Survey Text

2016
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2016
Survey form view entire document:  text  image
Question ID: BAL.060_06.000

Instrument Variable Name: BTYPE_6
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.
...Feeling off-balance or unsteady
* 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) [goto BTYPE_7]

Survey form view entire document:  text  image
Question ID: CBL.025_00.000

Instrument Variable Name: CBALSTED
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...
poor balance, an unsteady or woozy feeling that makes it difficult to stand up or walk?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample children 3+
Skip Instructions:
(1,2,R,D) [goto CBALMOTR]

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2012
Survey form view entire document:  text  image
Question ID:: CBL.025_00.000

Instrument Variable Name:: CBALSTED
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? Poor balance, an unsteady or woozy feeling that makes it difficult to stand up or walk?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 3+
SkipInstructions:
(1,2,R,D) [goto CBALMOTR]

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2008
Survey form view entire document:  text  image
Question ID:BAL.060_06.000

Instrument Variable Name:BTYPE_06
QuestionText:
* 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....Feeling off-balance or unsteady
* Read if necessary: Do not include times when drinking alcohol.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText:Sample adults 18+ who have had a problem(s) with dizziness or balance
SkipInstructions:
if (all BTYPE_01 -BTYPE_06 = 2,R,D) and (BDIZZ = 2,R,D) [goto BMEDIC];
else if two or more BTYPE_01 - BTYPE_06 = 1 then [goto BBOTH];
else if (only one BTYPE_01-BTYPE_06=1,R,D) or (all BTYPE_01 -BTYPE_06 = 2,R,D and (BDIZZ = 1) [goto
BAGE]