Behavioral Risk Factor Surveillance
System
Indiana Statewide Survey Data,
2009
Table of
Contents
Preface
Introduction:
Tables:
Core 01:
Health Status
C01Q01
Would you say that in general your health is: (GENHLTH)
Core 02:
Healthy Days—Health-Related Quality of Life
C02Q01
Now thinking about your physical health, which includes physical illness and
injury, for how many days during the past 30 days was your physical health not
good? (PHYSHLTH)
C02Q02
Now thinking about your mental health, which includes stress, depression, and
problems with emotions, for how many days during the past 30 days was your
mental health not good? (MENTHLTH)
C02Q03
During the past 30 days, for about how many days did poor physical or mental
health keep you from doing your usual activities, such as self-care, work, or
recreation? (POORHLTH)
Core 03:
Health Care Access
C03Q01 Do
you have any kind of health care coverage, including health insurance, prepaid
plans such as HMOs, or government plans such as Medicare?
(HLTHPLAN)
C03Q02 Do
you have one person you think of as your personal doctor or health care
provider? (PERSDOC2)
C03Q03
Was there a time in the past 12 months when you needed to see a doctor but could
not because of cost? (MEDCOST)
C03Q04
About how long has it been since you last visited a doctor for a routine
checkup? [A routine checkup is a general physical exam, not an exam for a
specific injury, illness, or condition.] (CHECKUP1)
Core 04:
Sleep
C04Q01
During the past 30 days, for about how many days have you felt you did not get
enough rest or sleep? (QLREST2)
Core 05:
Exercise
C05Q01
During the past month, other than your regular job, did you participate in any
physical activities or exercises such as running, calisthenics, golf, gardening,
or walking for exercise? (EXERANY2)
Core 06:
Diabetes
C06Q01
Have you ever been told by a doctor that you have diabetes?
(DIABETE2)
Module 02:
Diabetes
M02Q01
How old were you when you were told you have diabetes? (DIABAGE2)
M02Q02
Are you now taking insulin? (INSULIN)
M02Q03
About how often do you check your blood for glucose or sugar? Include times when
checked by a family member or friend, but do NOT include times when checked by a
health professional. (BLDSUGAR)
M02Q04
About how often do you check your feet for any sores or irritations? Include
times when checked by a family member or friend, but do NOT include times when
checked by a health professional. (FEETCHK2)
M02Q05
About how many times in the past 12 months have you seen a doctor, nurse, or
other health professional for your diabetes? (DOCTDIAB)
M02Q06 A
test for 'A one C' measures the average level of blood sugar over the past three
months. About how many times in the past 12 months has a doctor, nurse, or other
health professional checked you for 'A one C'? (CHKHEMO3)
M02Q07
About how many times in the past 12 months has a health professional checked
your feet for any sores or irritations? (FEETCHK)
M02Q08
When was the last time you had an eye exam in which the pupils were dilated?
This would have made you temporarily sensitive to bright light.
(EYEEXAM)
M02Q09
Has a doctor ever told you that diabetes has affected your eyes or that you had
retinopathy? (DIABEYE)
M02Q10
Have you ever taken a course or class in how to manage your diabetes yourself?
(DIABEDU)
Core 07:
Hypertension Awareness
C07Q01
Have you EVER been told by a doctor, nurse or other health professional that you
have high blood pressure? (BPHIGH4)
C07Q02
Are you currently taking medicine for your high blood pressure?
(BPMEDS)
Core 08:
Cholesterol Awareness
C08Q01
Blood cholesterol is a fatty substance found in the blood. Have you EVER had
your blood cholesterol checked? (BLOODCHO)
C08Q02
About how long has it been since you last had your blood cholesterol checked?
(CHOLCHK)
C08Q03
Have you EVER been told by a doctor, nurse or other health professional that
your blood cholesterol is high? (TOLDHI2)
Core 09:
Cardiovascular Disease Prevalence
C09Q01
Ever told you had a heart attack, also called a myocardial infarction?
