Survey Text

2007
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2007
Survey form view entire document:  text  image

Question ID: : ALT.476_00.000

Instrument Variable Name: AHRBTAKE
Question Text:
(book) ALT7
Please tell me which of these supplements you took in the PAST 30 DAYS. If you take more than one herb in a single
supplement, select "combination herb pill."
*Enter all that apply, separate with commas.
01 Combination herb pill
02 Androstenedione
03 Black cohosh
04 Carnitine
05 Chasteberry
06 Condroitin
07 Coenzyme Q-10
08 Comfrey
09 Conjugated Linolenic Acid (CLA)
10 Cranberry (pills, gelcaps)
11 Creatine
12 DHEA
13 Echinacea
14 Ephedra
15 Evening primrose
16 Feverfew
17 Fiber or Psyllium (pills or powder)
18 Fish oil or omega 3 or DHA fatty acid supplements
19 Flaxseed Oil or Pills
20 Garlic supplements (pills, gelcaps)
21 Ginger pills or gelcaps
22 Ginkgo biloba
23 Ginseng
24 Glucosamine
25 Goldenseal
26 Guarana
27 Grape Seed Extract
28 Green tea pills (not brewed tea)
29 EGCG (pills)
30 Hawthorn
31 Horny Goat Weed
32 Kava kava
33 Lecithin
34 Lutein
35 Lycopene
36 Melatonin
37 MSM (Methylsulfonylmethane)
38 Milk thistle
39 Prebiotics or Probiotics
40 SAM-e
41 Saw palmetto
42 Senna
43 Soy supplements or soy isoflavones
44 St. John's wort
45 Valerian
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who have taken herbal supplements in the past 30 days
Skip Instructions:
(1) [goto AHB_COMN
(2-45) if more than 2 herbs chosen [goto AHB_TOP2]; else if 1 or 2 herbs chosen (and herbs chosen do not
include (1)) [goto AHB_R1A]
(Refused,Don't know) [goto AHB_PRAC]

Survey form view entire document:  text  image

Question ID: : CAL.245_00.000

Instrument Variable Name: CHRBTAKE
Question Text:
(book) CAL3
Please tell me which supplements [S.C. name] took in the past 30 days. If [fill: he/she] took more than one herb in a
single supplement, select "combination herb pill."
*Enter all that apply, separate with commas.
01 Combination herb pill
02 Androstenedione
03 Black cohosh
04 Carnitine
05 Chasteberry
06 Chondroitin
07 Coenzyme Q-10
08 Comfrey
09 Conjugated Linolenic Acid (CAL)
10 Cranberry (pills, gelcaps)
11 Creatine
12 DHEA
13 Echinacea
14 Ephedra
15 Evening primrose
16 Feverfew
17 Fiber or Psyllium (pills or powder)
18 Fish oil or omega 3 or DHA fatty acid supplements
19 Flaxseed oil or pills
20 Garlic supplements (pills, gelcaps)
21 Ginger pills or gelcaps
22 Ginkgo biloba
23 Ginseng
24 Glucosamine
25 Goldenseal
26 Guarana
27 Grape seed extract
28 Green tea pills (not brewed tea)
29 EGCG (pills)
30 Hawthorn
31 Horny goat weed
32 Kava kava
33 Lecithin
34 Lutein
35 Lycopene
36 Melatonin
37 MSM (Methylsulfonylmethane)
38 Milk thistle
39 Prebiotics or Probiotics
40 SAM-e
41 Saw palmetto
42 Senna
43 Soy supplements or soy isoflavones
44 St. John wort
45 Valerian
97 Refused
99 Don't know
Universe Text: Sample children LT 18 who have taken herbal supplements in the past 30 days
Skip Instructions:
(1-45) if more than 2 herbs chosen [goto CHB_TOP2]; else [goto CHB_TRT1];
(R,D) [goto CHB_SPRT]