Barriers to Care for People with Chronic Health Conditions

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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

GEN General Health (GEN)

GEN General Health (GEN) - Question identifier:GEN_R01

This survey deals with various aspects of your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.

GEN General Health (GEN) - Question identifier:GEN_Q01

To start, in general, would you say your health is:

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor

GEN General Health (GEN) - Question identifier:GEN_Q02

Compared to one year ago, how would you say your health is now? Is it:

  • 1: Much better now than 1 year ago
  • 2: Somewhat better now than 1 year ago
  • 3: About the same as 1 year ago
  • 4: Somewhat worse now than 1 year ago
  • 5: Much worse now than 1 year ago

GEN General Health (GEN) - Question identifier:GEN_Q03

In general, would you say your mental health is:

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor

CCD Confirmation of Chronic Disease (CCD)

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_R01

Now I'd like to ask about certain chronic health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q01

To begin, do you have high blood pressure that has been diagnosed by a health professional?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q02

You have said that you do not have high blood pressure, diabetes, heart disease or effects of a stroke. Since this survey applies only to people with these conditions, you are not eligible to participate in today's survey. Thank you for your time.

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q03

Has a physician ever recommended that you take a medication for your high blood pressure?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q04

Currently, do you take medication for your high blood pressure?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q05

Do you have diabetes that has been diagnosed by a health professional?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q06

Currently, do you take medication for your diabetes?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q07

Do you take insulin?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q08

Do you have heart disease that has been diagnosed by a health professional?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q09

Has a physician ever recommended that you take a medication for your heart disease?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q10

Currently, do you take medication for your heart disease?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_Q11

Has a healthcare professional ever diagnosed you as having had a stroke?

  • 1: Yes
  • 2: No

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_R12

This survey applies to people with high blood pressure, diabetes, heart disease or effects of a stroke. Since you have not indicated that you have any of these conditions, you are not eligible to participate in today's survey. Thank you for your time.

CCD Confirmation of Chronic Disease (CCD) - Question identifier:CCD_R13

You have said that you have been diagnosed by a health professional as having ^DT_COND2E. This survey will ask questions about your experiences with health care in relation to this/these chronic condition(s). Please exclude experiences with health care that do NOT relate to the treatment of ^DT_CONDE.

PHC PHC Continuity and Coordination (PHC)

PHC PHC Continuity and Coordination (PHC) - Question identifier:PHC_R01

BCPCHC2011Main - PHC_R01 - The next questions are about your experiences when receiving health care for your ^DT_CONDE from the family physician or general practitioner who is most responsible for your regular care.

PHC PHC Continuity and Coordination (PHC) - Question identifier:PHC_Q01

Do you have a regular medical doctor?

  • 1: Yes
  • 2: No

PHC PHC Continuity and Coordination (PHC) - Question identifier:PHC_Q02

PHC_Q02 - Is there a place that you usually go to when you are sick or need advice about your health?

  • 1: Yes
  • 2: No

PHC PHC Continuity and Coordination (PHC) - Question identifier:PHC_Q03

PHC_Q03 - What kind of place is it?

  • 1: Doctor's office
  • 2: Community health centre / CLSC
  • 3: Walk-in clinic
  • 4: Appointment clinic
  • 5: Telephone health line (for example, HealthLinks, Health-Line, TeleCare)
  • 6: Hospital emergency room
  • 7: Hospital outpatient clinic

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP)

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_R01

Now I'd like to ask about your contacts with various health professionals, hospitalizations and emergency department use in the past 12 months, that is, from ^DT_PRVDATE to yesterday, for your ^DT_CONDE.

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q01

In the past 12 months, have you been a patient overnight in a hospital for your ^DT_CONDE?

  • 1: Yes
  • 2: No

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q02

For how many nights in the past 12 months?

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q03

In the past 12 months,^DT_HOSPE how many times have you seen or talked to a family doctor or general practitioner about your ^DT_CONDE?

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q04

CHP_Q04 - In the past 12 months,^DT_HOSPE how many times have you seen or talked to any other medical doctor or specialist about your ^DT_CONDE?

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q05

Why did you not see a specialist?

  • 1: I did not need to see a specialist
  • 2: My doctor did not recommend it / wouldn't send / provide a referral to me
  • 3: None available in the area that I live / too far to travel
  • 4: Unable to get time off work
  • 5: Wait list too long / would take months to see one
  • 6: Other - Specify

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q06

In the past 12 months,^DT_HOSPE how many times have you seen or talked to a nurse for care or advice about your ^DT_CONDE?

