I. Physical Measures

I. Physical Measures module of HRS 2014

item label type description
OI916 Question Saliva Why Not Complete
OI609 Question Breathing Test 1-2, Pause and Reset
OI608 Question Breathing Test Setup Instructions
OI607 Question Breathing Test Demonstration
OI606 Question Breathing Test Introduction
OI605 Question Timer Pacing Thrid Blood Pressure Measure
OI604 Question Timer Pacing Second Blood Pressure Measure
OI603 Question BP Setup Instructions to Interviewer
OI602 Question Blood Pressure Demonstration
OI601 Question Blood Pressure Introduction
OI600 Question Physical Measures Consent
OI812 Question HAND STRENGTH COMPLETE AT LEAST ONE TRIAL
OI811 Question Breathing Test R position
OI816 Question left first (kg)
OI817 Question Grip R Effort
OI814 Question Hand Strength TEST REASON NOT COMPLETE -Specify
OI815 Question Grip dominant hand
OI818 Question Hand Strength TEST R POSITION
OI819 Question Hand Strength rest arm
OI955 Question Why No Consent PHYSICAL MEASURES _Specify
OI954 Question Why No Consent Physical Measures
OI690 Question Flag determining when to Ask Physical Measures Consent
OI691 Question Physical Measures Consent Complete
OI692 Question Physical Measures Consent Form Name
OI693 Question Flag determining when to Ask Saliva Consent
OI694 Question Saliva Consent Complete
OI695 Question Saliva Consent Form Name
OI696 Question Flag determining when to Ask Blood Consent
OI697 Question Blood Consent Complete
OI698 Question Blood Consent Form Name
OI657 Question Blood-Collection Instructions (Gloved)
OI813 Question Hand Strength TEST REASON NOT COMPLETE
OI654 Question Blood Barcode 2, Manual Entry 1
OI888 Question BALANCE TEST SIDE-BY-SIDE Compensatory
OI919 Question Saliva Problems
OI918 Question Saliva Fill Vial
OI917 Question Saliva Not Complete _Specify
OI915 Question Saliva Complete
OI914 Question Saliva Eat Drank Etc
OI913 Question Saliva Consent
OI912 Question Waist Bulky Clothes
OI911 Question Waist Who Measured
OI655 Question Blood Barcode 2, Manual Entry 2
OI656 Question Blood Barcode 2, Manual Entry 3
OI650 Question Blood-Collection Setup (Pre-Glove) Instructions
OI651 Question Blood Barcode 1, Manual Entry 1
OI652 Question Blood Barcode 1, Manual Entry 2
OI653 Question Blood Barcode 1, Manual Entry 3
OI658 Question Section I Pre-Data-Entry Thank You Script
OI659 Question H/W/W Data-Entry Module Introduction Screen
OI869 Question Blood Pressure 3 Systolic (mmHg)
OI868 Question String I867_BloodPressure3_Time hour + minute
OI985 Question R Understanding of Waist Measurement Procedure
OI987 Question R Understanding of Saliva Procedure
OI863 Question String I862_BloodPressure2_Time hour + minute
OI862 Question Blood Pressure 2 Time
OI861 Question Blood Pressure 1 Pulse (bpm)
OI860 Question Blood Pressure 1 Diastolic (mmHg)
OI867 Question Blood Pressure 3 Time
OI866 Question Blood Pressure 2 Pulse (bpm)
OI865 Question Blood Pressure 2 Diastolic (mmHg)
OI864 Question Blood Pressure 2 Systolic (mmHg)
OI980 Question Height Safety Question
OI982 Question R Understanding of Weight Measurement Procedure
OI810 Question R Breathing Test Effort
OI989 Question R Understanding of Blood-Collection Procedure
OI618 Question Semi-Tandem, Instructions 2
OI619 Question Full-Tandem Balance Test Introduction and Demonstration
OI610 Question Breathing Test 2-3, Pause and Reset
OI612 Question Hand-Strength Introduction
OI613 Question Hand-Strength Instructions
OI614 Question Semi-Tandem Balance Test Introduction
OI615 Question Semi-Tandem Demonstration Instructions
OI616 Question R Injury/Discomfort Discussion
OI617 Question Semi-Tandem, Instructions 1
OI944 Question Why No Consent Blood_Specify
OI945 Question Blood Fill Spots Card 2
OI941 Question Why No Consent Saliva
OI829 Question Walking Aid Type -specify
OI828 Question Walking Aid Type
OI824 Question T walk trial time (seconds)
OI823 Question T walk trial time (seconds)
OI822 Question Walking Speed Reason Not Complete -Specify
OI821 Question Walking Speed Reason Not Complete
OI820 Question Walking Speed Complete at Least One Trial
OI669 Question Suspend Interview
OI668 Question Emergency Blood Pressure Protocol
OI667 Question Saliva Demo
OI666 Question Scale-Support Tile Used=
OI661 Question Completed Walking Speed as Directed -specify
OI660 Question Completed Walking Speed as Directed
OI663 Question BP Screening Question, Right Arm
OI662 Question BP Screening Question, Left Arm
OI908 Question Waist Difficulties
OI909 Question Waist Difficulties_Specify
OI621 Question Side-by-Side Measurement Setup Instructions
OI620 Question Side-by-Side Demonstration
OI623 Question Full-Tandem Balance Test Instructions 1
OI622 Question Side-by-Side Measurement Instructions
OI625 Question Introduction to Demonstration Video Intro
OI624 Question Full-Tandem Balance Test Instructions 2
OI627 Question Walking Speed Set Up 1
OI626 Question Introduction to Demonstration Video
OI629 Question Height Measurement Introduction
OI628 Question Walking Speed Set Up 2
OI874 Question Blood Pressure Position
OI876 Question Balance Test Semi-Tandem Stand
OI877 Question Balance Test Semi-Tandem Reason Not Complete
OI870 Question Blood Pressure 3 Diastolic (mmHg)
OI978 Question R Understanding of Walking Speed Procedure
OI975 Question R Understanding of Full Tandem Balance Test Procedure
OI977 Question Walking Speed Screening Question
OI971 Question Semi-Tandem Safety Question
OI970 Question Semi-Tandem Screening Question
OI973 Question Side-by-Side Safety Question
OI809 Question Puff Test 3 (L/min)
OI843 Question Weight floor surface -Specify
OI643 Question Saliva Barcode, Manual Entry 3
OI631 Question Height Measurement Introduction
OI881 Question Balance Test Semi-Tandem Compensatory
OI880 Question Balance Test Semi-Tandem Time
OI883 Question BALANCE TEST S-B-S Complete
OI885 Question BALANCE TEST S-B-S REASON NOT COMPLETE -Specify
OI884 Question BALANCE TEST S-B-S STAND REASON NOT COMPLETE
OI887 Question BALANCE TEST SIDE-BY-SIDE Time
OI886 Question BALANCE TEST S-B-S Hold Full Time
OI856 Question Blood Pressure Not Complete_Specify
OI857 Question Blood Pressure 1 Time
OI854 Question Blood Pressure Complete
OI807 Question Puff Test 1 (L/min)
OI806 Question Breath Test Reason Not Complete - Specify
OI808 Question Puff Test 2 (L/min)
OI838 Question Weight able to Measure
OI839 Question Weight Reason Not Complete
OI933 Question Saliva Barcode Entry, Scanned
OI935 Question Blood BarCode 2
OI934 Question Blood Barcode 1 Entry, Scanned
OI936 Question Finish Phy Measures
OI831 Question Measure R Height
OI832 Question Height Reason Not Complete
OI833 Question Height Reason Not Complete - specify
OI834 Question Height Measurement (inches)
OI837 Question Height wearing shoes
OI967 Question Affected hand(s)
OI842 Question Weight floor surface
OI904 Question WAIST Complete
OI906 Question Waist Not Complete_Specify
OI907 Question Waist Measurement (inches)
OI632 Question Weight Measurement Introduction
OI633 Question Waist Measurement Introduction
OI630 Question Prefacing Statement to Height-Weight-Waist Introductions
OI851 Question right first (kg)
OI636 Question Waist Measurement Screening Question
OI637 Question Waist Measurement Introduction
OI635 Question Waist Measurement Image
OI638 Question Saliva-Consent Introduction and Launch
OI639 Question Saliva Tips for Respondent
OI800 Question MODE OF INTERVIEW FOR PHYSICAL MEASURES
OI803 Question LIST OF MEASURES R IS ASKED TO COMPLETE
OI802 Question Physical Measures Consent
OI805 Question Breath Test Reason Not Complete
OI804 Question Breath Complete at east One Trial
OI968 Question Hand-Strength Safety Question
OI966 Question Injury, pain or surgery on hand(s)
OI964 Question Breathing Test Safety Question
OI963 Question Provide Blood Pressure Results to R
OI960 Question BP Screening Question
OI961 Question R Understanding of BP Procedure & Safety
OI898 Question BALANCE TEST FULL TANDEM STAND Compensatory
OI893 Question BALANCE TEST FULL TANDEM STAND Complete
OI896 Question BALANCE TEST FULL TANDEM STAND Hold Full Time
OI897 Question BALANCE TEST FULL TANDEM STAND Time
OI894 Question BALANCE TEST FULL TANDEM STAND REASON NOT Complete
OI895 Question BALANCE TEST FULL TANDEM STAND REASON NOT Complete - Specify
OI905 Question Waist Why Not Complete
OI844 Question Weight Wearing Shoes
OI871 Question Blood Pressure 3 Pulse (bpm)
OI846 Question PHYSICAL MEASURES INTRO
OI872 Question Blood Pressure Arm
OI841 Question Weight Measurement (lbs)
OI840 Question Weight Reason Not Complete - Specify
OI922 Question BLOOD Consent
OI923 Question Blood Complete
OI920 Question Saliva Problem - Specify
OI926 Question Blood What Problems
OI927 Question Blood Problem - Specify
OI924 Question Blood Why Not Complete
OI925 Question Blood NotComplete_Specify
OI929 Question Blood Fill Spots Card 1
OI878 Question Balance Test Semi-Tandem Reason Not Complete-Specify
OI879 Question Balance Test Semi-Tandem Hold Full Time
OI611 Question Hand Strength Demonstration
OI649 Question Blood-Collection Procedure Recap
OI648 Question Blood Sample-Consent Intro and Launch
OI642 Question Saliva Barcode, Manual Entry 2
OI641 Question Saliva Barcode, Manual Entry 1
OI640 Question Saliva Setup Instructions Instructions 1
OI647 Question Saliva Collection Instructions 4
OI646 Question Saliva Collection Instructions 3
OI645 Question Saliva Tips for Respondent
OI644 Question Saliva Collection Instructions 2
OI858 Question String I857_BloodPressure1_Time hour + minute
OI859 Question Blood Pressure 1 Systolic (mmHg)
OI855 Question Reason Blood Pressure Not Complete
OI852 Question left second(kg)
OI853 Question right second (kg)
OI942 Question Why No Consent Saliva _Specify
OI943 Question Why No Consent Blood
OI845 Question Finish Phy Measures
Start of I. Physical Measures
 
