I. Physical Measures (respondent)

I. Physical Measures (respondent) module of HRS 2008

item label type description
HHID System generated Household identification number
PN System generated Respondent person identification number
LSUBHH System generated 2008 sub household identification number
KSUBHH System generated 2006 sub household identification number
LPN_SP System generated 2008 spouse/partner person number
LCSR System generated 2008 whether coversheet respondent
LFAMR System generated 2008 whether family respondent
LFINR System generated 2008 whether financial respondent
LEFTFASSIGN System generated Enhanced ftf assignment
LNURSHM System generated 2008 nursing home status-tracker
LPMELIG System generated 2008 physical measures eligibility
LI800 Question Physical measures ftf iw
LI802 Question Physical measures consent form
LI954 Question Why no consent physical measures
LI855 Question Blood pressure not complete
LI857 System generated Bloodpressure time
LI859 Question Bloodpressure 1 systolic
LI860 Question Bloodpressure 1 diastolic
LI861 Question Bloodpressure 1 pulse
LI862 System generated Blood pressure 2 time
LI864 Question Bloodpressure 2 systolic
LI865 Question Bloodpressure 2 diastolic
LI866 Question Bloodpressure 2 pulse
LI867 System generated Bloodpressure 3 time
LI869 Question Bloodpressure 3 systolic
LI870 Question Bloodpressure 3 diastolic
LI871 Question Bloodpressure 3 pulse
LI872 Question Bloodpressure arm
LI873 Question Bloodpressure compliance
LI874 Question Bloodpressure position
LI875 Question Bloodpressure smoke etc
LI804 Question Breath complete at least one trial
LI805 Question Breath test reason not complete
LI807 System generated Puff test 1
LI808 System generated Puff test 2
LI809 System generated Puff test 3
LI810 Question R breathing test effort
LI811 Question Breathing test r position
LI812 Question Hand strength complete at least one trial
LI813 Question Hand strength test reason not complete
LI815 System generated Grip dominant hand
LI816 Question Left hand first
LI851 Question Right hand first
LI852 Question Left hand second
LI853 Question Right hand second
LI817 Question Grip r effort
LI818 Question Hand strength test r position
LI819 Question Hand strength rest arm
LI876 Question Balance test - semi-tandem stand
LI877 Question Balance semi-tandem reason not comp
LI879 Question Balance test semi-tandem hold full time
LI880 Question Balance test semi-tandem time
LI881 Question Balance test semi-tandem compensatory
LI883 Question Balance test s-b-s complete
LI884 Question Balance test sbs stand reason not comp
LI886 Question Balance test s-b-s hold full time
LI887 Question Balance test side-by-side time
LI888 Question Balance test side-by-side compensatory
LI889 Question Balance test s-b-s floor surface
LI891 Question Balance test s-b-s compliance
LI893 Question Balance test full tandem complete
LI894 Question Balance full tandem stand-not complete
LI896 Question Balance test full tandem hold full time
LI897 Question Balance test full tandem time
LI898 Question Balance test full tandem compensatory
LI899 Question Balance test full tandem floor surface
LI902 Question Balance test full tandem compliance
LI820 Question Walking test complete at least one trial
LI821 Question Walking test reason not complete
LI823 Question Walking test 1st trial time
LI824 Question Walking test 2nd trial time
LI825 Question T walk floor surface
LI828 Question Walking aid type
LI830 Question Walking test r effort
LI831 Question Measure r height
LI832 Question Height reason not complete
LI834 Question Height measurment
LI835 Question Height floor surface
LI837 Question Height wearing shoes
LI903 Question Height compliance
LI838 Question Weight able to measure
LI839 Question Weight reason not complete
LI841 Question Weight pounds measurment
LI842 Question Weight floor surface
LI844 Question Weight wearing shoes
LI947 Question Weight compliance
LI904 Question Waist complete
LI905 Question Waist why not complete
LI907 Question Waist measurment
LI908 Question Waist difficulties
LI910 Question Waist compliance
LI911 Question Waist who measured
LI912 Question Waist bulky clothes
LI913 Question Saliva consent
LI941 Question Why no consent saliva
LI914 Question Saliva sample eat drink etc
LI915 Question Saliva sample complete
LI916 Question Saliva why not complete
LI918 Question Saliva fill vial
LI919 Question Saliva problems
LI921 Question Saliva compliance
LI922 Question Blood sample consent
LI943 Question Why no consent blood
LI923 Question Blood sample complete
LI924 Question Why blood sample not complete
LI926 Question Blood sample what problems
LI928 Question Blood who measured
LI929 Question Amount of blood on first card
LI945 Question Amount of blood on storage card
LI854 Question Blood pressure complete
LI930 Question How many blood pricks
LI931 Question Blood sample compliance
LVDATE System generated 2008 data model version
LVERSION System generated 2008 data release version
Start of I. Physical Measures (respondent)
 
LI800

Physical measures ftf iw

ENTER CURRENT MODE OF INTERVIEW
expand
 
If Prefered mode of iwer = ENHANCEDFTF »
 
   
 
If Physical measures ftf iw = 2. F-t-f and R in nursing home = NO and LANGUAGE = SPANISH or ENGLISH »
 
     
   
LI802

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 THESE ACTIVITIES: A BREATHING TEST, A TEST OF HAND STRENGTH, [ A WALKING TEST, ] A BALANCE TEST, AND BLOOD PRESSURE, HEIGHT, [WEIGHT] AND WAIST MEASUREMENTS. 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. PLEASE DO NOT EAT, DRINK, SMOKE, OR BRUSH YOUR TEETH WHILE WE ARE CONDUCTING THE MEASUREMENTS. I WILL ALSO BE ASKING YOU TO REMOVE BULKY CLOTHING AND TO TAKE OFF YOUR SHOES DURING THE MEASUREMENTS. 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.

SHOW R THE FIRST CONSENT FORM IN THE PHYSICAL MEASURES & BIOMARKER BOOKLET. IF R REFUSES TO SIGN THE CONSENT FORM, ENTER CTRL-R. OTHERWISE, ENTER 1 TO CONTINUE.
expand
     
   
If Physical measures consent form = 1. Continue »
 
       
     
LI854

Blood pressure complete

BLOOD PRESSURE

DID R COMPLETE AT LEAST ONE BLOOD PRESSURE MEASUREMENT?
expand
       
     
If Blood pressure complete = 5. No »
 
         
       
LI855

Blood pressure not complete

BLOOD PRESSURE

WHY DIDN'T R COMPLETE THE BLOOD PRESSURE MEASUREMENT? (SELECT ALL THAT APPLY)
expand
         
     
ElseIf Blood pressure complete = 1. Yes »
 
         
       
LI857

Bloodpressure time

BLOOD PRESSURE - 1ST TIME

FIRST READING TIME OF READING

ENTER HOUR, COLON, MINUTES, AND EITHER 'AM' OR 'PM'. E.G., FOR A TIME OF 1:23PM, ENTER '1' FOLLOWED BY ':' FOLLOWED BY '23' FOLLOWED BY 'PM'. PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.