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q07

If your family physician wasn't available to see you regarding care of your ^DT_CONDE, would you be willing to receive health care services from a nurse practitioner? A nurse practitioner is one who has received special training to perform many of the services of a family doctor.

  • 1: Yes
  • 2: No

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q08

Why not?

  • 1: Does not have required skills, knowledge
  • 2: Does not know me or my history
  • 3: More comfortable with family doctors

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q09

In the past 12 months,^DT_HOSPE including your regular medical doctor, how many different doctors and specialists have you seen for your ^DT_CONDE?

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q10

Overall, how well organized would you say your healthcare related to your ^DT_CONDE is? Would you say it is...?

  • 1: Very organized
  • 2: Somewhat organized
  • 3: Somewhat disorganized
  • 4: Very disorganized

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q11

CHP_Q11 - How many times have you personally used a hospital emergency department for your ^DT_CONDE in the past 12 months?

CHP Contacts with Health Professionals, Hospitalizations and Emergency Department Use (CHP) - Question identifier:CHP_Q12

Thinking about the last time you went to the hospital emergency department for management of your ^DT_CONDE, was it for a problem that you thought could have been treated by your regular provider if they had been available?

  • 1: Yes
  • 2: No

MU Medication use (MU)

MU Medication use (MU) - Question identifier:MU_R01

MU_R01 - Now a few questions about medication.

MU Medication use (MU) - Question identifier:MU_Q01

MU_Q01 - In the past month, did you take aspirin or other ASA (acetylsalicylic acid) medication every day or every second day?

  • 1: Yes
  • 2: No

MU Medication use (MU) - Question identifier:MU_Q02

MU_Q02 - In the past month, did you take prescription medication such as Crestor, Lipitor or Zocor to control blood cholesterol?

  • 1: Yes
  • 2: No

MU Medication use (MU) - Question identifier:MU_Q03

MU_Q03 - How many different prescription medications are you taking on a regular or ongoing basis? Please include all prescribed medications you are taking.

MU Medication use (MU) - Question identifier:MU_Q04

MU_Q04 - Over the past 12 months, have you ever stopped taking one or more of your drugs as prescribed for a week or more?

  • 1: Yes
  • 2: No

MU Medication use (MU) - Question identifier:MU_Q05

MU_Q05 - What are the reasons that you did not take your medication as prescribed?

  • 1: Forgot to take medication
  • 2: Side-effects caused by medication
  • 3: Cost
  • 4: Medication not working
  • 5: Ran out of medication
  • 6: Condition controlled without medication
  • 7: Feels ok without medication / doesn't need medication
  • 8: Do not know how to take medication properly
  • 8: Other - Specify

INS Insurance Status (INS)

INS Insurance Status (INS) - Question identifier:INS_Q01

INS_Q01 - Do you currently have insurance that covers all or part of the cost of prescription medications?

  • 1: Yes
  • 2: No

INS Insurance Status (INS) - Question identifier:INS_Q02

INS_Q02 - Which of the following plans do you have?

  • 1: A government-sponsored plan such as Bluecross, Pharmacare, or the Saskatchewan drug plan
  • 2: An employer-sponsored plan
  • 3: A private plan
  • 4: A plan through spouse/other family member
  • 5: Other - Specify

INS Insurance Status (INS) - Question identifier:INS_Q03

INS_Q03 - Why not?

  • 1: I don't think I need coverage
  • 2: I'm not eligible for coverage through my employer or through a private insurance company (can't get it)
  • 3: I can't afford coverage (too expensive)
  • 4: Coverage isn't offered
  • 5: Other - Specify

INS Insurance Status (INS) - Question identifier:INS_Q04A

INS_Q04A -In the past 12 months, what were the out of pocket costs for your prescribed medicines, drugs and pharmaceutical products? Estimate the costs incurred by you. Include amounts not covered by insurance, such as exclusions, deductibles and expenses over limits. Exclude payments for which you have been or will be reimbursed. If it is easier for you, estimate your out-of-pocket costs in a 3 month period.

INS Insurance Status (INS) - Question identifier:INS_Q04B

INS_Q04B - Is that for 12 months or 3 months?

