Survey Text

2016
2012
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2016
Survey form view entire document:  text  image
Question ID: BAL.060_07.000

Instrument Variable Name: BTYPE_7
Questionnaire File Name: Sample Adult
Question Text:
* Read if necessary. This next question is about symptoms of dizziness or balance problems. Please tell me if you have had any of these problems in the past 12 months. Please say yes or no to each.
...Other dizziness or balance problem.
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample adults 18+ had a dizziness or balance problem in the last 12 months or at least one balance related problem in the past 12 months
Skip Instructions:
(1,2,R,D) if BALEV=2,R,D and (all BTYPE_1 -BTYPE_7 = 2,R,D) [goto BBIO1];
else if BALEV=1 and (all BRPROB1-BRPROB7= 2,R,D) and (all BTYPE_1 -BTYPE_7 = 2,R,D) [goto BHOSP2]
else if BDIZZ1=1 and (all BTYPE_1 -BTYPE_7 = 2,R,D) fill '7' in BBOTH1 and [goto BAGE1]
else if two or more BTYPE_1 - BTYPE_7 = 1,7,9 [goto BBOTH1];
else [goto BAGE1]

Survey form view entire document:  text  image
Question ID: CBL.039_00.000

Instrument Variable Name: CBALOTH
Questionnaire File Name: Sample Child
Question Text:
*Read if necessary.
DURING THE PAST 12 MONTHS, has [fill1: S.C. name] been bothered by episodes of any of the following dizziness or balance problems...
any other type of balance or dizziness problems?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample children 3+
Skip Instructions:
(1,2,R,D) if CBALVRTG=1 or CBALSTED=1 or CBALMOTR=1 or CBALFALL=1 or CBALPASS=1 or
CBALBLR=1 or CBALOTH=1 [goto CBALBHD]; else [goto CBALHDIJ]

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2012
Survey form view entire document:  text  image
Question ID:: CBL.040_00.000

Instrument Variable Name:: CBALOTH
QuestionText:
*Read if necessary. DURING THE PAST 12 MONTHS, has {fill1: S.C. name} been bothered by episodes of any of the following dizziness or balance problems? Any other type of balance or dizziness problems?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 3+
SkipInstructions:
(1,2,R,D) if CBALVRTG=1 or CBALSTED=1 or CBALMOTR=1 or CBALFALL=1 or CBALPASS=1 or CBALOTH=1 [goto CBALDGHP]; else [goto CAU.CUSUALPL]