USER NOTE: TIME OF DAY IS PRESENTED AS MILITARY TIME.


expand
         
       
LI859

Bloodpressure 1 systolic

BLOOD PRESSURE - 1ST SYSTOLIC

FIRST READING SYSTOLIC

ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
expand
         
       
If Bloodpressure 1 systolic != 9993 and Bloodpressure 1 systolic != 999. Refused »
 
           
         
LI860

Bloodpressure 1 diastolic

BLOOD PRESSURE - 1ST DIASTOLIC

FIRST READING DIASTOLIC
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LI861

Bloodpressure 1 pulse

BLOOD PRESSURE - 1ST PULSE

FIRST READING PULSE
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LI862

Blood pressure 2 time

BLOOD PRESSURE - 2ND TIME

SECOND READING TIME OF READING

IWER: ENTER HOUR, COLON, MINUTES, AND EITHER 'AM' OR 'PM'. E.G., FOR A TIME OF 1:23PM, ENTER '1' FOLLOWED BY ':' FOLLOWED BY '23' FOLLOWED BY 'PM'. PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.

USER NOTE: TIME OF DAY IS PRESENTED AS MILITARY TIME.


expand
           
         
LI864

Bloodpressure 2 systolic

BLOOD PRESSURE - 2ND SYSTOLIC

SECOND READING SYSTOLIC

ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
expand
           
         
If Bloodpressure 2 systolic != 9993 and Bloodpressure 2 systolic != 999. R chose not to do it »
 
             
           
LI865

Bloodpressure 2 diastolic

BLOOD PRESSURE - 2ND DIASTOLIC

SECOND READING DIASTOLIC
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LI866

Bloodpressure 2 pulse

BLOOD PRESSURE - 2ND PULSE

SECOND READING PULSE
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LI867

Bloodpressure 3 time

BLOOD PRESSURE - 3RD TIME

THIRD READING TIME OF READING

IWER: ENTER HOUR, COLON, MINUTES, AND EITHER 'AM' OR 'PM'. E.G., FOR A TIME OF 1:23PM, ENTER '1' FOLLOWED BY ':' FOLLOWED BY '23' FOLLOWED BY 'PM'. PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.

USER NOTE: TIME OF DAY IS PRESENTED AS MILITARY TIME.


expand
             
           
LI869

Bloodpressure 3 systolic

BLOOD PRESSURE - 3RD SYSTOLIC

THIRD READING SYSTOLIC

ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 999 IF R CHOSE NOT TO DO IT.
expand
             
           
If Bloodpressure 3 systolic != 9993 and Bloodpressure 3 systolic != 999. R chose not to do it »
 
               
             
LI870

Bloodpressure 3 diastolic

BLOOD PRESSURE - 3RD DIASTOLIC

THIRD READING DIASTOLIC
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LI871

Bloodpressure 3 pulse

BLOOD PRESSURE - 3RD PULSE

THIRD READING PULSE
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LI872

Bloodpressure arm

BLOOD PRESSURE - ARM

WHICH ARM WAS USED TO CONDUCT THE MEASUREMENTS?
expand
           
         
LI873

Bloodpressure compliance

BLOOD PRESSURE - COMPLIANCE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
           
         
LI874

Bloodpressure position

BLOOD PRESSURE - POSITION

WHAT WAS R'S POSITION FOR THIS TEST?
expand
           
         
LI875

Bloodpressure smoke etc

BLOOD PRESSURE - SMOKE ETC.

DID R SMOKE, EXERCISE, CONSUME ALCOHOL OR FOOD WITHIN THE 30 MINUTES PRIOR TO COMPLETING THE BLOOD PRESSURE TEST?
expand
           
     
LI804

Breath complete at least one trial

BREATHING TEST

DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
expand
       
     
If Breath complete at least one trial != 1. Yes »
 
         
       
LI805

Breath test reason not complete

BREATHING TEST

WHY DIDN'T R COMPLETE THE BREATHING TEST? (SELECT ALL THAT APPLY)
expand
         
     
If Breath complete at least one trial = 1. Yes »
 
         
       
LI807

Puff test 1

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.

USER NOTE: BREATHING TEST IS MEASURED IN LITERS PER MIN (L/MIN).
expand
         
       
LI808

Puff test 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.

USER NOTE: BREATHING TEST IS MEASURED IN LITERS PER MIN (L/MIN).
expand
         
       
LI809

Puff test 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.

USER NOTE: BREATHING TEST IS MEASURED IN LITERS PER MIN (L/MIN).
expand
         
       
LI810

R breathing test effort

BREATHING TEST

HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
         
       
LI811

Breathing test r position

BREATHING TEST

WHAT WAS THE R'S POSITION FOR THIS TEST?
expand
         
     
LI812

Hand strength complete at least one trial

HAND STRENGTH TEST

DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
expand
       
     
If Hand strength complete at least one trial != 1. Yes »
 
         
       
LI813

Hand strength test reason not complete

HAND STRENGTH TEST

WHY DIDN'T R COMPLETE THE HAND STRENGTH TEST? (SELECT ALL THAT APPLY)
expand
         
     
Else If Hand strength complete at least one trial = 1. Yes »
 
         
       
LI815

Grip dominant hand

HAND STRENGTH TEST

RECORD R'S DOMINANT HAND.

USER NOTE: GRIP STRENGTH IS MEASURED IN KILOGRAMS.
expand
         
       
LI816

Left hand first

HAND STRENGTH TEST

LEFT HAND, FIRST MEASUREMENT.

LEFT HAND, FIRST MEASUREMENT: RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT:

ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
expand
         
       
LI851

Right hand first

HAND STRENGTH TEST

RIGHT HAND, FIRST MEASUREMENT.

LEFT HAND, FIRST MEASUREMENT: [LEFT FIRST ] RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT:

ENTER THE RESULT TO THE THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
expand
         
       
LI852

Left hand second

HAND STRENGTH TEST

LEFT HAND, SECOND MEASUREMENT.

