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2023

No questionnaire text is available for this sample.

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2022

Survey form view entire document: text image

Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core

Question text:

Do you wear glasses or contact lenses?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto VISIONDF_A]

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2021

Survey form view entire document: text image

Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you wear glasses or contact lenses?
Read if necessary: Persons who wear glasses to read or to do other occasional tasks should answer yes to this question.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto VISIONDF_A]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME wear glasses ^CONTACTS?
Read if necessary: Persons who wear glasses to read or to do other occasional tasks should answer yes to this question.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^CONTACTS

Description: or contact lenses
Instruction:
If AGE=5-17 fill "or contact lenses"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto VISIONDF_C]

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2020

Survey form view entire document: text image

Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you wear glasses or contact lenses?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto VISIONDF_A]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME wear glasses ^CONTACTS?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^CONTACTS

Description: or contact lenses
Instruction:
If AGE=5-17 fill "or contact lenses"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto VISIONDF_C]

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2019

Survey form view entire document: text image

Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Do you wear glasses or contact lenses?

Read if necessary: Persons who wear glasses to read or to do other occasional tasks should answer yes to this question.

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK = [goto VISIONDF_A]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_C
Interview Module: Child
Content Type: Annual Core

Question Text:

Does ^SCNAME wear glasses ^CONTACTS?

Read if necessary: Persons who wear glasses to read or to do other occasional tasks should answer yes to this question.
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

^CONTACTS

Description or contact lenses
Instruction If AGE=5-17 fill "or contact lenses"

Response:

1 Yes
2 No
7 Refused
9 Do not Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,DK,RF = [goto VISIONDF_C]

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2017

Survey form view entire document: text image

Question ID: ACN.440_00.100

Instrument Variable Name: VIMGLASS
Questionnaire File Name: Sample Adult
Question Text:

Do you currently wear eyeglasses or contact lenses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who are not blind
Skip Instructions:

(1,) [go to VIMREAD];
(2,R,D) and AVISION=1 [go to AVISREH];
else (2,R,D) and AVISION=2,R,D [goto AVDF_NWS]

Survey form view entire document: text image

Question ID: CHS.270_00.025

Instrument Variable Name: CVISGLAS
Questionnaire File Name: Sample Child
Question Text:

Does [fill: SC name] wear eyeglasses or contact lenses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample children (18 who is not blind
Skip Instructions:

(1) [goto CVISDIST]
(2,R,D) [go to CVISACT]

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2016

Survey form view entire document: text image

Question ID: ACN.440_00.100

Instrument Variable Name: VIMGLASS
Questionnaire File Name: Sample Adult
Question Text:

Do you currently wear eyeglasses or contact lenses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who are not blind
Skip Instructions:

(1,) [go to VIMREAD];
(2,R,D) and AVISION=1 [go to AVISREH];
else (2,R,D) and AVISION=2,R,D [goto AVDF_NWS]

Survey form view entire document: text image

Question ID: CHS.270_00.025

Instrument Variable Name: CVISGLAS
Questionnaire File Name: Sample Child
Question Text:

Does [fill: SC name] wear eyeglasses or contact lenses?

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample children (18 who is not blind
Skip Instructions:

(1) [goto CVISDIST]
(2,R,D) [go to CVISACT]

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2008

Survey form view entire document: text image

Question ID:CHS.270_00.025

Instrument Variable Name:CVISGLAS
QuestionText:

Does [fill: SC name] wear eyeglasses or contact lenses?

1 Yes
2 No
7 Refused
9 Don't know

UniverseText:Sample children 6-17 years who are not blind
SkipInstructions:

(1) [goto CVISDIST]
(2,R,D) [go to CVISACT]

Survey form view entire document: text image

Question ID:ACN.440_00.100

Instrument Variable Name:VIMGLASS
QuestionText:

Do you currently wear eyeglasses or contact lenses?

1 Yes
2 No
7 Refused
9 Don't know

UniverseText:Sample adults 18+
SkipInstructions:

(1) [go to VIMREAD];
(2,R,D) and AVISION=1 [go to AVISREH];
else (2,R,D) and AVISION=2,R,D [goto AVDF_NWS]

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1988

Survey form view entire document: text image

Check Item 18
Refer to age of sample child.

1[] 3+ years old (1)
2[] Under 3 years old (3)

1. Does -- wear glasses or contact lenses?

1[] Yes
2[] No

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1982

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10. Do you have eyeglasses or contact lenses?

1[] Yes
2[] No

11a. Does -- have eyeglasses or contact lenses?

1[] Yes
2[] No

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1981

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2a. Does -- wear glasses or contact lenses?

1[] Y
2[] N (3)

b. Which does -- wear?

1[] Both glasses and contacts
2[] Glasses only
3[] Contacts only

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1980

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9a. Does anyone in the family use -
If "Yes," ask 9b and c

(1) Eyeglasses?

[] Y
[] N

(2) Contact lenses?

[] Y
[] N

(3) A hearing aid?

[] Y
[] N

b. Who is this? Mark box in person's column

1 [] Eyeglasses
2 [] Contact lenses
3 [] Hearing aid

c. Anyone else?

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1979

Survey form view entire document: text image

9a. Does anyone in the family use -
If "Yes," ask 9b and c

(1) Eyeglasses?

[] Y
[] N

(2) Contact lenses?

[] Y
[] N

(3) A hearing aid?

[] Y
[] N

b. Who is this? Mark box in person's column

1 [] Eyeglasses
2 [] Contact lenses
3 [] Hearing aid

c. Anyone else?

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1977

No questionnaire text is available for this sample.

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1973

Survey form view entire document: text image

PREVENTIVE CARE

S1

[] 40+ years (1)
[] 17-39 years (3)
[] 3-16 years (7)
[] Under 3 years (8)

4a. Does -- have eyeglasses or contact lenses?

1 [] Y
2 [] N

7a. Does -- have eyeglasses or contact lenses?

1 [] Y
2 [] N

2023	2019	1988	1979
2022	2017	1982	1977
2021	2016	1981	1973
2020	2008	1980

Survey Text