including
prediabetes, has"
If GESDIB_A=1 AND PREDIB_A=1: "Not including prediabetes
or gestational diabetes, has"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto DIBAGE_A]
2,RF,DK if PREDIB_A=1 [goto DIBPILL_A]
else if PREDIB_A=2,RF,DK [goto next section]
Question ID: DIB.0040.00.1
Variable: DIBAGE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How old were you when a doctor or other health professional FIRST told you that you had
diabetes^NOTPREGDM2?
* Enter '1' if reported age is 1 or younger.
Fills:
^NOTPREGDM2
Description: not including (gestational diabetes, prediabetes)
Instruction:
If GESDIB_A ne 1 AND PREDIB_A ne 1: NO FILL If GESDIB_A=1 AND PREDIB_A ne 1: ", not including
gestational diabetes"
If PREDIB_A=1 AND GESDIB_A ne 1: ", not including
prediabetes"
If GESDIB_A=1 AND PREDIB_A=1: ", not including prediabetes
or gestational diabetes"
Response:
001-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who were told they had diabetes
Skip Instructions:
1-120,RF,DK if DIBAGE_A gt GEN.AGE_FINAL [goto ERR_DIBAGE_A]
else [goto DIBPILL_A]
Hard Edit:
Check Text: ERR_DIBAGE_A
Check Description: DIBAGE_A age greater than SA age hard edit
Check Text: {check ERR_DIBAGE_A}
^DIBAGE_A years old is older than your age ^SA_AGE. Please correct.
Question ID: DIB.0050.00.1
Variable: DIBPILL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you NOW taking diabetic pills to lower your blood sugar? These are sometimes called oral
agents or oral hypoglycemic agents.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were told they had prediabetes and/or diabetes
Skip Instructions:
1-2,RF,DK [goto DIBINS_A]
Question ID: DIB.0060.00.1
Variable: DIBINS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Insulin can be taken by shot or pump. Are you NOW taking insulin?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were told they had prediabetes and/or diabetes
Skip Instructions:
1 if DIBEV_A=1 [goto DIBINSTIME_A]
else [goto next section]
2,RF,DK if DIBEV_A=1 [goto DIBTYPE_A]
else [goto next section]
Question ID: DIB.0070.00.3
Variable: DIBINSTIME_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you were first diagnosed with diabetes, how long was it before you started
taking insulin?
Response:
1 - Less than 1 month
2 - 1 month to less than 6 months
3 - 6 months to less than 1 year
4 - 1 year or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have diabetes and currently take insulin
Skip Instructions:
1-4,RF,DK [goto DIBINSSTOP_A]
Question ID: DIB.0080.00.3
Variable: DIBINSSTOP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Since you started taking insulin, have you ever stopped taking it for more than 6 months?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have diabetes and are taking insulin
Skip Instructions:
1 if DIBINSTIME_A IN (1,2,3) [goto DIBINSSTYR_A]
else [goto DIBTYPE_A]
2,RF,DK [goto DIBTYPE_A]
Question ID: DIB.0090.00.3
Variable: DIBINSSTYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Was this only during the first year after you were diagnosed with diabetes?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have diabetes, who started taking insulin less than 1 year from when they were diagnosed with diabetes, and who stopped taking insulin for more than 6 months
Skip Instructions:
1,2,RF,DK [goto DIBTYPE_A]
Question ID: DIB.0130.00.1
Variable: DIBTYPE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

According to your doctor or other health professional, what type of diabetes do you have? Is it
type 1, type 2, or some other type? If you don't remember or weren't told, that's OK.
Response:
1 - Type 1
2 - Type 2
3 - Other type of diabetes
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were told they had diabetes
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CON: Other Chronic Conditions
Question ID: CON.0010.00.1
Variable: COPDEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you EVER been told by a doctor or other health professional that you had
...Chronic Obstructive Pulmonary Disease, C.O.P.D., emphysema, or chronic bronchitis?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ARTHEV_A]
Question ID: CON.0020.00.1
Variable: ARTHEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia (fy-bro-my-AL-jeeuh)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto DEMENEV_A]
Question ID: CON.0030.00.1
Variable: DEMENEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Dementia, including Alzheimer's disease?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ANXEV_A]
Question ID: CON.0040.00.1
Variable: ANXEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Any type of anxiety disorder?
* Read if necessary: Some common types of anxiety disorders include generalized anxiety
disorder, social anxiety disorder, panic disorder, post-traumatic stress disorder, obsessivecompulsive disorder, and phobias.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto DEPEV_A]
Question ID: CON.0050.00.1
Variable: DEPEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Any type of depression?
* Read if necessary: Some common types of depression include major depression (or major
depressive disorder), bipolar depression, dysthymia, post-partum depression, and seasonal
affective disorder.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CFS: Chronic Fatigue Section
Question ID: CFS.0010.00.3
Variable: CFSEV_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had
...Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (My-AL-jick In-seff-ah-low-my-uhLIE-tiss) (ME)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CFSNOW_A]
2,RF,DK [goto next section]
Question ID: CFS.0020.00.3
Variable: CFSNOW_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Do you still have Chronic Fatigue Syndrome (CFS) or ME?
* Read if necessary: ME is also known as Myalgic Encephalomyelitis (My-AL-jick In-seff-ah-lowmy-uh-LIE-tiss).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been told by a doctor or other health professional that they had Chronic Fatigue Syndrome or Myalgic Encephalomyelitis
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ISN: Immunosuppression
Question ID: ISN.0010.00.3
Variable: MEDRXTRT_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the past 12 months, have you taken prescription medication or had any medical treatments that
a doctor or other health professional told you would weaken your immune system?
* Read if necessary: Examples include steroid or corticosteroid (Core-tih-coe-STAIR-oid) pills,
such as prednisone (PRED-nuh-sown), or other oral or injected medications for treating many
types of autoimmune conditions or certain cancers.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto HLTHCOND_A]
Question ID: ISN.0020.00.3
Variable: HLTHCOND_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Do you currently have a health condition that a doctor or other health professional told you
weakens the immune system^MEDTRT?
* Read if necessary: Examples include certain kinds of leukemia, lymphoma, or HIV infection.
Fills:
^MEDTRT
Description: , even without related medications or treatments
Instruction:
If MEDRXTRT_A=1, fill: ", even without related medications or treatments"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
EPI: Epilepsy
Question ID: EPI.0010.00.3
Variable: EPIEV_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Have you ever been told by a doctor or other health professional that you have a seizure
disorder or epilepsy?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto EPIMED_A]
2,RF,DK [goto next section]
Question ID: EPI.0020.00.3
Variable: EPIMED_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Are you currently taking any medicine to control your seizure disorder or epilepsy?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who ever had epilepsy
Skip Instructions:
1,2,RF,DK [goto EPINUMSEIZ_A]
Question ID: EPI.0030.00.3
Variable: EPINUMSEIZ_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Today is ^CURRENTDATE. Think back to the last year about the same time. About how many seizures
of any type have you had during the past 12 months?
* Read if necessary: Some people may call it a "convulsion," "fit," "falling out spell,"
"episode," "attack," "drop attack," "staring spell," or "out-of-touch."
* If the respondent mentions and counts "auras" as seizures accept the response.
* If the respondent indicates that he/she has had nothing more than an aura and is unsure about
counting the aura(s), do NOT count auras as seizures.
Fills:
^CURRENTDATE
Description: This fill will show the current date
Instruction:
Fill with current month, day, and year at the time of the interview.
Response:
0 - 0
1 - 1
2 - 2 or 3
3 - Between 4 and 10
4 - More than 10
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who ever had epilepsy
Skip Instructions:
0-4,RF,DK [goto EPIDR_A]
Question ID: EPI.0040.00.3
Variable: EPIDR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, have you seen a neurologist or epilepsy specialist for your seizure
disorder or epilepsy?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who ever had epilepsy
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
BMI: Current pregnancy, height, weight
Question ID: BMI.0010.00.1
Variable: PREGNOW_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you currently pregnant?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Female Sample Adults 18-49 or age is don't know or refused
Skip Instructions:
1,2,RF,DK [goto HEIGHTFT_A]
Question ID: BMI.0020.01.1
Variable: HEIGHTFT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How tall are you without shoes?
* Enter M to record metric measurements.
* If ^SANAME's height is less than 2 feet, enter 2. If ^SANAME's height is greater than 7 feet,
enter 7.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
02 - 2 feet
03 - 3 feet
04 - 4 feet
05 - 5 feet
06 - 6 feet
07 - 7 feet
M - Answered in Metric
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+
Skip Instructions:
If HEIGHTFT_A NE 2-7,RF,DK,M [goto ERR1_HEIGHTFT_A]
If HEIGHTFT_A = 2,3 [goto ERR2_HEIGHTFT_A]
2-7 [goto HEIGHTIN_A]
RF,DK [goto WEIGHTLB_A]
M [goto HEIGHTM_A]
Hard Edit:
Check Text: ERR1_HEIGHTFT_A
Check Description: Hard edit for height in feet
Check Text: {check ERR1_HEIGHTFT_A}
Only 2-7, Don't Know/Refused or M allowed in this field. Please correct.
Soft Edit:
Check Text: ERR2_HEIGHTFT_A
Check Description: Soft edit to verify height in feet
Check Text: {signal ERR2_HEIGHTFT_A}
Respondent's height in feet is ^HEIGHTFT? Please verify.
Question ID: BMI.0020.02.1
Variable: HEIGHTIN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Enter inches.
* Enter '0' if exactly ^HEIGHTFT feet tall.
Fills:
^HEIGHTFT
Description: {Value of HEIGHTFT_A}
Instruction:
Fill value from Adult.BMI.HEIGHTFT_A
Response:
00 - 0 inches
01 - 1 inch
02 - 2 inches
03 - 3 inches
04 - 4 inches
05 - 5 inches
06 - 6 inches
07 - 7 inches
08 - 8 inches
09 - 9 inches
10 - 10 inches
11 - 11 inches
97 - Refused
99 - Don't Know
Universe:
Sample Adult 18+ and height is 2-7ft
Skip Instructions:
0-11,RF,DK [goto WEIGHTLB_A]
Question ID: BMI.0020.04.1
Variable: HEIGHTM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How tall are you without shoes?
* Enter height in metric.
* If the height is given in centimeters, press '0' at meters and enter the measure in
centimeters (241 centimeters maximum).
Response:
0 - 0 meters
1 - 1 meter
2 - 2 meters
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who choose to give their height in metric measurements
Skip Instructions:
0-2 [goto HEIGHTCM_A]
RF,DK [goto WEIGHTLB_A]
Question ID: BMI.0020.05.1
Variable: HEIGHTCM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Enter centimeters.
* Enter height in metric.
* If ^SANAME's height is greater than 241 centimeters, enter 241.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
000-241 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who entered 0 to 2 meters for height
Skip Instructions:
0-241,RF,DK [goto WEIGHTLB_A]
Question ID: BMI.0030.01.1
Variable: WEIGHTLB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^PREGWEIGH
* Enter M to record metric measurements.
* If ^SANAME's weight is less than 50 pounds, enter 50. If ^SANAME's weight is greater than 500
pounds, enter 500.
Fills:
^PREGWEIGH
Description: How much did you weigh before your pregnancy?/How much do you weigh?

Instruction:
If GEN.SEX_FINAL=2 AND PREGNOW_A=1: "How much did you weigh before your pregnancy?"
else: "How much do you weigh?"
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
050-500 - Range of values
M - Answered in Metric
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
If WEIGHTLB_A lt 50 or WEIGHTLB_A gt 500 [goto ERR1_WEIGHTLB_A]
elseif ((GEN.SEX_FINAL[PX_A]=1 and (WEIGHTLB_A lt 113 or WEIGHTLB_A gt 316)) or (GEN.SEX_FINAL
[PX_A]=2 and (WEIGHTLB_A lt 96 or WEIGHTLB_A gt 293)) or (GEN.SEX_FINAL[PX_A] IN (RF,DK) and
(WEIGHTLB_A lt 96 or WEIGHTLB_A gt 316))) [goto ERR2_WEIGHTLB_A]
50-500,RF,DK [goto next section]
M [goto WEIGHTKG_A]
Hard Edit:
Check Text: ERR1_WEIGHTLB_A
Check Description: SA weight pounds hard edit
Check Text: {check ERR1_WEIGHTLB_A} Weight is out of range. Only "50-500" or "M" or "Don't know/Refused" allowed in this field.
Soft Edit:
Check Text: ERR2_WEIGHTLB_A
Check Description: SA weight pounds soft edit
Check Text: {signal ERR2_WEIGHTLB_A} Please verify that the weight was entered correctly. Probe only if necessary.
Question ID: BMI.0030.02.1
Variable: WEIGHTKG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^PREGWEIGH
* Enter weight in kilograms.
* If ^SANAME's weight is less than 23 kilograms, enter 23. If ^SANAME's weight is greater than
226 kilograms, enter 226.
Fills:
^PREGWEIGH
Description: How much did you weigh before your pregnancy?/How much do you weigh?

Instruction:
If GEN.SEX_FINAL=2 AND PREGNOW_A=1: "How much did you weigh before your pregnancy?"
else: "How much do you weigh?"
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
023-226 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who chose to give their weight in metric measurements
Skip Instructions:
If WEIGHTKG_A lt 23 or WEIGHTKG_A gt 226 [goto ERR1_WEIGHTKG_A]
elseif ((GEN.SEX_FINAL[PX]=1 and (WEIGHTKG_A lt 51 or WEIGHTKG_A gt 143)) or (GEN.SEX_FINAL
[PX]=2 and (WEIGHTKG_A lt 43 or WEIGHTKG_A gt 133)) or (GEN.SEX_FINAL[PX] IN (RF,DK) and
(WEIGHTKG_A lt 43 or WEIGHTKG_A gt 143)))[goto ERR2_WEIGHTKG_A]
23-226,RF,DK [goto next section]
Hard Edit:
Check Text: ERR1_WEIGHTKG_A
Check Description: SA weight KG hard edit
Check Text: {check ERR1_WEIGHTKG_A} Weight is out of range (23-226). Please correct.
Soft Edit:
Check Text: ERR2_WEIGHTKG_A
Check Description: SA weight KG soft edit
Check Text: {signal ERR2_WEIGHTKG_A} Please verify that the weight was entered correctly. Probe only if necessary.

2022 National Health Interview Survey (NHIS) Questionnaire
VIS: Vision
Question ID: VIS.0010.00.1
Variable: VISINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

The next questions ask about difficulties you may have doing certain activities because of a
health problem.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto WEARGLSS_A]
Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you wear glasses or contact lenses?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto VISIONDF_A]
Question ID: VIS.0030.00.1
Variable: VISIONDF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty ^AGLASSCNTS? Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
Fills:
^AGLASSCNTS
Description: seeing, even when wearing glasses or contact lenses/seeing
Instruction:
If WEARGLSS_A=1 fill "seeing, even when wearing glasses or contact lenses";
else fill "seeing"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
HEA: Hearing
Question ID: HEA.0010.00.1
Variable: HEARAID_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you use a hearing aid?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [HEARAIDFR_A]
2,RF,DK [HEARINGDF_A]
Question ID: HEA.0020.00.1
Variable: HEARAIDFR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How often do you use your hearing aid(s)? Would you say all of the time, some of the time,
rarely, or never?
Response:
1 - All of the time
2 - Some of the time
3 - Rarely
4 - Never
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use a hearing aid
Skip Instructions:
1-4,RF,DK [HEARINGDF_A]
Question ID: HEA.0030.00.1
Variable: HEARINGDF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty hearing^HEARAID? Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
Fills:
^HEARAID
Description: , even when using your hearing aid(s)
Instruction:
If HEARAID_A=1, fill: ", even when using your hearing aid (s)"
else NO FILL
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
MOB: Mobility
Question ID: MOB.0010.00.1
Variable: DIFF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty walking or climbing steps? Would you say no difficulty, some difficulty,
a lot of difficulty, or you cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto EQUIP_A]
Question ID: MOB.0020.00.1
Variable: EQUIP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you use any equipment or receive help for getting around?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CANEWLKR_A]
2,RF,DK [goto WLK100_A]
Question ID: MOB.0030.00.1
Variable: WLK100_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty walking 100 yards on level ground, that would be about the length of one
football field or one city block? Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who do not use equipment or receive help for getting around or refused or don't know
Skip Instructions:
1-3,RF,DK [goto WLK13M_A]
4 [goto STEPS_A]
Question ID: MOB.0040.00.1
Variable: WLK13M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty walking a third of a mile on level ground, that would be the length of
five football fields or five city blocks?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or refused or don't know
Skip Instructions:
1-4,RF,DK [goto STEPS_A]
Question ID: MOB.0050.00.1
Variable: STEPS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty walking up or down 12 steps?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who do not use equipment or receive help for getting around or refused or don't know
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: MOB.0060.00.1
Variable: CANEWLKR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you use any of the following...
...Cane or walker?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment or receive help for getting around
Skip Instructions:
1,2,RF,DK [goto WCHAIR_A]
Question ID: MOB.0070.00.1
Variable: WCHAIR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Do you use any of the following?
...Wheelchair or scooter?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment or receive help for getting around
Skip Instructions:
1,2,RF,DK [goto PERASST_A]
Question ID: MOB.0080.00.1
Variable: PERASST_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Do you use any of the following?
...Someone's assistance?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment or receive help for getting around
Skip Instructions:
1,2,RF,DK [goto NOEQWLK100_A]
Question ID: MOB.0090.00.1
Variable: NOEQWLK100_A
Interview Module: Adult
Content Type: Annual Core

Question text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking 100 yards on level ground, that
would be about the length of one football field or one city block? Would you say no difficulty,
some difficulty, a lot of difficulty, or you cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment or receive help for getting around
Skip Instructions:
1-3,RF,DK [goto NOEQWLK13M_A]
4 [goto NOEQSTEPS_A]
Question ID: MOB.0100.00.1
Variable: NOEQWLK13M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking a third of a mile on level ground,
that would be the length of five football fields or five city blocks?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards without the use of their aid or refused or don't know
Skip Instructions:
1-4,RF,DK [goto NOEQSTEPS_A]
Question ID: MOB.0110.00.1
Variable: NOEQSTEPS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking up or down 12 steps?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment
Skip Instructions:
1-4,RF,DK if WCHAIR_A ne 1 [goto EQWLK100_A]
else [goto next section]
Question ID: MOB.0120.00.1
Variable: EQWLK100_A
Interview Module: Adult
Content Type: Annual Core

Question text:

WHEN USING YOUR AID, do you have difficulty walking 100 yards on level ground, that would be
about the length of one football field or one city block?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment or receive help for getting around but do not use a wheelchair or scooter or refused or don't know
Skip Instructions:
1-3,RF,DK [goto EQWLK13M_A]
4 [goto EQSTEPS_A]
Question ID: MOB.0130.00.1
Variable: EQWLK13M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

WHEN USING YOUR AID, do you have difficulty walking a third of a mile on level ground, that
would be the length of five football fields or five city blocks?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards, when using their aid or refused or don't know
Skip Instructions:
1-4,RF,DK [goto EQSTEPS_A]
Question ID: MOB.0140.00.1
Variable: EQSTEPS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

WHEN USING YOUR AID, do you have difficulty walking up or down 12 steps?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who use equipment or receive help for getting around but do not use a wheelchair or scooter
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
COM: Communication
Question ID: COM.0010.00.1
Variable: COMDIFF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Using your usual language, do you have difficulty communicating, for example, understanding or
being understood?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
COG: Cognition
Question ID: COG.0010.00.1
Variable: COGMEMDFF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty remembering or concentrating?
*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF,DK [goto next section]
2-4 [goto COGTYPEDFF_A]
Question ID: COG.0020.00.1
Variable: COGTYPEDFF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Is that a difficulty with remembering, concentrating, or both?
Response:
1 - Difficulty remembering only
2 - Difficulty concentrating only
3 - Difficulty with both remembering and concentrating
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have some difficulty, a lot of difficulty, or are unable to remember or concentrate
Skip Instructions:
1,3 [goto COGFRQDFF_A]
2,RF,DK [goto next section]
Question ID: COG.0030.00.1
Variable: COGFRQDFF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How often do you have difficulty remembering? Would you say sometimes, often, or all of the
time?
Response:
1 - Sometimes
2 - Often
3 - All of the time
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have difficulty remembering or remembering and concentrating
Skip Instructions:
1-3,RF,DK [goto COGAMTDFF_A]
Question ID: COG.0040.00.1
Variable: COGAMTDFF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty remembering a few things, a lot of things, or almost everything?
Response:
1 - A few things
2 - A lot of things
3 - Almost everything
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have difficulty remembering or remembering and concentrating
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
UPP: Self-care and Upper Body
Question ID: UPP.0010.00.1
Variable: UPPSLFCR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no
difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto UPPRAISE_A]
Question ID: UPP.0020.00.1
Variable: UPPRAISE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty raising a 2 liter bottle of water or soda from waist to eye level?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto UPPOBJCT_A]
Question ID: UPP.0030.00.1
Variable: UPPOBJCT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have difficulty using your hands and fingers, such as picking up small objects, for
example, a button or pencil, or opening or closing containers or bottles?
*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
SOC: Social Functioning
Question ID: SOC.0010.00.1
Variable: SOCERRNDS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Because of a physical, mental, or emotional condition, do you have difficulty doing errands
alone such as visiting a doctor's office or shopping?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto SOCSCLPAR_A]
Question ID: SOC.0020.00.1
Variable: SOCSCLPAR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Because of a physical, mental, or emotional condition, do you have difficulty participating in
social activities such as visiting friends, attending clubs and meetings, or going to parties?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto SOCWRKLIM_A]
Question ID: SOC.0030.00.1
Variable: SOCWRKLIM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you limited in the kind OR amount of work you can do because of a physical, mental or
emotional problem?
* Read if necessary: Work includes paid work, volunteer work, school work, and homework.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ADO: Age of Disability Onset
Question ID: ADO.0010.00.3
Variable: DEVDONSET_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

You said that you have difficulty with ^DIFF. Did ^THISDIFF begin before age 22?
Fills:
^DIFF
Description: walking/climbing steps/walking or climbin steps/communicating/remembering/concentrating/remembering

Instruction:
rating/self-care/doing errands alone Instruction if (MOB.WLK100_A IN (3,4) or MOB.WLK13M_A IN (3,4) or
MOB.NOEQWLK100_A IN (3,4) or MOB.NOEQWLK13M_A IN (3,4)),
then fill "walking"
if (MOB.STEPS_A IN (3,4) or MOB.NOEQSTEPS_A IN (3,4)),
then fill "climbing steps"
if none of MOB.WLK100_A, MOB.WLK13M_A,
MOB.NOEQWLK100_A, MOB.NOEQWLK13M_A, MOB.STEPS_A, or
MOB.NOEQSTEPS_A = 3 or 4, but MOB.DIFF_A = 3 or 4, then
fill "walking or climbing steps"
If COM.COMDIFF_A IN (3,4), then fill "communicating"
If COG.COGMEMDFF_A IN (3,4),
If COG.COGTYPEDFF_A IN (1,3), then fill "remembering"
If COG.COGTYPEDFF_A IN (2,3), then fill "concentrating"
If COG.COGTYPEDFF_A IN (DK,RF), then fill "remembering
or concentrating"
If UPP.UPPSLFCR_A = 3 or 4, then fill "self-care"
If SOC.SOCERRNDS_A = 3 or 4, then fill "doing errands
alone"
If more than two of the above are true, then separate the
fills with commas and place an "and" before the last item.
If two of the above are true, separate them with "and"
^THISDIFF
Description: this difficulty/any of these difficulties
Instruction:
if ADO.countDIFF=1, fill "this difficulty" elseif ADO.countDIFF gt 1, fill "any of these
difficulties"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults age 22+ who said they had a lot of difficulty or could not do the following activities at all: Walking or climbing stairs, communicating, remembering or concentrating, self-care, or doing errands alone
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
INS: Health Insurance
Question ID: INS.0010.00.1
Variable: HICOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
The next questions are about health insurance. Include health insurance obtained through
employment or purchased directly as well as government programs like Medicare, Medicaid, and the
Children's Health Insurance Program that provide medical care or help pay medical bills. Are you
covered by any kind of health insurance or some other kind of health care plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF,DK [goto HIKIND_A]
2 if (GEN.AGE_FINAL[PX_A] ge 65 or Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2) [goto
MCAREPRB_A]
else [goto MCAIDPRB_A]
Question ID: INS.0020.00.1
Variable: HIKIND_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
What kinds of health insurance or health care coverage do you have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, a state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.
Response:
01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.
Skip Instructions:
if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A]
elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A]
elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto
MCAIDPRB_A]
else [goto SINCOVDE_A]
Hard Edit:
Check Text: ERR1_HIKIND_A
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_A}
Cannot mark "no coverage of any kind" and another type. Please correct.
Question ID: INS.0030.00.1
Variable: MCAREPRB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you covered by Medicare?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 65+ who have not indicated they had Medicare in HIKIND_A
Skip Instructions:
1,2,RF,DK [goto SINCOVDE_A]
Question ID: INS.0040.00.1
Variable: MCAIDPRB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
There is a program called Medicaid that pays for health care for persons in need. ^STATEMA Are
you covered by Medicaid?
Fills:
^STATEMA
Description: In ^STATENAME it is also called ^STMEDICAID.
Instruction:
if STMEDICAID ne empty, fill: "In ^STATENAME it is also called ^STMEDICAID."
else fill: blank
^STATENAME
Description: State name
Instruction:
If ST=AL, fill: Alabama else if ST=AK, fill: Alaska
else if ST=AR, fill: Arkansas
else if ST=AZ, fill: Arizona
else if ST=CA, fill: California
else if ST=CO, fill: Colorado
else if ST=CT, fill: Connecticut
else if ST=DE, fill: Delaware
else if ST=DC, fill: District of Columbia
else if ST=FL, fill: Florida
else if ST=GA, fill: Georgia
else if ST=HI, fill: Hawaii
else if ST=ID, fill: Idaho
else if ST=IL, fill: Illinois
else if ST=IN, fill: Indiana
else if ST=IA, fill: Iowa
else if ST=KS, fill: Kansas
else if ST=KY, fill: Kentucky
else if ST=LA, fill: Louisiana
else if ST=ME, fill: Maine
else if ST=MD, fill: Maryland
else if ST=MA, fill: Massachusetts
else if ST=MI, fill: Michigan
else if ST=MN, fill: Minnesota
else if ST=MS, fill: Mississippi
else if ST=MO, fill: Missouri
else if ST=MT, fill: Montana
else if ST=NE, fill: Nebraska
else if ST=NV, fill: Nevada
else if ST=NH, fill: New Hampshire
else if ST=NJ, fill: New Jersey
else if ST=NM, fill: New Mexico
else if ST=NY, fill: New York
else if ST=NC, fill: North Carolina
else if ST=ND, fill: North Dakota
else if ST=OH, fill: Ohio
else if ST=OK, fill: Oklahoma
else if ST=OR, fill: Oregon
else if ST=PA, fill: Pennsylvania
else if ST=RI, fill: Rhode Island
else if ST=SC, fill: South Carolina
else if ST=SD, fill: South Dakota
else if ST=TN, fill: Tennessee
else if ST=TX, fill: Texas
else if ST=UT, fill: Utah
else if ST=VT, fill: Vermont
else if ST=VA, fill: Virginia
else if ST=WA, fill: Washington
else if ST=WV, fill: West Virginia
else if ST=WI, fill: Wisconsin
else if ST=WY, fill: Wyoming
^STMEDICAID
Description: State Medicaid name
Instruction:
If AL then fill "Alabama Coordinated Health Network (ACHN)"
If AK then fill "DenaliCare"
If AZ then fill "Arizona Health Care Cost Containment
System (AHCCCS)"
If AR then fill "ARMedicaid; ARKids First; Arkansas Works;
Provider-led Arkansas Shared Savings Entity (PASSE)"
If CA then fill "Medi-Cal"
If CO then fill "Health First Colorado"
If CT then fill "HUSKY Health"
If DC then fill "DC Medicaid"
If DE then fill "Diamond State Health Plan (DSHP)"
If FL then fill "FL Medicaid; FL Statewide Medicaid
Managed Care (SMMC)"
If GA then fill "GA Medicaid; Georgia Families"
If HI then fill "Med-QUEST; QUEST Integration"
If ID then fill "Idaho Medicaid Health Plan"
If IL then fill "Medical Assistance"
If IN then fill "Healthy Indiana Plan (HIP); Hoosier
Healthwise"
If IA then fill "IA Health Link; Iowa Health and Wellness
Plan"
If KS then fill "KanCare; Kansas Medical Assistance
Program (KMAP); OneCare Kansas"
If KY then fill "Kentucky Medicaid"
If LA then fill "Healthy Louisiana"
If ME then fill "MaineCare"
If MD then fill "HealthChoice"
If MA then fill "MassHealth"
If MI then fill "MI Medicaid Health Plan; Healthy Michigan
Plan (HMP)"
If MN then fill "Medical Assistance (MA)"
If MS then fill "MississippiCAN"
If MO then fill "MO Healthnet"
If MT then fill "Passport to Health; Healthy Montana Kids
Plus (HMK Plus)"
If NC then fill "NC Medicaid Managed Care"
If ND then fill "North Dakota Medicaid"
If NE then fill "Heritage Health"
If NH then fill " Granite Advantage Health Care Program"
If NJ then fill "NJ Family Care"
If NM then fill "Centennial Care"
If NV then fill "Nevada Medicaid"
If NY then fill "New York Medicaid; New York Medicaid
Choice"
If OH then fill "Ohio Medicaid State Plan; Healthy
Families; Healthy Start; Alternative Benefit Plan (ABP)"
If OK then fill "SoonerCare"
If OR then fill "Oregon Health Plan (OHP)"
If PA then fill "Medical Assistance; HealthChoices"
If RI then fill "RIte Care;
If SC then fill "Healthy Connections"
If SD then fill "South Dakota Medicaid"
If TN then fill "TennCare"
If TX then fill "State of Texas Access Reform (STAR); STAR
+PLUS; STAR Kids"
If UT then fill "Utah Medicaid; Utah Medicaid Integrated
Care (UMIC)"
If VT then fill "Green Mountain Care; Dr. Dynasaur"
If VA then fill "Medallion 4.0; Commonwealth Care Plus
(CCC Plus); Cover Virginia"
If WA then fill "Apple Health"
If WV then fill "Mountain Health Trust (MHT)"
If WI then fill "ForwardHealth; BadgerCare Plus"
If WY then fill "WYhealth"
Response:
1 - Yes
2 - No
7 - Refused
- 9 - Don't Know
Universe:
Sample Adults 18-64 who have indicated they are uninsured, refused, or don't know their type of health insurance
Skip Instructions:
1,2,RF,DK [goto SINCOVDE_A]
Question ID: INS.0050.00.1
Variable: SINCOVDE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
^INADDITIONARE you covered by a SEPARATE plan that only pays for dental services?
Fills:
^INADDITIONARE
Description: In addition to ^HITYPEANOSS, are/Are
Instruction:
If (HIKIND_A=1-9 or MCAREPRB_A=1 or MCAIDPRB_A=1), fill "In addition to ^HITYPEANOSS, are"
else fill "Are"
^HITYPEANOSS
Description: Type of health care plans without single service plans
Instruction:
fill coverage types from HIKIND_A, except HIKIND_A=10, HIKIND_A=1 fill: "private health insurance"
HIKIND_A=2 fill: "Medicare"
HIKIND_A=3 fill: "Medicare Supplement or Medigap"
HIKIND_A=4 fill: "Medicaid"
HIKIND_A=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_A=6 fill: "military related health care"
HIKIND_A=7 fill: "Indian Health Service"
HIKIND_A=8 fill: "a state-sponsored health plan"
HIKIND_A=9 fill: "an other government program"
if MCAREPRB_A=1, fill "Medicare"
if MCAIDPRB_A=1, fill "Medicaid"
separate choices with a comma and seperate the last two
choices with "and"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto SINCOVVS_A]
Question ID: INS.0060.00.1
Variable: SINCOVVS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you covered by a SEPARATE plan that only pays for vision services?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto SINCOVRX_A]
Question ID: INS.0070.00.1
Variable: SINCOVRX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you covered by a SEPARATE plan that only pays for prescriptions?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto HICHANGE_A]
Question ID: INS.0080.00.1
Variable: HICHANGE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
I have recorded you are ^COVEREDA. Is this correct?
Fills:
^COVEREDA
Description: not covered by health insurance/covered by ^HITYPEA
Instruction:
if HIKIND_A=10,R,D and (MCAIDPRB_A=2,R,D or MCAREPRB_A= 2,R,D) and SINCOVDE_A=2,R,D and SINCOVVS_A=2,R,D and
SINCOVRX_A=2,R,D fill: "not covered by health insurance"
else fill: "covered by ^HITYPEA"
^HITYPEA
Description: Type of health care plans with single service plans
Instruction:
fill coverage types from HIKIND_A, except HIKIND_A=10, HIKIND_A=1 fill: "private health insurance"
HIKIND_A=2 fill: "Medicare"
HIKIND_A=3 fill: "Medicare Supplement or Medigap"
HIKIND_A=4 fill: "Medicaid"
HIKIND_A=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_A=6 fill: "military related health care"
HIKIND_A=7 fill: "Indian Health Service"
HIKIND_A=8 fill: "a state-sponsored health plan"
HIKIND_A=9 fill: "an other government program"
if MCAREPRB_A=1, fill "Medicare";
if MCAIDPRB_A=1, fill "Medicaid"
If SINCOVDE_A=1 and SINCOVRX_A=2,RF,DK and
SINCOVVS_A=2,RF,DK, fill: "a single service dental plan"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=1 and
SINCOVVS_A=2,RF,DK, fill: "a single service prescription
plan"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=2,RF,DK and
SINCOVVS_A=1, fill: "a single service vision plan"
If SINCOVDE_A=1 and SINCOVRX_A=1 and SINCOVVS_A=2,RF,DK,
fill: "single service dental and prescription plans"
If SINCOVDE_A=1 and SINCOVRX_A=2,RF,DK and SINCOVVS_A=1,
fill: "single service dental and vision plans"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=1 and SINCOVVS_A=1,
fill: "single service vision and prescription plans"
If SINCOVDE_A=1 and SINCOVRX_A=1 and SINCOVVS_A=1, fill:
"single service dental, vision and prescription plans"
separate choices with a comma and seperate the last two
choices with "and"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF,DK
if 02 in HIKIND_A or MCAREPRB_A=1[goto MCPART_A]
else if 04 in HIKIND_A or MCAIDPRB_A=1[goto MACHMN_A]
else if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A]
else if 09 in HIKIND_A [goto OGNAME_A]
else if 06 in HIKIND_A [goto MILSPC_A]
else if 07 in HIKIND_A [goto HINOTYR_A]
else if 10 in HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN (2,RF,DK))[goto HILAST_A]
else [goto FINISH_A]
2 [goto ERR1_HICHANGE_A]
Soft Edit:
Check Text: ERR1_HICHANGE_A
Check Description: Answered health insurance coverage is incorrect
Check Text: {signal ERR1_HICHANGE_A}
Suppress this error to go back to HIKIND_A and update coverage. Close this error to change your answer to HICHANGE_A.
Question ID: INS.0090.00.1
Variable: MCPART_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
What type of Medicare coverage do you have? Is it Part A - hospital insurance, Part B - medical
insurance, or both?
Response:
1 - Part A- hospital only
2 - Part B- medical only
3 - Both Part A and Part B
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicare
Skip Instructions:
1 [goto MCPARTD_A]
2-3,RF,DK [goto MCCHOICE_A]
Question ID: INS.0100.00.1
Variable: MCCHOICE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you enrolled in a Medicare Advantage plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicare that have part B Medicare or don't know or refused if they have part B Medicare
Skip Instructions:
1,2,RF,DK [goto MCHMO_A]
Question ID: INS.0110.00.1
Variable: MCHMO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you under a Medicare managed care arrangement, such as an HMO, that is, a Health Maintenance
Organization?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicare that have part B Medicare or don't know or refused if they have part B Medicare
Skip Instructions:
1 [goto MCANAME_A]
2,RF,DK if MCCHOICE_A=1 [goto MCANAME_A]
elseif MCCHOICE_A IN (2,RF,DK) [goto MCPARTD_A]
Question ID: INS.0120.00.1
Variable: MCANAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
What is the name of your Medicare Advantage or Medicare HMO plan?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed care arrangement
Skip Instructions:
allow 80,RF,DK [goto MCDNCOV_A]
Question ID: INS.0121.00.1
Variable: MCDNCOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Does ^MEDADVNAME_A pay for any of the costs for dental care?
Fills:
^MEDADVNAME_A
Description: {value of MCANAME_A}
Instruction:
If MCANAME_A=RESPONSE, fill value of MCANAME_A elseif MCANAME_A IN (DK,RF), fill: "this Medicare
Advantage or Medicare HMO plan"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed care arrangement
Skip Instructions:
1,2,RF,DK [goto MCVSCOV_A]
Question ID: INS.0122.00.1
Variable: MCVSCOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Does ^MEDADVNAME_A pay for any of the costs for routine vision care, such as glasses and contact
lenses?
Fills:
^MEDADVNAME_A
Description: {value of MCANAME_A}
Instruction:
If MCANAME_A=RESPONSE, fill value of MCANAME_A elseif MCANAME_A IN (DK,RF), fill: "this Medicare
Advantage or Medicare HMO plan"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed care arrangement
Skip Instructions:
1,2,RF,DK [goto MCPARTD_A]
Question ID: INS.0130.00.1
Variable: MCPARTD_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicare
Skip Instructions:
1,2,RF,DK
if 04 in HIKIND_A or MCAIDPRB_A=1 [goto MACHMN_A]
elseif 01 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0140.00.1
Variable: MACHMN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
The next questions are about Medicaid coverage. What is the name of your Medicaid health plan?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with Medicaid coverage
Skip Instructions:
allow 80,RF,DK [goto MAXCHNG_A]
Question ID: INS.0150.00.1
Variable: MAXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Was your Medicaid obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicaid coverage
Skip Instructions:
1,2,RF,DK [goto MAPREM_A]
Question ID: INS.0160.00.1
Variable: MAPREM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount you or a family member pay each month for health care
coverage. Do you or a family member pay a premium for this Medicaid plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicaid coverage
Skip Instructions:
1,2,RF,DK [goto MADEDUC_A]
Question ID: INS.0170.00.1
Variable: MADEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your Medicaid plan have an
annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicaid coverage
Skip Instructions:
1 [goto MAHDHP_A]
2,RF,DK
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A]
else if 09 in HIKIND_A [goto OGNAME_A]
else if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0180.00.1
Variable: MAHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with Medicaid coverage who have a deductible
Skip Instructions:
1,2,RF,DK
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0270.00.1
Variable: PLANNAME1_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Earlier I recorded that ^SCNAME was covered by ^HIPNAM1_C. Are you covered by this same plan as
^SCNAME?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage, where the Sample Child interview has already been conducted, the Sample Child is in the same family, and the Sample Child also had private health insurance, and the first private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.
Skip Instructions:
1 if Child.INS.bPlan[1].POLHLD_C ne 1 [goto POLHLDA1_A]
elseif Child.INS.bPlan[1].POLHLD_C=1 [goto PRPOLHP1_A]
2,RF,DK if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 and
INSPRI_FLG=1 and SAMEFAM_FLG=1 and CHILD.INS.PLANNAME2_C=empty [goto PLANNAME2_A] else [goto
HIPNAM1_A]
Question ID: INS.0280.00.1
Variable: POLHLDA1_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Health insurance plans are usually obtained in one person's name even if other family members
are covered by that plan. That person is called the policyholder. Are you the policyholder for
^HIPNAM1_C?
Fills:
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a shared private health plan with the Sample Child, where the child is not the policyholder for their first private plan or refused or don't know.
Skip Instructions:
1 if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 [goto
PLANNAME2_A]
else [goto MORPLAN_A]
2,RF,DK [goto PRPOLHP1_A]
Question ID: INS.0290.00.1
Variable: PRPOLHP1_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
How are you related to the policyholder for ^HIPNAM1_C? Are you the policyholder's child,
spouse, former spouse, or are you related in some other way?
Fills:
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
Response:
1 - Child
2 - Spouse
3 - Former spouse
4 - Some other relationship
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a shared private health plan with the Sample Child, where the Child is the policy holder or where the Sample Adult is not the policyholder for the first plan or refused or don't know.
Skip Instructions:
1-4,RF,DK if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1
[goto PLANNAME2_A]
else [goto MORPLAN_A]
Question ID: INS.0300.00.1
Variable: PLANNAME2_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Earlier I recorded that ^SCNAME was covered by a second plan: ^HIPNAM2_C. Are you covered by
this same plan as ^SCNAME?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage, where the Sample Child interview has already been conducted, the Sample Child is in the same family, and the Sample Child also had private health insurance, and listed two plans. The second private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.
Skip Instructions:
1 if Child.INS.bPlan[2].POLHLD_C ne 1 [goto POLHLDA2_A],
if Child.INS.bPlan[2].POLHLD_C=1 [goto PRPOLHP2_A]
2,RF,DK if PLANNAME1_A IN(2,RF,DK,empty) [goto HIPNAM1_A]
else [goto MORPLAN_A]
Question ID: INS.0310.00.1
Variable: POLHLDA2_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
* Read if necessary: Health insurance plans are usually obtained in one person's name even if
other family members are covered by that plan. That person is called the policyholder.
Are you the policyholder for ^HIPNAM2_C?
Fills:
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a shared private health plan with the Sample Child, where the child is not the policyholder for their second private plan or refused or don't know.
Skip Instructions:
1 if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
2,RF,DK[goto PRPOLHP2_A]
Question ID: INS.0320.00.1
Variable: PRPOLHP2_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
How are you related to the policyholder for ^HIPNAM2_C? Are you the policyholder's child,
spouse, former spouse, or are you related in some other way?
Fills:
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
Response:
1 - Child
2 - Spouse
3 - Former spouse
4 - Some other relationship
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a shared private health plan with the Sample Child, where the Sample Child is the policy holder for the second plan or the Sample Adult is not the policyholder for the second plan or refused or don't know.
Skip Instructions:
1-4,RF,DK if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0330.00.1
Variable: HIPNAM1_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
It is important that we record the complete and accurate name of each private health insurance
plan. What is the COMPLETE name of your plan? Do NOT include plans that only provide extra cash
while in the hospital or plans that pay for only one type of service such as long term care,
accidents, or dental care.
* Read if necessary: Do you have a health plan card or something with the plan name on it?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ enrolled in a Medigap plan or private health insurance and the sample adult did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample child
Skip Instructions:
allow 80,RF,DK [goto MORPLAN_A]
Question ID: INS.0340.00.1
Variable: MORPLAN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Are you covered by any other private health insurance plans?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ enrolled in a private health plan where the name of the plan was given or don't know or refused or the sample adult only shared one private plan with the Sample Child.
Skip Instructions:
1 [goto HIPNAM2_A]
2,RF,DK
if (PLANNAME1_A=1 or PLANNAME2_A=1) then
if 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
else [goto bPlan[1].POLHLD_A]
Question ID: INS.0350.00.1
Variable: HIPNAM2_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
What is the name of that private health insurance plan?
* Read if necessary: Do you have a health plan card or something with the plan name on it?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with a second private health insurance plan
Skip Instructions:
allow 80,RF,DK [goto bPlan[1].POLHLD_A]
Question ID: INS.0370.00.1
Variable: POLHLD_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
I am going to ask you some questions about ^FIRSTPLANA. Health insurance plans are usually
obtained in one person's name even if other family members are covered by that plan. That person
is called the policyholder. Are you the policyholder for ^THISPLANA?
Fills:
^FIRSTPLANA
Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan

Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
^THISPLANA
Description: this plan/^HIPNAM1_A/^HIPNAM2_A
Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) fill: "this plan"
else fill: "^HIPNAM1_A"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this plan"
Else fill: "^HIPNAM2_A"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know.
Skip Instructions:
1,RF,DK [goto PRPLCOV_A]
2 [goto PRPOLH_A]
Question ID: INS.0380.00.1
Variable: PRPLCOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does this plan cover someone other than yourself?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know and where the Sample Adult is the policyholder or refused or don't know
Skip Instructions:
1,2,RF,DK [goto PLNWRK_A]
Question ID: INS.0390.00.1
Variable: PRPOLH_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
How are you related to the policyholder? Are you the policyholder's child, spouse, former
spouse, or are you related in some other way?
Response:
1 - Child
2 - Spouse
3 - Former spouse
4 - Some other relationship
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance who are not the policyholder
Skip Instructions:
1-4,RF,DK [goto PLNWRK_A]
Question ID: INS.0400.00.1
Variable: PLNWRK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Which one of these categories best describes how this plan was obtained? Was it obtained through
an employer or union, purchased directly, obtained through Healthcare.gov or the Affordable Care
Act, also known as Obamacare, obtained through a state or local government or community program
or obtained in some other way?
Response:
1 - Through an employer, union, or professional association
2 - Purchased directly
3 - Through Healthcare.gov or the Affordable Care Act, also known as Obamacare
4 - Through a state or local government or community program
5 - Other
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know
Skip Instructions:
1,3 [goto PLNPAY_A]
2,4,RF,DK [goto PLNEXCHG_A]
5 [goto PLNWKSP_A]
Question ID: INS.0410.00.1
Variable: PLNWKSP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: How was this plan obtained?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know and private health insurance coverage was obtained from an other source
Skip Instructions:
allow 80,RF,DK [goto PLNEXCHG_A]
Question ID: INS.0420.00.1
Variable: PLNEXCHG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know that is directly purchased, or obtained through a state, local, government or community program, or obtained another way, or refused/don't know how obtained
Skip Instructions:
1,2,RF,DK [goto PLNPAY_A]
Question ID: INS.0430.00.1
Variable: PLNPAY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Who pays for this health insurance plan?
* Enter all that apply, separate with commas.
Response:
1 - Self or family (living in the household)
2 - Employer or union
3 - Someone outside the household
4 - Medicare
5 - Medicaid
6 - Other government program
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know.
Skip Instructions:
if 1 IN PLNPAY_A [goto HICOSTN_A]
else if 2-6 IN PLNPAY_A or PLNPAY_A IN (RF,DK)[goto PRDEDUC_A]
Question ID: INS.0440.00.1
Variable: HICOSTN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
How much ^DOYOUFAM currently spend for health insurance premiums for ^FIRSTPLANA? Please include
payroll deductions for premiums.
Fills:
^DOYOUFAM
Description: do you/does your family
Instruction:
if PCNT_A=1 fill "do you", else fill "does your family"
^FIRSTPLANA
Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan

Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
Response:
00001-99995 - Range of values
99997 - Refused
99999 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know who paid for by self or family
Skip Instructions:
20000-99995 [goto ERR1_HICOSTN_A]
1-19999 [goto HICOSTT_A]
RF,DK [goto PRDEDUC_A]
Soft Edit:
Check Text: ERR1_HICOSTN_A
Check Description:
Check Text: {signal ERR1_HICOSTN_A}[^HICOSTN_A] is unusually high. Please verify. Make corrections if necessary.
Question ID: INS.0440.02.1
Variable: HICOSTT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
* Enter time period for premium payments.
Response:
01 - Once a week
02 - Once every 2 weeks
03 - Once a month
04 - Twice a month
05 - Every two months
06 - Quarterly (every 3 months)
07 - Once a year
08 - Twice a year
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know who gave a premium amount.
Skip Instructions:
1-8,RF,DK [goto PRDEDUC_A]
Question ID: INS.0450.00.1
Variable: PRDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does this health plan have an annual
deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance plans where a plan name was given or refused or don't know.
Skip Instructions:
1 [goto PRHDHP_A]
2,RF,DK [goto INTROCOV_A]
Question ID: INS.0460.00.1
Variable: PRHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Is the ^FAM_A annual deductible for medical care for this plan less than ^HDHPAMT_A, or
^HDHPAMT_A or more? If there is a separate deductible for prescription drugs, hospitalization,
or out-of-network care, do not include those deductible amounts here.
Fills:
^FAM_A
Description: family
Instruction:
if POLHLD_A=2 or PRPLCOV_A=1, fill 'family'. Else no fill.
^HDHPAMT_A
Description: ^HDHPDED_family/^HDHPDED
Instruction:
if POLHLD_A=2 or PRPLCOV_A=1, fill "^HDHPDED_family" Else fill "^HDHPDED"
^HDHPDED_family
Description: Family deductible threshold (may change in future year)
Instruction:
Fill: $2,800
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Less than ^HDHPAMT_A
2 - ^HDHPAMT_A or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know with a deductible
Skip Instructions:
1 [goto INTROCOV_A]
2,RF,DK [goto HSAHRA_A]
Question ID: INS.0470.00.1
Variable: HSAHRA_A
Interview Module: Adult
Content Type: Annual Core

Question text:

There are special accounts or funds that can be used to pay for medical expenses, sometimes
referred to as Health Savings Accounts or HSAs, Health Reimbursement Accounts or HRAs, Personal
Care accounts, Personal Medical funds, or Choice funds. These are DIFFERENT from Flexible
Spending Accounts or FSAs. Is there one of these accounts or funds with this plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know with a high deductible
Skip Instructions:
1,2,RF,DK [goto INTROCOV_A]
Question ID: INS.0475.00.1
Variable: INTROCOV_A
Interview Module: Adult
Content Type:

Question text:

The next three questions are about services ^FIRSTPLANA may cover.
* Enter '1' to continue.
Fills:
^FIRSTPLANA
Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan

Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know
Skip Instructions:
1 [goto PRRXCOV_A]
Question ID: INS.0480.00.1
Variable: PRRXCOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does ^FIRSTPLANA pay for any of the costs for medications prescribed by a doctor?
* Read if necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you were prescribed medications.
Fills:
^FIRSTPLANA
Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan

Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where the name of the plan was given or refused or don't know
Skip Instructions:
1,2,RF,DK [goto PRDNCOV_A]
Question ID: INS.0490.00.1
Variable: PRDNCOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does ^FIRSTPLANA pay for any of the costs for dental care?
* Read if necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you did have dental care.
Fills:
^FIRSTPLANA
Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan

Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where the plan name was given or refused or don't know.
Skip Instructions:
1,2,RF,DK [goto PRVSCOV_A]
Question ID: INS.0500.00.1
Variable: PRVSCOV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does ^FIRSTPLANA pay for any of the costs for routine vision care, such as glasses and contact
lenses?
* Read if necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you did have vision care.
Fills:
^FIRSTPLANA
Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan

Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know.
Skip Instructions:
1,2,RF,DK If there is another plan [goto bPlan for next plan]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0510.00.1
Variable: CHNAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that you are covered by the Children's Health Insurance Program or CHIP. What
is the name of the plan?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with a CHIP plan
Skip Instructions:
allow 80,RF,DK [goto CHXCHNG_A]
Question ID: INS.0520.00.1
Variable: CHXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Was your CHIP plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a CHIP plan
Skip Instructions:
1,2,RF,DK [goto CHPREM_A]
Question ID: INS.0530.00.1
Variable: CHPREM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount you or a family member pays each month for health care
coverage. Do you or a family member pay a premium for this CHIP plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a CHIP plan
Skip Instructions:
1,2,RF,DK [goto CHDEDUC_A]
Question ID: INS.0540.00.1
Variable: CHDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your CHIP plan have an annual
deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a CHIP plan
Skip Instructions:
1 [goto CHHDHP_A]
2,RF,DK if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0550.00.1
Variable: CHHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have a CHIP plan deductible
Skip Instructions:
1,2,RF,DK if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0560.00.1
Variable: OPNAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that you are covered by a state-sponsored plan. What is the name of the plan?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with a state-sponsored plan
Skip Instructions:
allow 80,RF,DK [goto OPXCHNG_A]
Question ID: INS.0570.00.1
Variable: OPXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Was your state-sponsored plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a state-sponsored plan
Skip Instructions:
1,2,RF,DK [goto OPPREM_A]
Question ID: INS.0580.00.1
Variable: OPPREM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount you or a family member pays each month for health care
coverage. Do you or a family member pay a premium for this state-sponsored plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a state-sponsored plan
Skip Instructions:
1,2,RF,DK [goto OPDEDUC_A]
Question ID: INS.0590.00.1
Variable: OPDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your state-sponsored plan have
an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a state-sponsored plan
Skip Instructions:
1[goto OPHDHP_A]
2,RF,DK if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0600.00.1
Variable: OPHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a state-sponsored plan with a deductible
Skip Instructions:
1,2,RF,DK if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0610.00.1
Variable: OGNAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that you are covered by an other government program. What is the name of the
plan?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have an other government plan
Skip Instructions:
allow 80,RF,DK [goto OGXCHNG_A]
Question ID: INS.0620.00.1
Variable: OGXCHNG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Was your other government plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have an other government plan
Skip Instructions:
1,2,RF,DK [goto OGPREM_A]
Question ID: INS.0630.00.1
Variable: OGPREM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount you or a family member pays each month for health care
coverage. Do you or a family member pay a premium for your other government plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have an other government plan
Skip Instructions:
1,2,RF,DK [goto OGDEDUC_A]
Question ID: INS.0640.00.1
Variable: OGDEDUC_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your other government plan have
an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with an other government plan
Skip Instructions:
1 [goto OGHDHP_A]
2,RF,DK if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0650.00.1
Variable: OGHDHP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with an other government plan with a deductible
Skip Instructions:
1,2,RF,DK if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0660.00.1
Variable: MILSPC_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that you are covered by military related health care. What types of military
related health care are you covered by?
* Enter all that apply, separate with commas.
Response:
1 - VA health care
2 - TRICARE (CHAMPUS)
3 - CHAMP-VA (do not include CHAMPUS)
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with military related health care
Skip Instructions:
1-3,RF,DK [goto HINOTYR_A]
Question ID: INS.0670.00.1
Variable: HILAST_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How long has it been since you last had health care coverage that paid for doctor's visits or
hospital stays?
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe.
Skip Instructions:
1 [goto HILASTMY_A]
2,3 [goto HISTOPJOB_A]
4,5,6,0,RF,DK [goto RSNHICOST_A]
Question ID: INS.0680.00.1
Variable: HILASTMY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In the past 12 months, how many months were you without coverage?
* If less than 1 month, enter '1'.
Response:
01-12 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ without known health insurance who last had insurance at some time within the last 12 months
Skip Instructions:
1-12,RF,DK [goto HISTOPJOB_A]
Question ID: INS.0690.00.1
Variable: HISTOPJOB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Think about the last time that you did have health care coverage that paid for doctor's visits
or hospital stays. I am going to read a list of reasons why someone might no longer be enrolled
in coverage. Please tell me, yes or no, if this is a reason why you are no longer enrolled in
your last health care plan.
You or the policyholder retired, lost a job, or changed employers?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPMISS_A]
Question ID: INS.0700.00.1
Variable: HISTOPMISS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Are you no longer enrolled in your last health care plan because...
You missed a deadline for signing up or paying for the coverage?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPAGE_A]
Question ID: INS.0710.00.1
Variable: HISTOPAGE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Are you no longer enrolled in your last health care plan because...
You became ineligible because of your age or because you left school?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPCOST_A]
Question ID: INS.0720.00.1
Variable: HISTOPCOST_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Are you no longer enrolled in your last health care plan because...
The cost for your coverage increased?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPELIG_A]
Question ID: INS.0730.00.1
Variable: HISTOPELIG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
* Read if necessary: Are you no longer enrolled in your last health care plan because...
You had Medicaid or other public coverage, but were no longer eligible?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto RSNHICOST_A]
Question ID: INS.0740.00.1
Variable: RSNHICOST_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^INSREASONS Are you currently uninsured because coverage is not affordable?
Fills:
^INSREASONS
Description: RSNHICOST_A Introduction
Instruction:
If HILAST_A IN (0,4,5,6,RF,DK) fill: "There are many reasons why people do not have health insurance coverage."
If HILAST_A IN (1,2,3) fill: "We just discussed reasons
you lost coverage. Now I am going to ask you some
questions about why you haven't obtained coverage."
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe.
Skip Instructions:
1,2,RF,DK [goto RSNHIWANT_A]
Question ID: INS.0750.00.1
Variable: RSNHIWANT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

There are other reasons that people do not have health insurance coverage. ^PLUSCOSTA you
currently uninsured because...
...you do not need or want coverage?
Fills:
^PLUSCOSTA
Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill "In addition to cost, are" Else fill "Are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe.
Skip Instructions:
1,2,RF,DK [goto RSNHIELIG_A]
Question ID: INS.0760.00.1
Variable: RSNHIELIG_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...you are not eligible for coverage?
Fills:
^PLUSCOSTA
Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill "In addition to cost, are" Else fill "Are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe
Skip Instructions:
1,2,RF,DK [goto RSNHICONF_A]
Question ID: INS.0770.00.1
Variable: RSNHICONF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...the process of signing up for coverage is too difficult or confusing?
Fills:
^PLUSCOSTA
Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill "In addition to cost, are" Else fill "Are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe
Skip Instructions:
1,2,RF,DK [goto RSNHIMEET_A]
Question ID: INS.0780.00.1
Variable: RSNHIMEET_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...you cannot find a plan that meets your needs?
Fills:
^PLUSCOSTA
Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill "In addition to cost, are" Else fill "Are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe
Skip Instructions:
1,2,RF,DK [goto RSNHIWAIT_A]
Question ID: INS.0790.00.1
Variable: RSNHIWAIT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...you applied for coverage but it has not started yet?
Fills:
^PLUSCOSTA
Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill "In addition to cost, are" Else fill "Are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe
Skip Instructions:
1,2,RF,DK [goto RSNHIOTH_A]
Question ID: INS.0800.00.1
Variable: RSNHIOTH_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Is there another reason that you currently do not have health insurance coverage?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe
Skip Instructions:
1 [goto RSNHIOTHSP_A]
2,RF,DK [goto next section]
Question ID: INS.0810.00.1
Variable: RSNHIOTHSP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What is your other reason for not having coverage?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have another reason for not having coverage
Skip Instructions:
allow 80,RF,DK [goto next section]
Question ID: INS.0820.00.1
Variable: HINOTYR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In the past 12 months, was there any time when you did NOT have ANY health insurance or
coverage?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with known health insurance coverage or responded yes to the medicare probe or medicaid probe
Skip Instructions:
1 [goto HINOTMYR_A]
2,RF,DK [goto FINISH_A]
Question ID: INS.0830.00.1
Variable: HINOTMYR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In the past 12 months, about how many months were you without coverage?
* If less than 1 month, enter '1'.
Response:
01-12 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with known health insurance coverage and did not have health insurance for some period of time in the past 12 months
Skip Instructions:
1-12,RF,DK [goto FINISH_A]
Question ID: INS.0840.00.1
Variable: FINISH_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* The Sample Adult health insurance section is now complete.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
PAY: Difficulty Paying for Health Care
Question ID: PAY.0010.00.1
Variable: PAYINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
Now I am going to ask you about your medical bills. Include bills for doctors, dentists,
hospitals, therapists, medication, equipment, and nursing home or home care.
^Dormfill
* Enter '1' to continue.
Fills:
^Dormfill
Description: think about family living in family home
Instruction:
If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "When I ask about your family, please think about your
family living at ^HNO ^HNOSUF ^STRNAME."
else leave blank
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ living in same family as the Sample Child when the Sample Child PAY section has not been completed or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered don't or refused to PAYBLL12M_C and PAYNOBLLNW_C or Sample adults living in different families than the Sample Child
Skip Instructions:
1 [goto PAYBLL12M_A]
Replicate To: PAYINTRO_C
Question ID: PAY.0020.00.1
Variable: PAYBLL12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
In the past 12 months, did ^youanyone have problems paying or were unable to pay any medical
bills?
* Read if necessary: Include bills for doctors, dentists, hospitals, therapists, medication,
equipment, nursing home or home care.
Fills:
^youanyone
Description: you/anyone in the family
Instruction:
If GEN.PCNT_A=1 fill "you"; else fill "anyone in the family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ living in same family as the Sample Child when the Sample Child PAY section has not been completed or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered don't or refused to PAYBILL12M_C and PAYNOBLLNW_C or Sample adults living in different families than the Sample Child
Skip Instructions:
1,RF,DK [goto PAYNOBLLNW_A]
2 [goto PAYWORRY_A]
Replicate To: PAYBLL12M_C
Question ID: PAY.0030.00.1
Variable: PAYNOBLLNW_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^DoyouDoesanyoneinfam currently have any medical bills that you are unable to pay at all?
Fills:
^DoyouDoesanyoneinfam
Description: Do you/Does anyone in your family
Instruction:
If GEN.PCNT_A=1 fill "Do you"; else fill "Does anyone in your family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where anyone in the family has difficulty playing medical bills or don't know or refused and Sample Adult is living in same family as the Sample Child when the Sample Child PAY section has not been completed or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered don't or refused to PAYBILL12M_C and PAYNOBLLNW_C or Sample adults living in different families than the Sample Child AND who said they/anyone in their family has problems paying their medical bills or don't know or refuse to answer if they/anyone in their family has problems paying bills
Skip Instructions:
1,2,RF,DK [goto PAYWORRY_A]
Replicate To: PAYNOBLLNW_C
Question ID: PAY.0040.00.1
Variable: PAYWORRY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

If you get sick or have an accident, how worried are you that you will be able to pay your
medical bills? Are you very worried, somewhat worried, or not at all worried?
Response:
1 - Very worried
2 - Somewhat worried
3 - Not at all worried
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CVL: Long COVID
Question ID: CVL.0010.00.4
Variable: CVDINTRO_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

The next set of questions are about coronavirus or COVID-19.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CVDDIAG_A]
Question ID: CVL.0020.00.4
Variable: CVDDIAG_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Has a doctor or other health professional ever told you that you had or likely had coronavirus
or COVID-19?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto POSTEST_A]
Question ID: CVL.0030.00.4
Variable: POSTEST_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Did you ever take a test that showed you had coronavirus or COVID-19?
* Read if necessary: Testing includes antibody or blood tests as well as other forms of testing
for COVID-19, such as a nasal swabbing or throat swabbing.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CVDSEV_A]
2,RF,DK if CVDDIAG_A=1 [goto CVDSEV_A]
elseif CVDDIAG_A IN (2,RF,DK) [goto next section]
Question ID: CVL.0040.00.4
Variable: CVDSEV_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

How would you describe your coronavirus symptoms when they were at their worst? Would you say no
symptoms, mild symptoms, moderate symptoms, or severe symptoms?
Response:
1 - No symptoms
2 - Mild symptoms
3 - Moderate symptoms
4 - Severe symptoms
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have been told by a doctor or other health professional that they had or likely had coronavirus or COVID-19 or tested positive for COVID-19
Skip Instructions:
1 [goto next section]
2-4,RF,DK [goto LONGCVD_A]
Question ID: CVL.0050.00.4
Variable: LONGCVD_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Did you have any symptoms lasting 3 months or longer that you did not have prior to having
coronavirus or COVID-19?
* Read if necessary: Long term symptoms may include tiredness or fatigue, difficulty thinking,
concentrating, forgetfulness or memory problems, sometimes referred to as "brain fog,"
difficulty breathing or shortness of breath, joint or muscle pain, fast-beating or pounding
heart (also known as heart palpitations), chest pain, dizziness on standing, depression, anxiety
or mood changes.
Fills:
^menstrual
Description: menstrual changes
Instruction:
If GEN.SEX_FINAL=2,RF,DK and GEN.AGE_FINAL=9-58, fill "menstrual changes,"
else fill blank
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with mild, moderate, or severe symptoms when at their worst or refused or didn't know the severity of their symptoms
Skip Instructions:
1,2,RF,DK [goto SYMPNOW_A]
Question ID: CVL.0060.00.4
Variable: SYMPNOW_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Do you have symptoms NOW?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with mild, moderate, or severe symptoms when at their worst or refused or didn't know the severity of their symptoms
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DNC: Dental Care
Question ID: DNC.0010.00.2
Variable: DNCINTRO_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

These next questions ask about your dental care.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto DENPREV_A]
Question ID: DNC.0020.00.2
Variable: DENPREV_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

About how long has it been since you last had a dental examination or cleaning?
* Read if necessary: Include cleanings from all types of dental care providers such as dentists,
orthodontists, oral surgeons, dental hygienists, and all other dental specialists.
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0-6,RF,DK [goto DENDL12M_A]
Question ID: DNC.0030.00.2
Variable: DENDL12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, have you DELAYED getting dental care because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto DENNG12M_A]
Question ID: DNC.0040.00.2
Variable: DENNG12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, was there any time when you needed dental care, but DID NOT GET IT
because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
UTZ: Utilization
Question ID: UTZ.0010.00.1
Variable: UTZINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Now, I would like to ask you about your health care, not including dental care.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto LASTDR_A]
Question ID: UTZ.0020.00.1
Variable: LASTDR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

About how long has it been since you last saw a doctor or other health professional about your
health?
* Read if necessary: Include doctors seen while a patient in a hospital.
* Read if necessary: Do not include dental care.
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-6 [goto WELLNESS_A]
0,RF,DK [goto USUALPL_A]
Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was this a wellness visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and
blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health
professional may also discuss topics related to your health such as smoking, alcohol use, diet
and exercise. These visits are usually scheduled in advance and occur when you are not sick or
injured.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have seen a doctor
Skip Instructions:
1 [goto USUALPL_A]
2,RF,DK [goto WELLVIS_A]
Question ID: UTZ.0040.00.1
Variable: WELLVIS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

About how long has it been since you last saw a doctor or other health professional for a
wellness visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and
blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health
professional may also discuss topics related to your health such as smoking, alcohol use, diet
and exercise. These visits are usually scheduled in advance and occur when you are not sick or
injured.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have seen a doctor, but the last visit was not a wellness visit or they didn't know or refused whether it was a wellness visit
Skip Instructions:
0-6,RF,DK [goto USUALPL_A]
Question ID: UTZ.0050.00.1
Variable: USUALPL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Is there a place that you USUALLY go to if you are sick and need health care?
Response:
1 - Yes
2 - There is NO place
3 - There is MORE THAN ONE place
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,3,RF,DK [goto USPLKIND_A]
2 [goto URGENT12M_A]
Question ID: UTZ.0060.00.1
Variable: USPLKIND_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What kind of place ^ISITGOMSTOFT - a doctor's office or health center; an urgent care center, a
clinic in a drug store or grocery store; a hospital emergency room; a VA Medical Center or VA
outpatient clinic; or some other place?
* Read if necessary: A doctor's office or health center is a place where you see the same doctor
or the same group of doctors every visit, where you usually need to make an appointment ahead of
time, and where your medical records are on file.
* Read if necessary: Urgent care centers and clinics in a drug store or grocery store are places
where you do not need to make an appointment ahead of time, and do not usually see the same
health care provider at each visit.
Fills:
^ISITGOMSTOFT
Description: is it/do you go to most often
Instruction:
If USUALPL_A=1 fill "is it"; else fill "do you go to most often"
Response:
1 - A doctor's office or health center
2 - Urgent care center or clinic in a drug store or grocery store
3 - Hospital emergency room
4 - A VA Medical Center or VA outpatient clinic
5 - Some other place
6 - Does not go to one place most often
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with 1+ usual place of care or who don't know or refused to answer if they have a usual place of care
Skip Instructions:
1-6,RF,DK [goto URGENT12M_A]
Question ID: UTZ.0070.00.1
Variable: URGENT12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, how many times have you gone to an urgent care center or a clinic in
a drug store or grocery store about your health?
* Enter 96 if number is 96 or greater.
* Read if necessary: Urgent care centers and clinics in drug stores or grocery stores are places
where you do not need to make an appointment ahead of time, and do not usually see the same
health care provider at each visit.
* Read if necessary: This is different from a hospital emergency room.
Response:
00-95 - 0-95 times
96 - 96+ times
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0-39,RF,DK [goto EMERGE12M_A]
40-96 [goto ERR1_URGENT12M_A]
Soft Edit:
Check Text: ERR1_URGENT12M_A
Check Description: Urgent care 40-96 times
Check Text: {signal ERR1_URGENT12M_A}^URGENT12M_A is an unusually large number. Did you visit an urgent care center or clinic in a drug store or grocery store about your health ^URGENT12M_A times in the past 12 months? Please verify.
Question ID: UTZ.0080.00.1
Variable: EMERGE12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, how many times have you gone to a hospital emergency room about your
health?
* Read if necessary: This includes emergency room visits that resulted in a hospital admission.
* Enter 96 if number of times is 96 or more.
Response:
00-95 - 0-95 times
96 - 96+ times
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0-39,RF,DK [goto HOSPONGT_A]
40-96 [goto ERR1_EMERGE12M_A]
Soft Edit:
Check Text: ERR1_EMERGE12M_A
Check Description: ER 40-96 times
Check Text: {signal ERR1_EMERGE12M_A}^EMERGE12M_A is an unusually large number. Did you visit a hospital emergency room about your health ^EMERGE12M_A times in the past 12 months? Please verify.
Question ID: UTZ.0090.00.1
Variable: HOSPONGT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you been hospitalized overnight? ^PAST12MER_A
Fills:
^PAST12MER_A
Description: Do not include an overnight stay in the emergency room.
Instruction:
If ((EMERGE12M_A ge 01 and EMERGE12M_A le 96) or EMERGE12M_A IN (RF,DK): Fill: "Do not include an overnight
stay in the emergency room."
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto MEDDL12M_A]
Question ID: UTZ.0100.00.1
Variable: MEDDL12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you DELAYED getting medical care because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto MEDNG12M_A]
Question ID: UTZ.0110.00.1
Variable: MEDNG12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, was there any time when you needed medical care, but DID NOT GET IT
because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ABH: Access Barriers to Care
Question ID: ABH.0010.00.4
Variable: ABINSUR_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

There are many other reasons people delay or do not get medical care.
During the past 12 months, did you delay or not get medical care for any of the following
reasons
...Because you had difficulty finding a doctor, clinic, or hospital that would accept your
health insurance?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ABAVAIL_A]
Question ID: ABH.0020.00.4
Variable: ABAVAIL_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

* Read if necessary: During the past 12 months, did you delay or not get medical care for any of
the following reasons
...Because an appointment wasn't available when you needed it?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ABOPEN_A]
Question ID: ABH.0030.00.4
Variable: ABOPEN_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

* Read if necessary: During the past 12 months, did you delay or not get medical care for any of
the following reasons
...Because you couldn't get to the doctor's office or clinic when it was open?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ABTOOLONG_A]
Question ID: ABH.0040.00.4
Variable: ABTOOLONG_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

* Read if necessary: During the past 12 months, did you delay or not get medical care for any of
the following reasons
...Because it takes too long to get to the doctor's office or clinic from your house or work?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto ABTIME_A]
Question ID: ABH.0050.00.4
Variable: ABTIME_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

* Read if necessary: During the past 12 months, did you delay or not get medical care for any of
the following reasons
...Because you were too busy with work or other commitments to take the time?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
TLH: Telehealth
Question ID: TLH.0010.00.4
Variable: VIRAPP12M_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

During the past 12 months, have you had an appointment with a doctor, nurse, or other health
professional by video or by phone?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
HIT: Internet access and health information technology
Question ID: HIT.0010.00.4
Variable: ACCSSINT_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Do you have access to the Internet?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto ACCSSHOM_A]
2,RF,DK [goto next section]
Question ID: HIT.0020.00.4
Variable: ACCSSHOM_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Do you have access to the Internet from your home?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with access to the Internet
Skip Instructions:
1,2,RF,DK [goto HITLOOK_A]
Question ID: HIT.0030.00.4
Variable: HITLOOK_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

During the past 12 months, have you used the Internet for any of the following reasons?
To look for health or medical information.
* Read if necessary: Include Internet and data use through a computer, tablet, smartphone, or
other electronic device.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with access to the Internet
Skip Instructions:
1,2,RF,DK [goto HITCOMM_A]
Question ID: HIT.0040.00.4
Variable: HITCOMM_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

* Read if necessary: During the past 12 months, have you used the Internet for any of the
following reasons?
To communicate with a doctor or doctor's office.
* Read if necessary: Include Internet and data use through a computer, tablet, smartphone, or
other electronic device.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with access to the Internet
Skip Instructions:
1,2,RF,DK [goto HITTEST_A]
Question ID: HIT.0050.00.4
Variable: HITTEST_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

* Read if necessary: During the past 12 months, have you used the Internet for any of the
following reasons?
To look up medical test results.
* Read if necessary: Include Internet and data use through a computer, tablet, smartphone, or
other electronic device.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with access to the Internet
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
PMD: Prescription Medication
Question ID: PMD.0010.00.1
Variable: RX12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

At any time in the past 12 months, did you take prescription medication?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto RXSK12M_A]
2,RF,DK [goto RXDG12M_A]
Question ID: PMD.0020.00.1
Variable: RXSK12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, were any of the following true for you?
...You skipped medication doses to save money.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have taken prescription medication in the past 12 months
Skip Instructions:
1,2,RF,DK [goto RXLS12M_A]
Question ID: PMD.0030.00.1
Variable: RXLS12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: During the past 12 months, were any of the following true for you?
...You took less medication to save money.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have taken prescribed medication in the past 12 months
Skip Instructions:
1,2,RF,DK [goto RXDL12M_A]
Question ID: PMD.0040.00.1
Variable: RXDL12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: During the past 12 months, were any of the following true for you?
...You DELAYED filling a prescription to save money.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have taken prescribed medication in the past 12 months
Skip Instructions:
1,2,RF,DK [goto RXDG12M_A]
Question ID: PMD.0050.00.1
Variable: RXDG12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, was there any time when you needed prescription medication, but DID
NOT GET IT because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
IMS: Immunization with 2022 supplements
Question ID: IMS.0010.00.3
Variable: PREGFLUYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Were you pregnant any time ^AUGUSTYEAR?
Fills:
^AUGUSTYEAR
Description: period of pregnancy
Instruction:
If INTERVIEW_MONTH=1-3, fill "since August 1st, ^LASTYEAR" elseif INTERVIEW_MONTH=4-7, fill "from August ^LASTYEAR
through March ^YEAR"
elseif INTERVIEW_MONTH=8-12, fill "since August 1st,
^YEAR"
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YEAR
Description: Year of Interview
Instruction:
Current Year
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Female sample adults 18-49 years or age is refused or don't know and who are not currently pregnant or don't know if they are currently pregnant or who are currently pregnant and the interview occurred between April-July
Skip Instructions:
1,2,DK [goto LIVEBIRTH_A]
RF [goto FLUINTRO_A]
Question ID: IMS.0020.00.3
Variable: LIVEBIRTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you have a pregnancy that ended in a live birth?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Female sample adults aged 18-49 of age or age is refused or don't know who did not refuse to answer if they are currently pregnant or if they were pregnant in between August and March
Skip Instructions:
1,2,RF,DK [goto FLUINTRO_A]
Question ID: IMS.0025.00.1
Variable: FLUINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

There are currently vaccines available for seasonal influenza and coronavirus or COVID-19. I
will first ask you questions about seasonal flu vaccination and then about coronavirus or
COVID-19 vaccination.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SHTFLU12M_A]
Question ID: IMS.0030.00.1
Variable: SHTFLU12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

There are two types of flu vaccinations. One is a shot and the other is a spray, mist, or drop
in the nose. During the past 12 months, have you had a flu vaccination?
* Read if necessary: A flu vaccination is usually given in the fall and protects against
influenza for the flu season.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SHTFLUM_A]
2,RF,DK [goto SHTCVD191_A]
Question ID: IMS.0040.01.1
Variable: SHTFLUM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* 1 of 2
During what month and year did you receive your most recent flu vaccine?
Response:
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who had a flu shot in the past 12 months
Skip Instructions:
1-12,DK [goto SHTFLUY_A]
RF if Adult.BMI.PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A]
else [goto SHTCVD191_A]
Question ID: IMS.0040.02.1
Variable: SHTFLUY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* 2 of 2
* Enter year of most recent flu vaccine.
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
Sample Adults 18+ who gave a month for their last flu shot or who didn't know the month
Skip Instructions:
valid year,RF,DK
if SHTFLUM_A and SHTFLUY_A=a future date [goto ERR1_SHTFLUY_A]
elseif SHTFLUM_A and SHTFLUY_A=a date before 12 months ago [goto ERR2_SHTFLUY_A]
elseif PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A]
else [goto SHTCVD191_A]
Hard Edit:
Check Text: ERR1_SHTFLUY_A
Check Description: Future date hard edit
Check Text: {check ERR1_SHTFLUY_A} Future date invalid. Please correct.

Check Text: ERR2_SHTFLUY_A
Check Description: Date > 12 months ago hard edit
Check Text: {check ERR2_SHTFLUY_A}
Date more than 12 months ago. Please correct.
Question ID: IMS.0050.00.3
Variable: FLUPREG_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Did you get a flu vaccination before or during your current pregnancy?
Response:
1 - Before pregnancy
2 - During pregnancy
7 - Refused
9 - Don't Know
Universe:
Female Sample Adults 18-49 or refused or don't know their age who are currently pregnant and received a flu vaccination in the past 12 months and the interview takes place in Jan-March or Aug-Dec
Skip Instructions:
1,2,RF,DK [goto SHTCVD191_A]
Question ID: IMS.0060.00.3
Variable: FLUPREG2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Earlier you said you were pregnant sometime ^AUGUSTYEAR. Did you get a flu vaccination before,
during, or after your pregnancy?
Fills:
^AUGUSTYEAR
Description: period of pregnancy
Instruction:
If INTERVIEW_MONTH=1-3, fill "since August 1st, ^LASTYEAR" elseif INTERVIEW_MONTH=4-7, fill "from August ^LASTYEAR
through March ^YEAR"
elseif INTERVIEW_MONTH=8-12, fill "since August 1st,
^YEAR"
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YEAR
Description: Year of Interview
Instruction:
Current Year
Response:
1 - Before pregnancy
2 - During pregnancy
3 - After pregnancy
7 - Refused
9 - Don't Know
Universe:
Female Sample Adults 18-49 years of age or refused or don't know their age who reported a pregnancy during August-March and received a flu vaccination in the past 12 months
Skip Instructions:
1-3,RF,DK [goto SHTCVD191_A]
Question ID: IMS.0061.00.3
Variable: SHTCVD191_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

The next questions are about coronavirus or COVID-19 vaccination. Have you had at least one dose
of a COVID-19 vaccination?
* Read if necessary: The COVID-19 vaccination has been available since 2020.
* Read if necessary: There are three vaccines for COVID-19 approved for use in the United
States. The first is made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two
initial shots. The second is made by Moderna, is called Spikevax®, and also requires two initial
shots. The third is made by Johnson and Johnson and requires one initial shot.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SHTCVD19NM_A]
2,RF,DK [goto SHTPNUEV_A]
Question ID: IMS.0062.00.3
Variable: SHTCVD19NM_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

How many COVID-19 vaccinations have you received?
Response:
1 - 1 vaccination
2 - 2 vaccinations
3 - 3 vaccinations
4 - 4 or more vaccinations
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have received a COVID-19 vaccination
Skip Instructions:
1-4 [goto CVDVAC1M_A]
RF,DK [goto SHTPNUEV_A]
Question ID: IMS.0063.01.3
Variable: CVDVAC1M_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
During what month and year did you receive your most recent COVID-19 vaccination?
* Enter month of most recent COVID-19 vaccination.
Response:
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have had one or more COVID-19 vaccinations
Skip Instructions:
1-12,DK [goto CVDVAC1Y_A]
RF if SHTCVD19NM_A IN (2,3,4) [goto CVDVAC2M_A]
elseif SHTCVD19NM_A=1 [goto SHOTTYPE_A]
Question ID: IMS.0063.02.3
Variable: CVDVAC1Y_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
* Enter year of most recent COVID-19 vaccination.
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
Sample Adults 18+ who gave month of most recent COVID-19 vaccination or don't know
Skip Instructions:
current year,current year-1,current year-2,RF,DK if SHTCVD19NM_A IN (2,3,4) [goto CVDVAC2M_A]
else [goto SHOTTYPE1_A]
if CVDVAC1M_A and CVDVAC1Y_A=future date [goto ERR1_CVDVAC1Y_A];
if CVDVAC1M_A and CVDVAC1Y_A=date prior to birth [goto ERR2_CVDVAC1Y_A];
if CVDVAC1Y_A lt 2020 [goto ERR3_CVDVAC1Y_A]
if CVDVAC1M_A=1-11 and CVDVAC1Y=2020 [goto ERR4_CVDVAC1Y_A]
Hard Edit:
Check Text: ERR1_CVDVAC1Y_A
Check Description: First COVID-19 vaccination in future
Check Text: {check ERR1_CVDVAC1Y_A}
Future date invalid. Please correct.

Check Text: ERR3_CVDVAC1Y_A
Check Description: First COVID-19 vaccination before 2020
Check Text: {check ERR3_CVDVAC1Y_A}
Date before 2020. Please correct.

Check Text: ERR2_CVDVAC1Y_A
Check Description: First COVID-19 vaccination before DOB
Check Text: {check ERR2_CVDVAC1Y_A}
Date prior to birth. Please correct.
Soft Edit:
Check Text: ERR4_CVDVAC1Y_A
Check Description: Date of first COVID-19 vaccination Jan-Nov 2020
Check Text: {signal ERR4_CVDVAC1Y_A}
Date before December 2020 reported. Please verify and make corrections if necessary.
Question ID: IMS.0064.01.3
Variable: CVDVAC2M_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
During what month and year did you receive your next most recent COVID-19 vaccination?
* Enter month of the next most recent COVID-19 vaccination.
Response:
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have had two or more COVID-19 vaccinations
Skip Instructions:
1-12,DK [goto CVDVAC2Y_A]
RF [goto SHOTTYPE_A]
Question ID: IMS.0064.02.3
Variable: CVDVAC2Y_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
* Enter year of next most recent COVID-19 vaccination.
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
Sample Adults 18+ who gave month of second COVID-19 vaccination or don't know
Skip Instructions:
current year,current year-1,current year-2,RF,DK [goto SHOTTYPE1_A]
if CVDVAC2M_A and CVDVAC2Y_A=date in the future [goto ERR1_CVDVAC2Y_A]
if CVDVAC2M_A and CVDVAC2Y_A=date prior to birth [goto ERR2_CVDVAC2Y_A]
if CVDVAC2Y_A lt 2020 [goto ERR3_CVDVAC2Y_A]
if CVDVAC2M_A and CVDVAC2Y_A=date more recent than answer given in CVDVAC1M_A and CVDVAC1Y_A
[goto ERR4_CVDVAC2Y_A]
if CVDVAC2M_A=1-11 and CVDVAC2Y=2020 [goto ERR5_CVDVAC2Y_A]
Hard Edit:
Check Text: ERR1_CVDVAC2Y_A
Check Description: Second COVID-19 vaccination in future
Check Text: {check ERR1_CVDVAC2Y_A}
Future date invalid. Please correct.

Check Text: ERR3_CVDVAC2Y_A
Check Description: Second COVID-19 vaccination before 2020
Check Text: {check ERR3_CVDVAC2Y_A}
Date before 2020. Please correct.

Check Text: ERR2_CVDVAC2Y_A
Check Description: Second COVID-19 vaccination before DOB
Check Text: {check ERR2_CVDVAC2Y_A}
Date prior to birth. Please correct.
Soft Edit:
Check Text: ERR4_CVDVAC2Y_A
Check Description: Second COVID-19 vaccination after 1st COVID vaccination
Check Text: {signal ERR4_CVDVAC2Y_A}
The date entered for the second most recent COVID-19 vaccination is after the date of the most recent COVID-19 vaccination. Please verify.

Check Text: ERR5_CVDVAC2Y_A
Check Description: Date of second COVID-19 vaccination Jan-Nov 2020
Check Text: {signal ERR5_CVDVAC2Y_A}
Date before December 2020 reported. Please verify and make corrections if necessary.
Question ID: IMS.0065.00.3
Variable: SHOTTYPE1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

^FIRST_A brand of COVID-19 vaccine did you receive?
* Read if necessary: There are four vaccines for COVID-19 approved for use in the United States.
The first is made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two initial shots. The second is made by Moderna, is called Spikevax®, and also requires two initial shots. The third is made by Johnson and Johnson and requires one initial shot. The fourth is made by Novavax and requires two initial shots.
Response:
1 - Pfizer-BioNTech Comirnaty® shot
2 - Moderna Spikevax® shot
3 - Johnson and Johnson (Janssen) shot
4 - Novavax shot
5 - One of the brands that requires two initial shots, but not sure which
brand - brand
6 - None of these brands
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had at least one COVID-19 vaccination
Skip Instructions:
1-5,RF,DK [goto SHTPNUEV_A]
Question ID: IMS.0065.00.3
Variable: SHOTTYPE_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

^FIRST_A brand of COVID-19 vaccine did you receive?
* Read if necessary: There are three vaccines for COVID-19 approved for use in the United
States. The first is made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two
initial shots. The second is made by Moderna, is called Spikevax®, and also requires two initial
shots. The third is made by Johnson and Johnson and requires one initial shot.
Fills:
^FIRST_A
Description: For your first shot, which/Which
Instruction:
If SHTCVD19NM_A=2-4, fill: "For your first shot, which" else fill "Which"
Response:
1 - Pfizer-Biontech Comirnaty shot
2 - Moderna shot
3 - Johnson and Johnson (Janssen) shot
4 - One of the brands that requires two initial shots, but not sure which
brand - brand
5 - None of these brands
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had at least one COVID-19 vaccination
Skip Instructions:
1-5,RF,DK [goto SHTPNUEV_A]
Question ID: IMS.0070.00.1
Variable: SHTPNUEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

A pneumonia shot is also known as a pneumococcal vaccine. Have you EVER had a pneumonia shot?
* Read if necessary: There are two types of pneumonia shots: polysaccharide, also known as
Pneumovax®, and conjugate, also known as Prevnar®.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SHTPNEUNB_A]
2,RF,DK if GEN.AGE_FINAL[PX_A] ge 50 or ISN.MEDRXTRT_A=1 or ISN.HLTHCOND_A=1 [goto
SHTSHINGL1_A]
elseif (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN (DK,RF)) and LIVEBIRTH_A=1 [goto
TDAPPREG_A]
else [goto SHTTETANUS_A]
Question ID: IMS.0080.00.1
Variable: SHTPNEUNB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How many pneumonia shots have you ever had?
Response:
1 - One pneumonia shot
2 - Two pneumonia shots
3 - More than two pneumonia shots
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who ever had a pneumonia shot
Skip Instructions:
1-3,RF,DK if GEN.AGE_FINAL[PX_A] ge 50 or ISN.MEDRXTRT_A=1 or ISN.HLTHCOND_A=1 [goto
SHTSHINGL1_A]
elseif LIVEBIRTH_A=1 [goto TDAPPREG_A]
else [goto SHTTETANUS_A]
Question ID: IMS.0090.00.3
Variable: SHTSHINGL1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Have you had a vaccine for shingles?
* Read if necessary: Shingles is an illness that results in a rash or blisters on the skin, and
is usually painful. There are two vaccines that have been used to prevent shingles. The first
was Zostavax®, which was available from 2006 through 2020 and required one shot. The other is
Shingrix®, which has been available since 2017 and requires two shots.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 50+ or adults 18+ who have a weakened immune system
Skip Instructions:
1 [goto SHINGYEAR_A]
2,RF,DK [goto SHTTETANUS_A]
Question ID: IMS.0100.00.3
Variable: SHINGYEAR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

What year did you get your most recent shingles vaccine?
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
Sample Adults 50+ or adults 18+ who have a weakened immune system who had a shingles vaccine
Skip Instructions:
1900-2016 if date prior to birth [goto ERR2_SHINGYEAR_A]
elseif date prior to 2006 [goto ERR3_SHINGYEAR_A]
else [goto SHTTETANUS_A]
2017-2020 [goto SHINGRIX2_A]
2021-2022 [goto SHINGRIXFS_A]
2023-2030 [goto ERR1_SHINGYEAR_A]
RF,DK [goto SHINGWHEN1_A]
Hard Edit:
Check Text: ERR1_SHINGYEAR_A
Check Description: Future date hard edit
Check Text: {check ERR1_SHINGYEAR_A} Future date invalid. Please correct.