LEFT HAND, FIRST MEASUREMENT: [LEFT FIRST ] RIGHT HAND, FIRST MEASUREMENT: [RIGHT FIRST ] LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT:

ENTER THE RESULT TO THE THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
expand
         
       
LI853

Right hand second

HAND STRENGTH TEST

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:

ENTER THE RESULT TO THE THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
expand
         
       
LI817

Grip r effort

HAND STRENGTH TEST

HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
         
       
LI818

Hand strength test r position

HAND STRENGTH TEST

WHAT WAS THE R'S POSITION FOR THIS TEST?
expand
         
       
LI819

Hand strength rest arm

HAND STRENGTH TEST

DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
expand
         
     
LI876

Balance test - semi-tandem stand

BALANCE TEST - SEMI-TANDEM STAND

DID R COMPLETE THE SEMI-TANDEM STAND?
expand
       
     
If Balance test - semi-tandem stand != 1. Yes »
 
         
       
LI877

Balance semi-tandem reason not comp

BALANCE TEST - SEMI-TANDEM STAND

WHY DIDN'T R COMPLETE THE SEMI-TANDEM STAND? SELECT ALL THAT APPLY
expand
         
     
ElseIf Balance test - semi-tandem stand = 1. Yes »
 
         
       
LI879

Balance test semi-tandem hold full time

BALANCE TEST - SEMI-TANDEM STAND

DID R HOLD SEMI-TANDEM STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
expand
         
       
If Balance test semi-tandem hold full time = 1. Yes »
 
           
         
LI880

Balance test semi-tandem time

BALANCE TEST - SEMI-TANDEM STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
expand
           
       
If Balance test semi-tandem hold full time != 999. R chose not to do it and Balance test semi-tandem hold full time != 993. R tried but was unable »
 
           
         
LI881

Balance test semi-tandem compensatory

BALANCE TEST - SEMI-TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SEMI-TANDEM STAND?
expand
           
     
If Balance test - semi-tandem stand = 5. No or Balance test semi-tandem hold full time != 1. Yes »
 
         
       
LI883

Balance test s-b-s complete

BALANCE TEST - SIDE-BY-SIDE STAND

DID R COMPLETE THE SIDE-BY-SIDE STAND?
expand
         
       
If Balance test s-b-s complete != 1. Yes »
 
           
         
LI884

Balance test sbs stand reason not comp

BALANCE TEST - SIDE-BY-SIDE STAND

WHY DIDN'T R COMPLETE THE SIDE-BY-SIDE STAND? SELECT ALL THAT APPLY
expand
           
       
ElseIf Balance test s-b-s complete = 1. Yes »
 
           
         
LI886

Balance test s-b-s hold full time

BALANCE TEST - SIDE-BY-SIDE STAND

DID R HOLD SIDE-BY-SIDE STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
expand
           
         
If Balance test s-b-s hold full time = 1. Yes »
 
             
           
LI887

Balance test side-by-side time

BALANCE TEST - SIDE-BY-SIDE STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
             
         
If Balance test s-b-s hold full time != 993. R tried but was unable and Balance test s-b-s hold full time != 999. R chose not to do it »
 
             
           
LI888

Balance test side-by-side compensatory

BALANCE TEST - SIDE-BY-SIDE STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SIDE-BY-SIDE STAND?
expand
             
           
LI889

Balance test s-b-s floor surface

BALANCE TEST - SIDE-BY-SIDE STAND

RECORD TYPE OF FLOOR SURFACE
expand
             
           
LI891

Balance test s-b-s compliance

BALANCE TEST - SIDE-BY-SIDE STAND

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
             
     
Else
 
         
       
LI893

Balance test full tandem complete

BALANCE TEST - FULL TANDEM STAND

DID R COMPLETE THE FULL TANDEM STAND?
expand
         
       
If Balance test full tandem complete != 1. Yes »
 
           
         
LI894

Balance full tandem stand-not complete

BALANCE TEST - FULL TANDEM STAND

WHY DIDN'T R COMPLETE THE FULL -TANDEM STAND? SELECT ALL THAT APPLY
expand
           
       
Else
 
           
         
LI896

Balance test full tandem hold full time

BALANCE TEST - FULL TANDEM STAND

DID R HOLD FULL TANDEM STAND FOR FULL SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
expand
           
         
If Balance test full tandem hold full time = 1. Yes and R current age calculation > 70 »
 
             
           
LI897

Balance test full tandem time

BALANCE TEST - FULL TANDEM STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
             
         
If Balance test full tandem hold full time != 993. R tried but was unable and Balance test full tandem hold full time != 999. R chose not to do it »
 
             
           
LI898

Balance test full tandem compensatory

BALANCE TEST - FULL TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING FULL TANDEM STAND?
expand
             
           
LI899

Balance test full tandem floor surface

BALANCE TEST - FULL TANDEM

RECORD TYPE OF FLOOR SURFACE
expand
             
           
LI902

Balance test full tandem compliance

BALANCE TEST - FULL TANDEM STAND

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
             
     
If R current age calculation > 64 »
 
         
       
LI820

Walking test complete at least one trial

WALKING TEST

DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
expand
         
       
If Walking test complete at least one trial != 1. Yes »
 
           
         
LI821

Walking test reason not complete

WALKING TEST

WHY DIDN'T R COMPLETE THE WALKING TEST? (SELECT ALL THAT APPLY)
expand
           
       
Else
 
           
         
LI823

Walking test 1st trial time

WALKING TEST - TIME FROM FIRST TRIAL

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

FIRST TRIAL:

SECOND TRIAL:

ENTER 993 IF R WAS UNABLE TO DO IT ENTER 999 IF R CHOSE NOT TO DO IT
expand
           
         
If Walking test 1st trial time != 993 and Walking test 1st trial time != 999 »
 
             
           
LI824

Walking test 2nd trial time

WALKING TEST - TIME FROM SECOND TRIAL

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

FIRST TRIAL: [T WALK 1ST TRIAL TIME]

SECOND TRIAL:

ENTER 993 IF R WAS UNABLE TO DO IT ENTER 999 IF R CHOSE NOT TO DO IT
expand
             
           
LI825

T walk floor surface

WALKING TEST

RECORD TYPE OF FLOOR SURFACE
expand
             
           
LI828

Walking aid type

WALKING TEST

RECORD TYPE OF AID USED
expand
             
           
LI830

Walking test r effort

WALKING TEST

HOW COMPLIANT WAS R DURING THIS MEASUREMENT
expand
             
     
LI831

Measure r height

HEIGHT

WERE YOU ABLE TO MEASURE R'S HEIGHT?
expand
       
     
If Measure r height != 1. Yes »
 
         
       
LI832

Height reason not complete

HEIGHT

WHY WEREN'T YOU ABLE TO MEASURE R'S HEIGHT? (SELECT ALL THAT APPLY)
expand
         
     
Else
 
         
       
LI834

Height measurment

HEIGHT

ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.
         
