Survey Text

2016
2012
2008
top
2016
Survey form view entire document:  text  image
Question ID: BAL.360_00.000

Instrument Variable Name: BPROB1
Questionnaire File Name: Sample Adult
Question Text:
DURING THE PAST 12 MONTHS, how much of a problem was your dizziness or balance condition? Would you say it was no problem, a small problem, a moderate problem, a big problem, or a very big problem?
1 No problem
2 A small problem
3 A moderate problem
4 A big problem
5 A very big problem
7 Refused
9 Don't know
Universe Text: Sample adults 18+ who had a balance or dizziness problem in the past 12 months or who had at least one symptom in the past 12 months
Skip Instructions:
( 1-5,R,D) [goto BMED_1]

Survey form view entire document:  text  image
Question ID: CBL.060_00.000

Instrument Variable Name: CBALPROB
Questionnaire File Name: Sample Child
Question Text:
DURING THE PAST 12 MONTHS, how much of a problem were these episodes of dizziness or imbalance for [fill1: S.C. name]? Would you say it was...
*Read categories below.
1 No problem
2 A small problem
3 A moderate problem
4 A big problem
5 A very big problem
7 Refused
9 Don't know
Universe Text: Sample children 3+ who have had episodes of balance or dizziness in the past 12 months
Skip Instructions:
(1-5,R,D) [goto CBALHPYR]

top
2012
Survey form view entire document:  text  image
Question ID:: CBL.060_00.000

Instrument Variable Name:: CBALPROB
QuestionText:
DURING THE PAST 12 MONTHS, how much of a problem were these episodes of dizziness or imbalance for {fill1: S.C. name}? Would you say it was...
*Read categories below.
1 No problem
2 A small problem
3 A moderate problem
4 A big problem
5 A very big problem
7 Refused
9 Don't know
UniverseText: Sample children 3+ who have had episodes of balance problems or dizziness in the past 12 months
SkipInstructions:
(1-5,R,D) [goto CBALHPYR]

top
2008
Survey form view entire document:  text  image
Question ID:BAL.360_00.000

Instrument Variable Name:BPROB
QuestionText:
DURING THE PAST 12 MONTHS, how much of a problem was your dizziness or balance condition? Would you say it was no problem, a small problem, a moderate problem, a big problem, or a very big problem?
1 No problem
2 A small problem
3 A moderate problem
4 A big problem
5 A very big problem
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had symptoms of dizziness or at least one balance problem
SkipInstructions:
( 1-5, R, D) [goto BMED_01]