Check Text: ERR2_SHINGYEAR_A
Check Description: Date of most recent shingles shot is prior to Sample Adult's birth - hard edit
Check Text: {check ERR2_SHINGYEAR_A}
Date of most recent shingles shot is prior to Sample Adult's birth. Please correct.
Soft Edit:
Check Text: ERR3_SHINGYEAR_A
Check Description: Date of most recent shingles shot is prior to 2006- soft edit
Check Text: {signal ERR3_SHINGYEAR_A}
Date of most recent shingles shot is prior to 2006. Please verify.
Question ID: IMS.0110.00.3
Variable: SHINGWHEN1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Was it before 2017?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 50+ or adults 18+ who have a weakened immune system who had a shingles vaccination and refused or don't know the year they had it
Skip Instructions:
1 [goto SHTTETANUS_A]
2,RF,DK [goto SHINGRIX2_A]
Question ID: IMS.0120.00.3
Variable: SHINGRIX2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

There are two vaccines that have been used to prevent shingles. The first was Zostavax®, which
was available from 2006 through 2020 and required one shot. The other is Shingrix®, which has
been available since 2017 and requires two shots. Have you ever had any Shingrix® shots?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 50+ or adults 18+ who have a weakened immune system who had a shingles vaccine from 2017 through 2020
Skip Instructions:
1 [goto SHINGRIXN2_A]
2,RF,DK [goto SHTTETANUS_A]
Question ID: IMS.0140.00.3
Variable: SHINGRIXN2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

How many Shingrix® shots have you ever had?
Fills:
^shingles
Description: Shingrix®/shingles
Instruction:
if SHINGYEAR_A=2017-2020, fill "Shingrix®" elseif SHINGYEAR_A ge 2021, fill "shingles"
^shingrixRIN
Description: Read if necessary text about Shingrix
Instruction:
if SHINGYEAR_A ge 2021, fill: "* Read if necessary: Shingrix® is the vaccine which has
been available since 2017 and requires two shots."
else no fill
Response:
1 - One Shingrix shot
2 - Two Shingrix shots
7 - Refused
9 - Don't Know
Universe:
Sample Adults 50+ or adults 18+ who have a weakened immune system who had a Shingrix vaccine
Skip Instructions:
1,2,RF,DK [goto SHTTETANUS_A]
Question ID: IMS.0150.00.3
Variable: SHINGRIXFS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Shingrix® is the only shingles vaccine which has been available since 2021 and requires two
shots. Was your most recent Shingrix® shot in ^SHINGYEAR_A your first or second Shingrix® shot?
* Read if necessary: There are two vaccines that have been used to prevent shingles. The first
was Zostavax®, which was available from 2006 through 2020 and required one shot. The other is
Shingrix®, which has been available since 2017 and requires two shots.
Fills:
^SHINGYEAR_A
Description: {value of SHINGYEAR_A}
Instruction:
Fill value from IMS.SHINGYEAR_A
Response:
1 - First shot
2 - Second shot
7 - Refused
9 - Don't Know
Universe:
Sample Adults 50+ or adults 18+ who have a weakened immune system who had a or had most recent shingles vaccine in 2021-2022
Skip Instructions:
1,2,RF,DK [goto SHTTETANUS_A]
Question ID: IMS.0170.00.3
Variable: TDAPPREG_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

A Tdap vaccination is a tetanus booster shot that also includes pertussis (per-TUH-sis) or
whooping cough vaccine. Earlier you said that you had a pregnancy that ended in a live birth
during the past 12 months. Did you receive a Tdap vaccine during this pregnancy?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Female Sample Adults 18-49 or age is refused or don't know who had a live birth in the past 12 months
Skip Instructions:
1 if GEN.AGE_FINAL[PX_A] NOT IN (RF,DK) [goto SHTHPV_A]
else [goto WORKHEALTH_A]
2,RF,DK [goto SHTTETANUS_A]
Question ID: IMS.0180.00.3
Variable: SHTTETANUS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Have you received a tetanus shot in the past 10 years?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who did not have a Tdap vaccine during a recent pregnancy
Skip Instructions:
1 [goto SHTTDAP_A]
2,RF,DK if GEN.AGE_FINAL[PX_A] le 64 [goto SHTHPV_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0190.00.3
Variable: SHTTDAP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

There are currently two types of tetanus shots available. One is the Td or tetanus-diphtheria
vaccine and the others are called Tdap or Adacel® or Boostrix®. They are similar except the Tdap
shot also includes a pertussis (per-TUH-sis) or whooping cough vaccine. Thinking back to your
most recent tetanus shot, did your health care provider tell you or did the vaccine information
sheet say the vaccine included the pertussis or whooping cough vaccine?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a tetanus shot in the past 10 years
Skip Instructions:
1,2,RF,DK if GEN.AGE_FINAL[PX_A] le 64 [goto SHTHPV_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0200.00.3
Variable: SHTHPV_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

HPV is the Human Papillomavirus. Have you ever received an HPV shot or vaccine?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18-64
Skip Instructions:
1 [goto SHTHPVAGE_A]
2,RF,DK [goto WORKHEALTH_A]
Question ID: IMS.0210.00.3
Variable: SHTHPVAGE_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

How old were you when you received your first HPV shot?
* Enter 1 if reported age is 1 or younger.
* Read if necessary: HPV stands for Human Papillomavirus.
Response:
01-64 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18-64 who had an HPV shot
Skip Instructions:
1-64,RF,DK if SHTHPVAGE_A gt GEN.AGE_FINAL[PX_A] [goto ERR1_SHTHPVAGE_A]
elseif SHTHPVAGE_A lt 9 [goto ERR2_SHTHPVAGE_A]
else [goto WORKHEALTH_A]
Hard Edit:
Check Text: ERR1_SHTHPVAGE_A
Check Description: Age reported is greater than current age
Check Text: {check ERR1_SHTHPVAGE_A}
Age reported at first HPV vaccine is greater than current age. Please correct.
Soft Edit:
Check Text: ERR2_SHTHPVAGE_A
Check Description: Soft edit for HPV age
Check Text: {signal ERR2_SHTHPVAGE_A} Received an HPV shot before age 9? Please verify.
Question ID: IMS.0220.00.3
Variable: WORKHEALTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In your work or volunteer activities, do you provide direct medical care to patients, such as
being a doctor, nurse, dentist, therapist, home health care worker, or emergency responder?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto next section]
2,RF,DK [goto WRKHLTHFC_A]
Question ID: IMS.0230.00.3
Variable: WRKHLTHFC_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Even if you do not provide direct medical care to patients, do you do any kind of work or
volunteer activities in a health care facility, such as in a hospital, doctor's office,
dentist's office, clinic, nursing home, or residential care home?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who do not provide medical care to patients or refused or don't know
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
PTC: Physical and other therapeutic care
Question ID: PTC.0010.00.2
Variable: EYEEX12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, have you had an eye exam from an eye specialist such as an
optometrist, ophthalmologist, or eye doctor?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto THERA12M_A]
Question ID: PTC.0020.00.2
Variable: THERA12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, did you receive physical therapy, speech therapy, rehabilitative
therapy, or occupational therapy?
* Read if necessary: Do not include mental health therapy.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto HOMEHC12M_A]
Question ID: PTC.0030.00.2
Variable: HOMEHC12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, did you receive care at home from a nurse or other health
professional?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ANX: Anxiety
Question ID: ANX.0010.00.1
Variable: ANXFREQ_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How often do you feel worried, nervous or anxious? Would you say daily, weekly, monthly, a few
times a year, or never?
* If respondent asks whether they are to answer about their emotional states after taking moodregulating medications, say: "Please answer based on your usual use of medication."
Response:
1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-5,RF,DK [goto ANXMED_A]
Question ID: ANX.0020.00.1
Variable: ANXMED_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you take prescription medication for these feelings?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF,DK [goto ANXLEVEL_A]
2 if ANXFREQ_A=5 [goto next section]
else [goto ANXLEVEL_A]
Question ID: ANX.0030.00.1
Variable: ANXLEVEL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Thinking about the last time you felt worried, nervous or anxious, how would you describe the
level of these feelings? Would you say a little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who feel worried, anxious, or nervous daily, weekly, monthly, a few times a year or don't know or refused how often OR who do take medication for these feelings or don't know or refused if they take medication for these feelings
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DEP: Depression
Question ID: DEP.0010.00.1
Variable: DEPFREQ_A
Interview Module: Adult
Content Type: Annual Core

Question text:

How often do you feel depressed? Would you say daily, weekly, monthly, a few times a year, or
never?
* If respondent asks whether they are to answer about their emotional states after taking moodregulating medications, say: "Please answer based on your usual use of medication."
Response:
1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-5,RF,DK [goto DEPMED_A]
Question ID: DEP.0020.00.1
Variable: DEPMED_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you take prescription medication for depression?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF,DK [goto DEPLEVEL_A]
2 if DEPFREQ_A=5 [goto next section]
else [goto DEPLEVEL_A]
Question ID: DEP.0030.00.1
Variable: DEPLEVEL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Thinking about the last time you felt depressed, how depressed did you feel? Would you say a
little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who feel depressed daily, weekly, monthly, a few times a year or refused or don't know how often they feel depressed OR who do take medication or refused or don't know if they take medication for depression.
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
MHC: Mental Health Care
Question ID: MHC.0010.00.1
Variable: MHRX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, did you take prescription medication to help you with any other
emotions or with your concentration, behavior or mental health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have not taken medication for worry or don't know or refused if they have and have not taken medication for depression or don't know or refused if they have
Skip Instructions:
1,2,RF,DK [goto MHTHRPY_A]
Question ID: MHC.0020.00.1
Variable: MHTHRPY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, did you receive counseling or therapy from a mental health
professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF,DK [goto MHTPYNOW_A]
2 [goto MHTHDLY_A]
Question ID: MHC.0030.00.1
Variable: MHTPYNOW_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you currently receiving counseling or therapy from a mental health professional?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have received, or refused to answer or don't know if they have received counseling or therapy from a mental health professional in the past 12 months
Skip Instructions:
1,2,RF,DK [goto MHTHDLY_A]
Question ID: MHC.0040.00.1
Variable: MHTHDLY_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, have you DELAYED getting counseling or therapy from a mental health
professional because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto MHTHND_A]
Question ID: MHC.0050.00.1
Variable: MHTHND_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, was there any time when you needed counseling or therapy from a
mental health professional, but DID NOT GET IT because of the cost?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
PHQ: PHQ-8 Depression
Question ID: PHQ.0005.00.2
Variable: PHQINTRO_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Now I'm going to ask you about several problems. Please tell me how often you have been
bothered, over the last 2 weeks, by any of the following problems. For each problem there are 4
possible answers: not at all, several days, more than half of the days, or nearly every day.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto PHQ81_A]
Question ID: PHQ.0010.00.2
Variable: PHQ81_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Over the last two weeks, how often have you been bothered by
...Little interest or pleasure in doing things?
Would you say not at all, several days, more than half the days, or nearly every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ82_A]
Question ID: PHQ.0020.00.2
Variable: PHQ82_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Over the last two weeks, how often have you been bothered by
...Feeling down, depressed, or hopeless?
Would you say not at all, several days, more than half the days, or nearly every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ83_A]
Question ID: PHQ.0030.00.2
Variable: PHQ83_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Trouble falling or staying asleep, or sleeping too much?
* Read if necessary: Would you say not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ84_A]
Question ID: PHQ.0040.00.2
Variable: PHQ84_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Feeling tired or having little energy?
* Read if necessary: Would you say not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ85_A]
Question ID: PHQ.0050.00.2
Variable: PHQ85_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Poor appetite or overeating?
* Read if necessary: Would you say not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ86_A]
Question ID: PHQ.0060.00.2
Variable: PHQ86_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Feeling bad about yourself, or that you are a failure, or have let yourself or your family
down?
* Read if necessary: Would you say not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ87_A]
Question ID: PHQ.0070.00.2
Variable: PHQ87_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Trouble concentrating on things, such as reading the newspaper or watching television?
* Read if necessary: Would you say not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto PHQ88_A]
Question ID: PHQ.0080.00.2
Variable: PHQ88_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Moving or speaking so slowly that other people could have noticed? Or the opposite, being so
fidgety or restless that you have been moving around a lot more than usual?
* Read if necessary: Would you say not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
GAD: GAD-7 Anxiety
Question ID: GAD.0010.00.2
Variable: GAD71_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Over the last two weeks, how often have you been bothered by the following problems
...Feeling nervous, anxious, or on edge?
Would you say not at all, several days, more than half the days, or nearly every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto GAD72_A]
Question ID: GAD.0020.00.2
Variable: GAD72_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Not being able to stop or control worrying?
* Read if necessary: Would you say, not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto GAD73_A]
Question ID: GAD.0030.00.2
Variable: GAD73_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Worrying too much about different things?
* Read if necessary: Would you say, not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto GAD74_A]
Question ID: GAD.0040.00.2
Variable: GAD74_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Trouble relaxing?
* Read if necessary: Would you say, not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto GAD75_A]
Question ID: GAD.0050.00.2
Variable: GAD75_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Being so restless that it's hard to sit still?
* Read if necessary: Would you say, not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto GAD76_A]
Question ID: GAD.0060.00.2
Variable: GAD76_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Becoming easily annoyed or irritable?
* Read if necessary: Would you say, not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto GAD77_A]
Question ID: GAD.0070.00.2
Variable: GAD77_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* Read if necessary: Over the last two weeks, how often have you been bothered by
...Feeling afraid as if something awful might happen?
* Read if necessary: Would you say, not at all, several days, more than half the days, or nearly
every day?
Response:
1 - Not at all
2 - Several days
3 - More than half the days
4 - Nearly every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
FGE: Fatigue
Question ID: FGE.0010.00.2
Variable: FGEFRQTRD_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

In the past 3 months, how often did you feel very tired or exhausted? Would you say never, some
days, most days, or every day?
Response:
1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto next section]
2-4,RF,DK [goto FGELNGTRD_A]
Question ID: FGE.0020.00.2
Variable: FGELNGTRD_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Thinking about the last time you felt very tired or exhausted, how long did it last? Would you
say some of the day, most of the day, or all of the day?
Response:
1 - Some of the day
2 - Most of the day
3 - All of the day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who felt very tired or exhausted some days, most days, every day, or refused or don't know
Skip Instructions:
1-3,RF,DK [goto FGELEVTRD_A]
Question ID: FGE.0030.00.2
Variable: FGELEVTRD_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Thinking about the last time you felt this way, how would you describe the level of tiredness?
Would you say a little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who felt very tired or exhausted some days, most days, every day, or refused or don't know
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CIG: Cigarettes and E-cigarettes w/ Cigarette History and Smoking Quit Methods
Question ID: CIG.0010.00.1
Variable: CIGINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

These next questions are about cigarette smoking.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SMKEV_A]
Question ID: CIG.0020.00.1
Variable: SMKEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you smoked at least 100 cigarettes in your ENTIRE LIFE?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SMKAGE_A]
2,RF,DK [goto ECIGEV_A]
Question ID: CIG.0030.00.2
Variable: SMKAGE_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

How old were you when you FIRST started to smoke fairly regularly?
* Smoking regularly is respondent defined. If asked about what this means, say that "It is
whatever you consider as first starting to smoke fairly regularly."
* Enter '6' if less than 6 years old.
* Enter '95' if 95 years old or older.
* Enter '96' if never smoked regularly.
Response:
06-95 - Range of values
96 - Never smoked regularly
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who ever smoked 100 cigarettes
Skip Instructions:
6-95,96,RF,DK if SMKAGE_A gt GEN.AGE_FINAL and SMKAGE_A ne 96 [goto ERR1_SMKAGE_A]
else [goto SMKNOW_A]
Hard Edit:
Check Text: ERR1_SMKAGE_A
Check Description: Age starting smoking exceeds current age
Check Text: {check ERR1_SMKAGE_A}
Starting age exceeds current age. Please correct
Question ID: CIG.0040.00.1
Variable: SMKNOW_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you NOW smoke cigarettes every day, some days or not at all?
Response:
1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who ever smoked 100 cigarettes
Skip Instructions:
1 [goto CIGNOW_A]
2 [goto SMK30D_A]
3 [goto SMKQTN_A]
RF,DK [goto ECIGEV_A]
Question ID: CIG.0050.00.1
Variable: CIGNOW_A
Interview Module: Adult
Content Type: Annual Core

Question text:

On average, about how many cigarettes do you NOW smoke a day?
* Enter '1' if less than 1 cigarette.
* Enter '95' if 95 or more cigarettes.
Response:
01-95 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who are current every day smokers
Skip Instructions:
1-95,RF,DK [goto MENTHOLC_A]
Question ID: CIG.0060.00.1
Variable: SMK30D_A
Interview Module: Adult
Content Type: Annual Core

Question text:

On how many of the past 30 days did you smoke a cigarette?
* Enter '0' for None.
Response:
00-30 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who are current some day smokers
Skip Instructions:
0 [goto MENTHOLC_A]
1-30,RF,DK [goto CIG30D_A]
Question ID: CIG.0070.00.1
Variable: CIG30D_A
Interview Module: Adult
Content Type: Annual Core

Question text:

On average, when you smoked during the past 30 days, about how many cigarettes did you smoke a
day?
* Enter '1' if less than 1.
* Enter '95' if 95 or more cigarettes.
Response:
01-95 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have smoked any time in the past 30 days or refused or don't know
Skip Instructions:
1-95,RF,DK [goto MENTHOLC_A]
Question ID: CIG.0075.00.3
Variable: MENTHOLC_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Do you usually smoke menthol or non-menthol cigarettes?
Response:
1 - Menthol
2 - Non-menthol
3 - No usual type
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who currently smoke cigarettes every day or some days
Skip Instructions:
1-3,RF,DK [goto SMKQT12M_A]
Question ID: CIG.0080.00.2
Variable: SMKQT12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, have you stopped smoking for more than one day BECAUSE YOU WERE
TRYING TO QUIT SMOKING?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are every day or someday smokers
Skip Instructions:
1,2,RF,DK [goto SMKTLK1_A]
Question ID: CIG.0090.01.2
Variable: SMKQTN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
How long has it been since you quit smoking cigarettes?
* Enter number for time since quit smoking.
Response:
001-365 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who quit smoking
Skip Instructions:
1-365 [goto SMKQTTP_A]
RF,DK [goto MENTHOLF_A]
Question ID: CIG.0090.02.2
Variable: SMKQTTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for time since quit smoking.
Response:
1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who gave a number for how long ago they quit smoking
Skip Instructions:
1-3,RF,DK [goto MENTHOLF_A]
4 if SMKERR1_CALC_A lt 15 [goto ERR1_SMKQTTP_A]
elseif SMKERR2_CALC_A gt GEN.AGE_FINAL[PX_A] [goto ERR2_SMKQTTP_A]
else [goto MENTHOLF_A]
Hard Edit:
Check Text: ERR2_SMKQTTP_A
Check Description: Age started smoking plus years since quitting is greater than current age
Check Text: {check ERR2_SMKQTTP_A}
Age started smoking (^SMKAGE_A years) + years since quitting (^SMKQTN_A) exceeds current age. Please correct.
Soft Edit:
Check Text: ERR1_SMKQTTP_A
Check Description: Former smokers who quit before the age of 15
Check Text: {signal ERR1_SMKQTTP_A}
Respondent quit smoking before age 15? Please verify.
Question ID: CIG.0120.00.3
Variable: MENTHOLF_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to the 12 MONTHS BEFORE YOU QUIT SMOKING CIGARETTES, during that time, did you
usually smoke menthol or non-menthol cigarettes?
Response:
1 - Menthol
2 - Non-menthol
3 - No usual type
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who are former smokers
Skip Instructions:
1-3,RF,DK if ((SMKQTN_A le 365 and SMKQTTP_A=1) or (SMKQTN_A le 52 and SMKQTTP_A=2) or
(SMKQTN_A le 12 and SMKQTTP_A=3) or (SMKQTN_A le 1 and SMKQTTP_A=4)) [goto SMKTLK1_A]
else [goto ECIGEV_A]
Question ID: CIG.0140.00.2
Variable: SMKTLK1_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

In the past 12 months, has a doctor, dentist, or other health professional ADVISED you about
ways to stop smoking or prescribed medication to help you quit?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are current cigarette smokers or former cigarette smokers who have quit in the past 12 months
Skip Instructions:
1,2,RF,DK [goto ECIGEV_A]
Question ID: CIG.0150.00.1
Variable: ECIGEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you ever used an e-cigarette or other electronic vaping product, even just one time, in
your entire life?
* Read if necessary: Electronic cigarettes (e-cigarettes) and other electronic vaping products
include JUULs, vape pens, e-cigars, and others. These products are battery-powered and usually
contain nicotine and flavors such as fruit, mint, or candy.
* These questions concern electronic vaping products for nicotine use.
* Do not include marijuana use.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto ECIGNOW_A]
2,RF,DK if SMKNOW_A=3 and (SMKQTN_A le 365 and SMKQTTP_A=1) or (SMKQTN_A le 104 and
SMKQTTP_A=2) or (SMKQTN_A le 24 and SMKQTTP_A=3) or (SMKQTN_A le 2 and SMKQTTP_A=4) [goto
FQUITA1_A]
elseif SMKQT12M_A=1 [goto CQUITA1_A]
elseif SMKNOW_A IN (1,2) [goto QWANT_A]
else [goto next section]
Question ID: CIG.0160.00.1
Variable: ECIGNOW_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you NOW use e-cigarettes or other electronic vaping products every day, some days, or not at
all?
* These questions concern electronic vaping products for nicotine use.
* Do not include marijuana use.
Response:
1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have ever used e-cigarettes
Skip Instructions:
1-3,RF,DK if SMKNOW_A=3 and (SMKQTN_A le 365 and SMKQTTP_A=1) or (SMKQTN_A le 104 and
SMKQTTP_A=2) or (SMKQTN_A le 24 and SMKQTTP_A=3) or (SMKQTN_A le 2 and SMKQTTP_A=4) [goto
FQUITA1_A]
else if SMKQT12M_A=1 [goto CQUITA1_A]
elseif SMKNOW_A IN (1,2) [goto QWANT_A]
else [goto next section]
Question ID: CIG.0170.00.3
Variable: FQUITA1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you stopped smoking completely, did you use ANY of the following products
...A nicotine patch?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITA2_A]
Question ID: CIG.0180.00.3
Variable: FQUITA2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you stopped smoking completely, did you use ANY of
the following products
...A nicotine gum or lozenge (LA-zenj)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITA3_A]
Question ID: CIG.0190.00.3
Variable: FQUITA3_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you stopped smoking completely, did you use ANY of
the following products
...A nicotine containing nasal spray or inhaler?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITA4_A]
Question ID: CIG.0200.00.3
Variable: FQUITA4_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you stopped smoking completely, did you use ANY of
the following products
...A prescription pill called Chantix (CHAN-tix) or Varenicline (vuh-REN-ih-klin)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITA5_A]
Question ID: CIG.0210.00.3
Variable: FQUITA5_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you stopped smoking completely, did you use ANY of
the following products
...A prescription pill called Zyban (ZI-ban), Bupropion (byoo-PRO-pee-on), or Wellbutrin (wellBYOO-trin)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITB1_A]
Question ID: CIG.0220.00.3
Variable: FQUITB1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you stopped smoking completely, did you use ANY of the following
...A telephone help line or quit line?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITB2_A]
Question ID: CIG.0230.00.3
Variable: FQUITB2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you stopped smoking completely, did you use ANY of
the following
...One-on-one counseling?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK [goto FQUITB3_A]
Question ID: CIG.0240.00.3
Variable: FQUITB3_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you stopped smoking completely, did you use ANY of
the following
...A stop smoking clinic, class, or support group?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years
Skip Instructions:
1,2,RF,DK if ECIGEV_A=1 [goto FQUITE_A]
else [goto next section]
Question ID: CIG.0250.00.3
Variable: FQUITE_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you stopped smoking completely, did you try to quit by switching to
electronic or e-cigarettes?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who quit smoking in the past 2 years and who have ever used e-cigarettes
Skip Instructions:
1,2,RF,DK [goto next section]
Question ID: CIG.0260.00.3
Variable: CQUITA1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you tried to QUIT smoking in the PAST 12 MONTHS, did you use ANY of the
following products
...A nicotine patch?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITA2_A]
Question ID: CIG.0270.00.3
Variable: CQUITA2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you tried to QUIT smoking IN THE PAST 12 MONTHS, did
you use ANY of the following products
...A nicotine gum or lozenge (LA-zenj)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITA3_A]
Question ID: CIG.0280.00.3
Variable: CQUITA3_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you tried to QUIT smoking IN THE PAST 12 MONTHS, did
you use ANY of the following products
...A nicotine containing nasal spray or inhaler?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITA4_A]
Question ID: CIG.0290.00.3
Variable: CQUITA4_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you tried to QUIT smoking IN THE PAST 12 MONTHS, did
you use ANY of the following products
...A prescription pill called Chantix (CHAN-tix) or Varenicline (vuh-REN-ih-klin)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITA5_A]
Question ID: CIG.0300.00.3
Variable: CQUITA5_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you tried to QUIT smoking IN THE PAST 12 MONTHS, did
you use ANY of the following products
...A prescription pill called Zyban (ZI-ban), Bupropion (byoo-PRO-pee-on), or Wellbutrin (wellBYOO-trin)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITB1_A]
Question ID: CIG.0310.00.3
Variable: CQUITB1_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you tried to QUIT smoking in the PAST 12 MONTHS, did you use ANY of the
following
...A telephone help line or quit line?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITB2_A]
Question ID: CIG.0320.00.3
Variable: CQUITB2_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: Thinking back to when you tried to QUIT smoking IN THE PAST 12 MONTHS, did
you use ANY of the following
...One-on-one counseling?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CQUITB3_A]
Question ID: CIG.0330.00.3
Variable: CQUITB3_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: Thinking back to when you tried to QUIT smoking in the PAST 12 MONTHS, did
you use ANY of the following
...A stop smoking clinic, class, or support group?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months
Skip Instructions:
1,2,RF,DK if ECIGEV_A=1 [goto CQUITE_A]
else [goto QWANT_A]
Question ID: CIG.0340.00.3
Variable: CQUITE_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Thinking back to when you tried to QUIT smoking IN THE PAST 12 MONTHS, did you try to quit by
switching to electronic or e-cigarettes?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who tried to quit smoking in the past 12 months and have ever used ecigarettes
Skip Instructions:
1,2,RF,DK [goto QWANT_A]
Question ID: CIG.0350.00.3
Variable: QWANT_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Would you like to completely quit smoking cigarettes?
Response:
1 - Yes
2 - No
6 - Missing in error
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are everyday or someday smokers
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
OTB: Other Tobacco
Question ID: OTB.0010.00.3
Variable: CIGAREV_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Have you ever smoked a regular cigar, cigarillo, or a little filtered cigar EVEN ONE TIME?
* Read if necessary: "Cigarillos" are medium cigars that sometimes are sold with plastic or
wooden tips. Some common brands are Black and Mild, Swisher Sweets, Dutch Masters and Phillies
Blunts. Cigarillos are usually sold individually or in packs of 5 or fewer. Little filtered
cigars look like cigarettes and are usually brown in color. Like cigarettes, little filtered
cigars have a spongy filter and are sold in packs of 20. Some common brands are Prime Time and
Winchester.
* Read if necessary: Do not include electronic cigars or e-cigars.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+
Skip Instructions:
1 [goto CIGARCUR_A]
2,RF,DK [goto PIPEEV_A]
Question ID: OTB.0020.00.3
Variable: CIGARCUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Do you NOW smoke regular cigars, cigarillos, or little filtered cigars every day, some days, or
not at all?
Response:
1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+ who have ever smoked a regular cigar, cigarillo, or filtered cigar
Skip Instructions:
1,RF,DK [goto PIPEEV_A]
2,3 [goto CIGAR30D_A]
Question ID: OTB.0030.00.3
Variable: CIGAR30D_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

On how many of the past 30 days have you smoked a regular cigar, cigarillo, or little filtered
cigar?
Response:
00-30 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample adults 18+ who now smoke a regular cigar, cigarillo, or little filtered cigar some days or not at all
Skip Instructions:
0-30,RF,DK [goto PIPEEV_A]
Question ID: OTB.0040.00.3
Variable: PIPEEV_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Have you EVER smoked a pipe filled with tobacco - either a regular pipe, water pipe, or hookah
EVEN ONE TIME?
* Read if necessary: A hookah is a type of water pipe. It is sometimes called a "narghile" (NARge-lee) pipe. Do not include electronic hookah or e-hookahs.
* Read if necessary: Do not include electronic pipes or e-pipes.
Read if necessary: Do not include pipes filled with substances other than tobacco.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+
Skip Instructions:
1 [goto PIPECUR_A]
2,RF,DK [goto SMOKELSEV_A]
Question ID: OTB.0050.00.3
Variable: PIPECUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Do you NOW smoke pipes filled with tobacco - either regular pipes, water pipes, or hookahs,
every day, some days, or not at all?
* Read if necessary: Do not include pipes filled with substances other than tobacco.
Response:
1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+ who have ever smoked a regular pipe, water pipe or hookah filled with tobacco
Skip Instructions:
1-3,RF,DK [goto SMOKELSEV_A]
Question ID: OTB.0060.00.3
Variable: SMOKELSEV_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Smokeless tobacco products are placed in the mouth or nose and can include chewing tobacco,
snuff, dip, snus (SNOOSE), or dissolvable tobacco.
Have you ever used smokeless tobacco products EVEN ONE TIME?
* Read if necessary: Do not include nicotine replacement therapy products such as patch, gum,
lozenge, or spray, which are considered smoking cessation treatments.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+
Skip Instructions:
1 [goto SMOKELSCUR_A]
2,RF,DK [goto next section]
Question ID: OTB.0070.00.3
Variable: SMOKELSCUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Do you NOW use smokeless tobacco products every day, some days, or not at all?
Response:
1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+ who have ever used smokeless tobacco products
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
AQS: Advice to Quit Smoking
Question ID: AQS.0010.00.3
Variable: HPTOB3_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the past 12 months, has a medical doctor, dentist, or other health professional ADVISED you
to quit smoking or to quit using other kinds of tobacco?
Response:
1 - Yes
2 - No
6 - Missing in error
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are current cigarette smokers OR former cigarette smokers who have quit in the past 12 months OR currently smoke ecigarettes, cigars, pipes, or use smokeless tobacco every day or some days
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ALC: Alcohol Use
Question ID: ALC.0010.00.2
Variable: DRKLIFE_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

These next questions are about drinking alcoholic beverages.
Alcohol includes beer, wine, wine coolers, liquors such as vodka, whiskey or rum, mixed drinks
or cocktails with alcohol, and any other type of alcoholic drink.
In your ENTIRE LIFE, have you had at least 1 drink of any kind of alcohol, not counting small
tastes or sips?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto DRK12MN_A]
2,RF,DK [goto next section]
Question ID: ALC.0020.01.2
Variable: DRK12MN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
During the past 12 months, how many days per week, per month or per year did you drink any type
of alcoholic beverage?
* Read if necessary: Alcohol includes beer, wine, wine coolers, liquors such as vodka, whiskey
or rum, mixed drinks or cocktails with alcohol, and any other type of alcoholic drink.
* Enter number for how often alcoholic beverages were consumed in the past 12 months. Then enter
category of response (week, month, year).
* Enter '0' for Never.
Response:
000-365 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who have had at least 1 drink in their entire life
Skip Instructions:
0 [goto DRK12ANYR_A]
1-365 [goto DRK12MTP_A]
DK [goto DRKAVG12M_A]
RF [goto next section]
Question ID: ALC.0020.02.2
Variable: DRK12MTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for how often alcoholic beverages were consumed in the past year.
Response:
0 - Never
1 - Per week
2 - Per month
3 - Per year
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who gave a number for number of days drank per week/month/year
Skip Instructions:
1-3 if ((DRK12MN_A gt 7 and DRK12MTP_A=1) or (DRK12MN_A gt 31 and DRK12MTP_A=2))[goto
ERR1_DRK12MTP_A] else [goto DRKAVG12M_A]
RF,DK [goto DRKAVG12M_A]
Hard Edit:
Check Text: ERR1_DRK12MTP_A
Check Description: Number of days reported exceeds number of days in a given time period hard edit
Check Text: {check ERR1_DRK12MTP_A}
^DRK12MN_A days per ^DRK12MTP_A exceeds number possible in this time period. Please correct.
Question ID: ALC.0030.00.2
Variable: DRKAVG12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

When counting number of drinks, one drink is equal to a 12-ounce beer, a 5-ounce glass of wine,
or one shot or 1.5 ounces of liquor. A larger 40-ounce beer would count as 3 drinks, or a
cocktail drink with 2 shots would count as 2 drinks.
During the past 12 months, on those days that you drank alcoholic beverages, on average, how
many DRINKS did you have?
* Enter '1' if 1 or fewer drinks.
* Enter '95' if 95 or more drinks.
Response:
01-95 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who drank at least once in the past year or don't know
Skip Instructions:
1-3,RF,DK [goto DRKBNG12M_A]
4 if GEN.SEX_FINAL=2 [goto DRKANY30D_A]
elseif GEN.SEX_FINAL IN (1,RF,DK) [goto DRKBNG12M_A]
5-95 [goto DRKANY30D_A]
10-95 [goto ERR1_DRKAVG12M_A]
Soft Edit:
Check Text: ERR1_DRKAVG12M_A
Check Description: 10 or more daily drinks
Check Text: {signal ERR1_DRKAVG12M_A} ^DRKAVG12M_A drinks is an usually high number. Please verify. Do not probe.
Question ID: ALC.0040.00.2
Variable: DRK12ANYR_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

In ANY ONE YEAR, have you had at least 12 drinks of any type of alcoholic beverage?
* Read if necessary: One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a
drink with one shot (1.5 ounces) of liquor. A 40-ounce beer would count as 3 drinks or a
cocktail drink with 2 shots would count as 2 drinks.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have not had a drink in the past 12 months
Skip Instructions:
1,2,RF,DK [goto next section]
Question ID: ALC.0050.00.2
Variable: DRKBNG12M_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, did you ever have ^BINGE drinks in a day?
Fills:
^BINGE
Description: number of daily drinks at threshold for bingeing
Instruction:
If GEN.SEX_FINAL in (1,RF,DK) fill: "5 or more" If GEN.SEX_FINAL=2, fill: "4 or more"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who drank less than 4(female)/5(male, refused, don't know sex) drinks a day on average
Skip Instructions:
1 [goto DRKANY30D_A]
2,RF,DK if (DRKAVG12M_A IN (RF,DK) and DRK12MN_A GE 1) [goto DRKANY30D_A]
elseif (DRK12MN_A GE 1 or DRKAVG12M_A GE 1)[goto DRKADVISE1_A]
elseif (DRKAVG12M_A IN (RF,DK) AND DRK12MN_A=DK))[goto next section]
Question ID: ALC.0060.00.2
Variable: DRKANY30D_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

The next question will ask you about ONLY the past 30 days.
During the past 30 days, did you have at least one drink of any type of alcoholic beverage?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who drank 4+(female)/5+(male, refused, don't know sex) drinks in a day in the last year or refused or don't know
Skip Instructions:
1,RF,DK [goto DRKBNG30D_A]
2 [goto DRKADVISE1_A]
Question ID: ALC.0070.00.2
Variable: DRKBNG30D_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 30 days, how many times did you have ^BINGE drinks on an occasion?
* Read if necessary: A drinking occasion is considered to be approximately two hours.
* Enter '0' if none.
* Enter '60' if 60 or more times.
Fills:
^BINGE
Description: number of daily drinks at threshold for bingeing
Instruction:
If GEN.SEX_FINAL in (1,RF,DK) fill: "5 or more" If GEN.SEX_FINAL=2, fill: "4 or more"
Response:
00-60 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who drank in the past 30 days or refused or don't know
Skip Instructions:
0-60,RF,DK [goto DRKADVISE1_A]
Question ID: ALC.0080.00.2
Variable: DRKADVISE1_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, has a doctor, dentist, or other health professional ADVISED you to
stop or cut down on your drinking?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have had 1 or more drinks in the past 12 months
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
PHY: Physical Activity
Question ID: PHY.0010.01.2
Variable: MODN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
The next questions are about physical activities such as exercise, sports, or physically active
hobbies that you may do in your LEISURE time. We are interested in two types of physical
activity --- moderate and vigorous-intensity. Moderate-intensity activities cause moderate
increases in breathing or heart rate whereas vigorous-intensity activities cause large increases
in breathing or heart rate.
How often do you do MODERATE-INTENSITY LEISURE-TIME physical activities?
* If necessary, prompt with: How many times per day, per week, per month, or per year do you do
these activities?
* Enter number for moderate leisure-time physical activities.
* Enter '0' for Never.
* Enter '996' if unable to do this type of activity.
Response:
000-995 - Range of values
996 - Unable to do this type of activity
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-995 [goto MODTP_A]
0,996,RF,DK [goto VIGN_A]
Question ID: PHY.0010.02.2
Variable: MODTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for moderate leisure-time physical activities.
Response:
1 - Per day
2 - Per week
3 - Per month
4 - Per year
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who do moderate physical activities
Skip Instructions:
1-4 if ((MODN_A gt 4 and MODTP_A=1) or (MODN_A gt 28 and MODTP_A=2) or (MODN_A gt 31 and
MODTP_A=3) or (MODN_A gt 365 and MODTP_A=4)) [goto ERR1_MODTP_A]
else [goto MODLN_A]
RF,DK [goto VIGN_A]
Soft Edit:
Check Text: ERR1_MODTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_MODTP_A} ^MODN_A times per ^MODTP_A is unusually high. Please verify.
Question ID: PHY.0020.01.2
Variable: MODLN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
About how long do you do these moderate leisure-time physical activities each time?
Read if necessary: Moderate-intensity activities cause moderate increases in breathing or heart
rate.
* Enter number for length of moderate leisure-time physical activities.
Response:
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who do moderate physical activities
Skip Instructions:
1-995 [goto MODLTP_A]
RF,DK [goto VIGN_A]
Question ID: PHY.0020.02.2
Variable: MODLTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for length of moderate leisure-time physical activities.
Response:
1 - Minutes
2 - Hours
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who do moderate physical activities
Skip Instructions:
1,2 if ((MODLN_A ge 120 and MODLTP_A=1) or (MODLN_A ge 2 and MODLTP_A=2)) [goto ERR1_MODLTP_A]
elseif (MODLN_A ge 25 and MODLTP_A=2) [goto ERR2_MODLTP_A]
else [goto VIGN_A]
RF,DK [goto VIGN_A]
Hard Edit:
Check Text: ERR2_MODLTP_A
Check Description: Out of range hard edit
Check Text: {check ERR2_MODLTP_A} ^MODLN_A ^MODLTP_A is more than 24 hours a day and is not allowed. Please correct.
Soft Edit:
Check Text: ERR1_MODLTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_MODLTP_A} ^MODLN_A ^MODLTP_A is unusually high. Please verify.
Question ID: PHY.0030.01.2
Variable: VIGN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
How often do you do VIGOROUS-INTENSITY LEISURE-TIME physical activities?
* Read if necessary: Vigorous-intensity activities cause large increases in breathing or heart
rate.
* Read if necessary: How many times per day, per week, per month, or per year do you do these
activities?
* Enter number for vigorous leisure-time physical activities.
* Enter '0' for Never.
* Enter '996' if unable to do this type of activity.
Response:
000-995 - Range of values
996 - Unable to do this type of activity
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,996,RF,DK [goto STRN_A]
1-995 [goto VIGTP_A]
Question ID: PHY.0030.02.2
Variable: VIGTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for vigorous leisure-time physical activities.
Response:
1 - Per day
2 - Per week
3 - Per month
4 - Per year
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who do vigorous physical activities
Skip Instructions:
1-4 if (VIGN_A gt 4 and VIGTP_A=1) or (VIGN_A gt 28 and VIGTP_A=2) or (VIGN_A gt 31 and
VIGTP_A=3) or (VIGN_A gt 365 and VIGTP_A=4) [goto ERR1_VIGTP_A]
else [goto VIGLN_A]
Soft Edit:
Check Text: ERR1_VIGTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_VIGTP_A} ^VIGN_A times per ^VIGTP_A is unusually high. Please verify.
Question ID: PHY.0040.01.2
Variable: VIGLN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
About how long do you do these vigorous leisure-time physical activities each time?
* Read if necessary: Vigorous-intensity activities cause large increases in breathing or heart
rate.
* Enter number for length of vigorous leisure-time physical activities.
Response:
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who do vigorous physical activities
Skip Instructions:
1-995[goto VIGLTP_A]
RF,DK[goto STRN_A]
Question ID: PHY.0040.02.2
Variable: VIGLTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for length of vigorous leisure-time physical activities.
Response:
1 - Minutes
2 - Hours
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who do vigorous physical activities
Skip Instructions:
1,2 if (VIGLN_A ge 120 and VIGLTP_A=1) or (VIGLN_A ge 2 and VIGLTP_A=2) [goto ERR1_VIGLTP_A]
elseif (VIGLN_A ge 25 and VIGLTP_A=2) [goto ERR2_VIGLTP_A]
else [goto STRN_A]
RF,DK [goto STRN_A]
Hard Edit:
Check Text: ERR2_VIGLTP_A
Check Description: Out or range hard edit
Check Text: {check ERR2_VIGLTP_A} ^VIGLN_A ^VIGLNTP_A is more than 24 hours a day and is not allowed. Please correct.
Soft Edit:
Check Text: ERR1_VIGLTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_VIGLTP_A} ^VIGLN_A ^VIGLNTP_A is unusually high. Please verify.
Question ID: PHY.0050.01.2
Variable: STRN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
Including activities that you mentioned earlier, how often do you do LEISURE-TIME physical
activities specifically designed to STRENGTHEN your muscles such as sit-ups, push-ups, or
lifting weights?
* Read if necessary: How many times per day, per week, per month, or per year do you do these
activities?
* Enter number for strengthening activities.
* Enter '0' for Never.
* Enter '996' for Unable to do this type of activity.
Response:
000-995 - Range of values
996 - Unable to do this type of activity
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-995 [goto STRTP_A]
0,996,RF,DK [goto next section]
Question ID: PHY.0050.02.2
Variable: STRTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for strengthening activities.
Response:
1 - Per day
2 - Per week
3 - Per month
4 - Per year
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who do strengthening activities
Skip Instructions:
1-4 if (STRN_A gt 4 and STRTP_A=1) or (STRN_A gt 28 and STRTP_A=2) or (STRN_A gt 31 and
STRTP_A=3) or (STRN_A gt 365 and STRTP_A=4) [goto ERR1_STRTP_A]
else [goto next section]
Soft Edit:
Check Text: ERR1_STRTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_STRTP_A} ^STRN_A times per ^STRTP_A is unusually high. Please verify.