(CVDINFR4)
C09Q02
Ever told you had angina or coronary heart disease? (CVDCRHD4)
C09Q03
Ever told you had a stroke. (CVDSTRK3)
Core 10:
Asthma
C10Q01
Have you ever been told by a doctor, nurse, or other health professional that
you had asthma? (ASTHMA2)
C10Q02 Do
you still have asthma? (ASTHNOW)
Core 11:
Tobacco Use
C11Q01
Have you smoked at least 100 cigarettes in your entire life?
(SMOKE100)
C11Q02 Do
you now smoke cigarettes every day, some days, or not at all?
(SMOKDAY2)
C11Q03
During the past 12 months, have you stopped smoking for one day or longer
because you were trying to quit smoking? (STOPSMK2)
C11Q04
How long has it been since you last smoked cigarettes regularly?
(LASTSMK1)
C11Q05 Do
you currently use chewing tobacco, snuff, or snus every day, some days, or not
at all? (USENOW3)
Core 12:
Demographics
C12Q05
Have you ever served on active duty in the United States Armed Forces, either in
the regular military or in a National Guard or military reserve unit?
(VETERAN2)
C12Q15
What county do you live in? (CTYCODE_)
C12Q21 To
your knowledge, are you now pregnant? (PREGNANT)
Core 13:
Caregiver Status
C13Q01
During the past month, did you provide any such care or assistance to a friend
or family member? (CAREGIVE)
Core 14:
Disability
C14Q01
Are you limited in any way in any activities because of physical, mental, or
emotional problems? (QLACTLM2)
C14Q02 Do
you now have any health problem that requires you to use special equipment, such
as a cane, a wheelchair, a special bed, or a special telephone?
(USEEQUIP)
Core 15:
Alcohol Consumption
C15Q01
During the past 30 days, have you had at least one drink of any alcoholic
beverage such as beer, wine, a malt beverage or liquor?
(DRNKANY4)
C15Q02
During the past 30 days, how many days per week or per month did you have at
least one drink of any alcoholic beverage? (ALCDAY4)
C15Q03
During the past 30 days, on the days when you drank, about how many drinks did
you drink on the average? [A 40 ounce beer would count as 3 drinks, or a
cocktail drink with 2 shots would count as 2 drinks.] (AVEDRNK2)
C15Q04
Considering all types of alcoholic beverages, how many times during the past 30
days did you have 5 or more drinks for men or 4 or more drinks for women on an
occasion? (DRNK3GE5)
C15Q05
During the past 30 days, what is the largest number of drinks you had on any
occasion? (MAXDRNKS)
Core 16:
Immunization
C16Q01 A
flu shot is an influenza vaccine injected into your arm. During the past 12
months, have you had a flu shot? (FLUSHOT3)
C16Q03
During the past 12 months, have you had a flu vaccine that was sprayed in your
nose? The flu vaccine sprayed in the nose is also called FluMist™.
(FLUSPRY2)
C16Q05 A
pneumonia shot or pneumococcal vaccine is usually given only once or twice in a
person´s lifetime and is different from the flu shot. Have you ever had a
pneumonia shot? (PNEUVAC3)
Core 17:
Arthritis Burden
C17Q01
Have you ever been told by a doctor or other health professional that you have
some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
(Arthritis diagnoses include: rheumatism, polymyalgia rheumatica; joint
infection, etc. [See Questionnaire for Complete List] (HAVARTH2)
C17Q02
Are you now limited in any way in any of your usual activities because of
arthritis or joint symptoms? (LMTJOIN2)
C17Q03 Do
arthritis or joint symptoms now affect whether you work, the type of work you do
or the amount of work you do? (ARTHDIS2)
C17Q04
During the past 30 days, to what extent has your arthritis or joint symptoms
interfered with your normal social activities, such as going shopping, to the
movies, or to religious or social gatherings? (ARTHSOCL)
C17Q05
Please think about the past 30 days, keeping in mind all of your joint pain or
aching and whether or not you have taken medication. DURING THE PAST 30 DAYS,
how bad was your joint pain ON AVERAGE? (JOINPAIN)
Core 18: Fruit
and Vegetables
C18Q01
How often do you drink fruit juices such as orange, grapefruit, or tomato?