       
LI835

Height floor surface

HEIGHT

RECORD TYPE OF FLOOR SURFACE
expand
         
       
LI837

Height wearing shoes

HEIGHT

WAS R WEARING SHOES DURING MEASUREMENT?
expand
         
       
LI903

Height compliance

HEIGHT

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
         
     
If Weight in pounds < 300 »
 
         
       
LI838

Weight able to measure

WEIGHT

WERE YOU ABLE TO MEASURE R'S WEIGHT?
expand
         
       
If Weight able to measure != 1. Yes »
 
           
         
LI839

Weight reason not complete

WEIGHT

WHY WEREN'T YOU ABLE TO MEASURE R'S WEIGHT? (SELECT ALL THAT APPLY)
expand
           
       
Else
 
           
         
LI841

Weight pounds measurment

WEIGHT

ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 1/2 POUND). ENTER 99993 IF R TRIED BUT RECEIVED AN ERROR MESSAGE. ENTER 99999 IF R CHOSE NOT TO DO IT.
expand
           
         
LI842

Weight floor surface

WEIGHT

RECORD TYPE OF FLOOR SURFACE
expand
           
         
LI844

Weight wearing shoes

WEIGHT

WAS R WEARING SHOES DURING MEASUREMENT?
expand
           
         
LI947

Weight compliance

WEIGHT

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
           
     
LI904

Waist complete

WAIST CIRCUMFERENCE

WERE YOU ABLE TO MEASURE R'S WAIST CIRCUMFERENCE?
expand
       
     
If Waist complete != 1. Yes »
 
         
       
LI905

Waist why not complete

WAIST CIRCUMFERENCE

WERE YOU ABLE TO MEASURE R'S WAIST CIRCUMFERENCE? (SELECT ALL THAT APPLY)
expand
         
     
Else
 
         
       
LI907

Waist measurment

WAIST CIRCUMFERENCE -MEASUREMENT

ENTER RESPONDENT'S WAIST MEASUREMENT TO THE NEAREST QUARTER INCH.

ENTER 99993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 99999 IF R CHOSE NOT TO DO IT.
expand
         
       
If Waist measurment != 993 and Waist measurment != 999 »
 
           
         
LI908

Waist difficulties

WAIST CIRCUMFERENCE -MEASUREMENT

WHAT DIFFICULTIES OCCURRED DURING THIS MEASUREMENT? SELECT ALL THAT APPLY
expand
           
         
LI910

Waist compliance

WAIST CIRCUMFERENCE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
           
         
LI911

Waist who measured

WAIST CIRCUMFERENCE

WHO COMPLETED THE MEASUREMENT?
expand
           
         
LI912

Waist bulky clothes

WAIST CIRCUMFERENCE

WAS R WEARING BULKY CLOTHING DURING THIS MEASUREMENT?
expand
           
   
LI913

Saliva consent

SALIVA SAMPLE

DID R SIGN THE CONSENT FORM FOR THE SALIVA SAMPLE?
expand
     
   
If Saliva consent = 5. No »
 
       
     
LI941

Why no consent saliva

SALIVA SAMPLE

WHY DIDN'T R SIGN THE SALIVA CONSENT FORM? (SELECT ALL THAT APPLY)
expand
       
   
Else
 
       
     
LI915

Saliva sample complete

SALIVA SAMPLE

DID R COMPLETE THE SALIVA SAMPLE?
expand
       
     
If Saliva sample complete != 1. Yes »
 
         
       
LI916

Saliva why not complete

SALIVA SAMPLE

WHY DIDN'T R COMPLETE THE SALIVA SAMPLE? (SELECT ALL THAT APPLY)
expand
         
     
Else
 
         
       
LI918

Saliva fill vial

SALIVA SAMPLE

DID R FILL THE VIAL TO THE DESIRED LEVEL?
expand
         
       
LI919

Saliva problems

SALIVA SAMPLE

WHAT, IF ANY, PROBLEMS OCCURED? (SELECT ALL THAT APPLY)
expand
         
       
LI921

Saliva compliance

SALIVA SAMPLE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
         
   
LI922

Blood sample consent

BLOOD SAMPLE

DID R SIGN THE BLOOD SAMPLE CONSENT FORM?
expand
     
   
If Blood sample consent = 5. No »
 
       
     
LI943

Why no consent blood

BLOOD SAMPLE

WHY DIDN'T R SIGN THE BLOOD CONSENT FORM? (SELECT ALL THAT APPLY)
expand
       
   
Else
 
       
     
LI923

Blood sample complete

BLOOD SAMPLE

DID R COMPLETE THE BLOOD SAMPLE?
expand
       
     
If Blood sample complete != 1. Yes »
 
         
       
LI924

Why blood sample not complete

BLOOD SAMPLE

WHY DIDN'T R COMPLETE THE BLOOD SAMPLE? (SELECT ALL THAT APPLY)
expand
         
     
Else
 
         
       
LI926

Blood sample what problems

BLOOD SAMPLE

WHAT, IF ANY, PROBLEMS OCCURRED DURING THE COLLECTION OF THE BLOOD SAMPLE? (SELECT ALL THAT APPLY)
expand
         
       
LI928

Blood who measured

BLOOD SAMPLE

WHO PRICKED THE R'S FINGER(S)?
expand
         
       
LI929

Amount of blood on first card

BLOOD SAMPLE

HOW MANY CIRCLES WERE FILLED ON THE FIRST CARD?
expand
         
       
LI945

Amount of blood on storage card

BLOOD SAMPLE

HOW MANY CIRCLES WERE FILLED ON THE STORAGE CARD?
expand
         
       
LI930

How many blood pricks

BLOOD SAMPLE

HOW MANY TIMES DID THE R'S FINGER NEED TO BE PRICKED IN ORDER TO FILL THE CIRCLES?
expand
         
       
LI931

Blood sample compliance

BLOOD SAMPLE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
expand
         
End of I. Physical Measures (respondent)
Start of I. Physical Measures (respondent)

========================================================================
LI800
Physical measures ftf iw

ENTER CURRENT MODE OF INTERVIEW
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Phone
2. F-t-f
Blank. Inapplicable; partial interview

If Prefered mode of iwer (LX090_R) = ENHANCEDFTF »

If Physical measures ftf iw (LI800) = 2. F-t-f and R in nursing home (LA028) = NO and LANGUAGE = SPANISH or ENGLISH »

| | ========================================================================
| | 
LI802
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 THESE ACTIVITIES: A BREATHING TEST, A TEST OF HAND STRENGTH, [ A WALKING TEST, ] A BALANCE TEST, AND BLOOD PRESSURE, HEIGHT, [WEIGHT] AND WAIST MEASUREMENTS. 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. PLEASE DO NOT EAT, DRINK, SMOKE, OR BRUSH YOUR TEETH WHILE WE ARE CONDUCTING THE MEASUREMENTS. I WILL ALSO BE ASKING YOU TO REMOVE BULKY CLOTHING AND TO TAKE OFF YOUR SHOES DURING THE MEASUREMENTS. 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.