OI800

MODE OF INTERVIEW FOR PHYSICAL MEASURES

ENTER CURRENT MODE OF INTERVIEW
expand
 
If OX090_R = ENHANCEDFTF »
 
   
 
If MODE OF INTERVIEW FOR PHYSICAL MEASURES = 2 F-t-f and R IN NURSING HOME = NO and LANGUAGE = SPANISH or ENGLISH »
 
     
   
OI802

Physical Measures Consent

DID R SIGN THE PHYSICAL MEASURES CONSENT FORM?
IF YES, THE CONSENT WAS NOT PROPERLY SAVED. TO RE-LAUNCH AND RE-SIGN:
1) ENTER [1] YES
2) CLICK THE
expand
     
   
If Physical Measures Consent = 1 Yes »
 
       
     
OI854

Blood Pressure Complete

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF O
DID R COMPLETE AT LEAST ONE BLOOD PRESSURE MEASUREMENT?
expand
       
     
If Blood Pressure Complete = 5 No »
 
         
       
OI855

Reason Blood Pressure Not Complete

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS N OF O
WHY DIDN'T R COMPLETE THE BLOOD PRESSURE MEASUREMENT?
» ENTER ALL THAT APPLY.
expand
         
     
ElseIf Blood Pressure Complete = 1 Yes »
 
         
       
OI857

Blood Pressure 1 Time

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 1: J OF M -- OBS
» INSTRUCT THE R TO REMAIN STILL.
» PRESS THE START/STOP BUTTON AND RECORD MEASUREMENTS
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.
         
       
OI859

Blood Pressure 1 Systolic (mmHg)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 1: K OF M -- OBS
FIRST READING - SYSTOLIC
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
» ENTER [999] IF R CHOSE NOT TO DO IT.
         
       
If Blood Pressure 1 Systolic (mmHg) != 9993 and Blood Pressure 1 Systolic (mmHg) != 999 »
 
           
         
OI860

Blood Pressure 1 Diastolic (mmHg)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 1: L OF M -- OBS
FIRST READING - DIASTOLIC
           
         
OI861

Blood Pressure 1 Pulse (bpm)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 1: M OF M -- OBS
FIRST READING - PULSE
           
         
OI862

Blood Pressure 2 Time

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 2: J OF M -- OBS
ENSURE THAT YOU'VE ALLOWED 45 SECONDS TO ELAPSE SINCE FIRST MEASUREMENT.
SECOND 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.
           
         
OI864

Blood Pressure 2 Systolic (mmHg)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 2: K OF M -- OBS
SECOND READING - SYSTOLIC
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
» ENTER [999] IF R CHOSE NOT TO DO IT.
           
         
If Blood Pressure 2 Systolic (mmHg) != 9993 and Blood Pressure 2 Systolic (mmHg) != 999 »
 
             
           
OI865

Blood Pressure 2 Diastolic (mmHg)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 2: L OF M -- OBS
SECOND READING - DIASTOLIC
             
           
OI866

Blood Pressure 2 Pulse (bpm)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 2: M OF M -- OBS
SECOND READING - PULSE
             
           
OI867

Blood Pressure 3 Time

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 3: J OF M -- OBS
THIRD 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.
             
           
OI869

Blood Pressure 3 Systolic (mmHg)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 3: K OF M -- OBS
THIRD READING - SYSTOLIC
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
» ENTER [999] IF R CHOSE NOT TO DO IT.
             