(FRUITJUI)
C18Q02
Not counting juice, how often do you eat fruit? (FRUIT)
C18Q03
How often do you eat green salad? (GREENSAL)
C18Q04
How often do you eat potatoes not including french fries, fried potatoes, or
potato chips? (POTATOES)
C18Q05
How often do you eat carrots? (CARROTS)
C18Q06
Not counting carrots, potatoes, or salad, how many servings of vegetables do you
usually eat? (Example: A serving of vegetables at both lunch and dinner would be
two servings. (VEGETABL)
Core 19:
Physical Activity
C19Q01
When you are at work, which of the following best describes what you do? Would
you say —(If respondent has multiple jobs, include all
jobs.?(JOBACTIV)
C19Q02
Now, thinking about the moderate activities you do in a usual week, do you do
moderate activities for at least 10 minutes at a time? (MODPACT)
C19Q03
How many days per week do you do these moderate activities for at least 10
minutes at a time? (MODPADAY)
C19Q04 On
days when you do moderate activities for at least 10 minutes at a time, how much
total time per day do you spend doing these activities?
(MODPATIM)
C19Q05
Now, thinking about the vigorous activities you do in a usual week, do you do
vigorous activities for at least 10 minutes at a time? (VIGPACT)
C19Q06
How many days per week do you do these vigorous activities for at least 10
minutes at a time? (VIGPADAY)
C19Q07 On
days when you do vigorous activities for at least 10 minutes at a time, how much
total time per day do you spend doing these activities?
(VIGPATIM)
Core 20:
HIV/AIDS
C20Q01
Have you ever been tested for HIV? Do not count tests you may have had as part
of a blood donation. Include testing fluid from your mouth.
(HIVTST5)
C20Q03
Where did you have your last HIV test: at a private doctor or HMO office, at a
counseling and testing site, at a hospital, at a clinic, in a jail or prison, at
a drug treatment facility, at home, or somewhere else?
(WHRTST8)
C20Q04
Was it a rapid test where you could get your results within a couple of hours?
(HIVRDTST)
C20Q05 I
am going to read you a list. Do any of these situations apply to you?
(HIVRISK2)
Core 21:
Emotional Support and Life Satisfaction
C21Q01
How often do you get the social and emotional support you need?
(EMTSUPRT)
C21Q02 In
general, how satisfied are you with your life? (LSATISFY)
Core 22:
Cancer Survivors
C22Q01
Have you EVER been told by a doctor, nurse, or other health professional that
you had cancer? (CNCRHAVE)
C22Q02
How many different types of cancer have you had? (CNCRDIFF)
C22Q03 At
what age were you told that you had cancer? (CNCRAGE)
C22Q04
What type of cancer was it? OR With your most recent diagnoses of cancer, what
type of cancer was it? (CNCRTYPE)
Required
Module: Pandemic Flu (January – February)
C23Q01
What do you think is the most effective ONE thing you can do to prevent getting
sick from the flu? (PF09Q01)
C23Q02
What do you think is the most effective thing to do to prevent spreading the flu
to people when you are sick? (PF09Q02)
C23Q03 If
there is a pandemic flu outbreak and you do not get the pandemic flu
vaccination, what do you think your chances are of getting sick with the
pandemic flu? (PF09Q03)
C23Q04 If
there was a pandemic flu outbreak, how likely are you to get a pandemic flu
vaccination if it was available to you? (PF09Q04)
C23Q05 If
public health officials recommended that everyone go to a particular public
place such as a local school, fire station, or sports stadium to get vaccinated
to prevent the spread of pandemic flu, would you… (PF09Q05)
C23Q06
Imagine an outbreak of pandemic flu in the U.S. in the next year. What would be
the most important ONE thing you would want to know? (PF09Q06)
C23Q07
During a pandemic flu outbreak in the U.S., what would be your ONE most
preferred source for getting information about the pandemic flu? Please tell me
your one most preferred source. (PF09Q07)
C23Q08
Excluding vaccination, what is the ONE most likely thing you would do if a
pandemic flu outbreak were reported IN YOUR STATE? Please choose one from the
following list? (PF09Q08)
C23Q09 If
public health officials recommended that everyone stay at home for a month
because of a serious outbreak of pandemic flu in your community, are you very
likely, somewhat likely, somewhat unlikely, or very unlikely...