  • 1: 12 months
  • 2: 3 months

RC Recommended Care (RC)

RC Recommended Care (RC) - Question identifier:RC_R01

BCPCHC2011Main - RC_R01 - The next set of questions is about healthcare services you have received for your ^DT_CONDE from your primary care doctor or specialist.

RC Recommended Care (RC) - Question identifier:RC_Q01A

RC_Q01A - In the past 12 months, did you get the following tests or measurements: ... blood pressure measurement?

  • 1: Yes
  • 2: No

RC Recommended Care (RC) - Question identifier:RC_Q01B

RC_Q01B - The last time your blood pressure was measured by a healthcare professional, were you told that your blood pressure was...?

  • 1: normal (fine, ok, well-controlled)
  • 2: borderline
  • 3: high
  • 4: health professional didn't say

RC Recommended Care (RC) - Question identifier:RC_Q01C

RC_Q01C - What are the reasons that you have not had your blood pressure measurement taken in the past year?

  • 1: Have not gotten around to it
  • 2: Respondent - did not think it was necessary
  • 3: Doctor - did not think it was necessary
  • 4: Doctor - did not recommend it
  • 5: Personal or family responsibilities
  • 6: Not available - at time required
  • 7: Not available - at all in the area
  • 8: Waiting time was too long
  • 9: Transportation - problems
  • 10: Language - problem
  • 11: Cost
  • 12: Did not know where to go / uninformed
  • 13: Fear (e.g., painful, embarrassing, find something wrong)
  • 14: Unable to leave the house because of a health problem
  • 15: Other - Specify

RC Recommended Care (RC) - Question identifier:RC_Q02A

RC_Q02A - (In the past 12 months, did you get the following tests or measurements:) ... cholesterol measurement?

  • 1: Yes
  • 2: No

RC Recommended Care (RC) - Question identifier:RC_Q02B

RC_Q02B - What are the reasons that you have not had your cholesterol measurement taken in the past year?

  • 1: Have not gotten around to it
  • 2: Respondent - did not think it was necessary
  • 3: Doctor - did not think it was necessary
  • 4: Doctor - did not recommend it
  • 5: Personal or family responsibilities
  • 6: Not available - at time required
  • 7: Not available - at all in the area
  • 8: Waiting time was too long
  • 9: Transportation - problems
  • 10: Language - problem
  • 11: Cost
  • 12: Did not know where to go / uninformed
  • 13: Fear (e.g., painful, embarrassing, find something wrong)
  • 14: Unable to leave the house because of a health problem
  • 15: Other - Specify

RC Recommended Care (RC) - Question identifier:RC_Q03A

RC_Q03A - (In the past 12 months, did you get the following tests or measurements:) ... blood sugar measurement?

  • 1: Yes
  • 2: No

RC Recommended Care (RC) - Question identifier:RC_Q03B

RC_Q03B - What are the reasons that you have not had your blood sugar measurement taken in the past year?

  • 1: Have not gotten around to it
  • 2: Respondent - did not think it was necessary
  • 3: Doctor - did not think it was necessary
  • 4: Doctor - did not recommend it
  • 5: Personal or family responsibilities
  • 6: Not available - at time required
  • 7: Not available - at all in the area
  • 8: Waiting time was too long
  • 9: Transportation - problems
  • 10: Language - problem
  • 11: Cost
  • 12: Did not know where to go / uninformed
  • 13: Fear (e.g., painful, embarrassing, find something wrong)
  • 14: Unable to leave the house because of a health problem
  • 15: Other - Specify

SMH Self-management (SMH)

SMH Self-management (SMH) - Question identifier:SMH_R01

SMH_R01 - The next questions are about things that a doctor or other health professional may have suggested to help manage your ^DT_CONDE, and the things that people might do as a result.

SMH Self-management (SMH) - Question identifier:SMH_Q01

SMH_Q01 - Has a doctor or other health professional ever suggested / recommended: reducing the amount of salt you eat?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q02

SMH_Q02 - Did you ever limit your daily salt intake?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q03

SMH_Q03 - Are you still doing this...?

SMH Self-management (SMH) - Question identifier:SMH_Q04

SMH_Q04 - What are the reasons that you are not limiting your daily salt intake?