           
If Blood Pressure 3 Systolic (mmHg) != 9993 and Blood Pressure 3 Systolic (mmHg) != 999 »
 
               
             
OI870

Blood Pressure 3 Diastolic (mmHg)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 3: L OF M -- OBS
THIRD READING - DIASTOLIC
               
             
OI871

Blood Pressure 3 Pulse (bpm)

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE 3: M OF M -- OBS
THIRD READING - PULSE
               
         
OI872

Blood Pressure Arm

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS L OF O
WHICH ARM WAS USED TO CONDUCT THE MEASUREMENTS?
expand
           
         
OI874

Blood Pressure Position

BLOOD PRESSURE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS M OF O
WHAT WAS R'S POSITION FOR THIS TEST?
expand
           
     
OI804

Breath Complete at east One Trial

BREATHING TEST
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF N
DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
expand
       
     
If Breath Complete at east One Trial != 1 Yes »
 
         
       
OI805

Breath Test Reason Not Complete

BREATHING TEST
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF N
WHY DIDN'T R COMPLETE THE BREATHING TEST?
» ENTER ALL THAT APPLY.
expand
         
     
If Breath Complete at east One Trial = 1 Yes »
 
         
       
OI807

Puff Test 1 (L/min)

BREATHING TEST
INTRODUCTION -- DEMO -- SAFETY -- SETUP -- MEASURE J OF N -- OBS
FIRST READING - RECORD TO THE NEAREST 10 L/MIN
» ENTER [30] IF READING IS LESS THAN 60.
» ENTER [890] IF READING IS PAST LAST TICK MARK.
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
         
       
OI808

Puff Test 2 (L/min)

BREATHING TEST
INTRODUCTION -- DEMO -- SAFETY -- SETUP -- MEASURE L OF N -- OBS
SECOND READING - RECORD TO THE NEAREST 10 L/MIN
» ENTER [30] IS READING IS LESS THAN 60.
» ENTER [890] IS READING IS PAST LAST TICK MARK.
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
         
       
OI809

Puff Test 3 (L/min)

BREATHING TEST
INTRODUCTION -- DEMO -- SAFETY -- SETUP -- MEASURE N OF N -- OBS
THIRD READING - RECORD TO THE NEAREST 10 L/MIN
» ENTER [30] IS READING IS LESS THAN 60.
» ENTER [890] IS READING IS PAST LAST TICK MARK.
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
         
       
OI810

R Breathing Test Effort

BREATHING TEST
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS M OF N
HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
         
       
OI811

Breathing Test R position

BREATHING TEST
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS N OF N
WHAT WAS THE R'S POSITION FOR THIS TEST?
expand
         
     
OI812

HAND STRENGTH COMPLETE AT LEAST ONE TRIAL

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF N
DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
expand
       
     
If HAND STRENGTH COMPLETE AT LEAST ONE TRIAL != 1 Yes »
 
         
       
OI813

Hand Strength TEST REASON NOT COMPLETE

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF N
WHY DIDN'T R COMPLETE THE HAND STRENGTH TEST?
» ENTER ALL THAT APPLY.
expand
         
     
Else If HAND STRENGTH COMPLETE AT LEAST ONE TRIAL = 1 Yes »
 
         
       
OI815

Grip dominant hand

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP J OF K -- MEASURE -- OBS
WHICH IS YOUR DOMINANT HAND?
expand
         
       
OI816

left first (kg)

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE K OF M -- OBS
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
LEFT HAND, FIRST MEASUREMENT:
» ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
» ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
expand
         
       
OI851

right first (kg)

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE K OF M -- OBS
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
RIGHT HAND, FIRST MEASUREMENT:
» ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
» ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
expand
         
       
OI852

left second(kg)

HAND STRENGTH
INTRODUCTION -- DEMO -- SAFETY -- SETUP -- MEASURE L OF M -- OBS
LEFT HAND, SECOND MEASUREMENT:
» ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
» ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
expand
         
       
OI853

right second (kg)

HAND STRENGTH
INTRODUCTION -- DEMO -- SAFETY -- SETUP -- MEASURE M OF M -- OBS
RIGHT HAND, SECOND MEASUREMENT:
» ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
» ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
expand
         
       
OI817

Grip R Effort

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS L OF N
HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
expand
         
       
OI818

Hand Strength TEST R POSITION

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS M OF N
WHAT WAS THE R'S POSITION FOR THIS TEST?
expand
         
       
OI819

Hand Strength rest arm

HAND STRENGTH
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS N OF N
DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
expand
         
     
OI876

Balance Test Semi-Tandem Stand

BALANCE TEST: SEMI-TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE K OF L -- OBS
DID R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND?
expand
       
     
If Balance Test Semi-Tandem Stand != 1 Yes »
 
         
       
OI877

Balance Test Semi-Tandem Reason Not Complete

BALANCE TEST: SEMI-TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF L
WHY DIDN'T R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND?
» ENTER ALL THAT APPLY.
expand
         
     
ElseIf Balance Test Semi-Tandem Stand = 1 Yes »
 
         
       
OI879

Balance Test Semi-Tandem Hold Full Time

BALANCE TEST: SEMI-TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE J OF L -- OBS
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 »
 
           
         
OI880

Balance Test Semi-Tandem Time

BALANCE TEST: SEMI-TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE L OF L -- OBS
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
expand
           
       
If Balance Test Semi-Tandem Hold Full Time != 999 and Balance Test Semi-Tandem Hold Full Time != 993 »
 
           
         
OI881

Balance Test Semi-Tandem Compensatory

BALANCE TEST: SEMI-TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF L
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 »
 
         
       
OI883

BALANCE TEST S-B-S Complete

BALANCE TEST: SIDE-BY-SIDE STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE K OF L -- OBS
DID R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND?
expand
         
       
If BALANCE TEST S-B-S Complete != 1 Yes »
 
           
         
OI884

BALANCE TEST S-B-S STAND REASON NOT COMPLETE

BALANCE TEST: SIDE-BY-SIDE STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF L
WHY DIDN'T R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND?
» ENTER ALL THAT APPLY.
expand
           
       
ElseIf BALANCE TEST S-B-S Complete = 1 Yes »
 
           
         
OI886

BALANCE TEST S-B-S Hold Full Time

BALANCE TEST: SIDE-BY-SIDE STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE J OF L -- OBS
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 »
 
             
           
OI887

BALANCE TEST SIDE-BY-SIDE Time

BALANCE TEST: SIDE-BY-SIDE STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE L OF L -- OBS
» RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
expand
             
         
If BALANCE TEST S-B-S Hold Full Time != 993 and BALANCE TEST S-B-S Hold Full Time != 999 »
 
             
           
OI888

BALANCE TEST SIDE-BY-SIDE Compensatory

BALANCE TEST: SIDE-BY-SIDE STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF L
DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SIDE-BY-SIDE STAND?
expand
             
     
Else
 
         
       
OI893

BALANCE TEST FULL TANDEM STAND Complete

BALANCE TEST: FULL TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE K OF L -- OBS
DID R ATTEMPT TO COMPLETE THE FULL TANDEM STAND?
expand
         
       
If BALANCE TEST FULL TANDEM STAND Complete != 1 Yes »
 
           
         
OI894

BALANCE TEST FULL TANDEM STAND REASON NOT Complete

BALANCE TEST: FULL TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF L
WHY DIDN'T R ATTEMPT TO COMPLETE THE FULL-TANDEM STAND?
» ENTER ALL THAT APPLY.
expand
           
       
Else
 
           
         
OI896

BALANCE TEST FULL TANDEM STAND Hold Full Time

BALANCE TEST: FULL TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE J OF L -- OBS
DID R HOLD FULL TANDEM STAND FOR FULL 30 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
expand
           
         
If BALANCE TEST FULL TANDEM STAND Hold Full Time = 1 Yes and R CURRENT AGE CALCULATION > 70 »
 
             
           
OI897

BALANCE TEST FULL TANDEM STAND Time

BALANCE TEST: FULL TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE L OF L -- OBS
» RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
expand
             
