I. Physical Measures (respondent)
I. Physical Measures (respondent) module of HRS 2004
Start of I. Physical Measures (respondent)
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JI803
R elegible for physical measures
INTERVIEWER: R IS ELIGIBLE FOR THESE MEASUREMENTS: ([BREATHING TEST/HAND STRENGTH TEST/WALKING TEST/HEIGHT/WEIGHT]) INTERVIEWER: MARK THE TESTS THAT R IS ELIGIBLE TO COMPLETE ON THE FRONT PAGE OF THE PHYSICAL MEASURES BOOKLET AND SWITCH TO PHYSICAL MEASURES BOOKLET TO ADMINISTER THE TESTS NOW. WHEN YOU HAVE COMPLETED ALL MEASUREMENTS, PRESS 1 TO CONTINUE
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1. Continue
Blank. Inapplicable
INTERVIEWER: R IS ELIGIBLE FOR THESE MEASUREMENTS: ([BREATHING TEST/HAND STRENGTH TEST/WALKING TEST/HEIGHT/WEIGHT]) INTERVIEWER: MARK THE TESTS THAT R IS ELIGIBLE TO COMPLETE ON THE FRONT PAGE OF THE PHYSICAL MEASURES BOOKLET AND SWITCH TO PHYSICAL MEASURES BOOKLET TO ADMINISTER THE TESTS NOW. WHEN YOU HAVE COMPLETED ALL MEASUREMENTS, PRESS 1 TO CONTINUE
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1. Continue
Blank. Inapplicable
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JI802
Physical measures consent form
NOW I AM GOING TO ASK YOU TO DO A FEW SIMPLE ACTIVITIES FOR ME. RESEARCHERS ARE INTERESTED IN HOW PERFORMANCE ON THESE ACTIVITIES RELATES TO SOME OF THE OTHER FACTORS I HAVE ASKED YOU ABOUT IN THE INTERVIEW. I WILL ASK YOU TO DO ______ ACTIVITIES: ______ MY PRIMARY CONCERN IS FOR YOUR SAFETY, SO I WILL ASK YOU IF YOU FEEL IT WOULD BE SAFE FOR YOU TO COMPLETE EACH ACTIVITY. IF YOU HAVE ANY CONCERNS ABOUT THE ACTIVITY, PLEASE LET ME KNOW AND WE WILL SKIP IT. BEFORE WE BEGIN, I'D LIKE TO HAVE YOU READ AND SIGN A FORM EXPLAINING YOUR RIGHTS AS A PARTICIPANT IN THIS PART OF THE STUDY. INTERVIEWER: ENTER LOGGING ID ([SEE BLAISE SPECIFICATIONS FOR RTAB[1].X081_RLOGID ASSIGNMENT]) ON CONSENT FORM. INTERVIEWER: IF R REFUSES TO SIGN THE CONSENT FORM, ENTER CTRL-R. OTHERWISE, ENTER 1 TO CONTINUE.
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1. Continue
9. Refused
Blank. Inapplicable
NOW I AM GOING TO ASK YOU TO DO A FEW SIMPLE ACTIVITIES FOR ME. RESEARCHERS ARE INTERESTED IN HOW PERFORMANCE ON THESE ACTIVITIES RELATES TO SOME OF THE OTHER FACTORS I HAVE ASKED YOU ABOUT IN THE INTERVIEW. I WILL ASK YOU TO DO ______ ACTIVITIES: ______ MY PRIMARY CONCERN IS FOR YOUR SAFETY, SO I WILL ASK YOU IF YOU FEEL IT WOULD BE SAFE FOR YOU TO COMPLETE EACH ACTIVITY. IF YOU HAVE ANY CONCERNS ABOUT THE ACTIVITY, PLEASE LET ME KNOW AND WE WILL SKIP IT. BEFORE WE BEGIN, I'D LIKE TO HAVE YOU READ AND SIGN A FORM EXPLAINING YOUR RIGHTS AS A PARTICIPANT IN THIS PART OF THE STUDY. INTERVIEWER: ENTER LOGGING ID ([SEE BLAISE SPECIFICATIONS FOR RTAB[1].X081_RLOGID ASSIGNMENT]) ON CONSENT FORM. INTERVIEWER: IF R REFUSES TO SIGN THE CONSENT FORM, ENTER CTRL-R. OTHERWISE, ENTER 1 TO CONTINUE.