2022 National Health Interview Survey (NHIS) Questionnaire
WLK: Walking
Question ID: WLK.0010.00.2
Variable: WLKTRAN_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

The next questions are about walking for transportation. This is walking you might have done to
travel to and from work, to do errands, or to go from place to place. I will ask you separately
about walking for other reasons like relaxation, exercise, or walking the dog.
In the past 7 days, did you walk for transportation?
* Read if necessary: Include walking to or from a bus, train, or rail stop.
* Read if necessary: Do not include walking for relaxation or exercise.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are able to walk
Skip Instructions:
1 [goto WLKTRANDAY_A]
2,RF,DK [goto WLKLEIS_A]
Question ID: WLK.0020.00.2
Variable: WLKTRANDAY_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

In the past 7 days, how many days did you walk for transportation?
Response:
01-07 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have walked for transportation in the past 7 days
Skip Instructions:
1-7 [goto WLKTRANTPD_A]
RF,DK [goto WLKLEIS_A]
Question ID: WLK.0030.00.2
Variable: WLKTRANTPD_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

^WLKDAYT
Fills:
^WLKDAYT
Description: How many times did you walk for transportation tha day?/On average, how many times per day did you walk for

Instruction:
tion? Instruction If WLKTRANDAY_A=1, fill: "How many times did you walk for
transportation that day?"
elseif WLKTRANDAY_A IN (2-7), fill: "On average, how many
times per day did you walk for transportation?"
Response:
01-94 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have walked for transportation at least one day in the past 7 days
Skip Instructions:
1-94 [goto WLKTRANLGT_A]
RF,DK [goto WLKLEIS_A]
Question ID: WLK.0040.01.2
Variable: WLKTRANLGT_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
^WALKTIMETP
* Enter number for length of walk for transportation.
Fills:
^WALKTIMETP
Description: How long did that walk take?/On average, how long did those walks take?

Instruction:
If WLKTRANDAY_A=1 AND WLKTRANTPD_A=1, fill: "How long did that walk take?"
If WLKTRANDAY_A=2-7 OR WLKTRANTPD_A=2-94, fill: "On
average, how long did those walks take?"
Response:
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who have walked for transportation at least one time in the past 7 days
Skip Instructions:
1-995 [goto WLKTRANTP_A]
RF,DK [goto WLKLEIS_A]
Question ID: WLK.0040.02.2
Variable: WLKTRANTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for length of walking for transportation.
Response:
1 - Minutes
2 - Hours
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who entered a number for how long they walked for transportation in the past 7 days
Skip Instructions:
1,2 if ((WLKTRANLGT_A GT 119 and WLKTRANTP_A=1) or (WLKTRANLGT_A GT 1 and WLKTRANTP_A=2))[goto
ERR1_WLKTRANLGT_A]
1,2 if ((WLKTRANLGT_A GE 25 and WLKTRANTP_A=2))[goto ERR2_WLKTRANLGT_A]
else [goto WLKLEIS_A]
RF,DK [goto WLKLEIS_A]
Hard Edit:
Check Text: ERR2_WLKTRANLGT_A
Check Description: Amount of time walking is over 24 hours on average
Check Text: {check ERR2_WLKTRANLGT_A}
Amount of time walking is more than 24 hours and is not allowed. Please correct.
Soft Edit:
Check Text: ERR1_WLKTRANLGT_A
Check Description: Amount of time walking is over 2 hours on average
Check Text: {signal ERR1_WLKTRANLGT_A}
Amount of time walking is unusually high. Please verify.
Question ID: WLK.0050.00.2
Variable: WLKLEIS_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Sometimes you may walk for fun, relaxation, exercise, or to walk the dog. In the past 7 days,
did you walk for any of these reasons?
* Read if necessary: Do not include walking for transportation.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are able to walk
Skip Instructions:
1 [goto WLKLEISDAY_A]
2,RF,DK [goto next section]
Question ID: WLK.0060.00.2
Variable: WLKLEISDAY_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

In the past 7 days, how many days did you walk for leisure or exercise?
* Read if necessary: Walked for fun, relaxation, exercise, or to walk the dog.
* Read if necessary: Do not include walking for transportation.
Response:
01-07 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have walked for leisure in the past 7 days
Skip Instructions:
1-7 [goto WLKLEISTPD_A]
RF,DK [goto next section]
Question ID: WLK.0070.00.2
Variable: WLKLEISTPD_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

^WLKDAYL
Fills:
^WLKDAYL
Description: How many times did you walk for leisure or exercise tha day?/On average, how many times per day did you walk for

Instruction:
exercise? Instruction If WLKLEISDAY_A=1, fill: "How many times did you walk for
leisure or exercise that day?"
elseif WLKLEISDAY_A IN (2-7), fill: "On average, how many
times per day did you walk for leisure or exercise?"
Response:
01-94 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who have walked for leisure at least one day in the past 7 days
Skip Instructions:
1-94 [goto WLKLEISLGT_A]
RF,DK [goto next section]
Question ID: WLK.0080.01.2
Variable: WLKLEISLGT_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 1 of 2
^WALKTIMELE
* Enter number for length of walk for fun, relaxation, or exercise.
Fills:
^WALKTIMELE
Description: How long did that walk take?/On average, how long did those walks take?

Instruction:
If WLKLEISDAY_A=1 AND WLKLEISTPD_A=1, fill: "How long did that walk take?"
elseif WLKLEISDAY_A=2-7 OR WLKLEISTPD_A=2-94, fill: "On
average, how long did those walks take?"
Response:
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who have walked for leisure at least once in the past 7 days
Skip Instructions:
1-995 [goto WLKLEISTP_A]
RF,DK [goto next section]
Question ID: WLK.0080.02.2
Variable: WLKLEISTP_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

* 2 of 2
* Enter time period for length of walking for fun, relaxation, or exercise.
Response:
1 - Minutes
2 - Hours
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who gave a number for amount of time walked for leisure in the past 7 days
Skip Instructions:
1,2 if ((WLKLEISLGT_A GT 119 and WLKLEISTP_A=1) or (WLKLEISLGT_A GT 1 and WLKLEISTP_A=2))
[goto ERR1_WLKLEISLGT_A], then [goto next section]
1,2 if (WLKLEISLGT_A GE 25 and WLKLEISTP_A=2)) [goto ERR2_WLKLEISLGT_A]
RF,DK[goto next section]
Hard Edit:
Check Text: ERR2_WLKLEISLGT_A
Check Description: Amount of time walking is over 24 hours on average
Check Text: {check ERR2_WLKLEISLGT_A}
Amount of time walking is more than 24 hours and is not allowed. Please correct.
Soft Edit:
Check Text: ERR1_WLKLEISLGT_A
Check Description: Amount of time walking is over 2 hours on average
Check Text: {signal ERR1_WLKLEISLGT_A}
Amount of time walking is unusually high. Please verify.

2022 National Health Interview Survey (NHIS) Questionnaire
CPA: Content of Care - Physical Activity
Question ID: CPA.0010.00.2
Variable: ADVACTIVE_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 12 months, has a doctor or other health professional ADVISED you to increase the
amount of physical activity or exercise you get?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
SLP: Sleep
Question ID: SLP.0010.01.2
Variable: SLPHOURS_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

On average, how many hours of sleep do you get in a 24-hour period?
* Enter hours in whole numbers, rounding 30 minutes (1/2 hour) or more UP to the next whole hour
and dropping 29 or fewer minutes.
* Enter 1 if the respondent reports less than 1 hour of sleep.
Response:
01-24 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-5 [goto ERR1_SLPHOURS_A]
6-24,RF,DK [goto SLPREST_A]
Soft Edit:
Check Text: ERR1_SLPHOURS_A
Check Description: Soft error for few sleep hours
Check Text: {signal ERR1_SLPHOURS_A}
Average number of hours of sleep is ^SLPHOURS. Please verify.
Question ID: SLP.0020.00.2
Variable: SLPREST_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 30 days, how often did you wake up feeling well-rested?
Would you say never, some days, most days, or every day?
Response:
1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto SLPFLL_A]
Question ID: SLP.0030.00.2
Variable: SLPFLL_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

During the past 30 days, how often did you have trouble falling asleep?
Would you say never, some days, most days, or every day?
Response:
1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto SLPSTY_A]
Question ID: SLP.0040.00.2
Variable: SLPSTY_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Read if necessary: During the past 30 days...
How often did you have trouble staying asleep?
Read if necessary: Would you say never, some days, most days, or every day?
* Include waking up too early.
Response:
1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto SLPMED_A]
Question ID: SLP.0050.00.2
Variable: SLPMED_A
Interview Module: Adult
Content Type: Rotating Core

Question text:

Read if necessary: During the past 30 days...
How often did you take any medication to help you fall asleep or stay asleep? Include both
prescribed and over-the-counter medications.
Read if necessary: Would you say never, some days, most days, or every day?
Response:
1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DNU: Diet and Nutrition
Question ID: DNU.0010.01.3
Variable: SODANO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
These questions are about the different kinds of foods you ate or drank during the past month,
that is, the past 30 days. When answering, please include meals and snacks eaten at home, at
work or school, in restaurants, and any place else.
During the past month, how often did you drink REGULAR SODA or pop that contains sugar? Do NOT
include diet soda. You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto FRJUICNO_A]
1-995 [goto SODATP_A]
Question ID: DNU.0010.02.3
Variable: SODATP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who drank soda in the past month
Skip Instructions:
1 if SODANO_A gt 10 [goto ERR1_SODATP_A]
else [goto FRJUICNO_A]
2 if SODANO_A gt 70 [goto ERR1_SODATP_A]
else [goto FRJUICNO_A]
3 if SODANO_A gt 310 [goto ERR1_SODATP_A]
else [goto FRJUICNO_A]
Soft Edit:
Check Text: ERR1_SODATP_A
Check Description: Drank soda time period - soft edit
Check Text: {signal ERR1_SODATP_A}
^SODANO_A times per ^SODATP_A is unusually high. Please verify.
Question ID: DNU.0020.01.3
Variable: FRJUICNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you drink 100% PURE fruit juice such as orange, mango, apple, grape and pineapple
juices? Do NOT include fruit flavored drinks with added sugar or fruit juice you made at home
and added sugar to.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto COFFEEN1_A]
1-995 [goto FRJUICTP_A]
Question ID: DNU.0020.02.3
Variable: FRJUICTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who drank pure fruit juice in the past month
Skip Instructions:
1 if FRJUICNO_A gt 10 [goto ERR1_FRJUICTP_A]
else [goto COFFEENO_A]
2 if FRJUICNO_A gt 70 [goto ERR1_FRJUICTP_A]
else [goto COFFEENO_A]
3 if FRJUICNO_A gt 310 [goto ERR1_FRJUICTP_A]
else [goto COFFEENO_A]
Soft Edit:
Check Text: ERR1_FRJUICTP_A
Check Description: Drank fruit juice time period - soft edit
Check Text: {signal ERR1_FRJUICTP_A}
^FRJUICNO_A times per ^FRJUICTP_A is unusually high. Please verify.
Question ID: DNU.0030.01.3
Variable: COFFEENO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you drink COFFEE or tea that had sugar or honey added to it? Include coffee and
tea you sweetened yourself and presweetened tea and coffee drinks such as Arizona Iced Tea® and
Frappuccino. Do not include artificially sweetened coffee or diet tea.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto SPORDRNO_A]
1-995 [goto COFFEENOTP_A]
Question ID: DNU.0030.02.3
Variable: COFFEENOTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who drank coffee or tea with sugar in the past month
Skip Instructions:
1 if COFFEENO_A gt 10 [goto ERR1_COFFEENOTP_A]
else [goto SPORDRNO_A]
2 if COFFEENOTP_A gt 70 [goto ERR1_COFFEENOTP_A]
else [goto SPORDRNO_A]
3 if COFFEENO_A gt 310 [goto ERR1_COFFEENOTP_A]
else [goto SPORDRNO_A]
Soft Edit:
Check Text: ERR1_COFFEENOTP_A
Check Description: Drank coffee or tea time period - soft edit
Check Text: {signal ERR1_COFFEENOTP_A}
^COFFEENO_A times per ^COFFEENOTP_A is unusually high. Please verify.
Question ID: DNU.0040.01.3
Variable: SPORDRNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you drink SPORTS and ENERGY drinks such as Gatorade®, Red Bull®, and Vitamin
water®?
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto FRTDRNO_A]
1-995 [goto SPORDRTP_A]
Question ID: DNU.0040.02.3
Variable: SPORDRTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who drank sport or energy drinks in the past month
Skip Instructions:
1 if SPORDRNO_A gt 10 [goto ERR1_SPORDRTP_A]
else [goto FRTDRNO_A]
2 if SPORDRNO_A gt 70 [goto ERR1_SPORDRTP_A]
else [goto FRTDRNO_A]
3 if SPORDRNO_A gt 310 [goto ERR1_SPORDRTP_A]
else [goto FRTDRNO_A]
Soft Edit:
Check Text: ERR1_SPORDRTP_A
Check Description: Drank sport or energy drinks time period - soft edit
Check Text: {signal ERR1_SPORDRTP_A}
^SPORDRNO_A times per ^SPORDRTP_A is unusually high. Please verify.
Question ID: DNU.0050.01.3
Variable: FRTDRNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you drink sweetened fruit drinks, such as Kool-aid®, cranberry and lemonade?
Include fruit drinks you made at home and added sugar to.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto FRUITNO_A]
1-995 [goto FRTDRTP_A]
Question ID: DNU.0050.02.3
Variable: FRTDRTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who drank sweetened fruit drinks in the past month
Skip Instructions:
1 if FRTDRNO_A gt 10 [goto ERR1_FRTDRTP_A]
else [goto FRUITNO_A]
2 if FRTDRNO_A gt 70 [goto ERR1_FRTDRTP_A]
else [goto FRUITNO_A]
3 if FRTDRNO_A gt 310 [goto ERR1_FRTDRTP_A]
else [goto FRUITNO_A]
Soft Edit:
Check Text: ERR1_FRTDRTP_A
Check Description: Drank sweetened fruit drinks time period - soft edit
Check Text: {signal ERR1_FRTDRTP_A}
^FRTDRNO_A times per ^FRTDRTP_A is unusually high. Please verify.
Question ID: DNU.0060.01.3
Variable: FRUITNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you eat FRUIT? Include fresh, frozen, or canned fruit. Do NOT include juices.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto SALADNO_A]
1-995 [goto FRUITTP_A]
Question ID: DNU.0060.02.3
Variable: FRUITTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate fruit in the past month
Skip Instructions:
1 if FRUITNO_A gt 10 [goto ERR1_FRUITTP_A]
else [goto SALADNO_A]
2 if FRUITNO_A gt 70 [goto ERR1_FRUITTP_A]
else [goto SALADNO_A]
3 if FRUITNO_A gt 310 [goto ERR1_FRUITTP_A]
else [goto SALADNO_A]
Soft Edit:
Check Text: ERR1_FRUITTP_A
Check Description: Eat fruit time period - soft edit
Check Text: {signal ERR1_FRUITTP_A}
^FRUITNO_A times per ^FRUITTP_A is unusually high. Please verify.
Question ID: DNU.0070.01.3
Variable: SALADNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you eat a green leafy or lettuce SALAD, with or without other vegetables?
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto FRIESNO_A]
1-995 [goto SALADTP_A]
Question ID: DNU.0070.02.3
Variable: SALADTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate salad in the past month
Skip Instructions:
1 if SALADNO_A gt 10 [goto ERR1_SALADTP_A]
else [goto FRIESNO_A]
2 if SALADNO_A gt 70 [goto ERR1_SALADTP_A]
else [goto FRIESNO_A]
3 if SALADNO_A gt 310 [goto ERR1_SALADTP_A]
else [goto FRIESNO_A]
Soft Edit:
Check Text: ERR1_SALADTP_A
Check Description: Eat salad time period - soft edit
Check Text: {signal ERR1_SALADTP_A}
^SALADNO_A times per ^SALADTP_A is unusually high. Please verify.
Question ID: DNU.0080.01.3
Variable: FRIESNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you eat any kind of FRIED POTATOES, including french fries, home fries, or hash
brown potatoes?
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto POTATONO_A]
1-995 [goto FRIESTP_A]
Question ID: DNU.0080.02.3
Variable: FRIESTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate fried potatoes in the past month
Skip Instructions:
1 if FRIESNO_A gt 10 [goto ERR1_FRIESTP_A]
else [goto POTATONO_A]
2 if FRIESNO_A gt 70 [goto ERR1_FRIESTP_A]
else [goto POTATONO_A]
3 if FRIESNO_A gt 310 [goto ERR1_FRIESTP_A]
else [goto POTATONO_A]
Soft Edit:
Check Text: ERR1_FRIESTP_A
Check Description: Eat fried potatoes time period - soft edit
Check Text: {signal ERR1_FRIESTP_A}
^FRIESNO_A times per ^FRIESTP_A is unusually high. Please verify.
Question ID: DNU.0090.01.3
Variable: POTATONO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you eat any OTHER KINDS OF POTATOES, such as baked, boiled, mashed potatoes, sweet
potatoes, or potato salad?
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto BEANSNO_A]
1-995 [goto POTATOTP_A]
Question ID: DNU.0090.02.3
Variable: POTATOTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate other kinds of potatoes in the past month
Skip Instructions:
1 if POTATONO_A gt 10 [goto ERR1_POTATOTP_A]
else [goto BEANSNO_A]
2 if POTATONO_A gt 70 [goto ERR1_POTATOTP_A]
else [goto BEANSNO_A]
3 if POTATONO_A gt 310 [goto ERR1_POTATOTP_A]
else [goto BEANSNO_A]
Soft Edit:
Check Text: ERR1_POTATOTP_A
Check Description: Eat other kinds of potatoes time period - soft edit
Check Text: {signal ERR1_POTATOTP_A}
^POTATONO_A times per ^POTATOTP_A is unusually high. Please verify.
Question ID: DNU.0100.01.3
Variable: BEANSNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you eat refried beans, baked beans, beans in soup, pork and beans or any other
type of cooked dried beans? Do NOT include green beans.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto OVEGNO_A]
1-995 [goto BEANSTP_A]
Question ID: DNU.0100.02.3
Variable: BEANSTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate beans in the past month
Skip Instructions:
1 if BEANSNO_A gt 10 [goto ERR1_BEANSTP_A]
else [goto OVEGNO_A]
2 if BEANSNO_A gt 70 [goto ERR1_BEANSTP_A]
else [goto OVEGNO_A]
3 if BEANSNO_A gt 310 [goto ERR1_BEANSTP_A]
else [goto OVEGNO_A]
Soft Edit:
Check Text: ERR1_BEANSTP_A
Check Description: Eat beans time period - soft edit
Check Text: {signal ERR1_BEANSTP_A}
^BEANSNO_A times per ^BEANSTP_A is unusually high. Please verify.
Question ID: DNU.0110.01.3
Variable: OVEGNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
^VEGEXCLUDE often did you eat OTHER VEGETABLES?
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Fills:
^VEGEXCLUDE
Description: How/Not including what you just told me about (lettuce salads, potatoes, cooked dried beans), how

Instruction:
If SALADNO_A=1-995 and (FRIESNO_A=1-995 or POTATONO_A=1- 995) and BEANSNO_A=1-995, fill: "Not including what you
just told me about lettuce salads, potatoes, and cooked
dried beans, how"
Elseif SALADNO_A=1-995 and (FRIESNO_A=1-995 or
POTATONO_A=1-995), fill: "Not including what you just told
me about lettuce salads and potatoes, how"
Elseif SALADNO_A=1-995 and BEANSNO_A=1-995, fill: "Not
including what you just told me about lettuce salads and
cooked dried beans, how"
Elseif (FRIESNO_A=1-995 or POTATONO_A=1-995) and
BEANSNO_A=1-995, fill: "Not including what you just told
me about potatoes and cooked dried beans, how"
Elseif SALADNO_A=1-995, fill: "Not including what you just
told me about lettuce salads, how"
Elseif FRIESNO_A=1-995 or POTATONO_A=1-995, fill: "Not
including what you just told me about potatoes, how"
Elseif BEANSNO_A=1-995, fill: "Not including what you just
told me about cooked dried beans, how"
Else, fill: "How"
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto SALSANO_A]
1-995 [goto OVEGTP_A]
Question ID: DNU.0110.02.3
Variable: OVEGTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate other vegetables in the past month
Skip Instructions:
1 if OVEGNO_A gt 10 [goto ERR1_OVEGTP_A]
else [goto SALSANO_A]
2 if OVEGNO_A gt 70 [goto ERR1_OVEGTP_A]
else [goto SALSANO_A]
3 if OVEGNO_A gt 310 [goto ERR1_OVEGTP_A]
else [goto SALSANO_A]
Soft Edit:
Check Text: ERR1_OVEGTP_A
Check Description: Eat other vegetables time period - soft edit
Check Text: {signal ERR1_OVEGTP_A}
^OVEGNO_A times per ^OVEGTP_A is unusually high. Please verify.
Question ID: DNU.0120.01.3
Variable: SALSANO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you have Mexican-type SALSA made with tomato?
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto PIZZANO_A]
1-995 [goto SALSATP_A]
Question ID: DNU.0120.02.3
Variable: SALSATP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate salsa in the past month
Skip Instructions:
1 if SALSANO_A gt 10 [goto ERR1_SALSATP_A]
else [goto PIZZANO_A]
2 if SALSANO_A gt 70 [goto ERR1_SALSATP_A]
else [goto PIZZANO_A]
3 if SALSANO_A gt 310 [goto ERR1_SALSATP_A]
else [goto PIZZANO_A]
Soft Edit:
Check Text: ERR1_SALSATP_A
Check Description: Eat salsa time period - soft edit
Check Text: {signal ERR1_SALSATP_A}
^SALSANO_A times per ^SALSATP_A is unusually high. Please verify.
Question ID: DNU.0130.01.3
Variable: PIZZANO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you eat PIZZA? Include frozen pizza, fast food pizza, and homemade pizza.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto TOMSAUNO_A]
1-995 [goto PIZZATP_A]
Question ID: DNU.0130.02.3
Variable: PIZZATP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate pizza in the past month
Skip Instructions:
1 if PIZZANO_A gt 10 [goto ERR1_PIZZATP_A]
else [goto TOMSAUNO_A]
2 if PIZZANO_A gt 70 [goto ERR1_PIZZATP_A]
else [goto TOMSAUNO_A]
3 if PIZZANO_A gt 310 [goto ERR1_PIZZATP_A]
else [goto TOMSAUNO_A]
Soft Edit:
Check Text: ERR1_PIZZATP_A
Check Description: Eat pizza time period - soft edit
Check Text: {signal ERR1_PIZZATP_A}
^PIZZANO_A times per ^PIZZATP_A is unusually high. Please verify.
Question ID: DNU.0140.01.3
Variable: TOMSAUNO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 1 of 2
* Read if necessary: During the past month...
How often did you have TOMATO SAUCES such as with spaghetti or noodles or mixed into foods such
as lasagna? Do NOT include tomato sauce on pizza.
* Read if necessary: You can tell me per day, per week, or per month.
* Enter '0' for never.
Response:
000 - Never
001-995 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
0,RF,DK [goto next section]
1-995 [goto TOMSAUTP_A]
Question ID: DNU.0140.02.3
Variable: TOMSAUTP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* 2 of 2
Enter time period.
Response:
0 - Never
1 - Day
2 - Week
3 - Month
7 - Refused
9 - Don't know
Universe:
Sample Adults 18+ who ate tomato sauce in the past month
Skip Instructions:
1 if TOMSAUNO_A gt 10 [goto ERR1_TOMSAUTP_A]
else [goto next section]
2 if TOMSAUNO_A gt 70 [goto ERR1_TOMSAUTP_A]
else [goto next section]
3 if TOMSAUNO_A gt 310 [goto ERR1_TOMSAUTP_A]
else [goto next section]
Soft Edit:
Check Text: ERR1_TOMSAUTP_A
Check Description: Eat tomato sauce time period - soft edit
Check Text: {signal ERR1_TOMSAUTP_A}
^TOMSAUNO_A times per ^TOMSAUTP_A is unusually high. Please verify.

2022 National Health Interview Survey (NHIS) Questionnaire
CIH: Complementary and Integrative Health
Question ID: CIH.0010.00.3
Variable: CHIRO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, have you seen or talked to a chiropractor about your own health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto CHIROPAIN_A]
2,RF,DK [goto ACU_A]
Question ID: CIH.0020.00.3
Variable: CHIROPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a chiropractor
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a chiropractor in the past 12 months
Skip Instructions:
1,2,RF,DK [goto CHIROHLTH_A]
Question ID: CIH.0030.00.3
Variable: CHIROHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you see a chiropractor
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a chiropractor in the past 12 months
Skip Instructions:
1,2,RF,DK [goto ACU_A]
Question ID: CIH.0040.00.3
Variable: ACU_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a practitioner of acupuncture?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto ACUPAIN_A]
2,RF,DK [goto MASS_A]
Question ID: CIH.0050.00.3
Variable: ACUPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a practitioner of acupuncture
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a practitioner of acupuncture in the past 12 months
Skip Instructions:
1,2,RF,DK [goto ACUHLTH_A]
Question ID: CIH.0060.00.3
Variable: ACUHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you see a practitioner of acupuncture
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a practitioner of acupuncture in the past 12 months
Skip Instructions:
1,2,RF,DK [goto MASS_A]
Question ID: CIH.0070.00.3
Variable: MASS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a practitioner of massage?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto MASSPAIN_A]
2,RF,DK [goto NATUR_A]
Question ID: CIH.0080.00.3
Variable: MASSPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a practitioner of massage
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a practitioner of massage in the past 12 months
Skip Instructions:
1,2,RF,DK [goto MASSHLTH_A]
Question ID: CIH.0090.00.3
Variable: MASSHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you see a practitioner of massage
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a practitioner of massage in the past 12 months
Skip Instructions:
1,2,RF,DK [goto NATUR_A]
Question ID: CIH.0100.00.3
Variable: NATUR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

A naturopath (NAY-cher-uh-path) is a licensed doctor who went to naturopathic medical school and
uses both standard medical tests as well as massage, acupuncture, exercise, nutritional
counseling, and natural therapies such as herbs. During the past 12 months, did you see a
practitioner of naturopathy (NAY-cher-AH-puh-thee)?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto NATURPAIN_A]
2,RF,DK [goto ARTTHPY_A]
Question ID: CIH.0110.00.3
Variable: NATURPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a naturopath (NAY-cher-uh-path)
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a naturopath in the past 12 months
Skip Instructions:
1,2,RF,DK [goto NATURHLTH_A]
Question ID: CIH.0120.00.3
Variable: NATURHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you see a naturopath (NAY-cher-uh-path)
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a naturopath in the past 12 months
Skip Instructions:
1,2,RF,DK [goto ARTTHPY_A]
Question ID: CIH.0130.00.3
Variable: ARTTHPY_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Art therapists work with patients to make artwork to help with emotions. During the past 12
months, did you see an art therapist?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto MUSICTHPY_A]
Question ID: CIH.0140.00.3
Variable: MUSICTHPY_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Music therapists use music with patients to promote healing and quality of life. During the past
12 months, did you see a music therapist?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto MEDITATE_A]
Question ID: CIH.0150.00.3
Variable: MEDITATE_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Meditation includes Mindfulness, Mantra, and Spiritual meditation. In meditation a person
focuses, stills, or quiets the mind. During the past 12 months, did you use any of these types
of meditation?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto MEDIPAIN_A]
2,RF,DK [goto GIPR_A]
Question ID: CIH.0160.00.3
Variable: MEDIPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you use meditation
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used meditation in the past 12 months
Skip Instructions:
1,2,RF,DK [goto MEDIHLTH_A]
Question ID: CIH.0170.00.3
Variable: MEDIHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you use meditation
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used meditation in the past 12 months
Skip Instructions:
1,2,RF,DK [goto GIPR_A]
Question ID: CIH.0180.00.3
Variable: GIPR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Guided imagery uses visualization to relax. Progressive relaxation uses tensing and relaxing
muscle groups. During the past 12 months, did you use guided imagery or progressive relaxation?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto GIPRPAIN_A]
2,RF,DK [goto YOGA_A]
Question ID: CIH.0190.00.3
Variable: GIPRPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you use guided imagery or progressive relaxation
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used guided imagery or progressive relaxation in the past 12 months
Skip Instructions:
1,2,RF,DK [goto GIPRHLTH_A]
Question ID: CIH.0200.00.3
Variable: GIPRHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you use guided imagery or progressive
relaxation
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used guided imagery or progressive relaxation in the past 12 months
Skip Instructions:
1,2,RF,DK [goto YOGA_A]
Question ID: CIH.0210.00.3
Variable: YOGA_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you practice Yoga as part of a class or on your own?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto YOGABRTH_A]
2,RF,DK [goto next section]
Question ID: CIH.0220.00.3
Variable: YOGABRTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Breathing exercises may involve actively controlling the way air is drawn in, or the rate or
depth of breathing. Did you do breathing exercises as part of Yoga?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used yoga in the past 12 months
Skip Instructions:
1,2,RF,DK [goto YOGAMED_A]
Question ID: CIH.0230.00.3
Variable: YOGAMED_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Did you do meditation as part of Yoga?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used yoga in the past 12 months
Skip Instructions:
1,2,RF,DK [goto YOGAPAIN_A]
Question ID: CIH.0240.00.3
Variable: YOGAPAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you use Yoga
...to treat or manage physical pain?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used yoga in the past 12 months
Skip Instructions:
1,2,RF,DK [goto YOGAHLTH_A]
Question ID: CIH.0250.00.3
Variable: YOGAHLTH_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

* Read if necessary: During the past 12 months, did you use Yoga
...to restore your overall health?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who used yoga in the past 12 months
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
VSL: Voice, Swallowing, Speech, and Language Communication Disorders
Question ID: VSL.0010.00.3
Variable: VSLVYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you have problems or difficulty with your VOICE, such as having a
hoarse, raspy, tired, or strained voice, or trouble speaking loud enough to be heard?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto VSLVDYS_A]
2,RF,DK [goto VSLSWYR_A]
Question ID: VSL.0020.00.3
Variable: VSLVDYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, about how many days, weeks, or months did you have problems or
difficulty with your voice?
* Do not read categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
Response:
1 - 1 to 6 days (?less than a week?)
2 - 7 to 13 days (?one week or more, but less than two weeks?)
3 - 14 to 29 days (?2 weeks or more, but less than a month?)
4 - 30 to 89 days (?a month or more, but less than 3 months?)
5 - 90 days to 179 days (?3 months or more, but less than 6 months?)
6 - 180 days or more (?6 months or more?)
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a voice problem in the past 12 months
Skip Instructions:
1-6,RF,DK [goto VSLVDIF_A]
Question ID: VSL.0030.00.3
Variable: VSLVDIF_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, how much difficulty did you have with your voice? Would you say a
little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a voice problem in the past 12 months
Skip Instructions:
1-3,RF,DK [goto VSLSWYR_A]
Question ID: VSL.0040.00.3
Variable: VSLSWYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you have problems or difficulty with SWALLOWING, such as having
difficulty eating solid food, taking pills, or drinking liquids?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto VSLSWDYS_A]
2,RF,DK [goto VSLSPYR_A]
Question ID: VSL.0050.00.3
Variable: VSLSWDYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, about how many days, weeks, or months did you have problems or
difficulty with swallowing?
* Do not read categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
Response:
1 - 1 to 6 days (?less than a week?)
2 - 7 to 13 days (?one week or more, but less than two weeks?)
3 - 14 to 29 days (?2 weeks or more, but less than a month?)
4 - 30 to 89 days (?a month or more, but less than 3 months?)
5 - 90 days to 179 days (?3 months or more, but less than 6 months?)
6 - 180 days or more (?6 months or more?)
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a swallowing problem in the past 12 months
Skip Instructions:
1-6,RF,DK [goto VSLSWDIF_A]
Question ID: VSL.0060.00.3
Variable: VSLSWDIF_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, how much difficulty did you have with swallowing? Would you say a
little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a swallowing problem in the past 12 months
Skip Instructions:
1-3,RF,DK [goto VSLSPYR_A]
Question ID: VSL.0070.00.3
Variable: VSLSPYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you have problems or difficulty with your SPEECH, such as
stuttering, repeating words, or not being able to pronounce words correctly?
* Read if necessary: This refers to the language you are most comfortable with, not a second or
third language.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto VSLSPDYS_A]
2,RF,DK [goto VSLLGYR_A]
Question ID: VSL.0080.00.3
Variable: VSLSPDYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, about how many days, weeks, or months did you have problems or
difficulty with your speech?
Do not read categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
Response:
1 - 1 to 6 days (?less than a week?)
2 - 7 to 13 days (?one week or more, but less than two weeks?)
3 - 14 to 29 days (?2 weeks or more, but less than a month?)
4 - 30 to 89 days (?a month or more, but less than 3 months?)
5 - 90 days to 179 days (?3 months or more, but less than 6 months?)
6 - 180 days or more (?6 months or more?)
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a speech problem in the past 12 months
Skip Instructions:
1-6,RF,DK [goto VSLSPDIF_A]
Question ID: VSL.0090.00.3
Variable: VSLSPDIF_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, how much difficulty did you have with your speech? Would you say a
little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a speech problem in the past 12 months
Skip Instructions:
1-3,RF,DK [goto VSLSPST_A]
Question ID: VSL.0100.00.3
Variable: VSLSPST_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did your speech problems or difficulty include stuttering, trouble
pronouncing words correctly, or both?
Response:
1 - Stuttering
2 - Trouble pronouncing words correctly
3 - Both
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a speech problem in the past 12 months
Skip Instructions:
1-3,RF,DK [goto VSLLGYR_A]
Question ID: VSL.0110.00.3
Variable: VSLLGYR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you have problems or difficulty with LANGUAGE, such as difficulty
using, learning, or understanding words, sentences, or conversational interactions?
* Read if necessary: This refers to the language you are most comfortable with, not a second or
third language.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto VSLLGDYS_A]
2,RF,DK if VSLVYR_A=1 or VSLSWYR_A=1 or VSLSPYR_A=1 [goto VSLBRAIN_A]
else [goto next section]
Question ID: VSL.0120.00.3
Variable: VSLLGDYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, about how many days, weeks, or months did you have problems or
difficulty with language?
* Do not read categories unless the respondent says they don't know, at which time you can read
the wording in parentheses.
Response:
1 - 1 to 6 days (?less than a week?)
2 - 7 to 13 days (?one week or more, but less than two weeks?)
3 - 14 to 29 days (?2 weeks or more, but less than a month?)
4 - 30 to 89 days (?a month or more, but less than 3 months?)
5 - 90 days to 179 days (?3 months or more, but less than 6 months?)
6 - 180 days or more (?6 months or more?)
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a language problem in the past 12 months
Skip Instructions:
1-6,RF,DK [goto VSLLGDIF_A]
Question ID: VSL.0130.00.3
Variable: VSLLGDIF_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, how much difficulty did you have with language? Would you say a
little, a lot, or somewhere in between?
Response:
1 - A little
2 - A lot
3 - Somewhere in between
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a language problem in the past 12 months
Skip Instructions:
1-3,RF,DK [goto VSLBRAIN_A]
Question ID: VSL.0140.00.3
Variable: VSLBRAIN_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Did any of your ^VSLTYPE_A problems or difficulty follow a head or brain injury or stroke?
Fills:
^VSLTYPE_A
Description: voice/swallowing/speech/language
Instruction:
If VSLVYR_A=1 and VSLSWYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill: "voice, swallowing, speech, and
language"
Elseif VSLSWYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill:
"swallowing, speech, and language"
Elseif VSLVYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill:
"voice, speech, and language"
Elseif VSLVYR_A=1 and VSLSWYR_A=1 and VSLLGYR_A=1, fill:
"voice, swallowing, and language"
Elseif VSLVYR_A=1 and VSLSWYR_A=1 and VSLSPYR_A=1, fill:
"voice, swallowing, and speech"
Elseif VSLVYR_A=1 and VSLSWYR_A=1, fill: "voice and
swallowing"
Elseif VSLVYR_A=1 and VSLSPYR_A=1, fill: "voice and
speech"
Elseif VSLVYR_A=1 and VSLLGYR_A=1, fill: "voice and
language"
Elseif VSLSWYR_A=1 and VSLSPYR_A=1, fill: "swallowing and
speech"
Elseif VSLSWYR_A=1 and VSLLGYR_A=1, fill: "swallowing and
language"
Elseif VSLSPYR_A=1 and VSLLGYR_A=1, fill: "speech and
language"
Elseif VSLVYR_A=1, fill: "voice"
Elseif VSLSWYR_A=1, fill: "swallowing"
Elseif VSLSPYR_A=1, fill: "speech"
Elseif VSLLGYR_A=1, fill: "language"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who had a voice, swallowing, speech, or language problem in the past 12 months
Skip Instructions:
1,2,RF,DK [goto VSLPA_A]
Question ID: VSL.0150.00.3
Variable: VSLPA_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did you see a speech-language pathologist, doctor, or other health
care professional for evaluation, treatment, or rehabilitation services of your ^VSLTYPE_A
problems or difficulty?
* Read if necessary: Health care professionals can include early intervention specialists, ENT
doctors, otolaryngologists, audiologists, rehabilitation specialists, occupational or physical
therapists, internal medicine doctors, neurologists, gerontologists, and others.
Fills:
^VSLTYPE_A
Description: voice/swallowing/speech/language
Instruction:
If VSLVYR_A=1 and VSLSWYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill: "voice, swallowing, speech, and
language"
Elseif VSLSWYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill:
"swallowing, speech, and language"
Elseif VSLVYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill:
"voice, speech, and language"
Elseif VSLVYR_A=1 and VSLSWYR_A=1 and VSLLGYR_A=1, fill:
"voice, swallowing, and language"
Elseif VSLVYR_A=1 and VSLSWYR_A=1 and VSLSPYR_A=1, fill:
"voice, swallowing, and speech"
Elseif VSLVYR_A=1 and VSLSWYR_A=1, fill: "voice and
swallowing"
Elseif VSLVYR_A=1 and VSLSPYR_A=1, fill: "voice and
speech"
Elseif VSLVYR_A=1 and VSLLGYR_A=1, fill: "voice and
language"
Elseif VSLSWYR_A=1 and VSLSPYR_A=1, fill: "swallowing and
speech"
Elseif VSLSWYR_A=1 and VSLLGYR_A=1, fill: "swallowing and
language"
Elseif VSLSPYR_A=1 and VSLLGYR_A=1, fill: "speech and
language"
Elseif VSLVYR_A=1, fill: "voice"
Elseif VSLSWYR_A=1, fill: "swallowing"
Elseif VSLSPYR_A=1, fill: "speech"
Elseif VSLLGYR_A=1, fill: "language"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
-
Universe:
Sample Adults 18+ who had a voice, swallowing, speech, or language problem in the past 12 months
Skip Instructions:
1 [goto VSLPALF_A]
2,RF,DK [goto VSLBTWR_A]
Question ID: VSL.0160.00.3
Variable: VSLPALF_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

How did those evaluation, treatment, or rehabilitation services affect your life as a whole? Has
your life improved greatly, improved somewhat, stayed the same, or gotten worse?
Response:
1 - Improved greatly
2 - Improved somewhat
3 - Stayed the same
4 - Gotten worse
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who saw a speech-language pathologist or doctor for treatment
Skip Instructions:
1-4,RF,DK [goto VSLBTWR_A]
Question ID: VSL.0170.00.3
Variable: VSLBTWR_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

During the past 12 months, did your problems or difficulty with ^VSLTYPE_A get a lot better, get
a little better, stay the same, get a little worse, or get a lot worse?
Fills:
^VSLTYPE_A
Description: voice/swallowing/speech/language
Instruction:
If VSLVYR_A=1 and VSLSWYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill: "voice, swallowing, speech, and
language"
Elseif VSLSWYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill:
"swallowing, speech, and language"
Elseif VSLVYR_A=1 and VSLSPYR_A=1 and VSLLGYR_A=1, fill:
"voice, speech, and language"
Elseif VSLVYR_A=1 and VSLSWYR_A=1 and VSLLGYR_A=1, fill:
"voice, swallowing, and language"
Elseif VSLVYR_A=1 and VSLSWYR_A=1 and VSLSPYR_A=1, fill:
"voice, swallowing, and speech"
Elseif VSLVYR_A=1 and VSLSWYR_A=1, fill: "voice and
swallowing"
Elseif VSLVYR_A=1 and VSLSPYR_A=1, fill: "voice and
speech"
Elseif VSLVYR_A=1 and VSLLGYR_A=1, fill: "voice and
language"
Elseif VSLSWYR_A=1 and VSLSPYR_A=1, fill: "swallowing and
speech"
Elseif VSLSWYR_A=1 and VSLLGYR_A=1, fill: "swallowing and
language"
Elseif VSLSPYR_A=1 and VSLLGYR_A=1, fill: "speech and
language"
Elseif VSLVYR_A=1, fill: "voice"
Elseif VSLSWYR_A=1, fill: "swallowing"
Elseif VSLSPYR_A=1, fill: "speech"
Elseif VSLLGYR_A=1, fill: "language"
Response:
1 - Get a lot better
2 - Get a little better
3 - Stay the same
4 - Get a little worse
5 - Get a lot worse
7 - Refused
9 - Don't Know
-
Universe:
Sample Adults 18+ who had a voice, swallowing, speech, or language problem in the past 12 months
Skip Instructions:
1-5,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ORN: Sexual Orientation
Question ID: ORN.0010.00.1
Variable: ORNINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Next we have some questions about your demographic characteristics, including sexual
orientation, gender identity, income, employment, and veteran status. Like all your answers,
these will be used to understand the health of different groups in the population and will be
kept confidential.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto ORIENT_A]
Question ID: ORN.0020.00.1
Variable: ORIENT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you think of yourself as ^gaylesbian; straight, that is, not ^gaylesbian; bisexual; something
else; or you don't know the answer?
Fills:
^gaylesbian
Description: Gay/Lesbian or gay
Instruction:
If SEX=1 fill "Gay"; else if SEX='2',RF,DK fill "Lesbian or gay"
Response:
1 - ^GayLesbian
2 - Straight, that is, not ^gaylesbian
3 - Bisexual
4 - Something else
5 - I don't know the answer
7 - Refused
Universe:
Sample Adults 18+
Skip Instructions:
1-5,RF [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
GNI: Gender Identity
Question ID: GNI.0010.01.4
Variable: ASAB1_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