SHOW R THE FIRST CONSENT FORM IN THE PHYSICAL MEASURES & BIOMARKER BOOKLET. IF R REFUSES TO SIGN THE CONSENT FORM, ENTER CTRL-R. OTHERWISE, ENTER 1 TO CONTINUE.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Continue
9. Refused
Blank. Inapplicable; partial interview

| | If Physical measures consent form (LI802) = 1. Continue »

| | | ========================================================================
| | | 
LI854
Blood pressure complete

BLOOD PRESSURE

DID R COMPLETE AT LEAST ONE BLOOD PRESSURE MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | If Blood pressure complete (LI854) = 5. No »

| | | | ========================================================================
| | | | 
LI855
Blood pressure not complete

BLOOD PRESSURE

WHY DIDN'T R COMPLETE THE BLOOD PRESSURE MEASUREMENT? (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 a rash, cast, edema, etc. on arm; other health reason
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | ElseIf Blood pressure complete (LI854) = 1. Yes »

| | | | ========================================================================
| | | | 
LI857
Bloodpressure time

BLOOD PRESSURE - 1ST TIME

FIRST READING TIME OF READING

ENTER HOUR, COLON, MINUTES, AND EITHER 'AM' OR 'PM'. E.G., FOR A TIME OF 1:23PM, ENTER '1' FOLLOWED BY ':' FOLLOWED BY '23' FOLLOWED BY 'PM'. PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.

USER NOTE: TIME OF DAY IS PRESENTED AS MILITARY TIME.


- - - - - - - - - - - - - - - - - - - - - - - - -
00000000-09:59:00. Actual Value
99999998. Don't Know; Not Ascertained
99999999. Refused
Blank. Inapplicable

| | | | ========================================================================
| | | | 
LI859
Bloodpressure 1 systolic

BLOOD PRESSURE - 1ST SYSTOLIC

FIRST READING SYSTOLIC

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

| | | | If Bloodpressure 1 systolic (LI859) != 9993 and Bloodpressure 1 systolic (LI859) != 999. Refused »

| | | | | ========================================================================
| | | | | 
LI860
Bloodpressure 1 diastolic

BLOOD PRESSURE - 1ST DIASTOLIC

FIRST READING DIASTOLIC
- - - - - - - - - - - - - - - - - - - - - - - - -
998. Don't know; not ascertained
999. Refused

| | | | | ========================================================================
| | | | | 
LI861
Bloodpressure 1 pulse

BLOOD PRESSURE - 1ST PULSE

FIRST READING PULSE
- - - - - - - - - - - - - - - - - - - - - - - - -
998. Don't know; not ascertained
999. Refused

| | | | | ========================================================================
| | | | | 
LI862
Blood pressure 2 time

BLOOD PRESSURE - 2ND TIME

SECOND READING TIME OF READING

IWER: ENTER HOUR, COLON, MINUTES, AND EITHER 'AM' OR 'PM'. E.G., FOR A TIME OF 1:23PM, ENTER '1' FOLLOWED BY ':' FOLLOWED BY '23' FOLLOWED BY 'PM'. PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.

USER NOTE: TIME OF DAY IS PRESENTED AS MILITARY TIME.


- - - - - - - - - - - - - - - - - - - - - - - - -
00000000-09:59:00. Actual Value
99999998. Don't Know; Not Ascertained
99999999. Refused
Blank. Inapplicable

| | | | | ========================================================================
| | | | | 
LI864
Bloodpressure 2 systolic

BLOOD PRESSURE - 2ND SYSTOLIC

SECOND READING SYSTOLIC

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. R chose not to do it

| | | | | If Bloodpressure 2 systolic (LI864) != 9993 and Bloodpressure 2 systolic (LI864) != 999. R chose not to do it »

| | | | | | ========================================================================
| | | | | | 
LI865
Bloodpressure 2 diastolic

BLOOD PRESSURE - 2ND DIASTOLIC

SECOND READING DIASTOLIC
- - - - - - - - - - - - - - - - - - - - - - - - -
998. Don't know; not ascertained
999. Refused

| | | | | | ========================================================================
| | | | | | 
LI866
Bloodpressure 2 pulse

BLOOD PRESSURE - 2ND PULSE

SECOND READING PULSE
- - - - - - - - - - - - - - - - - - - - - - - - -
998. Don't know; not ascertained
999. Refused

| | | | | | ========================================================================
| | | | | | 
LI867
Bloodpressure 3 time

BLOOD PRESSURE - 3RD TIME

THIRD READING TIME OF READING

IWER: ENTER HOUR, COLON, MINUTES, AND EITHER 'AM' OR 'PM'. E.G., FOR A TIME OF 1:23PM, ENTER '1' FOLLOWED BY ':' FOLLOWED BY '23' FOLLOWED BY 'PM'. PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.

USER NOTE: TIME OF DAY IS PRESENTED AS MILITARY TIME.


- - - - - - - - - - - - - - - - - - - - - - - - -
00000000-09:59:00. Actual Value
99999998. Don't Know; Not Ascertained
99999999. Refused
Blank. Inapplicable; partial interview

| | | | | | ========================================================================
| | | | | | 
LI869
Bloodpressure 3 systolic

BLOOD PRESSURE - 3RD SYSTOLIC

THIRD READING SYSTOLIC

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. R chose not to do it

| | | | | | If Bloodpressure 3 systolic (LI869) != 9993 and Bloodpressure 3 systolic (LI869) != 999. R chose not to do it »

| | | | | | | ========================================================================
| | | | | | | 
LI870
Bloodpressure 3 diastolic

BLOOD PRESSURE - 3RD DIASTOLIC

THIRD READING DIASTOLIC
- - - - - - - - - - - - - - - - - - - - - - - - -
998. Don't know; not ascertained
999. Refused

| | | | | | | ========================================================================
| | | | | | | 
LI871
Bloodpressure 3 pulse

BLOOD PRESSURE - 3RD PULSE

THIRD READING PULSE
- - - - - - - - - - - - - - - - - - - - - - - - -
998. Don't know; not ascertained
999. Refused

| | | | | ========================================================================
| | | | | 
LI872
Bloodpressure arm

BLOOD PRESSURE - ARM

WHICH ARM WAS USED TO CONDUCT THE MEASUREMENTS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Left arm
2. Right arm
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI873
Bloodpressure compliance

BLOOD PRESSURE - COMPLIANCE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI874
Bloodpressure position

BLOOD PRESSURE - POSITION

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

| | | | | ========================================================================
| | | | | 
LI875
Bloodpressure smoke etc

BLOOD PRESSURE - SMOKE ETC.

DID R SMOKE, EXERCISE, CONSUME ALCOHOL OR FOOD WITHIN THE 30 MINUTES PRIOR TO COMPLETING THE BLOOD PRESSURE TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | ========================================================================
| | | 
LI804
Breath complete at least one trial

BREATHING TEST

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

| | | If Breath complete at least one trial (LI804) != 1. Yes »

| | | | ========================================================================
| | | | 
LI805
Breath test reason not complete

BREATHING TEST

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 could not participate due to health reasons
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | If Breath complete at least one trial (LI804) = 1. Yes »

| | | | ========================================================================
| | | | 
LI807
Puff test 1

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.

USER NOTE: BREATHING TEST IS MEASURED IN LITERS PER MIN (L/MIN).
- - - - - - - - - - - - - - - - - - - - - - - - -
993. R tried but was unable to do it
998. Don't know; not ascertained
999. R chose not to do it

| | | | ========================================================================
| | | | 
LI808
Puff test 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.

