Survey Text

2012
2007
2002
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2012
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QuestionID: ALT.553_00.000

Instrument Variable Name: TP1_DS1 Adult CAM
QuestionText:
[fill1: Not including the practitioner you saw for] [fill2: modality] DURING THE PAST 12 MONTHS, did you let your personal health care provider know about your use of [fill3: modality]?
*If practitioner for therapy is the same person as personal health care provider, enter '1'.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ who have used first of top three modalities and has a personal health care provider
SkipInstructions:
(1,R,D) [goto TP1_INF1]
(2) [goto TP1_DS2]

Survey form view entire document:  text  image
Question ID: CAL.553_00.000

Instrument Variable Name: CTP1DS1
QuestionText:
[fill1: Not including the practitioner [fill: S.C. name] saw for] [fill2: modality] DURING THE PAST 12 MONTHS, did you let [fill S.C. name]'s personal health care provider know about [fill: his/her] use of [fill3: modality]?
*If practitioner for therapy is the same person as personal health care provider, enter '1'.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 4+ who have used first of top three modalities and has a personal health care provider
SkipInstructions:
(1,R,D) [goto CTP1INF1]
(2) [goto CTP1DS2]

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2007
Survey form view entire document:  text  image
Question ID: : ALT.956_00.000

Instrument Variable Name: REL_DISC
Question Text:
(book) ALT3 ?[F1]
DURING THE PAST 12 MONTHS, did you let any of the CONVENTIONAL medical professionals know about your
use of [fill relaxation technique used most]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: Sample Adult 18+ who used a relaxation technique past 12 months
Skip Instructions:
(1) [goto RELPROF]
(2,Refused,Don't know) if RELE_MED=2 [goto RELNOUSE];
elseif RELU_MED=2 [goto RELNOYR];
else [goto PRA_SLFE]

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2002
Survey form view entire document:  text  image
ALT.332

DURING THE PAST 12 MONTHS, did you let any of these CONVENTIONAL medical professionals know about your use of (this/these) relaxation technique(s)?

FR: SHOW FLASHCARD A16
Card A16
You may choose more than one

1. Medical Doctor (M.D.) (including specialists)
2. Nurse PractitionerIPhysician Assistant
3. Psychiatrist
4. Dentist (including specialists)
REL_DISC
(1) Yes (ALT.334)
(2) No (ALT.336)
(3) Did not go/talk to any of these (ALT.336)
(7) Refused (ALT.336)
(9) Don't know (ALT.336)

ALT.334

Which ones?

FR: MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.

(1) Yes
(2) No
(7) Refused
(9) Don't know
RELPROF1 Medical Doctor (M.D.) (including specialists)
RELPROF2 Nurse Practitioner/Physician Assistant
RELPROF3 Psychiatrist
RELPROF4 Dentist (including specialists)