Behavioral Risk Factor Surveillance System

Indiana Statewide Survey Data, 2011

 

Table of Contents

 

Preface

 

Introduction:

 

 

Tables:

Core 01:  Health Status

C01.01 Would you say that in general your health is:

Core 02:  Healthy Days—Health-Related Quality of Life

C02.01 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?

C02.02 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?

C02.03 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?

Core 03:  Health Care Access

C03.01 Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?

C03.02 Do you have one person you think of as your personal doctor or health care provider?

C03.03 Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?

C03.04 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.]

Core 04:  Hypertension Awareness

C04.01 Have you EVER been told by a doctor, nurse, or other health professional that you have high blood pressure?

C04.02 Are you currently taking medicine for your high blood pressure?

Module 10: Actions to Control High Blood Pressure

M10.01 Are you now doing changing your eating habits to help lower or control your high blood pressure?

M10.02 Are you cutting down on salt (to help lower or control your high blood pressure)?

M10.03 Are you reducing alcohol use (to help lower or control your high blood pressure)?

M10.04 Are you exercising (to help lower or control your high blood pressure)?

M10.05 Has a doctor or other health professional ever advised you to change your eating habits to help lower or control your high blood pressure?

M10.06 Has a doctor or other health professional ever advised you to cut down on salt (to help lower or control your high blood pressure)?

M10.07 Has a doctor or other health professional ever advised you to reduce alcohol use (to help lower or control your high blood pressure)?

M10.08 Has a doctor or other health professional ever advised you to exercise (to help lower or control your high blood pressure)?

M10.09 Has a doctor or other health professional ever advised you to take medication (to help lower or control your high blood pressure)?

M10.10 Were you told on two or more visits by a doctor or other health professional that you had high blood pressure?

Core 05:  Cholesterol Awareness

C05.01 Have you EVER had your blood cholesterol checked?

C05.02 About how long has it been since you last had your blood cholesterol checked?

C05.03 Have you EVER been told by a doctor, nurse or other health professional that your blood cholesterol is high?

Core 06:  Chronic Health Conditions

C06.01 Ever told you that you had a heart attack also called a myocardial infarction?

C06.02 Ever told you had angina or coronary heart disease?

C06.03 Ever told you had a stroke?

C06.04 Ever told you had asthma?

C06.05 Do you still have asthma?

C06.06 Ever told you had skin cancer?

C06.07 Ever told you had other types of cancer?

C06.08 Ever told you have chronic obstructive pulmonary disease (COPD), emphysema or chronic bronchitis?

C06.09 Ever told you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?

C06.10 Ever told you have a depressive order (including depression, major depression, dysthymia, or minor depression)?

C06.11 Ever told you have kidney disease? Do NOT include kidney stones, bladder infection or incontinence.

C06.12 Ever told you have vision impairment in one or both eyes, even when wearing glasses?

C06.13 Ever told you have diabetes?

Module 01: Pre-Diabetes

M01.01 Have you had a test for high blood sugar or diabetes within the past three years?

M01.02 Have you ever been told by a doctor or other health professional that you have pre-diabetes or borderline diabetes?

Module 02:  Diabetes

M02.01 How old were you when you were told you have diabetes?

M02.02 Are you now taking insulin?

M02.03 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.

M02.04 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.

M02.05 About how many times in the past 12 months have you seen a doctor, nurse, or other health professional for your diabetes?

M02.06 About how many times in the past 12 months has a health professional checked you for 'A one C'?

M02.07 About how many times in the past 12 months has a health professional checked your feet for any sores or irritations?

M02.08 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.

M02.09 Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?

M02.10 Have you ever taken a course or class in how to manage your diabetes yourself?

Core 07:  Tobacco Use

C07.01 Have you smoked at least 100 cigarettes in your entire life?

C07.02 Do you now smoke cigarettes every day, some days, or not at all?

C07.03 During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?

C07.04 How long has it been since you last smoked a cigarette, even one or two puffs?

C07.05 Do you currently use chewing tobacco, snuff, or snus every day, some days, or not at all? (Snus (Swedish for snuff) is a moist smokeless tobacco)

Core 8:  Demographics

C08.05 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? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War.

C08.13 What county do you live in?

Core 9:   Fruits and Vegetables

C09.01 During the past month, how many times per day, week or month did you drink 100% PURE fruit juices? Do not include fruit-flavored drinks with added sugar or fruit juice you made at home and added sugar to. Only include 100% juice.

C09.02 During the past month, not counting juice, how many times per day, week, or month did you eat fruit? Count fresh, frozen, or canned fruit.

C09.03 During the past month, how many times per day, week, or month did you eat cooked or canned beans, such as refried, baked, black, garbanzo beans, beans in soup, soybeans, edamame, tofu or lentils? Do NOT include long green beans.

C09.04 During the past month, how many times per day, week, or month did you eat dark green vegetables; for example, broccoli or dark leafy greens including romaine, chard, collard greens or spinach?

C09.05 During the past month, how many times per day, week, or month did you eat orange-colored vegetables such as sweet potatoes, pumpkin, winter squash, or carrots?

C09.06 Not counting what you just told me about, during the past month, about how many times per day, week, or month did you eat OTHER vegetables? Examples of other vegetables include tomatoes, tomato juice or V-8 juice, corn, eggplant, peas, lettuce, cabbage, and white potatoes that are not fried such as baked or mashed potatoes.

Core 10: Exercise (Physical Activity)

C10.01 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?

Core 11:  Disability

C11.01 Are you limited in any way in any activities because of physical, mental, or emotional problems?

