Survey Text

2022 2017 2012 2007
2021 2016 2011 2006
2020 2015 2010
2019 2014 2009
2018 2013 2008
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2022
Survey form view entire document:  text  image
Question ID: VFY.0050.00.1
Variable: PROXYLNO_A
Interview Module: Adult
Content Type: Annual Core

Question text:

* Select the person in this household who is the proxy for ^SANAME.
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
01 - ^ALIASNAME[1]
02 - ^ALIASNAME[2]
03 - ^ALIASNAME[3]
04 - ^ALIASNAME[4]
05 - ^ALIASNAME[5]
06 - ^ALIASNAME[6]
07 - ^ALIASNAME[7]
08 - ^ALIASNAME[8]
09 - ^ALIASNAME[9]
10 - ^ALIASNAME[10]
11 - ^ALIASNAME[11]
12 - ^ALIASNAME[12]
13 - ^ALIASNAME[13]
14 - ^ALIASNAME[14]
15 - ^ALIASNAME[15]
16 - ^ALIASNAME[16]
17 - ^ALIASNAME[17]
18 - ^ALIASNAME[18]
19 - ^ALIASNAME[19]
20 - ^ALIASNAME[20]
21 - ^ALIASNAME[21]
22 - ^ALIASNAME[22]
23 - ^ALIASNAME[23]
24 - ^ALIASNAME[24]
25 - ^ALIASNAME[25]
97 - Refused
99 - Don't Know
-
Universe:
Sample adult proxy is a relative or non relative who lives in the household
Skip Instructions:
1-25 if PROXYLNO_A ne CURRES_A [goto INTMODE_A]
elseif PROXYLNO_A=CURRES_A and Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and
HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]

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2021
Survey form view entire document:  text  image
Question ID: VFY.0030.00.1
Variable: PROXY_A
Interview Module: Adult
Content Type: Annual Core
Question text:
Proxy interviews can be done for sample adults that have a mental or physical condition that prevents them from responding for themselves.
Is a family member or caregiver that is knowledgeable about ^SANAME's health available?
Fills:
^SANAME
Description: Sample Adult's name
Instruction:
Sample Adult's name
Response:
1 - Yes
2 - No
7 - Refused
9 - Don't Know
Universe:
The Sample Adult's physical or mental condition prohibits responding.
Skip Instructions:
1 [goto PROXYREL_A]
2,RF,DK [goto PROXYCALL_A]

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2020

No questionnaire text is available for this sample.


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2019

No questionnaire text is available for this sample.


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2018
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2017
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2016
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2015
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2014
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2013
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2012
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2011
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2010
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2009
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2008
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3

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2007

No questionnaire text is available for this sample.


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2006
Survey form view entire document:  text  image
Question ID: AID.010_00.000

Instrument Variable Name: PROX1
QuestionText:
* Proxy interviews can be done for sample adults that have a mental or physical condition that
prevents them from responding for themselves. Is a family member or caregiver that is knowledgeable about [fill: ALIAS of Sample Adult]'s health available?
1 Yes
2 No
UniverseText: The Sample Adult's physical or mental condition prohibits responding.
SkipInstructions:
(1) goto PROX2
(2) goto PROX3