USER NOTE: BREATHING TEST IS MEASURED IN LITERS PER MIN (L/MIN).
- - - - - - - - - - - - - - - - - - - - - - - - -
993. R tried but was unable to do it
998. Don't know; not ascertained
999. R chose not to do it

| | | | ========================================================================
| | | | 
LI809
Puff test 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.

USER NOTE: BREATHING TEST IS MEASURED IN LITERS PER MIN (L/MIN).
- - - - - - - - - - - - - - - - - - - - - - - - -
993. R tried but was unable to do it
998. Don't know; not ascertained
999. R chose not to do it

| | | | ========================================================================
| | | | 
LI810
R breathing test effort

BREATHING TEST

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; partial interview

| | | | ========================================================================
| | | | 
LI811
Breathing test r position

BREATHING TEST

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; partial interview

| | | ========================================================================
| | | 
LI812
Hand strength complete at least one trial

HAND STRENGTH TEST

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

| | | If Hand strength complete at least one trial (LI812) != 1. Yes »

| | | | ========================================================================
| | | | 
LI813
Hand strength test reason not complete

HAND STRENGTH TEST

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 could not participate due to surgery, swelling, etc.; other health reason
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | Else If Hand strength complete at least one trial (LI812) = 1. Yes »

| | | | ========================================================================
| | | | 
LI815
Grip dominant hand

HAND STRENGTH TEST

RECORD R'S DOMINANT HAND.

USER NOTE: GRIP STRENGTH IS MEASURED IN KILOGRAMS.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Right hand
2. Left hand
3. Both hands equally dominant
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI816
Left hand first

HAND STRENGTH TEST

LEFT HAND, FIRST MEASUREMENT.

LEFT HAND, FIRST MEASUREMENT: RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT:

ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
- - - - - - - - - - - - - - - - - - - - - - - - -
9993. R tried but was unable to complete the test
9998. Don't know; not ascertained
9999. R chose not to do it

| | | | ========================================================================
| | | | 
LI851
Right hand first

HAND STRENGTH TEST

RIGHT HAND, FIRST MEASUREMENT.

LEFT HAND, FIRST MEASUREMENT: [LEFT FIRST ] RIGHT HAND, FIRST MEASUREMENT: LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT:

ENTER THE RESULT TO THE THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
- - - - - - - - - - - - - - - - - - - - - - - - -
9993. R tried but was unable to complete the test
9999. R chose not to do it

| | | | ========================================================================
| | | | 
LI852
Left hand second

HAND STRENGTH TEST

LEFT HAND, SECOND MEASUREMENT.

LEFT HAND, FIRST MEASUREMENT: [LEFT FIRST ] RIGHT HAND, FIRST MEASUREMENT: [RIGHT FIRST ] LEFT HAND, SECOND MEASUREMENT: RIGHT HAND, SECOND MEASUREMENT:

ENTER THE RESULT TO THE THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
- - - - - - - - - - - - - - - - - - - - - - - - -
9993. R tried but was unable to complete the test
9999. R chose not to do it

| | | | ========================================================================
| | | | 
LI853
Right hand second

HAND STRENGTH TEST

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:

ENTER THE RESULT TO THE THE NEAREST 0.5 KILOGRAM.

ENTER 9993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT ENTER 9999 IF R CHOSE NOT TO DO IT
- - - - - - - - - - - - - - - - - - - - - - - - -
9993. R tried but was unable to complete the test
9999. R chose not to do it

| | | | ========================================================================
| | | | 
LI817
Grip r effort

HAND STRENGTH TEST

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
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI818
Hand strength test r position

HAND STRENGTH TEST

WHAT WAS THE R'S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI819
Hand strength rest arm

HAND STRENGTH TEST

DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | ========================================================================
| | | 
LI876
Balance test - semi-tandem stand

BALANCE TEST - SEMI-TANDEM STAND

DID R COMPLETE THE SEMI-TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | If Balance test - semi-tandem stand (LI876) != 1. Yes »

| | | | ========================================================================
| | | | 
LI877
Balance semi-tandem reason not comp

BALANCE TEST - SEMI-TANDEM STAND

WHY DIDN'T R COMPLETE THE SEMI-TANDEM STAND? 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 completing the test
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | ElseIf Balance test - semi-tandem stand (LI876) = 1. Yes »

| | | | ========================================================================
| | | | 
LI879
Balance test semi-tandem hold full time

BALANCE TEST - SEMI-TANDEM STAND

DID R HOLD SEMI-TANDEM STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
993. R tried but was unable
999. R chose not to do it
Blank. Inapplicable; partial interview

| | | | If Balance test semi-tandem hold full time (LI879) = 1. Yes »

| | | | | ========================================================================
| | | | | 
LI880
Balance test semi-tandem time

BALANCE TEST - SEMI-TANDEM STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
- - - - - - - - - - - - - - - - - - - - - - - - -
9993. R tried but was unable to do it

| | | | If Balance test semi-tandem hold full time (LI879) != 999. R chose not to do it and Balance test semi-tandem hold full time (LI879) != 993. R tried but was unable »

| | | | | ========================================================================
| | | | | 
LI881
Balance test semi-tandem compensatory

BALANCE TEST - SEMI-TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SEMI-TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
Blank. Inapplicable; partial interview

| | | If Balance test - semi-tandem stand (LI876) = 5. No or Balance test semi-tandem hold full time (LI879) != 1. Yes »

| | | | ========================================================================
| | | | 
LI883
Balance test s-b-s complete

BALANCE TEST - SIDE-BY-SIDE STAND

DID R COMPLETE THE SIDE-BY-SIDE STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | | If Balance test s-b-s complete (LI883) != 1. Yes »

| | | | | ========================================================================
| | | | | 
LI884
Balance test sbs stand reason not comp

BALANCE TEST - SIDE-BY-SIDE STAND

WHY DIDN'T R COMPLETE THE SIDE-BY-SIDE STAND? 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 completing the test
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | | ElseIf Balance test s-b-s complete (LI883) = 1. Yes »

| | | | | ========================================================================
| | | | | 
LI886
Balance test s-b-s hold full time

BALANCE TEST - SIDE-BY-SIDE STAND

DID R HOLD SIDE-BY-SIDE STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
993. R tried but was unable
999. R chose not to do it
Blank. Inapplicable; partial interview

| | | | | If Balance test s-b-s hold full time (LI886) = 1. Yes »

| | | | | | ========================================================================
| | | | | | 
LI887
Balance test side-by-side time

BALANCE TEST - SIDE-BY-SIDE STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

| | | | | If Balance test s-b-s hold full time (LI886) != 993. R tried but was unable and Balance test s-b-s hold full time (LI886) != 999. R chose not to do it »

| | | | | | ========================================================================
| | | | | | 
LI888
Balance test side-by-side compensatory