(PF09Q09)
C23Q10
I´m going to read you a list of job types. Please tell me if you currently work
in any of these fields. (PF09Q10)
Special
Modules: H1N1 Flu (adult, child, vaccine, health care
workers)
C25Q01
During the past month, were you ill with a fever? (H1N1AQ01)
C25Q02
Did you also have a cough and/or sore throat? (H1N1AQ02)
C25Q03
When did you first become ill with fever, cough or sore throat?
(H1N1AQ03)
C25Q04
Did you visit a doctor, nurse, or other health professional for this illness?
(H1N1AQ04)
C25Q05
What did the doctor, nurse, or other health professional tell you? Did they
say... (H1N1AQ05)
C25Q06
Did you have a flu test that was positive for this illness? Usually a swab from
your nose or throat is tested. Would you say… (H1N1AQ06)
C25Q07
Did you receive Tamiflu® or oseltamivir or an inhaled medicine called Relenza®
or zanamivir to treat this illness? (H1N1AQ07)
C25Q08
Did any other members of your household have a fever with cough or sore throat
during the past month? (H1N1AQ08)
C25Q09
How many household members, including you, were ill during the past month?
(H1N1AQ09)
C25Q10
How many people in your household, including you, were hospitalized for flu
during the past month? (H1N1AQ10)
C30Q01
Has the child had a fever with cough and/or sore throat during the past month?
(H1N1CQ01)
C30Q02
Did the child visit a doctor, nurse, or other health professional for this
illness? (H1N1CQ02)
C31Q01
Since September, 2009, have you been vaccinated either way for the H1N1 flu?
(H1N1AV01)
C31Q02
During what month did you receive your H1N1 flu vaccine?
(H1N1AV02)
C31Q03
Was this a shot or vaccine sprayed in the nose? (H1N1AV03)
C32Q01 Do
you currently volunteer or work in a hospital, medical clinic, doctor´s office,
dentist´s office, nursing home or some other health-care facility?
(WRKHCF1)
C32Q02 Do
you provide direct patient care as part of your routine work? By direct patient
care we mean physical or hands-on contact with patients.
(DIRCONT1)
C32Q03
Has a doctor, nurse, or other health professional ever said that you have: Lung
problems, other than asthma, Kidney problems, Anemia, including Sickle Cell, or
A weakened immune system caused by a chronic illness? (DRHPAD1)
C32Q04 Do
you still have (this/any of these) problem(s)? (HAVHPAD)
C33Q01
Since September, 2009, has [Fill: he/she] had a H1N1 flu vaccination?
(H1N1CV01)
C33Q02
Since September 2009, how many of these H1N1 vaccinations has [Fill: he/she]
received? (H1N1CV02)
C33Q03
During what month did s/he receive his/her first H1N1 flu or H1N1 flu vaccine?
(H1N1CV03)
C33Q04
Was this a shot or vaccine sprayed in the nose? (H1N1CV04)
C33Q05
During what month did s/he receive his/her second H1N1 flu vaccine?