SMH Self-management (SMH) - Question identifier:SMH_Q05

SMH_Q05 - Has a doctor or other health professional ever suggested / recommended: eating certain foods such as fruits and vegetables, fish or lean meats, foods high in fibre or foods low in fat?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q06

SMH_Q06 - Did you ever change the type of foods you eat, for example choosing more fruits and vegetables, fish or lean meats, foods high in fibre or foods low in fat?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q07

SMH_Q07 - Are you still doing this...?

SMH Self-management (SMH) - Question identifier:SMH_Q08

SMH_Q08 - What are the reasons you are not choosing these types of foods, (that is, fruits and vegetables, fish or lean meats, foods high in fibre or foods low in fat)?

SMH Self-management (SMH) - Question identifier:SMH_Q09

SMH_Q09 - Has a doctor or other health professional ever suggested / recommended: that you exercise or participate in physical activities?

SMH Self-management (SMH) - Question identifier:SMH_Q10

SMH_Q10 - Did you ever exercise or participate in physical activities?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q11

SMH_Q11 - Are you still doing this...?

SMH Self-management (SMH) - Question identifier:SMH_Q12

SMH_Q12 - What are the reasons that you are not exercising or participating in physical activities?

SMH Self-management (SMH) - Question identifier:SMH_Q13

SMH_Q13 - At any time since you were first diagnosed with a chronic condition, did you smoke? Include cigarettes, cigars and pipes.

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q14

SMH_Q14 - Has a doctor or other health professional ever suggested / recommended: quitting or cutting down on smoking?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q15

SMH_Q15 - Did you ever quit smoking, or cut down on smoking?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q16

SMH_Q16 - Are you continuing to maintain this change in your smoking habits...?

SMH Self-management (SMH) - Question identifier:SMH_Q17

SMH_Q17 - What are the reasons that you are not trying to quit smoking or cut down on smoking?

SMH Self-management (SMH) - Question identifier:SMH_Q18

SMH_Q18 - Has a doctor or other health professional ever suggested / recommended: that you control or lose weight?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q19

SMH_Q19 - Did you ever control or lose or try to lose weight?

  • 1: Yes
  • 2: No

SMH Self-management (SMH) - Question identifier:SMH_Q20

SMH_Q20 - Are you still doing this...?

GBC General Barriers to Care (GBC)

GBC General Barriers to Care (GBC) - Question identifier:GBC_R01

Now I will ask about health care services that you may require from your family doctor or general practitioner for your ^DT_CONDE, such as follow-up of your blood pressure, renewal of your prescriptions, or a physical exam.

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q01

In the past 12 months, did you require any health care services from your family doctor or general practitioner for your ^DT_CONDE?

  • 1: Yes
  • 2: No

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q02

GBC_Q02 - In the past 12 months, did you ever experience any difficulties getting these services?

  • 1: Much better now than 1 year ago
  • 2: Somewhat better now than 1 year ago
  • 3: About the same as 1 year ago
  • 4: Somewhat worse now than 1 year ago
  • 5: Much worse now than 1 year ago

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q03

What type of difficulties did you experience?

  • 1: Difficulty contacting a physician
  • 2: Difficulty getting an appointment
  • 3: Do not have personal / family physician
  • 4: Waited too long - to get an appointment
  • 5: Waited too long - to see the doctor (i.e. in-office waiting)
  • 6: Service not available - at time required
  • 7: Service not available - in the area
  • 8: Transportation - problems
  • 9: Language - problem
  • 10: Cost
  • 11: Did not know where to go (i.e. information problems)
  • 12: Unable to leave the house because of a health problem
  • 13: Other - Specify

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q04

In the past 12 months, was there ever a time that you needed specific care for your ^DT_CONDE but did NOT get the specific care or service you required?

  • 1: Yes
  • 2: No

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q05

Thinking of the most recent time, why didn't you get care?

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q06

Again, thinking of the most recent time, what was the type of care that was needed?

  • 1: Treatment of your chronic condition(s)
  • 2: Treatment of other physical problem
  • 3: Treatment of an emotional or mental health problem
  • 4: A regular check-up (including annual physical exam)
  • 5: Care of an injury
  • 6: Emergent or urgent care
  • 7: Other - Specify

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q07

Where did you try to get the care or service you were seeking?

  • 1: Doctor's office
  • 2: Hospital - emergency room
  • 3: Hôpital - salle d'urgence
  • 4: Hospital - outpatient clinic (e.g. day surgery)
  • 5: Other - Specify

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q08

Did the healthcare problem that was not met, get worse due to delayed care?

