Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

Instrument Variable Name: FLRELAX
QuestionText:

(book) A6 * Read lead-in if necessary. By yourself, and without using any special equipment, how difficult is it for you to... ...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all
6 Do not do this activity
7 Refused
9 Don't know

UniverseText: Sample adults 18+
SkipInstructions:

(1-4 or FLWALK= 1-4 or FLCLIMB= 1-4 or FLSTAND= 1-4 or FLSIT= 1-4 or FLSTOOP= 1-4 or FLREACH= 1-4 or FLGRASP= 1-4 or FLCARRY= 1-4 or FLPUSH= 1-4 or FLSHOP= 1-4 or FLSOCL= 1-4) [goto AFLHCA]

Else goto SMKEV (next section)

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

FR: SHOW FLASHCARD A7. [survey indicates card A7, correct card is A6)

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP...Go out to things like shopping, movies, or sporting events?
FLSOCL...Participate in social activities such as visiting friends, attending clubs and meetings, going to parties?
FLRELAX...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

FR: SHOW FLASHCARD A7. [survey indicates card A7, correct card is A6)

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP...Go out to things like shopping, movies, or sporting events?
FLSOCL...Participate in social activities such as visiting friends, attending clubs and meetings, going to parties?
FLRELAX...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

FR: SHOW FLASHCARD A7. [survey indicates card A7, correct card is A6)

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP...Go out to things like shopping, movies, or sporting events?
FLSOCL...Participate in social activities such as visiting friends, attending clubs and meetings, going to parties?
FLRELAX...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

FR: SHOW FLASHCARD A7. [survey indicates card A7, correct card is A6)

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW FLASHCARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP...Go out to things like shopping, movies, or sporting events?
FLSOCL...Participate in social activities such as visiting friends, attending clubs and meetings, going to parties?
FLRELAX...Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music)?

FR: SHOW CARD A4.

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(7) REFUSED
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(7) REFUSED
(9) Don't Know

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW CARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP ... Go out to things like shopping, movies, or sporting events?
FLSOCL ... Participate in social activities such as visiting friends, attending clubs and meetings, going to parties...?
FLRELAX ... Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music...)

FR: SHOW CARD A4.

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(7) REFUSED
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(7) REFUSED
(9) Don't Know

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW CARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP ... Go out to things like shopping, movies, or sporting events?
FLSOCL ... Participate in social activities such as visiting friends, attending clubs and meetings, going to parties...?
FLRELAX ... Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music...)

FR: SHOW CARD A4.

The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. By "health problem" we mean any physical, mental, or emotional problem or illness (not including pregnancy).

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(7) REFUSED
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all

FLWALK ... Walk a quarter of a mile - about 3 city blocks?
FLCLIMB ... Walk up 10 steps without resting?
FLSTAND ... Stand or be on your feet for about 2 hours?
FLSIT ... Sit for about 2 hours?
FLSTOOP ... Stoop, bend, or kneel?
FLREACH ... Reach up over your head?

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(7) REFUSED
(9) Don't Know

FLGRASP ... Use your fingers to grasp or handle small objects?
FLCARRY ... Lift or carry something as heavy as 10 pounds such as a full bag of groceries?
FLPUSH ... Push or pull large objects like a living room chair?

FR: SHOW CARD A6.
FR: READ LEAD-IN IF NECESSARY:

By yourself, and without using any special equipment, how difficult is it for you to...

(0) NOT AT ALL DIFFICULT
(1) ONLY A LITTLE DIFFICULT
(2) SOMEWHAT DIFFICULT
(3) VERY DIFFICULT
(4) CAN'T DO AT ALL
(6) DO NOT DO THIS ACTIVITY
(7) Refused
(9) Don't Know

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

FLSHOP ... Go out to things like shopping, movies, or sporting events?
FLSOCL ... Participate in social activities such as visiting friends, attending clubs and meetings, going to parties...?
FLRELAX ... Do things to relax at home or for leisure (reading, watching TV, sewing, listening to music...)