(H1N1CV05)
C33Q06
Was this a shot or vaccine sprayed in the nose? (H1N1CV06)
Calculated Variables
and Risk Factors
CLV_01
Adults with good or better health (_RFHLTH)
CLV_02
Respondents aged 18-64 that have any form of health care coverage
(_HCVU65)
CLV_03
Adults that report doing physical activity or exercise during the past 30 days
other than their regular job (_TOTINDA)
CLV_04
Adults who have been told they have high blood pressure by a doctor, nurse, or
other health professional (_RFHYPE5)
CLV_05
Cholesterol check within past five years (_CHOLCHK)
CLV_06
Adults who have had their cholesterol checked and have been told by a doctor,
nurse, or other health professional that it was high (_RFCHOL)
CLV_07
Adults who have ever been told they have asthma (_LTASTHM)
CLV_08
Adults who have been told they currently have asthma (_CASTHMA)
CLV_09
Computed asthma status (_ASTHMST)
CLV_10
Four-level smoker status: Everyday smoker, Someday smoker, Former smoker,
Non-smoker (_SMOKER3)
CLV_11
Adults who are current smokers (_RFSMOK3)
CLV_12
Three-categories of Body Mass Index (BMI) (_BMI4CAT)
CLV_13
Adults who have a body mass index greater than 25.00 (Overweight or Obese)
(_RFBMI4)
CLV_15
Binge drinkers (males having five or more drinks on one occasion, females having
four or more drinks on one occasion) (_RFBING4)
CLV_16
Calculated total number of alcoholic beverages consumed per day
(_DRNKDY3)
CLV_18
Heavy drinkers (adult men having more than two drinks per day and adult women
having more than one drink per day) (_RFDRHV3)
CLV_19
Adult Men that are Heavy drinkers (having more than two drinks per day)
(_RFDRMN3)
CLV_20
Adult Women that are Heavy drinkers (having more than one drink per day)
(_RFDRWM3)
CLV_21
Adults aged 65+ who have had a flu shot within the past year
(_FLSHOT4)
CLV_22
Adults aged 65+ who have ever had a pneumonia vaccination
(_PNEUMO2)
CLV_23
Respondents that have had a doctor diagnose them as having some form of
arthritis (_DRDXART)
CLV_31
Summary index for fruits and vegetables calculated variable
(_FRTINDX)
CLV_32
Consumed five or more servings of fruits or vegetables per day
(_FV5SRV)
CLV_35 3
level moderate physical activity category (MODCAT_)
CLV_36 3
level vigorous physical activity category (VIGCAT_)
CLV_37 5
level physical activity category (PACAT_)
CLV_38
Adults that have reported participating in either moderate physical activity
defined as 30 or more minutes per day for 5 or more days per week, or vigorous
activity for 20 or more minutes per day on 3 or more days
(_RFPAMOD)
CLV_39
Adults that have reported participating in vigorous activity for 20 or more
minutes per day on 3 or more days (_RFPAVIG)
CLV_40
Adults self reported physical activity level status (_RFPAREC)
CLV_41
Adults that have reported participating in physical activity or exercise
(_RFNOPA)
CLV_45
Adults that participated in 150 minutes of physical activity per week.
(_PA150RC)
CLV_46
Adults that participated in 300 minutes of physical activity per week.
(_PA300RC)
CLV_47
Adults aged 18-64 that have ever been tested for HIV (_AIDTST2)
Cell Phone Questions
(January – December)
CPDM01 Do
you have a cell phone for personal use? Please include cell phones used for both
business and personal use (CPDEMO1)
CPDM02 Do
you share a cell phone for personal use (at least one-third of the time with
other adults? (CPDEMO2)
CPDM03 Do
you usually share this cell phone (at least one-third of the time with any other
adults? (CPDEMO3)
CPDM04
Thinking about all the phone calls that you receive on your landline or cell
phone, what percent, between 0 and 100, are received on your cell phone?
(CPDEMO4)
Module 04:
Visual Impairment and Access to Eye Care
M04Q01
How much difficulty, if any, do you have in recognizing a friend across the
street? Would you say— (VIDFCLT2)
M04Q02
How much difficulty, if any, do you have reading print in newspaper, magazine,
recipe, menu, or numbers on the telephone? Would you say—
(VIREDIF2)
M04Q03
When was the last time you had your eyes examined by any doctor or eye care
provider? (VIPRFVS2)
M04Q04
What is the main reason you have not visited an eye care professional in the
past 12 months? (VINOCRE2)
M04Q05
When was the last time you had an eye exam in which the pupils were dilated?
This would have made you temporarily sensitive to bright light.