BALANCE TEST - SIDE-BY-SIDE STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SIDE-BY-SIDE STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
Blank. Inapplicable; partial interview

| | | | | | ========================================================================
| | | | | | 
LI889
Balance test s-b-s floor surface

BALANCE TEST - SIDE-BY-SIDE STAND

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; partial interview

| | | | | | ========================================================================
| | | | | | 
LI891
Balance test s-b-s compliance

BALANCE TEST - SIDE-BY-SIDE STAND

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

| | | Else

| | | | ========================================================================
| | | | 
LI893
Balance test full tandem complete

BALANCE TEST - FULL TANDEM STAND

DID R COMPLETE THE FULL TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | | If Balance test full tandem complete (LI893) != 1. Yes »

| | | | | ========================================================================
| | | | | 
LI894
Balance full tandem stand-not complete

BALANCE TEST - FULL TANDEM STAND

WHY DIDN'T R COMPLETE THE FULL -TANDEM STAND? 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 completing the test
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | | Else

| | | | | ========================================================================
| | | | | 
LI896
Balance test full tandem hold full time

BALANCE TEST - FULL TANDEM STAND

DID R HOLD FULL TANDEM STAND FOR FULL SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
993. R tried but was unable
999. R chose not to do it
Blank. Inapplicable; partial interview

| | | | | If Balance test full tandem hold full time (LI896) = 1. Yes and R current age calculation (LA019) > 70 »

| | | | | | ========================================================================
| | | | | | 
LI897
Balance test full tandem time

BALANCE TEST - FULL TANDEM STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

| | | | | If Balance test full tandem hold full time (LI896) != 993. R tried but was unable and Balance test full tandem hold full time (LI896) != 999. R chose not to do it »

| | | | | | ========================================================================
| | | | | | 
LI898
Balance test full tandem compensatory

BALANCE TEST - FULL TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING FULL TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
Blank. Inapplicable

| | | | | | ========================================================================
| | | | | | 
LI899
Balance test full tandem floor surface

BALANCE TEST - FULL TANDEM

RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete/brick
5. Not sure
7. Other (specify)
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | | | ========================================================================
| | | | | | 
LI902
Balance test full tandem compliance

BALANCE TEST - FULL TANDEM STAND

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | If R current age calculation (LA019) > 64 »

| | | | ========================================================================
| | | | 
LI820
Walking test complete at least one trial

WALKING TEST

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

| | | | If Walking test complete at least one trial (LI820) != 1. Yes »

| | | | | ========================================================================
| | | | | 
LI821
Walking test reason not complete

WALKING TEST

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
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | | Else

| | | | | ========================================================================
| | | | | 
LI823
Walking test 1st trial time

WALKING TEST - TIME FROM FIRST TRIAL

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

FIRST TRIAL:

SECOND TRIAL:

ENTER 993 IF R WAS UNABLE TO DO IT ENTER 999 IF R CHOSE NOT TO DO IT
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R unable to do it
99998. Don't know; not ascertained
99999. R chose not to do it

| | | | | If Walking test 1st trial time (LI823) != 993 and Walking test 1st trial time (LI823) != 999 »

| | | | | | ========================================================================
| | | | | | 
LI824
Walking test 2nd trial time

WALKING TEST - TIME FROM SECOND TRIAL

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

FIRST TRIAL: [T WALK 1ST TRIAL TIME]

SECOND TRIAL:

ENTER 993 IF R WAS UNABLE TO DO IT ENTER 999 IF R CHOSE NOT TO DO IT
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R was unable to do it
99998. Don't know; not ascertained
99999. R chose not to do it

| | | | | | ========================================================================
| | | | | | 
LI825
T walk floor surface

WALKING TEST

RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete/brick
5. Not sure
7. Other (specify)
Blank. Inapplicable; partial interview

| | | | | | ========================================================================
| | | | | | 
LI828
Walking aid type

WALKING TEST

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; partial interview

| | | | | | ========================================================================
| | | | | | 
LI830
Walking test r effort

WALKING TEST

HOW COMPLIANT WAS R DURING THIS MEASUREMENT
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant.
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

| | | ========================================================================
| | | 
LI831
Measure r height

HEIGHT

WERE YOU ABLE TO MEASURE R'S HEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | If Measure r height (LI831) != 1. Yes »

| | | | ========================================================================
| | | | 
LI832
Height reason not complete

HEIGHT

WHY WEREN'T YOU ABLE TO MEASURE R'S HEIGHT? (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 measurement
4. R tried but was unable to complete measurement
5. R did not understand the instructions
6. R is not able to stand; other health reason
7. No suitable space available
8. Problem with equipment or supplies
9. R too tall, interviewer could not reach
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | Else

| | | | ========================================================================
| | | | 
LI834
Height measurment

HEIGHT

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

| | | | ========================================================================
| | | | 
LI835
Height floor surface

HEIGHT

RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete/brick
5. Not sure
7. Other (specify)
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI837
Height wearing shoes

HEIGHT

WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI903
Height compliance

HEIGHT

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

| | | If Weight in pounds (LC139) < 300 »

| | | | ========================================================================
| | | | 
LI838
Weight able to measure

WEIGHT

WERE YOU ABLE TO MEASURE R'S WEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | | If Weight able to measure (LI838) != 1. Yes »

| | | | | ========================================================================
| | | | | 
LI839
Weight reason not complete

WEIGHT

WHY WEREN'T YOU ABLE TO MEASURE R'S WEIGHT? (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 measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. R is not able to stand or balance on scale; other health reason
7. No suitable space available
8. Scale did not work; other problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | | Else

| | | | | ========================================================================
| | | | | 
LI841
Weight pounds measurment

WEIGHT

ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 1/2 POUND). ENTER 99993 IF R TRIED BUT RECEIVED AN ERROR MESSAGE. ENTER 99999 IF R CHOSE NOT TO DO IT.
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R tried but received an error message
99999. R chose not to do it

| | | | | ========================================================================
| | | | | 
LI842
Weight floor surface

WEIGHT

RECORD TYPE OF FLOOR SURFACE
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood
2. Low-pile carpet
3. High-pile carpet
4. Concrete/brick
5. Not sure
7. Other (specify)
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI844
Weight wearing shoes

WEIGHT

WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI947
Weight compliance

WEIGHT

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

| | | ========================================================================
| | | 
LI904
Waist complete

WAIST CIRCUMFERENCE

WERE YOU ABLE TO MEASURE R'S WAIST CIRCUMFERENCE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | If Waist complete (LI904) != 1. Yes »

| | | | ========================================================================
| | | | 
LI905
Waist why not complete

WAIST CIRCUMFERENCE

WERE YOU ABLE TO MEASURE R'S WAIST CIRCUMFERENCE? (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 measurement
4. R tried but was unable to complete measurement
5. R did not understand the instructions
6. R is not able to stand; other health reason
7. No suitable space available
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | Else

| | | | ========================================================================
| | | | 
LI907
Waist measurment

WAIST CIRCUMFERENCE -MEASUREMENT

ENTER RESPONDENT'S WAIST MEASUREMENT TO THE NEAREST QUARTER INCH.