What sex were you assigned at birth, on your original birth certificate?
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where GNIPATH_FLG is set to 1 or 3
Skip Instructions:
1,2,RF,DK if GNIPATH_FLG=1 [goto GENDER1_A]
elseif GNIPATH_FLG=3 [goto GENDER2_A]
Question ID: GNI.0020.01.4
Variable: GENDER1_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Do you currently describe yourself as a man, as a woman, or in some other way?
Response:
1 - Man
2 - Woman
3 - Some other way
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where GNIPATH_FLG is set to 1 or 2
Skip Instructions:
1,2 if GNIPATH_FLG=2 [goto ASAB2_A]
elseif GNIPATH_FLG=1 and ASAB1_A=1,2 and GENDER1_A ne ASAB1_A and GICHECK_FLG=empty [goto
GICHECK_A]
else [goto next section]
3 [goto GENDSPEC1_A]
RF,DK if GNIPATH_FLG=2 [goto ASAB2_A]
else [goto next section]
Question ID: GNI.0030.01.4
Variable: GENDSPEC1_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

How would you describe yourself?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who identify their gender in some other way
Skip Instructions:
allow 80,RF,DK if GNIPATH_FLG=2 [goto ASAB2_A]
elseif GNIPATH_FLG=1 and ASAB1_A=1,2 and ASAB1_A ne GENDER1_A and GICHECK_FLG=empty [goto
GICHECK_A]
else [goto next section]
Question ID: GNI.0040.01.4
Variable: GENDER2_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Do you currently describe yourself as male, female, or transgender?
Response:
1 - Male
2 - Female
3 - Transgender
4 - None of these
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where GNIPATH_FLG is set to 3 or 4
Skip Instructions:
1-3 if GNIPATH_FLG=4 [goto ASAB2_A]
elseif GNIPATH_FLG=3 and ASAB1_A=1,2 and ASAB1_A ne GENDER2_A and GICHECK_FLG=empty [goto
GICHECK_A]
else [goto next section]
4 [goto GENDSPEC2_A]
RF,DK if GIDPATH_FLG=4 [goto ASAB2_A]
else [goto next section]
Question ID: GNI.0050.01.4
Variable: GENDSPEC2_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

How would you describe yourself?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who answered that they identify their gender as none of the options
Skip Instructions:
allow 80,RF,DK if GNIPATH_FLG=4 [goto ASAB2_A]
elseif GNIPATH_FLG=3 and ASAB1_A=1,2 and ASAB1_A ne GENDER2_A and GICHECK_FLG=empty [goto
GICHECK_A]
else [goto next section]
Question ID: GNI.0060.01.4
Variable: ASAB2_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

What sex were you assigned at birth, on your original birth certificate?
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where GNIPATH_FLG is set to 2 or 4
Skip Instructions:
1,2 if (GNIPATH_FLG=2 and GENDER1_A=1-3 and ASAB2_A ne GENDER1_A) or (GNIPATH_FLG=4 and
GENDER2_A=1-4 and ASAB2_A ne GENDER2_A) and GICHECK_FLG=empty [goto GICHECK_A]
else [goto next section]
RF,DK [goto next section]
Question ID: GNI.0070.00.4
Variable: GICHECK_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Just to confirm, your sex assigned at birth is ^gender_A and ^genderID_A. Is that correct?
Fills:
^gender_A
Description: male/female
Instruction:
if ASAB1_A=1 or ASAB2_A=1, fill "male" elseif ASAB1_A=2 or ASAB2_A=2, fill "female"
^genderID_A
Description: gender SA describes themselves as
Instruction:
if GENDER1_A=1 fill "you describe yourself as a man" if GENDER2_A=1, fill "you describe yourself as male"
if GENDER1_A=2, fill "you describe yourself as a woman"
if GENDER2_A=2, fill "you describe yourself as female"
if GENDER1_A=3 and GENSPEC1_A=response, fill "you describe
yourself as ^gendspec1_A"
if GENDER1_A=3 and GENSPEC1_A=DK, fill "when asked if you
described yourself as a man, woman, or in some other way,
you said don't know"
if GENDER1_A=3 and GENSPEC1_A=RF, fill "when asked if you
described yourself as a man, woman, or in some other way,
you didn't wish to tell us"
if GENDER2_A=3, fill "you describe yourself as
transgender"
if GENDER2_A=4 and GENSPEC2_A=response, fill "you describe
yourself as ^gendspec2_A"
if GENDER2_A=4 and GENSPEC2_A=DK, fill "when asked if you
described yourself as male, female, or transgender, you
said don't know"
if GENDER2_A=4 and GENSPEC2_A=RF, fill "when asked if you
described yourself as male, female, or transgender, you
didn't wish to tell us"
^gendspec1_A
Description: {value of GENDSPEC1_A}
Instruction:
fill value from GENDSPEC1_A
^gendspec2_A
Description: {value of GENDSPEC2_A}
Instruction:
fill value from GENDSPEC2_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where this is the first time through the gender identity block and a valid response was provided for sex and gender identity but they do not match
Skip Instructions:
1,RF,DK [goto next section]
2 if GICHECK_FLG=empty and GNIPATH_FLG=1,3 [goto ASAB1_A]
elseif GICHECK_FLG=empty and GNIPATH_FLG=2 [goto GENDER1_A]
elseif GICHECK_FLG=empty and GNIPATH_FLG=4 [goto GENDER2_A]

2022 National Health Interview Survey (NHIS) Questionnaire
MAR: Marital Status
Question ID: MAR.0010.00.1
Variable: MARITAL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

The next questions are about marriage and cohabitation. Are you now married, living with a
partner together as an unmarried couple, or neither?
* If respondent answers both married and living with a different partner together as an
unmarried couple, enter living with partner.
Response:
1 - Married
2 - Living with a partner together as an unmarried couple
3 - Neither
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and the Child PAR section has not been completed for the Sample Adult or the Child PAR section has been completed for the Sample Adult and the Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto SPOUSLIV_A]
2 if GEN.PCNT16PLUS=1 [got ERR1_MARITAL_A] else [goto PARTNERWHO_A]
3,RF,DK [goto EVRMARRIED_A]
Soft Edit:
Check Text: ERR1_MARITAL_A
Check Description: One person eligible to be living with a partner in household soft edit
Check Text: {signal ERR1_MARITAL_A}
Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.
Question ID: MAR.0020.00.1
Variable: SPOUSLIV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does your spouse live here?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are married
Skip Instructions:
1 if GEN.PCNT16PLUS=1 [goto ERR1_SPOUSLIV_C] else [goto SPOUSWHO_A]
2 [goto SPOUSEP_A]
RF,DK [goto next section]
Soft Edit:
Check Text: ERR1_SPOUSLIV_C
Check Description: Only one person eligible to be married in household soft edit
Check Text: {signal ERR1_SPOUSLIV_C}
Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.
Question ID: MAR.0030.00.1
Variable: SPOUSWHO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Which person is your spouse?
* Enter line number of spouse.
* Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.
Response:
00 - Not on roster
01-25 - Person Number
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with spouse in household
Skip Instructions:
0-25 [goto SPOUSSEX_A]
RF,DK [goto next section]
Question ID: MAR.0040.00.1
Variable: SPOUSSEX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

I previously recorded ^SPOUSENAME's ^spousesex. Is this correct?
Fills:
^SPOUSENAME
Description: Name of spouse
Instruction:
Fill name of spouse selected at SPOUSWHO_A
^spousesex
Description: sex is male/sex is female/sex was not provided
Instruction:
if GEN.SEX_FINAL[person selected at SPOUSWHO_A]=1, fill "sex is male"
if GEN.SEX_FINAL[person selected at SPOUSWHO_A]=2, fill
"sex is female"
if GEN.SEX_FINAL[person selected at SPOUSWHO_A] IN
(DK,RF), fill "sex was not provided"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with spouse in household who entered a line number for their spouse
Skip Instructions:
1,RF,DK [goto next section]
2 [goto SPOUNEWSEX_A]
Question ID: MAR.0050.00.1
Variable: SPOUNEWSEX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Is ^SPOUSENAME male or female?
Fills:
^SPOUSENAME
Description: Name of spouse
Instruction:
Fill name of spouse selected at SPOUSWHO_A
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with spouse with incorrect sex
Skip Instructions:
1,2,RF,DK [goto next section]
Question ID: MAR.0060.00.1
Variable: SPOUSEP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does your spouse not live here because you and your spouse are legally separated?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ whose spouse does not live in the household
Skip Instructions:
1,2,RF,DK [goto next section]
Question ID: MAR.0070.00.1
Variable: PARTNERWHO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Which person is your partner?
* Enter line number of partner.
* Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.
Response:
00 - Not on roster
01-25 - Person Number
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who are living with unmarried partner in household
Skip Instructions:
0-25 [goto PARTNERSEX_A]
RF,DK [goto EVRMARRIED_A]
Question ID: MAR.0080.00.1
Variable: PARTNERSEX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

I previously recorded ^PARTNERNAME's ^partnersex. Is this correct?
Fills:
^PARTNERNAME
Description: Name of partner
Instruction:
Fill name of partner selected at PARTNERWHO_A
^partnersex
Description: sex is male/sex is female/sex was not provided
Instruction:
if GEN.SEX_FINAL[person selected at PARTNERWHO_A]=1, fill "sex is male"
if GEN.SEX_FINAL[person selected at PARTNERWHO_A]=2, fill
"sex is female"
if GEN.SEX_FINAL[person selected at PARTNERWHO_A] IN
(DK,RF), fill "sex was not provided"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with partner in household who entered a line number for their partner
Skip Instructions:
1,RF,DK [goto EVRMARRIED_A]
2 [goto PARTNEWSEX_A]
Question ID: MAR.0090.00.1
Variable: PARTNEWSEX_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Is ^PARTNERNAME male or female?
Fills:
^PARTNERNAME
Description: Name of partner
Instruction:
Fill name of partner selected at PARTNERWHO_A
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with partner with incorrect sex
Skip Instructions:
1,2,RF,DK [goto EVRMARRIED_A]
Question ID: MAR.0100.00.1
Variable: EVRMARRIED_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you ever been married?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are living with unmarried partner or who are not married or living with an unmarried partner or refused or don't know
Skip Instructions:
1 if MARITAL_A=2 [goto LEGALSTAT_A]
elseif MARITAL_A=3 [goto WIDIVSEP_A]
else [goto next section]
2,RF,DK [goto next section]
Question ID: MAR.0110.00.1
Variable: LEGALSTAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What is your current legal marital status? Are you married, widowed, divorced, or separated?
Response:
1 - Married
2 - Widowed
3 - Divorced
4 - Separated
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are living with a partner but have been married
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: MAR.0120.00.1
Variable: WIDIVSEP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you widowed, divorced, or separated?
Response:
1 - Widowed
2 - Divorced
3 - Separated
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who are neither living with a partner nor married, but have been married
Skip Instructions:
1-3,RF,DK [goto FINISH_MAR_A]
Question ID: MAR.0130.00.1
Variable: FINISH_MAR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* The Sample Adult MAR section is now complete.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ and the Child PAR section has not been completed for the Sample Adult or the Child PAR section has been completed for the Sample Adult and the Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
VET: Veterans Status
Question ID: VET.0010.00.1
Variable: AFVET_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Did you ever serve on active duty in the U.S. Armed Forces, military Reserves, or National
Guard?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto AFVETTRN_A]
2,RF,DK [goto next section]
Question ID: VET.0020.00.1
Variable: AFVETTRN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Were you on active duty ONLY for training in the Reserves or National Guard?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have ever served in the armed forces
Skip Instructions:
1 [goto VADISB_A]
2,RF,DK [goto COMBAT_A]
Question ID: VET.0030.00.1
Variable: COMBAT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Did you ever serve in a foreign country during a time of armed conflict or on a humanitarian or
peace-keeping mission?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have ever served in the armed forces and who were not only activated for training in the Reserves or National Guard
Skip Instructions:
1,2,RF,DK [goto VADISB_A]
Question ID: VET.0040.00.1
Variable: VADISB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have a VA service-connected disability rating?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have ever served in the armed forces
Skip Instructions:
1,2,RF,DK [goto VAHOSP_A]
Question ID: VET.0050.00.1
Variable: VAHOSP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, did you receive any care at a Veteran's Health Administration
facility or receive any other health care paid for by the VA?
* Read if necessary: Veteran's Health Administration facilities include VA hospitals, VA medical
centers, VA outpatient clinics, and VA nursing homes.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have ever served in the armed forces
Skip Instructions:
1 [goto next section]
2,RF,DK if 1 IN Adult.INS.MILSPC_A [goto next section]
else [goto VACAREEV]
Question ID: VET.0060.00.1
Variable: VACAREEV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Have you ever enrolled in or used VA health care?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have ever served in the armed forces and did not receive care at a VHA facility or other health care paid for by the VA in the past 12 months and did not report VA health care when asked about insurance
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
NAT: Nativity
Question ID: NAT.0010.00.1
Variable: NATUSBORN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^Askverify_A Were you born in the United States or a U.S. territory?
Fills:
^Askverify_A
Description: FR Instruction
Instruction:
If GEN.SARESPSC_FLG=1, fill "* Ask or verify:"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto NATSTBORN_A]
2 [goto NATUSYR_A]
RF,DK [goto next section]
Question ID: NAT.0020.00.1
Variable: NATSTBORN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In what state or U.S. territory were you born?
Response:
AL - Alabama
AK - Alaska
AZ - Arizona
AR - Arkansas
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
DC - District of Columbia
FL - Florida
GA - Georgia
GU - Guam
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
- NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
VI - U.S. Virgin Islands
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
AS - American Samoa
MP - Northern Mariana Islands
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ born in the United States or U.S. territory
Skip Instructions:
American Samoa [goto CITIZEN_A]
else [goto next section]
Question ID: NAT.0040.00.1
Variable: NATUSYR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In what year did you come to the United States to stay?
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
Sample Adults 18+ not born in the United States or U.S. territory
Skip Instructions:
1900-Current Year,RF,DK if NATUSYR_A is a future year [goto ERR1_NATUSYR_A]
if NATUSYR_A lt VFY.BYEAR_A [goto ERR2_NATUSYR_A]
else [goto CITIZEN_A]
Hard Edit:
Check Text: ERR2_NATUSYR_A
Check Description: Year prior to birth hard edit
Check Text: {check ERR2_NATUSYR_A}
Year is prior to date of birth. Please correct.

Check Text: ERR1_NATUSYR_A
Check Description: Future year hard edit
Check Text: {check ERR1_NATUSYR_A} Future year invalid. Please correct.
Question ID: NAT.0050.00.1
Variable: CITIZEN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you a citizen of the United States?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ not born in the United States or U.S. territory or born in American Samoa
Skip Instructions:
1 [goto NATCTZN_A]
2,RF,DK [goto next section]
Question ID: NAT.0060.00.1
Variable: NATCTZN_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Were you born abroad to an American parent, born abroad and adopted by an American parent, or
did you become a U.S. citizen by naturalization?
Response:
1 - Born abroad to American parent
2 - Born abroad and adopted by an American parent
3 - Became U.S. citizen by naturalization
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ not born in the United States or a United States territory or born in the U.S. territory of American Samoa but are U.S. citizens
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
SCH: Schooling
Question ID: SCH.0010.00.1
Variable: SCHCURENR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Are you currently enrolled in or attending school?
* Read if necessary: School includes high school, college, trade school, and professional
school. Students may be enrolled part-time or full-time.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SCHDYSMSS_A]
2,RF,DK [goto next section]
Question ID: SCH.0020.00.1
Variable: SCHDYSMSS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, about how many days of school did you miss because you had an
illness, injury, or disability?
Response:
000-365 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who are currently enrolled in school
Skip Instructions:
0-99,RF,DK [goto next section]
100-365 [goto ERR1_SCHDYSMSS_A]
Soft Edit:
Check Text: ERR1_SCHDYSMSS_A
Check Description: Missed 100-365 days
Check Text: {signal ERR1_SCHDYSMSS_A}^SCHDYSMSS_A is an unusually large number. Did you miss ^SCHDYSMSS_A days of school because of illness, injury, or disability? Please verify.

2022 National Health Interview Survey (NHIS) Questionnaire
EMP: Employment
Question ID: EMP.0010.00.1
Variable: EMPLASTWK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

LAST WEEK, did you work for pay at a job or business?
* If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business,
enter '1' for yes.
Fills:
^heshetheywork
Description: he works/she works/they work
Instruction:
elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL IN (RF,DK) fill "they work"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto EMPHOURS_A]
2 [goto EMPNOWRK_A]
RF,DK [goto next section]
Question ID: EMP.0020.00.1
Variable: EMPNOWRK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Did you have a job or business LAST WEEK, but were temporarily absent due to illness, vacation,
family or maternity leave, or some other reason?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were not working for pay at a job or business last week
Skip Instructions:
1 [goto EMPHOURS_A]
2 [goto EMPWHYNOT_A]
RF,DK [goto next section]
Question ID: EMP.0030.00.1
Variable: EMPWHYNOT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

What is the MAIN reason you were not working for pay at a job or business last week?
* Probe if necessary.
Response:
01 - Unemployed, laid off, looking for work
02 - Seasonal/contract work
03 - Retired
04 - Unable to work for health reasons/disabled
05 - Taking care of house or family
06 - Going to school
07 - Working at a family-owned job or business not for pay
08 - Other
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ who were not working for pay and were not on temporary leave from a job or business last week
Skip Instructions:
1-6,8,RF,DK [goto EMPWHENWRK_A]
7 [goto EMPHOURS_A]
Question ID: EMP.0040.00.1
Variable: EMPWHENWRK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

When was the last time you worked for pay at a job or business, even if only for a few days?
Response:
1 - Within the past 12 months
2 - 1-5 years ago
3 - Over 5 years ago
4 - Never worked
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ whose main reason for not working last week was because they couldn't find work, did seasonal or contract work, were retired, unable to work for health reasons, taking care of the house/family, going to school, or some other reason, or refused or don't know
Skip Instructions:
1 if EMPWHYNOT_A=2 [goto EMPHOURS_A]
else [goto EMPSICKLV_A]
2-4,RF,DK [goto next section]
Question ID: EMP.0050.00.1
Variable: EMPHOURS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^Whenwork many hours do you USUALLY work in total at ALL jobs or businesses?
Fills:
^Whenwork
Description: When you are doing your seasonal or contract work, how/How
Instruction:
If EMPWHYNOT_A=2 fill "When you are doing your seasonal or contract work, how"
else fill "How"
Response:
001-168 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week, or worked but not for pay at a family business or had seasonal/contract work in the past 12 months
Skip Instructions:
1-94 [goto EMPSICKLV_A]
95-168 [goto ERR1_EMPHOURS_A], then [goto EMPSICKLV_A]
RF,DK [goto EMPFULLTIM_A]
Soft Edit:
Check Text: ERR1_EMPHOURS_A
Check Description: Hours worked last week/usually work per week unusually high
Check Text: {signal ERR1_EMPHOURS_A}
^EMPHOURS_A hours is unusually high. Please verify. Make corrections if necessary.
Question ID: EMP.0060.00.1
Variable: EMPFULLTIM_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^WhenworkDo you USUALLY work 35 hours or more per week in total at ALL jobs or businesses?
Fills:
^WhenworkDo
Description: When you are doing your seasonal or contract work, do/Do
Instruction:
If EMPWHYNOT_A=2 fill: "When you are doing your seasonal or contract work, do"
else "Do"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who refused or didn't know how many hours they usually work
Skip Instructions:
1,2,RF,DK [goto EMPSICKLV_A]
Question ID: EMP.0070.00.1
Variable: EMPSICKLV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^LASTJOB paid sick leave available if you ^workneed it?
Fills:
^LASTJOB
Description: When you last worked, was/Regarding your job or business, is

Instruction:
If EMPWHENWRK_A=1 and EMPWHYNOT_A ne 2 fill: "When you last worked, was"
else fill: "Regarding your job or business, is"
^workneed
Description: needed/need
Instruction:
If EMPWHENWRK_A=1 and EMPWHYNOT_A IN (1,3,4,5,6,8), fill: "needed";
else fill: "need"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week; who work, but not for pay at family business or who are not currently working but who had some period of employment in the past 12 months
Skip Instructions:
1,2,RF,DK [goto EMPHEALINS_A]
Question ID: EMP.0080.00.1
Variable: EMPHEALINS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^LASTJOB health insurance offered to you through your workplace?
Fills:
^LASTJOB
Description: When you last worked, was/Regarding your job or business, is

Instruction:
If EMPWHENWRK_A=1 and EMPWHYNOT_A ne 2 fill: "When you last worked, was"
else fill: "Regarding your job or business, is"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week; who work, but not for pay at family business or who are not currently working but who had some period of employment in the past 12 months
Skip Instructions:
1,2,RF,DK [goto EMPDAYMISS_A]
Question ID: EMP.0090.00.1
Variable: EMPDAYMISS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

During the past 12 months, about how many days of work did you miss because you had an illness,
injury, or disability?
* Read if necessary: Do not include family or ^paternitymaternity leave.
Fills:
^paternitymaternity
Description: paternity/maternity/maternity or paternity
Instruction:
If GEN.SEX_FINAL=1 fill "paternity" else if GEN.SEX_FINAL=2 fill "maternity"
else if GEN.SEX_FINAL=RF,DK fill "maternity or paternity"
Response:
000-365 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week; who work, but not for pay at family business or who are not currently working but who had some period of employment in the past 12 months
Skip Instructions:
0-99,RF,DK [goto next section]
100-365 [goto ERR1_EMPDAYMISS_A] then [goto next section]
Soft Edit:
Check Text: ERR1_EMPDAYMISS_A
Check Description: Days of work missed in the past 12 months unusually high
Check Text: {signal ERR1_EMPDAYMISS_A}
^EMPDAYMISS_A days is unusually high. Please verify. Make corrections if necessary.

2022 National Health Interview Survey (NHIS) Questionnaire
VOL: Volunteer Activities
Question ID: VOL.0010.00.4
Variable: CEVOLUN1_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

During the past 12 months, did you spend any time volunteering for any organization or
association?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,RF [goto next section]
2,DK [goto CEVOLUN2_A]
Question ID: VOL.0020.00.4
Variable: CEVOLUN2_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Some people don't think of activities they do infrequently or for children's schools or youth
organizations as volunteer activities. During the past 12 months, have you done any of these
types of activities?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who did not spend time volunteering in the past 12 months or don't know
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
FEM: Employment of family members
Question ID: FEM.0010.00.1
Variable: FEMINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Now I'm going to ask you about some of the other members of your family.
Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
If Sample Adult lives in a family with at least one other adult AND (Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FEM section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FEM section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1[goto tblFEM_A]
Replicate To: FEMINTRO_C
Question ID: FEM.0030.00.1
Variable: FEMWORK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does ^ALIASNAME work for pay at a job or business?
* If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business,
enter '1' for yes.
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^heshetheywork
Description: he works/she works/they work
Instruction:
elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL IN (RF,DK) fill "they work"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
If Sample Adult lives in a family with at least one other adult AND (Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FEM section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FEM section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1 [goto FEMWKFT_A]
2,RF,DK if there is another adult in the family [goto FEMWORK_A] for the next adult 18+
else [goto next section]
Replicate To: FEMWORK_C
Question ID: FEM.0040.00.1
Variable: FEMWKFT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Does ^ALIASNAME usually work 35 hours or more per week in total at ^hishertheir job or jobs?
Fills:
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
^hishertheir
Description: his/her/their
Instruction:
If GEN.SEX_FINAL=1 fill "his"; else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
If Sample Adult lives in a family with at least one other adult AND (Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FEM section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FEM section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1,2,RF,DK if another adult in the family [goto FEMWORK_A] for the next adult 18+
else [goto next section]
Replicate To: FEMWKFT_C

2022 National Health Interview Survey (NHIS) Questionnaire
INC: Family Income
Question ID: INC.0010.00.1
Variable: INCINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

The next questions are about your total ^FAMILY income in ^LASTYEAR BEFORE TAXES. ^INCSAFAM
* Read if necessary: Income is important in analyzing the health information we collect. For
example, with this information, we can learn whether persons in one income group use certain
types of medical services more or less often than those in another group. Please be assured
that, like all other information you have provided, these answers will remain confidential.
* Enter '1' to continue.
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^INCSAFAM
Description: Based on questions asked earlier we have that your family consists of ^SAFAM.

Instruction:
If more than one person in the Sample Adult's family, fill "Based on questions asked earlier we have that your family
consists of ^SAFAM."
else no fill
^SAFAM
Description: List of people in SA's family
Instruction:
For all people with FAMILYA_FLG =1 and are not Household Respondent, fill with their names.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
Include Sample Adult in this list.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto INCWRKO_A]
Replicate To: INCINTRO_C
Question ID: INC.0020.00.1
Variable: INCWRKO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In ^LASTYEAR, did ^YOUFAM18YRS receive income from wages, salaries, commissions, bonuses, tips,
or self-employment?
^INCSAFAMoptional
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAM18YRS
Description: you/you or any family members 18 or older
Instruction:
If PCNT18UP_A=1 fill "you" else if PCNT18UP_A GT 1 fill "you or any family members 18
or older"
^INCSAFAMoptional
Description: Read if necessary: For the purpose of this survey, your family includes ^FAMVERSA_fill

Instruction:
If more than one person in the Sample Adult's family, fill "* Read if necessary: For the purpose of this survey, your
family includes ^FAMVERSA_fill."
else no fill
^FAMVERSA_fill
Description: List of all people in Sample Adult's family
Instruction:
Loop through all persons on roster and add to list of names if:
-people related via REL (FAMA_REL_FLG = 1) or
-people who are related to the SA (RELATE = 1-13) or
-people in SC's family and the 1st person in HH in SC's
family are related to the SA (RELATE = 1-13)
Do not include Sample Adult on list.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
If only one person on the list of names and person ne
Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on
list and person is Household Respondent
(Roster.HHC.HHRESPAVAIL), follow list with "are".
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1,2,RF,DK [goto INCINTER_A]
Replicate To: INCWRKO_C
Question ID: INC.0030.00.1
Variable: INCINTER_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In ^LASTYEAR, did ^YOUFAMHERE receive income from interest-bearing accounts or investments,
dividends from stocks or mutual funds, net rental income, royalty income, or income from estates
and trusts?
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAMHERE
Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1,2,DK [goto INCSSRR_A]
RF if INCWRKO_A IN (1,2,DK) [goto INCSSRR_A]
else [goto next section]
Replicate To: INCINTER_C
Question ID: INC.0040.00.1
Variable: INCSSRR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Income from Social Security or Railroad Retirement?
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAMHERE
Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions
Skip Instructions:
1,2,RF,DK [goto INCSSISSDI_A]
Replicate To: INCSSRR_C
Question ID: INC.0050.00.1
Variable: INCSSISSDI_A
Interview Module: Adult
Content Type: Annual Core

Question text:

*Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Supplemental Security Income, SSI, or Social Security Disability Income, SSDI, which are
different from Social Security?
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAMHERE
Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions
Skip Instructions:
1 [goto SSISSDIBTH_A]
2,RF,DK [goto INCWELF_A]
Replicate To: INCSSISSDI_C
Question ID: INC.0060.00.1
Variable: SSISSDIBTH_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was this Supplemental Security Income, SSI, Social Security Disability Income, SSDI, or both?
Response:
1 - SSI
2 - SSDI
3 - Both SSI and SSDI
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where someone in the family gets SSI or SSDI and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1-3,RF,DK [goto SSISSDIDSB_A]
Replicate To: SSISSDIBTH_C
Question ID: INC.0070.00.1
Variable: SSISSDIDSB_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was this received as a disability benefit?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+ where someone in the family gets SSI or SSDI and Sample Child and Sample Adult are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 if GEN.PCNT_A gt 1 [goto SSISSDIP_A]
elseif GEN.PCNT_A=1 [goto INCWELF_A]
2,RF,DK [goto INCWELF_A]
Replicate To: SSISSDIDSB_C
Question ID: INC.0090.00.1
Variable: SSISSDIP_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In ^LASTYEAR, who received this disability benefit?
* Read if necessary: Do NOT include a benefit received on behalf of someone else.
* Enter all that apply, separate with commas.
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
Response:
00 - Not on roster
01-25 - Person Number
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+ with more than one person in the family where someone in the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1-25,RF,DK [goto INCWELF_A]
Replicate To: SSISSDIP_C
Question ID: INC.0100.00.1
Variable: INCWELF_A
Interview Module: Adult
Content Type: Annual Core

Question text:

In ^LASTYEAR, did ^YOUFAMHERE receive...
Any public assistance or welfare payments from the state or local welfare office?
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAMHERE
Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions
Skip Instructions:
1,2,RF,DK [goto INCRETIRE_A]
Replicate To: INCWELF_C
Question ID: INC.0110.00.1
Variable: INCRETIRE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Income from retirement, survivor, or disability pensions?
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAMHERE
Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions
Skip Instructions:
1,2,RF,DK [goto INCOTHR_A]
Replicate To: INCRETIRE_C
Question ID: INC.0120.00.1
Variable: INCOTHR_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Any other sources of income such as VA payments from the Veterans Benefits Administration,
unemployment compensation, child support, or alimony?
Fills:
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
^YOUFAMHERE
Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions
Skip Instructions:
1,2,RF,DK [goto INCTOTAL_A]
Replicate To: INCOTHR_C
Question ID: INC.0130.00.1
Variable: INCTOTAL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^INCALLFAM
What is your best estimate of ^TOTALINCOME from all sources, before taxes, in ^LASTYEAR?
* Enter '999995' if the reported income $999,995 or greater.
Fills:
^INCALLFAM
Description: INCTOTAL_A Introduction
Instruction:
IF PCNT_A GT 1 fill "When answering this next question, please remember to include your income PLUS the income of
all family members living in this household."
^TOTALINCOME
Description: your total income/the total income of all family members
Instruction:
If PCNT_A=1 fill "your total income" else if PCNT_A GT 1 fill "the total income of all family members"
^LASTYEAR
Description: Last year
Instruction:
Fill year prior to current year
Response:
000000-999995 - Range of values
999997 - Refused
999999 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions
Skip Instructions:
0-999 [goto ERR1_INCTOTAL_A]
250001-999995 [goto ERR2_INCTOTAL_A]
1000-250000 [goto next section]
RF,DK [goto INC250PCT_A]
Soft Edit:
Check Text: ERR1_INCTOTAL_A
Check Description: Income low soft edit
Check Text: {signal ERR1_INCTOTAL_A} Do not read to the respondent. ^INCTOTAL_A is unusually low. Make corrections if necessary.

Check Text: ERR2_INCTOTAL_A
Check Description: Income high soft edit
Check Text: {signal ERR2_INCTOTAL_A} Do not read to the respondent. ^INCTOTAL_A is unusually high. Make corrections if necessary. Replicate To: INCTOTAL_C
Question ID: INC.0150.01.1
Variable: INC250PCT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than ^250POVERTY_A or ^250POVERTY_A or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
^250POVERTY_A
Description: 250% of poverty threshold
Instruction:
Fill value stored in Adult.INC.INC250FILL_A
Response:
1 - Less than ^250POVERTY_A
2 - ^250POVERTY_A or more
7 - Refused
9 - Don't Know
Universe:
Sample Adult 18+ who don't know or refuse the total family income and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto INC138PCT_A]
2 if GEN.PCNT_A=1 or (GEN.PCNT_A=2 and GEN.PCNT66UP_A ge 1) [goto INC75K_A]
elseif ((GEN.PCNT_A=2 and GEN.PCNT66UP_A=0) or GEN.PCNT_A IN (3,5)) [goto INC100K_A]
elseif GEN.PCNT_A=4 or GEN.PCNT_A ge 6 [goto INC400PCT_A]
RF,DK [goto next section]
Replicate To: INC250PCT_C
Question ID: INC.0160.01.1
Variable: INC138PCT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than ^138POVERTY_A or ^138POVERTY_A or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
^138POVERTY_A
Description: 138% of poverty threshold
Instruction:
Fill value stored in Adult.INC.INC138FILL_A
Response:
1 - Less than ^138POVERTY_A
2 - ^138POVERTY_A or more
7 - Refused
9 - Don't Know
Universe:
Sample Adult 18+ answered less than 250% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto INC100PCT_A]
2 [goto INC200PCT_A]
RF,DK [goto next section]
Replicate To: INC138PCT_C
Question ID: INC.0170.01.1
Variable: INC100PCT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than ^100POVERTY_A or ^100POVERTY_A or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
^100POVERTY_A
Description: 100% of poverty threshold
Instruction:
Fill value stored in Adult.INC.INC100FILL_A
Response:
1 - Less than ^100POVERTY_A
2 - ^100POVERTY_A or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who answered less than 138% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1,2,RF,DK [goto next section]
Replicate To: INC100PCT_C
Question ID: INC.0180.01.1
Variable: INC200PCT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than ^200POVERTY_A or ^200POVERTY_A or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
^200POVERTY_A
Description: 200% of poverty threshold
Instruction:
Fill value stored in Adult.INC.INC200FILL_A
Response:
1 - Less than ^200POVERTY_A
2 - ^200POVERTY_A or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who answered 138% of poverty or more and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 if GEN.PCNT_A=9+ [goto INC100K_A]
else [goto next section]
2,RF,DK [goto next section]
Replicate To: INC200PCT_C
Question ID: INC.0190.00.1
Variable: INC75K_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than $75,000 or $75,000 or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
Response:
1 - Less than $75,000
2 - $75,000 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who answered 250% of poverty threshold or more and is from a 1 person family or is from a 2 person family and at least one adult is 66+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto INC400PCT_A]
2 [goto INC100K_A]
RF,DK [goto next section]
Replicate To: INC75K_C
Question ID: INC.0200.00.1
Variable: INC100K_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than $100,000 or $100,000 or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
Response:
1 - Less than $100,000
2 - $100,000 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who answered $75,000 or more OR answered 250% of poverty threshold or more and is from a 3 or 5 person family or is from a 2 person family and both adults are less than 66 years old OR answered 200% of poverty threshold and is from a family of 9 or more people and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 if GEN.PCNT_A=3 or (GEN.PCNT_A=2 and GEN.PCNT66UP_A=0) [goto INC400PCT_A]
else [goto next section]
2 if GEN.PCNT_A IN (1,2,3) [goto INC150K_A]
elseif GEN.PCNT_A=5 [goto INC400PCT_A]
elseif GEN.PCNT_A ge 9 [goto next section]
RF,DK [goto next section]
Replicate To: INC100K_C
Question ID: INC.0210.01.1
Variable: INC400PCT_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than ^400POVERTY_A or ^400POVERTY_A or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
^400POVERTY_A
Description: 400% of poverty threshold
Instruction:
Fill value stored in Adult.INC.INC400FILL_A
Response:
1 - Less than ^400POVERTY_A
2 - ^400POVERTY_A or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and answered less than $75,000 OR answered less than $100,000 and is from a 3 person family OR answered $100,000 or more and is from a 5 person family or 2 person family and both adults are less than 66 yers old or answered 250% of poverty threshold or more and is from a 4 or 6+ person family and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1 if GEN.PCNT_A IN (7,8) [goto INC150K_A]
else [goto next section]
2 if GEN.PCNT_A IN (1,2,3) or GEN.PCNT_A ge 6 [goto next section]
else if GEN.PCNT IN (4,5) [goto INC150K_A]
RF,DK [goto next section]
Replicate To: INC400PCT_C
Question ID: INC.0220.00.1
Variable: INC150K_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was your total ^FAMILY income from all sources less than $150,000 or $150,000 or more?
Fills:
^FAMILY
Description: family
Instruction:
If PCNT_A > 1 fill "family"
Response:
1 - Less than $150,000
2 - $150,000 or more
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ answered $100,000 or more and is from 1,2 or 3 person family OR respondent answered 400% of poverty or more and is from 4 or 5 person family OR respondent answered less than 400% of poverty and is from a family of 7 or 8 persons and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent
Skip Instructions:
1,2,RF,DK [goto next section]
Replicate To: INC150K_C

2022 National Health Interview Survey (NHIS) Questionnaire
FOO: Food Related Programs
Question ID: FOO.0010.00.1
Variable: FSNAP12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

At any time in the last 12 months did ^YOUFAMLVHERE_A receive ^FSSNAPNM?
* Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy
food.
Fills:
^YOUFAMLVHERE_A
Description: you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME

Instruction:
If GEN.PCNT_A=1, fill: "you"; elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS ne 1, fill: "any family members living
here"
elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS=1, fill "you or any family members
living at ^HNO ^HNOSUF ^STRNAME"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
^FSSNAPNM
Description: food stamp benefits/[state food stamp program name]
Instruction:
If AL then fill "Food Assistance Program or food stamp benefits"
If AK then fill "SNAP or food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp
benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits"
If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food stamp
benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "SNAP or food stamp benefits"
If GA then fill "Georgia Food Stamp Program or food stamp
benefits"
If HI then fill "SNAP or food stamp benefits"
If ID then fill "SNAP or food stamp benefits"
If IL then fill "SNAP or food stamp benefits"
If IN then fill "SNAP or food stamp benefits"
If IA then fill "SNAP or food stamp benefits"
If KS then fill "Food Assistance Program or food stamp
benefits"
If KY then fill "SNAP or food stamp benefits"
If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food stamp
benefits"
If MD then fill "SNAP or food stamp benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program (FSP) or food
stamp benefits"
If MN then fill "SNAP or food stamp benefits"
If MS then fill "SNAP or food stamp benefits"
If MO then fill "SNAP or food stamp benefits"
If MT then fill "SNAP or food stamp benefits"
If NE then fill "SNAP or food stamp benefits"
If NV then fill "SNAP or food stamp benefits"
If NH then fill "SNAP or food stamp benefits"
If NJ then fill "NJ SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits"
If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food stamp
benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "SNAP or food stamp benefits"
If OK then fill "SNAP or food stamp benefits"
If OR then fill "SNAP or food stamp benefits"
If PA then fill "SNAP or food stamp benefits"
If RI then fill "SNAP or food stamp benefits"
If SC then fill "SNAP or food stamp benefits"
If SD then fill "SNAP or food stamp benefits"
If TN then fill "SNAP or food stamp benefits"
If TX then fill "SNAP or food stamp benefits"
If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits"
If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food or food stamp benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp
benefits"
If WY then fill "SNAP or food stamp benefits"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
-
Universe:
Sample Adults 18+ where the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the Sample Adult is not the Sample Child respondent
Skip Instructions:
1 [goto FSNAP30D_A]
2,RF,DK if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M_A]
else [goto FINISH_FOO_A]
Replicate To: FSNAP12M_C
Question ID: FOO.0020.00.3
Variable: FSNAP30D_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

Did ^YOUFAMLVHERE_A receive ^FSSNAPNM in the LAST 30 days?
* Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy
food.
Fills:
^YOUFAMLVHERE_A
Description: you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME

Instruction:
If GEN.PCNT_A=1, fill: "you"; elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS ne 1, fill: "any family members living
here"
elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS=1, fill "you or any family members
living at ^HNO ^HNOSUF ^STRNAME"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
^FSSNAPNM
Description: food stamp benefits/[state food stamp program name]
Instruction:
If AL then fill "Food Assistance Program or food stamp benefits"
If AK then fill "SNAP or food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp
benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits"
If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food stamp
benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "SNAP or food stamp benefits"
If GA then fill "Georgia Food Stamp Program or food stamp
benefits"
If HI then fill "SNAP or food stamp benefits"
If ID then fill "SNAP or food stamp benefits"
If IL then fill "SNAP or food stamp benefits"
If IN then fill "SNAP or food stamp benefits"
If IA then fill "SNAP or food stamp benefits"
If KS then fill "Food Assistance Program or food stamp
benefits"
If KY then fill "SNAP or food stamp benefits"
If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food stamp
benefits"
If MD then fill "SNAP or food stamp benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program (FSP) or food
stamp benefits"
If MN then fill "SNAP or food stamp benefits"
If MS then fill "SNAP or food stamp benefits"
If MO then fill "SNAP or food stamp benefits"
If MT then fill "SNAP or food stamp benefits"
If NE then fill "SNAP or food stamp benefits"
If NV then fill "SNAP or food stamp benefits"
If NH then fill "SNAP or food stamp benefits"
If NJ then fill "NJ SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits"
If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food stamp
benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "SNAP or food stamp benefits"
If OK then fill "SNAP or food stamp benefits"
If OR then fill "SNAP or food stamp benefits"
If PA then fill "SNAP or food stamp benefits"
If RI then fill "SNAP or food stamp benefits"
If SC then fill "SNAP or food stamp benefits"
If SD then fill "SNAP or food stamp benefits"
If TN then fill "SNAP or food stamp benefits"
If TX then fill "SNAP or food stamp benefits"
If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits"
If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food or food stamp benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp
benefits"
If WY then fill "SNAP or food stamp benefits"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
-
Universe:
Sample Adults 18+ living in families where someone received food stamps in the last 12 months
Skip Instructions:
1,2,RF,DK if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M_A];
else [goto FINISH_FOO_A]
Replicate To: FSNAP30D_C
Question ID: FOO.0030.00.1
Variable: FWIC12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

At any time in the last 12 months did ^YOUFAMLVHERE_A receive benefits from the WIC program,
that is, the Women, Infants, and Children program?
Fills:
^YOUFAMLVHERE_A
Description: you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME

Instruction:
If GEN.PCNT_A=1, fill: "you"; elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS ne 1, fill: "any family members living
here"
elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS=1, fill "you or any family members
living at ^HNO ^HNOSUF ^STRNAME"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ living in families with females 12-55 years of age or children 0-5 years of age AND the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the Sample Adult is not the sample child respondent OR the Sample Adult and Sample Child are in the same family and at least one question asked in Sample Child FOO section has a valid answer (not dk/rf) and the received WIC benefits question was not asked in the Sample Child FOO section
Skip Instructions:
1,2,RF,DK if PCNTC517_A ge 1 [goto FLUNCH12M_A]
else [goto FINISH_FOO_A]
Replicate To: FWIC12M_C
Question ID: FOO.0040.00.1
Variable: FLUNCH12M_A
Interview Module: Adult
Content Type: Annual Core