(VIEYEXM2)
M04Q06 Do
you have any kind of health insurance coverage for eye care?
(VIINSUR2)
M04Q07
Have you been told by an eye doctor or other health care professional that you
NOW have cataracts? (VICTRCT2)
M04Q08
Have you EVER been told by an eye doctor or other health care professional that
you had glaucoma? (VIGLUMA2)
M04Q09
Have you EVER been told by an eye doctor or other health care professional that
you had age-related macular degeneration? (VIMACDG2)
Module 06:
Cardiovascular Health
M06Q01
Following your heart attack, did you go to any kind of outpatient
rehabilitation? This is sometimes called “rehab” (HAREHAB1)
M06Q02
Following your stroke did you go to any kind of outpatient rehabilitation? This
is sometimes called “rehab” (STREHAB1)
M06Q03 Do
you take aspirin daily or every other day? (CVDASPRN)
M06Q04 Do
you have a health problem or condition that makes taking aspirin unsafe for you?
(ASPUNSAF)
Module 08:
Heart Attack and Stroke
M08Q01 Do
you think pain or discomfort in the jaw, neck, or back are symptoms of a heart
attack? (HASYMP1)
M08Q02 Do
you think feeling weak, lightheaded, or faint are symptoms of a heart attack?
(HASYMP2)
M08Q03 Do
you think chest pain or discomfort are symptoms of a heart attack?
(HASYMP3)
M08Q04 Do
you think sudden trouble seeing in one or both eyes is a symptom of a heart
attack? (HASYMP4)
M08Q05 Do
you think pain or discomfort in the arms or shoulder are symptoms of a heart
attack? (HASYMP5)
M08Q06 Do
you think shortness of breath is a symptom of a heart attack?
(HASYMP6)
M08Q07 Do
you think sudden confusion or trouble speaking are symptoms of a stroke?
(STRSYMP1)
M08Q08 Do
you think sudden numbness or weakness of face, arm, or leg, especially on one
side are symptoms of a stroke? (STRSYMP2)
M08Q09 Do
you think sudden trouble seeing in one or both eyes is a symptom of a stroke?
(STRSYMP3)
M08Q10 Do
you think sudden chest pain or discomfort are symptoms of a stroke?
(STRSYMP4)
M08Q11 Do
you think sudden trouble walking, dizziness, or loss of balance are symptoms of
a stroke? (STRSYMP5)
M08Q12 Do
you think severe headache with no known cause is a symptom of a stroke?
(STRSYMP6)
M08Q13 If
you thought someone was having a heart attack or a stroke, what is the first
thing you would do? (FIRSTAID)
Module 20:
Reactions to Race
M20Q01
How do other people usually classify you in this country?
(RRCLASS2)
M20Q02
How often do you think about your race? Would you say never, once a year, once a
month, once a week, once a day, once an hour, or constantly?
(RRCOGNT2)
M20Q03
Within the past 12 months at work, do you feel you were treated worse than, the
same as, or better than people of other races? (RRATWRK2)
M20Q04
Within the past 12 months when seeking health care, do you feel your experiences
were worse than, the same as, or better than for people of other races?
(RRHCARE3)
M20Q05
Within the past 30 days, have you experienced any physical symptoms, as a result
of how you were treated based on your race? (RRPHYSM2)
M20Q06
Within the past 30 days, have you felt emotionally upset, for example angry,
sad, or frustrated, as a result of how you were treated based on your race?
(RREMTSM2)
Module 26:
Childhood Asthma Prevalence
M26Q01
Has a doctor, nurse or other health professional EVER said that the child has
asthma? (CASTHDX2)
M26Q02
Does the child still have asthma? (CASTHNO2)
Module 27:
Child Immunization
M27Q01
During the past 12 months, has s/he had a flu vaccination? There are two types
of flu vaccinations. One is a shot and the other is a spray in the nose.
(FLUSHCH1)
Appendices:
Appendix A
- Healthy
People 2010 in Indiana
Background
Progress
Appendix B - 2009
Behavioral Risk Factor Surveillance Survey Questionnaire ![]()