         
If BALANCE TEST FULL TANDEM STAND Hold Full Time != 993 and BALANCE TEST FULL TANDEM STAND Hold Full Time != 999 »
 
             
           
OI898

BALANCE TEST FULL TANDEM STAND Compensatory

BALANCE TEST: FULL TANDEM STAND
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF L
DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING FULL TANDEM STAND?
expand
             
     
If R CURRENT AGE CALCULATION > 64 »
 
         
       
OI820

Walking Speed Complete at Least One Trial

WALKING SPEED
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF P
DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
expand
         
       
If Walking Speed Complete at Least One Trial != 1 Yes »
 
           
         
OI821

Walking Speed Reason Not Complete

WALKING SPEED
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS O OF P
WHY DIDN`T R COMPLETE THE WALKING TEST?
» ENTER ALL THAT APPLY.
expand
           
       
Else
 
           
         
OI823

T walk trial time (seconds)

WALKING SPEED
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE K OF L -- OBS
TIME FROM FIRST TRIAL
» RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
» ENTER [993] IF R WAS UNABLE TO DO IT
» ENTER [999] IF R CHOSE NOT TO DO IT
expand
           
         
If T walk trial time (seconds) != 993 and T walk trial time (seconds) != 999 »
 
             
           
OI824

T walk trial time (seconds)

WALKING SPEED
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE L OF L -- OBS
TIME FROM SECOND TRIAL
» RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
» ENTER [993] IF R WAS UNABLE TO DO IT
» ENTER [999] IF R CHOSE NOT TO DO IT
expand
             
           
OI828

Walking Aid Type

WALKING SPEED
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF P
WHAT TYPE OF AID WAS USED?
expand
             
     
OI831

Measure R Height

HEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF N
WERE YOU ABLE TO MEASURE R`S HEIGHT?
expand
       
     
If Measure R Height != 1 Yes »
 
         
       
OI832

Height Reason Not Complete

HEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF N
WHY WEREN'T YOU ABLE TO MEASURE R`S HEIGHT?
» ENTER ALL THAT APPLY.
expand
         
     
Else
 
         
       
OI834

Height Measurement (inches)

HEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS M OF N
ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.
expand
         
       
OI837

Height wearing shoes

HEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS N OF N
WAS R WEARING SHOES DURING MEASUREMENT?
expand
         
     
If WEIGHT IN POUNDS < 300 »
 
         
       
OI838

Weight able to Measure

WEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF Q
WERE YOU ABLE TO MEASURE R`S WEIGHT?
expand
         
       
If Weight able to Measure != 1 Yes »
 
           
         
OI839

Weight Reason Not Complete

WEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS P OF Q
WHY WEREN'T YOU ABLE TO MEASURE R`S WEIGHT?
» ENTER ALL THAT APPLY.
expand
           
       
Else
 
           
         
OI841

Weight Measurement (lbs)

WEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF Q
ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 0.5 POUND).
» ENTER [993] IF R TRIED BUT RECEIVED AN ERROR MESSAGE.
» ENTER [999] IF R CHOSE NOT TO DO IT.
expand
           
         
OI842

Weight floor surface

WEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS L OF Q
RECORD TYPE OF FLOOR SURFACE
» IF YOU USED THE SUPPORT TILE, PLEASE RECORD THE SURFACE ON WHICH THE TILE WAS PLACED.
expand
           
         
OI844

Weight Wearing Shoes

WEIGHT
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS O OF Q
WAS R WEARING SHOES DURING MEASUREMENT?
expand
           
     
OI904

WAIST Complete

WAIST CIRCUMFERENCE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF Q
WERE YOU ABLE TO MEASURE R'S WAIST CIRCUMFERENCE?
expand
       
     
If WAIST Complete != 1 Yes »
 
         
       
OI905

Waist Why Not Complete

WAIST CIRCUMFERENCE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS P OF Q
WHY WEREN'T YOU ABLE TO MEASURE R'S WAIST?
» ENTER ALL THAT APPLY.
expand
         
     
Else
 
         
       
OI907

Waist Measurement (inches)

WAIST CIRCUMFERENCE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF Q
ENTER RESPONDENT'S WAIST MEASUREMENT TO THE NEAREST QUARTER INCH.
» ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.
» ENTER [999] IF R CHOSE NOT TO DO IT.
expand
         
       
If Waist Measurement (inches) != 993 and Waist Measurement (inches) != 999 »
 
           
         
OI908

Waist Difficulties

WAIST CIRCUMFERENCE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS L OF Q
WHAT DIFFICULTIES OCCURRED DURING THIS MEASUREMENT?
» ENTER ALL THAT APPLY.
expand
           
         
OI911

Waist Who Measured

WAIST CIRCUMFERENCE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS N OF Q
WHO COMPLETED THE MEASUREMENT?
expand
           
         
OI912

Waist Bulky Clothes

WAIST CIRCUMFERENCE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS O OF Q
WAS R WEARING BULKY CLOTHING DURING THIS MEASUREMENT?
expand
           
   
OI913

Saliva Consent

SALIVA SAMPLE
INTRO K OF K -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS
DID R SIGN THE SALIVA CONSENT FORM?
IF YES, THE CONSENT WAS NOT PROPERLY SAVED. TO RE-LAUNCH AND RE-SIGN:
1) ENTER [1] YES
2) CLICK THE
expand
     
   
If Saliva Consent = 5 No »
 
       
     
OI941

Why No Consent Saliva

SALIVA SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS P OF Q
WHY DIDN'T R SIGN THE SALIVA CONSENT FORM?
» ENTER ALL THAT APPLY.
expand
       
   
Else
 
       
     
OI915

Saliva Complete

expand
       
     
If Saliva Complete != 1 Yes »
 
         
       
OI916

Saliva Why Not Complete

SALIVA SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS N OF Q
WHY DIDN'T R COMPLETE THE SALIVA SAMPLE?
» ENTER ALL THAT APPLY.
expand
         
     
Else
 
         
       
OI918

Saliva Fill Vial

expand
         
       
OI919

Saliva Problems

expand
         
   
OI922

BLOOD Consent

BLOOD SAMPLE
INTRO K OF L -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS
DID R SIGN THE BLOOD SPOT CONSENT FORM?
IF YES, THE CONSENT WAS NOT PROPERLY SAVED. TO RE-LAUNCH AND RE-SIGN:
1) ENTER [1] YES
2) CLICK THE
expand
     
   
If BLOOD Consent = 5 No »
 
       
     
OI943

Why No Consent Blood

BLOOD SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS O OF R
WHY DIDN'T R SIGN THE BLOOD CONSENT FORM?
» ENTER ALL THAT APPLY.
expand
       
   
Else
 
       
     
OI923

Blood Complete

BLOOD SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS L OF R
DID R ATTEMPT TO COMPLETE THE BLOOD SAMPLE?
expand
       
     
If Blood Complete != 1 Yes »
 
         
       
OI924

Blood Why Not Complete

BLOOD SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS Q OF R
WHY DIDN'T R COMPLETE THE BLOOD SAMPLE?
» ENTER ALL THAT APPLY.
expand
         
     
Else
 
         
       
OI926

Blood What Problems

BLOOD SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS M OF R
WHAT, IF ANY, PROBLEMS OCCURRED DURING THE COLLECTION OF THE BLOOD SAMPLE?
» ENTER ALL THAT APPLY.
expand
         
       
OI929

Blood Fill Spots Card 1

BLOOD SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS J OF R
HOW MANY CIRCLES WERE FILLED ON THE FIRST CARD?
expand
         
