I. Physical Measures (respondent)

I. Physical Measures (respondent) module of HRS 2004

item label type description
HHID Question Household identification number
PN System generated Respondent person identification number
JSUBHH System generated 2004 sub household identification number
HSUBHH System generated 2002 sub household identification number
JPN_SP System generated 2004 spouse/partner person number
JCSR System generated 2004 whether coversheet respondent
JFAMR System generated 2004 whether family respondent
JFINR System generated 2004 whether financial respondent
JI800 Question Physical measures ftf iw
JI801 Question Certified physical measures
JI850 System generated Physical measure assignment
JI802 Question Physical measures consent form
JI803 Question R elegible for physical measures
JI804 Question Breathing test at least one trial
JI805 Question Reason not complete breathing test
JI807 Question Physical measures puff test reading
JI808 Question Physical measures puff test reading- 2
JI809 Question Physical measures puff test reading- 3
JI810 Question Breathing test effort
JI811 Question R position for breathing test
JI812 Question Hand strength at least one trial
JI813 Question Reason hand strength test not complete
JI815 Question Hand strength dominant hand
JI816 Question First left hand measurement
JI851 Question Right hand first measurement
JI852 Question Left hand second measurement
JI853 Question Right hand second measurement
JI817 Question R effort hand strength test
JI818 Question R position hand strength test
JI819 Question Rest arm during hand strength test
JI820 Question Walking test complete at least one trial
JI821 Question Reason not complete walking test
JI823 Question Walking test first trial time
JI824 Question Walking test second trial time
JI825 Question Walking test- type of floor surface
JI828 Question Walking test- type of aid used
JI830 Question Walking test- r effort
JI831 Question R height
JI832 Question Measure height- not complete
JI834 Question Height measurement
JI835 Question Height measurment- floor surface
JI837 Question Height measurement- r wearing shoes
JI838 Question Able to measure weight
JI839 Question Reason not complete weight measurement
JI841 Question R weight- pounds
JI842 Question Weight- floor surface
JI844 Question Weight- wearing shoes
JI845 Question Finish physical measures
JVDATE Question 2004 data model version
JVERSION System generated 2004 data release version
Start of I. Physical Measures (respondent)
 
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
expand
 
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.
expand
 
JI804

Breathing test at least one trial

BREATHING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
expand
 
If Breathing test at least one trial = 2 »
 
   
 
JI805

Reason not complete breathing test

BREATHING TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE BREATHING TEST? (SELECT ALL THAT APPLY)
expand
   
Else
 
   
 
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.
expand
   
 
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.
expand
   
 
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.
expand
   
 
JI810

Breathing test effort

BREATHING TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
   
 
JI811

R position for breathing test

BREATHING TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
expand
   
JI812

Hand strength at least one trial

HAND STRENGTH TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
expand
 
If Hand strength at least one trial = 2 »
 
   
 
JI813

Reason hand strength test not complete

HAND STRENGTH TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE HAND STRENGTH TEST? (SELECT ALL THAT APPLY)
expand
   
Else
 
   
 
JI815

Hand strength dominant hand

HAND STRENGTH TEST INTERVIEWER: RECORD R'S DOMINANT HAND.
expand
   
 
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
expand
   
 
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
expand
   
 
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
expand
   
 
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
expand
   
 
JI817

R effort hand strength test

HAND STRENGTH TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
   
 
JI818

R position hand strength test

HAND STRENGTH TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
expand
   
 
JI819

Rest arm during hand strength test

HAND STRENGTH TEST INTERVIEWER: DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
expand
   
JI820

Walking test complete at least one trial

WALKING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
expand
 
If Walking test complete at least one trial = 2 »
 
   
 
JI821

Reason not complete walking test

WALKING TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE WALKING TEST? (SELECT ALL THAT APPLY)
expand
   
Else
 
   
 
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
expand
   
 
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
expand
   
 
JI825

Walking test- type of floor surface

WALKING TEST INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
expand
   
 
JI828

Walking test- type of aid used

WALKING TEST INTERVIEWER: RECORD TYPE OF AID USED
expand
   
 
JI830

Walking test- r effort

WALKING TEST INTERVIEWER: HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
   
JI831

R height

HEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S HEIGHT?
expand
 
If R height = 2 »
 
   
 
JI832

Measure height- not complete

HEIGHT INTERVIEWER: WHY WEREN'T YOU ABLE TO MEASURE R'S HEIGHT? (SELECT ALL THAT APPLY)
expand
   
Else
 
   
 
JI834

Height measurement

HEIGHT INTERVIEWER: ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.
   
