Survey Text

2012
2007
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2012
Survey form view entire document:  text  image

QuestionID: ALT.302_00.000

Instrument Variable Name: AHB_LSTM Adult CAM
QuestionText:

(book) CAM2 Which of these supplements have you taken DURING THE PAST 30 DAYS? If you 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 Acai (pills, gelcaps)
03 Bee Pollen and other Bee products
04 Chondroitin
05 Co-enzyme Q10 (CoQ10)
06 Cranberry (pills or capsules)
07 Digestive Enzymes (lactaid)
08 Echinacea
09 Fish Oil or omega 3 or DHA fatty acid or EPA fatty acid supplements
10 Garlic supplements (pills, gelcaps)
11 Ginkgo Biloba
12 Ginseng
13 Glucosamine
14 Green tea pills (not brewed tea) or EGCG (pills)
15 Melatonin
16 Milk Thistle (silymarin)
17 MSM (Methylsulfonylmethane)
18 Probiotics or Prebiotics
19 SAM-e
20 Saw Palmetto
21 Valerian
22 Other herbs or non-vitamin supplements
97 Refused
99 Don't know
UniverseText: Sample adults 18+ who have taken herbs or other non-vitamin supplements in the past 30 days
SkipInstructions:

(1) [goto AHB_CHPN]
(1,2-21) if AHB_CNT GT 2 [goto AHB_CHPN] (then to AHB_CHP1 to AHB_TP2)
(1,2-21,22) if AHB_CNT GT 2[goto AHB_CHPN] (then to AHB_CHP1 to AHB_MOTH to AHB_LU1 (if more than 1 to AHB_LU2) goo AHB_TP2
(2-21) if AHB_CNT GT 2 [goto AHB_TP2]
(22) [goto AHB_MOTH];
(2-21,22) if AHB_CNT GT 2,[goto AHB_MOTH], to AHB_LU1 (if more than 1 to AHB_LU2) go to AHB_TP2 else if AHB_CNT LTE 2
(2-21) [goto AHB_EVR1]

Survey form view entire document:  text  image

Question ID: CAL.302_00.000

Instrument Variable Name: CHB_LSTM
QuestionText:
(book) CAM2
Which of these supplements has [S.C. name] taken DURING 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 Acai (pills, gelcaps)
03 Bee Pollen and other Bee products
04 Chondroitin
05 Co-enzyme Q10 (CoQ10)
06 Cranberry (pills or capsules)
07 Digestive Enzymes (lactaid)
08 Echinacea
09 Fish Oil or omega 3 or DHA fatty acid or EPA fatty acid supplements
10 Garlic supplements (pills, gelcaps)
11 Ginkgo Biloba
12 Ginseng
13 Glucosamine
14 Green tea pills (not brewed tea) or EGCG (pills)
15 Melatonin
16 Milk Thistle (silymarin)
17 MSM (Methylsulfonylmethane)
18 Probiotics or Prebiotics
19 SAM-e
20 Saw Palmetto
21 Valerian
22 Other herbs or non-vitamin supplements
97 Refused
99 Don't know
UniverseText: Sample children 4+ who have taken herbs or other non-vitamin supplements in the past 30 days
SkipInstructions:
(1) [goto CHB_CHPN]
(1,2-21) if CHB_CNT GT 2 [goto CHB_CHPN] (then to CHB_CHP1 to CHB_TP2)
(1,2-21,22) if CHB_CNT GT 2 [goto CHB_CHPN] (then to CHB_CHP1 to CHB_MOTH to CHB_LU1 (if more than 1 to CHB_LU2) [goto CHB_TP2]
(2-21) if CHB_CNT GT 2 [goto CHB_TP2]
(22) [goto CHB_MOTH];
(2-21,22) if CHB_CNT GT 2 [goto CHB_MOTH], to CHB_LU1 (if more than 1 to CHB_LU2) go to AHB_TP2 else if CHB_CNT LTE (2-21) [goto CHB_EVR1]

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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]

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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]