  • 1: Yes
  • 2: No

GBC General Barriers to Care (GBC) - Question identifier:GBC_Q09

Did the health care problem that was not met, result in a hospitalization or emergency room (ER) visit?

  • 1: Yes
  • 2: No

EBC Economic Barriers to Care (EBC)

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_R01

Now I would like to ask you questions about economic related barriers you may have experienced in accessing care.

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_Q01

In the past 12 months, how often have you had difficulty paying for services, equipment or medications you need to help you manage your chronic condition?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_Q02

In the past 12 months, how often did you not get the necessary services, equipment or medications you needed due to cost?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_Q03

What type of services, equipment or medication?

  • 1: Prescription medication
  • 2: Laboratory tests or other diagnostic tests
  • 3: Visits to a doctor
  • 4: Therapy services such as rehab services
  • 5: Equipment such as a glucometer, glucometer strips
  • 6: Mobility equipment (e.g. wheelchairs, walkers, etc)
  • 7: Other - Specify

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_Q04

In the past 12 months, did you work at a job or a business? Please include part-time jobs, seasonal work, contract work, self-employment, baby-sitting and any other paid work, regardless of the number of hours worked.

  • 1: Yes
  • 2: No
  • 3: Permanently unable to work

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_Q05

In the past 12 months, how often did you find it difficult to get healthcare services because of lost income from taking time off work?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

EBC Economic Barriers to Care (EBC) - Question identifier:EBC_Q06

In the past 12 months, how often did you find it difficult to get healthcare services because it was difficult to get time off work?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

RAH Reasonable access to health care services (RAH)

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_R01

Now I would like to ask you some questions about travelling to see your family doctor or specialist for care of your chronic condition(s).

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q01

Thinking about the last time that you visited your regular family doctor (or usual place of care), how long did it take to travel to his/her office from home?

  • 1: 15 minutes or less
  • 2: 16 to 30 minutes
  • 3: 31 to 60 minutes
  • 4: More than one hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q02

In your view, was this time...?

  • 1: Reasonable
  • 2: Not reasonable (or unreasonable)

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q03A

In your particular case, what do you think is a reasonable travel time to your family doctor (or usual place of care) from home?

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q03B

Is that minutes or hours?

  • 1: Minutes
  • 2: Hours

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q04

If you had to see your regular family doctor (or go to your usual place of care), how long would it take you to travel to see him/her from home?

  • 1: 15 minutes or less
  • 2: 16 to 30 minutes
  • 3: 31 to 60 minutes
  • 4: More than one hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q05

In your view, would this time be...?

  • 1: Reasonable
  • 2: Not reasonable (or unreasonable)

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q06A

In your particular case, what do you think is a reasonable travel time to your family doctor (or usual place of care) from home?

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q06B

Is that minutes or hours?

  • 1: Minutes
  • 2: Hours

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q07

What is your usual mode of transportation when you travel to your family doctor (or usual place of care)?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q08

In the past 12 months, how often did you find it difficult to get healthcare services because you could not travel to the health care facility?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q09

What type of problems did you experience?

  • 1: I don't drive
  • 2: I don't have a car
  • 3: There is no appropriate public transport
  • 4: I have nobody who would be willing to drive me
  • 5: I can't afford the cost of travel
  • 6: I can't afford to take time off work
  • 7: Parking difficulties (cost/availability)
  • 8: Traffic problems (weather or construction related)
  • 9: Too far
  • 10: Other - Specify

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_R10

Now we would like to ask about travelling to see a medical specialist.

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q10

You indicated that you visited a medical specialist for your chronic condition(s) in the past 12 months. Thinking about the last time you visited the medical specialist, how long did it take to travel to his/her office from home?

  • 1: 15 minutes or less
  • 2: 16 to 30 minutes
  • 3: 31 to 60 minutes
  • 4: More than one hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q11

In your view, was this time...?

  • 1: Reasonable
  • 2: Not reasonable (or unreasonable)

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q12A

In your particular case, what do you think is a reasonable travel time to a medical specialist?

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q12B

Is that minutes or hours?

  • 1: Minutes
  • 2: Hours

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q13

Individuals with chronic conditions often need to see medical specialists. If you had to see a specialist, how long would it take you to travel to see the medical specialist?

