Survey Text

2016
2008
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2016

No questionnaire text is available for this sample.


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2008
Survey form view entire document:  text  image
Question ID:BAL.050_01.000

Instrument Variable Name:BBAL_01
QuestionText:
DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol.
Please say yes or no to each.
...Muscle weakness that affects walking
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_02]
Question ID:BAL.050_02.000

Instrument Variable Name:BBAL_02
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Severe fatigue
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_03]
Question ID:BAL.050_03.000

Instrument Variable Name:BBAL_03
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each.
...Drifting to the side when trying to walk straight
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_04]
Question ID:BAL.050_04.000

Instrument Variable Name:BBAL_04
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Walking through a doorway without bumping into one side
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_05]
Question ID:BAL.050_05.000

Instrument Variable Name:BBAL_05
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each. ...Difficulty walking in the dark
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_06]
Question ID:BAL.050_06.000

Instrument Variable Name:BBAL_06
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty walking on uneven ground or surfaces
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_07]
Question ID:BAL.050_07.000

Instrument Variable Name:BBAL_07
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty walking with bi- or tri-focal or progressive lenses or contacts
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
* If respondent does not wear bi- or tri-focal progressive lenses or contacts, Enter '2'.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1-3,R,D) [goto BBAL_08]
Question ID:BAL.050_08.000

Instrument Variable Name:BBAL_08
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Blurred or fuzzy vision when moving your head
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_09]
Question ID:BAL.050_09.000

Instrument Variable Name:BBAL_09
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Fear of heights
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_10]
Question ID:BAL.050_10.000

Instrument Variable Name:BBAL_10
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Fear of large open spaces
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_11]
Question ID:BAL.050_11.000

Instrument Variable Name:BBAL_11
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty walking up a flight of stairs
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_12]
Question ID:BAL.050_12.000

Instrument Variable Name:BBAL_12
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty walking down a flight of stairs
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, don't have a driver's license, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_13]
Question ID:BAL.050_13.000

Instrument Variable Name:BBAL_13
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty riding an escalator or moving walkway
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) [goto BBAL_14]
Question ID:BAL.050_14.000

Instrument Variable Name:BBAL_14
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty going through tunnels
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D)[[goto BBAL_15]
Question ID:BAL.050_15.000

Instrument Variable Name: BBAL_15
QuestionText:
* Read if necessary. DURING THE PAST 12 MONTHS, have you had any of the following problems? Do not include times when drinking alcohol. Please say yes or no to each....Difficulty going over bridges
* If respondent is unable to do this activity for reasons OTHER than dizziness or balance, Enter '2'
Examples include respondents who are in a wheelchair, are deaf, blind, etc.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+
SkipInstructions:
(1,2,R,D) If BDIZZ =1 or (if any of BBAL_01 through BBAL_15 = 1) [goto BTYPE_01];
else BDIZZ=2,R,D and (if all of BBAL_01 to BBAL_15=2,R,D) [goto BMEDIC] (BAL.290).