Do you have difficulty with self care, such as washing all over or dressing? Would you say no
difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Sample Adults 18+

1-4,RF,DK [goto UPPRAISE_A]

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Sample Adults 18+

1-4,RF,DK [goto UPPRAISE_A]

Do you have difficulty with self care, such as washing all over or dressing? Would you say no
difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Sample Adults 18+

1-4,RF,DK [goto UPPRAISE_A]

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all
7 Refused
9 Do not Know

Sample Adults 18+

1-4,RF,DK = [goto UPPRAISE_A]

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

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+
Skip Instructions:

(1-4,R,D) goto UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
Question Text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/unable to do
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who were asked the family disability questions (FDB) and were randomly selected to receive the Functioning and Disability (AFD) section
Skip Instructions: (1-4,R,D) go to UB_1

Instrument Variable Name: UB_SS
QuestionText:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no difficulty, some difficulty, a lot of difficulty, or are you unable to do this?

1 No difficulty
2 Some difficulty
3 A lot of difficulty
4 Cannot do at all/Unable to do
7 Refused
9 Don't know

UniverseText: Sample adults 18+ who were not asked the family disability questions (FDB) and were randomly selected to receive the Quality of Life (QOL) section
SkipInstructions:

(1-4,R,D)[goto UB_1]