       
OI945

Blood Fill Spots Card 2

BLOOD SAMPLE
INTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS K OF R
HOW MANY CIRCLES WERE FILLED ON THE STORAGE CARD?
expand
         
End of I. Physical Measures
Start of I. Physical Measures

========================================================================
OI800
MODE OF INTERVIEW FOR PHYSICAL MEASURES

@/@S ENTER CURRENT MODE OF INTERVIEW@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Phone
2 F-t-f


If OX090_R = ENHANCEDFTF »

If MODE OF INTERVIEW FOR PHYSICAL MEASURES (OI800) = 2 F-t-f and R IN NURSING HOME (OA028) = NO and LANGUAGE = SPANISH or ENGLISH »

| |  ========================================================================
| | 
OI802
Physical Measures Consent

@/@SDID R SIGN THE PHYSICAL MEASURES CONSENT FORM?@S
@/@/@SIF YES, THE CONSENT WAS NOT PROPERLY SAVED. TO RE-LAUNCH AND RE-SIGN:@S
@/@/@|@S 1) ENTER [1] YES@S
@/@|@S 2) CLICK THE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| |  If Physical Measures Consent (OI802) = 1 Yes »

| | |  ========================================================================
| | | 
OI854
Blood Pressure Complete

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NO@N@D@S
@/@/@SDID R COMPLETE AT LEAST ONE BLOOD PRESSURE MEASUREMENT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Blood Pressure Complete (OI854) = 5 No »

| | | |  ========================================================================
| | | | 
OI855
Reason Blood Pressure Not Complete

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NN@N OF @NO@N@D@S
@/@/@SWHY DIDN'T R COMPLETE THE BLOOD PRESSURE MEASUREMENT?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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, a cast, edema, open sores or wounds, or significant bruise where the blood cuff would contact R's arm
7 No suitable space
8 Problem with equipment or supplies
97 Other (specify)


| | |  ElseIf Blood Pressure Complete (OI854) = 1 Yes »

| | | |  ========================================================================
| | | | 
OI857
Blood Pressure 1 Time

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 1: @NJ@N OF @NM@N@D -- OBS@S
@/@/@|@S@WW@W INSTRUCT THE R TO REMAIN STILL.@S
@/@/@|@S@WW@W PRESS THE START/STOP BUTTON AND RECORD MEASUREMENTS@S
@/@/@S@DFIRST@D READING - @DTIME@D OF READING@S
@/@/@|@S@WW@W 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'.@S
@/@/@|@S@WW@W PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.@S

| | | |  ========================================================================
| | | | 
OI859
Blood Pressure 1 Systolic (mmHg)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 1: @NK@N OF @NM@N@D -- OBS@S
@/@/@S@DFIRST@D READING - @DSYSTOLIC@D@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S

| | | |  If Blood Pressure 1 Systolic (mmHg) (OI859) != 9993 and Blood Pressure 1 Systolic (mmHg) (OI859) != 999 »

| | | | |  ========================================================================
| | | | | 
OI860
Blood Pressure 1 Diastolic (mmHg)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 1: @NL@N OF @NM@N@D -- OBS@S
@/@/@S@DFIRST@D READING - @DDIASTOLIC@D@S

| | | | |  ========================================================================
| | | | | 
OI861
Blood Pressure 1 Pulse (bpm)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 1: @NM@N OF @NM@N@D -- OBS@S
@/@/@S@DFIRST@D READING - @DPULSE@D@S

| | | | |  ========================================================================
| | | | | 
OI862
Blood Pressure 2 Time

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 2: @NJ@N OF @NM@N@D -- OBS@S
@/@/@SENSURE THAT YOU'VE ALLOWED 45 SECONDS TO ELAPSE SINCE FIRST MEASUREMENT.@S
@/@/@S@DSECOND@D READING - @DTIME@D OF READING@S
@/@/@|@S@WW@W 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'.@S
@/@/@|@S@WW@W PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.@S

| | | | |  ========================================================================
| | | | | 
OI864
Blood Pressure 2 Systolic (mmHg)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 2: @NK@N OF @NM@N@D -- OBS@S
@/@/@S@DSECOND@D READING - @DSYSTOLIC@D@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S

| | | | |  If Blood Pressure 2 Systolic (mmHg) (OI864) != 9993 and Blood Pressure 2 Systolic (mmHg) (OI864) != 999 »

| | | | | |  ========================================================================
| | | | | | 
OI865
Blood Pressure 2 Diastolic (mmHg)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 2: @NL@N OF @NM@N@D -- OBS@S
@/@/@S@DSECOND@D READING - @DDIASTOLIC@D@S

| | | | | |  ========================================================================
| | | | | | 
OI866
Blood Pressure 2 Pulse (bpm)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 2: @NM@N OF @NM@N@D -- OBS@S
@/@/@S@DSECOND@D READING - @DPULSE@D@S

| | | | | |  ========================================================================
| | | | | | 
OI867
Blood Pressure 3 Time

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 3: @NJ@N OF @NM@N@D -- OBS@S
@/@/@S@DTHIRD@D READING - @DTIME@D OF READING@S
@/@/@|@S@WW@W 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'.@S
@/@/@|@S@WW@W PLEASE CHECK TO MAKE SURE ENTRY DISPLAYS CORRECTLY BEFORE PROCEEDING.@S

| | | | | |  ========================================================================
| | | | | | 
OI869
Blood Pressure 3 Systolic (mmHg)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 3: @NK@N OF @NM@N@D -- OBS@S
@/@/@S@DTHIRD@D READING - @DSYSTOLIC@D@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S

| | | | | |  If Blood Pressure 3 Systolic (mmHg) (OI869) != 9993 and Blood Pressure 3 Systolic (mmHg) (OI869) != 999 »

| | | | | | |  ========================================================================
| | | | | | | 
OI870
Blood Pressure 3 Diastolic (mmHg)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 3: @NL@N OF @NM@N@D -- OBS@S
@/@/@S@DTHIRD@D READING - @DDIASTOLIC@D@S

| | | | | | |  ========================================================================
| | | | | | | 
OI871
Blood Pressure 3 Pulse (bpm)

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE 3: @NM@N OF @NM@N@D -- OBS@S
@/@/@S@DTHIRD@D READING - @DPULSE@D@S

| | | | |  ========================================================================
| | | | | 
OI872
Blood Pressure Arm

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NL@N OF @NO@N@D@S
@/@/@SWHICH ARM WAS USED TO CONDUCT THE MEASUREMENTS?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Left arm
2 Right arm


| | | | |  ========================================================================
| | | | | 
OI874
Blood Pressure Position

@/@SBLOOD PRESSURE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NM@N OF @NO@N@D@S
@/@/@SWHAT WAS R'S POSITION FOR THIS TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Standing
2 Sitting
3 Lying down


| | |  ========================================================================
| | | 
OI804
Breath Complete at east One Trial

@/@SBREATHING TEST@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NN@N@D@S
@/@/@SDID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Breath Complete at east One Trial (OI804) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI805
Breath Test Reason Not Complete

@/@SBREATHING TEST@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NN@N@D@S
@/@/@SWHY DIDN'T R COMPLETE THE BREATHING TEST?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
97 Other (specify)


| | |  If Breath Complete at east One Trial (OI804) = 1 Yes »

| | | |  ========================================================================
| | | | 
OI807
Puff Test 1 (L/min)