  • 1: 15 minutes or less
  • 2: 16 to 30 minutes
  • 3: 31 to 60 minutes
  • 4: More than one hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q14

In your view, would this time be...?

  • 1: Reasonable
  • 2: Not reasonable (or unreasonable)

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q15A

What do you think is a reasonable travel time to see a medical specialist?

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q15B

Is that minutes or hours?

  • 1: Minutes
  • 2: Hours

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q16

BCPCHC2011Main - RAH_Q16 - usual mode of transportation

BCPCHC2011Main - RAH_Q16 - usual mode of transportation

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q17

In the past 12 months, did you ever experience any travel related or other difficulties when trying to see a medical specialist?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q18

What type of difficulties did you experience?

  • 1: I don't drive
  • 2: I don't have a car
  • 3: There is no appropriate public transport
  • 4: I have nobody who would be willing to drive me
  • 5: I can't afford the cost of travel
  • 6: I can't afford to take time off work
  • 7: Parking difficulties (cost/availability)
  • 8: Traffic problems (weather or construction related)
  • 9: Too far
  • 10: Waited too long - between booking appointment and visit
  • 11: Waited too long - to see the doctor (in-office waiting)
  • 12: Cost
  • 13: Personal or family problems
  • 14: Other - Specify

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q19

Suppose your doctor arranged an appointment for next week with a specialist that you wanted to see in your city, would you have any travel related or other difficulties when trying to attend the appointment?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q20

Suppose your doctor arranged an appointment for next week with a specialist that you wanted to see. You plan to attend but the specialist is in ^DT_CITY. Would you have any travel related or other difficulties when trying to attend the appointment?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q21

Why?

  • 1: I don't drive
  • 2: I don't have a car
  • 3: There is no appropriate public transport
  • 4: I have nobody who would be willing to drive me
  • 5: I can't afford the cost of travel
  • 6: I can't afford to take time off work
  • 7: Parking difficulties (cost/availability)
  • 8: Traffic problems (weather or construction related)
  • 9: Too far
  • 10: Waited too long - between booking appointment and visit
  • 11: Waited too long - to see the doctor (in-office waiting)
  • 12: Cost
  • 13: Personal or family problems
  • 14: Other - Specify

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q22

Would availability of the same specialist in a city closer to your home be helpful?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q23

How close would the specialist have to be (how many minutes of travel) from home so that you could easily attend appointments?

  • 1: 15 minutes or less
  • 2: 16 to 30 minutes
  • 3: 31 to 60 minutes
  • 4: More than one hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_R24

Now I want to ask you some questions regarding telehealth facilities. Telehealth facilities are special clinics that patients travel to where doctors can view them and their health information using cameras and computers from another location. With telehealth, a doctor can talk to you, assess your health, prescribe medications, and make treatment decisions even if he or she is located in another city. Patients can travel to telehealth clinics close to their home rather than travelling to their doctor's office.

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q24

In the past 12 months, have you ever received care through a telehealth clinic?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q25

If it saved you time or money, would you be willing to interact with your family doctor by travelling to a telehealth clinic instead of travelling to his or her office?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q26

Why not?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q27

How much time would a telehealth appointment have to save you before you would prefer using telehealth to an in-person visit with your doctor? Please specify in hours or minutes.

  • 1: 0 minutes
  • 2: 1 - 10 minutes
  • 3: 11 - 20 minutes
  • 4: 21 - 30 minutes
  • 5: 31 - 40 minutes
  • 6: 41 - 50 minutes
  • 7: 51 - 60 minutes
  • 8: more than an hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q28

If it saved you time or money, would you be willing to interact with a specialist using telehealth instead of travelling to see him/her in person?

  • 1: Yes
  • 2: No

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q29

How much time would a telehealth appointment have to save you before you would prefer using telehealth to an in-person visit with the specialist? Please specify in hours or minutes.

  • 1: 0 minutes
  • 2: 1 - 10 minutes
  • 3: 11 - 20 minutes
  • 4: 21 - 30 minutes
  • 5: 31 - 40 minutes
  • 6: 41 - 50 minutes
  • 7: 51 - 60 minutes
  • 8: more than an hour

RAH Reasonable access to health care services (RAH) - Question identifier:RAH_Q30

Why not?