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1. Continue
9. Refused
Blank. Inapplicable
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JI804
Breathing test at least one trial
BREATHING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
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1. Yes
5. No
Blank. Inapplicable
BREATHING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
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1. Yes
5. No
Blank. Inapplicable
If Breathing test at least one trial (JI804) = 2 »
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JI805
Reason not complete breathing test
BREATHING TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE BREATHING TEST? (SELECT ALL THAT APPLY)
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1. R felt it would not be safe
2. Iwer felt it would not be safe
3. R refused or was not willing to complete the test
4. R tried but was unable to complete test
5. R did not understand the instructions
6. R had surgery, injury or other health condition that prevented r from taking the test
7. Other (specify)
11. Problem with equipment and/or consent form
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
BREATHING TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE BREATHING TEST? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. Iwer felt it would not be safe
3. R refused or was not willing to complete the test
4. R tried but was unable to complete test
5. R did not understand the instructions
6. R had surgery, injury or other health condition that prevented r from taking the test
7. Other (specify)
11. Problem with equipment and/or consent form
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
Else
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JI807
Physical measures puff test reading
BREATHING TEST FIRST READING: SECOND READING: THIRD READING: ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
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993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused
BREATHING TEST FIRST READING: SECOND READING: THIRD READING: ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
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993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused
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JI808
Physical measures puff test reading- 2
BREATHING TEST FIRST READING: (PUFF TEST 1) SECOND READING: THIRD READING: ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
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993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused
BREATHING TEST FIRST READING: (PUFF TEST 1) SECOND READING: THIRD READING: ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
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993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused
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JI809
Physical measures puff test reading- 3
BREATHING TEST FIRST READING: (PUFF TEST 1) SECOND READING: (PUFF TEST 2) THIRD READING: ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
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993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused
BREATHING TEST FIRST READING: (PUFF TEST 1) SECOND READING: (PUFF TEST 2) THIRD READING: ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
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993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused
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JI810
Breathing test effort
BREATHING TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
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1. R gave full effort
2. Full effort prevented by illness, pain, or other symptoms or discomforts
3. Full effort not given, but no obvious reason for this
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
BREATHING TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
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1. R gave full effort
2. Full effort prevented by illness, pain, or other symptoms or discomforts
3. Full effort not given, but no obvious reason for this
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI811
R position for breathing test
BREATHING TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
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1. Standing
2. Sitting
3. Lying down
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
BREATHING TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
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1. Standing
2. Sitting
3. Lying down
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI812
Hand strength at least one trial
HAND STRENGTH TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
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1. Yes
5. No
Blank. Inapplicable
HAND STRENGTH TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
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1. Yes
5. No
Blank. Inapplicable
If Hand strength at least one trial (JI812) = 2 »
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JI813
Reason hand strength test not complete
HAND STRENGTH TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE HAND STRENGTH TEST? (SELECT ALL THAT APPLY)
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1. R felt it would not be safe
2. Iwer felt it would not be safe
3. R refused or was not willing to complete the test
4. R tried but was unable to complete test
5. R did not understand the instructions
6. R had surgery, injury, swelling, etc. on both hands in past 6 months
7. Other (specify)
11. Problem with equipment and/or consent form
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
HAND STRENGTH TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE HAND STRENGTH TEST? (SELECT ALL THAT APPLY)
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1. R felt it would not be safe
2. Iwer felt it would not be safe
3. R refused or was not willing to complete the test
4. R tried but was unable to complete test
5. R did not understand the instructions
6. R had surgery, injury, swelling, etc. on both hands in past 6 months
7. Other (specify)
11. Problem with equipment and/or consent form
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
Else
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JI815
Hand strength dominant hand
HAND STRENGTH TEST INTERVIEWER: RECORD R'S DOMINANT HAND.
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1. Right hand
2. Left hand
3. Both hands equally dominant
Blank. Inapplicable
HAND STRENGTH TEST INTERVIEWER: RECORD R'S DOMINANT HAND.