Question text:

At any time in the last 12 months, did ^SCCHILDFAM_A receive free or reduced-cost breakfasts or
lunches at school?
* Read if necessary: The National School Lunch Program and the School Breakfast Program provide
cash assistance to states to operate breakfast and lunch programs in schools and residential
childcare institutions. The programs provide low-cost or free breakfasts and lunches to lowincome children in kindergarten through 12th grade.
Fills:
^SCCHILDFAM_A
Description: ^ALIASNAME/any child in your family
Instruction:
if PCNT517_A=1, fill: ^ALIASNAME of child in Sample Adult family,
elseif PCNT517_A gt 1, fill "any child in your family",
^ALIASNAME
Description: {Value of ALIAS}
Instruction:
Fill value from Roster.HHC.ALIAS[PX]
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ living in families with children between the ages of 5-17 and the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the sample adult is not the sample child respondent
Skip Instructions:
1,2,RF,DK [goto FINISH_FOO_A]
Replicate To: FLUNCH12M_C
Question ID: FOO.0050.00.1
Variable: FINISH_FOO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* The Sample Adult food related programs section is now complete.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+ where the Sample Adult FOO section has not been completed AND the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the sample adult is not the sample child respondent the OR Sample Adult and Sample Child are in the same family and at least one question asked in Sample Child FOO section has a valid answer (not dk/rf) and the received WIC benefits question was not asked in the Sample Child FOO section and within the family exist at least one female 12-55 years of age or child 0-5 years of age
Skip Instructions:
1 [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
FDS: Food Security
Question ID: FDS.0010.00.3
Variable: FDSINTRO_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

These next questions are about whether ^youyourfamily_A ^waswere always able to afford the food
you needed in the last 30 days. I'm going to read you several statements that people have made
about their food situation. For these statements, please tell me whether the statement was often
true, sometimes true, or never true for ^youyourfamily_A in the last 30 days.
* Enter '1' to continue.
Fills:
^youyourfamily_A
Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"
^waswere
Description: were/was
Instruction:
If PCNT_A=1 "were" else "was"
Response:
1 - Enter 1 to Continue
Universe:
Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1 [goto FDSRUNOUT_A]
Replicate To: FDSINTRO_C
Question ID: FDS.0020.00.3
Variable: FDSRUNOUT_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

The first statement is "^IWe_A worried whether ^myour_A food would run out before ^Iwe_A got
money to buy more." Was that often true, sometimes true, or never true for ^youyourfamily_A in
the last 30 days?
Fills:
^IWe_A
Description: I/We
Instruction:
If PCNT_A=1 fill: "I" else fill: "We"
^myour_A
Description: my/our
Instruction:
If PCNT_A=1 fill: "my" else fill: "our"
^youyourfamily_A
Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"
Response:
1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1-3,RF,DK [goto FDSLAST_A]
Replicate To: FDSRUNOUT_C
Question ID: FDS.0030.00.3
Variable: FDSLAST_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

"The food that ^Iwe_A bought just didn't last, and ^Iwe_A didn't have money to get more." Was
that often true, sometimes true, or never true for ^youyourfamily_A in the last 30 days?
Fills:
^Iwe_A
Description: I/We
Instruction:
If PCNT_A=1 fill: "I" else fill: "We"
^youyourfamily_A
Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"
Response:
1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1-3,RF,DK [goto FDSBALANCE_A]
Replicate To: FDSLAST_C
Question ID: FDS.0040.00.3
Variable: FDSBALANCE_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

^IWe_A couldn't afford to eat balanced meals." Was that often true, sometimes true, or never
true for ^youyourfamily_A in the last 30 days?
Fills:
^IWe_A
Description: I/We
Instruction:
If PCNT_A=1 fill: "I" else fill: "We"
^youyourfamily_A
Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"
Response:
1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people.
Skip Instructions:
1-2 [goto FDSSKIP_A]
3,RF,DK if FDSRUNOUT_A IN (1,2) OR FDSLAST_A IN (1,2) [goto FDSSKIP_A];
else [goto next section]
Replicate To: FDSBALANCE_C
Question ID: FDS.0050.00.3
Variable: FDSSKIP_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, did ^youorother_A ever cut the size of your meals or skip meals because
there wasn't enough money for food?
Fills:
^youorother_A
Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals
Skip Instructions:
1 [goto FDSSKIPDYS_A]
2,RF,DK [goto FDSLESS_A]
Replicate To: FDSSKIP_C
Question ID: FDS.0060.00.3
Variable: FDSSKIPDYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, how many days did this happen?
Response:
01-30 - Range of values
97 - Refused
99 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent said that they or other adults in their family cut the size of their meals or skipped meals due to cost.
Skip Instructions:
1-30,RF,DK [goto FDSLESS_A]
Replicate To: FDSSKIPDYS_C
Question ID: FDS.0070.00.3
Variable: FDSLESS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, did ^youorother_A ever eat less than you felt you should because there
wasn't enough money for food?
Fills:
^youorother_A
Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.
Skip Instructions:
1,2,RF,DK [goto FDSHUNGRY_A]
Replicate To: FDSLESS_C
Question ID: FDS.0080.00.3
Variable: FDSHUNGRY_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, were ^youorother_A ever hungry but didn't eat because there wasn't enough
money for food?
Fills:
^youorother_A
Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.
Skip Instructions:
1,2,RF,DK [goto FDSWEIGHT_A]
Replicate To: FDSHUNGRY_C
Question ID: FDS.0090.00.3
Variable: FDSWEIGHT_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, did ^youorother_A lose weight because there wasn't enough money for food?
Fills:
^youorother_A
Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.
Skip Instructions:
1 [goto FDSNOTEAT_A]
2,RF,DK if FDSSKIP_A=1 or FDSLESS_A=1 or FDSHUNGRY_A=1 [goto FDSNOTEAT_A]; else [goto next
section]
Replicate To: FDSWEIGHT_C
Question ID: FDS.0100.00.3
Variable: FDSNOTEAT_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, did ^youorother_A ever not eat for a whole day because there wasn't enough
money for food?
Fills:
^youorother_A
Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered they cut the size of the meals, skipped meals, were hungry but didn't eat, or lost weight in the last 30 days because there wasn't enough money for food.
Skip Instructions:
1 [goto FDSNEDAYS_A]
2,RF,DK [goto next section]
Replicate To: FDSNOTEAT_C
Question ID: FDS.0110.00.3
Variable: FDSNEDAYS_A
Interview Module: Adult
Content Type: Sponsored Content

Question text:

In the last 30 days, how many days did this happen?
Response:
01-30 - Range of values
97 - Refused
99 - Don't Know
Universe:
The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent didn't eat for a whole day in last 30 days because there wasn't enough money for food
Skip Instructions:
1-30,RF,DK [goto next section]
Replicate To: FDSNEDAYS_C

2022 National Health Interview Survey (NHIS) Questionnaire
HOU: Housing
Question ID: HOU.0010.00.1
Variable: HOUYRSLIV_A
Interview Module: Adult
Content Type: Annual Core

Question text:

About how long ^YRSLIV?
Fills:
^YRSLIV
Description: have you lived at ^HNO ^HNOSUF ^STRNAME/have you lived in this house/apartment

Instruction:
If Roster.HHC.tblname.bPerson[PX_A]ONOFFCAMPUS=1 fill "have you lived at ^HNO ^HNOSUF ^STRNAME"
else fill "have you lived in this house/apartment"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
Response:
1 - Less than 1 year
2 - 1 to 3 years
3 - 4 to 10 years
4 - 11 to 20 years
5 - More than 20 years
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1-5,RF,DK if ((GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=empty) or (GEN.SAMEFAM_FLG ne 1) or
(GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=2 and GEN.SARESPSC_FLG ne 1))[goto HOUTENURE_A]
else [goto next section]
If GEN.AGE_FINAL[PX_A] lt 21 and HOUYRSLIV_A=5 [goto ERR1_HOUYRSLIV_A]
Hard Edit:
Check Text: ERR1_HOUYRSLIV_A
Check Description: Hard check when years lived in home exceeds age
Check Text: {check ERR1_HOUYRSLIV_A}
Years in house/apartment exceed ^SANAME's age. Please correct.
Question ID: HOU.0020.00.1
Variable: HOUTENURE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^HOUTEN owned or rented by you ^SOMEFAM_A?
* If house has a mortgage, record as owned.
Fills:
^HOUTEN
Description: Is this house/apartment at ^HNO ^HNOSUF ^STRNAME/Is this house/apartment

Instruction:
If Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS=1, fill "Is the house/apartment at ^HNO ^HNOSUF ^STRNAME"
else fill "Is this house/apartment"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
^SOMEFAM_A
Description: or someone in your family
Instruction:
If PCNT18UP_A=1 fill: blank If PCNT18UP_A gt 1 fill: "or someone in your family"
Response:
1 - Owned or being bought
2 - Rented
3 - Other arrangement
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample child respondent answered refused or don't know to all questions in the sample child HOU section and the sample child respondent is not the sample adult respondent.
Skip Instructions:
1,3,RF,DK [goto next section]
2 [goto HOUGVASST_A]
Replicate To: HOUTENURE_C
Question ID: HOU.0030.00.1
Variable: HOUGVASST_A
Interview Module: Adult
Content Type: Annual Core

Question text:

^HOUGVT paying lower rent because the Federal, State, or local government is paying part of the
cost?
* Read if necessary: Federal, State, or Local government housing programs for persons with low
income may take many forms. Government housing assistance could come from monetary assistance to
help pay rent, a program called "Section 8," direct payments to landlords, vouchers, or other
types of assistance from a local housing authority. Living in public housing is considered
housing assistance from the government.
Fills:
^HOUGVT
Description: Are you/Are you or anyone in your family/Is your family at ^HNO ^HNOSUF ^STRNAME

Instruction:
If Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS ne 1 and GEN.PCNT18UP_A=1, fill "Are you"
elseif Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS ne 1
and PCNT18UP_A gt 1, fill "Are you or anyone in your
family"
elseif Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1,
fill "Is your family at ^HNO ^HNOSUF ^STRNAME"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with a house/apartment that is being rented AND Sample Adult and Sample Child are in the same family and the house/apartment is being owned/rented and the HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family section
Skip Instructions:
1,2,RF,DK [goto next section]
Replicate To: HOUGVASST_C

2022 National Health Interview Survey (NHIS) Questionnaire
TBH: Transportation Barrier to Care
Question ID: TBH.0010.00.4
Variable: TRANSPOR_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

In the past 12 months, has a lack of reliable transportation kept you from medical appointments,
meetings, work, or from getting things you needed for daily living?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CIV: Civic Engagement
Question ID: CIV.0010.00.4
Variable: CEMMETNG_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

During the past 12 months, did you attend a public meeting, such as a zoning or school board
meeting, that discussed a local issue?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto CEVOTELC_A]
Question ID: CIV.0020.00.4
Variable: CEVOTELC_A
Interview Module: Adult
Content Type: Emerging Content

Question text:

Did you vote in the LAST LOCAL elections, such as for mayor, councilmembers, or school board?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
REC: Person's name
Question ID: REC.0010.00.1
Variable: LNKFNAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Ask or verify: What is your full name?
* Enter first name.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
allow 20,RF,DK [goto LNKMNAME_A]
Question ID: REC.0020.00.1
Variable: LNKMNAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Enter middle name.
* Press "Enter" to skip to last name if respondent has no middle name.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
allow 20,RF,DK [goto LNKLNAME_A]
Question ID: REC.0030.00.1
Variable: LNKLNAME_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Enter last name.
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
allow 20,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
TEL: Telephone Use
Question ID: TEL.0010.00.1
Variable: TELCURWRK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Is there at least one telephone INSIDE ^HOME that is currently working and is not a cell phone?
Fills:
^HOME
Description: your home at ^HNO ^HNOSUF ^STRNAME/your home
Instruction:
If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "your home at ^HNO ^HNOSUF ^STRNAME"
else fill "your home"
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ where the Sample Adult and Sample Child are in the same family but TELCURWRK_C has not been asked OR Sample Adult and Sample Child are in the same family, TELCURWRK_C was answered don't know or refused and the Sample Adult is not the Sample Child Respondent or where the Sample Adult does not live in same family as Sample Child
Skip Instructions:
1,2,RF,DK [goto TELCEL_A]
Replicate To: TELCURWRK_C
Question ID: TEL.0020.00.1
Variable: TELCEL_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you have a working cell phone?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+
Skip Instructions:
1 if TELCURWRK_A=1 or (TELCURWRK_C=1 and GEN.SAMEFAM_FLG=1)[goto PHONEUSE_A]
else[goto TLNO_TEL_SA]
2,RF,DK if (GEN.SAMEFAM_FLG=1 and PHONELIVE_C=empty) or (GEN.SAMEFAM_FLG=1 and PHONELIVE_C IN
(RF,DK) and GEN.SARESPSC_A ne 1) or (GEN.SAMEFAM_FLG ne 1)) and GEN.PCNT_A gt 1 [goto
PHONELIVE_A]
else [goto TLNO_TEL_SA]
Question ID: TEL.0030.00.1
Variable: PHONELIVE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you live with anyone ^ATHOME who has a working cell phone?
Fills:
^ATHOME
Description: at your home at {Value of HNO} {Value of HNOSUF} {Value of STRNAME}

Instruction:
If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "at your home at ^HNO ^HNOSUF ^STRNAME"
else leave blank
^HNO
Description: {Value of HNO}
Instruction:
Fill GEN.HNO
^HNOSUF
Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF
^STRNAME
Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ in a family with at least one other person without working cell phones where Sample Adult does not live in same family as Sample Child or Sample Adult and Sample Child are in the same family but PHONELIVE_C has not been asked OR Sample Adult and Sample Child are in the same family, PHONELIVE_C was answered dk/rf and the Sample Adult is not the Sample Child Respondent.
Skip Instructions:
1,2,RF,DK [goto TLNO_TEL_SA]
Replicate To: PHONELIVE_C
Question ID: TEL.0040.00.1
Variable: PHONEUSE_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Of all the telephone calls that you answer, are all or almost all on your cell phones, some on
your cell phone and some on your home phone, or very few or none on your cell phones?
Response:
1 - All or almost all calls on cell phone
2 - Some on cell phone and some on home phone
3 - Very few or none on cell phone
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ with working personal cell phone and who said they have a working land-line in household or in the same family as sample child respondent who said they have a working landline in the household.
Skip Instructions:
1-3,RF,DK [goto TLNO_TEL_SA]

2022 National Health Interview Survey (NHIS) Questionnaire
LNK: Linkage
Question ID: LNK.0010.00.1
Variable: LNKINTRO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
We would like the last four digits of your Social Security Number^medicarenum. This information
will help us link your survey data with health-related records of other government agencies, and
allow us to conduct additional research without taking up your time with more questions. The
National Center for Health Statistics (NCHS) uses this information for research purposes only.
Providing this information is voluntary. There will be no effect on your benefits if you do not
provide this information. Federal laws authorize us to ask for this information. Like all other
answers you have provided, this information will remain confidential.
* Read if necessary: The specific federal laws protecting your privacy and the confidentiality
of your data are the Public Health Service Act (Title 42, U.S.C., Section 242m(d)), the
Confidential Information Protection and Statistical Efficiency Act of 2018 (Title III, Public
Law No. 115-435), and the Privacy Act of 1974 (5 U.S.C. § 552a).
* Read if necessary: NCHS collects health-related data from other government agencies, including
records from Medicare and Medicaid Services, Social Security, housing, and death certificates.
If you agree, NCHS will attempt to link records such as these with your survey data to give a
fuller picture of the kinds of things that affect health. NCHS does this linkage. Your name and
your information are not given to these agencies.
* Read if necessary: If asked: Your data will not be linked to records from the IRS (Internal
Revenue Service) or ICE (Immigration and Customs Enforcement).
* Enter '1' to continue.
Fills:
^medicarenum
Description: , and the last four characters of your Medicare number
Instruction:
If INS.HIKIND_A=2 or INS.MCAREPRB_A=1, fill ", and the last four characters of your Medicare number"
else, fill nothing
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto SSN4_A]
Question ID: LNK.0020.00.1
Variable: SSN4_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
What are the last four digits of your Social Security Number?
* Read if necessary: Providing this information is voluntary. There will be no effect on your
benefits if you do not provide this information. Federal laws authorize us to ask for this
information. Like all other information you have provided, these answers will remain
confidential.
* Read if asked about specific laws: The specific federal laws protecting your privacy and the
confidentiality of your data are the Public Health Service Act, which is Title 42, U.S.C.,
Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act of 2018,
which is Title III of Public Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. §
552a.
* Enter 'N' for no Social Security Number.
Response:
0001-9999 - Range of values
N - No Social Security Number
99997 - Refused
99999 - Don't Know
Skip Instructions:
if SSN4_A=000-999 [goto ERR2_SSN4_A]
elseif SSN4_A NOT IN (N,RF,DK,000-999,0001-9999) [goto ERR3_SSN4_A]
0001-9999 if.Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto LAST4C_A]
else [goto next section]
N,RF,DK if Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto LAST4C_A]
else [goto RLINK_A]
Hard Edit:
Check Text: ERR3_SSN4_A
Check Description: SSN last four digits are 0000 or a letter other than N hard edit
Check Text: {check ERR3_SSN4_A}
The last 4 digits of a SSN should be between 0001-9999. For a respondent who does not want to provide the SSN, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused.' If a respondent does not have a SSN, enter 'N'. Please correct.

Check Text: ERR2_SSN4_A
Check Description: Entered less than four digits hard edit
Check Text: {check ERR2_SSN4_A}
You must enter all four of the last four digits of the Social Security Number. Please correct.
Question ID: LNK.0040.00.1
Variable: LAST4C_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
* 1 of 2
What are the last four characters of your Medicare or Health Insurance Claim Number?
* Read if necessary: Providing this information is voluntary. There will be no effect on your
benefits if you do not provide this information. Federal laws authorize us to ask for this
information. Like all other information you have provided, these answers will remain
confidential.
* Read if asked about specific laws: The specific federal laws protecting your privacy and the
confidentiality of your data are the Public Health Service Act, which is Title 42, U.S.C.,
Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act of 2018,
which is Title III of Public Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. §
552a.
* Reports from memory are acceptable if the Medicare card (or some other form of documentation)
is not available.
* Enter the last four characters, which should be letter-letter-number-number.
Response:
Verbatim - Verbatim values
9997 - Refused
9999 - Don't Know
Universe:
Sample adults 18+ who have Medicare
Skip Instructions:
if anything lt 4 alphanumeric characters [goto ERR1_LAST4C_A]
elseif SSN4_A IN (N,RF,DK) or LAST4C_A IN (RF,DK) [goto RLINK_A]
else [goto next section]
Hard Edit:
Check Text: ERR1_LAST4C_A
Check Description: Medicare number less than 4 characters
Check Text: {check ERR1_LAST4C_A}
You must enter all four of the last four alphanumeric characters of the Medicare number. Please correct.
Question ID: LNK.0060.00.1
Variable: RLINK_A
Interview Module: Adult
Content Type: Annual Core

Question text:

?[F1]
May we try to link your survey data without a ^SSNMEDNUM?
* Read if necessary: Any data obtained are protected by strict federal laws, including the
Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential
Information Protection and Statistical Efficiency Act of 2018, which is Title III of Public Law
No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a.
Fills:
^SSNMEDNUM
Description: consent by SSN or Medicare number
Instruction:
if (SSN4_A IN (N,RF,DK) and ((Adult.INS.HIKIND_A ne 2 and Adult.INS.MCAREPRB_A ne 1) or (MCNO4_A ge 001 and MCNO4_A
le 9999) or (LAST4C_A NOT IN (empty,RF, DK)))) fill=
"social security number"
elseif ((SSN4_A ge 0001 and SSN4_A le 9999) and
(Adult.INS.HIKIND_A = 2 or Adult.INS.MCAREPRB_A =1) and
(MCNO4_A IN (RF, DK) or (LAST4C_A IN (RF,DK))) fill =
"Medicare or Health Insurance Claim Number"
else fill = "social security number, Medicare or Health
Insurance Claim Number"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample adults 18+ who answered no SSN or refused or don't know last 4 digits of SSN or who answered refused or don't know at last 4 of Medicare number
Skip Instructions:
1,2,RF,DK[goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
THX: Thanks
Question ID: THX.0080.00.1
Variable: THANKS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Thank respondent for answering these questions. If there is a Sample Child interview to
complete, ask for appropriate person to respond to these questions.
Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Adults 18+
Skip Instructions:
1 [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
VFY: Verification and demographic details
Question ID: VFY.0040.00.1
Variable: CURRES_C
Interview Module: Child
Content Type: Annual Core

Question text:

The next questions are about ^SCNAME.
* Enter the line number of the person to whom you are speaking.
* If Sample Child respondent refuses to participate enter CTRL-R.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused
-
Universe:
Sample Children 0-17
Skip Instructions:
RF if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
If CURRES_C not in Roster.FAM.KNOWSC [goto KNOAVAIL_C]
Else if CURRES_C ne LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC [goto AVAIL_C]
Else if CURRES_C = LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC AND CURRES_C not in
Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
Else if CURRES_C = LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC AND CURRES_C in
Roster.bREL.bPerson[PX_C].PARENTS[goto VFYALL_C]
Question ID: VFY.0060.00.1
Variable: KNOAVAIL_C
Interview Module: Child
Content Type: Annual Core

Question text:

^KNOAVAIL_C_fill
* Enter the line number of available respondent from list or press F9 to set up a callback if no
one is available or refused.
^KNOAVAIL_C_fill_2
Fills:
^KNOAVAIL_C_fill
Description: FR Instruction/I have recorded that ^KNOWSC ^areis_ knowledgeable about and responsible for ^SCNAME's health

Instruction:
IS currently available and willing to answer these questions?
Instruction If (KnowSC_Count = ActiveNotKnow_Count)
fill : "* If there are no other knowledgeable people to
select then press the end key."
ELSE
fill : "I have recorded that ^KNOWSC ^areis_c
knowledgeable about and responsible for ^SCNAME's health
care. ^WHOIS currently available and willing to answer
these questions?"
^KNOWSC
Description: List of household members who are knowledgeable about and responsible for the Sample Child

Instruction:
KNOWSC = list of people identified as being knowledge about and responsible for ^SCNAME's health as selected in
Roster.FAM.KNOWSC. Add "and" before last name if list >
1.
^areis_c
Description: is/are
Instruction:
If KNOAVAIL_Count = 1, fill 'is', else fill 'are'
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^WHOIS
Description: Is {Value of ALIAS}/Who is
Instruction:
If KNOAVAIL_Count = 1, fill "Is Alias[I]" else fill "Who is"
^KNOAVAIL_C_fill_2
Description: FR Instruction
Instruction:
If (ActiveNotKnow_Count > 0) fill : "* People listed in gray have said that they are
not knowledgeable about the SC. If you incorrectly set
someone as not knowledgeable then you may select that
person and continue the interview."
Response:
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
- 08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused
Universe:
Sample Children 0-17 and at least one knowledgeable person is still eligible for selection and speaking to the initial respondent and they are not knowledgeable OR speaking to a new respondent
Skip Instructions:
01-25 [goto INTMODE_C]
RF if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
F9 [goto bCallback.ARRANGE_CALLBACK]
Question ID: VFY.0080.00.1
Variable: INTMODE_C
Interview Module: Child
Content Type: Annual Core

Question text:

*How are you contacting ^KNOAVAIL_C?
Fills:
^KNOAVAIL_C
Description: Name of person selected at KNOAVAIL_C
Instruction:
Display name of person whose line number was selected at KNOAVAIL_C
Response:
1 - Personal visit
2 - Telephone
Universe:
Sample Children 0-17 and interviewer is speaking to a new respondent
Skip Instructions:
1 if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else if HHRESPSC_FLG=1 and LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
else [goto VFYALL_C]
2 [goto TINTRO_C]
Question ID: VFY.0090.00.1
Variable: TINTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

Hello, my name is (* say your name). I'm calling from the U.S. Census Bureau. We are conducting
the National Health Interview Survey on behalf of the National Center for Health Statistics,
part of the Centers for Disease Control and Prevention (CDC). This is a nationwide survey about
the health of both adults and children. I have some information from ^HHRESP. ^HHSEX told me
that you would be a good person to talk to about the health of ^SCNAME.
* Read if necessary: I believe I am calling you on a cell phone.
Before we continue, I have to ask: Are you currently driving a vehicle?
* Even if the respondent is using a hands-free device while driving, you must enter '1'.
Fills:
^HHRESP
Description: {Value of HHRESPAVAIL}
Instruction:
Display the name of the person selected at Roster.HHC.HHRESPAVAIL
^HHSEX
Description: He/She/They
Instruction:
If GEN.SEX_FINAL[LNO_HHRESP]=1, fill: He elseif GEN.SEX_FINAL[LNO_HHRESP]=2, fill: She
elseif GEN.SEX_FINAL[LNO_HHRESP] in (DK,RF), fill: They
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent
Skip Instructions:
1,RF,DK [goto ATTN_C]
2 [goto LETTER_C]
Question ID: VFY.0100.00.1
Variable: ATTN_C
Interview Module: Child
Content Type: Annual Core

Question text:

For your safety, we will call you back at another time.
* Enter 1 to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is driving
Skip Instructions:
1 [goto bCallback.CB_POSSIBLE]
Question ID: VFY.0110.00.1
Variable: LETTER_C
Interview Module: Child
Content Type: Annual Core

Question text:

* If sample child respondent is a new respondent read question below, otherwise enter 1
* Read if necessary: A letter describing the National Health Interview Survey was sent to your
home recently. Do you remember seeing the letter?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is not driving
Skip Instructions:
1,2,RF,DK [goto S_INTRO_C]
Question ID: VFY.0120.00.1
Variable: S_INTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
* If sample child respondent is a new respondent read question below, otherwise enter 1
* Read if necessary: There are a few things I need to cover before we continue. I'd like you to
know that taking part in this survey is voluntary. You may choose not to answer any questions
you don't wish to answer, or end the interview at any time without penalty. We are required by
Federal law to develop and follow strict procedures to protect the confidentiality of your
information and use your answers only for statistical research. I can describe these laws if you
wish. Except for the National Center for Health Statistics and Census Bureau employees and
specially designated agents, no one can see your answers until all information that could
identify you and/or your family has been removed. Only after that will your data be made
available to researchers. For most children, the survey will take less than ^SCTIME minutes. I'd
like to continue now unless you have any questions.
* If respondent asks for more information about the privacy laws, press F1.
Fills:
^SCTIME
Description: 20/30
Instruction:
If ASTAT=1 and SAMEFAM_FLG=1, fill: 20 Else, fill: 30
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is not driving
Skip Instructions:
1 if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else if HHRESPSC_FLG=1 and LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
else [goto VFYALL_C]
Question ID: VFY.0130.00.1
Variable: AVAIL_C
Interview Module: Child
Content Type: Annual Core

Question text:

I have recorded that you are knowledgeable about and responsible for ^SCNAME's health care. Is
that correct?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
Universe:
Sample Children 0-17 and at least one knowledgeable person is still eligible for section AND initial respondent wasn't the HH Resp and is knowledgeable OR picked a new respondent and respondent is not driving
Skip Instructions:
1If (LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS) {respondent is not a parent} [goto
RELTIV_C]
Else If Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) {Sample Child is on campus} [goto
VFYONCAMP_C]
Else [goto VFYALL_C]
2 if KNOAVAIL_Count gt 0 [goto KNOAVAIL_C]
Else [goto NOMORE_C]
RF if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
Question ID: VFY.0150.00.1
Variable: RELTIV_C
Interview Module: Child
Content Type: Annual Core

Question text:

What is your relationship to ^SCNAME?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01 - Parent (Biological, adoptive, or step)
02 - Grandparent
03 - Aunt/Uncle
04 - Brother/Sister
05 - Other relative
06 - Legal guardian
07 - Foster parent
08 - Other non-relative
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 where the current respondent has not refused AND at least one person is knowledgeable about and responsible for the sample child AND the respondent is not driving while on the telephone AND the respondent has not refused or said he/she is not available AND the respondent was not identified as a parent in the roster section
Skip Instructions:
9 [goto ERR_RELTIV_C]
4,5,8,RF,DK [goto VFYRESP_C]
1,2,3,6,7 if Roster.tblNAME.bPerson.[PX.C].ONOFFCAMPUS IN (1,RF,DK) and HHRESPSC_FLG ne 1
[goto VFYONCAMP_C]
Else [goto VFYALL_C]
Soft Edit:
Check Text: ERR_RELTIV_C
Check Description: RELTIV_C soft edit
Check Text: {signal ERR_RELTIV_C} The spouse or partner of the Sample Child cannot answer questions about him/her.
Question ID: VFY.0180.00.1
Variable: VFYRESP_C
Interview Module: Child
Content Type: Annual Core

Question text:

To confirm, are you RESPONSIBLE FOR ^SCNAME's health care?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 where person identified as Child respondent is Brother/Sister, Other Relative, Other Non-relative, refused or don't know
Skip Instructions:
2,RF,DKif KNOAVAIL_Count > 0 [goto KNOAVAIL_C]
else [goto NOMORE_C]
1 if Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) [goto VFYONCAMP_C]
Else [goto VFYALL_C]
Question ID: VFY.0190.00.1
Variable: VFYONCAMP_C
Interview Module: Child
Content Type: Annual Core

Question text:

I want to confirm some information.
Does ^SCNAME live in on-campus housing or off-campus housing?
*Read if necessary: On-campus housing includes residence halls and dorms where students live
together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - On campus
2 - Off campus
7 - Refused
9 - Don't Know
Universe:
A person who is knowledgeable or responsible for the sample child's health is available and the Sample Child is living in on-campus housing and the Sample Child respondent is not the household respondent and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1,RF,DK [goto VFYALL_C]
2 [goto NOMORE_C]
Question ID: VFY.0200.00.1
Variable: VFYALL_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Please verify the following information about the sample child before proceeding:
I have recorded ^childvsex, ^AGE_C, ^NATORG_C, and ^RACE_C. Would you like to make any changes
to this ^additionalinfo_C?
^RACEVRBATvalue_C
* If respondent "refuses" or says "don't know", enter "2" for "no."
* Read if necessary: By sex we mean sex at birth.
Fills:
^childvsex
Description: ^SCNAME is male/^SCNAME is female/^SCNAME's sex is not known/^SCNAME's sex was not provided

Instruction:
If SEX_FINAL=1, fill: "^SCNAME is male" If SEX_FINAL=2, fill: "^SCNAME is female"
If SEX_FINAL=DK, fill: "^SCNAME's sex is not known"
If SEX_FINAL=RF, fill: "^SCNAME's sex was not provided"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^AGE_C
Description: ^SCNAME is ^AGENO_C ^AGETP_C old/^SCNAME is under 18
Instruction:
If AGE_FINAL NE ('RF', 'DK'), fill: "^SCNAME is ^AGENO_C ^AGETP_C old"
If AGE_FINAL IN ('RF', 'DK'), fill: "^SCNAME is under 18"
^AGENO_C
Description: {Value of AGENO}
Instruction:
Fill value from Roster.HHC.AGENO[PX]
^AGETP_C
Description: {Value of AGETP}
Instruction:
Fill value from Roster.HHC.AGETP[PX]
^NATORG_C
Description: Verify Hispanic or Latino origin
Instruction:
If NATO_FINAL=1 fill: "^SCNAME is of Hispanic or Latino Origin"
If NATO_FINAL=2 fill: "^SCNAME is not of Hispanic or
Latino Origin"
If NATO_FINAL=DK fill: "whether ^SCNAME is of Hispanic or
Latino Origin is not known"
If NATO_FINAL=RF fill: "information about whether ^SCNAME
is of Hispanic or Latino Origin was not provided"
^RACE_C
Description: ^SCNAME is ^RACEFILLAND_C/^SCNAME's race is not known/^SCNAME's race was not provided

Instruction:
If GEN.RACE_FINAL[PX_C].RACE_FINAL NE 'RF' OR 'DK', fill: "^SCNAME is ^RACEFILLAND_C."
If GEN.RACE_FINAL[PX_C].RACE_FINAL='DK', fill: ^SCNAME's
race is not known"
If GEN.RACE_FINAL[PX_C].RACE_FINAL='RF', fill: ^SCNAME's
race was not provided"
^RACEFILLAND_C
Description: Categories selected at the RACE screen
Instruction:
Fill categories selected at the GEN.RACE_FINAL [PX_C].RACE_FINAL screen. If more than two categories
separate the categories with commas. Add the word "and"
before the last category.
For category 8 (GEN.RACE_FINAL[PX_C].RACE_FINAL=8),
if GEN.RACE_FINAL[PX_C].RACE_SP_FINAL not in ['ZZ',RF,DK]
display picklist selection from
GEN.RACE_FINAL[PX_C].RACE_SP_FINAL
elseif HHRESPSC_FLG=1 display GEN.RACE_FINAL
[PX_C].RACE_VRBAT_FINAL
else display "some other race"
^additionalinfo_C
Description: if any information is missing "or provide additional information about"

Instruction:
See attachment for fill instructions
^RACEVRBATvalue_C
Description: Information collected at RACE_VRBAT for Sample Child
Instruction:
IF GEN.HHRESPSC_FLG ne 1 and GEN.RACE_FINAL [PX_C].RACE_VRBAT_FINAL ne (empty,RF,DK), fill "* If
respondent wants information on which other race ^SCNAME
is listed as, say ^RACE_VRBAT."
^RACE_VRBAT
Description: {Value of RACE_VRBAT_FINAL}
Instruction:
Fill value from GEN.RACE_FINAL[PX].RACE_VRBAT_FINAL
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 where a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1 [goto VFYDEM_C]
2 if GEN.SEX_FINAL[PX_C] IN (RF,DK) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0210.00.1
Variable: VFYDEM_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Read if necessary: What should I change?
* Enter all that apply, separate with commas.
* Read if necessary: By sex we mean sex at birth.
Response:
1 - Sex
2 - Age
3 - Hispanic or Latino Origin
4 - Race
7 - Refused
9 - Don't Know
Universe:
Sample children 0-17 would like to change demographic information
Skip Instructions:
If 1 NOT IN VFYDEM_C and GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto SEXGUESS_C]
elseif 1 IN VFYDEM_C [goto NEWSEX_C]
elseif 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
RF,DK If GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0220.00.1
Variable: NEWSEX_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is ^SCNAME male or female?
* Read if necessary: By sex we mean sex at birth.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Male
2 - Female
7 - Refused
9 - Don't Know
Universe:
Respondent said sample child's sex is not correct
Skip Instructions:
if GEN.SEX_FINAL[PX_C]=RF,DK and NEWSEX_C=RF,DK [goto SEXGUESS_C]
elseif 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0230.00.1
Variable: SEXGUESS_C
Interview Module: Child
Content Type: Annual Core

Question text:

*Enter your best guess of ^SCNAME's sex
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Male
2 - Female
Universe:
Sample children for whom there is no sex provided by the household respondent and did not give a sex when asked to verify information and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1,2
if 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0240.01.1
Variable: NEWAGENO_C
Interview Module: Child
Content Type: Annual Core

Question text:

* 1 of 2
How old is ^SCNAME?
* Enter number for age.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
001-120 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Children 0-17 whose age is not correct
Skip Instructions:
goto [NEWAGETP_C]
Question ID: VFY.0240.02.1
Variable: NEWAGETP_C
Interview Module: Child
Content Type: Annual Core

Question text:

* 2 of 2
* Enter number for age time period.
Response:
1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)
Universe:
Valid number entered at NEWAGENO_C
Skip Instructions:
1,2,3,4 if 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0260.00.1
Variable: NEWNATORG_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is ^SCNAME Hispanic or Latino?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 whose Hispanic Origin is not correct
Skip Instructions:
1,2,RF,DK if 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0270.00.1
Variable: NEWRACE_C
Interview Module: Child
Content Type: Annual Core

Question text:

What race or races is ^SCNAME? Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific
Islander, Asian, or some other race?
Enter all that apply, separate with commas.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 whose race is not correct
Skip Instructions:
if NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0280.00.1
Variable: HISPTYPE_C
Interview Module: Child
Content Type: Annual Core

Question text:

What is ^SCNAME's Hispanic or Latino ancestry or origin, such as Mexican, Mexican American,
^CHICANOA, Central or South American, Puerto Rican, Cuban, Dominican (Republic), or Other
Hispanic, ^LATINOA, or Spanish -- and if ^SCNAME has more than one, tell me all of them.
* Enter all that apply, separate with commas.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^CHICANOA
Description: Chicano/Chicano or Chicana
Instruction:
If SEX_FINAL = 1 fill: "Chicano" if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"
^LATINOA
Description: Latino/Latino or Latina
Instruction:
If SEX_FINAL= 1 fill: "Latino" if SEX_FINAL = 2,DK,RF fill "Latino or Latina"
Response:
01 - Mexican, Mexican American, or Chicano(a)
02 - Central American
03 - South American
04 - Puerto Rican
05 - Cuban
06 - Dominican (Republic)
07 - Other Hispanic, Latino(a), or Spanish (specify)
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 are of Hispanic Origin and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
7 [goto HISPOTHER_C]
1-6,RF,DK
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (HHRESPSC_FLG ne 1 and RACE_SP[PX_C] in
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0290.00.1
Variable: HISPOTHER_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
What is ^SCNAME's Hispanic or Latino ancestry or origin? If ^SCNAME has more than one, tell me
all of them.
Start typing and then select from list. If Hispanic or Latino ancestry is not on the list, type
"ZZ" and enter verbatim.
If any of the following are mentioned, backup to previous screen and correct the entry.
Mexican
Mexican American
Chicano/Chicana
Central American (REFER TO HELP SCREEN)
South American (REFER TO HELP SCREEN)
Puerto Rican (Boricua)
Cuban/Cuban American
Dominican (Republic)
* If respondent provides more than one other Hispanic or Latino ancestry or origin, select 'ZZ'
from the lookup table. At the next question, enter ALL the other Hispanic or Latino ancestries
or origins in the verbatim field.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Sample Child is of Other Hispanic Origin
Skip Instructions:
ZZ [goto HISPVRBAT_C]
lookup table selection,RF,DK
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0300.00.1
Variable: HISPVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Read if necessary: What is ^SCNAME's Hispanic or Latino ancestry or origin? If ^SCNAME has
more than one, tell me all of them.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Child 0-17 where some other Hispanic Ancestry is reported and this is not chosen from the picklist
Skip Instructions:
allow 80,RF,DK if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0310.00.1
Variable: PITYPE_C
Interview Module: Child
Content Type: Annual Core

Question text:

I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group or groups is
^SCNAME-- such as Guamanian or Chamorro, Samoan, or other Pacific Islander? If ^SCNAME is more
than one, tell me all of them.
Enter all that apply, separate with comma
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Guamanian or Chamorro
2 - Samoan
3 - Other Pacific Islander
7 - Refused
9 - Don't Know
Universe:
Sample children 0-17 identified as Pacific Islanders and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
3 [goto PIOTHER_C]
1,2,RF,DK if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0320.00.1
Variable: PIOTHER_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific ethnic
group or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of them.
* Start typing and then select from list. If Pacific Islander ethnic group is not on the list,
type "ZZ" and enter verbatim.
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Sample Child who is "Other Pacific Islander"
Skip Instructions:
ZZ [goto PIVRBAT_C]
lookup table selection, RF, DK
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0330.00.1
Variable: PIVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question text:

Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group
or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of them.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Child are some other group of Pacific Islander and this is not chosen from the picklist
Skip Instructions:
allow 80,RF,DK
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0340.00.1
Variable: ASIANTYPE_C
Interview Module: Child
Content Type: Annual Core

Question text:

I have recorded that ^SCNAME is Asian. What specific ethnic group or groups is ^SCNAME-- such as
Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian? If ^SCNAME is
more than one, tell me all of them.
Enter all that apply, separate with commas.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01 - Asian Indian
02 - Chinese
03 - Filipino
04 - Japanese
05 - Korean
06 - Vietnamese
07 - Other Asian
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 identified as Asian and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
7 [goto ASIANOTHER_C]
1-6,RF,DK
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0350.00.1
Variable: ASIANOTHER_C
Interview Module: Child
Content Type: Annual Core

Question text:

What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has more than one, tell me
all of them.
Start typing and then select from list. If Asian ethnic group is not on the list, type "ZZ" and
enter verbatim.
If any of the following are mentioned, backup to previous screen and correct the entry.
(Asian) Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Sample Child who is "other Asian"
Skip Instructions:
ZZ [goto ASIANVRBAT_C]
lookup table selection,RF,DK
if GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG ne 1 and
ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0360.00.1
Variable: ASIANVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question text:

Read if necessary: What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has more
than one, tell me all of them.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Child is some other ethnic group of Asian and this is not chosen from the picklist
Skip Instructions:
allow 80,RF,DK
if GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG ne 1 and
ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]
Question ID: VFY.0370.00.1
Variable: RACEOTHER_C
Interview Module: Child
Content Type: Annual Core

Question text:

What other race or races is ^SCNAME?
Start typing and then select from list. If race is not on the list, type "ZZ" and enter
verbatim.
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the
next question, enter ALL the other races in the verbatim field.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
ZZ - Other
97 - Refused
99 - Don't Know
Universe:
Sample Child's race was changed to "some other race" in verification section or where the Sample Child respondent is not the Household respondent and were identified by the household respondent as being "some other race" not on the roster other race picklist and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
ZZ [goto RACEVRBAT_C]
lookup table selection, RF,DK [goto BMONTH_C]
Question ID: VFY.0380.00.1
Variable: RACEVRBAT_C
Interview Module: Child
Content Type: Annual Core

Question text:

Read if necessary: What other race or races is ^SCNAME?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Child's race was change to include "some other race" in verification section or where the Sample Child respondent is not the Household respondent and were identified by the household respondent as being "some other race" not on the roster other race picklist and the Sample Child Respondent did not select it from the Sample Adult other race picklist.
Skip Instructions:
verbatim,RF,DK [goto BMONTH_C]
Question ID: VFY.0410.01.1
Variable: BMONTH_C
Interview Module: Child
Content Type: Annual Core

Question text:

* 1 of 3
What is ^SCNAME's date of birth?
Please give month, day, and year for the date of birth.
* Enter month of birth.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
97 - Refused
99 - Don't Know
Universe:
A person who is knowledgeable or responsible for the sample child's health is available or there is only one parent over 18 and no other adults in the child's family or there are more than two adults and one of them is a parent who was identified as available at AVAIL_C AND date of birth was verified as incorrect fewer than 2 times and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1-12,RF,DK [goto BDAY_C]
Question ID: VFY.0410.02.1
Variable: BDAY_C
Interview Module: Child
Content Type: Annual Core

Question text:

* 2 of 3
* Enter day of birth.
Response:
01-31 - Range of values
97 - Refused
99 - Don't Know
Universe:
A person who is knowledgeable or responsible for the sample child's health is available or there is only one parent over 18 and no other adults in the child's family or there are more than two adults and one of them is a parent who was identified as available at AVAIL_C AND date of birth was verified as incorrect fewer than 2 times and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1-31,RF,DK Only allow valid days for month entered. if days not valid [goto ERR_BDAY_C]
else [goto BYEAR_C]
Hard Edit:
Check Text: ERR_BDAY_C
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAY_C}
^BDAY_C is not a valid day for ^BMONTH_C.
Question ID: VFY.0410.03.1
Variable: BYEAR_C
Interview Module: Child
Content Type: Annual Core

Question text:

* 3 of 3
* Enter year of birth.
Response:
Year - Year
9997 - Refused
9999 - Don't Know
Universe:
A person who is knowledgeable or responsible for the sample child's health is available or there is only one parent over 18 and no other adults in the child's family or there are more than two adults and one of them is a parent who was identified as available at AVAIL_C AND date of birth was verified as incorrect fewer than 2 times and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1900-current year,RF,DK
if (BYEAR_C gt current year) or (BYEAR_C=current year and BMONTH_C gt current month) or
(BYEAR_C=current year and BMONTH_C=current month and BDAY_C gt current day) [goto ERR_BYEAR_C]
elseif BDAY_C=29 and BMONTH_C=2 and (BYEAR=2000 or BYEAR_C/4 remainder ne 0) [goto
ERR_BDAYLEAP_C]
elseif AGETEMP_C in (RF,DK) AND BYEAR_C in (RF,DK) [goto NOMORE_C]
elseif ((BYEAR_C not IN (RF,DK) and AGETEMP_C not IN (RF,DK) and AGETEMP_C ne AGE_CALC_C) AND
(AGETEMP_C not IN (RF,DK) and AGETEMP_C ne AGE_CALCMINUS1_C)) and DOB_COUNT_C ne 1 [goto
VFYDOB_C]
elseif (AGETEMP_C eq AGE_CALC_C or AGE_CALCMINUS1_C) or DOB_COUNT_C=1
if AGE_FINAL ge 18 [goto NOMORE_C]
else [goto next section]
Hard Edit:
Check Text: ERR_BYEAR_C
Check Description: Future date hard edit
Check Text: {check ERR_BYEAR_C} Future date invalid.

