Survey Text

2022
2021
2020
2019
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2022
Survey form view entire document:  text  image
Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Was this a wellness visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and
blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health
professional may also discuss topics related to your health such as smoking, alcohol use, diet
and exercise. These visits are usually scheduled in advance and occur when you are not sick or
injured.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have seen a doctor
Skip Instructions:
1 [goto USUALPL_A]
2,RF,DK [goto WELLVIS_A]

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2021
Survey form view entire document:  text  image
Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core
Question text:
Was this a wellness visit, physical, or general purpose check-up?
Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health professional may also discuss topics related to your health such as smoking, alcohol use, diet and exercise. These visits are usually scheduled in advance and occur when you are not sick or injured.
Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have seen a doctor
Skip Instructions:
1 [goto USUALPL_A]
2,RF,DK [goto WELLVIS_A]
Question ID: UTZ.0040.00.1
Variable: WELLNESS_C
Interview Module: Child
Content Type: Annual Core
Question text:
Was this a well ^babychild visit, physical, or general purpose check-up?
Read if necessary: This kind of visit typically includes: height and weight measurements, vaccinations, and vision or hearing checks. The doctor or other health professional may also discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur when ^hesheistheyare_C not sick.
Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Fills:
^babychild
Description: baby/child
Instruction:
If AGE LE 2 fill "baby"; else if AGE GE 3 or AGE IN ('DK','RF') fill "child"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^hesheistheyare_C
Description: he is/she is/they are
Instruction:
If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Children 0-17 who have seen a doctor
Skip Instructions:
1 [goto USUALPL_C]
2,RF,DK [goto WELLVIS_C]

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2020
Survey form view entire document:  text  image
Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core
Question text:
Was this a wellness visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and
blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health
professional may also discuss topics related to your health such as smoking, alcohol use, diet
and exercise. These visits are usually scheduled in advance and occur when you are not sick or
injured.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample Adults 18+ who have seen a doctor
Skip Instructions:
1 [goto USUALPL_A]
2,RF,DK [goto WELLVIS_A]
Question ID: UTZ.0030.00.1
Variable: WELLNESS_C
Interview Module: Child
Content Type: Annual Core
Question text:
Was this a well ^babychild visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: height and weight measurements,
vaccinations, and vision or hearing checks. The doctor or other health professional may also
discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and
exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur
when ^hesheistheyare_C not sick.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Fills:
^babychild
Description: baby/child
Instruction:
If AGE LE 2 fill "baby"; else if AGE GE 3 or AGE IN ('DK','RF') fill "child"
^SCNAME
Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1
^hisher_C
Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"
^hesheistheyare_C
Description: he is/she is/they are
Instruction:
If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
Sample children 0-17 who have seen a doctor
Skip Instructions:
1 [goto USUALPL_C]
2,RF,DK [goto WELLVIS_C]

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2019
Survey form view entire document:  text  image
Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Was this a wellness visit, physical, or general purpose check-up?
Response:
1 Yes
2 No
7 Refused
9 Do not Know
Universe:
Sample Adults 18+ who have seen a doctor
Skip Instructions:
1 = [goto USUALPL_A]
2,RF,DK = [goto WELLVIS_A]
Question ID: UTZ.0030.00.1
Variable: WELLNESS_C
Interview Module: Child
Content Type: Annual Core


Question Text:

Was this a well ^babychild visit, physical, or general purpose check-up?
Fills:
^babychild

Description baby/child
Instruction If AGE LE 2 fill "baby";
else if AGE GE 3 or AGE IN ('DK','RF')
fill "child"
Response:
1 Yes
2 No
7 Refused
9 Do not Know
Universe:
Sample children 0-17 who have seen a doctor
Skip Instructions:
1 = [goto USUALPL_C]
2,RF,DK = [goto WELLVIS_C]