questionnaires from the ANES 2008-2009 Panel Study

401 Pages·2010·5.22 MB·English

ANES 2008-2009 Panel Study Off Wave Questionnaires
December 2009

This document contains the questionnaire programming specifications for the non ANES-
sponsored questionnaires from the ANES 2008-2009 Panel Study: March, April, May,
July, August, December 2008 and February, March, April, June, September, and
October 2009 are included.

Questionnaires from the ANES sponsored waves of the survey (January, February, June,
September, October, November 2008 and January, May July and August 2009) can be
found in a separate document.

These questionnaires were administered entirely over the Internet.

Contents of this Document

1. Wave 3 (March) questionnaire…………………………………………………………2
2. Wave 4 (April) questionnaire ..……………………………………………………….35
3. Wave 5 (May) questionnaire …………………………………………………………62
4. Wave 7 (July) questionnaire ………………………………………………………….77
5. Wave 8 (August) questionnaire ………………………………………………………89
6. Wave 12 (December) questionnaire ………………………………………………...123
7. Wave 14 (February ’09) questionnaire ……………………………………………...154
8. Wave 15 (March ’09) questionnaire ………………………………………………...190
9. Wave 16 (April ’09) questionnaire ………………………………………………….225
10. Wave 18 (June ’09) questionnaire …………………………………………………278
11. Wave 21 (September ’09) questionnaire …………………………………………..322
12. Wave 22 (October '09) questionnaire........................................................................355
1
1. Wave 3 (March) questionnaire

ANES Wave 3 Questionnaire
- March 2008 -
[DISPLAY]
This [IF NOT PRETEST: month’s] survey will cover two general areas: health and television viewing
habits. First, we'll be asking about your health and illnesses you or any member in your household
may have now or had in the past. We realize this is private information. However, your answers will
remain confidential and will help us better understand the health issues and concerns of U.S residents.

[IF PRETEST: Sometimes you may get a survey that looks like one you have already filled out. This is
because the questions may seem the same but are actually slightly different, or it may just be time to
update the information you have given to us before.

Even if some of the following questions look familiar, please answer them as best as possible. If you
like, you can give us your comments about any or all of today’s questions at the end of this survey.]

Thank you for your help!

[SP]
Q1a. In general, would you say your physical health is…

Excellent ............................................................ 1
Very good .......................................................... 2
Good .................................................................. 3
Fair .................................................................... 4
Poor .................................................................. 5

[NUMBER BOXES]
Q2. How tall are you without shoes? Please type in the number of feet and inches separately. For
example, if you are 6'0" tall, type 6 in the feet box and 0 in the inches box.

Feet [NUMBER BOX WITH RANGE 2 TO 7]

Inches [NUMBER BOX WITH RANGE 0 TO 11]

[NUMBER BOX]
Q3. How much do you weigh without shoes?

Pounds [NUMBER BOX WITH RANGE 50 - 500]

2
[SP]
Q4. During an average week, how often do you exercise? Examples of exercising are aerobics,
brisk walking or running, bicycling, playing tennis, lifting weights, calisthenics, etc.

Never ................................................................. 1
Less than once a week ...................................... 2
1-2 times a week ............................................... 3
3-5 times a week ............................................... 4
6 or more times a week ..................................... 5

[SP]
Q59. The next several screens will ask about Have you EVER been told by a doctor or other health
professional that you had high cholesterol?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q60 IF “YES” SELECTED IN Q59.

[SP]
Q60. During the past 12 months, have you had high cholesterol?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q62. Have you EVER been told by a doctor or other health professional that you had hypertension,
also called high blood pressure?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q63 IF “YES” SELECTED IN Q62.

[SP]
Q63. Were you told on two or more DIFFERENT visits that you had hypertension, also called high
blood pressure?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

3
SHOW Q64 IF “YES” SELECTED IN Q62.

[SP]
Q64. During the past 12 months, have you had hypertension, also called high blood pressure?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q46. Have you EVER been told by a doctor or other health professional that you had coronary heart
disease?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q47 IF “YES” SELECTED IN Q46.

[SP]
Q47. During the past 12 months, have you had coronary heart disease?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q48. Have you EVER been told by a doctor or other health professional that you had angina, also
called angina pectoris?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q49 IF “YES” SELECTED IN Q48.

[SP]
Q49. During the past 12 months, have you had angina, also called angina pectoris?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

4
[SP]
Q50. Have you EVER been told by a doctor or other health professional that you had a heart attack
(also called myocardial infarction)?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q51 IF “YES” SELECTED IN 50

[SP]
Q51. During the past 12 months, have you had a heart attack (also called myocardial infarction)?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q92. Have you EVER been told by a doctor or other health professional that you had a stroke?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q93 IF “YES” SELECTED IN Q92.

[SP]
Q93. During the past 12 months, have you had a stroke?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q71. Have you EVER been told by a doctor or other health professional that you had asthma?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

5
SHOW Q72 IF “YES” SELECTED IN Q71.

[SP]
Q72. Do you still have asthma?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q73 IF “YES” SELECTED IN Q71.

[SP]
Q73. During the past 12 months, have you had an episode of asthma or an asthma attack?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q74 IF “YES” SELECTED IN Q71.

[SP]
Q74. During the past 12 months, have you had to visit an emergency room or urgent care center
because of asthma?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q75. Have you EVER been told by a doctor or other health professional that you had emphysema?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q76 IF “YES” SELECTED IN Q75.