C11.02 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?

Core 12: Arthritis Burden

C12.01 Are you now limited in any way in any of your usual activities because of arthritis or join symptoms?

C12.02 Do arthritis or joint symptoms now affect whether you work, the type of work you do, or the amount of work you do?

C12.03 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?

C12.04 During the past 30 days, how bad was your joint pain ON AVERAGE?

Core 13: Seatbelt Use

C13.01 How often do you use seat belts when you drive or ride in a car? 

Core 14: Immunization

C14.01 During the past 12 months, have you had either a seasonal flu shot or a seasonal flu vaccine that was sprayed in your nose?

C14.03 At what kind of place did you get your last flu shot/vaccine?

C14.04 Have you ever had a pneumonia shot?

Core 15:   Alcohol Consumption

C15.01 During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage?

C15.02 One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?

C15.03 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?

C15.04 During the past 30 days, what is the largest number of drinks you had on any occasion?

Core 16:  HIV/AIDS

C16.01 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.

C16.03 I am going to read you a list. When I am done, please tell me if any of the situations apply to you. You do not need to tell me which one. [Risk factors for HIV.]

Calculated Variables and Risk Factors:

CLV01.01 Adults with good or better health

CLV03.01 Respondents aged 18-64 that have any form of health care coverage

CLV04.01 Adults who have been told they have high blood pressure by a doctor, nurse, or other health care professional

CLV05.01 Cholesterol check within past five years

CLV05.02 Adults who have had their cholesterol checked and have been told by a doctor, nurse, or other health professional that it was high

CLV06.01 Adults who have ever been told they have asthma

CLV06.02 Adults who have been told they currently have asthma

CLV06.03 Computed asthma status

CLV06.04 Respondents that have had a doctor diagnose them as having some form of arthritis

CLV07.01 Four-level smoker status: Everyday smoker, Someday smoker, Former smoker, Non-smoker

CLV07.02 Adults who are current smokers

CLV08.18 Four-categories of Body Mass Index (BMI)

CLV08.19 Adults who have a body mass index greater than 25.00 (Overweight or Obese)

CLV10.01 Adults that report doing physical activity or exercise during the past 30 days other than their regular job

CLV10.23 Physical Activity Index

CLV10.24 Adults that participated in 150 minutes (or vigorous equivalent minutes) of physical activity per week

CLV10.25 Adults that participated in 300 minutes (or vigorous equivalent minutes) of physical activity per week

CLV10.27 Adults that participated in 300 minutes (or vigorous equivalent minutes) of physical activity per week

CLV10.28 Adults that participated in 300 minutes (or vigorous equivalent minutes) of physical activity per week

CLV13.01 Always or nearly always wear seat belts calculated variable

CLV13.02 Always wear seat belts calculated variable

CLV14.01 Adults aged 65+ who have had a flu shot within the past year

CLV14.02 Adults aged 65+ who have ever had a pneumonia vaccination

CLV15.03 Binge drinkers (males having five or more drinks on one occasion, females having four or more drinks on one occasion)

CLV15.04 Calculated total number of alcoholic beverages consumed per day

CLV15.06 Heavy drinkers (adult men having more than two drinks per day and adult women having more than one drink per day)

CLV15.07 Adult Men that are Heavy drinkers (having more than two drinks per day)

CLV15.08 Adult Women that are Heavy drinkers (having more than one drink per day)

Module 05: Preconception Health / Family Planning

M05.01 Has a doctor, nurse, or other health care worker ever talked with you about ways to prepare for a healthy pregnancy and baby?

M05.02 Have you ever been pregnant?

M05.03 Did you or your husband/partner do anything the LAST TIME YOU HAD SEX to keep from getting pregnant?

M05.04 What did you or your husband/partner do the LAST TIME YOU HAD SEX to keep you from getting pregnant?

M05.05 What was your main reason for not doing anything the LAST TIME YOU HAD SEX to keep you from getting pregnant?

M05.06 How do you feel about having a child now or something in the future?

M05.07 How many times a week do you currently take a multivitamin, a prenatal vitamin, or a folic acid vitamin?

Module 09:  Cardiovascular Health

M09.01 Following your heart attack, did you go to any kind of outpatient rehabilitation (rehab)?

M09.02 Following your stroke, did you go to any kind of outpatient rehabilitation (rehab)?

M09.03 Do you take aspirin daily or every other day?

M09.04 Do you have a health problem or condition that makes taking aspirin unsafe for you?

Module 16: Secondhand Smoke

M16.01 On how many days did you breathe the smoke at your workplace from SOMEONE OTHER THAN YOU who was smoking tobacco?

M16.02 On how many days did SOMEONE OTHER THAN YOU smoke tobacco inside your home while you were at home?

M16.03 On how many days did you ride in a vehicle where SOMEONE OTHER THAN YOU was smoking tobacco?

M16.04 On how many days did you breathe the smoke from SOMEONE ELSE who was smoking in an indoor public place?

M16.05 Not counting desks, porches, or garages, inside your home, is smoking...?

M16.06 Not counting motorcycles, in the vehicles that you or family members who live with you own or lease, is smoking...?

M16.07 At workplaces, do you think smoking indoors should be...?

Module 33:  Childhood Asthma Prevalence

M33.01 Has a doctor, nurse or other health professional EVER said that your child has asthma?

M33.02 Does the child still have asthma?

Appendices:

 

Appendix A - Healthy People 2020 in Indiana


            Appendix B - 2011 Behavioral Risk Factor Surveillance Survey Questionnaire

 

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