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1. Right hand
2. Left hand
3. Both hands equally dominant
Blank. Inapplicable
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JI816
First left hand measurement
HAND STRENGTH TEST INTERVIEWER: LEFT HAND, FIRST MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
HAND STRENGTH TEST INTERVIEWER: LEFT HAND, FIRST MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
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JI851
Right hand first measurement
HAND STRENGTH TEST INTERVIEWER: RIGHT HAND, FIRST MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: (LEFT FIRST) RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
HAND STRENGTH TEST INTERVIEWER: RIGHT HAND, FIRST MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: (LEFT FIRST) RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
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JI852
Left hand second measurement
HAND STRENGTH TEST INTERVIEWER: LEFT HAND, SECOND MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: (LEFT FIRST) RIGHT HAND, FIRST MEASUREMENT: (RIGHT FIRST) LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
HAND STRENGTH TEST INTERVIEWER: LEFT HAND, SECOND MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: (LEFT FIRST) RIGHT HAND, FIRST MEASUREMENT: (RIGHT FIRST) LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
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JI853
Right hand second measurement
HAND STRENGTH TEST INTERVIEWER: RIGHT HAND, SECOND MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: (LEFT FIRST) RIGHT HAND, FIRST MEASUREMENT: (RIGHT FIRST) LEFT HAND, SECOND MEASUREMENT: (LEFT SECOND) RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
HAND STRENGTH TEST INTERVIEWER: RIGHT HAND, SECOND MEASUREMENT. LEFT HAND, FIRST MEASUREMENT: (LEFT FIRST) RIGHT HAND, FIRST MEASUREMENT: (RIGHT FIRST) LEFT HAND, SECOND MEASUREMENT: (LEFT SECOND) RIGHT HAND, SECOND MEASUREMENT: INTERVIEWER: ENTER THE RESULT TO THE NEAREST WHOLE NUMBER (KILOGRAMS). ENTER 99993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 99999 IF R CHOSE NOT TO DO IT
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99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it
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JI817
R effort hand strength test
HAND STRENGTH TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
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1. R gave full effort
2. Full effort prevented by illness, pain, or other symptoms or discomforts
3. Full effort not given, but no obvious reason for this
9. Refused
Blank. Inapplicable
HAND STRENGTH TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R gave full effort
2. Full effort prevented by illness, pain, or other symptoms or discomforts
3. Full effort not given, but no obvious reason for this
9. Refused
Blank. Inapplicable
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JI818
R position hand strength test
HAND STRENGTH TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
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1. Standing
2. Sitting
3. Lying down
9. Refused
Blank. Inapplicable
HAND STRENGTH TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down
9. Refused
Blank. Inapplicable
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JI819
Rest arm during hand strength test
HAND STRENGTH TEST INTERVIEWER: DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
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1. Yes
5. No
9. Refused
Blank. Inapplicable
HAND STRENGTH TEST INTERVIEWER: DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
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1. Yes
5. No
9. Refused
Blank. Inapplicable
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JI820
Walking test complete at least one trial
WALKING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
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1. Yes
5. No
Blank. Inapplicable
WALKING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
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1. Yes
5. No
Blank. Inapplicable
If Walking test complete at least one trial (JI820) = 2 »
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JI821
Reason not complete walking test
WALKING TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE WALKING TEST? (SELECT ALL THAT APPLY)
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1. R felt it would not be safe
2. Iwer felt it would not be safe
3. R refused or was not willing to complete the test
4. R tried but was unable to complete test
5. R did not understand the instructions
6. R had surgery, injury, or other health condition that prevented r from walking
7. No suitable space available
11. Problem with equipment and/or consent form
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
WALKING TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE WALKING TEST? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. Iwer felt it would not be safe
3. R refused or was not willing to complete the test
4. R tried but was unable to complete test
5. R did not understand the instructions
6. R had surgery, injury, or other health condition that prevented r from walking
7. No suitable space available
11. Problem with equipment and/or consent form
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
Else
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JI823
Walking test first trial time
WALKING TEST INTERVIEWER: RECORD TIME IN SECONDS TO TWO DECIMAL PLACES FIRST TRIAL: SECOND TRIAL: ENTER 99993 IF R WAS UNABLE TO DO IT ENTER 99999 IF R CHOSE NOT TO DO IT
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999993. R was unable to do it
999998. Don't know; not ascertained
999999. R chose not to do it
WALKING TEST INTERVIEWER: RECORD TIME IN SECONDS TO TWO DECIMAL PLACES FIRST TRIAL: SECOND TRIAL: ENTER 99993 IF R WAS UNABLE TO DO IT ENTER 99999 IF R CHOSE NOT TO DO IT
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999993. R was unable to do it
999998. Don't know; not ascertained
999999. R chose not to do it
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JI824