 
JI835

Height measurment- floor surface

HEIGHT INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
expand
   
 
JI837

Height measurement- r wearing shoes

HEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
expand
   
JI838

Able to measure weight

WEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S WEIGHT?
expand
 
If Able to measure weight = 2 »
 
   
 
JI839

Reason not complete weight measurement

WEIGHT INTERVIEWER: WHY WEREN'T YOU ABLE TO MEASURE R'S WEIGHT? (SELECT ALL THAT APPLY)
expand
   
Else
 
   
 
JI841

R weight- pounds

WEIGHT INTERVIEWER: ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 1/2 POUND).
   
 
JI842

Weight- floor surface

WEIGHT INTERVIEWER: RECORD TYPE OF FLOOR SURFACE
expand
   
 
JI844

Weight- wearing shoes

WEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
expand
   
End of I. Physical Measures (respondent)
Start of I. Physical Measures (respondent)

========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Continue
Blank. Inapplicable

========================================================================
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.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Continue
9. Refused
Blank. Inapplicable

========================================================================
JI804
Breathing test at least one trial

BREATHING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable

If Breathing test at least one trial (JI804) = 2 »

| ========================================================================
JI805
Reason not complete breathing test

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

| ========================================================================
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.
- - - - - - - - - - - - - - - - - - - - - - - - -
993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused

| ========================================================================
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.
- - - - - - - - - - - - - - - - - - - - - - - - -
993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused

| ========================================================================
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.
- - - - - - - - - - - - - - - - - - - - - - - - -
993. R tried but was unable to do it.
998. Don't know; not ascertained
999. Refused

| ========================================================================
JI810
Breathing test effort

BREATHING 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

| ========================================================================
JI811
R position for breathing test

BREATHING TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable

========================================================================
JI812
Hand strength at least one trial

HAND STRENGTH TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable

If Hand strength at least one trial (JI812) = 2 »

| ========================================================================
JI813
Reason hand strength test not complete

HAND STRENGTH TEST INTERVIEWER: WHY DIDN'T R COMPLETE THE HAND STRENGTH 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, 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

| ========================================================================
JI815
Hand strength dominant hand

HAND STRENGTH TEST INTERVIEWER: RECORD R'S DOMINANT HAND.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Right hand
2. Left hand
3. Both hands equally dominant
Blank. Inapplicable

| ========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it

| ========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it

| ========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it

| ========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R was unable to perform this measurement
99998. Don't know; not ascertained
99999. R chose not to do it

| ========================================================================
JI817
R effort hand strength test

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

| ========================================================================
JI818
R position hand strength test

HAND STRENGTH TEST INTERVIEWER: WHAT WAS THE R'S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down
9. Refused
Blank. Inapplicable

| ========================================================================
JI819
Rest arm during hand strength test

HAND STRENGTH TEST INTERVIEWER: DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
9. Refused
Blank. Inapplicable

========================================================================
JI820
Walking test complete at least one trial

WALKING TEST INTERVIEWER: DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable

If Walking test complete at least one trial (JI820) = 2 »

| ========================================================================
JI821
Reason not complete walking test

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

| ========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
999993. R was unable to do it
999998. Don't know; not ascertained
999999. R chose not to do it

| ========================================================================
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
- - - - - - - - - - - - - - - - - - - - - - - - -
999993. R was unable to do it
999998. Don't know; not ascertained
999999. R chose not to do it

| ========================================================================
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

| ========================================================================
JI828
Walking test- type of aid used

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

| ========================================================================
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

========================================================================
JI831
R height

HEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S HEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable

If R height (JI831) = 2 »

| ========================================================================
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

Else

| ========================================================================
JI834
Height measurement

HEIGHT INTERVIEWER: ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.

| ========================================================================
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

| ========================================================================
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

========================================================================
JI838
Able to measure weight

WEIGHT INTERVIEWER: WERE YOU ABLE TO MEASURE R'S WEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable

If Able to measure weight (JI838) = 2 »

| ========================================================================
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

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).

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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

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JI844
Weight- wearing shoes

WEIGHT INTERVIEWER: WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable

End of I. Physical Measures (respondent)