Check Text: ERR_BDAYLEAP_C
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAYLEAP_C}
^BDAY_C is not a valid day for ^BMONTH_C.
Question ID: VFY.0430.00.1
Variable: VFYDOB_C
Interview Module: Child
Content Type: Annual Core

Question text:

There is a difference between the age the computer calculated from ^SCNAME's date of birth of
^AGEDOB_C_fill and the age I had previously recorded of ^TEMPAGE_C.
I recorded ^SCNAME's ^dateofbirth_C
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^AGEDOB_C_fill
Description: Age(s) calculated from Date of Birth for SC
Instruction:
Fill one age calculated from AGE_CALC_C as "(age) year(s) old"
Fill two ages calculated from AGE_CALC_C and
AGE_CALCMINUS1_C as "(age) or (age) year(s) old"
If AGE_CALC_C or AGE_CALCMINUS1_C is equal to 0, then
display as "less than 1"
^TEMPAGE_C
Description: {Value of AGETEMP_C} year(s) old/less than 1
Instruction:
fill value of AGETEMP_C as "(age) year(s) old" If AGETEMP_C is equal to 0, then display as "less than 1"
^dateofbirth_C
Description: date of birth when any of BDAY_C, BMONTH_C or BYEAR_C are not valid

Instruction:
If BDAY_C, BMONTH_C and BYEAR_C are all valid, fill: "date of birth as ^BMONTH_C ^BDAY_C, ^BYEAR_C, is that correct?"
If only BMONTH_C and BYEAR_C are valid, fill: "date of
birth as ^BMONTH_C ^BYEAR_C, is that correct?"
If only BDAY_C and BYEAR_C are valid, fill: "year of birth
as ^BYEAR_C, is that correct?"
If only BYEAR_C is valid, fill: "year of birth as
^BYEAR_C, is that correct?"
^BMONTH_C
Description: {Value of BMONTH_C}
Instruction:
Fill value from Child.VFY.BMONTH_C
^BDAY_C
Description: {Value of BDAY_C}
Instruction:
Fill value from Child.VFY.BDAY_C
^BYEAR_C
Description: {Value of BYEAR_C}
Instruction:
Fill value from Child.VFY.BYEAR_C
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children whose age provided in either HHC or NEWAGE_C does not match either age calculated from date of birth information and the Sample Child's spouse or partner is not the respondent
Skip Instructions:
1,RF,DK if GEN.AGE_FINAL[PX_C] ge 18 [goto NOMORE_C]
else [goto next section]
2 if DOB_COUNT_C le 1 [goto BMONTH_C]
elseif GEN.AGE_FINAL[PX_C] ge 18 [goto NOMORE_C]
else [goto next section]
Question ID: VFY.0440.00.1
Variable: NOMORE_C
Interview Module: Child
Content Type: Annual Core

Question text:

* ^SCNAME no longer meets the requirements to be sample child for this family. End this
interview and begin the Sample Adult Interview. If there is no Sample Adult or the Sample Adult
interview has been completed, EXIT
^auxNoMore
Not everyone in our survey is asked all questions. I have all the information that I need from
you about ^SCNAME.
* Enter '1' to continue.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^auxNoMore
Description: If there is still a knowledgeable respondent available, back up and select that person.

Instruction:
IF KNOAVAIL_Count = 0, fill "* If there is still a knowledgeable respondent available, back up and select
that person."
Response:
1 - Enter 1 to Continue
Universe:
Sample child whose age is now over 17 or whose age is refused or don't know or who lives offcampus or there is no knowledgeable sample child respondent
Skip Instructions:
If there is a callback set for Sample Adult [goto BCK.THANKS_CB]
else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

2022 National Health Interview Survey (NHIS) Questionnaire
HIS: Health Status
Question ID: HIS.0010.00.1
Variable: PHSTAT_C
Interview Module: Child
Content Type: Annual Core

Question text:

Would you say ^SCNAME's health in general is excellent, very good, good, fair, or poor?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Excellent
2 - Very Good
3 - Good
4 - Fair
5 - Poor
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1-5,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
LS1: Satisfaction with life
Question ID: LS1.0010.00.3
Variable: LSATIS11_C
Interview Module: Child
Content Type: Sponsored Content

Question text:

Using a scale of 0 to 10, where 0 means "very dissatisfied" and 10 means "very satisfied", how
do you think ^SCNAME feels about ^hisher_C life as a whole these days?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
00-10 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Children 12-17
Skip Instructions:
0-10,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
AST: Asthma
Question ID: AST.0010.00.1
Variable: ASTINTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

Now I am going to ask you about certain medical conditions.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto ASEV_C]
Question ID: AST.0020.00.1
Variable: ASEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has a doctor or other health professional EVER told you that ^SCNAME had asthma?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto ASTILL_C]
2,RF,DK [goto next section]
Question ID: AST.0030.00.1
Variable: ASTILL_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME still have asthma?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who were ever told they have asthma
Skip Instructions:
1,2,RF,DK [goto ASAT12M_C]
Question ID: AST.0040.00.1
Variable: ASAT12M_C
Interview Module: Child
Content Type: Annual Core

Question text:

During the past 12 months, has ^SCNAME had an episode of asthma or an asthma attack?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who were ever told they had asthma
Skip Instructions:
1,2,RF,DK [goto ASER12M_C]
Question ID: AST.0050.00.1
Variable: ASER12M_C
Interview Module: Child
Content Type: Annual Core

Question text:

During the past 12 months, did ^SCNAME have to visit an emergency room or urgent care center
because of ^hisher_C asthma?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who were ever told they had asthma
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DIB: Diabetes
Question ID: DIB.0010.00.1
Variable: PREDIB_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has a doctor or other health professional EVER told you that ^SCNAME had prediabetes or
borderline diabetes?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample children 0-17
Skip Instructions:
1,2,RF,DK [goto DIBEV_C]
Question ID: DIB.0020.00.1
Variable: DIBEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

^NOTPRED a doctor or other health professional EVER told you that ^SCNAME had diabetes?
Fills:
^NOTPRED
Description: Not including prediabetes, has/Has
Instruction:
If PREDIB_C=1: "Not including prediabetes, has" If PREDIB_C IN ('2','DK','RF'): "Has"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DLD: Developmental and Learning Disabilities
Question ID: DLD.0010.00.1
Variable: ADHDEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has a doctor or other health professional ever told you that ^SCNAME had AttentionDeficit/Hyperactivity Disorder or ADHD or Attention-Deficit Disorder or ADD?
* Read if necessary: Health professionals can include school psychologists and school nurses.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1 [goto ADHDNW_C]
2,RF,DK [goto IDEV1_C]
Question ID: DLD.0020.00.1
Variable: ADHDNW_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME currently have Attention-Deficit/Hyperactivity Disorder or ADHD or AttentionDeficit Disorder or ADD?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17 who had an ADHD diagnosis
Skip Instructions:
1,2,RF,DK [goto IDEV1_C]
Question ID: DLD.0030.00.1
Variable: IDEV1_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has a doctor or other health professional ever told you that ^SCNAME had an intellectual
disability, previously known as mental retardation?
* Read if necessary: Health professionals can include school psychologists and school nurses.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto IDNW1_C]
2,RF,DK [goto ASDEV_C] if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17, else [goto
DDEV_C]
Question ID: DLD.0040.00.1
Variable: IDNW1_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME currently have an intellectual disability, previously known as mental retardation?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who had an intellectual disability diagnosis
Skip Instructions:
1,2,RF,DK if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto ASDEV_C]
else [goto DDEV_C]
Question ID: DLD.0050.00.1
Variable: ASDEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has a doctor or other health professional ever told you that ^SCNAME had Autism, Asperger's
disorder, pervasive developmental disorder, or autism spectrum disorder?
* Read if necessary: Health professionals can include school psychologists and school nurses.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1 [goto ASDNW_C]
2,RF,DK [goto DDEV_C]
Question ID: DLD.0060.00.1
Variable: ASDNW_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME currently have Autism, Asperger's disorder, pervasive developmental disorder, or
autism spectrum disorder?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17 who had an autism spectrum disorder diagnosis
Skip Instructions:
1,2,RF,DK [goto DDEV_C]
Question ID: DLD.0070.00.1
Variable: DDEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

^NOTEVER a doctor or other health professional ever told you that ^SCNAME had any other
developmental delay?
* Read if necessary: Health professionals can include school psychologists and school nurses.
* Read if necessary: Developmental delays are significant delays in a child's development.
Examples include cognitive, motor, speech, social, emotional and behavioral delays.
Fills:
^NOTEVER
Description: Has/Not including (ADHD, intellectual disability, autism spectrum disorder), has

Instruction:
If ADHDEV_C ne 1 AND IDEV1_C ne 1 and ASDEV_C ne 1 fill: "Has"
If ADHDEV_C=1 AND IDEV1_C ne 1 and ASDEV_C ne 1 fill: "Not
including ADHD, has"
If ADHDEV_C ne 1 AND IDEV1_C=1 and ASDEV_C ne 1 fill: "Not
including an intellectual disability, has"
If ADHDEV_C ne 1 AND IDEV1_C ne 1 and ASDEV_C=1 fill: "Not
including autism spectrum disorder, has"
If ADHDEV_C=1 AND IDEV1_C=1 and ASDEV_C ne fill: "Not
including ADHD or an intellectual disability, has"
If ADHDEV_C=1 AND IDEV1_C ne 1 and ASDEV_C=1 fill: "Not
including ADHD or autism spectrum disorder, has"
If ADHDEV_C ne 1 AND IDEV1_C=1 and ASDEV_C=1 fill: "Not
including an intellectual disability or autism spectrum
disorder, has"
If ADHDEV_C=1 AND IDEV1_C=1 and ASDEV_C=1 fill: "Not
including ADHD, an intellectual disability or autism
spectrum disorder, has"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto DDNW_C]
2,RF,DK if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto LDEV_C]
else [goto next section]
Question ID: DLD.0080.00.1
Variable: DDNW_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME still have this other developmental delay?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who had any other developmental delay diagnosis
Skip Instructions:
1,2,RF,DK if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto LDEV_C]
else [goto next section]
Question ID: DLD.0090.00.1
Variable: LDEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has a representative from a school or a health professional ever told you that ^SCNAME had a
learning disability?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1 [goto LDNW_C]
2,RF,DK [goto next section]
Question ID: DLD.0100.00.1
Variable: LDNW_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME currently have a learning disability?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17 who had a learning disability diagnosis
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
BMI: Height and Weight
Question ID: BMI.0010.01.2
Variable: HEIGHTFT_C
Interview Module: Child
Content Type: Rotating Core

Question text:

How tall is ^SCNAME without shoes?
* Enter feet.
* If the child's height is given in inches, press '0' at feet and enter the measure in inches
(36 inches maximum).
* Enter 'M' to record metric measurements.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
00 - 0 feet
01 - 1 foot
02 - 2 feet
03 - 3 feet
04 - 4 feet
05 - 5 feet
06 - 6 feet
07 - 7 feet
M - Answered in Metric
97 - Refused
99 - Don't Know
Universe:
Sample Children 10-17
Skip Instructions:
if HEIGHTFT_C ne 0-7,RF,DK,M [goto ERR1_HEIGHTFT_C]
0-7 [goto HEIGHTIN_C]
RF,DK [goto WEIGHTLB_C]
M [goto HEIGHTM_C]
Hard Edit:
Check Text: ERR1_HEIGHTFT_C
Check Description: Hard edit for height in feet
Check Text: {check ERR1_HEIGHTFT_C}
Only 0-7, Don't know/Refused, or M allowed in this field. Please correct.
Question ID: BMI.0010.02.2
Variable: HEIGHTIN_C
Interview Module: Child
Content Type: Rotating Core

Question text:

* Enter inches.
* Enter '0' if exactly ^HEIGHTFT_C feet tall.
Fills:
^HEIGHTFT_C
Description: {Value of HEIGHTFT_C}
Instruction:
fill value from HEIGHTFT_C
Response:
00 - 0 inches
01 - 1 inch
02 - 2 inches
03 - 3 inches
04 - 4 inches
05 - 5 inches
06 - 6 inches
07 - 7 inches
08 - 8 inches
09 - 9 inches
10 - 10 inches
11 - 11 inches
97 - Refused
99 - Don't Know
Universe:
Sample Children 10-17 whose height in feet is 0-7
Skip Instructions:
If (HEIGHTFT_C=0) and (HEIGHTIN_C=0) [goto ERR1_HEIGHTIN_C]
elseif HEIGHTFT_C=1-7 and HEIGHTIN_C ge 12 [goto ERR2_HEIGHTIN_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (CHTINCH_C lt 50 or CHTINCH_C gt 60)) or
(GEN.AGE_FINAL=011 and (CHTINCH_C lt 52 or CHTINCH_C gt 62)) or
(GEN.AGE_FINAL=012 and (CHTINCH_C lt 53 or CHTINCH_C gt 64)) or
(GEN.AGE_FINAL=013 and (CHTINCH_C lt 56 or CHTINCH_C gt 67)) or
(GEN.AGE_FINAL=014 and (CHTINCH_C lt 58 or CHTINCH_C gt 70)) or
(GEN.AGE_FINAL=015 and (CHTINCH_C lt 61 or CHTINCH_C gt 72)) or
(GEN.AGE_FINAL=016 and (CHTINCH_C lt 63 or CHTINCH_C gt 74)) or
(GEN.AGE_FINAL=017 and (CHTINCH_C lt 63 or CHTINCH_C gt 74))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (CHTINCH_C lt 50 or CHTINCH_C gt 60)) or
(GEN.AGE_FINAL=011 and (CHTINCH_C lt 51 or CHTINCH_C gt 62)) or
(GEN.AGE_FINAL=012 and (CHTINCH_C lt 54 or CHTINCH_C gt 65)) or
(GEN.AGE_FINAL=013 and (CHTINCH_C lt 57 or CHTINCH_C gt 67)) or
(GEN.AGE_FINAL=014 and (CHTINCH_C lt 58 or CHTINCH_C gt 68)) or
(GEN.AGE_FINAL=015 and (CHTINCH_C lt 59 or CHTINCH_C gt 69)) or
(GEN.AGE_FINAL=016 and (CHTINCH_C lt 59 or CHTINCH_C gt 69)) or
(GEN.AGE_FINAL=017 and (CHTINCH_C lt 59 or CHTINCH_C gt 69))) [goto ERR3_HEIGHTIN_C]
else 0-36,RF,DK [goto WEIGHTLB_C]
Hard Edit:
Check Text: ERR1_HEIGHTIN_C
Check Description: Hard edit for height in inches
Check Text: {check ERR1_HEIGHTIN_C}
Must enter an answer in at least the inches item. Please correct.

Check Text: ERR2_HEIGHTIN_C
Check Description: Hard edit for height in inches
Check Text: {check ERR2_HEIGHTIN_C}
Number of inches exceeds maximum allowed. Please correct.
Soft Edit:
Check Text: ERR3_HEIGHTIN_C
Check Description: Soft edit for height in inches
Check Text: {signal ERR3_HEIGHTIN_C}
Please verify that the height was entered correctly. Probe only if necessary.
Question ID: BMI.0010.04.2
Variable: HEIGHTM_C
Interview Module: Child
Content Type: Rotating Core

Question text:

How tall is ^SCNAME without shoes?
* Enter height in metric.
* If the child's height is given in centimeters, press '0' at meters and enter the measure in
centimeters (241 centimeters maximum).
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
0 - 0 meters
1 - 1 meter
2 - 2 meters
7 - Refused
9 - Don't Know
Universe:
Sample Children 10-17 whose current height will be entered in metric
Skip Instructions:
0-2 [goto HEIGHTCM_C]
RF,DK [goto WEIGHTLB_C]
Question ID: BMI.0010.05.2
Variable: HEIGHTCM_C
Interview Module: Child
Content Type: Rotating Core

Question text:

* Enter height in centimeters.
Response:
000-241 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Children 10-17 whose height will be entered in metric, and who entered 0-2 for height in meters
Skip Instructions:
If (HEIGHTM_C IN (0)) and (HEIGHTCM_C IN (0)) [goto ERR1_HEIGHTCM_C]
elseif (HEIGHTM_C=2 and HEIGHTCM_C gt 41) or (HEIGHTM_C=1 and HEIGHTCM_C gt 141) [goto
ERR2_HEIGHTCM_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (CHTCM_C lt 127 or CHTCM_C gt 152)) or
(GEN.AGE_FINAL=011 and (CHTCM_C lt 131 or CHTCM_C gt 157)) or
(GEN.AGE_FINAL=012 and (CHTCM_C lt 136 or CHTCM_C gt 164)) or
(GEN.AGE_FINAL=013 and (CHTCM_C lt 142 or CHTCM_C gt 171)) or
(GEN.AGE_FINAL=014 and (CHTCM_C lt 149 or CHTCM_C gt 179)) or
(GEN.AGE_FINAL=015 and (CHTCM_C lt 155 or CHTCM_C gt 184)) or
(GEN.AGE_FINAL=016 and (CHTCM_C lt 159 or CHTCM_C gt 187)) or
(GEN.AGE_FINAL=017 and (CHTCM_C lt 161 or CHTCM_C gt 189))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (CHTCM_C lt 126 or CHTCM_C gt 151)) or
(GEN.AGE_FINAL=011 and (CHTCM_C lt 131 or CHTCM_C gt 158)) or
(GEN.AGE_FINAL=012 and (CHTCM_C lt 137 or CHTCM_C gt 165)) or
(GEN.AGE_FINAL=013 and (CHTCM_C lt 144 or CHTCM_C gt 170)) or
(GEN.AGE_FINAL=014 and (CHTCM_C lt 148 or CHTCM_C gt 173)) or
(GEN.AGE_FINAL=015 and (CHTCM_C lt 150 or CHTCM_C gt 174)) or
(GEN.AGE_FINAL=016 and (CHTCM_C lt 150 or CHTCM_C gt 175)) or
(GEN.AGE_FINAL=017 and (CHTCM_C lt 151 or CHTCM_C gt 175))) [goto ERR3_HEIGHTCM_C]
0-241,RK,DK [goto WEIGHTLB_C]
Hard Edit:
Check Text: ERR1_HEIGHTCM_C
Check Description: Hard edit for height in centimeters
Check Text: {check ERR1_HEIGHTCM_C}
Must enter an answer at least in centimeters item. Please correct.

Check Text: ERR2_HEIGHTCM_C
Check Description: Hard edit for height in centimeters
Check Text: {check ERR2_HEIGHTCM_C}
Total height exceeds maximum allowed. Please correct.
Soft Edit:
Check Text: ERR3_HEIGHTCM_C
Check Description: Soft edit for height in centimeters
Check Text: {signal ERR3_HEIGHTCM_C}
Please verify that the height was entered correctly. Probe only if necessary.
Question ID: BMI.0020.01.2
Variable: WEIGHTLB_C
Interview Module: Child
Content Type: Rotating Core

Question text:

How much does ^SCNAME weigh now?
* Enter 'M' to record metric measurements.
* Enter '500' if 500 pounds or more.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
001-500 - Range of values
M - Answered in Metric
997 - Refused
999 - Don't Know
Universe:
Sample Children 10-17
Skip Instructions:
if WEIGHTLB_C lt 1 or WEIGHTLB_C gt 500 [goto ERR1_WEIGHTLB_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (WEIGHTLB_C lt 53 or WEIGHTLB_C gt 109)) or
(GEN.AGE_FINAL=011 and (WEIGHTLB_C lt 59 or WEIGHTLB_C gt 124)) or
(GEN.AGE_FINAL=012 and (WEIGHTLB_C lt 65 or WEIGHTLB_C gt 140)) or
(GEN.AGE_FINAL=013 and (WEIGHTLB_C lt 73 or WEIGHTLB_C gt 155)) or
(GEN.AGE_FINAL=014 and (WEIGHTLB_C lt 82 or WEIGHTLB_C gt 170)) or
(GEN.AGE_FINAL=015 and (WEIGHTLB_C lt 92 or WEIGHTLB_C gt 184)) or
(GEN.AGE_FINAL=016 and (WEIGHTLB_C lt 101 or WEIGHTLB_C gt 196)) or
(GEN.AGE_FINAL=017 and (WEIGHTLB_C lt 109 or WEIGHTLB_C gt 207))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (WEIGHTLB_C lt 53 or WEIGHTLB_C gt 113)) or
(GEN.AGE_FINAL=011 and (WEIGHTLB_C lt 59 or WEIGHTLB_C gt 129)) or
(GEN.AGE_FINAL=012 and (WEIGHTLB_C lt 66 or WEIGHTLB_C gt 145)) or
(GEN.AGE_FINAL=013 and (WEIGHTLB_C lt 74 or WEIGHTLB_C gt 160)) or
(GEN.AGE_FINAL=014 and (WEIGHTLB_C lt 81 or WEIGHTLB_C gt 171)) or
(GEN.AGE_FINAL=015 and (WEIGHTLB_C lt 87 or WEIGHTLB_C gt 180)) or
(GEN.AGE_FINAL=016 and (WEIGHTLB_C lt 92 or WEIGHTLB_C gt 186)) or
(GEN.AGE_FINAL=017 and (WEIGHTLB_C lt 96 or WEIGHTLB_C gt 190))) [goto ERR2_WEIGHTLB_C]
1-500,RF,DK [goto next section]
M [goto WEIGHTKG_C]
Hard Edit:
Check Text: ERR1_WEIGHTLB_C
Check Description: Hard error for weight in pounds
Check Text: {check ERR1_WEIGHTLB_C}
Weight is out of range (1-500). Please correct.
Soft Edit:
Check Text: ERR2_WEIGHTLB_C
Check Description: Soft edit for weight in pounds
Check Text: {signal ERR2_WEIGHTLB_C}
Please verify that the weight was entered correctly. Probe only if necessary.
Question ID: BMI.0020.02.2
Variable: WEIGHTKG_C
Interview Module: Child
Content Type: Rotating Core

Question text:

How much does ^SCNAME weigh now?
* Enter weight in kilograms.
* Enter '226' if 226 kilograms or more.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
001-226 - Range of values
997 - Refused
999 - Don't Know
Universe:
Sample Children 10-17 whose weight will be entered in metric
Skip Instructions:
if WEIGHTKG_C lt 1 or WEIGHTKG_C gt 226 [goto ERR1_WEIGHTKG_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (WEIGHTKG_C lt 24 or WEIGHTKG_C gt 49)) or
(GEN.AGE_FINAL=011 and (WEIGHTKG_C lt 27 or WEIGHTKG_C gt 56)) or
(GEN.AGE_FINAL=012 and (WEIGHTKG_C lt 29 or WEIGHTKG_C gt 63)) or
(GEN.AGE_FINAL=013 and (WEIGHTKG_C lt 33 or WEIGHTKG_C gt 70)) or
(GEN.AGE_FINAL=014 and (WEIGHTKG_C lt 37 or WEIGHTKG_C gt 77)) or
(GEN.AGE_FINAL=015 and (WEIGHTKG_C lt 42 or WEIGHTKG_C gt 83)) or
(GEN.AGE_FINAL=016 and (WEIGHTKG_C lt 46 or WEIGHTKG_C gt 89)) or
(GEN.AGE_FINAL=017 and (WEIGHTKG_C lt 49 or WEIGHTKG_C gt 94))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (WEIGHTKG_C lt 24 or WEIGHTKG_C gt 51)) or
(GEN.AGE_FINAL=011 and (WEIGHTKG_C lt 27 or WEIGHTKG_C gt 59)) or
(GEN.AGE_FINAL=012 and (WEIGHTKG_C lt 30 or WEIGHTKG_C gt 66)) or
(GEN.AGE_FINAL=013 and (WEIGHTKG_C lt 33 or WEIGHTKG_C gt 72)) or
(GEN.AGE_FINAL=014 and (WEIGHTKG_C lt 37 or WEIGHTKG_C gt 78)) or
(GEN.AGE_FINAL=015 and (WEIGHTKG_C lt 40 or WEIGHTKG_C gt 82)) or
(GEN.AGE_FINAL=016 and (WEIGHTKG_C lt 42 or WEIGHTKG_C gt 84)) or
(GEN.AGE_FINAL=017 and (WEIGHTKG_C lt 43 or WEIGHTKG_C gt 86))) [goto ERR2_WEIGHTKG_C]
1-226,RF,DK [goto next section]
Hard Edit:
Check Text: ERR1_WEIGHTKG_C
Check Description: Hard edit for weight in kilograms
Check Text: {check ERR1_WEIGHTKG_C}
Weight is out of range (1-226). Please correct.
Soft Edit:
Check Text: ERR2_WEIGHTKG_C
Check Description: Soft edit for weight in kilograms
Check Text: {signal ERR2_WEIGHTKG_C}
Please verify that the weight was entered correctly. Probe only if necessary.

2022 National Health Interview Survey (NHIS) Questionnaire
VIS: Vision
Question ID: VIS.0010.00.1
Variable: VISINTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

I would like to ask you some questions about difficulties ^SCNAME may have.
* Enter '1' to continue.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 2-17
Skip Instructions:
1 [goto WEARGLSS_C]
Question ID: VIS.0020.00.1
Variable: WEARGLSS_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME wear glasses ^CONTACTS?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^CONTACTS
Description: or contact lenses
Instruction:
If AGE=5-17 fill "or contact lenses"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1,2,RF,DK [goto VISIONDF_C]
Question ID: VIS.0030.00.1
Variable: VISIONDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

^GLASSCONTACT ^SCNAME have difficulty seeing? Would you say ^SCNAME has: no difficulty, some
difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?
Fills:
^GLASSCONTACT
Description: When wearing glasses ^CONTACTS does/Does
Instruction:
If WEARGLSS_C=1 fill "When wearing glasses ^CONTACTS does" else if WEARGLSS_C ne 1 "Does"
^CONTACTS
Description: or contact lenses
Instruction:
If AGE=5-17 fill "or contact lenses"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
HEA: Hearing
Question ID: HEA.0010.00.1
Variable: HEARAID_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME use a hearing aid?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1,2,RF,DK [goto HEARINGDF_C]
Question ID: HEA.0020.00.1
Variable: HEARINGDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

^USEHRAID_C ^SCNAME have difficulty hearing sounds like people's voices or music? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?
Fills:
^USEHRAID_C
Description: When using ^hisher_C hearing aid(s) does/Does
Instruction:
If HEARAID_C=1 fill "When using ^hisher_C hearing aid(s) does " else fill "Does "
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
MOB: Mobility
Question ID: MOB.0010.00.1
Variable: EQUIP_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME use any equipment or receive assistance for walking?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1 if GEN.AGE_FINAL[PX_C]=2-4 [goto NOEQWLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto NOEQWLK100_C]
2,RF,DK if GEN.AGE_FINAL[PX_C]=2-4 [goto WLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto WLK100_C]
Question ID: MOB.0020.00.1
Variable: NOEQWLKDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

Without using ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking? Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this
at all?
Fills:
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4 who use equipment or assistance for walking
Skip Instructions:
1-4,RF,DK [goto EQWLKDF_C]
Question ID: MOB.0030.00.1
Variable: EQWLKDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

When using ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4 who use equipment or assistance for walking
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: MOB.0040.00.1
Variable: WLKDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty walking? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4 who do not use equipment or assistance for walking or Refused or Don't Know
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: MOB.0050.00.1
Variable: NOEQWLK100_C
Interview Module: Child
Content Type: Annual Core

Question text:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking 100 yards
on level ground? That would be about the length of 1 football field or 1 city block. Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this
at all?
Fills:
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17 who use equipment or assistance for walking
Skip Instructions:
1-3,RF,DK [goto NOEQWLK13M_C]
4 [goto EQWLK100_C]
Question ID: MOB.0060.00.1
Variable: NOEQWLK13M_C
Interview Module: Child
Content Type: Annual Core

Question text:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking a third of
a mile on level ground? That would be about the length of 5 football fields or 5 city blocks.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17 who use equipment or assistance for walking and have no, some or a lot difficulty walking 100 yards when not using their equipment/assistance or Refused or Don't Know
Skip Instructions:
1-4,RF,DK [goto EQWLK100_C]
Question ID: MOB.0070.00.1
Variable: EQWLK100_C
Interview Module: Child
Content Type: Annual Core

Question text:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking 100 yards on
level ground? That would be about the length of 1 football field or 1 city block.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17 who use equipment or assistance for walking.
Skip Instructions:
1-3,RF,DK [goto EQWLK13M_C]
4 [goto next section]
Question ID: MOB.0080.00.1
Variable: EQWLK13M_C
Interview Module: Child
Content Type: Annual Core

Question text:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking a third of a
mile on level ground? That would be about the length of 5 football fields or 5 city blocks.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17 who use equipment or assistance for walking and have no, some or a lot of difficulty walking 100 yards when using their equipment/assistance or Refused or Don't Know
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: MOB.0090.00.1
Variable: WLK100_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty walking 100 yards on level
ground? That would be about the length of 1 football field or 1 city block. Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17 who do not use equipment or assistance for walking or Refused or Don't Know
Skip Instructions:
1-3,RF,DK [goto WLK13M_C]
4 [goto next section]
Question ID: MOB.0100.00.1
Variable: WLK13M_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty walking a third of a mile
on level ground? That would be about the length of 5 football fields or 5 city blocks.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17 who do not use equipment or assistance for walking and have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or Refused or Don't Know
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
UPP: Upper Body, Motor skills and self care
Question ID: UPP.0010.00.1
Variable: PICKUPDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty picking up small objects
with ^hisher_C hands?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: UPP.0020.00.1
Variable: SELFCAREDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have difficulty with self care, such as eating or dressing?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
COM: Communication
Question ID: COM.0010.00.1
Variable: UNDRSTYOU_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have difficulty understanding you?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4
Skip Instructions:
1-4,RF,DK [goto UNDRSTCHD_C]
Question ID: COM.0020.00.1
Variable: UNDRSTCHD_C
Interview Module: Child
Content Type: Annual Core

Question text:

When ^SCNAME speaks, do you have difficulty understanding ^himherthem_C?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^himherthem_C
Description: him/her/them
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "him"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "them"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: COM.0030.00.1
Variable: UNDRSTIHH_C
Interview Module: Child
Content Type: Annual Core

Question text:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being understood by people inside of
this household?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^doesheshedothey_C
Description: does he/does she/do they
Instruction:
If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto UNDRSTOHH_C]
Question ID: COM.0040.00.1
Variable: UNDRSTOHH_C
Interview Module: Child
Content Type: Annual Core

Question text:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being understood by people outside of
this household?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^doesheshedothey_C
Description: does he/does she/do they
Instruction:
If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
COG: Cognition
Question ID: COG.0010.00.1
Variable: LEARNDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty learning things?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-17
Skip Instructions:
1-4,RF,DK [goto REMEMBERDF_C]
Question ID: COG.0020.00.1
Variable: REMEMBERDF_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty remembering things?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
ANX: Anxiety
Question ID: ANX.0010.00.1
Variable: ANXFREQ_C
Interview Module: Child
Content Type: Annual Core

Question text:

How often does ^SCNAME seem very anxious, nervous, or worried? Would you say: daily, weekly,
monthly, a few times a year, or never?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-5,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DEP: Depression
Question ID: DEP.0010.00.1
Variable: DEPFREQ_C
Interview Module: Child
Content Type: Annual Core

Question text:

How often does ^SCNAME seem very sad or depressed? Would you say: daily, weekly, monthly, a few
times a year, or never?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-5,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
BEH: Behavior
Question ID: BEH.0010.00.1
Variable: BEHDFPLYG_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty playing? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4
Skip Instructions:
1-4,RF,DK [goto BEHKBHYG_C]
Question ID: BEH.0020.00.1
Variable: BEHKBHYG_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, how much does ^SCNAME kick, bite, or hit other children
or adults? Would you say: not at all, the same or less, more, or a lot more?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - The same or less
3 - More
4 - A lot more
7 - Refused
9 - Don't Know
Universe:
Sample Children 2-4
Skip Instructions:
1-4,RF,DK [goto next section]
Question ID: BEH.0030.00.1
Variable: BEHDFCNTR_C
Interview Module: Child
Content Type: Annual Core

Question text:

Compared with children of the same age, does ^SCNAME have difficulty controlling ^hisher_C
behavior?
Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto BEHDFFCS_C]
Question ID: BEH.0040.00.1
Variable: BEHDFFCS_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have difficulty concentrating on an activity that ^heshe_C enjoy^s doing?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
^s
Description: s
Instruction:
if SEX_FINAL[PX_C]=1,2 fill "s" else fill blank
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto BEHDFCHG_C]
Question ID: BEH.0050.00.1
Variable: BEHDFCHG_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have difficulty accepting changes in ^hisher_C routine?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto BEHDFMKFR_C]
Question ID: BEH.0060.00.1
Variable: BEHDFMKFR_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have difficulty making friends?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
1-4,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
BSC: Baby Pediatric Symptom Checklist
Question ID: BSC.0010.00.1
Variable: BSCINTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

* The following statements are not to be read to the respondent. They are displayed and included
here for legal reasons.
* The Baby Pediatric Symptom Checklist is part of the larger Survey of Well-being of Young
Children, copyrighted by Tufts Medical Center. For more information go to
https://www.floatinghospital.org/The-Survey-of-Wellbeing-of-Young-Children/Overview.aspx
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Children under 2 years
Skip Instructions:
1 [goto BSCNWPPL_C]
Question ID: BSC.0020.00.1
Variable: BSCNWPPL_C
Interview Module: Child
Content Type: Annual Core

Question text:

These next questions are about ^SCNAME's behavior. Think about what you would expect of other
children the same age, and tell me how much each statement applies to ^SCNAME.
Does ^SCNAME have a hard time being with new people? Would you say not at all, somewhat, or very
much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCNWPLCS_C]
Question ID: BSC.0030.00.1
Variable: BSCNWPLCS_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have a hard time in new places? Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCCHG_C]
Question ID: BSC.0040.00.1
Variable: BSCCHG_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have a hard time with change?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCHLOPPL_C]
Question ID: BSC.0050.00.1
Variable: BSCHLOPPL_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME mind being held by other people?
Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCCRYALT_C]
Question ID: BSC.0060.00.1
Variable: BSCCRYALT_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME cry a lot?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCCLMDWN_C]
Question ID: BSC.0070.00.1
Variable: BSCCLMDWN_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have a hard time calming down?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCFUSSY_C]
Question ID: BSC.0080.00.1
Variable: BSCFUSSY_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is ^SCNAME fussy or irritable?
Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCSTHE_C]
Question ID: BSC.0090.00.1
Variable: BSCSTHE_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is it hard to comfort ^SCNAME?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCSCHD_C]
Question ID: BSC.0100.00.1
Variable: BSCSCHD_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is it hard to keep ^SCNAME on a schedule or routine?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCPTSLP_C]
Question ID: BSC.0110.00.1
Variable: BSCPTSLP_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is it hard to put ^SCNAME to sleep?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCSTYSLP_C]
Question ID: BSC.0120.00.1
Variable: BSCSTYSLP_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME have trouble staying asleep?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto BSCPRLKSL_C]
Question ID: BSC.0130.00.1
Variable: BSCPRLKSL_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is it hard for ^youmembersoffamily to get enough sleep because of ^SCNAME?
* Read if necessary: Would you say not at all, somewhat, or very much?
Fills:
^youmembersoffamily
Description: you/members of your family
Instruction:
If PCNT='2' fill "you" else fill "members of your family"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know
Universe:
Sample Children with Age under 2 years
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
SCH: Schooling
Question ID: SCH.0010.00.1
Variable: SCHDYSMSS_C
Interview Module: Child
Content Type: Annual Core

Question text:

