Survey Text

2016
2012
2008
top
2016
Survey form view entire document:  text  image
Question ID: BAL.310_00.000

Instrument Variable Name: BCHNG1
Questionnaire File Name: Sample Adult
Question Text:
Do your dizziness or balance problems prevent you in any way from doing things you otherwise could do?
1 Yes
2 No
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) [goto BCHG1_01]
(2, R,D) [goto BM12WS]

Survey form view entire document:  text  image
Question ID: CBL.055_00.000

Instrument Variable Name: CBALPART
Questionnaire File Name: Sample Child
Question Text:
Did any of these episodes of dizziness or balance problems keep [fill1: S.C. name] from participating in home, school, [fill2: work,] or recreational activities?
1 Yes
2 No
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:
(1,2,R,D) [goto CBALPROB]

top
2012
Survey form view entire document:  text  image
Question ID:: CBL.055_00.000

Instrument Variable Name:: CBALPART
QuestionText:
Did any of these episodes of dizziness or balance problems keep {fill1: S.C. name} from participating in home, school, {fill2: work,} or recreational activities?
1 Yes
2 No
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:
(1,2,R,D) [goto CBALPROB]

top
2008
Survey form view entire document:  text  image
Question ID:BAL.310_00.000

Instrument Variable Name:BCHNG
QuestionText:
Do your dizziness or balance problems prevent you in any way from doing things you otherwise could do?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had symptoms of dizziness or at least one balance problem
SkipInstructions:
( 1 )[goto BCHNG_01]
(2, R,D) [goto BMISSWK]