PAL Patient Activation and Literacy (PAL)

PAL Patient Activation and Literacy (PAL) - Question identifier:PAL_R01

The following questions are related to how comfortable you are in thinking about medical information and about educational materials that may help you manage your chronic condition.

PAL Patient Activation and Literacy (PAL) - Question identifier:PAL_Q01

How confident are you filling out medical forms by yourself?

  • 1: Very confident
  • 2: Quite a bit confident
  • 3: Somewhat confident
  • 4: A little confident
  • 5: Not at all confident

PAL Patient Activation and Literacy (PAL) - Question identifier:PAL_Q02

How often do you have someone (like a family member, friend, hospital/ clinic worker or caregiver) help you read hospital materials?

  • 1: At least once a day
  • 2: At least once a week
  • 3: At least once a month
  • 4: At least once a year
  • 5: Never

PAL Patient Activation and Literacy (PAL) - Question identifier:PAL_Q03

How often do you have problems learning about your medical condition because of difficulty understanding written information?

  • 1: At least once a day
  • 2: At least once a week
  • 3: At least once a month
  • 4: At least once a year
  • 5: Never

PAL Patient Activation and Literacy (PAL) - Question identifier:PAL_Q04

Overall, do you feel that you have enough information to help you manage your chronic condition?

  • 1: I have all the information I need
  • 2: I have enough information to get by
  • 3: I do not have enough information
  • 4: A support group
  • 5: A course or class
  • 6: The media, for example, television, radio, newspapers or magazines
  • 7: The internet
  • 8: Telephone advice/help line (staffed with healthcare professional)
  • 9: Cell phone (text message)
  • 10: Patient care coordinator / Patient navigator / Case Manager
  • 11: Health Care Provider
  • 12: Medical association (e.g. Canadian Diabetes Society, The Heart and Stroke Foundation)
  • 13: Provincial or federal government health care authority (e.g. Health Canada, Alberta Health and Wellness)
  • 14: Private companies or commercial organizations
  • 15: University or health care professional school
  • 16: Other - Specify

PAL Patient Activation and Literacy (PAL) - Question identifier:PAL_Q05

If you needed additional information about your chronic condition, what source of information would you find most useful for learning about how to manage your chronic disease; for example, pamphlets, CD or DVD, internet site, class or course, etc.?

  • 1: A book, pamphlet, or brochure
  • 2: A CD, DVD, or video tape
  • 3: A package insert included with medication
  • 4: A support group
  • 5: A course or class
  • 6: The media, for example, television, radio, newspapers or magazines
  • 7: The internet
  • 8: Telephone advice/help line (staffed with healthcare professional)
  • 9: Cell phone (text message)
  • 10: Patient care coordinator / Patient navigator / Case Manager
  • 11: Health Care Provider
  • 12: Medical association (e.g. Canadian Diabetes Society, The Heart and Stroke Foundation)
  • 13: Provincial or federal government health care authority (e.g. Health Canada, Alberta Health and Wellness)
  • 14: Private companies or commercial organizations
  • 15: University or health care professional school
  • 16: Other - Specify

IT IT use (IT)

IT IT use (IT) - Question identifier:IT_R01

IT_R01 - The next set of questions is about ways that technology may be used to help you better manage your health and chronic conditions.

IT IT use (IT) - Question identifier:IT_Q01

Do you have daily access to a computer with internet service?

  • 1: Yes
  • 2: No

IT IT use (IT) - Question identifier:IT_Q02

Where do you have access to a computer?

  • 1: work / business
  • 2: home
  • 3: relative / friend's home
  • 4: other

IT IT use (IT) - Question identifier:IT_Q03

In the past 12 months, did you use the Internet to search for medical or health related information for yourself?

  • 1: Yes
  • 2: No

IT IT use (IT) - Question identifier:IT_Q04

In the past 12 months, how often did you use the Internet to search for medical or health-related information for your ^DT_CONDE?

  • 1: At least once a day
  • 2: At least once a week
  • 3: At least once a month
  • 4: At least once a year
  • 5: Never

IT IT use (IT) - Question identifier:IT_Q05

Do you know how to send and receive email messages?

  • 1: Yes
  • 2: No

IT IT use (IT) - Question identifier:IT_Q06A

Suppose your doctor has received the results from your most recent medical test and has offered to send them to you via email. Would you be willing to get the results in this way?