[SP]
Q76. During the past 12 months, have you had emphysema?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

6
[SP]
Q24. Have you EVER been told by a doctor or other health professional that you had chronic pain
excluding migraine or other headaches?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q25 IF “YES” SELECTED IN Q24.

[SP]
Q25. During the past 12 months, have you had chronic pain, excluding migraine or other headaches?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q25A IF Q24 = 1

[MP]
Q24A. Is that joint pain (or osteoarthritis), back pain, neck pain, fibromyalgia, or some other
type of pain?

Joint pain (osteoarthritis) ................................... 1
Back pain ........................................................... 2
Neck pain ........................................................... 3
Fibromyalgia ...................................................... 1
Some other kind of pain ..................................... 2

SHOW Q25B IF Q24 = 1

SP
Q24B. Would you say that the pain is mild, moderate, or severe?

Mild .................................................................... 1
Moderate ........................................................... 2
Severe ............................................................... 3

[SP]
Q14. Have you EVER been told by a doctor or other health professional that you had some form of
arthritis, rheumatoid arthritis, gout, or fibromyalgia?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

7
SHOW Q15 IF “YES” SELECTED IN Q14.

[MP]
Q15. What kind of arthritis were you diagnosed with?
Osteoarthritis ..................................................... 1
Rheumathoid arthritis ........................................ 2
Don’t know/Not Sure .......................................... 4
None of these [SINGLE SELECT] ......................... 5

SHOW Q16 IF “YES” SELECTED IN Q14.

[SP]
Q16. During the past 12 months, have you had arthritis?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

[SP]
Q32. [IF PPGENDER = 2: Other than during pregnancy, have / ELSE: Have] you EVER been told by
a doctor or other health professional that you have diabetes or sugar diabetes?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q33 IF “YES” SELECTED IN Q32.

[SP]
Q33. Is the diabetes Type 1 or Type 2?

Type 1 (insulin-dependent diabetes) ................. 1
Type 2 (includes gestational diabetes) .............. 2
Don’t know/Not Sure .......................................... 3

SHOW Q34 IF “TYPE 2” SELECTED IN Q33.

[MP]
Q34. Which of the following do you do in order to manage your Type 2 diabetes?

[RANDOMIZE ALL CHOICES EXCEPT “SOMETHING ELSE”.]

Take insulin ....................................................... 1
Take prescribed oral medication(s) ................... 2
Regularly test blood glucose level ..................... 3
Maintain controlled / balanced diet .................... 4
Control through exercise ................................... 5
Limit alcohol consumption ................................. 6
Something else, please specify: ______ ........... 7
8
[SP]
Q17. Have you EVER been told by a doctor or other health professional that you had cancer or a
malignancy of any kind?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q18 IF “YES” SELECTED IN Q17.

[MP]
Q18. What kind of cancer was it?

Bladder .............................................................. 1
Blood ................................................................. 2
Bone .................................................................. 3
Brain .................................................................. 4
Breast ................................................................ 5
Cervix ................................................................ 6
Colon ................................................................. 7
Esophagus ......................................................... 8
Gallbladder ........................................................ 9
Kidney............................................................... 10
Larynx-windpipe ............................................... 11
Leukemia .......................................................... 12
Liver .................................................................. 13
Lung.................................................................. 14
Lymphoma ........................................................ 15
Melanoma ......................................................... 16
Mouth/tongue/lip ............................................... 17
Ovary ................................................................ 18
Pancreas .......................................................... 19
Prostate ............................................................ 20
Rectum ............................................................. 21
Skin (non-melanoma) ....................................... 22
Skin (don’t know what kind ............................... 23
Soft tissue (muscle or fat) ................................. 24
Stomach ........................................................... 25
Testis ................................................................ 26
Throat-pharynx ................................................. 27
Thyroid .............................................................. 28
Uterus ............................................................... 29
Other ................................................................. 30
Don’t Know/Not Sure ........................................ 31

9
SHOW Q19 FOR FIRST SELECTION IN Q18 IF ANY SELECTED IN Q18.

[NUMBER BOX; RANGE 00-99; DO NOT DISPLAY RANGE ON SCREEN]
Q19. How old were you when the [FIRST SELECTION FROM Q18] cancer was diagnosed?

___________________________

SHOW Q20 FOR SECOND SELECTION IN Q18 IF ANY SELECTED IN Q18.

[NUMBER BOX; RANGE 00-99; DO NOT DISPLAY RANGE ON SCREEN]
Q20. How old were you when the [SECOND SELECTION FROM Q18] cancer was diagnosed?

___________________________
SHOW Q19 FOR THIRD SELECTION IN Q18 IF ANY SELECTED IN Q18.

[NUMBER BOX; RANGE 00-99; DO NOT DISPLAY RANGE ON SCREEN]
Q21. How old were you when the [THIRD SELECTION FROM Q18] cancer was diagnosed?

___________________________

[SP]
Q56. Have you EVER been told by a doctor or other health professional that you had hepatitis?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

SHOW Q57 IF “YES” SELECTED IN Q56.

[MP]
Q57. What kind of Hepatitis were you diagnosed with?

Hepatitis A ......................................................... 1
Hepatitis B ......................................................... 2
Hepatitis C ......................................................... 3
Not sure/don’t know [SINGLE SELECT] ................ 4

SHOW Q58 IF “YES” SELECTED IN Q56.

[SP]
Q58. During the past 12 months, have you had hepatitis?

Yes .................................................................... 1
No ...................................................................... 2
Don’t Know/Not Sure ......................................... 3

10