ENTER 99993 IF R TRIED BUT WAS UNABLE TO DO IT. ENTER 99999 IF R CHOSE NOT TO DO IT.
- - - - - - - - - - - - - - - - - - - - - - - - -
99993. R tried but was unable to complete the test
99999. R chose not to do it

| | | | If Waist measurment (LI907) != 993 and Waist measurment (LI907) != 999 »

| | | | | ========================================================================
| | | | | 
LI908
Waist difficulties

WAIST CIRCUMFERENCE -MEASUREMENT

WHAT DIFFICULTIES OCCURRED DURING THIS MEASUREMENT? SELECT ALL THAT APPLY
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. R had breathing difficulties
3. R was unable to hold breath at end of exhale
4. R was prevented from giving full effort by illness, pain, or other symptoms or discomforts
5. R did not appear to give full effort, but no obvious reason for this.
6. Had difficulty or unable to locate navel
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI910
Waist compliance

WAIST CIRCUMFERENCE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI911
Waist who measured

WAIST CIRCUMFERENCE

WHO COMPLETED THE MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R completed the measurement
2. Iwer completed the measurement
8. Don't know; not ascertained
Blank. Inapplicable; partial interview

| | | | | ========================================================================
| | | | | 
LI912
Waist bulky clothes

WAIST CIRCUMFERENCE

WAS R WEARING BULKY CLOTHING DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | ========================================================================
| | 
LI913
Saliva consent

SALIVA SAMPLE

DID R SIGN THE CONSENT FORM FOR THE SALIVA SAMPLE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | If Saliva consent (LI913) = 5. No »

| | | ========================================================================
| | | 
LI941
Why no consent saliva

SALIVA SAMPLE

WHY DIDN'T R SIGN THE SALIVA CONSENT FORM? (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 measurement
4. R tried but was unable to complete measurement
5. R did not understand the instructions
6. R could not complete the measurement due to health reasons
7. No suitable space
8. R ate, drank, smoked, or brushed teeth in last 30 minutes
11. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | Else

| | | ========================================================================
| | | 
LI915
Saliva sample complete

SALIVA SAMPLE

DID R COMPLETE THE SALIVA SAMPLE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | If Saliva sample complete (LI915) != 1. Yes »

| | | | ========================================================================
| | | | 
LI916
Saliva why not complete

SALIVA SAMPLE

WHY DIDN'T R COMPLETE THE SALIVA SAMPLE? (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 measurement
4. R tried but was unable to complete measurement
5. R did not understand the instructions
6. R could not complete the measurement due to health problems
7. No suitable space available
8. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | | Else

| | | | ========================================================================
| | | | 
LI918
Saliva fill vial

SALIVA SAMPLE

DID R FILL THE VIAL TO THE DESIRED LEVEL?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI919
Saliva problems

SALIVA SAMPLE

WHAT, IF ANY, PROBLEMS OCCURED? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. Solution in cover leaked before vial was sealed
3. Saliva spilled
4. R was unable to produce enough saliva
5. Collection container leaked; other problem with equipment or supplies
97. Other (specify)
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI921
Saliva compliance

SALIVA SAMPLE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

| | ========================================================================
| | 
LI922
Blood sample consent

BLOOD SAMPLE

DID R SIGN THE BLOOD SAMPLE CONSENT FORM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | If Blood sample consent (LI922) = 5. No »

| | | ========================================================================
| | | 
LI943
Why no consent blood

BLOOD SAMPLE

WHY DIDN'T R SIGN THE BLOOD CONSENT FORM? (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 measurement
4. R tried but was unable to complete measurement
5. R did not understand the instructions
6. R has hemophilia or is on medication that thins the blood (anticoagulant); other health reason
7. No suitable space
8. R ate, drank, smoked, or brushed teeth in last 30 minutes
11. Problem with equipment or supplies
97. Other (specify)
98. Don't know; not ascertained
99. Refused
Blank. Inapplicable; partial interview

| | Else

| | | ========================================================================
| | | 
LI923
Blood sample complete

BLOOD SAMPLE

DID R COMPLETE THE BLOOD SAMPLE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
Blank. Inapplicable; partial interview

| | | If Blood sample complete (LI923) != 1. Yes »

| | | | ========================================================================
| | | | 
LI924
Why blood sample not complete

BLOOD SAMPLE

WHY DIDN'T R COMPLETE THE BLOOD SAMPLE? (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 measurement
4. R tried but was unable to complete measurement
5. R did not understand the instructions
6. R has hemophilia or is on medication that thins the blood (anticoagulant); other health reason
7. No suitable space
8. Problem with equipment or supplies
97. Other (specify)
Blank. Inapplicable; partial interview

| | | Else

| | | | ========================================================================
| | | | 
LI926
Blood sample what problems

BLOOD SAMPLE

WHAT, IF ANY, PROBLEMS OCCURRED DURING THE COLLECTION OF THE BLOOD SAMPLE? (SELECT ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. R became lightheaded, fainted, or became nauseous
3. R had difficulty getting finger to stop bleeding
4. Unable to obtain enough blood
5. Problem with equipment or supplies
97. Other (specify)
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI928
Blood who measured

BLOOD SAMPLE

WHO PRICKED THE R'S FINGER(S)?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R pricked own finger(s)
2. Iwer pricked r's finger(s)
3. Both r and iwer pricked r's finger(s)
4. Someone else pricked r's finger(s)
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI929
Amount of blood on first card

BLOOD SAMPLE

HOW MANY CIRCLES WERE FILLED ON THE FIRST CARD?
- - - - - - - - - - - - - - - - - - - - - - - - -
0. Zero
1. One
2. Two
3. Three
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI945
Amount of blood on storage card

BLOOD SAMPLE

HOW MANY CIRCLES WERE FILLED ON THE STORAGE CARD?
- - - - - - - - - - - - - - - - - - - - - - - - -
0. Zero
1. One
2. Two
3. Three
8. Don't know; not ascertained
9. Refused
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI930
How many blood pricks

BLOOD SAMPLE

HOW MANY TIMES DID THE R'S FINGER NEED TO BE PRICKED IN ORDER TO FILL THE CIRCLES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. One time
2. Two times
3. Two times, but r was unable to fill all four circles with blood
Blank. Inapplicable; partial interview

| | | | ========================================================================
| | | | 
LI931
Blood sample compliance

BLOOD SAMPLE

HOW COMPLIANT WAS R DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R was fully compliant
2. R was prevented from fully complying due to illness, pain, or other symptoms or discomforts
3. R was not fully compliant, but no obvious reason for this
Blank. Inapplicable; partial interview

End of I. Physical Measures (respondent)