  • 1: Very willing
  • 2: Somewhat willing
  • 3: Somewhat unwilling
  • 4: Very unwilling

IT IT use (IT) - Question identifier:IT_Q06B

Why not?

  • 1: I don't know how to use email
  • 2: I don't like using/checking email
  • 3: My email is not private (e.g. I share an email address with a family member/friend/co-worker)
  • 4: I don't feel I need this (I don't feel it would be a useful service)
  • 5: I find it annoying
  • 6: I don't have time to read content
  • 7: I don't trust that the information would remain private and secure
  • 8: Want to talk to doctor if there is a problem
  • 9: Other - Specify

IT IT use (IT) - Question identifier:IT_Q07

IT_Q07 - Do you own a cell phone?

IT IT use (IT) - Question identifier:IT_Q08

Do you know how to send and receive text messages on your cell phone?

  • 1: Yes
  • 2: No

IT IT use (IT) - Question identifier:IT_Q09

How concerned ^DT_AREYOU about giving personal health and medical information to a healthcare provider using a cell phone?

  • 1: Not at all concerned
  • 2: Concerned
  • 3: Somewhat concerned
  • 4: Very concerned
  • 5: Neutral (neither concerned or not concerned)

IT IT use (IT) - Question identifier:IT_Q10A

Some doctors send advice and reminders about how to manage chronic diseases, like a reminder to check your blood pressure or sugar levels, by text messaging to their patient's cell phones. Would you say that you would be willing to receive information from your doctor in this way?

  • 1: Very willing
  • 2: Somewhat willing
  • 3: Somewhat unwilling
  • 4: Very unwilling

IT IT use (IT) - Question identifier:IT_Q10B

Why not?

  • 1: I don't know how to use text messages
  • 2: I don't like using/checking text messages
  • 3: My text messages are not private
  • 4: I don't feel I need this (I don't feel it would be a useful service)
  • 5: I find it annoying
  • 6: It's too costly / I don't want to be charged
  • 7: I don't have time to read content
  • 8: Other - Specify

LES Legal and Ethical Secondary use (LES)

LES Legal and Ethical Secondary use (LES) - Question identifier:LES_R01

During the course of your health care, your doctor collects information about your medical history and test results.

LES Legal and Ethical Secondary use (LES) - Question identifier:LES_Q01

Suppose you have been found to be eligible for a research study as a result of your medical history and test results. How willing would you be to be contacted by a researcher to determine your interest in participating in a research study?

  • 1: Very willing
  • 2: Somewhat willing
  • 3: Somewhat unwilling
  • 4: Very unwilling

LES Legal and Ethical Secondary use (LES) - Question identifier:LES_Q02

People with chronic diseases often provide urine and blood samples for future medical research, though their exact use might not be known at the time of collection. Suppose a researcher would like to conduct a new study using your stored samples. Should they ask you for your permission each time?

  • 1: Yes
  • 2: No

LES Legal and Ethical Secondary use (LES) - Question identifier:LES_Q03

Consider that a researcher does some tests on your sample and finds out information related to your health that is unrelated to the original study - for example, they discover that you were at an increased risk for cancer or heart disease. What should the researcher do? Should they...?

  • 1: Do nothing
  • 2: Notify my doctor
  • 3: Notify me
  • 4: Notify both me and my doctor

TT Time Tradeoff (TT)

TT Time Tradeoff (TT) - Question identifier:TT_R01

TT_R01 - Several behaviours may affect your future health, and these behaviours might be impacted by how you feel about taking risks and how you feel about the future.

TT Time Tradeoff (TT) - Question identifier:TT_Q01

TT_Q01 - Are you generally a person who is fully prepared to take risks, or do you try to avoid taking risks? On a scale ranging from 1 (Unwilling to take risks) to 10 (Fully prepared to take risks), where would you place yourself?

  • 1: Unwilling to take risks
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5
  • 6: 6
  • 7: 7
  • 8: 8
  • 9: 9
  • 10: Fully prepared to take risks

TT Time Tradeoff (TT) - Question identifier:TT_Q02

In planning your saving and spending, which of the following time periods is most important to you?

LI Linkage (LI)

LI Linkage (LI) - Question identifier:LI_R01

Statistics Canada will combine your responses from this survey with information you provided on the 2011 Canadian Community Health Survey. Statistics Canada may also add information from other surveys or administrative data sources.

HWT Height and weight - Self-reported (HWT)

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