@/@SBREATHING TEST@S
@/@SINTRODUCTION -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NJ@N OF @NN@N@D -- OBS@S
@/@/@|@S@DFIRST@D READING - RECORD TO THE NEAREST 10 L/MIN@S
@/@/@|@S@WW@W ENTER [30] IF READING IS LESS THAN 60.@S
@/@/@|@S@WW@W ENTER [890] IF READING IS PAST LAST TICK MARK.@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S

| | | |  ========================================================================
| | | | 
OI808
Puff Test 2 (L/min)

@/@SBREATHING TEST@S
@/@SINTRODUCTION -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NL@N OF @NN@N@D -- OBS@S
@/@/@|@S@DSECOND@D READING - RECORD TO THE NEAREST 10 L/MIN@S
@/@/@|@S@WW@W ENTER [30] IS READING IS LESS THAN 60.@S
@/@/@|@S@WW@W ENTER [890] IS READING IS PAST LAST TICK MARK.@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S

| | | |  ========================================================================
| | | | 
OI809
Puff Test 3 (L/min)

@/@SBREATHING TEST@S
@/@SINTRODUCTION -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NN@N OF @NN@N@D -- OBS@S
@/@/@|@S@DTHIRD@D READING - RECORD TO THE NEAREST 10 L/MIN@S
@/@/@|@S@WW@W ENTER [30] IS READING IS LESS THAN 60.@S
@/@/@|@S@WW@W ENTER [890] IS READING IS PAST LAST TICK MARK.@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S

| | | |  ========================================================================
| | | | 
OI810
R Breathing Test Effort

@/@SBREATHING TEST@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NM@N OF @NN@N@D@S
@/@/@SHOW MUCH EFFORT DID THE R GIVE TO THIS TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R gave full effort
2 R was prevented from giving full effort by illness, pain, or other symptoms or discomforts
3 R did not appear to give full effort, but no obvious reason for this


| | | |  ========================================================================
| | | | 
OI811
Breathing Test R position

@/@SBREATHING TEST@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NN@N OF @NN@N@D@S
@/@/@SWHAT WAS THE R'S POSITION FOR THIS TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Standing
2 Sitting
3 Lying down


| | |  ========================================================================
| | | 
OI812
HAND STRENGTH COMPLETE AT LEAST ONE TRIAL

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NN@N@D@S
@/@/@SDID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If HAND STRENGTH COMPLETE AT LEAST ONE TRIAL (OI812) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI813
Hand Strength TEST REASON NOT COMPLETE

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NN@N@D@S
@/@/@SWHY DIDN'T R COMPLETE THE HAND STRENGTH TEST?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
97 Other (specify)


| | |  Else If HAND STRENGTH COMPLETE AT LEAST ONE TRIAL (OI812) = 1 Yes »

| | | |  ========================================================================
| | | | 
OI815
Grip dominant hand

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- @DSETUP @NJ@N OF @NK@N@D -- MEASURE -- OBS@S
@/@/WHICH IS YOUR DOMINANT HAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Right hand
2 Left hand
3 Both hands equally dominant


| | | |  ========================================================================
| | | | 
OI816
left first (kg)

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NK@N OF @NM@N@D -- OBS@S
@/@/@S@DREMEMBER:@D RESET THE GAUGE BETWEEN MEASURES.@S
@/@/@|@S@D LEFT HAND, FIRST MEASUREMENT:@D@S
@/@/@|@S@WW@W ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.@S
@/@/@|@S@WW@W ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | |  ========================================================================
| | | | 
OI851
right first (kg)

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NK@N OF @NM@N@D -- OBS@S
@/@/@S@DREMEMBER:@D RESET THE GAUGE BETWEEN MEASURES.@S
@/@/@|@S@D RIGHT HAND, FIRST MEASUREMENT:@D@S
@/@/@|@S@WW@W ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.@S
@/@/@|@S@WW@W ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | |  ========================================================================
| | | | 
OI852
left second(kg)

@/@SHAND STRENGTH@S
@/@SINTRODUCTION -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NL@N OF @NM@N@D -- OBS@S
@/@/@|@S@D LEFT HAND, SECOND MEASUREMENT:@D@S
@/@/@|@S@WW@W ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.@S
@/@/@|@S@WW@W ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | |  ========================================================================
| | | | 
OI853
right second (kg)

@/@SHAND STRENGTH@S
@/@SINTRODUCTION -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NM@N OF @NM@N@D -- OBS@S
@/@/@|@S@D RIGHT HAND, SECOND MEASUREMENT:@D@S
@/@/@|@S@WW@W ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.@S
@/@/@|@S@WW@W ENTER [993] IF R WAS UNABLE TO PERFORM THIS MEASUREMENT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | |  ========================================================================
| | | | 
OI817
Grip R Effort

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NL@N OF @NN@N@D@S
@/@/@SHOW MUCH EFFORT DID THE R GIVE TO THIS TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R gave full effort
2 R was prevented from giving full effort by illness, pain, or other symptoms or discomforts
3 R did not appear to give full effort, but no obvious reason for this


| | | |  ========================================================================
| | | | 
OI818
Hand Strength TEST R POSITION

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NM@N OF @NN@N@D@S
@/@/@SWHAT WAS THE R'S POSITION FOR THIS TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Standing
2 Sitting
3 Lying down


| | | |  ========================================================================
| | | | 
OI819
Hand Strength rest arm

@/@SHAND STRENGTH@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NN@N OF @NN@N@D@S
@/@/@SDID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Both hands
2 Left hand only
3 Right hand only
5 No


| | |  ========================================================================
| | | 
OI876
Balance Test Semi-Tandem Stand

@/@SBALANCE TEST: SEMI-TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NK@N OF @NL@N@D -- OBS@S
@/@/@SDID R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Balance Test Semi-Tandem Stand (OI876) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI877
Balance Test Semi-Tandem Reason Not Complete

@/@SBALANCE TEST: SEMI-TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NL@N@D@S
@/@/@SWHY DIDN'T R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
5 R did not understand the instructions
6 R has surgery, injury, or other health condition that prevented R from standing
97 Other (specify)


| | |  ElseIf Balance Test Semi-Tandem Stand (OI876) = 1 Yes »

| | | |  ========================================================================
| | | | 
OI879
Balance Test Semi-Tandem Hold Full Time

@/@SBALANCE TEST: SEMI-TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NJ@N OF @NL@N@D -- OBS@S
@/@/@SDID R HOLD SEMI-TANDEM STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | |  If Balance Test Semi-Tandem Hold Full Time (OI879) = 1 Yes »

| | | | |  ========================================================================
| | | | | 
OI880
Balance Test Semi-Tandem Time

@/@SBALANCE TEST: SEMI-TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NL@N OF @NL@N@D -- OBS@S
@/@/@SRECORD TIME IN SECONDS TO TWO DECIMAL PLACES@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | |  If Balance Test Semi-Tandem Hold Full Time (OI879) != 999 and Balance Test Semi-Tandem Hold Full Time (OI879) != 993 »

| | | | |  ========================================================================
| | | | | 
OI881
Balance Test Semi-Tandem Compensatory

@/@SBALANCE TEST: SEMI-TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NL@N@D@S
@/@/@SDID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SEMI-TANDEM STAND?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Balance Test Semi-Tandem Stand (OI876) = 5 No or Balance Test Semi-Tandem Hold Full Time (OI879) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI883
BALANCE TEST S-B-S Complete

@/@SBALANCE TEST: SIDE-BY-SIDE STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NK@N OF @NL@N@D -- OBS@S
@/@/@SDID R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | |  If BALANCE TEST S-B-S Complete (OI883) != 1 Yes »

| | | | |  ========================================================================
| | | | | 
OI884
BALANCE TEST S-B-S STAND REASON NOT COMPLETE

@/@SBALANCE TEST: SIDE-BY-SIDE STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NL@N@D@S
@/@/@SWHY DIDN'T R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
5 R did not understand the instructions
6 R has surgery, injury, or other health condition that prevented R from standing
97 Other (specify)


| | | |  ElseIf BALANCE TEST S-B-S Complete (OI883) = 1 Yes »

| | | | |  ========================================================================
| | | | | 
OI886
BALANCE TEST S-B-S Hold Full Time

@/@SBALANCE TEST: SIDE-BY-SIDE STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NJ@N OF @NL@N@D -- OBS@S
@/@/@SDID R HOLD SIDE-BY-SIDE STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | | |  If BALANCE TEST S-B-S Hold Full Time (OI886) = 1 Yes »

| | | | | |  ========================================================================
| | | | | | 
OI887
BALANCE TEST SIDE-BY-SIDE Time

@/@SBALANCE TEST: SIDE-BY-SIDE STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NL@N OF @NL@N@D -- OBS@S
@/@/@|@S@WW@W RECORD TIME IN SECONDS TO TWO DECIMAL PLACES@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | | |  If BALANCE TEST S-B-S Hold Full Time (OI886) != 993 and BALANCE TEST S-B-S Hold Full Time (OI886) != 999 »

| | | | | |  ========================================================================
| | | | | | 
OI888
BALANCE TEST SIDE-BY-SIDE Compensatory

@/@SBALANCE TEST: SIDE-BY-SIDE STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NL@N@D@S
@/@/@SDID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SIDE-BY-SIDE STAND?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  Else

| | | |  ========================================================================
| | | | 
OI893
BALANCE TEST FULL TANDEM STAND Complete

@/@SBALANCE TEST: FULL TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NK@N OF @NL@N@D -- OBS@S
@/@/@SDID R ATTEMPT TO COMPLETE THE FULL TANDEM STAND?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | |  If BALANCE TEST FULL TANDEM STAND Complete (OI893) != 1 Yes »

| | | | |  ========================================================================
| | | | | 
OI894
BALANCE TEST FULL TANDEM STAND REASON NOT Complete

@/@SBALANCE TEST: FULL TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NL@N@D@S
@/@/@SWHY DIDN'T R ATTEMPT TO COMPLETE THE FULL-TANDEM STAND?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
5 R did not understand the instructions
6 R has surgery, injury, or other health condition that prevented R from standing
97 Other (specify)


| | | |  Else

| | | | |  ========================================================================
| | | | | 
OI896
BALANCE TEST FULL TANDEM STAND Hold Full Time

@/@SBALANCE TEST: FULL TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NJ@N OF @NL@N@D -- OBS@S
@/@/@SDID R HOLD FULL TANDEM STAND FOR FULL @D30@D SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | | |  If BALANCE TEST FULL TANDEM STAND Hold Full Time (OI896) = 1 Yes and R CURRENT AGE CALCULATION (OA019) > 70 »

| | | | | |  ========================================================================
| | | | | | 
OI897
BALANCE TEST FULL TANDEM STAND Time

@/@SBALANCE TEST: FULL TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NL@N OF @NL@N@D -- OBS@S
@/@/@|@S@WW@W RECORD TIME IN SECONDS TO TWO DECIMAL PLACES@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | | |  If BALANCE TEST FULL TANDEM STAND Hold Full Time (OI896) != 993 and BALANCE TEST FULL TANDEM STAND Hold Full Time (OI896) != 999 »

| | | | | |  ========================================================================
| | | | | | 
OI898
BALANCE TEST FULL TANDEM STAND Compensatory

@/@SBALANCE TEST: FULL TANDEM STAND@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NL@N@D@S
@/@/@SDID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING FULL TANDEM STAND?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If R CURRENT AGE CALCULATION (OA019) > 64 »

| | | |  ========================================================================
| | | | 
OI820
Walking Speed Complete at Least One Trial

@/@SWALKING SPEED@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NP@N@D@S
@/@/@SDID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | |  If Walking Speed Complete at Least One Trial (OI820) != 1 Yes »

| | | | |  ========================================================================
| | | | | 
OI821
Walking Speed Reason Not Complete

@/@SWALKING SPEED@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NO@N OF @NP@N@D@S
@/@/@SWHY DIDN`T R COMPLETE THE WALKING TEST?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
97 Other (specify)


| | | |  Else

| | | | |  ========================================================================
| | | | | 
OI823
T walk trial time (seconds)

@/@SWALKING SPEED@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NK@N OF @NL@N@D -- OBS@S
@/@/@S@DTIME@D FROM @DFIRST@D TRIAL@S
@/@/@|@S@WW@W RECORD TIME IN SECONDS TO TWO DECIMAL PLACES@S
@/@/@|@S@WW@W ENTER [993] IF R WAS UNABLE TO DO IT@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | | |  If T walk trial time (seconds) (OI823) != 993 and T walk trial time (seconds) (OI823) != 999 »

| | | | | |  ========================================================================
| | | | | | 
OI824
T walk trial time (seconds)

@/@SWALKING SPEED@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- @DMEASURE @NL@N OF @NL@N@D -- OBS@S
@/@/@S@DTIME@D FROM @DSECOND@D TRIAL@S
@/@/@|@S@WW@W RECORD TIME IN SECONDS TO TWO DECIMAL PLACES@S
@/@/@|@S@WW@W ENTER [993] IF R WAS UNABLE TO DO IT@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | | | |  ========================================================================
| | | | | | 
OI828
Walking Aid Type

@/@SWALKING SPEED@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NP@N@D@S
@/@/@SWHAT TYPE OF AID WAS USED?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 None
2 Walking stick or cane
3 Elbow crutches
4 Walking frame
7 Other (specify)


| | |  ========================================================================
| | | 
OI831
Measure R Height

@/@SHEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NN@N@D@S
@/@/@SWERE YOU ABLE TO MEASURE R`S HEIGHT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Measure R Height (OI831) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI832
Height Reason Not Complete

@/@SHEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NN@N@D@S
@/@/@SWHY WEREN'T YOU ABLE TO MEASURE R`S HEIGHT?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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 Respondent too tall, interviewer could not reach
7 No suitable space available
97 Other (specify)


| | |  Else

| | | |  ========================================================================
| | | | 
OI834
Height Measurement (inches)

@/@SHEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NM@N OF @NN@N@D@S
@/@/@SENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..99

| | | |  ========================================================================
| | | | 
OI837
Height wearing shoes

@/@SHEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NN@N OF @NN@N@D@S
@/@/@SWAS R WEARING SHOES DURING MEASUREMENT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If WEIGHT IN POUNDS (OC139) < 300 »

| | | |  ========================================================================
| | | | 
OI838
Weight able to Measure

@/@SWEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NQ@N@D@S
@/@/@SWERE YOU ABLE TO MEASURE R`S WEIGHT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | |  If Weight able to Measure (OI838) != 1 Yes »

| | | | |  ========================================================================
| | | | | 
OI839
Weight Reason Not Complete

@/@SWEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NP@N OF @NQ@N@D@S
@/@/@SWHY WEREN'T YOU ABLE TO MEASURE R`S WEIGHT?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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 Respondent was too heavy; did not attempt
7 No suitable space available
8 Scale did not work
97 Other (specify)


| | | |  Else

| | | | |  ========================================================================
| | | | | 
OI841
Weight Measurement (lbs)

@/@SWEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NQ@N@D@S
@/@/@SENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 0.5 POUND). @S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT RECEIVED AN ERROR MESSAGE.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..1000

| | | | |  ========================================================================
| | | | | 
OI842
Weight floor surface

@/@SWEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NL@N OF @NQ@N@D@S
@/@/@SRECORD TYPE OF FLOOR SURFACE@S
@/@/@|@S@WW@W IF YOU USED THE SUPPORT TILE, PLEASE RECORD THE SURFACE ON WHICH THE TILE WAS PLACED.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Linoleum/tile/wood
2 Low-pile carpet
3 High-pile carpet
4 Concrete
5 Not sure
7 Other (specify)


| | | | |  ========================================================================
| | | | | 
OI844
Weight Wearing Shoes

@/@SWEIGHT@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NO@N OF @NQ@N@D@S
@/@/@SWAS R WEARING SHOES DURING MEASUREMENT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  ========================================================================
| | | 
OI904
WAIST Complete

@/@SWAIST CIRCUMFERENCE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NQ@N@D@S
@/@/@SWERE YOU ABLE TO MEASURE R'S WAIST CIRCUMFERENCE?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If WAIST Complete (OI904) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI905
Waist Why Not Complete

@/@SWAIST CIRCUMFERENCE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NP@N OF @NQ@N@D@S
@/@/@SWHY WEREN'T YOU ABLE TO MEASURE R'S WAIST?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
97 Other (specify)


| | |  Else

| | | |  ========================================================================
| | | | 
OI907
Waist Measurement (inches)

@/@SWAIST CIRCUMFERENCE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NQ@N@D@S
@/@/@SENTER RESPONDENT'S WAIST MEASUREMENT TO THE NEAREST QUARTER INCH.@S
@/@/@|@S@WW@W ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT.@S
@/@/@|@S@WW@W ENTER [999] IF R CHOSE NOT TO DO IT.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0..999

| | | |  If Waist Measurement (inches) (OI907) != 993 and Waist Measurement (inches) (OI907) != 999 »

| | | | |  ========================================================================
| | | | | 
OI908
Waist Difficulties

@/@SWAIST CIRCUMFERENCE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NL@N OF @NQ@N@D@S
@/@/@SWHAT DIFFICULTIES OCCURRED DURING THIS MEASUREMENT?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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)


| | | | |  ========================================================================
| | | | | 
OI911
Waist Who Measured

@/@SWAIST CIRCUMFERENCE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NN@N OF @NQ@N@D@S
@/@/@SWHO COMPLETED THE MEASUREMENT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 R completed the measurement
2 IWER completed the measurement


| | | | |  ========================================================================
| | | | | 
OI912
Waist Bulky Clothes

@/@SWAIST CIRCUMFERENCE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NO@N OF @NQ@N@D@S
@/@/@SWAS R WEARING BULKY CLOTHING DURING THIS MEASUREMENT?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| |  ========================================================================
| | 
OI913
Saliva Consent

@/@SSALIVA SAMPLE@S
@/@S@DINTRO @NK@N OF @NK@N@D -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS@S
@/@/@SDID R SIGN THE SALIVA CONSENT FORM?@S
@/@/@SIF YES, THE CONSENT WAS NOT PROPERLY SAVED. TO RE-LAUNCH AND RE-SIGN:@S
@/@/@|@S 1) ENTER [1] YES@S
@/@|@S 2) CLICK THE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| |  If Saliva Consent (OI913) = 5 No »

| | |  ========================================================================
| | | 
OI941
Why No Consent Saliva

@/@SSALIVA SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NP@N OF @NQ@N@D@S
@/@/@SWHY DIDN'T R SIGN THE SALIVA CONSENT FORM?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
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
9 Problem with equipment or supplies
97 Other (specify)


| |  Else

| | |  ========================================================================
| | | 
OI915
Saliva Complete

- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Saliva Complete (OI915) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI916
Saliva Why Not Complete

@/@SSALIVA SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NN@N OF @NQ@N@D@S
@/@/@SWHY DIDN'T R COMPLETE THE SALIVA SAMPLE?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
5 R did not understand the instructions
8 Problem with equipment or supplies
97 Other (specify)


| | |  Else

| | | |  ========================================================================
| | | | 
OI918
Saliva Fill Vial

- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | | |  ========================================================================
| | | | 
OI919
Saliva Problems

- - - - - - - - - - - - - - - - - - - - - - - - -
1 None
2 Solution in cover leaked before vial was sealed
3 Saliva spilled
4 R was unable to produce enough saliva
97 Other (specify)


| |  ========================================================================
| | 
OI922
BLOOD Consent

@/@SBLOOD SAMPLE@S
@/@S@DINTRO @NK@N OF @NL@N@D -- DEMO -- SAFETY -- SETUP -- MEASURE -- OBS@S
@/@/@SDID R SIGN THE BLOOD SPOT CONSENT FORM?@S
@/@/@SIF YES, THE CONSENT WAS NOT PROPERLY SAVED. TO RE-LAUNCH AND RE-SIGN:@S
@/@/@|@S 1) ENTER [1] YES@S
@/@|@S 2) CLICK THE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| |  If BLOOD Consent (OI922) = 5 No »

| | |  ========================================================================
| | | 
OI943
Why No Consent Blood

@/@SBLOOD SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NO@N OF @NR@N@D@S
@/@/@SWHY DIDN'T R SIGN THE BLOOD CONSENT FORM?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
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
9 Problem with equipment or supplies
97 Other (specify)


| |  Else

| | |  ========================================================================
| | | 
OI923
Blood Complete

@/@SBLOOD SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NL@N OF @NR@N@D@S
@/@/@SDID R ATTEMPT TO COMPLETE THE BLOOD SAMPLE?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
5 No


| | |  If Blood Complete (OI923) != 1 Yes »

| | | |  ========================================================================
| | | | 
OI924
Blood Why Not Complete

@/@SBLOOD SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NQ@N OF @NR@N@D@S
@/@/@SWHY DIDN'T R COMPLETE THE BLOOD SAMPLE?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
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
5 R did not understand the instructions
6 R has hemophilia or is on medication that thins the blood (anticoagulant); other health reason
8 Problem with equipment or supplies
97 Other (specify)


| | |  Else

| | | |  ========================================================================
| | | | 
OI926
Blood What Problems

@/@SBLOOD SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NM@N OF @NR@N@D@S
@/@/@SWHAT, IF ANY, PROBLEMS OCCURRED DURING THE COLLECTION OF THE BLOOD SAMPLE?@S
@/@/@|@S@WW@W ENTER ALL THAT APPLY.@S
- - - - - - - - - - - - - - - - - - - - - - - - -
1 None
2 R became lightheaded, fainted, or became nauseous
3 R had difficulty getting finger to stop bleeding
97 Other (specify)


| | | |  ========================================================================
| | | | 
OI929
Blood Fill Spots Card 1

@/@SBLOOD SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NJ@N OF @NR@N@D@S
@/@/@SHOW MANY CIRCLES WERE FILLED ON THE @UFIRST@U CARD?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0 Zero
1 One
2 Two
3 Three
4 Four
5 Five


| | | |  ========================================================================
| | | | 
OI945
Blood Fill Spots Card 2

@/@SBLOOD SAMPLE@S
@/@SINTRO -- DEMO -- SAFETY -- SETUP -- MEASURE -- @DOBS @NK@N OF @NR@N@D@S
@/@/@SHOW MANY CIRCLES WERE FILLED ON THE @USTORAGE@U CARD?@S
- - - - - - - - - - - - - - - - - - - - - - - - -
0 Zero
1 One
2 Two
3 Three
4 Four
5 Five


End of I. Physical Measures