Walking test second trial time
WALKING TEST INTERVIEWER: RECORD TIME IN SECONDS TO TWO DECIMAL PLACES FIRST TRIAL: (T WALK 1ST TRIAL TIME) SECOND TRIAL: ENTER 99993 IF R WAS UNABLE TO DO IT ENTER 99999 IF R CHOSE NOT TO DO IT
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999993. R was unable to do it
999998. Don't know; not ascertained
999999. R chose not to do it
WALKING TEST INTERVIEWER: RECORD TIME IN SECONDS TO TWO DECIMAL PLACES FIRST TRIAL: (T WALK 1ST TRIAL TIME) SECOND TRIAL: ENTER 99993 IF R WAS UNABLE TO DO IT ENTER 99999 IF R CHOSE NOT TO DO IT
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999993. R was unable to do it
999998. Don't know; not ascertained
999999. R chose not to do it
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JI825
Walking test- type of floor surface
WALKING TEST INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete
5. Not sure
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
WALKING TEST INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete
5. Not sure
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI828
Walking test- type of aid used
WALKING TEST INTERVIEWER: RECORD TYPE OF AID USED
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1. None
2. Walking stick or cane
3. Elbow crutches
4. Walking frame
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
WALKING TEST INTERVIEWER: RECORD TYPE OF AID USED
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. Walking stick or cane
3. Elbow crutches
4. Walking frame
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI830
Walking test- r effort
WALKING TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R gave full effort
2. Full effort prevented by illness, pain, or other symptoms or discomforts
3. Full effort not given, but no obvious reason for this
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
WALKING TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R gave full effort
2. Full effort prevented by illness, pain, or other symptoms or discomforts
3. Full effort not given, but no obvious reason for this
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI831
R height
HEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S HEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable
HEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S HEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable
If R height (JI831) = 2 »
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JI832
Measure height- not complete
HEIGHT INTERVIEWER: WHY WEREN'T YOU ABLE TO MEASURE R'S HEIGHT? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. Iw felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. Respondent too tall, interviewer could not reach
7. No suitable space available
11. Problem with equipment and/or consent form
12. R not in sample for this test
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
HEIGHT INTERVIEWER: WHY WEREN'T YOU ABLE TO MEASURE R'S HEIGHT? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. Iw felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. Respondent too tall, interviewer could not reach
7. No suitable space available
11. Problem with equipment and/or consent form
12. R not in sample for this test
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
Else
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JI834
Height measurement
HEIGHT INTERVIEWER: ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.
HEIGHT INTERVIEWER: ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.
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JI835
Height measurment- floor surface
HEIGHT INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete
5. Not sure
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
HEIGHT INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete
5. Not sure
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI837
Height measurement- r wearing shoes
HEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
HEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable
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JI838
Able to measure weight
WEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S WEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable
WEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S WEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable
If Able to measure weight (JI838) = 2 »
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JI839
Reason not complete weight measurement
WEIGHT INTERVIEWER: WHY WEREN'T YOU ABLE TO MEASURE R'S WEIGHT? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. Iw felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. Respondent was too heavy; did not attempt
7. No suitable space available
8. Scale did not work
11. Problem with equipment and/or consent form
12. R not in sample for this test
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
WEIGHT INTERVIEWER: WHY WEREN'T YOU ABLE TO MEASURE R'S WEIGHT? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. Iw felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. Respondent was too heavy; did not attempt
7. No suitable space available
8. Scale did not work
11. Problem with equipment and/or consent form
12. R not in sample for this test
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable
Else
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JI841
R weight- pounds
WEIGHT INTERVIEWER: ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 1/2 POUND).
WEIGHT INTERVIEWER: ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 1/2 POUND).
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JI842
Weight- floor surface
WEIGHT INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete
5. Not sure
7. Other (specify)
Blank. Inapplicable
WEIGHT INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete
5. Not sure
7. Other (specify)
Blank. Inapplicable
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JI844
Weight- wearing shoes
WEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable
WEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable
End of I. Physical Measures (respondent)