During the past 12 months, about how many days of school did ^SCNAME miss because ^HeShe_C had
an illness, injury, or disability?
* Enter '996' if child did not go to school in the past 12 months.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^HeShe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
000-365 - Range of values
996 - No school in past 12 months
997 - Refused
999 - Don't Know
Universe:
Sample Children 5-17
Skip Instructions:
0-99,996,RF,DK [goto SCHSPEDEV_C]
100-365 [goto ERR1_SCHDYSMSS_C]
366-995 [goto ERR2_SCHDYSMSS_C]
Hard Edit:
Check Text: ERR2_SCHDYSMSS_C
Check Description: hard check for days of missed school
Check Text: {check ERR2_SCHDYSMSS_C}
"366-995" days not allowed in this field.
Soft Edit:
Check Text: ERR1_SCHDYSMSS_C
Check Description: soft edit for 100-365 days of missed school
Check Text: {signal ERR1_SCHDYSMSS_C}
^SCHDYSMSS_C is an unusually large number, did ^SCNAME miss ^SCHDYSMSS_C days of school because of illness, injury, or disability? Please verify.
Question ID: SCH.0020.00.1
Variable: SCHSPEDEV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Has ^SCNAME ever had a special education or early intervention plan, such as an Individualized
Education Plan, an IEP, or an Individualized Family Service Plan, an IFSP?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto SCHSPED_C]
2,RF,DK [goto next section]
Question ID: SCH.0030.00.1
Variable: SCHSPED_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME currently have a special education or early intervention plan?
*Read if necessary: Consider special education or early intervention plans received during the
past school year.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who ever received special education services
Skip Instructions:
1 [goto SCHSPEDEM_C]
2,RF,DK [goto next section]
Question ID: SCH.0040.00.1
Variable: SCHSPEDEM_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^SCNAME receive these services to help with ^hisher_C emotions, concentration, behavior, or
mental health?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have received services in the past 12 months
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
INS: Health Insurance
Question ID: INS.0010.00.1
Variable: HICOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
The next questions are about health insurance. Include health insurance obtained through
employment or purchased directly as well as government programs like Medicare, Medicaid, and the
Children's Health Insurance Program that provide medical care or help pay medical bills. Is
^SCNAME covered by any kind of health insurance or some other kind of health care plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,R,D [goto HIKIND_C]
2 [goto MCAIDPRB_C]
Question ID: INS.0020.00.1
Variable: HIKIND_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
What kinds of health insurance or health care coverage does ^SCNAME have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.
Skip Instructions:
if 1 answer selected and (10> in HIKIND_C) [goto ERR1_HIKIND_C]
else if HIKIND_C=RF,DK or (10 in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]
Hard Edit:
Check Text: ERR1_HIKIND_C
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_C}
Cannot mark "no coverage of any kind" and another type. Please correct.
Question ID: INS.0030.00.1
Variable: MCAIDPRB_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
There is a program called Medicaid that pays for health care for persons in need. ^STATEMA Is
^SCNAME covered by Medicaid?
Fills:
^STATEMA
Description: In ^STATENAME it is also called ^STMEDICAID.
Instruction:
if STMEDICAID ne empty, fill: "In ^STATENAME it is also called ^STMEDICAID."
else fill: blank
^STATENAME
Description: State name
Instruction:
If ST=AL, fill: Alabama else if ST=AK, fill: Alaska
else if ST=AR, fill: Arkansas
else if ST=AZ, fill: Arizona
else if ST=CA, fill: California
else if ST=CO, fill: Colorado
else if ST=CT, fill: Connecticut
else if ST=DE, fill: Delaware
else if ST=DC, fill: District of Columbia
else if ST=FL, fill: Florida
else if ST=GA, fill: Georgia
else if ST=HI, fill: Hawaii
else if ST=ID, fill: Idaho
else if ST=IL, fill: Illinois
else if ST=IN, fill: Indiana
else if ST=IA, fill: Iowa
else if ST=KS, fill: Kansas
else if ST=KY, fill: Kentucky
else if ST=LA, fill: Louisiana
else if ST=ME, fill: Maine
else if ST=MD, fill: Maryland
else if ST=MA, fill: Massachusetts
else if ST=MI, fill: Michigan
else if ST=MN, fill: Minnesota
else if ST=MS, fill: Mississippi
else if ST=MO, fill: Missouri
else if ST=MT, fill: Montana
else if ST=NE, fill: Nebraska
else if ST=NV, fill: Nevada
else if ST=NH, fill: New Hampshire
else if ST=NJ, fill: New Jersey
else if ST=NM, fill: New Mexico
else if ST=NY, fill: New York
else if ST=NC, fill: North Carolina
else if ST=ND, fill: North Dakota
else if ST=OH, fill: Ohio
else if ST=OK, fill: Oklahoma
else if ST=OR, fill: Oregon
else if ST=PA, fill: Pennsylvania
else if ST=RI, fill: Rhode Island
else if ST=SC, fill: South Carolina
else if ST=SD, fill: South Dakota
else if ST=TN, fill: Tennessee
else if ST=TX, fill: Texas
else if ST=UT, fill: Utah
else if ST=VT, fill: Vermont
else if ST=VA, fill: Virginia
else if ST=WA, fill: Washington
else if ST=WV, fill: West Virginia
else if ST=WI, fill: Wisconsin
else if ST=WY, fill: Wyoming
^STMEDICAID
Description: State Medicaid name
Instruction:
If AL then fill "Alabama Coordinated Health Network (ACHN)"
If AK then fill "DenaliCare"
If AZ then fill "Arizona Health Care Cost Containment
System (AHCCCS)"
If AR then fill "ARMedicaid; ARKids First; Arkansas Works;
Provider-led Arkansas Shared Savings Entity (PASSE)"
If CA then fill "Medi-Cal"
If CO then fill "Health First Colorado"
If CT then fill "HUSKY Health"
If DC then fill "DC Medicaid"
If DE then fill "Diamond State Health Plan (DSHP)"
If FL then fill "FL Medicaid; FL Statewide Medicaid
Managed Care (SMMC)"
If GA then fill "GA Medicaid; Georgia Families"
If HI then fill "Med-QUEST; QUEST Integration"
If ID then fill "Idaho Medicaid Health Plan"
If IL then fill "Medical Assistance"
If IN then fill "Healthy Indiana Plan (HIP); Hoosier
Healthwise"
If IA then fill "IA Health Link; Iowa Health and Wellness
Plan"
If KS then fill "KanCare; Kansas Medical Assistance
Program (KMAP); OneCare Kansas"
If KY then fill "Kentucky Medicaid"
If LA then fill "Healthy Louisiana"
If ME then fill "MaineCare"
If MD then fill "HealthChoice"
If MA then fill "MassHealth"
If MI then fill "MI Medicaid Health Plan; Healthy Michigan
Plan (HMP)"
If MN then fill "Medical Assistance (MA)"
If MS then fill "MississippiCAN"
If MO then fill "MO Healthnet"
If MT then fill "Passport to Health; Healthy Montana Kids
Plus (HMK Plus)"
If NC then fill "NC Medicaid Managed Care"
If ND then fill "North Dakota Medicaid"
If NE then fill "Heritage Health"
If NH then fill " Granite Advantage Health Care Program"
If NJ then fill "NJ Family Care"
If NM then fill "Centennial Care"
If NV then fill "Nevada Medicaid"
If NY then fill "New York Medicaid; New York Medicaid
Choice"
If OH then fill "Ohio Medicaid State Plan; Healthy
Families; Healthy Start; Alternative Benefit Plan (ABP)"
If OK then fill "SoonerCare"
If OR then fill "Oregon Health Plan (OHP)"
If PA then fill "Medical Assistance; HealthChoices"
If RI then fill "RIte Care;
If SC then fill "Healthy Connections"
If SD then fill "South Dakota Medicaid"
If TN then fill "TennCare"
If TX then fill "State of Texas Access Reform (STAR); STAR
+PLUS; STAR Kids"
If UT then fill "Utah Medicaid; Utah Medicaid Integrated
Care (UMIC)"
If VT then fill "Green Mountain Care; Dr. Dynasaur"
If VA then fill "Medallion 4.0; Commonwealth Care Plus
(CCC Plus); Cover Virginia"
If WA then fill "Apple Health"
If WV then fill "Mountain Health Trust (MHT)"
If WI then fill "ForwardHealth; BadgerCare Plus"
If WY then fill "WYhealth"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
- 2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have indicated they are uninsured, refused, or don't know if they are insured
Skip Instructions:
1,2,RF,DK [goto SINCOVDE_C]
Question ID: INS.0040.00.1
Variable: SINCOVDE_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
^INADDITIONIS ^SCNAME covered by a SEPARATE plan that only pays for dental services?
Fills:
^INADDITIONIS
Description: In addition to ^HITYPECNOSS, is/Is
Instruction:
If (HIKIND_C=1-9 or MCAIDPRB_C=1), fill "In addition to ^HITYPECNOSS, is"
else fill "Is"
^HITYPECNOSS
Description: Type of health care plans without single service plans
Instruction:
fill coverage types from HIKIND_C, except HIKIND_C=10, HIKIND_C=1 fill: "private health insurance"
HIKIND_C=2 fill: "Medicare"
HIKIND_C=3 fill: "Medicare Supplement or Medigap"
HIKIND_C=4 fill: "Medicaid"
HIKIND_C=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_C=6 fill: "military related health care"
HIKIND_C=7 fill: "Indian Health Service"
HIKIND_C=8 fill: "a state-sponsored health plan"
HIKIND_C=9 fill: "an other government program"
if MCAIDPRB_C=1, fill "Medicaid"
separate choices with a comma and seperate the last two
choices with "and"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,2,RF,DK [goto SINCOVVS_C]
Question ID: INS.0050.00.1
Variable: SINCOVVS_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is ^SCNAME covered by a SEPARATE plan that only pays for vision services?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,2,RF,DK [goto SINCOVRX_C]
Question ID: INS.0060.00.1
Variable: SINCOVRX_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is ^SCNAME covered by a SEPARATE plan that only pays for prescriptions?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,2,RF,DK [goto HICHANGE_C]
Question ID: INS.0070.00.1
Variable: HICHANGE_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
I have recorded ^SCNAME is ^COVEREDC. Is this correct?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^COVEREDC
Description: not covered by health insurance/covered by ^HITYPEC
Instruction:
if HIKIND_C=10,R,D and MCAIDPRB_C=2,R,D and SINCOVDE_C=2,R,D and SINCOVVS_C=2,R,D and SINCOVRX_C=2,R,D
fill: "not covered by health insurance"
else fill: "covered by ^HITYPEC"
^HITYPEC
Description: Type of health care plans with single service plans
Instruction:
fill coverage types from HIKIND_C, except HIKIND_C=10, HIKIND_C=1 fill: "private health insurance"
HIKIND_C=2 fill: "Medicare"
HIKIND_C=3 fill: "Medicare Supplement or Medigap"
HIKIND_C=4 fill: "Medicaid"
HIKIND_C=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_C=6 fill: "military related health care"
HIKIND_C=7 fill: "Indian Health Service"
HIKIND_C=8 fill: "a state-sponsored health plan"
HIKIND_C=9 fill: "an other government program"
if MCAIDPRB_C=1, fill "Medicaid"
If SINCOVDE_C=1 and SINCOVRX_C=2,RF,DK and
SINCOVVS_C=2,RF,DK, fill: "a single service dental plan"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=1 and
SINCOVVS_C=2,RF,DK, fill: "a single service prescription
plan"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=2,RF,DK and
SINCOVVS_C=1, fill: "a single service vision plan"
If SINCOVDE_C=1 and SINCOVRX_C=1 and SINCOVVS_C=2,RF,DK,
fill: "single service dental and prescription plans"
If SINCOVDE_C=1 and SINCOVRX_C=2,RF,DK and SINCOVVS_C=1,
fill: "single service dental and vision plans"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=1 and SINCOVVS_C=1,
fill: "single service vision and prescription plans"
If SINCOVDE_C=1 and SINCOVRX_C=1 and SINCOVVS_C=1, fill:
"single service dental, vision, and prescription plans"
separate choices with a comma and separate the last two
choices with "and"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,RF,DK
if 2 in HIKIND_C [goto MCPART_C]
else if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C]
else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else if 7 in HIKIND_C [goto HINOTYR_C]
else if 10 in HIKIND_C and MCAIDPRB_C IN (2,RF,DK) [goto HILAST_C]
else [goto FINISH_C]
2 [goto ERR1_HICHANGE_C]
Hard Edit:
Check Text: ERR1_HICHANGE_C
Check Description:
Check Text: {check ERR1_HICHANGE_C} Press enter to go back to HIKIND_C and update coverage.
Question ID: INS.0080.00.1
Variable: MCPART_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
What type of Medicare coverage does ^SCNAME have? Is it Part A - hospital insurance, Part B -
medical insurance, or both?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Part A- hospital only
2 - Part B- medical only
3 - Both Part A and Part B
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicare
Skip Instructions:
2,3,RF,DK [goto MCCHOICE_C] less than 1> [goto MCPARTD_C]
Question ID: INS.0090.00.1
Variable: MCCHOICE_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is ^SCNAME enrolled in a Medicare Advantage plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicare part B only or both parts A and B
Skip Instructions:
1,2,RF,DK [goto MCHMO_C]
Question ID: INS.0100.00.1
Variable: MCHMO_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is ^SCNAME under a Medicare managed care arrangement, such as an HMO, that is, a Health
Maintenance Organization?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicare part B only or both parts A and B
Skip Instructions:
1 [goto MCANAME_C]
2,RF,DK if MCCHOICE_C=1 [goto MCANAME_C]
else if MCCHOICE_C=2,RF,DK, [goto MCPARTD_C]
Question ID: INS.0110.00.1
Variable: MCANAME_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
What is the name of ^SCNAME's Medicare Advantage or Medicare HMO plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with a Medicare Advantage plan or a Medicare managed care arrangement
Skip Instructions:
verbatim, RF, DK [goto MCDNCOV_C]
Question ID: INS.0111.00.1
Variable: MCDNCOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Does ^MEDADVNAME_C pay for any of the costs for dental care?
Fills:
^MEDADVNAME_C
Description: {Value of MCANAME_C}/this Medicare Advantage or Medicare HMO plan

Instruction:
If MCANAME_C has value, fill value of MCANAME_C If MCANAME_C is DK/RF, fill: "this Medicare Advantage or
Medicare HMO plan"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a Medicare Advantage plan or a Medicare managed care arrangement
Skip Instructions:
1,2,RF,DK [goto MCVSCOV_C]
Question ID: INS.0112.00.1
Variable: MCVSCOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Does ^MEDADVNAME_C pay for any of the costs for routine vision care, such as glasses and contact
lenses?
Fills:
^MEDADVNAME_C
Description: {Value of MCANAME_C}/this Medicare Advantage or Medicare HMO plan

Instruction:
If MCANAME_C has value, fill value of MCANAME_C If MCANAME_C is DK/RF, fill: "this Medicare Advantage or
Medicare HMO plan"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a Medicare Advantage plan or a Medicare managed care arrangement
Skip Instructions:
1,2,RF,DK [goto MCPARTD_C]
Question ID: INS.0120.00.1
Variable: MCPARTD_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is ^SCNAME enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicare
Skip Instructions:
1,2,RF,DK
if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C]
else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0130.00.1
Variable: MACHMN_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
The next questions are about Medicaid coverage. What is the name of ^SCNAME's Medicaid health
plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with Medicaid coverage
Skip Instructions:
allow 80, RF, DK [goto MAXCHNG_C]
Question ID: INS.0140.00.1
Variable: MAXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Was ^SCNAME's Medicaid obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicaid coverage
Skip Instructions:
1,2,RF,DK [goto MAPREM_C]
Question ID: INS.0150.00.1
Variable: MAPREM_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this Medicaid plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicaid coverage
Skip Instructions:
1,2,RF,DK [goto MADEDUC_C]
Question ID: INS.0160.00.1
Variable: MADEDUC_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's Medicaid plan have an
annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicaid coverage
Skip Instructions:
1 [goto MAHDHP_C]
2,RF,DK
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0170.00.1
Variable: MAHDHP_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with Medicaid coverage who have a deductible
Skip Instructions:
1,2,RF,DK
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0260.00.1
Variable: PLANNAME1_C
Interview Module: Child
Content Type: Annual Core

Question text:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by ^HIPNAM1_A. Is ^SCNAME covered by this
same plan as ^YOUSANAME?
Fills:
^YOUSANAME
Description: you/^SANAME
Instruction:
If GEN.SARESPSC_FLG=1, fill "you" else fill "^SANAME"
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
^WEREWAS
Description: were/was
Instruction:
If SARESPSC_FLG=1, fill "were", else "was"
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage, where the Sample Adult interview has already been conducted, the Sample Adult is in the same family, and the Sample Adult also had private health insurance, and the first private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.
Skip Instructions:
1 if Adult.INS.bPlan[1].POLHLD_A ne 1 [goto POLHLDA1_C],
if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1 [goto
PLANNAME2_C] else [goto MORPLAN_C]
2,RF,DK if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1
[goto PLANNAME2_C] else [goto HIPNAM1_C]
Question ID: INS.0270.00.1
Variable: POLHLDA1_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Health insurance plans are usually obtained in one person's name even if other family members
are covered by that plan. That person is called the policyholder. Is ^SCNAME the policyholder
for ^HIPNAM1_A?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^HIPNAM1_A
Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a shared private health plan with the Sample Adult, where the Sample Adult is not the policyholder for their first private plan or refused or don't know.
Skip Instructions:
1,2,RF,DK if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1
[goto PLANNAME2_C]
else [goto MORPLAN_C]
Question ID: INS.0280.00.1
Variable: PLANNAME2_C
Interview Module: Child
Content Type: Annual Core

Question text:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by a second plan ^HIPNAM2_A. Is ^SCNAME
covered by this same plan as ^YOUSANAME?
Fills:
^YOUSANAME
Description: you/^SANAME
Instruction:
If GEN.SARESPSC_FLG=1, fill "you" else fill "^SANAME"
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
^WEREWAS
Description: were/was
Instruction:
If SARESPSC_FLG=1, fill "were", else "was"
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage, where the Sample Adult interview has already been conducted, the Sample Adult is in the same family, and the Sample Adult also had private health insurance, and listed two plans. The second private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.
Skip Instructions:
1 if Adult.INS.bPlan[2].POLHLD_A ne 1 [goto POLHLDA2_C],
else if PLANNAME1_C IN(2,RF,DK) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
2,RF,DK if PLANNAME1_C IN (2,RF,DK,empty) [goto HIPNAM1_C]
else [goto MORPLAN_C]
Question ID: INS.0290.00.1
Variable: POLHLDA2_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
* Read if necessary: Health insurance plans are usually obtained in one person's name even if
other family members are covered by that plan. That person is called the policyholder.
Is ^SCNAME the policyholder for ^HIPNAM2_A?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^HIPNAM2_A
Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a shared private health plan with the Sample Adult, where the adult is not the policyholder for their second private plan or refused or don't know
Skip Instructions:
1,2,RF,DK if PLANNAME1_C IN(2,RF,DK,empty) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0300.00.1
Variable: HIPNAM1_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
It is important that we record the complete and accurate name of each private health insurance
plan. What is the COMPLETE name of ^SCNAME's plan? Do NOT include plans that only provide extra
cash while in the hospital or plans that pay for only one type of service such as long term
care, accidents, or dental care.
*Read if necessary: Do you have a health plan card or something with the plan name on it?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 enrolled in a Medigap plan or private health insurance and the sample child did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample adult
Skip Instructions:
allow 80,RF,DK [goto MORPLAN_C]
Question ID: INS.0310.00.1
Variable: MORPLAN_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is ^SCNAME covered by any other private health insurance plans?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 enrolled in a private health plan where the name of the plan was given or don't know or refused or the sample child only shared one private plan with the Sample Adult
Skip Instructions:
1 [goto HIPNAM2_C]
2,RF,DK
if (PLANNAME1_C = 1 or PLANNAME2_C = 1) then
if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
else [goto bPlan[1].POLHLD_C]
Question ID: INS.0320.00.1
Variable: HIPNAM2_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
What is the name of that private health insurance plan?
* Read if necessary: Do you have a health plan card or something with the plan name on it?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with a second private health insurance plan
Skip Instructions:
allow 80,RF,DK [goto bPlan[1].POLHLD_C]
Question ID: INS.0340.00.1
Variable: POLHLD_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
I am going to ask you some questions about ^FIRSTPLANC. Health insurance plans are usually
obtained in one person's name even if other family members are covered by that plan. That person
is called the policyholder. Is ^SCNAME the policyholder for ^THISPLANC?
Fills:
^FIRSTPLANC
Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan

Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^THISPLANC
Description: this plan/^HIPNAM1_C/^HIPNAM2_C
Instruction:
if PlanNum=1 then if HIPNAM1_C IN('RF','DK') fill: "this plan"
Else fill: "^HIPNAM1_C"
if PlanNum=2 then
if HIPNAM2_C IN('RF','DK') fill: "this plan"
Else fill: "^HIPNAM2_C"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know.
Skip Instructions:
1,RF,DK [goto PRPLCOV_C]
2 [goto PLNWRK_C]
Question ID: INS.0350.00.1
Variable: PRPLCOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does this plan cover someone other than ^SCNAME?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and where the Sample Child is the policyholder or refused or don't know.
Skip Instructions:
1,2,RF,DK [goto PLNWRK_C]
Question ID: INS.0360.00.1
Variable: PLNWRK_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Which one of these categories best describes how this plan was obtained? Was it obtained through
an employer or union, purchased directly, obtained through Healthcare.gov or the Affordable Care
Act, also known as Obamacare, obtained through a state or local government or community program
or obtained in some other way?
Response:
1 - Through an employer, union, or professional association
2 - Purchased directly
3 - Through Healthcare.gov or the Affordable Care Act, also known as Obamacare
4 - Through a state or local government or community program
5 - Other
7 - Refused
9 - Don't Know
Universe:
Sample Children with private health insurance coverage where a plan name was given or refused or don't know.
Skip Instructions:
1,3 [goto PLNPAY_C]
2,4,RF,DK [goto PLNEXCHG_C]
5 [goto PLNWKSP_C]
Question ID: INS.0370.00.1
Variable: PLNWKSP_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Read if necessary: How was this plan obtained?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and private health insurance coverage was obtained from an other source
Skip Instructions:
allow 80,RF,DK [goto PLNEXCHG_C]
Question ID: INS.0380.00.1
Variable: PLNEXCHG_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and who have private coverage that is directly purchased, or obtained through a state, local, government or community program, or obtained another way, or refused/don't know how obtained
Skip Instructions:
1,2,RF,DK [goto PLNPAY_C]
Question ID: INS.0390.00.1
Variable: PLNPAY_C
Interview Module: Child
Content Type: Annual Core

Question text:

Who pays for this health insurance plan?
* Enter all that apply, separate with commas.
Response:
1 - ^SCNAME or family (living in the household)
2 - Employer or union
3 - Someone outside the household
4 - Medicare
5 - Medicaid
6 - Other government program
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and were enrolled in a private health plan where a plan name was given or refused or don't know.
Skip Instructions:
1-6,RF,DK if 1 IN PLNPAY_C [goto HICOSTN_C]
else [goto PRDEDUC_C]
Question ID: INS.0400.01.1
Variable: HICOSTN_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
How much does ^SCNAME's family currently spend for health insurance premiums for ^FIRSTPLANC?
Please include payroll deductions for premiums.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^FIRSTPLANC
Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan

Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
Response:
00001-99995 - Range of values
99997 - Refused
99999 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know who paid for by self or family
Skip Instructions:
20000-99995 [goto ERR1_HICOSTN_C]
1-19999 [goto HICOSTT_C]
RF,DK [goto PRDEDUC_C]
Soft Edit:
Check Text: ERR1_HICOSTN_C
Check Description: Premium unusually high soft edit
Check Text: {signal ERR1_HICOSTN_C}
[^HICOSTN_C] is unusually high. Please verify. Make corrections if necessary.
Question ID: INS.0400.02.1
Variable: HICOSTT_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
* Enter time period for premium payments.
Response:
01 - Once a week
02 - Once every 2 weeks
03 - Once a month
04 - Twice a month
05 - Every two months
06 - Quarterly (every 3 months)
07 - Once a year
08 - Twice a year
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know who gave a premium amount.
Skip Instructions:
1-8,RF,DK [goto PRDEDUC_C]
Question ID: INS.0410.00.1
Variable: PRDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does this health plan have an annual
deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance plans where a plan name was given or refused or don't know.
Skip Instructions:
1 [goto PRHDHP_C]
2,RF,DK [goto INTROCOV_C]
Question ID: INS.0420.00.1
Variable: PRHDHP_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is the ^FAM_C annual deductible for medical care for this plan less than ^HDHPAMT_C, or
^HDHPAMT_C or more? If there is a separate deductible for prescription drugs, hospitalization,
or out-of-network care, do not include those deductible amounts here.
Fills:
^FAM_C
Description: family
Instruction:
if POLHLD_C=2 or PRPLCOV_C=1, fill 'family'. Else no fill.
^HDHPAMT_C
Description: ^HDHPDED_family/^HDHPDED
Instruction:
if POLHLD_C=2 or PRPLCOV_C=1, fill "^HDHPDED_family" Else fill "^HDHPDED"
^HDHPDED_family
Description: Family deductible threshold (may change in future year)
Instruction:
Fill: $2,800
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Less than ^HDHPAMT_C
2 - ^HDHPAMT_C or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know with a deductible.
Skip Instructions:
1 [goto INTROCOV_C]
2,RF,DK [goto HSAHRA_C]
Question ID: INS.0430.00.1
Variable: HSAHRA_C
Interview Module: Child
Content Type: Annual Core

Question text:

There are special accounts or funds that can be used to pay for medical expenses, sometimes
referred to as Health Savings Accounts or HSAs, Health Reimbursement Accounts or HRAs, Personal
Care accounts, Personal Medical funds, or Choice funds. These are DIFFERENT from Flexible
Spending Accounts or FSAs. Is there one of these accounts or funds with this plan?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know with a high deductible
Skip Instructions:
1,2,RF,DK [goto INTROCOV_C]
Question ID: INS.0435.00.1
Variable: INTROCOV_C
Interview Module: Child
Content Type:

Question text:

The next three questions are about services ^FIRSTPLANC may cover.
Enter '1' to continue.
Fills:
^FIRSTPLANC
Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan

Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know
Skip Instructions:
1 [goto PRRXCOV_C]
Question ID: INS.0440.00.1
Variable: PRRXCOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^FIRSTPLANC pay for any of the costs for medications prescribed by a doctor?
* Read if necessary: Even if ^SCNAME has not used this benefit, please answer if this plan would
cover at least some of the costs if ^SCNAME were prescribed medications.
Fills:
^FIRSTPLANC
Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan

Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where the name of the plan was given or refused or don't know.
Skip Instructions:
1,2,RF,DK [goto PRDNCOV_C]
Question ID: INS.0450.00.1
Variable: PRDNCOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^FIRSTPLANC pay for any of the costs for dental care?
* Read if necessary: Even if ^SCNAME has not used this benefit, please answer if this plan would
cover at least some of the costs if ^SCNAME did have dental care.
Fills:
^FIRSTPLANC
Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan

Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where the plan name was given or refused or don't know.
Skip Instructions:
1,2,RF,DK [goto PRVSCOV_C]
Question ID: INS.0460.00.1
Variable: PRVSCOV_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does ^FIRSTPLANC pay for any of the costs for routine vision care, such as glasses and contact
lenses?
* Read if necessary: Even if ^SCNAME has not used this benefit, please answer if this plan would
cover at least some of the costs if ^SCNAME did have vision care.
Fills:
^FIRSTPLANC
Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan

Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"
^HIPNAM1_C
Description: {Value of HIPNAM1_C}
Instruction:
Fill value from Child.INS.HIPNAM1_C
^HIPNAM2_C
Description: {Value of HIPNAM2_C}
Instruction:
Fill value from Child.INS.HIPNAM2_C
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know.
Skip Instructions:
1,2,RF,DK If there is another plan [goto bPlan for next plan]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0470.00.1
Variable: CHNAME_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by the Children's Health Insurance Program or CHIP.
What is the name of the plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with a CHIP plan
Skip Instructions:
allow 80,RF,DK [goto CHXCHNG_C]
Question ID: INS.0480.00.1
Variable: CHXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Was ^SCNAME's CHIP plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a CHIP plan
Skip Instructions:
1,2,RF,DK [goto CHPREM_C]
Question ID: INS.0490.00.1
Variable: CHPREM_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this CHIP plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a CHIP plan
Skip Instructions:
1,2,RF,DK [goto CHDEDUC_C]
Question ID: INS.0500.00.1
Variable: CHDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's CHIP plan have an
annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a CHIP plan
Skip Instructions:
1 [goto CHHDHP_C]
2,RF,DK if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0510.00.1
Variable: CHHDHP_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Children with a CHIP plan who have a deductible
Skip Instructions:
1,2,RF,DK if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0520.00.1
Variable: OPNAME_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by a state-sponsored plan. What is the name of the
plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with a state-sponsored plan
Skip Instructions:
verbatim,RF,DK [goto OPXCHNG_C]
Question ID: INS.0530.00.1
Variable: OPXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Was ^SCNAME's state-sponsored plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a state-sponsored plan
Skip Instructions:
1,2,RF,DK [goto OPPREM_C]
Question ID: INS.0540.00.1
Variable: OPPREM_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this state-sponsored plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a state-sponsored plan
Skip Instructions:
1,2,RF,DK [goto OPDEDUC_C]
Question ID: INS.0550.00.1
Variable: OPDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's state-sponsored plan
have an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a state-sponsored plan
Skip Instructions:
1[goto OPHDHP_C]
2,RF,DK if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0560.00.1
Variable: OPHDHP_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with a state-sponsored plan with a deductible
Skip Instructions:
1,2,RF,DK if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0570.00.1
Variable: OGNAME_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by an other government program. What is the name of
the plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 who have an other government plan
Skip Instructions:
allow 80,RF,DK [goto OGXCHNG_C]
Question ID: INS.0580.00.1
Variable: OGXCHNG_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Was ^SCNAME's other government plan obtained through Healthcare.gov or the ^MARKETPLACE?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^MARKETPLACE
Description: Health Insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such as
Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such as NY
State of Health"
If PA then fill "Health Insurance Marketplace, such as
Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Health Plan Finder"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have an other government plan
Skip Instructions:
1,2,RF,DK [goto OGPREM_C]
Question ID: INS.0590.00.1
Variable: OGPREM_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this other government plan?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have an other government plan
Skip Instructions:
1,2,RF,DK [goto OGDEDUC_C]
Question ID: INS.0600.00.1
Variable: OGDEDUC_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's other government plan
have an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with an other government plan
Skip Instructions:
1 [goto OGHDHP_C]
2,RF,DK if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0610.00.1
Variable: OGHDHP_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.
Fills:
^HDHPDED
Description: Deductible threshold (may change in future year)
Instruction:
Fill: $1,400
Response:
1 - Deductible is less than $1,400
2 - Deductible is $1,400 or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with an other government plan with a deductible
Skip Instructions:
1,2,RF,DK if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
Question ID: INS.0620.00.1
Variable: MILSPC_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by military related health care. What types of
military related health care ^areisSEX_C ^heshe_C covered by?
* Enter all that apply, separate with commas.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^areisSEX_C
Description: is/are
Instruction:
if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is" elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
2 - TRICARE (CHAMPUS)
3 - CHAMP-VA (do not include CHAMPUS)
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with military related health care
Skip Instructions:
2-3,RF,DK [goto HINOTYR_C]
Question ID: INS.0630.00.1
Variable: HILAST_C
Interview Module: Child
Content Type: Annual Core

Question text:

How long has it been since ^SCNAME last had health care coverage that paid for doctor's visits
or hospital stays?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.
Skip Instructions:
1 [goto HILASTMY_C]
2,3 [goto HISTOPJOB_C]
4,5,6,0,RF,DK [goto RSNHICOST_C]
Question ID: INS.0640.00.1
Variable: HILASTMY_C
Interview Module: Child
Content Type: Annual Core

Question text:

In the past 12 months, how many months was ^SCNAME without coverage?
* If less than 1 month, enter '1'.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01-12 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 without known health insurance who last had insurance at some time within the last 12 months
Skip Instructions:
1-12,RF,DK [goto HISTOPJOB_C]
Question ID: INS.0650.00.1
Variable: HISTOPJOB_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Think about the last time that ^SCNAME did have health care coverage. I am going to read a list
of reasons why someone might no longer be enrolled in coverage. Please tell me, yes or no, if
this is a reason why ^SCNAME is no longer enrolled in ^hisher_C last health care plan.
The policyholder retired, lost a job, or changed employer?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPMISS_C]
Question ID: INS.0660.00.1
Variable: HISTOPMISS_C
Interview Module: Child
Content Type: Annual Core

Question text:

*Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
A deadline was missed for signing up or paying for ^hisher_C coverage?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPAGE_C]
Question ID: INS.0670.00.1
Variable: HISTOPAGE_C
Interview Module: Child
Content Type: Annual Core

Question text:

*Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
^HeShe_C became ineligible because of ^hisher_C age or because ^heshe_C left school?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^HeShe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPCOST_C]
Question ID: INS.0680.00.1
Variable: HISTOPCOST_C
Interview Module: Child
Content Type: Annual Core

Question text:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
The cost for the coverage increased?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto HISTOPELIG_C]
Question ID: INS.0690.00.1
Variable: HISTOPELIG_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
* Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
^HeShe_C had Medicaid, CHIP, or other public coverage, but ^werewas_C no longer eligible?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^HeShe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
^werewas_C
Description: was/were
Instruction:
If SEX_FINAL_C=1,2 fill "was" else if SEX_FINAL_C=DK, RF fill "were"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have been uninsured for less than 3 years
Skip Instructions:
1,2,RF,DK [goto RSNHICOST_C]
Question ID: INS.0700.00.1
Variable: RSNHICOST_C
Interview Module: Child
Content Type: Annual Core

Question text:

^INSREASONS_C Is ^SCNAME currently uninsured because coverage is not affordable?
Fills:
^INSREASONS_C
Description: RSNHICOST_C Introduction
Instruction:
If HILAST_C=0,4,5,6,RF,DK, fill: "There are many reasons why people do not have health insurance coverage."
If HILAST_C=1,2,3, fill: "We just discussed reasons you
lost coverage, now I am going to ask you some questions
about why ^SCNAME hasn't obtained coverage."
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.
Skip Instructions:
1,2,RF,DK [goto RSNHIWANT_C]
Question ID: INS.0710.00.1
Variable: RSNHIWANT_C
Interview Module: Child
Content Type: Annual Core

Question text:

There are other reasons that people do not have health insurance coverage. ^PLUSCOSTC ^SCNAME
currently uninsured because...
...your family does not need or want coverage for ^SCNAME?
Fills:
^PLUSCOSTC
Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill "In addition to cost, is" Else fill "Is"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.
Skip Instructions:
1,2,RF,DK [goto RSNHIELIG_C]
Question ID: INS.0720.00.1
Variable: RSNHIELIG_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...^heshe_C ^areisSEX_C not eligible for coverage?
Fills:
^PLUSCOSTC
Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill "In addition to cost, is" Else fill "Is"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
^areisSEX_C
Description: is/are
Instruction:
if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is" elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe
Skip Instructions:
1,2,RF,DK [goto RSNHICONF_C]
Question ID: INS.0730.00.1
Variable: RSNHICONF_C
Interview Module: Child
Content Type: Annual Core

Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...the process of signing up for coverage for ^SCNAME is too difficult or confusing?
Fills:
^PLUSCOSTC
Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill "In addition to cost, is" Else fill "Is"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe
Skip Instructions:
1,2,RF,DK [goto RSNHIMEET_C]
Question ID: INS.0740.00.1
Variable: RSNHIMEET_C
Interview Module: Child
Content Type: Annual Core

Question text:

*Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...your family cannot find a plan that meets ^SCNAME's needs?
Fills:
^PLUSCOSTC
Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill "In addition to cost, is" Else fill "Is"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe
Skip Instructions:
1,2,RF,DK [goto RSNHIWAIT_C]
Question ID: INS.0750.00.1
Variable: RSNHIWAIT_C
Interview Module: Child
Content Type: Annual Core

Question text:

*Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...you applied for coverage for ^SCNAME but it has not started yet?
Fills:
^PLUSCOSTC
Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill "In addition to cost, is" Else fill "Is"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe
Skip Instructions:
1,2,RF,DK [goto RSNHIOTH_C]
Question ID: INS.0760.00.1
Variable: RSNHIOTH_C
Interview Module: Child
Content Type: Annual Core

Question text:

Is there another reason that ^SCNAME currently does not have health insurance coverage?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe
Skip Instructions:
1 [goto RSNHIOTHSP_C]
2,RF,DK [goto FINISH_C]
Question ID: INS.0770.00.1
Variable: RSNHIOTHSP_C
Interview Module: Child
Content Type: Annual Core

Question text:

What is the other reason for not having coverage?
Response:
Verbatim - Verbatim values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 who have another reason for not having coverage
Skip Instructions:
allow 80,RF,DK [goto FINISH_C]
Question ID: INS.0780.00.1
Variable: HINOTYR_C
Interview Module: Child
Content Type: Annual Core

Question text:

In the past 12 months, was there any time when ^SCNAME did NOT have ANY health insurance or
coverage?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with known health insurance coverage or responded yes to the medicaid probe
Skip Instructions:
1 [goto HINOTMYR_C]
2,RF,DK [goto FINISH_C]
Question ID: INS.0790.00.1
Variable: HINOTMYR_C
Interview Module: Child
Content Type: Annual Core

Question text:

In the past 12 months, about how many months was ^SCNAME without coverage?
* If less than 1 month, enter '1'.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
01-12 - Range of values
97 - Refused
99 - Don't Know
Universe:
Sample Children 0-17 with known health insurance coverage and did not have health insurance for some period of time in the past 12 months
Skip Instructions:
1-12,RF,DK [goto FINISH_C]
Question ID: INS.0800.00.1
Variable: FINISH_C
Interview Module: Child
Content Type: Annual Core

Question text:

* The Sample Child health insurance section is now complete.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
PAY: Difficulty Paying for Health Care
Question ID: PAY.0010.00.1
Variable: PAYINTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
Now I am going to ask you about your family's medical bills. Include bills for doctors,
dentists, hospitals, therapists, medication, equipment, and nursing home or home care.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17 living in same family as the Sample Adult when the PAY section of the Sample Adult has not been completed or Sample Children living in same family as Sample Adult when the Sample Child respondent is not the Sample Adult and the Sample Adult answered don't or refused to PAYBLL12M_A and PAYNOBLLNW_A or Sample children living in different families than the Sample Adult.
Skip Instructions:
1 [goto PAYBILL12M_C]
Replicate To: PAYINTRO_A
Question ID: PAY.0020.00.1
Variable: PAYBLL12M_C
Interview Module: Child
Content Type: Annual Core

Question text:

?[F1]
In the past 12 months, did anyone in your family have problems paying or were unable to pay any
medical bills?
* Read if necessary: Include bills for doctors, dentists, hospitals, therapists, medication,
equipment, nursing home or home care.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 living in same family as the Sample Adult when the PAY section of the Sample Adult has not been completed or Sample Children living in same family as Sample Adult when the Sample Child respondent is not the Sample Adult and the Sample Adult answered don't or refused to PAYBILL12M_A and PAYNOBLLNW_A or Sample children living in different families than the Sample Adult.
Skip Instructions:
1,RF,DK [goto PAYNOBLLNW_C]
2 [goto PAYWORRY_C]
Replicate To: PAYBLL12M_A
Question ID: PAY.0030.00.1
Variable: PAYNOBLLNW_C
Interview Module: Child
Content Type: Annual Core

Question text:

Does anyone in your family currently have any medical bills that you are unable to pay at all?
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who said someone in their family had trouble paying bills and Sample Adult and Sample Child are in the same family and Sample Adult PAY section has not been completed OR the Sample Child and Sample Adult are not in the same family AND said anyone in their family had problems paying medical bills in the past 12 months or refused or didn't know if they had problems paying medical bills.
Skip Instructions:
1,2,RF,DK [goto PAYWORRY_C]
Replicate To: PAYNOBLLNW_A
Question ID: PAY.0040.00.1
Variable: PAYWORRY_C
Interview Module: Child
Content Type: Annual Core

Question text:

If ^SCNAME gets sick or has an accident, how worried are you that your family will be able to
pay ^hisher_C medical bills? Are you very worried, somewhat worried, or not at all worried?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
1 - Very worried
2 - Somewhat worried
3 - Not at all worried
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1-3,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
CVL: Long COVID
Question ID: CVL.0010.00.4
Variable: CVDINTRO_C
Interview Module: Child
Content Type: Emerging Content

Question text:

The next set of questions are about coronavirus or COVID-19.
* Enter '1' to continue.
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto CVDDIAG_C]
Question ID: CVL.0020.00.4
Variable: CVDDIAG_C
Interview Module: Child
Content Type: Emerging Content

Question text:

Has a doctor or other health professional ever told you that ^SCNAME had or likely had
coronavirus or COVID-19?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1,2,RF,DK [goto POSTEST_C]
Question ID: CVL.0030.00.4
Variable: POSTEST_C
Interview Module: Child
Content Type: Emerging Content

Question text:

Did ^SCNAME ever take a test that showed ^heshe_C had coronavirus or COVID-19?
* Read if necessary: Testing includes antibody or blood tests as well as other forms of testing
for COVID-19, such as a nasal swabbing or throat swabbing.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto CVDSEV_C]
2,RF,DK if CVDDIAG_C=1 [goto CVDSEV_C]
elseif CVDDIAG_C=2,RF,DK [goto next section]
Question ID: CVL.0040.00.4
Variable: CVDSEV_C
Interview Module: Child
Content Type: Emerging Content

Question text:

How would you describe ^SCNAME's coronavirus symptoms when they were at their worst? Would you
say no symptoms, mild symptoms, moderate symptoms, or severe symptoms?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - No symptoms
2 - Mild symptoms
3 - Moderate symptoms
4 - Severe symptoms
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have been told by a doctor or other health professional that they had or likely had coronavirus or COVID-19 or tested positive for COVID-19
Skip Instructions:
1 [goto next section]
2-4,RF,DK [goto LONGCVD_C]
Question ID: CVL.0050.00.4
Variable: LONGCVD_C
Interview Module: Child
Content Type: Emerging Content

Question text:

Did ^SCNAME have any symptoms lasting 3 months or longer that ^heshe_C did not have prior to
having coronavirus or COVID-19?
* Read if necessary: Long term symptoms may include tiredness or fatigue, difficulty thinking,
concentrating, forgetfulness or memory problems, sometimes referred to as "brain fog,"
difficulty breathing or shortness of breath, joint or muscle pain, fast-beating or pounding
heart (also known as heart palpitations), chest pain, dizziness on standing, depression, anxiety
or mood changes.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^heshe_C
Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She"
elseif SEX_FINAL_C =blank: fill "They"
^menstrual
Description: menstrual changes
Instruction:
If GEN.SEX_FINAL=2,RF,DK and GEN.AGE_FINAL=9-58, fill "menstrual changes,"
else fill blank
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with mild, moderate, or severe symptoms when at their worst or refused or didn't know the severity of their symptoms
Skip Instructions:
1,2,RF,DK [goto SYMPNOW_C]â??
Question ID: CVL.0060.00.4
Variable: SYMPNOW_C
Interview Module: Child
Content Type: Emerging Content

Question text:

Does ^SCNAME have symptoms NOW?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 with mild, moderate, or severe symptoms when at their worst or refused or didn't know the severity of their symptoms
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
DNC: Dental Care
Question ID: DNC.0010.00.2
Variable: DNCINTRO_C
Interview Module: Child
Content Type: Rotating Core

Question text:

These next questions ask about ^SCNAME's dental care.
* Enter '1' to continue.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Enter 1 to Continue
Universe:
Sample children 1-17
Skip Instructions:
1 [goto DENPREV_C]
Question ID: DNC.0020.00.2
Variable: DENPREV_C
Interview Module: Child
Content Type: Rotating Core

Question text:

About how long has it been since ^SCNAME last had a dental examination or cleaning?
* Read if necessary: Include cleanings from all types of dental care providers such as dentists,
orthodontists, oral surgeons, dental hygienists, and all other dental specialists.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 1-17
Skip Instructions:
0-6,RF,DK [goto DENDL12M_C]
Question ID: DNC.0030.00.2
Variable: DENDL12M_C
Interview Module: Child
Content Type: Rotating Core

Question text:

During the past 12 months, has ^SCNAME been DELAYED in getting dental care because of the cost?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 1-17
Skip Instructions:
1,2,RF,DK [goto DENNG12M_C]
Question ID: DNC.0040.00.2
Variable: DENNG12M_C
Interview Module: Child
Content Type: Rotating Core

Question text:

During the past 12 months, was there any time when ^SCNAME needed dental care, but DID NOT GET
IT because of the cost?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 1-17
Skip Instructions:
1,2,RF,DK [goto next section]

2022 National Health Interview Survey (NHIS) Questionnaire
UTZ: Utilization
Question ID: UTZ.0010.00.1
Variable: UTZINTRO_C
Interview Module: Child
Content Type: Annual Core

Question text:

^UTZINTRO2_C
* Enter '1' to continue.
Fills:
^UTZINTRO2_C
Description: UTZ introduction
Instruction:
If AGE LT 1 fill "I would like to ask you about ^SCNAME's health care." else fill "Now, I would like to ask you
about ^SCNAME's health care, not including dental care."
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Enter 1 to Continue
Universe:
Sample Children 0-17
Skip Instructions:
1 [goto LASTDR_C]
Question ID: UTZ.0020.00.1
Variable: LASTDR_C
Interview Module: Child
Content Type: Annual Core

Question text:

About how long has it been since ^SCNAME last saw a doctor or other health professional about
^hisher_C health?
* Read if necessary: Include doctors seen while a patient in a hospital.
* Read if necessary: Do not include dental care.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17
Skip Instructions:
1-6 if GEN.AGE_FINAL[PX_C] ge 0 and GEN.AGE_FINAL[PX_C] le 11 [goto WELLNESS_C]
1-6 if GEN.AGE_FINAL[PX_C] ge 12 and GEN.AGE_FINAL[PX_C] le 17 [goto TIMEALONE_C]
0,RF,DK [goto USUALPL_C]
Question ID: UTZ.0030.00.4
Variable: TIMEALONE_C
Interview Module: Child
Content Type: Emerging Content

Question text:

At their last medical care visit, did ^SCNAME have a chance to speak with a doctor or other
health professional privately, without you or another caregiver in the room?
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample children 12-17 who saw a doctor
Skip Instructions:
1,2,RF,DK [goto WELLNESS_C]
Question ID: UTZ.0040.00.1
Variable: WELLNESS_C
Interview Module: Child
Content Type: Annual Core

Question text:

Was this a well ^babychild visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: height and weight measurements,
vaccinations, and vision or hearing checks. The doctor or other health professional may also
discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and
exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur
when ^hesheistheyare_C not sick.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Fills:
^babychild
Description: baby/child
Instruction:
If AGE LE 2 fill "baby"; else if AGE GE 3 or AGE IN ('DK','RF') fill "child"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^hesheistheyare_C
Description: he is/she is/they are
Instruction:
If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have seen a doctor
Skip Instructions:
1 [goto USUALPL_C]
2,RF,DK [goto WELLVIS_C]
Question ID: UTZ.0050.00.1
Variable: WELLVIS_C
Interview Module: Child
Content Type: Annual Core

Question text:

About how long has it been since ^SCNAME last saw a doctor or other health professional for a
well ^babychild visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: height and weight measurements,
vaccinations, and vision or hearing checks. The doctor or other health professional may also
discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and
exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur
when ^hesheistheyare_C not sick.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Fills:
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^babychild
Description: baby/child
Instruction:
If AGE LE 2 fill "baby"; else if AGE GE 3 or AGE IN ('DK','RF') fill "child"
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^hesheistheyare_C
Description: he is/she is/they are
Instruction:
If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"
Response:
0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 were reported to have seen a doctor, but the last visit was not a wellness visit or they didn't know or refused whether it was a wellness visit
Skip Instructions:
0,RF,DK [goto USUALPL_C]
1-6 if 0 less than =GEN.AGE_FINAL less than =11 [goto USUALPL_C]
1-6 if 12 less than =GEN.AGE_FINAL less than =17 [goto PTIMEALONE_C]
Question ID: UTZ.0060.00.4
Variable: PTIMEALONE_C
Interview Module: Child
Content Type: Emerging Content

Question text:

At their last well-child visit, physical, or general purpose check-up did ^SCNAME have a chance
to speak with a doctor or other health professional privately, without you or another caregiver
in the room?
Fills: