Section SS [SENSORY AND PHYSICAL IMPAIRMENTS AND SYMPTOMS] Sequence: 14

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Adelia Morris
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1 NHATS Round Section SS [SENSORY AND PHYSICAL IMPAIRMENTS AND SYMPTOMS] Sequence: 4 SS3PRE SS3PRE T ON FILE Now let's talk about how well {you hear/sp hears}. PRESS AND ENTER TO CONTINUE SS3 ssheringaid R SS3 HEARING AID USED DISPLAY QUESTION TEXT In the last month AS BOLD UNDERLINED TEXT In the last month, {have you/has {he/she}} used a hearing aid or other hearing device? 7 DEAF SS7PRE SS4a sshearphone R SS4A SP CAN USE TELEPHONE IF SS3= (, HEARING AID) DISPLAY "When {you use/sp uses} a hearing aid, {do you/does {he/she}} " ELSE DISPLAY "{Do you/does SP} " FOR ITEMS SS4a, SS4b, SS4c USE "SAME QUESTION STEM" DISPLAY {When {you use/sp uses} a hearing aid, {do you/does {he/she}}/{do you/does SP}} hear well enough to use the telephone? SS4b ssconvwradi R SS4B CONVERSATIN WTH TV RADIO Page of 0 NHATS Round :: SS

2 IF SS3= (, HEARING AID) DISPLAY "When {you use/sp uses} a hearing aid, {do you/does {he/she}}." ELSE DISPLAY "{Do you/does SP} " FOR ITEMS SS4a, SS4b, SS4c USE "SAME QUESTION STEM" DISPLAY {When {you use/sp uses} a hearing aid, {do you/does {he/she}}/{do you/does SP}} hear well enough to carry on a conversation in a room with a radio or TV playing? SS7PRE SS4c ssconvquiet R SS4C CONVERS IN QUIET ROOM IF SS3= (, HEARING AID) DISPLAY "When {you use/sp uses} a hearing aid, {do you/does {he/she}} " ELSE DISPLAY "{Do you/does SP} " FOR ITEMS SS4a, SS4b, SS4c USE "SAME QUESTION STEM" DISPLAY {When {you use/sp uses} a hearing aid, {do you/does {he/she}}/{do you/does SP}} hear well enough to carry on a conversation in a quiet room? SS7PRE SS7PRE T ON FILE Now I have a few questions about how well {you/sp} can see. PRESS AND ENTER TO CONTINUE SS7 ssglasseswr R SS7 WEARS GLASSES CONTCTS DISPLAY QUESTION TEXT "at a distance" IN BOLD UNDERLINED TEXT {Do you/does SP} wear glasses or contacts to help {you/him/her} see things at a distance? Page of 0 NHATS Round :: SS

3 7 BLIND SS3PRE SS8a ssseewellst R SS8A SEES ACROSS THE STREET IF SS7= (GLASSES/CONTACTS FOR DISTANCE) THEN DISPLAY "When {you use/sp uses} glasses or contacts, {do you/does {he/she}} " ELSE DISPLAY "{Do you/does SP} " FOR ITEMS SS8a AND SS8b, USE "SAME QUESTION STEM" DISPLAY {When {you use/sp uses} glasses or contacts, {do you/does {he/she}}/{do you/does SP}} see well enough to recognize someone across the street? SS0 SS8b ssseestvgls R SS8B TV ACROSS ROOM W GLASSES IF SS7= (GLASSES OR CONTACTS FOR DISTANCE), DISPLAY "When {you use/sp uses} glasses or contacts, {do you/does {he/she}} " ELSE DISPLAY "{Do you/does SP} " FOR ITEMS SS8a AND SS8b, USE "SAME QUESTION STEM" DISPLAY {When {you use/sp uses} glasses or contacts, {do you/does {he/she}}/{do you/does SP}} see well enough to watch television across the room? SS0 ssglasscls R SS0 WEAR GLS CONTCS SEE CLOS Page 3 of 0 NHATS Round :: SS

4 DISPLAY QUESTION TEXT "close up" AS BOLD UNDERLINED TEXT {Do you/does SP} wear glasses or contacts to help {you/him/her} see things close up? SS ssothvisaid R SS USED OTHER VISION AIDS In the last month, did {you/sp} use other vision aids such as a magnifying glass to help {you/him/her} see things close up? IF NEEDED: Vision aids include things like a magnifying glass, large-print books, and other tools to help people with vision impairments. SS ssglrednewp R SS CAN READ NEWSPAPER PRINT IF SS0 = (GLASSES OR CONTACTS FOR CLOSE UP) ) AND SS= (VISION AID) DISPLAY "When {you use/sp uses} glasses or contacts and vision aids", and "do you/does {he/she}" ELSE IF SS0= (GLASSES OR CONTACTS FOR CLOSE UP) AND SS NE DISPLAY "When {you use/sp uses} glasses or contacts", and "do you/does {he/she}" ELSE IF SS= (VISION AID) DISPLAY "When {you use/sp uses} vision aids", and "do you/does {he/she}" ELSE DISPLAY "{Do you/does SP}" {When {you use/sp uses} glasses or contacts/when {you use/sp uses} vision aids/when {you use/sp uses} glasses or contacts and vision aids}, {{do you/does {he/she}} /{Do you/does SP}} see well enough to read newspaper print? Page 4 of 0 NHATS Round :: SS

5 SS3PRE SS3PRE T ON FILE Now I have some questions about health related problems that {you/sp} may have had in the last month. PRESS AND ENTER TO CONTINUE SS3 ssprobchswl R SS3 PROBLEMS CHEW OR SWALLOW DISPLAY QUESTION TEXT "in the last month" AS BOLD UNDERLINED TEXT In the last month, did {you/sp} have problems with chewing or swallowing that caused difficulty when {you/he/she} ate? SS4 ssprobspeak R SS4 PROBLEMS SPEAKING DISPLAY QUESTION TEXT "in the last month" AS BOLD UNDERLINED TEXT In the last month because of {your/sp's} health, did {you/he/she} have any problems in speaking or in making {yourself/herself/himself} understood when {you talk/he talks/she talks)? SS5 sspainbothr R SS5 BOTHERED BY PAIN DISPLAY QUESTION TEXT "in the last month" AS BOLD UNDERLINED TEXT In the last month, {have you/has {he/she}} been bothered by pain? Page 5 of 0 NHATS Round :: SS

6 SS8a SS9 SS9 SS7 sspainlimts R SS7 PAIN EVER LIMTS ACTIVIT DISPLAY QUESTION TEXT "In the last month" AS BOLD UNDERLINED TEXT In the last month, has pain ever limited {your/sp's} activities? SS8A sspainmedof R SS8A LST MNTH OFTEN PAIN MED SHOWCARD SS In the last month, how often did {you/sp} take medication for pain? Would you say every day, most days, some days, rarely or never? EVERY DAY (7 DAYS A WEEK) MOST DAYS (5-6 DAYS A WEEK) SOME DAYS (-4 DAYS A WEEK) RARELY (ONCE A WEEK OR LESS) NEVER BOX SS8B BOXSS8B T ON FILE If SS5= (PAIN) or SS8A= (PAIN MEDS EVERY DAY), (PAIN MEDS MOST DAYS), 3 (PAIN MEDS SOME DAYS), or 4 (PAIN MEDS RARELY), go to SS8B Otherwise, go to SS9 SS8B sspainwhe R SS8B BACK PAIN IN LAST MNTH sspainwhe sspainwhe3 sspainwhe4 R SS8B HIP PAIN IN LAST MONTH R SS8B KNEE PAIN IN LAST MNTH R SS8B FOOT PAIN IN LAST MNTH Page 6 of 0 NHATS Round :: SS

7 sspainwhe5 sspainwhe6 sspainwhe7 sspainwhe8 sspainwhe9 sspainwheo sspainwhe sspainwhe sspainwhe3 R SS8B HAND PAIN IN LAST MNTH R SS8B WRIST PAIN IN LAST MNTH R SS8B SHOULDR PAIN LST MNTH R SS8B HEAD PAIN IN LAST MNTH R SS8B NECK PAIN IN LAST MNTH R SS8B ARM PAIN IN LAST MNTH (from SS8c) R SS8B LEG PAIN IN LAST MNTH (from SS8c) R SS8B STOMACH PAIN LAST MNTH (from SS8c) R SS8B OTHR SPCFY PAIN LST MO SHOW CARD SS Please look at this card and tell me where {you have/sp has} had pain in the last month. SELECT ALL THAT APPLY BACK HIPS KNEES FEET HANDS WRISTS SHOULDERS HEAD NECK OTHER PLACES (SPECIFY) SS9 SS9 SS9 SS9 SS9 SS9 SS9 SS9 SS9 SS8C SS8C T ON FILE SPECIFY OTHER PLACES SP HAD PAIN ENTER TEXT Length 50 SS9 ssprobbreat R SS9 BREATHING PROBLEMS In the last month, did {you/sp} have any breathing problems, including shortness of breath or difficulty breathing? Page 7 of 0 NHATS Round :: SS

8 SS SS SS SS0 ssprbbrlimt R SS0 BREATH PROBLS LIMT ACTIV In the last month, did {your/sp's} breathing problems ever limit {your/his/her} activities? SS ssstrnglmup R SS UPPER BOD STRENGTH LIMIT In the last month, did {you/sp} have limited strength or movement in {your/his/her} shoulders, arms, or hands? SS3 SS3 SS3 SS ssuplimtact R SS UP BOD STRNGTH LIMT ACT In the last month, did this problem with {your/sp's} shoulders, arms, or hands ever limit {your/his/her} activities? SS3 sslwrbodstr R SS3 LOWER BODY STRNGTH LIMIT In the last month, did {you/sp} have limited strength or movement in {your/his/her} hips, legs, knees, or feet? Page 8 of 0 NHATS Round :: SS

9 SS5 SS5 SS5 SS4 sslwrbodimp R SS4 LWER BOD STRNGTH IMT ACT In the last month, did this problem with {your/sp's} hips, legs, knees, or feet ever limit {your/his/her} activities? SS5 sslowenergy R SS5 LOW ENERGY IN LAST MONTH In the last month, did {you/sp} have low energy or {were you/was SP} easily exhausted? SS7 SS7 SS7 SS6 ssloenlmtat R SS6 LOW ENERGY EVER LIM ACT In the last month, did {your/sp's} low energy or exhaustion ever limit {your/his/her} activities? SS7 ssprbbalcrd R SS7 BALANCE OR COORD PROBS In the last month, did {you/sp} have problems with balance or coordination? Page 9 of 0 NHATS Round :: SS

10 SECTION PC SECTION PC SECTION PC SS8 ssprbbalcnt R SS8 BAL COORD PROB LIMIT ACT In the last month, did {your/sp's} balance or coordination problems ever limit {your/sp's} activities? PROGRAMMER INSTRUCTIONS: Go to Section PC Physical Capacity Page 0 of 0 NHATS Round :: SS

Section SS [SENSORY IMPAIRMENTS AND SYMPTOMS] Sequence: 14. In the last month, {have you/has {he/she}} used a hearing aid or other hearing device?

NHATS Round Section SS [SENSORY IMPAIRMENTS AND SYMPTOMS] Sequence: 4 BOX SS3PRE BOX SS3PRE T ON FILE If LAST INT DEAF flag = (), go to BOX SS4. Otherwise, go to SS3PRE. SS3PRE SS3PRE T ON FILE Now let