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2017

Survey form view entire document: text image

Question ID: ACN.441_00.030

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

*Read if necessary:
[Fill1: Even when wearing glasses or contacts lenses, because of your eyesight, / Fill 2: Because of your eyesight,] how difficult is it for you
...To go down steps, stairs, or curbs in dim light or at night
*Read categories below.

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all because of eyesight
6 Do not do this activity for other reasons
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who are not blind
Skip Instructions:

(0-4,6,R,D) [goto AVDF_DRV]

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2016

Survey form view entire document: text image

Question ID: ACN.441_00.030

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

*Read if necessary:
[Fill1: Even when wearing glasses or contacts lenses, because of your eyesight, / Fill 2: Because of your eyesight,] how difficult is it for you
...To go down steps, stairs, or curbs in dim light or at night
*Read categories below.

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all because of eyesight
6 Do not do this activity for other reasons
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who are not blind
Skip Instructions:

(0-4,6,R,D) [goto AVDF_DRV]

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2008

Survey form view entire document: text image

Question ID:ACN.441_00.030

Instrument Variable Name:AVDF_NIT
QuestionText:

[Book] A6
*Read if necessary:
[Fill1: Even when wearing glasses or contacts lenses, because / Fill 2: Because ] of your eyesight, how difficult is it for you ...To go down steps, stairs, or curbs in dim light or at night

0 Not at all difficult
1 Only a little difficult
2 Somewhat difficult
3 Very difficult
4 Can't do at all because of eyesight
6 Do not do this activity for other reasons
7 Refused
9 Don't know

UniverseText:Sample adults 18+ who are not blind
SkipInstructions:

(0-4,6,R,D) [goto AVDF_DRV]

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2002

Survey form view entire document: text image

ACN.440.050

Even when wearing glasses or contacts lenses, because of your eyesight, how difficult is it for you...

FR: SHOW FLASHCARD A4.

Card A4

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all
6. Do not do this activity

AVDF

(0) Not at all difficult
(1) Only a little difficult
(2) Somewhat difficult
(3) Very difficult
(4) Can't do at all
(6) Do not do this activity
(7) Refused
(9) Don't know

AVDFNWS ...To read ordinary print in newspapers?
AVDFCLS ...To do work or hobbies that require you to see well up close such as cooking, sewing, fixing things around the house, or using hand tools?
AVDFNIT ...To go down steps, stairs or curbs in dim light or at night?
AVDFDRV ...To drive during daytime in familiar places?
AVDFPER ...To notice objects off to the side while you are walking along?
AVDFCRD ...To find something on a crowded shelf?

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1999

Survey form view entire document: text image

ACN.440.010

FR: SHOW CARD A4
Even when wearing glasses or contact lenses, because of your eyesight, how difficult is it for
you...
(0) Not at all difficult
(1) Only a little difficult
(2) Some what difficult
(3) Very difficult
(4) Can't do at all
(7) Refused
(9) Don't know

Card A4

0. Not at all difficult
1. Only a little difficult
2. Somewhat difficult
3. Very difficult
4. Can't do at all

NWS...To read ordinary print in newspapers?
CLS...To do work or hobbies that require you to see well up close such as cooking, sewing, fixing things around the house, or using hand tools?
NIT...To go down steps, stairs or curbs in dim light or at night?
DRV...To drive during daytime in familiar places?
PER...To notice objects off to the side while you are walking along?
CRD...Finding something on a crowded shelf?

Survey Text